Sample records for mcat total scores

  1. Validity of four approaches of using repeaters' MCAT scores in medical school admissions to predict USMLE Step 1 total scores.

    PubMed

    Zhao, Xiaohui; Oppler, Scott; Dunleavy, Dana; Kroopnick, Marc

    2010-10-01

    This study investigated the validity of four approaches (the average, most recent, highest-within-administration, and highest-across-administration approaches) of using repeaters' Medical College Admission Test (MCAT) scores to predict Step 1 scores. Using the differential predication method, this study investigated the magnitude of differences in the expected Step 1 total scores between MCAT nonrepeaters and three repeater groups (two-time, three-time, and four-time test takers) for the four scoring approaches. For the average score approach, matriculants with the same MCAT average are expected to achieve similar Step 1 total scores regardless of whether the individual attempted the MCAT exam one or multiple times. For the other three approaches, repeaters are expected to achieve lower Step 1 scores than nonrepeaters; for a given MCAT score, as the number of attempts increases, the expected Step 1 decreases. The effect was strongest for the highest-across-administration approach, followed by the highest-within-administration approach, and then the most recent approach. Using the average score is the best approach for considering repeaters' MCAT scores in medical school admission decisions.

  2. Use of a Simulated MCAT to Predict Real MCAT Scores.

    ERIC Educational Resources Information Center

    Pohlman, Mary; And Others

    1979-01-01

    A simulated Medical College Admission Test (MCAT) was administered to 39 premedical students two weeks prior to the new MCAT. High correlations between simulated and active test scores were obtained in the biology, chemistry, physics, science problems, reading, and quantitative areas. (MH)

  3. A twelve-year profile of students' SAT scores, GPAs, and MCAT scores from a small university's premedical program.

    PubMed

    Montague, J R; Frei, J K

    1993-04-01

    To determine whether significant correlations existed among quantitative and qualitative predictors of students' academic success and quantitative outcomes of such success over a 12-year period in a small university's premedical program. A database was assembled from information on the 199 graduates who earned BS degrees in biology from Barry University's School of Natural and Health Sciences from 1980 through 1991. The quantitative variables were year of BS degree, total score on the Scholastic Aptitude Test (SAT), various measures of undergraduate grade-point averages (GPAs), and total score on the Medical College Admission Test (MCAT); and the qualitative variables were minority (54% of the students) or majority status and transfer (about one-third of the students) or nontransfer status. The statistical methods were multiple analysis of variance and stepwise multiple regression. Statistically significant positive correlations were found among SAT total scores, final GPAs, biology GPAs versus nonbiology GPAs, and MCAT total scores. These correlations held for transfer versus nontransfer students and for minority versus majority students. Over the 12-year period there were significant fluctuations in mean MCAT scores. The students' SAT scores and GPAs proved to be statistically reliable predictors of MCAT scores, but the minority or majority status and the transfer or nontransfer status of the students were statistically insignificant.

  4. Do MCAT scores predict USMLE scores? An analysis on 5 years of medical student data.

    PubMed

    Gauer, Jacqueline L; Wolff, Josephine M; Jackson, J Brooks

    2016-01-01

    The purpose of this study was to determine the associations and predictive values of Medical College Admission Test (MCAT) component and composite scores prior to 2015 with U.S. Medical Licensure Exam (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores, with a focus on whether students scoring low on the MCAT were particularly likely to continue to score low on the USMLE exams. Multiple linear regression, correlation, and chi-square analyses were performed to determine the relationship between MCAT component and composite scores and USMLE Step 1 and Step 2 CK scores from five graduating classes (2011-2015) at the University of Minnesota Medical School ( N =1,065). The multiple linear regression analyses were both significant ( p <0.001). The three MCAT component scores together explained 17.7% of the variance in Step 1 scores ( p< 0.001) and 12.0% of the variance in Step 2 CK scores ( p <0.001). In the chi-square analyses, significant, albeit weak associations were observed between almost all MCAT component scores and USMLE scores (Cramer's V ranged from 0.05 to 0.24). Each of the MCAT component scores was significantly associated with USMLE Step 1 and Step 2 CK scores, although the effect size was small. Being in the top or bottom scoring range of the MCAT exam was predictive of being in the top or bottom scoring range of the USMLE exams, although the strengths of the associations were weak to moderate. These results indicate that MCAT scores are predictive of student performance on the USMLE exams, but, given the small effect sizes, should be considered as part of the holistic view of the student.

  5. The impact of testing accommodations on MCAT scores: descriptive results.

    PubMed

    Julian, Ellen R; Ingersoll, Deborah J; Etienne, Patricia M; Hilger, Anthony E

    2004-04-01

    Medical College Admission Test (MCAT) examinees with disabilities who receive accommodations receive flagged scores indicating nonstandard administration. This report compares MCAT examinees who received accommodations and their performances with standard examinees. Aggregate history records of all 1994-2000 MCAT examinees were identified as flagged (2,401) or standard (297,880), then further sorted by race/ethnicity (broadly identified as underrepresented minority and non-URM, at the time of testing) and gender. Those with flagged scores were also classified by disability (LD = learning disability, ADHD = attention deficit hyperactivity disorder, LD/ADHD = learning disability and attention deficit hyperactivity disorder, and Other = other disability) and type of accommodation. Mean MCAT scores were calculated for all groups. A group of 866 examinees took the MCAT first as a standard administration and subsequently with accommodations. In a separate analysis, their two sets of scores were compared. Less than 1% of examinees (2,401) had accommodations; of these, 55% were LD, 17% ADHD, 5% LD/ADHD, and 23% Other. Extended time was the most frequently provided accommodation. Mean flagged scores slightly exceeded mean standard scores on all MCAT sections. Examinees who retook the MCAT with accommodations after a standard administration increased their scores by six points, quadrupling the average gain Standard-Standard retest cohort from another study. The small but statistically significant different higher flagged scores may reflect either appropriate compensation or overly generous accommodations. Extended time had a positive impact on the scores of those who retested with this accommodation. The validity the flagged MCAT in predicting success in medical school is not known, and further investigation is underway.

  6. Do MCAT scores predict USMLE scores? An analysis on 5 years of medical student data

    PubMed Central

    Gauer, Jacqueline L.; Wolff, Josephine M.; Jackson, J. Brooks

    2016-01-01

    Introduction The purpose of this study was to determine the associations and predictive values of Medical College Admission Test (MCAT) component and composite scores prior to 2015 with U.S. Medical Licensure Exam (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores, with a focus on whether students scoring low on the MCAT were particularly likely to continue to score low on the USMLE exams. Method Multiple linear regression, correlation, and chi-square analyses were performed to determine the relationship between MCAT component and composite scores and USMLE Step 1 and Step 2 CK scores from five graduating classes (2011–2015) at the University of Minnesota Medical School (N=1,065). Results The multiple linear regression analyses were both significant (p<0.001). The three MCAT component scores together explained 17.7% of the variance in Step 1 scores (p<0.001) and 12.0% of the variance in Step 2 CK scores (p<0.001). In the chi-square analyses, significant, albeit weak associations were observed between almost all MCAT component scores and USMLE scores (Cramer's V ranged from 0.05 to 0.24). Discussion Each of the MCAT component scores was significantly associated with USMLE Step 1 and Step 2 CK scores, although the effect size was small. Being in the top or bottom scoring range of the MCAT exam was predictive of being in the top or bottom scoring range of the USMLE exams, although the strengths of the associations were weak to moderate. These results indicate that MCAT scores are predictive of student performance on the USMLE exams, but, given the small effect sizes, should be considered as part of the holistic view of the student. PMID:27702431

  7. An Empirical Investigation of Change in MCAT Scores upon Retest.

    ERIC Educational Resources Information Center

    Hynes, Kevin; Givner, Nathaniel

    1980-01-01

    An investigation of Medical College Admission Test (MCAT) retest scores indicates that limited retest improvement may result when initial scores are fairly low or below what might be predicted based on grade point averages. However, when initial scores approach the national, standardized MCAT mean, or are above what might be predicted, significant…

  8. Racial/Ethnic Differences in the Predictive Validity of MCAT Scores.

    ERIC Educational Resources Information Center

    Jones, Robert F.; Mitchell, Karen

    Medical College Admission Test (MCAT) score differences were examined for Black and White examinees who entered American medical schools in 1978 and 1979. The incidence of academic difficulty resulting in delayed graduation, withdrawal, or dismissal was also examined. The MCAT provides six scores: biology, chemistry, physics, science problems,…

  9. The influence of MCAT and GPA preadmission academic metrics on interview scores.

    PubMed

    Gay, Steven E; Santen, Sally A; Mangrulkar, Rajesh S; Sisson, Thomas H; Ross, Paula T; Zaidi, Nikki L Bibler

    2018-03-01

    Medical school admissions interviews are used to assess applicants' nonacademic characteristics as advocated by the Association of American Medical Colleges' Advancing Holistic Review Initiative. The objective of this study is to determine whether academic metrics continue to significantly influence interviewers' scores in holistic processes by blinding interviewers to applicants' undergraduate grade point averages (uGPA) and Medical College Admission Test (MCAT). This study examines academic and demographic predictors of interview scores for two applicant cohorts at the University of Michigan Medical School. In 2012, interviewers were provided applicants' uGPA and MCAT scores; in 2013, these academic metrics were withheld from interviewers' files. Hierarchical regression analysis was conducted to examine the influence of academic and demographic variables on overall cohort interview scores. When interviewers were provided uGPA and MCAT scores, academic metrics explained more variation in interview scores (7.9%) than when interviewers were blinded to these metrics (4.1%). Further analysis showed a statistically significant interaction between cohort and uGPA, indicating that the association between uGPA and interview scores was significantly stronger for the 2012 unblinded cohort compared to the 2013 blinded cohort (β = .573, P < .05). By contrast, MCAT scores had no interactive effects on interviewer scores. While MCAT scores accounted for some variation in interview scores for both cohorts, only access to uGPA significantly influenced interviewers' scores when looking at interaction effects. Withholding academic metrics from interviewers' files may promote assessment of nonacademic characteristics independently from academic metrics.

  10. MCAT Verbal Reasoning score: less predictive of medical school performance for English language learners.

    PubMed

    Winegarden, Babbi; Glaser, Dale; Schwartz, Alan; Kelly, Carolyn

    2012-09-01

    Medical College Admission Test (MCAT) scores are widely used as part of the decision-making process for selecting candidates for admission to medical school. Applicants who learned English as a second language may be at a disadvantage when taking tests in their non-native language. Preliminary research found significant differences between English language learners (ELLs), applicants who learned English after the age of 11 years, and non-ELL examinees on the Verbal Reasoning (VR) sub-test of the MCAT. The purpose of this study was to determine if relationships between VR sub-test scores and measures of medical school performance differed between ELL and non-ELL students. Scores on the MCAT VR sub-test and student performance outcomes (grades, examination scores, and markers of distinction and difficulty) were extracted from University of California San Diego School of Medicine admissions files and the Association of American Medical Colleges database for 924 students who matriculated in 1998-2005 (graduation years 2002-2009). Regression models were fitted to determine whether MCAT VR sub-test scores predicted medical school performance similarly for ELLs and non-ELLs. For several outcomes, including pre-clerkship grades, academic distinction, US Medical Licensing Examination Step 2 Clinical Knowledge scores and two clerkship shelf examinations, ELL status significantly affects the ability of the VR score to predict performance. Higher correlations between VR score and medical school performance emerged for non-ELL students than for ELL students for each of these outcomes. The MCAT VR score should be used with discretion when assessing ELL applicants for admission to medical school. © Blackwell Publishing Ltd 2012.

  11. The predictive validity of the MCAT exam in relation to academic performance through medical school: a national cohort study of 2001-2004 matriculants.

    PubMed

    Dunleavy, Dana M; Kroopnick, Marc H; Dowd, Keith W; Searcy, Cynthia A; Zhao, Xiaohui

    2013-05-01

    Most research examining the predictive validity of the Medical College Admission Test (MCAT) has focused on the relationship between MCAT scores and scores on the United States Medical Licensing Examination Step exams. This study examined whether MCAT scores predict students' unimpeded progress toward graduation (UP), which the authors defined as not withdrawing or being dismissed for academic reasons, graduating within five years of matriculation, and passing the Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills exams on the first attempt. Students who matriculated during 2001-2004 at 119 U.S. medical schools were included in the analyses. Logistic regression analyses were used to estimate the relationships between UP and MCAT total scores alone, undergraduate grade point averages (UGPAs) alone, and UGPAs and MCAT total scores together. All analyses were conducted at the school level and were considered together to evaluate relationships across schools. The majority of matriculants experienced UP. Together, UGPAs and MCAT total scores predicted UP well. MCAT total scores alone were a better predictor than UGPAs alone. Relationships were similar across schools; however, there was more variability across schools in the relationship between UP and UGPAs than between UP and MCAT total scores. The combination of UGPAs and MCAT total scores performs well as a predictor of UP. Both UGPAs and MCAT total scores are strong predictors of academic performance in medical school through graduation, not just the first two years. Further, these relationships generalize across medical schools.

  12. Predicting MCAT Examination Scores.

    ERIC Educational Resources Information Center

    Dawson-Saunders, Beth; And Others

    Acceptable performance on the Medical College Admissions Test (MCAT) is necessary for acceptance into medical school; therefore, students planning a career in medicine and their advisors would benefit by having information useful in predicting performance on this examination. The present study examined the validity of the ACT Assessment as such a…

  13. Does the MCAT predict medical school and PGY-1 performance?

    PubMed

    Saguil, Aaron; Dong, Ting; Gingerich, Robert J; Swygert, Kimberly; LaRochelle, Jeffrey S; Artino, Anthony R; Cruess, David F; Durning, Steven J

    2015-04-01

    The Medical College Admissions Test (MCAT) is a high-stakes test required for entry to most U. S. medical schools; admissions committees use this test to predict future accomplishment. Although there is evidence that the MCAT predicts success on multiple choice-based assessments, there is little information on whether the MCAT predicts clinical-based assessments of undergraduate and graduate medical education performance. This study looked at associations between the MCAT and medical school grade point average (GPA), Medical Licensing Examination (USMLE) scores, observed patient care encounters, and residency performance assessments. This study used data collected as part of the Long-Term Career Outcome Study to determine associations between MCAT scores, USMLE Step 1, Step 2 clinical knowledge and clinical skill, and Step 3 scores, Objective Structured Clinical Examination performance, medical school GPA, and PGY-1 program director (PD) assessment of physician performance for students graduating 2010 and 2011. MCAT data were available for all students, and the PGY PD evaluation response rate was 86.2% (N = 340). All permutations of MCAT scores (first, last, highest, average) were weakly associated with GPA, Step 2 clinical knowledge scores, and Step 3 scores. MCAT scores were weakly to moderately associated with Step 1 scores. MCAT scores were not significantly associated with Step 2 clinical skills Integrated Clinical Encounter and Communication and Interpersonal Skills subscores, Objective Structured Clinical Examination performance or PGY-1 PD evaluations. MCAT scores were weakly to moderately associated with assessments that rely on multiple choice testing. The association is somewhat stronger for assessments occurring earlier in medical school, such as USMLE Step 1. The MCAT was not able to predict assessments relying on direct clinical observation, nor was it able to predict PD assessment of PGY-1 performance. Reprint & Copyright © 2015 Association of

  14. IRT Equating of the MCAT. MCAT Monograph.

    ERIC Educational Resources Information Center

    Hendrickson, Amy B.; Kolen, Michael J.

    This study compared various equating models and procedures for a sample of data from the Medical College Admission Test(MCAT), considering how item response theory (IRT) equating results compare with classical equipercentile results and how the results based on use of various IRT models, observed score versus true score, direct versus linked…

  15. A comparison of statistical criteria for setting optimally discriminating MCAT and GPA thresholds in medical school admissions.

    PubMed

    Albanese, Mark A; Farrell, Philip; Dottl, Susan L

    2005-01-01

    Using Medical College Admission Test-grade point average (MCAT-GPA) scores as a threshold has the potential to address issues raised in recent Supreme Court cases, but it introduces complicated methodological issues for medical school admissions. To assess various statistical indexes to determine optimally discriminating thresholds for MCAT-GPA scores. Entering classes from 1992 through 1998 (N = 752) are used to develop guidelines for cut scores that optimize discrimination between students who pass and do not pass the United States Medical Licensing Examination (USMLE) Step 1 on the first attempt. Risk differences, odds ratios, sensitivity, and specificity discriminated best for setting thresholds. Compensatory versus noncompensatory procedures both accounted for 54% of Step 1 failures, but demanded different performance requirements (noncompensatory MCAT-biological sciences = 8, physical sciences = 7, verbal reasoning = 7--sum of scores = 22; compensatory MCAT total = 24). Rational and defensible intellectual achievement thresholds that are likely to comply with recent Supreme Court decisions can be set from MCAT scores and GPAs.

  16. Association of MCAT scores obtained with standard vs extra administration time with medical school admission, medical student performance, and time to graduation.

    PubMed

    Searcy, Cynthia A; Dowd, Keith W; Hughes, Michael G; Baldwin, Sean; Pigg, Trey

    2015-06-09

    Individuals with documented disabilities may receive accommodations on the Medical College Admission Test (MCAT). Whether such accommodations are associated with MCAT scores, medical school admission, and medical school performance is unclear. To determine the comparability of MCAT scores obtained with standard vs extra administration time with respect to likelihood of acceptance to medical school and future medical student performance. Retrospective cohort study of applicants to US medical schools for the 2011-2013 entering classes who reported MCAT scores obtained with standard time (n = 133,962) vs extra time (n = 435), and of students who matriculated in US medical schools from 2000-2004 who reported MCAT scores obtained with standard time (n = 76,262) vs extra time (n = 449). Standard or extra administration time during MCAT. Primary outcome measures were acceptance rates at US medical schools and graduation rates within 4 or 5 years after matriculation. Secondary outcome measures were pass rates on the United States Medical Licensing Examination (USMLE) Step examinations and graduation rates within 6 to 8 years after matriculation. Acceptance rates were not significantly different for applicants who had MCAT scores obtained with standard vs extra time (44.5% [59,585/133,962] vs 43.9% [191/435]; difference, 0.6% [95% CI, -4.1 to 5.3]). Students who tested with extra time passed the Step examinations on first attempt at significantly lower rates (Step 1, 82.1% [344/419] vs 94.0% [70,188/74,668]; difference, 11.9% [95% CI, 9.6% to 14.2%]; Step 2 CK, 85.5% [349/408] vs 95.4% [70,476/73,866]; difference, 9.9% [95% CI, 7.8% to 11.9%]; Step 2 CS, 92.0% [288/313] vs 97.0% [60,039/61,882]; difference, 5.0% [95% CI, 3.1% to 6.9%]). They also graduated from medical school at significantly lower rates at different times (4 years, 67.2% [285/424] vs 86.1% [60,547/70,305]; difference, 18.9% [95% CI, 15.6% to 22.2%]; 5 years, 81.6% [346/424] vs 94.4% [66

  17. From MCAT to M.D.: Predicting Success in Medical School.

    ERIC Educational Resources Information Center

    Jones, Robert F.

    The effectiveness of Medical College Admission Test (MCAT) scores in predicting success during the first phase of medical education is investigated. The process by which medical students are educated and evaluated, the nature and purpose of the MCAT, and the MCAT Interpretive Studies Program developed by the Association of American Medical…

  18. The MCAT and Success in Medical School.

    ERIC Educational Resources Information Center

    Feitz, Robert H.

    This study looked at Medical College Admissions Test (MCAT) scores by race in relation to medical college status. It was found that promoted students differed significantly on all four MCAT subtests from those dismissed for academic difficulties and those repeating a year. For both black and white racial groups, the latter two status categories…

  19. Cross-Year Comparison of Test-Retest MCAT Performance

    ERIC Educational Resources Information Center

    Land, Marcia S.; Feitz, Robert H.

