Hyperfine coupling constants of the nitrogen and phosphorus atoms: A challenge for exact-exchange density-functional and post-Hartree-Fock methods

NASA Astrophysics Data System (ADS)

Kaupp, Martin; Arbuznikov, Alexei V.; Heßelmann, Andreas; Görling, Andreas

2010-05-01

The isotropic hyperfine coupling constants of the free N(S4) and P(S4) atoms have been evaluated with high-level post-Hartree-Fock and density-functional methods. The phosphorus hyperfine coupling presents a significant challenge to both types of methods. With large basis sets, MP2 and coupled-cluster singles and doubles calculations give much too small values for the phosphorus atom. Triple excitations are needed in coupled-cluster calculations to achieve reasonable agreement with experiment. None of the standard density functionals reproduce even the correct sign of this hyperfine coupling. Similarly, the computed hyperfine couplings depend crucially on the self-consistent treatment in exact-exchange density-functional theory within the optimized effective potential (OEP) method. Well-balanced auxiliary and orbital basis sets are needed for basis-expansion exact-exchange-only OEP approaches to come close to Hartree-Fock or numerical OEP data. Results from the localized Hartree-Fock and Krieger-Li-Iafrate approximations deviate notably from exact OEP data in spite of very similar total energies. Of the functionals tested, only full exact-exchange methods augmented by a correlation functional gave at least the correct sign of the P(S4) hyperfine coupling but with too low absolute values. The subtle interplay between the spin-polarization contributions of the different core shells has been analyzed, and the influence of even very small changes in the exchange-correlation potential could be identified.

Repeated significance tests of linear combinations of sensitivity and specificity of a diagnostic biomarker

PubMed Central

Wu, Mixia; Shu, Yu; Li, Zhaohai; Liu, Aiyi

2016-01-01

A sequential design is proposed to test whether the accuracy of a binary diagnostic biomarker meets the minimal level of acceptance. The accuracy of a binary diagnostic biomarker is a linear combination of the marker’s sensitivity and specificity. The objective of the sequential method is to minimize the maximum expected sample size under the null hypothesis that the marker’s accuracy is below the minimal level of acceptance. The exact results of two-stage designs based on Youden’s index and efficiency indicate that the maximum expected sample sizes are smaller than the sample sizes of the fixed designs. Exact methods are also developed for estimation, confidence interval and p-value concerning the proposed accuracy index upon termination of the sequential testing. PMID:26947768

Screening large-scale association study data: exploiting interactions using random forests.

PubMed

Lunetta, Kathryn L; Hayward, L Brooke; Segal, Jonathan; Van Eerdewegh, Paul

2004-12-10

Genome-wide association studies for complex diseases will produce genotypes on hundreds of thousands of single nucleotide polymorphisms (SNPs). A logical first approach to dealing with massive numbers of SNPs is to use some test to screen the SNPs, retaining only those that meet some criterion for further study. For example, SNPs can be ranked by p-value, and those with the lowest p-values retained. When SNPs have large interaction effects but small marginal effects in a population, they are unlikely to be retained when univariate tests are used for screening. However, model-based screens that pre-specify interactions are impractical for data sets with thousands of SNPs. Random forest analysis is an alternative method that produces a single measure of importance for each predictor variable that takes into account interactions among variables without requiring model specification. Interactions increase the importance for the individual interacting variables, making them more likely to be given high importance relative to other variables. We test the performance of random forests as a screening procedure to identify small numbers of risk-associated SNPs from among large numbers of unassociated SNPs using complex disease models with up to 32 loci, incorporating both genetic heterogeneity and multi-locus interaction. Keeping other factors constant, if risk SNPs interact, the random forest importance measure significantly outperforms the Fisher Exact test as a screening tool. As the number of interacting SNPs increases, the improvement in performance of random forest analysis relative to Fisher Exact test for screening also increases. Random forests perform similarly to the univariate Fisher Exact test as a screening tool when SNPs in the analysis do not interact. In the context of large-scale genetic association studies where unknown interactions exist among true risk-associated SNPs or SNPs and environmental covariates, screening SNPs using random forest analyses can significantly reduce the number of SNPs that need to be retained for further study compared to standard univariate screening methods.

Are P values and statistical assessments in poster abstracts presented at annual meetings of Taiwan Society of Anesthesiologists relative to the characteristics of hospitals?

PubMed

Lee, Fu-Jung; Wu, Chih-Cheng; Peng, Shih-Yen; Fan, Kuo-Tung

2007-09-01

Many anesthesiologists in medical centers (MC) or in anesthesiologist-training hospitals (ATH) are accustomed to present their research data in the form of poster abstracts at the annual meetings of Taiwan Society of Anesthesiologists (TSA) to represent their academic gainings in a designated period of time. However, an orphaned P value without mentioning the related specified statistical test has frequently been found in these articles. The difference in presentation of statistical test after P value between MC/ATH and non-MC/non-ATH in recent three TSA consecutive annual meetings was explored in this article. We collected the proceedings handbooks of TSA annual meetings in a period spanning 3 yrs (2003 to 2005) and analyzed the hospital characteristic of first institute-byliner in the poster abstract. Data were analyzed with Fisher's exact test and statistical significance was assumed if P < 0.05. Included were 101 poster abstracts with byliners of 20 hospitals. Only 2 of the 20 hospitals were accredited as non-ATH and 4 as non-MC. There were 64 (63%) abstracts without specified statistical test after P value and no significant difference was found among each category. (P = 0.47 in ATH vs. non-ATH and P = 0.07 in MC vs. non-MC). The basic concept of P value with specified statistical test was not applicable comprehensively in poster abstracts of the annual conferences. Based on our wishful intention, we suggest that the anesthesia administrators and senior anesthesiologists at ATH or MC, and the members of the committee responsible for running academic affairs in TSA, should pay attention to this prodigy and work together to improve our basic statistics in poster presentation.

Laplace-Beltrami operator and exact solutions for branes

NASA Astrophysics Data System (ADS)

Zheltukhin, A. A.

2013-02-01

Proposed is a new approach to finding exact solutions of nonlinear p-brane equations in D-dimensional Minkowski space based on the use of various initial value constraints. It is shown that the constraints Δx→=0 and Δx→=-Λ(t,σr)x→ give two sets of exact solutions.

PP-16 WEAK ACID REFLUX A TRIGGER FOR RECURRENT RESPIRATORY DISEASES IN CHILDREN.

PubMed

Kostovski, Aco; Zdraveska, Nikolina

2015-10-01

The main advantage of multichannel intraluminar impedance (MII) compared with pH monitoring is its ability to detect both acid and non-acid gastroesophageal reflux (GER) and to determine the characteristics of reflux (liquid or gas). To compare the value of pH monitoring and MII for diagnosis of GER in children who present with refractory respiratory symptoms. A prospective study that included 37 patients, aged 4.25 ± 3.15 years, using combined MII-pH monitoring was performed. Patients were referred for investigation because of suspected GER as the etiology of recurrent respiratory diseases, including recurrent obstructive bronchitis, recurrent pneumonia, laryngitis, and chronic cough. We analyzed the percentage of time during which the pH was less than 4, the numeric and percentile values of acid, weak acid, and non-acid reflux episodes, and the values of liquid and mixed reflux. Diagnostic values were determined separately for pH monitoring and MII using Fisher's exact test. Reflux was detected in 31 patients. pH monitoring was positive in 20 patients (% time during which pH <4 was 17.72 ± 12.06) and negative in 17 patients (2.93% ± 1.67). Both pH and MII were positive in 19 patients: in 11 patients, MII was positive and pH was negative, and in 6 patients, both were negative. Fisher's exact test showed significant statistical difference and superiority of MII in diagnosing GER (p = 0.033). Out of 30 patients with MII-positive results, 15 had both acid and weak acid reflux episodes, 3 had only acid reflux, 8 had weak acid reflux, and 3 had non-acid reflux. Sixteen patients had mixed (liquid and gas) reflux, and 14 had both liquid and mixed reflux. This study suggests that significant numbers of GER include weak acid reflux that cannot be detected by pH probes alone. The weak acid reflux could be a trigger for recurrent respiratory symptoms. Combining pH with MII monitoring is a valuable diagnostic method for diagnosing GER in children.

Effect of pH Test-Strip Characteristics on Accuracy of Readings.

PubMed

Metheny, Norma A; Gunn, Emily M; Rubbelke, Cynthia S; Quillen, Terrilynn Fox; Ezekiel, Uthayashanker R; Meert, Kathleen L

2017-06-01

Little is known about characteristics of colorimetric pH test strips that are most likely to be associated with accurate interpretations in clinical situations. To compare the accuracy of 4 pH test strips with varying characteristics (ie, multiple vs single colorimetric squares per calibration, and differing calibration units [1.0 vs 0.5]). A convenience sample of 100 upper-level nursing students with normal color vision was recruited to evaluate the accuracy of the test strips. Six buffer solutions (pH range, 3.0 to 6.0) were used during the testing procedure. Each of the 100 participants performed 20 pH tests in random order, providing a total of 2000 readings. The sensitivity and specificity of each test strip was computed. In addition, the degree to which the test strips under- or overestimated the pH values was analyzed using descriptive statistics. Our criterion for correct readings was an exact match with the pH buffer solution being evaluated. Although none of the test strips evaluated in our study was 100% accurate at all of the measured pH values, those with multiple squares per pH calibration were clearly superior overall to those with a single test square. Test strips with multiple squares per calibration were associated with greater overall accuracy than test strips with a single square per calibration. However, because variable degrees of error were observed in all of the test strips, use of a pH meter is recommended when precise readings are crucial. ©2017 American Association of Critical-Care Nurses.

Testing Small Variance Priors Using Prior-Posterior Predictive p Values.

PubMed

Hoijtink, Herbert; van de Schoot, Rens

2017-04-03

Muthén and Asparouhov (2012) propose to evaluate model fit in structural equation models based on approximate (using small variance priors) instead of exact equality of (combinations of) parameters to zero. This is an important development that adequately addresses Cohen's (1994) The Earth is Round (p < .05), which stresses that point null-hypotheses are so precise that small and irrelevant differences from the null-hypothesis may lead to their rejection. It is tempting to evaluate small variance priors using readily available approaches like the posterior predictive p value and the DIC. However, as will be shown, both are not suited for the evaluation of models based on small variance priors. In this article, a well behaving alternative, the prior-posterior predictive p value, will be introduced. It will be shown that it is consistent, the distributions under the null and alternative hypotheses will be elaborated, and it will be applied to testing whether the difference between 2 means and the size of a correlation are relevantly different from zero. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Salivary pathogen and serum antibody to assess the progression of chronic periodontitis: a 24-mo prospective multicenter cohort study.

PubMed

Morozumi, T; Nakagawa, T; Nomura, Y; Sugaya, T; Kawanami, M; Suzuki, F; Takahashi, K; Abe, Y; Sato, S; Makino-Oi, A; Saito, A; Takano, S; Minabe, M; Nakayama, Y; Ogata, Y; Kobayashi, H; Izumi, Y; Sugano, N; Ito, K; Sekino, S; Numabe, Y; Fukaya, C; Yoshinari, N; Fukuda, M; Noguchi, T; Kono, T; Umeda, M; Fujise, O; Nishimura, F; Yoshimura, A; Hara, Y; Nakamura, T; Noguchi, K; Kakuta, E; Hanada, N; Takashiba, S; Yoshie, H

2016-12-01

A diagnosis of periodontitis progression is presently limited to clinical parameters such as attachment loss and radiographic imaging. The aim of this multicenter study was to monitor disease progression in patients with chronic periodontitis during a 24-mo follow-up program and to evaluate the amount of bacteria in saliva and corresponding IgG titers in serum for determining the diagnostic usefulness of each in indicating disease progression and stability. A total of 163 patients with chronic periodontitis who received trimonthly follow-up care were observed for 24 mo. The clinical parameters and salivary content of Porphyromonas gingivalis, Prevotella intermedia and Aggregatibacter actinomycetemcomitans were assessed using the modified Invader PLUS assay, and the corresponding serum IgG titers were measured using ELISA. The changes through 24 mo were analyzed using cut-off values calculated for each factor. One-way ANOVA or Fisher's exact test was used to perform between-group comparison for the data collected. Diagnostic values were calculated using Fisher's exact test. Of the 124 individuals who completed the 24-mo monitoring phase, 62 exhibited periodontitis progression, whereas 62 demonstrated stable disease. Seven patients withdrew because of acute periodontal abscess. The ratio of P. gingivalis to total bacteria and the combination of P. gingivalis counts and IgG titers against P. gingivalis were significantly related to the progression of periodontitis. The combination of P. gingivalis ratio and P. gingivalis IgG titers was significantly associated with the progression of periodontitis (p = 0.001, sensitivity = 0.339, specificity = 0.790). It is suggested that the combination of P. gingivalis ratio in saliva and serum IgG titers against P. gingivalis may be associated with the progression of periodontitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Gender and ethnic differences in chronic myelogenous leukemia prognosis and treatment response: a single-institution retrospective study

PubMed Central

Lee, Justin P; Birnstein, Elliott; Masiello, David; Yang, Dongyun; Yang, Allen S

2009-01-01

Background In the last decade the importance of ethnicity, socio-economic and gender differences in relation to disease incidence, diagnosis, and prognosis has been realized. Differences in these areas have become a major health policy focus in the United States. Our study was undertaken to examine the demographic and clinical features of chronic myelogenous leukemia (CML) patients presenting initially at the LAC+USC Medical Center, which serves an ethnically diverse population. Results Patients were evenly split by gender, overwhelmingly Hispanic (60.9%), and quite young (median age 39, range 17–65) compared with previously reported CML patient populations. Previous CML studies identified significant anemia (Hgb <12 g/dl), significant thrombocytosis (platelets >450 × 109/l), and significant leukocytosis (WBC >50 × 109/l) as significant adverse pretreatment prognostic factors. Using these indicators, in addition to the validated Hasford and Sokal scores, patients were stratified and analyzed via gender and ethnicity. A significantly greater proportion of women presented with significant anemia (p = 0.019, Fisher's exact test) and significant thrombocytosis (p = 0.041, Fisher's exact test) compared to men, although no differences were found in risk stratification or treatment response. MCV values for women were significantly (p = 0.02, 2-sample t-test) lower than those for men, suggesting iron deficiency anemia. Focusing on ethnicity, Hispanics as a whole had significantly lower Hasford risk stratification (p = 0.046, Fisher's exact test), and significantly greater likelihood (p = 0.016, Fisher's exact test) of achieving 3-month complete haematological remission (CHR) compared with non-Hispanics at LAC+USC Medical Center, though differences in treatment outcome were no longer significant with analysis limited to patients treated with first-line imatinib. Conclusion Female CML patients at LAC+USC Medical Center present with more significant adverse pre-treatment prognostic factors compared to men, but achieve comparable outcomes. Hispanic patients present with lower risk profile CML and achieve better treatment responses compared to non-Hispanic patients as a whole; these ethnic differences are no longer significant when statistical analysis is limited to patients given imatinib as first-line therapy. Our patients achieve response rates inferior to those of large-scale national studies. This constellation of findings has not been reported in previous studies, and is likely reflective of a unique patient population. PMID:19630970

The effect of antacid on salivary pH in patients with and without dental erosion after multiple acid challenges.

PubMed

Dhuhair, Sarah; Dennison, Joseph B; Yaman, Peter; Neiva, Gisele F

2015-04-01

To evaluate the effect of antacid swish in the salivary pH values and to monitor the pH changes in subjects with and without dental erosion after multiple acid challenge tests. 20 subjects with tooth erosion were matched in age and gender with 20 healthy controls according to specific inclusion/exclusion criteria. Baseline measures were taken of salivary pH, buffering capacity and salivary flow rate using the Saliva Check System. Subjects swished with Diet Pepsi three times at 10-minute intervals. Changes in pH were monitored using a digital pH meter at 0-, 5-, and 10- minute intervals and at every 5 minutes after the third swish until pH resumed baseline value or 45 minutes relapse. Swishing regimen was repeated on a second visit, followed by swishing with sugar-free liquid antacid (Mylanta Supreme). Recovery times were also recorded. Data was analyzed using independent t-tests, repeated measures ANOVA, and Fisher's exact test (α= 0.05). Baseline buffering capacity and flow rate were not significantly different between groups (P= 0.542; P= 0.2831, respectively). Baseline salivary pH values were similar between groups (P= 0.721). No significant differences in salivary pH values were found between erosion and non-erosion groups in response to multiple acid challenges (P= 0.695) or antacid neutralization (P= 0.861). Analysis of salivary pH recovery time revealed no significant differences between groups after acid challenges (P= 0.091) or after the use of antacid (P= 0.118). There was a highly significant difference in the survival curves of the two groups on Day 2, with the non-erosion group resolving significantly faster than the erosion group (P= 0.0086).

"Meta-analyses and P-curves support robust cycle shifts in women's mate preferences: Reply to Wood and Carden (2014) and Harris, Pashler, and Mickes (2014)": Correction to Gildersleeve, Haselton, and Fales (2014).

PubMed

2017-11-01

Reports an error in "Meta-analyses and p -curves support robust cycle shifts in women's mate preferences: Reply to Wood and Carden (2014) and Harris, Pashler, and Mickes (2014)" by Kelly Gildersleeve, Martie G. Haselton and Melissa R. Fales ( Psychological Bulletin , 2014[Sep], Vol 140[5], 1272-1280). In the article, all p -curve analyses examining the Context Moderation Hypothesis Prediction mistakenly included the p-value from Little, Jones, Burt, & Perrett (2007) Study 2 for the simple effect of fertility on attraction to facial symmetry in a short-term relationship context ( p < .001). The analyses should have instead included the p -value for the fertility X relationship context interaction ( p = .011). In addition, the p -curve analyses examining exact two-tailed p -values for the Cycle Shift Prediction should have included an additional p -value from Provost et al. (2008) Study 1 for the main effect of fertility on attraction to gait masculinity. The reported p -value for this effect was .05, making it ineligible for inclusion in p -curves of reported p-values. However, the exact recalculated two-tailed p -value was .049, making it eligible for inclusion in p -curves of exact p -values. The corrected p -curve of exact two-tailed p -values evaluating the Cycle Shift Prediction and Context Moderation Prediction (displayed in Figure 2) now includes a total of 15 p -values ( N = 1442) is no longer significantly right skewed χ²(30) = 41.25, p = .08. The corrected p -curve of exact two-tailed p -values evaluating the Cycle Shift Prediction, Context Moderation Prediction, and Partner Qualities Moderation Prediction (displayed in Figure 3) now includes a total of 21 p -values ( N = 1707) and continues to be significantly right skewed Χ²(42) = 69.83, p = .004. As part of this correction, the online supplemental materials have been updated. (The following abstract of the original article appeared in record 2014-35938-003.) Two meta-analyses evaluated shifts across the ovulatory cycle in women's mate preferences but reported very different findings. In this journal, we reported robust evidence for the pattern of cycle shifts predicted by the ovulatory shift hypothesis (Gildersleeve, Haselton, & Fales, 2014). However, Wood, Kressel, Joshi, and Louie (2014) claimed an absence of compelling support for this hypothesis and asserted that the few significant cycle shifts they observed were false positives resulting from publication bias, p-hacking, or other research artifacts. How could 2 meta-analyses of the same literature reach such different conclusions? We reanalyzed the data compiled by Wood et al. These analyses revealed problems in Wood et al.'s meta-analysis-some of which are reproduced in Wood and Carden's (2014) comment in the current issue of this journal-that led them to overlook clear evidence for the ovulatory shift hypothesis in their own set of effects. In addition, we present right-skewed p-curves that directly contradict speculations by Wood et al.; Wood and Carden; and Harris, Pashler, and Mickes (2014) that supportive findings in the cycle shift literature are false positives. Therefore, evidence from both of the meta-analyses and the p-curves strongly supports genuine, robust effects consistent with the ovulatory shift hypothesis and contradicts claims that these effects merely reflect publication bias, p-hacking, or other research artifacts. Unfounded speculations about p-hacking distort the research record and risk unfairly damaging researchers' reputations; they should therefore be made only on the basis of firm evidence. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Reliability of the rapid bedside whole-blood quantitative cardiac troponin T assay in the diagnosis of myocardial injury in patients with acute coronary syndrome.

PubMed

Saadeddin, Salam; Habbab, Mohammed; Siddieg, Hisham; Fayomi, Mahmoud; Dafterdar, Rofaida

2004-03-01

A rapid bedside whole-blood quantitative cTnT assay has recently been developed. We evaluated the reliability of this test for the diagnosis of myocardial injury in patients with acute coronary syndrome (ACS). Whole-blood cTnT levels were measured in 96 patients with ACS using the Roche Cardiac Reader(R) rapid bedside assay device, and the results were compared with serum cTnT levels in the same patients measured by the Roche Elecsys(R) Immunoanalyzer. There were 50 patients with clinical evidence of myocardial injury and 56 without. From the qualitative point of view (reporting negative or positive tests), the results of the rapid bedside tests were identical to those obtained by the serum immunoanalyzer. From quantitative the point of view, the rapid bedside tests could not measure exact values below 0.1 ng/ml (reported negative) or above 2.0 ng/ml (reported >2.0). The measurements made by the rapid bedside tests within the range of 0.1 to 2.0 ng/ml correlated well with those of the serum immunoanalyzer (Cardiac Reader(R) cTnT=0.61, Elecsys(R) cTnT+0.12; r=0.88), but their mean values were significantly lower (1.20I0.71 vs. 1.41I1.03, p=0.0007). The rapid bedside cTnT assay correlates well with immunoanalyzer measurements between the values of 0.1 and 2.0 ng/ml. However, they tend to give significantly lower values and fail to give exact values below 0.1 and above 2.0 ng/ml, which may affect their performance in monitoring and managing patients with ACS, and limit their use in predicting outcome.

SOX9 Is a Progressive Factor in Prostate Cancer

DTIC Science & Technology

2013-09-01

immunohis- tochemical analyses of BCa xenografts or mouse mammary tis- sues are detailed in the supplemental data. Meta- analysis of Gene Expression—SOX9mRNA...accession no. GSE5460) using dChip software (29). The analysis of variance function in dChip identified gene probes with significant correlation to...tumor grade groups (right panel). The p values of the difference analysis (Fisher’s Exact Test) are indicated. SOX9 Controlled Wnt/-catenin Activity

Exact Green's function method of solar force-free magnetic-field computations with constant alpha. I - Theory and basic test cases

NASA Technical Reports Server (NTRS)

Chiu, Y. T.; Hilton, H. H.

1977-01-01

Exact closed-form solutions to the solar force-free magnetic-field boundary-value problem are obtained for constant alpha in Cartesian geometry by a Green's function approach. The uniqueness of the physical problem is discussed. Application of the exact results to practical solar magnetic-field calculations is free of series truncation errors and is at least as economical as the approximate methods currently in use. Results of some test cases are presented.

[The relationship between Ridit analysis and rank sum test for one-way ordinal contingency table in medical research].

PubMed

Wang, Ling; Xia, Jie-lai; Yu, Li-li; Li, Chan-juan; Wang, Su-zhen

2008-06-01

To explore several numerical methods of ordinal variable in one-way ordinal contingency table and their interrelationship, and to compare corresponding statistical analysis methods such as Ridit analysis and rank sum test. Formula deduction was based on five simplified grading approaches including rank_r(i), ridit_r(i), ridit_r(ci), ridit_r(mi), and table scores. Practical data set was verified by SAS8.2 in clinical practice (to test the effect of Shiwei solution in treatment for chronic tracheitis). Because of the linear relationship of rank_r(i) = N ridit_r(i) + 1/2 = N ridit_r(ci) = (N + 1) ridit_r(mi), the exact chi2 values in Ridit analysis based on ridit_r(i), ridit_r(ci), and ridit_r(mi), were completely the same, and they were equivalent to the Kruskal-Wallis H test. Traditional Ridit analysis was based on ridit_r(i), and its corresponding chi2 value calculated with an approximate variance (1/12) was conservative. The exact chi2 test of Ridit analysis should be used when comparing multiple groups in the clinical researches because of its special merits such as distribution of mean ridit value on (0,1) and clear graph expression. The exact chi2 test of Ridit analysis can be output directly by proc freq of SAS8.2 with ridit and modridit option (SCORES =). The exact chi2 test of Ridit analysis is equivalent to the Kruskal-Wallis H test, and should be used when comparing multiple groups in the clinical researches.

Denjoy minimal sets and Birkhoff periodic orbits for non-exact monotone twist maps

NASA Astrophysics Data System (ADS)

Qin, Wen-Xin; Wang, Ya-Nan

2018-06-01

A non-exact monotone twist map φbarF is a composition of an exact monotone twist map φ bar with a generating function H and a vertical translation VF with VF ((x , y)) = (x , y - F). We show in this paper that for each ω ∈ R, there exists a critical value Fd (ω) ≥ 0 depending on H and ω such that for 0 ≤ F ≤Fd (ω), the non-exact twist map φbarF has an invariant Denjoy minimal set with irrational rotation number ω lying on a Lipschitz graph, or Birkhoff (p , q)-periodic orbits for rational ω = p / q. Like the Aubry-Mather theory, we also construct heteroclinic orbits connecting Birkhoff periodic orbits, and show that quasi-periodic orbits in these Denjoy minimal sets can be approximated by periodic orbits. In particular, we demonstrate that at the critical value F =Fd (ω), the Denjoy minimal set is not uniformly hyperbolic and can be approximated by smooth curves.

A weighted exact test for mutually exclusive mutations in cancer

PubMed Central

Leiserson, Mark D.M.; Reyna, Matthew A.; Raphael, Benjamin J.

2016-01-01

Motivation: The somatic mutations in the pathways that drive cancer development tend to be mutually exclusive across tumors, providing a signal for distinguishing driver mutations from a larger number of random passenger mutations. This mutual exclusivity signal can be confounded by high and highly variable mutation rates across a cohort of samples. Current statistical tests for exclusivity that incorporate both per-gene and per-sample mutational frequencies are computationally expensive and have limited precision. Results: We formulate a weighted exact test for assessing the significance of mutual exclusivity in an arbitrary number of mutational events. Our test conditions on the number of samples with a mutation as well as per-event, per-sample mutation probabilities. We provide a recursive formula to compute P-values for the weighted test exactly as well as a highly accurate and efficient saddlepoint approximation of the test. We use our test to approximate a commonly used permutation test for exclusivity that conditions on per-event, per-sample mutation frequencies. However, our test is more efficient and it recovers more significant results than the permutation test. We use our Weighted Exclusivity Test (WExT) software to analyze hundreds of colorectal and endometrial samples from The Cancer Genome Atlas, which are two cancer types that often have extremely high mutation rates. On both cancer types, the weighted test identifies sets of mutually exclusive mutations in cancer genes with fewer false positives than earlier approaches. Availability and Implementation: See http://compbio.cs.brown.edu/projects/wext for software. Contact: braphael@cs.brown.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:27587696

An evaluation of plastic surgery resident selection factors.

PubMed

Liang, Fan; Rudnicki, Pamela A; Prince, Noah H; Lipsitz, Stuart; May, James W; Guo, Lifei

2015-01-01

Our purpose was to provide a metric by which evaluation criteria are prioritized during resident selection. In this study, we assessed which residency applicant qualities are deemed important by members of the American Association of Plastic Surgeons (AAPS). A survey was distributed to all 580 AAPS members, and 295 responded to rate the importance of resident metrics, including measures of competency and personal characteristics. Demographic information, background training, and interaction with residents were also noted. Using SAS v9.2 (SAS Institute, Cary, NC), outcomes were analyzed across demographic groups with column trend exact (CTE) test for ordinal variables, Mantel-Haenszel trend test for interval variables, and Fisher exact test for discrete variables. Regarding competency metrics, letters of recommendation from known sources is the most important factor, whereas letters from unknown sources ranks the lowest. Character evaluations identified honesty as the most desirable trait; dishonesty was the most despised. Across demographic groups, academic surgeons and program directors value letters from known sources more than nonacademicians or nonprogram directors (CTE p = 0.005 and 0.002, respectively). Academicians and current program directors regard research more highly than their counterparts do (CTE p = 0.022 and 0.022, respectively). Currently, practicing surgeons, academicians, and program directors value hard work more than others (CTE p = 0.008, 0.033, and 0.029, respectively). Program directors emphasize maturity and patient commitment and are less tolerant of narcissism (CTE p = 0.002, 0.005, and 0.003, respectively). Lastly, academic surgeons and program directors look more favorably upon strong team players (CTE p < 0.00001 and p = 0.008, respectively), but less so over time (Mantel-Haenszel trend p = 0.006). We have examined applicant metrics that were deemed important by AAPS members and assessed their demographic interpretation. We hope this article provides a framework for plastic surgery resident selection and a guide for applicants to ascertain which qualities are highly regarded by programs. Although these attributes are highly desirable, future studies could identify if they are predictive of successful and productive plastic surgery residencies and careers. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Ictal semiology in hippocampal versus extrahippocampal temporal lobe epilepsy.

PubMed

Gil-Nagel, A; Risinger, M W

1997-01-01

We have analysed retrospectively the clinical features and electroencephalograms in 35 patients with complex partial seizures of temporal lobe origin who were seizure-free after epilepsy surgery. Two groups were differentiated for statistical analysis: 16 patients had hippocampal temporal lobe seizures (HTS) and 19 patients had extrahippocampal temporal lobe seizures (ETS) associated with a small tumour of the lateral or inferior temporal cortex. All patients in the HTS group had ictal onset verified with intracranial recordings (depth or subdural electrodes). In the ETS group, extrahippocampal onset was verified with intracranial recordings in eight patients and assumed, because of failure of a previous amygdalohippocampectomy, in one patient. Historical information, ictal semiology and ictal EEG of typical seizures were analysed in each patient. The occurrence of early and late oral automatisms and dystonic posturing of an upper extremity was analysed separately. A prior history of febrile convulsions was obtained in 13 HTS patients (81.3%) but in none with ETS (P < 0.0001, Fisher's exact test). An epigastric aura preceded seizures in five patients with HTS (31.3%) and none with ETS (P = 0.0135, Fisher's exact test), while an aura with experiential content was recalled by nine patients with ETS (47.4%) and none with HTS (P = 0.0015), Fisher's exact test). Early oral automatisms occurred in 11 patients with HTS (68.8%) and in two with ETS (10.5%) (P = 0.0005, Fisher's exact test). Early motor involvement of the contralateral upper extremity without oral automatisms occurred in three patients with HTS (18.8%) and in 10 with ETS (52.6%) (P = 0.0298, Fisher's exact test). Arrest reaction, vocalization, speech, facial grimace, postictal cough, late oral automatisms and late motor involvement of the contralateral arm and hand occurred with similar frequency in both groups. These observations show that the early clinical features of HTS and ETS are different.

[Prediabetes as a riskmarker for stress-induced hyperglycemia in critically ill adults].

PubMed

García-Gallegos, Diego Jesús; Luis-López, Eliseo

2017-01-01

It is not known if patients with prediabetes, a subgroup of non-diabetic patients that usually present hyperinsulinemia, have higher risk to present stress-induced hyperglycemia. The objective was to determine if prediabetes is a risk marker to present stress-induced hyperglycemia. Analytic, observational, prospective cohort study of non-diabetic critically ill patients of a third level hospital. We determined plasmatic glucose and glycated hemoglobin (HbA1c) at admission to diagnose stress-induced hyperglycemia (glucose ≥ 140 mg/dL) and prediabetes (HbA1c between 5.7 and 6.4%), respectively. We examined the proportion of non-prediabetic and prediabetic patients that developed stress hyperglycemia with contingence tables and Fisher's exact test for nominal scales. Of 73 patients studied, we found a proportion of stress-induced hyperglycemia in 6.6% in those without prediabetes and 61.1% in those with prediabetes. The Fisher's exact test value was 22.46 (p < 0.05). Prediabetes is a risk marker for stress-induced hyperglycemia in critically ill adults.

Prediction of ocular irritancy of 26 chemicals and 26 cosmetic products with isolated rabbit eye (IRE) test.

PubMed

Guo, Xiang; Yang, Xing Fen; Yang, Ying; Hans, Raabe; Cai, Jing Heng; Xue, Jin Yu; Tan, Xiao Hua; Xie, Xiao Ping; Xiong, Xi Kun; Huang, Jun Ming

2012-06-01

This study aims to establish and evaluate the methodology of isolated rabbit eye (IRE) test. IRE test was performed according to modifications of the in vitro toxicology (INVITTOX) Protocol No.85: Rabbit enucleated eye test by European Centre for the Validation of Alternative Methods (ECVAM), and then 26 chemicals and 26 cosmetic products were tested in both in vitro IRE and in vivo Draize tests. A statistical analysis was conducted to determine the relevance of the IRE test to the data generated in the Draize test. IRE test was established successfully in our laboratory. It was shown that ranking correlation and class concordance were fairly well between the IRE test and the Draize test for 26 reference chemicals (Fisher's Exact Test χ(2)=51.314, P<0.001; McNemar P=0.261; Gamma=0.960, P<0.001; Kappa=0.843, P<0.001) and 26 cosmetic products (Fisher's Exact Test χ(2)=15.522, P<0.001; McNemar P=0.311; Gamma=0.967, P<0.001; Kappa=0.611, P<0.001). IRE test was established successfully for in vitro testing of eye irritation as an alternative to Draize test. Copyright © 2012 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

Bioimpedance to screen for abdominal fat in patients with breast cancer treatment-related lymphedema.

PubMed

de Fátima Guerreiro Godoy, Maria; Silva, Edivandra Buzato; de Godoy, Jose Maria Pereira

2016-07-28

One of the dreaded complications after the treatment of breast cancer is lymphedema. Therapies used in the treatment of breast cancer such as surgery, radiotherapy, hormone therapy and chemotherapy may be adversely affected by obesity. The objective of this study was to use bioimpedance to assess abdominal fat in women with breast cancer treatment-related lymphedema and suggest this as a screening method. Forty-five female patients with clinical diagnosis of breast cancer treatment-related lymphedema were evaluated in this quantitative cross-sectional study. A control group, composed of 38 patients with varicose veins and women attending a social support group, was matched for age and body mass index (BMI). All participants were submitted to a bioimpedance evaluation (In Body S 10), with particular attention being paid to abdominal fat and their BMI. The unpaired t -test, Fisher Exact test and Mann-Whitney test were used for statistical analysis and an alpha error of 5%. There was no significant difference (p -value = 0.23) in the mean BMI between the study group (27.79 kg∕m2) and the control group (28.80 kg∕m2). The mean abdominal circumference, a measure of abdominal fat, of the women in the study group was 130.54 cm2 and for the control group it was 102.24 cm2 (p -value = 0.0037). Thus the study group had more abdominal fat (p -value = 0.0003). Moreover, on comparing obese patients in the two groups, the study group had more abdominal fat (p -value = 0.02). However, no significant difference was observed comparing non-obese patients (p -value = 0.6). The comparison of obese patients with non-obese patients in the control group identifies an association between obesity and abdominal fat (p -value < 0.04). Overweight and obese women with breast cancer treatment-related lymphedema are more likely to have increased abdominal fat than the general population with bioimpedance.

The comparability of the universalism value over time and across countries in the European Social Survey: exact vs. approximate measurement invariance

PubMed Central

Zercher, Florian; Schmidt, Peter; Cieciuch, Jan; Davidov, Eldad

2015-01-01

Over the last decades, large international datasets such as the European Social Survey (ESS), the European Value Study (EVS) and the World Value Survey (WVS) have been collected to compare value means over multiple time points and across many countries. Yet analyzing comparative survey data requires the fulfillment of specific assumptions, i.e., that these values are comparable over time and across countries. Given the large number of groups that can be compared in repeated cross-national datasets, establishing measurement invariance has been, however, considered unrealistic. Indeed, studies which did assess it often failed to establish higher levels of invariance such as scalar invariance. In this paper we first introduce the newly developed approximate approach based on Bayesian structural equation modeling (BSEM) to assess cross-group invariance over countries and time points and contrast the findings with the results from the traditional exact measurement invariance test. BSEM examines whether measurement parameters are approximately (rather than exactly) invariant. We apply BSEM to a subset of items measuring the universalism value from the Portrait Values Questionnaire (PVQ) in the ESS. The invariance of this value is tested simultaneously across 15 ESS countries over six ESS rounds with 173,071 respondents and 90 groups in total. Whereas, the use of the traditional approach only legitimates the comparison of latent means of 37 groups, the Bayesian procedure allows the latent mean comparison of 73 groups. Thus, our empirical application demonstrates for the first time the BSEM test procedure on a particularly large set of groups. PMID:26089811

Phaco-efficiency test and re-aspiration analysis of repulsed particle in phacoemulsification.

PubMed

Kim, Jae-hyung; Ko, Dong-Ah; Kim, Jae Yong; Kim, Myoung Joon; Tchah, Hungwon

2013-04-01

To measure the efficiency of phacoemulsification, we have developed a new experimental model for testing phaco-efficiency and analyzed re-aspiration of repulsed particles. Using a Kitaro wetlab system, a piece of blood agar (BA) was placed in an artificial chamber and the phacoemulsifier was placed horizontally. The settings of the phacoemulsifier (Infiniti, Alcon Laboratories) were 26 cc/min for aspiration, 350 cc/min for vacuum, and 95 cm of bottle height. The time to remove BAs was measured using Ozil 100 %, Ozil 40 %, and longitudinal 40 % of phaco power. The angle between the re-aspirated BA particles and the axis of the phacoemulsifier (re-aspiration zone, degree) was analyzed. The average time (seconds) to remove BAs was lower in the Ozil 100 % and the Ozil 40 % mode than in the longitudinal mode (0.37 ± 0.39, 0.85 ± 0.57, and 2.22 ± 1.40 respectively, P value < 0.01). Repulsion exceeding 1 mm occurred more frequently in the longitudinal mode than in the Ozil 100 % mode (100 % vs 40 %, P value = 0.01, Fisher's exact test). The average of re-aspiration zone was 25.9 ± 14.5 in the longitudinal 40 % and 54.0 ± 23.0 in the Ozil 40 % (P value = 0.016). The Ozil mode was more efficient than the longitudinal mode. In addition, the Ozil mode provided less repulsion and wider aspiration zone.

Expression of Hypoxia-Associated Protein HIF-1α in Follicular Thyroid Cancer is Associated with Distant Metastasis.

PubMed

Klaus, Aumayr; Fathi, Osmen; Tatjana, Traub-Weidinger; Bruno, Niederle; Oskar, Koperek

2018-04-01

Follicular thyroid carcinomas (FTCs) are the second most common malignant neoplasia of the thyroid and in general its prognosis is quite favorable. However, the occurrence of metastases or non-responsiveness to radioiodine therapy worsens the prognosis considerably. We evaluated immunohistochemically the expression of hypoxia-associated proteins by hypoxia-induced factor 1α (HIF-1α), the stroma-remodeling marker Tenascin C, as well as markers for the epithelial-mesenchymal transition (EMT), namely E-cadherin and slug in a series of 59 sporadic FTCs. In addition, various clinicopathologic parameters were assessed like TNM-staging, age, tumor size as well as tumor characteristics like desmoplasia, necrosis, and calcification. Overexpression of HIF-1α was seen in 29 of 59 tumors (49.2%) including 21 (35.6%) FTC with strong expression of tumor cell groups. HIF-1α correlated significantly with metastasis (p < 0.001; Mann-Whitney U test), degree of desmoplasia (p = 0.042, Kruskal-Wallis test), tenascin C expression (p = 0.042, Kruskal-Wallis test), calcification (p < 0.025, Kruskal-Wallis test), necrosis (p = 0.002), age (p = 0.011, Kruskal-Wallis test) and tumor stage UICC (p = 0.022, Kruskal-Wallis test). Furthermore, metastasis was associated with the degree of desmoplasia (p = 0.014; Fisher's exact test), calcification (p = 0.008, Fisher's exact test), necrosis (p = 0.042, Fisher's exact test), tumor size (p = 0.015, Mann-Whitney U test), and age (p = 0.001, Mann-Whitney U test). In a Cox proportional hazards model, only metastasis remained as an independent risk factor for overall survival (hazard rate: 10.2 [95% CI, 02.19 to 47.26]; p = 0.003). Our data suggest that HIF-1α plays a critical role in the remodeling of the extracellular matrix as well as metastasizing process of follicular thyroid carcinoma and targeting hypoxia-associated and -regulated proteins may be considered as potential targets for personalized medicine.

Multitarget stool DNA testing for colorectal-cancer screening.

PubMed

Imperiale, Thomas F; Ransohoff, David F; Itzkowitz, Steven H; Levin, Theodore R; Lavin, Philip; Lidgard, Graham P; Ahlquist, David A; Berger, Barry M

2014-04-03

An accurate, noninvasive test could improve the effectiveness of colorectal-cancer screening. We compared a noninvasive, multitarget stool DNA test with a fecal immunochemical test (FIT) in persons at average risk for colorectal cancer. The DNA test includes quantitative molecular assays for KRAS mutations, aberrant NDRG4 and BMP3 methylation, and β-actin, plus a hemoglobin immunoassay. Results were generated with the use of a logistic-regression algorithm, with values of 183 or more considered to be positive. FIT values of more than 100 ng of hemoglobin per milliliter of buffer were considered to be positive. Tests were processed independently of colonoscopic findings. Of the 9989 participants who could be evaluated, 65 (0.7%) had colorectal cancer and 757 (7.6%) had advanced precancerous lesions (advanced adenomas or sessile serrated polyps measuring ≥1 cm in the greatest dimension) on colonoscopy. The sensitivity for detecting colorectal cancer was 92.3% with DNA testing and 73.8% with FIT (P=0.002). The sensitivity for detecting advanced precancerous lesions was 42.4% with DNA testing and 23.8% with FIT (P<0.001). The rate of detection of polyps with high-grade dysplasia was 69.2% with DNA testing and 46.2% with FIT (P=0.004); the rates of detection of serrated sessile polyps measuring 1 cm or more were 42.4% and 5.1%, respectively (P<0.001). Specificities with DNA testing and FIT were 86.6% and 94.9%, respectively, among participants with nonadvanced or negative findings (P<0.001) and 89.8% and 96.4%, respectively, among those with negative results on colonoscopy (P<0.001). The numbers of persons who would need to be screened to detect one cancer were 154 with colonoscopy, 166 with DNA testing, and 208 with FIT. In asymptomatic persons at average risk for colorectal cancer, multitarget stool DNA testing detected significantly more cancers than did FIT but had more false positive results. (Funded by Exact Sciences; ClinicalTrials.gov number, NCT01397747.).

Case control study of dry eye and related ocular surface abnormalities in Ibadan, Nigeria.

PubMed

Bekibele, C O; Baiyeroju, A M; Ajaiyeoba, A; Akang, E E U; Ajayi, B G K

2010-02-01

Tear instability is associated with symptoms of ocular discomfort and irritation. Many patients with dry eyes remain untreated due to improper diagnoses. To identify symptoms and surface abnormalities associated with dry eyes. One hundred and fifty-six eyes of 78 subjects attending the Eye Clinic of the University College Hospital Ibadan were screened for dry eyes/tear instability using rose Bengal stain (graded 0-9), tear break-up time (TBUT), Schirmer's 1 tests, tear meniscus height and a standardised symptoms questionnaire. Grades 4-9 rose Bengal staining were considered as positive dry eye and were compared with grades 0-3 staining eyes as negative controls. Mean tear meniscus height, Schirmer's test and TBUT were lower among cases than their corresponding control eyes. The difference between the mean Schirmer's test values of cases and their controls were statistically significant (P = 0.00 for right eyes and P = 0.002 for left eyes). Rose Bengal grades were inversely correlated with the mean Schirmer's values (Pearson correlation -0.429, P = 0.05 for right eyes and -0.335, P = 0.03 for left eyes) and TBUT (Pearson correlation -0.316, P = 0.05 for right eyes and -0.212, P = 0.06 for left eyes). About 95.8% of the cases were symptomatic, as opposed to 70.4% of the controls (P = 0.01, Fisher's exact test) and 95.8% of dry right eyes compared to 61.1% of their controls had ocular surface abnormalities (P = 0.001), while 89.5% of dry left eyes compared to 62.7% of controls had surface abnormalities (P = 0.07). A close relationship exists between ocular irritation symptoms, surface abnormalities and functional evidence of tear instability. Such patients should be treated empirically or screened for dry eyes.

The Tumour Response to Induction Chemotherapy has Prognostic Value for Long-Term Survival Outcomes after Intensity-Modulated Radiation Therapy in Nasopharyngeal Carcinoma.

PubMed

Peng, Hao; Chen, Lei; Zhang, Yuan; Li, Wen-Fei; Mao, Yan-Ping; Liu, Xu; Zhang, Fan; Guo, Rui; Liu, Li-Zhi; Tian, Li; Lin, Ai-Hua; Sun, Ying; Ma, Jun

2016-04-21

The prognostic value of the tumour response to induction chemotherapy (IC) for long-term survival outcomes after intensity-modulated radiation therapy in nasopharyngeal carcinoma (NPC) remains unknown. We retrospectively reviewed 1811 consecutive patients with newly diagnosed NPC treated using IMRT, and 399 eligible patients with pre- and post-induction chemotherapy magnetic resonance images were recruited. The clinicopathological features of patients with different tumour responses were compared using the Chi-square test or Fisher's exact test. Prognostic value was assessed using a multivariate Cox proportional hazards model. After IC, 101/399 (25.3%) patients had a complete tumour response overall (CR), 262 (65.7%) had a partial response (PR) and 36 (9.0%) had stable disease (SD). The 4-year disease-free survival (DFS), overall survival (OS), distant metastasis-free survival (DMFS) and locoregional relapse-free survival (LRRFS) rates for CR vs. PR vs. SD were 90.0% vs. 79.0% vs. 58.2% (CR vs. PR: P1 = 0.007; CR vs. SD: P2 < 0.001; PR vs. SD: P3 = 0.004), 95.7% vs. 88.7% vs. 70.2% (P1 = 0.017, P2 < 0.001, P3 = 0.005), 92.0% vs. 87.4% vs. 74.3% (P1 = 0.162, P2 = 0.005, P3 = 0.029) and 95.9% vs. 88.8% vs. 81.8% (P1 = 0.024, P2 = 0.006, P3 = 0.268), respectively. Multivariate analysis identified that the tumour response to IC was an independent prognostic factor for DFS, OS and LRRFS.

An exact stiffness theory for unidirectional xFRP composites

NASA Astrophysics Data System (ADS)

Klasztorny, M.; Konderla, P.; Piekarski, R.

2009-01-01

UD xFRP composites, i.e., isotropic plastics reinforced with long transversely isotropic fibres packed unidirectionally according to the hexagonal scheme are considered. The constituent materials are geometrically and physically linear. The previous formulations of the exact stiffness theory of such composites are revised, and the theory is developed further based on selected boundary-value problems of elasticity theory. The numerical examples presented are focussed on testing the theory with account of previous variants of this theory and experimental values of the effective elastic constants. The authors have pointed out that the exact stiffness theory of UD xFRP composites, with the modifications proposed in our study, will be useful in the engineering practice and in solving the current problems of the mechanics of composite materials.

Risk factors associated with hypovitaminosis D in HIV/aids-infected adults.

PubMed

Canuto, Juliana Maria Palmeira; Canuto, Virginia Maria Palmeira; de Lima, Matheus Henrique Alves; de Omena, Ana Luiza Costa Silva; Morais, Thayná Melo de Lima; Paiva, Arthur Maia; Diniz, Erik Trovão; de Almeida, David Joseph Ferreira Tenório; Ferreira, Sonia Maria Soares

2015-02-01

To investigate risk factors associated with hypovitaminosis D in adult patients infected with HIV/aids, at a referral hospital in Maceió, Brazil. This cross-sectional study involved 125 patients evaluated from April to September 2013 by means of interviews, review of medical records, physical examination, and laboratory tests. The data were analyzed using the SPSS® software, version 17.0; the prevalence of hypovitaminosis D and mean levels of vitamin D were determined. The association between hypovitaminosis D and the independent variables was assessed using the Chi-square or the Fisher's exact tests; mean vitamin D concentrations were analyzed using Kolmogorov-Smirnov, Mann-Whitney, and Kruskal-Wallis tests. The level of significance was set at 5% across tests. The prevalence of hypovitaminosis D was 24%, with a significant association with higher household income (p < 0.05). Higher vitamin D levels were associated with female gender (p < 0.001), no use of sunscreen (p < 0.05), and previous opportunistic infections (p < 0.01). Lower values were associated with the use of antiretroviral medication (p < 0.05), overweight and obesity (p < 0.01). Lower vitamin D concentrations were significantly associated with well-known risk factors for hypovitaminosis D: use of sunscreen, antiretroviral medication, overweight, and obesity. The prevalence of hypovitaminosis D in this study, considering values > 20 ng/mL or > 30 ng/mL as vitamin D sufficiency, was lower to that of previous studies with HIV-infected patients, a fact that might be related to the low latitude and high intensity of solar radiation of the location of the present study.

Two simple clinical tests for predicting onset of medial tibial stress syndrome: shin palpation test and shin oedema test.

PubMed

Newman, Phil; Adams, Roger; Waddington, Gordon

2012-09-01

To examine the relationship between two clinical test results and future diagnosis of (Medial Tibial Stress Syndrome) MTSS in personnel at a military trainee establishment. Data from a preparticipation musculoskeletal screening test performed on 384 Australian Defence Force Academy Officer Cadets were compared against 693 injuries reported by 326 of the Officer Cadets in the following 16 months. Data were held in an Injury Surveillance database and analysed using χ² and Fisher's Exact tests, and Receiver Operating Characteristic Curve analysis. Diagnosis of MTSS, confirmed by an independent blinded health practitioner. Both the palpation and oedema clinical tests were each found to be significant predictors for later onset of MTSS. Specifically: Shin palpation test OR 4.63, 95% CI 2.5 to 8.5, Positive Likelihood Ratio 3.38, Negative Likelihood Ratio 0.732, Pearson χ² p<0.001; Shin oedema test OR 76.1 95% CI 9.6 to 602.7, Positive Likelihood Ratio 7.26, Negative Likelihood Ratio 0.095, Fisher's Exact p<0.001; Combined Shin Palpation Test and Shin Oedema Test Positive Likelihood Ratio 7.94, Negative Likelihood Ratio <0.001, Fisher's Exact p<0.001. Female gender was found to be an independent risk factor (OR 2.97, 95% CI 1.66 to 5.31, Positive Likelihood Ratio 2.09, Negative Likelihood Ratio 0.703, Pearson χ² p<0.001) for developing MTSS. The tests for MTSS employed here are components of a normal clinical examination used to diagnose MTSS. This paper confirms that these tests and female gender can also be confidently applied in predicting those in an asymptomatic population who are at greater risk of developing MTSS symptoms with activity at some point in the future.

A prospective randomized single blind trial of Fleet phosphate enema versus glycerin suppositories as preparation for flexible sigmoidoscopy.

PubMed

Underwood, D; Makar, R R; Gidwani, A L; Najfi, S M; Neilly, P; Gilliland, R

2010-03-01

This study compared the efficacy and patient acceptability of two methods of bowel preparation for flexible sigmoidoscopy. Patients attending for outpatient flexible sigmoidoscopy were prospectively randomized to receive one Fleet ready-to-use enema or 2 x 4 g glycerin suppositories, 2 h preprocedure. Patient and endoscopist questionnaires were used to compare the outcomes. From November 2000 to August 2001, 203 (male = 95; female = 108) patients were randomized. Patient data available for 163 patients (enema = 93; suppository = 70) revealed: ease of use (enema = 52; suppository = 25; P < 0.02, Fisher's exact); assistance required (enema = 19; suppository = 3; P < 0.005, Fisher's exact); grade of effectiveness (enema = 83; suppository = 44; P < 0.0001, Fisher's exact), and whether patients wished to try another preparation in future (enema = 16; suppository = 24; P = 0.016, Fisher's exact). Endoscopist data available for 151 patients (enema = 76; suppository = 75) revealed: average depth of insertion (enema = 53.6 +/- 11.6 cm; suppository 46.3 +/- 13.7 cm; P < 0.001, Student's t test); acceptable (excellent + good) quality of preparation [enema = 60 (78.9%); suppository = 34 (45.3%); P < 0.0001, Fisher's exact]. Bowel preparation for flexible sigmoidoscopy using a single Fleet enema is acceptable to patients and more effective than glycerin suppositories.

Critical assessment of the pH of children's soap.

PubMed

Mendes, Bruna Rafaela; Shimabukuro, Danielle Midori; Uber, Marjorie; Abagge, Kerstin Taniguchi

2016-01-01

To evaluate the pH value of children's antibacterial soaps and syndets used in children's baths and verify whether there is information regarding pH on the product label. Quantitative, cross-sectional, analytical observational study that included ninety soap samples, both in bar and liquid presentations, as follows: 67 children's soap (group 1), 17 antibacterial soaps (group 2), and 6 syndets (group 3). Each sample had its pH measured after 1% dilution. In addition to descriptive statistics, the Pearson-Yates chi-squared test and Student's t-tests were applied, considering the minimal significance level of 5%. The Wilcoxon-Mann-Whitney test, Fisher's exact test, and the Kruskal-Wallis test were used for inferential statistics. The pH levels varied considerably between liquid and bar presentations, with lower levels (4.4-7.9) found for the liquids (p<0.05). Syndets showed pH levels close to the ideal (slightly acid) and the antibacterial soaps showed the highest pH levels (up to 11.34) (p<0.05). Only two of the soaps included in the study had information about their pH levels on the product packaging. Knowledge of the pH of children's soap by doctors and users is important, considering the great pH variability found in this study. Moreover, liquid soaps, and especially syndets, are the most recommended for the sensitive skin of neonates and infants, in order to guarantee skin barrier efficacy. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Test Control Center

NASA Image and Video Library

2000-10-25

At the test observation periscope in the Test Control Center exhibit in StenniSphere at the John C. Stennis Space Center in Hancock County, Miss., visitors can observe a test of a Space Shuttle Main Engine exactly as test engineers might see it during a real engine test. The Test Control Center exhibit exactly simulates not only the test control environment, but also the procedure of testing a rocket engine. Designed to entertain while educating, StenniSphere includes informative dispays and exhibits from NASA's lead center for rocket propulsion and remote sensing applications. StenniSphere is open free of charge from 9 a.m. to 5 p.m. daily.

Thyrotropin receptor autoantibodies and early miscarriages in patients with Hashimoto thyroiditis: a case-control study.

PubMed

Toulis, Konstantinos A; Goulis, Dimitrios G; Tsolakidou, Konstantina; Hilidis, Ilias; Fragkos, Marios; Polyzos, Stergios A; Gerofotis, Antonios; Kita, Marina; Bili, Helen; Vavilis, Dimitrios; Daniilidis, Michail; Tarlatzis, Basil C; Papadimas, Ioannis

2013-08-01

We have previously hypothesized that early miscarriage in women with Hashimoto thyroiditis might be the result of a cross-reactivity process, in which blocking autoantibodies against thyrotropin receptor (TSHr-Ab) antagonize hCG action on its receptor on the corpus luteum. To test this hypothesis from the clinical perspective, we investigated the presence of TSHr-Ab in Hashimoto thyroiditis patients with apparently unexplained, first-trimester recurrent miscarriages compared to that in Hashimoto thyroiditis patients with documented normal fertility. A total of 86 subjects (43 cases and 43 age-matched controls) were finally included in a case-control study. No difference in the prevalence of TSHr-Ab positivity was detected between cases and controls (Fisher's exact test, p value = 1.00). In patients with recurrent miscarriages, TSHr-Ab concentrations did not predict the number of miscarriages (univariate linear regression, p value = 0.08). These results were robust in sensitivity analyses, including only cases with full investigation or those with three or more miscarriages. We conclude that no role could be advocated for TSHr-Ab in the aetiology of recurrent miscarriages in women with Hashimoto thyroiditis.

Loss of heterozygosity patterns provide fingerprints for genetic heterogeneity in multistep cancer progression of tobacco smoke-induced non-small cell lung cancer.

PubMed

Pan, Hongjie; Califano, Joseph; Ponte, Jose F; Russo, Andrea L; Cheng, Kuang-hung; Thiagalingam, Arunthathi; Nemani, Pratima; Sidransky, David; Thiagalingam, Sam

2005-03-01

Dilution end point loss of heterozygosity (LOH) analysis, a novel approach for the analysis of LOH, was used to evaluate allelic losses with the use of 21 highly polymorphic microsatellite markers at nine chromosomal sites most frequently affected in smoking-related non-small cell lung cancers. Allelotyping was done for bronchial epithelial cells and matching blood samples from 23 former and current smokers and six nonsmokers as well as in 33 adenocarcinomas and 25 squamous cell carcinomas (SCC) and corresponding matching blood from smokers. Major conclusions from these studies are as follows: (a) LOH at chromosomal sites 8p, 9p, 11q, and 13q (P >0.05, Fisher's exact test) are targeted at the early stages, whereas LOH at 1p, 5q, 17p, and 18q (P <0.05, Fisher's exact test) occur at the later stages of non-small cell lung cancer progression; (b) LOH at 1p, 3p, 5q, 8p, 9p, 11q, 13q, 17p, and 18q occurs in over 45% of the tobacco smokers with SCC and adenocarcinoma; (c) compared with bronchial epithelial cells from smokers, there is a significantly higher degree of LOH at 1p, 5q, and 18q in adenocarcinoma and at 1p, 3p, and 17p in SCC (P <0.05, Fisher's exact test). We propose that lung cancer progression induced by tobacco smoke occurs in a series of target gene inactivations/activations in defined modules of a global network. The gatekeeper module consists of multiple alternate target genes, which is inclusive of but not limited to genes localized to chromosomal loci 8p, 9p, 11q, and 13q.

Disease clusters, exact distributions of maxima, and P-values.

PubMed

Grimson, R C

1993-10-01

This paper presents combinatorial (exact) methods that are useful in the analysis of disease cluster data obtained from small environments, such as buildings and neighbourhoods. Maxwell-Boltzmann and Fermi-Dirac occupancy models are compared in terms of appropriateness of representation of disease incidence patterns (space and/or time) in these environments. The methods are illustrated by a statistical analysis of the incidence pattern of bone fractures in a setting wherein fracture clustering was alleged to be occurring. One of the methodological results derived in this paper is the exact distribution of the maximum cell frequency in occupancy models.

Diagnostic value of isoproterenol testing in arrhythmogenic right ventricular cardiomyopathy.

PubMed

Denis, Arnaud; Sacher, Frédéric; Derval, Nicolas; Lim, Han S; Cochet, Hubert; Shah, Ashok J; Daly, Matthew; Pillois, Xavier; Ramoul, Khaled; Komatsu, Yuki; Zemmoura, Adlane; Amraoui, Sana; Ritter, Philippe; Ploux, Sylvain; Bordachar, Pierre; Hocini, Mélèze; Jaïs, Pierre; Haïssaguerre, Michel

2014-08-01

Although the Task Force Criteria for arrhythmogenic right ventricular cardiomyopathy (ARVC) have recently been updated, the diagnosis remains challenging in the early stages. The aim of this study was to evaluate the diagnostic value of β-adrenergic stimulation in ARVC. We evaluated 412 consecutive patients (213 men, age 41.5±16 years) referred for premature ventricular contractions evaluation or suspected ARVC. Isoproterenol testing was performed with continuous infusion of isoproterenol (45 μg/min) for 3 minutes. It was considered positive if there were either (1) polymorphic premature ventricular contractions with ≥1 couplet or (2) sustained or nonsustained ventricular tachycardia with left bundle branch block excluding right ventricular outflow tract ventricular tachycardia. ARVC was diagnosed in 35 patients at initial evaluation (23 men, aged 42±15 years). Isoproterenol testing was positive in 32 of 35 (91.4%) patients with ARVC and in 42 of 377 (11.1%) patients without ARVC (P<0.0001). Sensitivity, specificity, positive, and negative predictive values of isoproterenol testing to diagnose ARVC were 91.4%, 88.9%, 43.2%, and 99.1%, respectively. During a mean follow-up period of 5.6±4.4 years, 6 additional patients met diagnostic criteria for ARVC. Importantly, initial isoproterenol testing was positive in 6 of 6 (100%) of these patients. Survival free from ARVC diagnosis was significantly lower in the positive isoproterenol group than in the negative isoproterenol group (P<0.0001, exact log-rank test). Ventricular arrhythmogenicity during isoproterenol testing is highly sensitive (sensitivity, 91.4%) for the diagnosis of ARVC, particularly in its early stages. © 2014 American Heart Association, Inc.

Intraoperative Gastric Suctioning and Postoperative Nausea, Retching, and Vomiting.

DTIC Science & Technology

1984-07-01

the experimental group, and the stomach was evacuated. The anesthetic technique of oxygen/nitrous oxide/methohexital/succinylcholine/fentanyl was...Way Analysis of Variance. Based on the Fisher’s Exact Test, nausea occurred less frequently in the experimental group than in the control group for...Fisher’s Exact Test, nausea occurred less f quently in the experimental group than in the control roup for the re- covery room time-frame (p - 0.0371

No Association between Mycotoxin Exposure and Autism: A Pilot Case-Control Study in School-Aged Children

PubMed Central

Duringer, Jennifer; Fombonne, Eric; Craig, Morrie

2016-01-01

Evaluation of environmental risk factors in the development of autism spectrum disorder (ASD) is needed for a more complete understanding of disease etiology and best approaches for prevention, diagnosis, and treatment. A pilot experiment in 54 children (n = 25 ASD, n = 29 controls; aged 12.4 ± 3.9 years) screened for 87 urinary mycotoxins via liquid chromatography-tandem mass spectrometry to assess current exposure. Zearalenone, zearalenone-4-glucoside, 3-acetyldeoxynivalenol, and altenuene were detected in 9/54 (20%) samples, most near the limit of detection. No mycotoxin/group of mycotoxins was associated with ASD-diagnosed children. To identify potential correlates of mycotoxin presence in urine, we further compared the nine subjects where a urinary mycotoxin was confirmed to the remaining 45 participants and found no difference based on the presence or absence of mycotoxin for age (t-test; p = 0.322), gender (Fisher’s exact test; p = 0.456), exposure or not to selective serotonin reuptake inhibitors (Fisher’s exact test; p = 0.367), or to other medications (Fisher’s exact test; p = 1.00). While no positive association was found, more sophisticated sample preparation techniques and instrumentation, coupled with selectivity for a smaller group of mycotoxins, could improve sensitivity and detection. Further, broadening sampling to in utero (mothers) and newborn-toddler years would cover additional exposure windows. PMID:27447670

Effects of a soy-based dietary supplement compared with low-dose hormone therapy on the urogenital system: a randomized, double-blind, controlled clinical trial.

PubMed

Carmignani, Lucio O; Pedro, Adriana Orcesi; Montemor, Eliana B; Arias, Victor A; Costa-Paiva, Lucia H; Pinto-Neto, Aarão M

2015-07-01

This study aims to compare the effects of a soy-based dietary supplement, low-dose hormone therapy (HT), and placebo on the urogenital system in postmenopausal women. In this double-blind, randomized, placebo-controlled trial, 60 healthy postmenopausal women aged 40 to 60 years (mean time since menopause, 4.1 y) were randomized into three groups: a soy dietary supplement group (90 mg of isoflavone), a low-dose HT group (1 mg of estradiol plus 0.5 mg of norethisterone), and a placebo group. Urinary, vaginal, and sexual complaints were evaluated using the urogenital subscale of the Menopause Rating Scale. Vaginal maturation value was calculated. Transvaginal sonography was performed to evaluate endometrial thickness. Genital bleeding pattern was assessed. Statistical analysis was performed using χ(2) test, Fisher's exact test, paired Student's t test, Kruskal-Wallis test, Kruskal-Wallis nonparametric test, and analysis of variance. For intergroup comparisons, Kruskal-Wallis nonparametric test (followed by Mann-Whitney U test) was used. Vaginal dryness improved significantly in the soy and HT groups (P = 0.04). Urinary and sexual symptoms did not change with treatment in the three groups. After 16 weeks of treatment, there was a significant increase in maturation value only in the HT group (P < 0.01). Vaginal pH decreased only in this group (P < 0.01). There were no statistically significant differences in endometrial thickness between the three groups, and the adverse effects evaluated were similar. This study shows that a soy-based dietary supplement used for 16 weeks fails to exert estrogenic action on the urogenital tract but improves vaginal dryness.

The natural history of perforated marginal ulcers after gastric bypass surgery.

PubMed

Altieri, Maria S; Pryor, Aurora; Yang, Jie; Yin, Donglei; Docimo, Salvatore; Bates, Andrew; Talamini, Mark; Spaniolas, Konstantinos

2018-03-01

Although perforated marginal ulcers (pMU) following Roux-en-Y Gastric Bypass (RYGB) represent a surgical emergency, the epidemiology and outcome of this condition is not well understood. The purpose of this study was to evaluate incidence of pMU following RYGB and assess the natural history of this complication. The SPARCS administrative database was used to identify patients undergoing RYGB between 2005 and 2010. With the use of a unique identifier, we followed patients up to 2014 for subsequent admission and re-intervention (repair or revision) for perforated MU. Groups were compared using Chi square tests with exact p values based on Monte Carlo simulation, t test with unequal variances, and the Wilcoxon rank-sum test when appropriate. We identified 35,080 RYGB patients; 292 patients (0.83%) developed pMU 937 (443-1546) days following RYGB [Median (Q1-Q3)]. Among these 292 patients, tobacco use was present in one-third of patients. Repair of the perforation was performed in 115 patients, while anastomotic revision was reported in 64. Patients who underwent revision were more likely to have respiratory complications. Hospital length of stay was significantly longer for patients managed with RYGB revision (Median, Q1-Q3:7, 5-14, vs 6, 4-7, days, p = 0.001). Recurrence of marginal ulcer was common after either intervention (26.09% for repair and 29.69% for revision, p = 0.726). Following RYGB, the incidence of pMU is small. Anastomotic revision for pMU is associated with prolonged length of stay compared to repair alone. Importantly, recurrence after intervention of pMU is common, suggesting possible value of a routine surveillance program for patients following pMU.

Early outcomes of on-pump versus off-pump coronary artery bypass grafting.

PubMed

Hussain, Ghulam; Azam, Hammad; Baig, Mirza Ahmad Raza; Ahmad, Naseem

2016-01-01

To see the early post-operative outcomes of off-pump versus on-pump coronary artery bypass graft surgery. This retrospective analytical study was conducted at Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Our Primary outcome variables were; necessity of inotropic support, nonfatal myocardial infarction, ICU stay, nonfatal stroke, new renal failure requiring dialysis and death within 30 days after operation. There were two groups of patients; Group-I (On-pump group) and Group-II (Off-pump Group). SPSS V17 was used for data analysis. Independent sample t-test and Mann Whitney U test were used to compare quantitative Variables. Chi-square test and Fisher's exact test were used to analyze qualitative variables. P-value ≤ 0.05 was considered significant. Three hundred patients were included in this study. There were no significant difference regarding risk factors except hyper-cholestrolemia which was high in off pump group (p-value 0.05). Angiographic and Echocardiographic characteristics e.g. preoperative ejection fraction, LV function grade and severity of CAD was same between the groups. Mortality risk scores and Priority status for surgery were also same. Regarding post-operative outcomes; Post-op CKMB Levels, need and duration of inotropic support, mechanical ventilation time and ICU stay was significantly less in Off-Pump group (p-value 0.001, <0.0001, 0.006, 0.025 and 0.001 resp.). Peri-operative chest drainage was significantly high in On-pump CABG group (p-value 0.027). Incidence of post-op complications was not statistically different between the groups. At 30 days follow-up, Incidence of myocardial infarction, necessity and duration of inotropic support, ICU stay period and peri-operative bleeding were significantly less in off-pump group. The incidence of neurologic, pulmonary and renal complications was same between the off-pump and on-pump groups.

Early outcomes of on-pump versus off-pump coronary artery bypass grafting

PubMed Central

Hussain, Ghulam; Azam, Hammad; Baig, Mirza Ahmad Raza; Ahmad, Naseem

2016-01-01

Objectives: To see the early post-operative outcomes of off-pump versus on-pump coronary artery bypass graft surgery. Methods: This retrospective analytical study was conducted at Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Our Primary outcome variables were; necessity of inotropic support, nonfatal myocardial infarction, ICU stay, nonfatal stroke, new renal failure requiring dialysis and death within 30 days after operation. There were two groups of patients; Group-I (On-pump group) and Group-II (Off-pump Group). SPSS V17 was used for data analysis. Independent sample t-test and Mann Whitney U test were used to compare quantitative Variables. Chi-square test and Fisher’s exact test were used to analyze qualitative variables. P-value ≤ 0.05 was considered significant. Results: Three hundred patients were included in this study. There were no significant difference regarding risk factors except hyper-cholestrolemia which was high in off pump group (p-value 0.05). Angiographic and Echocardiographic characteristics e.g. preoperative ejection fraction, LV function grade and severity of CAD was same between the groups. Mortality risk scores and Priority status for surgery were also same. Regarding post-operative outcomes; Post-op CKMB Levels, need and duration of inotropic support, mechanical ventilation time and ICU stay was significantly less in Off-Pump group (p-value 0.001, <0.0001, 0.006, 0.025 and 0.001 resp.). Peri-operative chest drainage was significantly high in On-pump CABG group (p-value 0.027). Incidence of post-op complications was not statistically different between the groups. Conclusions: At 30 days follow-up, Incidence of myocardial infarction, necessity and duration of inotropic support, ICU stay period and peri-operative bleeding were significantly less in off-pump group. The incidence of neurologic, pulmonary and renal complications was same between the off-pump and on-pump groups. PMID:27648039

What exactly do numbers mean?

PubMed Central

Huang, Yi Ting; Spelke, Elizabeth; Snedeker, Jesse

2014-01-01

Number words are generally used to refer to the exact cardinal value of a set, but cognitive scientists disagree about their meanings. Although most psychological analyses presuppose that numbers have exact semantics (two means EXACTLY TWO), many linguistic accounts propose that numbers have lower-bounded semantics (AT LEAST TWO), and that speakers restrict their reference through a pragmatic inference (scalar implicature). We address this debate through studies of children who are in the process of acquiring the meanings of numbers. Adults and 2- and 3-year-olds were tested in a novel paradigm that teases apart semantic and pragmatic aspects of interpretation (the covered box task). Our findings establish that when scalar implicatures are cancelled in the critical trials of this task, both adults and children consistently give exact interpretations for number words. These results, in concert with recent work on real-time processing, provide the first unambiguous evidence that number words have exact semantics. PMID:25285053

Magnetic Resonance Imaging Assessment of Lipomatous Soft-tissue Tumors

PubMed Central

CORAN, ALESSANDRO; ORTOLAN, PAOLO; ATTAR, SHADY; ALBERIOLI, ENRICO; PERISSINOTTO, EGLE; TOSI, ANNA LISA; MONTESCO, MARIA CRISTINA; ROSSI, CARLO RICCARDO; TROPEA, SAVERIA; RASTRELLI, MARCO; STRAMARE, ROBERTO

2017-01-01

To establish the accuracy of magnetic resonance imaging (MRI) in distinguishing between benign and malignant lipomatous tumors; to evaluate the reproducibility of the MRI interpretation assessing the agreement between judgments of two radiologists with the same experience in soft-tissue sarcomas; to identify an association among MRI findings (size, depth, septa, nodules, signal homogeneity) and nature of the lesion. Materials and Methods: A total of 54 patients (28 men and 26 women), with a mean age of 56 (range=27-84) were included years. All subjects followed-up by the Multidisciplinary Sarcoma Group. The following MRI findings were judged in a blind study by two radiologists: size, localization, septa, nodules and signal homogeneity. A diagnostic indication was then given from among lipoma, atypical lipomatous tumour (ALT) and liposarcoma. Accuracy in distinguishing between benign and malignant lesions, and between lipoma and ALT (Fisher’s exact test), inter-operator agreement (Cohen’s kappa), association of MRI findings and malignancy of the lesion (Fisher’s exact test and odds ratio) were evaluated. Results: The inter-operator agreement was complete (100%). The agreement between diagnostic hypothesis and histological diagnosis was statistically significant (p<0.05). Among the radiological findings taken into account, only septa and signal homogeneity were significantly associated with the malignancy of the lesion (p<0.05). Conclusion: MRI could be helpful in distinguishing lipomatous tumors, allowing biopsy to be avoided in some cases (negative predictive value=100%). PMID:28438867

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

PubMed

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

2017-02-01

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

Multidetector CT features of pulmonary focal ground-glass opacity: differences between benign and malignant

PubMed Central

Fan, L; Liu, S-Y; Li, Q-C; Yu, H; Xiao, X-S

2012-01-01

Objective To evaluate different features between benign and malignant pulmonary focal ground-glass opacity (fGGO) on multidetector CT (MDCT). Methods 82 pathologically or clinically confirmed fGGOs were retrospectively analysed with regard to demographic data, lesion size and location, attenuation value and MDCT features including shape, margin, interface, internal characteristics and adjacent structure. Differences between benign and malignant fGGOs were analysed using a χ2 test, Fisher's exact test or Mann–Whitney U-test. Morphological characteristics were analysed by binary logistic regression analysis to estimate the likelihood of malignancy. Results There were 21 benign and 61 malignant lesions. No statistical differences were found between benign and malignant fGGOs in terms of demographic data, size, location and attenuation value. The frequency of lobulation (p=0.000), spiculation (p=0.008), spine-like process (p=0.004), well-defined but coarse interface (p=0.000), bronchus cut-off (p=0.003), other air-containing space (p=0.000), pleural indentation (p=0.000) and vascular convergence (p=0.006) was significantly higher in malignant fGGOs than that in benign fGGOs. Binary logistic regression analysis showed that lobulation, interface and pleural indentation were important indicators for malignant diagnosis of fGGO, with the corresponding odds ratios of 8.122, 3.139 and 9.076, respectively. In addition, a well-defined but coarse interface was the most important indicator of malignancy among all interface types. With all three important indicators considered, the diagnostic sensitivity, specificity and accuracy were 93.4%, 66.7% and 86.6%, respectively. Conclusion An fGGO with lobulation, a well-defined but coarse interface and pleural indentation gives a greater than average likelihood of being malignant. PMID:22128130

Determination of pK(a) of felodipine using UV-Visible spectroscopy.

PubMed

Pandey, M M; Jaipal, A; Kumar, A; Malik, R; Charde, S Y

2013-11-01

In the present study, for the first time, experimental pKa value of felodipine is reported. Dissociation constant, pKa, is one of the very important physicochemical properties of drugs. It is of paramount significance from the perspective of pharmaceutical analysis and dosage form design. The method used for the pKa determination of felodipine was essentially a UV-Visible spectrophotometric method. The spectrophotometric method for the pKa determination was opted by acknowledging the established fact that spectrophotometric determination of pKa produces most precise values. The pKa of felodipine was found to be 5.07. Furthermore, the ruggedness of the determined value is also validated in this study in order to produce exact pKa of the felodipine. Copyright © 2013 Elsevier B.V. All rights reserved.

A maximally selected test of symmetry about zero.

PubMed

Laska, Eugene; Meisner, Morris; Wanderling, Joseph

2012-11-20

The problem of testing symmetry about zero has a long and rich history in the statistical literature. We introduce a new test that sequentially discards observations whose absolute value is below increasing thresholds defined by the data. McNemar's statistic is obtained at each threshold and the largest is used as the test statistic. We obtain the exact distribution of this maximally selected McNemar and provide tables of critical values and a program for computing p-values. Power is compared with the t-test, the Wilcoxon Signed Rank Test and the Sign Test. The new test, MM, is slightly less powerful than the t-test and Wilcoxon Signed Rank Test for symmetric normal distributions with nonzero medians and substantially more powerful than all three tests for asymmetric mixtures of normal random variables with or without zero medians. The motivation for this test derives from the need to appraise the safety profile of new medications. If pre and post safety measures are obtained, then under the null hypothesis, the variables are exchangeable and the distribution of their difference is symmetric about a zero median. Large pre-post differences are the major concern of a safety assessment. The discarded small observations are not particularly relevant to safety and can reduce power to detect important asymmetry. The new test was utilized on data from an on-road driving study performed to determine if a hypnotic, a drug used to promote sleep, has next day residual effects. Copyright © 2012 John Wiley & Sons, Ltd.

Evaluation of torque maintenance of abutment and cylinder screws with Morse taper implants.

PubMed

Ferreira, Mayara Barbosa; Delben, Juliana Aparecida; Barão, Valentim Adelino Ricardo; Faverani, Leonardo Perez; Dos Santos, Paulo Henrique; Assunção, Wirley Gonçalves

2012-11-01

The screw loosening of implant-supported prostheses is a common mechanical failure and is related to several factors as insertion torque and preload. The aim of this study was to evaluate the torque maintenance of retention screws of tapered abutments and cylinders of Morse taper implants submitted to retightening and detorque measurements. Two groups were obtained (n = 12): group I-tapered abutment connected to the implant with titanium retention screw and group II-cylinder with metallic base connected to tapered abutment with titanium retention screw. The detorque values were measured by an analogic torque gauge after 3 minutes of torque insertion. The detorque was measured 10 times for each retention screw of groups I and II, totalizing 120 detorque measurements in each group. Data were submitted to ANOVA and Fisher exact test (P < 0.05). Both groups presented reduced detorque value (P < 0.05) in comparison to the insertion torque in all measurement periods. There was a statistically significant difference (P < 0.05) between the detorque values of the first measurement and the other measurement periods for the abutment screw. However, there was no statistically significant difference (P > 0.05) for the detorque values of all measurement periods for the cylinder screw. In conclusion, the abutment and cylinder screws exhibited torque loss after insertion, which indicates the need for retightening during function of the implant-supported prostheses.

Perturbative test of exact vacuum expectation values of local fields in affine Toda theories

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

Ahn, Changrim; Baseilhac, P.; Kim, Chanju

Vacuum expectation values of local fields for all dual pairs of nonsimply laced affine Toda field theories recently proposed are checked against perturbative analysis. The computations based on Feynman diagram expansion are performed up to the two-loop level. We obtain, good agreement.

A unified framework for weighted parametric multiple test procedures.

PubMed

Xi, Dong; Glimm, Ekkehard; Maurer, Willi; Bretz, Frank

2017-09-01

We describe a general framework for weighted parametric multiple test procedures based on the closure principle. We utilize general weighting strategies that can reflect complex study objectives and include many procedures in the literature as special cases. The proposed weighted parametric tests bridge the gap between rejection rules using either adjusted significance levels or adjusted p-values. This connection is made by allowing intersection hypotheses of the underlying closed test procedure to be tested at level smaller than α. This may be also necessary to take certain study situations into account. For such cases we introduce a subclass of exact α-level parametric tests that satisfy the consonance property. When the correlation is known only for certain subsets of the test statistics, a new procedure is proposed to fully utilize this knowledge within each subset. We illustrate the proposed weighted parametric tests using a clinical trial example and conduct a simulation study to investigate its operating characteristics. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Monte Carlo Simulations Comparing Fisher Exact Test and Unequal Variances t Test for Analysis of Differences Between Groups in Brief Hospital Lengths of Stay.

PubMed

Dexter, Franklin; Bayman, Emine O; Dexter, Elisabeth U

2017-12-01

We examined type I and II error rates for analysis of (1) mean hospital length of stay (LOS) versus (2) percentage of hospital LOS that are overnight. These 2 end points are suitable for when LOS is treated as a secondary economic end point. We repeatedly resampled LOS for 5052 discharges of thoracoscopic wedge resections and lung lobectomy at 26 hospitals. Unequal variances t test (Welch method) and Fisher exact test both were conservative (ie, type I error rate less than nominal level). The Wilcoxon rank sum test was included as a comparator; the type I error rates did not differ from the nominal level of 0.05 or 0.01. Fisher exact test was more powerful than the unequal variances t test at detecting differences among hospitals; estimated odds ratio for obtaining P < .05 with Fisher exact test versus unequal variances t test = 1.94, with 95% confidence interval, 1.31-3.01. Fisher exact test and Wilcoxon-Mann-Whitney had comparable statistical power in terms of differentiating LOS between hospitals. For studies with LOS to be used as a secondary end point of economic interest, there is currently considerable interest in the planned analysis being for the percentage of patients suitable for ambulatory surgery (ie, hospital LOS equals 0 or 1 midnight). Our results show that there need not be a loss of statistical power when groups are compared using this binary end point, as compared with either Welch method or Wilcoxon rank sum test.

Lesion stiffness measured by shear-wave elastography: Preoperative predictor of the histologic underestimation of US-guided core needle breast biopsy.

PubMed

Park, Ah Young; Son, Eun Ju; Kim, Jeong-Ah; Han, Kyunghwa; Youk, Ji Hyun

2015-12-01

To determine whether lesion stiffness measured by shear-wave elastography (SWE) can be used to predict the histologic underestimation of ultrasound (US)-guided 14-gauge core needle biopsy (CNB) for breast masses. This retrospective study enrolled 99 breast masses from 93 patients, including 40 high-risk lesions and 59 ductal carcinoma in situ (DCIS), which were diagnosed by US-guided 14-gauge CNB. SWE was performed for all breast masses to measure quantitative elasticity values before US-guided CNB. To identify the preoperative factors associated with histologic underestimation, patients' age, symptoms, lesion size, B-mode US findings, and quantitative SWE parameters were compared according to the histologic upgrade after surgery using the chi-square test, Fisher's exact test, or independent t-test. The independent factors for predicting histologic upgrade were evaluated using multivariate logistic regression analysis. The underestimation rate was 28.3% (28/99) in total, 25.0% (10/40) in high-risk lesions, and 30.5% (18/59) in DCIS. All elasticity values of the upgrade group were significantly higher than those of the non-upgrade group (P<0.001). On multivariate analysis, the mean (Odds ratio [OR]=1.021, P=0.001), maximum (OR=1.015, P=0.008), and minimum (OR=1.028, P=0.001) elasticity values were independently associated with histologic underestimation. The patients' age, lesion size, and final assessment category on US of the upgrade group were higher than those of the non-upgrade group (P=0.046 for age; P=0.021 for lesion size; P=0.030 for US category), but these were not independent predictors of histologic underestimation on multivariate analysis. Breast lesion stiffness quantitatively measured by SWE could be helpful to predict the underestimation of malignancy in US-guided 14-gauge CNB. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effects of contamination by either blood or a hemostatic agent on the shear bond strength of orthodontic buttons

PubMed Central

Alkis, Huseyin; Turkkahraman, Hakan

2013-01-01

Objective To evaluate the effects of contamination by either blood or a hemostatic agent on the shear bond strength (SBS) of orthodontic buttons. Methods We used 45 freshly extracted, non-carious, impacted third molars that were divided into 3 groups of 15. Each tooth was etched with 37% phosphoric acid gel for 30 s. Human blood or the blood stopper agent was applied to the tooth surface in groups I and II, respectively. Group III teeth were untreated (controls). Orthodontic buttons were bonded to the teeth using light-curing composite resin. After bonding, the SBS of the button was determined using a Universal testing machine. Any adhesive remaining after debonding was assessed and scored according to the modified adhesive remnant index (ARI). ANOVA with post-hoc Tukey's test was used to determine significant differences in SBS and Fisher's exact test, to determine significant differences in ARI scores among groups. Results ANOVA indicated a significant difference between groups (p < 0.001). The highest SBS values were measured in group III (10.73 ± 0.96 MPa). The SBS values for teeth in groups I and II were significantly lower than that of group III (p < 0.001). The lowest SBS values were observed in group I teeth (4.17 ± 1.11 MPa) (p < 0.001). Conclusions Contamination of tooth surfaces with either blood or hemostatic agent significantly decreased the SBS of orthodontic buttons. When the contamination risk is high, it is recommended to use the blood stopper agent when bonding orthodontic buttons on impacted teeth. PMID:23671834

Using Least Squares to Solve Systems of Equations

ERIC Educational Resources Information Center

Tellinghuisen, Joel

2016-01-01

The method of least squares (LS) yields exact solutions for the adjustable parameters when the number of data values n equals the number of parameters "p". This holds also when the fit model consists of "m" different equations and "m = p", which means that LS algorithms can be used to obtain solutions to systems of…

Clostridium difficile Testing in the Clinical Laboratory by Use of Multiple Testing Algorithms ▿

PubMed Central

Novak-Weekley, Susan M.; Marlowe, Elizabeth M.; Miller, John M.; Cumpio, Joven; Nomura, Jim H.; Vance, Paula H.; Weissfeld, Alice

2010-01-01

The incidence of Clostridium difficile infection (CDI) has risen almost 3-fold in the United States over the past decade, emphasizing the need for rapid and accurate tests for CDI. The Cepheid Xpert C. difficile assay is an integrated, closed, nucleic acid amplification system that automates sample preparation and real-time PCR detection of the toxin B gene (tcdB). A total of 432 stool specimens from symptomatic patients were tested by a glutamate dehydrogenase (GDH) assay, a toxin A and B enzyme immunoassay (EIA), the Xpert C. difficile assay, and a cell culture cytotoxicity neutralization assay (CCCN). The results of these methods, used individually and in combination, were compared to those of toxigenic culture. Results for the Xpert C. difficile assay alone showed a sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of 94.4, 96.3, 84.0, and 98.8%, while the EIA alone gave corresponding values of 58.3, 94.7, 68.9, and 91.9%, respectively. An algorithm using the GDH assay and the EIA (plus the CCCN if the EIA was negative) showed corresponding values of 83.1, 96.7, 83.1, and 96.1%. The Xpert C. difficile assay was statistically superior to the EIA (P, <0.001 by Fisher's exact test) and to the GDH-EIA-CCCN algorithm (P, 0.0363). Combining the GDH and Xpert C. difficile assays lowered both the sensitivity and the NPV of the Xpert assay. The GDH-EIA-CCCN procedure required, on average, 2 days to complete testing on GDH-positive results, while testing by the Xpert C. difficile assay was completed, on average, in less than 1 h. Xpert C. difficile testing yielded the highest sensitivity and NPV, in the least amount of time, of the individual- and multiple-test algorithms evaluated in this study. PMID:20071552

Statistical testing of association between menstruation and migraine.

PubMed

Barra, Mathias; Dahl, Fredrik A; Vetvik, Kjersti G

2015-02-01

To repair and refine a previously proposed method for statistical analysis of association between migraine and menstruation. Menstrually related migraine (MRM) affects about 20% of female migraineurs in the general population. The exact pathophysiological link from menstruation to migraine is hypothesized to be through fluctuations in female reproductive hormones, but the exact mechanisms remain unknown. Therefore, the main diagnostic criterion today is concurrency of migraine attacks with menstruation. Methods aiming to exclude spurious associations are wanted, so that further research into these mechanisms can be performed on a population with a true association. The statistical method is based on a simple two-parameter null model of MRM (which allows for simulation modeling), and Fisher's exact test (with mid-p correction) applied to standard 2 × 2 contingency tables derived from the patients' headache diaries. Our method is a corrected version of a previously published flawed framework. To our best knowledge, no other published methods for establishing a menstruation-migraine association by statistical means exist today. The probabilistic methodology shows good performance when subjected to receiver operator characteristic curve analysis. Quick reference cutoff values for the clinical setting were tabulated for assessing association given a patient's headache history. In this paper, we correct a proposed method for establishing association between menstruation and migraine by statistical methods. We conclude that the proposed standard of 3-cycle observations prior to setting an MRM diagnosis should be extended with at least one perimenstrual window to obtain sufficient information for statistical processing. © 2014 American Headache Society.

A model-based test for treatment effects with probabilistic classifications.

PubMed

Cavagnaro, Daniel R; Davis-Stober, Clintin P

2018-05-21

Within modern psychology, computational and statistical models play an important role in describing a wide variety of human behavior. Model selection analyses are typically used to classify individuals according to the model(s) that best describe their behavior. These classifications are inherently probabilistic, which presents challenges for performing group-level analyses, such as quantifying the effect of an experimental manipulation. We answer this challenge by presenting a method for quantifying treatment effects in terms of distributional changes in model-based (i.e., probabilistic) classifications across treatment conditions. The method uses hierarchical Bayesian mixture modeling to incorporate classification uncertainty at the individual level into the test for a treatment effect at the group level. We illustrate the method with several worked examples, including a reanalysis of the data from Kellen, Mata, and Davis-Stober (2017), and analyze its performance more generally through simulation studies. Our simulations show that the method is both more powerful and less prone to type-1 errors than Fisher's exact test when classifications are uncertain. In the special case where classifications are deterministic, we find a near-perfect power-law relationship between the Bayes factor, derived from our method, and the p value obtained from Fisher's exact test. We provide code in an online supplement that allows researchers to apply the method to their own data. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Comparison of fit accuracy and torque maintenance of zirconia and titanium abutments for internal tri-channel and external-hex implant connections.

PubMed

Siadat, Hakimeh; Beyabanaki, Elaheh; Mousavi, Niloufar; Alikhasi, Marzieh

2017-08-01

This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. Two regular platform dental implants, one with external connection (Brånemark, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at α=0.05 of significance. There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups ( P <.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom ( P <.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments ( P <.001). However, neither connection type ( P =.15) nor abutment material ( P =.38) affected torque loss. Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values.