    1976-01-01

    Scores were examined for students who repeated the Medical School Admissions Test (MCAT) within the same calendar year for years 1970-74. Nearly all repeaters showed improvement, low ability groups more and high ability students less. No pattern of greater MCAT improvement over time was found. (JT)

  20. Comparative Predictive Validity of the New MCAT Using Different Admissions Criteria.

    ERIC Educational Resources Information Center

    Golmon, Melton E.; Berry, Charles A.

    1981-01-01

    New Medical College Admission Test (MCAT) scores and undergraduate academic achievement were examined for their validity in predicting the performance of two select student populations at Northwestern University Medical School. The data support the hypothesis that New MCAT scores possess substantial predictive validity. (Author/MLW)

  1. Do racial and ethnic group differences in performance on the MCAT exam reflect test bias?

    PubMed

    Davis, Dwight; Dorsey, J Kevin; Franks, Ronald D; Sackett, Paul R; Searcy, Cynthia A; Zhao, Xiaohui

    2013-05-01

    The Medical College Admission Test (MCAT) is a standardized examination that assesses fundamental knowledge of scientific concepts, critical reasoning ability, and written communication skills. Medical school admission officers use MCAT scores, along with other measures of academic preparation and personal attributes, to select the applicants they consider the most likely to succeed in medical school. In 2008-2011, the committee charged with conducting a comprehensive review of the MCAT exam examined four issues: (1) whether racial and ethnic groups differ in mean MCAT scores, (2) whether any score differences are due to test bias, (3) how group differences may be explained, and (4) whether the MCAT exam is a barrier to medical school admission for black or Latino applicants. This analysis showed that black and Latino examinees' mean MCAT scores are lower than white examinees', mirroring differences on other standardized admission tests and in the average undergraduate grades of medical school applicants. However, there was no evidence that the MCAT exam is biased against black and Latino applicants as determined by their subsequent performance on selected medical school performance indicators. Among other factors which could contribute to mean differences in MCAT performance, whites, blacks, and Latinos interested in medicine differ with respect to parents' education and income. Admission data indicate that admission committees accept majority and minority applicants at similar rates, which suggests that medical students are selected on the basis of a combination of attributes and competencies rather than on MCAT scores alone.

  2. A Multidimensional Computerized Adaptive Short-Form Quality of Life Questionnaire Developed and Validated for Multiple Sclerosis: The MusiQoL-MCAT.

    PubMed

    Michel, Pierre; Baumstarck, Karine; Ghattas, Badih; Pelletier, Jean; Loundou, Anderson; Boucekine, Mohamed; Auquier, Pascal; Boyer, Laurent

    2016-04-01

    The aim was to develop a multidimensional computerized adaptive short-form questionnaire, the MusiQoL-MCAT, from a fixed-length QoL questionnaire for multiple sclerosis.A total of 1992 patients were enrolled in this international cross-sectional study. The development of the MusiQoL-MCAT was based on the assessment of between-items MIRT model fit followed by real-data simulations. The MCAT algorithm was based on Bayesian maximum a posteriori estimation of latent traits and Kullback-Leibler information item selection. We examined several simulations based on a fixed number of items. Accuracy was assessed using correlations (r) between initial IRT scores and MCAT scores. Precision was assessed using the standard error measurement (SEM) and the root mean square error (RMSE).The multidimensional graded response model was used to estimate item parameters and IRT scores. Among the MCAT simulations, the 16-item version of the MusiQoL-MCAT was selected because the accuracy and precision became stable with 16 items with satisfactory levels (r ≥ 0.9, SEM ≤ 0.55, and RMSE ≤ 0.3). External validity of the MusiQoL-MCAT was satisfactory.The MusiQoL-MCAT presents satisfactory properties and can individually tailor QoL assessment to each patient, making it less burdensome to patients and better adapted for use in clinical practice.

  3. Predictive value of grade point average (GPA), Medical College Admission Test (MCAT), internal examinations (Block) and National Board of Medical Examiners (NBME) scores on Medical Council of Canada qualifying examination part I (MCCQE-1) scores.

    PubMed

    Roy, Banibrata; Ripstein, Ira; Perry, Kyle; Cohen, Barry

    2016-01-01

    To determine whether the pre-medical Grade Point Average (GPA), Medical College Admission Test (MCAT), Internal examinations (Block) and National Board of Medical Examiners (NBME) scores are correlated with and predict the Medical Council of Canada Qualifying Examination Part I (MCCQE-1) scores. Data from 392 admitted students in the graduating classes of 2010-2013 at University of Manitoba (UofM), College of Medicine was considered. Pearson's correlation to assess the strength of the relationship, multiple linear regression to estimate MCCQE-1 score and stepwise linear regression to investigate the amount of variance were employed. Complete data from 367 (94%) students were studied. The MCCQE-1 had a moderate-to-large positive correlation with NBME scores and Block scores but a low correlation with GPA and MCAT scores. The multiple linear regression model gives a good estimate of the MCCQE-1 (R2 =0.604). Stepwise regression analysis demonstrated that 59.2% of the variation in the MCCQE-1 was accounted for by the NBME, but only 1.9% by the Block exams, and negligible variation came from the GPA and the MCAT. Amongst all the examinations used at UofM, the NBME is most closely correlated with MCCQE-1.

  4. A Factor Comparison of Old and New MCAT Scales.

    ERIC Educational Resources Information Center

    Jones, Robert F.; Thomae-Forgues, Maria

    1981-01-01

    The old Medical College Admission Test (MCAT) and the New MCAT were compared by factor-analyzing the scores of a sample of 1,484 examinees who took both tests during 1976-77. Three common factors are interpreted: a general science quantitative factor, verbal ability, and interpretation skills. Variances are noted and implications of the data for…

  5. The Impact of MCAT Intervention Efforts on Medical Student Acceptance Rates

    PubMed Central

    Pisano, Joseph C.; Epps, Anna Cherrie

    1983-01-01

    This study examines the role of Medical College Admissions Test review course in medical school admissions, and evaluates the relationship between undergraduate grade point average and MCAT scores. The results indicate that enrollment in a MCAT review course enhances medical school admissions for minority students. PMID:6631986

  6. Validity of the MCAT in Predicting Performance in the First Two Years of Medical School.

    ERIC Educational Resources Information Center

    Jones, Robert F.; Thomae-Forgues, Maria

    1984-01-01

    The first systematic summary of predictive validity research on the new Medical College Admission Test (MCAT) is presented. The results show that MCAT scores have significant predictive validity with respect to first- and second-year medical school course grades. Further directions for MCAT validity research are described. (Author/MLW)

  7. The MCAT physics test

    NASA Astrophysics Data System (ADS)

    Blado, Gardo Garnet

    2000-09-01

    The present paper discusses the physics portion of the Medical College Admission Test (MCAT). Various methods of incorporating "MCAT-type" questions in introductory physics courses to help pre-medical students prepare for the MCAT, are carefully examined.

  8. Prediction of Osteopathic Medical School Performance on the basis of MCAT score, GPA, sex, undergraduate major, and undergraduate institution.

    PubMed

    Dixon, Donna

    2012-04-01

    The relationships of students' preadmission academic variables, sex, undergraduate major, and undergraduate institution to academic performance in medical school have not been thoroughly examined. To determine the ability of students' preadmission academic variables to predict osteopathic medical school performance and whether students' sex, undergraduate major, or undergraduate institution influence osteopathic medical school performance. The study followed students who graduated from New York College of Osteopathic Medicine of New York Institute of Technology in Old Westbury between 2003 and 2006. Student preadmission data were Medical College Admission Test (MCAT) scores, undergraduate grade point averages (GPAs), sex, undergraduate major, and undergraduate institutional selectivity. Medical school performance variables were GPAs, clinical performance (ie, clinical subject examinations and clerkship evaluations), and scores on the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2-Clinical Evaluation (CE). Data were analyzed with Pearson product moment correlation coefficients and multivariate linear regression analyses. Differences between student groups were compared with the independent-samples, 2-tailed t test. A total of 737 students were included. All preadmission academic variables, except nonscience undergraduate GPA, were statistically significant predictors of performance on COMLEX-USA Level 1, and all preadmission academic variables were statistically significant predictors of performance on COMLEX-USA Level 2-CE. The MCAT score for biological sciences had the highest correlation among all variables with COMLEX-USA Level 1 performance (Pearson r=0.304; P<.001) and Level 2-CE performance (Pearson r=0.272; P<.001). All preadmission variables were moderately correlated with the mean clinical subject examination scores. The mean clerkship evaluation score was moderately correlated with mean clinical examination

  9. Test-Taking Intervention: Its Effects on Minority Students' MCAT Scores.

    ERIC Educational Resources Information Center

    Frierson, Henry T., Jr.

    Test-taking intervention procedures were implemented for minority premedical students. The intent of the intervention was to modify expected performances on the science subtest of the Medical College Admission Test (MCAT). The group used to determine the effectiveness of the test intervention procedures consisted of 11 students who had previously…

  10. Modeling respiratory mechanics in the MCAT and spline-based MCAT phantoms

    NASA Astrophysics Data System (ADS)

    Segars, W. P.; Lalush, D. S.; Tsui, B. M. W.

    2001-02-01

    Respiratory motion can cause artifacts in myocardial SPECT and computed tomography (CT). The authors incorporate models of respiratory mechanics into the current 4D MCAT and into the next generation spline-based MCAT phantoms. In order to simulate respiratory motion in the current MCAT phantom, the geometric solids for the diaphragm, heart, ribs, and lungs were altered through manipulation of parameters defining them. Affine transformations were applied to the control points defining the same respiratory structures in the spline-based MCAT phantom to simulate respiratory motion. The Non-Uniform Rational B-Spline (NURBS) surfaces for the lungs and body outline were constructed in such a way as to be linked to the surrounding ribs. Expansion and contraction of the thoracic cage then coincided with expansion and contraction of the lungs and body. The changes both phantoms underwent were spline-interpolated over time to create time continuous 4D respiratory models. The authors then used the geometry-based and spline-based MCAT phantoms in an initial simulation study of the effects of respiratory motion on myocardial SPECT. The simulated reconstructed images demonstrated distinct artifacts in the inferior region of the myocardium. It is concluded that both respiratory models can be effective tools for researching effects of respiratory motion.

  11. Changing MCAT.

    PubMed

    Ortolon, Ken

    2011-07-01

    A special committee of the Association of American Medical Colleges is recommending major changes to the Medical College Admission Test (MCAT) to more closely align its subject matter with the science knowledge needed to practice 21st century medicine. But while the proposed new MCAT increases the emphasis on biochemistry and cellular and molecular biology, it also sharpens the focus on critical analysis and behavioral and social sciences that affect the more human side of medicine.

  12. New and Old MCAT: A Preliminary Comparison

    ERIC Educational Resources Information Center

    Givner, Nathaniel; Hynes, Kevin

    1978-01-01

    Sixty-six medical school applicants responded to both old and new forms of the Medical College Admission Test (MCAT). The results supported the claim that the new MCAT assesses skills not measured by the old MCAT. Available from: Sage Publications, Inc., 275 South Beverly Drive, Beverly Hills, California 90212. (Author/JAC)

  13. Multidimensional CAT Item Selection Methods for Domain Scores and Composite Scores: Theory and Applications

    ERIC Educational Resources Information Center

    Yao, Lihua

    2012-01-01

    Multidimensional computer adaptive testing (MCAT) can provide higher precision and reliability or reduce test length when compared with unidimensional CAT or with the paper-and-pencil test. This study compared five item selection procedures in the MCAT framework for both domain scores and overall scores through simulation by varying the structure…

  14. Redesigning the MCAT exam: balancing multiple perspectives.

    PubMed

    Schwartzstein, Richard M; Rosenfeld, Gary C; Hilborn, Robert; Oyewole, Saundra Herndon; Mitchell, Karen

    2013-05-01

    The authors of this commentary discuss the recently completed review of the current Medical College Admission Test (MCAT), which has been used since 1991, and describe the blueprint for the new test that will be introduced in 2015. The design of the MCAT exam reflects changes in medical education, medical science, health care delivery, and the needs of the populations served by graduates of U.S. and Canadian medical schools. The authors describe how balancing the ambitious goals for the new exam and the varying priorities of the testing program's many stakeholders made blueprint design complex. They discuss the tensions and trade-offs that characterized the design process as well as the deliberations and data that shaped the blueprint.The blueprint for the MCAT exam balances the assessment of a broad range of competencies in the natural, social, and behavioral sciences and critical analysis and reasoning skills that are essential to entering students' success in medical school. The exam will include four sections: Biological and Biochemical Foundations of Living Systems; Chemical and Physical Foundations of Biological Systems; Psychological, Social, and Biological Foundations of Behavior; and Critical Analysis and Reasoning Skills.The authors also offer recommendations for admission committees, advising them to review applicants' test scores, course work, and other academic, personal, and experiential credentials as part of a holistic admission process and in relation to their institutions' educational, scientific, clinical, and service-oriented goals.

  15. Microcomputer aided tracking (MCAT)

    NASA Astrophysics Data System (ADS)

    Mays, A. B.; Cross, D. C.; Walters, J. L.

    1983-07-01

    The goal of the MCAT project was to investigate the effectiveness of operator initiated tracks followed by automatic tracking. Adding this capability to a display was intended to relieve operator overload and fatigue which results when the operator is limited to grease pencil tracking. MCAT combines several microprocessors and a microcomputer-driven PPI(Plan Position Indications) with graphics capability. The operator is required to make the initial detection and MCAT then performs automatic detection and tracking in a limited area centered around the detection. This approach was chosen because it is far less costly than a full-up auto detect and track approach. MCAT is intended for use in a non-NTDS (Naval Tactical Data System) environment where operator aids are minimal at best. There are approximately 200 non-NTDS ships in today's Navy. Each of these ships has a combat information center (CIC) which includes numerous PPIs typically SPA-25s, SPA-66s, SPA-50s) and various manual means (e.g., air summary plotboards, NC-2 plotters) of producing summary plots and performing calculations (e.g., maneuvering board paper) pertinent to tracks in progress. The operator's duties are time-consuming and there are many things that could be done via computer control and graphics displays that the non-NTDS operate must now do manually. Because there is much manual information handling, accumulation of data is slow and there is a large probability of error.

  16. Incremental Validity of the New MCAT.

    ERIC Educational Resources Information Center

    Friedman, Charles P.; Bakewell, William E., Jr.

    1980-01-01

    The ability of the new Medical College Admission Test (MCAT) to predict performance of first-year medical students at the University of North Carolina was studied. Its incremental validity, determined by computing the additional variance in performance explainable by the MCAT after the effects of other admissions variables were taken into account,…

  17. Score Reporting for the 1991 Medical College Admission Test.

    ERIC Educational Resources Information Center

    Mitchell, Karen J.; Haynes, Robert

    1990-01-01

    Data used in a major review of the system for reporting scores on the Medical College Admission Test (MCAT) are presented and discussed. The data demonstrated the value of the current score-reporting system and led to retention of the 15-point MCAT score scale in 1991. (Author/MSE)

  18. The predictive validity of the MCAT for medical school performance and medical board licensing examinations: a meta-analysis of the published research.

    PubMed

    Donnon, Tyrone; Paolucci, Elizabeth Oddone; Violato, Claudio

    2007-01-01

    To conduct a meta-analysis of published studies to determine the predictive validity of the MCAT on medical school performance and medical board licensing examinations. The authors included all peer-reviewed published studies reporting empirical data on the relationship between MCAT scores and medical school performance or medical board licensing exam measures. Moderator variables, participant characteristics, and medical school performance/medical board licensing exam measures were extracted and reviewed separately by three reviewers using a standardized protocol. Medical school performance measures from 11 studies and medical board licensing examinations from 18 studies, for a total of 23 studies, were selected. A random-effects model meta-analysis of weighted effects sizes (r) resulted in (1) a predictive validity coefficient for the MCAT in the preclinical years of r = 0.39 (95% confidence interval [CI], 0.21-0.54) and on the USMLE Step 1 of r = 0.60 (95% CI, 0.50-0.67); and (2) the biological sciences subtest as the best predictor of medical school performance in the preclinical years (r = 0.32 95% CI, 0.21-0.42) and on the USMLE Step 1 (r = 0.48 95% CI, 0.41-0.54). The predictive validity of the MCAT ranges from small to medium for both medical school performance and medical board licensing exam measures. The medical profession is challenged to develop screening and selection criteria with improved validity that can supplement the MCAT as an important criterion for admission to medical schools.

  19. Association between the Medical College Admission Test scores and Alpha Omega Alpha Medical Honors Society membership.

    PubMed

    Gauer, Jacqueline L; Jackson, J Brooks

    2017-01-01

    Medical schools worldwide are faced with the challenge of selecting from among many qualified applicants. One factor that might help admissions committees identify future exceptional medical students is scores on standardized entrance exams. The purpose of this study was to determine the association between scores on the most commonly used standardized medical school entrance exam in the USA, the Medical College Admission Test (MCAT), and election to the US medical honors society, Alpha Omega Alpha (AOA). MCAT scores and AOA membership data were analyzed for all the students pursuing Doctor of Medicine degrees at the University of Minnesota Medical School and who graduated between 2012-2016 (n=1,309). An independent-samples t -test found a significant difference (t=6.132, p <0.001) in MCAT scores between those who were elected to AOA (n=179) and those who were not (n=1,130). On average, students who were elected to AOA had composite MCAT scores of 1.65 points higher than those who were not. Percentages of students elected to AOA gradually but inconsistently increased with MCAT score. No student who scored <27 on the MCAT was elected to AOA. Among students with MCAT scores at the 99th percentile or above (scores of ≥38), 13 of 48 (27.1%) were elected to AOA. Election to AOA during medical school was significantly associated with higher MCAT scores. Admissions committees should carefully consider the role of standardized entrance exam scores, in the context of a holistic review, when selecting for exceptional medical students.

  20. Association between the Medical College Admission Test scores and Alpha Omega Alpha Medical Honors Society membership

    PubMed Central

    Gauer, Jacqueline L; Jackson, J Brooks

    2017-01-01

    Introduction Medical schools worldwide are faced with the challenge of selecting from among many qualified applicants. One factor that might help admissions committees identify future exceptional medical students is scores on standardized entrance exams. The purpose of this study was to determine the association between scores on the most commonly used standardized medical school entrance exam in the USA, the Medical College Admission Test (MCAT), and election to the US medical honors society, Alpha Omega Alpha (AOA). Method MCAT scores and AOA membership data were analyzed for all the students pursuing Doctor of Medicine degrees at the University of Minnesota Medical School and who graduated between 2012–2016 (n=1,309). Results An independent-samples t-test found a significant difference (t=6.132, p<0.001) in MCAT scores between those who were elected to AOA (n=179) and those who were not (n=1,130). On average, students who were elected to AOA had composite MCAT scores of 1.65 points higher than those who were not. Percentages of students elected to AOA gradually but inconsistently increased with MCAT score. No student who scored <27 on the MCAT was elected to AOA. Among students with MCAT scores at the 99th percentile or above (scores of ≥38), 13 of 48 (27.1%) were elected to AOA. Discussion Election to AOA during medical school was significantly associated with higher MCAT scores. Admissions committees should carefully consider the role of standardized entrance exam scores, in the context of a holistic review, when selecting for exceptional medical students. PMID:28979178

  1. cDNA cloning of Brassica napus malonyl-CoA:ACP transacylase (MCAT) (fab D) and complementation of an E. coli MCAT mutant.

    PubMed

    Simon, J W; Slabas, A R

    1998-09-18

    The GenBank database was searched using the E. coli malonyl CoA:ACP transacylase (MCAT) sequence, for plant protein/cDNA sequences corresponding to MCAT, a component of plant fatty acid synthetase (FAS), for which the plant cDNA has not been isolated. A 272-bp Zea mays EST sequence (GenBank accession number: AA030706) was identified which has strong homology to the E. coli MCAT. A PCR derived cDNA probe from Zea mays was used to screen a Brassica napus (rape) cDNA library. This resulted in the isolation of a 1200-bp cDNA clone which encodes an open reading frame corresponding to a protein of 351 amino acids. The protein shows 47% homology to the E. coli MCAT amino acid sequence in the coding region for the mature protein. Expression of a plasmid (pMCATrap2) containing the plant cDNA sequence in Fab D89, an E. coli mutant, in MCAT activity restores growth demonstrating functional complementation and direct function of the cloned cDNA. This is the first functional evidence supporting the identification of a plant cDNA for MCAT.

  2. Should the MCAT exam be used for medical school admissions in Canada?

    PubMed

    Eskander, Antoine; Shandling, Maureen; Hanson, Mark D

    2013-05-01

    In light of the structural and content changes to the Medical College Admission Test (MCAT) to be implemented in 2015 and the recent diversity- and social-accountability-based recommendations of the Future of Medical Education in Canada (FMEC) project, the authors review and reexamine the use of the MCAT exam in Canadian medical school admissions decisions.This Perspective article uses a point-counterpoint format to discuss three main advantages and disadvantages of using the MCAT exam in the medical school admissions process, from a Canadian perspective. The authors examine three questions regarding the FMEC recommendations and the revised MCAT exam: (1) Is the MCAT exam equal and useful in Canadian admissions? (2) Does the MCAT exam affect matriculant diversity? and (3) Is the MCAT exam a strong predictor of future performance? They present the most recent arguments and evidence for and against use of the MCAT exam, with the purpose of summarizing these different perspectives for readers.

  3. Adult Learners: Relationships of Reading, MCAT, and USMLE Step 1 Test Results for Medical Students.

    ERIC Educational Resources Information Center

    Haught, Patricia A.; Walls, Richard T.

    This study examined the possible relationship between scores on the Nelson-Denny Reading Test (current forms G and H) and performance on the Medical College Admissions Test (MCAT) and the United States Medical Licensing Examination (USMLE) Step 1 examination scores. Participants were 730 medical students at a mid-Atlantic university, and for 572…

  4. The New MCAT and Medical Student Performance.

    ERIC Educational Resources Information Center

    Friedman, Charles P.; Bakewell, William E., Jr.

    1980-01-01

    An analysis of the new Medical College Admission Test (MCAT) and its relationship to the criterion of class standing achieved in the school year ending in the spring of 1979 has been undertaken by the University of California, Irvine, to determine the MCAT's predictive power so that test results can be used in admissions procedure. (Author/JMD)

  5. Factor Structure of the MCAT and Pilot Essay.

    ERIC Educational Resources Information Center

    Mitchell, Karen J.; Molidor, John B.

    1986-01-01

    Research reported in this paper considered the construct validity of a trial essay administered in 1985-87 Medical College Admission Test (MCAT). The addition of the essay caused the non-science factor observed in previous MCAT research to be more strongly defined. (Author/LMO)

  6. The crystal structure of MCAT from Mycobacterium tuberculosis reveals three new catalytic models.

    PubMed

    Li, Zexuan; Huang, Yishu; Ge, Jing; Fan, Hang; Zhou, Xiaohong; Li, Shentao; Bartlam, Mark; Wang, Honghai; Rao, Zihe

    2007-08-24

    The malonyl coenzyme A (CoA)-acyl carrier protein (ACP) transacylase (MCAT) plays a key role in cell wall biosynthesis in Mycobacterium tuberculosis and other bacteria. The M. tuberculosis MCAT (MtMCAT) is encoded by the FabD gene and catalyzes the transacylation of malonate from malonyl-CoA to holo-ACP. Malonyl-ACP is the substrate in fatty acid biosynthesis and is a by-product of the transacylation reaction. This ability for fatty acid biosynthesis enables M. tuberculosis to survive in hostile environments, and thus understanding the mechanism of biosynthesis is important for the design of new anti-tuberculosis drugs. The 2.3 A crystal structure of MtMCAT reported here shows that its catalytic mechanism differs from those of ScMCAT and EcMCAT, whose structures have previously been determined. In MtMCAT, the C(beta)-O(gamma) bond of Ser91 turns upwards, resulting in a different orientation and thus an overall change of the active pocket compared to other known MCAT enzymes. We identify three new nucleophilic attack chains from the MtMCAT structure: His90-Ser91, Asn155-Wat6-Ser91 and Asn155-His90-Ser91. Enzyme activity assays show that His90A, Asn155A and His90A-Asn155A mutants all have substantially reduced MCAT activity, indicating that M. tuberculosis MCAT supports a unique means of proton transfer. Furthermore, His194 cannot form part of a His-Ser catalytic dyad and only stabilizes the substrate. This new discovery should provide a deeper insight into the catalytic mechanisms of MCATs.

  7. Development of the NASA MCAT Auxiliary Telescope for Orbital Debris Research

    NASA Technical Reports Server (NTRS)

    Frith, James; Lederer, Sue; Cowardin, Heather; Buckalew, Brent; Hickson, Paul; Anz-Meador, Phillip

    2016-01-01

    The National Aeronautical Space Administration has deployed the Meter Class Autonomous Telescope (MCAT) to Ascension Island with plans for it to become fully operational by summer 2016. This telescope will be providing data in support of research being conducted by the Orbital Debris Program Office at the Johnson Space Center. In addition to the main observatory, a smaller, auxiliary telescope is being deployed to the same location to augment and support observations generated by MCAT. It will provide near-simultaneous photometry and astrometry of debris objects, independent measurements of the seeing conditions, and offload low priority targets from MCAT's observing queue. Its hardware and software designs are presented here The National Aeronautical and Space Administration (NASA) has recently deployed the Meter Class Autonomous Telescope (MCAT) to Ascension Island. MCAT will provide NASA with a dedicated optical sensor for observations of orbital debris with the goal of statistically sampling the orbital and photometric characteristics of the population from low Earth to Geosynchronous orbits. Additionally, a small auxiliary telescope, co-located with MCAT, is being deployed to augment its observations by providing near-simultaneous photometry and astrometry, as well as offloading low priority targets from MCAT's observing queue. It will also serve to provide an independent measurement of the seeing conditions to help monitor the quality of the data being produced by the larger telescope. Comprised of off-the-shelf-components, the MCAT Auxiliary Telescope will have a 16-inch optical tube assembly, Sloan g'r'i'z' and Johnson/Cousins BVRI filters, and a fast tracking mount to help facilitate the tracking of objects in low Earth orbit. Tracking modes and tasking will be similar to MCAT except an emphasis will be placed on observations that provide more accurate initial orbit determination for the objects detected by MCAT. The near-simultaneous observations will

  8. Appraising the Dimensionality of the Medical College Admission Test. MCAT Monograph.

    ERIC Educational Resources Information Center

    Meara, Kevin; Sireci, Stephen G.

    To provide a better understanding of the structure of the Medical College Admission Test (MCAT) and to determine if there are structural differences across selected groups of MCAT examinees, several dimensionality analyses were conducted on data from recent administrations of the MCAT. The first set of analyses focused on the global structure of…

  9. Dynamic heart model for the mathematical cardiac torso (MCAT) phantom to represent the invariant total heart volume

    NASA Astrophysics Data System (ADS)

    Pretorius, P. H.; King, Michael A.; Tsui, Benjamin M.; LaCroix, Karen; Xia, Weishi

    1998-07-01

    This manuscript documents the alteration of the heart model of the MCAT phantom to better represent cardiac motion. The objective of the inclusion of motion was to develop a digital simulation of the heart such that the impact of cardiac motion on single photon emission computed tomography (SPECT) imaging could be assessed and methods of quantitating cardiac function could be investigated. The motion of the dynamic MCAT's heart is modeled by a 128 time frame volume curve. Eight time frames are averaged together to obtain a gated perfusion acquisition of 16 time frames and ensure motion within every time frame. The position of the MCAT heart was changed during contraction to rotate back and forth around the long axis through the center of the left ventricle (LV) using the end systolic time frame as turning point. Simple respiratory motion was also introduced by changing the orientation of the heart model in a 2 dimensional (2D) plane with every time frame. The averaging effect of respiratory motion in a specific time frame was modeled by randomly selecting multiple heart locations between two extreme orientations. Non-gated perfusion phantoms were also generated by averaging over all time frames. Maximal chamber volumes were selected to fit a profile of a normal healthy person. These volumes were changed during contraction of the ventricles such that the increase in volume in the atria compensated for the decrease in volume in the ventricles. The myocardium were modeled to represent shortening of muscle fibers during contraction with the base of the ventricles moving towards a static apex. The apical region was modeled with moderate wall thinning present while myocardial mass was conserved. To test the applicability of the dynamic heart model, myocardial wall thickening was measured using maximum counts and full width half maximum measurements, and compared with published trends. An analytical 3D projector, with attenuation and detector response included, was used

  10. The Persisting Racial Scoring Gap on Graduate and Professional School Admission Tests.

    ERIC Educational Resources Information Center

    Journal of Blacks in Higher Education, 2003

    2003-01-01

    Discusses the racial scoring gap on tests for admission to medical, business, law, and other graduate programs, noting that in the highest-scoring brackets on the Medical College Admission Test (MCAT), the racial gap is even larger. Whites are five times, twelve times, and seven times more likely, respectively, to score higher on the MCAT, Law…

  11. Role for malonyl coenzyme A:acyl carrier protein transacylase (MCAT) in the growth-inhibitory effect of the calmodulin antagonist trifluoperazine in Mycobacterium bovis BCG.

    PubMed

    Sinha, Indrajit; Dick, Thomas

    2004-06-01

    To determine whether the fatty acid synthesis enzyme malonyl coenzyme A:acyl carrier protein transacylase (MCAT) is involved in the growth-inhibitory effect of trifluoperazine in the tubercle bacillus Mycobacterium bovis BCG. BCG was grown in liquid culture with various concentrations of trifluoperazine and growth was monitored by OD measurement. To determine the effect of trifluoperazine on MCAT protein level, total protein was extracted from BCG cultures and was analysed by 2D gel electrophoresis and western blot. To confirm trifluoperazine-dependent reduction in the MCAT protein level, two BCG strains overexpressing MCAT at a low and high constitutive level were similarly tested. The synergic effect of trifluoperazine and isoniazid was tested at sub-MIC levels in liquid cultures. Trifluoperazine inhibition of growth correlates with reduction in the steady-state level of MCAT protein. Overexpression of MCAT confers resistance to trifluoperazine. Trifluoperazine acts synergically (albeit weakly) with isoniazid and no resistance towards isoniazid alone was observed due to overexpression of MCAT. This suggests MCAT to be a specific target of trifluoperazine. These results indicate MCAT as a target of trifluoperazine and provide an explanation for the inhibitory effect of trifluoperazine on mycobacterial lipid synthesis observed earlier. This makes MCAT a potential target for new antimycobacterials.

  12. NASA's Optical Program on Ascension Island: Bringing MCAT to Life as the Eugene Stansbery-Meter Class Autonomous Telescope (ES-MCAT)

    NASA Astrophysics Data System (ADS)

    Lederer, S. M.; Hickson, P.; Cowardin, H. M.; Buckalew, B.; Frith, J.; Alliss, R.

    In June 2015, the construction of the Meter Class Autonomous Telescope was completed and MCAT saw the light of the stars for the first time. In 2017, MCAT was newly dedicated as the Eugene Stansbery-MCAT telescope by NASA’s Orbital Debris Program Office (ODPO), in honour of his inspiration and dedication to this newest optical member of the NASA ODPO. Since that time, MCAT has viewed the skies with one engineering camera and two scientific cameras, and the ODPO optical team has begun the process of vetting the entire system. The full system vetting includes verification and validation of: (1) the hardware comprising the system (e.g. the telescopes and its instruments, the dome, weather systems, all-sky camera, FLIR cloud infrared camera, etc.), (2) the custom-written Observatory Control System (OCS) master software designed to autonomously control this complex system of instruments, each with its own control software, and (3) the custom written Orbital Debris Processing software for post-processing the data. ES-MCAT is now capable of autonomous observing to include Geosyncronous survey, TLE (Two-line element) tracking of individual catalogued debris at all orbital regimes (Low-Earth Orbit all the way to Geosynchronous (GEO) orbit), tracking at specified non-sidereal rates, as well as sidereal rates for proper calibration with standard stars. Ultimately, the data will be used for validation of NASA’s Orbital Debris Engineering Model, ORDEM, which aids in engineering designs of spacecraft that require knowledge of the orbital debris environment and long-term risks for collisions with Resident Space Objects (RSOs).

  13. NASA's Optical Program on Ascension Island: Bringing MCAT to Life as the Eugene Stansbery-Meter Class Autonomous Telescope (ES-MCAT)

    NASA Technical Reports Server (NTRS)

    Lederer, S. M.; Hickson, P.; Cowardin, H. M.; Buckalew, B.; Frith, J.; Alliss, R.

    2017-01-01

    In June 2015, the construction of the Meter Class Autonomous Telescope was completed and MCAT saw the light of the stars for the first time. In 2017, MCAT was newly dedicated as the Eugene Stansbery-MCAT telescope by NASA's Orbital Debris Program Office (ODPO), in honor of his inspiration and dedication to this newest optical member of the NASA ODPO. Since that time, MCAT has viewed the skies with one engineering camera and two scientific cameras, and the ODPO optical team has begun the process of vetting the entire system. The full system vetting includes verification and validation of: (1) the hardware comprising the system (e.g. the telescopes and its instruments, the dome, weather systems, all-sky camera, FLIR cloud infrared camera, etc.), (2) the custom-written Observatory Control System (OCS) master software designed to autonomously control this complex system of instruments, each with its own control software, and (3) the custom written Orbital Debris Processing software for post-processing the data. ES-MCAT is now capable of autonomous observing to include Geosynchronous survey, TLE (Two-line element) tracking of individual catalogued debris at all orbital regimes (Low-Earth Orbit all the way to Geosynchronous (GEO) orbit), tracking at specified non-sidereal rates, as well as sidereal rates for proper calibration with standard stars. Ultimately, the data will be used for validation of NASA's Orbital Debris Engineering Model, ORDEM, which aids in engineering designs of spacecraft that require knowledge of the orbital debris environment and long-term risks for collisions with Resident Space Objects (RSOs).

  14. Development of the NASA MCAT Auxiliary Telescope for Orbital Debris Research

    NASA Technical Reports Server (NTRS)

    Frith, James; Lederer, Susan; Cowardin, Heather; Buckalew, Brent; Hickson, Paul; Anz-Meador, Phillip

    2016-01-01

    The National Aeronautical and Space Administration (NASA) has recently deployed the Meter Class Autonomous Telescope (MCAT) to Ascension Island. MCAT will provide NASA with a dedicated optical sensor for observations of orbital debris with the goal of statistically sampling the orbital and photometric characteristics of the population from low Earth to Geosynchronous orbits. Additionally, a small auxiliary telescope, co-located with MCAT, is being deployed to augment its observations by providing near-simultaneous photometry and astrometry, as well as offloading low priority targets from MCAT's observing queue. It will also be available to provide observational measurements to the Space Surveillance Network for the United States Air Force.

  15. MCAT is not required for in vitro polyketide synthesis in a minimal actinorhodin polyketide synthase from Streptomyces coelicolor.

    PubMed

    Matharu, A L; Cox, R J; Crosby, J; Byrom, K J; Simpson, T J

    1998-12-01

    It has been proposed that Streptomyces malonyl CoA: holo acyl carrier protein transacylases (MCATs) provide a link between fatty acid and polyketide biosynthesis. Two recent studies have provided evidence that the presence of MCAT is essential for polyketide synthesis to proceed in reconstituted minimal polyketide synthases (PKSs). In contrast to this, we previously showed that the holo acyl carrier proteins (ACPs) from type II PKSs are capable of catalytic self-malonylation in the presence of malonyl CoA, which suggests that MCAT might not be necessary for polyketide biosynthesis. We reconstituted a homologous actinorhodin (act) type II minimal PKS in vitro. When act holo-ACP is present in limiting concentrations, MCAT is required by the synthase complex in order for polyketide biosynthesis to proceed. When holo-ACP is present in excess, however, efficient polyketide synthesis proceeds without MCAT. The rate of polyketide production increases with holo-ACP concentration, but at low ACP concentration or equimolar AC:KS:CLF (KS, ketosynthase; CLF, chain length determining factor) concentrations this rate is significantly lower than expected, indicating that free holo-ACP is sequestered by the KS/CLF complex. The rate of polyketide biosynthesis is dictated by the ratio of holo-ACP to KS and CLF, as well as by the total protein concentration. There is no absolute requirement for MCAT in polyketide biosynthesis in vitro, although the role of MCAT during polyketide synthesis in vivo remains an open question. MCAT might be responsible for the rate enhancement of malonyl transfer at very low free holo-ACP concentrations or it could be required to catalyse the transfer of malonyl groups from malonyl CoA to sequestered holo-ACP.

  16. The predictive validity of three versions of the MCAT in relation to performance in medical school, residency, and licensing examinations: a longitudinal study of 36 classes of Jefferson Medical College.

    PubMed

    Callahan, Clara A; Hojat, Mohammadreza; Veloski, Jon; Erdmann, James B; Gonnella, Joseph S

    2010-06-01

    The Medical College Admission Test (MCAT) has undergone several revisions for content and validity since its inception. With another comprehensive review pending, this study examines changes in the predictive validity of the MCAT's three recent versions. Study participants were 7,859 matriculants in 36 classes entering Jefferson Medical College between 1970 and 2005; 1,728 took the pre-1978 version of the MCAT; 3,032 took the 1978-1991 version, and 3,099 took the post-1991 version. MCAT subtest scores were the predictors, and performance in medical school, attrition, scores on the medical licensing examinations, and ratings of clinical competence in the first year of residency were the criterion measures. No significant improvement in validity coefficients was observed for performance in medical school or residency. Validity coefficients for all three versions of the MCAT in predicting Part I/Step 1 remained stable (in the mid-0.40s, P < .01). A systematic decline was observed in the validity coefficients of the MCAT versions in predicting Part II/Step 2. It started at 0.47 for the pre-1978 version, decreased to between 0.42 and 0.40 for the 1978-1991 versions, and to 0.37 for the post-1991 version. Validity coefficients for the MCAT versions in predicting Part III/Step 3 remained near 0.30. These were generally larger for women than men. Although the findings support the short- and long-term predictive validity of the MCAT, opportunities to strengthen it remain. Subsequent revisions should increase the test's ability to predict performance on United States Medical Licensing Examination Step 2 and must minimize the differential validity for gender.