Predictive Value of Serum Creatinine, Blood Urea Nitrogen, Uric Acid, and β2-Microglobulin in the Evaluation of Acute Kidney Injury after Orthotopic Liver Transplantation.

PubMed

Lu, Hai-Yang; Ning, Xin-Yu; Chen, Ying-Qi; Han, Shu-Jun; Chi, Ping; Zhu, Sai-Nan; Yue, Yun

2018-05-05

As a major complication after orthotopic liver transplantation (OLT), the occurrence of acute kidney injury (AKI) is frequently defined by serum creatinine (Cr); however, the accuracy of commonly used blood urea nitrogen (BUN), uric acid (UA), and β 2 -microglobulin (β 2 -MG) remains to be explored. This retrospective study compared the accuracy of these parameters for post-OLT AKI evaluation. Patients who underwent OLT in three centers between July 2003 and December 2013 were enrolled. The postoperative AKI group was diagnosed by the Kidney Disease Improving Global Outcomes (KDIGO) criteria and classified by stage. Measurement data were analyzed using the t-test or Wilcoxon rank-sum test; enumerated data were analyzed using the Chi-square test or Fisher's exact test. Diagnostic reliability and predictive accuracy were evaluated using receiver operating characteristic (ROC) curve analysis. This study excluded 976 cases and analyzed 697 patients (578 men and 119 women); the post-OLT AKI incidence was 0.409. Compared with the no-AKI group, the AKI group showed very significant differences in Model for End-stage Liver Disease score (14.74 ± 9.91 vs. 11.07 ± 9.54, Z = 5.404; P < 0.001), hepatic encephalopathy (45 [15.8%] vs. 30 [7.3%], χ 2 = 12.699; P < 0.001), hemofiltration (28 [9.8%] vs. 0 [0.0%], χ 2 = 42.171; P < 0.001), and 28-day mortality (23 [8.1%] vs. 9 [2.2%], χ 2 = 13.323; P <0.001). Moreover, mean values of Cr, BUN, UA, and β 2 -MG in the AKI group differed significantly at postoperative days 1, 3, and 7 (all P < 0.001). ROC curve area was 0.847 of Cr for the detection of AKI Stage 1 (sensitivity 80.1%, specificity 75.7%, cutoff value 88.23 μmol/L), 0.916 for Stage 2 (sensitivity 87.6%, specificity 82.6%, cutoff value 99.9 μmol/L), and 0.972 for Stage 3 (sensitivity 94.1%, specificity 88.2%, cutoff value 122.90 μmol/L). The sensitivity and specificity of serum Cr might be a high-value indicator for the diagnosis and grading of post-OLT AKI.

Serum uric acid levels correlate with benign paroxysmal positional vertigo.

PubMed

Celikbilek, A; Gencer, Z K; Saydam, L; Zararsiz, G; Tanik, N; Ozkiris, M

2014-01-01

Benign paroxysmal positional vertigo (BPPV) is a frequently encountered condition that can severely affect the quality of life. In this study, we aimed to assess the possible relations between serum uric acid (SUA) levels and BPPV. Fifty patients with BPPV, and 40 age- and sex-matched control subjects were enrolled in the study. All the patients and controls underwent a complete audio-vestibular test battery including the Dix-Hallpike maneuver and supine roll test for posterior semicircular canal (PSC) and horizontal semicircular canal, respectively. Routine hematological and biochemical analyses were performed in both groups. In the BPPV group, measurements of SUA levels were repeated 1 month after the vertigo attack. The lipid profiles and SUA levels were higher in patients with BPPV than detected in controls (P < 0.05 and P < 0.001, respectively). Albumin and SUA values were independently associated with BPPV in multiple logistic regression models (P < 0.05 and P < 0.001, respectively). A cutoff value of 4 for SUA level with a sensitivity of 0.72 (0.58-0.84) and a specificity of 0.60 (0.43-0.75) was obtained in the receiver operating characteristic analyses. There was a significant decrement in SUA level 1 month after the vertigo attack compared with the values obtained during the attack (P < 0.001). Among the most involved type of BPPV (PSC BPPV), the right side was affected in 26 patients (57.8%) and the left side in 19 patients (42.2%). SUA levels did not differ statistically in patients with PSC BPPV for either the right or left sides (P > 0.05). Elevated SUA is positively correlated with BPPV, requiring further efforts to clarify the exact mechanism. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.

Characteristics of quantitative perfusion parameters on dynamic contrast‐enhanced MRI in mammographically occult breast cancer

PubMed Central

Ryu, Jung Kyu; Rhee, Sun Jung; Song, Jeong Yoon; Cho, Soo Hyun

2016-01-01

The purpose of this study was to compare the characteristics of quantitative perfusion parameters obtained from dynamic contrast‐enhanced (DCE) magnetic resonance imaging (MRI) in patients with mammographically occult (MO) breast cancers and those with mammographically visible (MV) breast cancers. Quantitative parameters (AUC, Ktrans,kep,ve,vp, and wi) from 13 MO breast cancers and 16 MV breast cancers were mapped after the DCE‐MRI data were acquired. Various prognostic factors, including axillary nodal status, estrogen receptor (ER), progesterone receptor (PR), Ki‐67, p53, E‐cadherin, and human epidermal growth factor receptor 2 (HER2) were obtained in each group. Fisher's exact test was used to compare any differences of the various prognostic factors between the two groups. The Mann‐Whitney U test was applied to compare the quantitative parameters between these two groups. Finally, Spearman's correlation was used to investigate the relationships between perfusion indices and four factors — age, tumor size, Ki‐67, and p53 — for each group. Although age, tumor size, and the prognostic factors were not statistically different between the two groups, the mean values of the quantitative parameters, except wi in the MV group, were higher than those in the MO group without statistical significance (p=0.219). The kep value was significantly different between the two groups (p=0.048), but the other parameters were not. In the MO group, vp with size, ve with p53, and Ktrans and vp with Ki‐67 had significant correlations (p<0.05). However, in the MV group, only kep showed significant correlation with age. The kep value was only the perfusion parameter of statistical significance between MO and MV breast cancers. PACS number(s): 87.19.U‐, 87.61.‐c PMID:27685105

Hepatitis B birth dose vaccination rates among children in Beijing: A comparison of local residents and first and second generation migrants

PubMed Central

Chen, Ruohan; Li, Youwei; Wangen, Knut Reidar; Nicholas, Stephen; Maitland, Elizabeth; Wang, Jian

2016-01-01

ABSTRACT Providing hepatitis B vaccine to all neonates within 24 hours of birth (Timely Birth Dose, TBD) is the key preventative measure to control perinatal hepatitis B virus infection. Previous Chinese studies of TBD only differentiated between migrant and non-migrant (local-born generation-LG) children. Our study is the first to stratify migrants in Beijing into first generation migrants (FGM) and second generation migrants (SGM). Based on a questionnaire survey of 2682 people in 3 Beijing villages, we identified 283 children aged 0–15 years, from 246 households, who were eligible for a TBD. Multinomial logistic regression and statistical analyses were used to examine factors explaining TBD rates for LG, FGM and SGM children. Surprisingly, the TBD for LG Beijing children was not significantly different from migrant children. But after stratifying migrant children into FGM and SGM, revealed significant TBD differences were revealed across LG, FGM and SGM according to domicile (p-value < 0.001, OR = 3.24), first vaccination covered by government policy (p-value < 0.05, OR = 3.24), mother's knowledge of hepatitis B (p-value < 0.05, OR = 1.01) and the government's HBV policy environment (p-value < 0.05, OR = 2.338). Birthplace (p-value = 0.002, OR = 6.21) and better policy environments (p-value = 0.01, OR = 2.80) were associated with higher TBD rate for LG and SGM children. Compared with FGM children, SGM had a significantly poorer TBD rate (Fisher exact test of chi-square = 0.013). We identified SGM as a special risk group; proposed Hukou reform to improve SGM TBD; and called for Beijing health authorities to match TBD rates in other provinces, especially by improving practices by health authorities and knowledge of parents. PMID:27043864

Hepatitis B birth dose vaccination rates among children in Beijing: A comparison of local residents and first and second generation migrants.

PubMed

Chen, Ruohan; Li, Youwei; Wangen, Knut Reidar; Nicholas, Stephen; Maitland, Elizabeth; Wang, Jian

2016-05-03

Providing hepatitis B vaccine to all neonates within 24 hours of birth (Timely Birth Dose, TBD) is the key preventative measure to control perinatal hepatitis B virus infection. Previous Chinese studies of TBD only differentiated between migrant and non-migrant (local-born generation-LG) children. Our study is the first to stratify migrants in Beijing into first generation migrants (FGM) and second generation migrants (SGM). Based on a questionnaire survey of 2682 people in 3 Beijing villages, we identified 283 children aged 0-15 years, from 246 households, who were eligible for a TBD. Multinomial logistic regression and statistical analyses were used to examine factors explaining TBD rates for LG, FGM and SGM children. Surprisingly, the TBD for LG Beijing children was not significantly different from migrant children. But after stratifying migrant children into FGM and SGM, revealed significant TBD differences were revealed across LG, FGM and SGM according to domicile (p-value < 0.001, OR = 3.24), first vaccination covered by government policy (p-value < 0.05, OR = 3.24), mother's knowledge of hepatitis B (p-value < 0.05, OR = 1.01) and the government's HBV policy environment (p-value < 0.05, OR = 2.338). Birthplace (p-value = 0.002, OR = 6.21) and better policy environments (p-value = 0.01, OR = 2.80) were associated with higher TBD rate for LG and SGM children. Compared with FGM children, SGM had a significantly poorer TBD rate (Fisher exact test of chi-square = 0.013). We identified SGM as a special risk group; proposed Hukou reform to improve SGM TBD; and called for Beijing health authorities to match TBD rates in other provinces, especially by improving practices by health authorities and knowledge of parents.

Empirical dual energy calibration (EDEC) for cone-beam computed tomography.

PubMed

Stenner, Philip; Berkus, Timo; Kachelriess, Marc

2007-09-01

Material-selective imaging using dual energy CT (DECT) relies heavily on well-calibrated material decomposition functions. These require the precise knowledge of the detected x-ray spectra, and even if they are exactly known the reliability of DECT will suffer from scattered radiation. We propose an empirical method to determine the proper decomposition function. In contrast to other decomposition algorithms our empirical dual energy calibration (EDEC) technique requires neither knowledge of the spectra nor of the attenuation coefficients. The desired material-selective raw data p1 and p2 are obtained as functions of the measured attenuation data q1 and q2 (one DECT scan = two raw data sets) by passing them through a polynomial function. The polynomial's coefficients are determined using a general least squares fit based on thresholded images of a calibration phantom. The calibration phantom's dimension should be of the same order of magnitude as the test object, but other than that no assumptions on its exact size or positioning are made. Once the decomposition coefficients are determined DECT raw data can be decomposed by simply passing them through the polynomial. To demonstrate EDEC simulations of an oval CTDI phantom, a lung phantom, a thorax phantom and a mouse phantom were carried out. The method was further verified by measuring a physical mouse phantom, a half-and-half-cylinder phantom and a Yin-Yang phantom with a dedicated in vivo dual source micro-CT scanner. The raw data were decomposed into their components, reconstructed, and the pixel values obtained were compared to the theoretical values. The determination of the calibration coefficients with EDEC is very robust and depends only slightly on the type of calibration phantom used. The images of the test phantoms (simulations and measurements) show a nearly perfect agreement with the theoretical micro values and density values. Since EDEC is an empirical technique it inherently compensates for scatter components. The empirical dual energy calibration technique is a pragmatic, simple, and reliable calibration approach that produces highly quantitative DECT images.

Influence of abutment type and esthetic veneering on preload maintenance of abutment screw of implant-supported crowns.

PubMed

Delben, Juliana Aparecida; Barão, Valentim Adelino Ricardo; Dos Santos, Paulo Henrique; Assunção, Wirley Gonçalves

2014-02-01

The effect of veneering materials on screw joint stability remains inconclusive. Thus, this study evaluated the preload maintenance of abutment screws of single crowns fabricated with different abutments and veneering materials. Sixty crowns were divided into five groups (n = 12): UCLA abutment in gold alloy with ceramic (group GC) and resin (group GR) veneering, UCLA abutment in titanium with ceramic (group TiC) and resin (group TiR) veneering, and zirconia abutment with ceramic veneering (group ZiC). Abutment screws made of gold were used with a 35 Ncm insertion torque. Detorque measurements were obtained initially and after mechanical cycling. Data were analyzed by ANOVA and Fisher's exact test at a significance level of 5%. For the initial detorque means (in Ncm), group TiC (21.4 ± 1.78) exhibited statistically lower torque maintenance than groups GC (23.9 ± 0.91), GR (24.1 ± 1.34), and TiR (23.2 ± 1.33) (p < 0.05, Fisher's exact test). Group ZiC (21.9 ± 2.68) exhibited significantly lower torque maintenance than groups GC, GR, and TiR (p < 0.05, Fisher's exact test). After mechanical cycling, there was a statistically significant difference between groups TiC (22.1 ± 1.86) and GR (23.8 ± 1.56); between groups ZiC (21.7 ± 2.02) and GR; and also between groups ZiC and TiR (23.6 ± 1.30) (p < 0.05, Fisher's exact test). Detorque reduction occurred regardless of abutment type and veneering material. More irregular surfaces in the hexagon area of the castable abutments were observed. The superiority of any veneering material concerning preload maintenance was not established. © 2013 by the American College of Prosthodontists.

Closed-Suction Drainage and Cerebrospinal Fluid Leakage Following Microvascular Decompression : A Retrospective Comparison Study

PubMed Central

Kim, Young-Hoon; Kim, Chae-Yong; Oh, Chang Wan

2013-01-01

Objective We performed this study to investigate whether the use of closed-suction drainage following microvascular decompression (MVD) causes cerebrospinal fluid (CSF) leakage. Methods Between 2004 and 2011, a total of 157 patients with neurovascular compression were treated with MVD. MVD was performed for hemifacial spasm in 150 (95.5%) cases and for trigeminal neuralgia in 7 (4.5%) cases. The mean age of the patients was 49.8±9.6 years (range, 20-69). Dural substitutes were used in 44 (28.0%) patients. Ninety-two patients (58.6%) were underwent a 4-5 cm craniotomy using drainage (drainage group), and 65 (41.4%) did a small 2-2.5 cm retromastoid craniectomy without closed-suction drainage (no-drainage group). Results Eleven (7.0%) patients experienced CSF leakage following MVD based on the criteria of this study; all of these patients were in the drainage group. In the unadjusted analyses, the incidence of CSF leakage was significantly related with the use of closed-suction drainage following MVD (12.0% in the drainage group vs. 0% in the no-drainage group, respectively; p=0.003; Fisher's exact test). Those who received dural substitutes and the elderly (cut-off value=60 years) exhibited a tendency to develop CSF leakage (p=0.075 and p=0.090, respectively; Fisher's exact test). In the multivariate analysis, only the use of closed-suction drainage was significantly and independently associated with the development of CSF leakage following MVD (odds ratio=9.900; 95% confidence interval, 1.418 to infinity; p=0.017). Conclusion The use of closed-suction drainage following MVD appears to be related to the development of CSF leakage. PMID:24175025

Effect of electron-hole asymmetry on optical conductivity in 8 -P m m n borophene

NASA Astrophysics Data System (ADS)

Verma, Sonu; Mawrie, Alestin; Ghosh, Tarun Kanti

2017-10-01

We present a detailed theoretical study of the Drude weight and optical conductivity of 8-P m m n borophene having tilted anisotropic Dirac cones. We provide exact analytical expressions of x x and y y components of the Drude weight as well as maximum optical conductivity. We also obtain exact analytical expressions of the minimum energy (ɛ1) required to trigger the optical transitions and energy (ɛ2) needed to attain maximum optical conductivity. We find that the Drude weight and optical conductivity are highly anisotropic as a consequence of the anisotropic Dirac cone. The optical conductivities have a nonmonotonic behavior with photon energy in the regime between ɛ1 and ɛ2, as a result of the tilted parameter vt. The tilted parameter can be extracted by knowing ɛ1 and ɛ2 from optical measurements. The maximum values of the components of the optical conductivity do not depend on the carrier density and the tilted parameter. The product of the maximum values of the anisotropic conductivities has the universal value (e2/4ℏ ) 2. The tilted anisotropic Dirac cones in 8-P m m n borophene can be realized by the optical conductivity measurement.

Comparison of effectiveness and cost of patent ductus arteriosus device occlusion versus surgical ligation of patent ductus arteriosus.

PubMed

Zulqarnain, Arif; Younas, Muhammad; Waqar, Tariq; Beg, Ahsan; Asma, Touseef; Baig, Mirza Ahmad Raza

2016-01-01

Comparison of effectiveness and cost of transcatheter occlusion of patent ductus arteriosus (PDA) with surgical ligation of PDA. This retrospective comparative study was conducted in the pediatric cardiology department of Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Data of 250 patients who underwent patent ductus arteriosus (PDA) closure either surgical or trans-catheter closure using SHSMA Occluder having weight >5 kg from April 2012 to October 2015 were included in this study. SPSS version 20 was used for data analysis. Quantitative variables were compared using independent sample t-test. Chi-square test and fishers exact was used for qualitative variables. P-value <0.05 was considered statistically significant. There were one hundred and twenty (120) patients who underwent transcatheter occlusion of PDA using SHSMA occluder (PDA Device Group) and one hundred and thirty (130) patients who underwent surgical ligation of PDA (Surgical Group). Incidence of residual shunting was two (1.5%) in surgical group and 0 (0.0%) in PDA Device group for one month follow up period. There were 4 (3.1%) major complications in surgical group. The rate of blood transfusions were high in surgical group (p-value 0.04). Hospital stay time was significantly less in PDA Device group (P-value <0.001). Total procedural cost was 110695+1054 Pakistani rupees in PDA Device group and 92414+3512 in surgical group (p-value <0.001). The cost of PDA device closure was 16.52% higher than the surgical ligation of PDA. There was no operative mortality. The transcatheter closure of PDA is an effective and less invasive method as compared to the surgical ligation. There is a lower rate of complications and the cost is not much high as compared to surgical PDA ligation.

Advanced control of dissolved oxygen concentration in fed batch cultures during recombinant protein production.

PubMed

Kuprijanov, A; Gnoth, S; Simutis, R; Lübbert, A

2009-02-01

Design and experimental validation of advanced pO(2) controllers for fermentation processes operated in the fed-batch mode are described. In most situations, the presented controllers are able to keep the pO(2) in fermentations for recombinant protein productions exactly on the desired value. The controllers are based on the gain-scheduling approach to parameter-adaptive proportional-integral controllers. In order to cope with the most often appearing distortions, the basic gain-scheduling feedback controller was complemented with a feedforward control component. This feedforward/feedback controller significantly improved pO(2) control. By means of numerical simulations, the controller behavior was tested and its parameters were determined. Validation runs were performed with three Escherichia coli strains producing different recombinant proteins. It is finally shown that the new controller leads to significant improvements in the signal-to-noise ratio of other key process variables and, thus, to a higher process quality.

ABO, Secretor and Lewis histo-blood group systems influence the digestive form of Chagas disease.

PubMed

Bernardo, Cássia Rubia; Camargo, Ana Vitória Silveira; Ronchi, Luís Sérgio; de Oliveira, Amanda Priscila; de Campos Júnior, Eumildo; Borim, Aldenis Albaneze; Brandão de Mattos, Cinara Cássia; Bestetti, Reinaldo Bulgarelli; de Mattos, Luiz Carlos

2016-11-01

Chagas disease, caused by Trypanosoma cruzi, can affect the heart, esophagus and colon. The reasons that some patients develop different clinical forms or remain asymptomatic are unclear. It is believed that tissue immunogenetic markers influence the tropism of T. cruzi for different organs. ABO, Secretor and Lewis histo-blood group systems express a variety of tissue carbohydrate antigens that influence the susceptibility or resistance to diseases. This study aimed to examine the association of ABO, secretor and Lewis histo-blood systems with the clinical forms of Chagas disease. We enrolled 339 consecutive adult patients with chronic Chagas disease regardless of gender (cardiomyopathy: n=154; megaesophagus: n=119; megacolon: n=66). The control group was composed by 488 healthy blood donors. IgG anti-T. cruzi antibodies were detected by ELISA. ABO and Lewis phenotypes were defined by standard hemagglutination tests. Secretor (FUT2) and Lewis (FUT3) genotypes, determined by Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), were used to infer the correct histo-blood group antigens expressed in the gastrointestinal tract. The proportions between groups were compared using the χ2 test with Yates correction and Fisher's exact test and the Odds Ratio (OR) and 95% Confidence Interval (95% CI) were calculated. An alpha error of 5% was considered significant with p-values <0.05 being corrected for multiple comparisons (pc). No statistically significant differences were found for the ABO (X 2 : 2.635; p-value=0.451), Secretor (X 2 : 0.056; p-value=0.812) or Lewis (X 2 : 2.092; p-value=0.351) histo-blood group phenotypes between patients and controls. However, B plus AB Secretor phenotypes were prevalent in pooled data from megaesophagus and megacolon patients (OR: 5.381; 95% CI: 1.230-23.529; p-value=0.011; pc=0.022) in comparison to A plus O Secretor phenotypes. The tissue antigen variability resulting from the combined action of ABO and Secretor histo-blood systems is associated with the digestive forms of Chagas disease. Copyright © 2016 Elsevier B.V. All rights reserved.

Study of anti-endothelial cell antibodies in SLE patients with acute ischemic stroke.

PubMed

Cojocaru, Inimioara Mihaela; Cojocaru, M; Butnaru, Ludmila; Miu, Gabriela; Tănăsescu, R

2010-01-01

Endothelial dysfunction is the predominant manifestation of SLE. Anti-endothelial cell antibodies (AECA) are a heterogeneous group of autoantibodies directed against different antigens in endothelial cells. The objective of this study was to assess the possible correlation between the presence of AECA and ischemic stroke manifestations in SLE. The AECA titers in serum from 34 patients with SLE and acute ischemic stroke (8 men and 26 women, mean age 38.37 +/- 3.25 years) and in 32 controls (11 men and 21 women, mean age 37.52 +/- 3.86 years) were tested. The method used was ELISA. The data were expressed as mean +/- SD from indicated number of patients. Comparison between patients and controls was expressed as relative risk with its 95% confidence interval (RR[95% CI]), where lower limit > 1.0 was considered significant. All p values were determined by Fisher's exact test. A value of p < 0.05 was considered statistically significant. AECA were positive in 31 out of 34 patients, mean value 19.2 +/- 16.3 U/mL and in 8 out of 32 controls, mean value 5.5 +/- 2.6 U/mL (RR 7.154 [95% CI 2.801 to 18.274]), p < 0.0001. Patients with SLE and acute ischemic stroke tended to have higher mean values of AECA. AECA play a pivotal role in the pathogenesis of neurologic complications of SLE. AECA titers in SLE patients with acute ischemic stroke support a role for AECA as potential diagnostic marker possibly associated to cerebral manifestations of SLE patients. Further study is needed in order to clarify if AECA presence is related to systemic diseases severity and to situate their importance among other markers of endothelial dysfunction.

Primary stability and self-tapping blades: biomechanical assessment of dental implants in medium-density bone.

PubMed

Kim, Yung-Soo; Lim, Young-Jun

2011-10-01

The aim of this biomechanical study was to assess the influence of self-tapping blades in terms of primary implant stability between implants with self-tapping blades and implants without self-tapping blades using five different analytic methods, especially in medium-density bone. Two different types of dental implants (4 × 10 mm) were tested: self-tapping and non-self-tapping. The fixture design including thread profiles was exactly the same between the two groups; the only difference was the presence of cutting blades on one half of the apical portion of the implant body. Solid rigid polyurethane blocks with corresponding densities were selected to simulate medium-density bone. Five mechanical assessments (insertion torque, resonance frequency analysis [RFA], reverse torque, pull-out and push in test) were performed for primary stability. Implants without self-tapping blades showed significantly higher values (P<0.001) in four biomechanical assessments, except RFA (P=0.684). However, a statistically significant correlation could not be detected between insertion torque values with the four different outcome variables (P>0.05). The outcomes of the present study indicate that the implant body design without self-tapping blades has a good primary stability compared with that with self-tapping blades in medium-density bone. Considering the RFA, a distinct layer of cortical bone on marginal bone will yield implant stability quotient values similar to those in medium-bone density when implants have the same diameter. © 2011 John Wiley & Sons A/S.

The Laplace method for probability measures in Banach spaces

NASA Astrophysics Data System (ADS)

Piterbarg, V. I.; Fatalov, V. R.

1995-12-01

Contents §1. Introduction Chapter I. Asymptotic analysis of continual integrals in Banach space, depending on a large parameter §2. The large deviation principle and logarithmic asymptotics of continual integrals §3. Exact asymptotics of Gaussian integrals in Banach spaces: the Laplace method 3.1. The Laplace method for Gaussian integrals taken over the whole Hilbert space: isolated minimum points ([167], I) 3.2. The Laplace method for Gaussian integrals in Hilbert space: the manifold of minimum points ([167], II) 3.3. The Laplace method for Gaussian integrals in Banach space ([90], [174], [176]) 3.4. Exact asymptotics of large deviations of Gaussian norms §4. The Laplace method for distributions of sums of independent random elements with values in Banach space 4.1. The case of a non-degenerate minimum point ([137], I) 4.2. A degenerate isolated minimum point and the manifold of minimum points ([137], II) §5. Further examples 5.1. The Laplace method for the local time functional of a Markov symmetric process ([217]) 5.2. The Laplace method for diffusion processes, a finite number of non-degenerate minimum points ([116]) 5.3. Asymptotics of large deviations for Brownian motion in the Hölder norm 5.4. Non-asymptotic expansion of a strong stable law in Hilbert space ([41]) Chapter II. The double sum method - a version of the Laplace method in the space of continuous functions §6. Pickands' method of double sums 6.1. General situations 6.2. Asymptotics of the distribution of the maximum of a Gaussian stationary process 6.3. Asymptotics of the probability of a large excursion of a Gaussian non-stationary process §7. Probabilities of large deviations of trajectories of Gaussian fields 7.1. Homogeneous fields and fields with constant dispersion 7.2. Finitely many maximum points of dispersion 7.3. Manifold of maximum points of dispersion 7.4. Asymptotics of distributions of maxima of Wiener fields §8. Exact asymptotics of large deviations of the norm of Gaussian vectors and processes with values in the spaces L_k^p and l^2. Gaussian fields with the set of parameters in Hilbert space 8.1 Exact asymptotics of the distribution of the l_k^p-norm of a Gaussian finite-dimensional vector with dependent coordinates, p > 1 8.2. Exact asymptotics of probabilities of high excursions of trajectories of processes of type \\chi^2 8.3. Asymptotics of the probabilities of large deviations of Gaussian processes with a set of parameters in Hilbert space [74] 8.4. Asymptotics of distributions of maxima of the norms of l^2-valued Gaussian processes 8.5. Exact asymptotics of large deviations for the l^2-valued Ornstein-Uhlenbeck process Bibliography

Magnetic Resonance Imaging Assessment of Lipomatous Soft-tissue Tumors.

PubMed

Coran, Alessandro; Ortolan, Paolo; Attar, Shady; Alberioli, Enrico; Perissinotto, Egle; Tosi, Anna Lisa; Montesco, Maria Cristina; Rossi, Carlo Riccardo; Tropea, Saveria; Rastrelli, Marco; Stramare, Roberto

2017-01-01

To establish the accuracy of magnetic resonance imaging (MRI) in distinguishing between benign and malignant lipomatous tumors; to evaluate the reproducibility of the MRI interpretation assessing the agreement between judgments of two radiologists with the same experience in soft-tissue sarcomas; to identify an association among MRI findings (size, depth, septa, nodules, signal homogeneity) and nature of the lesion. A total of 54 patients (28 men and 26 women), with a mean age of 56 (range=27-84) were included years. All subjects followed-up by the Multidisciplinary Sarcoma Group. The following MRI findings were judged in a blind study by two radiologists: size, localization, septa, nodules and signal homogeneity. A diagnostic indication was then given from among lipoma, atypical lipomatous tumour (ALT) and liposarcoma. Accuracy in distinguishing between benign and malignant lesions, and between lipoma and ALT (Fisher's exact test), inter-operator agreement (Cohen's kappa), association of MRI findings and malignancy of the lesion (Fisher's exact test and odds ratio) were evaluated. The inter-operator agreement was complete (100%). The agreement between diagnostic hypothesis and histological diagnosis was statistically significant (p<0.05). Among the radiological findings taken into account, only septa and signal homogeneity were significantly associated with the malignancy of the lesion (p<0.05). MRI could be helpful in distinguishing lipomatous tumors, allowing biopsy to be avoided in some cases (negative predictive value=100%). Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Relative Moldiness Index as Predictor of Childhood Respiratory Illness

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

Vesper, Sephen J.; McKinstry, Craig A.; Haugland, Richard A.

2007-01-01

This study compared two classification methods to evaluate the mold condition in 271 homes of infants, 144 of which later developed symptoms of respiratory illness. A method using on-site visual mold inspection was compared to another method using a quantitative index of moldiness, calculated from mold specific quantitative PCR (MSQPCR) measurements on the concentration of 36 species of molds in floor dust samples called the EPA relative moldiness index© (ERMI©). The binary classification of homes as either moldy or non-moldy by on-site visual home inspection was not predictive of the development of wheeze and/or rhinitis. The odds-ratio of moldy vs.more » non-moldy homes to experience respiratory illness was estimated at 1.33 (p=0.27, Fisher’s exact test). Further, this method offers little flexibility in how it may be applied in support of decisions on mold remediation. On the other hand, a method developed and validated in this paper using the ERMI© index fit to a logistic function, can be used to predict the occurrence of illness in homes and allows stake holders to choose among various levels of risk. An example is given where an ERMI© value of -4.29 is used as a threshold for binary classification of homes producing an odds ratio of 2.53 (p=0.003, Fisher’s exact test). The ERMI© based methods presented here provide a new and more flexible platform to support mold remediation decisions.« less

Prevalence of alveolar bone loss in healthy children treated at private pediatric dentistry clinics

PubMed Central

GUIMARÃES, Maria do Carmo Machado; de ARAÚJO, Valéria Martins; AVENA, Márcia Raquel; DUARTE, Daniel Rocha da Silva; FREITAS, Francisco Valter

2010-01-01

Objectives The purpose of this study was to evaluate the prevalence of alveolar bone loss (BL) in healthy children treated at private pediatric dentistry clinics in Brasília, Brazil. Material and Methods The research included 7,436 sites present in 885 radiographs from 450 children. The BL prevalence was estimated by measuring the distance from the cementoenamel junction (CEJ) to alveolar bone crest (ABC). Data were divided in groups: (I) No BL: distance from CEJ to ABC is ≤2 mm; (II) questionable BL (QBL): distance from CEJ to ABC is >2 and <3 mm; (III) definite BL (DBL): distance from CEJ to ABC ≥3 mm. Data were treated by the chi-square nonparametric test and Fisher's exact test (p<0.05). Results Among males, 89.31% were classified in group I, 9.82% were classified in group II and 0.85% in group III. Among females, 93.05%, 6.48% and 0.46% patients were classified in Group I, II and III, respectively. The differences between genders were not statistically significant (Chi-square test, p = 0.375). Group composition according to patients’ age showed that 91.11% of individuals were classified as group I, 8.22% in group II and 0.67% in group III. The differences among the age ranges were not statistically significant (Chi-square test, p = 0.418). The mesial and distal sites showed a higher prevalence of BL in the jaw, QBL (89.80%) and DBL (79.40%), and no significant difference was observed in the distribution of QBL (Fisher’s exact test p = 0.311) and DBL (Fisher’s exact test p = 0.672) in the dental arches. The distal sites exhibited higher prevalence of both QBL (77.56%) and DBL (58.82%). Conclusions The periodontal status of children should never be underestimated because BL occurs even in healthy populations, although in a lower frequency. PMID:20857009

Prevalence of alveolar bone loss in healthy children treated at private pediatric dentistry clinics.

PubMed

Guimarães, Maria do Carmo Machado; de Araújo, Valéria Martins; Avena, Márcia Raquel; Duarte, Daniel Rocha da Silva; Freitas, Francisco Valter

2010-01-01

The purpose of this study was to evaluate the prevalence of alveolar bone loss (BL) in healthy children treated at private pediatric dentistry clinics in Brasília, Brazil. The research included 7,436 sites present in 885 radiographs from 450 children. The BL prevalence was estimated by measuring the distance from the cementoenamel junction (CEJ) to alveolar bone crest (ABC). Data were divided in groups: (I) No BL: distance from CEJ to ABC is <2 mm; (II) questionable BL (QBL): distance from CEJ to ABC is >2 and <3 mm; (III) definite BL (DBL): distance from CEJ to ABC >3 mm. Data were treated by the chi-square nonparametric test and Fisher's exact test (p<0.05). Among males, 89.31% were classified in group I, 9.82% were classified in group II and 0.85% in group III. Among females, 93.05%, 6.48% and 0.46% patients were classified in Group I, II and III, respectively. The differences between genders were not statistically significant (Chi-square test, p = 0.375). Group composition according to patients' age showed that 91.11% of individuals were classified as group I, 8.22% in group II and 0.67% in group III. The differences among the age ranges were not statistically significant (Chi-square test, p = 0.418). The mesial and distal sites showed a higher prevalence of BL in the jaw, QBL (89.80%) and DBL (79.40%), and no significant difference was observed in the distribution of QBL (Fisher's exact test p = 0.311) and DBL (Fisher's exact test p = 0.672) in the dental arches. The distal sites exhibited higher prevalence of both QBL (77.56%) and DBL (58.82%). The periodontal status of children should never be underestimated because BL occurs even in healthy populations, although in a lower frequency.

Related factors of dental caries and molar incisor hypomineralisation in a group of children with cystic fibrosis.

PubMed

Peker, S; Mete, S; Gokdemir, Y; Karadag, B; Kargul, B

2014-08-01

To investigate dental caries and molar incisor hypomineralisation (MIH)-related factors such as treatment, diet, brushing and salivary factors in children with cystic fibrosis (CF) compared with healthy peers. A cohort study was performed. This study was performed on 30 CF children comprising patients at the Faculty of Medicine and 30 control children recruited from the Dental School. Salivary factors, dental caries, MIH, daily diet, brushing habits were analysed. Statistical analysis was calculated by SPSS for Windows. Decay missing filled teeth (DMF-T) score was 4.6 ± 4.0 in CF and 7.7 ± 2.7 in control (p = 0.001). 43% of CF children with MIH were found to use antibiotics, but no significant difference in the caries experience was found with antibiotic usage (p > 0.05). DMF-T of CF adolescents (23%) who use Tobramycin was 7 ± 3.5. DMF-T of CF children (20%) who take other antibiotics was 2.5 ± 3.5, but no statistical difference was found (p = 0.054). Saliva pH, salivary flow rate, and buffering capacity were not found statistically significant (p > 0.05). Percentage arithmetic mean value, standard deviation, independent sample t test, Fisher's exact test, Chi-square test and Mann-Whitney U test were used, while a p value of <0.05 was considered statistically significant. Medication and diet could be considered as a risk factor for dental caries and factors such as salivary pH, good oral hygiene could play a protective role for oral health CF children. MIH frequency and lower caries experience seen in CF children could be due to salivary factors or pharmacological treatment they take. The multidisciplinary approach team would be advantageous in the management of children with CF and oral health should be under control during early years of life by paediatric dentists.

Perceptions regarding genetic testing in populations at risk for nephropathy.

PubMed

Freedman, Barry I; Fletcher, Alison J; Sanghani, Vivek R; Spainhour, Mitzie; Graham, Angelina W; Russell, Gregory B; Cooke Bailey, Jessica N; Iltis, Ana S; King, Nancy M P

2013-01-01

Population ancestry-based differences exist in genetic risk for many kidney diseases. Substantial debate remains regarding returning genetic test results to participants. African-Americans (AAs) and European-Americans (EAs) at risk for end-stage kidney disease were queried for views on the value and use of genetic testing in research. A standardized survey regarding attitudes toward genetic testing was administered to 130 individuals (64 AA, 66 EA) with first-degree relatives on dialysis. Fisher's exact test was used to assess differences in participant attitudes between population groups. Mean (SD) age of surveyed AAs and EAs was 45.5 (12.8) and 50.5 (14.4) years, respectively (p = 0.04), with similar familial relationships (p = 0.22). AAs and EAs wished to know their test results if risk could be: (1) reduced by diet or exercise (100 and 98%, p = 0.99); (2) reduced by medical treatment (100 and 98%, p = 0.99), or (3) if no treatments were available (90 and 82%, p = 0.21). If informed they lacked a disease susceptibility variant, 87% of AAs and 88% of EAs would be extremely or pretty likely to inform family members (p = 0.84). If informed they had a disease susceptibility variant, 92% of AAs and 89% of EAs would be extremely or pretty likely to inform their family (p = 0.43). Attitudes toward obtaining and using genetic test results for disease in research contexts were similar in AAs and EAs at risk for end-stage kidney disease. A substantial majority would want information regardless of available treatments and would share the information with the family. These results have important implications for patient care, study design and the informed consent process. © 2013 S. Karger AG, Basel.

The value of multi ultra high-b-value DWI in grading cerebral astrocytomas and its association with aquaporin-4.

PubMed

Tan, Yan; Zhang, Hui; Wang, Xiao-Chun; Qin, Jiang-Bo; Wang, Le

2018-06-01

To investigate the value of multi-ultrahigh-b-value diffusion-weighted imaging (UHBV-DWI) in differentiating high-grade astrocytomas (HGAs) from low-grade astrocytomas (LGAs), analyze its association with aquaporin (AQP) expression. 40 astrocytomas divided into LGAs (N = 15) and HGAs (N = 25) were studied. Apparent diffusion coefficient (ADC) and UHBV-ADC values in solid parts and peritumoral edema were compared between LGAs and HGAs groups by the t-test. Using receiver operating characteristic curves to identify the better parameter. Using real time polymerase chain reaction to assess AQP messenger ribonucleic acid (mRNA). Using spearman correlation analysis to assess the correlation of AQP mRNA with each parameter. ADC values in solid parts of HGAs were significantly lower than LGAs (p = 0.02), while UHBV-ADC values of HGAs were significantly higher than LGAs (p < 0.01). Area under the curve (AUC) of UHBV-ADC (0.810) was larger than ADC (0.713), and the area under the curve of UHBV-ADC was significantly higher than that of ADC (p = 0.041). AQP4 mRNA was significantly higher in HGAs than that in LGAs (p < 0.01); there was less AQP9 mRNA and no AQP1 mRNA in LGAs and HGAs groups (p > 0.05); ADC value showed a negative correlation with AQP4 mRNA (r = -0.357; p = 0.024). UHBV-ADC value positively correlated with the AQP4 mRNA (r = 0.646; p < 0.01). UHBV-DWI allowed for a more accurate grading of cerebral astrocytoma than DWI, and UHBV-ADC value may be related with the AQP4 mRNA levels. UHBV-DWI could be of value in the assessment of astrocytoma. Advances in knowledge: UHBV-DWI generated by multi UHBV could have particular value for astrocytoma grading, and the level of AQP4 mRNA might be potentially linked to the change of UHBV-DWI parameter, and we might find the exact reason for the difference of UHBV-ADC between the LGAs and HGAs.

Substructure of a Tunisian Berber population as inferred from 15 autosomal short tandem repeat loci.

PubMed

Khodjet-El-Khil, Houssein; Fadhlaoui-Zid, Karima; Gusmão, Leonor; Alves, Cíntia; Benammar-Elgaaied, Amel; Amorim, Antonio

2008-08-01

Currently, language and cultural practices are the only criteria to distinguish between Berber autochthonous Tunisian populations. To evaluate these populations' possible genetic structure and differentiation, we have analyzed 15 autosomal short tandem repeat loci (CSF1PO, D3S1358, D5S818, D7S820, D8S1179, D13S317, D16S539, D18S51, D21S11, FGA, TH01, TPOX, VWA, D2S1338, and D19S433) in three southern Tunisian Berber groups: Sened, Matmata, and Chenini-Douiret. The exact test of population differentiation based on allele frequencies at the 15 loci shows significant P values at 7 loci between Chenini-Douiret and both Sened and Matmata, whereas just 5 loci show significant P values between Sened and Matmata. Comparative analyses between the three Berber groups based on genetic distances show that P values for F(ST) distances are significant between the three Berber groups. Population analysis performed using Structure shows a clear differentiation between these Berber groups, with strong genetic isolation of Chenini-Douiret. These results confirm at the autosomal level the high degree of heterogeneity of Tunisian Berber populations that had been previously reported for uniparental markers.

Employment outcomes following successful renal transplantation.

PubMed

Eng, Mary; Zhang, Jie; Cambon, Alexander; Marvin, Michael R; Gleason, John

2012-01-01

Data on employment outcomes after successful renal transplantation are few. We conducted this study to identify favorable factors for employment after transplantation. Adult patients <65 yr of age who underwent renal transplantation between January 1, 2002 and December 31, 2007 were surveyed. Patients with graft survival <1 yr were excluded. We also tested their knowledge of Medicare coverage after transplantation. Data were analyzed using chi-squared and Fisher's exact tests. p-Value <0.05 was considered statistically significant. A 55% response rate was obtained where 56% of respondents were employed after transplantation. Race, marital status, previous transplant, and complicated post-operative course did not influence employment. Favorable factors include male gender (p=0.04), younger age (<40 [p=0.0003] or <50 yr [p<0.0001]), having ≥1 dependent (p=0.04), higher education (minimum high school degree [p=0.003] or some college [p=0.002]), live donor recipient (p=0.004), wait time <2 yr (p=0.03), dialysis <2 yr (p<0.0001) or pre-dialysis (p=0.04), and pre-transplantation employment (p<0.0001). Mean time for employment was 4.9±6.3 months (median three months). Common reasons for unemployment were disability (59%) and retirement (27%). Finally, 7% correctly responded that Medicare benefits end 36 months following transplantation. Potentially modifiable factors to improve employment are earlier referral and better education regarding Medicare eligibility. © 2011 John Wiley & Sons A/S.

Do framing effects reveal irrational choice?

PubMed

Mandel, David R

2014-06-01

Framing effects have long been viewed as compelling evidence of irrationality in human decision making, yet that view rests on the questionable assumption that numeric quantifiers used to convey the expected values of choice options are uniformly interpreted as exact values. Two experiments show that when the exactness of such quantifiers is made explicit by the experimenter, framing effects vanish. However, when the same quantifiers are given a lower bound (at least) meaning, the typical framing effect is found. A 3rd experiment confirmed that most people spontaneously interpret the quantifiers in standard framing tests as lower bounded and that their interpretations strongly moderate the framing effect. Notably, in each experiment, a significant majority of participants made rational choices, either choosing the option that maximized expected value (i.e., lives saved) or choosing consistently across frames when the options were of equal expected value. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Bak-Sneppen model: Local equilibrium and critical value.

PubMed

Fraiman, Daniel

2018-04-01

The Bak-Sneppen (BS) model is a very simple model that exhibits all the richness of self-organized criticality theory. At the thermodynamic limit, the BS model converges to a situation where all particles have a fitness that is uniformly distributed between a critical value p_{c} and 1. The p_{c} value is unknown, as are the variables that influence and determine this value. Here we study the BS model in the case in which the lowest fitness particle interacts with an arbitrary even number of m nearest neighbors. We show that p_{c} verifies a simple local equilibrium relation. Based on this relation, we can determine bounds for p_{c} of the BS model and exact results for some BS-like models. Finally, we show how transformations of the original BS model can be done without altering the model's complex dynamics.

Impact of specimen adequacy on the assessment of renal allograft biopsy specimens.

PubMed

Cimen, S; Geldenhuys, L; Guler, S; Imamoglu, A; Molinari, M

2016-01-01

The Banff classification was introduced to achieve uniformity in the assessment of renal allograft biopsies. The primary aim of this study was to evaluate the impact of specimen adequacy on the Banff classification. All renal allograft biopsies obtained between July 2010 and June 2012 for suspicion of acute rejection were included. Pre-biopsy clinical data on suspected diagnosis and time from renal transplantation were provided to a nephropathologist who was blinded to the original pathological report. Second pathological readings were compared with the original to assess agreement stratified by specimen adequacy. Cohen's kappa test and Fisher's exact test were used for statistical analyses. Forty-nine specimens were reviewed. Among these specimens, 81.6% were classified as adequate, 6.12% as minimal, and 12.24% as unsatisfactory. The agreement analysis among the first and second readings revealed a kappa value of 0.97. Full agreement between readings was found in 75% of the adequate specimens, 66.7 and 50% for minimal and unsatisfactory specimens, respectively. There was no agreement between readings in 5% of the adequate specimens and 16.7% of the unsatisfactory specimens. For the entire sample full agreement was found in 71.4%, partial agreement in 20.4% and no agreement in 8.2% of the specimens. Statistical analysis using Fisher's exact test yielded a P value above 0.25 showing that - probably due to small sample size - the results were not statistically significant. Specimen adequacy may be a determinant of a diagnostic agreement in renal allograft specimen assessment. While additional studies including larger case numbers are required to further delineate the impact of specimen adequacy on the reliability of histopathological assessments, specimen quality must be considered during clinical decision making while dealing with biopsy reports based on minimal or unsatisfactory specimens.

Permutational distribution of the log-rank statistic under random censorship with applications to carcinogenicity assays.

PubMed

Heimann, G; Neuhaus, G

1998-03-01

In the random censorship model, the log-rank test is often used for comparing a control group with different dose groups. If the number of tumors is small, so-called exact methods are often applied for computing critical values from a permutational distribution. Two of these exact methods are discussed and shown to be incorrect. The correct permutational distribution is derived and studied with respect to its behavior under unequal censoring in the light of recent results proving that the permutational version and the unconditional version of the log-rank test are asymptotically equivalent even under unequal censoring. The log-rank test is studied by simulations of a realistic scenario from a bioassay with small numbers of tumors.

A Novel Polygonal Finite Element Method: Virtual Node Method

NASA Astrophysics Data System (ADS)

Tang, X. H.; Zheng, C.; Zhang, J. H.

2010-05-01

Polygonal finite element method (PFEM), which can construct shape functions on polygonal elements, provides greater flexibility in mesh generation. However, the non-polynomial form of traditional PFEM, such as Wachspress method and Mean Value method, leads to inexact numerical integration. Since the integration technique for non-polynomial functions is immature. To overcome this shortcoming, a great number of integration points have to be used to obtain sufficiently exact results, which increases computational cost. In this paper, a novel polygonal finite element method is proposed and called as virtual node method (VNM). The features of present method can be list as: (1) It is a PFEM with polynomial form. Thereby, Hammer integral and Gauss integral can be naturally used to obtain exact numerical integration; (2) Shape functions of VNM satisfy all the requirements of finite element method. To test the performance of VNM, intensive numerical tests are carried out. It found that, in standard patch test, VNM can achieve significantly better results than Wachspress method and Mean Value method. Moreover, it is observed that VNM can achieve better results than triangular 3-node elements in the accuracy test.

Household point of care CD4 testing and isoniazid preventive therapy initiation in a household TB contact tracing programme in two districts of South Africa.

PubMed

Page-Shipp, Liesl; Lewis, James J; Velen, Kavindhran; Senoge, Sedikanelo; Zishiri, Elizabeth; Popane, Flora; Chihota, Violet N; Clark, Dave; Churchyard, Gavin J; Charalambous, Salome

2018-01-01

In South Africa, TB household contact tracing provides an opportunity for increased TB and HIV case finding. We aimed to determine the effect of two new potential interventions for TB contact tracing programmes: Point of Care CD4 (PoC CD4) on HIV linkage to care and household Isoniazid Preventive Therapy (IPT) provision on uptake and retention of IPT. A pragmatic, three-arm, cluster-randomized trial was undertaken. TB Household contacts were randomised to 3 arms: 1) Standard of Care TB and HIV testing (SOC); 2) SOC with POC CD4 for those testing HIV positive; 3) SOC with POC CD4 and IPT for eligible household members. Linkage to care within 90 days was assessed either through patient visits (at 10 weeks and 6 months) or via telephonic contact. 2,243 index TB patients and 3,012 contacts (64,3% female, median age 30 years) were enrolled. On self-report, 26(1.2%) were currently receiving TB treatment and 1816 (60.3%) reported a prior HIV test. HIV testing uptake was 34.7% in the SoC arm, 40.2% in the PoC CD4 arm (RR1.16, CI 0.99-1.36, p-value = 0.060) and 39.9% in the PoC CD4 + HH-IPT arm (RR = 1.15, CI 0.99-1.35, p-value = 0.075). Linkage to care within 3 months was 30.8% in the SoC arm and 42.1% in the POC CD4 arms (RR 1.37; CI: 0.68-2.76, p-value = 0.382). 20/21 contacts (95.2%) initiated IPT in the PoC CD4 + HH-IPT arm, compared to 3/20 (15.0%) in the PoC CD4 arm (p = 0.004; p-value from Fisher's exact test < 0.001). Among 3,008 contacts screened for tuberculosis, 15 (3.4%) had bacteriologically confirmed TB with an overall yield of TB of 0.5% (95% CI: 0.3%, 0.8%). Household PoC CD4 testing and IPT initiation is feasible. There was only weak evidence that PoCCD4 led to a small increase in HCT uptake and no evidence for an increase in linkage-to-care. IPT initiation and completion was increased by the household intervention. Although feasible, these interventions had low impact due to the low uptake of HIV testing in households.

[Clinical research XVII. χ(2) test, from the expected to the observed].

PubMed

Rivas-Ruiz, Rodolfo; Castelán-Martínez, Osvaldo D; Pérez, Marcela; Talavera, Juan O

2013-01-01

When you want to show if there is a statistical association or differences between categorical variables, it is recommended to use the χ(2) test. This nonparametric test is one of the most used in clinical research; it contrasts nominal or ordinal qualitative variables that are observed in clinical practice. This test calculates the p value that determines whether differences between groups are real or due to chance. The χ(2) test is the basis of other tests to analyze qualitative ordinal variables as χ(2) for linear trend, which compares three groups with two outcomes or McNemar test, which contrasts two related samples (a before and afterward comparison) or Mantel-Haenszel χ(2), which controls for potential confounding variables. When using small samples, where the expected results are less than 5, Fisher's exact test should be used. These tests are the most widely used in the medical literature; however, they do not give us the magnitude or the direction of the event and a proper interpretation that requires clinical judgment is needed.

Statistics on continuous IBD data: Exact distribution evaluation for a pair of full(half)-sibs and a pair of a (great-) grandchild with a (great-) grandparent

PubMed Central

Stefanov, Valeri T

2002-01-01

Background Pairs of related individuals are widely used in linkage analysis. Most of the tests for linkage analysis are based on statistics associated with identity by descent (IBD) data. The current biotechnology provides data on very densely packed loci, and therefore, it may provide almost continuous IBD data for pairs of closely related individuals. Therefore, the distribution theory for statistics on continuous IBD data is of interest. In particular, distributional results which allow the evaluation of p-values for relevant tests are of importance. Results A technology is provided for numerical evaluation, with any given accuracy, of the cumulative probabilities of some statistics on continuous genome data for pairs of closely related individuals. In the case of a pair of full-sibs, the following statistics are considered: (i) the proportion of genome with 2 (at least 1) haplotypes shared identical-by-descent (IBD) on a chromosomal segment, (ii) the number of distinct pieces (subsegments) of a chromosomal segment, on each of which exactly 2 (at least 1) haplotypes are shared IBD. The natural counterparts of these statistics for the other relationships are also considered. Relevant Maple codes are provided for a rapid evaluation of the cumulative probabilities of such statistics. The genomic continuum model, with Haldane's model for the crossover process, is assumed. Conclusions A technology, together with relevant software codes for its automated implementation, are provided for exact evaluation of the distributions of relevant statistics associated with continuous genome data on closely related individuals. PMID:11996673

Comparison of fit accuracy and torque maintenance of zirconia and titanium abutments for internal tri-channel and external-hex implant connections

PubMed Central

Siadat, Hakimeh; Beyabanaki, Elaheh; Mousavi, Niloufar

2017-01-01

PURPOSE This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. MATERIALS AND METHODS Two regular platform dental implants, one with external connection (Brånemark, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at α=0.05 of significance. RESULTS There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups (P<.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom (P<.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments (P<.001). However, neither connection type (P=.15) nor abutment material (P=.38) affected torque loss. CONCLUSION Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values. PMID:28874994

Evaluation of Different Dose-Response Models for High Hydrostatic Pressure Inactivation of Microorganisms

PubMed Central

2017-01-01

Modeling of microbial inactivation by high hydrostatic pressure (HHP) requires a plot of the log microbial count or survival ratio versus time data under a constant pressure and temperature. However, at low pressure and temperature values, very long holding times are needed to obtain measurable inactivation. Since the time has a significant effect on the cost of HHP processing it may be reasonable to fix the time at an appropriate value and quantify the inactivation with respect to pressure. Such a plot is called dose-response curve and it may be more beneficial than the traditional inactivation modeling since short holding times with different pressure values can be selected and used for the modeling of HHP inactivation. For this purpose, 49 dose-response curves (with at least 4 log10 reduction and ≥5 data points including the atmospheric pressure value (P = 0.1 MPa), and with holding time ≤10 min) for HHP inactivation of microorganisms obtained from published studies were fitted with four different models, namely the Discrete model, Shoulder model, Fermi equation, and Weibull model, and the pressure value needed for 5 log10 (P5) inactivation was calculated for all the models above. The Shoulder model and Fermi equation produced exactly the same parameter and P5 values, while the Discrete model produced similar or sometimes the exact same parameter values as the Fermi equation. The Weibull model produced the worst fit (had the lowest adjusted determination coefficient (R2adj) and highest mean square error (MSE) values), while the Fermi equation had the best fit (the highest R2adj and lowest MSE values). Parameters of the models and also P5 values of each model can be useful for the further experimental design of HHP processing and also for the comparison of the pressure resistance of different microorganisms. Further experiments can be done to verify the P5 values at given conditions. The procedure given in this study can also be extended for enzyme inactivation by HHP. PMID:28880255

Coarsened Exact Matching of Phaco-Trabectome to Trabectome in Phakic Patients: Lack of Additional Pressure Reduction from Phacoemulsification

PubMed Central

Parikh, Hardik A.; Bussel, Igor I.; Schuman, Joel S.; Brown, Eric N.; Loewen, Nils A.

2016-01-01

Purpose To compare intraocular pressure (IOP) after trabectome-mediated ab interno trabeculectomy surgery in phakic patients (T) and trabectome with same session phacoemulsification (PT) using Coarsened Exact Matching. Although phacoemulsification is associated with IOP reduction when performed on its own, it is not known how much it contributes in PT. Methods Subjects were divided into phakic T and PT. Exclusion criteria were follow-up for <12 months and additional glaucoma surgery. Demographics were compared by the Mann-Whitney U test and chi-squared test for continuous and categorical variables, respectively. Multiple imputation was utilized to avoid eliminating data with missing values. Groups were then matched using Coarsened Exact Matching based on age, race, type of glaucoma, baseline IOP, and number of preoperative glaucoma medications. Univariate linear regression was used to examine IOP reduction after surgery; those variables that were statistically significant were included in the final multivariate regression model. Results A total of 753 cases were included (T: 255, PT: 498). When all variables except for age were kept constant, there was an additional IOP reduction of 0.05±0.01 mmHg conferred for every yearly increment in age. Every 1 mmHg increase in baseline IOP correlated to an additional IOP reduction of 0.80±0.02 mmHg. Phacoemulsification was not found to be a statistically significant contributor to IOP when comparing T and PT (p≥0.05). T had a 21% IOP reduction to 15.9±3.5 mmHg (p<0.01) while PT had an 18% reduction to 15.5±3.6 mmHg (p<0.01). Number of medications decreased (p<0.01) in both groups from 2.4±1.2 to 1.9±1.3 and from 2.3±1.1 to 1.7±1.3, respectively. Conclusion Phacoemulsification does not make a significant contribution to postoperative IOP or number of medications when combined with trabectome surgery in phakic patients. PMID:26895293

The Stool DNA Test is More Accurate than the Plasma Septin 9 Test in Detecting Colorectal Neoplasia

PubMed Central

Ahlquist, David A.; Taylor, William R.; Mahoney, Douglas W.; Zou, Hongzhi; Domanico, Michael; Thibodeau, Stephen N.; Boardman, Lisa A.; Berger, Barry M.; Lidgard, Graham P.

2014-01-01

Background & Aims Several noninvasive tests have been developed for colorectal cancer (CRC) screening. We compared the sensitivities of a multi-marker test for stool DNA (sDNA) and a plasma test for methylated Septin 9 (SEPT9) in identifying patients with large adenomas or CRC. Methods We analyzed paired stool and plasma samples from 30 patients with CRC and 22 with large adenomas from Mayo Clinic archives. Stool (n=46) and plasma (n=49) samples from age- and sex-matched patients with normal colonoscopy results were used as controls. The sDNA test is an assay for methylated BMP3, NDRG4, vimentin, and TFPI2; mutant KRAS; the β-actin gene, and quantity of hemoglobin (by the porphyrin method). It was performed blindly at Exact Sciences (Madison WI); the test for SEPT9 was performed at ARUP Laboratories (Salt Lake City UT). Results were considered positive based on the manufacturer's specificity cutoff values of 90% and 89%, respectively. Results The sDNA test detected adenomas (median 2 cm, range 1–5 cm) with 82% sensitivity (95% confidence interval [CI], 60%–95%); SEPT9 had 14% sensitivity (95% CI, 3%–35%; P=.0001). The sDNA test identified patients with CRC with 87% sensitivity (95% CI, 69%–96%); SEPT9 had 60% sensitivity (95% CI, 41%–77%; P=.046). The sDNA test identified patients with stage I–III CRC with 91% sensitivity (95% CI, 71%–99%); SEPT9 had 50% sensitivity (95% CI, 28%–72%; P=.013); for stage IV CRC, sensitivity values were 75% (95% CI, 35%–97%) and 88% (95% CI, 47%–100%), respectively (P=.56). False-positive rates were 7% for the sDNA test and 27% for SEPT9. Conclusions Based on analyses of paired samples, the sDNA test detects non-metastatic CRC and large adenomas with significantly greater levels of sensitivity than the SEPT9 test. These findings might be used to modify approaches for CRC prevention and early detection. PMID:22019796

Effect of repaglinide versus glyburide on postprandial glucose and insulin values in elderly patients with type 2 diabetes.

PubMed

Meneilly, Graydon S

2011-01-01

studies in younger patients with diabetes have shown that insulin profiles are more physiologic and postprandial glucose levels are lower with repaglinide than with glyburide. We conducted this study to determine if the differences in insulin/glucose profiles between repaglinide and glyburide were similar or different in the elderly. thirteen elderly patients with diabetes were given glyburide or repaglinide in randomized crossover design, followed by a meal tolerance test. Samples were taken at regular intervals to measure glucose and insulin values. the 0-30 min area under the curve (AUC) for insulin was higher (glyburide, 294  ±  37 pM; repaglinide, 382  ±  39 pM) (P < 0.01), and the 180-240 min AUC for insulin was lower (glyburide, 325  ±  50 pM; repaglinide, 196 ± 20 pM) (P < 0.01) with repaglinide. The 0-240 min AUC for glucose was not different between treatments (glyburide, 7.4 ±  0.5 mM; repaglinide, 7.1 ±  0.3 mM) (P = not significant). Five subjects treated with glyburide and no subjects treated with repaglinide required glucose from 180 to 240 min (P < 0.05, Fisher's exact test). we conclude that repaglinide results in a more physiologic insulin profile and less frequent hypoglycemia than glyburide in the elderly.

An R2 statistic for fixed effects in the linear mixed model.

PubMed

Edwards, Lloyd J; Muller, Keith E; Wolfinger, Russell D; Qaqish, Bahjat F; Schabenberger, Oliver

2008-12-20

Statisticians most often use the linear mixed model to analyze Gaussian longitudinal data. The value and familiarity of the R(2) statistic in the linear univariate model naturally creates great interest in extending it to the linear mixed model. We define and describe how to compute a model R(2) statistic for the linear mixed model by using only a single model. The proposed R(2) statistic measures multivariate association between the repeated outcomes and the fixed effects in the linear mixed model. The R(2) statistic arises as a 1-1 function of an appropriate F statistic for testing all fixed effects (except typically the intercept) in a full model. The statistic compares the full model with a null model with all fixed effects deleted (except typically the intercept) while retaining exactly the same covariance structure. Furthermore, the R(2) statistic leads immediately to a natural definition of a partial R(2) statistic. A mixed model in which ethnicity gives a very small p-value as a longitudinal predictor of blood pressure (BP) compellingly illustrates the value of the statistic. In sharp contrast to the extreme p-value, a very small R(2) , a measure of statistical and scientific importance, indicates that ethnicity has an almost negligible association with the repeated BP outcomes for the study.

Six-Month Follow-Up of a Randomized Controlled Trial Augmenting Serotonin Reuptake Inhibitor Treatment With Exposure and Ritual Prevention for Obsessive-Compulsive Disorder

PubMed Central

Foa, Edna B.; Simpson, Helen Blair; Liebowitz, Michael R.; Powers, Mark B.; Rosenfield, David; Cahill, Shawn P.; Campeas, Raphael; Franklin, Martin; Hahn, Chang-Gyu; Hembree, Elizabeth A.; Huppert, Jonathan D.; Schmidt, Andrew B.; Vermes, Donna; Williams, Monnica T.

2014-01-01

Objective This article describes the long-term effects of augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention or stress management training in patients with DSM-IV obsessive-compulsive disorder (OCD). Method Between November 2000 and November 2006, 111 OCD patients from 2 academic outpatient centers with partial SRI response were randomized to the addition of exposure and ritual prevention or stress management training, delivered twice weekly for 8 weeks (acute phase); 108 began treatment. Responders (38 of 52 in the exposure and ritual prevention condition, 11 of 52 in the stress management training condition) entered a 24-week maintenance phase. The Yale-Brown Obsessive Compulsive Scale (YBOCS) was the primary outcome measure. Results After 24 weeks, patients randomized to and receiving exposure and ritual prevention versus stress management training had significantly better outcomes (mean YBOCS scores of 14.69 and 21.37, respectively; t = 2.88, P = .005), higher response rates (decrease in YBOCS scores ≥ 25%: 40.7% vs 9.3%, Fisher exact test P < .001), and higher rates of excellent response (YBOCS score ≤ 12: 24.1% vs 5.6%, Fisher exact test P = .01). During the maintenance phase, the slope of change in YBOCS scores was not significant in either condition (all P values ≥ .55), with no difference between exposure and ritual prevention and stress management training (P > .74). Better outcome was associated with baseline variables: lower YBOCS scores, higher quality of life, fewer comorbid Axis I diagnoses, and male sex. Conclusions Augmenting SRIs with exposure and ritual prevention versus stress management training leads to better outcome after acute treatment and 24 weeks later. Maintenance outcome, however, was primarily a function of OCD severity at entrance. Greater improvement during the acute phase influences how well patients maintain their gains, regardless of treatment condition. PMID:23759449

The effect of tranexamic acid in unilateral and bilateral total knee arthroplasty in the South Asian population: A retrospective cohort study.

PubMed

Mufarrih, Syed Hamza; Malik, Azeem Tariq; Qureshi, Nada Qaisar; Lakdawala, Riaz Hussain; Rabbani, Muhammad Umar; Ali, Arif; Noordin, Shahryar

2018-04-01

Together with evidence of higher bleeding tendencies, the vulnerability of the South-Asian population to anemia secondary to a higher prevalence of hemoglobinopathies and micronutrient deficiencies merits further exploration of the effects of tranexamic acid on this population. Additionally, limited access to self-care facilities and certain sociocultural beliefs and practices may not be conducive to a speedy recovery from surgical complications. The aim of this study is to investigate the effects of intraoperative administration of tranexamic acid during total knee arthroplasty when considering the South-Asian population. Medical record files of 355 patients who underwent total knee arthroplasty (2007-2015) were reviewed to collect data regarding patient characteristics, surgical variables and post-operative complications. Unilateral and Bilateral total knee arthroplasty were studied separately. Analysis was done using t-test, Mann-Whitney U test, chi-square and Fisher's exact square where appropriate. The threshold for significance was p < 0.05. The study showed that for unilateral surgery, tranexamic acid caused a significant reduction in estimated blood loss (p-value=0.011), total operative time, calculated blood loss, and hemoglobin change (p-value<0.001) whereas in bilateral surgery, tranexamic acid only caused a significant reduction in calculated blood loss (p-value < 0.001) and hemoglobin change (p-value=0.001). Interestingly, in those who received tranexamic acid vs. those who did not, there was a significant increase in length of hospital stay (p<0.001) and special care unit admissions (p-value=0.033) in unilateral and bilateral surgery respectively. Although tranexamic acid effectively reduces intraoperative blood loss, it does not have an effect on the need for post-operative blood transfusions. The increased length of stay and special care unit admissions associated with tranexamic acid use should be explored further to reveal the complete safety profile of tranexamic acid administration in the South-Asian population during total knee arthroplasty. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

COMPARISON OF THORACIC ULTRASONOGRAPHY AND RADIOGRAPHY FOR THE DETECTION OF INDUCED SMALL VOLUME PNEUMOTHORAX IN THE HORSE.

PubMed

Partlow, Jessica; David, Florent; Hunt, Luanne Michelle; Relave, Fabien; Blond, Laurent; Pinilla, Manuel; Lavoie, Jean-Pierre

2017-05-01

Small volume pneumothorax can be challenging to diagnose in horses. The current standard method for diagnosis is standing thoracic radiography. We hypothesized that thoracic ultrasonography would be more sensitive. Objectives of this prospective, experimental study were to describe a thoracic ultrasound method for detection of small volume pneumothorax in horses and to compare results of radiography and ultrasound in a sample of horses with induced small volume pneumothorax. Six mature healthy horses were recruited for this study. For each horse, five 50 ml air boluses were sequentially introduced via a teat cannula into the pleural space. Lateral thoracic radiographs and standardized ultrasound (2D and M-mode) examinations of both hemithoraces were performed following administration of each 50 ml air bolus. Radiographs and ultrasound images/videos were analyzed for detection of pneumothorax by four independent investigators who were unaware of treatment status. Sensitivity, specificity, positive predictive values, negative predictive values, and agreement among investigators (Kappa test, κ) were calculated for radiography, 2D and M-mode ultrasound. Comparisons were made using a chi-squared exact test with significance set at P < 0.05. Two-dimensional (84%) and M-mode (80%) ultrasound were more sensitive than radiography (48%) for pneumothorax detection (P = 0.02 and P = 0.04, respectively). Specificity and positive predictive values were similar for all three imaging modalities (P = 1). Agreement between investigators for pneumothorax detection was excellent for 2D ultrasound (κ = 1), very good for M-mode ultrasound (κ = 0.87), and good for radiography (κ = 0.79). Findings from this experimental study supported the use of thoracic ultrasonography as a diagnostic method for detecting pneumothorax in horses. © 2017 American College of Veterinary Radiology.

Human Papilloma Virus Infection Does Not Predict Response to Interferon Therapy in Ocular Surface Squamous Neoplasia.

PubMed

Galor, Anat; Garg, Nisha; Nanji, Afshan; Joag, Madhura; Nuovo, Gerard; Palioura, Sotiria; Wang, Gaofeng; Karp, Carol L

2015-11-01

To identify the frequency of human papilloma virus (HPV) in ocular surface squamous neoplasia (OSSN) and to evaluate differences in clinical features and treatment response of tumors with positive versus negative HPV results. Retrospective case series. Twenty-seven patients with OSSN. Ocular surface squamous neoplasia specimens were analyzed for the presence of HPV. Clinical features and response to interferon were determined retrospectively and linked to the presence (versus absence) of HPV. Clinical characteristics of OSSN by HPV status. Twenty-one of 27 tumors (78%) demonstrated positive HPV results. The HPV genotypes identified included HPV-16 in 10 tumors (48%), HPV-31 in 5 tumors, HPV-33 in 1 tumor, HPV-35 in 2 tumors, HPV-51 in 2 tumors, and a novel HPV in 3 tumors (total of 23 tumors because 1 tumor had 3 identified genotypes). Tumors found in the superior limbus were more likely to show positive HPV results (48% vs. 0%; P=0.06, Fisher exact test). Tumors with positive HPV-16 results were larger (68 vs. 34 mm2; P=0.08, Mann-Whitney U test) and were more likely to have papillomatous morphologic features (50% vs. 12%; P=0.07, Fisher exact test) compared with tumors showing negative results for HPV-16. Human papilloma virus status was not found to be associated with response to interferon therapy (P=1.0, Fisher exact test). Metrics found to be associated with a nonfavorable response to interferon were male gender and tumors located in the superior conjunctivae. The presence of HPV in OSSN seems to be more common in lesions located in the nonexposed, superior limbus. Human papilloma virus presence does not seem to be required for a favorable response to interferon therapy. Copyright © 2015 American Academy of Ophthalmology. All rights reserved.

Reduction of Complications of Local Anaesthesia in Dental Healthcare Setups by Application of the Six Sigma Methodology: A Statistical Quality Improvement Technique.

PubMed

Akifuddin, Syed; Khatoon, Farheen

2015-12-01

Health care faces challenges due to complications, inefficiencies and other concerns that threaten the safety of patients. The purpose of his study was to identify causes of complications encountered after administration of local anaesthesia for dental and oral surgical procedures and to reduce the incidence of complications by introduction of six sigma methodology. DMAIC (Define, Measure, Analyse, Improve and Control) process of Six Sigma was taken into consideration to reduce the incidence of complications encountered after administration of local anaesthesia injections for dental and oral surgical procedures using failure mode and effect analysis. Pareto analysis was taken into consideration to analyse the most recurring complications. Paired z-sample test using Minitab Statistical Inference and Fisher's exact test was used to statistically analyse the obtained data. The p-value <0.05 was considered as significant value. Total 54 systemic and 62 local complications occurred during three months of analyse and measure phase. Syncope, failure of anaesthesia, trismus, auto mordeduras and pain at injection site was found to be most recurring complications. Cumulative defective percentage was 7.99 in case of pre-improved data and decreased to 4.58 in the control phase. Estimate for difference was 0.0341228 and 95% lower bound for difference was 0.0193966. p-value was found to be highly significant with p= 0.000. The application of six sigma improvement methodology in healthcare tends to deliver consistently better results to the patients as well as hospitals and results in better patient compliance as well as satisfaction.

Random crystal field effects on the integer and half-integer mixed-spin system

NASA Astrophysics Data System (ADS)

Yigit, Ali; Albayrak, Erhan

2018-05-01

In this work, we have focused on the random crystal field effects on the phase diagrams of the mixed spin-1 and spin-5/2 Ising system obtained by utilizing the exact recursion relations (ERR) on the Bethe lattice (BL). The distribution function P(Di) = pδ [Di - D(1 + α) ] +(1 - p) δ [Di - D(1 - α) ] is used to randomize the crystal field.The phase diagrams are found to exhibit second- and first-order phase transitions depending on the values of α, D and p. It is also observed that the model displays tricritical point, isolated point, critical end point and three compensation temperatures for suitable values of the system parameters.

Transferability of genome-wide associated loci for asthma in African Americans.

PubMed

Faruque, Mezbah U; Chen, Guanjie; Doumatey, Ayo P; Zhou, Jie; Huang, Hanxia; Shriner, Daniel; Adeyemo, Adebowale A; Rotimi, Charles N; Dunston, Georgia M

2017-01-02

Transferability of significantly associated loci or GWAS "hits" adds credibility to genotype-disease associations and provides evidence for generalizability across different ancestral populations. We sought evidence of association of known asthma-associated single nucleotide polymorphisms (SNPs) in an African American population. Subjects comprised 661 participants (261 asthma cases and 400 controls) from the Howard University Family Study. Forty-eight SNPs previously reported to be associated with asthma by GWAS were selected for testing. We adopted a combined strategy by first adopting an "exact" approach where we looked-up only the reported index SNP. For those index SNPs missing form our dataset, we used a "local" approach that examined all the regional SNPs in LD with the index SNP. Out of the 48 SNPs, our cohort had genotype data available for 27, which were examined for exact replication. Of these, two SNPs were found positively associated with asthma. These included: rs10508372 (OR = 1.567 [95%CI, 1.133-2.167], P = 0.0066) and rs2378383 (OR = 2.147 [95%CI, 1.149-4.013], P = 0.0166), located on chromosomal bands 10p14 and 9q21.31, respectively. Local replication of the remaining 21 loci showed association at two chromosomal loci (9p24.1-rs2381413 and 6p21.32-rs3132947; Bonferroni-corrected P values: 0.0033 and 0.0197, respectively). Of note, multiple SNPs in LD with rs2381413 located upstream of IL33 were significantly associated with asthma. This study has successfully transferred four reported asthma-associated loci in an independent African American population. Identification of several asthma-associated SNPs in the upstream of the IL33, a gene previously implicated in allergic inflammation of asthmatic airway, supports the generalizability of this finding.

Prediction of calcium level in melamine-related urinary calculi with helical CT: diagnostic performance evaluation and clinical significance.

PubMed

Yuan, Li; Xiaorui, Ru; Gang, Huang; Xinsheng, Xi; Xiaogang, Huang; Li, Dong; Yirong, Chen

2012-06-01

The aim of the study was to investigate the relationship between CT-attenuation and stone calcium level in melamine-related urinary calculi (MRUC). A total of 25 MRUC with known composition and calcium level were included (11 uric acid stones, 2 calcium oxalate stones and 12 mixture stones of uric acid and calcium oxalate). Of all, 18 renal stones accepted alkalization therapy except for 5 lower urinary tract stones and 2 stones of unknown position. With well-matched composition, 61 adult urinary stones were included as controls. Every stone was scanned by helical CT (80 kV/120 kV, 300 mA, pitch 0.625 mm) and the highest CT-attenuation value measured. CT-attenuation values of MRUC increased gradually from uric acid stones, mixture stones to calcium oxalate stones, but were always lower than the values of controls. Furthermore, a strong positive correlation was found between stone CT-attenuation value and stone calcium level (n = 25, r (80kV) = 0.883, p = 0.000; r (120kV) = 0.855, p = 0.000). Compared with alkalization-therapy-alone group, stone CT-attenuation values and stone calcium level in the comprehensive-therapy group were significantly greater (CT(80kV) 1,057 ± 639 vs. 172 ± 61 HU, p = 0.001; CT(120kV) 783 ± 476 vs. 162 ± 60 HU, p = 0.001; Ca 19.83 ± 7.48% vs. 1.30 ± 1.51%, p = 0.000). Fisher's exact test suggested that the stones with higher CT-attenuation values tended to resist alkalization when 400 HU served as the cutoff value (P (80kV) = 0.002, P (120kV) = 0.000). In conclusion, the study was the first to illustrate that the CT-attenuation value could reflect calcium level in MRUC and found that stones with higher CT-attenuation value were not amenable to alkalization because they probably contained greater calcium. For those patients, we believe that comprehensive therapy will be the best choice.

The relationship between area deprivation and contact with community intellectual disability psychiatry.

PubMed

Nicholson, L; Hotchin, H

2015-05-01

People with intellectual disabilities (ID) have high rates of psychiatric illness and are known to live in more deprived areas than the general population. This study investigated the relationship between area deprivation and contact with ID psychiatry. Psychiatric case notes and electronic records were used to identify all patients who had face-to-face contact with community ID psychiatric services over 1 year in the North East Community Health Partnership of Greater Glasgow and Clyde (estimated population 177,867). The Scottish Index of Multiple Deprivation (SIMD) were determined for the patient sample and for the general population living in the same area. Between 1 June 2012 and 1 June 2013, 184 patients were seen by ID psychiatry over a total of 553 contacts, with valid SIMD data for 179 patients and 543 contacts. Fifty-two per cent of patients (n = 93) lived in the most deprived SIMD decile, and 90.5% (n = 152) in the lowest 5 deciles. Compared with the general population, there were significantly more patients than expected living in the most deprived decile (Fisher's Exact test, P = 0.009) and in the most deprived 5 deciles (Fisher's Exact test, P = 0.001). The median number of contacts was 2 (interquartile range = 1-3). There was no significant association between the number of contacts and SIMD decile. Forty-eight point one per cent (n = 261) of all contacts were with patients living in the most deprived decile and 88.6% (n = 481) in the most deprived 5 deciles. This was significantly more than expected compared with general population data (Fisher's Exact test, P = 0.008 and Fisher's Exact test, P ≤ 0.001). In the area under study, contact with ID psychiatry was greater in more deprived areas. Given the high psychiatric morbidity of people with ID, if services do not adjust for deprivation, this may lead to further discrimination in an already disadvantaged population. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Hard-sphere mixture excess free energy at infinite size ratio

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

Tukur, N.M.; Hamad, E.Z.; Mansoori, G.A.

1999-02-01

This article presents the exact limiting value of the derivative of the excess Helmholtz energy, A{sup E}, with respect to molecular size at constant temperature, density and composition for a binary mixture of hard spheres with an infinite size ratio ({sigma}{sub 11}/{sigma}{sub 22}{r_arrow}{infinity}); i.e., lim{sub {sigma}{sub 22}{r_arrow}0}[({partial_derivative}A{sub hs}{sup E}/RT)/{partial_derivative}{sigma}{sub 22}]{sub T,{rho},x,{sigma}{sub 11}}=({pi}/2){rho}x{sub 1}x{sub 2}{sigma}{sub 11}{sup 2}/(1{minus}({pi}/6){rho}x{sub 1}{sigma}{sub 11}{sup 3}). This limiting value is compared with the Mansoori{endash}Carnahan{endash}Starling{endash}Leland (MCSL) and also used to test the limits of some commonly used models in estimating the excess free energy of solvents in mixtures or polymer solutions. The models evaluated include the van Laar,more » Wilson, Edmond{endash}Ogston, Flory{endash}Huggins, Lacome{endash}Sanchez, Scott{endash}Magat, and Chen {ital et al.} It is shown that while the MCSL equation of state produces the same limiting value as the exact value reported here the other mixture models deviate from the exact value. This expression may be utilized to correct the mixture theories at their infinite size ratio limits. {copyright} {ital 1999 American Institute of Physics.}« less

The value of losartan suppression test in the confirmatory diagnosis of primary aldosteronism in patients over 50 years old.

PubMed

Kuo, Chin-Chi; Balakrishnan, Poojitha; Hsein, Yenh-Chen; Wu, Vin-Cent; Chueh, Shih-Chieh Jeff; Chen, Yung-Ming; Wu, Kwan-Dun; Wang, Ming-Jiuh

2015-09-01

The diagnosis of primary aldosteronism (PA) among the older-aged population has posed a crucial challenge. Among patients over 50 years old, this trial assessed comparability of the performance of two PA diagnostic tests: losartan and captopril suppression tests. A post-hoc subgroup analysis from a prospective cohort was conducted by the TAIPAI (Taiwan Primary Aldosteronism Investigation) group between July 2003 and July 2006. Of the 160 patients in the cohort, 60 patients over 50 years old received captopril and losartan tests to confirm PA. Among the 60 patients over 50 years old, 31 patients had PA confirmed by standardized protocol. The area under the receiver-operating characteristic (ROC) curve for post-captopril aldosterone was significantly less than that for post-losartan plasma aldosterone concentration (PAC) (0.87 vs 0.94, p=0.02). Using the aldosterone-renin ratio (ARR)>35 with PAC>10 ng/dl, the specificity was 82.76% vs 93.1% and the sensitivity was 77.42% vs 87.10% for the captopril and losartan tests, respectively. The equivalence between the two tests were confirmed by the exact McNemar's test (p=1.0). The losartan test showed comparable accuracy to confirm PA. Verification of this "elderly-friendly" confirmatory test will be the first step to prepare a specific diagnostic model of PA for the older-aged population. © The Author(s) 2014.

The Value of Losartan Suppression Test in the Confirmatory Diagnosis of Primary Aldosteronism in Patients Over 50 Years Old

PubMed Central

Kuo, Chin-Chi; Balakrishnan, Poojitha; Hsein, Yenh-Chen; Wu, Vin-Cent; Chueh, Shih-Chieh Jeff; Chen, Yung-Ming; Wu, Kwan-Dun; Wang, Ming-Jiuh

2013-01-01

Objective The diagnosis of primary aldosteronism (PA) among the older-aged population has posed a crucial challenge. Among patients over 50 years old, this trial assessed comparability of the performance of two PA diagnostic tests: losartan and captoril suppression tests. Methods A post-hoc subgroup analysis from a prospective cohort was conducted by TAIPAI (Taiwan Primary Aldosteornism Investigation) group between July 2003 and July 2006. Of the 160 patients in the cohort, 60 patients over 50 years received captopril and losartan tests to confirm PA. Results Among the 60 patients over 50 years old, 31 patients had PA confirmed by standardized protocol. The area under the receiver-operating characteristic (ROC) curve of the post-captopril aldosterone was significantly less than that of the post-losartan plasma aldosterone concentration (0.87 vs. 0.94, p = 0.02). Using ARR>35 with PAC>10 ng/dL, the specificity was 82.76% vs. 93.1% and the sensitivity was 77.42% vs. 87.10% for the captopril and losartan tests, respectively. The equivalence between the two tests were confirmed by exact McNemar test (p= 1.0). Conclusion The losartan test showed comparable accuracy to confirm PA. Verification of this “elderly-friendly” confirmatory test will be the first step to prepare the specific diagnostic model of PA for older-aged population. PMID:25031295

Evaluation of efficacy and indications of surgical fixation for multiple rib fractures: a propensity-score matched analysis.

PubMed

Uchida, K; Nishimura, T; Takesada, H; Morioka, T; Hagawa, N; Yamamoto, T; Kaga, S; Terada, T; Shinyama, N; Yamamoto, H; Mizobata, Y

2017-08-01

The purpose of this study was to assess the effects of recent surgical rib fixation and establish its indications not only for flail chest but also for multiple rib fractures. Between 2007 and 2015, 187 patients were diagnosed as having multiple rib fractures in our institution. After the propensity score matching was performed, ten patients who had performed surgical rib fixation and ten patients who had treated with non-operative management were included. Categorical variables were analyzed with Fischer's exact test and non-parametric numerical data were compared using the Mann-Whitney U test. Wilcoxon signed-rank test was performed for comparison of pre- and postoperative variables. All statistical data are presented as median (25-75 % interquartile range [IQR]) or number. The surgically treated patients extubated significantly earlier than non-operative management patients (5.5 [1-8] vs 9 [7-12] days: p = 0.019). The duration of continuous intravenous narcotic agents infusion days (4.5 [3-6] vs 12 [9-14] days: p = 0.002) and the duration of intensive care unit stay (6.5 [3-9] vs 12 [8-14] days: p = 0.008) were also significantly shorter in surgically treated patients. Under the same ventilating conditions, the postoperative values of tidal volume and respiratory rate improved significantly compared to those values measured just before the surgery. The incidence of pneumonia as a complication was significantly higher in non-operative management group (p = 0.05). From the viewpoints of early respiratory stabilization and intensive care unit disposition without any complications, surgical rib fixation is a sufficiently acceptable procedure not only for flail chest but also for repair of severe multiple rib fractures.

A comparison of exact tests for trend with binary endpoints using Bartholomew's statistic.

PubMed

Consiglio, J D; Shan, G; Wilding, G E

2014-01-01

Tests for trend are important in a number of scientific fields when trends associated with binary variables are of interest. Implementing the standard Cochran-Armitage trend test requires an arbitrary choice of scores assigned to represent the grouping variable. Bartholomew proposed a test for qualitatively ordered samples using asymptotic critical values, but type I error control can be problematic in finite samples. To our knowledge, use of the exact probability distribution has not been explored, and we study its use in the present paper. Specifically we consider an approach based on conditioning on both sets of marginal totals and three unconditional approaches where only the marginal totals corresponding to the group sample sizes are treated as fixed. While slightly conservative, all four tests are guaranteed to have actual type I error rates below the nominal level. The unconditional tests are found to exhibit far less conservatism than the conditional test and thereby gain a power advantage.

Clinical significance of prominent retraction clefts in invasive urothelial carcinoma.

PubMed

Shah, Tanmay S; Kaag, Matthew; Raman, Jay D; Chan, Wilson; Tran, Truc; Kunchala, Sudhir; Shuman, Lauren; DeGraff, David J; Chen, Guoli; Warrick, Joshua I

2017-03-01

Micropapillary morphology in invasive urothelial carcinoma is an established predictor of aggressive disease. It is unknown, however, if prominent retraction is associated with more aggressive disease in the absence of classic micropapillary morphology. We reviewed a retrospective series of 309 radical cystectomy specimens with clinical follow-up data and documented the presence or absence of invasive urothelial carcinoma with prominent retraction clefts, defined as invasive carcinoma with retraction involving the majority of invasive tumor nests in at least one 100× field but without classic micropapillary morphology. Invasive carcinomas with plasmacytoid, sarcomatoid, nested, and small cell morphology were excluded, as were cases without lymph node sampling. In invasive conventional urothelial carcinoma, the presence of prominent retraction clefts was associated lymph node metastasis (odds ratio 4.7, P = .0015, Fisher exact test) but not pathologic tumor stage or several other oncologic parameters (all Ps > .10). Similarly, invasive urothelial carcinoma with micropapillary morphology had lymph node metastasis more frequently than conventional urothelial carcinoma without prominent retraction clefts (P < .001, Fisher exact test), but there was no difference in pathologic tumor stage or oncologic parameters (all Ps > .10). There was no statistically significant difference in rates of lymph node metastasis between invasive urothelial carcinoma with micropapillary morphology and conventional urothelial carcinoma with prominent retraction clefts (P = .54, Fisher exact test). The findings suggest that prominent retraction in invasive urothelial carcinoma may be associated with more aggressive disease, even in the absence of classic micropapillary morphology. Copyright © 2016 Elsevier Inc. All rights reserved.

Relation Between Firing Statistics of Spiking Neuron with Delayed Fast Inhibitory Feedback and Without Feedback

NASA Astrophysics Data System (ADS)

Vidybida, Alexander; Shchur, Olha

We consider a class of spiking neuronal models, defined by a set of conditions typical for basic threshold-type models, such as the leaky integrate-and-fire or the binding neuron model and also for some artificial neurons. A neuron is fed with a Poisson process. Each output impulse is applied to the neuron itself after a finite delay Δ. This impulse acts as being delivered through a fast Cl-type inhibitory synapse. We derive a general relation which allows calculating exactly the probability density function (pdf) p(t) of output interspike intervals of a neuron with feedback based on known pdf p0(t) for the same neuron without feedback and on the properties of the feedback line (the Δ value). Similar relations between corresponding moments are derived. Furthermore, we prove that the initial segment of pdf p0(t) for a neuron with a fixed threshold level is the same for any neuron satisfying the imposed conditions and is completely determined by the input stream. For the Poisson input stream, we calculate that initial segment exactly and, based on it, obtain exactly the initial segment of pdf p(t) for a neuron with feedback. That is the initial segment of p(t) is model-independent as well. The obtained expressions are checked by means of Monte Carlo simulation. The course of p(t) has a pronounced peculiarity, which makes it impossible to approximate p(t) by Poisson or another simple stochastic process.

Spatio-temporal analysis of the genetic diversity and complexity of Plasmodium falciparum infections in Kedougou, southeastern Senegal.

PubMed

Niang, Makhtar; Thiam, Laty G; Loucoubar, Cheikh; Sow, Abdourahmane; Sadio, Bacary D; Diallo, Mawlouth; Sall, Amadou A; Toure-Balde, Aissatou

2017-01-19

Genetic analyses of the malaria parasite population and its temporal and spatial dynamics could provide an assessment of the effectiveness of disease control strategies. The genetic diversity of Plasmodium falciparum has been poorly documented in Senegal, and limited data are available from the Kedougou Region. This study examines the spatial and temporal variation of the genetic diversity and complexity of P. falciparum infections in acute febrile patients in Kedougou, southeastern Senegal. A total of 263 sera from patients presenting with acute febrile illness and attending Kedougou health facilities between July 2009 and July 2013 were obtained from a collection established as part of arbovirus surveillance in Kedougou. Samples identified as P. falciparum by nested PCR were characterized for their genetic diversity and complexity using msp-1 and msp-2 polymorphic markers. Samples containing only P. falciparum accounted for 60.83% (160/263) of the examined samples. All three msp-1 allelic families (K1, MAD20 and RO33) and two msp-2 allelic families (FC27 and 3D7) were detected in all villages investigated over the 5-year collection period. The average genotype per allelic family was comparable between villages. Frequencies of msp-1 and msp-2 allelic types showed no correlation with age (Fisher's exact test, P = 0.59) or gender (Fisher's exact test, P = 0.973), and were similarly distributed throughout the 5-year sampling period (Fisher's exact test, P = 0.412) and across villages (Fisher's exact test, P = 0.866). Mean multiplicity of infection (MOI) for both msp-1 and msp-2 was highest in Kedougou village (2.25 and 2.21, respectively) and among younger patients aged ≤ 15 years (2.12 and 2.00, respectively). The mean MOI was highest in 2009 and decreased progressively onward. Characterization of the genetic diversity and complexity of P. falciparum infections in Kedougou revealed no spatio-temporal variation in the genetic diversity of P. falciparum isolates. However, mean MOI varied with time of sera collection and decreased over the course of the study (July 2009 to July 2013). This suggests a slow progressive decrease of malaria transmission intensity in Kedougou Region despite the limited impact of preventive and control measures implemented by the National Malaria Control Programme on malaria morbidity and mortality.

Quality of life and functional capacity in patients with rheumatoid arthritis - Cross-sectional study.

PubMed

Rosa-Gonçalves, Diana; Bernardes, Miguel; Costa, Lúcia

2017-04-08

To analyze the Health related Quality of Life (HRQoL) and physical function in rheumatoid arthritis (RA) patients and compare it with the general population. We also intended to analyze about disease activity influence in HRQoL and functional capacity, as well as determine potential determinants for these outcomes. A cross-sectional study was conducted in RA patients from a university hospital of Portugal. We obtained Short Form 36, EuroQoL 5D, health assessment questionnaire, visual analog scale for pain and patient's assessment of disease activity. Comparisons between SF-36 and EQ-5D values with our population reference values were conducted using the Mann-Whitney test. Data were compared in different levels of disease activity, using Kruskal Wallis test and Fisher's exact test. A multiple regression analysis was conducted to identify the potential determinants of outcomes. RA sample showed significantly lower values than the portuguese general population on physical summary measure of SF-36 (median=32 vs. 50, p<0.001) and EQ-5D (median=0.620 vs. 0.758 respectively; p<0.001). Lower disease activity levels had better PROs and this was true even when compared patients achieving remission with those in low disease activity. The HAQ (r 2 =67%), VAS-P (r 2 =62%) and VAS-DA (r 2 =58%) were the variables that strongly related to SF-36. Considering HAQ, the strongest relation was found with VAS-P, VAS-DA and age (r 2 =60%, 61% and 33%, respectively). Multiple regression analysis identified HAQ, VAS-P and educational status as determinants of the HRQoL; age, female gender, employment, VAS-P and VAS-DA as determinants of physical function. Impairment of HRQoL in RA patients is enormous. We found significant differences between different levels of disease activity, showing higher HRQoL and functional capacity at lower disease activity levels. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Comparison of effectiveness and cost of patent ductus arteriosus device occlusion versus surgical ligation of patent ductus arteriosus

PubMed Central

Zulqarnain, Arif; Younas, Muhammad; Waqar, Tariq; Beg, Ahsan; Asma, Touseef; Baig, Mirza Ahmad Raza

2016-01-01

Objectives: Comparison of effectiveness and cost of transcatheter occlusion of patent ductus arteriosus (PDA) with surgical ligation of PDA. Methods: This retrospective comparative study was conducted in the pediatric cardiology department of Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Data of 250 patients who underwent patent ductus arteriosus (PDA) closure either surgical or trans-catheter closure using SHSMA Occluder having weight >5 kg from April 2012 to October 2015 were included in this study. SPSS version 20 was used for data analysis. Quantitative variables were compared using independent sample t-test. Chi-square test and fishers exact was used for qualitative variables. P-value <0.05 was considered statistically significant. Results: There were one hundred and twenty (120) patients who underwent transcatheter occlusion of PDA using SHSMA occluder (PDA Device Group) and one hundred and thirty (130) patients who underwent surgical ligation of PDA (Surgical Group). Incidence of residual shunting was two (1.5%) in surgical group and 0 (0.0%) in PDA Device group for one month follow up period. There were 4 (3.1%) major complications in surgical group. The rate of blood transfusions were high in surgical group (p-value 0.04). Hospital stay time was significantly less in PDA Device group (P-value <0.001). Total procedural cost was 110695+1054 Pakistani rupees in PDA Device group and 92414+3512 in surgical group (p-value <0.001). The cost of PDA device closure was 16.52% higher than the surgical ligation of PDA. There was no operative mortality. Conclusion: The transcatheter closure of PDA is an effective and less invasive method as compared to the surgical ligation. There is a lower rate of complications and the cost is not much high as compared to surgical PDA ligation. PMID:27648051

Anisotropic strange star with Tolman V potential

NASA Astrophysics Data System (ADS)

Shee, Dibyendu; Deb, Debabrata; Ghosh, Shounak; Ray, Saibal; Guha, B. K.

In this paper, we present a strange stellar model using Tolman V-type metric potential employing simplest form of the MIT bag equation of state (EOS) for the quark matter. We consider that the stellar system is spherically symmetric, compact and made of an anisotropic fluid. Choosing different values of n we obtain exact solutions of the Einstein field equations and finally conclude that for a specific value of the parameter n = 1/2, we find physically acceptable features of the stellar object. Further, we conduct different physical tests, viz., the energy condition, generalized Tolman-Oppeheimer-Volkoff (TOV) equation, Herrera’s cracking concept, etc., to confirm the physical validity of the presented model. Matching conditions provide expressions for different constants whereas maximization of the anisotropy parameter provides bag constant. By using the observed data of several compact stars, we derive exact values of some of the physical parameters and exhibit their features in tabular form. It is to note that our predicted value of the bag constant satisfies the report of CERN-SPS and RHIC.

A comparison of semiautomated versus manual Goldmann kinetic perimetry in patients with visually significant glaucoma.

PubMed

Ramirez, Adriana M; Chaya, Craig J; Gordon, Lynn K; Giaconi, Joann A

2008-03-01

To determine if semiautomated kinetic perimetry (SKP) is reproducible and comparable to Goldmann manual kinetic perimetry (GVF). Glaucoma patients were recruited to perform visual field testing using GVF and SKP. Specific isopters were tested, quantified, and compared. Visual field patterns were analyzed for shape and defect. Ten patients (16 eyes) underwent visual field studies using SKP and GVF, and 8 patients completed a second SKP on a different day. Individual isopter areas were similar between GVF and SKP, although 60% of isopters were larger on SKP by an average of 15%. This was statistically significant for the smaller isopters, I4e (P=0.02) and I2e (P=0.05). Retesting with SKP on a separate day, showed similar isopter areas (P values=0.3 to 1.0), however, the exact location of isopters in degrees from central fixation tended to vary with the smaller test object sizes. Isopter position in degrees from the central axis agreed in at least 3 quadrants in approximately 65% of fields compared. SKP visual field defects and patterns were similar between test strategies. SKP and GVF testing produce similar visual field results in glaucoma patients, and SKP testing seems to be reliable and reproducible in this population. However, overlapping isopters, typically associated with nonorganic vision loss, and jagged isopters were sometimes observed in SKP visual fields. Further study of SKP is needed to explore these findings.

Role of clinician's experience and implant design on implant stability. An ex vivo study in artificial soft bones.

PubMed

Romanos, Georgios E; Basha-Hijazi, Abdulaziz; Gupta, Bhumija; Ren, Yan-Fang; Malmstrom, Hans

2014-04-01

Clinical experience in implant placement is important in order to prevent implant failures. However, the implant design affects the primary implant stability (PS) especially in poor quality bones. Therefore, the aim of this study was to compare the effect of clinician surgical experience on PS, when placing different type of implant designs. A total of 180 implants (90 parallel walled-P and 90 tapered-T) were placed in freshly slaughtered cow ribs. Bone quality was evaluated by two examiners during surgery and considered as 'type IV' bone. Implants (ø 5 mm, length: 15 mm, Osseotite, BIOMET 3i, Palm Beach Gardens, FL, USA) were placed by three different clinicians (master/I, good/II, non-experienced/III, under direct supervision of a manufacturer representative; 30 implants/group). An independent observer assessed the accuracy of placement by resonance frequency analysis (RFA) with implant stability quotient (ISQ) values. Two-way analysis of variance (ANOVA) and Tukey's post hoc test were used to detect the surgical experience of the clinicians and their interaction and effects of implant design on the PS. All implants were mechanically stable. The mean ISQ values were: 49.57(± 18.49) for the P-implants and 67.07(± 8.79) for the T-implants. The two-way ANOVA showed significant effects of implant design (p < .0001), clinician (p < .0001), and their interaction (p < .0001). The Tukey's multiple comparison test showed significant differences in RFA for the clinician group I/II (p = .015) and highly significant (p < .0001) between I/III and II/III. The P-implants presented (for I, II, and III) mean ISQ values 31.25/49.18/68.17 and the T-implants showed higher ISQ values, 70.15/62.08/68.98, respectively. Clinicians I and II did not show extreme differences for T-implants (p = .016). In contrast, clinician III achieved high ISQ values using P- and T-implants following the exact surgical protocol based on the manufacturer guidelines. T-implants provided high stability for experienced clinicians compared with P-implants. T-implants achieved greater PS than the P-implants. All clinicians consistently achieved PS; however, experienced clinicians achieved higher ISQ values with T-implants in poor quality bone. © 2012 Wiley Periodicals, Inc.

Understanding patient portal use: implications for medication management.

PubMed

Osborn, Chandra Y; Mayberry, Lindsay Satterwhite; Wallston, Kenneth A; Johnson, Kevin B; Elasy, Tom A

2013-07-03

The Internet can be leveraged to provide disease management support, including medication adherence promotion that, when tailored, can effectively improve adherence to medications. The growing adoption of patient portals represents an opportunity to support medication management and adherence more broadly, but virtually no data exist about the real and potential impact of existing portals on these outcomes. We sought to (1) understand who uses an existing patient portal and reasons for use and nonuse, (2) understand how portal users are using a portal to manage their medications, and (3) explore participants' ideas for improving portal functionality for medication management and adherence support. A total of 75 adults with type 2 diabetes participated in a mixed-methods study involving focus groups, a survey, and a medical chart review. We used quantitative data to identify differences between portal users and nonusers, and to test the relationship between the frequency of portal use and glycemic control among users. We used qualitative methods to understand how and why participants use a portal and their ideas for improving its medication management functionality. Of the enrolled participants, 81% (61/75) attended a focus group and/or completed a survey; portal users were more likely than nonusers to participate in that capacity (Fisher exact test; P=.01). Users were also more likely than nonusers to be Caucasian/white (Fisher exact test; P<.001), have higher incomes (Fisher exact test; P=.005), and be privately insured (Fisher exact test; P<.001). Users also tended to have more education than nonusers (Mann-Whitney U; P=.05), although this relationship was not significant at P<.05. Among users, more frequent use of a portal was associated with better A1C (Spearman rho =-0.30; P=.02). Reasons for nonuse included not knowing about the portal (n=3), not having access to a computer (n=3), or having a family member serve as an online delegate (n=1). Users reported using the portal to request prescription refills/reauthorizations and to view their medication list, and they were enthusiastic about the idea of added refill reminder functionality. They were also interested in added functionality that could streamline the refill/reauthorization process, alert providers to fill/refill nonadherence, and provide information about medication side effects and interactions. Although there are disparities in patient portal use, patients use portals to manage their medications, are enthusiastic about further leveraging portals to support medication management and adherence, and those who use a portal more frequently have better glycemic control. However, more features and functionality within a portal platform is needed to maximize medication management and adherence promotion.

Fibrinogen: cardiometabolic risk marker in obese or overweight children and adolescents.

PubMed

Azevedo, Waldeneide F; Cantalice, Anajás S C; Gonzaga, Nathalia C; Simões, Mônica O da S; Guimarães, Anna Larissa V; Carvalho, Danielle F de; Medeiros, Carla Campos Muniz

2015-01-01

To determine the prevalence of increased serum fibrinogen levels and its association with cardiometabolic risk factors in overweight or obese children and adolescents. Cross-sectional study with 138 children and adolescents (overweight or obese) followed at a reference outpatient clinic of the public health care network. Fibrinogen concentration was divided into quartiles, and values above or equal to the third quartile were considered high. The association between high fibrinogen values and cardiometabolic risk factors was assessed using Pearson's chi-squared test or Fisher's exact test, as necessary. Logistic regression was used to adjust variables predictive of fibrinogen levels. Analyses were performed using SPSS version 22.0 and SAS software, considering a confidence interval of 95%. Serum fibrinogen levels were elevated in 28.3% of individuals, showing association with the presence of high CRP (p=0.003, PR: 2.41, 95% CI: 1.30-4.46) and the presence of four or more risk factors (p=0.042; PR: 1.78, 95% CI: 1.00-3.17). After a logistic regression, only elevated CRP remained associated with altered fibrinogen levels (p=0.024; PR: 1.32; 95% CI: 1.09-5.25). Increased fibrinogen was prevalent in the study population and was associated with ultrasensitive C-reactive protein and the presence of four or more cardiovascular risk factors; it should be included in the assessment of individuals at risk. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Testing the Nonce Borrowing Hypothesis: Counter-Evidence from English-Origin Verbs in Welsh

ERIC Educational Resources Information Center

Stammers, Jonathan R.; Deuchar, Margaret

2012-01-01

According to the nonce borrowing hypothesis (NBH), "[n]once borrowings pattern exactly like their native counterparts in the (unmixed) recipient language" (Poplack & Meechan, 1998a, p. 137). Nonce borrowings (Sankoff, Poplack & Vanniarajan, 1990, p. 74) are "lone other-language items" which differ from established borrowings in terms of frequency…

A comparison of the surface contaminants of handwritten recycled and printed electronic parenteral nutrition prescriptions and their transfer to bag surfaces during delivery to hospital wards.

PubMed

Austin, Peter David; Hand, Kieran Sean; Elia, Marinos

2014-02-01

Handwritten recycled paper prescription for parenteral nutrition (PN) may become a concentrated source of viable contaminants, including pathogens. This study examined the effect of using fresh printouts of electronic prescriptions on these contaminants. Cellulose sponge stick swabs with neutralizing buffer were used to sample the surfaces of PN prescriptions (n = 32 handwritten recycled; n = 32 printed electronic) on arrival to the pharmacy or following printing and PN prescriptions and bags packaged together during delivery (n = 38 handwritten recycled; n = 34 printed electronic) on arrival to hospital wards. Different media plates and standard microbiological procedures identified the type and number of contaminants. Staphylococcus aureus, fungi, and mold were infrequent contaminants. nonspecific aerobes more frequently contaminated handwritten recycled than printed electronic prescriptions (into pharmacy, 94% vs 44%, fisher exact test P .001; onto wards, 76% vs 50%, p = .028), with greater numbers of colony-forming units (CFU) (into pharmacy, median 130 [interquartile range (IQR), 65260] VS 0 [075], Mann-Whitney U test, P .001; onto wards, median 120 [15320] vs 10 [040], P = .001). packaging with handwritten recycled prescriptions led to more frequent nonspecific aerobic bag surface contamination (63% vs 41%, fisher exact test P = .097), with greater numbers of CFU (median 40 [IQR, 080] VS 0 [040], Mann-Whitney U test, P = .036). The use of printed electronic PN prescriptions can reduce microbial loads for contamination of surfaces that compromises aseptic techniques.

Application of the exact exchange potential method for half metallic intermediate band alloy semiconductor.

PubMed

Fernández, J J; Tablero, C; Wahnón, P

2004-06-08

In this paper we present an analysis of the convergence of the band structure properties, particularly the influence on the modification of the bandgap and bandwidth values in half metallic compounds by the use of the exact exchange formalism. This formalism for general solids has been implemented using a localized basis set of numerical functions to represent the exchange density. The implementation has been carried out using a code which uses a linear combination of confined numerical pseudoatomic functions to represent the Kohn-Sham orbitals. The application of this exact exchange scheme to a half-metallic semiconductor compound, in particular to Ga(4)P(3)Ti, a promising material in the field of high efficiency solar cells, confirms the existence of the isolated intermediate band in this compound. (c) 2004 American Institute of Physics.

Conscious Sedation Procedures Using Intravenous Midazolam for Dental Care in Patients with Different Cognitive Profiles: A Prospective Study of Effectiveness and Safety

PubMed Central

Collado, Valérie; Faulks, Denise; Nicolas, Emmanuel; Hennequin, Martine

2013-01-01

The use of midazolam for dental care in patients with intellectual disability is poorly documented. This study aimed to evaluate the effectiveness and safety of conscious sedation procedures using intravenous midazolam in adults and children with intellectual disability (ID) compared to dentally anxious patients (DA). Ninety-eight patients with ID and 44 patients with DA programmed for intravenous midazolam participated in the study over 187 and 133 sessions, respectively. Evaluation criteria were success of dental treatment, cooperation level (modified Venham scale), and occurrence of adverse effects. The mean intravenous dose administered was 8.8±4.9 mg and 9.8±4.1 mg in ID and DA sessions respectively (t-test, NS). 50% N2O/O2 was administered during cannulation in 51% of ID sessions and 61% of DA sessions (NS, Fisher exact test). Oral or rectal midazolam premedication was administered for cannulation in 31% of ID sessions and 3% of DA sessions (p<0,001, Fisher exact test). Dental treatment was successful in 9 out of 10 sessions for both groups. Minor adverse effects occurred in 16.6% and 6.8% of ID and DA sessions respectively (p = 0.01, Fisher exact test). Patients with ID were more often very disturbed during cannulation (25.4% ID vs. 3.9% DA sessions) and were less often relaxed after induction (58.9% ID vs. 90.3% DA) and during dental treatment (39.5% ID vs. 59.7% DA) (p<0.001, Fisher exact test) than patients with DA. When midazolam sedation was repeated, cooperation improved for both groups. Conscious sedation procedures using intravenous midazolam, with or without premedication and/or inhalation sedation (50% N2O/O2), were shown to be safe and effective in patients with intellectual disability when administered by dentists. PMID:23940729

Reduction of Complications of Local Anaesthesia in Dental Healthcare Setups by Application of the Six Sigma Methodology: A Statistical Quality Improvement Technique

PubMed Central

Khatoon, Farheen

2015-01-01

Background Health care faces challenges due to complications, inefficiencies and other concerns that threaten the safety of patients. Aim The purpose of his study was to identify causes of complications encountered after administration of local anaesthesia for dental and oral surgical procedures and to reduce the incidence of complications by introduction of six sigma methodology. Materials and Methods DMAIC (Define, Measure, Analyse, Improve and Control) process of Six Sigma was taken into consideration to reduce the incidence of complications encountered after administration of local anaesthesia injections for dental and oral surgical procedures using failure mode and effect analysis. Pareto analysis was taken into consideration to analyse the most recurring complications. Paired z-sample test using Minitab Statistical Inference and Fisher’s exact test was used to statistically analyse the obtained data. The p-value <0.05 was considered as significant value. Results Total 54 systemic and 62 local complications occurred during three months of analyse and measure phase. Syncope, failure of anaesthesia, trismus, auto mordeduras and pain at injection site was found to be most recurring complications. Cumulative defective percentage was 7.99 in case of pre-improved data and decreased to 4.58 in the control phase. Estimate for difference was 0.0341228 and 95% lower bound for difference was 0.0193966. p-value was found to be highly significant with p= 0.000. Conclusion The application of six sigma improvement methodology in healthcare tends to deliver consistently better results to the patients as well as hospitals and results in better patient compliance as well as satisfaction. PMID:26816989

A Gaussian wave packet phase-space representation of quantum canonical statistics

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

Coughtrie, David J.; Tew, David P.

2015-07-28

We present a mapping of quantum canonical statistical averages onto a phase-space average over thawed Gaussian wave-packet (GWP) parameters, which is exact for harmonic systems at all temperatures. The mapping invokes an effective potential surface, experienced by the wave packets, and a temperature-dependent phase-space integrand, to correctly transition from the GWP average at low temperature to classical statistics at high temperature. Numerical tests on weakly and strongly anharmonic model systems demonstrate that thermal averages of the system energy and geometric properties are accurate to within 1% of the exact quantum values at all temperatures.

DNA sequences and proteic antigens of H. pylori in cholecystic bile and tissue of patients with gallstones.

PubMed

Neri, V; Margiotta, M; de Francesco, V; Ambrosi, A; Valle, N Della; Fersini, A; Tartaglia, N; Minenna, M F; Ricciardelli, C; Giorgio, F; Panella, C; Ierardi, E

2005-10-15

Although Helicobacter pylori DNA sequences have been detected in cholecystic bile and tissue of patients with gallstones, controversial results are reported from different geographic areas. To detect H. pylori in cholecystic bile and tissue of patients with gallstones from a previously uninvestigated geographic area, southern Italy. Detection included both the bacterial DNA and the specific antigen (H. pylori stool antigen) identified in the stools of infected patients for diagnostic purposes. The study enclosed 33 consecutive patients undergoing laparoscopic cholecystectomy for gallstones. DNA sequences of H. pylori were detected by polymerase chain reaction in both cholecystic bile and tissue homogenate. Moreover, we assayed H.pylori stool antigen on gall-bladder cytosolic and biliary proteins after their extraction. Bacterial presence in the stomach was assessed by urea breath test in all patients and Deltadelta13CPDB value assumed as marker of intragastric load. Fisher's exact probability and Student's t-tests were used for statistical analysis. DNA sequences of H. pylori in bile were found in 51.5% and significantly correlated with its presence in cholecystic tissue homogenate (P<0.005), H. pylori stool antigen in gall-bladder (P=0.0013) and bile (P=0.04) proteins, gastric infection (P<0.01) and intragastric bacterial load (P<0.001). No correlation was found, however, with sex and age of the patients. Our prevalence value of bacterial DNA in bile and gall-bladder of patients with gallstones agreed with that of the only other Italian study. The simultaneous presence of both bacterial DNA and proteic antigen suggests that the same prototype of bacterium could be located at both intestinal and cholecystic level and, therefore, the intestine represents the source of biliary contagion.

How conservative is Fisher's exact test? A quantitative evaluation of the two-sample comparative binomial trial.

PubMed

Crans, Gerald G; Shuster, Jonathan J

2008-08-15

The debate as to which statistical methodology is most appropriate for the analysis of the two-sample comparative binomial trial has persisted for decades. Practitioners who favor the conditional methods of Fisher, Fisher's exact test (FET), claim that only experimental outcomes containing the same amount of information should be considered when performing analyses. Hence, the total number of successes should be fixed at its observed level in hypothetical repetitions of the experiment. Using conditional methods in clinical settings can pose interpretation difficulties, since results are derived using conditional sample spaces rather than the set of all possible outcomes. Perhaps more importantly from a clinical trial design perspective, this test can be too conservative, resulting in greater resource requirements and more subjects exposed to an experimental treatment. The actual significance level attained by FET (the size of the test) has not been reported in the statistical literature. Berger (J. R. Statist. Soc. D (The Statistician) 2001; 50:79-85) proposed assessing the conservativeness of conditional methods using p-value confidence intervals. In this paper we develop a numerical algorithm that calculates the size of FET for sample sizes, n, up to 125 per group at the two-sided significance level, alpha = 0.05. Additionally, this numerical method is used to define new significance levels alpha(*) = alpha+epsilon, where epsilon is a small positive number, for each n, such that the size of the test is as close as possible to the pre-specified alpha (0.05 for the current work) without exceeding it. Lastly, a sample size and power calculation example are presented, which demonstrates the statistical advantages of implementing the adjustment to FET (using alpha(*) instead of alpha) in the two-sample comparative binomial trial. 2008 John Wiley & Sons, Ltd

Statistical analyses of the relative risk.

PubMed Central

Gart, J J

1979-01-01

Let P1 be the probability of a disease in one population and P2 be the probability of a disease in a second population. The ratio of these quantities, R = P1/P2, is termed the relative risk. We consider first the analyses of the relative risk from retrospective studies. The relation between the relative risk and the odds ratio (or cross-product ratio) is developed. The odds ratio can be considered a parameter of an exponential model possessing sufficient statistics. This permits the development of exact significance tests and confidence intervals in the conditional space. Unconditional tests and intervals are also considered briefly. The consequences of misclassification errors and ignoring matching or stratifying are also considered. The various methods are extended to combination of results over the strata. Examples of case-control studies testing the association between HL-A frequencies and cancer illustrate the techniques. The parallel analyses of prospective studies are given. If P1 and P2 are small with large samples sizes the appropriate model is a Poisson distribution. This yields a exponential model with sufficient statistics. Exact conditional tests and confidence intervals can then be developed. Here we consider the case where two populations are compared adjusting for sex differences as well as for the strata (or covariate) differences such as age. The methods are applied to two examples: (1) testing in the two sexes the ratio of relative risks of skin cancer in people living in different latitudes, and (2) testing over time the ratio of the relative risks of cancer in two cities, one of which fluoridated its drinking water and one which did not. PMID:540589

DFT treatment of transport through Anderson junction: exact results and approximations

NASA Astrophysics Data System (ADS)

Burke, Kieron

2012-02-01

Since the pioneering break-junction experiments of Reed and Tour measuring the conductance of dithiolated benzene between gold leads, many researchers in physics and chemistry have been calculating conductance for such systems using density functional theory (DFT). Off resonance, the predicted current is often 10-100 times larger than that measured. This error is often ascribed to the application of ground-state DFT to a non-equilibrium problem. I will argue that, in fact, this is largely due to errors in the density functional approximations in popular use, rather than necessarily errors in the methodology. A stark illustration of this principle is the ability of DFT to reproduce the exact transmission through an Anderson junction at zero-temperature and weak bias, including the Kondo plateau, but only if the exact ground-state density functional is used. In fact, this case can be used to reverse-engineer the exact functional for this problem. Popular approximations can also be tested, including both smooth and discontinuous functionals of the density, as well as symmetry-broken approaches. [4pt] [1] Kondo effect given exactly by density functional theory, J. P. Bergfield, Z. Liu, K. Burke, and C. A. Stafford, arXiv:1106.3104; [0pt] [2] Broadening of the Derivative Discontinuity in Density Functional Theory, F. Evers, and P. Schmitteckert, arXiv:1106.3658; [0pt] [3] DFT-based transport calculations, Friedel's sum rule and the Kondo effect, P. Tr"oster, P. Schmitteckert, and F. Evers, arXiv:1106.3669; [0pt] [4] Towards a description of the Kondo effect using time-dependent density functional theory, G. Stefanucci, and S. Kurth, arXiv:1106.3728.

Product of Ginibre matrices: Fuss-Catalan and Raney distributions.

PubMed

Penson, Karol A; Zyczkowski, Karol

2011-06-01

Squared singular values of a product of s square random Ginibre matrices are asymptotically characterized by probability distributions P(s)(x), such that their moments are equal to the Fuss-Catalan numbers of order s. We find a representation of the Fuss-Catalan distributions P(s)(x) in terms of a combination of s hypergeometric functions of the type (s)F(s-1). The explicit formula derived here is exact for an arbitrary positive integer s, and for s=1 it reduces to the Marchenko-Pastur distribution. Using similar techniques, involving the Mellin transform and the Meijer G function, we find exact expressions for the Raney probability distributions, the moments of which are given by a two-parameter generalization of the Fuss-Catalan numbers. These distributions can also be considered as a two-parameter generalization of the Wigner semicircle law.

Prevalence of upper airway obstruction in patients with apparently asymptomatic euthyroid multi nodular goitre

PubMed Central

Menon, Sunil K.; Jagtap, Varsha S.; Sarathi, Vijaya; Lila, Anurag R.; Bandgar, Tushar R.; Menon, Padmavathy S; Shah, Nalini S.

2011-01-01

Aims: To study the prevalence of upper airway obstruction (UAO) in “apparently asymptomatic” patients with euthyroid multinodular goitre (MNG) and find correlation between clinical features, UAO on pulmonary function test (PFT) and tracheal narrowing on computerised tomography (CT). Materials and Methods: Consecutive patients with apparently asymptomatic euthyroid MNG attending thyroid clinic in a tertiary centre underwent clinical examination to elicit features of UAO, PFT, and CT of neck and chest. Statistical Analysis Used: Statistical analysis was done with SPSS version 11.5 using paired t-test, Chi square test, and Fisher's exact test. P value of <0.05 was considered to be significant. Results: Fifty-six patients (52 females and four males) were studied. The prevalence of UAO (PFT) and significant tracheal narrowing (CT) was 14.3%. and 9.3%, respectively. Clinical features failed to predict UAO or significant tracheal narrowing. Tracheal narrowing (CT) did not correlate with UAO (PFT). Volume of goitre significantly correlated with degree of tracheal narrowing. Conclusions: Clinical features do not predict UAO on PFT or tracheal narrowing on CT in apparently asymptomatic patients with euthyroid MNG. PMID:21966649

The correlations between alteration of p16 gene and clinicopathological factors and prognosis in squamous cell carcinomas of the buccal mucosa.

PubMed

Dong, Yuying; Wang, Jie; Dong, Fusheng; Wang, Xu; Zhang, Yinghuai

2012-07-01

To evaluate relationships between the alteration of p16 gene and the clinical status and prognosis of the patients with squamous cell carcinoma of the buccal mucosa. Thirty buccal cancers were included in the analysis. Deletion analysis was performed by PCR. Point mutation analysis was used by PCR-SSCP and direct sequencing. Methylation-specific PCR methods were adopted for the evaluation of p16 methylation. The correlation between alteration of p16 gene and clinicopathological factors buccal cancer was evaluated by Fisher's exact test. Kaplan-Meier and Cox regression were used to investigate the relationship between p16 alteration and survival time. The frequency of p16 alteration was 63.3% in buccal carcinomas. P16 deletion was associated significantly with tumor size (P = 0.01). P16 point mutation was associated significantly with differentiation (P = 0.006). P16 methylation was associated significantly with nodes metastasis (P = 0.027). The overall survival rate of 30 buccal carcinomas was 53.3%. The Log-rank test (P = 0.021) and univariate Cox regression analysis (P = 0.030) revealed that p16 methylation was significantly associated with the overall survival rate. Multivariate analysis showed that p16 deletion, p16 mutation, and p16 methylation were not statistically significant. The alterations of p16 gene may play a major role in malignancy and development and metastases of buccal carcinoma and may be an excellent marker of aggressive clinical behavior. P16 methylation has a prognostic value in buccal carcinoma but not an independent prognosis factor. P16 point mutation and p16 deletion have not prognostic significance in buccal carcinoma. © 2012 John Wiley & Sons A/S.

Test Procedures for Semiconductor Random Access Memories

DTIC Science & Technology

1979-11-01

of each cell exactly complement to each other, the read operations on the base cell in (g) of step 2 following operations ko S odd and in (p) of step...contents of Sko (these cells this address. Furthermore, when more than one contained I at test time and even if the con- cell is accessed then the output

An Algorithm for the Calculation of Exact Term Discrimination Values.

ERIC Educational Resources Information Center

Willett, Peter

1985-01-01

Reports algorithm for calculation of term discrimination values that is sufficiently fast in operation to permit use of exact values. Evidence is presented to show that relationship between term discrimination and term frequency is crucially dependent upon type of inter-document similarity measure used for calculation of discrimination values. (13…

Autosomal Dominant Hyper-IgE Syndrome in the USIDNET Registry.

PubMed

Gernez, Yael; Freeman, Alexandra F; Holland, Steven M; Garabedian, Elizabeth; Patel, Niraj C; Puck, Jennifer M; Sullivan, Kathleen E; Akhter, Javeed; Secord, Elizabeth; Chen, Karin; Buckley, Rebecca; Haddad, Elie; Ochs, Hans D; Fuleihan, Ramsay; Routes, John; Muskat, Mica; Lugar, Patricia; Mancini, Julien; Cunningham-Rundles, Charlotte

Autosomal dominant hyper-IgE syndrome (AD-HIES) is a rare condition. Data from the USIDNET Registry provide a resource to examine the characteristics of patients with rare immune deficiency diseases. A query was submitted to the USIDNET requesting deidentified data for patients with physician-diagnosed AD-HIES through July 2016. Data on 85 patients diagnosed with AD-HIES (50 males; 35 females) born between 1950 and 2013, collected by 14 physicians from 25 states and Quebec, were entered into the USIDNET Registry by July 2016. Cumulative follow-up was 2157 years. Of these patients, 45.9% had a family history of HIES. The complications reported included skin abscesses (74.4%), eczema (57.7%), retained primary teeth (41.4%), fractures (39%), scoliosis (34.1%), and cancer (7%). Reported allergic diseases included food (37.8%), environmental (18%), and drugs (42.7%). The mean serum IgE level was 8383.7 kU/mL and was inversely correlated to the patient's age. A total of 49.4% had eosinophilia; 56% were known to be on trimethoprim-sulfamethoxazole, 26.6% on antifungal coverage, and 30.6% on immunoglobulin replacement therapy. Pneumonias were more commonly attributed to Staphylococcus aureus (55.3%) or Aspergillus fumigatus (22.4%); 19.5% had a history of lung abscess; these were most often associated with Pseudomonas aeruginosa (P Fisher's exact test = .029) or A. fumigatus (P Fisher's exact test = .016). Lung abscesses were significantly associated with drug reactions (P χ 2  = .01; odds ratio: 4.03 [1.2-12.97]), depression (P Fisher's exact test = .036), and lower Karnofsky index scores (P Mann-Whitney = .007). Data from the USIDNET Registry summarize the currently reported clinical characteristics of a large cohort of subjects with AD-HIES. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

How Accurately Does the Free Complement Wave Function of a Helium Atom Satisfy the Schroedinger Equation?

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

Nakashima, Hiroyuki; Nakatsuji, Hiroshi

2008-12-12

The local energy defined by H{psi}/{psi} must be equal to the exact energy E at any coordinate of an atom or molecule, as long as the {psi} under consideration is exact. The discrepancy from E of this quantity is a stringent test of the accuracy of the calculated wave function. The H-square error for a normalized {psi}, defined by {sigma}{sup 2}{identical_to}<{psi}|(H-E){sup 2}|{psi}>, is also a severe test of the accuracy. Using these quantities, we have examined the accuracy of our wave function of a helium atom calculated using the free complement method that was developed to solve the Schroedinger equation.more » Together with the variational upper bound, the lower bound of the exact energy calculated using a modified Temple's formula ensured the definitely correct value of the helium fixed-nucleus ground state energy to be -2.903 724 377 034 119 598 311 159 245 194 4 a.u., which is correct to 32 digits.« less

Determining the sample size for co-dominant molecular marker-assisted linkage detection for a monogenic qualitative trait by controlling the type-I and type-II errors in a segregating F2 population.

PubMed

Hühn, M; Piepho, H P

2003-03-01

Tests for linkage are usually performed using the lod score method. A critical question in linkage analyses is the choice of sample size. The appropriate sample size depends on the desired type-I error and power of the test. This paper investigates the exact type-I error and power of the lod score method in a segregating F(2) population with co-dominant markers and a qualitative monogenic dominant-recessive trait. For illustration, a disease-resistance trait is considered, where the susceptible allele is recessive. A procedure is suggested for finding the appropriate sample size. It is shown that recessive plants have about twice the information content of dominant plants, so the former should be preferred for linkage detection. In some cases the exact alpha-values for a given nominal alpha may be rather small due to the discrete nature of the sampling distribution in small samples. We show that a gain in power is possible by using exact methods.

Transmitter Pulse Estimation and Measurements for Airborne TDEM Systems

NASA Astrophysics Data System (ADS)

Vetrov, A.; Mejzr, I.

2013-12-01

The processing and interpretation of Airborne Time Domain EM data requires precise description of the transmitter parameters, including shape, amplitude and length of the transmitted pulse. There are several ways to measure pulse shape of the transmitter loop. Transmitted pulse can be recorded by a current monitor installed on the loop. The current monitor readings do not give exact image due to own time-domain physical characteristics of the current monitor. Another way is to restore the primary pulse shape from the receiver data recorded on-time, if such is possible. The receiver gives exact image of the primary field projection combined with the ground response, which can be minimized at high altitude pass, usually with a transmitter elevation higher than 1500 ft from the ground. The readings on the receiver are depending on receiver position and orientation. Modeling of airborne TDEM transmitter pulse allows us to compare estimated and measured shape of the pulse and apply required corrections. Airborne TDEM system transmitter pulse shape has been studied by authors while developing P-THEM system. The data has been gathered during in-doors and out-doors ground tests in Canada, as well as during flight tests in Canada and in India. The P-THEM system has three-axes receiver that is suspended on a tow-cable in the midpoint between the transmitter and the helicopter. The P-THEM receiver geometry does not require backing coils to dump the primary field. The system records full-wave data from the receiver and current monitor installed on the transmitter loop, including on-time and off-time data. The modeling of the transmitter pulse allowed us to define the difference between estimated and measured values. The higher accuracy pulse shape can be used for better data processing and interpretation. A developed model can be applied to similar systems and configurations.

Mathematics of the total alkalinity-pH equation - pathway to robust and universal solution algorithms: the SolveSAPHE package v1.0.1

NASA Astrophysics Data System (ADS)

Munhoven, G.

2013-08-01

The total alkalinity-pH equation, which relates total alkalinity and pH for a given set of total concentrations of the acid-base systems that contribute to total alkalinity in a given water sample, is reviewed and its mathematical properties established. We prove that the equation function is strictly monotone and always has exactly one positive root. Different commonly used approximations are discussed and compared. An original method to derive appropriate initial values for the iterative solution of the cubic polynomial equation based upon carbonate-borate-alkalinity is presented. We then review different methods that have been used to solve the total alkalinity-pH equation, with a main focus on biogeochemical models. The shortcomings and limitations of these methods are made out and discussed. We then present two variants of a new, robust and universally convergent algorithm to solve the total alkalinity-pH equation. This algorithm does not require any a priori knowledge of the solution. SolveSAPHE (Solver Suite for Alkalinity-PH Equations) provides reference implementations of several variants of the new algorithm in Fortran 90, together with new implementations of other, previously published solvers. The new iterative procedure is shown to converge from any starting value to the physical solution. The extra computational cost for the convergence security is only 10-15% compared to the fastest algorithm in our test series.

Association between bacteria occurring in the apical canal system and expression of bone-resorbing mediators and matrix metalloproteinases in apical periodontitis.

PubMed

Takahama, A; Rôças, I N; Faustino, I S P; Alves, F R F; Azevedo, R S; Gomes, C C; Araújo-Filho, W R; Siqueira, J F

2018-07-01

To evaluate the association between the presence of selected bacterial species/groups in the apical root canal and expression of mediators of soft and bone tissue destruction in apical periodontitis lesions. Relationships between bacteria and some other features of apical periodontitis were also investigated. Seventeen freshly extracted teeth with pulp necrosis and apical periodontitis were included. The apical root segment was sectioned and cryopulverized; DNA was extracted and evaluated for the presence of 9 bacterial species/groups using real-time polymerase chain reaction. Lesions were processed for histopathological and immunohistochemical analyses, which targeted matrix metalloproteinase-2 (MMP-2) and -9 (MMP-9), receptor activator of NFκB (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG). Associations of the target bacteria with expression of these mediators, presence of symptoms, lesion size and histopathological diagnosis were evaluated. Data were analysed using the chi-square, Fisher's exact, Mann-Whitney and Pearson tests. P values lower than 0.05 were considered significant. All pulverized apical root samples were positive for bacteria. The most prevalent taxa were Actinobacteria (53%), Streptococcus species (35%), Fusobacterium species and Parvimonas micra (18%). The target mediators exhibited a high mean expression in the lesions (MMP-2: 82%; MMP-9: 73%; RANK: 78%; RANKL; 81%; OPG; 83%). Mean RANKL:OPG ratio was significantly higher in granulomas than cysts (P < 0.05, Mann-Whitney test). Actinobacteria were associated with granulomas, higher MMP-2 expression, lower OPG expression, and higher RANKL:OPG ratio (P < 0.05 for all, Fisher's exact test or Mann-Whitney test). No other significant associations were found. Actinobacteria may play an important role in the active phase of soft and bone tissue destruction in apical periodontitis. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Spectral Doppler Waveforms for Diagnosis of Appendicitis: Potential Utility of Point Peak Systolic Velocity and Resistive Index Values.

PubMed

Shin, Lewis K; Jeffrey, R Brooke; Berry, Gerald J; Olcott, Eric W

2017-12-01

Purpose To test the hypothesis that appendiceal spectral Doppler waveforms can distinguish patients with and patients without appendicitis. Materials and Methods In this retrospective study, Doppler waveforms were obtained from intramural appendiceal arteries identified with color Doppler imaging in 60% (93 of 155) of consecutive patients whose appendices were visualized at graded compression ultrasonography (US) performed for suspected appendicitis (53 male and 40 female; age, 1-56 years; mean, 14.5 years) over the 5-month period from November 2015 through March 2016. Point, non-angle-corrected peak systolic velocity (PSV) and resistive index (RI) values were compared between patients with and patients without appendicitis by utilizing histopathologically proven appendicitis and 6-week clinical follow-up as diagnostic reference standards. Data were assessed by using the Student t test, exact binomial distribution, two-sample test of proportions, and receiver operating characteristic analysis. Results Among the 93 patients, 36 (38.7%) had proven appendicitis (mean PSV, 19.7 cm/sec; mean RI, 0.69) and 57 patients (61.2%) did not (mean PSV, 7.1 cm/sec, P < .0001; mean RI, 0.50, P < .0001). The area under the receiver operating characteristic curve for the diagnosis of appendicitis was 0.97 (95% confidence interval [CI]: 0.95, 1.00) for PSV and 0.86 (95% CI: 0.78, 0.95; P = .011) for RI. Chosen discriminatory criteria of PSV greater than 10 cm/sec and RI greater than 0.65 yielded specificity for appendicitis of 94.7% and 96.5% with sensitivity of 88.9% and 63.9% (P = .013) and negative predictive value of 93.1% and 80.9% (P = .045), respectively. Original clinical graded compression US interpretations based on established US findings demonstrated specificity of 96.2% and sensitivity of 100.0%. Considering the subset of 20 patients whose maximum outer diameter measured 6-8 mm, the discriminatory criteria of PSV greater than 10 cm/sec and RI greater than 0.65 yielded specificity for appendicitis of 88.9% each, with sensitivity of 100.0% and 63.6% and negative predictive value of 100.0% and 66.6%, respectively. Conclusion In patients with visualized appendices at US, those with appendicitis exhibit significantly higher point PSV and point RI values than do patients without appendicitis and are distinguishable with high specificity by using a PSV greater than 10 cm/sec and an RI greater than 0.65 as diagnostic criteria. © RSNA, 2017.

Influence of the baseline 18F-fluoro-2-deoxy-D-glucose positron emission tomography results on survival and pathologic response in patients with gastroesophageal cancer undergoing chemoradiation.

PubMed

Javeri, Heta; Xiao, Lianchun; Rohren, Eric; Komaki, Ritsuko; Hofstetter, Wayne; Lee, Jeffrey H; Maru, Dipen; Bhutani, Manoop S; Swisher, Stephen G; Wang, Xuemei; Ajani, Jaffer A

2009-02-01

In patients with esophageal cancer who receive chemoradiation, tools to predict/prognosticate outcome before administering therapy are lacking. The authors evaluated initial standardized unit value (iSUV) of 18F-fluoro-2-deoxy-D-glucose positron emission tomography and its association with overall survival and the degree of pathologic response after surgery. The authors analyzed 161 patients with esophageal adenocarcinoma who had chemoradiation followed by surgery. The log-rank test, univariate Cox proportional hazards model, Kaplan-Meier survival plot, and Fisher exact test were used to analyze dichotomized iSUV and its association with overall survival and pathologic response. The median age of 161 patients was 61 years (range, 26-80 years) and the majority of patients had lower esophageal or gastroesophageal junction involvement. All patients received fluoropyrimidine and, most commonly, a taxane or platinum compound with concomitant radiation. The median radiation dose was 45 grays (Gy) (range, 45 Gy-50.4 Gy). The median iSUV for all patients was 10.1 (range, 0-58). Using the Fisher exact test, iSUV was not found to be associated with the location of the primary cancer. iSUV higher than the median (10.1) was associated with a better pathologic response (P = .06). Patients with primary cancer with iSUV >10.1 had a lower risk for death (hazards ratio of 0.56) compared with those with iSUV < or = 10.1. Higher iSUV was nonsignificantly associated with improved survival (P = .07). Data from the current study suggest that lower iSUV is associated with poor survival and lower probability of response to chemoradiation. iSUV needs to be further evaluated because it may be used to complement other imaging or biomarker assessments to individualize therapy. (c) 2008 American Cancer Society.

Anomalous diffusion associated with nonlinear fractional derivative fokker-planck-like equation: exact time-dependent solutions

PubMed

Bologna; Tsallis; Grigolini

2000-08-01

We consider the d=1 nonlinear Fokker-Planck-like equation with fractional derivatives ( partial differential/ partial differentialt)P(x,t)=D( partial differential(gamma)/ partial differentialx(gamma))[P(x,t)](nu). Exact time-dependent solutions are found for nu=(2-gamma)/(1+gamma)(-infinity

[Elderly, poor, solitary and marginal patients: geriatric vulnerability in emergency services].

PubMed

Marín Gámez, N; Kessel Sardiñas, H; López Martínez, G; Barnosi Marín, A; Montoya Vergel, J; Navarro Corral, A; Delgado Rodríguez, M

1998-07-01

Status is a powerful determinant of health, and it may influence on the demand of Hospital emergency services. The aim of our investigation is to assess whether elderly patients usually wandering emergency services gather more negative socioeconomic conditions. A cross-sectional study on 800 randomised patients cared in emergency services was carried out. A questionnaire about economic, educational and professional levels, domestic violence, loneliness and life style was applied. A crude analysis was used to assess the age-factor (>/= 65 y.o.) by BMDP (PC 90). The trial was approved by the local Bioethics board. Low incomes, low educational level and loneliness were clinic and statistically related with age (65 and more). Data is offered as n (%), X2 and p < 0.0001 (Fisher exact Test two sided p value). Elderly patients frequently demanding hospital emergency services gather more vulnerability conditions, not merely medical. Low incomes, low educational level and loneliness are probably working as key factors on the geriatric demand of emergency services.

Voidage correction algorithm for unresolved Euler-Lagrange simulations

NASA Astrophysics Data System (ADS)

Askarishahi, Maryam; Salehi, Mohammad-Sadegh; Radl, Stefan

2018-04-01

The effect of grid coarsening on the predicted total drag force and heat exchange rate in dense gas-particle flows is investigated using Euler-Lagrange (EL) approach. We demonstrate that grid coarsening may reduce the predicted total drag force and exchange rate. Surprisingly, exchange coefficients predicted by the EL approach deviate more significantly from the exact value compared to results of Euler-Euler (EE)-based calculations. The voidage gradient is identified as the root cause of this peculiar behavior. Consequently, we propose a correction algorithm based on a sigmoidal function to predict the voidage experienced by individual particles. Our correction algorithm can significantly improve the prediction of exchange coefficients in EL models, which is tested for simulations involving Euler grid cell sizes between 2d_p and 12d_p . It is most relevant in simulations of dense polydisperse particle suspensions featuring steep voidage profiles. For these suspensions, classical approaches may result in an error of the total exchange rate of up to 30%.

Factors associated with the success of external cephalic version (ECV) of breech presentation at term.

PubMed

Obeidat, N; Lataifeh, I; Al-Khateeb, M; Zayed, F; Khriesat, W; Amarin, Z

2011-01-01

To evaluate the predictors of success of ECV for breech presentation at term. A retrospective study was conducted over a 3-year period from 2005-2007, where 101 patients who had singleton breech presentation at term were undergoing external cephalic version (ECV) after 37 weeks of gestation at two major teaching hospitals in the North of Jordan. Comparative analysis was made between the successful ECV and unsuccessful ECV groups. The collected data were analysed by using statistical analysis Sudent's t-test and Mann-Whitney test as appropriate and on discrete results chi square or Fisher's exact test when appropriate. The differences were considered significant at a p value of < 0.05. The ECV success rate was 72.3%. Favourable factors for success were multiparity (95.5% vs 4.1%, p = 0.0001), flexed breeches (74% vs 26%, p = 0.002), posterior placenta (38.6% vs 16.4%, p = 0.0001) and anterior fetal back (53.4% vs 34.8%, p = 0.03). Once turned the babies remained cephalic until delivery. All the 28 cases who had failed ECV had caesarean section. Among those who had a successful external cephalic version, the incidence of intrapartum caesarean section was only 8.2% which was lower than that of the average of both units caesarean rate (28%). There were no complications related to the ECV procedure in the study. Multiparity, flexed breech, posterior placenta, and anterior foetal back were the most favourable factors for successful ECV in our study. Moreover, with careful evaluation of individual predictors patient selection and success rates can be optimised.

[Prevalence and factors associated with anemia in pregnant women attending the General Hospital in Douala].

PubMed

Tchente, Charlotte Nguefack; Tsakeu, Eveline Ngouadjeu Dongho; Nguea, Arlette Géraldine; Njamen, Théophile Nana; Ekane, Gregory Halle; Priso, Eugene Belley

2016-01-01

Anemia is a public health problem, prevalent among children and women of childbearing age. Our study aims to determine the prevalence and factors associated with anemia in pregnant women at Douala General Hospital. We conducted a cross sectional study from July 2012 to July 2013. All consenting pregnant women attending antenatal consultation and having undergone complete blood count (CBC) were included in the study. Sociodemographic characteristics, individual's obstetrical history and the results of the CBC were recorded on a pre tested data collection sheet. Anemia was defined according to the WHO criteria. After some descriptive statistics, we performed a bivariate analysis using the Chi-square test and Fisher exact probability test in order to determine the factors associated with anemia. P value <0.05 was considered significant. A total of 415 pregnant women were enrolled in the study. Anemia prevalence was 39,8%. The average age was 29,89±4,835 years. The mean hemoglobin level was 10.93 ± 1.23. Normochromic normocytic anemia (53,3%) was prevalent. Anaemia was severe in 2,4% of cases. Anemia in pregnancy was significantly associated with a personal history of chronic diseases (P = 0.02) and of anemia in a previous pregnancy (P = 0.003). Anemia was more frequently observed during the 3rd trimester (P = 0.04) and breastfeeding played a protective role (P = 0.02). The prevalence of anemia during pregnancy remains high. A better management of chronic diseases in pregnant women and of postpartum follow-up is necessary to treat anemia before a subsequent pregnancy.

Can early postoperative intraocular pressure predict success following mitomycin-C augmented trabeculectomy in primary angle-closure glaucoma.

PubMed

Rong, S S; Feng, M Y; Wang, N; Meng, H; Thomas, R; Fan, S; Wang, R; Wang, X; Tang, X; Liang, Y B

2013-03-01

To evaluate the association between early and late postoperative intraocular pressure (IOP) and determine if early postoperative IOP can predict the surgical outcome. A total of 165 consecutive patients with primary angle-closure glaucoma (PACG) undergoing primary mitomycin-C-augmented trabeculectomy underwent a comprehensive eye examination before surgery and were followed-up on days 1, 7, 14, and 30, and months 3, 6, 12, and 18. IOPs on days 1, 7, 14, and 30 were stratified into groups A (<10 mm Hg), B (≥10 and <15 mm Hg), C (≥15 and <20 mm Hg), and D (≥20 mm Hg). Differences between groups were analyzed using analysis of variance (ANOVA) and Fisher's exact test. Multivariable regression was used to exam the predictive ability of early IOP for final outcome. The mean age was 62.5±7.9 years and 41.21% (n=68) were males. Stratified by IOP on days 1, 7, 14, and 30, respectively, mean IOPs at month 18 were different among groups A, B, C, and D (ANOVA, P=0.047, P=0.033, P=0.008, and P<0.001, respectively). Once the IOPs were settled with interventions on day 7 a higher IOP level was associated with decreasing success rate under different outcome definitions, final IOP <15 mm Hg (Fisher's exact P=0.001) and <20 mm Hg (P=0.039) without medication. Multiple regression showed early IOP predicted final IOP independently from baseline variables. A cutoff value of 13.5 mm Hg on day 7 achieved an accuracy of 80.0 and 57.1% in predicting IOP<15 mm Hg without medication and failure after surgery, respectively. The IOP at 18 months following primary antifibrotic-augmented trabeculectomy in PACG patients is associated with and predicted by the postoperative IOPs at 1 month. Control of early IOP to 13.5 or less may provide better outcomes.

Percolation critical polynomial as a graph invariant

DOE PAGES

Scullard, Christian R.

2012-10-18

Every lattice for which the bond percolation critical probability can be found exactly possesses a critical polynomial, with the root in [0; 1] providing the threshold. Recent work has demonstrated that this polynomial may be generalized through a definition that can be applied on any periodic lattice. The polynomial depends on the lattice and on its decomposition into identical finite subgraphs, but once these are specified, the polynomial is essentially unique. On lattices for which the exact percolation threshold is unknown, the polynomials provide approximations for the critical probability with the estimates appearing to converge to the exact answer withmore » increasing subgraph size. In this paper, I show how the critical polynomial can be viewed as a graph invariant like the Tutte polynomial. In particular, the critical polynomial is computed on a finite graph and may be found using the deletion-contraction algorithm. This allows calculation on a computer, and I present such results for the kagome lattice using subgraphs of up to 36 bonds. For one of these, I find the prediction p c = 0:52440572:::, which differs from the numerical value, p c = 0:52440503(5), by only 6:9 X 10 -7.« less

An evaluation of hernia education in surgical residency programs.

PubMed

Hope, W W; O'Dwyer, B; Adams, A; Hooks, W B; Kotwall, C A; Clancy, T V

2014-08-01

The purpose of this study was to evaluate surgical residents' educational experience related to ventral hernias. A 16-question survey was sent to all program coordinators to distribute to their residents. Consent was obtained following a short introduction of the purpose of the survey. Comparisons based on training level were made using χ(2) test of independence, Fisher's exact, and Fisher's exact with Monte Carlo estimate as appropriate. A p value <0.05 was considered significant. The survey was returned by 183 residents from 250 surgical programs. Resident postgraduate year (PG-Y) level was equivalent among groups. Preferred techniques for open ventral hernia varied; the most common (32 %) was intra-abdominal placement of mesh with defect closure. Twenty-two percent of residents had not heard of the retrorectus technique for hernia repair, 48 % had not performed the operation, and 60 % were somewhat comfortable with and knew the general categories of mesh prosthetics products. Mesh choices, biologic and synthetic, varied among the different products. The most common type of hernia education was teaching in the operating room in 87 %, didactic lecture 69 %, and discussion at journal club 45 %. Number of procedures, comfort level with open and laparoscopic techniques, indications for mesh use and technique, familiarity and use of retrorectus repair, and type of hernia education varied significantly based on resident level (p < 0.05). Exposure to hernia techniques and mesh prosthetics in surgical residency programs appears to vary. Further evaluation is needed and may help in standardizing curriculums for hernia repair for surgical residents.

VEGF-A polymorphisms predict progression-free survival among advanced castration-resistant prostate cancer patients treated with metronomic cyclophosphamide

PubMed Central

Orlandi, P; Fontana, A; Fioravanti, A; Di Desidero, T; Galli, L; Derosa, L; Canu, B; Marconcini, R; Biasco, E; Solini, A; Francia, G; Danesi, R; Falcone, A; Bocci, G

2013-01-01

Background: No data are available on the pharmacogenetics of metronomic chemotherapy in prostate cancer. The aim of this study was to evaluate the association between VEGF-A sequence variants and prostate-specific antigen (PSA) progression, progression-free survival (PFS) and overall survival (OS), in advanced castration-resistant prostate cancer patients treated with metronomic cyclophosphamide (CTX), celecoxib and dexamethasone. Methods: Forty-three patients were enrolled, and genomic DNA was extracted. VEGF-A gene SNPs (−2578A/C, −634C/G, +936C/T) were analysed using TaqMan PCR assays. Hardy–Weinberg equilibrium was tested for each SNP, and genetic effects were evaluated by Fisher's exact test. PFS and OS were analysed with GraphPad Prism software, using the product limit method of Kaplan and Meier, and comparing survival curves using both the log-rank test and the Gehan–Wilcoxon test. We used Bonferroni correction to account for multiple testing, and a two-tailed P-value of <0.017 was considered statistically significant. Results: Overall, 20 patients (46%) experienced a reduction in PSA levels from baseline and, among them, 14 (32%) showed a confirmed PSA ≥50% decrease. In non-responders, the −2578CC genotype was more frequent (18.60% vs 2.33% in responders; P=0.0212) whereas the −634CC genotype frequency was 22.73% vs 0% in responders (P=0.0485). With regard to PFS, patients harbouring the −634CC genotype had a median PFS of 2.2 months whereas patients with the genotype −634CG/GG had a median PFS of 6.25 months (P=0.0042). Conclusion: The −634CC genotype is significantly associated with a shorter PFS in patients treated with a metronomic CTX schedule. PMID:23860526

Stratified exact tests for the weak causal null hypothesis in randomized trials with a binary outcome.

PubMed

Chiba, Yasutaka

2017-09-01

Fisher's exact test is commonly used to compare two groups when the outcome is binary in randomized trials. In the context of causal inference, this test explores the sharp causal null hypothesis (i.e. the causal effect of treatment is the same for all subjects), but not the weak causal null hypothesis (i.e. the causal risks are the same in the two groups). Therefore, in general, rejection of the null hypothesis by Fisher's exact test does not mean that the causal risk difference is not zero. Recently, Chiba (Journal of Biometrics and Biostatistics 2015; 6: 244) developed a new exact test for the weak causal null hypothesis when the outcome is binary in randomized trials; the new test is not based on any large sample theory and does not require any assumption. In this paper, we extend the new test; we create a version of the test applicable to a stratified analysis. The stratified exact test that we propose is general in nature and can be used in several approaches toward the estimation of treatment effects after adjusting for stratification factors. The stratified Fisher's exact test of Jung (Biometrical Journal 2014; 56: 129-140) tests the sharp causal null hypothesis. This test applies a crude estimator of the treatment effect and can be regarded as a special case of our proposed exact test. Our proposed stratified exact test can be straightforwardly extended to analysis of noninferiority trials and to construct the associated confidence interval. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Prognostic factors for melanoma patients with lesions 0.76 - 1.69 mm in thickness. An appraisal of "thin" level IV lesions.

PubMed Central

Day, C L; Mihm, M C; Sober, A J; Harris, M N; Kopf, A W; Fitzpatrick, T B; Lew, R A; Harrist, T J; Golomb, F M; Postel, A; Hennessey, P; Gumport, S L; Raker, J W; Malt, R A; Cosimi, A B; Wood, W C; Roses, D F; Gorstein, F; Rigel, D; Friedman, R J; Mintzis, M M

1982-01-01

Fourteen variables were tested for their prognostic usefulness in 203 patients with clinical Stage I melanoma and primary tumor 0.76-169 mm thick. Only two variables, primary tumor location and level of invasion, were useful in predicting death from melanoma for these patients. Of the 12 deaths from melanoma, 11 occurred in patients with primary tumors located on the upper back, posterior arm, posterior neck, and posterior scalp (=BANS). There has been only one death from melanoma in 136 patients with melanoma located at other sites (11/67 vs 1/136, p less than 0.0001 Fisher's Exact Test). Of the 67 BANS patients, 51 had level II or level III lesions and five (10%0 died of melanoma. This compared with six deaths from melanoma in 16 patients (37.5%) with level IV BANS lesions (5/51 vs 6/16, p = 0.01 Fisher's Exact Test). The relatively high incidence of both melanoma deaths and regional node metastases for the BANS group merits consideration for testing the efficacy of elective regional node dissection for these patients. PMID:7055381

[Comparison of refraction with or without cycloplegia using Retinomax® or Plusoptix® devices].

PubMed

Bui Quoc, E; Guilmin Crepon, S; Tinguely, S; Lavallee, G; Busquet, G; Angot, M; Vera, L

2017-03-01

To evaluate the refraction in children measured with Plusoptix ® without cycloplegia vs. Retinomax ® apparatus with cycloplegia. Measure of refraction with Plusoptix ® in children>1year old referred for systematic vision screening, then measurement after cycloplegia with cyclopentolate by the Retinomax ® device. Thirty-three children were included, i.e. 66eyes. Mean age was 40.7months (minimum 12; maximum 114). The Spearman correlation coefficient for the spherical equivalent was 0.52 (Plusoptix ® vs. Retinomax ® comparison; P<0.0001=moderate correlation). The Spearman correlation coefficient was 0.73 for astigmatism (Plusoptix ® vs. Retinomax ® comparison; P<0.0001=strong correlation). The Plusoptix ® sensitivity for measurement of refraction was 57%, 43% and 43% respectively for spherical equivalent, sphere and astigmatism. The correlation of astigmatism values is strong, whereas the correlation of sphere values is moderate. Plusoptix ® seems to be unable to measure the exact refraction, because there is too large a dispersion of refraction measurements with Plusoptix ® , compared to the exact refraction measured with the Retinomax ® . Moreover, the sensitivity of Plusoptix ® is low. Cycloplegic refraction remains indispensable in children. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The use of one- versus two-tailed tests to evaluate prevention programs.

PubMed

Ringwalt, Chris; Paschall, M J; Gorman, Dennis; Derzon, James; Kinlaw, Alan

2011-06-01

Investigators have used both one- and two-tailed tests to determine the significance of findings yielded by program evaluations. While the literature that addresses the appropriate use of each type of significance test should be used is historically inconsistent, almost all authorities now agree that one-tailed tests are rarely (if ever) appropriate. A review of 85 published evaluations of school-based drug prevention curricula specified on the National Registry of Effective Programs and Practices revealed that 20% employed one-tailed tests and, within this subgroup, an additional 4% also employed two-tailed tests. The majority of publications either did not specify the type of statistical test employed or used some other criterion such as effect sizes or confidence intervals. Evaluators reported that they used one-tailed tests either because they stipulated the direction of expected findings in advance, or because prior evaluations of similar programs had yielded no negative results. The authors conclude that one-tailed tests should never be used because they introduce greater potential for Type I errors and create an uneven playing field when outcomes are compared across programs. The authors also conclude that the traditional threshold of significance that places α at .05 is arbitrary and obsolete, and that evaluators should consistently report the exact p values they find.

Spatial extent of branching Brownian motion.

PubMed

Ramola, Kabir; Majumdar, Satya N; Schehr, Grégory

2015-04-01

We study the one-dimensional branching Brownian motion starting at the origin and investigate the correlation between the rightmost (X(max)≥0) and leftmost (X(min)≤0) visited sites up to time t. At each time step the existing particles in the system either diffuse (with diffusion constant D), die (with rate a), or split into two particles (with rate b). We focus on the regime b≤a where these two extreme values X(max) and X(min) are strongly correlated. We show that at large time t, the joint probability distribution function (PDF) of the two extreme points becomes stationary P(X,Y,t→∞)→p(X,Y). Our exact results for p(X,Y) demonstrate that the correlation between X(max) and X(min) is nonzero, even in the stationary state. From this joint PDF, we compute exactly the stationary PDF p(ζ) of the (dimensionless) span ζ=(X(max)-X(min))/√[D/b], which is the distance between the rightmost and leftmost visited sites. This span distribution is characterized by a linear behavior p(ζ)∼1/2(1+Δ)ζ for small spans, with Δ=(a/b-1). In the critical case (Δ=0) this distribution has a nontrivial power law tail p(ζ)∼8π√[3]/ζ(3) for large spans. On the other hand, in the subcritical case (Δ>0), we show that the span distribution decays exponentially as p(ζ)∼(A(2)/2)ζexp(-√[Δ]ζ) for large spans, where A is a nontrivial function of Δ, which we compute exactly. We show that these asymptotic behaviors carry the signatures of the correlation between X(max) and X(min). Finally we verify our results via direct Monte Carlo simulations.

Spatial extent of branching Brownian motion

NASA Astrophysics Data System (ADS)

Ramola, Kabir; Majumdar, Satya N.; Schehr, Grégory

2015-04-01

We study the one-dimensional branching Brownian motion starting at the origin and investigate the correlation between the rightmost (Xmax≥0 ) and leftmost (Xmin≤0 ) visited sites up to time t . At each time step the existing particles in the system either diffuse (with diffusion constant D ), die (with rate a ), or split into two particles (with rate b ). We focus on the regime b ≤a where these two extreme values Xmax and Xmin are strongly correlated. We show that at large time t , the joint probability distribution function (PDF) of the two extreme points becomes stationary P (X ,Y ,t →∞ )→p (X ,Y ) . Our exact results for p (X ,Y ) demonstrate that the correlation between Xmax and Xmin is nonzero, even in the stationary state. From this joint PDF, we compute exactly the stationary PDF p (ζ ) of the (dimensionless) span ζ =(Xmax-Xmin) /√{D /b } , which is the distance between the rightmost and leftmost visited sites. This span distribution is characterized by a linear behavior p (ζ ) ˜1/2 (1 +Δ ) ζ for small spans, with Δ =(a/b -1 ) . In the critical case (Δ =0 ) this distribution has a nontrivial power law tail p (ζ ) ˜8 π √{3 }/ζ3 for large spans. On the other hand, in the subcritical case (Δ >0 ), we show that the span distribution decays exponentially as p (ζ ) ˜(A2/2 ) ζ exp(-√{Δ }ζ ) for large spans, where A is a nontrivial function of Δ , which we compute exactly. We show that these asymptotic behaviors carry the signatures of the correlation between Xmax and Xmin. Finally we verify our results via direct Monte Carlo simulations.

Analysis of the single-vehicle cyclic inventory routing problem

NASA Astrophysics Data System (ADS)

Aghezzaf, El-Houssaine; Zhong, Yiqing; Raa, Birger; Mateo, Manel

2012-11-01

The single-vehicle cyclic inventory routing problem (SV-CIRP) consists of a repetitive distribution of a product from a single depot to a selected subset of customers. For each customer, selected for replenishments, the supplier collects a corresponding fixed reward. The objective is to determine the subset of customers to replenish, the quantity of the product to be delivered to each and to design the vehicle route so that the resulting profit (difference between the total reward and the total logistical cost) is maximised while preventing stockouts at each of the selected customers. This problem appears often as a sub-problem in many logistical problems. In this article, the SV-CIRP is formulated as a mixed-integer program with a nonlinear objective function. After a thorough analysis of the structure of the problem and its features, an exact algorithm for its solution is proposed. This exact algorithm requires only solutions of linear mixed-integer programs. Values of a savings-based heuristic for this problem are compared to the optimal values obtained for a set of some test problems. In general, the gap may get as large as 25%, which justifies the effort to continue exploring and developing exact and approximation algorithms for the SV-CIRP.

Accuracy of an HRP-2/panLDH rapid diagnostic test to detect peripheral and placental Plasmodium falciparum infection in Papua New Guinean women with anaemia or suspected malaria.

PubMed

Umbers, Alexandra J; Unger, Holger W; Rosanas-Urgell, Anna; Wangnapi, Regina A; Kattenberg, Johanna H; Jally, Shadrach; Silim, Selina; Lufele, Elvin; Karl, Stephan; Ome-Kaius, Maria; Robinson, Leanne J; Rogerson, Stephen J; Mueller, Ivo

2015-10-19

The diagnosis of malaria during pregnancy is complicated by placental sequestration, asymptomatic infection, and low-density peripheral parasitaemia. Where intermittent preventive treatment (IPT) with sulfadoxine-pyrimethamine is threatened by drug resistance, or is inappropriate due to low transmission, intermittent screening and treatment (ISTp) with rapid diagnostic tests for malaria (RDT) could be a valuable alternative. Therefore, the accuracy of RDTs to detect peripheral and placental infection was assessed in a declining transmission setting in Papua New Guinea (PNG). The performance of a combination RDT detecting histidine-rich protein-2 (HRP-2) and Plasmodium lactate dehydrogenase (pLDH), and light microscopy (LM), to diagnose peripheral Plasmodium falciparum and Plasmodium vivax infections during pregnancy, were assessed using quantitative real-time PCR (qPCR) as the reference standard. Participants in a malaria prevention trial in PNG with a haemoglobin ≤90 g/L, or symptoms suggestive of malaria, were tested. Ability of RDT and LM to detect active placental infection on histology was evaluated in some participants. Among 876 women, 1162 RDTs were undertaken (anaemia: 854 [73.5 %], suspected malaria: 308 [26.5 %]). qPCR detected peripheral infection during 190 RDT episodes (165 P. falciparum, 19 P. vivax, 6 mixed infections). Overall, RDT detected peripheral P. falciparum infection with 45.6 % sensitivity (95 % CI 38.0-53.4), a specificity of 96.4 % (95.0-97.4), a positive predictive value of 68.4 % (59.1-76.8), and a negative predictive value of 91.1 % (89.2-92.8). RDT performance to detect P. falciparum was inferior to LM, more so amongst anaemic women (18.6 vs 45.3 % sensitivity, Liddell's exact test, P < 0.001) compared to symptomatic women (72.9 vs 82.4 % sensitivity, P = 0.077). RDT and LM missed 88.0 % (22/25) and 76.0 % (19/25) of P. vivax infections, respectively. In a subset of women tested at delivery and who had placental histology (n = 158) active placental infection was present in 19.6 %: all three peripheral blood infection detection methods (RDT, LM, qPCR) missed >50 % of these infections. In PNG, HRP-2/pLDH RDTs may be useful to diagnose peripheral P. falciparum infections in symptomatic pregnant women. However, they are not sufficiently sensitive for use in intermittent screening amongst asymptomatic (anaemic) women. These findings have implications for the management of malaria in pregnancy. The adverse impact of infections undetected by RDT or LM on pregnancy outcomes needs further evaluation.

Parameters of blood count and tumor markers in patients with borderline ovarian tumors: a retrospective analysis and relation to staging.

PubMed

Nomelini, Rosekeila Simões; da Silva, Taísa Morete; Tavares Murta, Beatriz Martins; Murta, Eddie Fernando Candido

2012-01-01

The aim of this paper was to evaluate the parameters of blood count and tumor markers in borderline ovarian tumors. We evaluated 21 patients who had confirmed histopathologic diagnosis of borderline ovarian tumor. We recorded age, parity, tumor type, stage of cancer, serum levels of tumor markers (CA-125, CA-15.3, CA-19.9, CEA, AFP), and the parameters of blood count, fasting glucose, disease-free survival and overall. The patients were divided into two groups, stage IA (n = 13) and stage IB-IIIC (n = 8). The unpaired t-test and Fisher's exact test were used, with P values of less than 0.05 being considered to indicate statistical significance. Levels of red blood cells, hematocrit, and hemoglobin were significantly higher in stage IA when compared with stage IB-IIIC (P < 0.05). The levels of tumor marker CEA had a tendency to be higher in the group stage IB-IIIC (0.08). Abnormal levels of CEA and CA-19.9 were found more frequently in stages IB-IIIC. Therefore, parameters of blood count, CEA, and CA-19.9 should be targeted for further research in identifying prognostic factors in borderline tumors.

Piecewise-homotopy analysis method (P-HAM) for first order nonlinear ODE

NASA Astrophysics Data System (ADS)

Chin, F. Y.; Lem, K. H.; Chong, F. S.

2013-09-01

In homotopy analysis method (HAM), the determination for the value of the auxiliary parameter h is based on the valid region of the h-curve in which the horizontal segment of the h-curve will decide the valid h-region. All h-value taken from the valid region, provided that the order of deformation is large enough, will in principle yield an approximation series that converges to the exact solution. However it is found out that the h-value chosen within this valid region does not always promise a good approximation under finite order. This paper suggests an improved method called Piecewise-HAM (P-HAM). In stead of a single h-value, this method suggests using many h-values. Each of the h-values comes from an individual h-curve while each h-curve is plotted by fixing the time t at a different value. Each h-value is claimed to produce a good approximation only about a neighborhood centered at the corresponding t which the h-curve is based on. Each segment of these good approximations is then joined to form the approximation curve. By this, the convergence region is enhanced further. The P-HAM is illustrated and supported by examples.

Cytotoxic constituents of Pachyrhizus tuberosus from Peruvian amazon.

PubMed

Leuner, Olga; Havlik, Jaroslav; Budesinsky, Milos; Vrkoslav, Vladimir; Chu, Jessica; Bradshaw, Tracey D; Hummelova, Jana; Miksatkova, Petra; Lapcik, Oldrich; Valterova, Irena; Kokoska, Ladislav

2013-10-01

Investigations into the chemical constituents of the seeds of the neglected tuber crop Pachyrhizus tuberosus (Leguminosae) resulted in the isolation of seven components: five rotenoids [12a-hydroxyerosone (1), 12a-hydroxydolineone (2), erosone (3), 12a-hydroxyrotenone (4) and rotenone (6)], a phenylfuranocoumarin [pachyrrhizine (5)] and an isoflavanone [neotenone (7)]. The compounds were isolated using several chromatography techniques and characterized and verified by NMR and HPLC/MS. The MTT assay was used to examine the selective cytotoxic effects of the methanolic P. tuberosus extract and isolated compounds in two human cancer cell lines [breast (MCF-7) and colorectal (HCT-116)] and in non-transformed human fibroblasts (MRC-5); IC50 values were calculated. The methanolic P. tuberosus extract displayed respectable cytotoxic effects against HCT-116 and MCF-7 cells with IC50 values of 7.3 and 6.3 microg/mL, respectively. Of the compounds, 6 exacted greatest cytotoxicity and selectivity towards the cancer cell lines tested, yielding IC50 values of 0.3 microg/mL against both MCF-7 and HCT-116 cells, and a 6-fold reduced activity against MRC-5 fibroblasts. Compound 4 also demonstrated cytotoxicity against MCF-7 and HCT-116 (1.1 and 1.8 microg/mL, respectively), and reduced cytotoxicity towards MRC-5 cells (7.5 mirog/mL). The results revealed from the in vitro cytotoxic MTT assay are worthy of further antitumor investigation.

Could texture features from preoperative CT image be used for predicting occult peritoneal carcinomatosis in patients with advanced gastric cancer?

PubMed

Kim, Hae Young; Kim, Young Hoon; Yun, Gabin; Chang, Won; Lee, Yoon Jin; Kim, Bohyoung

2018-01-01

To retrospectively investigate whether texture features obtained from preoperative CT images of advanced gastric cancer (AGC) patients could be used for the prediction of occult peritoneal carcinomatosis (PC) detected during operation. 51 AGC patients with occult PC detected during operation from January 2009 to December 2012 were included as occult PC group. For the control group, other 51 AGC patients without evidence of distant metastasis including PC, and whose clinical T and N stage could be matched to those of the patients of the occult PC group, were selected from the period of January 2011 to July 2012. Each group was divided into test (n = 41) and validation cohort (n = 10). Demographic and clinical data of these patients were acquired from the hospital database. Texture features including average, standard deviation, kurtosis, skewness, entropy, correlation, and contrast were obtained from manually drawn region of interest (ROI) over the omentum on the axial CT image showing the omentum at its largest cross sectional area. After using Fisher's exact and Wilcoxon signed-rank test for comparison of the clinical and texture features between the two groups of the test cohort, conditional logistic regression analysis was performed to determine significant independent predictor for occult PC. Using the optimal cut-off value from receiver operating characteristic (ROC) analysis for the significant variables, diagnostic sensitivity and specificity were determined in the test cohort. The cut-off value of the significant variables obtained from the test cohort was then applied to the validation cohort. Bonferroni correction was used to adjust P value for multiple comparisons. Between the two groups, there was no significant difference in the clinical features. Regarding the texture features, the occult PC group showed significantly higher average, entropy, standard deviation, and significantly lower correlation (P value < 0.004 for all). Conditional logistic regression analysis demonstrated that entropy was significant independent predictor for occult PC. When the cut-off value of entropy (> 7.141) was applied to the validation cohort, sensitivity and specificity for the prediction of occult PC were 80% and 90%, respectively. For AGC patients whose PC cannot be detected with routine imaging such as CT, texture analysis may be a useful adjunct for the prediction of occult PC.

Efficient exact motif discovery.

PubMed

Marschall, Tobias; Rahmann, Sven

2009-06-15

The motif discovery problem consists of finding over-represented patterns in a collection of biosequences. It is one of the classical sequence analysis problems, but still has not been satisfactorily solved in an exact and efficient manner. This is partly due to the large number of possibilities of defining the motif search space and the notion of over-representation. Even for well-defined formalizations, the problem is frequently solved in an ad hoc manner with heuristics that do not guarantee to find the best motif. We show how to solve the motif discovery problem (almost) exactly on a practically relevant space of IUPAC generalized string patterns, using the p-value with respect to an i.i.d. model or a Markov model as the measure of over-representation. In particular, (i) we use a highly accurate compound Poisson approximation for the null distribution of the number of motif occurrences. We show how to compute the exact clump size distribution using a recently introduced device called probabilistic arithmetic automaton (PAA). (ii) We define two p-value scores for over-representation, the first one based on the total number of motif occurrences, the second one based on the number of sequences in a collection with at least one occurrence. (iii) We describe an algorithm to discover the optimal pattern with respect to either of the scores. The method exploits monotonicity properties of the compound Poisson approximation and is by orders of magnitude faster than exhaustive enumeration of IUPAC strings (11.8 h compared with an extrapolated runtime of 4.8 years). (iv) We justify the use of the proposed scores for motif discovery by showing our method to outperform other motif discovery algorithms (e.g. MEME, Weeder) on benchmark datasets. We also propose new motifs on Mycobacterium tuberculosis. The method has been implemented in Java. It can be obtained from http://ls11-www.cs.tu-dortmund.de/people/marschal/paa_md/.

Prevalence of Human Parainfluenza Viruses and Noroviruses Genomes on Office Fomites.

PubMed

Stobnicka, Agata; Gołofit-Szymczak, Małgorzata; Wójcik-Fatla, Angelina; Zając, Violetta; Korczyńska-Smolec, Joanna; Górny, Rafał L

2018-06-01

The aim of this study was to evaluate the potential role of office fomites in respiratory (human parainfluenza virus 1-HPIV1, human parainfluenza virus 3-HPIV3) and enteric (norovirus GI-NoV GI, norovirus GII-NoV GII) viruses transmission by assessing the occurrence of these viruses on surfaces in office buildings. Between 2016 and 2017, a total of 130 surfaces from open-space and non-open-space rooms in office buildings located in one city were evaluated for HPIV1, HPIV3, NoV GI, and NoV GII viral RNA presence. Detection of viruses was performed by RT-qPCR method. Study revealed 27 positive samples, among them 59.3% were HPIV3-positive, 25.9% HPIV1-positive, and 14.8% NoV GII-positive. All tested surfaces were NoV GI-negative. Statistical analysis of obtained data showed that the surfaces of office equipment including computer keyboards and mice, telephones, and desktops were significantly more contaminated with respiratory viruses than the surfaces of building equipment elements such as door handles, light switches, or ventilation tracts (χ 2 p = 0.006; Fisher's Exact p = 0.004). All examined surfaces were significantly more contaminated with HPIVs than NoVs (χ 2 p = 0.002; Fisher's Exact p = 0.003). Office fomites in open-space rooms were more often contaminated with HPIVs than with NoVs (χ 2 p = 0.016; Fisher's Exact p = 0.013). The highest average concentration of HPIVs RNA copies was observed on telephones (1.66 × 10 2 copies/100 cm 2 ), while NoVs on the light switches (1.40 × 10 2 copies/100 cm 2 ). However, the Kruskal-Wallis test did not show statistically significant differences in concentration levels of viral RNA copies on surfaces between the all tested samples. This study unequivocally showed that individuals in office environment may have contact with both respiratory and enteric viral particles present on frequently touched surfaces.

Intravenous magnesium sulfate for vaso-occlusive episodes in sickle cell disease.

PubMed

Goldman, Ran D; Mounstephen, William; Kirby-Allen, Melanie; Friedman, Jeremy N

2013-12-01

Vaso-occlusive episodes (VOEs) are the most common complication of sickle cell disease in children. Treatment with magnesium seems to improve cellular hydration and may result in reduced vaso-occlusion. This study aimed to determine if intravenous (IV) magnesium sulfate (MgSO4) reduces length of stay (LOS) in hospital, pain scores, and cumulative analgesia when compared with placebo. Randomized, double-blind, placebo-controlled trial in children aged 4 to 18 years requiring admission to hospital with a sickle cell disease VOE requiring IV analgesia. Participating children received IV MgSO4 (100 mg/kg) every 8 hours or placebo in addition to standard therapy. We used a t test or Mann-Whitney test (continuous variables), Fisher's exact test, or χ2 test (frequencies). P values were considered significant if <.05, and 95% confidence intervals were calculated for the difference between groups. One hundred six children were randomly assigned to the study, and 104 were included. Fifty-one (49%) received MgSO4. Children's mean age was 12.4 years (range: 4-18 years; SD: 3.8 years), and 56 (54%) were females. There was no significant difference in the primary outcome measure, LOS in hospital, with a mean of 132.6 and 117.7 hours in the MgSO4 and placebo groups, respectively (P = .41). There was no significant difference between groups for the secondary outcomes of mean pain scores (4.9 ± 2.6 vs 4.8 ± 2.6, respectively; P = .92) or analgesic requirements (continuous morphine infusion [P = .928], boluses of IV morphine [P = .82], acetaminophen [P = .34], ibuprofen [P = .15], naproxen [P = .10]). Only minor adverse events were recorded in both groups. Pain at the infusion site was more common in the MgSO4 group. IV MgSO4 was well tolerated but had no effect on the LOS in hospital, pain scores, or cumulative analgesia use in admitted children with a VOE.

A comparison of the effect of early insertion of standard latex and silver-impregnated latex foley catheters on urinary tract infections in burn patients.

PubMed

Newton, Terry; Still, Joseph M; Law, Edward

2002-04-01

A retrospective study was designed to compare the incidence of urinary tract infections during two different time periods in burn patients treated with two different types of Foley catheters. In time period 1, latex catheters present on admission were not changed. In time period 2, catheters were replaced on admission with silver alloy-impregnated catheters. In time period 1, the rate of symptomatic urinary tract infections was 7.2 per 1,000 catheter-days. In time period 2, the rate was 4.4 per 1,000 catheter-days. Results, compared using Fisher's exact test, revealed a statistically significant P value of .029. The use of silver-impregnated catheters significantly lowered the rate of urinary tract infection at our burn center.

ELA-DRA polymorphisms are not associated with Equine Arteritis Virus infection in horses from Argentina.

PubMed

Kalemkerian, P B; Metz, G E; Peral-Garcia, P; Echeverria, M G; Giovambattista, G; Díaz, S

2012-12-01

Polymorphisms at Major Histocompatibility Complex (MHC) genes have been associated with resistance/susceptibility to infectious diseases in domestic animals. The aim of this investigation was to evaluate whether polymorphisms of the DRA gene the Equine Lymphocyte Antigen is associated with susceptibility to Equine Arteritis Virus (EAV) infection in horses in Argentina. The equine DRA gene was screened for polymorphisms using Pyrosequencing® Technology which allowed the detection of three ELA-DRA exon 2 alleles. Neither allele frequencies nor genotypic differentiation exhibited any statistically significant (P-values=0.788 and 0.745) differences between the EAV-infected and no-infected horses. Fisher's exact test and OR calculations did not show any significant association. As a consequence, no association could be established between the serological condition and ELA-DRA. Copyright © 2012 Elsevier Ltd. All rights reserved.

Influence of torque control motors and the operator's proficiency on ProTaper failures.

PubMed

Yared, Ghassan; Bou Dagher, Fadia; Kulkarni, Kiran

2003-08-01

The purpose of this study was to evaluate the influence of 2 electric torque control motors and operator experience with a specific nickel-titanium rotary instrumentation technique on the incidence of deformation and separation of instruments. ProTaper (PT) nickel-titanium rotary instruments were used at 300 rpm. In the first part of the study, electric high torque control (group 1) and low torque control (group 2) motors were compared. In the second part of the study, 3 operators with varying experience (groups 3, 4, and 5) were also compared. Twenty sets of PT instruments and 100 canals of extracted human molars were used in each group. Each set of PT instruments was used in up to 5 canals and sterilized before each case. For irrigation, 2.5% NaOCl was used. The number of deformed and separated instruments among the groups (within each part of the study) was statistically analyzed for significance with pair-wise comparisons by using the Fisher exact test (alpha =.05). In part 1, instrument deformation and separation did not occur in groups 1 and 2. In part 2, 25 and 12 instruments were deformed and separated, respectively, with the least experienced operator. Instrument deformation and separation did not occur with the most experienced operator. The Fisher exact test revealed a significant difference between groups 3 and 4 with respect to instrument deformation (P =.0296). In addition, the Fisher exact test revealed that the incidence of instrument deformation was statistically different between groups 3 and 5 (P <.0001) and groups 4 and 5 (P =.0018). The incidence of instrument separation was significantly higher in group 5 than in groups 3 and 4 (P =.001). Preclinical training in the use of the PT technique at 300 rpm is crucial to prevent instrument separation and reduce the incidence of instrument deformation. The use of an electric high torque control motor is safe with the experienced operator.

Supragingival calculus in children with gastrostomy feeding: significant reduction with a caregiver-applied tartar-control dentifrice.

PubMed

Brown, Laurie M; Casamassimo, Paul S; Griffen, Ann; Tatakis, Dimitris

2006-01-01

This study assessed the anti-calculus benefit of Crest Dual Action Whitening Toothpaste in gastrostomy (GT) children compared to a control anti-caries dentifrice. A double-blind randomized crossover design was used to compare the two dentifrices. A convenience sample of 24 GT subjects, 3-12 years old, was given a consensus baseline Volpe-Manhold Index calculus score by 2 trained examiners, followed by a dental prophylaxis to remove all calculus. Each child was randomly assigned to either study or control dentifrice groups. Caregivers brushed subjects' teeth twice daily with the unlabelled dentifrice for at least 45 seconds. Calculus was scored at 8 weeks (+/- 1 week) by the same investigators. Subjects then had a prophylaxis and received the alternative dentifrice. Subjects returned 8 weeks (+/- 1 week) later for final calculus scoring. The study dentifrice significantly reduced supragingival calculus from baseline by 58% compared to control dentifrice (p<0.005 need exact p-value unless it is <.001; maybe it's reported in the paper). Calculus levels decreased by 68% over the study duration, irrespective of dentifrice. ANOVA found no significant differences in calculus scores based on gender, race, history of reflux, aspiration pneumonia, or oral intake of food. Calculus was significantly related to history of aspiration pneumonia (p<0.05 need exact p-value here). Crest Dual Action Whitening Toothpaste was effective and better than anti-caries control dentifrice in reducing calculus in GT children.

[Reduced fasting time improves comfort and satisfaction of elderly patients undergoing anesthesia for hip fracture].

PubMed

Imbelloni, Luiz Eduardo; Pombo, Illova Anaya Nasiane; Filho, Geraldo Borges de Morais

2015-01-01

Patient's satisfaction is a standard indicator of care quality. The aim of this study was to evaluate whether a preoperative oral ingestion of 200mL of a carbohydrate drink can improve comfort and satisfaction with anesthesia in elderly patients with hip fracture. Prospective randomized clinical trial conducted in a Brazilian public hospital, with patients ASA I-III undergoing surgery for hip fracture. The control group (NPO) received nothing by mouth after 9:00 p.m. the night before, while patients in the experimental group (CHO) received 200mL of a carbohydrate drink 2-4hours before the operation. Patients' characteristics, subjective perceptions, thirst and hunger and satisfaction were determined in four steps. Mann-Whitney U-test and Fisher exact test were used for comparison of control and experimental groups. A p-value <0.05 was considered significant. A total of 100 patients were included in one of two regimens of preoperative fasting. Fasting time decreased significantly in the study group. Patients drank 200mL 2:59h before surgery and showed no hunger (p <0.00) and thirsty on arrival to OR (p <0.00), resulting in increased satisfaction with the perioperative anesthesia care (p <0.00). The satisfaction questionnaire for surgical patient could become a useful tool in assessing the quality of care. In conclusion, CHO significantly reduces preoperative discomfort and increases satisfaction with anesthesia care. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Prevalence of scientific misconduct among a group of researchers in Nigeria.

PubMed

Okonta, Patrick; Rossouw, Theresa

2013-12-01

There is a dearth of information on the prevalence of scientific misconduct from Nigeria. This study aimed at determining the prevalence of scientific misconduct in a group of researchers in Nigeria. Factors associated with the prevalence were ascertained. A descriptive study of researchers who attended a scientific conference in 2010 was conducted using the adapted Scientific Misconduct Questionnaire-Revised (SMQ-R). Ninety-one researchers (68.9%) admitted having committed at least one of the eight listed forms of scientific misconduct. Disagreement about authorship was the most common form of misconduct committed (36.4%) while plagiarism was the least (9.2%). About 42% of researchers had committed falsification of data or plagiarism. Analysis of specific acts of misconduct showed that committing plagiarism was inversely associated with years in research (Fisher exact p-value = 0.02); falsifying data was related to perceived low effectiveness of the institution's rules and procedures for reducing scientific misconduct (X(2) = 6.44, p-value = 0.01); and succumbing to pressure from study sponsor to engage in unethical practice was related to sex of researcher (Fisher exact p-value = 0.02). The emergent data from this study is a cause for serious concern and calls for prompt intervention. The best response to reducing scientific misconduct will proceed from measures that contain both elements of prevention and enforcement. Training on research ethics has to be integrated into the curriculum of undergraduate and postgraduate students while provision should be made for in-service training of researchers. Penalties against acts of scientific misconduct should be enforced at institutional and national levels. © 2012 John Wiley & Sons Ltd.

Multi-Sample Cluster Analysis Using Akaike’s Information Criterion.