  17. Predictive Validity of the MCAT as a Function of Undergraduate Institution.

    ERIC Educational Resources Information Center

    Zeleznik, Carter; And Others

    1987-01-01

    A study examining how the Medical College Admission Test's (MCAT) ability to predict early medical school performance differed for students from different undergraduate institutions raised questions about the use of the MCAT for admissions decisions. (MSE)

  18. Do Reading Experts Agree with MCAT Verbal Reasoning Item Classifications?

    ERIC Educational Resources Information Center

    Jackson, Evelyn W.; And Others

    1994-01-01

    Examined whether expert raters (n=5) could agree about classification of Medical College Admission Test (MCAT) items and whether they agreed with MCAT student manual in labeling skill being measured by each test item. Results revealed difficulties in replicating authors' labeling of skills for reading items on practice test provided with 1991 MCAT…

  19. Predictors of scoring at least 600 on COMLEX-USA Level 1: successful preparation strategies.

    PubMed

    Vora, Aditya; Maltezos, Nathan; Alfonzo, Lauren; Hernandez, Nilda; Calix, Erica; Fernandez, M Isabel

    2013-02-01

    Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 scores are an important criterion used by residency directors to make residency placement decisions. To explore the association between scoring at least 600 on COMLEX-USA Level 1 and grade point average (GPA), scores on the Medical College Admission Test (MCAT), and different test preparation strategies. Third-year osteopathic medical students at Nova Southeastern University were invited to complete a self-administered survey regarding their COMLEX-USA preparation strategies and to provide consent for the researchers to access their preclinical GPA and their MCAT and COMLEX-USA scores. Descriptive analyses were conducted to understand examination preparation procedures and resources used, and bivariate analyses were conducted to identify the statisically significant predictors of scoring 600 or higher. Two separate logistic regressions were also run. The first included all of the statisically significant factors that emerged from the bivariate analyses, and the second examined which candidate predictors remained statistically significant once the effects of GPA and MCAT scores were removed. One hundred twenty-two students completed the survey, and 113 (93%) provided informed consent to access their preclinical GPA and their MCAT and COMLEX-USA scores. In the first regression, scoring 600 or higher was associated with a higher GPA (P<.02), a higher MCAT score (P<.05), earlier preparation initiation (P<.05), and not ranking the Comprehensive Osteopathic Medical Self-Assessment Examination (COMSAE) as the most helpful practice examination (P<.04). In the second regression, scoring 600 or higher was associated with earlier initiation of examination preparation (P<.01) and not ranking COMBANK (question bank for COMLEX-USA) as the most helpful question bank (P<.03). Among the different examination preparation methods, the specific resources ranked as most helpful were First Aid for the USMLE

  20. Scylla and Charybdis: The MCAT, USMLE, and Degrees of Freedom in Undergraduate Medical Education.

    PubMed

    Gliatto, Peter; Leitman, I Michael; Muller, David

    2016-11-01

    In recent years, medical educators have been making meaningful attempts to rethink how premedical students are prepared for medical school, and how medical students are prepared for residency. Among the many challenges to redesigning premedical and medical school curricula, one that stands out is the constraint imposed by our current methods of assessing aptitude, particularly our use of the Medical College Admissions Test (MCAT) and the United States Medical Licensing Examination (USMLE). For much of the past century, medical school and residency admissions committees have relied heavily on MCAT and USMLE scores to evaluate and rank candidates to their programs. These high-stakes exams determine to a large extent what is taught, and what is stressed, in preparation for and during medical school-despite the fact that scores have limited ability to predict future success in clinical medicine or biomedical research. Additionally, evidence indicates that students from disadvantaged and minority backgrounds do not fare as well on these exams and, as a result, may be disproportionately excluded from the medical profession. While medical school admissions committees have made limited incremental gains in holistic review, residency programs appear to be increasingly focused on USMLE Step scores and veering away from the spirit of holistic review. The authors propose that substantive change will remain slow in coming unless members of the medical education community radically rethink how we report scores from these exams, and how we use them in our selection of future medical students and residents.

  1. Functional characterizations of malonyl-CoA:acyl carrier protein transacylase (MCAT) in Eimeria tenella.

    PubMed

    Sun, Mingfei; Zhu, Guan; Qin, Zonghua; Wu, Caiyan; Lv, Minna; Liao, Shenquan; Qi, Nanshan; Xie, Mingquan; Cai, Jianping

    2012-07-01

    Eimeria tenella, an apicomplexan parasite in chickens, possesses an apicoplast and its associated metabolic pathways including the Type II fatty acid synthesis (FAS II). Malonyl-CoA:acyl-carry protein transacylase (MCAT) encoded by the fabD gene is one of the essential enzymes in the FAS II system. In the present study, the entire E. tenella MCAT gene (EtfabD) was cloned and sequenced. Immunolabeling located this protein in the apicoplast organelle in coccidial sporozoites. Functional replacement of the fabD gene with amber mutation of E. coli temperature-sensitive LA2-89 strain by E. tenella EtMCAT demonstrated that EcFabD and EtMCAT perform the same biochemical function. The recombinant EtMCAT protein was expressed and its general biochemical features were also determined. An alkaloid natural product corytuberine (CAS: 517-56-6) could specifically inhibit the EtMCAT activity (IC(50)=16.47μM), but the inhibition of parasite growth in vitro by corytuberine was very weak (the predicted MIC(50)=0.65mM). Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Characterization and inhibitor discovery of one novel malonyl-CoA: acyl carrier protein transacylase (MCAT) from Helicobacter pylori.

    PubMed

    Liu, Weizhi; Han, Cong; Hu, Lihong; Chen, Kaixian; Shen, Xu; Jiang, Hualiang

    2006-01-23

    Type II fatty acid synthesis (FAS II) is an essential process for bacteria survival, and malonyl-CoA:acyl carrier protein transacylase (MCAT) is a key enzyme in FAS II pathway, which is responsible for transferring the malonyl group from malonyl-CoA to the holo-ACP by forming malonyl-ACP. In this work, we described the cloning, characterization and enzymatic inhibition of a new MCAT from Helicobacter pylori strain SS1 (HpMCAT), and the gene sequence of HpfabD was deposited in the GenBank database (Accession No. AY738332 ). Enzymatic characterization of HpMCAT showed that the K(m) value for malonyl-CoA was 21.01+/-2.3 microM, and the thermal- and guanidinium hydrochloride-induced unfolding processes for HpMCAT were quantitatively investigated by circular dichroism spectral analyses. Moreover, a natural product, corytuberine, was discovered to demonstrate inhibitory activity against HpMCAT with IC(50) value at 33.1+/-3.29 microM. Further enzymatic assay results indicated that corytuberine inhibits HpMCAT in an uncompetitive manner. To our knowledge, this is the firstly reported MCAT inhibitor to date. This current work is hoped to supply useful information for better understanding the MCAT features of H. pylori strain, and corytuberine might be used as a potential lead compound in the discovery of the antibacterial agents using HpMCAT as target.

  3. MCAT elements and the TEF-1 family of transcription factors in muscle development and disease.

    PubMed

    Yoshida, Tadashi

    2008-01-01

    MCAT elements are located in the promoter-enhancer regions of cardiac, smooth, and skeletal muscle-specific genes including cardiac troponin T, beta-myosin heavy chain, smooth muscle alpha-actin, and skeletal alpha-actin, and play a key role in the regulation of these genes during muscle development and disease. The binding factors of MCAT elements are members of the transcriptional enhancer factor-1 (TEF-1) family. However, it has not been fully understood how these transcription factors confer cell-specific expression in muscle, because their expression patterns are relatively broad. Results of recent studies revealed multiple mechanisms whereby TEF-1 family members control MCAT element-dependent muscle-specific gene expression, including posttranslational modifications of TEF-1 family members, the presence of muscle-selective TEF-1 cofactors, and cell-selective control of TEF-1 accessibility to MCAT elements. In addition, of particular interest, recent studies regarding MCAT element-dependent transcription of the myocardin gene and the smooth muscle alpha-actin gene in muscle provide evidence for the transcriptional diversity among distinct cell types and subtypes. This article summarizes the role of MCAT elements and the TEF-1 family of transcription factors in muscle development and disease, and reviews recent progress in our understanding of the transcriptional regulatory mechanisms involved in MCAT element-dependent muscle-specific gene expression.

  4. The effectiveness of AGU-MCAT in predicting medical student performance in year one of the College of Medicine of the Arabian Gulf University.

    PubMed

    Alnasir, F A; Jaradat, A A

    2011-08-01

    To graduate good doctors, medical schools should adopt proper student procedures to select among applicant students. When selecting students, many medical colleges focus solely on their academic achievement on high school examinations, which do not reflect all, important attributes of student. For several years, the College of Medicine and Medical Sciences of the Arabian Gulf University has introduced and administered the AGU-MCAT (Arabian Gulf University Medical College Assessment Test) for screening student applicants. This study aimed to assess the ability of the AGU-MCAT to predict students' performance during their first year college study, as an example of one school's multi-dimensional admissions screening process. The AGU-MCAT is made up of three parts, including a written test on science, a test of students' English language skills and an interview. In the first part, students' science knowledge is tested with 100 multiple choice questions. The English exam assesses students. English reading and listening skills. Lastly, students are interviewed by two faculty members and one senior student to assess their personal qualities. The 138 students who passed the AGU-MCAT in September 2008 and matriculated in the school were studied. Their performance during Year One including their performance on exams in the various disciplines was compared to their achievement on the three AGU-MCAT components. AGU-MCAT's total mark and its science component had the highest linear relationship to students' performance in the various disciplines in Year One, while the strongest predictor of students' performance at the end of Year One was the AGU-MCAT's science test (R2=45.5%). Students' grades in high school did not predict their achievement in Year One. The AGU-MCAT used to screen applicants to the school also predicts students' performance during their first year of medical school.

  5. Characteristics of the 1999 MCAT Examinees.

    ERIC Educational Resources Information Center

    Association of American Medical Colleges, Washington, DC.

    This publication is designed to help admissions committees, other medical school officials, and health professional advisors interpret student Medical College Admission (MCAT) performance. Data presented in this publication may be useful for those providing career counseling or designing programs to attract students to the practice of medicine.…

  6. Characteristics of the 1998 MCAT Examinees.

    ERIC Educational Resources Information Center

    Peck, Jeremy; Cooke, Amy Isenberg

    This publication is designed to help admissions committees, other medical school officers, and health professions advisors interpret students' Medical College Admission Test (MCAT) performance. The data can also help in comparing individual students with their peers in terms of attitudes, preferences, and beliefs about medical school and medical…

  7. Cloning, purification, crystallization and preliminary X-ray crystallographic analysis of MCAT from Synechocystis sp. PCC 6803.

    PubMed

    Liu, Yinghui; Zhang, Yanming; Cao, Xupeng; Xue, Song

    2013-11-01

    Malonyl-coenzymeA:acyl-carrier protein transacylase (MCAT), which catalyzes the transfer of the malonyl group from malonyl-CoA to acyl-carrier protein (ACP), is an essential enzyme in type II fatty-acid synthesis. The enzyme MCAT from Synechocystis sp. PCC 6803 (spMCAT), the first MCAT counterpart from a cyanobacterium, was cloned, purified and crystallized in order to determine its three-dimensional crystal structure. A higher-quality crystal with better diffraction was obtained by crystallization optimization. The crystal diffracted to 1.8 Å resolution and belonged to the orthorhombic space group P2(1)2(1)2, with unit-cell parameters a = 43.22, b = 149.21, c = 40.59 Å. Matthews coefficient calculations indicated that the crystal contained one spMCAT molecule in the asymmetric unit with a Matthews coefficient of 2.18 Å(3) Da(-1) and a solvent content of 43.65%.

  8. Cloning, purification, crystallization and preliminary X-ray crystallographic analysis of MCAT from Staphylococcus aureus.

    PubMed

    Hong, Seung Kon; Kim, Kook Han; Kim, Eunice EunKyeong

    2010-01-01

    Malonyl-CoA:acyl-carrier protein transacylase (MCAT), encoded by the fabd gene, is a key enzyme in type II fatty-acid biosynthesis. It is responsible for transferring the malonyl group from malonyl-CoA to the holo acyl-carrier protein (ACP). Since the type II system differs from the type I system that mammals use, it has received enormous attention as a possible antibiotic target. In particular, only a single isoform of MCAT has been reported and a continuous coupled enzyme assay has been developed. MCAT from Staphylococcus aureus was overexpressed in Escherichia coli and the protein was purified and crystallized. Diffraction data were collected to 1.2 A resolution. The crystals belonged to space group P2(1), with unit-cell parameters a = 41.608, b = 86.717, c = 43.163 A, alpha = gamma = 90, beta = 106.330 degrees . The asymmetric unit contains one SaMCAT molecule.

  9. A simpler method for total scalp irradiation: the multijaw-size concave arc technique.

    PubMed

    Inoue, Minoru; Konno, Masahiro; Ogawa, Hirofumi; Harada, Hideyuki; Asakura, Hirofumi; Fuji, Hiroshi; Murayama, Shigeyuki; Nishimura, Tetsuo

    2014-07-08

    The lateral electron-photon technique (LEPT) and intensity-modulated radiation therapy (IMRT) are commonly used for total scalp irradiation. However, the treatment planning and irradiation are laborious and time-consuming. We herein present the multijaw-size concave arc technique (MCAT) as a total scalp irradiation method that overcomes these problems. CT datasets for eight patients previously treated for angiosarcoma of the scalp were replanned using MCAT, LEPT, and IMRT. The MCAT was designed with a dynamic conformal arc for the total scalp, with a multileaf collimator to shield the brain. Two additional conformal arcs with a decreased upper-jaw position of the first dynamic conformal arc were used to reduce the cranial hotspots. The prescribed dose was 40 Gy (2 Gy/fraction) to 95% of the planning target volume (PTV, defined as the total scalp plus a 4 mm margin). MCAT was compared with LEPT and IMRT with respect to the PTV dose homogeneity (D5%-95%), underdosage (V < 90%), overdosage (V > 110%), doses to the brain, and the delivery time and monitor units (MUs) for single irradiation. We were able to formulate treatment plans for all three techniques that could deliver the prescription dose in all patients. MCAT was significantly superior to LEPT with respect to PTV dose homogeneity, overdosage, and underdosage, although MCAT was inferior to IMRT with respect to dose homogeneity and overdosage. The mean brain dose and high-dosage volume of all three techniques were low, but IMRT provided larger volume to the brain than did the other two techniques in the low dosage region. In MCAT, the mean delivery time could be reduced by approximately half or more, and the mean MUs could be reduced by at least 100 compared to the other two techniques. MCAT can achieve total scalp irradiation with substantially fewer MUs and a shorter delivery time than LEPT and IMRT.

  10. Practical Implications of Test Dimensionality for Item Response Theory Calibration of the Medical College Admission Test. MCAT Monograph.

    ERIC Educational Resources Information Center

    Childs, Ruth A.; Oppler, Scott H.

    The use of item response theory (IRT) in the Medical College Admission Test (MCAT) testing program has been limited. This study provides a basis for future IRT analyses of the MCAT by exploring the dimensionality of each of the MCAT's three multiple-choice test sections (Verbal Reasoning, Physical Sciences, and Biological Sciences) and the…

  11. 49 CFR Appendix D to Part 213 - Minimally Compliant Analytical Track (MCAT) Simulations Used for Qualifying Vehicles To Operate...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... key responses observed during qualification testing. (b) MCAT layout. MCAT consists of nine segments, each designed to test a vehicle's performance in response to a specific type of track perturbation. The basic layout of MCAT is shown in figure 1 of this appendix, by type of track (curving or tangent), class...

  12. 49 CFR Appendix D to Part 213 - Minimally Compliant Analytical Track (MCAT) Simulations Used for Qualifying Vehicles To Operate...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... key responses observed during qualification testing. (b) MCAT layout. MCAT consists of nine segments, each designed to test a vehicle's performance in response to a specific type of track perturbation. The basic layout of MCAT is shown in figure 1 of this appendix, by type of track (curving or tangent), class...

  13. What Role Does Schema Play in Preparing Minority Postbaccalaureate Students for the Reading Comprehension Section of the Medical College Admissions Test (MCAT)?

    ERIC Educational Resources Information Center

    Paul, Gina; Verhulst, Steve

    2007-01-01

    Problem: Minority students often score lower than majority students on the Medical College Admissions Test (MCAT) Verbal Reasoning section. Method: To determine what role schema plays in reading comprehension in 64 adult minority students, the Treatment group viewed a slide presentation regarding a topic that both groups would be tested on in a…

  14. Use of MCAT Data in Admissions. A Guide for Medical School Admissions Officers and Faculty.

    ERIC Educational Resources Information Center

    Mitchell, Karen J.

    A description of the standardized, multiple-choice Medical College Admission Test (MCAT) and how to use it is offered. Medical school admissions officers medical educators, college faculty members, and practicing physicians are active participants in selecting content, drafting test specifications, and authoring questions for the exam. The MCAT is…

  15. Two MCAT elements of the SM alpha-actin promoter function differentially in SM vs. non-SM cells.

    PubMed

    Swartz, E A; Johnson, A D; Owens, G K

    1998-08-01

    Transcriptional activity of the smooth muscle (SM) alpha-actin gene is differentially regulated in SM vs. non-SM cells. Contained within the rat SM alpha-actin promoter are two MCAT motifs, binding sites for transcription enhancer factor 1 (TEF-1) transcriptional factors implicated in the regulation of many muscle-specific genes. Transfections of SM alpha-actin promoter-CAT constructs containing wild-type or mutagenized MCAT elements were performed to evaluate their functional significance. Mutation of the MCAT elements resulted in increased transcriptional activity in SM cells, whereas these mutations either had no effect or decreased activity in L6 myotubes or endothelial cells. High-resolution gel shift assays resolved several complexes of different mobilities that were formed between MCAT oligonucleotides and nuclear extracts from the different cell types, although no single band was unique to SM. Western blot analysis of nuclear extracts with polyclonal antibodies to conserved domains of the TEF-1 gene family revealed multiple reactive bands, some that were similar and others that differed between SM and non-SM. Supershift assays with a polyclonal antibody to the TEF-related protein family demonstrated that TEF-1 or TEF-1-related proteins were contained in the shifted complexes. Results suggest that the MCAT elements may contribute to cell type-specific regulation of the SM alpha-actin gene. However, it remains to be determined whether the differential transcriptional activity of MCAT elements in SM vs. non-SM is due to differences in expression of TEF-1 or TEF-1-related proteins or to unique (cell type specific) combinatorial interactions of the MCAT elements with other cis-elements and trans-factors.

  16. A simpler method for total scalp irradiation: the multijaw‐size concave arc technique

    PubMed Central

    Konno, Masahiro; Ogawa, Hirofumi; Harada, Hideyuki; Asakura, Hirofumi; Fuji, Hiroshi; Murayama, Shigeyuki; Nishimura, Tetsuo

    2014-01-01

    The lateral electron‐photon technique (LEPT) and intensity‐modulated radiation therapy (IMRT) are commonly used for total scalp irradiation. However, the treatment planning and irradiation are laborious and time‐consuming. We herein present the multijaw‐size concave arc technique (MCAT) as a total scalp irradiation method that overcomes these problems. CT datasets for eight patients previously treated for angiosarcoma of the scalp were replanned using MCAT, LEPT, and IMRT. The MCAT was designed with a dynamic conformal arc for the total scalp, with a multileaf collimator to shield the brain. Two additional conformal arcs with a decreased upper‐jaw position of the first dynamic conformal arc were used to reduce the cranial hotspots. The prescribed dose was 40 Gy (2 Gy/fraction) to 95% of the planning target volume (PTV, defined as the total scalp plus a 4 mm margin). MCAT was compared with LEPT and IMRT with respect to the PTV dose homogeneity (D5%–95%), underdosage (V < 90%), overdosage (V > 110%), doses to the brain, and the delivery time and monitor units (MUs) for single irradiation. We were able to formulate treatment plans for all three techniques that could deliver the prescription dose in all patients. MCAT was significantly superior to LEPT with respect to PTV dose homogeneity, overdosage, and underdosage, although MCAT was inferior to IMRT with respect to dose homogeneity and overdosage. The mean brain dose and high‐dosage volume of all three techniques were low, but IMRT provided larger volume to the brain than did the other two techniques in the low dosage region. In MCAT, the mean delivery time could be reduced by approximately half or more, and the mean MUs could be reduced by at least 100 compared to the other two techniques. MCAT can achieve total scalp irradiation with substantially fewer MUs and a shorter delivery time than LEPT and IMRT. PACS number: 87.55.D‐ PMID:25207405

  17. MCAT, LSAT and Physics Bachelor's. Focus On

    ERIC Educational Resources Information Center

    Statistical Research Center of the American Institute of Physics, 2013

    2013-01-01

    Physics majors pursue a wide variety of career paths, many of which are not what you might expect. Some pursue advanced training by applying to graduate schools, medical schools, or law schools. The Medical College Admissions Test (MCAT) and Law School Admission Test (LSAT) data in this report show that the physics majors who applied to either…

  18. NASA's Orbital Debris Optical and IR Ground-based Observing Program: Utilizing the MCAT, UKIRT, and Magellan Telescopes

    NASA Astrophysics Data System (ADS)

    Lederer, S.; Cowardin, H.; Buckalew, B.; Frith, J.; Hickson, P.; Pace, L.; Matney, M.; Anz-Meador, P.; Seitzer, P.; Stansbery, E.; Glesne, T.

    2016-09-01

    Characterizing debris in Earth-orbit has become increasingly important as the growing population of debris poses greater threats to active satellites each year. Currently, the Joint Space Operations is tracking > 23,000 objects ranging in size from 1-meter and larger in Geosychronous orbits (GEO) to 10-cm and larger at low-Earth orbits (LEO). Model estimates suggest that there are hundreds of thousands of pieces of spacecraft debris larger than 10 cm currently in orbit around the Earth. With such a small fraction of the total population being tracked, and new break-ups occurring from LEO to GEO, new assets, techniques, and approaches for characterizing this debris are needed. With this in mind, NASA's Orbital Debris Program Office has actively tasked a suite of telescopes around the world. In 2015, the newly-built 1.3m optical Meter Class Autonomous Telescope (MCAT) came on-line on Ascension Island and is now being commissioned. MCAT is designed to track Earth-orbiting objects above 200km, conduct surveys at GEO, and work with a co-located Raven-class commercial-off-the-shelf system, a 0.4m telescope with a field-of-view similar to MCAT's and research-grade instrumentation designed to complement MCAT. The 3.8m infrared UKIRT telescope on Mauna Kea, Hawaii has been heavily tasked to collect data on individual targets and in survey modes to study both the general GEO population and a break-up event. Data collected include photometry and spectroscopy in the near-Infrared (0.85 - 2.5μm) and the mid-infrared (8-16μm). Finally, the 6.5-m Baade Magellan telescope at Las Campanas Observatory in Chile was used to collect optical photometric survey data in October 2015 of two GEO Titan transtage breakups, focusing on locations of possible debris concentrations as indicated by the NASA standard break-up model.

  19. Premedical special master’s programs increase USMLE STEP1 scores and improve residency placements

    PubMed Central

    Khuder, Sadik

    2017-01-01

    The effectiveness of Special Master’s Programs (SMPs) in benefiting a potential medical student’s career beyond admission into an MD-program is largely unknown. This study aims to evaluate the role of SMPs, if any, in affecting the performance and outcomes of students during their medical school career. This study analyzed anonymous surveys of students and residents from the University of Toledo. The data analysis is used to evaluate a student’s academic performance before, during and after medical school. Measured metrics included: MCAT Scores, undergraduate GPA, USMLE STEP 1 scores, participation in research, number of research publications, and residency placement. Of 500 people surveyed 164 medical students or residents responded. Based on their responses, the respondents were divided into traditional (non-SMP) and SMP groups. As anticipated, MCAT scores (SMP: 29.82 vs. traditional 31.10) are significantly (p<0.05) different between the two groups. Interestingly, there is no significant difference in USMLE STEP 1 scores (SMP: 232.7 vs. traditional: 233.8) and when normalized relative to MCAT scores, USMLE STEP 1 scores for SMP-students are significantly (p<0.05) higher than their traditional counterparts (p<0.05). Additionally, SMP-students did not outperform the traditional students with regards to research publications. But, they did demonstrate a significant (p<0.05) proclivity towards surgical residencies when compared to the traditional students. Overall, our results highlight that SMPs potentiate USMLE STEP 1 performance and competitive residency-placements for its students. PMID:29190691

  20. Structural and biochemical characterization of MCAT from photosynthetic microorganism Synechocystis sp. PCC 6803 reveal its stepwise catalytic mechanism.

    PubMed

    Liu, Yinghui; Feng, Yanbin; Wang, Yayue; Li, Xia; Cao, Xupeng; Xue, Song

    2015-02-13

    Malonyl-coenzyme A: acyl-carrier protein transacylase (MCAT) catalyzes the transfer of malonyl group from malonyl-CoA to the holo-acyl carrier protein (Holo-ACP), yielding malonyl-ACP. The overall reaction has been extensively studied in heterotrophic microorganisms, while its mechanism in photosynthetic autotrophs as well as the stepwise reaction information remains unclear. Here the 2.42 Å crystal structure of MCAT from photosynthetic microorganism Synechocystis sp. PCC 6803 is presented. It demonstrates that Arg113, Ser88 and His188 constitute catalytic triad. The second step involved ACP-MCAT-malonyl intermediate is speed-limited instead of the malonyl-CoA-MCAT intermediate in the first step. Therefore His87, Arg113 and Ser88 render different contributions for the two intermediates. Additionally, S88T mutant initializes the reaction by H87 deprotonating S88T which is different from the wild type. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Contrasting the effects of proton irradiation on dendritic complexity of subiculum neurons in wild type and MCAT mice.

    PubMed

    Chmielewski, Nicole N; Caressi, Chongshan; Giedzinski, Erich; Parihar, Vipan K; Limoli, Charles L

    2016-06-01

    Growing evidence suggests that radiation-induced oxidative stress directly affects a wide range of biological changes with an overall negative impact on CNS function. In the past we have demonstrated that transgenic mice over-expressing human catalase targeted to the mitochondria (MCAT) exhibit a range of neuroprotective phenotypes following irradiation that include improved neurogenesis, dendritic complexity, and cognition. To determine the extent of the neuroprotective phenotype afforded by MCAT expression in different hippocampal regions, we analyzed subiculum neurons for changes in neuronal structure and synaptic integrity after exposure to low dose (0.5 Gy) 150 MeV proton irradiation. One month following irradiation of WT and MCAT mice, a range of morphometric parameters were quantified along Golgi-Cox impregnated neurons. Compared with WT mice, subiculum neurons from MCAT mice exhibited increased trends (albeit not statistically significant) toward increased dendritic complexity in both control and irradiated cohorts. However, Sholl analysis of MCAT mice revealed significantly increased arborization of the distal dendritic tree, indicating a protective effect on secondary and tertiary branching. Interestingly, radiation-induced increases in postsynaptic density protein (PSD-95) puncta were not as pronounced in MCAT compared with WT mice, and were significantly lower after the 0.5 Gy dose. As past data has linked radiation exposure to reduced dendritic complexity, elevated PSD-95 and impaired cognition, reductions in mitochondrial oxidative stress have proven useful in ameliorating many of these radiation-induced sequelae. Data presented here shows similar trends, and again points to the potential benefits of reducing oxidative stress in the brain to attenuate radiation injury. Environ. Mol. Mutagen. 57:364-371, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Orbital Debris Detection and Tracking Strategies for the NASA/AFRL Meter Class Autonomous Telescope (MCAT)

    NASA Technical Reports Server (NTRS)

    Mulrooney, M.; Hickson, P.; Stansbery, Eugene G.

    2010-01-01

    MCAT (Meter-Class Autonomous Telescope) is a 1.3m f/4 Ritchey-Chr tien on a double horseshoe equatorial mount that will be deployed in early 2011 to the western pacific island of Legan in the Kwajalein Atoll to perform orbital debris observations. MCAT will be capable of tracking earth orbital objects at all inclinations and at altitudes from 200 km to geosynchronous. MCAT s primary objective is the detection of new orbital debris in both low-inclination low-earth orbits (LEO) and at geosynchronous earth orbit (GEO). MCAT was thus designed with a fast focal ratio and a large unvignetted image circle able to accommodate a detector sized to yield a large field of view. The selected primary detector is a close-cycle cooled 4Kx4K 15um pixel CCD camera that yields a 0.9 degree diagonal field. For orbital debris detection in widely spaced angular rate regimes, the camera must offer low read-noise performance over a wide range of framing rates. MCAT s 4-port camera operates from 100 kHz to 1.5 MHz per port at 2 e- and 10 e- read noise respectively. This enables low-noise multi-second exposures for GEO observations as well as rapid (several frames per second) exposures for LEO. GEO observations will be performed using a counter-sidereal time delay integration (TDI) technique which NASA has used successfully in the past. For MCAT the GEO survey, detection, and follow-up prediction algorithms will be automated. These algorithms will be detailed herein. For LEO observations two methods will be employed. The first, Orbit Survey Mode (OSM), will scan specific orbital inclination and altitude regimes, detect new orbital debris objects against trailed background stars, and adjust the telescope track to follow the detected object. The second, Stare and Chase Mode (SCM), will perform a stare, then detect and track objects that enter the field of view which satisfy specific rate and brightness criteria. As with GEO, the LEO operational modes will be fully automated and will be

  3. Apparent growth phase-dependent phosphorylation of malonyl coenzyme A:acyl carrier protein transacylase (MCAT), a major fatty acid synthase II component in Mycobacterium bovis BCG.

    PubMed

    Sinha, Indrajit; Boon, Calvin; Dick, Thomas

    2003-10-10

    Probing protein extracts from exponentially growing and stationary phase cultures of Mycobacterium bovis BCG with anti-phospho amino acid antibodies revealed a 31-kDa anti-phospho threonine antibody-reactive protein specific to growing culture. The corresponding protein was purified via two-dimensional gel electrophoresis and identified via mass spectrometry to be malonyl coenzyme A:acyl carrier protein transacylase (MCAT), a component of the fatty acid biosynthetic pathway. MCAT tagged with histidine reacted with anti-phospho threonine antibody and was positive in an in-gel chemical assay for phospho proteins. Analysis of the growth phase dependence of MCAT-His phosphorylation and protein levels showed that phosphorylated MCAT-His can be detected only in growing culture. In contrast, MCAT-His protein level was growth phase-independent. These results suggest that MCAT may be a substrate of a protein kinase and phosphatase, and that aspects of fatty acid synthesis in tubercle bacilli are regulated by protein phosphorylation.

  4. Characterizing the Survey Strategy and Initial Orbit Determination Abilities of the NASA MCAT Telescope for Geosynchronous Orbital Debris Environmental Studies

    NASA Technical Reports Server (NTRS)

    Frith, James; Barker, Ed; Cowardin, Heather; Buckalew, Brent; Anz-Meado, Phillip; Lederer, Susan

    2017-01-01

    The NASA Orbital Debris Program Office (ODPO) recently commissioned the Meter Class Autonomous Telescope (MCAT) on Ascension Island with the primary goal of obtaining population statistics of the geosynchronous (GEO) orbital debris environment. To help facilitate this, studies have been conducted using MCAT's known and projected capabilities to estimate the accuracy and timeliness in which it can survey the GEO environment. A simulated GEO debris population is created and sampled at various cadences and run through the Constrained Admissible Region Multi Hypotheses Filter (CAR-MHF). The orbits computed from the results are then compared to the simulated data to assess MCAT's ability to determine accurately the orbits of debris at various sample rates. Additionally, estimates of the rate at which MCAT will be able produce a complete GEO survey are presented using collected weather data and the proposed observation data collection cadence. The specific methods and results are presented here.

  5. Association Between Undergraduate Performance Predictors and Academic and Clinical Performance of Osteopathic Medical Students.

    PubMed

    Agahi, Farshad; Speicher, Mark R; Cisek, Grace

    2018-02-01

    Medical schools use a variety of preadmission indices to select potential students. These indices generally include undergraduate grade point average (GPA), Medical College Admission Test (MCAT) scores, and preadmission interviews. To investigate whether the admission indices used by Midwestern University Arizona College of Osteopathic Medicine are associated with the academic and clinical performance of their students. Associations between the prematriculation variables of undergraduate science GPA, undergraduate total GPA, MCAT component scores, and interview scores and the academic and clinical variables of the first- and second-year medical school GPA, Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2-Cognitive Evaluation (CE) total and discipline scores, scores in clinical rotations for osteopathic competencies, COMLEX-USA Level 2-Performance Evaluation passage, and match status were evaluated. Two-tailed Pearson product-moment correlations with a Bonferroni adjustment were used to examine these relationships. The traditional predictors of science and total undergraduate GPA as well as total and component MCAT scores had small to moderate associations with first- and second-year GPA, as well as COMLEX-USA Level 1 and Level 2-CE total scores. Of all predictors, only the MCAT biological sciences score had a statistically significant correlation with failure of the COMLEX-USA Level 2-Performance Evaluation examination (P=.009). Average interview scores were associated only with the osteopathic competency of medical knowledge (r=0.233; n=209; P=.001), as assessed by clerkship preceptors. No predictors were associated with scores in objective structured clinical encounters or with failing to match to a residency position. The data indicate that traditional predictors of academic performance (undergraduate GPA, undergraduate science GPA, and MCAT scores) have small to moderate association with medical school grades and

  6. Predictors of medical school clerkship performance: a multispecialty longitudinal analysis of standardized examination scores and clinical assessments.

    PubMed

    Casey, Petra M; Palmer, Brian A; Thompson, Geoffrey B; Laack, Torrey A; Thomas, Matthew R; Hartz, Martha F; Jensen, Jani R; Sandefur, Benjamin J; Hammack, Julie E; Swanson, Jerry W; Sheeler, Robert D; Grande, Joseph P

    2016-04-27

    Evidence suggests that poor performance on standardized tests before and early in medical school is associated with poor performance on standardized tests later in medical school and beyond. This study aimed to explore relationships between standardized examination scores (before and during medical school) with test and clinical performance across all core clinical clerkships. We evaluated characteristics of 435 students at Mayo Medical School (MMS) who matriculated 2000-2009 and for whom undergraduate grade point average, medical college aptitude test (MCAT), medical school standardized tests (United States Medical Licensing Examination [USMLE] 1 and 2; National Board of Medical Examiners [NBME] subject examination), and faculty assessments were available. We assessed the correlation between scores and assessments and determined USMLE 1 cutoffs predictive of poor performance (≤10th percentile) on the NBME examinations. We also compared the mean faculty assessment scores of MMS students vs visiting students, and for the NBME, we determined the percentage of MMS students who scored at or below the tenth percentile of first-time national examinees. MCAT scores correlated robustly with USMLE 1 and 2, and USMLE 1 and 2 independently predicted NBME scores in all clerkships. USMLE 1 cutoffs corresponding to poor NBME performance ranged from 220 to 223. USMLE 1 scores were similar among MMS and visiting students. For most academic years and clerkships, NBME scores were similar for MMS students vs all first-time examinees. MCAT, USMLE 1 and 2, and subsequent clinical performance parameters were correlated with NBME scores across all core clerkships. Even more interestingly, faculty assessments correlated with NBME scores, affirming patient care as examination preparation. USMLE 1 scores identified students at risk of poor performance on NBME subject examinations, facilitating and supporting implementation of remediation before the clinical years. MMS students were

  7. Correlation between MCAT biology content specifications and topic scope and sequence of general education college biology textbooks.

    PubMed

    Rissing, Steven W

    2013-01-01

    Most American colleges and universities offer gateway biology courses to meet the needs of three undergraduate audiences: biology and related science majors, many of whom will become biomedical researchers; premedical students meeting medical school requirements and preparing for the Medical College Admissions Test (MCAT); and students completing general education (GE) graduation requirements. Biology textbooks for these three audiences present a topic scope and sequence that correlates with the topic scope and importance ratings of the biology content specifications for the MCAT regardless of the intended audience. Texts for "nonmajors," GE courses appear derived directly from their publisher's majors text. Topic scope and sequence of GE texts reflect those of "their" majors text and, indirectly, the MCAT. MCAT term density of GE texts equals or exceeds that of their corresponding majors text. Most American universities require a GE curriculum to promote a core level of academic understanding among their graduates. This includes civic scientific literacy, recognized as an essential competence for the development of public policies in an increasingly scientific and technological world. Deriving GE biology and related science texts from majors texts designed to meet very different learning objectives may defeat the scientific literacy goals of most schools' GE curricula.

  8. Correlation between MCAT Biology Content Specifications and Topic Scope and Sequence of General Education College Biology Textbooks

    PubMed Central

    Rissing, Steven W.

    2013-01-01

    Most American colleges and universities offer gateway biology courses to meet the needs of three undergraduate audiences: biology and related science majors, many of whom will become biomedical researchers; premedical students meeting medical school requirements and preparing for the Medical College Admissions Test (MCAT); and students completing general education (GE) graduation requirements. Biology textbooks for these three audiences present a topic scope and sequence that correlates with the topic scope and importance ratings of the biology content specifications for the MCAT regardless of the intended audience. Texts for “nonmajors,” GE courses appear derived directly from their publisher's majors text. Topic scope and sequence of GE texts reflect those of “their” majors text and, indirectly, the MCAT. MCAT term density of GE texts equals or exceeds that of their corresponding majors text. Most American universities require a GE curriculum to promote a core level of academic understanding among their graduates. This includes civic scientific literacy, recognized as an essential competence for the development of public policies in an increasingly scientific and technological world. Deriving GE biology and related science texts from majors texts designed to meet very different learning objectives may defeat the scientific literacy goals of most schools’ GE curricula. PMID:24006392

  9. NASA's Orbital Debris Optical and IR Ground-Based Observing Program Utilizing the MCAT, UKIRT, and Magellan Telescopes

    NASA Technical Reports Server (NTRS)

    Lederer, Susan; Cowardin, H. M.; Buckalew, B.; Frith, J.; Hickson, P.; Pace, L.; Matney, M.; Anz-Meador, P.; Seitzer, P.; Stansbery, E.; hide

    2016-01-01

    Characterizing debris in Earth-orbit has become increasingly important as the population growth rises steadily, posing greater and greater threats to active satellites with each passing year. Currently, the Joint Space Operations is tracking over 23,000 pieces of debris, ranging in size from 1-meter and larger in geosychronous orbits (GEO) to 10-cm and larger at low-Earth orbits (LEO). Model estimates suggest that there may be more than 500,000 pieces of spacecraft debris larger than 1 cm currently in orbit around the Earth. With such a small fraction of the total population being tracked, and new break-ups occurring in LEO, GEO, and Geo Transfer Orbits, new assets, techniques, and approaches for characterizing this debris are needed. With this in mind, NASA's Orbital Debris Program Office has actively tasked a suite of telescopes around the world. In 2015, the newly-built 1.3m optical Meter Class Autonomous Telescope (MCAT) came on-line on Ascension Island in the South Atlantic Ocean and is currently in its commissioning phase. MCAT is designed to track Earth-orbiting objects above 200km, conduct surveys at GEO, and work in tandem with a newly-installed Raven-class commercial-off-the-shelf system, a 0.4-meter telescope co-located on Ascension with a field-of-view similar to MCAT's and research-grade instrumentation designed to complement MCAT for observations taken either simultaneously or in tandem. The 3.8m infrared UKIRT telescope on Mauna Kea, Hawaii, has been heavily tasked throughout 2015 and into 2016, collecting data on individual targets as well as in survey modes to study both the general GEO population as well as an individual break-up event of a BRIZ-M Rocket body that occurred in January 2016. Data collected include photometry and spectroscopy in the near-Infrared (0.85-2.5 m) and the mid-infrared (8-16 m). Finally, the 6.5-m Baade Magellan telescope at Las Campanas Observatory in Chile was used to collect optical photometric survey data in October

  10. Estimating Total-Test Scores from Partial Scores in a Matrix Sampling Design.

    ERIC Educational Resources Information Center

    Sachar, Jane; Suppes, Patrick

    1980-01-01

    The present study compared six methods, two of which utilize the content structure of items, to estimate total-test scores using 450 students and 60 items of the 110-item Stanford Mental Arithmetic Test. Three methods yielded fairly good estimates of the total-test score. (Author/RL)

  11. Estimating Total-test Scores from Partial Scores in a Matrix Sampling Design.

    ERIC Educational Resources Information Center

    Sachar, Jane; Suppes, Patrick

    It is sometimes desirable to obtain an estimated total-test score for an individual who was administered only a subset of the items in a total test. The present study compared six methods, two of which utilize the content structure of items, to estimate total-test scores using 450 students in grades 3-5 and 60 items of the ll0-item Stanford Mental…

  12. Comparison of COMLEX-USA scores, medical school performance, and preadmission variables between women and men.

    PubMed

    Dixon, Donna

    2015-04-01

    Previous studies by the author showed differences in preadmission variables and Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) scores between women and men at the New York Institute of Technology College of Osteopathic Medicine (NYIT-COM). It is pertinent to reexamine the preadmission variables, medical school performance, and COMLEX-USA scores of women and men to determine whether these differences still exist. To examine the relationship between student sex and performance on COMLEX-USA Level 1 and Level 2-Cognitive Evaluation (CE), performance during medical school, and preadmission academic variables at NYIT-COM. Scores on COMLEX-USA Level 1 and COMLEX-USA Level 2-CE, grades in all courses taken during the first 2 years of medical school, the National Board of Osteopathic Medical Examiners' clinical science subject examination scores, Medical College Admission Test (MCAT) scores, and undergraduate grade point averages (GPAs) were compared between women and men in the classes graduating between 2009 and 2012. Data from 748 students were analyzed. Men had statistically significantly higher scores than women on COMLEX-USA Level 1 in 2009 (540 vs 500; P<.001) and 2010 (537 vs 496; P<.001). No statistically significant difference in COMLEX-USA Level 2-CE scores was found between women and men. The performance of women and men was comparable during the first 2 years of medical school and on clinical science subject examinations in years 3 and 4. Men had statistically significantly higher MCAT scores than women, but no statistically significant differences were found between women's and men's undergraduate GPAs. Men were found to have higher scores than women on COMLEX-USA Level 1 and the MCAT. However, the reasons behind these data have yet to be elucidated. Although a stronger background in basic science could explain the discrepancy in scores between women and men, women were found to have equally high science GPAs and performed

  13. Evaluation of the IRT Parameter Invariance Property for the MCAT.

    ERIC Educational Resources Information Center

    Kelkar, Vinaya; Wightman, Linda F.; Luecht, Richard M.