DTIC Science & Technology

1982-12-20

Intervals. For more details on these test procedures refer to Gabriel [7J, Krishnaiah (CIlUj, [11]), Srivastava [16), and others. -3- As noted in Consul...723. (4] Consul, P. C. (1969), "The Exact Distributions of Likelihood Criteria for Different Hypotheses," in P. R. Krishnaiah (Ed.), Multivariate...1178. [7] Gabriel, K. R. (1969), "A Comparison of Some lethods of Simultaneous Inference in MANOVA," in P. R. Krishnaiah (Ed.), Multivariate Analysis-lI

Differential DNA hypermethylation of critical genes mediates the stage-specific tobacco smoke-induced neoplastic progression of lung cancer.

PubMed

Russo, Andrea L; Thiagalingam, Arunthathi; Pan, Hongjie; Califano, Joseph; Cheng, Kuang-hung; Ponte, Jose F; Chinnappan, Dharmaraj; Nemani, Pratima; Sidransky, David; Thiagalingam, Sam

2005-04-01

Promoter DNA methylation status of six genes in samples derived from 27 bronchial epithelial cells and matching blood samples from 22 former/current smokers and five nonsmokers as well as 49 primary non-small cell lung cancer samples with corresponding blood controls was determined using methylation-specific PCR (MSP). Lung tumor tissues showed a significantly higher frequency of promoter DNA methylation in p16, MGMT, and DAPK (P < 0.05; Fisher's exact test). p16 promoter DNA methylation in tumors was observed at consistently higher levels when compared with all the other samples analyzed (P = 0.001; Fisher's exact test). ECAD and DAPK exhibited statistically insignificant differences in their levels of DNA methylation among the tumors and bronchial epithelial cells from the smokers. Interestingly, similar levels of methylation were observed in bronchial epithelial cells and corresponding blood from smokers for all four genes (ECAD, p16, MGMT, and DAPK) that showed smoking/lung cancer-associated methylation changes. In summary, our data suggest that targeted DNA methylation silencing of ECAD and DAPK occurs in the early stages and that of p16 and MGMT in the later stages of lung cancer progression. We also provide preliminary evidence that peripheral lymphocytes could potentially be used as a surrogate for bronchial epithelial cells to detect altered DNA methylation in smokers.

Magnifying endoscopy for the diagnosis of specialized intestinal metaplasia in short-segment Barrett's esophagus.

PubMed

Ham, Nam Seok; Jang, Jae Young; Ryu, Sung Woo; Kim, Ji Hye; Park, Eui Ju; Lee, Woong Cheul; Shim, Kwang Yeun; Jeong, Soung Won; Kim, Hyun Gun; Lee, Tae Hee; Jeon, Sung Ran; Cho, Jun Hyung; Cho, Joo Young; Jin, So Young; Lee, Ji Sung

2013-11-07

To determine whether magnified observation of short-segment Barrett's esophagus (BE) is useful for the detection of specialized intestinal metaplasia (SIM). Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to × 80. The magnified images were analyzed with respect to their pit-patterns, which were simultaneously classified into five epithelial types [I (small round), II (straight), III (long oval), IV (tubular), V (villous)] by Endo's classification. Then, a 0.5% solution of methylene blue (MB) was sprayed over columnar mucosa. The patterns of the magnified image and MB staining were analyzed. Biopsies were obtained from the regions previously observed by magnifying endoscopy and MB chromoendoscopy. Three of five patients with a type V (villous) epithelial pattern had SIM, whereas 21 patients with a non-type V epithelial patterns did not have SIM. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of pit-patterns in detecting SIM were 100%, 91.3%, 92.3%, 60% and 100%, respectively (P = 0.004). Three of the 12 patients with positive MB staining had SIM, whereas 14 patients with negative MB staining did not have SIM. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of MB staining in detecting SIM were 100%, 60.9%, 65.4%, 25% and 100%, respectively (P = 0.085). The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar's test (P = 0.0391). The magnified observation of a short-segment BE according to the mucosal pattern and its classification can be predictive of SIM.

A note on Poisson goodness-of-fit tests for ionizing radiation induced chromosomal aberration samples.

PubMed

Higueras, Manuel; González, J E; Di Giorgio, Marina; Barquinero, J F

2018-06-13

To present Poisson exact goodness-of-fit tests as alternatives and complements to the asymptotic u-test, which is the most widely used in cytogenetic biodosimetry, to decide whether a sample of chromosomal aberrations in blood cells comes from an homogeneous or inhomogeneous exposure. Three Poisson exact goodness-of-fit test from the literature are introduced and implemented in the R environment. A Shiny R Studio application, named GOF Poisson, has been updated for the purpose of giving support to this work. The three exact tests and the u-test are applied in chromosomal aberration data from clinical and accidental radiation exposure patients. It is observed how the u-test is not an appropriate approximation in small samples with small yield of chromosomal aberrations. Tools are provided to compute the three exact tests, which is not as trivial as the implementation of the u-test. Poisson exact goodness-of-fit tests should be considered jointly to the u-test for detecting inhomogeneous exposures in the cytogenetic biodosimetry practice.

On optimizing the treatment of exchange perturbations.

NASA Technical Reports Server (NTRS)

Hirschfelder, J. O.; Chipman, D. M.

1972-01-01

Most theories of exchange perturbations would give the exact energy and wave function if carried out to an infinite order. However, the different methods give different values for the second-order energy, and different values for E(1), the expectation value of the Hamiltonian corresponding to the zeroth- plus first-order wave function. In the presented paper, it is shown that the zeroth- plus first-order wave function obtained by optimizing the basic equation which is used in most exchange perturbation treatments is the exact wave function for the perturbation system and E(1) is the exact energy.

Evaluation and Comparison of Multiple Test Methods, Including Real-time PCR, for Legionella Detection in Clinical Specimens

PubMed Central

Peci, Adriana; Winter, Anne-Luise; Gubbay, Jonathan B.

2016-01-01

Legionella is a Gram-negative bacterium that can cause Pontiac fever, a mild upper respiratory infection and Legionnaire’s disease, a more severe illness. We aimed to compare the performance of urine antigen, culture, and polymerase chain reaction (PCR) test methods and to determine if sputum is an acceptable alternative to the use of more invasive bronchoalveolar lavage (BAL). Data for this study included specimens tested for Legionella at Public Health Ontario Laboratories from 1st January, 2010 to 30th April, 2014, as part of routine clinical testing. We found sensitivity of urinary antigen test (UAT) compared to culture to be 87%, specificity 94.7%, positive predictive value (PPV) 63.8%, and negative predictive value (NPV) 98.5%. Sensitivity of UAT compared to PCR was 74.7%, specificity 98.3%, PPV 77.7%, and NPV 98.1%. Out of 146 patients who had a Legionella-positive result by PCR, only 66 (45.2%) also had a positive result by culture. Sensitivity for culture was the same using either sputum or BAL (13.6%); sensitivity for PCR was 10.3% for sputum and 12.8% for BAL. Both sputum and BAL yield similar results regardless testing methods (Fisher Exact p-values = 1.0, for each test). In summary, all test methods have inherent weaknesses in identifying Legionella; therefore, more than one testing method should be used. Obtaining a single specimen type from patients with pneumonia limits the ability to diagnose Legionella, particularly when urine is the specimen type submitted. Given ease of collection and similar sensitivity to BAL, clinicians are encouraged to submit sputum in addition to urine when BAL submission is not practical from patients being tested for Legionella. PMID:27630979

The effect of pheniramine on fentanyl-induced cough: a randomized, double blinded, placebo controlled clinical study.

PubMed

Arslan, Zakir; Çalık, Eyup Serhat; Kaplan, Bekir; Ahiskalioglu, Elif Oral

2016-01-01

There are many studies conducted on reducing the frequency and severity of fentayl-induced cough during anesthesia induction. We propose that pheniramine maleate, an antihistaminic, may suppress this cough. We aim to observe the effect of pheniramine on fentanyl-induced cough during anesthesia induction. This is a double-blinded, prospective, three-arm parallel, randomized clinical trial of 120 patients with ASA (American Society of Anesthesiologists) physical status III and IV who aged ≥18 and scheduled for elective open heart surgery during general anesthesia. Patients were randomly assigned to three groups of 40 patients, using computer-generated random numbers: placebo group, pheniramine group, and lidocaine group. Cough incidence differed significantly between groups. In the placebo group, 37.5% of patients had cough, whereas the frequency was significantly decreased in pheniramine group (5%) and lidocaine group (15%) (Fischer exact test, p=0.0007 and p=0.0188, respectively). There was no significant change in cough incidence between pheniramine group (5%) and lidocaine group (15%) (Fischer exact test, p=0.4325). Cough severity did also change between groups. Post Hoc tests with Bonferroni showed that mean cough severity in placebo differed significantly than that of pheniramine group and lidocaine group (p<0.0001 and p=0.009, respectively). There was no significant change in cough severity between pheniramine group and lidocaine group (p=0.856). Intravenous pheniramine is as effective as lidocaine in preventing fentayl-induced cough. Our results emphasize that pheniramine is a convenient drug to decrease this cough. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Robust validation of approximate 1-matrix functionals with few-electron harmonium atoms

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

Cioslowski, Jerzy, E-mail: jerzy@wmf.univ.szczecin.pl; Piris, Mario; Matito, Eduard

2015-12-07

A simple comparison between the exact and approximate correlation components U of the electron-electron repulsion energy of several states of few-electron harmonium atoms with varying confinement strengths provides a stringent validation tool for 1-matrix functionals. The robustness of this tool is clearly demonstrated in a survey of 14 known functionals, which reveals their substandard performance within different electron correlation regimes. Unlike spot-testing that employs dissociation curves of diatomic molecules or more extensive benchmarking against experimental atomization energies of molecules comprising some standard set, the present approach not only uncovers the flaws and patent failures of the functionals but, even moremore » importantly, also allows for pinpointing their root causes. Since the approximate values of U are computed at exact 1-densities, the testing requires minimal programming and thus is particularly suitable for rapid screening of new functionals.« less

Penny for Your Reference

NASA Technical Reports Server (NTRS)

2004-01-01

15 April 2004 This close-up image of a penny shows the degree to which the microscopic imager on the Mars Exploration Rover Spirit can zoom in on a target. The penny is seen exactly as it would be on Mars if it were placed under the microscopic imager. This picture was taken by the imager during testing at JPL.

[figure removed for brevity, see original site] Spirit's Microscopic Vision Demonstrated

This close-up image of a penny shows the power of the microscopic imager onboard the Mars Exploration Rover Spirit to see fine details. The picture was taken by the imager during testing at JPL.

Exact test-based approach for equivalence test with parameter margin.

PubMed

Cassie Dong, Xiaoyu; Bian, Yuanyuan; Tsong, Yi; Wang, Tianhua

2017-01-01

The equivalence test has a wide range of applications in pharmaceutical statistics which we need to test for the similarity between two groups. In recent years, the equivalence test has been used in assessing the analytical similarity between a proposed biosimilar product and a reference product. More specifically, the mean values of the two products for a given quality attribute are compared against an equivalence margin in the form of ±f × σ R , where ± f × σ R is a function of the reference variability. In practice, this margin is unknown and is estimated from the sample as ±f × S R . If we use this estimated margin with the classic t-test statistic on the equivalence test for the means, both Type I and Type II error rates may inflate. To resolve this issue, we develop an exact-based test method and compare this method with other proposed methods, such as the Wald test, the constrained Wald test, and the Generalized Pivotal Quantity (GPQ) in terms of Type I error rate and power. Application of those methods on data analysis is also provided in this paper. This work focuses on the development and discussion of the general statistical methodology and is not limited to the application of analytical similarity.

Effort-Reward Imbalance and its Association with Health among Pluckers in a Tea Plantation in South India.

PubMed

Tomy, Chitra; Ramesh, Naveen; Fathima, Farah N; D'cunha, Rodney L; Chakravathi, Kote A

2017-01-01

Work-related stress is associated with cardiovascular diseases, musculoskeletal disorders, psychological ailments, and work-related injuries. Imbalance between high effort and low reward at work can lead to work stress among plantation workers. To assess the effort-reward imbalance (ERI) among pluckers in tea plantations in South India and its association on chronic health problems, substance abuses, and workplace injuries. A cross-sectional study was conducted among 346 tea pluckers from May to June 2015 in six selected tea plantations in Anamalai, South India. A short version of ERI questionnaire was used to assess the work-related stress among them. Along with ERI questionnaire, sociodemographic details, chronic diseases, substance abuses, and workplace injuries were ascertained. Sociodemographic variables were described as frequency and measures of central tendency. Tests of association, such as Chi-square test, were applied. Among the study population, 322 (93.1%) reported more effort, 23 (6.6%) reported more reward, and one (0.3%) had no imbalance between effort and reward. Those in older age group (≥51 years) experienced more effort compared to those in younger age group (≤50 years) (Fisher's exact = 21.905, P = 0.001). Educational status (Fisher's exact = 15.639, P = 0.027) and work experience (Fisher's exact = 23.122, P = 0.003) increased the effort rather than increasing the reward associated with work. No significant association was found between ERI and any chronic diseases, substance abuses, or injuries. Majority of pluckers in tea plantation experienced more effort compared to reward.

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

Derrida, B.; Nadal, J.P.

It is possible to construct diluted asymmetric models of neural networks for which the dynamics can be calculated exactly. The authors test several learning schemes, in particular, models for which the values of the synapses remain bounded and depend on the history. Our analytical results on the relative efficiencies of the various learning schemes are qualitatively similar to the corresponding ones obtained numerically on fully connected symmetric networks.

Applying translabial ultrasound to detect synthetic slings-You can do it too! A comparison of urology trainees to an attending radiologist.

PubMed

Shen, Jim K; Faaborg, Daniel; Rouse, Glenn; Kelly, Isaac; Li, Roger; Alsyouf, Muhannad; Myklak, Kristene; Distelberg, Brian; Staack, Andrea

2017-09-01

Translabial ultrasound (TUS) is a useful tool for identifying and assessing synthetic slings. This study evaluates the ability of urology trainees to learn basic pelvic anatomy and sling assessment on TUS. Eight urology trainees (six residents and two medical students) received a lecture reviewing basic anatomy and sling assessment on TUS followed by review of two training cases. Next, they underwent a 126-question examination assessing their ability to identify anatomic planes and structures in those planes, identify the presence of slings, and assess the location and intactness of a sling. The correct response rate was compared to that of an attending radiologist experienced in reading TUS. Non-parametric tests (Fisher's exact, chi-squared tests, and Yates correction) were used for statistical analysis, with P < 0.05 considered significant. 847/1008 (84.0%) of questions were answered correctly by eight trainees compared to 119/126 (94.4%) by the radiologist (P = 0.001). The trainees' correct response rates and Fisher's exact test P values associated with the difference in correct answers between radiologist and trainee were as follows: identification of anatomic plane (94.4%; P = 0.599), identification of structure in sagittal view (80.6%; P = 0.201), identification of structure in transverse view (88.2%; P = 0.696), presence of synthetic sling (95.8%; P = 1.000), location of sling along the urethra in (71.5%; P = 0.403), intactness of sling (82.6%; P = 0.311), and laterality of sling disruption (75.0%; P = 0.076). Urology trainees can quickly learn to identify anatomic landmarks and assess slings on TUS with reasonable proficiency compared to an experienced attending radiologist. © 2017 Wiley Periodicals, Inc.

A retrospective study of antibiotic prophylaxis value in surgical treatment of lower limb fracture.

PubMed

Bandalović, Ante; Zindović, Antonija; Boschi, Vladimir; Bakota, Bore; Marinović, Marin; Čoklo, Miran; Rošin, Matko; Parać, Zlatko; Čukelj, Fabijan

2015-11-01

Surgical site infections (SSI) are nosocomial infections that cause considerable problems in orthopaedic surgery. Antibiotic prophylaxis can be used to reduce the risk for SSI. There is no universal antibiotic that can be recommended for prophylaxis in terms of coverage of all possible pathogens because of antibiotic resistance, and there are no universal recommendations for different types of patients in terms of injury type, selected operation and risk factors for development of SSI. The aim of this study was to analyse the effectiveness of antibiotic prophylaxis in surgical treatment (ORIF) of closed lower limb fractures in young, healthy patients. Patient details were collected from the patient histories. Inclusion criteria for participants were age 20-30 years, not suffering from any type of chronic disease or state that may affect postoperative infection and ISS≤9. Antibiotic prophylaxis use and outcome (SSI) were compared between two groups of patients. Data were analysed using descriptive statistics, Fisher's exact test and t-test for proportions. A total of 347 patients with closed lower limb fractures treated with ORIF met the inclusion criteria. There were 290 male and 57 female patients, with an average age of 24.47 years. Prophylactic antibiotics were given to 242 patients (69.74%); 2g ceftriaxone was administered to 88.02% of the patients who received antibiotic prophylaxis. Ten patients developed postoperative infection (eight out of 242 with antibiotic prophylaxis and two out of 105 without antibiotic prophylaxis). The difference between the two groups was not statistically significant (Fisher's exact test, P=0.749). Antibiotic prophylaxis was ineffective in preventing SSI in patients with no risk factors for SSI who were undergoing ORIF for closed lower limb fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

Learning styles of postgraduate and undergraduate medical students.

PubMed

Shukr, Irfan; Zainab, Roop; Rana, Mowadat H

2013-01-01

To compare learning styles of undergraduate and postgraduate medical students. Observational, comparative study. Department of Medical Education, Army Medical College, NUST, Rawalpindi, Pakistan, during February and March 2012. A total of 170 students were divided into two equal groups of undergraduate students of Army Medical College, and postgraduate students of Armed Forces Post Graduate Medical Institute, Rawalpindi. Learning Style Questionnaire (LSQ) was used to assess and categorize the participants into Honey and Mumford classification of learning styles. The responses of each student ranging from 'very strong,' 'strong', 'moderate', and 'low' preference towards activist, theorist, reflector and pragmatist learning styles were compiled. The two groups were compared using SPSS version 17, using Fisher's exact test and the chi-square test. A p-value of $lt; 0.05 was considered significant. Preferences for all four learning styles were present in both groups. The results reveal an overall statistically significant difference in the 'very strong' preference in learning styles between the two study groups (p=0.002). Among the undergraduate students, 45% had a very strong preference for being an activist, whereas in postgraduate students, 38% had very strong preference for reflector, and 35% for theorist. This was statistically significant for activist, and reflector, and attained a p-value of < 0.001, for activist, and of 0.018 for reflector. The most uncommon 'very strong', and 'strong preference' for learning style was pragmatist in both undergraduate and postgraduate students. Diversity of learning styles at undergraduate and postgraduate level of medical education calls for multiplicity of instructional and assessment modalities to match them. The learning styles amongst the undergraduate medical students are different from the postgraduates. The postgraduates commonly have the reflector learning style while the undergraduates are predominantly activists and theorists.

Prognostic implication of serum hepatocyte growth factor in stage II/III breast cancer patients who received neoadjuvant chemotherapy.

PubMed

Kim, Hyori; Youk, Jeonghwan; Yang, Yaewon; Kim, Tae-Yong; Min, Ahrum; Ham, Hye-Seon; Cho, Seongcheol; Lee, Kyung-Hun; Keam, Bhumsuk; Han, Sae-Won; Oh, Do-Youn; Ryu, Han Suk; Han, Wonshik; Park, In Ae; Kim, Tae-You; Noh, Dong-Young; Im, Seock-Ah

2016-03-01

In stage II/III breast cancer, neoadjuvant chemotherapy (NAC) is a standard treatment. Although several biomarkers are used to predict prognosis in breast cancer, there is no reliable predictive biomarker for NAC success. Recently, the hepatocyte growth factor (HGF) and cMet signaling pathway demonstrated to be involved in breast cancer tumor progression, and its potential as a biomarker is under active investigation. In this study, we assessed the potential of serum HGF as a prognostic biomarker for NAC efficacy. Venous blood samples were drawn from patients diagnosed with stage II/III breast cancer and treated with NAC in Seoul National University Hospital from August 2004 to November 2009. Serum HGF level was determined using an ELISA system. We reviewed the medical records of the patients and investigated the association of HGF level with patients' clinicopathologic characteristics. A total of 121 female patients (median age = 45 years old) were included. Median level of HGF was 934 pg/ml (lower quartile: 772, upper quartile: 1145 pg/ml). Patients with higher HGF level than median value were significantly more likely to have clinically detectable regional node metastasis (p = 0.017, Fisher's exact test). Patients with complete and partial response according to the American Joint Committee on Cancer 7th Edition criteria tended to have higher HGF level (p = 0.105 by t test). Patients with an HGF level higher than the upper quartile value had longer relapse-free survival than the other patients (106 vs. 85 months, p = 0.008). High serum HGF levels in breast cancer patients are associated with clinically detectable regional node metastasis and, paradoxically, with longer relapse-free survival in stage II/III breast cancer.

TERT promoter mutated WHO grades II and III gliomas are located preferentially in the frontal lobe and avoid the midline.

PubMed

Sun, Ze-Lin; Chan, Aden Ka-Yin; Chen, Ling-Chao; Tang, Chao; Zhang, Zhen-Yu; Ding, Xiao-Jie; Wang, Yang; Sun, Chong-Ran; Ng, Ho-Keung; Yao, Yu; Zhou, Liang-Fu

2015-01-01

The promoter region of telomerase reverse transcriptase (TERTp) and isocitrate dehydrogenase (IDH) have been regarded as biomarkers with distinct clinical and phenotypic features. Investigated the possible correlations between tumor location and genetic alterations would enhance our understanding of gliomagenesis and heterogeneity of glioma. We examined mutations of TERTp and IDH by direct sequencing and fluorescence in-situ hybridization in a cohort of 225 grades II and III diffuse gliomas. Correlation analysis between molecular markers and tumor locations was performed by Chi-square tests/Fisher's exact test and multivariate logistic regression analysis. We found gliomas in frontal lobe showed higher frequency of TERTp mutation (P=0.0337) and simultaneously mutations of IDH and TERTp (IDH (mut)-TERTp(mut)) (P=0.0281) than frequency of biomarkers mutation of tumors in no-Frontal lobes, while lower frequency of TERTp mutation (P<0.0001) and simultaneously wild type of IDH and TERTp (IDH (wt)-TERTp(wt)) (P<0.0001) in midline than no-midline lobes. Logistic regression analysis indicated that locations of tumors associated with TERTp mutation (OR=0.540, 95% CI 0.324-0.900, P=0.018) and status of combinations of IDH and TERTp (IDH (mut)-TERTp (mut) vs. IDH (wt)-TERTp (wt) OR=0.162, 95% CI 0.075-0.350, P<0.001). In conclusion, grades II and III gliomas harboring TERTp mutation were located preferentially in the frontal lobe and rarely in midline. Association of IDH-TERTp status and tumor location suggests their potential values in molecular classification of grades II and III gliomas.

Biomarkers and Molecular Analysis to Improve Bloodstream Infection Diagnostics in an Emergency Care Unit

PubMed Central

Loonen, Anne J. M.; de Jager, Cornelis P. C.; Tosserams, Janna; Kusters, Ron; Hilbink, Mirrian; Wever, Peter C.; van den Brule, Adriaan J. C.

2014-01-01

Molecular pathogen detection from blood is still expensive and the exact clinical value remains to be determined. The use of biomarkers may assist in preselecting patients for immediate molecular testing besides blood culture. In this study, 140 patients with ≥ 2 SIRS criteria and clinical signs of infection presenting at the emergency department of our hospital were included. C-reactive protein (CRP), neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT) and soluble urokinase plasminogen activator receptor (suPAR) levels were determined. One ml EDTA blood was obtained and selective pathogen DNA isolation was performed with MolYsis (Molzym). DNA samples were analysed for the presence of pathogens, using both the MagicPlex Sepsis Test (Seegene) and SepsiTest (Molzym), and results were compared to blood cultures. Fifteen patients had to be excluded from the study, leaving 125 patients for further analysis. Of the 125 patient samples analysed, 27 presented with positive blood cultures of which 7 were considered to be contaminants. suPAR, PCT, and NLCR values were significantly higher in patients with positive blood cultures compared to patients without (p < 0.001). Receiver operating characteristic curves of the 4 biomarkers for differentiating bacteremia from non-bacteremia showed the highest area under the curve (AUC) for PCT (0.806 (95% confidence interval 0.699–0.913)). NLCR, suPAR and CRP resulted in an AUC of 0.770, 0.793, and 0.485, respectively. When compared to blood cultures, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for SepsiTest and MagicPlex Sepsis Test were 11%, 96%, 43%, 80%, and 37%, 77%, 30%, 82%, respectively. In conclusion, both molecular assays perform poorly when one ml whole blood is used from emergency care unit patients. NLCR is a cheap, fast, easy to determine, and rapidly available biomarker, and therefore seems most promising in differentiating BSI from non-BSI patients for subsequent pathogen identification using molecular diagnostics. PMID:24475269

Biomarkers and molecular analysis to improve bloodstream infection diagnostics in an emergency care unit.

PubMed

Loonen, Anne J M; de Jager, Cornelis P C; Tosserams, Janna; Kusters, Ron; Hilbink, Mirrian; Wever, Peter C; van den Brule, Adriaan J C

2014-01-01

Molecular pathogen detection from blood is still expensive and the exact clinical value remains to be determined. The use of biomarkers may assist in preselecting patients for immediate molecular testing besides blood culture. In this study, 140 patients with ≥ 2 SIRS criteria and clinical signs of infection presenting at the emergency department of our hospital were included. C-reactive protein (CRP), neutrophil-lymphocyte count ratio (NLCR), procalcitonin (PCT) and soluble urokinase plasminogen activator receptor (suPAR) levels were determined. One ml EDTA blood was obtained and selective pathogen DNA isolation was performed with MolYsis (Molzym). DNA samples were analysed for the presence of pathogens, using both the MagicPlex Sepsis Test (Seegene) and SepsiTest (Molzym), and results were compared to blood cultures. Fifteen patients had to be excluded from the study, leaving 125 patients for further analysis. Of the 125 patient samples analysed, 27 presented with positive blood cultures of which 7 were considered to be contaminants. suPAR, PCT, and NLCR values were significantly higher in patients with positive blood cultures compared to patients without (p < 0.001). Receiver operating characteristic curves of the 4 biomarkers for differentiating bacteremia from non-bacteremia showed the highest area under the curve (AUC) for PCT (0.806 (95% confidence interval 0.699-0.913)). NLCR, suPAR and CRP resulted in an AUC of 0.770, 0.793, and 0.485, respectively. When compared to blood cultures, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for SepsiTest and MagicPlex Sepsis Test were 11%, 96%, 43%, 80%, and 37%, 77%, 30%, 82%, respectively. In conclusion, both molecular assays perform poorly when one ml whole blood is used from emergency care unit patients. NLCR is a cheap, fast, easy to determine, and rapidly available biomarker, and therefore seems most promising in differentiating BSI from non-BSI patients for subsequent pathogen identification using molecular diagnostics.

The potential for increased power from combining P-values testing the same hypothesis.

PubMed

Ganju, Jitendra; Julie Ma, Guoguang

2017-02-01

The conventional approach to hypothesis testing for formal inference is to prespecify a single test statistic thought to be optimal. However, we usually have more than one test statistic in mind for testing the null hypothesis of no treatment effect but we do not know which one is the most powerful. Rather than relying on a single p-value, combining p-values from prespecified multiple test statistics can be used for inference. Combining functions include Fisher's combination test and the minimum p-value. Using randomization-based tests, the increase in power can be remarkable when compared with a single test and Simes's method. The versatility of the method is that it also applies when the number of covariates exceeds the number of observations. The increase in power is large enough to prefer combined p-values over a single p-value. The limitation is that the method does not provide an unbiased estimator of the treatment effect and does not apply to situations when the model includes treatment by covariate interaction.

Repeat Gamma-Knife Radiosurgery for Refractory or Recurrent Trigeminal Neuralgia with Consideration About the Optimal Second Dose.

PubMed

Park, Seong-Cheol; Kwon, Do Hoon; Lee, Do Hee; Lee, Jung Kyo

2016-02-01

To investigate adequate radiation doses for repeat Gamma Knife radiosurgery (GKS) for trigeminal neuralgia in our series and meta-analysis. Fourteen patients treated by ipsilateral repeat GKS for trigeminal neuralgia were included. Median age of patients was 65 years (range, 28-78), the median target dose, 140-180). Patients were followed a median of 10.8 months (range, 1-151) after the second gamma-knife surgery. Brainstem dose analysis and vote-counting meta-analysis of 19 studies were performed. After the second gamma-knife radiosurgeries, pain was relieved effectively in 12 patients (86%; Barrow Neurological Institute Pain Intensity Score I-III). Post-gamma-knife radiosurgery trigeminal nerve deficits were mild in 5 patients. No serious anesthesia dolorosa was occurred. The second GKS radiation dose ≤ 60 Gy was significantly associated with worse pain control outcome (P = 0.018 in our series, permutation analysis of variance, and P = 0.009 in the meta-analysis, 2-tailed Fisher's exact test). Cumulative dose ≤ 140-150 Gy was significantly associated with poor pain control outcome (P = 0.033 in our series and P = 0.013 in the meta-analysis, 2-tailed Fisher's exact test). A cumulative brainstem edge dose >12 Gy tended to be associated with trigeminal nerve deficit (P = 0.077). Our study suggests that the second GKS dose is a potentially important factor. Copyright © 2016 Elsevier Inc. All rights reserved.

ASSOCIATIONS BETWEEN THREE CLINICAL ASSESSMENT TOOLS FOR POSTURAL STABILITY

PubMed Central

Saxion, Casie E.; Cameron, Kenneth L.; Gerber, J. Parry

2010-01-01

Study Design: Clinical Measurement, Correlation, Reliability Objectives: To assess the relationship between the Single Leg Balance (SLB), modified Balance Error Scoring System (mBESS), and modified Star Excursion Balance (mSEBT) tests and secondarily to assess inter-rater and test-retest reliability of these tests. Background: Ankle sprains often result in chronic instability and dysfunction. Several clinical tests assess postural deficits as a potential cause of this dysfunction; however, limited information exists pertaining to the relationship that these tests have with one another. Methods: Two independent examiners measured the performance of 34 healthy participants completing the SLB Test, mBESS test, and mSEBT at two different time periods. The relationship between tests was assessed using the Pearson Correlation and Fisher's Exact Tests. Inter-rater and test-retest reliability were assessed using the intraclass correlation coefficient (ICC) and Kappa statistics. Results: A significant correlation (r = -0.35) was observed between the mSEBT and the mBESS. Fisher's Exact Test showed a significant association between the SLB Test and mBESS (P = .048), but no association between the SLB and mSEBT (P = 1.000). Inter-rater reliability was excellent for the mSEBT and fair for the mBESS (ICCs of .91 and .61 respectively). Excellent agreement was observed between raters for the SLB test (k = 1.00). Test-retest reliability was excellent for the mSEBT (ICC = 0.98) and fair for the mBESS (ICC = 0.74). There was poor test-retest agreement for the SLB test (k = .211). Conclusion: There was a significant relationship observed between the SLB Test, mBESS test, and mSEBT: however; strength of association measures showed limited overlap between these tests. This suggests that these tests are interrelated but may not assess equal components of postural stability. PMID:21589668

Influence of surface sealing on color stability and roughness of composite submitted to ultraviolet-accelerated aging.

PubMed

Catelan, Anderson; Suzuki, Thaís Yumi Umeda; Becker, Francisco; Briso, André Luiz Fraga; Dos Santos, Paulo Henrique

2017-05-01

In the present study, we evaluated the influence of surface sealing on color stability and surface roughness of a composite resin after accelerated artificial aging. Thirty-two specimens of a composite were prepared. After 24 h, the specimens were polished and divided into four groups (n = 8), according to the surface sealant used, including the control, which had no sealant application. Baseline color was measured according to the CIELab system using a reflection spectrophotometer. Surface roughness was determined using a profilometer with a cut-off of 0.25 mm. After these tests, specimens were aged for 252 h in an ultraviolet (UV)-accelerated aging chamber. Color stability was determined by difference between coordinates obtained before and after the aging procedure. Data of color change and roughness were evaluated by anova and Fisher's exact test (α = 0.05). The results showed that the unsealed group had the highest color change compared to other groups (P = 0.0289), and there was no significant difference between groups sealed with surface sealant (P > 0.05). The artificial aging caused an increase in roughness values independent of the experimental group studied (P = 0.0015). The sealed composites showed lower color change after UV aging, but all groups showed clinically-acceptable color change, and only liquid polish decreased roughness. © 2016 John Wiley & Sons Australia, Ltd.

Approximate tensor-product preconditioners for very high order discontinuous Galerkin methods

NASA Astrophysics Data System (ADS)

Pazner, Will; Persson, Per-Olof

2018-02-01

In this paper, we develop a new tensor-product based preconditioner for discontinuous Galerkin methods with polynomial degrees higher than those typically employed. This preconditioner uses an automatic, purely algebraic method to approximate the exact block Jacobi preconditioner by Kronecker products of several small, one-dimensional matrices. Traditional matrix-based preconditioners require O (p2d) storage and O (p3d) computational work, where p is the degree of basis polynomials used, and d is the spatial dimension. Our SVD-based tensor-product preconditioner requires O (p d + 1) storage, O (p d + 1) work in two spatial dimensions, and O (p d + 2) work in three spatial dimensions. Combined with a matrix-free Newton-Krylov solver, these preconditioners allow for the solution of DG systems in linear time in p per degree of freedom in 2D, and reduce the computational complexity from O (p9) to O (p5) in 3D. Numerical results are shown in 2D and 3D for the advection, Euler, and Navier-Stokes equations, using polynomials of degree up to p = 30. For many test cases, the preconditioner results in similar iteration counts when compared with the exact block Jacobi preconditioner, and performance is significantly improved for high polynomial degrees p.

[Risk factors of teenage pregnancies, deliveries and post-partum in the department of Loiret].

PubMed

Alouini, S; Randriambololona, D; Randriamboavonjy, R

2015-05-01

To evaluate the obstetric outcome of teenage pregnancies compared to adult women in the department of Loiret. A retrospective study of adolescents (10-19 years) delivered after 22 weeks compared to adult women aged 20-35 years (controls) from the first January to the 31 December 2012 in a maternity level 3. The two groups were compared by the Chi(2) test or the exact test of Fisher. A P-value < 0.05 was considered significant. Adolescent had less prenatal consultations than controls (4 versus 7). They used more tobacco during pregnancy than adult controls. Urinary infections and preterm threat and births were more frequent in the adolescent group compared to the controls (P=0.04 and 0.018). However, the gestational diabetes was less frequent in the adolescent group versus controls (P=0.0005, OR: 0.16 [IC95%: 0.03-0.54]). The adolescent group represented 2.38 of total deliveries. The rate of vaginal deliveries and caesarean section was similar in the two groups. Vaginal tears were significantly more frequent among adolescents than controls (P=0.0019). The adolescents were more likely to preterm delivery and to have urinary infections than the adult women (controls). They are less likely to have gestational diabetes than older women. The rates of vaginal deliveries are comparable; however, the adolescents are more likely to experience vaginal tears than controls. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Influence of rotational speed, torque and operator proficiency on failure of Greater Taper files.

PubMed

Yared, G M; Dagher, F E Bou; Machtou, P; Kulkarni, G K

2002-01-01

The purpose of this study was to evaluate the influence of rotational speed. torque, and operator experience on the incidence of locking, deformation, and separation of instruments when using a specific Ni-Ti rotary instrumentation technique in extracted human teeth. Greater Taper Ni-Ti rotary instruments (GT) were used in a crown-down technique. In one group (rotational speed evaluation) of canals (n = 300) speeds of 150, 2 50 and 350 r.p.m. (subgroups 1, 2 and 3) were used. Each one of the subgroups included 100 canals. In a second group (evaluation of torque) (n = 300) torque was set at 20, 30 and 55 Ncm (subgroups 4, 5 and 6). In the third group (evaluation of operator proficiency) (n = 300 three operators with varying experience (subgroups 7, 8 and 9) were also compared. Each subgroup included the use of 10 sets of GT rotary instruments and 100 canals of extracted human molars. Each set of instruments was used in up to 10 canals and sterilized before each case. NaOCl 2.5% was used as an irrigant. The number of locked, deformed, and separated instruments was recorded for each group. Statistical analysis was carried out with pairwise comparisons using Fisher's exact tests for each of the failure type. When the influence of rotational speed was evaluated, instrument deformation and separation did not occur in subgroups 1 (150) r.p.m.), 2 (250 r.p.m.), and 3 (350) r.p.m.). Instrument locking occurred in subgroup 3 only. Statistical analysis demonstrated a significant difference between the 150 and 350 r.p.m. groups and between the 250 and 350 r.p.m. groups with respect to instrument locking. In torque evaluation, neither separation, deformation nor locking occurred during the use of the instruments, at 150 r.p.m., and at the different torque values. When the operators were compared, although two instruments were separated in canals prepared by the least experienced operator. Fisher's exact tests did not demonstrate a significant difference between the three subgroups. Instrument locking, deformation, and separation did not occur with the most experienced operator. None of the instruments separated with the trained operator. Preclinical training in the use of the GT rotary instruments when used with a crown-down technique at 150 r.p.m. was crucial in avoiding instrument separation and reducing the incidence of instrument locking and deformation.

The mechanical and microbiological integrity of surgical gloves.

PubMed

Jamal, Ala; Wilkinson, Stephen

2003-03-01

Several manufacturers supply surgical gloves that have been individually tested (IT) for leaks. Other manufacturers supply gloves in which sample gloves from each batch are tested for leaks (batch tested: BT). The latter brands may be rejected by surgeons because of presumed increased risk of wound infection and staff exposure to patient pathogens. The influence of differences between glove brands on performance in surgery has not been extensively studied. The aims of the present study were to test the mechanical and microbiological integrity of IT compared to BT gloves. A total of 110 unused gloves from each of an IT and a BT brand were tested for leaks, first, by observation of water-jets from water-filled gloves and second, by measuring electrical resistance between inside and outside the glove surfaces, to give a baseline measure. A total of 304 IT and 280 BT gloves were then similarly leak-tested after 98 clean surgical procedures. The hands and gloves of scrub team members were cultured postsurgery. A total of 1/110 BT and 0/110 IT unused gloves contained leaks (NS, Fisher's exact test). Operative perforation rates were lower for BT compared with IT (8/280 cf. 22/304; P < 0.05 Fisher's exact test). There was no bias in types of operations or scrub team members to account for the difference. Growth of normal skin flora was found on virtually every wearer's hands post-operatively. Similar bacteria were frequently cultured from the outside of gloves at the conclusion of surgery (111/152 pairs IT cf. 122/140 pairs BT; P < 0.01, Fisher's exact test). This study provides evidence that the clinical performance of BT gloves is no different to IT gloves. There was no significant difference in mechanical leak rates for unused gloves. Paradoxically, although IT gloves were more likely to show macro-perforations after surgery, the incidence of contamination on the surface of BT gloves was greater, possibly reflecting a qualitative difference in glove material. This study suggests that both types of gloves develop microporosity during use, which may allow transfer of bacteria from the surgeon's skin to the surface of the glove.

Inherited and acquired thrombophilia in Indian women experiencing unexplained recurrent pregnancy loss.

PubMed

Patil, Rucha; Ghosh, Kanjaksha; Vora, Sonal; Shetty, Shrimati

2015-10-01

The most frequently hypothesized cause of unexplained recurrent pregnancy loss (RPL) refers to a defective maternal haemostatic response leading to uteroplacental thrombosis. Approximately 20% women suffering from pregnancy loss (PL) are associated with autoimmune disorders and more than 50% remain idiopathic after common traditional investigations. The present study aims to investigate the prevalence of different genetic and acquired thrombophilia markers in a large series of Indian women with RPL. Such studies will help analyze the markers which pose maximum risk and help in the appropriate treatment in subsequent pregnancies. The study comprised of 587 women with no apparent etiological causes of RPL and 115 healthy women controls. p values were calculated with two tailed Fisher's exact test; statistical significance was assumed at p<0.05, 95% confidence interval. Relative risks were also calculated. Among genetic thrombophilia, the risk of PL was highest with protein S deficiency (16%, p=0.006) followed by plasminogen activator inhibitor-1 4G/4G (23%, p=0.007) polymorphism. Among acquired markers, the risk of PL was the highest in women with anti-cardiolipin antibodies (24%, p=0.0001), followed by anti-annexin V antibodies (23%, p=0.0009) and lupus anticoagulants (8%, p=0.02). Thrombophilia, inherited and acquired, is an important contributing factor in unexplained RPL and should be screened in the order of its prevalence. Copyright © 2015 Elsevier Inc. All rights reserved.

Risk factors of fatal occupational accidents in Iran.

PubMed

Asady, Hadi; Yaseri, Mehdi; Hosseini, Mostafa; Zarif-Yeganeh, Morvarid; Yousefifard, Mahmoud; Haghshenas, Mahin; Hajizadeh-Moghadam, Parisa

2018-01-01

Occupational accidents are of most important consequences of globalization in developing countries. Therefore, investigating the causes of occupational accidents for improving the job situation and making operational policy is necessary. So the aim of this study was to investigate factors affecting the fatal occupational accidents and also calculate the years of life lost for dead workers. This cross-sectional study was conducted on data related to the 6052 injured workers that was registered in the 2013 registry system of the Ministry of Health and Medical Education of Iran. Variables including sex, education, age, job tenure, injury cause, referred location of injured workers, occupation, shift work, season, accident day, damaged part of the body were chosen as independent variables. The Chi-squared and Fisher exact tests were used for univariate analysis and then exact multiple logistic regression was carried out to identify independent risk factors of fatal occupational accidents. Finally, for dead workers, years of life lost, according to the injury causes was calculated. Among the 6052 accidents reported, 33 deaths were recorded. Chi-square and Fisher exact tests showed that factors including: current job tenure ( p  = 0.01), damaged parts of the body ( p  < 0.001) and injury cause ( p  < 0.001) are associated with the fatal accidents. Also exact multiple logistic regression analysis showed a significant association between electric shocks as a cause of injury (OR = 7.04; 95% CI: 1.01-43.74; p  = 0.02) and current job tenure more than 1 year (OR = 0.21; 95% CI: 0.05-0.70; p  = 0.005) with the fatal accidents. The total amount of years of life lost based on causes of injuries was estimated 1289.12 years. In Iran, fatal accident odds in workers with job tenure more than 1 year was less in comparing to the workers with job tenure less and equal to 1 year. Also odd of death for electrical shock was more than other causes of injuries. So it seems that employing of workers who have more than one-year work experience in a specific job and using of appropriate safeguards will be useful for the reducing of fatal occupational accidents.

[Reference values for erythrocyte cholinesterase activity in the working population of Antioquia, Colombia, according to the Michel and EQM techniques].

PubMed

Carmona-Fonseca, Jaime

2003-11-01

To establish reference values for erythrocyte cholinesterase (EC 3.1.1.7) activity for the active working population of two regions of the department of Antioquia, Colombia, that are located at different altitudes above sea level. We took representative samples from populations of active working persons 18 to 59 years old from two regions in the department of Antioquia: (1) the Aburrá Valley (1 540 m above sea level) and (2) the near east of the department (2 150 m above sea level). We excluded workers who were using cholinesterase-inhibiting substances in their work or at home, those who had a disease that altered their cholinesterase levels, and those who said they were not in good health. We measured the erythrocyte cholinesterase activity using two methods: (1) the Michel method and (2) the EQM method (EQM Research, Cincinnati, Ohio, United States of America). We carried out the measurements with 827 people, 415 from the Aburrá Valley and 412 from the near east region. We compared proportions using the chi-square test and Fisher's exact test. We utilized the Student's t test for independent samples to compare two averages. To simultaneously compare three or more averages, analysis of variance was used, followed by the Newman-Keuls multiple-range test. When the variables were not normally distributed or when the variances were not homogeneous, Kruskal-Wallis nonparametric analysis of variance was used to compare the medians. Three computer software programs were used in the statistical analysis: SPSS 9.0, SGPlus 7.1, and Epi Info 6.04. In all the statistical tests the level of significance was set at P < 0.05. The average erythrocyte cholinesterase activity value that we found for the studied population by using the Michel method was 0.857 delta pH/hour (95% confidence interval (CI): 0.849 to 0.866), and the average value found through the EQM method was 35.21 U/g hemoglobin (95% CI: 34.82 to 35.60). With the Michel method: (1) the enzymatic activity differed significantly between the two regions, according to the Newman-Keuls test; (2) within each region, the enzymatic activity was significantly higher among males than among females, according to the Newman-Keuls test; and (3) in none of the region-sex strata was there a statistically significant influence of age on the enzymatic activity. Using the EQM method, there were no statistically significant differences by region, sex, or age group. The erythrocyte cholinesterase activity values found by the two analytical techniques were significantly higher than the values from outside Colombia that are now being used as reference values in the country, which poses both clinical and epidemiological problems. We recommend that the data from this study be adopted as the reference values in Colombia.

Identified OAS3 gene variants associated with coexistence of HBsAg and anti-HBs in chronic HBV infection.

PubMed

Wang, S; Wang, J; Fan, M-J; Li, T-Y; Pan, H; Wang, X; Liu, H-K; Lin, Q-F; Zhang, J-G; Guan, L-P; Zhernakova, D V; O'Brien, S J; Feng, Z-R; Chang, L; Dai, E-H; Lu, J-H; Xi, H-L; Zeng, Z; Yu, Y-Y; Wang, B-B

2018-03-27

The underlying mechanism of coexistence of hepatitis B surface antigen (HBsAg) and hepatitis B surface antigen antibody (anti-HBs) is still controversial. To identify the host genetic factors related to this unusual clinical phenomenon, a two-stage study was conducted in the Chinese Han population. In the first stage, we performed a case-control (1:1) age- and gender-matched study of 101 cases with concurrent HBsAg and anti-HBs and 102 controls with negative HBsAg and positive anti-HBs using whole exome sequencing. In the second validation stage, we directly sequence the 16 exons on the OAS3 gene in two dependent cohorts of 48 cases and 200 controls. Although, in the first stage, a genome-wide association study of 58,563 polymorphism variants in 101 cases and 102 controls found no significant loci (P-value ≤ .05/58563), and neither locus achieved a conservative genome-wide significance threshold (P-value ≤ 5e-08), gene-based burden analysis showed that OAS3 gene rare variants were associated with the coexistence of HBsAg and anti-HBs. (P-value = 4.127e-06 ≤ 0.05/6994). A total of 16 rare variants were screened out from 21 cases and 3 controls. In the second validation stage, one case with a stop-gained rare variant was identified. Fisher's exact test of all 149 cases and 302 controls showed that the rare coding sequence mutations were more frequent in cases vs controls (P-value = 7.299e-09, OR = 17.27, 95% CI [5.01-58.72]). Protein-coding rare variations on the OAS3 gene are associated with the coexistence of HBsAg and anti-HBs in patients with chronic HBV infection in Chinese Han population. © 2018 John Wiley & Sons Ltd.

Comparison of qualitative and quantitative evaluation of diffusion-weighted MRI and chemical-shift imaging in the differentiation of benign and malignant vertebral body fractures.

PubMed

Geith, Tobias; Schmidt, Gerwin; Biffar, Andreas; Dietrich, Olaf; Dürr, Hans Roland; Reiser, Maximilian; Baur-Melnyk, Andrea

2012-11-01

The objective of our study was to compare the diagnostic value of qualitative diffusion-weighted imaging (DWI), quantitative DWI, and chemical-shift imaging in a single prospective cohort of patients with acute osteoporotic and malignant vertebral fractures. The study group was composed of patients with 26 osteoporotic vertebral fractures (18 women, eight men; mean age, 69 years; age range, 31 years 6 months to 86 years 2 months) and 20 malignant vertebral fractures (nine women, 11 men; mean age, 63.4 years; age range, 24 years 8 months to 86 years 4 months). T1-weighted, STIR, and T2-weighted sequences were acquired at 1.5 T. A DW reverse fast imaging with steady-state free precession (PSIF) sequence at different delta values was evaluated qualitatively. A DW echo-planar imaging (EPI) sequence and a DW single-shot turbo spin-echo (TSE) sequence at different b values were evaluated qualitatively and quantitatively using the apparent diffusion coefficient. Opposed-phase sequences were used to assess signal intensity qualitatively. The signal loss between in- and opposed-phase images was determined quantitatively. Two-tailed Fisher exact test, Mann-Whitney test, and receiver operating characteristic analysis were performed. Sensitivities, specificities, and accuracies were determined. Qualitative DW-PSIF imaging (delta = 3 ms) showed the best performance for distinguishing between benign and malignant fractures (sensitivity, 100%; specificity, 88.5%; accuracy, 93.5%). Qualitative DW-EPI (b = 50 s/mm(2) [p = 1.00]; b = 250 s/mm(2) [p = 0.50]) and DW single-shot TSE imaging (b = 100 s/mm(2) [p = 1.00]; b = 250 s/mm(2) [p = 0.18]; b = 400 s/mm(2) [p = 0.18]; b = 600 s/mm(2) [p = 0.39]) did not indicate significant differences between benign and malignant fractures. DW-EPI using a b value of 500 s/mm(2) (p = 0.01) indicated significant differences between benign and malignant vertebral fractures. Quantitative DW-EPI (p = 0.09) and qualitative opposed-phase imaging (p = 0.06) did not exhibit significant differences, quantitative DW single-shot TSE imaging (p = 0.002) and quantitative chemical-shift imaging (p = 0.01) showed significant differences between benign and malignant fractures. The DW-PSIF sequence (delta = 3 ms) had the highest accuracy in differentiating benign from malignant vertebral fractures. Quantitative chemical-shift imaging and quantitative DW single-shot TSE imaging had a lower accuracy than DW-PSIF imaging because of a large overlap. Qualitative assessment of opposed-phase, DW-EPI, and DW single-shot TSE sequences and quantitative assessment of the DW-EPI sequence were not suitable for distinguishing between benign and malignant vertebral fractures.

ERRATUM: Erratum: Lifetimes of excited levels in P I-P V, Physica Scripta 3 197, 1971

NASA Astrophysics Data System (ADS)

Curtis, L. J.; Martinson, I.; Buchta, R.

1990-01-01

A recent investigation [1] indicated generally good agreement with the lifetimes reported in our experiment, with the notable exception of the P III 1 380 Å 3p2 2D-3p3 2D transition. This prompted us to reexamine our data and revealed that a copying error had indeed occurred in our manuscript, resulting in a wholly spurious value being reported for this one transition. The meanlife extracted from our original (single exponential) decay curve was actually in exact agreement with the value reported in ref. [1]. Thus, the ninth row, fourth column of Table II on page 200 should read 10 ±1 ns (not 1.8 ±0.4 ns). We are very grateful to Drs Livingston, Kernahan, Irwin and Pinnington for pointing out this unfortunate error. [1] A E Livingston, J A Kernahan, D J G Irwin and E H Pinnington Physica Scripta 12, 233 (1975)

[Clinical application of artificial dermis combined with basic fibroblast growth factor in the treatment of cicatrix and deep skin wounds].

PubMed

Liu, Yang; Zhang, Yilan; Huang, Yalan; Luo, Gaoxing; Peng, Yizhi; Yan, Hong; Luo, Qizhi; Zhang, Jiaping; Wu, Jun; Peng, Daizhi

2016-04-01

To observe the effects of artificial dermis combined with basic fibroblast growth factor (bFGF) on the treatment of cicatrix and deep skin wounds. The clinical data of 72 patients with wounds repaired with artificial dermis, hospitalized in our unit from October 2010 to April 2015, conforming to the study criteria, were retrospectively analyzed. The types of wounds were wounds after resection of cicatrices, deep burn wounds without exposure of tendon or bone, and wounds with exposure of small area of tendon or bone, in a total number of 102. Wounds were divided into artificial dermis group (A, n=60) and artificial dermis+ bFGF group (B, n=42) according to whether or not artificial dermis combined with bFGF. In group A, after release and resection of cicatrices or thorough debridement of deep skin wounds, artificial dermis was directly grafted to wounds in the first stage operation. After complete vascularization of artificial dermis, wounds were repaired with autologous split-thickness skin grafts in the second stage operation. In group B, all the procedures were exactly the same as those in group A except that artificial dermis had been soaked in bFGF for 30 min before grafting. Operation area, complete vascularization time of artificial dermis, survival of skin grafts, and the follow-up condition of wounds in the two groups were recorded. Data were processed with t test and Fisher's exact test. (1) Operation areas of wounds after resection of cicatrices, deep burn wounds without exposure of tendon or bone, and wounds with exposure of small area of tendon or bone in the two groups were about the same (with t values from -1.853 to -0.200, P values above 0.05). Complete vascularization time of artificial dermis in wounds after resection of cicatrices, deep burn wounds without exposure of tendon or bone, and wounds with exposure of small area of tendon or bone in group B were respectively (15.6 ± 2.9), (14.7 ± 2.7), and (20.3 ± 4.4) d, and they were shorter by an average time of 2.7, 4.0, 7.4 d, respectively, as compared with those in corresponding types of wounds in group A [respectively (18.3 ± 4.7), (18.7 ± 4.2), and (27.7 ± 8.8) d, with t values from -2.779 to -2.383, P values below 0.05]. (2) The ratio of skin grafts with excellent survival in the three types of wounds in group B were higher than those in corresponding types of wounds in group A, but there were no statistically significant differences (with P values above 0.05). (3) Patients were followed up for 1 to 48 months, and there were no obvious cicatrices in skin graft sites and the donor sites during the following time. Artificial dermis combined with bFGF can effectively shorten the vascularization time of artificial dermis in wounds after resection of cicatrices and deep skin wounds.

[Comparison of thromboelastography and routine coagulation tests for evaluation of blood coagulation function in patients].

PubMed

Chen, Guan-Yi; Ou Yang, Xi-Lin; Wu, Jing-Hui; Wang, Li-Hua; Yang, Jin-Hua; Gu, Li-Nan; Lu, Zhu-Jie; Zhao, Xiao-Zi

2015-04-01

To investigate the correlation and consistency between thromboelastography(TEG) and routine coagulation tests, and to evaluate the value of the two methods in determining the blood coagulation of patients. The TEG, routine coagulation tests and platelet counts of 182 patients from the Intensive Care Unit(ICU) and Department of Gastroenterology in our hospital from January to September 2014 were performed and analyzed retrospectively for their correlation, Kappa identity test analysis and chi-square test, and the diagnostic sensitivity and specificity of both methods in the patients with bleeding were evaluated. The TEG R time and PT, R time and APTT showed a linear dependence (P<0.01). The relationship between the TEG K value, α-Angle, MA and Fibrinogen showed a linear dependence (P<0.001). And the relationship between the TEG K value, α-Angle, MA and the platelet count were in a linear dependent way (P<0.001). The Kappa values of the TEG R time with PT and APTT were 0.038 (P>0.05) and 0.061 (P>0.05), respectively. The chi-square test values of the TEG R time with PT and APTT were 35.309 (P<0.001) and 15.848 (P<0.001), respectively. The Fibrinogen and the TEG K value, α-Angle, MA value had statistical significance (P<0.001), with a Kappa value of 0.323, 0.288 and 0.427, respectively. The chi-square test values between Fibrinogen and the TEG K value, α-Angle, MA value were not statistically significant, with X2=1.091 (P=0.296), X2=1.361 (P=0.243), X2=0.108 (P=0.742). The Kappa values of the platelet count and the TEG K value, α-Angle, MA value were 0.379, 0.208 and 0.352, respectively, which were also statistically significant difference (P<0.001). The chi-square test values between the platelet count and the TEG K value, α-Angle, MA value showed a statistically significant difference (P<0.001), with X2=37.5, X2=37.23, X2=26.630. The diagnostic sensitivity of the two methods for the patients with bleeding was less than 50%. There was a significant correlation between some TEG parameters and routine coagulation tests, but the consistency is weak. Moreover, the diagnostic sensitivity of two methods in the patients with bleeding is low. It was concluded that the TEG cannot replace the conventional coagulation tests, and the preferable method remains uncertain which could reflect the risk of bleeding.

Estimating Cost Growth in Engineering and Schedule Cost Catergories Using a Two-Pronged Regression Approach

DTIC Science & Technology

2004-03-01

test is for homoscedasticity (constant variance). With a p- value of 0.86, we pass the Breusch - Pagan test for homoscedasticity of the residuals...variance). With a p- value of 0.28, we pass the Breusch - Pagan test for homoscedasticity of the residuals, since the p-value is greater than 0.05...a Breusch - Pagan calculation which results in a p-value. P-values below 0.05 indicate a failure of this assumption. Once we have completed our

PREVALENCE OF SCIENTIFIC MISCONDUCT AMONG A GROUP OF RESEARCHERS IN NIGERIA

PubMed Central

OKONTA, PATRICK; ROSSOUW, THERESA

2012-01-01

Background There is a dearth of information on the prevalence of scientific misconduct from Nigeria. Objectives This study aimed at determining the prevalence of scientific misconduct in a group of researchers in Nigeria. Factors associated with the prevalence were ascertained. Method A descriptive study of researchers who attended a scientific conference in 2010 was conducted using the adapted Scientific Misconduct Questionnaire- Revised (SMQ-R). Results Ninety-one researchers (68.9%) admitted having committed at least one of the eight listed forms of scientific misconduct. Disagreement about authorship was the most common form of misconduct committed (36.4%) while plagiarism was the least (9.2%). About 42% of researchers had committed falsification of data or plagiarism. Analysis of specific acts of misconduct showed that committing plagiarism was inversely associated with years in research (Fisher exact p-value = 0.02); falsifying data was related to perceived low effectiveness of the institution’s rules and procedures for reducing scientific misconduct (X2 = 6.44, p-value = 0.01); and succumbing to pressure from study sponsor to engage in unethical practice was related to sex of researcher (Fisher exact p-value = 0.02). Conclusions The emergent data from this study is a cause for serious concern and calls for prompt intervention. The best response to reducing scientific misconduct will proceed from measures that contain both elements of prevention and enforcement. Training on research ethics has to be integrated into the curriculum of undergraduate and postgraduate students while provision should be made for in-service training of researchers. Penalties against acts of scientific misconduct should be enforced at institutional and national levels. PMID:22994914

Large deviations of a long-time average in the Ehrenfest urn model

NASA Astrophysics Data System (ADS)

Meerson, Baruch; Zilber, Pini

2018-05-01

Since its inception in 1907, the Ehrenfest urn model (EUM) has served as a test bed of key concepts of statistical mechanics. Here we employ this model to study large deviations of a time-additive quantity. We consider two continuous-time versions of the EUM with K urns and N balls: with and without interactions between the balls in the same urn. We evaluate the probability distribution that the average number of balls in one urn over time T, , takes any specified value aN, where . For long observation time, , a Donsker–Varadhan large deviation principle holds: , where … denote additional parameters of the model. We calculate the rate function exactly by two different methods due to Donsker and Varadhan and compare the exact results with those obtained with a variant of WKB approximation (after Wentzel, Kramers and Brillouin). In the absence of interactions the WKB prediction for is exact for any N. In the presence of interactions the WKB method gives asymptotically exact results for . The WKB method also uncovers the (very simple) time history of the system which dominates the contribution of different time histories to .

Epidemiological characteristics and deaths of premature infants in a referral hospital for high-risk pregnancies

PubMed Central

de Freitas, Brunnella Alcantara Chagas; Sant'Ana, Luciana Ferreira da Rocha; Longo, Giana Zarbato; Siqueira-Batista, Rodrigo; Priore, Silvia Eloiza; Franceschin, Sylvia do Carmo Castro

2012-01-01

Objective To analyze the process of care provided to premature infants in a neonatal intensive care unit and the factors associated with their mortality. Methods Cross-sectional retrospective study of premature infants in an intensive care unit between 2008 and 2010. The characteristics of the mothers and premature infants were described, and a bivariate analysis was performed on the following characteristics: the study period and the "death" outcome (hospital, neonatal and early) using Pearson's chi-square test, Fisher's exact test or a chi-square test for linear trends. Bivariate and multivariable logistic regression analyses were performed using a stepwise backward logistic regression method between the variables with p<0.20 and the "death" outcome. A p value <0.05 was considered to be significant. Results In total, 293 preterm infants were studied. Increased access to complementary tests (transfontanellar ultrasound and Doppler echocardiogram) and breastfeeding rates were indicators of improving care. Mortality was concentrated in the neonatal period, especially in the early neonatal period, and was associated with extreme prematurity, small size for gestational age and an Apgar score <7 at 5 minutes after birth. The late-onset sepsis was also associated with a greater chance of neonatal death, and antenatal corticosteroids were protective against neonatal and early deaths. Conclusions Although these results are comparable to previous findings regarding mortality among premature infants in Brazil, the study emphasizes the need to implement strategies that promote breastfeeding and reduce neonatal mortality and its early component. PMID:23917938

Symphysis pubis width and unaffected hip joint width in patients with slipped upper femoral epiphysis: widening compared with normal values.

PubMed

Tins, Bernhard; Cassar-Pullicino, Victor; Haddaway, Mike

2010-04-01

The exact pathomechanism of slipped upper femoral epiphysis (SUFE) remains elusive. This paper suggests a generalised abnormality of the development or maturation of cartilage as a possible cause. It is proposed that SUFE is part of a generalised abnormality of the cartilage formation or maturation resulting in abnormal measurements of cartilaginous joint structures. Radiographs of SUFE patients were assessed for the width of the unaffected hip joint and the symphysis pubis. Comparison with previously published normal values was made. Fifty-one patients were assessed, 35 male, 16 female. The average age was 12 years and 11 months combined for both sexes, 13 years 8 months for boys, 11 years 4 months for girls. Width of the symphysis pubis was assessed on 46 datasets, and comparison with normal values was performed using the Wilcoxon paired rank test. Statistical significance was set as p < 0.05. The average expected width was 5.8 mm (5.4-6.2 mm), the average measured width was 7.3 mm (3.5-12 mm), median value 7.0 mm, and the difference is statistically significant. Cartilage thickness of the uninvolved hip joint could be assessed in 46 cases, and comparison using the Wilcoxon paired rank test resulted in a statistically significant difference (significance set as p < 0.05). The average expected width was 4.9 mm (3.6-6.5 mm), the average measured width was 5.5 mm (4-8 mm), and median 5.3 mm. The results indicate that SUFE patients display a generalised increased width of joint cartilage for their age. This could be due to increased cartilage formation or decreased maturation or a combination of the two, and could explain the increased mechanical vulnerability of these children to normal or abnormal stresses, despite histologically normal organisation of the physis as shown in previous studies.

A simple and fast heuristic for protein structure comparison.

PubMed

Pelta, David A; González, Juan R; Moreno Vega, Marcos

2008-03-25

Protein structure comparison is a key problem in bioinformatics. There exist several methods for doing protein comparison, being the solution of the Maximum Contact Map Overlap problem (MAX-CMO) one of the alternatives available. Although this problem may be solved using exact algorithms, researchers require approximate algorithms that obtain good quality solutions using less computational resources than the formers. We propose a variable neighborhood search metaheuristic for solving MAX-CMO. We analyze this strategy in two aspects: 1) from an optimization point of view the strategy is tested on two different datasets, obtaining an error of 3.5%(over 2702 pairs) and 1.7% (over 161 pairs) with respect to optimal values; thus leading to high accurate solutions in a simpler and less expensive way than exact algorithms; 2) in terms of protein structure classification, we conduct experiments on three datasets and show that is feasible to detect structural similarities at SCOP's family and CATH's architecture levels using normalized overlap values. Some limitations and the role of normalization are outlined for doing classification at SCOP's fold level. We designed, implemented and tested.a new tool for solving MAX-CMO, based on a well-known metaheuristic technique. The good balance between solution's quality and computational effort makes it a valuable tool. Moreover, to the best of our knowledge, this is the first time the MAX-CMO measure is tested at SCOP's fold and CATH's architecture levels with encouraging results.

Weighted Kolmogorov-Smirnov test: accounting for the tails.

PubMed

Chicheportiche, Rémy; Bouchaud, Jean-Philippe

2012-10-01

Accurate goodness-of-fit tests for the extreme tails of empirical distributions is a very important issue, relevant in many contexts, including geophysics, insurance, and finance. We have derived exact asymptotic results for a generalization of the large-sample Kolmogorov-Smirnov test, well suited to testing these extreme tails. In passing, we have rederived and made more precise the approximate limit solutions found originally in unrelated fields, first in [L. Turban, J. Phys. A 25, 127 (1992)] and later in [P. L. Krapivsky and S. Redner, Am. J. Phys. 64, 546 (1996)].

Coronary Flow Velocity Reserve during Dobutamine Stress Echocardiography

PubMed Central

de Abreu, José Sebastião; Lima, José Wellington Oliveira; Diógenes, Tereza Cristina Pinheiro; Siqueira, Jordana Magalhães; Pimentel, Nayara Lima; Gomes, Pedro Sabino; de Abreu, Marília Esther Benevides; Paes, José Nogueira

2014-01-01

Background A coronary flow velocity reserve (CFVR) ≥ 2 is adequate to infer a favorable prognosis or the absence of significant coronary artery disease. Objective To identify parameters which are relevant to obtain CFVR (adequate or inadequate) in the left anterior descending coronary artery (LAD) during dobutamine stress echocardiography (DSE). Methods 100 patients referred for detection of myocardial ischemia by DSE were evaluated; they were instructed to discontinue the use of β-blockers 72 hours prior to the test. CFVR was calculated as a ratio of the diastolic peak velocity (cm/s) (DPV) on DSE (DPV-DSE) to baseline DPV at rest (DPV-Rest). In group I, CFVR was < 2 and, in group II, CFVR was ≥ 2. The Fisher's exact test and Student's t test were used for the statistical analyses. P values < 0.05 were considered statistically significant. Results At rest, the time (in seconds) to obtain Doppler in LAD in groups I and II was not different (53±31 vs. 45±32; p=0.23). During DSE, LAD was recorded in 92 patients. Group I patients were older (65.9±9.3 vs. 61.2±10.8 years; p=0.04), had lower ejection fraction (61±10 vs. 66±6%; p=0.005), higher DPV-Rest (36.81±08 vs. 25.63 ± 06cm/s; p<0.0001) and lower CFVR (1.67 ± 0.24 vs. 2.53 ± 0.57; p<0.0001), but no difference was observed regarding DPVDSE (61.40±16 vs. 64.23±16cm/s; p=0.42). β-blocker discontinuation was associated with a 4-fold higher chance of a CFVR < 2 (OR= 4; 95% CI [1.171-13.63], p=0.027). Conclusion DPV-Rest was the main parameter to determine an adequate CFVR. β-blocker discontinuation was significantly associated with inadequate CFVR. The high feasibility and the time to record the LAD corroborate the use of this methodology. PMID:24676368

Mistreatment of university students most common during medical studies

PubMed Central

Rautio, Arja; Sunnari, Vappu; Nuutinen, Matti; Laitala, Marja

2005-01-01

Background This study concerns the occurrence of various forms of mistreatment by staff and fellow students experienced by students in the Faculty of Medicine and the other four faculties of the University of Oulu, Finland. Methods A questionnaire with 51 questions on various forms of physical and psychological mistreatment was distributed to 665 students (451 females) after lectures or examinations and filled in and returned. The results were analysed by gender and faculty. The differences between the males and females were assessed statistically using a test for the equality of two proportions. An exact two-sided P value was calculated using a mid-P approach to Fisher's exact test (the null hypothesis being that there is no difference between the two proportions). Results About half of the students answering the questionnaire had experienced some form of mistreatment by staff during their university studies, most commonly humiliation and contempt (40%), negative or disparaging remarks (34%), yelling and shouting (23%), sexual harassment and other forms of gender-based mistreatment (17%) and tasks assigned as punishment (13%). The students in the Faculty of Medicine reported every form of mistreatment more commonly than those in the Faculties of Humanities, Education, Science and Technology. Experiences of mistreatment varied, but clear messages regarding its patterns were to be found in each faculty. Female students reported more instances of mistreatment than males and were more disturbed by them. Professors, lecturers and other staff in particular mistreated female students more than they mistreated males. About half of the respondents reported some form of mistreatment by their fellow students. Conclusion Students in the Faculty of Medicine reported the greatest amount of mistreatment. If a faculty mistreats its students, its success in the main tasks of universities, research, teaching and learning, will be threatened. The results challenge university teachers, especially in faculties of medicine, to evaluate their ability to create a safe environment conducive to learning. PMID:16232310

Comparison of preoperative nepafenac (0.1%) and flurbiprofen (0.03%) eye drops in maintaining mydriasis during small incision cataract surgery in patients with senile cataract: A randomized, double-blind study.

PubMed

Sarkar, Saumya; Mondal, Kanchan Kumar; Roy, Sukalyan Saha; Gayen, Sharmistha; Ghosh, Abhishek; De, Radha Raman

2015-01-01

This study compared the effectiveness of prophylactic administration of topical flurbiprofen 0.03% and nepafenac 0.1% in maintaining mydriasis during small incision cataract surgery (SICS). This study was a prospective, randomized, double-blind comparative study in adult cataract patients given topical flurbiprofen or nepafenac prior to SICS and capsular bag intraocular lens (IOL) implantation at a tertiary care hospital. Horizontal and vertical diameters of pupil were measured at the beginning and end of surgery, and the mean values were compared across the two groups. Unpaired t-test and Fisher's exact test were used to analyse the results. A total of 70 eyes of cataract surgery patients, 33 males and 37 females, with a mean age of 58.5 ± 11.24 years, were included in the study. The mean horizontal and vertical diameters of the two groups were similar at the start of surgery. Significant differences were seen after IOL implantation, with the nepafenac group having the larger mean diameters in both horizontal (P = 0.03) and vertical (P = 0.04) pupillary measurements. Topical nepafenac has been shown to be a more effective inhibitor of meiosis during SICS and provides a more stable mydriatic effect compared to topical flurbiprofen.

Digital signal processor and processing method for GPS receivers

NASA Technical Reports Server (NTRS)

Thomas, Jr., Jess B. (Inventor)

1989-01-01

A digital signal processor and processing method therefor for use in receivers of the NAVSTAR/GLOBAL POSITIONING SYSTEM (GPS) employs a digital carrier down-converter, digital code correlator and digital tracking processor. The digital carrier down-converter and code correlator consists of an all-digital, minimum bit implementation that utilizes digital chip and phase advancers, providing exceptional control and accuracy in feedback phase and in feedback delay. Roundoff and commensurability errors can be reduced to extremely small values (e.g., less than 100 nanochips and 100 nanocycles roundoff errors and 0.1 millichip and 1 millicycle commensurability errors). The digital tracking processor bases the fast feedback for phase and for group delay in the C/A, P.sub.1, and P.sub.2 channels on the L.sub.1 C/A carrier phase thereby maintaining lock at lower signal-to-noise ratios, reducing errors in feedback delays, reducing the frequency of cycle slips and in some cases obviating the need for quadrature processing in the P channels. Simple and reliable methods are employed for data bit synchronization, data bit removal and cycle counting. Improved precision in averaged output delay values is provided by carrier-aided data-compression techniques. The signal processor employs purely digital operations in the sense that exactly the same carrier phase and group delay measurements are obtained, to the last decimal place, every time the same sampled data (i.e., exactly the same bits) are processed.

Plasmodium vivax circumsporozoite genotypes: a limited variation or new subspecies with major biological consequences?

PubMed Central

2010-01-01

Background Plasmodium vivax circumsporozoite variants have been identified in several geographical areas. The real implication of the genetic variation in this region of the P. vivax genome has been questioned for a long time. Although previous studies have observed significant association between VK210 and the Duffy blood group, we present here that evidences of this variation are limited to the CSP central portion. Methods The phylogenetic analyses were accomplished starting from the amplification of conserved domains of 18 SSU RNAr and Cyt B. The antibodies responses against the CSP peptides, MSP-1, AMA-1 and DBP were detected by ELISA, in plasma samples of individuals infected with two P. vivax CS genotypes: VK210 and P. vivax-like. Results These analyses of the two markers demonstrate high similarity among the P. vivax CS genotypes and surprisingly showed diversity equal to zero between VK210 and P. vivax-like, positioning these CS genotypes in the same clade. A high frequency IgG antibody against the N- and C-terminal regions of the P. vivax CSP was found as compared to the immune response to the R- and V- repetitive regions (p = 0.0005, Fisher's Exact test). This difference was more pronounced when the P. vivax-like variant was present in the infection (p = 0.003, Fisher's Exact test). A high frequency of antibody response against MSP-1 and AMA-1 peptides was observed for all P. vivax CS genotypes in comparison to the same frequency for DBP. Conclusions This results target that the differences among the P. vivax CS variants are restrict to the central repeated region of the protein, mostly nucleotide variation with important serological consequences. PMID:20573199

Copy-Number Variation of the Glucose Transporter Gene SLC2A3 and Congenital Heart Defects in the 22q11.2 Deletion Syndrome.

PubMed

Mlynarski, Elisabeth E; Sheridan, Molly B; Xie, Michael; Guo, Tingwei; Racedo, Silvia E; McDonald-McGinn, Donna M; Gai, Xiaowu; Chow, Eva W C; Vorstman, Jacob; Swillen, Ann; Devriendt, Koen; Breckpot, Jeroen; Digilio, Maria Cristina; Marino, Bruno; Dallapiccola, Bruno; Philip, Nicole; Simon, Tony J; Roberts, Amy E; Piotrowicz, Małgorzata; Bearden, Carrie E; Eliez, Stephan; Gothelf, Doron; Coleman, Karlene; Kates, Wendy R; Devoto, Marcella; Zackai, Elaine; Heine-Suñer, Damian; Shaikh, Tamim H; Bassett, Anne S; Goldmuntz, Elizabeth; Morrow, Bernice E; Emanuel, Beverly S

2015-05-07

The 22q11.2 deletion syndrome (22q11DS; velocardiofacial/DiGeorge syndrome; VCFS/DGS) is the most common microdeletion syndrome and the phenotypic presentation is highly variable. Approximately 65% of individuals with 22q11DS have a congenital heart defect (CHD), mostly of the conotruncal type, and/or an aortic arch defect. The etiology of this phenotypic variability is not currently known. We hypothesized that copy-number variants (CNVs) outside the 22q11.2 deleted region might increase the risk of being born with a CHD in this sensitized population. Genotyping with Affymetrix SNP Array 6.0 was performed on two groups of subjects with 22q11DS separated by time of ascertainment and processing. CNV analysis was completed on a total of 949 subjects (cohort 1, n = 562; cohort 2, n = 387), 603 with CHDs (cohort 1, n = 363; cohort 2, n = 240) and 346 with normal cardiac anatomy (cohort 1, n = 199; cohort 2, n = 147). Our analysis revealed that a duplication of SLC2A3 was the most frequent CNV identified in the first cohort. It was present in 18 subjects with CHDs and 1 subject without (p = 3.12 × 10(-3), two-tailed Fisher's exact test). In the second cohort, the SLC2A3 duplication was also significantly enriched in subjects with CHDs (p = 3.30 × 10(-2), two-tailed Fisher's exact test). The SLC2A3 duplication was the most frequent CNV detected and the only significant finding in our combined analysis (p = 2.68 × 10(-4), two-tailed Fisher's exact test), indicating that the SLC2A3 duplication might serve as a genetic modifier of CHDs and/or aortic arch anomalies in individuals with 22q11DS. Copyright © 2015 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

The CODATA 2017 values of h, e, k, and N A for the revision of the SI

NASA Astrophysics Data System (ADS)

Newell, D. B.; Cabiati, F.; Fischer, J.; Fujii, K.; Karshenboim, S. G.; Margolis, H. S.; de Mirandés, E.; Mohr, P. J.; Nez, F.; Pachucki, K.; Quinn, T. J.; Taylor, B. N.; Wang, M.; Wood, B. M.; Zhang, Z.

2018-04-01

Sufficient progress towards redefining the International System of Units (SI) in terms of exact values of fundamental constants has been achieved. Exact values of the Planck constant h, elementary charge e, Boltzmann constant k, and Avogadro constant N A from the CODATA 2017 Special Adjustment of the Fundamental Constants are presented here. These values are recommended to the 26th General Conference on Weights and Measures to form the foundation of the revised SI.

The prevalence of dental caries and fissure sealants in 12 year old children by disadvantaged status in Dublin (Ireland).

PubMed

Sagheri, D; McLoughlin, J; Clarkson, J J

2009-03-01

The aim was to record dental caries levels and the presence of fissure sealants in 12-year-old schoolchildren whose domestic water supply had been fluoridated since birth in Dublin (Ireland). Cross-sectional study. Participants A representative, random sample of 12-year-old schoolchildren in north-west Dublin. Dental caries levels were recorded using WHO criteria and fissure sealant was recorded when sealant was detectable on a permanent molar tooth. Medical card ownership, as a surrogate for disadvantage, was recorded by use of a questionnaire. Three-hundred and thirty-two (332) children were examined. The mean DMFT was 0.80 (SD 1.24). Analysis (Mann-Whitney U test) based on stratification of the sample according to medical-card status revealed no statistically significant difference between DMFT median scores of children of medical-card holders (i.e., social disadvantage background) and non medical-card holders (p-value = 0.23). However, the data revealed a social gradient in the presence of at least one fissure sealant. Approximately 10% more children in the group of medical-card holders had no fissure sealants present. Fisher's exact test was used to examine the association between the absence of fissure sealants and at least one fissure sealant between the two groups and was considered to be statistically significant (p-value = 0.04). This study demonstrated a social gradient in the presence of fissure sealants, but no such gradient in dental caries levels. This demonstrates the importance of population-based measures in the prevention of dental caries, such as water fluoridation, in reducing oral health inequalities.

Adolescent Sleep and the Impact of Technology Use Before Sleep on Daytime Function.

PubMed

Johansson, Ann E E; Petrisko, Maria A; Chasens, Eileen R

2016-01-01

Technology has become pervasive in our culture, particularly among adolescents. The purpose of this study is to examine associations between use of technology before sleep and daytime function in adolescents. This study is a secondary analysis of respondents aged 13 to 21 years (N = 259) from the 2011 National Sleep Foundation's Sleep in America Poll. The survey included questions on demographics, sleep habits, and use of technology in the hour before bedtime. Daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Student's t-tests, Mann-Whitney U, and Fischer's exact tests were performed to detect differences in demographics, sleep duration, and technology use in the total sample, and between respondents with "adequate" compared to "inadequate" sleep. Correlations were calculated between technology frequency and daytime function. Adolescents had mean sleep duration of 7.3 ± 1.3 h. Almost all respondents (97%) used some form of technology before sleep. Increased technology use and the frequency of being awoken in the night by a cell phone were significantly associated with waking too early, waking unrefreshed, and daytime sleepiness (p < 0.05). Adolescents who reported "inadequate" sleep had shorter sleep duration, greater frequency of technology use before bedtime, feeling unrefreshed on waking, and greater daytime sleepiness than those reporting "adequate" sleep (all p-values < 0.05). Technology use before sleep by adolescents had negative consequences on nighttime sleep and on daytime function. Healthcare professionals who interact with adolescents should encourage technology to be curtailed before bedtime and for adolescents to value obtaining adequate sleep. Copyright © 2016 Elsevier Inc. All rights reserved.

Exact solution of a quantum forced time-dependent harmonic oscillator

NASA Technical Reports Server (NTRS)

Yeon, Kyu Hwang; George, Thomas F.; Um, Chung IN

1992-01-01

The Schrodinger equation is used to exactly evaluate the propagator, wave function, energy expectation values, uncertainty values, and coherent state for a harmonic oscillator with a time dependent frequency and an external driving time dependent force. These quantities represent the solution of the classical equation of motion for the time dependent harmonic oscillator.

Red blood cell distribution width as a predictor of survival in nasal-type, extranodal natural killer/T-cell lymphoma

PubMed Central

He, Qiao; Cai, Shaolei; Li, Shi; Zeng, Jian; Zhang, Qing; Gao, Yu; Yu, Sisi

2017-01-01

We retrospectively enrolled 191 nasal-type, extranodal natural killer/T-cell lymphoma (ENKTL) patients newly diagnosed from 2008 to 2016 at the Sichuan Cancer Hospital, in order to evaluate the relationship between disease outcomes, demographic and clinical factors, and red blood cell distribution width (RDW). C-index, fisher's exact test, univariate analysis, and cox regression analysis were applied. The median age of patients was 44 years and 134 (70%) were men. The cutoff of RDW was 46.2 fL determined by Cutoff Finder. Patients with RDW≤46.2 fL had significantly better progression-free survival (PFS) (3-year PFS, 80.4% vs. 63.1%; P=0.01) and overall survival (OS) (3-year OS, 83.2% vs. 65.5%; P=0.004) than those with RDW>46.2 fL. Multivariate analysis demonstrated that elevated RDW is an independent adverse predictor of OS (P=0.021, HR=2.04). RDW is an independent predictor of survival outcomes in ENKTL, which we found to be superior to both the prognostic index of natural killer lymphoma (PINK) and the Korean Prognostic Index (KPI) in discriminating patients with different outcomes in low-risk and high-risk groups (all P < 0.05). The new models combining RDW with the International Prognostic Index (IPI), KPI, and PINK showed more powerful prognostic value than corresponding original models. RDW represents an easily available and inexpensive marker for risk stratification in patients with ENKTL treated with radiotherapy-based treatment. Further prospective studies are warranted to confirm the prognostic value of RDW in ENKTL. PMID:29190934

Red blood cell distribution width as a predictor of survival in nasal-type, extranodal natural killer/T-cell lymphoma.

PubMed

Luo, Huaichao; Quan, Xiaoying; Song, Xiao-Yu; Zhang, Li; Yin, Yilin; He, Qiao; Cai, Shaolei; Li, Shi; Zeng, Jian; Zhang, Qing; Gao, Yu; Yu, Sisi

2017-11-03

We retrospectively enrolled 191 nasal-type, extranodal natural killer/T-cell lymphoma (ENKTL) patients newly diagnosed from 2008 to 2016 at the Sichuan Cancer Hospital, in order to evaluate the relationship between disease outcomes, demographic and clinical factors, and red blood cell distribution width (RDW). C-index, fisher's exact test, univariate analysis, and cox regression analysis were applied. The median age of patients was 44 years and 134 (70%) were men. The cutoff of RDW was 46.2 fL determined by Cutoff Finder. Patients with RDW≤46.2 fL had significantly better progression-free survival (PFS) (3-year PFS, 80.4% vs. 63.1%; P =0.01) and overall survival (OS) (3-year OS, 83.2% vs. 65.5%; P =0.004) than those with RDW>46.2 fL. Multivariate analysis demonstrated that elevated RDW is an independent adverse predictor of OS ( P =0.021, HR=2.04). RDW is an independent predictor of survival outcomes in ENKTL, which we found to be superior to both the prognostic index of natural killer lymphoma (PINK) and the Korean Prognostic Index (KPI) in discriminating patients with different outcomes in low-risk and high-risk groups (all P < 0.05). The new models combining RDW with the International Prognostic Index (IPI), KPI, and PINK showed more powerful prognostic value than corresponding original models. RDW represents an easily available and inexpensive marker for risk stratification in patients with ENKTL treated with radiotherapy-based treatment. Further prospective studies are warranted to confirm the prognostic value of RDW in ENKTL.

[Significance of bacteria detection with filter paper method on diagnosis of diabetic foot wound infection].

PubMed

Zou, X H; Zhu, Y P; Ren, G Q; Li, G C; Zhang, J; Zou, L J; Feng, Z B; Li, B H

2017-02-20

Objective: To evaluate the significance of bacteria detection with filter paper method on diagnosis of diabetic foot wound infection. Methods: Eighteen patients with diabetic foot ulcer conforming to the study criteria were hospitalized in Liyuan Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from July 2014 to July 2015. Diabetic foot ulcer wounds were classified according to the University of Texas diabetic foot classification (hereinafter referred to as Texas grade) system, and general condition of patients with wounds in different Texas grade was compared. Exudate and tissue of wounds were obtained, and filter paper method and biopsy method were adopted to detect the bacteria of wounds of patients respectively. Filter paper method was regarded as the evaluation method, and biopsy method was regarded as the control method. The relevance, difference, and consistency of the detection results of two methods were tested. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of filter paper method in bacteria detection were calculated. Receiver operating characteristic (ROC) curve was drawn based on the specificity and sensitivity of filter paper method in bacteria detection of 18 patients to predict the detection effect of the method. Data were processed with one-way analysis of variance and Fisher's exact test. In patients tested positive for bacteria by biopsy method, the correlation between bacteria number detected by biopsy method and that by filter paper method was analyzed with Pearson correlation analysis. Results: (1) There were no statistically significant differences among patients with wounds in Texas grade 1, 2, and 3 in age, duration of diabetes, duration of wound, wound area, ankle brachial index, glycosylated hemoglobin, fasting blood sugar, blood platelet count, erythrocyte sedimentation rate, C-reactive protein, aspartate aminotransferase, serum creatinine, and urea nitrogen (with F values from 0.029 to 2.916, P values above 0.05), while there were statistically significant differences among patients with wounds in Texas grade 1, 2, and 3 in white blood cell count and alanine aminotransferase (with F values 4.688 and 6.833 respectively, P <0.05 or P <0.01). (2) According to the results of biopsy method, 6 patients were tested negative for bacteria, and 12 patients were tested positive for bacteria, among which 10 patients were with bacterial number above 1×10(5)/g, and 2 patients with bacterial number below 1×10(5)/g. According to the results of filter paper method, 8 patients were tested negative for bacteria, and 10 patients were tested positive for bacteria, among which 7 patients were with bacterial number above 1×10(5)/g, and 3 patients with bacterial number below 1×10(5)/g. There were 7 patients tested positive for bacteria both by biopsy method and filter paper method, 8 patients tested negative for bacteria both by biopsy method and filter paper method, and 3 patients tested positive for bacteria by biopsy method but negative by filter paper method. Patients tested negative for bacteria by biopsy method did not tested positive for bacteria by filter paper method. There was directional association between the detection results of two methods ( P =0.004), i. e. if result of biopsy method was positive, result of filter paper method could also be positive. There was no obvious difference in the detection results of two methods ( P =0.250). The consistency between the detection results of two methods was ordinary (Kappa=0.68, P =0.002). (3) The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of filter paper method in bacteria detection were 70%, 100%, 1.00, 0.73, and 83.3%, respectively. Total area under ROC curve of bacteria detection by filter paper method in 18 patients was 0.919 (with 95% confidence interval 0-1.000, P =0.030). (4) There were 13 strains of bacteria detected by biopsy method, with 5 strains of Acinetobacter baumannii, 5 strains of Staphylococcus aureus, 1 strain of Pseudomonas aeruginosa, 1 strain of Streptococcus bovis, and 1 strain of bird Enterococcus . There were 11 strains of bacteria detected by filter paper method, with 5 strains of Acinetobacter baumannii, 3 strains of Staphylococcus aureus, 1 strain of Pseudomonas aeruginosa, 1 strain of Streptococcus bovis, and 1 strain of bird Enterococcus . Except for Staphylococcus aureus, the sensitivity and specificity of filter paper method in the detection of the other 4 bacteria were all 100%. The consistency between filter paper method and biopsy method in detecting Acinetobacter baumannii was good (Kappa=1.00, P <0.01), while that in detecting Staphylococcus aureus was ordinary (Kappa=0.68, P <0.05). (5) There was no obvious correlation between the bacteria number of wounds detected by filter paper method and that by biopsy method ( r =0.257, P =0.419). There was obvious correlation between the bacteria numbers detected by two methods in wounds with Texas grade 1 and 2 (with r values as 0.999, P values as 0.001). There was no obvious correlation between the bacteria numbers detected by two methods in wounds with Texas grade 3 ( r =-0.053, P =0.947). Conclusions: The detection result of filter paper method is in accordance with that of biopsy method in the determination of bacterial infection, and it is of great importance in the diagnosis of local infection of diabetic foot wound.

Data Analysis and Its Impact on Predicting Schedule & Cost Risk

DTIC Science & Technology

2006-03-01

variance of the error term by performing a Breusch - Pagan test for constant variance (Neter et al., 1996:239). In order to test the normality of...is constant variance. Using Microsoft Excel®, we calculate a p- 68 value of 0.225678 for the Breusch - Pagan test . We again compare this p-value to...calculate a p-value of 0.121211092 Breusch - Pagan test . We again compare this p-value to an alpha of 0.05 indicating our assumption of constant variance

Density functional theory fragment descriptors to quantify the reactivity of a molecular family: application to amino acids.

PubMed

Senet, P; Aparicio, F

2007-04-14

By using the exact density functional theory, one demonstrates that the value of the local electronic softness of a molecular fragment is directly related to the polarization charge (Coulomb hole) induced by a test electron removed (or added) from (at) the fragment. Our finding generalizes to a chemical group a formal relation between these molecular descriptors recently obtained for an atom in a molecule using an approximate atomistic model [P. Senet and M. Yang, J. Chem. Sci. 117, 411 (2005)]. In addition, a practical ab initio computational scheme of the Coulomb hole and related local descriptors of reactivity of a molecular family having in common a similar fragment is presented. As a blind test, the method is applied to the lateral chains of the 20 isolated amino acids. One demonstrates that the local softness of the lateral chain is a quantitative measure of the similarity of the amino acids. It predicts the separation of amino acids in different biochemical groups (aliphatic, basic, acidic, sulfur contained, and aromatic). The present approach may find applications in quantitative structure activity relationship methodology.