    The purpose of this study was to investigate the viability of the property of parameter invariance for the one-parameter (1P), two-parameter (2P), and three-parameter (3P) item response theory (IRT) models for the Medical College Admissions Tests (MCAT). Invariance of item parameters across different gender, ethnic, and language groups and the…

  14. Medical colleges admission test in Punjab, Pakistan.

    PubMed

    Khan, Junaid Sarfraz; Biggs, John S G; Bano, Tahira; Mukhtar, Osama; Tabasum, Saima; Mubasshar, Malik Hussain

    2013-01-01

    Nearly 18,000 candidates securing 60% and above marks in Higher Secondary School Certificate (HSSC) examination contest for admission in Medical Colleges, in Punjab, Pakistan by sitting in the Medical College Admission Test (MCAT) each summer. This cross-sectional study was conducted to identify patterns related to demographic, economic and educational backgrounds, over a two-year-period, in this population, and how HSSC and MCAT marks predict future performance of the selected candidates. Marks obtained by candidates in HSSC, MCAT, and 1st Professional MBBS (Part-I) Examinations over two years 2008-2009, were analysed using parametric tests in SPSS. Total 18,090 candidates in 2008 and 18,486 in 2009 sat in the MCAT. National IHSSC candidates scored higher marks in HSSC and MCAT but lower marks than their foreign qualified HSSC counterparts (e.g., Advanced-levels from Cambridge University, UK) in Part-I overall and in all its subcomponents individually (p < 0.05). Female students scored higher marks than males in HSSC (p > 0.05). MCAT (p > 0.05) and Part-I theory, practical, viva voce, continuous assessment and Objective-Structured Performance Evaluation (OSPE) components (p < 0.05). In both years, students from the Dera Ghazi Khan District scored the highest marks in the HSSC Examinations (p < 0.05) but least marks in MCAT in 2008 (p < 0.05) and in Part-I in 2008 and 2009 (p < 0.05). Students from 'tougher' Boards like Rawalpindi in 2008 and the Federal Board in 2009 who scored least marks in HSSC scored highest marks in MCAT. and in Part-I Examinations (p < 0.05). Linear regression on Part-I by taking HSSC and MCAT marks as independent variables showed that the MCAT marks exerted the greatest positive influence consistently at 0.104 (2008) and 0.106 (2009). In 2009 HSSC marks were shown to exert a negative influence (-0.08) on Part-I. There is need to standardise HSSC education and examination across all Intermediate Boards. MCAT is a better predictor of Medical

  15. A Multidimensional Computerized Adaptive Short-Form Quality of Life Questionnaire Developed and Validated for Multiple Sclerosis

    PubMed Central

    Michel, Pierre; Baumstarck, Karine; Ghattas, Badih; Pelletier, Jean; Loundou, Anderson; Boucekine, Mohamed; Auquier, Pascal; Boyer, Laurent

    2016-01-01

    Abstract The aim was to develop a multidimensional computerized adaptive short-form questionnaire, the MusiQoL-MCAT, from a fixed-length QoL questionnaire for multiple sclerosis. A total of 1992 patients were enrolled in this international cross-sectional study. The development of the MusiQoL-MCAT was based on the assessment of between-items MIRT model fit followed by real-data simulations. The MCAT algorithm was based on Bayesian maximum a posteriori estimation of latent traits and Kullback–Leibler information item selection. We examined several simulations based on a fixed number of items. Accuracy was assessed using correlations (r) between initial IRT scores and MCAT scores. Precision was assessed using the standard error measurement (SEM) and the root mean square error (RMSE). The multidimensional graded response model was used to estimate item parameters and IRT scores. Among the MCAT simulations, the 16-item version of the MusiQoL-MCAT was selected because the accuracy and precision became stable with 16 items with satisfactory levels (r ≥ 0.9, SEM ≤ 0.55, and RMSE ≤ 0.3). External validity of the MusiQoL-MCAT was satisfactory. The MusiQoL-MCAT presents satisfactory properties and can individually tailor QoL assessment to each patient, making it less burdensome to patients and better adapted for use in clinical practice. PMID:27057832

  16. Deploying the NASA Meter Class Autonomous Telescope (MCAT) on Ascension Island

    NASA Technical Reports Server (NTRS)

    Lederer, S. M.; Pace, L.; Hickson, P.; Cowardin, H. M.; Frith, J.; Buckalew, B.; Glesne, T.; Maeda, R.; Douglas, D.; Nishimoto, D.

    2015-01-01

    NASA has successfully constructed the 1.3m Meter Class Autonomous Telescope (MCAT) facility on Ascension Island in the South Atlantic Ocean. MCAT is an optical telescope designed specifically to collect ground-based data for the statistical characterization of orbital debris ranging from Low Earth Orbit (LEO) through Middle Earth Orbits (MEO) and beyond to Geo Transfer and Geosynchronous Orbits (GTO/GEO). The location of Ascension Island has two distinct advantages. First, the near-equatorial location fills a significant longitudinal gap in the Ground-based Electro-Optical Deep Space Surveillance (GEODSS) network of telescopes, and second, it allows access to objects in Low Inclination Low-Earth Orbits (LILO). The MCAT facility will be controlled by a sophisticated software suite that operates the dome and telescope, assesses sky and weather conditions, conducts all necessary calibrations, defines an observing strategy (as dictated by weather, sky conditions and the observing plan for the night), and carries out the observations. It then reduces the collected data via four primary observing modes ranging from tracking previously cataloged objects to conducting general surveys for detecting uncorrelated debris. Nightly observing plans, as well as the resulting text file of reduced data, will be transferred to and from Ascension, respectively, via a satellite connection. Post-processing occurs at NASA Johnson Space Center. Construction began in September, 2014 with dome and telescope installation occurring in April through early June, 2015. First light was achieved in June, 2015. Acceptance testing, full commissioning, and calibration of this soon-to-be fully autonomous system commenced in summer 2015. The initial characterization of the system from these tests is presented herein.

  17. Deploying the NASA Meter Class Autonomous Telescope (MCAT) on Ascension Island

    NASA Astrophysics Data System (ADS)

    Lederer, S.; Pace, L. F.; Hickson, P.; Glesne, T.; Cowardin, H. M.; Frith, J. M.; Buckalew, B.; Maeda, R.; Douglas, D.; Nishimoto, D.

    NASA has successfully constructed the 1.3m Meter Class Autonomous Telescope (MCAT) facility on Ascension Island in the South Atlantic Ocean. MCAT is an optical telescope designed specifically to collect ground-based data for the statistical characterization of orbital debris ranging from Low Earth Orbit (LEO) through Middle Earth Orbits (MEO) and beyond to Geo Transfer and Geosynchronous Orbits (GTO/GEO). The location of Ascension Island has two distinct advantages. First, the near-equatorial location fills a significant longitudinal gap in the Ground-based Electro-Optical Deep Space Surveillance (GEODSS) network of telescopes, and second, it allows access to objects in Low Inclination Low-Earth Orbits (LILO). The MCAT facility will be controlled by a sophisticated software suite that operates the dome and telescope, assesses sky and weather conditions, conducts all necessary calibrations, defines an observing strategy (as dictated by weather, sky conditions, and the observing plan for the night), and carries out the observations. It then reduces the collected data via four primary observing modes ranging from tracking previously cataloged objects to conducting general surveys for detecting uncorrelated debris. Nightly observing plans, as well as the resulting text file of reduced data, will be transferred to and from Ascension, respectively, via a satellite connection. Post-processing occurs at NASA Johnson Space Center. Construction began in September, 2014 with dome and telescope installation occurring in April through early June, 2015. First light was achieved in June, 2015. Acceptance testing, full commissioning, and calibration of this soon-to-be fully autonomous system commenced in summer 2015. The initial characterization of the system from these tests is presented herein.

  18. GRB2 interaction with the ecotropic murine leukemia virus receptor, mCAT-1, controls virus entry and is stimulated by virus binding.

    PubMed

    Chen, Zeming; Kolokoltsov, Andrey A; Wang, Jia; Adhikary, Shramika; Lorinczi, Marta; Elferink, Lisa A; Davey, Robert A

    2012-02-01

    For retroviruses such as HIV-1 and murine leukemia virus (MLV), active receptor recruitment and trafficking occur during viral entry. However, the underlying mechanisms and cellular factors involved in the process are largely uncharacterized. The viral receptor for ecotropic MLV (eMLV), a classical model for retrovirus infection mechanisms and pathogenesis, is mouse cationic amino acid transporter 1 (mCAT-1). Growth factor receptor-bound protein 2 (GRB2) is an adaptor protein that has been shown to couple cell surface receptors, such as epidermal growth factor receptor (EGFR) and hepatocyte growth factor receptor, to intracellular signaling events. Here we examined if GRB2 could also play a role in controlling infection by retroviruses by affecting receptor function. The GRB2 RNA interference (RNAi)-mediated suppression of endogenous GRB2 resulted in a consistent and significant reduction of virus binding and membrane fusion. The binding between eMLV and cells promoted increased GRB2-mCAT-1 interactions, as detected by immunoprecipitation. Consistently, the increased colocalization of GRB2 and mCAT-1 signals was detected by confocal microscopy. This association was time dependent and paralleled the kinetics of cell-virus membrane fusion. Interestingly, unlike the canonical binding pattern seen for GRB2 and growth factor receptors, GRB2-mCAT-1 binding does not depend on the GRB2-SH2 domain-mediated recognition of tyrosine phosphorylation on the receptor. The inhibition of endogenous GRB2 led to a reduction in surface levels of mCAT-1, which was detected by immunoprecipitation and by a direct binding assay using a recombinant MLV envelope protein receptor binding domain (RBD). Consistent with this observation, the expression of a dominant negative GRB2 mutant (R86K) resulted in the sequestration of mCAT-1 from the cell surface into intracellular vesicles. Taken together, these findings suggest a novel role for GRB2 in ecotropic MLV entry and infection by facilitating

  19. Comparison of the Incremental Validity of the Old and New MCAT.

    ERIC Educational Resources Information Center

    Wolf, Fredric M.; And Others

    The predictive and incremental validity of both the Old and New Medical College Admission Test (MCAT) was examined and compared with a sample of over 300 medical students. Results of zero order and incremental validity coefficients, as well as prediction models resulting from all possible subsets regression analyses using Mallow's Cp criterion,…

  20. Integrating Concepts in Biology Textbook Increases Learning: Assessment Triangulation Using Concept Inventory, Card Sorting, and MCAT Instruments, Followed by Longitudinal Tracking

    PubMed Central

    Luckie, Douglas B.; Hoskinson, Anne-Marie; Griffin, Caleigh E.; Hess, Andrea L.; Price, Katrina J.; Tawa, Alex; Thacker, Samantha M.

    2017-01-01

    The purpose of this study was to examine the educational impact of an intervention, the inquiry-focused textbook Integrating Concepts in Biology (ICB), when used in a yearlong introductory biology course sequence. Student learning was evaluated using three published instruments: 1) The Biology Concept Inventory probed depth of student mastery of fundamental concepts in organismal and cellular topics when confronting misconceptions as distractors. ICB students had higher gains in all six topic categories (+43% vs. peers overall, p < 0.01). 2) The Biology Card Sorting Task assessed whether students organized biological ideas more superficially, as novices do, or based on deeper concepts, like experts. The frequency with which ICB students connected deep-concept pairs, or triplets, was similar to peers; but deep understanding of structure/function was much higher (for pairs: 77% vs. 25%, p < 0.01). 3) A content-focused Medical College Admission Test (MCAT) posttest compared ICB student content knowledge with that of peers from 15 prior years. Historically, MCAT performance for each semester ranged from 53% to 64%; the ICB cohort scored 62%, in the top quintile. Longitudinal tracking in five upper-level science courses the following year found ICB students outperformed peers in physiology (85% vs. 80%, p < 0.01). PMID:28389429

  1. A Comparison of the Predictive Validity of the MCAT for Coached and Uncoached Students.

    ERIC Educational Resources Information Center

    Jones, Robert F.

    1986-01-01

    A study that addressed the question of whether coaching for the MCAT biases the relationship between test performance and medical school performance is described. The criterion used was whether or not a student experienced academic problems in medical school. (MLW)

  2. Relationships of Reading, MCAT, and USMLE Step 1 Test Results for Medical Students

    ERIC Educational Resources Information Center

    Haught, Patricia; Walls, Richard

    2004-01-01

    Students (N = 730) took the Nelson-Denny Reading Test (current forms G or H) during orientation to medical school. Stepwise regression analyses showed the Nelson-Denny Reading Vocabulary, Comprehension, and Rate were significant predictors of MCAT (taken prior to admission to medical school) verbal reasoning. Reading Vocabulary was a significant…

  3. Fit for the frontline? identification of mission-critical auditory tasks (MCATs) carried out by infantry and combat-support personnel.

    PubMed

    Semeraro, Hannah D; Bevis, Zoë L; Rowan, Daniel; van Besouw, Rachel M; Allsopp, Adrian J

    2015-01-01

    The ability to listen to commands in noisy environments and understand acoustic signals, while maintaining situational awareness, is an important skill for military personnel and can be critical for mission success. Seventeen auditory tasks carried out by British infantry and combat-support personnel were identified through a series of focus groups conducted by Bevis et al. For military personnel, these auditory tasks are termed mission-critical auditory tasks (MCATs) if they are carried in out in a military-specific environment and have a negative consequence when performed below a specified level. A questionnaire study was conducted to find out which of the auditory tasks identified by Bevis et al. satisfy the characteristics of an MCAT. Seventy-nine British infantry and combat-support personnel from four regiments across the South of England participated. For each auditory task participants indicated: 1) the consequences of poor performance on the task, 2) who performs the task, and 3) how frequently the task is carried out. The data were analysed to determine which tasks are carried out by which personnel, which have the most negative consequences when performed poorly, and which are performed the most frequently. This resulted in a list of 9 MCATs (7 speech communication tasks, 1 sound localization task, and 1 sound detection task) that should be prioritised for representation in a measure of auditory fitness for duty (AFFD) for these personnel. Incorporating MCATs in AFFD measures will help to ensure that personnel have the necessary auditory skills for safe and effective deployment on operational duties.

  4. Fit for the frontline? Identification of mission-critical auditory tasks (MCATs) carried out by infantry and combat-support personnel

    PubMed Central

    Semeraro, Hannah D.; Bevis, Zoë L.; Rowan, Daniel; van Besouw, Rachel M.; Allsopp, Adrian J.

    2015-01-01

    The ability to listen to commands in noisy environments and understand acoustic signals, while maintaining situational awareness, is an important skill for military personnel and can be critical for mission success. Seventeen auditory tasks carried out by British infantry and combat-support personnel were identified through a series of focus groups conducted by Bevis et al. For military personnel, these auditory tasks are termed mission-critical auditory tasks (MCATs) if they are carried in out in a military-specific environment and have a negative consequence when performed below a specified level. A questionnaire study was conducted to find out which of the auditory tasks identified by Bevis et al. satisfy the characteristics of an MCAT. Seventy-nine British infantry and combat-support personnel from four regiments across the South of England participated. For each auditory task participants indicated: 1) the consequences of poor performance on the task, 2) who performs the task, and 3) how frequently the task is carried out. The data were analysed to determine which tasks are carried out by which personnel, which have the most negative consequences when performed poorly, and which are performed the most frequently. This resulted in a list of 9 MCATs (7 speech communication tasks, 1 sound localization task, and 1 sound detection task) that should be prioritised for representation in a measure of auditory fitness for duty (AFFD) for these personnel. Incorporating MCATs in AFFD measures will help to ensure that personnel have the necessary auditory skills for safe and effective deployment on operational duties. PMID:25774613

  5. Training Scientific Thinking Skills: Evidence from an MCAT[superscript 2015]-Aligned Classroom Module

    ERIC Educational Resources Information Center

    Stevens, Courtney; Witkow, Melissa R.

    2014-01-01

    The present study reports on the development and evaluation of a classroom module to train scientific thinking skills. The module was implemented in two of four parallel sections of introductory psychology. To assess learning, a passage-based question set from the medical college admissions test (MCAT[superscript 2015]) preview guide was included…

  6. Structure of Mycobacterium tuberculosis mtFabD, a malonyl-CoA:acyl carrier protein transacylase (MCAT).

    PubMed

    Ghadbane, Hemza; Brown, Alistair K; Kremer, Laurent; Besra, Gurdyal S; Fütterer, Klaus

    2007-10-01

    Mycobacteria display a unique and unusual cell-wall architecture, central to which is the membrane-proximal mycolyl-arabinogalactan-peptidoglycan core (mAGP). The biosynthesis of mycolic acids, which form the outermost layer of the mAGP core, involves malonyl-CoA:acyl carrier protein transacylase (MCAT). This essential enzyme catalyses the transfer of malonyl from coenzyme A to acyl carrier protein AcpM, thus feeding these two-carbon units into the chain-elongation cycle of the type II fatty-acid synthase. The crystal structure of M. tuberculosis mtFabD, the mycobacterial MCAT, has been determined to 3.0 A resolution by multi-wavelength anomalous dispersion. Phasing was facilitated by Ni2+ ions bound to the 20-residue N-terminal affinity tag, which packed between the two independent copies of mtFabD.

  7. Datagram: Medical College Admission Test

    ERIC Educational Resources Information Center

    Nelson, Bonnie C.

    1974-01-01

    Presents data concerning the Medical College Admission Test (MCAT): number of MCAT examinations, 1968-73; characteristics of examinee population; comparison of percentages; mean MCAT scores by sex; and mean score by undergraduate major. (Author/PG)

  8. Undergraduate GPAs, MCAT scores, and academic performance the first 2 years in podiatric medical school at Des Moines University.