Follow-up chest radiographic findings in patients with MERS-CoV after recovery

PubMed Central

Das, Karuna M; Lee, Edward Y; Singh, Rajvir; Enani, Mushira A; Al Dossari, Khalid; Van Gorkom, Klaus; Larsson, Sven G; Langer, Ruth D

2017-01-01

Purpose: To evaluate the follow-up chest radiographic findings in patients with Middle East respiratory syndrome coronavirus (MERS-CoV) who were discharged from the hospital following improved clinical symptoms. Materials and Methods: Thirty-six consecutive patients (9 men, 27 women; age range 21–73 years, mean ± SD 42.5 ± 14.5 years) with confirmed MERS-CoV underwent follow-up chest radiographs after recovery from MERS-CoV. The 36 chest radiographs were obtained at 32 to 230 days with a median follow-up of 43 days. The reviewers systemically evaluated the follow-up chest radiographs from 36 patients for lung parenchymal, airway, pleural, hilar and mediastinal abnormalities. Lung parenchyma and airways were assessed for consolidation, ground-glass opacity (GGO), nodular opacity and reticular opacity (i.e., fibrosis). Follow-up chest radiographs were also evaluated for pleural thickening, pleural effusion, pneumothorax and lymphadenopathy. Patients were categorized into two groups: group 1 (no evidence of lung fibrosis) and group 2 (chest radiographic evidence of lung fibrosis) for comparative analysis. Patient demographics, length of ventilations days, number of intensive care unit (ICU) admission days, chest radiographic score, chest radiographic deterioration pattern (Types 1-4) and peak lactate dehydrogenase level were compared between the two groups using the student t-test, Mann-Whitney U test and Fisher's exact test. Results: Follow-up chest radiographs were normal in 23 out of 36 (64%) patients. Among the patients with abnormal chest radiographs (13/36, 36%), the following were found: lung fibrosis in 12 (33%) patients GGO in 2 (5.5%) patients, and pleural thickening in 2 (5.5%) patients. Patients with lung fibrosis had significantly greater number of ICU admission days (19 ± 8.7 days; P value = 0.001), older age (50.6 ± 12.6 years; P value = 0.02), higher chest radiographic scores [10 (0-15.3); P value = 0.04] and higher peak lactate dehydrogenase levels (315-370 U/L; P value = 0.001) when compared to patients without lung fibrosis. Conclusion: Lung fibrosis may develop in a substantial number of patients who have recovered from Middle East respiratory syndrome coronavirus (MERS-CoV). Significantly greater number of ICU admission days, older age, higher chest radiographic scores, chest radiographic deterioration patterns and peak lactate dehydrogenase levels were noted in the patients with lung fibrosis on follow-up chest radiographs after recovery from MERS-CoV. PMID:29089687

Intrauterine myelomeningocele repair: effect on short-term complications of prematurity.

PubMed

Hamdan, A H; Walsh, W; Bruner, J P; Tulipan, N

2004-01-01

To determine whether short-term complications of prematurity are affected by intrauterine myelomeningocele repair. Medical records of the first 100 infants undergoing intrauterine myelomeningocele repair (IUMR) at the Vanderbilt University Medical Center were reviewed. Infants born at <34 weeks' gestation were identified. Two controls were identified for each IUMR infant. Controls were matched for gestational age, sex, birth weight, antenatal steroids, and mode and month of delivery. Development of respiratory distress syndrome, intraventricular hemorrhage, and chronic lung disease and days on ventilator and length of hospital stay were recorded. The results are expressed as mean values and ranges. Comparison of data between groups was performed using the Mann-Whitney U test. Categorical data were compared using the chi-square test and Fisher's exact test. p

Somatic mutations in PIK3CA and activation of AKT in intraductal tubulopapillary neoplasms of the pancreas.

PubMed

Yamaguchi, Hiroshi; Kuboki, Yuko; Hatori, Takashi; Yamamoto, Masakazu; Shiratori, Keiko; Kawamura, Shunji; Kobayashi, Makio; Shimizu, Michio; Ban, Shinichi; Koyama, Isamu; Higashi, Morihiro; Shin, Nobuhiro; Ishida, Kazuyuki; Morikawa, Takanori; Motoi, Fuyuhiko; Unno, Michiaki; Kanno, Atsushi; Satoh, Kennichi; Shimosegawa, Tooru; Orikasa, Hideki; Watanabe, Tomoo; Nishimura, Kazuhiko; Harada, Youji; Furukawa, Toru

2011-12-01

Intraductal tubulopapillary neoplasm (ITPN) is a recently recognized rare variant of intraductal neoplasms of the pancreas. Molecular aberrations underlying the neoplasm remain unknown. We investigated somatic mutations in PIK3CA, PTEN, AKT1, KRAS, and BRAF. We also investigated aberrant expressions of phosphorylated AKT, phosphatase and tensin homolog (PTEN), tumor protein 53 (TP53), SMAD4, and CTNNB1 in 11 cases of ITPNs and compared these data with those of 50 cases of intraductal papillary mucinous neoplasm (IPMN), another distinct variant of pancreatic intraductal neoplasms. Mutations in PIK3CA were found in 3 of 11 ITPNs but not in IPMNs (P = 0.005; Fisher exact test). In contrast, mutations in KRAS were found in none of the ITPNs but were found in 26 of the 50 IPMNs (P = 0.001; Fisher exact test). PIK3CA mutations were associated with strong expression of phosphorylated AKT (P < 0.001; the Mann-Whitney U test). Moreover, the expression of phosphorylated AKT was apparent in most ITPNs but only in a few IPMNs (P < 0.001; the Mann-Whitney U test). Aberrant expressions of TP53, SMAD4, and CTNNB1 were not statistically different between these neoplasms. Mutations in PIK3CA and the expression of phosphorylated AKT were not associated with age, sex, tissue invasion, and patients' prognosis in ITPNs. These results indicate that activation of the phosphatidylinositol 3-kinase pathway may play a crucial role in ITPNs but not in IPMNs. In contrast, the mutation in KRAS seems to play a major role in IPMNs but not in ITPNs. The activated phosphatidylinositol 3-kinase pathway may be a potential target for molecular diagnosis and therapy of ITPNs.

Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases.

PubMed

Costantinides, F; Biasotto, M; Maglione, M; Di Lenarda, R

2016-11-01

The choice of the anaesthetic modality is one of the primary steps during planning of third molar surgery. The aim of the present study was to compare the risk of developing neurological injures of the inferior alveolar nerve (IAN) and lingual nerve (LN) in patients treated for wisdom teeth removal under general anaesthesia (GA) with a group treated under local anaesthesia (LA). This is an observational retrospective, unicentric study; between September 2013 and September 2014, 534 patients underwent third molar surgery, 194 (36,3%) under GA and 340 (63,7%) under LA by the same oral surgeon. Difference in the incidence of IAN and LN injures between groups have been statistically analyzed with Fisher exact test and estimated odd ratio for development of such complications has been calculated. In GA patients the incidence of IAN and LN injures was 4.6% and 2.1%, respectively while in the LA group it was and 0.3% and 0%, respectively. A significant difference in IAN and LN involvement between groups was observed (IAN lesion: Fisher exact test, p<0.001; LN lesions: Fisher exact test, p<0.05). The estimated odd ratio for development of IAN injures after GA was 16.49 (95% CI: 2.07-131.19) and was not calculable for LN injures because no cases were observed in the LA group. Since GA is a perioperative variable that seems to significantly increase the risk of developing IAN and LN lesions, when treating patients that request GA, they must be adequately informed that an higher incidence of post-surgical sensory disturbances is expected.

Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases

PubMed Central

Biasotto, Matteo; Maglione, Michele; Di Lenarda, Roberto

2016-01-01

Background The choice of the anaesthetic modality is one of the primary steps during planning of third molar surgery. The aim of the present study was to compare the risk of developing neurological injures of the inferior alveolar nerve (IAN) and lingual nerve (LN) in patients treated for wisdom teeth removal under general anaesthesia (GA) with a group treated under local anaesthesia (LA). Material and Methods This is an observational retrospective, unicentric study; between September 2013 and September 2014, 534 patients underwent third molar surgery, 194 (36,3%) under GA and 340 (63,7%) under LA by the same oral surgeon. Differences in the incidence of IAN and LN injures between groups have been statistically analyzed with Fisher exact test and estimated odd ratio for development of such complications has been calculated. Results In GA patients the incidence of IAN and LN injures was 4.6% and 2.1%, respectively while in the LA group it was and 0.3% and 0%, respectively. A significant difference in IAN and LN involvement between groups was observed (IAN lesion: Fisher exact test, p<0.001; LN lesions: Fisher exact test, p<0.05). The estimated odd ratio for development of IAN injures after GA was 16.49 (95% CI: 2.07-131.19) and was not calculable for LN injures because no cases were observed in the LA group. Conclusions Since GA is a perioperative variable that seems to significantly increase the risk of developing IAN and LN lesions, when treating patients that request GA, they must be adequately informed that an higher incidence of post-surgical sensory disturbances is expected. Key words:Third molars, general anaesthesia, local anaesthesia, inferior alveolar nerve, lingual nerve. PMID:27694783

OPATs: Omnibus P-value association tests.

PubMed

Chen, Chia-Wei; Yang, Hsin-Chou

2017-07-10

Combining statistical significances (P-values) from a set of single-locus association tests in genome-wide association studies is a proof-of-principle method for identifying disease-associated genomic segments, functional genes and biological pathways. We review P-value combinations for genome-wide association studies and introduce an integrated analysis tool, Omnibus P-value Association Tests (OPATs), which provides popular analysis methods of P-value combinations. The software OPATs programmed in R and R graphical user interface features a user-friendly interface. In addition to analysis modules for data quality control and single-locus association tests, OPATs provides three types of set-based association test: window-, gene- and biopathway-based association tests. P-value combinations with or without threshold and rank truncation are provided. The significance of a set-based association test is evaluated by using resampling procedures. Performance of the set-based association tests in OPATs has been evaluated by simulation studies and real data analyses. These set-based association tests help boost the statistical power, alleviate the multiple-testing problem, reduce the impact of genetic heterogeneity, increase the replication efficiency of association tests and facilitate the interpretation of association signals by streamlining the testing procedures and integrating the genetic effects of multiple variants in genomic regions of biological relevance. In summary, P-value combinations facilitate the identification of marker sets associated with disease susceptibility and uncover missing heritability in association studies, thereby establishing a foundation for the genetic dissection of complex diseases and traits. OPATs provides an easy-to-use and statistically powerful analysis tool for P-value combinations. OPATs, examples, and user guide can be downloaded from http://www.stat.sinica.edu.tw/hsinchou/genetics/association/OPATs.htm. © The Author 2017. Published by Oxford University Press.

Online education improves pediatric residents' understanding of atopic dermatitis.

PubMed

Craddock, Megan F; Blondin, Heather M; Youssef, Molly J; Tollefson, Megha M; Hill, Lauren F; Hanson, Janice L; Bruckner, Anna L

2018-01-01

Pediatricians manage skin conditions such as atopic dermatitis (AD) but report that their dermatologic training is inadequate. Online modules may enhance medical education when sufficient didactic or clinical teaching experiences are lacking. We assessed whether an online module about AD improved pediatric residents' knowledge and changed their clinical management of AD. Target and control cohorts of pediatric residents from two institutions were recruited. Target subjects took a 30-question test about AD early in their residency, reviewed the online module, and repeated the test 6 months and 1 year later. The control subjects, who had 1 year of clinical experience but had not reviewed the online module, also took the test. The mean percentage of correct answers was calculated and compared using two-sided, two-sample independent t tests and repeated-measures analysis of variance. For a subset of participants, clinical documentation from AD encounters was reviewed and 13 practice behaviors were compared using the Fisher exact test. Twenty-five subjects in the target cohort and 29 subjects in the control cohort completed the study. The target cohort improved from 18.0 ± 3.2 to 23.4 ± 3.4 correctly answered questions over 1 year (P < .001). This final value was greater than that of the control cohort (20.7 ± 4.5; P = .01). Meaningful differences in practice behaviors were not seen. Pediatric residents who reviewed an online module about AD demonstrated statistically significant improvement in disease-specific knowledge over time and had statistically significantly higher scores than controls. Online dermatology education may effectively supplement traditional clinical teaching. © 2017 Wiley Periodicals, Inc.

Dual diagnosis vs. triple diagnosis in HIV: a comparative study to evaluate the differences in psychopathology and suicidal risk in HIV positive male subjects.

PubMed

Gupta, M; Kumar, K; Garg, P D

2013-12-01

The problem of triple diagnosis of HIV, substance abuse and psychiatric disorders is a complex one with difficult solutions. HIV disease progression is affected by substance use as well as psychiatric illness burden due to both direct as well as indirect factors. Continuing substance abuse with poor drug adherence coexists with psychiatric disorders leading to increased morbidity and mortality. A total of 100 HIV positive subjects comprising of two groups each having 50 subjects with and without substance abuse were assessed using detailed history, mental state examination, WHO schedule for clinical assessment in neuropsychiatry (SCAN 2.0) and Beck's Scale for Suicidal Ideation (BSS). Statistical analysis used Chi-Square test, Fischer's exact test, Student's t-test, Pearson's correlation coefficient, univariate and multiple regression analysis, univariate and multiple logistic regression analysis. p-Value<0.05 was considered to denote statistical significance. Subjects with substance use disorder had higher rates of psychiatric morbidity (52% vs. 24%, 95% CI=0.5200, p<0.05). The rate of antiretroviral therapy default was almost double in subjects with substance abuse, as compared to subjects without substance use. Suicidal risk was significantly increased (p<0.05) in subjects with co-morbid medical disorders but substance abuse did not increase the risk. Substance abuse inflicts a much greater burden on HIV positive individuals as compared to subjects without substance use. Concomitant substance abuse resulted in significantly increased duration of illness and psychiatric morbidity. Copyright © 2013 Elsevier B.V. All rights reserved.

Statistical auditing and randomness test of lotto k/N-type games

NASA Astrophysics Data System (ADS)

Coronel-Brizio, H. F.; Hernández-Montoya, A. R.; Rapallo, F.; Scalas, E.

2008-11-01

One of the most popular lottery games worldwide is the so-called “lotto k/N”. It considers N numbers 1,2,…,N from which k are drawn randomly, without replacement. A player selects k or more numbers and the first prize is shared amongst those players whose selected numbers match all of the k randomly drawn. Exact rules may vary in different countries. In this paper, mean values and covariances for the random variables representing the numbers drawn from this kind of game are presented, with the aim of using them to audit statistically the consistency of a given sample of historical results with theoretical values coming from a hypergeometric statistical model. The method can be adapted to test pseudorandom number generators.

Can the Griess Nitrite Test and a Urinary Pus Cell Count of ≥5 Cells Per Micro Litre of Urine in Pregnant Women be Used for the Screening or the Early Detection of Urinary Tract Infections in Rural India?

PubMed

Thakre, Sushama S; Dhakne, Supriya S; Thakre, Subhash B; Thakre, Amol D; Ughade, Suresh M; Kale, Priya

2012-11-01

Urinary Tract Infection (UTI) is a common problem in pregnancy due to the morphological and the physiological changes that take place in the genitourinary tract during pregnancy. Screening methods may be useful, because a full bacteriological analysis could be reserved for those patients who are symptomatic or those who have positive screening test results. The exact prevalence of UTI in rural, pregnant women is unknown. The present study was undertaken to estimate the prevalence of UTI in pregnant women and for ascertaining the utility of the Griess Nitrite test and the Urinary Pus Cell Count of ≥5 cells per micro litre test for the screening or the early detection of UTI in them at primary health care clinics. Occurrence of urinary complaints was compared in UTI and non UTI women. We conducted a study on 300 randomly selected, pregnant women from rural areas. Urine cultures, pus-cell counts and the Griess nitrite test were used for diagnosis of UTI. The screening tests for UTI were evaluated in terms of their sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and the percentage of correctly classified. In the present study, the prevalence of UTI was found to be 29/300 (9.6%, 95% confidence interval 9.57-9.63). The specificities of the two screening tests were comparable (97.05% and 94.47%). Also, the negative predictive values of the two tests were almost similar (97.77% and 96.96%). The percentage of correctly classified by the Griess nitrite test and the urine pus cell count were found to be 95.33% and 92.33% respectively. The proportion of the women with various urinary complaints was significantly higher (P<0.00) in the UTI subjects as compared to that in the non-UTI subjects. Urine culture remains the gold standard for the detection of asymptomatic bacteriuria. The Nitrite test of uncentrifuged urine was observed to be the best among the screening tests which were evaluated in terms of their efficiency and validity.

HEALER: homomorphic computation of ExAct Logistic rEgRession for secure rare disease variants analysis in GWAS

PubMed Central

Wang, Shuang; Zhang, Yuchen; Dai, Wenrui; Lauter, Kristin; Kim, Miran; Tang, Yuzhe; Xiong, Hongkai; Jiang, Xiaoqian

2016-01-01

Motivation: Genome-wide association studies (GWAS) have been widely used in discovering the association between genotypes and phenotypes. Human genome data contain valuable but highly sensitive information. Unprotected disclosure of such information might put individual’s privacy at risk. It is important to protect human genome data. Exact logistic regression is a bias-reduction method based on a penalized likelihood to discover rare variants that are associated with disease susceptibility. We propose the HEALER framework to facilitate secure rare variants analysis with a small sample size. Results: We target at the algorithm design aiming at reducing the computational and storage costs to learn a homomorphic exact logistic regression model (i.e. evaluate P-values of coefficients), where the circuit depth is proportional to the logarithmic scale of data size. We evaluate the algorithm performance using rare Kawasaki Disease datasets. Availability and implementation: Download HEALER at http://research.ucsd-dbmi.org/HEALER/ Contact: shw070@ucsd.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:26446135

Study of analytical method to seek for exact solutions of variant Boussinesq equations.

PubMed

Khan, Kamruzzaman; Akbar, M Ali

2014-01-01

In this paper, we have been acquired the soliton solutions of the Variant Boussinesq equations. Primarily, we have used the enhanced (G'/G)-expansion method to find exact solutions of Variant Boussinesq equations. Then, we attain some exact solutions including soliton solutions, hyperbolic and trigonometric function solutions of this equation. 35 K99; 35P05; 35P99.

Effect of ethanol on psychomotor performance and on risk taking behaviour.

PubMed

Farquhar, K; Lambert, K; Drummond, G B; Tiplady, B; Wright, P

2002-12-01

Ethanol may increase the willingness to take risks, but this issue remains controversial. We used a risk-taking paradigm in which volunteers answered a series of general knowledge questions with numerical answers and were asked to judge the length of a line that would just fit into a given gap. A maximum score was given for an exactly correct answer. For answers that were less than the correct value, the score was reduced gradually to zero, while answers even slightly over the correct value were penalized considerably. Total points were rewarded by cash payments, so volunteers were taking real risks when making their responses. Performance was assessed in a two-period, double-blind crossover study, comparing ethanol (0.7 g/kg) with placebo in 20 female volunteers aged 19-20 years. Tests were carried out before and at 45 min after dosing. Mean (SD) ethanol blood alcohol concentrations were 65 (10.5) mg/100 ml. Ethanol impaired the skill/ability measure of the length estimation test (SD of difference between length of line and gap), which increased from 5.9 to 6.6 (p < 0.05), indicating a reduced accuracy of estimation. The risk measures in both tasks were not significantly affected. The skill/ability measure in the general knowledge task was not significantly affected. Other performance tests showed that ethanol produced the expected impairment of both speed and accuracy. These results suggest that risk-taking is not increased by ethanol at doses approaching the UK legal limit for driving.

A Conservative Inverse Normal Test Procedure for Combining P-Values in Integrative Research.

ERIC Educational Resources Information Center

Saner, Hilary

1994-01-01

The use of p-values in combining results of studies often involves studies that are potentially aberrant. This paper proposes a combined test that permits trimming some of the extreme p-values. The trimmed statistic is based on an inverse cumulative normal transformation of the ordered p-values. (SLD)

“Soldier's Heart”: A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder

PubMed Central

Pollard, Harvey B.; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M.; Dalgard, Clifton L.; Srivastava, Meera; Wilkerson, Matthew D.; Stein, Murray B.; Ursano, Robert J.

2016-01-01

“Soldier's Heart,” is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test (P = 3 × 10−54). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test (P = 1.8 × 10−16). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation. PMID:27721742

"Soldier's Heart": A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder.

PubMed

Pollard, Harvey B; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M; Dalgard, Clifton L; Srivastava, Meera; Wilkerson, Matthew D; Stein, Murray B; Ursano, Robert J

2016-01-01

"Soldier's Heart," is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test ( P = 3 × 10 -54 ). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test ( P = 1.8 × 10 -16 ). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation.

The Pearson walk with shrinking steps in two dimensions

NASA Astrophysics Data System (ADS)

Serino, C. A.; Redner, S.

2010-01-01

We study the shrinking Pearson random walk in two dimensions and greater, in which the direction of the Nth step is random and its length equals λN-1, with λ<1. As λ increases past a critical value λc, the endpoint distribution in two dimensions, P(r), changes from having a global maximum away from the origin to being peaked at the origin. The probability distribution for a single coordinate, P(x), undergoes a similar transition, but exhibits multiple maxima on a fine length scale for λ close to λc. We numerically determine P(r) and P(x) by applying a known algorithm that accurately inverts the exact Bessel function product form of the Fourier transform for the probability distributions.

An Unconditional Test for Change Point Detection in Binary Sequences with Applications to Clinical Registries.

PubMed

Ellenberger, David; Friede, Tim

2016-08-05

Methods for change point (also sometimes referred to as threshold or breakpoint) detection in binary sequences are not new and were introduced as early as 1955. Much of the research in this area has focussed on asymptotic and exact conditional methods. Here we develop an exact unconditional test. An unconditional exact test is developed which assumes the total number of events as random instead of conditioning on the number of observed events. The new test is shown to be uniformly more powerful than Worsley's exact conditional test and means for its efficient numerical calculations are given. Adaptions of methods by Berger and Boos are made to deal with the issue that the unknown event probability imposes a nuisance parameter. The methods are compared in a Monte Carlo simulation study and applied to a cohort of patients undergoing traumatic orthopaedic surgery involving external fixators where a change in pin site infections is investigated. The unconditional test controls the type I error rate at the nominal level and is uniformly more powerful than (or to be more precise uniformly at least as powerful as) Worsley's exact conditional test which is very conservative for small sample sizes. In the application a beneficial effect associated with the introduction of a new treatment procedure for pin site care could be revealed. We consider the new test an effective and easy to use exact test which is recommended in small sample size change point problems in binary sequences.

Numerical solution of sixth-order boundary-value problems using Legendre wavelet collocation method

NASA Astrophysics Data System (ADS)

Sohaib, Muhammad; Haq, Sirajul; Mukhtar, Safyan; Khan, Imad

2018-03-01

An efficient method is proposed to approximate sixth order boundary value problems. The proposed method is based on Legendre wavelet in which Legendre polynomial is used. The mechanism of the method is to use collocation points that converts the differential equation into a system of algebraic equations. For validation two test problems are discussed. The results obtained from proposed method are quite accurate, also close to exact solution, and other different methods. The proposed method is computationally more effective and leads to more accurate results as compared to other methods from literature.

Mathematical Analysis for Peristaltic Flow of Two Phase Nanofluid in a Curved Channel

NASA Astrophysics Data System (ADS)

Nadeem, S.; Shahzadi, Iqra

2015-11-01

This paper describes the theoretical analysis for peristaltic motion of water base nanofluid containing distinct types of the nanoparticles like Cu, TiO2, and Al2O3. Equations of nano fluid are modelled and simplified by constructing the suppositions of low Reynolds number as well as long wave length. The reduced equations are solved exactly. Solutions are represented through graphs. Outcomes for the velocity, temperature, pressure rise and stream lines are analyzed graphically. The work presented here is based on the fictitious values, however some other values can be tested experimentally.

Bremsstrahlung function, leading Lüscher correction at weak coupling and localization

NASA Astrophysics Data System (ADS)

Bonini, Marisa; Griguolo, Luca; Preti, Michelangelo; Seminara, Domenico

2016-02-01

We discuss the near BPS expansion of the generalized cusp anomalous dimension with L units of R-charge. Integrability provides an exact solution, obtained by solving a general TBA equation in the appropriate limit: we propose here an alternative method based on supersymmetric localization. The basic idea is to relate the computation to the vacuum expectation value of certain 1/8 BPS Wilson loops with local operator insertions along the contour. These observables localize on a two-dimensional gauge theory on S 2, opening the possibility of exact calculations. As a test of our proposal, we reproduce the leading Lüscher correction at weak coupling to the generalized cusp anomalous dimension. This result is also checked against a genuine Feynman diagram approach in {N}=4 Super Yang-Mills theory.

Value of the Cosmological Constant in Emergent Quantum Gravity

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

Hogan, Craig

It is suggested that the exact value of the cosmological constant could be derived from first principles, based on entanglement of the Standard Model field vacuum with emergent holographic quantum geometry. For the observed value of the cosmological constant, geometrical information is shown to agree closely with the spatial information density of the QCD vacuum, estimated in a free-field approximation. The comparison is motivated by a model of exotic rotational fluctuations in the inertial frame that can be precisely tested in laboratory experiments. Cosmic acceleration in this model is always positive, but fluctuates with characteristic coherence lengthmore » $$\\approx 100$$km and bandwidth $$\\approx 3000$$ Hz.« less

Multifunctional Nanocomposites for Breast Cancer Imaging and Therapy

DTIC Science & Technology

2008-07-01

compounds, because of the low stability of the thiolate -capped PbS QDs at physiological pH values. The following approach, consisting of 3 phases, was...syntheses employed amphiphilic polymers to stabilize CdSe/ZnS QDs, or phospholipids micelles to stabilize Si QDs, or used ligand exchange followed...attached per surface. However, it is very difficult to estimate the exact amount within the large G6- polymer of MW= 69,351 without measuring the 800 or

Ex-PRESS outcomes using mitomycin-C, Ologen alone, Ologen with 5-fluorouracil.

PubMed

Menda, Shivali A; Lowry, Eugene A; Porco, Travis C; Stamper, Robert L; Rubin, Michel R; Han, Ying

2015-06-01

To compare the complication rate and effectiveness of mitomycin C (MMC), Ologen alone, and Ologen with 5-fluorouracil (5-FU) as adjunctives with Ex-PRESS mini shunt for medically uncontrolled glaucoma. Retrospective comparative study of 59 Ex-PRESS mini shunt trabeculectomy operations coupled with Ologen implantation alone, transient MMC application or Ologen implantation with 5-FU as adjunctive treatment. Eight eyes (7 patients) received Ologen alone, 37 eyes (34 patients) received MMC, and 14 eyes (14 patients) received Ologen with 5-FU as adjunctive therapy. Baseline characteristics, adjunctive used during operation, along with outcomes including intraocular pressure (IOP), number of anti-hypertensive drops, visual acuity, and complications were documented and compared. The primary outcome was IOP at 12 months. Variables were compared with r × c Fisher tests. The Ologen only group had a significantly higher IOP at 12 months (20.5 ± 10.23 mmHg) compared with Ologen combined with 5-FU (12.2 ± 1.47 mmHg) or MMC (13.8 ± 4.37 mmHg) (p = 0.015, linear mixed model). The Ologen only cohort also had a higher re-operation rate (p = 0.01, Fisher's Exact Test) and higher rate of bleb leak (p = 0.02, Fisher's Exact Test). Visual acuity was similar among all three groups. 5-FU with Ologen is as effective as MMC in maintaining IOP following Ex-PRESS shunt surgery at 1 year. However, Ologen alone may not be as effective as the other two adjunctive agents.

[Hospitalization period and nutritional status in hospitalized patients].

PubMed

Merhi, V A Leandro; de Oliveira, Ma R Marques; Caran, A L; Tristão, T Menuzzo Graupner; Ambo, R Miante; Tanner, M A; Vergna, C Marton

2007-01-01

With the objective of studying the nutritional status and its relationship with hospitalization period, a cross-sectional study was done with patients from a private hospital representing a population with a better socioeconomic condition. The anthropometric data of 267 patients, 46% males and 54% females ranging from 20 to 80 years of age, were assessed on the second day of hospitalization. Hospitalization period associated with nutritional status. The data were analyzed by the software Excel and Sigma Stat, using Fisher's exact test and the chi-square test. The studied population presented a body mass index of 25.9 +/- 5.3 and most patients lost weight during hospitalization. The longest hospitalization periods were found among patients with lung diseases (13 days), some being pre-obese (40%) with a small prevalence of undernutrition (4%). The percentage distribution of nutritional status among the groups according to diagnosis was different (P < 0.01) when assessed by the Fisher's exact test and the percentage distribution in weight variation between men and women was different (P < 0.02) when assessed by the chi-square test. When the population was segmented according to age, the percentage distribution of the nutritional status between > 60 and < or = 60 did not present a difference when assessed by the chi-square test. The results of this study show that the nutritional status in some diseases deserves special attention given the greater risk found in these situations, contributing to a longer hospitalization period.

Novel endoscopic delivery modality of infrared coagulation therapy for internal hemorrhoids.

PubMed

McLemore, Elisabeth C; Rai, Rudra; Siddiqui, Junaid; Basu, P Patrick; Tabbaa, Mousab; Epstein, Michael S

2012-11-01

A novel endoscopic delivery system for infrared coagulation therapy (IRC) has been designed recently. IRC is a well-established treatment for symptomatic internal hemorrhoids. Patients frequently undergo lower endoscopy before hemorrhoid treatment to eliminate other sources of bleeding. Current treatment options are difficult to perform without an anal retractor, adequate lighting, and specialized instruments. Endoscopic IRC is an attractive alternative to standard IRC, because it can be performed during the lower endoscopy. Endoscopic IRC utilizes infrared radiation generated by a control box, which is applied to the tissue through a flexible, fiber optic light guide (Precision Endoscopic Infrared Coagulator™). The light guide is placed through the colonoscope or flexible sigmoidoscope in the same chamber as other endoscopic instruments. A retrospective review was performed using a prospectively collected database. A standardized protocol was utilized in all patients. Patients graded their symptoms before and after therapy by using the visual analog symptom severity scoring system (range, 0-10). These results were analyzed by using the nonparametric Wilcoxon signed-rank test. Exact P values were computed by using the R function wilcox.exact. A total of 55 patients underwent endoscopic IRC for predominately grade II and grade III symptomatic internal hemorrhoids (71 %). There were 22 (40 %) female patients. Posttherapy results indicated a significant improvement in global symptoms (pretreatment average global score = 2.24 vs. posttreatment average global score = 0.28; P < 0.0001). There have been no adverse events reported to date. Endoscopic IRC provides improved visibility and efficiency, allowing simultaneous treatment of symptomatic internal hemorrhoids at the time of lower endoscopy. Patients experienced significant improvement in their symptoms after a single session of endoscopic IRC. There are a variety of additional endoscopic IRC therapeutic utilities: endoscopic management of angiodysplasia, inflammation, hemostasis, and NOTES applications.

The Influence of Agility Training on Physiological and Cognitive Performance

DTIC Science & Technology

2010-11-01

attenuate the fat gain. We did not measure exact calorie expenditure or intake during the protocol but we did strictly equilibrate duration, frequency...bodyweight change between groups was significant (pɘ.05.) Both groups increased their percentages of body fat from pre to post testing, although the...traditional group gained slightly more fat (1.6 kg) than the agility group (0.9 kg). VO2max increased by 6.1%, or 2.6 ml/kg/min, (pɘ.05) in the

Estimates of Pertussis Vaccine Effectiveness in United States Air Force Pediatric Dependents

DTIC Science & Technology

2015-06-22

SAS 9.3 (SAS Institute Inc., Cary, NC). Chi- square and Fisher’s exact tests were used to examine demographic and vaccination status differences...members were sig- nificantly (95% CI: 1.70, 9.37; p < 0.001) protected from pertussis, having 74.9% reduced odds of disease (OR = 0.25). Latino ...children had higher odds of pertussis than non- Latinos (OR = 1.98, 95% CI: 0.66, 5.94; p = 0.22), a non-significant finding. No significant trends were

Dispersion of Vapor from LNG Spills -- Simulation in a Meteorological Wind Tunnel of Spills at China Lake Naval Weapons Center, California.

DTIC Science & Technology

1979-03-01

and Diffusion Laboratory Department of Civil Engineering, , / """..,--. Colorado State University DOT-CG-75279-A) )V Fnrt Cnl lin. Colorado 80523 ype...Film Aspirating Probe ......... .. 20 3.5.2 Errors in Concentration Measurement . . 21 4.0 TEST PROGRAM RESULTS ..... ............... .. 23 4.1...Coriolis Force Viscous Diffusivity Prandtl number Pr = v/(k/P C ViThrma Diffusivity0 0 p Thermal Diffusivity Eckert number Ec = /Cpo (AT)o 5 For exact

Can diffusion-weighted imaging distinguish between benign and malignant pediatric liver tumors?

PubMed

Caro-Domínguez, Pablo; Gupta, Abha A; Chavhan, Govind B

2018-01-01

There are limited data on utility of diffusion-weighted imaging (DWI) in the evaluation of pediatric liver lesions. To determine whether qualitative and quantitative DWI can be used to differentiate benign and malignant pediatric liver lesions. We retrospectively reviewed MRIs in children with focal liver lesions to qualitatively evaluate lesions noting diffusion restriction, T2 shine-through, increased diffusion, hypointensity on DWI and apparent diffusion coefficient (ADC) maps, and intermediate signal on both, and to measure ADC values. Pathology confirmation or a combination of clinical, laboratory and imaging features, and follow-up was used to determine final diagnosis. We included 112 focal hepatic lesions in 89 children (median age 11.5 years, 51 female), of which 92 lesions were benign and 20 malignant. Interobserver agreement was almost perfect for both qualitative (kappa 0.8735) and quantitative (intraclass correlation coefficient [ICC] 0.96) diffusion assessment. All malignant lesions showed diffusion restriction. Most benign lesions other than abscesses were not restricted. There was significant association of qualitative restriction with malignancy and non-restriction with benignancy (Fisher exact test P<0.0001). Mean normalized ADC values of malignant lesions (1.23x10 -3  mm 2 /s) were lower than benign lesions (1.62x10 -3  mm 2 /s; Student's t-test, P<0.015). However, there was significant overlap of ADC between benign and malignant lesions, with wide range for each diagnosis. Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.63 for predicting malignancy using an ADC cut-off value of ≤1.20x10 -3  mm 2 /s, yielding a sensitivity of 78% and a specificity of 54% for differentiating malignant from benign lesions. Qualitative diffusion restriction in pediatric liver lesions is a good predictor of malignancy and can help to differentiate between benign and malignant lesions, in conjunction with conventional MR sequences. Even though malignant lesions demonstrated significantly lower ADC values than benign lesions, the use of quantitative diffusion remains limited in its utility for distinguishing them because of the significant overlap and wide ranges of ADC values.

Noninvasive molecular screening for oral precancer in Fanconi anemia patients.

PubMed

Smetsers, Stephanie E; Velleuer, Eunike; Dietrich, Ralf; Wu, Thijs; Brink, Arjen; Buijze, Marijke; Deeg, Dorly J H; Soulier, Jean; Leemans, C René; Braakhuis, Boudewijn J M; Brakenhoff, Ruud H

2015-11-01

LOH at chromosome arms 3p, 9p, 11q, and 17p are well-established oncogenetic aberrations in oral precancerous lesions and promising biomarkers to monitor the development of oral cancer. Noninvasive LOH screening of brushed oral cells is a preferable method for precancer detection in patients at increased risk for head and neck squamous cell carcinoma (HNSCC), such as patients with Fanconi anemia. We determined the prevalence of LOH in brushed samples of the oral epithelium of 141 patients with Fanconi anemia and 144 aged subjects, and studied the association between LOH and HNSCC. LOH was present in 14 (9.9%) nontransplanted patients with Fanconi anemia, whereas LOH was not detected in a low-risk group (n = 50, >58 years, nonsmoking/nonalcohol history) and a group with somewhat increased HNSCC risk (n = 94, >58 years, heavy smoking/excessive alcohol use); Fisher exact test, P = 0.023 and P = 0.001, respectively. Most frequent genetic alteration was LOH at 9p. Age was a significant predictor of LOH (OR, 1.13, P = 0.001). Five patients with Fanconi anemia developed HNSCC during the study at a median age of 39.6 years (range, 24.8-53.7). LOH was significantly associated with HNSCC (Fisher exact test, P = 0.000). Unexpectedly, the LOH assay could not be used for transplanted patients with Fanconi anemia because donor DNA in brushed oral epithelium, most likely from donor leukocytes present in the oral cavity, disturbed the analysis. Noninvasive screening using a LOH assay on brushed samples of the oral epithelium has a promising outlook in patients with Fanconi anemia. However, assays need to be adapted in case of stem cell transplantation, because of contaminating donor DNA. ©2015 American Association for Cancer Research.

The role of clinically significant antiphospholipid antibodies in systemic lupus erythematosus.

PubMed

Taraborelli, M; Lazzaroni, M G; Martinazzi, N; Fredi, M; Cavazzana, I; Franceschini, F; Tincani, A

2016-12-16

The objective is to investigate the role of clinically significant antiphospholipid antibodies (aPL) in a cohort of systemic lupus erythematosus (SLE) patients. All SLE patients followed for at least 5 years and with available aPL profile at the beginning of the follow-up in our center were studied. Clinically significant aPL were defined as: positive lupus anticoagulant test, anti-cardiolipin and/or anti- β2Glycoprotein I IgG/IgM >99th percentile on two or more occasions at least 12 weeks apart. Patients with and without clinically significant aPL were compared by univariate (Chi square or Fisher's exact test for categorical variables and Student's t or Mann-Whitney test for continuous variables) and multivariate analysis (logistic regression analysis). P values <0.05 were considered significant. Among 317 SLE patients studied, 117 (37%) had a clinically significant aPL profile at baseline. Such patients showed at univariate analysis an increased prevalence of deep venous thrombosis, pulmonary embolism, cardiac valvular disease, cognitive dysfunction and antiphospholipid syndrome (APS), but a reduced prevalence of acute cutaneous lupus and anti-extractable nuclear antigens (ENA) when compared with patients without clinically significant aPL. Multivariate analysis confirmed the association between clinically significant aPL and reduced risk of acute cutaneous lupus [p=0.003, odds ratio (OR) 0.43] and ENA positivity (p<0.001, OR 0.37), with increased risk of cardiac valvular disease (p=0.024, OR 3.1) and APS (p<0.0001, OR 51.12). Triple positivity was the most frequent profile and was significantly associated to APS (p<0.0001, OR 28.43). Our study showed that one third of SLE patients had clinically significant aPL, and that this is associated with an increased risk, especially for triple positive, of APS, and to a different clinical and serological pattern of disease even in the absence of APS.

Impact of a bladder scan protocol on discharge efficiency within a care pathway for ambulatory inguinal herniorraphy.

PubMed

Antonescu, I; Baldini, G; Watson, D; Kaneva, P; Fried, G M; Khwaja, K; Vassiliou, M C; Carli, F; Feldman, L S

2013-12-01

Postoperative urinary retention (POUR) is a common complication of ambulatory inguinal herniorraphy, with an incidence reaching 38%, and many surgeons require patients to void before discharge. This study aimed to assess whether the implementation of a bladder scan-based voiding protocol reduces the time until discharge after ambulatory inguinal herniorraphy without increasing the rate of POUR. As part of a perioperative care pathway, a protocol was implemented to standardize decision making after elective inguinal hernia repair (February 2012). Patients were assessed with a bladder scan, and those with <600 mL of urine were discharged home, whereas those with more than 600 mL of urine had an in-and-out catheterization before discharge. The patients received written information about urinary symptoms and instructions to present to the emergency department if they were unable to void at home. An audit of scheduled outpatient inguinal hernia repairs between October 2011 and July 2012 was performed. Comparisons were made using the t test, Fisher's exact test, and Wilcoxon rank sum test where appropriate. Statistical significance was defined a priori as a p value lower than 0.05. During the study period, 124 patients underwent hernia repair: 60 before and 64 after implementation of the protocol. The findings showed no significant differences in patient characteristics, laparoscopic approach (35 vs. 33%; p = 0.80), proportion receiving general anesthesia (70 vs. 73%; p = 0.67), or amount of intravenous fluids given (793 vs. 663 mL; p = 0.07). The proportion of patients voiding before discharge was higher after protocol implementation (73 vs. 89%; p = 0.02). The protocol had no impact on median time to discharge (190 vs. 205 min; p = 0.60). Only one patient in each group presented to the emergency department with POUR (2%). After ambulatory inguinal herniorraphy, implementation of a bladder scan-based voiding protocol did not result in earlier discharge. The incidence of POUR was lower than reported in the literature.

Modelling of single walled carbon nanotube cylindrical structures with finite element method simulations

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

Günay, E.

In this study, the modulus of elasticity and shear modulus values of single-walled carbon nanotubes SWCNTs were modelled by using both finite element method and the Matlab code. Initially, cylindrical armchair and zigzag single walled 3D space frames were demonstrated as carbon nanostructures. Thereafter, macro programs were written by the Matlab code producing the space truss for zigzag and armchair models. 3D space frames were introduced to the ANSYS software and then tension, compression and additionally torsion tests were performed on zigzag and armchair carbon nanotubes with BEAM4 element in obtaining the exact values of elastic and shear modulus values.more » In this study, two different boundary conditions were tested and especially used in torsion loading. The equivalent shear modulus data was found by averaging the corresponding values obtained from ten different nodal points on the nanotube path. Finally, in this study it was determined that the elastic constant values showed proportional changes by increasing the carbon nanotube diameters up to a certain level but beyond this level these values remained stable.« less

Mathematical Modelling of the Infusion Test

NASA Astrophysics Data System (ADS)

Cieslicki, Krzysztof

2007-01-01

The objective of this paper was to improve the well established in clinical practice Marmarou model for intracranial volume-pressure compensation by adding the pulsatile components. It was demonstrated that complicated pulsation and growth in intracranial pressure during infusion test could be successfully modeled by the relatively simple analytical expression derived in this paper. The CSF dynamics were tested in 25 patients with clinical symptoms of hydrocephalus. Basing on the frequency spectrum of the patient's baseline pressure and identified parameters of CSF dynamic, for each patient an "ideal" infusion test curve free from artefacts and slow waves was simulated. The degree of correlation between simulated and real curves obtained from clinical observations gave insight into the adequacy of assumptions of Marmarou model. The proposed method of infusion tests analysis designates more exactly the value of the reference pressure, which is usually treated as a secondary and of uncertain significance. The properly identified value of the reference pressure decides on the degree of pulsation amplitude growth during IT, as well as on the value of elastance coefficient. The artificially generated tests with various pulsation components were also applied to examine the correctness of the used algorithm of identification of the original Marmarou model parameters.

An improved exact inversion formula for solenoidal fields in cone beam vector tomography

NASA Astrophysics Data System (ADS)

Katsevich, Alexander; Rothermel, Dimitri; Schuster, Thomas

2017-06-01

In this paper we present an improved inversion formula for the 3D cone beam transform of vector fields supported in the unit ball which is exact for solenoidal fields. It is well known that only the solenoidal part of a vector field can be determined from the longitudinal ray transform of a vector field in cone beam geometry. The inversion formula, as it was developed in Katsevich and Schuster (2013 An exact inversion formula for cone beam vector tomography Inverse Problems 29 065013), consists of two parts. The first part is of the filtered backprojection type, whereas the second part is a costly 4D integration and very inefficient. In this article we tackle this second term and obtain an improved formula, which is easy to implement and saves one order of integration. We also show that the first part contains all information about the curl of the field, whereas the second part has information about the boundary values. More precisely, the second part vanishes if the solenoidal part of the original field is tangential at the boundary. A number of numerical tests presented in the paper confirm the theoretical results and the exactness of the formula. Also, we obtain an inversion algorithm that works for general convex domains.

Explorations in statistics: hypothesis tests and P values.

PubMed

Curran-Everett, Douglas

2009-06-01

Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This second installment of Explorations in Statistics delves into test statistics and P values, two concepts fundamental to the test of a scientific null hypothesis. The essence of a test statistic is that it compares what we observe in the experiment to what we expect to see if the null hypothesis is true. The P value associated with the magnitude of that test statistic answers this question: if the null hypothesis is true, what proportion of possible values of the test statistic are at least as extreme as the one I got? Although statisticians continue to stress the limitations of hypothesis tests, there are two realities we must acknowledge: hypothesis tests are ingrained within science, and the simple test of a null hypothesis can be useful. As a result, it behooves us to explore the notions of hypothesis tests, test statistics, and P values.

A simple and fast heuristic for protein structure comparison

PubMed Central

Pelta, David A; González, Juan R; Moreno Vega, Marcos

2008-01-01

Background Protein structure comparison is a key problem in bioinformatics. There exist several methods for doing protein comparison, being the solution of the Maximum Contact Map Overlap problem (MAX-CMO) one of the alternatives available. Although this problem may be solved using exact algorithms, researchers require approximate algorithms that obtain good quality solutions using less computational resources than the formers. Results We propose a variable neighborhood search metaheuristic for solving MAX-CMO. We analyze this strategy in two aspects: 1) from an optimization point of view the strategy is tested on two different datasets, obtaining an error of 3.5%(over 2702 pairs) and 1.7% (over 161 pairs) with respect to optimal values; thus leading to high accurate solutions in a simpler and less expensive way than exact algorithms; 2) in terms of protein structure classification, we conduct experiments on three datasets and show that is feasible to detect structural similarities at SCOP's family and CATH's architecture levels using normalized overlap values. Some limitations and the role of normalization are outlined for doing classification at SCOP's fold level. Conclusion We designed, implemented and tested.a new tool for solving MAX-CMO, based on a well-known metaheuristic technique. The good balance between solution's quality and computational effort makes it a valuable tool. Moreover, to the best of our knowledge, this is the first time the MAX-CMO measure is tested at SCOP's fold and CATH's architecture levels with encouraging results. Software is available for download at . PMID:18366735

Testes-specific protease 50 as an independent risk factor for poor prognosis in patients with non-small cell lung cancer

PubMed Central

Qiao, Wen-Liang; Shi, Bo-Wen; Han, Yu-Dong; Tang, Hua-Mei; Lin, Jun; Hu, Hai-Yang; Lin, Qiang

2018-01-01

Testes-specific protease 50 (TSP50) is normally expressed in the testes and is overexpressed in various types of human cancers, including breast cancer, colorectal carcinoma and laryngocarcinoma. However, little has been reported on the association between TSP50 and non-small cell lung cancer (NSCLC). The present study aimed to detect TSP50 expression in 198 strict follow-up cases of paired NSCLC and 15 cases of normal lung parenchymal specimens using immunohistochemical staining. The expression levels of TSP50 were then correlated with the clinicopathological factors of NSCLC to assess its potential diagnostic and prognostic value. The relationship between TSP50 expression and the clinicopathological parameters of NSCLC was evaluated using χ2 and Fisher's exact tests. Survival rates for the overall population (n=198) were calculated using the Kaplan-Meier method, and univariate and multivariate analyses were performed using the Cox's proportional hazards regression model. P<0.05 was considered to indicate a statistically significant difference. The expression of TSP50 was significantly increased in NSCLC tissue compared with in adjacent non-tumor or normal lung parenchymal tissue (P<0.001). A significant association was revealed between high expression levels of TSP50 and clinicopathological characteristics including tumor differentiation (P=0.012), late tumor status (P=0.004) and late tumor node metastasis stage (P=0.026), as well as a reduced disease free survival (P=0.009) and overall survival rate (P=0.002) in all patients with NSCLC. Multivariate analyses demonstrated that high TSP50 expression in tumor tissues was significantly associated with a shorter disease-free survival rate [hazard ratio (HR) =1.590, 95% confidence interval (CI): 1.035–2.441], and with a shorter overall survival rate (HR=1.814; 95% CI: 1.156–2.846). In conclusion, the present data demonstrated that increased TSP50 protein expression may be a potential predictor of early recurrence and poor prognosis in NSCLC, and that TSP50 expression levels possess the potential to be used as a biomarker and therapeutic target for the treatment of patients with NSCLC. PMID:29805619

Testes-specific protease 50 as an independent risk factor for poor prognosis in patients with non-small cell lung cancer.

PubMed

Qiao, Wen-Liang; Shi, Bo-Wen; Han, Yu-Dong; Tang, Hua-Mei; Lin, Jun; Hu, Hai-Yang; Lin, Qiang

2018-06-01

Testes-specific protease 50 (TSP50) is normally expressed in the testes and is overexpressed in various types of human cancers, including breast cancer, colorectal carcinoma and laryngocarcinoma. However, little has been reported on the association between TSP50 and non-small cell lung cancer (NSCLC). The present study aimed to detect TSP50 expression in 198 strict follow-up cases of paired NSCLC and 15 cases of normal lung parenchymal specimens using immunohistochemical staining. The expression levels of TSP50 were then correlated with the clinicopathological factors of NSCLC to assess its potential diagnostic and prognostic value. The relationship between TSP50 expression and the clinicopathological parameters of NSCLC was evaluated using χ 2 and Fisher's exact tests. Survival rates for the overall population (n=198) were calculated using the Kaplan-Meier method, and univariate and multivariate analyses were performed using the Cox's proportional hazards regression model. P<0.05 was considered to indicate a statistically significant difference. The expression of TSP50 was significantly increased in NSCLC tissue compared with in adjacent non-tumor or normal lung parenchymal tissue (P<0.001). A significant association was revealed between high expression levels of TSP50 and clinicopathological characteristics including tumor differentiation (P=0.012), late tumor status (P=0.004) and late tumor node metastasis stage (P=0.026), as well as a reduced disease free survival (P=0.009) and overall survival rate (P=0.002) in all patients with NSCLC. Multivariate analyses demonstrated that high TSP50 expression in tumor tissues was significantly associated with a shorter disease-free survival rate [hazard ratio (HR) =1.590, 95% confidence interval (CI): 1.035-2.441], and with a shorter overall survival rate (HR=1.814; 95% CI: 1.156-2.846). In conclusion, the present data demonstrated that increased TSP50 protein expression may be a potential predictor of early recurrence and poor prognosis in NSCLC, and that TSP50 expression levels possess the potential to be used as a biomarker and therapeutic target for the treatment of patients with NSCLC.

Magnetic properties of the ternary alloy with a structure of Prussian blue analogs

NASA Astrophysics Data System (ADS)

Dely, J.; Bobák, A.

2007-01-01

The magnetic properties (phase diagram, compensation temperature, magnetic susceptibility, and magnetization) of the ABpC1-p ternary alloy in the presence of a single-ion anisotropy on the B ions only are investigated by the use of a mean-field theory. Depending on the values of the parameters in the model Hamiltonian, the present system may exhibit one, two or even three compensation temperatures Tk. It is shown that the total magnetic susceptibility of the ferrimagnetic system can generally take a finite value at transition temperature Tc only if the relation Tc=Tk is exactly satisfied. Also, by using this model, some characteristics observed in the Prussian blue analog of the type (FepIIMn1-pII)1.5[CrIII(CN)6]·nH2O are quantitatively or qualitatively well reproduced.

Matrix superpotentials

NASA Astrophysics Data System (ADS)

Nikitin, Anatoly G.; Karadzhov, Yuri

2011-07-01

We present a collection of matrix-valued shape invariant potentials which give rise to new exactly solvable problems of SUSY quantum mechanics. It includes all irreducible matrix superpotentials of the generic form W=kQ+\\frac{1}{k} R+P, where k is a variable parameter, Q is the unit matrix multiplied by a real-valued function of independent variable x, and P and R are the Hermitian matrices depending on x. In particular, we recover the Pron'ko-Stroganov 'matrix Coulomb potential' and all known scalar shape invariant potentials of SUSY quantum mechanics. In addition, five new shape invariant potentials are presented. Three of them admit a dual shape invariance, i.e. the related Hamiltonians can be factorized using two non-equivalent superpotentials. We find discrete spectrum and eigenvectors for the corresponding Schrödinger equations and prove that these eigenvectors are normalizable.

Detection of circulating tumour cells may add value in endometrial cancer management.

PubMed

Ni, T; Sun, X; Shan, B; Wang, J; Liu, Y; Gu, S-L; Wang, Y-D

2016-12-01

To evaluate the role of circulating tumour cells (CTCs) in patients with endometrial cancer (EC). This study included 40 patients with a pre-operative diagnosis of high-risk EC between April 2015 and May 2016. Patients were further divided into high-risk (grade 3, non-endometrioid, myometrial invasion ≥1/2 and stage III-IV) and high-intermediate-risk (grade 2-3, endometrioid, myometrial invasion <1/2 and stage I-II) groups according to postoperative pathological results. CTCs were detected using the CellSearch system, and CTC results were correlated with standard clinicopathological characteristics and serum tumour marker CA125/HE4 status using Chi-squared test, continuity correction or Fisher's exact test. The pharmacodynamic effect was detected after the first cycle of adjuvant therapy. Patients were followed up for 13 months to assess outcomes. Fifteen percent of patients had one or more CTCs. The presence of CTCs was found to be significantly associated with cervical involvement (83.33% vs 11.76%, p=0.00). No significant difference in CTC-positive rates was detected between the high-risk and high-intermediate-risk groups, and no significant correlation was found between CTCs and serum CA125/HE4, either by positive rates or exact serum levels of the conventional tumour markers. No more CTCs were detected after the first cycle of standard chemotherapy in this study, and no distant metastases or recurrence were found in the CTC-positive patients during the follow-up period. The presence of CTCs was correlated with cervical involvement. Early-stage EC patients with CTCs may benefit from additional adjuvant therapies. Assessment of CTCs may be useful in the management of high-risk EC patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dual tracer 11C-choline and FDG-PET in the diagnosis of biochemical prostate cancer relapse after radical treatment.

PubMed

Richter, José A; Rodríguez, Macarena; Rioja, Jorge; Peñuelas, Iván; Martí-Climent, Josep; Garrastachu, Puy; Quincoces, Gemma; Zudaire, Javier; García-Velloso, María J

2010-04-01

The purpose of this study was to evaluate a dual tracer 2-deoxy-2-[F-18]fluoro-D: -glucose (FDG) and (11)C-choline positron emission tomography (PET) protocol in the detection of biochemical prostate cancer relapse. Seventy-three patients (median Prostate Specific Antigen (PSA) Test value 2.7 ng/ml (1.1-5.4)) after radical treatment. PET scans were performed by means of a ECAT-Exact HR+ in the first 18 patients and in a PET/computed tomography Biograph II in the remaining 55 patients. The sensitivity of (11)C-choline and FDG was 60.6% and 31%. In PSA levels over 1.9 ng/ml, sensitivity increased to 80% and 40%, respectively. In the group receiving adjuvant hormone therapy, the diagnostic yields were 71.2% and 43%, respectively. While (11)C-choline-PET could not differentiate well and poorly differentiated Gleason score patients, FDG-PET results were almost significant (p = 0.058). A PSA value higher than 1.9 ng/ml determines a significant increase in the diagnostic yield. Adjuvant hormonotherapy has no influence on the PET results. FDG has a better correlation with the Gleason score than (11)C-choline.

Anomalous transport in turbulent plasmas and continuous time random walks

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

Balescu, R.

1995-05-01

The possibility of a model of anomalous transport problems in a turbulent plasma by a purely stochastic process is investigated. The theory of continuous time random walks (CTRW`s) is briefly reviewed. It is shown that a particular class, called the standard long tail CTRW`s is of special interest for the description of subdiffusive transport. Its evolution is described by a non-Markovian diffusion equation that is constructed in such a way as to yield exact values for all the moments of the density profile. The concept of a CTRW model is compared to an exact solution of a simple test problem:more » transport of charged particles in a fluctuating magnetic field in the limit of infinite perpendicular correlation length. Although the well-known behavior of the mean square displacement proportional to {ital t}{sup 1/2} is easily recovered, the exact density profile cannot be modeled by a CTRW. However, the quasilinear approximation of the kinetic equation has the form of a non-Markovian diffusion equation and can thus be generated by a CTRW.« less

Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129

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

Galloway, Thomas J., E-mail: thomas.galloway@fccc.edu; Zhang, Qiang; Nguyen-Tan, Phuc Felix

Purpose: To determine the relationship between p16 status and the regional response of patients with node-positive oropharynx cancer treated on NRG Oncology RTOG 0129. Methods and Materials: Patients with N1-N3 oropharynx cancer and known p16 status who underwent treatment on RTOG 0129 were analyzed. Pathologic complete response (pCR) rates in patients treated with a postchemoradiation neck dissection (with p16-positive or p16-negative cancer) were compared by Fisher exact test. Patients managed expectantly were compared with those treated with a neck dissection. Results: Ninety-nine (34%) of 292 patients with node-positive oropharynx cancer and known p16 status underwent a posttreatment neck dissection (p16-positive:more » n=69; p16-negative: n=30). The remaining 193 patients with malignant lymphadenopathy at diagnosis were observed. Neck dissection was performed a median of 70 (range, 17-169) days after completion of chemoradiation. Neither the pretreatment nodal stage (P=.71) nor the postradiation, pre-neck dissection clinical/radiographic neck assessment (P=.42) differed by p16 status. A pCR was more common among p16-positive patients (78%) than p16-negative patients (53%, P=.02) and was associated with a reduced incidence of local–regional failure (hazard ratio 0.33, P=.003). On multivariate analysis of local–regional failure, a test for interaction between pCR and p16 status was not significant (P=.37). One-hundred ninety-three (66%) of 292 of initially node-positive patients were managed without a posttreatment neck dissection. Development of a clinical (cCR) was not significantly influenced by p16-status (P=.42). Observed patients with a clinical nodal CR had disease control outcomes similar to those in patients with a pCR neck dissection. Conclusions: Patients with p16-positive tumors had significantly higher pCR and locoregional control rates than those with p16-negative tumors.« less

Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129.

PubMed

Galloway, Thomas J; Zhang, Qiang Ed; Nguyen-Tan, Phuc Felix; Rosenthal, David I; Soulieres, Denis; Fortin, André; Silverman, Craig L; Daly, Megan E; Ridge, John A; Hammond, J Alexander; Le, Quynh-Thu

2016-10-01

To determine the relationship between p16 status and the regional response of patients with node-positive oropharynx cancer treated on NRG Oncology RTOG 0129. Patients with N1-N3 oropharynx cancer and known p16 status who underwent treatment on RTOG 0129 were analyzed. Pathologic complete response (pCR) rates in patients treated with a postchemoradiation neck dissection (with p16-positive or p16-negative cancer) were compared by Fisher exact test. Patients managed expectantly were compared with those treated with a neck dissection. Ninety-nine (34%) of 292 patients with node-positive oropharynx cancer and known p16 status underwent a posttreatment neck dissection (p16-positive: n=69; p16-negative: n=30). The remaining 193 patients with malignant lymphadenopathy at diagnosis were observed. Neck dissection was performed a median of 70 (range, 17-169) days after completion of chemoradiation. Neither the pretreatment nodal stage (P=.71) nor the postradiation, pre-neck dissection clinical/radiographic neck assessment (P=.42) differed by p16 status. A pCR was more common among p16-positive patients (78%) than p16-negative patients (53%, P=.02) and was associated with a reduced incidence of local-regional failure (hazard ratio 0.33, P=.003). On multivariate analysis of local-regional failure, a test for interaction between pCR and p16 status was not significant (P=.37). One-hundred ninety-three (66%) of 292 of initially node-positive patients were managed without a posttreatment neck dissection. Development of a clinical (cCR) was not significantly influenced by p16-status (P=.42). Observed patients with a clinical nodal CR had disease control outcomes similar to those in patients with a pCR neck dissection. Patients with p16-positive tumors had significantly higher pCR and locoregional control rates than those with p16-negative tumors. Copyright © 2016 Elsevier Inc. All rights reserved.

Hypothesis Testing, "p" Values, Confidence Intervals, Measures of Effect Size, and Bayesian Methods in Light of Modern Robust Techniques

ERIC Educational Resources Information Center

Wilcox, Rand R.; Serang, Sarfaraz

2017-01-01

The article provides perspectives on p values, null hypothesis testing, and alternative techniques in light of modern robust statistical methods. Null hypothesis testing and "p" values can provide useful information provided they are interpreted in a sound manner, which includes taking into account insights and advances that have…

Exact Scheffé-type confidence intervals for output from groundwater flow models: 2. Combined use of hydrogeologic information and calibration data

USGS Publications Warehouse

Cooley, Richard L.

1993-01-01

Calibration data (observed values corresponding to model-computed values of dependent variables) are incorporated into a general method of computing exact Scheffé-type confidence intervals analogous to the confidence intervals developed in part 1 (Cooley, this issue) for a function of parameters derived from a groundwater flow model. Parameter uncertainty is specified by a distribution of parameters conditioned on the calibration data. This distribution was obtained as a posterior distribution by applying Bayes' theorem to the hydrogeologically derived prior distribution of parameters from part 1 and a distribution of differences between the calibration data and corresponding model-computed dependent variables. Tests show that the new confidence intervals can be much smaller than the intervals of part 1 because the prior parameter variance-covariance structure is altered so that combinations of parameters that give poor model fit to the data are unlikely. The confidence intervals of part 1 and the new confidence intervals can be effectively employed in a sequential method of model construction whereby new information is used to reduce confidence interval widths at each stage.

A probabilistic approach to radiative energy loss calculations for optically thick atmospheres - Hydrogen lines and continua

NASA Technical Reports Server (NTRS)

Canfield, R. C.; Ricchiazzi, P. J.

1980-01-01

An approximate probabilistic radiative transfer equation and the statistical equilibrium equations are simultaneously solved for a model hydrogen atom consisting of three bound levels and ionization continuum. The transfer equation for L-alpha, L-beta, H-alpha, and the Lyman continuum is explicitly solved assuming complete redistribution. The accuracy of this approach is tested by comparing source functions and radiative loss rates to values obtained with a method that solves the exact transfer equation. Two recent model solar-flare chromospheres are used for this test. It is shown that for the test atmospheres the probabilistic method gives values of the radiative loss rate that are characteristically good to a factor of 2. The advantage of this probabilistic approach is that it retains a description of the dominant physical processes of radiative transfer in the complete redistribution case, yet it achieves a major reduction in computational requirements.

Nasal potential difference in cystic fibrosis considering severe CFTR mutations.

PubMed

Ng, Ronny Tah Yen; Marson, Fernando Augusto de Lima; Ribeiro, Jose Dirceu; Ribeiro, Antonio Fernando; Bertuzzo, Carmen Silvia; Ribeiro, Maria Angela Gonçalves de Oliveira; Severino, Silvana Dalge; Sakano, Eulalia

2015-01-01

The gold standard for diagnosing cystic fibrosis (CF) is a sweat chloride value above 60 mEq/L. However, this historical and important tool has limitations; other techniques should be studied, including the nasal potential difference (NPD) test. CFTR gene sequencing can identify CFTR mutations, but this method is time-consuming and too expensive to be used in all CF centers. The present study compared CF patients with two classes I-III CFTR mutations (10 patients) (G1), CF patients with classes IV-VI CFTR mutations (five patients) (G2), and 21 healthy subjects (G3). The CF patients and healthy subjects also underwent the NPD test. A statistical analysis was performed using the Mann-Whitney, Kruskal-Wallis, χ(2), and Fisher's exact tests, α = 0.05. No differences were observed between the CF patients and healthy controls for the PDMax, Δamiloride, and Δchloride + free + amiloride markers from the NPD test. For the finger value, a difference between G2 and G3 was described. The Wilschanski index values were different between G1 and G3. In conclusion, our data showed that NPD is useful for CF diagnosis when classes I-III CFTR mutations are screened. However, if classes IV-VI are considered, the NPD test showed an overlap in values with healthy subjects.

Nasal Potential Difference in Cystic Fibrosis considering Severe CFTR Mutations

PubMed Central

Ng, Ronny Tah Yen; Marson, Fernando Augusto de Lima; Ribeiro, Jose Dirceu; Ribeiro, Antonio Fernando; Bertuzzo, Carmen Silvia; Ribeiro, Maria Angela Gonçalves de Oliveira; Severino, Silvana Dalge; Sakano, Eulalia

2015-01-01

The gold standard for diagnosing cystic fibrosis (CF) is a sweat chloride value above 60 mEq/L. However, this historical and important tool has limitations; other techniques should be studied, including the nasal potential difference (NPD) test. CFTR gene sequencing can identify CFTR mutations, but this method is time-consuming and too expensive to be used in all CF centers. The present study compared CF patients with two classes I-III CFTR mutations (10 patients) (G1), CF patients with classes IV-VI CFTR mutations (five patients) (G2), and 21 healthy subjects (G3). The CF patients and healthy subjects also underwent the NPD test. A statistical analysis was performed using the Mann-Whitney, Kruskal-Wallis, χ 2, and Fisher's exact tests, α = 0.05. No differences were observed between the CF patients and healthy controls for the PDMax, Δamiloride, and Δchloride + free + amiloride markers from the NPD test. For the finger value, a difference between G2 and G3 was described. The Wilschanski index values were different between G1 and G3. In conclusion, our data showed that NPD is useful for CF diagnosis when classes I-III CFTR mutations are screened. However, if classes IV-VI are considered, the NPD test showed an overlap in values with healthy subjects. PMID:25667564

Tryptophan Hydroxylase 2 Gene Polymorphism in Anxiety and Depressive Disorder in Kashmiri Population

PubMed Central

Shoib, Sheikh; Shah, Tabindah; Mushtaq, Sahil

2014-01-01

Background: The gene of tryptophan hydroxylase is widely recognized as a major candidate gene in many psychiatric disorders. However, no study has been done which investigates tryptophan hydroxylase 2 gene polymorphism in anxiety and depressive disorders in Kashmiri population (India). Objectives: To study tryptophan hydroxylase 2 (TPH2) C 11993 A gene polymorphism in anxiety and depressive disorders. Method: Sixty patients of depression disorder, 60 patients of anxiety disorder and 40 unrelated healthy volunteers (control) were studied in a case control design. Polymorphism was determined using polymerase chain reaction (PCR) and agarose gel electrophoresis after digestion with HAP II enzyme. Genotypes and allele frequencies were compared using Chi-square tests, Fischer’s exact test, odds ratio, 95% confidence interval (C.I) and p-value of <0.05 was considered to be statistical significant. Results: The mean age ± SD of anxiety, depression and control group was 32.73±10.99, 32.20±10 and 29.75±10.12 respectively and the difference was found to be statistically non significant (p=0.349).The mean HAM-A (Hamilton rating scale for anxiety) score and HAM-D (Hamilton rating scale for depression) score was high in both groups (anxiety and depression) and found to be statistically significant (p=0.001).Depression group had AA genotype (55.2%) than control (37.5%) and was found to be statistically non significant (p=0.890).Comparison of allelic frequency revealed no association of A allele in anxiety group (76.67%) compared with control (75.5%) and was found to be statistically non significant (p= 0.866), OR 1.09 (0.56-2.11). Conclusion: TPH2C 11993 A gene was not found to be associated with major depressive disorder (MDD) and anxiety disorder in Kashmiri population. PMID:25121048

Role of 5-HTTLPR Polymorphism in the Development of the Inward/Outward Personality Organization: A Genetic Association Study

PubMed Central

Nardi, Bernardo; Marini, Alessandra; Turchi, Chiara; Arimatea, Emidio; Tagliabracci, Adriano; Bellantuono, Cesario

2013-01-01

Reciprocity with primary caregivers affects subjects' adaptive abilities toward the construction of the most useful personal meaning organization (PMO) with respect to their developmental environment. Within cognitive theory the post-rationalist approach has outlined two basic categories of identity construction and of regulation of cognitive and emotional processes: the Outward and the Inward PMO. The presence of different, consistent clinical patterns in Inward and Outward subjects is paralleled by differences in cerebral activation during emotional tasks on fMRI and by different expression of some polymorphisms in serotonin pathways. Since several lines of evidence support a role for the 5-HTTLPR polymorphism in mediating individual susceptibility to environmental emotional stimuli, this study was conducted to investigate its influence in the development of the Inward/Outward PMO. PMO was assessed and the 5-HTTLPR polymorphism investigated in 124 healthy subjects who were subdivided into an Inward (n = 52) and an Outward (n = 72) group. Case-control comparisons of short allele (S) frequencies showed significant differences between Inwards and Outwards (p = 0.036, χ2 test; p = 0.026, exact test). Genotype frequencies were not significantly different although values slightly exceeded p≤0.05 (p = 0.056, χ2 test; p = 0.059, exact test). Analysis of the 5-HTTLPR genotypes according to the recessive inheritance model showed that the S/S genotype increased the likelihood of developing an Outward PMO (p = 0.0178, χ2 test; p = 0.0143, exact test; OR = 3.43, CI (95%) = 1.188–9.925). A logistic regression analysis confirmed the association between short allele and S/S genotypes with the Outward PMO also when gender and age were considered. However none of the differences remained significant after correction for multiple testing, even though using the recessive model they approach significance. Overall our data seem to suggest a putative genetic basis for interindividual differences in PMO development. PMID:24358153

Static and dynamic balance of children and adolescents with sensorineural hearing loss.

PubMed

Melo, Renato de Souza; Marinho, Sônia Elvira Dos Santos; Freire, Maryelly Evelly Araújo; Souza, Robson Arruda; Damasceno, Hélio Anderson Melo; Raposo, Maria Cristina Falcão

2017-01-01

To assess the static and dynamic balance performance of students with normal hearing and with sensorineural hearing loss. A cross-sectional study assessing 96 students, 48 with normal hearing and 48 with sensorineural hearing loss of both sexes, aged 7 and 18 years. To evaluate static balance, Romberg, Romberg-Barré and Fournier tests were used; and for the dynamic balance, we applied the Unterberger test. Hearing loss students showed more changes in static and dynamic balance as compared to normal hearing, in all tests used (p<0.001). The same difference was found when subjects were grouped by sex. For females, Romberg, Romberg-Barré, Fournier and Unterberger test p values were, respectively, p=0.004, p<0.001, p<0.001 and p=0.023; for males, the p values were p=0.009, p<0.001, p<0.001 and p=0.002, respectively. The same difference was observed when students were classified by age. For 7 to 10 years old students, the p values for Romberg, Romberg-Barré and Fournier tests were, respectively, p=0.007, p<0.001 and p=0.001; for those aged 11 and 14 years, the p values for Romberg, Romberg-Barré, Fournier and Unterberger tests were p=0.002, p<0.001, p<0.001 and p=0.015, respectively; and for those aged 15 and 18 years, the p values for Romberg-Barré, Fournier and Unterberger tests were, respectively, p=0.037, p<0.001 and p=0.037. Hearing-loss students showed more changes in static and dynamic balance comparing to normal hearing of same sex and age groups.

F-Test Alternatives to Fisher's Exact Test and to the Chi-Square Test of Homogeneity in 2x2 Tables.

ERIC Educational Resources Information Center

Overall, John E.; Starbuck, Robert R.

1983-01-01

An alternative to Fisher's exact test and the chi-square test for homogeneity in two-by-two tables is developed. The method provides for Type I error rates which are closer to the stated alpha level than either of the alternatives. (JKS)

Accurate collision-induced line-coupling parameters for the fundamental band of CO in He - Close coupling and coupled states scattering calculations

NASA Technical Reports Server (NTRS)

Green, Sheldon; Boissoles, J.; Boulet, C.

1988-01-01

The first accurate theoretical values for off-diagonal (i.e., line-coupling) pressure-broadening cross sections are presented. Calculations were done for CO perturbed by He at thermal collision energies using an accurate ab initio potential energy surface. Converged close coupling, i.e., numerically exact values, were obtained for coupling to the R(0) and R(2) lines. These were used to test the coupled states (CS) and infinite order sudden (IOS) approximate scattering methods. CS was found to be of quantitative accuracy (a few percent) and has been used to obtain coupling values for lines to R(10). IOS values are less accurate, but, owing to their simplicity, may nonetheless prove useful as has been recently demonstrated.

Theoretical nuclear physics

NASA Astrophysics Data System (ADS)

Rost, E.; Shephard, J. R.

1992-08-01

This report discusses the following topics: Exact 1-loop vacuum polarization effects in 1 + 1 dimensional QHD; exact 1-fermion loop contributions in 1 + 1 dimensional solitons; exact scalar 1-loop contributions in 1 + 3 dimensions; exact vacuum calculations in a hyper-spherical basis; relativistic nuclear matter with self-consistent correlation energy; consistent RHA-RPA for finite nuclei; transverse response functions in the (triangle)-resonance region; hadronic matter in a nontopological soliton model; scalar and vector contributions to (bar p)p yields (bar lambda)lambda reaction; 0+ and 2+ strengths in pion double-charge exchange to double giant-dipole resonances; and nucleons in a hybrid sigma model including a quantized pion field.

Grading system to categorize breast MRI using BI-RADS 5th edition: a statistical study of non-mass enhancement descriptors in terms of probability of malignancy.

PubMed

Asada, Tatsunori; Yamada, Takayuki; Kanemaki, Yoshihide; Fujiwara, Keishi; Okamoto, Satoko; Nakajima, Yasuo

2018-03-01

To analyze the association of breast non-mass enhancement descriptors in the BI-RADS 5th edition with malignancy, and to establish a grading system and categorization of descriptors. This study was approved by our institutional review board. A total of 213 patients were enrolled. Breast MRI was performed with a 1.5-T MRI scanner using a 16-channel breast radiofrequency coil. Two radiologists determined internal enhancement and distribution of non-mass enhancement by consensus. Corresponding pathologic diagnoses were obtained by either biopsy or surgery. The probability of malignancy by descriptor was analyzed using Fisher's exact test and multivariate logistic regression analysis. The probability of malignancy by category was analyzed using Fisher's exact and multi-group comparison tests. One hundred seventy-eight lesions were malignant. Multivariate model analysis showed that internal enhancement (homogeneous vs others, p < 0.001, heterogeneous and clumped vs clustered ring, p = 0.003) and distribution (focal and linear vs segmental, p < 0.001) were the significant explanatory variables. The descriptors were classified into three grades of suspicion, and the categorization (3, 4A, 4B, 4C, and 5) by sum-up grades showed an incremental increase in the probability of malignancy (p < 0.0001). The three-grade criteria and categorization by sum-up grades of descriptors appear valid for non-mass enhancement.

Adolescent Sleep and the Impact of Technology Use Before Sleep on Daytime Function

PubMed Central

Johansson, Ann E. E.; Petrisko, Maria A.; Chasens, Eileen R.

2016-01-01

Purpose Technology has become pervasive in our culture, particularly among adolescents. The purpose of this study is to examine associations between use of technology before sleep and daytime function in adolescents. Design and Methods This study is a secondary analysis of respondents aged 13 to 21 years (N= 259) from the 2011 National Sleep Foundation’s Sleep in America Poll. The survey included questions on demographics, sleep habits, and use of technology in the hour before bedtime. Daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Student’s t-tests, Mann-Whitney U, and Fischer’s exact tests were performed to detect differences in demographics, sleep duration, and technology use in the total sample, and between respondents with “adequate” compared to “inadequate” sleep. Correlations were calculated between technology frequency and daytime function. Results Adolescents had mean sleep duration of 7.3±1.3 hours. Almost all respondents (97%) used some form of technology before sleep. Increased technology use and the frequency of being awoken in the night by a cell phone were significantly associated with waking too early, waking unrefreshed, and daytime sleepiness (p<0.05). Adolescents who reported “inadequate” sleep had shorter sleep duration, greater frequency of technology use before bedtime, feeling unrefreshed on waking, and greater daytime sleepiness than those reporting “adequate” sleep (all p-values<0.05). Conclusion Technology use before sleep by adolescents had negative consequences on nighttime sleep and on daytime function. Practice Implications Healthcare professionals who interact with adolescents should encourage technology to be curtailed before bedtime and for adolescents to value obtaining adequate sleep. PMID:27184356

Diagnostic Accuracy of Centrally Restricted Diffusion in the Differentiation of Treatment-Related Necrosis from Tumor Recurrence in High-Grade Gliomas.

PubMed

Zakhari, N; Taccone, M S; Torres, C; Chakraborty, S; Sinclair, J; Woulfe, J; Jansen, G H; Nguyen, T B

2018-02-01

Centrally restricted diffusion has been demonstrated in recurrent high-grade gliomas treated with bevacizumab. Our purpose was to assess the accuracy of centrally restricted diffusion in the diagnosis of radiation necrosis in high-grade gliomas not treated with bevacizumab. In this prospective study, we enrolled patients with high-grade gliomas who developed a new ring-enhancing necrotic lesion and who underwent re-resection. The presence of a centrally restricted diffusion within the ring-enhancing lesion was assessed visually on diffusion trace images and by ADC measurements on 3T preoperative diffusion tensor examination. The percentage of tumor recurrence and radiation necrosis in each surgical specimen was defined histopathologically. The association between centrally restricted diffusion and radiation necrosis was assessed using the Fisher exact test. Differences in ADC and the ADC ratio between the groups were assessed via the Mann-Whitney U test, and receiver operating characteristic curve analysis was performed. Seventeen patients had re-resected ring-enhancing lesions: 8 cases of radiation necrosis and 9 cases of tumor recurrence. There was significant association between centrally restricted diffusion by visual assessment and radiation necrosis ( P = .015) with a sensitivity of 75% and a specificity of 88.9%, a positive predictive value 85.7%, and a negative predictive value of 80% for the diagnosis of radiation necrosis. There was a statistically significant difference in the ADC and ADC ratio between radiation necrosis and tumor recurrence ( P = .027). The presence of centrally restricted diffusion in a new ring-enhancing lesion might indicate radiation necrosis rather than tumor recurrence in high-grade gliomas previously treated with standard chemoradiation without bevacizumab. © 2018 by American Journal of Neuroradiology.

Emergency department assessment of abdominal pain: clinical indicator tests for detecting peritonism.

PubMed

Taylor, Scott; Watt, Martin

2005-12-01

Peritonism is a finding that leads to a more cautious approach in the emergency department management of abdominal pain. This study examined whether peritonism assessment using inspiration, expiration and cough tests was associated with the patient's clinical management. This prospective observational study evaluated consecutive patients presenting directly to the emergency department for 3 months from June 2000 with abdominal pain. Triage initial observations of blood pressure, pulse, respiratory rate, oxygen saturation and temperature were recorded. The examining emergency physician recorded each patient's response and pain score to the individual peritonism tests and scored it as positive if there was an indication of it being a painful manoeuvre. The results were blinded from the receiving specialty if subsequent referral was required. Sixty-seven patients had peritonism tests performed. No individual test was more painful than the others with similar values in pain scores. In all, 70% (7/10) were admitted when all three tests were positive, compared with 21% (12/57) when two or less of the tests scored positive (P=0.004, Fisher's exact test). Admission was not associated with any individual test or combination of tests, or any other variable. The peritonism tests were not associated with any other physiological observation or measurement. These peritonism tests represent a simple investigation, and are significantly associated with admission when all three tests are positive. They seem to be a clinical predictor of cases in which continuing assessment was required, and may be useful as a departmental 'safety net' in the management of abdominal pain.

Lower pH values of weakly acidic refluxes as determinants of heartburn perception in gastroesophageal reflux disease patients with normal esophageal acid exposure.

PubMed

de Bortoli, N; Martinucci, I; Savarino, E; Franchi, R; Bertani, L; Russo, S; Ceccarelli, L; Costa, F; Bellini, M; Blandizzi, C; Savarino, V; Marchi, S

2016-01-01

Multichannel impedance pH monitoring has shown that weakly acidic refluxes are able to generate heartburn. However, data on the role of different pH values, ranging between 4 and 7, in the generation of them are lacking. The aim of this study was to evaluate whether different pH values of weakly acidic refluxes play a differential role in provoking reflux symptoms in endoscopy-negative patients with physiological esophageal acid exposure time and positive symptom index and symptom association probability for weakly acidic refluxes. One hundred and forty-three consecutive patients with gastroesophageal reflux disease, nonresponders to proton pump inhibitors (PPIs), were allowed a washout from PPIs before undergoing: upper endoscopy, esophageal manometry, and multichannel impedance pH monitoring. In patients with both symptom index and symptom association probability positive for weakly acidic reflux, each weakly acidic reflux was evaluated considering exact pH value, extension, physical characteristics, and correlation with heartburn. Forty-five patients with normal acid exposure time and positive symptom association probability for weakly acidic reflux were identified. The number of refluxes not heartburn related was higher than those heartburn related. In all distal and proximal liquid refluxes, as well as in distal mixed refluxes, the mean pH value of reflux events associated with heartburn was significantly lower than that not associated. This condition was not confirmed for proximal mixed refluxes. Overall, a low pH of weakly acidic reflux represents a determinant factor in provoking heartburn. This observation contributes to better understand the pathophysiology of symptoms generated by weakly acidic refluxes, paving the way toward the search for different therapeutic approaches to this peculiar condition of esophageal hypersensitivity. © 2014 International Society for Diseases of the Esophagus.

Quality-of-Life (QOL) during Screening for Phase 1 Trial Studies in Patients with Advanced Solid Tumors and Its Impact on Risk for Serious Adverse Events.

PubMed

Anwar, Sidra; Tan, Wei; Hong, Chi-Chen; Admane, Sonal; Dozier, Askia; Siedlecki, Francine; Whitworth, Amy; DiRaddo, Ann Marie; DePaolo, Dawn; Jacob, Sandra M; Ma, Wen Wee; Miller, Austin; Adjei, Alex A; Dy, Grace K

2017-06-26

Background : Serious adverse events (SAEs) and subject replacements occur frequently in phase 1 oncology clinical trials. Whether baseline quality-of-life (QOL) or social support can predict risk for SAEs or subject replacement among these patients is not known. Methods : Between 2011-2013, 92 patients undergoing screening for enrollment into one of 22 phase 1 solid tumor clinical trials at Roswell Park Cancer Institute were included in this study. QOL Questionnaires (EORTC QLQ-C30 and FACT-G), Medical Outcomes Study Social Support Survey (MOSSSS), Charlson comorbidity scores (CCS) and Royal Marsden scores (RMS) were obtained at baseline. Frequency of dose limiting toxicities (DLTs), subject replacement and SAEs that occurred within the first 4 cycles of treatment were recorded. Fisher's exact test and Mann-Whitney-Wilcoxon test were used to study the association between categorical and continuous variables, respectively. A linear transformation was used to standardize QOL scores. p -value ≤ 0.05 was considered statistically significant. Results : Baseline QOL, MOSSSS, CCS and RMS were not associated with subject replacement nor DLTs. Baseline EORTC QLQ-C30 scores were significantly lower among patients who encountered SAEs within the first 4 cycles ( p = 0.04). Conclusions : Lower (worse) EORTC QLQ-C30 score at baseline is associated with SAE occurrence during phase 1 oncology trials.

Clinical relevance of KRAS mutation detection in metastatic colorectal cancer treated by Cetuximab plus chemotherapy

PubMed Central

Di Fiore, F; Blanchard, F; Charbonnier, F; Le Pessot, F; Lamy, A; Galais, M P; Bastit, L; Killian, A; Sesboüé, R; Tuech, J J; Queuniet, A M; Paillot, B; Sabourin, J C; Michot, F; Michel, P; Frebourg, T

2007-01-01

The predictive value of KRAS mutation in metastatic colorectal cancer (MCRC) patients treated with cetuximab plus chemotherapy has recently been suggested. In our study, 59 patients with a chemotherapy-refractory MCRC treated with cetuximab plus chemotherapy were included and clinical response was evaluated according to response evaluation criteria in solid tumours (RECIST). Tumours were screened for KRAS mutations using first direct sequencing, then two sensitive methods based on SNaPshot and PCR-ligase chain reaction (LCR) assays. Clinical response was evaluated according to gene mutations using the Fisher exact test. Times to progression (TTP) were calculated using the Kaplan–Meier method and compared with log-rank test. A KRAS mutation was detected in 22 out of 59 tumours and, in six cases, was missed by sequencing analysis but detected using the SNaPshot and PCR-LCR assays. Remarkably, no KRAS mutation was found in the 12 patients with clinical response. KRAS mutation was associated with disease progression (P=0.0005) and TTP was significantly decreased in mutated KRAS patients (3 vs 5.5 months, P=0.015). Our study confirms that KRAS mutation is highly predictive of a non-response to cetuximab plus chemotherapy in MCRC and highlights the need to use sensitive molecular methods, such as SNaPshot or PCR-LCR assays, to ensure an efficient mutation detection. PMID:17375050

Relationship between fumonisin contamination of feed and mystery swine disease. A case-control study.

PubMed

Bane, D P; Neumann, E J; Hall, W F; Harlin, K S; Slife, R L

1992-02-01

Fumonisin is a recently identified mycotoxin that has been shown to be the cause of pulmonary edema disease in swine and leukoencephalomalacia in horses. Mystery Swine Disease (MSD), is an economically devastating disease complex of unknown etiology that has been reported to have occurred in several swine producing states since 1988. To determine the relationship between MSD and fumonisin, a case-control study was carried out in Illinois in mid-1990. Feed samples collected from 12 case and 9 control farms were analyzed for fumonisin. Sera from swine on all farms was screened for titers against encephalomyocarditis (EMC) virus and concentrations of alpha-1 acid glycoprotein (an acute phase reactive protein). Fumonisin concentrations greater than or equal to 20 ppm were found on 1 control farm (1/9) and 8 case farms (8/12). Titers against EMC virus (greater than or equal to 1:16) were found on 5 control farms (5/9) and on 6 case farms (6/12). Farms with greater than or equal to 20 ppm fumonisin in the feed were at significantly increased risk (OR = 11.2, Fisher's exact test p = 0.037) for MSD. Furthermore, the pi2 test for trend was (p = 0.017), meaning that as the level of fumonisin in the feed increased, the risk of MSD also increased. The presence of EMC virus titers in the sow herd was not a significant risk for MSD (OR = 1.25, Fisher's exact test p = 0.75). Alpha-1 acid glycoprotein concentrations obtained from a 2-week old nursing pigs differed significantly (p = 0.0005) between MSD case and control herds.

The Relationship of Amount of Resection and Time for Recovery of Bell’s Phenomenon after Levator Resection in Congenital Ptosis

PubMed Central

Goel, Ruchi; Kishore, Divya; Nagpal, Smriti; Jain, Sparshi; Agarwal, Tushar

2017-01-01

Background: Recovery of Bell`s phenomenon after levator resection is unpredicatable. Delayed recovery can result in vision threatening corneal complications. Aim: To study the variability of Bell’s phenomenon and time taken for its recovery following levator resection for blepharoptosis and to correlate it with the amount of resection. Methods: A prospective observational study was conducted on 32 eyes of 32 patients diagnosed as unilateral simple congenital blepharoptosis who underwent levator resection at a tertiary care center between July 2013 and May 2015. Patients were followed up for 5 months and correction of ptosis, type of Bell`s, duration of Bell`s recovery and complications were noted. Results: The study group ranged from 16-25 years with 15:17 male: female ratio. There were 9 mild, 16 moderate and 7 severe ptosis. Satisfactory correction was achieved in all cases. Good Bell`s recovery occurred in 13 eyes on first post-op day, in 2-14 days in 19 eyes and 28 days in 1 eye. Inverse Bell`s was noted along with lid oedema and ecchymosis in 2 patients. Large resections (23-26mm) were associated with poor Bell`s on the first postoperative day (p=0.027, Fisher`s exact test). However, the duration required for recovery of Bell`s phenomenon did not show any significant difference with the amount of resection. (p=0.248, Mann Whitney test). Larger resections resulted in greater lagophthalmos (correlation=0.830, p<0.0001). Patients with recovery of Bell`s delayed for more than 7 days were associated with greater number of complications (p=0.001 Fisher`s Exact Test). Conclusion: Close monitoring for Bell`s recovery is required following levator resection. PMID:28584563

Sex Differences in Working Memory after Mild Traumatic Brain Injury: A Functional MR Imaging Study.

PubMed

Hsu, Hui-Ling; Chen, David Yen-Ting; Tseng, Ying-Chi; Kuo, Ying-Sheng; Huang, Yen-Lin; Chiu, Wen-Ta; Yan, Feng-Xian; Wang, Wei-Shuan; Chen, Chi-Jen

2015-09-01

To evaluate sex differences in mild traumatic brain injury (MTBI) with working memory functional magnetic resonance (MR) imaging. Research ethics committee approval and patient written informed consent were obtained. Working memory brain activation patterns were assessed with functional MR imaging in 30 patients (15 consecutive men and 15 consecutive women) with MTBI and 30 control subjects (15 consecutive men and 15 consecutive women). Two imaging studies were performed in patients: the initial study, which was performed within 1 month after the injury, and a follow-up study, which was performed 6 weeks after the first study. For each participant, digit span and continuous performance testing were performed before functional MR imaging. Clinical data were analyzed by using Kruskal-Wallis, Mann-Whitney U, Wilcoxon signed rank, and Fisher exact tests. Within- and between-group differences of functional MR imaging data were analyzed with one- and two-sample t tests, respectively. Among female participants, the total digit span score was lower in the MTBI group than in the control group (P = .044). In initial working memory functional MR imaging studies, hyperactivation was found in the male MTBI group and hypoactivation was found in the female MTBI group compared with control male and female groups, respectively. At the 6-week follow-up study, the female MTBI group showed persistent hypoactivation, whereas the male MTBI group showed a regression of hyperactivation at visual comparison of activation maps. The male MTBI group was also found to have a higher initial ß value than the male control group (P = .040), and there was no significant difference between the male MTBI group and the male control group (P = .221) at follow-up evaluation, which was comparable to findings on activation maps. In the female MTBI group, average ß values at both initial and follow-up studies were lower compared with those in the female control group but were not statistically significant (P = .663 and P = .191, respectively). Female patients with MTBI had lower digit span scores than did female control subjects, and functional MR imaging depicted sex differences in working memory functional activation; hypoactivation with nonrecovery of activation change at follow-up studies may suggest a worse working memory outcome in female patients with MTBI.

[Health-related behavior in a sample of Brazilian college students: gender differences].

PubMed

Colares, Viviane; Franca, Carolina da; Gonzalez, Emília

2009-03-01

This study investigated whether undergraduate students' health-risk behaviors differed according to gender. The sample consisted of 382 subjects, aged 20-29 years, from public universities in Pernambuco State, Brazil. Data were collected using the National College Health Risk Behavior Survey, previously validated in Portuguese. Descriptive and inferential statistical techniques were used. Associations were analyzed with the chi-square test or Fisher's exact test. Statistical significance was set at p < or = 0.05. In general, females engaged in the following risk behaviors less frequently than males: alcohol consumption (p = 0.005), smoking (p = 0.002), experimenting with marijuana (p = 0.002), consumption of inhalants (p < or = 0.001), steroid use (p = 0.003), carrying weapons (p = 0.001), and involvement in physical fights (p = 0.014). Meanwhile, female students displayed more concern about losing or maintaining weight, although they exercised less frequently than males. The findings thus showed statistically different health behaviors between genders. In conclusion, different approaches need to be used for the two genders.

Indirect NMR spin-spin coupling constants in diatomic alkali halides

NASA Astrophysics Data System (ADS)

Jaszuński, Michał; Antušek, Andrej; Demissie, Taye B.; Komorovsky, Stanislav; Repisky, Michal; Ruud, Kenneth

2016-12-01

We report the Nuclear Magnetic Resonance (NMR) spin-spin coupling constants for diatomic alkali halides MX, where M = Li, Na, K, Rb, or Cs and X = F, Cl, Br, or I. The coupling constants are determined by supplementing the non-relativistic coupled-cluster singles-and-doubles (CCSD) values with relativistic corrections evaluated at the four-component density-functional theory (DFT) level. These corrections are calculated as the differences between relativistic and non-relativistic values determined using the PBE0 functional with 50% exact-exchange admixture. The total coupling constants obtained in this approach are in much better agreement with experiment than the standard relativistic DFT values with 25% exact-exchange, and are also noticeably better than the relativistic PBE0 results obtained with 50% exact-exchange. Further improvement is achieved by adding rovibrational corrections, estimated using literature data.

LETTER TO THE EDITOR: Exact energy distribution function in a time-dependent harmonic oscillator

NASA Astrophysics Data System (ADS)

Robnik, Marko; Romanovski, Valery G.; Stöckmann, Hans-Jürgen

2006-09-01

Following a recent work by Robnik and Romanovski (2006 J. Phys. A: Math. Gen. 39 L35, 2006 Open Syst. Inf. Dyn. 13 197-222), we derive an explicit formula for the universal distribution function of the final energies in a time-dependent 1D harmonic oscillator, whose functional form does not depend on the details of the frequency ω(t) and is closely related to the conservation of the adiabatic invariant. The normalized distribution function is P(x) = \\pi^{-1} (2\\mu^2 - x^2)^{-\\frac{1}{2}} , where x=E_1- \\skew3\\bar{E}_1 ; E1 is the final energy, \\skew3\\bar{E}_1 is its average value and µ2 is the variance of E1. \\skew3\\bar{E}_1 and µ2 can be calculated exactly using the WKB approach to all orders.

Detection of Functional Change Using Cluster Trend Analysis in Glaucoma.

PubMed

Gardiner, Stuart K; Mansberger, Steven L; Demirel, Shaban

2017-05-01

Global analyses using mean deviation (MD) assess visual field progression, but can miss localized changes. Pointwise analyses are more sensitive to localized progression, but more variable so require confirmation. This study assessed whether cluster trend analysis, averaging information across subsets of locations, could improve progression detection. A total of 133 test-retest eyes were tested 7 to 10 times. Rates of change and P values were calculated for possible re-orderings of these series to generate global analysis ("MD worsening faster than x dB/y with P < y"), pointwise and cluster analyses ("n locations [or clusters] worsening faster than x dB/y with P < y") with specificity exactly 95%. These criteria were applied to 505 eyes tested over a mean of 10.5 years, to find how soon each detected "deterioration," and compared using survival models. This was repeated including two subsequent visual fields to determine whether "deterioration" was confirmed. The best global criterion detected deterioration in 25% of eyes in 5.0 years (95% confidence interval [CI], 4.7-5.3 years), compared with 4.8 years (95% CI, 4.2-5.1) for the best cluster analysis criterion, and 4.1 years (95% CI, 4.0-4.5) for the best pointwise criterion. However, for pointwise analysis, only 38% of these changes were confirmed, compared with 61% for clusters and 76% for MD. The time until 25% of eyes showed subsequently confirmed deterioration was 6.3 years (95% CI, 6.0-7.2) for global, 6.3 years (95% CI, 6.0-7.0) for pointwise, and 6.0 years (95% CI, 5.3-6.6) for cluster analyses. Although the specificity is still suboptimal, cluster trend analysis detects subsequently confirmed deterioration sooner than either global or pointwise analyses.

Sublingual ketorolac versus sublingual tramadol for moderate to severe post-traumatic bone pain in children: a double-blind, randomised, controlled trial.

PubMed

Neri, Elena; Maestro, Alessandra; Minen, Federico; Montico, Marcella; Ronfani, Luca; Zanon, Davide; Favret, Anna; Messi, Gianni; Barbi, Egidio

2013-09-01

To assess the effectiveness of sublingual ketorolac versus sublingual tramadol in reducing the pain associated with fracture or dislocation of extremities in children. A double-blind, randomised, controlled, non-inferiority trial was conducted in the paediatric emergency department of a research institute. One hundred and thirty-one children aged 4-17 years with suspected bone fracture or dislocation were enrolled. Eligible children were randomised to ketorolac (0.5 mg/kg) and placebo, or to tramadol (2 mg/kg) and placebo by sublingual administration, using a double-dummy technique. Pain was assessed by the patients every 20 min, for a maximum period of 2 h, using the McGrath scale for patients up to 6 years of age, and the Visual Analogue Scale for those older than 6 years of age. The mean pain scores fell significantly from eight to four and five in the ketorolac and tramadol groups, respectively, by 100 min (Wilcoxon sign rank test, p<0.001). The mean pain scores for ketorolac were lower than those for tramadol, but these differences were not significant at any time point (Mann-Whitney U Test, p values: 0-20 min: 0.167; 20-40 min: 0.314; 40-60 min: 0.223; 60-80 min: 0.348; 80-100 min: 0.166; 100-120 min: 0.08). The rescue dose of paracetamol-codeine was administered in 2/60 children in the ketorolac group versus 8/65 in the tramadol group (Fisher exact test, p=0.098). There were no statistically significant differences between the two groups in the frequency of adverse effects. Both sublingual ketorolac and tramadol were equally effective for pain management in children with suspected fractures or dislocations.

The thresholds for statistical and clinical significance – a five-step procedure for evaluation of intervention effects in randomised clinical trials

PubMed Central

2014-01-01

Background Thresholds for statistical significance are insufficiently demonstrated by 95% confidence intervals or P-values when assessing results from randomised clinical trials. First, a P-value only shows the probability of getting a result assuming that the null hypothesis is true and does not reflect the probability of getting a result assuming an alternative hypothesis to the null hypothesis is true. Second, a confidence interval or a P-value showing significance may be caused by multiplicity. Third, statistical significance does not necessarily result in clinical significance. Therefore, assessment of intervention effects in randomised clinical trials deserves more rigour in order to become more valid. Methods Several methodologies for assessing the statistical and clinical significance of intervention effects in randomised clinical trials were considered. Balancing simplicity and comprehensiveness, a simple five-step procedure was developed. Results For a more valid assessment of results from a randomised clinical trial we propose the following five-steps: (1) report the confidence intervals and the exact P-values; (2) report Bayes factor for the primary outcome, being the ratio of the probability that a given trial result is compatible with a ‘null’ effect (corresponding to the P-value) divided by the probability that the trial result is compatible with the intervention effect hypothesised in the sample size calculation; (3) adjust the confidence intervals and the statistical significance threshold if the trial is stopped early or if interim analyses have been conducted; (4) adjust the confidence intervals and the P-values for multiplicity due to number of outcome comparisons; and (5) assess clinical significance of the trial results. Conclusions If the proposed five-step procedure is followed, this may increase the validity of assessments of intervention effects in randomised clinical trials. PMID:24588900

Effects of drying agents on bond strength of etch-and-rinse adhesive systems to enamel immediately after bleaching.

PubMed

Niat, Alireza Boruzi; Yazdi, Fatmeh Maleknejad; Koohestanian, Niloufar

2012-12-01

To determine the effect of drying agents and adhesive solvents on the bond strength of resin composite to enamel immediately after bleaching. Sixty healthy human premolars were bleached using 15% carbamide peroxide gel and randomly divided into three groups according to the immersing solutions applied immediately after bleaching: 70% alcohol, acetone, and distilled water. Each group was randomly divided into two subgroups according to the adhesives that were applied: an alcohol-based adhesive (Single Bond) and an acetone-based adhesive (One Step). By using rubber washers, composite Z100 was placed onto the enamel and shear bond strength was evaluated in a universal testing machine at a crosshead speed of 1 mm/min. The type of failure was also assessed using a stereomicroscope. The data were statistically analyzed by two-way ANOVA and Tukey's post-hoc test (α = 0.05). Fisher's Exact test was used to evaluate differences in the failure modes. Statistical analysis showed that the bond strength of the distilled water groups was significantly lower than that of the other groups, but the bond strengths of the two groups where a drying agent was applied were similar to that of the unbleached group. The acetone-based adhesive (One Step) provided higher bond strength than did the alcohol-based adhesive (Single Bond) (p < 0.05). There was no interaction between the two variables (p > 0.05). Fisher's Exact test showed there was no significant difference in the failure mode of all the experimental groups (p > 0.05). The application of drying agents improves the bond strength of resin composite to bleached enamel. Furthermore, the acetone-based adhesive used in the study had a higher bond strength to bleached enamel than did the alcohol-based adhesive used.

Endocrine effects of adjuvant letrozole + triptorelin compared with tamoxifen + triptorelin in premenopausal patients with early breast cancer.

PubMed

Rossi, Emanuela; Morabito, Alessandro; De Maio, Ermelinda; Di Rella, Francesca; Esposito, Giuseppe; Gravina, Adriano; Labonia, Vincenzo; Landi, Gabriella; Nuzzo, Francesco; Pacilio, Carmen; Piccirillo, Maria Carmela; D'Aiuto, Giuseppe; D'Aiuto, Massimiliano; Rinaldo, Massimo; Botti, Gerardo; Gallo, Ciro; Perrone, Francesco; de Matteis, Andrea

2008-01-10

To compare the endocrine effects of 6 months of adjuvant treatment with letrozole + triptorelin or tamoxifen + triptorelin in premenopausal patients with early breast cancer within an ongoing phase 3 trial (Hormonal Adjuvant Treatment Bone Effects study). Prospectively collected hormonal data were available for 81 premenopausal women, of whom 30 were assigned to receive tamoxifen + triptorelin and 51 were assigned letrozole + triptorelin +/- zoledronate. Serum 17-beta-estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), Delta4-androstenedione, testosterone, dehydroepiandrosterone-sulfate, progesterone, adrenocorticotropic hormone (ACTH), and cortisol were measured at baseline and after 6 months of treatment. For each hormone, 6-month values were compared between treatment groups by the Wilcoxon-Mann-Whitney exact test. Median age was 44 years for both groups of patients. Letrozole + triptorelin (+/- zoledronate) induced a stronger suppression of median E2 serum levels (P = .0008), LH levels (P = .0005), and cortisol serum levels (P < .0001) compared with tamoxifen + triptorelin. Median FSH serum levels were suppressed in both groups, but such suppression was lower among patients receiving letrozole, who showed significantly higher median FSH serum levels (P < .0001). No significant differences were observed for testosterone, progesterone, ACTH, androstenedione, and dehydroepiandrosterone between the two groups of patients. Letrozole in combination with triptorelin induces a more intense estrogen suppression than tamoxifen + triptorelin in premenopausal patients with early breast cancer.

Role of warm saline mouth rinse in prevention of alveolar osteitis: a randomized controlled trial.

PubMed

Osunde, Otasowie Daniel; Bassey, Godwin Obi

2015-01-01

The present study was aimed at determining the role warm saline rinse in the prevention of alveolar osteitis following dental extractions. Apparently patients aged 16 and above who were referred to the Oral Surgery Clinic of our institution, with an indication for non-surgical extraction of pathologic teeth were prospectively and uniformly randomized into warm saline group and control. The experimental group (n = 80) were instructed to gargle 6 times daily with warm saline and no such instructions were given to the second group (n = 80) to serve as controls. Information on demographic, indications for extraction, and development of alveolar osteitis were obtained and analyzed. Comparative statistics were done using Pearson's chi square or Fisher's exact test as appropriate. A p value of less than 0.05 was considered significant. The demographic and other baseline parameters such as indications for extractions were comparable among the study groups (p > 0.05). The overall prevalence of alveolar osteitis was 13.7%. There was a statistical significant difference between the study groups with respect to development of alveolar osteitis (X2 = 15.00, df = 1, p = 0.001).The risk of development of alveolar osteitis was 4 times higher in the control group (OR = 4.33, P = 0.001). Warm saline mouth rinse instruction is beneficial in the prevention of development of alveolar osteitis after dental extractions.

Accuracy of MRI-compatible contrast media injectors.

PubMed

Saake, M; Wuest, W; Becker, S; Uder, M; Janka, R

2014-03-01

To analyze the exactness of MRI-compatible contrast media (CM) injectors in an experimental setup and clinical use. Ejected fluid volumes and amounts of CM were quantified for single and double piston injections. The focus was on small volumes, as used in pediatric examination and test-bolus measurements. Samples were collected before and after clinical MRI scans and amounts of CM were measured. For single piston injections the volume differences were minimal (mean difference 0.01  ml). For double piston injections the volume of the first injection was decreased (mean 20.74  ml, target 21.00  ml, p < 0.01). After a position change of the Y-piece of the injection system, the amount of CM differed significantly from the target value (mean 1.23  mmol and 0.83  mmol at 1  ml/s flow rate, target 1.00  mmol, p < 0.01), independently of the wait time. The clinical samples confirmed these findings. The pistons of modern CM injectors work exactly. However, for small CM volumes the injected amount of CM can differ significantly from the target value in both directions. Influence factors are an incomplete elimination of air and exchange processes between the CM and saline chaser in the injection system. • In MRI examinations of children and test-bolus measurements, small amounts of CM are used. • The accuracy of single piston injections is high. • In double piston injections the injected amount of CM can differ significantly from the target value. © Georg Thieme Verlag KG Stuttgart · New York.

Same Abbreviated Injury Scale Values May Be Associated with Different Risks to Mortality in Trauma Patients: A Cross-Sectional Retrospective Study Based on the Trauma Registry System in a Level I Trauma Center.

PubMed

Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2017-12-11

The Abbreviated Injury Scale (AIS) measures injury severity of a trauma patient with a numeric method for ranking anatomy-based specific injuries. The summation of the squares of the three most severe injuries in the AIS of six predefined body regions comprises the Injury Severity Score (ISS). It assumes that the mortality of a given AIS value is similar across all body regions. However, such an assumption is less explored in the literature. In this study, we aimed to compare the mortality rates of the patients with the same AIS value in different injured body regions in a level I trauma center. Hospitalized adult trauma patients with isolated serious to critical injury (AIS of 3 to 5) between 1 January 2009, and 31 December 2016, from the Trauma Registry System in a level I trauma center were grouped according to the injured body regions (including, the head/neck, thorax, abdomen, or extremities) and were exclusively compared according to their AIS stratum. Categorical data were compared using the two-sided Fisher exact or Pearson chi-square tests. ANOVA with Games-Howell post hoc test was performed to assess the differences in continuous data of the patients with injury in different body regions. The primary outcome of the study was in-hospital mortality. The adjusted odds ratios (AORs) were estimated using a stepwise selection of a multivariable regression model adjusted by controlling the confounding variables such as sex, age, comorbidities, and ISS. Survival curves were estimated with the Kaplan-Meier approach with a corresponding log-rank test. The patients with AIS of 5 for abdomen injury and those with AIS of 3 for extremity injury had a significantly lower odds of adjusted mortality (adjusted odds ratio (AOR) 0.1, 95% confidence interval (CI) 0.01-0.39, p = 0.004 and AOR 0.3, 95% CI 0.15-0.51, p < 0.001, respectively) than that of the patients with head/neck injury. However, the patients with AIS of 4 for extremity injury demonstrated significantly higher odds of adjusted mortality (AOR 8.4, 95% CI 2.84-25.07, p < 0.001) than the patients with head/neck injury. This study found that the risks to mortality in the patients with a given AIS value of serious to critical injury in different injured body regions were not the same, even after controlling for confounding variables such as sex, age, comorbidities, and ISS.

Same Abbreviated Injury Scale Values May Be Associated with Different Risks to Mortality in Trauma Patients: A Cross-Sectional Retrospective Study Based on the Trauma Registry System in a Level I Trauma Center

PubMed Central

Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun

2017-01-01

The Abbreviated Injury Scale (AIS) measures injury severity of a trauma patient with a numeric method for ranking anatomy-based specific injuries. The summation of the squares of the three most severe injuries in the AIS of six predefined body regions comprises the Injury Severity Score (ISS). It assumes that the mortality of a given AIS value is similar across all body regions. However, such an assumption is less explored in the literature. In this study, we aimed to compare the mortality rates of the patients with the same AIS value in different injured body regions in a level I trauma center. Hospitalized adult trauma patients with isolated serious to critical injury (AIS of 3 to 5) between 1 January 2009, and 31 December 2016, from the Trauma Registry System in a level I trauma center were grouped according to the injured body regions (including, the head/neck, thorax, abdomen, or extremities) and were exclusively compared according to their AIS stratum. Categorical data were compared using the two-sided Fisher exact or Pearson chi-square tests. ANOVA with Games-Howell post hoc test was performed to assess the differences in continuous data of the patients with injury in different body regions. The primary outcome of the study was in-hospital mortality. The adjusted odds ratios (AORs) were estimated using a stepwise selection of a multivariable regression model adjusted by controlling the confounding variables such as sex, age, comorbidities, and ISS. Survival curves were estimated with the Kaplan–Meier approach with a corresponding log-rank test. The patients with AIS of 5 for abdomen injury and those with AIS of 3 for extremity injury had a significantly lower odds of adjusted mortality (adjusted odds ratio (AOR) 0.1, 95% confidence interval (CI) 0.01–0.39, p = 0.004 and AOR 0.3, 95% CI 0.15–0.51, p < 0.001, respectively) than that of the patients with head/neck injury. However, the patients with AIS of 4 for extremity injury demonstrated significantly higher odds of adjusted mortality (AOR 8.4, 95% CI 2.84–25.07, p < 0.001) than the patients with head/neck injury. This study found that the risks to mortality in the patients with a given AIS value of serious to critical injury in different injured body regions were not the same, even after controlling for confounding variables such as sex, age, comorbidities, and ISS. PMID:29232883

Differentiation characteristics and source analysis of heavy metals in typical brown soil under different vegetation

NASA Astrophysics Data System (ADS)

Dong, Zhicheng; Zhang, Lina; Li, Xueshuang; Lv, Shuangyan; He, Shijie; Liu, Ying; Ma, Xuanxuan

2017-08-01

Anomalous enrichment of soil elements (especially heavy metals) has aroused popular attention in China. In order to discuss distribution characteristics and analyze sources of elements in brown soil, field investigation and sample collection were carried out under different vegetation (cherry, apple, bamboos and pine) in Qixia, a typical apple production base in China. Element contents, pH, electrical conductivity (EC) and magnetic susceptibility (MS) were tested. Results showed that element concentrations were about roughly 2.48 times as China’s background values, while significantly lower than the class ii of National soil Environment Quality Standard (Ni excepted). Meanwhile, vertical distribution and accumulation characteristics of elements in typical brown soil were significantly different under different vegetation. In detail, elements (Zn excepted) of Pine soil accumulated in surface, while they (Cd, Arsenic excepted) increased with depth under other vegetation. Moreover, pH and EC changed like elements, while MS was exactly opposite. It was found that those differences above were mainly caused by human activities (such as improper use of fertilizer, pesticide and inadequate use of organic fertilizer, etc.). Additionally, differences in composition and decomposition rate of vegetation litter also resulted in vertical differentiations of soil elements under different vegetation.

Doctoral Theses from Nursing Postgraduate Programs in Brazil and their Association with the Millennium Development Goals.

PubMed

Rodrigues, Rosalina Aparecida Partezani; Robazzi, Maria Lúcia do Carmo Cruz; Erdmann, Alacoque Lorenzini; Fernandes, Josicélia Dumet; de Barros, Alba Lucia Bottura Leite; Ramos, Flávia Regina Souza

2015-01-01

The Millennium Development Goals are centered around combatting poverty and other social evils all over the world. Thus, this study seeks to identify the Millennium Development Goals as an object of study in theses from Postgraduate Nursing Programs in Brazil scoring 5 (national excellence) and 6 or 7 (international excellence), and evaluate the association between the score for the program and achieving the Millennium Development Goals. Exploratory descriptive document research. Data were collected from the Notes on Indicators/Coordination for Higher Education Personnel Improvement for the 15 Postgraduate Nursing Courses scoring between 5 and 7 in the three-year-period of 2010/2012. of the 8 Millennium Development Objectives, 6 were dealt with in the theses. There was an association (Fisher's exact test p-value=0.0059) between the distribution of the theses and the program scores in relation to the Millennium Development Objectives (p-valor=0.0347)CONCLUSION: the doctoral theses were slightly related to the Millennium Development Objectives, covering the population's economic development, health conditions and quality of life. It is recommended that Postgraduate Programs in Nursing pay closer attention to the Millennium Development Objectives.

Doctoral Theses from Nursing Postgraduate Programs in Brazil and their Association with the Millennium Development Goals

PubMed Central

Rodrigues, Rosalina Aparecida Partezani; Robazzi, Maria Lúcia do Carmo Cruz; Erdmann, Alacoque Lorenzini; Fernandes, Josicélia Dumet; de Barros, Alba Lucia Bottura Leite; Ramos, Flávia Regina Souza

2015-01-01

OBJECTIVES: The Millennium Development Goals are centered around combatting poverty and other social evils all over the world. Thus, this study seeks to identify the Millennium Development Goals as an object of study in theses from Postgraduate Nursing Programs in Brazil scoring 5 (national excellence) and 6 or 7 (international excellence), and evaluate the association between the score for the program and achieving the Millennium Development Goals. METHOD: Exploratory descriptive document research. Data were collected from the Notes on Indicators/Coordination for Higher Education Personnel Improvement for the 15 Postgraduate Nursing Courses scoring between 5 and 7 in the three-year-period of 2010/2012. RESULTS: of the 8 Millennium Development Objectives, 6 were dealt with in the theses. There was an association (Fisher's exact test p-value=0.0059) between the distribution of the theses and the program scores in relation to the Millennium Development Objectives (p-valor=0.0347) CONCLUSION: the doctoral theses were slightly related to the Millennium Development Objectives, covering the population's economic development, health conditions and quality of life. It is recommended that Postgraduate Programs in Nursing pay closer attention to the Millennium Development Objectives.. PMID:26312631

The value of physical examination in the diagnosis of hip osteoarthritis.

PubMed

Chong, Timothy; Don, Darren W; Kao, Ming-Chih; Wong, Dexter; Mitra, Raj

2013-01-01

To compare the sensitivity of physical examination (internal rotation of the hip) with radiographs (using the Kellgren-Lawrence grading scale) in the diagnosis of clinically significant hip osteoarthritis. Case Series, Retrospective chart review of hip pain patients that underwent fluoroscopically guided hip steroid and anesthetic injections. 10 patients with hip pain patients seen at an academic outpatient center over a 2 year period were analyzed. Fluoroscopically guided hip steroid and anesthetic injection. Pain relief and change in VAS pain score after intra-articular hip steroid and lidocaine injection was the main outcome measure. Based on Fisher's exact test, there was no association between severity of radiographic hip arthritis and pain relief with intra-articular anesthetic/steroid injection (p=0.45). Physical examination (provocative hip internal rotation) however was associated with a significant decrease in VAS pain score after intra-articular lidocaine and corticosteroid hip injection (p=0.022). Simple hip radiographs alone are not sufficient to diagnose clinically significant hip osteoarthritis. Physical examination (hip internal rotation) was found to be more accurate than simple radiographs in the diagnosis of clinically significant hip osteoarthritis. Radiographs seem to best utilized when they are an extension of the physical examination and patient history.

Prognostic relevance of oxidative stress measurement in chronic lymphocytic leukaemia.

PubMed

D'Arena, Giovanni; Vitale, Candida; Perbellini, Omar; Coscia, Marta; La Rocca, Francesco; Ruggieri, Vitalba; Visco, Carlo; Di Minno, Nicola Matteo Dario; Innocenti, Idanna; Pizza, Vincenzo; Deaglio, Silvia; Di Minno, Giovanni; Giudice, Aldo; Calapai, Gioacchino; Musto, Pellegrino; Laurenti, Luca; Iorio, Eugenio Luigi

2017-10-01

To evaluate the prognostic significance of oxidative stress (OS) and antioxidant defence status measurement in patients with chronic lymphocytic leukaemia (CLL). d-ROMs test and BAP test were evaluated at diagnosis of 165 patients with CLL and correlated with clinical-biological features and prognosis. An increased oxidative damage (d-ROMs test) and a reduced antioxidant potential (BAP test) were found in CLL patients than normal controls (P<.0001). CLL patients with higher d-ROMs values had higher number of circulating white blood cells and lymphocytes, and higher values of β 2 -microglobulin. Higher d-ROMs values were found in female (P=.0003), in patients with unmutated IgVH (P=.04), unfavourable cytogenetics (P=.002) and more advanced clinical stage (P=.002). Higher BAP test values were found in patients expressing CD49d (P=.01) and with more advanced clinical stage (P=.004). At a median follow-up of 48 months, CLL patients with d-ROMs ≥418 CARR U were found to have a shorter time to first treatment (TFT) (P=.0002), and a reduced survival (P=.006) than others. CLL patients with BAP test values ≥2155 μmol/L had a shorter TFT (P=.008) and a shorter survival (P=.003). OS can affect CLL patients by concomitantly increasing reactive oxygen metabolites production and decreasing antioxidant defences. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Expression of COX-2 and bcl-2 in oral lichen planus lesions and lichenoid reactions

PubMed Central

Arreaza, Alven J; Rivera, Helen; Correnti, María

2014-01-01

Oral lichen planus and lichenoid reactions are autoimmune type inflammatory conditions of the oral mucosa with similar clinical and histological characteristics. Recent data suggest that oral lichenoid reactions (OLR) present a greater percentage of malignant transformation than oral lichen planus (OLP). Objective To compare the expression of bcl-2 and COX-2 in OLP and OLR. Methods The study population consisted of 65 cases; 34 cases diagnosed as OLR and 31 as OLP. A retrospective study was done, and bcl-2 and COX-2 expression was semiquantitatively analysed. Results Fifty-three per cent (18/34) of the ORL samples tested positive for COX-2, whereas in the OLP group, 81% of the samples (25/31) immunostained positive for COX-2. The Fisher’s exact test for the expression of COX-2 revealed that there are significant differences between the two groups, P = 0.035. With respect to the expression of the bcl-2 protein, 76% (26/34) of the samples were positive in OLR, while 97% (30/31) were positive in the group with OLP. The Fisher’s exact test for the expression of bcl-2 revealed that there are significant statistical differences between the two groups, P = 0.028. Conclusions The expression of bcl-2 and COX-2 was more commonly expressed in OLP when compared with OLR. PMID:24834112

Boxing fatalities in relation to rule changes in Japan: secondary data analysis.

PubMed

Teramoto, Masaru; Cross, Chad L; Cushman, Daniel M; Willick, Stuart E

2018-01-18

To examine whether changing weigh-in from the same day of the match to the day before the match and prohibiting 6-oz gloves are associated with fatalities in boxing matches sanctioned by the Japan Boxing Commission (JBC). We analyzed the rates of boxing fatalities before and after the two rule changes above via secondary analysis of data. Demographics and boxing records of deceased boxers were examined using descriptive statistics, exact binomial test the Mann-Whitney-Wilcoxon test and Fisher's exact tests. As of this study, a total of 38 boxers (23.9 ± 3.3 years of age) reportedly died due to injuries sustained in JBC-sanctioned boxing matches since 1952. Changing weigh-in to the day before the match or prohibiting 6-oz gloves was not significantly associated with the rates of boxing fatalities 5 years and 10 years before and after the rule changes (p > 0.05). Deceased boxers after these rule changes were significantly older, completed significantly more rounds in the final match, and were significantly less likely to lose the previous match (prior to the final match) and to do so by knockouts (p < 0.05). Changing weigh-in to the day before the match and prohibiting 6-oz gloves may not result in reducing boxing fatalities.

Distribution of genome shared identical by descent by two individuals in grandparent-type relationship.

PubMed Central

Stefanov, V T

2000-01-01

A methodology is introduced for numerical evaluation, with any given accuracy, of the cumulative probabilities of the proportion of genome shared identical by descent (IBD) on chromosome segments by two individuals in a grandparent-type relationship. Programs are provided in the popular software package Maple for rapidly implementing such evaluations in the cases of grandchild-grandparent and great-grandchild-great-grandparent relationships. Our results can be used to identify chromosomal segments that may contain disease genes. Also, exact P values in significance testing for resemblance of either a grandparent with a grandchild or a great-grandparent with a great-grandchild can be calculated. The genomic continuum model, with Haldane's model for the crossover process, is assumed. This is the model that has been used recently in the genetics literature devoted to IBD calculations. Our methodology is based on viewing the model as a special exponential family and elaborating on recent research results for such families. PMID:11063711

A BEFORE AND AFTER TRIAL OF THE EFFECTIVENESS OF NETWORK ANALYSIS IN HEALTH OPERATIONS MANAGEMENT.

PubMed

Bhalwar, R; Srivastava, M; Verma, S S; Vaze, M; Tilak, V W

1996-10-01

An intervention trial using "before-and-after" approach was undertaken to address the question whether network analysis as a health managerial tool of control can favourably affect the delays that occur in planning and executing the antimalaria operations of a Station Health Organization in a large military station. Exposure variable of interest was intervention with a network diagram, by which the potential causes of delay along the various activities were assessed and remedial measures were introduced during the second year. Sample size was calculated using conventional alpha and beta error levels. The study indicated that there was a definite beneficial outcome in that the operations could be started as well as completed in time during the intervention year. There was reduction in time requirement in 5 out of the 9 activities, the exact 'p' value being 0.08, by both parametric and non-parametric tests. The use of network analysis in health care management has been recommended.

Exact solution of the hidden Markov processes.

PubMed

Saakian, David B

2017-11-01

We write a master equation for the distributions related to hidden Markov processes (HMPs) and solve it using a functional equation. Thus the solution of HMPs is mapped exactly to the solution of the functional equation. For a general case the latter can be solved only numerically. We derive an exact expression for the entropy of HMPs. Our expression for the entropy is an alternative to the ones given before by the solution of integral equations. The exact solution is possible because actually the model can be considered as a generalized random walk on a one-dimensional strip. While we give the solution for the two second-order matrices, our solution can be easily generalized for the L values of the Markov process and M values of observables: We should be able to solve a system of L functional equations in the space of dimension M-1.

Exact solution of the hidden Markov processes

NASA Astrophysics Data System (ADS)

Saakian, David B.

2017-11-01

We write a master equation for the distributions related to hidden Markov processes (HMPs) and solve it using a functional equation. Thus the solution of HMPs is mapped exactly to the solution of the functional equation. For a general case the latter can be solved only numerically. We derive an exact expression for the entropy of HMPs. Our expression for the entropy is an alternative to the ones given before by the solution of integral equations. The exact solution is possible because actually the model can be considered as a generalized random walk on a one-dimensional strip. While we give the solution for the two second-order matrices, our solution can be easily generalized for the L values of the Markov process and M values of observables: We should be able to solve a system of L functional equations in the space of dimension M -1 .

Small fiber neuropathy in women with fibromyalgia. An in vivo assessment using corneal confocal bio-microscopy.

PubMed

Ramírez, Manuel; Martínez-Martínez, Laura-Aline; Hernández-Quintela, Everardo; Velazco-Casapía, Jorge; Vargas, Angélica; Martínez-Lavín, Manuel

2015-10-01

A consistent line of investigation suggests that fibromyalgia is a neuropathic pain syndrome. This outlook has been recently reinforced by several controlled studies that describe decreased small nerve fiber density in skin biopsies of patients with fibromyalgia. The cornea receives the densest small fiber innervation of the body. Corneal confocal bio-microscopy is a new noninvasive method to evaluate small nerve fiber morphology. Our objective was to assess corneal small nerve fiber morphology in patients with fibromyalgia, and to associate corneal nerve microscopic features with neuropathic pain descriptors and other fibromyalgia symptoms. We studied 17 female patients with fibromyalgia and 17 age-matched healthy control subjects. All the participants completed different questionnaires regarding the symptoms of fibromyalgia, including a neuropathic pain survey. A central corneal thickness scan was obtained with a confocal microscope. Nerve measurements were made by a single ophthalmologist without knowledge of the clinical diagnosis. Stromal nerve thickness was defined as the mean value between the widest and the narrowest portion of each analyzed stromal nerve. Corneal sub-basal plexus nerve density was also assessed. Patients with fibromyalgia had stromal nerve thickness of 5.0 ± 1.0 µm (mean ± standard deviation) significantly different from that of control's values (6.1 ± 1.3) p = 0.01. Patients also had decreased sub-basal plexus nerve density per square millimeter (85 ± 29) vs. 107 ± 26 of controls p = 0.02. When controls and patients were grouped together, there was an association between stromal nerve slenderness and neuropathic pain descriptors (Fisher's exact test p = 0.007). Women suffering from fibromyalgia have thinner corneal stromal nerves and diminished sub-basal plexus nerve density when compared to healthy controls. Nerve scarcity is associated with neuropathic pain descriptors. Small fiber neuropathy may play a role in the pathogenesis of fibromyalgia pain. Corneal confocal microscopy could become a useful test in the study of patients with fibromyalgia. Copyright © 2015. Published by Elsevier Inc.

Weighted Kolmogorov-Smirnov test: Accounting for the tails

NASA Astrophysics Data System (ADS)

Chicheportiche, Rémy; Bouchaud, Jean-Philippe

2012-10-01

Accurate goodness-of-fit tests for the extreme tails of empirical distributions is a very important issue, relevant in many contexts, including geophysics, insurance, and finance. We have derived exact asymptotic results for a generalization of the large-sample Kolmogorov-Smirnov test, well suited to testing these extreme tails. In passing, we have rederived and made more precise the approximate limit solutions found originally in unrelated fields, first in [L. Turban, J. Phys. A1361-644710.1088/0305-4470/25/3/008 25, 127 (1992)] and later in [P. L. Krapivsky and S. Redner, Am. J. Phys.AJPIAS0002-950510.1119/1.18152 64, 546 (1996)].

Urate oxidase for the prevention and treatment of tumour lysis syndrome in children with cancer.

PubMed

Cheuk, Daniel Kl; Chiang, Alan Ks; Chan, Godfrey Cf; Ha, Shau Yin

2017-03-08

Tumour lysis syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death. Previous reviews did not find clear evidence of benefit of urate oxidase in children with cancer. This review is the second update of a previously published Cochrane review. To assess the effects and safety of urate oxidase for the prevention and treatment of TLS in children with malignancies. In March 2016 we searched CENTRAL, MEDLINE, Embase, and CINAHL. In addition, we searched the reference lists of all identified relevant papers, trials registers and other databases. We also screened conference proceedings and we contacted experts in the field and the manufacturer of rasburicase, Sanofi-aventis. Randomised controlled trials (RCT) and controlled clinical trials (CCT) of urate oxidase for the prevention or treatment of TLS in children under 18 years with any malignancy. Two review authors independently extracted trial data and assessed individual trial quality. We used risk ratios (RR) for dichotomous data and mean difference (MD) for continuous data. We included seven trials, involving 471 participants in the treatment groups and 603 participants in the control groups. No new studies were identified in the update. One RCT and five CCTs compared urate oxidase and allopurinol. Three trials tested Uricozyme, and three trials tested rasburicase for the prevention of TLS.The RCT did not evaluate the primary outcome (incidence of clinical TLS). It showed no clear evidence of a difference in mortality (both all-cause mortality (Fisher's exact test P = 0.23) and mortality due to TLS (no deaths in either group)), renal failure (Fisher's exact test P = 0.46), and adverse effects between the treatment and the control groups (Fisher's exact test P = 1.0). The frequency of normalisation of uric acid at four hours (10 out of 10 participants in the treatment group versus zero out of nine participants in the control group, Fisher's exact test P < 0.001) and area under the curve of uric acid at four days (MD -201.00 mg/dLhr, 95% CI -258.05 mg/dLhr to -143.95 mg/dLhr; P < 0.00001) were significantly better in the treatment group.One CCT evaluated the primary outcome; no clear evidence of a difference was identified between the treatment and the control groups (RR 0.77, 95% CI 0.44 to 1.33; P = 0.34). Pooled results of three CCTs showed significantly lower mortality due to TLS in the treatment group (RR 0.05, 95% CI 0.00 to 0.89; P = 0.04); no clear evidence of a difference in all-cause mortality was identified between the groups (RR 0.19, 95% CI 0.01 to 3.42; P = 0.26). Pooled results from five CCTs showed significantly lower incidence of renal failure in the treatment group (RR 0.26, 95% CI 0.08 to 0.89; P = 0.03). Results of CCTs also showed significantly lower uric acid in the treatment group at two days (three CCTs: MD -3.80 mg/dL, 95% CI -7.37 mg/dL to -0.24 mg/dL; P = 0.04), three days (two CCTs: MD -3.13 mg/dL, 95% CI -6.12 mg/dL to -0.14 mg/dL; P = 0.04), four days (two CCTs: MD -4.60 mg/dL, 95% CI -6.39 mg/dL to -2.81 mg/dL; P < 0.00001), and seven days (one CCT: MD -1.74 mg/dL, 95% CI -3.01 mg/dL to -0.47 mg/dL; P = 0.007) after therapy, but not one day (three CCTs: MD -3.00 mg/dL, 95% CI -7.61 mg/dL to 1.60 mg/dL; P = 0.2), five days (one CCT: MD -1.02 mg/dL, 95% CI -2.24 mg/dL to 0.20 mg/dL; P = 0.1), and 12 days (one CCT: MD -0.80 mg/dL, 95% CI -2.51 mg/dL to 0.91 mg/dL; P = 0.36) after therapy. Pooled results from three CCTs showed higher frequency of adverse effects in participants who received urate oxidase (RR 9.10, 95% CI 1.29 to 64.00; P = 0.03).Another included RCT, with 30 participants, compared different doses of rasburicase (0.2 mg/kg versus 0.15 mg/kg). The primary outcome was not evaluated. No clear evidence of a difference in mortality (all-cause mortality (Fisher's exact test P = 1.0) and mortality due to TLS (no deaths in both groups)) and renal failure (no renal failure in both groups) was identified. It demonstrated no clear evidence of a difference in uric acid normalisation (RR 1.07, 95% CI 0.89 to 1.28; P = 0.49) and uric acid level at four hours (MD 8.10%, 95% CI -0.99% to 17.19%; P = 0.08). Common adverse events of urate oxidase included hypersensitivity, haemolysis, and anaemia, but no clear evidence of a difference between treatment groups was identified (RR 0.54, 95% CI 0.12 to 2.48; P = 0.42).The quality of evidence ranks from very low to low because of imprecise results, and all included trials were highly susceptible to biases. Although urate oxidase might be effective in reducing serum uric acid, it is unclear whether it reduces clinical TLS, renal failure, or mortality. Adverse effects might be more common for urate oxidase compared with allopurinol. Clinicians should weigh the potential benefits of reducing uric acid and uncertain benefits of preventing mortality or renal failure from TLS against the potential risk of adverse effects.

Exact finite volume expectation values of local operators in excited states

NASA Astrophysics Data System (ADS)

Pozsgay, B.; Szécsényi, I. M.; Takács, G.

2015-04-01

We present a conjecture for the exact expression of finite volume expectation values in excited states in integrable quantum field theories, which is an extension of an earlier conjecture to the case of general diagonal factorized scattering with bound states and a nontrivial bootstrap structure. The conjectured expression is a spectral expansion which uses the exact form factors and the excited state thermodynamic Bethe Ansatz as building blocks. The conjecture is proven for the case of the trace of the energy-moment tensor. Concerning its validity for more general operators, we provide numerical evidence using the truncated conformal space approach. It is found that the expansion fails to be well-defined for small values of the volume in cases when the singularity structure of the TBA equations undergoes a non-trivial rearrangement under some critical value of the volume. Despite these shortcomings, the conjectured expression is expected to be valid for all volumes for most of the excited states, and as an expansion above the critical volume for the rest.

Foot reflexology in feet impairment of people with type 2 diabetes mellitus: randomized trial.

PubMed

da Silva, Natália Chantal Magalhães; Chaves, Érika de Cássia Lopes; de Carvalho, Emilia Campos; Carvalho, Leonardo César; Iunes, Denise Hollanda

2015-01-01

to evaluate the effect of foot reflexology on feet impairment of people with type 2 diabetes mellitus. this is a randomized, controlled and blind clinical trial. The sample was comprised by people with type 2 diabetes mellitus who, after being randomized into Treated group (n = 21) and Control group (n = 24), received guidelines on foot self-care. To the Treated Group it was also provided 12 sessions of foot reflexology. The scores of impairment indicators related to skin and hair, blood circulation, tissue sensitivity and temperature were measured by means of the instrument for assessing tissue integrity of the feet of people with diabetes mellitus. Chi-square test, Fisher exact test, Mann-Whitney test and regression analyzes were applied to the data, considering a significance level of 5% (P value <0.05). participants who received the therapy showed better scores in some impairment indicators related to skin and hair (hair growth, elasticity/turgor, hydration, perspiration, texture and integrity of the skin/ skin peeling). the foot reflexology had a beneficial effect on feet impairment of people with type 2 diabetes mellitus, which makes it a viable therapy, deserving investment. This study was registered in the Brazilian Registry of Clinical Trials - RBR-8zk8sz.

Foot reflexology in feet impairment of people with type 2 diabetes mellitus: randomized trial 1

PubMed Central

da Silva, Natália Chantal Magalhães; Chaves, Érika de Cássia Lopes; de Carvalho, Emilia Campos; Carvalho, Leonardo César; Iunes, Denise Hollanda

2015-01-01

Abstract Objective: to evaluate the effect of foot reflexology on feet impairment of people with type 2 diabetes mellitus. Method: this is a randomized, controlled and blind clinical trial. The sample was comprised by people with type 2 diabetes mellitus who, after being randomized into Treated group (n = 21) and Control group (n = 24), received guidelines on foot self-care. To the Treated Group it was also provided 12 sessions of foot reflexology. The scores of impairment indicators related to skin and hair, blood circulation, tissue sensitivity and temperature were measured by means of the instrument for assessing tissue integrity of the feet of people with diabetes mellitus. Chi-square test, Fisher exact test, Mann-Whitney test and regression analyzes were applied to the data, considering a significance level of 5% (P value <0.05). Results: participants who received the therapy showed better scores in some impairment indicators related to skin and hair (hair growth, elasticity/turgor, hydration, perspiration, texture and integrity of the skin/ skin peeling). Conclusion: the foot reflexology had a beneficial effect on feet impairment of people with type 2 diabetes mellitus, which makes it a viable therapy, deserving investment. This study was registered in the Brazilian Registry of Clinical Trials - RBR-8zk8sz. PMID:26444161

Separate-channel analysis of two-channel microarrays: recovering inter-spot information.

PubMed

Smyth, Gordon K; Altman, Naomi S

2013-05-26

Two-channel (or two-color) microarrays are cost-effective platforms for comparative analysis of gene expression. They are traditionally analysed in terms of the log-ratios (M-values) of the two channel intensities at each spot, but this analysis does not use all the information available in the separate channel observations. Mixed models have been proposed to analyse intensities from the two channels as separate observations, but such models can be complex to use and the gain in efficiency over the log-ratio analysis is difficult to quantify. Mixed models yield test statistics for the null distributions can be specified only approximately, and some approaches do not borrow strength between genes. This article reformulates the mixed model to clarify the relationship with the traditional log-ratio analysis, to facilitate information borrowing between genes, and to obtain an exact distributional theory for the resulting test statistics. The mixed model is transformed to operate on the M-values and A-values (average log-expression for each spot) instead of on the log-expression values. The log-ratio analysis is shown to ignore information contained in the A-values. The relative efficiency of the log-ratio analysis is shown to depend on the size of the intraspot correlation. A new separate channel analysis method is proposed that assumes a constant intra-spot correlation coefficient across all genes. This approach permits the mixed model to be transformed into an ordinary linear model, allowing the data analysis to use a well-understood empirical Bayes analysis pipeline for linear modeling of microarray data. This yields statistically powerful test statistics that have an exact distributional theory. The log-ratio, mixed model and common correlation methods are compared using three case studies. The results show that separate channel analyses that borrow strength between genes are more powerful than log-ratio analyses. The common correlation analysis is the most powerful of all. The common correlation method proposed in this article for separate-channel analysis of two-channel microarray data is no more difficult to apply in practice than the traditional log-ratio analysis. It provides an intuitive and powerful means to conduct analyses and make comparisons that might otherwise not be possible.

Mean-field description of topological charge 4e superconductors

NASA Astrophysics Data System (ADS)

Gabriele, Victoria; Luo, Jing; Teo, Jeffrey C. Y.

BCS superconductors can be understood by a mean-field approximation of two-body interacting Hamiltonians, whose ground states break charge conservation spontaneously by allowing non-vanishing expectation values of charge 2e Cooper pairs. Topological superconductors, such as one-dimensional p-wave wires, have non-trivial ground states that support robust gapless boundary excitations. We construct a four-body Hamiltonian in one dimension and perform a mean-field analysis. The mean-field Hamiltonian is now quartic in fermions but is still exactly solvable. The ground state exhibits 4-fermion expectation values instead of Cooper pair ones. There also exists a topological phase, where the charge 4e superconductor carries exotic zero energy boundary excitations.

Outpatient case management in low-income epilepsy patients.

PubMed

Tatum, William O; Al-Saadi, Sam; Orth, Thomas L

2008-12-01

Case management (CM) has been shown to improve the medical care of patients in several paradigms of general medicine. This study was undertaken to assess the impact of CM on low-income patients with epilepsy. From 2002 to 2003, 737 epilepsy patients had CM provided by a non-profit, state-supported, epilepsy service subserving a four county region in southeastern Florida. Standardized survey forms distributed by the Florida Department of Health were completed by 159 consecutive patients at program admission. Follow-up information regarding seizure frequency, antiepileptic drugs, and quality of life self-rating was performed after 1 year of CM. The patients evaluated were composed of 58.5% men, with a mean age of 41.0 years. After CM, an increase in self-reported seizure control was seen in 40.2% of patients (p<0.0001, Fisher's exact test), in addition to a shift in the principal utilization of the older to the newer antiepileptic drugs. Furthermore, the total number of emergency department (ED) visits was reduced by 90% with a mean reduction of ED visits per patient from 1.83 per patient per year before CM to 0.14 per patient per year after CM (p<0.0001, Wilcoxon matched-pairs test). Following CM, fewer patients reported difficulty with friends, employers, problems socializing, and feelings of anger (p<0.05, Fisher's exact test). CM of low-income patients with epilepsy resulted in self-reported improvement in seizure control, QoL, and significantly reduced ED visitation. CM in epilepsy is feasible and represents a cost-effective improvement in outpatient epilepsy management.

Normal findings in vulvar examination and vulvoscopy.

PubMed

van Beurden, M; van der Vange, N; de Craen, A J; Tjong-A-Hung, S P; ten Kate, F J; ter Schegget, J; Lammes, F B

1997-03-01

To determine the normal vulvar findings by naked eye examination and by vulvoscopy in healthy women without vulvar complaints. Observational study. Forty healthy volunteers without vulvar complaints recruited via a newspaper advertisement. Vulvar examination, human papillomavirus (HPV) polymerase chain reaction of vulvar and cervical swabs, saline and KOH smears and vulvoscopy before and after the application of 5% acetic acid. Prevalence of vestibular erythema, vestibular papillomatosis, HPV infection on the vulva and in the cervix and vulvoscopic findings. The mean age of the women was 37.8 years (median 38.0, range 21-56). Nine women were current smokers and 21 had previously smoked. Naked eye vulvar examination showed vestibular papillomatosis in 13 women (33%) and vestibular erythema in 17 women (43%). The touch test was positive in 9 of the 17 women (53%) with vestibular erythema. Vulvoscopy after the application of acetic acid 5% showed an acetowhite vestibule in all women. Twelve women (30%) had acetowhite lesions outside the vestibule. Six women (15%) were positive for HPV DNA. The presence of HPV DNA did not correlate with vestibular erythema or vestibular papillomatosis. There was a weak association between HPV DNA and acetowhite lesions outside the vestibule (P = 0.055, Fisher's exact test). In this group the younger women significantly more often had vestibular papillomatosis (t-statistic = 3.07; P = 0.003) and women who smoke more often had a genital HPV infection (P = 0.016, Fisher's exact test). Vestibular erythema, vestibular papillomatosis, and acetowhite lesions are common in this group of healthy women without vulvar complaints.

Patients with inflammatory bowel disease have increased risk of autoimmune and inflammatory diseases

PubMed Central

Halling, Morten L; Kjeldsen, Jens; Knudsen, Torben; Nielsen, Jan; Hansen, Lars Koch

2017-01-01

AIM To investigate whether immune mediated diseases (IMD) are more frequent in patients with inflammatory bowel disease (IBD). METHODS In this population based registry study, a total of 47325 patients with IBD were alive and registered in the Danish National Patient Registry on December 16, 2013. Controls were randomly selected from the Danish Civil Registration System (CRS) and matched for sex, age, and municipality. We used ICD 10 codes to identify the diagnoses of the included patients. The IBD population was divided into three subgroups: Ulcerative colitis (UC), Crohn’s disease (CD) and Both the latter referring to those registered with both diagnoses. Subsequently, odds-ratios (OR) and 95%CI were obtained separately for each group and their respective controls. The use of Bonferoni post-test correction adjusted the significance level to P < 0.00125. P-values were estimated using Fisher’s exact test. RESULTS There were significantly more women than men in the registry, and a greater percentage of comorbidity in the IBD groups (P < 0.05). Twenty different IMDs were all significantly more frequent in the IBD group. Sixteen were associated with UC versus twelve with CD. In both UC and CD ORs were significantly increased (P < 0.00125) for primary sclerosing cholangitis (PSC), celiac disease, type 1 diabetes (T1D), sarcoidosis, asthma, iridocyclitis, psoriasis, pyoderma gangrenosum, rheumatoid arthritis, and ankylosing spondylitis. Restricted to UC (P < 0.00125) were autoimmune hepatitis, primary biliary cholangitis, Grave’s disease, polymyalgia rheumatica, temporal arteritis , and atrophic gastritis. Restricted to CD (P < 0.00125) were psoriatic arthritis and episcleritis. Restricted to women with UC (P < 0.00125) were atrophic gastritis, rheumatoid arthritis, temporal arteritis, and polymyalgia rheumatica. Restricted to women with CD were episcleritis, rheumatoid arthritis, and psoriatic arthritis. The only disease restricted to men (P < 0.00125) was sarcoidosis. CONCLUSION Immune mediated diseases were significantly more frequent in patients with IBD. Our results strengthen the hypothesis that some IMDs and IBD may have overlapping pathogenic pathways. PMID:28970729

Patients with inflammatory bowel disease have increased risk of autoimmune and inflammatory diseases.

PubMed

Halling, Morten L; Kjeldsen, Jens; Knudsen, Torben; Nielsen, Jan; Hansen, Lars Koch

2017-09-07

To investigate whether immune mediated diseases (IMD) are more frequent in patients with inflammatory bowel disease (IBD). In this population based registry study, a total of 47325 patients with IBD were alive and registered in the Danish National Patient Registry on December 16, 2013. Controls were randomly selected from the Danish Civil Registration System (CRS) and matched for sex, age, and municipality. We used ICD 10 codes to identify the diagnoses of the included patients. The IBD population was divided into three subgroups: Ulcerative colitis (UC), Crohn's disease (CD) and Both the latter referring to those registered with both diagnoses. Subsequently, odds-ratios (OR) and 95%CI were obtained separately for each group and their respective controls. The use of Bonferoni post-test correction adjusted the significance level to P < 0.00125. P -values were estimated using Fisher's exact test. There were significantly more women than men in the registry, and a greater percentage of comorbidity in the IBD groups ( P < 0.05). Twenty different IMDs were all significantly more frequent in the IBD group. Sixteen were associated with UC versus twelve with CD. In both UC and CD ORs were significantly increased ( P < 0.00125) for primary sclerosing cholangitis (PSC), celiac disease, type 1 diabetes (T1D), sarcoidosis, asthma, iridocyclitis, psoriasis, pyoderma gangrenosum, rheumatoid arthritis, and ankylosing spondylitis. Restricted to UC ( P < 0.00125) were autoimmune hepatitis, primary biliary cholangitis, Grave's disease, polymyalgia rheumatica, temporal arteritis , and atrophic gastritis. Restricted to CD ( P < 0.00125) were psoriatic arthritis and episcleritis. Restricted to women with UC ( P < 0.00125) were atrophic gastritis, rheumatoid arthritis, temporal arteritis, and polymyalgia rheumatica. Restricted to women with CD were episcleritis, rheumatoid arthritis, and psoriatic arthritis. The only disease restricted to men ( P < 0.00125) was sarcoidosis. Immune mediated diseases were significantly more frequent in patients with IBD. Our results strengthen the hypothesis that some IMDs and IBD may have overlapping pathogenic pathways.

Diffuse Reflectance Spectroscopy: Getting the Capillary Refill Test Under One's Thumb.

PubMed

Henricson, Joakim; Toll John, Rani; Anderson, Chris D; Björk Wilhelms, Daniel

2017-12-02

The capillary refill test was introduced in 1947 to help estimate circulatory status in critically ill patients. Guidelines commonly state that refill should occur within 2 s after releasing 5 s of firm pressure (e.g., by the physician's finger) in the normal healthy supine patient. A slower refill time indicates poor skin perfusion, which can be caused by conditions including sepsis, blood loss, hypoperfusion, and hypothermia. Since its introduction, the clinical usefulness of the test has been debated. Advocates point out its feasibility and simplicity and claim that it can indicate changes in vascular status earlier than changes in vital signs such as heart rate. Critics, on the other hand, stress that the lack of standardization in how the test is performed and the highly subjective nature of the naked eye assessment, as well as the test's susceptibility to ambient factors, markedly lowers the clinical value. The aim of the present work is to describe in detail the course of the refill event and to suggest potentially more objective and exact endpoint values for the capillary refill test using diffuse polarization spectroscopy.

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

Singleton, Jr., Robert; Israel, Daniel M.; Doebling, Scott William

For code verification, one compares the code output against known exact solutions. There are many standard test problems used in this capacity, such as the Noh and Sedov problems. ExactPack is a utility that integrates many of these exact solution codes into a common API (application program interface), and can be used as a stand-alone code or as a python package. ExactPack consists of python driver scripts that access a library of exact solutions written in Fortran or Python. The spatial profiles of the relevant physical quantities, such as the density, fluid velocity, sound speed, or internal energy, are returnedmore » at a time specified by the user. The solution profiles can be viewed and examined by a command line interface or a graphical user interface, and a number of analysis tools and unit tests are also provided. We have documented the physics of each problem in the solution library, and provided complete documentation on how to extend the library to include additional exact solutions. ExactPack’s code architecture makes it easy to extend the solution-code library to include additional exact solutions in a robust, reliable, and maintainable manner.« less

Shannon entropies and Fisher information of K-shell electrons of neutral atoms

NASA Astrophysics Data System (ADS)

Sekh, Golam Ali; Saha, Aparna; Talukdar, Benoy

2018-02-01

We represent the two K-shell electrons of neutral atoms by Hylleraas-type wave function which fulfils the exact behavior at the electron-electron and electron-nucleus coalescence points and, derive a simple method to construct expressions for single-particle position- and momentum-space charge densities, ρ (r) and γ (p) respectively. We make use of the results for ρ (r) and γ (p) to critically examine the effect of correlation on bare (uncorrelated) values of Shannon information entropies (S) and of Fisher information (F) for the K-shell electrons of atoms from helium to neon. Due to inter-electronic repulsion the values of the uncorrelated Shannon position-space entropies are augmented while those of the momentum-space entropies are reduced. The corresponding Fisher information are found to exhibit opposite behavior in respect of this. Attempts are made to provide some plausible explanation for the observed response of S and F to electronic correlation.

New Exact Solutions of Relativistic Hydrodynamics for Longitudinally Expanding Fireballs

NASA Astrophysics Data System (ADS)

Csörgő, Tamás; Kasza, Gábor; Csanád, Máté; Jiang, Zefang

2018-06-01

We present new, exact, finite solutions of relativistic hydrodynamics for longitudinally expanding fireballs for arbitrary constant value of the speed of sound. These new solutions generalize earlier, longitudinally finite, exact solutions, from an unrealistic to a reasonable equation of state, characterized by a temperature independent (average) value of the speed of sound. Observables like the rapidity density and the pseudorapidity density are evaluated analytically, resulting in simple and easy to fit formulae that can be matched to the high energy proton-proton and heavy ion collision data at RHIC and LHC. In the longitudinally boost-invariant limit, these new solutions approach the Hwa-Bjorken solution and the corresponding rapidity distributions approach a rapidity plateaux.

The generative basis of natural number concepts.

PubMed

Leslie, Alan M; Gelman, Rochel; Gallistel, C R

2008-06-01

Number concepts must support arithmetic inference. Using this principle, it can be argued that the integer concept of exactly ONE is a necessary part of the psychological foundations of number, as is the notion of the exact equality - that is, perfect substitutability. The inability to support reasoning involving exact equality is a shortcoming in current theories about the development of numerical reasoning. A simple innate basis for the natural number concepts can be proposed that embodies the arithmetic principle, supports exact equality and also enables computational compatibility with real- or rational-valued mental magnitudes.

Comparison of serum Concentration of Se, Pb, Mg, Cu, Zn, between MS patients and healthy controls

PubMed Central

Alizadeh, Anahita; Mehrpour, Omid; Nikkhah, Karim; Bayat, Golnaz; Espandani, Mahsa; Golzari, Alireza; Jarahi, Lida; Foroughipour, Mohsen

2016-01-01

Introduction Multiple Sclerosis (MS) is defined as one of the inflammatory autoimmune disorders and is common. Its exact etiology is unclear. There are some evidences on the role of environmental factors in susceptible genetics. The aim of this study is to evaluate the possible role of Selenium, Zinc, Copper, Lead and Magnesium metals in Multiple Sclerosis patients. Methods In the present analytical cross-sectional study, 56 individuals including 26 patients and 30 healthy controls were enrolled in the evaluation. The serum level of Se, Zn, Cu, Pb were quantified in graphite furnace conditions and flame conditions by utilizing an atomic absorption Perkin Elmer spectrophotometer 3030. The serum levels of Mg were measured by auto analyzer 1500 BT. The mean level of minerals (Zn, Pb, Cu, Mg, Se) in serum samples were compared in both cases and controls. The mean level of minerals (Zn, Pb, Cu, Mg, Se) in serum samples were compared in both cases and controls by using independent-samples t-test for normal distribution and Mann-Whitney U test as a non-parametric test. All statistical analyses were carried out using SPSS 11.0. Results As well as the Zn, Cu, and Se, there was no significant difference between MS patients and healthy individuals in Pb concentrations (p-value = 0.11, 0.14, 0.32, 0.20 respectively) but the level of Mg was significantly different (p= 0.001). Conclusion All serum concentrations of Zn, Pb, Se, Cu in both groups were in normal ranges and there was no difference in MS patients compared with the healthy group who were matched in genetics. Blood level of Mg was significantly lower in MS patients. But it should be noted that even with the low level of serum magnesium in MS patients, this value is still in the normal range. PMID:27757186

Steroid eye drop treatment (difluprednate ophthalmic emulsion) is effective in reducing refractory diabetic macular edema.

PubMed

Nakano, Sakiko; Yamamoto, Teiko; Kirii, Eriko; Abe, Sachi; Yamashita, Hidetoshi

2010-06-01

To evaluate the efficacy of treatment of refractory diabetic macular edema (DME) after vitrectomy with difluprednate ophthalmic emulsion 0.05% (Durezol(TM)), and to compare this treatment with sub-Tenon's injection of triamcinolone (STTA). This study enrolled patients with refractory diabetic macular edema that persisted despite pars plana vitrectomy in our clinic. In all subjects, more than 3 months had passed since prior treatment. Eleven eyes in ten subjects were treated with STTA (STTA group), and 11 eyes in seven subjects were treated with difluprednate ophthalmic emulsion 0.05% (Durezol(TM), Sirion Therapeutics Inc., USA) 4 times daily for the first month and then twice daily for 2 months (eye drop group). In the eye drop group, mean VA (+/- SD) was 0.67 +/- 0.35 logMAR and mean retinal thickness was 500.6 +/- 207.7 mum at baseline. After 3 months of treatment, mean VA was 0.67 +/- 0.29 and mean retinal thickness had decreased to 341.2 +/- 194.8 mum. The mean minimum value of RT during the treatment period was 300.6 +/- 123.2 mum, and significantly lower than that at baseline (Mann-Whitney U test: P = 0.003). In the STTA group, mean VA (+/- SD) was 0.67 +/- 0.35 logMAR, and mean retinal thickness was 543.3 +/- 132.6 mum at baseline. After 3 months of treatment, mean VA was 0.49 +/- 0.67, and mean retinal thickness had decreased to 378.6 +/- 135 mum. The mean minimum value of RT during the treatment period was 349.9 +/- 113.8 mum, and significantly lower than at baseline (Mann-Whitney U test: P = 0.003). The rate of effective improvement in RT did not differ between the eye drop group (73%) and STTA group (84%) (Fisher's exact test: P = 1). Comparable improvements of retinal thickness were observed in the STTA and eye drop groups. Instillation of difluprednate ophthalmic emulsion 0.05% is a safe and effective treatment that does not require surgical intervention and does not produce severe side-effects.

Patterns of everyday technology use and activity involvement in mild cognitive impairment: a five-year follow-up study.

PubMed

Hedman, Annicka; Kottorp, Anders; Nygård, Louise

2018-05-01

The aims were to describe longitudinal patterns in terms of perceived ability to use everyday technology (ET) and involvement in everyday activities over five years in older adults with mild cognitive impairment (MCI), and to examine the predictive value of these patterns regarding diagnostic outcomes. Thirty older adults diagnosed with MCI at inclusion, reported their perceived ability in using ET and involvement in everyday activities on seven occasions over five years. Individual longitudinal case plots and a pattern-oriented analysis were used to compare the participants' distribution in earlier identified stable/ascending, fluctuating and descending patterns of functioning (year 0-2). Fisher's exact test was used for testing the relation between pattern and diagnostic outcomes. An initial descending pattern of functioning tended to continue; none of these participants later developed a more stable pattern. More congruent trajectories of change appeared over time. Pattern affinity years 0-2 and diagnostic outcome were significantly related (p = .05), with a dementia diagnosis being more likely for those initially displaying an early descending pattern Conclusion: These findings point to a need for early support focusing on the use of ET for persons with MCI who early after diagnosis descend in functioning.

Promoter hypermethylation of the DNA repair gene O(6)-methylguanine-DNA methyltransferase is associated with the presence of G:C to A:T transition mutations in p53 in human colorectal tumorigenesis.

PubMed

Esteller, M; Risques, R A; Toyota, M; Capella, G; Moreno, V; Peinado, M A; Baylin, S B; Herman, J G

2001-06-15

Defects in DNA repair may be responsible for the genesis of mutations in key genes in cancer cells. The tumor suppressor gene p53 is commonly mutated in human cancer by missense point mutations, most of them G:C to A:T transitions. A recognized cause for this type of change is spontaneous deamination of the methylcytosine. However, the persistence of a premutagenic O(6)-methylguanine can also be invoked. This last lesion is removed in the normal cell by the DNA repair enzyme O(6)-methylguanine-DNA methyltransferase (MGMT). In many tumor types, epigenetic silencing of MGMT by promoter hypermethylation has been demonstrated and linked to the appearance of G to A mutations in the K-ras oncogene in colorectal tumors. To study the relevance of defective MGMT function by aberrant methylation in relation to the presence of p53 mutations, we studied 314 colorectal tumors for MGMT promoter hypermethylation and p53 mutational spectrum. Inactivation of MGMT by aberrant methylation was associated with the appearance of G:C to A:T transition mutations at p53 (Fischer's exact test, two-tailed; P = 0.01). Overall, MGMT methylated tumors displayed p53 transition mutations in 43 of 126 (34%) cases, whereas MGMT unmethylated tumors only showed G:C to A:T changes in 37 of 188 (19%) tumors. A more striking association was found in G:C to A:T transitions in non-CpG dinucleotides; 71% (12 of 17) of the total non-CpG transition mutations in p53 were observed in MGMT aberrantly methylated tumors (Fischer's exact test, two-tailed; P = 0.008). Our data suggest that epigenetic silencing of MGMT by promoter hypermethylation may lead to G:C to A:T transition mutations in p53.

[Clinical study on application of intermittent hemofiltration combined with hemoperfusion in the early stage of severe burn in the prevention and treatment of sepsis].

PubMed

Guo, Wanli; Lei, Jin; Duan, Peng; Ma, Xiaoming

2015-08-01

To investigate the effects of application of intermittent hemofiltration combined with hemoperfusion (HP) in the early stage of severe burn in the prevention and treatment of sepsis. Forty severely burned patients, admitted to our burn ward from June 2011 to March 2013, conforming to the study criteria, were divided into conventional treatment group (CT, n=20) and blood purification group (BP, n=20) according to the random number table. Patients in group CT received CT according to the accepted principles of treatment for a severe burn. Patients in group BP received CT and intermittent hemofiltration combined with HP once respectively on post injury day (PID) 3, 5, and 7, spanning 6 to 8 hours for each treatment. On PID 3, 5, 7, 10, and 14, body temperature, heart rate, and respiratory rate were recorded; white blood cell count (WBC), neutrophil granulocytes, blood urea nitrogen (BUN), and creatinine were determined; levels of IL-1, IL-6, TNF-α, and high-mobility group box 1 (HMGB1) in serum were determined by ELISA; level of LPS in serum was determined with the chromogenic substrate limulus amebocyte lysate method; level of procalcitonin (PCT) in serum was determined by double antibody sandwich immune chemiluminescence method. The symptoms and signs of sepsis were observed during the treatment. Data were processed with Fisher's exact test, chi-square test, analysis of variance for repeated measurement, and LSD-t test. (1) Except for that on PID 5, the mean body temperature of patients in group BP was significantly lower than that of group CT at each of the rest time points (with t values from 1.87 to 2.97, P values below 0.05). The heart rate was significantly slower in patients of group BP than in group CT from PID 3 to 14 (with t values from 1.78 to 3.59, P values below 0.05). Except for that on PID 3, the respiratory rate of patients in group BP was significantly slower than that of group CT at each of the rest time points (with t values from 1.93 to 2.85, P values below 0.05). (2) The levels of WBC, neutrophil granulocytes, BUN, and creatinine of patients in group BP were significantly lower than those of group CT (with t values from 1.78 to 4.23, P values below 0.05). (3) Except for that on PID 3, the level of IL-1 of patients in group BP was significantly lower than that of group CT at each of the rest time points (with t values from 1.97 to 4.16, P values below 0.05). Except for that on PID 7, the level of IL-6 of patients in group BP was significantly lower than that of group CT at each of the rest time points (with t values from 2.11 to 6.34, P values below 0.05). The levels of TNF-α and HMGB1 of patients in group BP were significantly lower than those of group CT from PID 3 to 14 (with t values from 1.98 to 5.29, P values below 0.05). (4) On PID 3, 5, 7, 10, and 14, the levels of LPS and PCT of patients in group BP were respectively (0.23 ± 0.07), (0.27 ± 0.09), (0.22 ± 0.06), (0.20 ± 0.08), (0.15 ± 0.07) EU/mL, and (0.44 ± 0.12), (0.67 ± 0.13), (0.74 ± 0.13), (0.64 ± 0.12), (0.71 ± 0.10) ng/mL, and they were lower than those of group CT [(0.37 ± 0.08), (0.45 ± 0.09), (0.56 ± 0.09), (0.48 ± 0.08), (0.40 ± 0.08) EU/mL, and (0.74 ± 0.11), (1.16 ± 0.12), (1.40 ± 0.13), (1.55 ± 0.15), (1.49 ± 0.14) ng/mL, with t values from 1.88 to 3.43, P values below 0.05]. (5) The incidence of sepsis of patients in group BP was obviously lower than that of group CT (χ² = 6.94, P<0.01). Intermittent hemofiltration combined with HP can effectively improve blood biochemical indexes and vital signs and reduce the occurrence of burn sepsis by decreasing the levels of proinflammatory cytokines, LPS, and PCT.

Real-time holographic deconvolution techniques for one-way image transmission through an aberrating medium: characterization, modeling, and measurements.

PubMed

Haji-Saeed, B; Sengupta, S K; Testorf, M; Goodhue, W; Khoury, J; Woods, C L; Kierstead, J

2006-05-10

We propose and demonstrate a new photorefractive real-time holographic deconvolution technique for adaptive one-way image transmission through aberrating media by means of four-wave mixing. In contrast with earlier methods, which typically required various codings of the exact phase or two-way image transmission for correcting phase distortion, our technique relies on one-way image transmission through the use of exact phase information. Our technique can simultaneously correct both amplitude and phase distortions. We include several forms of image degradation, various test cases, and experimental results. We characterize the performance as a function of the input beam ratios for four metrics: signal-to-noise ratio, normalized root-mean-square error, edge restoration, and peak-to-total energy ratio. In our characterization we use false-color graphic images to display the best beam-intensity ratio two-dimensional region(s) for each of these metrics. Test cases are simulated at the optimal values of the beam-intensity ratios. We demonstrate our results through both experiment and computer simulation.

[Pathogenesis and therapy of hydronephrosis after hematopoietic stem cell transplantation].

PubMed

Yu, Lu-ping; Xu, Tao; Huang, Xiao-bo; Wang, Xiao-feng

2014-08-18

To investigate the pathogenesis and therapy of hydronephrosis after hematopoietic stem cell transplantation (HSCT). From March 2004 to March 2014, 23 patients with hydronephrosis after HSCT were identified. With these data, the pathogenesis of hydronephrosis after HSCT were analyzed. According to the surgical intervention of hydronephrosis and ureteral dialation of ureteral stricture, the patients were divided into two groups, rank-sum test and exact probability test were used to evaluate whether there were significant differences in the time of hemorrhagic cystitis (HC) occurred, ureteritis and viremia. HC, ureteritis, ureteral stenosis were all the causes of hydronephrosis after HSCT. In this study, 69.6% (16/23) of the patients suffered from HSCT were cured by conservative treatment, 30.4% (7/23) by surgical intervention, and 13.0% (3/23) by insertion DJ stent or nephrostomy.Of the patients [17.4% (4/23)] who suffered ureteral stenosis, 2 were cured after the balloon dialation of ureter, 1 needed DJ tube long-term insertion, and 1 was still followed-up. rank-sum test and exact probability test results showed that the patients who needed surgical intervention might suffer from HC later than other patients, and their incidences of viremia and ureteritis were higher, but the differences between the two groups were not statistically significant (P = 0.524, P = 0.169, and P = 0.124, respectively). The results also showed that the ureteritis incidences of the patients who suffered from ureteral stricture and needed ureteral dialation were higher than that of the other patients, and the difference between the two groups was statistically significant (P = 0.024). The patients who needed ureteral dialation suffered from HC later and their incidences of viremia was higher, but the differences between the two groups were not statistically significant (P = 0.73 and P = 0.27). HC, ureteritis and ureteral stenosis may cause hydronephrosis after HSCT. Patients may treated by conservative treatment first. Patients who suffered from HC later, viremia and especially ureteritis should be paid more attention to, and be treated with surgical intervention when necessary. The patients with ureteral stenosis could be treated by ureteral balloon dialation.

Accuracy of Time Phasing Aircraft Development using the Continuous Distribution Function

DTIC Science & Technology

2015-03-26

Breusch - Pagan test ; the reported p-value of 0.5264 fails to rejects the null hypothesis of constant... Breusch - Pagan Test : P-value – 0.6911 0 2 4 6 8 10 12 -1 -0.75 -0.5 -0.25 0 0.25 0.5 0.75 1 Shapiro-Wilk W Test Prob. < W: 0.9849 -1...Weibull Scale Parameter β – Constant Variance Breusch - Pagan Test : P-value – 0.5176 Beta Shape Parameter α – Influential Data

Fortuin-Kasteleyn and damage-spreading transitions in random-bond Ising lattices

NASA Astrophysics Data System (ADS)

Lundow, P. H.; Campbell, I. A.

2012-10-01

The Fortuin-Kasteleyn and heat-bath damage-spreading temperatures TFK(p) and TDS(p) are studied on random-bond Ising models of dimensions 2-5 and as functions of the ferromagnetic interaction probability p; the conjecture that TDS(p)˜TFK(p) is tested. It follows from a statement by Nishimori that in any such system, exact coordinates can be given for the intersection point between the Fortuin-Kasteleyn TFK(p) transition line and the Nishimori line [pNL,FK,TNL,FK]. There are no finite-size corrections for this intersection point. In dimension 3, at the intersection concentration [pNL,FK], the damage spreading TDS(p) is found to be equal to TFK(p) to within 0.1%. For the other dimensions, however, TDS(p) is observed to be systematically a few percent lower than TFK(p).

Patients with a new variant of endemic pemphigus foliaceus have autoantibodies against arrector pili muscle, colocalizing with MYZAP, p0071, desmoplakins 1 and 2 and ARVCF.

PubMed

Abreu-Velez, A M; Valencia-Yepes, C A; Upegui-Zapata, Y A; Upegui-Quiceno, E; Mesa-Herrera, N R; Velazquez-Velez, J E; Howard, M S

2017-12-01

We identified a new variant of endemic pemphigus foliaceus in El Bagre, Colombia, South America, which we term El Bagre-EPF, and observed reactivity to arrector pili muscle (APM), thus we tested for autoimmunity to APM. We took skin biopsies from 30 patients with El Bagre-EPF and 30 healthy controls (HCs) matched by age, sex and occupation, who were all from the endemic area, and tested these using direct immunofluorescence (DIF), confocal microscopy, immunohistochemistry and immunoblotting (IB). Of the 30 patients with El Bagre-EPF, 27 had autoantibodies to APM that colocalized with commercial antibodies to myocardium-enriched zonula occludens-1-associated protein (MYZAP), desmoplakin (DP)1 and DP2, plakophilin 4, and Armadillo repeat gene deleted in velo-cardio-facial syndrome (ARVCF) (P < 0.001, Fisher exact test). The positive staining also colocalized with Junctional Adhesion Molecule 1 (JAM-A), a control antibody for gap cell junctions. No HC samples were positive. In 27 of the 30 patients, serum that was APM-positive also displayed IB colocalization of their autoantibody molecular weights with the Progen antibodies (P < 0.001, Fisher exact test). Patients affected by El Bagre-EPF have autoantibodies to APM, colocalizing with the antibodies MYZAP, ARVCF, p0071, DP1 and DP2, suggesting that these molecules are El Bagre-EPF antigens. Further, all of these antigens represent components of cell junctions, indicating that the immune response is directed, at least partially, against cell junctions. The immune response in patients affected by El Bagre-EPF is polyclonal, and it includes B and T lymphocytes, mast cells, IgG, IgA, IgM, IgD, IgE, fibrinogen, albumin, complement/C1q, C3c and C4. © 2017 British Association of Dermatologists.

Better Object Recognition and Naming Outcome With MRI-Guided Stereotactic Laser Amygdalohippocampotomy for Temporal Lobe Epilepsy

PubMed Central

Drane, Daniel L.; Loring, David W.; Voets, Natalie L.; Price, Michele; Ojemann, Jeffrey G.; Willie, Jon T.; Saindane, Amit M.; Phatak, Vaishali; Ivanisevic, Mirjana; Millis, Scott; Helmers, Sandra L.; Miller, John W.; Meador, Kimford J.; Gross, Robert E.

2015-01-01

SUMMARY OBJECTIVES Temporal lobe epilepsy (TLE) patients experience significant deficits in category-related object recognition and naming following standard surgical approaches. These deficits may result from a decoupling of core processing modules (e.g., language, visual processing, semantic memory), due to “collateral damage” to temporal regions outside the hippocampus following open surgical approaches. We predicted stereotactic laser amygdalohippocampotomy (SLAH) would minimize such deficits because it preserves white matter pathways and neocortical regions critical for these cognitive processes. METHODS Tests of naming and recognition of common nouns (Boston Naming Test) and famous persons were compared with nonparametric analyses using exact tests between a group of nineteen patients with medically-intractable mesial TLE undergoing SLAH (10 dominant, 9 nondominant), and a comparable series of TLE patients undergoing standard surgical approaches (n=39) using a prospective, non-randomized, non-blinded, parallel group design. RESULTS Performance declines were significantly greater for the dominant TLE patients undergoing open resection versus SLAH for naming famous faces and common nouns (F=24.3, p<.0001, η2=.57, & F=11.2, p<.001, η2=.39, respectively), and for the nondominant TLE patients undergoing open resection versus SLAH for recognizing famous faces (F=3.9, p<.02, η2=.19). When examined on an individual subject basis, no SLAH patients experienced any performance declines on these measures. In contrast, 32 of the 39 undergoing standard surgical approaches declined on one or more measures for both object types (p<.001, Fisher’s exact test). Twenty-one of 22 left (dominant) TLE patients declined on one or both naming tasks after open resection, while 11 of 17 right (non-dominant) TLE patients declined on face recognition. SIGNIFICANCE Preliminary results suggest 1) naming and recognition functions can be spared in TLE patients undergoing SLAH, and 2) the hippocampus does not appear to be an essential component of neural networks underlying name retrieval or recognition of common objects or famous faces. PMID:25489630

Exact nonparametric confidence bands for the survivor function.

PubMed

Matthews, David

2013-10-12

A method to produce exact simultaneous confidence bands for the empirical cumulative distribution function that was first described by Owen, and subsequently corrected by Jager and Wellner, is the starting point for deriving exact nonparametric confidence bands for the survivor function of any positive random variable. We invert a nonparametric likelihood test of uniformity, constructed from the Kaplan-Meier estimator of the survivor function, to obtain simultaneous lower and upper bands for the function of interest with specified global confidence level. The method involves calculating a null distribution and associated critical value for each observed sample configuration. However, Noe recursions and the Van Wijngaarden-Decker-Brent root-finding algorithm provide the necessary tools for efficient computation of these exact bounds. Various aspects of the effect of right censoring on these exact bands are investigated, using as illustrations two observational studies of survival experience among non-Hodgkin's lymphoma patients and a much larger group of subjects with advanced lung cancer enrolled in trials within the North Central Cancer Treatment Group. Monte Carlo simulations confirm the merits of the proposed method of deriving simultaneous interval estimates of the survivor function across the entire range of the observed sample. This research was supported by the Natural Sciences and Engineering Research Council (NSERC) of Canada. It was begun while the author was visiting the Department of Statistics, University of Auckland, and completed during a subsequent sojourn at the Medical Research Council Biostatistics Unit in Cambridge. The support of both institutions, in addition to that of NSERC and the University of Waterloo, is greatly appreciated.

Analysis of Multiple Contingency Tables by Exact Conditional Tests for Zero Partial Association.

ERIC Educational Resources Information Center

Kreiner, Svend

The tests for zero partial association in a multiple contingency table have gained new importance with the introduction of graphical models. It is shown how these may be performed as exact conditional tests, using as test criteria either the ordinary likelihood ratio, the standard x squared statistic, or any other appropriate statistics. A…

An evaluation of inferential procedures for adaptive clinical trial designs with pre-specified rules for modifying the sample size.

PubMed

Levin, Gregory P; Emerson, Sarah C; Emerson, Scott S

2014-09-01

Many papers have introduced adaptive clinical trial methods that allow modifications to the sample size based on interim estimates of treatment effect. There has been extensive commentary on type I error control and efficiency considerations, but little research on estimation after an adaptive hypothesis test. We evaluate the reliability and precision of different inferential procedures in the presence of an adaptive design with pre-specified rules for modifying the sampling plan. We extend group sequential orderings of the outcome space based on the stage at stopping, likelihood ratio statistic, and sample mean to the adaptive setting in order to compute median-unbiased point estimates, exact confidence intervals, and P-values uniformly distributed under the null hypothesis. The likelihood ratio ordering is found to average shorter confidence intervals and produce higher probabilities of P-values below important thresholds than alternative approaches. The bias adjusted mean demonstrates the lowest mean squared error among candidate point estimates. A conditional error-based approach in the literature has the benefit of being the only method that accommodates unplanned adaptations. We compare the performance of this and other methods in order to quantify the cost of failing to plan ahead in settings where adaptations could realistically be pre-specified at the design stage. We find the cost to be meaningful for all designs and treatment effects considered, and to be substantial for designs frequently proposed in the literature. © 2014, The International Biometric Society.

Neurocritical Care Education During Residency: Opinions (NEURON) Study.

PubMed

Lerner, David P; Kim, Jennifer; Izzy, Saef

2017-02-01

The American Academy of Neurology (AAN) has established a core curriculum of topics for residency training in neurocritical care. At present there is limited data evaluating neurology residency education within the neurological intensive care unit. This study evaluates learner concerns with the neurological intensive care unit. The Communication Committee and Resident & Fellow Taskforce within the Neurocritical Care Society (NCS) developed an online survey that consisted of 20 selection and free-text based questions. The survey was distributed to NCS members and then to neurology residency program directors. Statistical analysis of neurocritical care exposure were completed with t or Fisher exact test with p-value <0.05 considered significant. A total of 95 individuals from 32 different residency programs (36.5 % response rate) responded to the questionnaire. Most individuals train with neurocritical care attendings, fellows and advanced practitioners and have neurocritical care exposure during multiple years of residency training. 54 % of responders cite improvement in education as a means to improve neurocritical care training. Those that raised concern had no difference in time in the neurocritical care unit (9.4 weeks vs 8.8 weeks), exposure to trained neurointensivists, neurocritical care fellows or advanced providers (p value 0.53, 0.19, 0.83, respectively). There is significant learner concern regarding education within the neurointensive care unit. Although there are educational guidelines and focused neurocritical care educational materials, these alone do not satisfy residents' educational needs. This study demonstrates the need for educational changes, but it does not assess best strategies nor curricular content.

Factors associated with abnormal eating attitudes among Greek adolescents.

PubMed

Bilali, Aggeliki; Galanis, Petros; Velonakis, Emmanuel; Katostaras, Theofanis

2010-01-01

To estimate the prevalence of abnormal eating attitudes among Greek adolescents and identify possible risk factors associated with these attitudes. Cross-sectional, school-based study. Six randomly selected schools in Patras, southern Greece. The study population consisted of 540 Greek students aged 13-18 years, and the response rate was 97%. The dependent variable was scores on the Eating Attitudes Test-26, with scores > or = 20 indicating abnormal eating attitudes. Bivariate analysis included independent Student t test, chi-square test, and Fisher's exact test. Multivariate logistic regression analysis was applied for the identification of the predictive factors, which were associated independently with abnormal eating attitudes. A 2-sided P value of less than .05 was considered statistically significant. The prevalence of abnormal eating attitudes was 16.7%. Multivariate logistic regression analysis demonstrated that females, urban residents, and those with a body mass index outside normal range, a perception of being overweight, body dissatisfaction, and a family member on a diet were independently related to abnormal eating attitudes. The results indicate that a proportion of Greek adolescents report abnormal eating attitudes and suggest that multiple factors contribute to the development of these attitudes. These findings are useful for further research into this topic and would be valuable in designing preventive interventions. Copyright 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Histopathologic Grading of Anaplasia in Retinoblastoma

PubMed Central

Mendoza, Pia R.; Specht, Charles S.; Hubbard, G. Baker; Wells, Jill R.; Lynn, Michael J.; Zhang, Qing; Kong, Jun; Grossniklaus, Hans E.

2014-01-01

Purpose To determine whether the degree of tumor anaplasia has prognostic value by evaluating its correlation with high-risk histopathologic features and clinical outcomes in a series of retinoblastoma patients. Design Retrospective clinicopathologic study. Methods The clinical and pathologic findings in 266 patients who underwent primary enucleation for retinoblastoma were reviewed. The histologic degree of anaplasia was graded as retinocytoma, mild, moderate, or severe as defined by increasing cellular pleomorphism, number of mitoses, nuclear size, and nuclear hyperchromatism. Nuclear morphometric characteristics were measured. The clinical and pathologic data of 125 patients were compared using Kaplan-Meier estimates of survival. Fisher's exact test and multivariate regression were used to analyze the association between anaplasia grade and high-risk histologic features. Results Increasing grade of anaplasia was associated with decreased overall survival (p=0.003) and increased risk of metastasis (p=0.0007). Histopathologic features that were associated with anaplasia included optic nerve invasion (p<0.0001), choroidal invasion (p=<0.0001), and anterior segment invasion (p=0.04). Multivariate analysis considering high-risk histopathology and anaplasia grading as predictors of distant metastasis and death showed that high-risk histopathology was statistically significant as an independent predictor (p=0.01 for metastasis, p=0.03 for death) but anaplasia was not (p=0.63 for metastasis, p=0.30 for death). In the absence of high-risk features, however, severe anaplasia identified an additional risk for metastasis (p=0.0004) and death (p=0.01). Conclusion Grading of anaplasia may be a useful adjunct to standard histopathologic criteria in identifying retinoblastoma patients who do not have high-risk histologic features but still have an increased risk of metastasis and may need adjuvant therapy. PMID:25528954

Insecticide resistance status of the Anopheles funestus population in Central African Republic: a challenge in the war.

PubMed

Sangba, Marina Lidwine Olé; Deketramete, Tanguy; Wango, Solange Patricia; Kazanji, Mirdad; Akogbeto, Martin; Ndiath, Mamadou Ousmane

2016-04-25

In the Central African Republic, malaria is a major public health problem and the leading cause of death among children. This disease appears to be hyperendemic but no substantial entomological data, including data on Anopheles spp. susceptibility to insecticides, is available. This study evaluates, for the first time in the CAR, the status of insecticide resistance in the Anopheles funestus population, the second major vector of malaria in Africa. WHO standard bioassay susceptibility tests were performed on the An. funestus population using F1 generation from gravid females mosquitoes (F0) collected by manual aspirator sampling of households in Gbanikola, Bangui in October 2014 to assess: (i) An. funestus susceptibility to bendiocarb, malathion, permethrin, lamda-cyhalothrin, deltamethrin and DDT, and (ii) the effect of pre-exposure to the piperonyl butoxide (PBO) synergist on insecticide susceptibility. Additional tests were conducted to investigate metabolic resistance status (cytochrome P450 monooxygenases, glutathione S-transferases, and esterases). A high phenotypic resistance of An. funestus population to malathion, DDT and pyrethroids was observed with a mortality rate ranging from 23 to 74%. For the pyrethroid groups, the mortality rate was 35, 31 and 23% for lambda-cyhalothrin, deltamethrin, and permethrin, respectively. In contrast a 100% mortality rate to bendiocarb was recorded. Knockdown time (KDT) was long for all pyrethroids, DDT and malathion with KDT50 higher than 50 min. Pre-exposure of An. funestus to PBO synergist significantly restored susceptibility to all pyrethroids (Fisher's exact test P <0.0001) but not in DDT (Fisher's exact test P = 0.724). Data from biochemical tests suggest the involvement of cytochrome P450 monooxygenases, esterases and glutatione S-transferases in the resistance of An. funestus population from Gbanikola (Wilcoxon test P <0.05). Evidence of biochemical resistance to insecticide was detected in An. funestus population from the district of Gbanikola, Bangui. This study suggests that detoxifying enzymes are involved in insecticide resistance of An. funestus. However, despite disruptive violence, further research is urgently needed to assess the insecticide susceptibility status of An. funestus population in all CAR regions; insecticide resistance could rapidly compromise the success of malaria control programs.