    PubMed

    Yoho, Robert M; Antonopoulos, Kosta; Vardaxis, Vassilios

    2012-01-01

    This study was performed to determine the relationship between undergraduate academic performance and total Medical College Admission Test score and academic performance in the podiatric medical program at Des Moines University. The allopathic and osteopathic medical professions have published educational research examining this relationship. To our knowledge, no such educational research has been published for podiatric medical education. The undergraduate cumulative and science grade point averages and total Medical College Admission Test scores of four podiatric medical classes (2007-2010, N = 169) were compared with their academic performance in the first 2 years of podiatric medical school using pairwise Pearson product moment correlations and multiple regression analysis. Significant low to moderate positive correlations were identified between undergraduate cumulative and science grade point averages and student academic performance in years 1 and 2 of podiatric medical school for each of the four classes (except one) and the pooled data. There was no significant correlation between Medical College Admission Test score and academic performance in years 1 and 2 (except one) and the pooled data. These results identify undergraduate cumulative grade point average as the strongest cognitive admissions variable in predicting academic performance in the podiatric medicine program at Des Moines University, followed by undergraduate science grade point average. These results also suggest limitations of the total Medical College Admission Test score in predicting academic performance. Information from this study can be used in the admissions process and to monitor student progress.

  9. "It's on the MCAT for a Reason": Premedical Students and the Perceived Utility of Sociology

    ERIC Educational Resources Information Center

    Olsen, Lauren D.

    2016-01-01

    Biomedical socialization and premed culture have been shown to promote reductionist and depersonalized approaches to understanding human difference, a serious problem in contemporary health care. In 2015, the Association for American Medical Colleges (AAMC) launched a new version of its Medical College Admission Test (MCAT) that included material…

  10. Fv1-like restriction of N-tropic replication-competent murine leukaemia viruses in mCAT-1-expressing human cells.

    PubMed

    Aagaard, Lars; Mikkelsen, Jacob Giehm; Warming, Søren; Duch, Mogens; Pedersen, Finn Skou

    2002-02-01

    To study the replication of murine leukaemia viruses in human cells we have used full-length as well as EGFP-tagged ecotropic viruses in combination with mCAT-1-expressing human cells. We present results showing that N-tropic murine leukaemia viruses are restricted in both infection and replication in such cells while B-tropic viruses, modified at capsid position 110, escape restriction. These results support a recently reported Fv1-like restriction in mammalian cells. We extend the analysis of Fv1-like restriction by demonstrating that NB-tropic viruses also escape restriction and human mCAT-1-expressing cells are thus similar to murine Fv1(b) cells with respect to infection though the ecotropic receptor pathway.

  11. GRB2 Interaction with the Ecotropic Murine Leukemia Virus Receptor, mCAT-1, Controls Virus Entry and Is Stimulated by Virus Binding

    PubMed Central

    Chen, Zeming; Kolokoltsov, Andrey A.; Wang, Jia; Adhikary, Shramika; Lorinczi, Marta; Elferink, Lisa A.

    2012-01-01

    For retroviruses such as HIV-1 and murine leukemia virus (MLV), active receptor recruitment and trafficking occur during viral entry. However, the underlying mechanisms and cellular factors involved in the process are largely uncharacterized. The viral receptor for ecotropic MLV (eMLV), a classical model for retrovirus infection mechanisms and pathogenesis, is mouse cationic amino acid transporter 1 (mCAT-1). Growth factor receptor-bound protein 2 (GRB2) is an adaptor protein that has been shown to couple cell surface receptors, such as epidermal growth factor receptor (EGFR) and hepatocyte growth factor receptor, to intracellular signaling events. Here we examined if GRB2 could also play a role in controlling infection by retroviruses by affecting receptor function. The GRB2 RNA interference (RNAi)-mediated suppression of endogenous GRB2 resulted in a consistent and significant reduction of virus binding and membrane fusion. The binding between eMLV and cells promoted increased GRB2–mCAT-1 interactions, as detected by immunoprecipitation. Consistently, the increased colocalization of GRB2 and mCAT-1 signals was detected by confocal microscopy. This association was time dependent and paralleled the kinetics of cell-virus membrane fusion. Interestingly, unlike the canonical binding pattern seen for GRB2 and growth factor receptors, GRB2–mCAT-1 binding does not depend on the GRB2-SH2 domain-mediated recognition of tyrosine phosphorylation on the receptor. The inhibition of endogenous GRB2 led to a reduction in surface levels of mCAT-1, which was detected by immunoprecipitation and by a direct binding assay using a recombinant MLV envelope protein receptor binding domain (RBD). Consistent with this observation, the expression of a dominant negative GRB2 mutant (R86K) resulted in the sequestration of mCAT-1 from the cell surface into intracellular vesicles. Taken together, these findings suggest a novel role for GRB2 in ecotropic MLV entry and infection by

  12. Validity of the Medical College Admission Test for predicting MD-PhD student outcomes.

    PubMed

    Bills, James L; VanHouten, Jacob; Grundy, Michelle M; Chalkley, Roger; Dermody, Terence S

    2016-03-01

    The Medical College Admission Test (MCAT) is a quantitative metric used by MD and MD-PhD programs to evaluate applicants for admission. This study assessed the validity of the MCAT in predicting training performance measures and career outcomes for MD-PhD students at a single institution. The study population consisted of 153 graduates of the Vanderbilt Medical Scientist Training Program (combined MD-PhD program) who matriculated between 1963 and 2003 and completed dual-degree training. This population was divided into three cohorts corresponding to the version of the MCAT taken at the time of application. Multivariable regression (logistic for binary outcomes and linear for continuous outcomes) was used to analyze factors associated with outcome measures. The MCAT score and undergraduate GPA (uGPA) were treated as independent variables; medical and graduate school grades, time-to-PhD defense, USMLE scores, publication number, and career outcome were dependent variables. For cohort 1 (1963-1977), MCAT score was not associated with any assessed outcome, although uGPA was associated with medical school preclinical GPA and graduate school GPA (gsGPA). For cohort 2 (1978-1991), MCAT score was associated with USMLE Step II score and inversely correlated with publication number, and uGPA was associated with preclinical GPA (mspGPA) and clinical GPA (mscGPA). For cohort 3 (1992-2003), the MCAT score was associated with mscGPA, and uGPA was associated with gsGPA. Overall, MCAT score and uGPA were inconsistent or weak predictors of training metrics and career outcomes for this population of MD-PhD students.

  13. The Model of Children's Active Travel (M-CAT): a conceptual framework for examining factors influencing children's active travel.

    PubMed

    Pont, Karina; Ziviani, Jenny; Wadley, David; Abbott, Rebecca

    2011-06-01

    The current decline in children's participation in physical activity has attracted the attention of those concerned with children's health and wellbeing. A sustainable approach to ensuring children engage in adequate amounts of physical activity is to support their involvement in incidental activity such as active travel (AT), which includes walking or riding a bicycle to or from local destinations, such as school or a park. Understanding how we can embed physical activity into children's everyday occupational roles is a way in which occupational therapists can contribute to this important health promotion agenda. To present a simple, coherent and comprehensive framework as a means of examining factors influencing children's AT. Based on current literature, this conceptual framework incorporates the observable environment, parents' perceptions and decisions regarding their children's AT, as well as children's own perceptions and decisions regarding AT within their family contexts across time. The Model of Children's Active Travel (M-CAT) highlights the complex and dynamic nature of factors impacting the decision-making process of parents and children in relation to children's AT. The M-CAT offers a way forward for researchers to examine variables influencing active travel in a systematic manner. Future testing of the M-CAT will consolidate understanding of the factors underlying the decision-making process which occurs within families in the context of their communities. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

  14. Diversity efforts, admissions, and national rankings: can we align priorities?

    PubMed

    Heller, Caren A; Rúa, Sandra Hurtado; Mazumdar, Madhu; Moon, Jennifer E; Bardes, Charles; Gotto, Antonio M

    2014-01-01

    Increasing student body diversity is a priority for national health education and professional organizations and for many medical schools. However, national rankings of medical schools, such as those published by U.S. News & World Report, place a heavy emphasis on grade point average (GPA) and Medical College Admissions Test (MCAT) scores, without considering student body diversity. These rankings affect organizational reputation and admissions outcomes, even though there is considerable controversy surrounding the predictive value of GPA and MCAT scores. Our aim in this article was to explore the relationship between standard admissions practices, which typically aim to attract students with the highest academic scores, and student body diversity. We examined how changes in GPA and MCAT scores over 5 years correlated with the percentage of enrolled students who are underrepresented in medicine. In a majority of medical schools in the United States from 2005 to 2009, average GPA and MCAT scores of applicants increased, whereas the percentage of enrolled students who are underrepresented in medicine decreased. Our findings suggest that efforts to increase the diversity of medical school student bodies may be complicated by a desire to maintain high average GPA and MCAT scores. We propose that U.S. News revise its ranking methodology by incorporating a new diversity score into its student selectivity score and by reducing the weight placed on GPA and MCAT scores.

  15. The CERAD Neuropsychologic Battery Total Score and the progression of Alzheimer disease.

    PubMed

    Rossetti, Heidi C; Munro Cullum, C; Hynan, Linda S; Lacritz, Laura H

    2010-01-01

    To establish the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychologic battery as a valid measure of cognitive progression in Alzheimer disease (AD) by deriving annualized CERAD Total Change Scores and corresponding confidence intervals in AD and controls from which to define clinically meaningful change. Subjects included 383 normal control (NC) and 655 AD subjects with serial data from the CERAD registry database. Annualized CERAD Total Change Scores were derived and Reliable Change Indexes (RCIs) calculated to establish statistically reliable change values. CERAD Change Scores were compared with annualized change scores from the Mini-Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR) Sum of Boxes, and Blessed Dementia Rating Scale (BDRS). For the CERAD Total Score, the AD sample showed significantly greater decline than the NC sample over the 4-year interval, with AD subjects declining an average of 22.2 points compared with the NCs' improving an average 2.8 points from baseline to last visit [Group x Time interaction [F(4,1031)=246.08, P<0.001)]. By Visit 3, the majority of AD subjects (65.2%) showed a degree of cognitive decline that fell outside the RCI. CERAD Change Scores significantly correlated (P<0.001) with MMSE (r=-0.66), CDR (r=-0.42), and BDRS (r=-0.38) change scores. Results support the utility of the CERAD Total Score as a measure of AD progression and provide comparative data for annualized change in CERAD Total Score and other summary measures.

  16. Constructing an Online MCAT Preparation Program as an Alternative to On-Site Preparation for Medical School

    ERIC Educational Resources Information Center

    Navarre, Berengaria; Perez, Norma A.; Smith, Sarah Toombs

    2017-01-01

    Based on a successful five-week summer program, we constructed an online alternative to prepare Hispanic students to take the Medical College Admission Test (MCAT). We used input from student premed advisors, students, a faculty mentor, a Verbal Reasoning coach, and the program administrator. Online activities were provided to support the student…

  17. Correlation between MCAT Biology Content Specifications and Topic Scope and Sequence of General Education College Biology Textbooks

    ERIC Educational Resources Information Center

    Rissing, Steven W.

    2013-01-01

    Most American colleges and universities offer gateway biology courses to meet the needs of three undergraduate audiences: biology and related science majors, many of whom will become biomedical researchers; premedical students meeting medical school requirements and preparing for the Medical College Admissions Test (MCAT); and students completing…

  18. Cryptic MCAT enhancer regulation in fibroblasts and smooth muscle cells. Suppression of TEF-1 mediated activation by the single-stranded DNA-binding proteins, Pur alpha, Pur beta, and MSY1.

    PubMed

    Carlini, Leslie E; Getz, Michael J; Strauch, Arthur R; Kelm, Robert J

    2002-03-08

    An asymmetric polypurine-polypyrimidine cis-element located in the 5' region of the mouse vascular smooth muscle alpha-actin gene serves as a binding site for multiple proteins with specific affinity for either single- or double-stranded DNA. Here, we test the hypothesis that single-stranded DNA-binding proteins are responsible for preventing a cryptic MCAT enhancer centered within this element from cooperating with a nearby serum response factor-interacting CArG motif to trans-activate the minimal promoter in fibroblasts and smooth muscle cells. DNA binding studies revealed that the core MCAT sequence mediates binding of transcription enhancer factor-1 to the double-stranded polypurine-polypyrimidine element while flanking nucleotides account for interaction of Pur alpha and Pur beta with the purine-rich strand and MSY1 with the complementary pyrimidine-rich strand. Mutations that selectively impaired high affinity single-stranded DNA binding by fibroblast or smooth muscle cell-derived Pur alpha, Pur beta, and MSY1 in vitro, released the cryptic MCAT enhancer from repression in transfected cells. Additional experiments indicated that Pur alpha, Pur beta, and MSY1 also interact specifically, albeit weakly, with double-stranded DNA and with transcription enhancer factor-1. These results are consistent with two plausible models of cryptic MCAT enhancer regulation by Pur alpha, Pur beta, and MSY1 involving either competitive single-stranded DNA binding or masking of MCAT-bound transcription enhancer factor-1.

  19. An Investigation into the Possible Speededness of the Medical College Admission Test. MCAT Monograph 3.

    ERIC Educational Resources Information Center

    Neustel, Sandra

    As a continuing part of its validity studies, the Association of American Medical Colleges commissioned a study of the speediness of the Medical College Admission Test (MCAT). If speed is a hidden part of the test, it is a threat to its construct validity. As a general rule, the criterion used to indicate lack of speediness is that 80% of the…

  20. Reliability of Total Test Scores When Considered as Ordinal Measurements

    ERIC Educational Resources Information Center

    Biswas, Ajoy Kumar

    2006-01-01

    This article studies the ordinal reliability of (total) test scores. This study is based on a classical-type linear model of observed score (X), true score (T), and random error (E). Based on the idea of Kendall's tau-a coefficient, a measure of ordinal reliability for small-examinee populations is developed. This measure is extended to large…

  1. Structure of Mycobacterium tuberculosis mtFabD, a malonyl-CoA:acyl carrier protein transacylase (MCAT)

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

    Ghadbane, Hemza; Brown, Alistair K.; Kremer, Laurent

    2007-10-01

    Binding of Ni{sup 2+} ions to the uncleaved affinity tag facilitated de novo phasing of the crystal structure of M. tuberculosis mtFabD to 3.0 Å resolution. Mycobacteria display a unique and unusual cell-wall architecture, central to which is the membrane-proximal mycolyl-arabinogalactan-peptidoglycan core (mAGP). The biosynthesis of mycolic acids, which form the outermost layer of the mAGP core, involves malonyl-CoA:acyl carrier protein transacylase (MCAT). This essential enzyme catalyses the transfer of malonyl from coenzyme A to acyl carrier protein AcpM, thus feeding these two-carbon units into the chain-elongation cycle of the type II fatty-acid synthase. The crystal structure of M. tuberculosismore » mtFabD, the mycobacterial MCAT, has been determined to 3.0 Å resolution by multi-wavelength anomalous dispersion. Phasing was facilitated by Ni{sup 2+} ions bound to the 20-residue N-terminal affinity tag, which packed between the two independent copies of mtFabD.« less

  2. Integrating Concepts in Biology Textbook Increases Learning: Assessment Triangulation Using Concept Inventory, Card Sorting, and MCAT Instruments, Followed by Longitudinal Tracking.

    PubMed

    Luckie, Douglas B; Hoskinson, Anne-Marie; Griffin, Caleigh E; Hess, Andrea L; Price, Katrina J; Tawa, Alex; Thacker, Samantha M

    2017-01-01

    The purpose of this study was to examine the educational impact of an intervention, the inquiry-focused textbook Integrating Concepts in Biology ( ICB ), when used in a yearlong introductory biology course sequence. Student learning was evaluated using three published instruments: 1) The Biology Concept Inventory probed depth of student mastery of fundamental concepts in organismal and cellular topics when confronting misconceptions as distractors. ICB students had higher gains in all six topic categories (+43% vs. peers overall, p < 0.01). 2) The Biology Card Sorting Task assessed whether students organized biological ideas more superficially, as novices do, or based on deeper concepts, like experts. The frequency with which ICB students connected deep-concept pairs, or triplets, was similar to peers; but deep understanding of structure/function was much higher (for pairs: 77% vs. 25%, p < 0.01). 3) A content-focused Medical College Admission Test (MCAT) posttest compared ICB student content knowledge with that of peers from 15 prior years. Historically, MCAT performance for each semester ranged from 53% to 64%; the ICB cohort scored 62%, in the top quintile. Longitudinal tracking in five upper-level science courses the following year found ICB students outperformed peers in physiology (85% vs. 80%, p < 0.01). © 2017 D. B. Luckie et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  3. 34 CFR 600.55 - Additional criteria for determining whether a foreign graduate medical school is eligible to...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Admission Test (MCAT) and to have reported their scores to the foreign graduate medical school; and (2) A..., on request, to the Secretary, the scores on the MCAT or successor examination, of all students...

  4. An Inexpensive Predictor of Student Performance on Licensure Examinations.

    ERIC Educational Resources Information Center

    Hyde, R. M.; And Others

    1987-01-01

    The construction of a comprehensive final examination over the basic medical sciences is described. Performance on the exam was a better predictor of NBME-I scores than GPA in basic science or MCAT scores and a better predictor of NBME-II scores than preclinical course performance and MCAT scores. (Author/RH)

  5. The Influence of MCAT and GPA Preadmission Academic Metrics on Interview Scores

    ERIC Educational Resources Information Center

    Gay, Steven E.; Santen, Sally A.; Mangrulkar, Rajesh S.; Sisson, Thomas H.; Ross, Paula T.; Zaidi, Nikki L. Bibler

    2018-01-01

    Medical school admissions interviews are used to assess applicants' nonacademic characteristics as advocated by the Association of American Medical Colleges' Advancing Holistic Review Initiative. The objective of this study is to determine whether academic metrics continue to significantly influence interviewers' scores in holistic processes by…

  6. MCAT to XCAT: The Evolution of 4-D Computerized Phantoms for Imaging Research

    PubMed Central

    Paul Segars, W.; Tsui, Benjamin M. W.

    2012-01-01

    Recent work in the development of computerized phantoms has focused on the creation of ideal “hybrid” models that seek to combine the realism of a patient-based voxelized phantom with the flexibility of a mathematical or stylized phantom. We have been leading the development of such computerized phantoms for use in medical imaging research. This paper will summarize our developments dating from the original four-dimensional (4-D) Mathematical Cardiac-Torso (MCAT) phantom, a stylized model based on geometric primitives, to the current 4-D extended Cardiac-Torso (XCAT) and Mouse Whole-Body (MOBY) phantoms, hybrid models of the human and laboratory mouse based on state-of-the-art computer graphics techniques. This paper illustrates the evolution of computerized phantoms toward more accurate models of anatomy and physiology. This evolution was catalyzed through the introduction of nonuniform rational b-spline (NURBS) and subdivision (SD) surfaces, tools widely used in computer graphics, as modeling primitives to define a more ideal hybrid phantom. With NURBS and SD surfaces as a basis, we progressed from a simple geometrically based model of the male torso (MCAT) containing only a handful of structures to detailed, whole-body models of the male and female (XCAT) anatomies (at different ages from newborn to adult), each containing more than 9000 structures. The techniques we applied for modeling the human body were similarly used in the creation of the 4-D MOBY phantom, a whole-body model for the mouse designed for small animal imaging research. From our work, we have found the NURBS and SD surface modeling techniques to be an efficient and flexible way to describe the anatomy and physiology for realistic phantoms. Based on imaging data, the surfaces can accurately model the complex organs and structures in the body, providing a level of realism comparable to that of a voxelized phantom. In addition, they are very flexible. Like stylized models, they can easily be

  7. Scoring the full extent of periodontal disease in the dog: development of a total mouth periodontal score (TMPS) system.

    PubMed

    Harvey, Colin E; Laster, Larry; Shofer, Frances; Miller, Bonnie

    2008-09-01

    The development of a total mouth periodontal scoring system is described. This system uses methods to score the full extent of gingivitis and periodontitis of all tooth surfaces, weighted by size of teeth, and adjusted by size of dog.