HIV coping self-efficacy: a key to understanding stigma and HIV test acceptance among incarcerated men in Jamaica.

PubMed

Andrinopoulos, Katherine; Kerrigan, Deanna; Figueroa, J Peter; Reese, Richard; Ellen, Jonathan M

2010-03-01

Although prisons have been noted as important venues for HIV testing, few studies have explored the factors within this context that may influence HIV test acceptance. Moreover, there is a dearth of research related to HIV and incarcerated populations in middle and low-income countries, where both the burden of HIV and the number of people incarcerated is higher compared to high-income countries. This study explores the relationship between HIV coping self-efficacy, HIV-related stigma, and HIV test acceptance in the largest prisons in Jamaica. A random sample of inmates (n=298) recruited from an HIV testing demonstration project were asked to complete a cross-sectional quantitative survey. Participants who reported high HIV coping self-efficacy (adjusted odds ratio (AOR) 1.86: 95% confidence interval CI 1.24-2.78, p-value=0.003), some perceived risk of HIV (AOR 2.51: 95% (CI) 1.57-4.01, p-value=0.000), and low HIV testing stigma (AOR 1.71: 95% CI 1.05-2.79, p-value=0.032) were more likely to test for HIV. Correlates of HIV coping self-efficacy included external and internal HIV stigma (AOR 1.28: 95% CI 1.25-1.32, p-value=0.000 and AOR 1.76: 95% CI 1.34-2.30, p-value=0.000, respectively), social support (AOR 2.09: 95% CI 1.19-3.68, p-value=0.010), and HIV knowledge (AOR 2.33: 95% CI 1.04-5.22, p-value=0.040). Policy and programs should focus on the interrelationships of these constructs to increase participation in HIV testing in prison.

Effect of Community-based Behavior Change Communication on Delivery and Newborn Health Care Practices in a Resettlement Colony of Delhi.

PubMed

Parashar, Mamta; Singh, Sv; Kishore, Jugal; Kumar, Ajay; Bhardwaj, Milan

2013-01-01

Neonatal morbidity and mortality in India continue to be high. Among other reasons, newborn care practices are major contributors for such high rates. To assess the effect of behavior change communication (BCC) package among pregnant women regarding neonatal care. Semistructured and pretested schedule was used to interview 200 multigravidas on various aspects of neonatal care. Based on the preliminary data, BCC package was designed and implemented in intervention block in the community. Follow-up was done to find out change in their behavior. Data were analyzed using Epi info and Fischer exact test and chi-square test were applied in the baseline data. A P value of less than 0.05 was considered significant. Effect of the BCC package is given in terms of relative risk. BCC package increased 1.76 times higher number of deliveries conducted by trained dais in intervention group. There was significant improvement in using sterile cord tie (P = 0.01), applied nothing to the cord (P < 0.0001) and giving bath to their baby within 6 h of birth (P = 0.02) in intervention group as compared to nonintervention group. Significant difference was found between the two groups with regard to breastfeeding practices of baby. Harmful practices were reduced in the intervention group. Significant improvement was found in intervention group as compared to nonintervention group with regard to knowledge of danger signals, physiological variants, management of breastfeeding-related problems, and awareness of skin-to-skin technique for the management of hypothermic baby. Inadequate knowledge and adverse practices regarding neonatal care among mothers in study areas were found. BCC package had favorable impact on behavior of mothers for neonatal care in intervention group.

Robust inference from multiple test statistics via permutations: a better alternative to the single test statistic approach for randomized trials.

PubMed

Ganju, Jitendra; Yu, Xinxin; Ma, Guoguang Julie

2013-01-01

Formal inference in randomized clinical trials is based on controlling the type I error rate associated with a single pre-specified statistic. The deficiency of using just one method of analysis is that it depends on assumptions that may not be met. For robust inference, we propose pre-specifying multiple test statistics and relying on the minimum p-value for testing the null hypothesis of no treatment effect. The null hypothesis associated with the various test statistics is that the treatment groups are indistinguishable. The critical value for hypothesis testing comes from permutation distributions. Rejection of the null hypothesis when the smallest p-value is less than the critical value controls the type I error rate at its designated value. Even if one of the candidate test statistics has low power, the adverse effect on the power of the minimum p-value statistic is not much. Its use is illustrated with examples. We conclude that it is better to rely on the minimum p-value rather than a single statistic particularly when that single statistic is the logrank test, because of the cost and complexity of many survival trials. Copyright © 2013 John Wiley & Sons, Ltd.

[Quantitative Color Vision Defect Evaluation - Lanthony Test and its Modified Interpretation].

PubMed

Veselý, P; Urbánek, D; Synek, S; Hanák, L

2016-01-01

Our aim was to develop quick and exact instrument for examination of color vision defects (CVD). We used Lanthony saturated and desaturated test. Data were evaluated according the Vingrys and King-Smith study. We had together 123 eyes of 86 patients. From all subjects we received these average values: AA 44.32 (min -87.13, max 80.64), TES 13.36 (min 8.84, max 30.30), SI 1.97 (min 1.22, max 5.69) and CI 1.66 (min 1.0, max 3.94). At the base of counting algorithm and average values form saturated and desaturated test we revealed 25 (29 %) patients with CVD. Twelve patients (14 %) classified as CVD+ had dichromacy and all had inborn CVD. Eight patients (9 %) from this group had deutranopia and four patient (5 %) protanopia. Anomaly trichromacy we revealed in thirteen patients (15 %). Eight (9 %) of these patients had inborn CVD. Six (7 %) of these patients had protanomalia, one (1 %) had deuteranomalia and one tritanomalia. We established and specified TES, CI and SI critical values, which was used to dividing patients into specific groups. Lanthony test, color vision defect, index of selectivity, index of confusion, total error score.

Antifungal prescribing pattern and attitude towards the treatment of oral candidiasis among dentists in Jordan.

PubMed

Al-Shayyab, Mohammad H; Abu-Hammad, Osama A; Al-Omiri, Mahmoud K; Dar-Odeh, Najla S

2015-08-01

The aim of this study was to evaluate the attitude of Jordanian dentists towards the treatment of oral candidiasis and their current antifungal prescribing habits, shedding more light on the possible influence of their socio-professional factors on the pattern of prescribing and practice. A structured validated questionnaire was developed and tested; it was then emailed to a random sample of 600 Jordanian dental practitioners during the period of this cross-sectional survey. The questionnaire recorded practitioners' personal details and their attitude and prescribing of antifungal therapy for oral candidiasis. Statistical significance was based on probability values of <0.05 and was measured using the chi-square and Fisher's exact tests. Multiple logistic regression analysis was used to analyse the influence of respondents' socio-professional factors on their attitude towards oral candidiasis. Of the 423 questionnaires returned, only 330 were included. The attitude of respondents was significantly influenced by their experience [odds ratio (OR) = 0.14; P < 0.001] and workplace (OR = 4.70; P < 0.001). Nystatin was the most commonly prescribed antifungal agent (78.2%), followed by miconazole (62.4%), which was prescribed for topical use. Systemic antifungals were prescribed by 21.2% of respondents, with a significant (P < 0.05) association with the country in which their qualification was obtained. The attitude towards the treatment of oral candidiasis is much better among the least-experienced dentists working in private practice. Nystatin and miconazole are the most popular choices of antifungal agents among Jordanian dentists. © 2015 FDI World Dental Federation.

Nestin: A biomarker of aggressive uterine cancers.

PubMed

Hope, Erica R; Mhawech-Fauceglia, Paulette; Pejovic, Tanja; Zahn, Christopher M; Wang, Guisong; Conrads, Thomas P; Larry Maxwell, G; Hamilton, Chad A; Darcy, Kathleen M; Syed, Viqar

2016-03-01

Evidence of potential prognostic and predictive value for nestin was investigated in well-annotated uterine cancers (UCs). Nestin expression and previously-published biomarkers were evaluated by immunohistochemistry (IHC) in UC tissue microarrays. Biomarkers were categorized as low vs. high, and nestin was cut at 10% positive staining. Relationship between nestin and clinicopathologic factors, biomarkers and outcome were evaluated using exact/log-rank testing or logistic/Cox modeling. There were 323 eligible cases, 34% had advanced stage disease, 37% had type II disease, and 5% were carcinosarcomas. High nestin, observed in 19% of cases, was more common in advanced vs. early stage disease, type II cancers or uterine carcinosarcoma vs. type I cancers, grade 3 disease, positive lymphovascular space invasion (LVSI) and tumors >6cm (p<0.05). Nestin was inversely correlated with ER, PR and TFF3, and correlated with p53 and IMP3. Women with high vs. low nestin had worse progression-free survival (PFS) and cancer-specific survival overall, and worse PFS in the subset who received no adjuvant therapy or radiation, or had early stage, type I disease or tumors with both low and high ER, PR, TFF3, PTEN, p53 or IMP3. The relationship between nestin and PFS was independent of stage, LVSI and risk categorization but not type of UC. High nestin was more common in UCs with aggressive features and poor outcome. Nestin may represent a predictive biomarker for treatment selection for patients previously considered to be lower risk and a candidate for no or radiation-based adjuvant therapy, and compliment ER/PR testing. Published by Elsevier Inc.

Trust in health information sources differs between young/middle and oldest old.

PubMed

Le, Thai; Chaudhuri, Shomir; White, Cathy; Thompson, Hilaire; Demiris, George

2014-01-01

Examine differences in trust of health information sources between the oldest old and young/middle old. Cross-sectional survey using convenience sampling. Eleven retirement communities. Older adults ≥65 years (N = 353). Self-rated trust in health information sources. Mann-Whitney U-test or Fisher exact test to compare trust between age groups; multinomial ordered logistic regression analyses to model trust in Internet information sources. The overall survey response rate was 26.6%. Differences in trust were identified between oldest old (n = 108) and young/middle old (n = 245) for pharmacist (p < .05), Internet (p < .001), television (p < .05), radio (p < .001), and newspaper (p < .05) sources. In the oldest old, we found associations between levels of trust in Internet sources and frequency of Internet use (β = 4.13, p < .001). Understanding where differences in trust arise can inform the design of resources to support the information-seeking process. When planning widespread distribution of health information to these distinct groups, program developers need to consider these differences.

Can the Griess Nitrite Test and a Urinary Pus Cell Count of ≥5 Cells Per Micro Litre of Urine in Pregnant Women be Used for the Screening or the Early Detection of Urinary Tract Infections in Rural India?

PubMed Central

Thakre, Sushama S.; Dhakne, Supriya S.; Thakre, Subhash B.; Thakre, Amol D.; Ughade, Suresh M.; Kale, Priya

2012-01-01

Objectives Urinary Tract Infection (UTI) is a common problem in pregnancy due to the morphological and the physiological changes that take place in the genitourinary tract during pregnancy. Screening methods may be useful, because a full bacteriological analysis could be reserved for those patients who are symptomatic or those who have positive screening test results. The exact prevalence of UTI in rural, pregnant women is unknown. The present study was undertaken to estimate the prevalence of UTI in pregnant women and for ascertaining the utility of the Griess Nitrite test and the Urinary Pus Cell Count of ≥5 cells per micro litre test for the screening or the early detection of UTI in them at primary health care clinics. Occurrence of urinary complaints was compared in UTI and non UTI women. Method We conducted a study on 300 randomly selected, pregnant women from rural areas. Urine cultures, pus-cell counts and the Griess nitrite test were used for diagnosis of UTI. The screening tests for UTI were evaluated in terms of their sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and the percentage of correctly classified. Results In the present study, the prevalence of UTI was found to be 29/300 (9.6%, 95% confidence interval 9.57-9.63). The specificities of the two screening tests were comparable (97.05% and 94.47%). Also, the negative predictive values of the two tests were almost similar (97.77% and 96.96%). The percentage of correctly classified by the Griess nitrite test and the urine pus cell count were found to be 95.33% and 92.33% respectively. The proportion of the women with various urinary complaints was significantly higher (P<0.00) in the UTI subjects as compared to that in the non-UTI subjects. Conclusion Urine culture remains the gold standard for the detection of asymptomatic bacteriuria. The Nitrite test of uncentrifuged urine was observed to be the best among the screening tests which were evaluated in terms of their efficiency and validity. PMID:23285444

Evaluation of cognitive characteristics of patients developing manifestations of parkinsonism secondary to long-term ephedrone use.

PubMed

Koksal, Ayhan; Keskinkılıc, Cahit; Sozmen, Mehmet Vedat; Dirican, Ayten Ceyhan; Aysal, Fikret; Altunkaynak, Yavuz; Baybas, Sevim

2014-01-01

In this study, cognitive functions of 9 patients developing parkinsonism due to chronic manganese intoxication by intravenous methcathinone solution were investigated using detailed neuropsychometric tests. Attention deficit, verbal and nonverbal memory, visuospatial function, constructive ability, language, and executive (frontal) functions of 9 patients who were admitted to our clinic with manifestations of chronic manganese intoxication and 9 control subjects were assessed using neuropsychometric tests. Two years later, detailed repeat neuropsychometric tests were performed in the patient group. The results were evaluated using the χ(2) test, Fisher's exact probability test, Student's t test and the Mann-Whitney U test. While there was no statistically significant difference between the two groups in language functions, visuospatial functions and constructive ability, a statistically significant difference was noted between both groups regarding attention (p = 0.032), calculation (p = 0.004), recall and recognition domains of verbal memory, nonverbal memory (p = 0.021) and some domains of frontal functions (Stroop-5 and spontaneous recovery) (p = 0.022 and 0.012). Repeat neuropsychometric test results of the patients were not statistically significant 2 years later. It has been observed that cognitive dysfunction seen in parkinsonism secondary to chronic manganese intoxication may be long-lasting and may not recover as observed in motor dysfunction. © 2014 S. Karger AG, Basel.

Advances in Significance Testing for Cluster Detection

NASA Astrophysics Data System (ADS)

Coleman, Deidra Andrea

Over the past two decades, much attention has been given to data driven project goals such as the Human Genome Project and the development of syndromic surveillance systems. A major component of these types of projects is analyzing the abundance of data. Detecting clusters within the data can be beneficial as it can lead to the identification of specified sequences of DNA nucleotides that are related to important biological functions or the locations of epidemics such as disease outbreaks or bioterrorism attacks. Cluster detection techniques require efficient and accurate hypothesis testing procedures. In this dissertation, we improve upon the hypothesis testing procedures for cluster detection by enhancing distributional theory and providing an alternative method for spatial cluster detection using syndromic surveillance data. In Chapter 2, we provide an efficient method to compute the exact distribution of the number and coverage of h-clumps of a collection of words. This method involves defining a Markov chain using a minimal deterministic automaton to reduce the number of states needed for computation. We allow words of the collection to contain other words of the collection making the method more general. We use our method to compute the distributions of the number and coverage of h-clumps in the Chi motif of H. influenza.. In Chapter 3, we provide an efficient algorithm to compute the exact distribution of multiple window discrete scan statistics for higher-order, multi-state Markovian sequences. This algorithm involves defining a Markov chain to efficiently keep track of probabilities needed to compute p-values of the statistic. We use our algorithm to identify cases where the available approximation does not perform well. We also use our algorithm to detect unusual clusters of made free throw shots by National Basketball Association players during the 2009-2010 regular season. In Chapter 4, we give a procedure to detect outbreaks using syndromic surveillance data while controlling the Bayesian False Discovery Rate (BFDR). The procedure entails choosing an appropriate Bayesian model that captures the spatial dependency inherent in epidemiological data and considers all days of interest, selecting a test statistic based on a chosen measure that provides the magnitude of the maximumal spatial cluster for each day, and identifying a cutoff value that controls the BFDR for rejecting the collective null hypothesis of no outbreak over a collection of days for a specified region.We use our procedure to analyze botulism-like syndrome data collected by the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT).

Simulation program for estimating statistical power of Cox's proportional hazards model assuming no specific distribution for the survival time.

PubMed

Akazawa, K; Nakamura, T; Moriguchi, S; Shimada, M; Nose, Y

1991-07-01

Small sample properties of the maximum partial likelihood estimates for Cox's proportional hazards model depend on the sample size, the true values of regression coefficients, covariate structure, censoring pattern and possibly baseline hazard functions. Therefore, it would be difficult to construct a formula or table to calculate the exact power of a statistical test for the treatment effect in any specific clinical trial. The simulation program, written in SAS/IML, described in this paper uses Monte-Carlo methods to provide estimates of the exact power for Cox's proportional hazards model. For illustrative purposes, the program was applied to real data obtained from a clinical trial performed in Japan. Since the program does not assume any specific function for the baseline hazard, it is, in principle, applicable to any censored survival data as long as they follow Cox's proportional hazards model.

A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis

PubMed Central

Eversden, Lis; Maggs, Fiona; Nightingale, Peter; Jobanputra, Paresh

2007-01-01

Background Hydrotherapy is highly valued by people with rheumatoid arthritis yet few studies have compared the benefits of exercises in heated water against exercises on land. In particular, data on quality of life is rarely reported. This is especially important because patients treated with hydrotherapy often report an enhanced sense of well-being. We report a randomised controlled trial in which we compared the effects of hydrotherapy with exercises on land on overall response to treatment, physical function and quality of life in patients with rheumatoid arthritis. Methods One hundred and fifteen patients with RA were randomised to receive a weekly 30-minute session of hydrotherapy or similar exercises on land for 6 weeks. Our primary outcome was a self-rated global impression of change – a measure of treatment effect on a 7-point scale ranging from 1(very much worse) to 7 (very much better) assessed immediately on completion of treatment. Secondary outcomes including EuroQol health related quality of life, EuroQol health status valuation, HAQ, 10 metre walk time and pain scores were collected at baseline, after treatment and 3 months later. Binary outcomes were analysed by Fisher's exact test and continuous variables by Wilcoxon or Mann-Whitney tests. Results Baseline characteristics of the two groups were comparable. Significantly more patients treated with hydrotherapy (40/46, 87%) were much better or very much better than the patients treated with land exercise (19/40, 47.5%), p < 0.001 Fisher's exact test. Eleven patients allocated land exercise failed to complete treatment compared with 4 patients allocated hydrotherapy (p = 0.09). Sensitivity analyses confirmed an advantage for hydrotherapy if we assumed non-completers would all not have responded (response rates 70% versus 38%; p < 0.001) or if we assumed that non-completers would have had the same response as completers (response rates 82% versus 55% p = 0.002). Ten metre walk time improved after treatment in both cases (median pre-treatment time for both groups combined 10.9 seconds, post-treatment 9.1 s, and 3 months later 9.6 s). There was however no difference between treatment groups. Similarly there were no significant differences between groups in terms of changes to HAQ, EQ-5D utility score, EQ VAS and pain VAS. Conclusion Patients with RA treated with hydrotherapy are more likely to report feeling much better or very much better than those treated with land exercises immediately on completion of the treatment programme. This perceived benefit was not reflected by differences between groups in 10-metre walk times, functional scores, quality of life measures and pain scores. PMID:17331241

A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis.

PubMed

Eversden, Lis; Maggs, Fiona; Nightingale, Peter; Jobanputra, Paresh

2007-03-01

Hydrotherapy is highly valued by people with rheumatoid arthritis yet few studies have compared the benefits of exercises in heated water against exercises on land. In particular, data on quality of life is rarely reported. This is especially important because patients treated with hydrotherapy often report an enhanced sense of well-being. We report a randomised controlled trial in which we compared the effects of hydrotherapy with exercises on land on overall response to treatment, physical function and quality of life in patients with rheumatoid arthritis. One hundred and fifteen patients with RA were randomised to receive a weekly 30-minute session of hydrotherapy or similar exercises on land for 6 weeks. Our primary outcome was a self-rated global impression of change--a measure of treatment effect on a 7-point scale ranging from 1(very much worse) to 7 (very much better) assessed immediately on completion of treatment. Secondary outcomes including EuroQol health related quality of life, EuroQol health status valuation, HAQ, 10 metre walk time and pain scores were collected at baseline, after treatment and 3 months later. Binary outcomes were analysed by Fisher's exact test and continuous variables by Wilcoxon or Mann-Whitney tests. Baseline characteristics of the two groups were comparable. Significantly more patients treated with hydrotherapy (40/46, 87%) were much better or very much better than the patients treated with land exercise (19/40, 47.5%), p < 0.001 Fisher's exact test. Eleven patients allocated land exercise failed to complete treatment compared with 4 patients allocated hydrotherapy (p = 0.09). Sensitivity analyses confirmed an advantage for hydrotherapy if we assumed non-completers would all not have responded (response rates 70% versus 38%; p < 0.001) or if we assumed that non-completers would have had the same response as completers (response rates 82% versus 55% p = 0.002). Ten metre walk time improved after treatment in both cases (median pre-treatment time for both groups combined 10.9 seconds, post-treatment 9.1 s, and 3 months later 9.6 s). There was however no difference between treatment groups. Similarly there were no significant differences between groups in terms of changes to HAQ, EQ-5D utility score, EQ VAS and pain VAS. Patients with RA treated with hydrotherapy are more likely to report feeling much better or very much better than those treated with land exercises immediately on completion of the treatment programme. This perceived benefit was not reflected by differences between groups in 10-metre walk times, functional scores, quality of life measures and pain scores.

Reduction in blood transfusion in a cohort of infants having cardiac surgery with cardiopulmonary bypass after instituting a goal-directed transfusion policy.

PubMed

Machovec, Kelly A; Smigla, Gregory; Ames, Warwick A; Schwimer, Courtney; Homi, H Mayumi; Dhakal, Ishwori B; Jaquiss, Robert D B; Lodge, Andrew J; Jooste, Edmund H

2016-10-01

Current trends in pediatric cardiac surgery and anesthesiology include goal-directed allogeneic blood transfusion, but few studies address the transfusion of platelets and cryoprecipitate. We report a quality improvement initiative to reduce the transfusion of platelets and cryoprecipitate in infants having cardiac surgery with cardiopulmonary bypass (CPB). Data from 50 consecutive patients weighing four to ten kilograms having cardiac surgery with CPB were prospectively collected after the institution of a policy to obtain each patient's platelet and fibrinogen levels during the rewarming phase of CPB. Data from 48 consecutive patients weighing four to ten kilograms having cardiac surgery with CPB prior to the implementation of the policy change were retrospectively collected. Demographics, laboratory values and blood product transfusion data were compared between the groups, using the Chi-square/Fisher's exact test or the T-Test/Wilcoxon Rank-Sum test, as appropriate. The results showed more total blood product exposures in the control group during the time from bypass through the first twenty-four post-operative hours (median of 2 units versus 1 unit in study group, p=0.012). During the time period from CPB separation through the first post-operative day, 67% of patients in the control group received cryoprecipitate compared to 32% in the study group (p=0.0006). There was no difference in platelet exposures between the groups. Checking laboratory results during the rewarming phase of CPB reduced cryoprecipitate transfusion by 50%. This reproducible strategy avoids empiric and potentially unnecessary transfusion in this vulnerable population. © The Author(s) 2016.

Clinical competence of biopsychosocially trained physicians and controls.

PubMed

Adler, Rolf H; Minder, Christoph E

2012-07-25

To assess and compare clinical observations and interpretations by physicians trained in biopsychosocial internal medicine (group A) and a control group (C) of physicians with no such special training. A verbatim first-interview of a 36-year old woman, seen for consultation by RHA, was presented to both groups (A, trained physicians: n = 30, and C, controls: n = 29). The patient's symptoms included: shaky knees, strange sensations in the abdomen and chest, insecurity and dizziness. The symptoms had begun before her final nursing- exam and exacerbated on her mother's 60th birthday two months later. The patient's mother is the sole caretaker for the patient's sister, who also attended the birthday party. The patient's sister is 19 and had been diagnosed with storage disease and is wheelchair-bound. The doctors were asked to record their observations and interpretations while reviewing the case report. Group A-physicians mentioned and interpreted the physician-patient relationship and the patient's body language as described in the case report more often (p = 0.002, Wilcoxon-Mann-Whitney rank sum test (RS)), mentioned physical symptoms more often (p = 0.0099, Fisher's exact test (FE)) and more often interpreted illness settings with respect to the patient's fear and guilt (Fisher's exact test, p = 0.007 and p = 0.015). A precise integrative diagnosis (life events leading to stress, the latter evoking fear and guilt, leading to symptoms of the fight-flight reaction) was suggested by 7 of group A and 4 of group C. Extensive laboratory work-up and requests for consultations were more frequently asked for by the C group (p = 0.048, RS). Residency training in biopsychosocial medicine in an Internal Medicine Department increased sensitivity to and interpretation of biological and psychosocial data many years after the training and decreased the extent of work-up and consultation costs. However it only tended to enhance psychosomatic conceptualisation with respect to anxiety/guilt/hyperventilation and conversion symptoms.

Comparing Magnetic Resonance Imaging and High-Resolution Dynamic Ultrasonography for Diagnosis of Plantar Plate Pathology: A Case Series.

PubMed

Donegan, Ryan J; Stauffer, Anthony; Heaslet, Michael; Poliskie, Michael

Plantar plate pathology has gained noticeable attention in recent years as an etiology of lesser metatarsophalangeal joint pain. The heightened clinical awareness has led to the need for more effective diagnostic imaging accuracy. Numerous reports have established the accuracy of both magnetic resonance imaging and ultrasonography for the diagnosis of plantar plate pathology. However, no conclusions have been made regarding which is the superior imaging modality. The present study reports a case series directly comparing high-resolution dynamic ultrasonography and magnetic resonance imaging. A multicenter retrospective comparison of magnetic resonance imaging versus high-resolution dynamic ultrasonography to evaluate plantar plate pathology with surgical confirmation was conducted. The sensitivity, specificity, and positive and negative predictive values for magnetic resonance imaging were 60%, 100%, 100%, and 33%, respectively. The overall diagnostic accuracy compared with the intraoperative findings was 66%. The sensitivity, specificity, and positive and negative predictive values for high-resolution dynamic ultrasound imaging were 100%, 100%, 100%, and 100%, respectively. The overall diagnostic accuracy compared with the intraoperative findings was 100%. The p value using Fisher's exact test for magnetic resonance imaging and high-resolution dynamic ultrasonography was p = .45, a difference that was not statistically significant. High-resolution dynamic ultrasonography had greater accuracy than magnetic resonance imaging in diagnosing lesser metatarsophalangeal joint plantar plate pathology, although the difference was not statistically significant. The present case series suggests that high-resolution dynamic ultrasonography can be considered an equally accurate imaging modality for plantar plate pathology at a potential cost savings compared with magnetic resonance imaging. Therefore, high-resolution dynamic ultrasonography warrants further investigation in a prospective study. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Salivary bacterial leakage into implant-abutment connections: preliminary results of an in vitro study.

PubMed

Mencio, F; Papi, P; Di Carlo, S; Pompa, G

2016-06-01

The occurrence of bacterial leakage in the internal surface of implants, through implant-abutment interface (IAI), is one of the parameters for analyzing the fabrication quality of the connections. The aim of this in vitro study is to evaluate two different types of implant-abutment connections: the screwed connection (Group 1) and the cemented connection (Group 2), analyzing the permeability of the IAI to bacterial colonization, using human saliva as culture medium. A total of twelve implants were tested, six in each experimental group. Five healthy patients were enrolled in this study. Two milliliters of non-stimulated saliva were collected from each subject and mixed in a test tube. After 14 days of incubation of the bacteria sample in the implant fixtures, a PCR-Real Time analysis was performed. Fisher's exact test was used to compare the proportions of implant-abutment assembled structures detected with bacterial leakage. Differences in the bacterial counts of the two groups were compared using the Mann-Whitney U test. A p value < 0.05 was considered significant. The results showed a decreased stability with the screwed implant-abutment connections compared to the cemented implant-abutment connections. A mean total bacterial count of 1.2E+07 (± 0.25E+07) for Group 1 and of 7.2E+04 (± 14.4E+04) for Group 2 was found, with a high level of significance, p = .0001. Within the limitations of this study it can be concluded that bacterial species from human saliva may penetrate along the implant-abutment interface in both connections, however the cemented connection implants showed the lowest amount of bacterial colonization.

Interior radiances in optically deep absorbing media. 1: Exact solutions for one-dimensional model

NASA Technical Reports Server (NTRS)

Kattawar, G. W.; Plass, G. N.

1973-01-01

The exact solutions are obtained for a one dimensional model of a scattering and absorbing medium. The results are given for both the reflected and transmitted radiance for any arbitrary surface albedo as well as for the interior radiance. These same quantities are calculated by the matrix operator method. The relative error of the solutions is obtained by comparison with the exact solutions as well as by an error analysis of the equations. The importance of an accurate starting value for the reflection and transmission operators is shown. A fourth order Runge-Kutta method can be used to solve the differential equations satisfied by these operators in order to obtain such accurate starting values.

Use of a Self-Instructional Radiographic Anatomy Module for Dental Hygiene Faculty Calibration.

PubMed

Brame, Jennifer L; AlGheithy, Demah Salem; Platin, Enrique; Mitchell, Shannon H

2017-06-01

Purpose: Dental hygiene educators often provide inconsistent instruction in clinical settings and various attempts to address the lack of consistency have been reported in the literature. The purpose of this pilot study was to determine if the use of a use of a self-instructional, radiographic anatomy (SIRA) module improved DH faculty calibration regarding the identifica-tion of normal intraoral and extraoral radiographic anatomy and whether its effect could be sustained over a period of four months. Methods: A convenience sample consisting of all dental hygiene faculty members involved in clinical instruction (N=23) at the University of North Carolina (UNC) was invited to complete the four parts of this online pilot study: a pre-test, review of the SIRA module, an immediate post-test, and a four-month follow-up post-test. Descriptive analyses, the Friedman's ANOVA, and the exact form of the Wilcoxon-Signed-Rank test were used to an-alyze the data. Level of significance was set at 0.05. Participants who did not complete all parts of the study were omitted from data analysis comparing the pre to post-test performance. Results: The pre-test response rate was 73.9% (N=17), and 88.2% (N=15) of those initial participants completed both the immediate and follow-up post-tests. Faculty completing all parts of the study consisted of: 5 full-time faculty, 5 part-time faculty, and 5 graduate teaching assistants. The Friedman's ANOVA revealed no statistically significant difference (P=0.179) in percentages of correct responses between the three tests (pre, post and follow-up). The exact form of the Wilcoxon-Signed-Rank test revealed marginal significance when comparing percent of correct responses at pre-test and immediate post-test (P=0.054), and no statistically significant difference when comparing percent of correct responses at immediate post-test and the follow-up post-test four months later (P=0.106). Conclusions: Use of a SIRA module did not significantly affect DH faculty test performance. Lack of statistical significance in the percentages of correct responses between the three tests may have been affected by the small number of participants completing all four parts of the study (N=15). Additional research is needed to identify and improve methods for faculty calibration. Copyright © 2017 The American Dental Hygienists’ Association.

Some Exact Conditional Tests of Independence for R X C Cross-Classification Tables

ERIC Educational Resources Information Center

Agresti, Alan; Wackerly, Dennis

1977-01-01

Exact conditional tests of independence in cross-classification tables are formulated based on chi square and other statistics with stronger operational interpretations, such as some nominal and ordinal measures of association. Guidelines for table dimensions and sample sizes for which the tests are economically implemented on a computer are…

Standardized Definitions for Code Verification Test Problems

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

Doebling, Scott William

This document contains standardized definitions for several commonly used code verification test problems. These definitions are intended to contain sufficient information to set up the test problem in a computational physics code. These definitions are intended to be used in conjunction with exact solutions to these problems generated using Exact- Pack, www.github.com/lanl/exactpack.

Exact Algorithms for Output Encoding, State Assignment and Four-Level Boolean Minimization

DTIC Science & Technology

1989-10-01

APPROVED FOR PUBLIC DISTRIBUTION • DTIC MASSACHUSETTS INTITUTE OF TECHNOLOGY M VLSI PUBLICATIONSJAN 17 1990 VLSI Memo No. 89-569 JN. 9October 1989...nunijize large funclions exacly within reasonable amocunt. of CPt targeting twro-level logic imnplemientations involve finding ap- time. However, thle ,, m ...0(NV!) m ~iimizations . n5 10 The inptut encoding problemt can be exactly solved using mrultiple-valued Boolean nimuization. We present an exact (a) (b

Fourth-order self-energy contribution to the Lamb shift

NASA Astrophysics Data System (ADS)

Mallampalli, S.; Sapirstein, J.

1998-03-01

Two-loop self-energy contributions to the fourth-order Lamb shift of ground-state hydrogenic ions are treated to all orders in Zα by using exact Dirac-Coulomb propagators. A rearrangement of the calculation into four ultraviolet finite parts, the M, P, F, and perturbed orbital (PO) terms, is made. Reference-state singularities present in the M and P terms are shown to cancel. The most computationally intensive part of the calculation, the M term, is evaluated for hydrogenlike uranium and bismuth, the F term is evaluated for a range of Z values, but the P term is left for a future calculation. For hydrogenlike uranium, previous calculations of the PO term give -0.971 eV: the contributions from the M and F terms calculated here sum to -0.325 eV.

Stanniocalcin 2 is an estrogen-responsive gene coexpressed with the estrogen receptor in human breast cancer.

PubMed

Bouras, Toula; Southey, Melissa C; Chang, Andy C; Reddel, Roger R; Willhite, Dorian; Glynne, Richard; Henderson, Michael A; Armes, Jane E; Venter, Deon J

2002-03-01

Differences in gene expression are likely to explain the phenotypic variation between hormone-responsive and hormone-unresponsive breast cancers. In this study, DNA microarray analysis of approximately 10,000 known genes and 25,000 expressed sequence tag clusters was performed to identify genes induced by estrogen and repressed by the pure antiestrogen ICI 182 780 in vitro that correlated with estrogen receptor (ER) expression in primary breast carcinomas in vivo. Stanniocalcin (STC) 2 was identified as one of the genes that fulfilled these criteria. DNA microarray hybridization showed a 3-fold induction of STC2 mRNA expression in MCF-7 cells in < or = 3 h of estrogen exposure and a 3-fold repression in the presence of antiestrogen (one-way ANOVA, P < 0.0005). In 13 ER-positive and 12 ER-negative breast carcinomas, the microarray-derived mRNA levels observed for STC2 correlated with tumor ER mRNA (Pearson's correlation, r = 0.85; P < 0.0001) and ER protein status (Spearman's rank correlation, r = 0.73; P < 0.0001). The expression profile of STC2 was further confirmed by in situ hybridization and immunohistochemistry on a larger cohort of 236 unselected breast carcinomas using tissue microarrays. STC2 mRNA and protein expression were found to be associated with tumor ER status (Fisher's exact test, P < 0.005). The related gene, STC1, was also examined and shown to be associated with ER status in breast carcinomas (Fisher's exact test, P < 0.05). This study demonstrates the feasibility of using global gene expression data derived from an in vitro model to pinpoint novel estrogen-responsive genes of potential clinical relevance.

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

Diwaker, E-mail: diwakerphysics@gmail.com; Chakraborty, Aniruddha

The Smoluchowski equation with a time-dependent sink term is solved exactly. In this method, knowing the probability distribution P(0, s) at the origin, allows deriving the probability distribution P(x, s) at all positions. Exact solutions of the Smoluchowski equation are also provided in different cases where the sink term has linear, constant, inverse, and exponential variation in time.

Heritability of Boldness and Hypoxia Avoidance in European Seabass, Dicentrarchus labrax.

PubMed

Ferrari, Sébastien; Horri, Khaled; Allal, François; Vergnet, Alain; Benhaim, David; Vandeputte, Marc; Chatain, Béatrice; Bégout, Marie-Laure

2016-01-01

To understand the genetic basis of coping style in European seabass, fish from a full factorial mating (10 females x 50 males) were reared in common garden and individually tagged. Individuals coping style was characterized through behavior tests at four different ages, categorizing fish into proactive or reactive: a hypoxia avoidance test (at 255 days post hatching, dph) and 3 risk-taking tests (at 276, 286 and 304 dph). We observed significant heritability of the coping style, higher for the average of risk-taking scores (h2 = 0.45 ± 0.14) than for the hypoxia avoidance test (h2 = 0.19 ± 0.10). The genetic correlations between the three risk-taking scores were very high (rA = 0.96-0.99) showing that although their repeatability was moderately high (rP = 0.64-0.72), successive risk-taking tests evaluated the same genetic variation. A mild genetic correlation between the results of the hypoxia avoidance test and the average of risk-taking scores (0.45 ± 0.27) suggested that hypoxia avoidance and risk-taking tests do not address exactly the same behavioral and physiological responses. Genetic correlations between weight and risk taking traits showed negative values whatever the test used in our population i.e. reactive individual weights were larger. The results of this quantitative genetic analysis suggest a potential for the development of selection programs based on coping styles that could increase seabass welfare without altering growth performances. Overall, it also contributes to a better understanding of the origin and the significance of individual behavioral differences.

In Spinal Anaesthesia for Cesarean Section the Temperature of Bupivacaine Affects the Onset of Shivering but Not the Incidence: A Randomized Control Trial

PubMed Central

Kishore, Nand; Kumar, Nidhi; Chauhan, Nidhi

2016-01-01

Introduction Postoperative shivering is a frequent event after cesarean section under spinal anaesthesia. Shivering is uncomfortable for the patient and may interfere with monitoring. The exact aetiology of shivering is unknown and therefore has no definite treatment. Aim The temperature of injectate affects the spread of drug and so its effect. Therefore the aim of this study was to compare the effect of temperature of bupivacaine on post-spinal shivering in cesarean section. Materials and Methods In this prospective, randomized, controlled, double-blind clinical trial 105 ASA-I/II pregnant women scheduled for caesarean section under spinal anaesthesia were selected and randomized into three groups of 35 each. In all pregnant women spinal anaesthesia was achieved with 2.2 ml of 0.5% hyperbaric bupivacaine given either at L3-L4 or L4-L5 interspace. The temperature of bupivacaine was adjusted to 4°C (group T4), 22°C (group T22) and 37°C (group T37). Shivering characteristic, onset and incidence was noted. All three groups were compared using analysis of variance (ANOVA), adverse effects was compared using chi-square test and Kruskal-Wallis H-test. The p-value < 0.05-considered as significant and p-value <0.01-considered highly significant Results There were no differences between the groups regarding age, weight, height, amount of fluid used and blood loss. The incidence of shivering was 51.42%, 51.42% and 45.71% in group T4, group T22 and group T37 respectively, this difference in the incidence was statistically not significant (p=0.858). However, the onset of shivering was earliest (9.87±1.82 min) in group T4 as compared to 14.27±3.02 min and 12.16±2.89 min in group T22 and group T37 respectively and this difference in the onset was highly significant (p= 0.0001) Conclusion In spinal anaesthesia for cesarean section, the temperature of bupivacaine does not influence the overall incidence of post spinal shivering; however cold bupivacaine can provoke early onset of shivering. PMID:26894154

Non-inferiority tests for anti-infective drugs using control group quantiles.

PubMed

Fay, Michael P; Follmann, Dean A

2016-12-01

In testing for non-inferiority of anti-infective drugs, the primary endpoint is often the difference in the proportion of failures between the test and control group at a landmark time. The landmark time is chosen to approximately correspond to the qth historic quantile of the control group, and the non-inferiority margin is selected to be reasonable for the target level q. For designing these studies, a troubling issue is that the landmark time must be pre-specified, but there is no guarantee that the proportion of control failures at the landmark time will be close to the target level q. If the landmark time is far from the target control quantile, then the pre-specified non-inferiority margin may not longer be reasonable. Exact variable margin tests have been developed by Röhmel and Kieser to address this problem, but these tests can have poor power if the observed control failure rate at the landmark time is far from its historic value. We develop a new variable margin non-inferiority test where we continue sampling until a pre-specified proportion of failures, q, have occurred in the control group, where q is the target quantile level. The test does not require any assumptions on the failure time distributions, and hence, no knowledge of the true [Formula: see text] control quantile for the study is needed. Our new test is exact and has power comparable to (or greater than) its competitors when the true control quantile from the study equals (or differs moderately from) its historic value. Our nivm R package performs the test and gives confidence intervals on the difference in failure rates at the true target control quantile. The tests can be applied to time to cure or other numeric variables as well. A substantial proportion of new anti-infective drugs being developed use non-inferiority tests in their development, and typically, a pre-specified landmark time and its associated difference margin are set at the design stage to match a specific target control quantile. If through changing standard of care or selection of a different population the target quantile for the control group changes from its historic value, then the appropriateness of the pre-specified margin at the landmark time may be questionable. Our proposed test avoids this problem by sampling until a pre-specified proportion of the controls have failed. © The Author(s) 2016.

Current–Voltage Characterization of Individual As-Grown Nanowires Using a Scanning Tunneling Microscope

PubMed Central

2013-01-01

Utilizing semiconductor nanowires for (opto)electronics requires exact knowledge of their current–voltage properties. We report accurate on-top imaging and I–V characterization of individual as-grown nanowires, using a subnanometer resolution scanning tunneling microscope with no need for additional microscopy tools, thus allowing versatile application. We form Ohmic contacts to InP and InAs nanowires without any sample processing, followed by quantitative measurements of diameter dependent I–V properties with a very small spread in measured values compared to standard techniques. PMID:24059470

Current-voltage characterization of individual as-grown nanowires using a scanning tunneling microscope.

PubMed

Timm, Rainer; Persson, Olof; Engberg, David L J; Fian, Alexander; Webb, James L; Wallentin, Jesper; Jönsson, Andreas; Borgström, Magnus T; Samuelson, Lars; Mikkelsen, Anders

2013-11-13

Utilizing semiconductor nanowires for (opto)electronics requires exact knowledge of their current-voltage properties. We report accurate on-top imaging and I-V characterization of individual as-grown nanowires, using a subnanometer resolution scanning tunneling microscope with no need for additional microscopy tools, thus allowing versatile application. We form Ohmic contacts to InP and InAs nanowires without any sample processing, followed by quantitative measurements of diameter dependent I-V properties with a very small spread in measured values compared to standard techniques.

Anti-resonance scattering at defect levels in the quantum conductance of a one-dimensional system

NASA Astrophysics Data System (ADS)

Sun, Z. Z.; Wang, Y. P.; Wang, X. R.

2002-03-01

For the ballistic quantum transport, the conductance of one channel is quantized to a value of 2e^2/h described by the Landauer formula. In the presence of defects, electrons will be scattered by these defects. Thus the conductance will deviate from the values of the quantized conductance. We show that an anti-resonance scattering can occur when an extra defect level is introduced into a conduction band. At the anti-resonance scattering, exact one quantum conductance is destroyed. The conductance takes a non-zero value when the Fermi energy is away from the anti-resonance scattering. The result is consistent with recent numerical calculations given by H. J. Choi et al. (Phys. Rev. Lett. 84, 2917(2000)) and P. L. McEuen et al. (Phys. Rev. Lett. 83, 5098(1999)).

Numerical simulation of vortical ideal fluid flow through curved channel

NASA Astrophysics Data System (ADS)

Moshkin, N. P.; Mounnamprang, P.

2003-04-01

A numerical algorithm to study the boundary-value problem in which the governing equations are the steady Euler equations and the vorticity is given on the inflow parts of the domain boundary is developed. The Euler equations are implemented in terms of the stream function and vorticity. An irregular physical domain is transformed into a rectangle in the computational domain and the Euler equations are rewritten with respect to a curvilinear co-ordinate system. The convergence of the finite-difference equations to the exact solution is shown experimentally for the test problems by comparing the computational results with the exact solutions on the sequence of grids. To find the pressure from the known vorticity and stream function, the Euler equations are utilized in the Gromeka-Lamb form. The numerical algorithm is illustrated with several examples of steady flow through a two-dimensional channel with curved walls. The analysis of calculations shows strong dependence of the pressure field on the vorticity given at the inflow parts of the boundary. Plots of the flow structure and isobars, for different geometries of channel and for different values of vorticity on entrance, are also presented.

Nursing Performance and Mobile Phone Use: Are Nurses Aware of Their Performance Decrements?

PubMed

McBride, Deborah; LeVasseur, Sandra A; Li, Dongmei

2015-04-23

Prior research has documented the effect of concurrent mobile phone use on medical care. This study examined the extent of hospital registered nurses' awareness of their mobile-phone-associated performance decrements. The objective of this study was to compare self-reported performance with reported observed performance of others with respect to mobile phone use by hospital registered nurses. In March 2014, a previously validated survey was emailed to the 10,978 members of the Academy of Medical Surgical Nurses. The responses were analyzed using a two-proportion z test (alpha=.05, two-tailed) to examine whether self-reported and observed rates of error were significantly different. All possible demographic and employment confounders which could potentially contribute to self-reported and observed performance errors were tested for significance. Of the 950 respondents, 825 (8.68%, 825/950) met the inclusion criteria for analysis. The representativeness of the sample relative to the US nursing workforce was assessed using a two-proportion z test. This indicated that sex and location of primary place of employment (urban/rural) were represented appropriately in the study sample. Respondents in the age groups <40 years old were underrepresented, while age groups >55 years old were overrepresented. Whites, American Indians/Alaskan natives, and Native Hawaiian or Pacific Islanders were underrepresented, while Hispanic and multiple/other ethnicities were overrepresented. It was decided to report the unweighted, rather than the weighted survey data, with the recognition that the results, while valuable, may not be generalizable to the entire US registered nursing workforce. A significant difference was found between registered nurses' self-reported and observed rates of errors associated with concurrent mobile phone use in following three categories (1) work performance (z=-26.6142, P<.001, Fisher's exact test), (2) missing important clinical information (z=-13.9882, P=.008, Fisher's exact test), and (3) making a medical error (z=-9.6798, P<.001, Fisher's exact test). Respondents reported that personal mobile phone use by nurses at work was a serious distraction; always (13%, 107/825), often (29.6%, 244/825), sometimes (44.6%, 368/825), rarely (8.7%, 72/825), or never (1.2%, 10/825). On balance, 69.5% (573/825) of respondents believed that nurses' use of personal mobile phones while working had a negative effect on patient care. Since all possible confounders were tested and none were deemed significant, a multivariate analysis was not considered necessary. Many hospitals are drawing up policies that allow workers to decide how to use their devices at work. This study found that nurses express a disproportionately high confidence in their ability to manage the risk associated with the use of mobile phones and may not be able to accurately assess when it is appropriate to use these devices at work.

Some exact solutions for maximally symmetric topological defects in Anti de Sitter space

NASA Astrophysics Data System (ADS)

Alvarez, Orlando; Haddad, Matthew

2018-03-01

We obtain exact analytical solutions for a class of SO( l) Higgs field theories in a non-dynamic background n-dimensional anti de Sitter space. These finite transverse energy solutions are maximally symmetric p-dimensional topological defects where n = ( p + 1) + l. The radius of curvature of anti de Sitter space provides an extra length scale that allows us to study the equations of motion in a limit where the masses of the Higgs field and the massive vector bosons are both vanishing. We call this the double BPS limit. In anti de Sitter space, the equations of motion depend on both p and l. The exact analytical solutions are expressed in terms of standard special functions. The known exact analytical solutions are for kink-like defects ( p = 0 , 1 , 2 , . . . ; l = 1), vortex-like defects ( p = 1 , 2 , 3; l = 2), and the 't Hooft-Polyakov monopole ( p = 0; l = 3). A bonus is that the double BPS limit automatically gives a maximally symmetric classical glueball type solution. In certain cases where we did not find an analytic solution, we present numerical solutions to the equations of motion. The asymptotically exponentially increasing volume with distance of anti de Sitter space imposes different constraints than those found in the study of defects in Minkowski space.

A pilot study analyzing PSA, serum testosterone, lipid profile, body mass index and race in a small sample of patients with and without carcinoma of the prostate.

PubMed

Mydlo, J H; Tieng, N L; Volpe, M A; Chaiken, R; Kral, J G

2001-01-01

Androgens, diet, race and obesity are thought to play some roles in the pathogenesis of prostate cancer. We wanted to evaluate if there were any inter-relationships between prostate specific antigen (PSA), serum testosterone, serum cholesterol, HDL, triglycerides, body mass index (BMI) and race, in older patients with and without prostate cancer (CaP). We evaluated 308 patients referred to urologists in private practice offices and clinics with and without prostate cancer with regard to race, serum PSA, age, serum testosterone, full lipid profile, height and weight, and stage of cancer. We used multivariate analysis, Fisher's exact test and t-tests as well as logistic regression analysis. Data was analyzed using SPSS computer software, and P-values<0.05 were considered statistically significant. Significantly higher levels of serum testosterone were found in black men with CaP than black men without CaP (526+/-28 vs 404+/-19, respectively.) We also found significantly higher levels of serum testosterone in white men with CaP than white men without CaP (409+/-20 vs 302+/-14, respectively, P<0.05). HDL was higher in black men than white men, and triglycerides were higher in white men than black men. Cholesterol was similar across all groups, but BMI was highest in white men with CaP. We also found a significant association between BMI and pathological stage of prostate cancer patients among both black and white men (P<0.05). Our study demonstrated that black men who developed CaP had higher serum testosterone levels, on average, than white men who developed CaP. Furthermore, BMI was highest in white men developing CaP compared to black men, but we found a significant association between pathological stage and BMI in both black and white patients. Although it is controversial whether obesity is considered to be a risk factor for prostate cancer, this small pilot study suggests that BMI may play a role in the progression of the disease once it is established.Prostate Cancer and Prostatic Diseases (2001) 4, 101-105

Formative evaluation of a proposed mHealth program for childhood illness management in a resource-limited setting in Peru.

PubMed

Calderón, T A; Martin, H; Volpicelli, K; Diaz, C; Gozzer, E; Buttenheim, A M

2015-08-01

To conduct a formative evaluation of a proposed mobile health (mHealth) program designed to educate caregivers about management of common childhood illnesses. A cluster-randomized sample (n = 220) of mothers in Cono Norte, Arequipa, Peru with at least one child under five completed an iPad-based survey. This descriptive study examined trends in mobile phone ownership and feasibility of and interest in mHealth across sociodemographic categories. Fisher's exact tests were used to evaluate associations. Univariate logistic regression models were fitted to calculate odds ratios and 95% confidence intervals. Of 220 participants, 82.3% and 95.0% reported mobile phone ownership and access, respectively. Ownership was significantly associated with educational level (P = 0.031); however, even among mothers with the lowest education, ownership approached 80%. Educational level and age, respectively, were associated with the ability to open (P < 0.001; P < 0.001), read (P < 0.001; P < 0.001), write (P < 0.001; P < 0.001), and send (P = 0.006; P = 0.047) text messages. Over 85% of mothers were interested in using their mobile phones to receive health advice for their child and to seek help during illness. Regression analyses revealed that ability to use a mobile phone was positively associated with the mother's intention to participate in the mHealth program. The study findings confirm widespread access to mobile phones and sufficient ability to utilize text messaging within this population of caregivers. In addition to access and feasibility, high levels of interest in using mobile phones for health-related purposes suggest the potential value associated with an mHealth program designed to improve childhood illness management in this community.

Adjuvant Liraglutide and Insulin Versus Insulin Monotherapy in the Closed-Loop System in Type 1 Diabetes: A Randomized Open-Labeled Crossover Design Trial.

PubMed

Ilkowitz, Jeniece Trast; Katikaneni, Ranjitha; Cantwell, Martin; Ramchandani, Neesha; Heptulla, Rubina A

2016-09-01

The closed-loop (CL) system delivers insulin in a glucose-responsive manner and optimal postprandial glycemic control is difficult to achieve with the algorithm and insulin available. We hypothesized that adjunctive therapy with liraglutide, a once-daily glucagon-like peptide-1 agonist, would be more effective in normalizing postprandial hyperglycemia versus insulin monotherapy in the CL system, in patients with type 1 diabetes. This was a randomized, controlled, open-label, crossover design trial comparing insulin monotherapy versus adjuvant subcutaneous liraglutide 1.2 mg and insulin, using the CL system in 15 patients. Blood glucose (BG), insulin, and glucagon concentrations were analyzed. The liraglutide arm was associated with overall decreased mean BG levels (P = .0002). The average BG levels from 8:00 pm (day 1) to 9:00 pm (day 2) were lower in the liraglutide arm (144.6 ± 36.31 vs 159.7 ± 50.88 mg/dl respectively; P = .0002). Two-hour postbreakfast and lunch BG profiles were better in the liraglutide arm (P < .05) and the insulin and glucagon assay values were lower (P < .0001). Postprandially, the area under the curve (AUC) for 2-hour postbreakfast and lunch BG levels were significant (P = .01, P = .03) and the AUC for glucagon, postbreakfast (P < .0001) and lunch (P < .05), was also significant. The incidence of hypoglycemia did not differ between arms (P = .83, Fisher's exact test). Overall, adjunct liraglutide therapy plus CL was well tolerated even with expected side effects. This is a proof-of-concept study showing liraglutide can be a potential adjunctive therapy in addition to CL with insulin to reduce postprandial hyperglycemia in type 1 diabetes. © 2016 Diabetes Technology Society.

Regional gastrointestinal transit and pH studied in 215 healthy volunteers using the wireless motility capsule: influence of age, gender, study country and testing protocol.

PubMed

Wang, Y T; Mohammed, S D; Farmer, A D; Wang, D; Zarate, N; Hobson, A R; Hellström, P M; Semler, J R; Kuo, B; Rao, S S; Hasler, W L; Camilleri, M; Scott, S M

2015-09-01

The wireless motility capsule (WMC) offers the ability to investigate luminal gastrointestinal (GI) physiology in a minimally invasive manner. To investigate the effect of testing protocol, gender, age and study country on regional GI transit times and associated pH values using the WMC. Regional GI transit times and pH values were determined in 215 healthy volunteers from USA and Sweden studied using the WMC over a 6.5-year period. The effects of test protocol, gender, age and study country were examined. For GI transit times, testing protocol was associated with differences in gastric emptying time (GET; shorter with protocol 2 (motility capsule ingested immediately after meal) vs. protocol 1 (motility capsule immediately before): median difference: 52 min, P = 0.0063) and colonic transit time (CTT; longer with protocol 2: median 140 min, P = 0.0189), but had no overall effect on whole gut transit time. Females had longer GET (by median 17 min, P = 0.0307), and also longer CTT by (104 min, P = 0.0285) and whole gut transit time by (263 min, P = 0.0077). Increasing age was associated with shorter small bowel transit time (P = 0.002), and study country also influenced small bowel and CTTs. Whole gut and CTTs showed clustering of data at values separated by 24 h, suggesting that describing these measures as continuous variables is invalid. Testing protocol, gender and study country also significantly influenced pH values. Regional GI transit times and pH values, delineated using the wireless motility capsule (WMC), vary based on testing protocol, gender, age and country. Standardisation of testing is crucial for cross-referencing in clinical practice and future research. © 2015 John Wiley & Sons Ltd.

Anti-Toxoplasma gondii antibodies in patients with beta-hemoglobinopathies: the first report in the Americas.

PubMed

Ferreira, Marina Neves; Bonini-Domingos, Claudia Regina; Fonseca Estevão, Isabeth; de Castro Lobo, Clarice Lopes; Souza Carrocini, Gisele Cristina; Silveira-Carvalho, Aparecida Perpétuo; Ricci, Octávio; de Mattos, Luiz Carlos; Brandão de Mattos, Cinara Cássia

2017-06-14

In Brazil, there have been no previous studies of Toxoplasma gondii infection in sickle cell anemia patients and carriers of severe forms of beta-thalassemia. This study evaluated T. gondii infection in patients with beta-hemoglobinopathies. A total of 158 samples, 77 (48.7%) men and 81 (51.3%) women, were evaluated. Three groups were formed: G1 (85 patients with sickle cell disease); G2 (11 patients with homozygous beta-thalassemia; G3 (62 patients with heterozygous beta-thalassemia). ELISA was employed to identify anti-T. gondii IgM and IgG antibodies, and molecular analysis was performed to determine beta-hemoglobin mutations. Fisher's exact test was used to compare frequencies of anti-T. gondii IgM and IgG antibodies in respect to gender and age. Anti-T. gondii IgG antibodies were found in 43.5% of individuals in G1, 18.1% in G2 and 50% in G3. All samples from G1 and G2 were seronegative for anti-T. gondii IgM antibodies, but 3.2% from G3 were seropositive. Considering anti-T. gondii IgG antibodies, no statistical significant differences were found between these groups nor in seroprevalence between genders within each group. Despite this, comparisons of the mean ages between G1, G2 and G3 were statistically significant (G2 vs. G1: p value = 0.0001; G3 vs. G1: p-value <0.0001; G3 vs. G2: p-value = 0.0001). A comparison by age of patients with sickle cell anemia showed a trend of lower risk of infection among younger individuals. Therefore, this study demonstrates that T. gondii infection occurs in patients with beta-thalassemia and sickle cell anemia in Brazil as seen by the presence of anti-T. gondii IgM and IgG antibodies.

Exome Array Analysis of Susceptibility to Pneumococcal Meningitis

PubMed Central

Kloek, Anne T.; van Setten, Jessica; van der Ende, Arie; Bots, Michiel L.; Asselbergs, Folkert W.; Serón, Mercedes Valls; Brouwer, Matthijs C.; van de Beek, Diederik; Ferwerda, Bart

2016-01-01

Host genetic variability may contribute to susceptibility of bacterial meningitis, but which genes contribute to the susceptibility to this complex disease remains undefined. We performed a genetic association study in 469 community-acquired pneumococcal meningitis cases and 2072 population-based controls from the Utrecht Health Project in order to find genetic variants associated with pneumococcal meningitis susceptibility. A HumanExome BeadChip was used to genotype 102,097 SNPs in the collected DNA samples. Associations were tested with the Fisher exact test. None of the genetic variants tested reached Bonferroni corrected significance (p-value <5 × 10−7). Our strongest signals associated with susceptibility to pneumococcal meningitis were rs139064549 on chromosome 1 in the COL11A1 gene (p = 1.51 × 10−6; G allele OR 3.21 [95% CI 2.05–5.02]) and rs9309464 in the EXOC6B gene on chromosome 2 (p = 6.01 × 10−5; G allele OR 0.66 [95% CI 0.54–0.81]). The sequence kernel association test (SKAT) tests for associations between multiple variants in a gene region and pneumococcal meningitis susceptibility yielded one significant associated gene namely COL11A1 (p = 1.03 × 10−7). Replication studies are needed to validate these results. If replicated, the functionality of these genetic variations should be further studied to identify by which means they influence the pathophysiology of pneumococcal meningitis. PMID:27389768

Bayesian model checking: A comparison of tests

NASA Astrophysics Data System (ADS)

Lucy, L. B.

2018-06-01

Two procedures for checking Bayesian models are compared using a simple test problem based on the local Hubble expansion. Over four orders of magnitude, p-values derived from a global goodness-of-fit criterion for posterior probability density functions agree closely with posterior predictive p-values. The former can therefore serve as an effective proxy for the difficult-to-calculate posterior predictive p-values.

GRiP - A flexible approach for calculating risk as a function of consequence, vulnerability, and threat.

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

Whitfield, R. G.; Buehring, W. A.; Bassett, G. W.

2011-04-08

Get a GRiP (Gravitational Risk Procedure) on risk by using an approach inspired by the physics of gravitational forces between body masses! In April 2010, U.S. Department of Homeland Security Special Events staff (Protective Security Advisors [PSAs]) expressed concern about how to calculate risk given measures of consequence, vulnerability, and threat. The PSAs believed that it is not 'right' to assign zero risk, as a multiplicative formula would imply, to cases in which the threat is reported to be extremely small, and perhaps could even be assigned a value of zero, but for which consequences and vulnerability are potentially high.more » They needed a different way to aggregate the components into an overall measure of risk. To address these concerns, GRiP was proposed and developed. The inspiration for GRiP is Sir Isaac Newton's Universal Law of Gravitation: the attractive force between two bodies is directly proportional to the product of their masses and inversely proportional to the squares of the distance between them. The total force on one body is the sum of the forces from 'other bodies' that influence that body. In the case of risk, the 'other bodies' are the components of risk (R): consequence, vulnerability, and threat (which we denote as C, V, and T, respectively). GRiP treats risk as if it were a body within a cube. Each vertex (corner) of the cube represents one of the eight combinations of minimum and maximum 'values' for consequence, vulnerability, and threat. The risk at each of the vertices is a variable that can be set. Naturally, maximum risk occurs when consequence, vulnerability, and threat are at their maximum values; minimum risk occurs when they are at their minimum values. Analogous to gravitational forces among body masses, the GRiP formula for risk states that the risk at any interior point of the box depends on the squares of the distances from that point to each of the eight vertices. The risk value at an interior (movable) point will be dominated by the value of one vertex as that point moves closer and closer to that one vertex. GRiP is a visualization tool that helps analysts better understand risk and its relationship to consequence, vulnerability, and threat. Estimates of consequence, vulnerability, and threat are external to GRiP; however, the GRiP approach can be linked to models or data that provide estimates of consequence, vulnerability, and threat. For example, the Enhanced Critical Infrastructure Program/Infrastructure Survey Tool produces a vulnerability index (scaled from 0 to 100) that can be used for the vulnerability component of GRiP. We recognize that the values used for risk components can be point estimates and that, in fact, there is uncertainty regarding the exact values of C, V, and T. When we use T = t{sub o} (where t{sub o} is a value of threat in its range), we mean that threat is believed to be in an interval around t{sub o}. Hence, a value of t{sub o} = 0 indicates a 'best estimate' that the threat level is equal to zero, but still allows that it is not impossible for the threat to occur. When t{sub o} = 0 but is potentially small and not exactly zero, there will be little impact on the overall risk value as long as the C and V components are not large. However, when C and/or V have large values, there can be large differences in risk given t{sub o} = 0, and t{sub o} = epsilon (where epsilon is small but greater than a value of zero). We believe this scenario explains the PSA's intuition that risk is not equal to zero when t{sub o} = 0 and C and/or V have large values. (They may also be thinking that if C has an extremely large value, it is unlikely that T is equal to 0; in the terrorist context, T would likely be dependent on C when C is extremely large.) The PSAs are implicitly recognizing the potential that t{sub o} = epsilon. One way to take this possible scenario into account is to replace point estimates for risk with interval values that reflect the uncertainty in the risk components. In fact, one could argue that T never equals zero for a man-made hazard. This paper describes the thought process that led to the GRiP approach and the mathematical formula for GRiP and presents a few examples that will provide insights about how to use GRiP and interpret its results.« less

Evaluation of Chemical Composition and Antileishmanial and Antituberculosis Activities of Essential Oils of Piper Species.

PubMed

Bernuci, Karine Zanoli; Iwanaga, Camila Cristina; Fernadez-Andrade, Carla Maria Mariano; Lorenzetti, Fabiana Brusco; Torres-Santos, Eduardo Caio; Faiões, Viviane Dos Santos; Gonçalves, José Eduardo; do Amaral, Wanderlei; Deschamps, Cícero; Scodro, Regiane Bertin de Lima; Cardoso, Rosilene Fressatti; Baldin, Vanessa Pietrowski; Cortez, Diógenes Aparício Garcia

2016-12-12

Essential oils from fresh Piperaceae leaves were obtained by hydrodistillation and analyzed by gas chromatography mass spectrometry (GC-MS), and a total of 68 components were identified. Principal components analysis results showed a chemical variability between species, with sesquiterpene compounds predominating in the majority of species analyzed. The composition of the essential oil of Piper mosenii was described for the first time. The cytotoxicity of the essential oils was evaluated in peritoneal macrophages and the oils of P. rivinoides , P. arboretum , and P. aduncum exhibited the highest values, with cytotoxic concentration at 50% (CC 50 ) > 200 µg/mL. Both P. diospyrifolium and P. aduncum displayed activity against Leishmania amazonensis , and were more selective for the parasite than for the macrophages, with a selectivity index (SI) of 2.35 and >5.52, respectively. These SI values were greater than the 1 for the standard drug pentamidine. The antileishmanial activity of the essential oils of P. diospyrifolium and P. aduncum was described for the first time. P. rivinoides, P. cernuum , and P. diospyrifolium displayed moderate activity against the Mycobacterium tuberculosis H 37 Rv bacillus, with a minimum inhibitory concentration (MIC) of 125 µg/mL. These results are relevant and suggests their potential for therapeutic purposes. Nevertheless, further studies are required to explain the exact mechanism of action of these essential oils.

Students' Reasoning about p-Values

ERIC Educational Resources Information Center

Aquilonius, Birgit C.; Brenner, Mary E.

2015-01-01

Results from a study of 16 community college students are presented. The research question concerned how students reasoned about p-values. Students' approach to p-values in hypothesis testing was procedural. Students viewed p-values as something that one compares to alpha values in order to arrive at an answer and did not attach much meaning to…

Study of audiovestibular dysfunction in children with systemic lupus erythematosus.

PubMed

Gad, Ghada Ibrahim; Mohamed, Somaia Tawfik; Awwad, Khaled Salah; Mohamed, Rehab Fetoh

2013-09-01

Inner ear dysfunction in systemic lupus erythematosis patients has been reported but audiovestibular involvement is not well documented especially in pediatrics. This study was designed to evaluate silent audiovestibular dysfunction among SLE children. Case control study examined in allergy and immunology clinic; pediatrics hospital and audiovestibular clinic; Ain Shams University from January 2009 to December 2010. Thirty-five systemic lupus erythematosus children (diagnosed according to American College of Rheumatology); age group 8-16 years, were randomly selected. Five of them were excluded due to one or more exclusion criteria (previous otitis media, stroke, lupus cerebritis, meningitis or encephalitis, audiovestibular symptom). Ten of them refused enrollment or could not complete full battery. Seventeen females and three males, mean age 12.9 ± 2.6 years, completed the study. Control group included 20 normal subjects, age and sex matched. Full clinical assessment, basic audiological evaluation and vestibular testing (videonystagmography VNG and computerized dynamic posturography CDP) were conducted for children included in the study. Five systemic lupus erythematosus patients had sensorineural hearing loss strongly associated with +ve antiphospholipid antibody and two had conductive hearing loss. Two children in control group had conductive hearing loss (p=0.05). Abnormal VNG findings was significantly higher among systemic lupus erythematosus children (40%) compared to controls (0%) and associated with +ve antiphospholipid antibodies (χ(2)=10, p=0.002, Fisher exact test=0.003). Twenty-five percentage of systemic lupus erythematosus children had abnormal CDP findings reflecting impaired balance function associated with positive antiphospholipid antibodies showing significant statistical difference compared to controls (0% affection) (χ(2)=5.7, p=0.017, Fisher exact test=0.047). Silent audiovestibular dysfunction is prevalent among systemic lupus erythematosus children especially those positive for antiphospholipid antibodies necessitating routine regular evaluation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Fixation and its role in the causation, laterality and location of pterygium: a study in amblyopes and non-amblyopes.

PubMed

Sudhalkar, A

2012-03-01

To evaluate the role of fixation in causing pterygium and determining its laterality and location. This is a prospective, observational, case-control study. Cases were defined as patients with primary pterygium who had unilateral amblyopia with eccentric fixation. Controls were age-matched patients with primary pterygium, but without amblyopia and eccentric fixation. All patients underwent complete ocular, orthoptic, and systemic examination and a detailed risk-factor assessment (latitude of residence, exposure to sunlight, sand, and a high-reflectance environment). The role of fixation in the causation, laterality and location of pterygium was evaluated. Fisher's exact test, the unpaired t-test, and odds ratio (OR) were carried out to determine the significance of the observations. The mean age of subjects was 47.1±5.25 years in cases (n=107) and 48.2±4.75 years in controls (n=310; P=0.78). As far as known risk factors were concerned, both groups were evenly matched. Among the cases, 88 (82.2%) patients demonstrated suppression of the amblyopic eye and 19 (17.8%) patients had abnormal retinal correspondence (ARC). Patients with suppression had a unilateral pterygium in the better (fixating) eye, whereas those with ARC had bilateral pterygia. Among the controls, 192 (61.9%) eyes had bilateral pterygia and 118 (38.1%) eyes had unilateral pterygium. In controls, the dominant eye had a higher prevalence of pterygium. All patients in both groups had a nasal pterygium. Pterygium and fixation were strongly associated (P=0.007; Fisher's exact test; OR -15.98; P=0.008). Fixation appears to have an important role in causing pterygium and determining its location and laterality.

Use of Granulocyte Colony–Stimulating Factor During Pregnancy in Women With Chronic Neutropenia

PubMed Central

Boxer, Laurence A.; Bolyard, Audrey Anna; Kelley, Merideth L.; Marrero, Tracy M.; Phan, Lan; Bond, Jordan M.; Newburger, Peter E.; Dale, David C.

2014-01-01

Objective To report outcomes associated with the administration of granulocyte colony–stimulating factor (G-CSF) to women with chronic neutropenia during pregnancy. Methods We conducted an observational study of women of child-bearing potential with congenital, cyclic, idiopathic, or autoimmune neutropenia enrolled in the Severe Chronic Neutropenia International Registry to determine outcomes of pregnancies, without and with chronic G-CSF therapy, 1999–2014. Treatment decisions were made by the patients’ personal physicians. A research nurse conducted telephone interviews of all enrolled U.S. women of child-bearing potential using a standard questionnaire. Comparisons utilized Fisher’s exact test analysis and Student’s t-test. Results One-hundred seven women reported 224 pregnancies, 124 without G-CSF therapy and 100 on chronic G-CSF therapy (median dose: 1.0 mcg/kg/day, range 0.02–8.6 mcg/kg/day). There were no significant differences in adverse events between the groups considering all pregnancies or individual mothers, e.g., spontaneous terminations (all pregnancies: no G-CSF 27/124, G-CSF 13/100; P=0.11, Fisher’s exact test,), preterm labors (all pregnancies, no G-CSF 9/124, G-CSF 2/100, P=0.12,). A study with at least 300 per group would be needed to detect a difference in these events with 80% statistical power (alpha=0.05). Four newborns of mothers with idiopathic or autoimmune neutropenia not on G-CSF (4/101) had life-threatening infections, whereas there were no similar events (0/90) in the treated group, but this difference was also not statistically significant. (p=0.124). Adverse events in the neonates were similar for the two groups. Conclusions This observational study showed no significant adverse effects of administration of G-CSF to women with severe chronic neutropenia during pregnancy. PMID:25560125

RANDOMIZED PROSPECTIVE STUDY ON TRAUMATIC PATELLAR DISLOCATION: CONSERVATIVE TREATMENT VERSUS RECONSTRUCTION OF THE MEDIAL PATELLOFEMORAL LIGAMENT USING THE PATELLAR TENDON, WITH A MINIMUM OF TWO YEARS OF FOLLOW-UP.

PubMed

Bitar, Alexandre Carneiro; D'Elia, Caio Oliveira; Demange, Marco Kawamura; Viegas, Alexandre Christo; Camanho, Gilberto Luis

2011-01-01

The aim of this study was to compare the surgical results from reconstruction of the medial patellofemoral ligament (MPFL) with non-operative treatment of primary patellar dislocation. Thirty-nine patients (41 knees) with patellar dislocation were randomized into two groups. One group was treated conservatively (immobilization and physiotherapy) and other was treated surgically with reconstruction of the MPFL, and the results were evaluated with a minimum follow-up of two years. The Kujala questionnaire was applied to assess pain and quality of life, and recurrences were evaluated. Pearson's chi-square test and Fisher's exact test were used in the statistical evaluation. The statistical analysis showed that the mean Kujala score was significantly lower in the conservative group (70.8), compared with the mean value in the surgical group (88.9), with p = 0.001. The surgical group presented a higher percentage of "good/excellent" Kujala score results (71.43%) than in the conservative group (25.0%), with p = 0.003. The conservative group presented a greater number of recurrences (35% of the cases), while in the surgical group there were no reports of recurrences and/or subluxation. Treatment with reconstruction of the medial patellofemoral ligament using the patellar tendon produced better results, based on the analysis of post-treatment recurrences and the better final results from the Kujala questionnaire after a minimum follow-up period of two years.

[How reliable is the monitoring for doping?].

PubMed

Hüsler, J

1990-12-01

The reliability of the dope control, of the chemical analysis of the urine probes in the accredited laboratories and their decisions, is discussed using probabilistic and statistical methods. Basically, we evaluated and estimated the positive predictive value which means the probability that an urine probe contains prohibited dope substances given a positive test decision. Since there are not statistical data and evidence for some important quantities in relation to the predictive value, an exact evaluation is not possible, only conservative, lower bounds can be given. We found that the predictive value is at least 90% or 95% with respect to the analysis and decision based on the A-probe only, and at least 99% with respect to both A- and B-probes. A more realistic observation, but without sufficient statistical confidence, points to the fact that the true predictive value is significantly larger than these lower estimates.

Comment on "Atomic structure calculations and identification of EUV and SXR spectral lines in Sr XXX" by A. Goyal, I. Khatri, S. Aggarwal, A.K. Singh, M. Mohan [J Quant Spectrosc Radiat Transf 2015;161:157

NASA Astrophysics Data System (ADS)

Aggarwal, Kanti M.

2015-11-01

Recently, Goyal et al. [1] reported energies and lifetimes (τ) for the lowest 113 levels of the 2s22p5, 2s2p6, 2s22p43ℓ, 2s2p53ℓ and 2p63ℓ configurations of F-like Sr XXX. For the calculations they adopted the multi-configuration Dirac-Fock (MCDF) and the flexible atomic code (FAC). Additionally, they also listed radiative rates (A- values), oscillator strengths (f- values) and line strengths (S- values) for four types of transitions, namely electric dipole (E1), electric quadrupole (E2), magnetic dipole (M1) and magnetic quadrupole (M2), but only from the ground to the higher excited levels. However, there are two clear anomalies in their reported data. Firstly, the f-values listed from FAC in their Tables 3-6 are larger than from MCDF by a factor of two, for all transitions. This is because they have blindly listed the output from FAC without realising that, unlike MCDF, FAC lists ωf where ω is the statistical weight, and happens to be exactly 2 in the present case. Secondly, their lifetime for level 2 (2s22p51/2 o 2P) is incorrect. This is because the dominant contributing transition for this level is 1-2 M1 for which A=3.25×106 s-1, listed (correctly) in their Table 5, and this leads to τ=3.08×10-7 s, and not 1.54×10-7 s, as listed in their Table 1.

The average direct current offset values for small digital audio recorders in an acoustically consistent environment.

PubMed

Koenig, Bruce E; Lacey, Douglas S

2014-07-01

In this research project, nine small digital audio recorders were tested using five sets of 30-min recordings at all available recording modes, with consistent audio material, identical source and microphone locations, and identical acoustic environments. The averaged direct current (DC) offset values and standard deviations were measured for 30-sec and 1-, 2-, 3-, 6-, 10-, 15-, and 30-min segments. The research found an inverse association between segment lengths and the standard deviation values and that lengths beyond 30 min may not meaningfully reduce the standard deviation values. This research supports previous studies indicating that measured averaged DC offsets should only be used for exclusionary purposes in authenticity analyses and exhibit consistent values when the general acoustic environment and microphone/recorder configurations were held constant. Measured average DC offset values from exemplar recorders may not be directly comparable to those of submitted digital audio recordings without exactly duplicating the acoustic environment and microphone/recorder configurations. © 2014 American Academy of Forensic Sciences.

Impact of Non-caregiving Related Stressors on Informal Caregiver Outcomes

PubMed Central

Lu, Yvonne Yueh-Feng; Perkins, Anthony J.; Boustani, Malaz; Callahan, Christopher M.; Hendrie, Hugh C.

2014-01-01

Background Caregivers of persons with dementia are stressed. Stressors not related to care recipients’ needs impact caregiver outcomes, yet are seldom reported. Methods 31 caregivers completed the Most Stressful Event form, Patient Health Questionnaire (PHQ-9) and the Revised Memory Behavioral Problem Checklist (R-MBPC). Fisher’s exact test and two-sample t-test were used to compare Most Stressful Events between caregivers. ANOVA model tested whether the PHQ-9 and R-MBPC subscales differed by stressor. Results Caregivers reported no stressors 21.5%, 1–2 stressors 25%, and 3 stressors 53% of the time with 318 stressors total. Care recipient needs (30.2%), caregiver needs (26.7%), and decision-making (16.7%) were the most frequently reported stressors. Using a mixed effects model, there were associations between Most Stressful Events and depression (p=0.016), mobility (p=0.024) and caregiver issues (p=0.009) subscales of R-MBPC. Conclusion Results can be used to develop intervention and support strategies for caregivers experiencing non-caregiving related stressors. PMID:24413541

Sleep quality and communication aspects in children.

PubMed

de Castro Corrêa, Camila; José, Maria Renata; Andrade, Eduardo Carvalho; Feniman, Mariza Ribeiro; Fukushiro, Ana Paula; Berretin-Felix, Giédre; Maximino, Luciana Paula

2017-09-01

To correlate quality of life of children in terms of sleep, with their oral language skills, auditory processing and orofacial myofunctional aspects. Nineteen children (12 males and seven females, in the mean age 9.26) undergoing otorhinolaryngological and speech evaluations participated in this study. The OSA-18 questionnaire was applied, followed by verbal and nonverbal sequential memory tests, dichotic digit test, nonverbal dichotic test and Sustained Auditory Attention Ability Test, related to auditory processing. The Phonological Awareness Profile test, Rapid Automatized Naming and Phonological Working Memory were used for assessment of the phonological processing. Language was assessed by the ABFW Child Language Test, analyzing the phonological and lexical levels. Orofacial myofunctional aspects were evaluated through the MBGR Protocol. Statistical tests used: the Mann-Whitney Test, Fisher's exact test and Spearman Correlation. Relating the performance of children in all evaluations to the results obtained in the OSA-18, there was a statistically significant correlation in the phonological working memory for backward digits (p = 0.04); as well as in the breathing item (p = 0.03), posture of the mandible (p = 0.03) and mobility of lips (p = 0.04). A correlation was seen between the sleep quality of life and the skills related to the phonological processing, specifically in the phonological working memory in backward digits, and related to orofacial myofunctional aspects. Copyright © 2017 Elsevier B.V. All rights reserved.

An Immunoassay to Rapidly Measure Acetaminophen Protein Adducts Accurately Identifies Patients with Acute Liver Injury or Failure

PubMed Central

Roberts, Dean W.; Lee, William M.; Hinson, Jack A.; Bai, Shasha; Swearingen, Christopher J.; Stravitz, R. Todd; Reuben, Adrian; Letzig, Lynda; Simpson, Pippa M.; Rule, Jody; Fontana, Robert J.; Ganger, Daniel; Reddy, K. Rajender; Liou, Iris; Fix, Oren; James, Laura P.

2017-01-01

Background & Aims A rapid, reliable point-of-care assay to detect acetaminophen protein adducts in serum of patients with acute liver injury could improve diagnosis and management. AcetaSTAT is a competitive immunoassay used to measure acetaminophen protein adducts formed by toxic metabolites in serum samples from patients. We compared the accuracy of AcetaSTAT vs high-pressure liquid chromatography with electrochemical detection (HPLC-EC, a sensitive and specific quantitative analytical assay) to detect acetaminophen protein adducts. Methods We collected serum samples from 19 healthy individuals (no liver injury, no recent acetaminophen use), 29 patients without acetaminophen-associated acute liver injury, and 33 patients with acetaminophen-associated acute liver injury participating in the Acute Liver Failure Study Group registry. Each serum sample was analyzed by AcetaSTAT (reported as test band amplitude) and HPLC-EC (the reference standard). We also collected data on patient age, sex, weight, level of alanine aminotransferase on test day and peak values, concentration of acetaminophen, diagnoses (by site investigator and causality review committee), and outcome after 21 days. Differences between groups were analyzed using Fisher’s Exact for categorical variables and Kruskal-Wallis Test or Rank-Sum test for continuous variables. Results AcetaSTAT discriminated between patients with and without acetaminophen-associated acute liver injury; the median (and range) AcetaSTAT test band amplitude for patients with acetaminophen-associated acute liver injury was 584 (range, 222–1027) vs 3678 (range, 394–8289) for those without (P<.001). AcetaSTAT identified patients with acetaminophen-associated acute liver injury with 100% sensitivity, 86.2% specificity, a positive-predictive value of 89.2%, and a negative-predictive value of 100%. Results from AcetaSTAT were positive in 4 subjects who received a causality review committee diagnosis of non-acetaminophen–associated acute liver injury; HPLC-EC and biochemical profiles were consistent with acetaminophen-associated acute liver injury in 3 of these cases. Conclusion The competitive immunoassay AcetaSTAT demonstrates a high degree of concordance with HPLC-EC results in identifying patients with acetaminophen-associated acute liver injury. This rapid and simple assay could increase early detection of this disorder and aid clinical management. PMID:27641661

Comic books can educate children about burn safety in developing countries.

PubMed

Sinha, Indranil; Patel, Anup; Kim, Francis Sun; Maccorkle, Mary Lu; Watkins, James Frease

2011-01-01

Burns in developing countries account for significant morbidity and many occur within the pediatric population. This study investigates whether a comic book can increase burn awareness in primary school age children, both domestically and abroad. Based on demographic data regarding pediatric burns in developing nations, a comic book was developed to educate primary school age children on key risk factors regarding burn safety, including teaching children to not touch active stoves, not to light fireworks without supervision, and to "stop, drop, and roll" after burn injury. Students, aged 5 to 7 years, in both West Virginia, United States (N = 74), and West Bengal, India (N = 39), answered a three-question survey regarding these issues both before and after reading the comic book. Groups were compared using Fisher's exact test and significance was defined as P < .05. Initially, students answered 67.8 and 66.9% of the questionnaire correctly overall in West Virginia and West Bengal, respectively. These scores improved to 81.6 and 99.1% (P < .01 for each group), respectively, after reading the comic as a class. Specifically, there were significant increases in both groups for the questions regarding avoiding hot stoves (P < .01) and fireworks (P < .01). The lesson required 30 minutes total per class. The teachers reported that students enjoyed reading the comic and were engaged during the sessions. This study demonstrates that a comic book has value in teaching children about burn awareness. Comic books may be a cost-effective method as an outreach tool for children.

Oral colonisation and infection by Candida sp. in diabetic and non-diabetic patients with chronic kidney disease on dialysis.

PubMed

de la Rosa-García, Estela; Miramontes-Zapata, Mónica; Sánchez-Vargas, Luis-Octavio; Mondragón-Padilla, Arnoldo

2013-11-13

Oral candidiasis (OC) is a common opportunistic infection in immunocompromised patients. Species identification is sometimes important for treatment. objective: to determine the prevalence of different Candida species colonising or infecting the oral mucosa (OM) of diabetic (DM) and non-diabetic (non-DM) chronic kidney disease patients, comparing both groups and exploring potential risk factors. 56 DM and 80 non-DM patients on chronic dialysis were examined. OM swabs were cultured on Sabouraud dextrose agar plates. Candida species were identified with API® galleries. OC was confirmed by exfoliative cytology. Statistical associations were analysed using χ2, Fisher's exact test (ET), and multiple logistic regression. Candida prevalence was 43.4%: 53.6% DM and 36.3% non-DM, (p=.045). The species identified were C. albicans 74.6%, C. glabrata 22.0%, C. tropicalis 15.2%, C. parapsilosis 3.4 %, C. kefyr 3.4% and C. famata 1.7% without difference between groups. DM patients had a higher xerostomia prevalence (p=.002) and lower salivary flow (p=.008) and lower serum albumin (p=.018). 16.9% of patients had OC, 23.2% DM compared with 12.5% non-DM, (p=.101). The following were associated with the presence of Candida in the OM: the use of dental prostheses (odds ratio [OR] 25.6, 95% confidence interval [CI] 2.5 to 253, P=.001), xerostomia (OR 9.6, 95% CI 2.4 to 38.1, P=.001) and low serum albumin values (OR 0.41, 95% CI 0.22 to 0.98, P=.044). The presence of Candida sp. in the OM was associated with dental prostheses, xerostomia and low serum albumin.

Relative lumbar lordosis and lordosis distribution index: individualized pelvic incidence-based proportional parameters that quantify lumbar lordosis more precisely than the concept of pelvic incidence minus lumbar lordosis.

PubMed

Yilgor, Caglar; Sogunmez, Nuray; Yavuz, Yasemin; Abul, Kadir; Boissiére, Louis; Haddad, Sleiman; Obeid, Ibrahim; Kleinstück, Frank; Sánchez Pérez-Grueso, Francisco Javier; Acaroğlu, Emre; Mannion, Anne F; Pellise, Ferran; Alanay, Ahmet

2017-12-01

OBJECTIVE The subtraction of lumbar lordosis (LL) from the pelvic incidence (PI) offers an estimate of the LL required for a given PI value. Relative LL (RLL) and the lordosis distribution index (LDI) are PI-based individualized measures. RLL quantifies the magnitude of lordosis relative to the ideal lordosis as defined by the magnitude of PI. LDI defines the magnitude of lower arc lordosis in proportion to total lordosis. The aim of this study was to compare RLL and PI - LL for their ability to predict postoperative complications and their correlations with health-related quality of life (HRQOL) scores. METHODS Inclusion criteria were ≥ 4 levels of fusion and ≥ 2 years of follow-up. Mechanical complications were proximal junctional kyphosis/proximal junctional failure, distal junctional kyphosis/distal junctional failure, rod breakage, and implant-related complications. Correlations between PI - LL, RLL, PI, and HRQOL were analyzed using the Pearson correlation coefficient. Mechanical complication rates in PI - LL, RLL, LDI, RLL, and LDI interpreted together, and RLL subgroups for each PI - LL category were compared using chi-square tests and the exact test. Predictive models for mechanical complications with RLL and PI - LL were analyzed using binomial logistic regressions. RESULTS Two hundred twenty-two patients (168 women, 54 men) were included. The mean age was 52.2 ± 19.3 years (range 18-84 years). The mean follow-up was 28.8 ± 8.2 months (range 24-62 months). There was a significant correlation between PI - LL and PI (r = 0.441, p < 0.001), threatening the use of PI - LL to quantify spinopelvic mismatch for different PI values. RLL was not correlated with PI (r = -0.093, p > 0.05); therefore, it was able to quantify divergence from ideal lordosis for all PI values. Compared with PI - LL, RLL had stronger correlations with HRQOL scores (p < 0.05). Discrimination performance was better for the model with RLL than for PI - LL. The agreement between RLL and PI - LL was high (κ = 0.943, p < 0.001), moderate (κ = 0.455, p < 0.001), and poor (κ = -0.154, p = 0.343), respectively, for large, average, and small PI sizes. When analyzed by RLL, each PI - LL category was further divided into distinct groups of patients who had different mechanical complication rates (p < 0.001). CONCLUSIONS Using the formula of PI - LL may be insufficient to quantify normolordosis for the whole spectrum of PI values when applied as an absolute numeric value in conjunction with previously reported population-based average thresholds of 10° and 20°. Schwab PI - LL groups were found to constitute an inhomogeneous group of patients. RLL offers an individualized quantification of LL for all PI sizes. Compared with PI - LL, RLL showed a greater association with both mechanical complications and HRQOL. The use of RLL and LDI together, instead of PI - LL, for surgical planning may result in lower mechanical complication rates and better long-term HRQOL.

Hopelessness is associated with decreased heart rate variability during championship chess games.

PubMed

Schwarz, Alfons M; Schächinger, Hartmut; Adler, Rolf H; Goetz, Stefan M

2003-01-01

Clinical observations suggest that negative affects such as helplessness/hopelessness (HE/HO) may induce autonomic duration; affects were assessed for every move after reconstruction of the games. In all games compiled, 18 situation of intense confidence/optimism and 20 of intense helplessness/hopelessness were observed. Intense affects of HE/HO were associated with decreasing HF-HRV (Fisher exact test, p =.003), increasing "nervousness" (p =.0005), decreasing "optimism" (p =.0005), and decreasing "calmness" (p =.0005). Investigation of championship chess game players with an ELO strength > or = 2300 in a natural field setting revealed increasing HE/HO being associated with reduced HF-HRV suggestive of vagal withdrawal. Thus, our data may help link negative mood states, autonomic nervous system disturbances, and cardiac events.

Exact solutions for (1 + 1)-dimensional nonlinear dispersive modified Benjamin-Bona-Mahony equation and coupled Klein-Gordon equations.

PubMed

Khan, Kamruzzaman; Akbar, M Ali; Islam, S M Rayhanul

2014-01-01

In this work, recently developed modified simple equation (MSE) method is applied to find exact traveling wave solutions of nonlinear evolution equations (NLEEs). To do so, we consider the (1 + 1)-dimensional nonlinear dispersive modified Benjamin-Bona-Mahony (DMBBM) equation and coupled Klein-Gordon (cKG) equations. Two classes of explicit exact solutions-hyperbolic and trigonometric solutions of the associated equations are characterized with some free parameters. Then these exact solutions correspond to solitary waves for particular values of the parameters. 02.30.Jr; 02.70.Wz; 05.45.Yv; 94.05.Fg.

Pre-marital HIV testing in couples from faith-based organisations: experience in Port Harcourt, Nigeria.

PubMed

Akani, C I; Erhabor, O; Babatunde, S

2005-01-01

This descriptive cross-sectional study was conducted among prospective couples referred from Faith-Based Organisations in Port Harcourt, Nigeria for pre-marital HIV screening. The study sought to establish the sero-prevalence of human immunodeficiency virus (HIV) in this peculiar study group. A total of 84 healthy heterosexual couples who required pre-marital HIV screening were tested between January 2000 and December 2003 using a Double ELISA confirmatory test of Immunocomb and Genscreen HIV I&II Kits. Amongst the 168 individuals tested, 35 (20.8%) were found positive. Seroprevalence was significantly higher among females 23 (27.4%) compared to males 12 (14.3%). Infection rate was highest in the 25-29 years group (29.7%, n=22) and lowest in those of 35-39 years (6.1 %, n=2), though this difference was not statistically significant (p-value=0.058). Infection rate was significantly higher among females (p-value=0.036); among prospective couples from Orthodox churches (p-value=0.021); couples with prolonged courtship (>6 months) (p-value=0.0001); couples with history of premarital sex (p-value=0.0001); and couples with history of cohabitation (p-value=0.0001). Our findings prompt a wake-up call for faith-based organizations (FBOs) to urgently initiate or be more receptive of measures that emphasize behavioural and social changes amongst members. Government and non-governmental organizations should organise capacity building training for religious based organizations to enable them cope with the challenges of HIV/AIDS. The outcomes of this study further underscores the value of voluntary counselling and confidential HIV testing and especially pre- and post-test counselling as the basis of pre-marital HIV testing.

Bioclinical Test to Predict Nephropathia Epidemica Severity at Hospital Admission.

PubMed

Hentzien, Maxime; Mestrallet, Stéphanie; Halin, Pascale; Pannet, Laure-Anne; Lebrun, Delphine; Dramé, Moustapha; Bani-Sadr, Firouzé; Galempoix, Jean-Marc; Strady, Christophe; Reynes, Jean-Marc; Penalba, Christian; Servettaz, Amélie

2018-06-01

We conducted a multicenter, retrospective cohort study of hospitalized patients with serologically proven nephropathia epidemica (NE) living in Ardennes Department, France, during 2000-2014 to develop a bioclinical test predictive of severe disease. Among 205 patients, 45 (22.0%) had severe NE. We found the following factors predictive of severe NE: nephrotoxic drug exposure (p = 0.005, point value 10); visual disorders (p = 0.02, point value 8); microscopic or macroscopic hematuria (p = 0.04, point value 7); leukocyte count >10 × 10 9 cells/L (p = 0.01, point value 9); and thrombocytopenia <90 × 10 9 /L (p = 0.003, point value 11). When point values for each factor were summed, we found a score of <10 identified low-risk patients (3.3% had severe disease), and a score >20 identified high-risk patients (45.3% had severe disease). If validated in future studies, this test could be used to stratify patients by severity in research studies and in clinical practice.

The ADA*2 allele of the adenosine deaminase gene (20q13.11) and recurrent spontaneous abortions: an age-dependent association

PubMed Central

Nunes, Daniela Prudente Teixeira; Spegiorin, Lígia Cosentino Junqueira Franco; de Mattos, Cinara Cássia Brandão; Oliani, Antonio Helio; Vaz-Oliani, Denise Cristina Mós; de Mattos, Luiz Carlos

2011-01-01

OBJECTIVE: Adenosine deaminase acts on adenosine and deoxyadenosine metabolism and modulates the immune response. The adenosine deaminase G22A polymorphism (20q.11.33) influences the level of adenosine deaminase enzyme expression, which seems to play a key role in maintaining pregnancy. The adenosine deaminase 2 phenotype has been associated with a protective effect against recurrent spontaneous abortions in European Caucasian women. The aim of this study was to investigate whether the G22A polymorphism of the adenosine deaminase gene is associated with recurrent spontaneous abortions in Brazilian women. METHODS: A total of 311 women were recruited to form two groups: G1, with a history of recurrent spontaneous abortions (N = 129), and G2, without a history of abortions (N = 182). Genomic DNA was extracted from peripheral blood with a commercial kit and PCR-RFLP analysis was used to identify the G22A genetic polymorphism. Fisher's exact test and odds ratio values were used to compare the proportions of adenosine deaminase genotypes and alleles between women with and without a history of recurrent spontaneous abortion (p<0.05). The differences between mean values for categorical data were calculated using unpaired t tests. The Hardy-Weinberg equilibrium was assessed with a chi-square test. RESULTS: Statistically significant differences were identified for the frequencies of adenosine deaminase genotypes and alleles between the G1 and G2 groups when adjusted for maternal age. CONCLUSIONS: The results suggest that the adenosine deaminase *2 allele is associated with a low risk for recurrent spontaneous abortions, but this association is dependent on older age. PMID:22086524

The use of free online educational resources by Canadian emergency medicine residents and program directors.

PubMed

Purdy, Eve; Thoma, Brent; Bednarczyk, Joseph; Migneault, David; Sherbino, Jonathan

2015-03-01

Introduction Online educational resources (OERs) are increasingly available for emergency medicine (EM) education. This study describes and compares the use of free OERs by the Royal College of Physicians and Surgeons of Canada (RCPSC) EM residents and program directors (PDs) and investigates the relationship between the use of OERs and peer-reviewed literature. A bilingual, online survey was distributed to RCPSC-EM residents and PDs using a modified Dillman method. The chi-square test and Fisher's exact test were used to compare the responses of residents and PDs. The survey was completed by 214/350 (61%) residents and 11/14 (79%) PDs. Free OERs were used by residents most frequently for general EM education (99.5%), procedural skills training (96%), and learning to interpret diagnostic tests (92%). OER modalities used most frequently included wikis (95%), file-sharing websites (95%), e-textbooks (94%), and podcasts (91%). Residents used wikis, podcasts, vodcasts, and file-sharing websites significantly more frequently than PDs. Relative to PDs, residents found entertainment value to be more important for choosing OERs (p<0.01). Some residents (23%) did not feel that literature references were important, whereas all PDs did. Both groups reported that OERs increased the amount of peer-reviewed literature (75% and 60%, respectively) that they read. EM residents make extensive use of OERs and differ from their PDs in the importance that they place on their entertainment value and incorporation of peer-reviewed references. OERs may increase the use of peer-reviewed literature in both groups. Given the prevalence of OER use for core educational goals among RCPSC-EM trainees, future efforts to facilitate critical appraisal and appropriate resource selection are warranted.

Evaluation of a novel electronic genetic screening and clinical decision support tool in prenatal clinical settings.

PubMed

Edelman, Emily A; Lin, Bruce K; Doksum, Teresa; Drohan, Brian; Edelson, Vaughn; Dolan, Siobhan M; Hughes, Kevin; O'Leary, James; Vasquez, Lisa; Copeland, Sara; Galvin, Shelley L; DeGroat, Nicole; Pardanani, Setul; Gregory Feero, W; Adams, Claire; Jones, Renee; Scott, Joan

2014-07-01

"The Pregnancy and Health Profile" (PHP) is a free prenatal genetic screening and clinical decision support (CDS) software tool for prenatal providers. PHP collects family health history (FHH) during intake and provides point-of-care risk assessment for providers and education for patients. This pilot study evaluated patient and provider responses to PHP and effects of using PHP in practice. PHP was implemented in four clinics. Surveys assessed provider confidence and knowledge and patient and provider satisfaction with PHP. Data on the implementation process were obtained through semi-structured interviews with administrators. Quantitative survey data were analyzed using Chi square test, Fisher's exact test, paired t tests, and multivariate logistic regression. Open-ended survey questions and interviews were analyzed using qualitative thematic analysis. Of the 83% (513/618) of patients that provided feedback, 97% felt PHP was easy to use and 98% easy to understand. Thirty percent (21/71) of participating physicians completed both pre- and post-implementation feedback surveys [13 obstetricians (OBs) and 8 family medicine physicians (FPs)]. Confidence in managing genetic risks significantly improved for OBs on 2/6 measures (p values ≤0.001) but not for FPs. Physician knowledge did not significantly change. Providers reported value in added patient engagement and reported mixed feedback about the CDS report. We identified key steps, resources, and staff support required to implement PHP in a clinical setting. To our knowledge, this study is the first to report on the integration of patient-completed, electronically captured and CDS-enabled FHH software into primary prenatal practice. PHP is acceptable to patients and providers. Key to successful implementation in the future will be customization options and interoperability with electronic health records.

Local Approximation and Hierarchical Methods for Stochastic Optimization

NASA Astrophysics Data System (ADS)

Cheng, Bolong

In this thesis, we present local and hierarchical approximation methods for two classes of stochastic optimization problems: optimal learning and Markov decision processes. For the optimal learning problem class, we introduce a locally linear model with radial basis function for estimating the posterior mean of the unknown objective function. The method uses a compact representation of the function which avoids storing the entire history, as is typically required by nonparametric methods. We derive a knowledge gradient policy with the locally parametric model, which maximizes the expected value of information. We show the policy is asymptotically optimal in theory, and experimental works suggests that the method can reliably find the optimal solution on a range of test functions. For the Markov decision processes problem class, we are motivated by an application where we want to co-optimize a battery for multiple revenue, in particular energy arbitrage and frequency regulation. The nature of this problem requires the battery to make charging and discharging decisions at different time scales while accounting for the stochastic information such as load demand, electricity prices, and regulation signals. Computing the exact optimal policy becomes intractable due to the large state space and the number of time steps. We propose two methods to circumvent the computation bottleneck. First, we propose a nested MDP model that structure the co-optimization problem into smaller sub-problems with reduced state space. This new model allows us to understand how the battery behaves down to the two-second dynamics (that of the frequency regulation market). Second, we introduce a low-rank value function approximation for backward dynamic programming. This new method only requires computing the exact value function for a small subset of the state space and approximate the entire value function via low-rank matrix completion. We test these methods on historical price data from the PJM Interconnect and show that it outperforms the baseline approach used in the industry.

Comparison of noninferiority margins reported in protocols and publications showed incomplete and inconsistent reporting.

PubMed

Dekkers, Olaf M; Cevallos, Myriam; Bührer, Jonas; Poncet, Antoine; Ackermann Rau, Sabine; Perneger, Thomas V; Egger, Matthias

2015-05-01

To compare noninferiority margins defined in study protocols and trial registry records with margins reported in subsequent publications. Comparison of protocols of noninferiority trials submitted 2001 to 2005 to ethics committees in Switzerland and The Netherlands with corresponding publications and registry records. We searched MEDLINE via PubMed, the Cochrane Controlled Trials Register (Cochrane Library issue 01/2012), and Google Scholar in September 2013 to identify published reports, and the International Clinical Trials Registry Platform of the World Health Organization in March 2013 to identify registry records. Two readers recorded the noninferiority margin and other data using a standardized data-abstraction form. The margin was identical in study protocol and publication in 43 (80%) of 54 pairs of study protocols and articles. In the remaining pairs, reporting was inconsistent (five pairs, 9%), or the noninferiority margin was either not reported in the publication (five pairs, 9%) or not defined in the study protocol (one pair). The confidence interval or the exact P-value required to judge whether the result was compatible with noninferior, inferior, or superior efficacy was reported in 43 (80%) publications. Complete and consistent reporting of both noninferiority margin and confidence interval (or exact P-value) was present in 39 (72%) protocol-publication pairs. Twenty-nine trials (54%) were registered in trial registries, but only one registry record included the noninferiority margin. The reporting of noninferiority margins was incomplete and inconsistent with study protocols in a substantial proportion of published trials, and margins were rarely reported in trial registries. Copyright © 2015 Elsevier Inc. All rights reserved.

In vivo wound healing and in vitro antioxidant activities of Bletilla striata phenolic extracts.

PubMed

Song, Yi; Zeng, Rui; Hu, Lingli; Maffucci, Katherine G; Ren, Xiaodong; Qu, Yan

2017-09-01

Bletilla striata has attracted extensive research interest due to the potential uses for its extracts to treat skin burns and inflammatory disorders in a clinical setting. My current research focuses on Bletilla striata polysaccharides (BSP), and often ignores the residues that remain after polysaccharide extraction. It also remains unclear whether the residues have medical value related its traditional clinic function. During this work, we firstly identified the contents of the post-extraction residue by UPLC-Q-Exactive Orbitrap-MS and evaluated its in vivo wound healing and in vitro antioxidant activity. The wound healing activity of the ointment containing residue was assessed for 15days the scald model was used in mice, followed by histopathology and histomorphological analysis. The in vitro antioxidant effect of Bletilla residue was researched using DPPH, ABTS, Hydroxyl radical scavenging, superoxideanion radical scavenging, and reducing power assays. AUPLC-Q-Exactive Orbitrap-MS analysis identified 6 phenolic compounds: protocatechuic acid, p-hydroxybenzoic acid, caffeic acid, p-hydroxybenzaldehyde, 3-Hydroxycinnamic acid, and ferulic acid. Animals treated with "mixed ointment" experienced inflammatory infiltration, which was lower than that of other groups. Both "BSPG ointment" and "Bletilla phenolic ointment" demonstrated superior tissue repair compared to the control. This study was the first to confirm that the residual liquid after polysaccharide extraction has excellent antioxidant and wound healing activities. In addition to Bletilla striata polysaccharides, the residual liquid can improve skin regeneration after burns and reduce inflammatory marker levels. These results have implications that the residual liquid has potential wound healing medicinal value. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Exact tests using two correlated binomial variables in contemporary cancer clinical trials.

PubMed

Yu, Jihnhee; Kepner, James L; Iyer, Renuka

2009-12-01

New therapy strategies for the treatment of cancer are rapidly emerging because of recent technology advances in genetics and molecular biology. Although newer targeted therapies can improve survival without measurable changes in tumor size, clinical trial conduct has remained nearly unchanged. When potentially efficacious therapies are tested, current clinical trial design and analysis methods may not be suitable for detecting therapeutic effects. We propose an exact method with respect to testing cytostatic cancer treatment using correlated bivariate binomial random variables to simultaneously assess two primary outcomes. The method is easy to implement. It does not increase the sample size over that of the univariate exact test and in most cases reduces the sample size required. Sample size calculations are provided for selected designs.

Computational tools for exact conditional logistic regression.

PubMed

Corcoran, C; Mehta, C; Patel, N; Senchaudhuri, P

Logistic regression analyses are often challenged by the inability of unconditional likelihood-based approximations to yield consistent, valid estimates and p-values for model parameters. This can be due to sparseness or separability in the data. Conditional logistic regression, though useful in such situations, can also be computationally unfeasible when the sample size or number of explanatory covariates is large. We review recent developments that allow efficient approximate conditional inference, including Monte Carlo sampling and saddlepoint approximations. We demonstrate through real examples that these methods enable the analysis of significantly larger and more complex data sets. We find in this investigation that for these moderately large data sets Monte Carlo seems a better alternative, as it provides unbiased estimates of the exact results and can be executed in less CPU time than can the single saddlepoint approximation. Moreover, the double saddlepoint approximation, while computationally the easiest to obtain, offers little practical advantage. It produces unreliable results and cannot be computed when a maximum likelihood solution does not exist. Copyright 2001 John Wiley & Sons, Ltd.

Is simple nephrectomy truly simple? Comparison with the radical alternative.

PubMed

Connolly, S S; O'Brien, M Frank; Kunni, I M; Phelan, E; Conroy, R; Thornhill, J A; Grainger, R

2011-03-01

The Oxford English dictionary defines the term "simple" as "easily done" and "uncomplicated". We tested the validity of this terminology in relation to open nephrectomy surgery. Retrospective review of 215 patients undergoing open, simple (n = 89) or radical (n = 126) nephrectomy in a single university-affiliated institution between 1998 and 2002. Operative time (OT), estimated blood loss (EBL), operative complications (OC) and length of stay in hospital (LOS) were analysed. Statistical analysis employed Fisher's exact test and Stata Release 8.2. Simple nephrectomy was associated with shorter OT (mean 126 vs. 144 min; p = 0.002), reduced EBL (mean 729 vs. 859 cc; p = 0.472), lower OC (9 vs. 17%; 0.087), and more brief LOS (mean 6 vs. 8 days; p < 0.001). All parameters suggest favourable outcome for the simple nephrectomy group, supporting the use of this terminology. This implies "simple" nephrectomies are truly easier to perform with less complication than their radical counterpart.

A 3-Year Study of Predictive Factors for Positive and Negative Appendicectomies.

PubMed

Chang, Dwayne T S; Maluda, Melissa; Lee, Lisa; Premaratne, Chandrasiri; Khamhing, Srisongham

2018-03-06

Early and accurate identification or exclusion of acute appendicitis is the key to avoid the morbidity of delayed treatment for true appendicitis or unnecessary appendicectomy, respectively. We aim (i) to identify potential predictive factors for positive and negative appendicectomies; and (ii) to analyse the use of ultrasound scans (US) and computed tomography (CT) scans for acute appendicitis. All appendicectomies that took place at our hospital from the 1st of January 2013 to the 31st of December 2015 were retrospectively recorded. Test results of potential predictive factors of acute appendicitis were recorded. Statistical analysis was performed using Fisher exact test, logistic regression analysis, sensitivity, specificity, and positive and negative predictive values calculation. 208 patients were included in this study. 184 patients had histologically proven acute appendicitis. The other 24 patients had either nonappendicitis pathology or normal appendix. Logistic regression analysis showed statistically significant associations between appendicitis and white cell count, neutrophil count, C-reactive protein, and bilirubin. Neutrophil count was the test with the highest sensitivity and negative predictive values, whereas bilirubin was the test with the highest specificity and positive predictive values (PPV). US and CT scans had high sensitivity and PPV for diagnosing appendicitis. No single test was sufficient to diagnose or exclude acute appendicitis by itself. Combining tests with high sensitivity (abnormal neutrophil count, and US and CT scans) and high specificity (raised bilirubin) may predict acute appendicitis more accurately.

Electrons for Neutrinos: Using Electron Scattering to Develop New Energy Reconstruction for Future Deuterium-Based Neutrino Detectors

NASA Astrophysics Data System (ADS)

Silva, Adrian; Schmookler, Barak; Papadopoulou, Afroditi; Schmidt, Axel; Hen, Or; Khachatryan, Mariana; Weinstein, Lawrence

2017-09-01

Using wide phase-space electron scattering data, we study a novel technique for neutrino energy reconstruction for future neutrino oscillation experiments. Accelerator-based neutrino oscillation experiments require detailed understanding of neutrino-nucleus interactions, which are complicated by the underlying nuclear physics that governs the process. One area of concern is that neutrino energy must be reconstructed event-by-event from the final-state kinematics. In charged-current quasielastic scattering, Fermi motion of nucleons prevents exact energy reconstruction. However, in scattering from deuterium, the momentum of the electron and proton constrain the neutrino energy exactly, offering a new avenue for reducing systematic uncertainties. To test this approach, we analyzed d (e ,e' p) data taken with the CLAS detector at Jefferson Lab Hall B and made kinematic selection cuts to obtain quasielastic events. We estimated the remaining inelastic background by using d (e ,e' pπ-) events to produce a simulated dataset of events with an undetected π-. These results demonstrate the feasibility of energy reconstruction in a hypothetical future deuterium-based neutrino detector. Supported by the Paul E. Gray UROP Fund, MIT.

The distribution of P-values in medical research articles suggested selective reporting associated with statistical significance.

PubMed

Perneger, Thomas V; Combescure, Christophe

2017-07-01

Published P-values provide a window into the global enterprise of medical research. The aim of this study was to use the distribution of published P-values to estimate the relative frequencies of null and alternative hypotheses and to seek irregularities suggestive of publication bias. This cross-sectional study included P-values published in 120 medical research articles in 2016 (30 each from the BMJ, JAMA, Lancet, and New England Journal of Medicine). The observed distribution of P-values was compared with expected distributions under the null hypothesis (i.e., uniform between 0 and 1) and the alternative hypothesis (strictly decreasing from 0 to 1). P-values were categorized according to conventional levels of statistical significance and in one-percent intervals. Among 4,158 recorded P-values, 26.1% were highly significant (P < 0.001), 9.1% were moderately significant (P ≥ 0.001 to < 0.01), 11.7% were weakly significant (P ≥ 0.01 to < 0.05), and 53.2% were nonsignificant (P ≥ 0.05). We noted three irregularities: (1) high proportion of P-values <0.001, especially in observational studies, (2) excess of P-values equal to 1, and (3) about twice as many P-values less than 0.05 compared with those more than 0.05. The latter finding was seen in both randomized trials and observational studies, and in most types of analyses, excepting heterogeneity tests and interaction tests. Under plausible assumptions, we estimate that about half of the tested hypotheses were null and the other half were alternative. This analysis suggests that statistical tests published in medical journals are not a random sample of null and alternative hypotheses but that selective reporting is prevalent. In particular, significant results are about twice as likely to be reported as nonsignificant results. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Ballesteros, Ángel, E-mail: angelb@ubu.es; Enciso, Alberto, E-mail: aenciso@icmat.es; Herranz, Francisco J., E-mail: fjherranz@ubu.es

In this paper we quantize the N-dimensional classical Hamiltonian system H=(|q|)/(2(η+|q|)) p{sup 2}−k/(η+|q|) , that can be regarded as a deformation of the Coulomb problem with coupling constant k, that it is smoothly recovered in the limit η→0. Moreover, the kinetic energy term in H is just the one corresponding to an N-dimensional Taub–NUT space, a fact that makes this system relevant from a geometric viewpoint. Since the Hamiltonian H is known to be maximally superintegrable, we propose a quantization prescription that preserves such superintegrability in the quantum mechanical setting. We show that, to this end, one must choose asmore » the kinetic part of the Hamiltonian the conformal Laplacian of the underlying Riemannian manifold, which combines the usual Laplace–Beltrami operator on the Taub–NUT manifold and a multiple of its scalar curvature. As a consequence, we obtain a novel exactly solvable deformation of the quantum Coulomb problem, whose spectrum is computed in closed form for positive values of η and k, and showing that the well-known maximal degeneracy of the flat system is preserved in the deformed case. Several interesting algebraic and physical features of this new exactly solvable quantum system are analyzed, and the quantization problem for negative values of η and/or k is also sketched.« less

Characterization of hepatocellular carcinoma (HCC) in non-alcoholic fatty liver disease (NAFLD) patients without cirrhosis.

PubMed

Mohamad, Bashar; Shah, Vaishal; Onyshchenko, Mykola; Elshamy, Mohammed; Aucejo, Federico; Lopez, Rocio; Hanouneh, Ibrahim A; Alhaddad, Razan; Alkhouri, Naim

2016-07-01

The incidence of hepatocellular carcinoma (HCC) has increased significantly in United States over the last few decades in parallel with the epidemic of nonalcoholic fatty liver disease (NAFLD). Limited data suggests that HCC could arise in steatotic liver without the presence of cirrhosis. The present study was conducted to characterize patients with NAFLD presenting with HCC in non-cirrhotic liver (NCL) compared to the NAFLD- HCC patients in association with cirrhotic liver (CL). A retrospective analysis of all patients diagnosed with HCC and NAFLD diagnosis seen at our institution between 2003 and 2012 was done. The patients were characterized based on demographic and clinical variables as well as histological and tumor features. Comparisons between the NCL and CL groups were done using analysis of variance (ANOVA) or the non-parametric Kruskal-Wallis tests and Pearson's chi-square tests or Fisher's Exact tests as appropriate. P value of <0.05 was considered statistically significant. Thirty-six patients with NAFLD and HCC in NCL (HCC-NCL group) were identified and compared to 47 patients with NAFLD-HCC and Liver Cirrhosis (HCC-LC group). Liver fibrosis was not present in 55.9 % of patients in the HCC-NCL group (F0), stage 1 was present in 17.6 %, stage 2 in 8.8 % and stage 3 in 17.6 %. Lobular inflammation was present in 63.6 % of non-cirrhotic patients. Patients in the HCC-NCL were older (67.5 ± 12.3 vs. 62.7 ± 8.1 years), and less likely to be obese (52 % vs. 83 %) or have type 2 diabetes (38 % vs. 83 %), with p value <0.05 for all. More importantly, compared with the HCC-CL group, those in the HCC-NCL group were more likely to present with a single nodule (80.6 % vs. 52.2 %), larger nodule size (>5 cm) (77.8 % vs. 10.6 %), and receive hepatic resection as the modality of HCC treatment (66.7 % vs. 17 %); and were less likely to receive loco-regional therapy (22.3 % vs. 61.7 %) or orthotopic liver transplantation (OLT) (0 % vs. 72.3 %), with p value <0.001 for all. Furthermore, 86 % of patients without cirrhosis had HCC recurrence compared to only 14 % in patients with cirrhosis (p < 0.001). Unadjusted analysis indicates that non-cirrhotics had worse survival with mortality rate of 47 % vs. 28 % in CL group (p = 0.03); however this difference in survival between two groups was not significant after adjusting for age or OLT (p > 0.05). Patients with HCC in the absence of liver cirrhosis are more likely to present at an older age with larger tumor and have higher rates of tumor recurrence. Studies to assess the cost-effectiveness of HCC surveillance in this group should be conducted.

A worksite intervention to reduce the cardiovascular risk: proposal of a study design easy to integrate within Italian organization of occupational health surveillance.

PubMed

Mastrangelo, Giuseppe; Marangi, Gianluca; Bontadi, Danilo; Fadda, Emanuela; Cegolon, Luca; Bortolotto, Melania; Fedeli, Ugo; Marchiori, Luciano

2015-01-21

Despite the substantial amount of knowledge on effectiveness of worksite health promotion (WHP) in reducing cardiovascular disease (CVD) risk, WHP programs are not systematically applied in Italy. The aim was to design an intervention easy to integrate within the Italian organization of workplace health surveillance. We used the "pretest-posttest design". Workers were employed in multiple occupations and resident in Veneto region, Italy. Occupational physicians (OPs) performed all examinations, including laboratory evaluation (capillary blood sampling and measure of glycaemia and cholesterolemia with portable devices), during the normal health surveillance at worksite. CVD risk was computed based on sex, age, smoking habit, diabetes, systolic pressure and cholesterol level. After excluding those with <40 years of age, missing consent, CVD diagnosis or current therapy for CVD, missing information, CVD risk <5%, out of 5,536 workers 451 underwent the intervention and 323 male workers were re-examined at 1 year. CVD risk was the most compelling argument for changing lifestyle. The counseling was based on the individual risk factors. Individuals examined at posttest were a small fraction of the whole (6% = 323/5,536). In these workers we computed the ratio pretest/posttest of proportions (such as percent of subjects with cardiovascular risk >5%) as well as the exact McNemar significance probability or the exact test of table symmetry. CVD risk decreased by 24% (McNemar p = 0.0000) after the intervention; in a sensitivity analysis assuming that all subjects lost to follow-up kept their pretest cardiovascular risk value, the effect (-18%) was still significant (symmetry p < 0.0000). Each prevented CVD case was expected to cost about 5,700 euro. The present worksite intervention promoted favorable changes of CVD risk that were reasonably priced and consistent across multiple occupations.

On exact solutions for disturbances to the asymptotic suction boundary layer: transformation of Barnes integrals to convolution integrals

NASA Astrophysics Data System (ADS)

Russell, John

2000-11-01

A modified Orr-Sommerfeld equation that applies to the asymptotic suction boundary layer was reported by Bussmann & Münz in a wartime report dated 1942 and by Hughes & Reid in J.F.M. ( 23, 1965, p715). Fundamental systems of exact solutions of the Orr-Sommerfeld equation for this mean velocity distribution were reported by D. Grohne in an unpublished typescript dated 1950. Exact solutions of the equation of Bussmann, Münz, Hughes, & Reid were reported by P. Baldwin in Mathematika ( 17, 1970, p206). Grohne and Baldwin noticed that these exact solutions may be expressed either as Barnes integrals or as convolution integrals. In a later paper (Phil. Trans. Roy. Soc. A, 399, 1985, p321), Baldwin applied the convolution integrals in the contruction of large-Reynolds number asymptotic approximations that hold uniformly. The present talk discusses the subtleties that arise in the construction of such convolution integrals, including several not reported by Grohne or Baldwin. The aim is to recover the full set of seven solutions (one well balanced, three balanced, and three dominant-recessive) postulated by W.H. Reid in various works on the uniformly valid solutions.

Role of human papilloma virus-16 in the pathogenesis of oral lichen planus--an immunohistochemical study.

PubMed

Pol, Chetan A; Ghige, Suvarna K; Gosavi, Suchitra R

2015-02-01

Oral lichen planus (OLP) is a common chronic inflammatory immune-mediated disease with an aetiopathogenesis associated with cell-mediated immunological dysfunction. It is possible that oral mucosal viral infections, including human papilloma virus-16 (HPV-16) infection, may have a causative role in OLP pathogenesis. To assess the prevalence of HPV-16 in histopathologically diagnosed specimens of OLP and to evaluate whether any clinical features (such as the localisation of specimens) or the age or gender of patients, are correlated with the presence of this virus. This study was conducted on 30 specimens with a histopathological diagnosis of OLP, using the immunohistochemical marker HPV-16. Thirty normal oral mucosa specimens were also included as controls. Brown nuclear staining was accepted as positive for the HPV-16 antibody. The results were analysed using Fisher's exact test. P values<0.05 were considered to be significant. Significant correlation (P=0.0001) was observed between HPV-16 infection and samples with OLP. No statistical conclusions could be drawn regarding age, gender, localisation and HPV-16 positivity. Our study showed that HPV-16 may play a role in the pathogenesis of OLP. Taking into account the oncogenic potential of HPV-16, patients with OLP should be screened for the presence of this virus. © 2014 FDI World Dental Federation.

The development of a reliable amateur boxing performance analysis template.

PubMed

Thomson, Edward; Lamb, Kevin; Nicholas, Ceri

2013-01-01

The aim of this study was to devise a valid performance analysis system for the assessment of the movement characteristics associated with competitive amateur boxing and assess its reliability using analysts of varying experience of the sport and performance analysis. Key performance indicators to characterise the demands of an amateur contest (offensive, defensive and feinting) were developed and notated using a computerised notational analysis system. Data were subjected to intra- and inter-observer reliability assessment using median sign tests and calculating the proportion of agreement within predetermined limits of error. For all performance indicators, intra-observer reliability revealed non-significant differences between observations (P > 0.05) and high agreement was established (80-100%) regardless of whether exact or the reference value of ±1 was applied. Inter-observer reliability was less impressive for both analysts (amateur boxer and experienced analyst), with the proportion of agreement ranging from 33-100%. Nonetheless, there was no systematic bias between observations for any indicator (P > 0.05), and the proportion of agreement within the reference range (±1) was 100%. A reliable performance analysis template has been developed for the assessment of amateur boxing performance and is available for use by researchers, coaches and athletes to classify and quantify the movement characteristics of amateur boxing.

Impact of Ultrasound on Short Peripheral Intravenous Catheter Placement on Vein Thrombosis Risk.

PubMed

Holder, Max R; Stutzman, Sonja E; Olson, DaiWai M

Approximately 90% of hospitalized patients have a short peripheral intravenous catheter (SPC) placed. Methods of inserting the catheter have evolved over time and now include the use of ultrasound (US)-guided procedures for placement. Little is known about the impact that US-guided procedures have on the vein. This study compared the rate of venous thrombosis in patients with and without US-guided catheter placement. This prospective, single-blind, observational study assessed for venous thrombosis in 153 veins from 135 patients. Veins were evaluated by a research nurse blinded to the method of placement between 48 and 72 hours after the SPC was placed. The Fisher exact test showed a significant difference between vessel compressibility and catheter insertion method (P = .0012). The proportion of noncompressible veins was significantly greater when US was used in comparison with freehand SPC insertion. The Mantel-Haenszel chi-square value of 10.34 (P = .0013) showed that US insertion technique is associated with a higher likelihood of noncompressible veins. This pilot study provides compelling evidence that the use of US to assist with catheter placement is associated with a higher rate of noncompressible veins at day 2 or 3. Further studies are needed with a larger sample to determine the generalizability of the results from this pilot study.

Exact Tests for the Rasch Model via Sequential Importance Sampling

ERIC Educational Resources Information Center

Chen, Yuguo; Small, Dylan

2005-01-01

Rasch proposed an exact conditional inference approach to testing his model but never implemented it because it involves the calculation of a complicated probability. This paper furthers Rasch's approach by (1) providing an efficient Monte Carlo methodology for accurately approximating the required probability and (2) illustrating the usefulness…

Effect of Interaction on the Majorana Zero Modes in the Kitaev Chain at Half Filling

NASA Astrophysics Data System (ADS)

Li, Zhidan; Han, Qiang

2018-04-01

The one dimension interacting Kitaev chain at half filling is studied. The symmetry of the Hamiltonian is examined by dual transformations and various physical quantities as functions of the fermion-fermion interaction $U$ are calculated systematically using the density matrix renormalization group method. A special value of interaction $U_p$ is revealed in the topological region of the phase diagram. We show that at $U_p$ the ground states are strictly two-fold degenerate even though the chain length is finite and the zero-energy peak due to the Majorana zero modes is maximally enhanced and exactly localized at the end sites. $U_p$ may be attractive or repulsive depending on other system parameters. We also give a qualitative understanding of the effect of interaction under the self-consistent mean field framework.

Analytic materials

PubMed Central

2016-01-01

The theory of inhomogeneous analytic materials is developed. These are materials where the coefficients entering the equations involve analytic functions. Three types of analytic materials are identified. The first two types involve an integer p. If p takes its maximum value, then we have a complete analytic material. Otherwise, it is incomplete analytic material of rank p. For two-dimensional materials, further progress can be made in the identification of analytic materials by using the well-known fact that a 90° rotation applied to a divergence-free field in a simply connected domain yields a curl-free field, and this can then be expressed as the gradient of a potential. Other exact results for the fields in inhomogeneous media are reviewed. Also reviewed is the subject of metamaterials, as these materials provide a way of realizing desirable coefficients in the equations. PMID:27956882

P-Hacking in Orthopaedic Literature: A Twist to the Tail.

PubMed

Bin Abd Razak, Hamid Rahmatullah; Ang, Jin-Guang Ernest; Attal, Hersh; Howe, Tet-Sen; Allen, John Carson

2016-10-19

"P-hacking" occurs when researchers preferentially select data or statistical analyses until nonsignificant results become significant. We wanted to evaluate if the phenomenon of p-hacking was evident in orthopaedic literature. We text-mined through all articles published in three top orthopaedic journals in 2015. For anonymity, we cipher-coded the three journals. We included all studies that reported a single p value to answer their main hypothesis. These p values were then charted and frequency graphs were generated to illustrate any evidence of p-hacking. Binomial tests were employed to look for evidence of evidential value and significance of p-hacking. Frequency plots for all three journals revealed evidence of p-hacking. Binomial tests for all three journals were significant for evidence of evidential value (p < 0.0001 for all). However, the binomial test for p-hacking was significant only for one journal (p = 0.0092). P-hacking is an evolving phenomenon that threatens to jeopardize the evidence-based practice of medicine. Although our results show that there is good evidential value for orthopaedic literature published in our top journals, there is some evidence of p-hacking of which authors and readers should be wary. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

[Curative effects of platelet-rich plasma combined with negative-pressure wound therapy on sternal osteomyelitis and sinus tract after thoracotomy].

PubMed

Hao, Daifeng; Feng, Guang; Li, Tao; Chu, Wanli; Chen, Zequn; Li, Shanyou; Zhang, Xinjian; Zhao, Jingfeng; Zhao, Fan

2016-06-01

To observe the curative effects of platelet-rich plasma (PRP) combined with negative-pressure wound therapy (NPWT) on patients with sternal osteomyelitis and sinus tract after thoracotomy. Sixty-two patients with sternal osteomyelitis and sinus tract after thoracotomy, hospitalized from March 2011 to June 2015, were retrospectively analyzed. Based on whether receiving PRP or not, patients were divided into two groups, group NPWT ( 22 patients hospitalized from March 2011 to December 2012) and combination treatment group (CT, 40 patients hospitalized from January 2013 to June 2015). After debridement, patients in group NPWT were treated with continuous NPWT (negative pressure values from -15.96 to -13.30 kPa), while those in group CT were treated with PRP gel (blood platelet counts in PRP ranged from 1 450×10(9)/L to 1 800×10(9)/L, with 10-15 mL in each dosage) made on the surgery day to fill the sinus tract and wound, followed by NPWT. Negative pressure materials were changed every 5 days until 20 days after surgery in patients of both groups. PRP gel was replenished before changing of negative pressure materials in patients of group CT. The sinus tract sealing time, wound healing time, number of patients who had secondary repair surgery, number of patients who had recurrence of sinus tract within three months after wound healing, and length of hospital stay were recorded. Data were processed with t test, Fisher's exact test, and chi-square test. The sinus tract sealing time, wound healing time, and length of hospital stay in patients of group CT were (16±8), (27±13), and (43±13) d respectively, which were all significantly shorter than those in group NPWT [(29±14), (41±17), and (60±20) d, with t values from 3.88 to 4.67, P values below 0.01]. The number of patients who had secondary repair surgery in group CT was less than that in group NPWT (P<0.01). There was no statistically significant difference in the number of patients who had recurrence of sinus tract between two groups (P>0.05). Compared with NPWT only, PRP combined with NPWT has great curative effects on patients with sternal osteomyelitis and sinus tract after thoracotomy, for it shortens sinus tract sealing time, wound healing time, and length of hospital stay, and avoids the secondary repair surgery. This method is simple and safe with little injury.

[The frequency of burnout syndrome in physicians in Mostar University Hospital].

PubMed

Vukojević, Mladenka; Brzica, Jerko; Petrov, Bozo

2014-01-01

To determine the prevalence of burnout syndrome in clinical physicians in Mostar University Hospital. The study included 94 subjects who were familiar with the purpose of research and were classified into three specialty groups. The first consisted of doctors in the Department of Internal Medicine and Department of Pediatrics, the second group of doctors in the Department of Surgery and Department of Gynecology and Obstetrics, while the third group (CL-specialization) were doctors of the Clinic of Dermatology and Venereal Diseases, Department of Otorhinolaryngology and Department of Ophthalmology. All subjects were handed anonymous questionnaire to assess burnout. The questionnaire consisted of 18 statements with numbers from 1 to 3, 1 meaning rarely, 2 often and 3 always The task was to circle an appropriate number depending on how the statement described them. Along with these statements the questionnaire contained information on the place of employment, years of work experience and gender. In the studied sample of respondents most (n = 81, 86.2%) didn't have symptoms of burnout syndrome. As for the people who had these symptoms, they all belonged to the moderate intensity (chi2 test = 49.19, df = 1, P < 0.001), while none had severe symptoms of this syndrome. The intensity of the symptoms in the subjects was not significantly different between males and females (chi2 test = 0.85, df = 1, P = 0.355). Also, the intensity of symptoms in the subjects did not differ significantly depending on the number of working years (exact test, P = 0.888). After the formation of three groups from seven departments involved in the research of so far perceived intensity of stress, no significant differences in the intensity of the symptoms of burnout were found between them (exact test, P = 0.536). Regarding the individual items in the overall survey sample, in five items high intensity symptoms of burnout were most often circled. The most frequently reported high intensity of the symptoms was the sense of inability to change something at work (chi2 test = 78.04, df = 14, P < 0.001) CONCLUSION: The majority of respondents did not have symptoms of burnout syndrome, and those who had them were in the moderate stage of burnout. No statistically significant differences in the incidence of burnout syndrome between the groups of specialties were found.

Comparison of pH and refractometry index with calcium concentrations in preparturient mammary gland secretions of mares.

PubMed

Korosue, Kenji; Murase, Harutaka; Sato, Fumio; Ishimaru, Mutsuki; Kotoyori, Yasumitsu; Tsujimura, Koji; Nambo, Yasuo

2013-01-15

To test the usefulness of measuring pH and refractometry index, compared with measuring calcium carbonate concentration, of preparturient mammary gland secretions for predicting parturition in mares. Evaluation study. 27 pregnant Thoroughbred mares. Preparturient mammary gland secretion samples were obtained once or twice daily 10 days prior to foaling until parturition. The samples were analyzed for calcium carbonate concentration with a water hardness kit (151 samples), pH with pH test paper (222 samples), and refractometry index with a Brix refractometer (214 samples). The sensitivity, specificity, and positive and negative predictive values for each test were calculated for evaluation of predicting parturition. The PPV within 72 hours and the NPV within 24 hours for calcium carbonate concentration determination (standard value set to 400 μg/g) were 93.8% and 98.3%, respectively. The PPV within 72 hours and the NPV within 24 hours for the pH test (standard value set at 6.4) were 97.9% and 99.4%, respectively. The PPV within 72 hours and the NPV within 24 hours for the Brix test (standard value set to 20%) were 73.2% and 96.5%, respectively. Results suggested that the pH test with the standard value set at a pH of 6.4 would be useful in the management of preparturient mares by predicting when mares are not ready to foal. This was accomplished with equal effectiveness of measuring calcium carbonate concentration with a water hardness kit.

Quantitative repeated open application testing with a rinse-off product in methyldibromo glutaronitrile-sensitive patients: results of the IVDK.

PubMed

Heratizadeh, Annice; Killig, Claudia; Worm, Margitta; Soost, Stephanie; Simon, Dagmar; Bauer, Andrea; Mahler, Vera; Schuster, Christian; Szliska, Christiane; Frambach, Yvonne; Eben, Ricarda; Werfel, Thomas; Uter, Wolfgang; Schnuch, Axel

2010-06-01

While the use of methyldibromo glutaronitrile (MDBGN) in leave-on products is clearly associated with high sensitization or elicitation risk, such a clear-cut relation could be questioned with regard to rinse-off products. The objective of this study was to find a maximum non-eliciting concentration for rinse-off products in MDBGN patch test-positive patients. We performed a use-related test [repeated open application test (ROAT)] in patients sensitized to MDBGN with a liquid soap containing three concentrations of MDBGN (50, 200, and 400 p.p.m. MDBGN, respectively). The soap at 50 p.p.m. was used twice daily for 4 weeks. If no reaction of the skin was observed, the product with the next higher concentration was used for another 4 weeks, etc. In total, 32/37 evaluated cases [86.5%; lower exact one-sided 95% confidence limit (CL): 73.7%] did not react to any of the preparations. The remaining reacted as follows: 1/37 reacted to 50 p.p.m., 3/37 to 200 p.p.m., and 1/37 to 400 p.p.m. The cumulative non-response to 50 p.p.m. was 97.3% (lower CL: 87.8%). The majority of subjects sensitized to MDBGN-tolerated rinse-off products containing a maximum concentration of 400 p.p.m. A concentration in rinse-off products in the range of 50 p.p.m. could be regarded as safe for most individuals already sensitized. These concentrations will presumably prevent induction (sensitization) also.

Backtest and novelty behavior of female and castrated male piglets, with diverging social breeding values for growth.

PubMed

Reimert, I; Rodenburg, T B; Ursinus, W W; Duijvesteijn, N; Camerlink, I; Kemp, B; Bolhuis, J E

2013-10-01

Pigs housed together in a group influence each other's growth. Part of this effect is genetic and can be represented in a social breeding value. It is unknown, however, which traits are associated with social breeding values. The aim of this study was, therefore, to investigate whether personality and response to novelty could be associated with social breeding values for growth in piglets. Female and castrated male piglets from 80 litters, with either an estimated relative positive or negative social breeding value (+SBV or -SBV) for growth, were individually tested in a backtest and novel environment test, and group-wise in a novel object (i.e., a feeder with feed) test and human approach test. All tests were performed during the suckling period. No differences between +SBV and -SBV piglets were found for the frequency and latency of struggling and vocalizing in the backtest (at least, P > 0.30). In the novel object test, piglets with a +SBV for growth touched the feeder faster than piglets with -SBV for growth (P = 0.01) and were more frequently present near the person in the human approach test (P < 0.01). No behavioral differences between +SBV and -SBV piglets were found in the novel environment test (at least, P > 0.40), but piglets that struggled more in the backtest walked more in this test (P = 0.02). Behavior was affected by gender in each test. Female piglets were faster than castrated male piglets to start struggling in the backtest (P = 0.047). In the novel object test, females were faster than males to touch the feeder and sample the feed. In the human approach test, they were also faster than male piglets to touch a person (all, P < 0.001). Females were also more frequently present near the feeder (P < 0.001) and person (P = 0.03). In the novel environment test, female piglets explored the floor more (P = 0.046), produced less low- (P = 0.04) and high-pitched vocalizations (P = 0.02), and defecated (P = 0.08) and urinated less than male piglets (P < 0.01). It was concluded that +SBV and -SBV piglets do not differ in their response to the backtest, and only subtle differences were found in their response to novelty. More research is warranted to identify the traits underlying SBV for growth in pigs. Moreover, castrated male piglets seemed to react more fearfully to each test than female piglets.

Examining the differences in format and characteristics of zoonotic virus surveillance data on state agency websites.

PubMed

Scotch, Matthew; Baarson, Brittany; Beard, Rachel; Lauder, Robert; Varman, Aarthi; Halden, Rolf U

2013-04-26

Zoonotic viruses are infectious organisms transmittable between animals and humans. Agencies of public health, agriculture, and wildlife conduct surveillance of zoonotic viruses and often report data on their websites. However, the format and characteristics of these data are not known. To describe and compare the format and characteristics of statistics of zoonotic viruses on state public health, agriculture, and wildlife agency websites. For each state, we considered the websites of that state's public health, agriculture, and wildlife agency. For each website, we noted the presence of any statistics for zoonotic viruses from 2000-2012. We analyzed the data using numerous categories including type of statistic, temporal and geographic level of detail, and format. We prioritized our analysis within each category based on assumptions of individuals' preferences for extracting and analyzing data from websites. Thus, if two types of data (such as city and state-level) were present for a given virus in a given year, we counted the one with higher priority (city). External links from agency sites to other websites were not considered. From 2000-2012, state health departments had the most extensive virus data, followed by agriculture, and then wildlife. We focused on the seven viruses that were common across the three agencies. These included rabies, West Nile virus, eastern equine encephalitis, St. Louis encephalitis, western equine encephalitis, influenza, and dengue fever. Simple numerical totals were most often used to report the data (89% for public health, 81% for agriculture, and 82% for wildlife), and proportions were not different (chi-square P=.15). Public health data were most often presented yearly (66%), while agriculture and wildlife agencies often described cases as they occurred (Fisher's Exact test P<.001). Regarding format, public health agencies had more downloadable PDF files (68%), while agriculture (61%) and wildlife agencies (46%) presented data directly in the text of the HTML webpage (Fisher's Exact test P<.001). Demographics and other information including age, gender, and host were limited. Finally, a Fisher's Exact test showed no association between geography data and agency type (P=.08). However, it was noted that agriculture department data was often at the county level (63%), while public health was mixed between county (38%) and state (35%). This study focused on the format and characteristics of statistics of zoonotic viruses on websites of state public health, wildlife, and agriculture agencies in the context of population health surveillance. Data on zoonotic viruses varied across agencies presenting challenges for researchers needing to integrate animal and human data from different websites.

The Immunohistochemical Analysis of SOCS3 Protein Identifies a Subgroup of Prostatic Cancer Biopsies With Aggressive Behavior.

PubMed

Pierconti, Francesco; Martini, Maurizio; Cenci, Tonia; Larocca, Luigi M

Recently, we demonstrated that hypermethylation of SOCS3 determines a significant reduction of its mRNA and protein expression and identifies a subgroup of prostate cancer with aggressive behavior. In this paper, our objective was to investigate whether the immunohistochemical expression of the SOCS3 protein could represent an alternative method to molecular analysis for the individualization of aggressive prostate carcinoma. We analyzed the SOCS3 immunohistochemical expression in 65 patients undergoing biopsies at the Institute of Urology of our hospital between September 2011 and October 2011 (median age, 66.4 y; range, 50 to 73 y), and in 35 cases, a subset of 65 cases originally used for the immunohistochemical study, we studied the methylation status of the SOCS3 promoter. We found that the percentage of cases with SOCS3 negativity (-) or with SOCS3 weak staining in <50% of the neoplastic glands (+/-) correlated to the worst prognosis in terms of the Gleason score (P=0.0001; Fisher's exact test), the pT stage (P=0.012; Fisher's exact test), and progression-free survival (P=0.0334; hazard ratio, 0.34; and 95% confidence interval, from 0.1261 to 0.9188). Moreover, some cases with an SOCS3 unmethylated pattern showed SOCS3-negative immunostaining (-) or SOCS3-negative glands with weak cytoplasmatic staining in <50% of the neoplastic glands (+/-). Our data suggest that in prostatic cancer biopsies, the immunohistochemical analysis of SOCS3 protein expression may provide a method that is less expensive and easier to apply than SOCS3 methylation analysis for the distinction of a subgroup of prostate cancer with a more aggressive behavior.

Changing epidemiology of Pneumocystis pneumonia, Northern Ireland, UK and implications for prevention, 1 July 2011-31 July 2012.

PubMed

Patterson, Lynsey; Coyle, Peter; Curran, Tanya; Verlander, Neville Q; Johnston, Jillian

2017-11-01

There is a lack of consensus about which non-human immunodeficiency virus (HIV) patient groups would benefit from prophylaxis. Here, we analysed an enhanced Pneumocystis jirovecii database to describe the epidemiology of Pneumocystis pneumonia (PCP) and P. jirovecii colonizations in Northern Ireland (NI) with a view to identifying risk groups who may benefit from prophylaxis. We prospectively collected information on demographics, clinical severity and clinical features for all hospital inpatients in NI aged ≥18 years with P. jirovecii confirmed in any respiratory tract sample. We defined P. jirovecii colonization or PCP according to clinical symptoms and radiological findings. We compared P. jirovecii colonization to PCP using exact logistic regression and presented the odds ratios (OR), 95 % confidence intervals (CI) and likelihood ratio test P-values.Results/Key findings. Overall, 36/49 (73 %) of P. jirovecii detections were categorized as PCP. A total of 28/36 (78 %) were in non-HIV patients, of which 18 (64 %) had cancer. The odds of PCP compared to P. jirovecii colonization were eight times higher in those with current exposure to chemotherapy (OR 8.73; 95 % CI 0.84, ∞), 16 times higher for those diagnosed with HIV (OR 16.2; 95 % CI 1.71, ∞) and 12 times higher for those ever exposed to another immunosuppressive drug (OR 12.1; 95 % CI 1.94, ∞). The greatest burden of PCP is now in the non-HIV group, particularly cancer patients. We recommend increasing clinician awareness of PCP risk and strengthening prevention guidelines in non-HIV patients, and promoting the consideration of prophylaxis on a case-by-case basis.

Explorations in Statistics: Hypothesis Tests and P Values

ERIC Educational Resources Information Center

Curran-Everett, Douglas

2009-01-01

Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This second installment of "Explorations in Statistics" delves into test statistics and P values, two concepts fundamental to the test of a scientific null hypothesis. The essence of a test statistic is that it compares what…

Educational Value of Digital Whole Slides Accompanying Published Online Pathology Journal Articles: A Multi-Institutional Study.

PubMed

Yin, Feng; Han, Gang; Bui, Marilyn M; Gibbs, Julie; Martin, Ian; Sundharkrishnan, Lohini; King, Lauren; Jabcuga, Christine; Stuart, Lauren N; Hassell, Lewis A

2016-07-01

-Despite great interest in using whole slide imaging (WSI) in pathology practice and education, few pathology journals have published WSI pertinent to articles within their pages or as supplemental materials. -To evaluate whether there is measurable added educational value of including WSI in publications. -Thirty-seven participants, 16 (43.3%), 15 (40.5%), and 6 (16.2%) junior pathology residents (postgraduate year 1-2), senior pathology residents (postgraduate year 3-4), and board-certified pathologists, respectively, read a sequence of 10 journal articles on a wide range of pathology topics. A randomized subgroup also reviewed the WSI published with the articles. Both groups completed a survey tool assessing recall of text-based content and of image-based material pertinent to the diseases but not present in the fixed published images. -The group examining WSI had higher performance scores in 72% of image-based questions (36 of 50 questions) as compared with the non-WSI group. As an internal study control, the WSI group had higher performance scores in only 40% of text-based questions (6 of 15 questions). The WSI group had significantly better performance than the non-WSI group for image-based questions compared with text-based questions (P < .05, Fisher exact test). -Our study provides supporting evidence that WSI offers enhanced value to the learner beyond the text and fixed images selected by the author. We strongly encourage more journals to incorporate WSI into their publications.

Outcomes following operative vs. non-operative management of blunt traumatic pancreatic injuries: a retrospective multi-institutional study.

PubMed

Addison, Poppy; Iurcotta, Toni; Amodu, Leo I; Crandall, Geoffrey; Akerman, Meredith; Galvin, Daniel; Glazer, Annemarie; Christopherson, Nathan; Prince, Jose; Bank, Matthew; Sorrentino, Christopher; Cagliani, Joaquin; Nicastro, Jeffrey; Coppa, Gene; Molmenti, Ernesto P; Rilo, Horacio L Rodriguez

2016-01-01

Traumatic pancreatic injuries are rare, and guidelines specifying management are controversial and difficult to apply in the acute clinical setting. Due to sparse data on these injuries, we carried out a retrospective review to determine outcomes following surgical or non-surgical management of traumatic pancreatic injuries. We hypothesize a higher morbidity and mortality rate in patients treated surgically when compared to patients treated non-surgically. We performed a retrospective review of data from four trauma centers in New York from 1990-2014, comparing patients who had blunt traumatic pancreatic injuries who were managed operatively to those managed non-operatively. We compared continuous variables using the Mann-Whitney U test and categorical variables using the chi-square and Fisher's exact tests. Univariate analysis was performed to determine the possible confounding factors associated with mortality in both treatment groups. Twenty nine patients were managed operatively and 32 non-operatively. There was a significant difference between the operative and non-operative groups in median age (37.0 vs. 16.2 years, P  = 0.016), grade of pancreatic injury (grade I; 30.8 vs. 85.2%, P value for all comparisons <0.0001), median injury severity score (ISS) (16.0 vs. 4.0, P  = 0.002), blood transfusion (55.2 vs. 15.6%, P  = 0.0012), other abdominal injuries (79.3 vs. 38.7%, P  = 0.0014), pelvic fractures (17.2 vs. 0.00%, P  = 0.020), intensive care unit (ICU) admission (86.2 vs. 50.0%, P  = 0.003), median length of stay (LOS) (16.0 vs. 4.0 days, P <0.0001), and mortality (27.6 vs. 3.1%, P  = 0.010). Patients with traumatic pancreatic injuries treated operatively were more severely injured and suffered greater complications than those treated non-operatively. The greater morbidity and mortality associated with these patients warrants further study to determine optimal triage strategies and which subset of patients is likely to benefit from surgery.

Comparison of Results of Measurement of Dimensions of the Placed Dental Implants on Cone Beam Computed Tomography with Dimensions of the Producers of the Implants.

PubMed

Repesa, Merisa; Sofic, Amela; Jakupovic, Selma; Tosum, Selma; Kazazic, Lejla; Dervisevic, Almir

2017-06-01

One of the most frequently used method for scanning patients with indication for dental implantation in dentistry is cone beam computed tomography. Implantation, CBCT imaging and implant programme are inevitable when planning a successful replacement of lost teeth. CBCT offers exact information about available bone and its density, adjacent tooth roots, the place of mandibular canal and maxillary sinus and adjacent anatomical structure. The goal of this study is to estimate accuracy of measurements on CBCT images ofpatients who have implants of different producers and determine if there is any statistically significant correlation between four test groups regardless of the alloy of which implants are made. The study was a prospective-comparative, and included fifteen patients with hundred dental implants divided in four groups depending on the producer. Over dimensioning in the gained measurements of the whole sample on CBCT images in relation to dimensions of producers is between 0.1006mm and 0.368mm. Even though over dimensioning is measured in millimetres, it has to be taken into consideration in clinical practice when planning an implant placement, and we can recommend safety zone of 0.5mm. There have been no statistically significant differences in the gained results in over dimensioning of implants of different alloys for horizontal and vertical measurements on CBCT images of Astra Tech, Brendet titanium implants and Straumann titanium-zirconium implants. Based on the goals of the study there have been confirmed statistically significant correlations of great value (from 0.841 to 0.936) of high level of importance between manufactured value of dimensions and average dimensions values gained through CBCT imaging in four types of implants (four test groups). The total exactness of measurements on CBCT scan in this research is 96.66% for horizontal measuring and 96.92% for vertical measuring. Therefore, we can conclude that CBCT as radiological method has an unavoidable importance in planning and successful realisation of dental implant procedure. Cone Beam Computed Tomography provides exact measurements of dimensions of placed dental implant in relation to dimensions of the producers of the implant because the material from which dental implants have been made does not significantly affect the precision of the measurement.

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

Keller, J; Hardin, M; Giaddui, T

Purpose: To test whether unified vendor specified beam conformance for matched machines implies volumetric modulated arc radiotherapy(VMAT) delivery consistency. Methods: Twenty-two identical patient QA plans, eleven 6MV and eleven 15MV, were delivered to the Delta{sup 4}(Scandidos, Uppsala, Sweden) on two Varian TrueBEAM matched machines. Sixteen patient QA plans, nine 6 MV and seven 10 MV, were delivered to Delta{sup 4} on two Elekta Agility matched machines. The percent dose deviation(%DDev), distance-to-agreement(DTA), and the gamma analysis(γ) were collected for all plans and the differences in measurements were tabulated between matched machines. A paired t-test analysis of the data with an alphamore » of 0.05 determines statistical significance. Power(P) was calculated to detect a difference of 5%; all data except Elekta %DDev sets were strong with above a 0.85 power. Results: The average differences for Varian machines (%DDev, DTA, and γ) are 6.4%, 1.6% and 2.7% for 6MV, respectively, and 8.0%, 0.6%, and 2.5% for 15MV. The average differences for matched Elekta machines (%DDev, DTA, and γ) are 10.2%, 0.6% and 0.9% for 6 MV, respectively, and 7.0%, 1.9%, and 2.8% for 10MV.A paired t-test shows for Varian the %DDev difference is significant for 6MV and 15MV(p-value6MV=0.019, P6MV=0.96; p-value15MV=0.0003, P15MV=0.86). Differences in DTA are insignificant for both 6MV and 15MV(p-value6MV=0.063, P6MV=1; p-value15MV=0.907, P15MV=1). Varian differences in gamma are significant for both energies(p-value6MV=0.025, P6MV=0.99; p-value15MV=0.013, P15MV=1). A paired t-test shows for Elekta the difference in %DDev is significant for 6MV but not 10MV(p-value6MV=0.00065, P6MV=0.68; p-value10MV=0.262, P10MV=0.39). Differences in DTA are statistically insignificant(p-value6MV=0.803, P6MV = 1; p-value10MV=0.269, P10MV=1). Elekta differences in gamma are significant for 10MV only(p-value6MV=0.094, P6MV=1; p-value10MV=0.011, P10MV=1). Conclusion: These results show vendor specified beam conformance across machines does not ensure equivalent patient specific QA pass rates. Gamma differences are statistically significant in three of the four comparisons for two pairs of vendor matched machines.« less

Endoscopic resection of upper neck masses via retroauricular approach is feasible with excellent cosmetic outcomes.

PubMed

Lee, Hyoung Shin; Lee, Dongwon; Koo, Yong Cheol; Shin, Hyang Ae; Koh, Yoon Woo; Choi, Eun Chang

2013-03-01

In this study, the authors introduce and evaluate the feasibility of endoscopic resection using the retroauricular approach for various benign lesions of the upper neck. A retrospective comparative analysis was performed on the clinical outcomes of patients who underwent surgery for upper neck masses as endoscopic resection using the retroauricular approach or conventional transcervical resection at the authors' center from January 2010 through August 2011. The primary outcome was the cosmetic satisfaction of the patients in each group. In addition, the feasibility of the procedure was evaluated by comparing the operation time; hospital stay; amount and duration of drainage; complications such as marginal mandibular nerve, lingual, or hypoglossal nerve palsy; paresthesia of the ear lobe; and wound problems such as hematoma and skin necrosis. Statistical analysis was performed by independent-samples t test and the Fisher exact test, and a P value less than .05 was considered statistically significant. Thirty-six patients underwent endoscopic resection (endo group; 15 men, 21 women; mean age, 38.8 ± 15.0 years) and 40 patients underwent conventional transcervical resection (conventional group; 18 men, 22 women; mean age, 45.1 ± 14.1 years). The operating time in the endo group was longer than in the conventional group (P = .003). No significant difference was observed in the overall perioperative complications between the 2 groups. Cosmetic satisfaction evaluated with a graded scale showed much better results in the endo group (P < .001). Endoscopic resection using the retroauricular approach is feasible for various benign upper neck masses when conducted by an experienced endoscopic surgeon, with excellent cosmetic results. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The Efficacy of Crocin of Saffron (Crocus sativus L.) on the Components of Metabolic Syndrome: A Randomized Controlled Clinical Trial

PubMed Central

Kermani, Tayyebe; Kazemi, Toba; Molki, Somayye; Ilkhani, Khadije; Sharifzadeh, Gholamreza; Rajabi, Omid

2017-01-01

Objective: Metabolic syndrome is a set of cardiac risk factors with increased risk of chronic diseases. The aim of this study is to evaluate the efficacy of crocin of saffron on metabolic syndrome. Methods: This double-blind, randomized clinical trial was conducted on metabolic syndrome patients who were randomly assigned to crocin of saffron or control (placebo) groups. The intervention group received 100 mg/day crocin tablets (a constituent of saffron) for 6 weeks. Then, the changes in metabolic syndrome component were compared between two groups. The trial was registered in the Iranian Registry of Clinical Trials. Data were entered to SPSS 15. Chi-square, Fisher's exact, paired t-test, and independent t-test were used to analyze data. P < 0.05 was defined as statistical significant level. Findings: Totally, 48 patients included in the trial (24 intervention and 24 placebo participants). There were significant reductions from baseline measurements in the levels of total cholesterol (P < 0.001) and triglyceride (P = 0.003) after the 6-week crocin administration. However, this decrease in lipid profile was not significant when compared with placebo group. There was no significant change in other laboratory values, blood pressure, and anthropometric measures. Conclusion: The present study indicated that the dose of about 100 mg crocin of saffron was well tolerated and has no complication for 6 weeks of oral administration. However, the dosage used in our study had no effect on metabolic syndrome. Further studies are required to assess this effect with the higher dosages of crocin as well as long time effects of its administration on metabolic syndrome patients. PMID:29417083

A Mathematical Motivation for Complex-Valued Convolutional Networks.

PubMed

Tygert, Mark; Bruna, Joan; Chintala, Soumith; LeCun, Yann; Piantino, Serkan; Szlam, Arthur

2016-05-01

A complex-valued convolutional network (convnet) implements the repeated application of the following composition of three operations, recursively applying the composition to an input vector of nonnegative real numbers: (1) convolution with complex-valued vectors, followed by (2) taking the absolute value of every entry of the resulting vectors, followed by (3) local averaging. For processing real-valued random vectors, complex-valued convnets can be viewed as data-driven multiscale windowed power spectra, data-driven multiscale windowed absolute spectra, data-driven multiwavelet absolute values, or (in their most general configuration) data-driven nonlinear multiwavelet packets. Indeed, complex-valued convnets can calculate multiscale windowed spectra when the convnet filters are windowed complex-valued exponentials. Standard real-valued convnets, using rectified linear units (ReLUs), sigmoidal (e.g., logistic or tanh) nonlinearities, or max pooling, for example, do not obviously exhibit the same exact correspondence with data-driven wavelets (whereas for complex-valued convnets, the correspondence is much more than just a vague analogy). Courtesy of the exact correspondence, the remarkably rich and rigorous body of mathematical analysis for wavelets applies directly to (complex-valued) convnets.

The enduring value of Gánti's chemoton model and life criteria: Heuristic pursuit of exact theoretical biology.

PubMed

Griesemer, James

2015-09-21

Gánti's chemoton model of the minimal chemical organization of living systems and life criteria for the living state and a living world are characterized. It is argued that these are better interpreted as part of a heuristic pursuit of an exact theoretical biology than as a "definition of life." Several problems with efforts to define life are discussed. Clarifying the proper use of Gánti's ideas to serve constructive engineering idealizations helps to show their enduring value. Copyright © 2015 Elsevier Ltd. All rights reserved.

Interior radiances in optically deep absorbing media. I - Exact solutions for one-dimensional model.

NASA Technical Reports Server (NTRS)

Kattawar, G. W.; Plass, G. N.

1973-01-01

An exact analytic solution to the one-dimensional scattering problem with arbitrary single scattering albedo and arbitrary surface albedo is presented. Expressions are given for the emergent flux from a homogeneous layer, the internal flux within the layer, and the radiative heating. A comparison of these results with the values calculated from the matrix operator theory indicates an exceedingly high accuracy. A detailed study is made of the error in the matrix operator results and its dependence on the accuracy of the starting value.

[Permanence of the piamontese culture on food practices in third generation descendants in Piamonte (Province of Santa Fe, Argentina)].

PubMed

Andreatta, María M; Muñoz, Sonia E; Navarro, Alicia

2004-01-01

This paper describes the influence of the piemontese culture on food practices of students living in Piamonte, Santa Fe, Argentina. Food practices of 96 students with Piamontese ancestry (PA) (n = 57) and without Piamontese ancestry (No-PA) (n = 39) were studied along 2002 using a self-administered questionnare. Data were analysed by Chi square test, Fisher's exact test, multiple correspondance analysis and logistic regression. Consumption of bagna cauda (p < 0.05) and polenta (p < 0.1) were higher among PA. Differences on the elaboration of polenta and pasta were found: PA add them cheese (p < 0.05) and cream (p < 0.05) whereas no-PA make use of meat (p < 0.05) and tomato sauce (p < 0.05), respectively. The frequency of consumption of traditional Piamontese meals and the role of the mother in the purchase, the elaboration and the serving of the food were similar on both groups. In conclusion, food practices of Piamontese's descendants recall the food culture of their ancestry with some reasonable adaptations to the local context.

Using economic evaluations to make formulary coverage decisions. So much for guidelines.

PubMed

Anis, A H; Gagnon, Y

2000-07-01

It is mandatory for drug manufacturers requesting formulary inclusion under the British Columbia (BC) provincial drug plan to submit a pharmacoeconomic analysis according to published guidelines. These submissions are reviewed by the Pharmacoeconomic Initiative (PI) of BC. To assess the compliance of submitted studies with specific criteria outlined in the guidelines, to assess the methodological quality of individual submissions, and to demonstrate the importance of submitting guidelines-compliant pharmacoeconomic analyses. All submissions between January 1996 and April 1999 assessed by the PI of BC were included. Submissions were reviewed according to a checklist to establish compliance with respect to choice of comparator drug, study perspective, sensitivity analysis, analytical horizon and discounting. Submissions were examined for association between analytical technique and author, and between source of submission and compliance. Association between compliance and recommendation for approval was also examined. 95 applications were reviewed. Seven submitted no analyses. There were 25 cost-comparison/consequence, 14 cost-effectiveness, 11 cost-minimisation, 9 cost-utility/benefit and 29 budget-impact analyses. 65 of these 88 submissions failed to comply with guidelines. Of these, 45% used an inappropriate comparator drug, 61% lacked a sensitivity analysis, 73% used a third-party payer and excluded a societal perspective, 66% did not provide a long term evaluation and 25% did not specify any time horizon. 80% of noncompliant studies were cost-comparison/consequence or budget-impact analyses (p < 0.001, Fisher's Exact). Of 25 cost-comparison/consequence and 29 budget-impact analyses, 19 (76%) and 24 (83%), respectively, were industry-conducted, whereas cost-effectiveness (11 of 14) and cost-utility/benefit (6 of 9) analyses were mostly subcontracted to private consultants or academics (p < 0.001, Fisher's Exact). 74% of all submissions (compliant and noncompliant) were not recommended by the PI for listing as a provincial drug plan benefit, 16% received approval for restricted benefit and 9% were recommended as full benefit. 80% of the noncompliant submissions were not recommended (p = 0.06, Fisher's Exact test). Moreover, a strong association between type of analysis and type of recommendation was found (p = 0.03, Fisher's Exact test). Cost-comparison/consequence and budget-impact analyses were less likely to be recommended. IMPLICATIONS OF FINDINGS: Our findings show poor compliance with guidelines, especially among industry-conducted studies. Possible explanations are lack of expertise in pharmacoeconomics and/or scepticism regarding the importance of guidelines and submission quality in decision making. As corroborated by the strong associations between type of recommendation and compliance, and between type of recommendation and type of analysis, these 2 characteristics have a significant impact on decision making.

Chronic vulvovaginitis in women older than 50 years: analysis of a prospective database.

PubMed

Nyirjesy, Paul; Leigh, Randi D; Mathew, Leny; Lev-Sagie, Ahinoam; Culhane, Jennifer F

2012-01-01

This study aimed to examine differences in symptoms and diagnoses between women 50 years and younger and women older than 50 years who have chronic vulvovaginal complaints. New patients of the Drexel University Vaginitis Center with chronic vulvovaginal complaints were eligible. Participants underwent a standardized medical evaluation and completed detailed questionnaires. Data were analyzed using the t test, χ test, and the Fisher exact test. Subjects were 469 women aged 18 to 79 years. Subjects 50 years and younger (group A) were more likely to complain of vaginal itching and were less likely to complain of burning, irritation, or soreness (p ≤ .05 for all). Subjects older than 50 years (group B) were more likely to be diagnosed with atrophic vaginitis (p = .000), desquamative inflammatory vaginitis (DIV; p = .001), lichen planus (LP; p = .000), and lichen sclerosus (p = .000). Diagnosis of LS, LP, or DIV was associated with increased likelihood of multiparity and decreased likelihood of a history of systemic estrogen use. Postmenopausal women are more likely than premenopausal women to be diagnosed with DIV, LP, or LS. Both childbirth and estrogen nonuse were associated with the occurrence of these latter 3 conditions.

Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

PubMed Central

Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

2016-01-01

Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil. PMID:26959332

Getting the first birth right: A retrospective study of outcomes for low-risk primiparous women receiving standard care versus midwifery model of care in the same tertiary hospital.

PubMed

Wong, Nola; Browne, Jenny; Ferguson, Sally; Taylor, Jan; Davis, Deborah

2015-12-01

There is national and international concern for increasing obstetric intervention in childbirth and rising caesarean section rates. Repeat caesarean section is a major contributing factor, making primiparous women an important target for strategies to reduce unnecessary intervention and surgeries in childbirth. The aim was to compare outcomes for a cohort of low risk primiparous women who accessed a midwifery continuity model of care with those who received standard public care in the same tertiary hospital. A retrospective comparative cohort study design was implemented drawing on data from two databases held by a tertiary hospital for the period 1 January 2010 to 31 December 2011. Categorical data were analysed using the chi-squared statistic and Fisher's exact test. Continuous data were analysed using Student's t-test. Comparisons are presented using unadjusted and adjusted odds ratios, with 95% confidence intervals (CIs) and p-values with significance set at 0.05. Data for 426 women experiencing continuity of midwifery care and 1220 experiencing standard public care were compared. The study found increased rates of normal vaginal birth (57.7% vs. 48.9% p=0.002) and spontaneous vaginal birth (38% vs. 22.4% p=<0.001) and decreased rates of instrumental birth (23.5% vs. 28.5% p=0.050) and caesarean sections (18.8% vs. 22.5% p=0.115) in the midwifery continuity cohort. There were also fewer interventions in this group. No differences were found in neonatal outcomes. Strategies for reducing caesarean section rates and interventions in childbirth should focus on primiparous women as a priority. This study demonstrates the effectiveness of continuity midwifery models, suggesting that this is an important strategy for improving outcomes in this population. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Discrete Radon transform has an exact, fast inverse and generalizes to operations other than sums along lines

PubMed Central

Press, William H.

2006-01-01

Götz, Druckmüller, and, independently, Brady have defined a discrete Radon transform (DRT) that sums an image's pixel values along a set of aptly chosen discrete lines, complete in slope and intercept. The transform is fast, O(N2log N) for an N × N image; it uses only addition, not multiplication or interpolation, and it admits a fast, exact algorithm for the adjoint operation, namely backprojection. This paper shows that the transform additionally has a fast, exact (although iterative) inverse. The inverse reproduces to machine accuracy the pixel-by-pixel values of the original image from its DRT, without artifacts or a finite point-spread function. Fourier or fast Fourier transform methods are not used. The inverse can also be calculated from sampled sinograms and is well conditioned in the presence of noise. Also introduced are generalizations of the DRT that combine pixel values along lines by operations other than addition. For example, there is a fast transform that calculates median values along all discrete lines and is able to detect linear features at low signal-to-noise ratios in the presence of pointlike clutter features of arbitrarily large amplitude. PMID:17159155

Discrete Radon transform has an exact, fast inverse and generalizes to operations other than sums along lines.

PubMed

Press, William H

2006-12-19

Götz, Druckmüller, and, independently, Brady have defined a discrete Radon transform (DRT) that sums an image's pixel values along a set of aptly chosen discrete lines, complete in slope and intercept. The transform is fast, O(N2log N) for an N x N image; it uses only addition, not multiplication or interpolation, and it admits a fast, exact algorithm for the adjoint operation, namely backprojection. This paper shows that the transform additionally has a fast, exact (although iterative) inverse. The inverse reproduces to machine accuracy the pixel-by-pixel values of the original image from its DRT, without artifacts or a finite point-spread function. Fourier or fast Fourier transform methods are not used. The inverse can also be calculated from sampled sinograms and is well conditioned in the presence of noise. Also introduced are generalizations of the DRT that combine pixel values along lines by operations other than addition. For example, there is a fast transform that calculates median values along all discrete lines and is able to detect linear features at low signal-to-noise ratios in the presence of pointlike clutter features of arbitrarily large amplitude.

Normal stress differences from Oldroyd 8-constant framework: Exact analytical solution for large-amplitude oscillatory shear flow

NASA Astrophysics Data System (ADS)

Saengow, C.; Giacomin, A. J.

2017-12-01

The Oldroyd 8-constant framework for continuum constitutive theory contains a rich diversity of popular special cases for polymeric liquids. In this paper, we use part of our exact solution for shear stress to arrive at unique exact analytical solutions for the normal stress difference responses to large-amplitude oscillatory shear (LAOS) flow. The nonlinearity of the polymeric liquids, triggered by LAOS, causes these responses at even multiples of the test frequency. We call responses at a frequency higher than twice the test frequency higher harmonics. We find the new exact analytical solutions to be compact and intrinsically beautiful. These solutions reduce to those of our previous work on the special case of the corotational Maxwell fluid. Our solutions also agree with our new truncated Goddard integral expansion for the special case of the corotational Jeffreys fluid. The limiting behaviors of these exact solutions also yield new explicit expressions. Finally, we use our exact solutions to see how η∞ affects the normal stress differences in LAOS.

Problem Internet Use and Internet Gaming Disorder: a survey of health literacy among psychiatrists from Australia and New Zealand.

PubMed

Dullur, Pravin; Hay, Phillipa

2017-04-01

Research is limited on psychiatrists' opinions on the concepts of Internet Gaming Disorder (IGD) and Problematic Internet Use (PIU). We aimed to assess health literacy among psychiatrists on IGD/PIU. A self-report survey was administered online to members of the Royal Australia and New Zealand College of Psychiatrists (RANZCP) ( n=289). The majority (93.7%) were familiar with the concepts of IGD/PIU. The majority (78.86%) thought it is possible to be 'addicted' to non-gaming internet content, and 76.12% thought non-gaming addictions could possibly be included in classificatory systems. Forty-eight (35.6%) felt that IGD maybe common in their practice. Only 22 (16.3%) felt they were confident in managing IGD. Child psychiatrists were more likely to screen routinely for IGD (11/45 vs. 7/95; Fishers Exact test χ 2 =7.95, df=1, p<0.01) and were more likely to elicit specific symptoms of addiction (16/45 vs. 9/95; Fishers Exact test χ 2 =14.16, df=1, p<0.001). We recommend adoption of terms alternate to PIU/IGD which are more in line with the content of material irrespective of medium of access. Screening instruments/ protocols are needed to assist in early diagnosis and service planning. Barriers to screening would need to be addressed both in research and service settings.

Determination of the exact range of the value of the parameter corresponding to chaos based on the Silnikov criterion

NASA Astrophysics Data System (ADS)

Li, Wei-Yi; Zhang, Qi-Chang; Wang, Wei

2010-06-01

Based on the Silnikov criterion, this paper studies a chaotic system of cubic polynomial ordinary differential equations in three dimensions. Using the Cardano formula, it obtains the exact range of the value of the parameter corresponding to chaos by means of the centre manifold theory and the method of multiple scales combined with Floque theory. By calculating the manifold near the equilibrium point, the series expression of the homoclinic orbit is also obtained. The space trajectory and Lyapunov exponent are investigated via numerical simulation, which shows that there is a route to chaos through period-doubling bifurcation and that chaotic attractors exist in the system. The results obtained here mean that chaos occurred in the exact range given in this paper. Numerical simulations also verify the analytical results.

Green turtles (Chelonia mydas) foraging at Arvoredo Island in Southern Brazil: Genetic characterization and mixed stock analysis through mtDNA control region haplotypes

PubMed Central

2009-01-01

We analyzed mtDNA control region sequences of green turtles (Chelonia mydas) from Arvoredo Island, a foraging ground in southern Brazil, and identified eight haplotypes. Of these, CM-A8 (64%) and CM-A5 (22%) were dominant, the remainder presenting low frequencies (< 5%). Haplotype (h) and nucleotide (π) diversities were 0.5570 ± 0.0697 and 0.0021 ± 0.0016, respectively. Exact tests of differentiation and AMOVA ΦST pairwise values between the study area and eight other Atlantic foraging grounds revealed significant differences in most areas, except Ubatuba and Rocas/Noronha, in Brazil (p > 0.05). Mixed Stock Analysis, incorporating eleven Atlantic and one Mediterranean rookery as possible sources of individuals, indicated Ascension and Aves islands as the main contributing stocks to the Arvoredo aggregation (68.01% and 22.96%, respectively). These results demonstrate the extensive relationships between Arvoredo Island and other Atlantic foraging and breeding areas. Such an understanding provides a framework for establishing adequate management and conservation strategies for this endangered species. PMID:21637527

Outcomes of synchronous pulmonary nodules detected on computed tomography in head and neck cancer patients: 12-year retrospective review of a consecutive cohort.

PubMed

Zammit-Maempel, I; Kurien, R; Paleri, V

2016-06-01

To investigate the long-term outcomes of pulmonary nodules detected on chest computed tomography in a consecutive cohort of patients with newly diagnosed or recurrent head and neck squamous cell cancer staged between 2001 and 2003. The study included 222 patients, 148 patients with newly diagnosed head and neck cancer (group 1) and 74 patients with recurrent cancer (group 2). Abnormalities were identified in 101 patients (45.4 per cent); these were predominantly benign in group 1 (61.7 per cent) as compared to predominantly malignant in group 2 (64.3 per cent) (Fisher's exact test; p = 0.0009). Only four patients (7.4 per cent) with an initially benign-looking pulmonary nodule went on to develop malignancy over time, conferring a negative predictive value of 93 per cent for the whole cohort. Chest computed tomography abnormalities in patients with recurrent head and neck cancer are statistically more likely to be malignant. Very few patients with an initially benign-appearing nodule develop chest malignancy over time.

Correcting for bias in the selection and validation of informative diagnostic tests.

PubMed

Robertson, David S; Prevost, A Toby; Bowden, Jack

2015-04-15

When developing a new diagnostic test for a disease, there are often multiple candidate classifiers to choose from, and it is unclear if any will offer an improvement in performance compared with current technology. A two-stage design can be used to select a promising classifier (if one exists) in stage one for definitive validation in stage two. However, estimating the true properties of the chosen classifier is complicated by the first stage selection rules. In particular, the usual maximum likelihood estimator (MLE) that combines data from both stages will be biased high. Consequently, confidence intervals and p-values flowing from the MLE will also be incorrect. Building on the results of Pepe et al. (SIM 28:762-779), we derive the most efficient conditionally unbiased estimator and exact confidence intervals for a classifier's sensitivity in a two-stage design with arbitrary selection rules; the condition being that the trial proceeds to the validation stage. We apply our estimation strategy to data from a recent family history screening tool validation study by Walter et al. (BJGP 63:393-400) and are able to identify and successfully adjust for bias in the tool's estimated sensitivity to detect those at higher risk of breast cancer. © 2015 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

Comparison of Two Base Materials Regarding Their Effect on Root Canal Treatment Success in Primary Molars with Furcation Lesions

PubMed Central

Sonmez, Hayriye; Sari, Saziye

2016-01-01

Introduction. The aim of this study was to compare MTA with another base material, IRM, which is generally used on pulpal floor after root canal treatment, regarding their effect on the success of root canal treatment of primary teeth with furcation lesions. Materials and Methods. Fifty primary teeth with furcation lesions were divided into 2 groups. Following root canal treatment, the pulpal floor was coated with MTA in the experimental group and with IRM in the control group. Teeth were followed up considering clinical (pain, pathological mobility, tenderness to percussion and palpation, and any soft tissue pathology and sinus tract) and radiographical (pathological root resorption, reduced size or healing of existing lesion, and absence of new lesions at the interradicular or periapical area) criteria for 18 months. For the statistical analysis, Fisher's exact test and Pearson's chi-square tests were used and a p value of <0.05 was considered to be statistically significant. Results. Although there were no statistically significant differences between two groups in terms of treatment success, lesions healed significantly faster in the MTA group. Conclusion. In primary teeth with furcation lesions, usage of MTA on the pulpal floor following root canal treatment can be a better alternative since it induced faster healing. PMID:27957486

Comparison of Two Base Materials Regarding Their Effect on Root Canal Treatment Success in Primary Molars with Furcation Lesions.

PubMed

Arikan, Volkan; Sonmez, Hayriye; Sari, Saziye

2016-01-01

Introduction. The aim of this study was to compare MTA with another base material, IRM, which is generally used on pulpal floor after root canal treatment, regarding their effect on the success of root canal treatment of primary teeth with furcation lesions. Materials and Methods. Fifty primary teeth with furcation lesions were divided into 2 groups. Following root canal treatment, the pulpal floor was coated with MTA in the experimental group and with IRM in the control group. Teeth were followed up considering clinical (pain, pathological mobility, tenderness to percussion and palpation, and any soft tissue pathology and sinus tract) and radiographical (pathological root resorption, reduced size or healing of existing lesion, and absence of new lesions at the interradicular or periapical area) criteria for 18 months. For the statistical analysis, Fisher's exact test and Pearson's chi-square tests were used and a p value of <0.05 was considered to be statistically significant. Results. Although there were no statistically significant differences between two groups in terms of treatment success, lesions healed significantly faster in the MTA group. Conclusion. In primary teeth with furcation lesions, usage of MTA on the pulpal floor following root canal treatment can be a better alternative since it induced faster healing.

Interleukin-4 receptor alpha overexpression in human bladder cancer correlates with the pathological grade and stage of the disease.

PubMed

Joshi, Bharat H; Leland, Pamela; Lababidi, Samir; Varrichio, Frederick; Puri, Raj K

2014-12-01

Previously, we have demonstrated that interleukin-4 receptor α (IL-4Rα) is overexpressed on a variety of human cancers and can serve as target for IL-4 immunotoxin comprised of IL-4 and a mutated Pseudomonas exotoxin. However, its expression and association with grade and clinical stage of bladder cancer has not been studied. IL-4Rα expression was examined in human bladder cancer cell lines, mouse xenografts, and biopsy specimens at mRNA and protein levels by real-time RT-PCR and IHC/ISH techniques. We also examined the effect of IL-4 on proliferation and invasion of bladder carcinoma cell lines. For tissue microarray (TMA) results, we analyzed the precision data using exact binomial proportion with exact two-sided P-values. We used Cochran-Armitage Statistics with exact two-sided P-values to examine the trend analysis of IL-4Rα over grade or stage of the bladder cancer specimens. The influence of age and gender covariates was also analyzed using multiple logistic regression models. IL-4Rα is overexpressed in five bladder cancer cell lines, while normal bladder and human umbilical vein cell lines (HUVEC) expressed at low levels. Two other chains of IL-4 receptor complex, IL-2RγC and IL-13Rα1, were absent or weakly expressed. IL-4 modestly inhibited the cell proliferation, but enhanced cell invasion of bladder cancer cell lines in a concentration-dependent manner. Bladder cancer xenografts in immunodeficient mice also maintained IL-4Rα overexpression in vivo. Analysis of tumor biopsy specimens in TMAs revealed significantly higher IL-4Rα immunostaining (≥ 2+) in Grade 2 (85%) and Grade 3 (97%) compared to Grade 1 tumors (0%) (P ≤ 0.0001). Similarly, 9% stage I tumors were positive for IL-4Rα (≥ 2+) compared to 84% stage II (P ≤ 0.0001) and 100% stages III-IV tumors (P ≤ 0.0001). IL-13Rα1 was also expressed in tumor tissues but at low levels and it did not show any correlation with the grade and stage of disease. However, the IL-2RγC was not expressed. Ten normal bladder specimens demonstrated ≤ 1+ staining for IL-4Rα and IL-13Rα1 and no staining for IL-2RγC. These results demonstrate that IL-4Rα is overexpressed in human bladder cancer, which correlates with advanced grade and stage of the disease. Thus, IL-4Rα may be a bladder tumor-associated protein and a prognostic biomarker. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. Cancer Medicine published by John Wiley & Sons Ltd.

Evaluation of Clinical Outcomes and Renal Vascular Pathology among Patients with Lupus

PubMed Central

Barber, Claire; Herzenberg, Andrew; Aghdassi, Ellie; Su, Jiandong; Lou, Wendy; Qian, Gan; Yip, Jonathan; Nasr, Samih H.; Thomas, David; Scholey, James W.; Wither, Joan; Urowitz, Murray; Gladman, Dafna; Reich, Heather

2012-01-01

Summary Background and objectives The objective of this study was to determine the clinical significance of renal vascular lesions in lupus nephritis. Design, setting, participants, & measurements Renal vascular lesions defined as thrombotic microangiopathy, lupus vasculopathy, uncomplicated vascular immune deposits, and arterial sclerosis were evaluated in relation to renal and vascular morbidity and overall mortality. Results Biopsies from 161 patients revealed thrombotic microangiopathy (13), lupus vasculopathy (5), and arterial sclerosis (93). No renal vascular lesions were found in 24.8% of patients. At the time of biopsy, arterial sclerosis or lupus vasculopathy patients were older (arterial sclerosis=37.9±13.0 and lupus vasculopathy=44.4±8.9 versus controls=33.1±8.9 years, P<0.05), and the mean arterial pressure was higher in all groups compared with controls. Nephritis subtype, activity indices, and proteinuria were similar between groups, estimated GFR was lower in arterial sclerosis (70.5±33.3 versus 84.5±26.6 ml/min per 1.73 m2, P=0.03), and chronicity index (thrombotic microangiopathy=3.5, lupus vasculopathy=4.5, and arterial sclerosis=2.5) was higher in all renal vascular lesions subgroups versus controls (1.0, P<0.05). In 133 patients with similar follow-up, the association between renal vascular lesions and vascular events was significant (Fisher exact test, P=0.002) and remained so after multivariate analysis (exact conditional scores test, P=0.04), where the difference between arterial sclerosis and uncomplicated vascular immune deposits was most noticeable (odds ratio [95% confidence interval]=8.35[0.98, 83.12], P=0.05). The associations between renal vascular lesions, renal outcomes, and death were not significant, likely because of insufficient power. Conclusions Renal vascular lesions are common in SLE patients with nephritis and may be associated with arterial vascular events. PMID:22442181

A simulation study of the strength of evidence in the recommendation of medications based on two trials with statistically significant results

PubMed Central

Ioannidis, John P. A.

2017-01-01

A typical rule that has been used for the endorsement of new medications by the Food and Drug Administration is to have two trials, each convincing on its own, demonstrating effectiveness. “Convincing” may be subjectively interpreted, but the use of p-values and the focus on statistical significance (in particular with p < .05 being coined significant) is pervasive in clinical research. Therefore, in this paper, we calculate with simulations what it means to have exactly two trials, each with p < .05, in terms of the actual strength of evidence quantified by Bayes factors. Our results show that different cases where two trials have a p-value below .05 have wildly differing Bayes factors. Bayes factors of at least 20 in favor of the alternative hypothesis are not necessarily achieved and they fail to be reached in a large proportion of cases, in particular when the true effect size is small (0.2 standard deviations) or zero. In a non-trivial number of cases, evidence actually points to the null hypothesis, in particular when the true effect size is zero, when the number of trials is large, and when the number of participants in both groups is low. We recommend use of Bayes factors as a routine tool to assess endorsement of new medications, because Bayes factors consistently quantify strength of evidence. Use of p-values may lead to paradoxical and spurious decision-making regarding the use of new medications. PMID:28273140