  8. Functional overload increases beta-MHC promoter activity in rodent fast muscle via the proximal MCAT (betae3) site.

    PubMed

    Giger, Julia M; Haddad, Fadia; Qin, Anqi X; Baldwin, Kenneth M

    2002-03-01

    Functional overload (OL) of the rat plantaris muscle by the removal of synergistic muscles induces a shift in the myosin heavy chain (MHC) isoform expression profile from the fast isoforms toward the slow type I, or, beta-MHC isoform. Different length rat beta-MHC promoters were linked to a firefly luciferase reporter gene and injected in control and OL plantaris muscles. Reporter activities of -3,500, -914, -408, and -215 bp promoters increased in response to 1 wk of OL. The smallest -171 bp promoter was not responsive to OL. Mutation analyses of putative regulatory elements within the -171 and -408 bp region were performed. The -408 bp promoters containing mutations of the betae1, distal muscle CAT (MCAT; betae2), CACC, or A/T-rich (GATA), were still responsive to OL. Only the proximal MCAT (betae3) mutation abolished the OL response. Gel mobility shift assays revealed a significantly higher level of complex formation of the betae3 probe with nuclear protein from OL plantaris compared with control plantaris. These results suggest that the betae3 site functions as a putative OL-responsive element in the rat beta-MHC gene promoter.

  9. Molecular interactions between single-stranded DNA-binding proteins associated with an essential MCAT element in the mouse smooth muscle alpha-actin promoter.

    PubMed

    Kelm, R J; Cogan, J G; Elder, P K; Strauch, A R; Getz, M J

    1999-05-14

    Transcriptional activity of the mouse vascular smooth muscle alpha-actin gene in fibroblasts is regulated, in part, by a 30-base pair asymmetric polypurine-polypyrimidine tract containing an essential MCAT enhancer motif. The double-stranded form of this sequence serves as a binding site for a transcription enhancer factor 1-related protein while the separated single strands interact with two distinct DNA binding activities termed VACssBF1 and 2 (Cogan, J. G., Sun, S., Stoflet, E. S., Schmidt, L. J., Getz, M. J., and Strauch, A. R. (1995) J. Biol. Chem. 270, 11310-11321; Sun, S., Stoflet, E. S., Cogan, J. G., Strauch, A. R., and Getz, M. J. (1995) Mol. Cell. Biol. 15, 2429-2936). VACssBF2 has been recently cloned and shown to consist of two closely related proteins, Puralpha and Purbeta (Kelm, R. J., Elder, P. K., Strauch, A. R., and Getz, M. J. (1997) J. Biol. Chem. 272, 26727-26733). In this study, we demonstrate that Puralpha and Purbeta interact with each other via highly specific protein-protein interactions and bind to the purine-rich strand of the MCAT enhancer in the form of both homo- and heteromeric complexes. Moreover, both Pur proteins interact with MSY1, a VACssBF1-like protein cloned by virtue of its affinity for the pyrimidine-rich strand of the enhancer. Interactions between Puralpha, Purbeta, and MSY1 do not require the participation of DNA. Combinatorial interactions between these three single-stranded DNA-binding proteins may be important in regulating activity of the smooth muscle alpha-actin MCAT enhancer in fibroblasts.

  10. History of Not Completing Courses as Predictor of Academic Difficulty among First-Year Students.

    ERIC Educational Resources Information Center

    Jackson, Evelyn W.; Dawson-Saunders, Beth

    1987-01-01

    A study found that variables significant in predicting minority students with academic difficulty include science grade-point average, Medical College Admission Test (MCAT) reading subtest score, and number of course withdrawals. For majority students, they include MCAT biology subtest score and number of incompletes taken in courses. (MSE)

  11. Cross-cultural adaptation and validation of Persian Achilles tendon Total Rupture Score.

    PubMed

    Ansari, Noureddin Nakhostin; Naghdi, Soofia; Hasanvand, Sahar; Fakhari, Zahra; Kordi, Ramin; Nilsson-Helander, Katarina

    2016-04-01

    To cross-culturally adapt the Achilles tendon Total Rupture Score (ATRS) to Persian language and to preliminary evaluate the reliability and validity of a Persian ATRS. A cross-sectional and prospective cohort study was conducted to translate and cross-culturally adapt the ATRS to Persian language (ATRS-Persian) following steps described in guidelines. Thirty patients with total Achilles tendon rupture and 30 healthy subjects participated in this study. Psychometric properties of floor/ceiling effects (responsiveness), internal consistency reliability, test-retest reliability, standard error of measurement (SEM), smallest detectable change (SDC), construct validity, and discriminant validity were tested. Factor analysis was performed to determine the ATRS-Persian structure. There were no floor or ceiling effects that indicate the content and responsiveness of ATRS-Persian. Internal consistency was high (Cronbach's α 0.95). Item-total correlations exceeded acceptable standard of 0.3 for the all items (0.58-0.95). The test-retest reliability was excellent [(ICC)agreement 0.98]. SEM and SDC were 3.57 and 9.9, respectively. Construct validity was supported by a significant correlation between the ATRS-Persian total score and the Persian Foot and Ankle Outcome Score (PFAOS) total score and PFAOS subscales (r = 0.55-0.83). The ATRS-Persian significantly discriminated between patients and healthy subjects. Explanatory factor analysis revealed 1 component. The ATRS was cross-culturally adapted to Persian and demonstrated to be a reliable and valid instrument to measure functional outcomes in Persian patients with Achilles tendon rupture. II.

  12. A Longitudinal Study of Commonly Used Admissions Measures and Disenrollment from Medical School and Graduate Medical Education Probation or Termination from Training.

    PubMed

    Dong, Ting; Gilliland, William R; Cruess, David; Hutchinson, Jeffrey; Morres, Lisa; Curtis, Jerri; Hewitt-Clarke, Gail-Selina; Durning, Steven J

    2018-04-27

    This is an empirical study to better understand commonly used medical school admission measures and disenrollment decisions during undergraduate medical education as well as graduate medical education (GME) probation or termination decisions. Based on the data of USUHS medical students matriculating between 1998 and 2011 (N = 2,460), we compared medical school graduates and those disenrolled from medical school on MCAT scores, undergraduate BCPM (Biology, Chemistry, Physics, Math) GPA, and undergraduate overall GPA. We also reported more specific reasons for disenrollment decisions. Next, we compared the students who were referred to the student promotion committee (SPC) with other students on these measures. Moving onto GME, we compared trainees who were put on probation or terminated from training with those who were not on MCAT and undergraduate GPA measures. In addition, we examined the association between being referred to the SPC and GME probation or termination. There were 2,347 graduates and 113 disenrolled students from medical school (4.8%). For the disenrolled students, 43 (38.7%) students were disenrolled for exclusively (or primarily) non-academic reasons, and 68 (61.3%) were disenrolled for exclusively (or primarily) academic reasons. The t-tests showed statistically significant differences on the MCAT score of the first attempt (t(2,449) = 7.22, P < 0.01, Cohen's d = 0.70), average MCAT score (t(2,449) = 4.22, P < 0.01, Cohen's d = 0.41), and highest MCAT score (t(2,449) = 3.51, P < 0.01, Cohen's d = 0.34). Logistic regression model selection also revealed that the best predictor for disenrollment was the first MCAT score (exp(b) = 0.83, 95% CI = (0.78, 0.88)). No significant differences on these measures were found from the group comparisons on SPC and GME probation or termination. There was no significant association between SPC appearance and GME probation or termination. Academic difficulties, especially in the basic sciences, appear to be the

  13. Multiplex Controller Aptitude Test and Occupational Knowledge Test: Selection Tools for Air Traffic Controllers.

    DTIC Science & Technology

    1981-12-15

    for 6o7e (B), which became slightly more platykurtic . Thus, there appeared to be a learning effect transferred from MCAT1 to MCAT2 resulting in higher... platykurtic ) except for positive 0.27 for OKT 102E. There was a more uniform distilbution of scores for the OKT than for the MCAT tests. The test scoies

  14. 34 CFR 600.55 - Additional criteria for determining whether a foreign graduate medical school is eligible to...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., nationals, or permanent residents to have taken the Medical College Admission Test (MCAT) and to have... Secretary, the scores on the MCAT or successor examination, of all students admitted during the preceding...

  15. 34 CFR 600.55 - Additional criteria for determining whether a foreign graduate medical school is eligible to...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., nationals, or permanent residents to have taken the Medical College Admission Test (MCAT) and to have... Secretary, the scores on the MCAT or successor examination, of all students admitted during the preceding...

  16. 34 CFR 600.55 - Additional criteria for determining whether a foreign graduate medical school is eligible to...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., nationals, or permanent residents to have taken the Medical College Admission Test (MCAT) and to have... Secretary, the scores on the MCAT or successor examination, of all students admitted during the preceding...

  17. Changes in the Qualifications of Medical School Applicants, 1981 to 1985.

    ERIC Educational Resources Information Center

    Beran, Robert L.

    1987-01-01

    Changes were analyzed using both Medical College Admission Test (MCAT) scores and grade point average. Modest gains were shown: in the men and women applicants' scores on the MCAT biology, chemistry, physics, and science problems subtests; in all age categories except over 32; and for all ethnic or racial groups except blacks. (Author/LB)

  18. Sensitivity and Specificity of the Coma Recovery Scale--Revised Total Score in Detection of Conscious Awareness.

    PubMed

    Bodien, Yelena G; Carlowicz, Cecilia A; Chatelle, Camille; Giacino, Joseph T

    2016-03-01

    To describe the sensitivity and specificity of Coma Recovery Scale-Revised (CRS-R) total scores in detecting conscious awareness. Data were retrospectively extracted from the medical records of patients enrolled in a specialized disorders of consciousness (DOC) program. Sensitivity and specificity analyses were completed using CRS-R-derived diagnoses of minimally conscious state (MCS) or emerged from minimally conscious state (EMCS) as the reference standard for conscious awareness and the total CRS-R score as the test criterion. A receiver operating characteristic curve was constructed to demonstrate the optimal CRS-R total cutoff score for maximizing sensitivity and specificity. Specialized DOC program. Patients enrolled in the DOC program (N=252, 157 men; mean age, 49y; mean time from injury, 48d; traumatic etiology, n=127; nontraumatic etiology, n=125; diagnosis of coma or vegetative state, n=70; diagnosis of MCS or EMCS, n=182). Not applicable. Sensitivity and specificity of CRS-R total scores in detecting conscious awareness. A CRS-R total score of 10 or higher yielded a sensitivity of .78 for correct identification of patients in MCS or EMCS, and a specificity of 1.00 for correct identification of patients who did not meet criteria for either of these diagnoses (ie, were diagnosed with vegetative state or coma). The area under the curve in the receiver operating characteristic curve analysis is .98. A total CRS-R score of 10 or higher provides strong evidence of conscious awareness but resulted in a false-negative diagnostic error in 22% of patients who demonstrated conscious awareness based on CRS-R diagnostic criteria. A cutoff score of 8 provides the best balance between sensitivity and specificity, accurately classifying 93% of cases. The optimal total score cutoff will vary depending on the user's objective. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Interobserver Reliability of the Total Body Score System for Quantifying Human Decomposition.

    PubMed

    Dabbs, Gretchen R; Connor, Melissa; Bytheway, Joan A

    2016-03-01

    Several authors have tested the accuracy of the Total Body Score (TBS) method for quantifying decomposition, but none have examined the reliability of the method as a scoring system by testing interobserver error rates. Sixteen participants used the TBS system to score 59 observation packets including photographs and written descriptions of 13 human cadavers in different stages of decomposition (postmortem interval: 2-186 days). Data analysis used a two-way random model intraclass correlation in SPSS (v. 17.0). The TBS method showed "almost perfect" agreement between observers, with average absolute correlation coefficients of 0.990 and average consistency correlation coefficients of 0.991. While the TBS method may have sources of error, scoring reliability is not one of them. Individual component scores were examined, and the influences of education and experience levels were investigated. Overall, the trunk component scores were the least concordant. Suggestions are made to improve the reliability of the TBS method. © 2016 American Academy of Forensic Sciences.

  20. Writing, self-reflection, and medical school performance: the Human Context of Health Care.

    PubMed

    Stephens, Mark B; Reamy, Brian V; Anderson, Denise; Olsen, Cara; Hemmer, Paul A; Durning, Steven J; Auster, Simon

    2012-09-01

    Finding ways to improve communication and self-reflection skills is an important element of medical education and continuing professional development. This study examines the relationship between self-reflection and educational outcomes. We correlate performance in a preclinical course that focuses on self-reflection as it relates to contextual elements of patient care (Human Context of Health Care), with educational measures such as overall grade point average, clinical clerkship scores, and Medical College Admission Test (MCAT) scores. Student performance in Human Context of Health Care correlated with MCAT-Verbal scores, MCAT-writing sample scores, clerkship grades, and overall medical school grade point average (R = 0.3; p < 0.001). Writing and self-reflection skills are often neglected in undergraduate medical curricula. Our findings suggest that these skills are important and correlate with recognized long-term educational outcomes.

  1. Impact of student ethnicity and primary childhood language on communication skill assessment in a clinical performance examination.

    PubMed

    Fernandez, Alicia; Wang, Frances; Braveman, Melissa; Finkas, Lindsay K; Hauer, Karen E

    2007-08-01

    Clinical performance examinations (CPX) with standardized patients (SPs) have become a preferred method to assess communication skills in US medical schools. Little is known about how trainees' backgrounds impact CPX performance. The objective of this paper is to examine the impact of student ethnicity, primary childhood language, and experience of diversity on the communication scores of a high-stakes CPX using SPs. This research was designed as an observational study. The participants of this study were third-year medical students at one US medical school. The measurements used in this study were CPX scores from mandatory exam, student demographics and experience with diversity measured by self-report on a survey, and Medical College Admission Test (MCAT) and United States Medical Licensing Examination (USMLE) scores. A total of 135 students participated. Asian and black students scored lower than white students on the communication portion of the CPX by approximately half a standard deviation (Asian, 67.4%; black, 64.4%; white, 69.4%, p < .05). There were no differences by ethnicity on history/physical exam scores. Multivariate analysis controlling for MCAT verbal scores reduced ethnic differences in communication scores (Asian-white mean differences = 1.95, p = 0.02), but Asian-white differences were eliminated only after sequential models included primary childhood language (difference = 0.57, p = 0.6). Even after controlling for English language knowledge as measured in MCAT verbal scores, speaking a primary childhood language other than English is associated with lower CPX communication scores for Asian students. While poorer communication skills cannot be ruled out, SP exams may contain measurement bias associated with differences in childhood language or culture. Caution is indicated when interpreting CPX communication scores among diverse examinees.

  2. The Pre-Health Collection within MedEdPORTAL's iCollaborative: Helping Faculty Prepare Students for the Competencies in the New MCAT[superscript 2015] Exam

    ERIC Educational Resources Information Center

    Jakubowski, Henry V.; Zapanta, Laura S.

    2013-01-01

    To help faculty prepare and revise courses in all the disciplines represented in the MCAT[superscript 2015], the American Association of Medical Colleges, through its MedEdPORTAL's iCollaborative, has established the Pre-health Collection, a repository of reviewed web resources that are openly and freely available to faculty, and indirectly…

  3. Factors Associated With Surgery Clerkship Performance and Subsequent USMLE Step Scores.

    PubMed

    Dong, Ting; Copeland, Annesley; Gangidine, Matthew; Schreiber-Gregory, Deanna; Ritter, E Matthew; Durning, Steven J

    2018-03-12

    We conducted an in-depth empirical investigation to achieve a better understanding of the surgery clerkship from multiple perspectives, including the influence of clerkship sequence on performance, the relationship between self-logged work hours and performance, as well as the association between surgery clerkship performance with subsequent USMLE Step exams' scores. The study cohort consisted of medical students graduating between 2015 and 2018 (n = 687). The primary measures of interest were clerkship sequence (internal medicine clerkship before or after surgery clerkship), self-logged work hours during surgery clerkship, surgery NBME subject exam score, surgery clerkship overall grade, and Step 1, Step 2 CK, and Step 3 exam scores. We reported the descriptive statistics and conducted correlation analysis, stepwise linear regression analysis, and variable selection analysis of logistic regression to answer the research questions. Students who completed internal medicine clerkship prior to surgery clerkship had better performance on surgery subject exam. The subject exam score explained an additional 28% of the variance of the Step 2 CK score, and the clerkship overall score accounted for an additional 24% of the variance after the MCAT scores and undergraduate GPA were controlled. Our finding suggests that the clerkship sequence does matter when it comes to performance on the surgery NBME subject exam. Performance on the surgery subject exam is predictive of subsequent performance on future USMLE Step exams. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  4. A Study of Cognitive Achievement in a Special Premedical Program

    ERIC Educational Resources Information Center

    Agbor-Baiyee, William

    2009-01-01

    Purpose: In common with most standardized admissions tests, the Medical College Admission Test (MCAT) scores disproportionately screen out applicants from disadvantaged and underrepresented minority groups, relative to their demographic importance. The impact of programs to prepare students for the MCAT has not been adequately addressed. The…

  5. Development and Validation of a Novel Scoring System for Predicting Technical Success of Chronic Total Occlusion Percutaneous Coronary Interventions: The PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) Score.

    PubMed

    Christopoulos, Georgios; Kandzari, David E; Yeh, Robert W; Jaffer, Farouc A; Karmpaliotis, Dimitri; Wyman, Michael R; Alaswad, Khaldoon; Lombardi, William; Grantham, J Aaron; Moses, Jeffrey; Christakopoulos, Georgios; Tarar, Muhammad Nauman J; Rangan, Bavana V; Lembo, Nicholas; Garcia, Santiago; Cipher, Daisha; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

    2016-01-11

    This study sought to develop a novel parsimonious score for predicting technical success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) performed using the hybrid approach. Predicting technical success of CTO PCI can facilitate clinical decision making and procedural planning. We analyzed clinical and angiographic parameters from 781 CTO PCIs included in PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) using a derivation and validation cohort (2:1 sampling ratio). Variables with strong association with technical success in multivariable analysis were assigned 1 point, and a 4-point score was developed from summing all points. The PROGRESS CTO score was subsequently compared with the J-CTO (Multicenter Chronic Total Occlusion Registry in Japan) score in the validation cohort. Technical success was 92.9%. On multivariable analysis, factors associated with technical success included proximal cap ambiguity (beta coefficient [b] = 0.88), moderate/severe tortuosity (b = 1.18), circumflex artery CTO (b = 0.99), and absence of "interventional" collaterals (b = 0.88). The resulting score demonstrated good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow chi-square = 2.633; p = 0.268, and receiver-operator characteristic [ROC] area = 0.778) and validation (Hosmer-Lemeshow chi-square = 5.333; p = 0.070, and ROC area = 0.720) subset. In the validation cohort, the PROGRESS CTO and J-CTO scores performed similarly in predicting technical success (ROC area 0.720 vs. 0.746, area under the curve difference = 0.026, 95% confidence interval = -0.093 to 0.144). The PROGRESS CTO score is a novel useful tool for estimating technical success in CTO PCI performed using the hybrid approach. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  6. NASA's Newest Orbital Debris Ground-based Telescope Assets: MCAT and UKIRT

    NASA Technical Reports Server (NTRS)

    Lederer, S. M.; Frith, J. M.; Pace, L. F.; Cowardin, H. M.; Cowardin, H. M.; Hickson, P.; Glesne, T.; Maeda, R.; Buckalew, B.; Nishimoto, D.; hide

    2014-01-01

    NASA's Orbital Debris Program Office (ODPO) will break ground on Ascension Island in 2014 to build the newest optical (0.30 - 1.06 micrometers) ground-based telescope asset dedicated to the study of orbital debris. The Meter Class Autonomous Telescope (MCAT) is a 1.3m optical telescope designed to track objects in orbits ranging from Low Earth Orbit (LEO) to Geosynchronous Earth Orbit (GEO). Ascension Island is located in the South Atlantic Ocean, offering longitudinal sky coverage not afforded by the Ground-based Electro-Optical Deep Space Surveillance (GEODSS) network. With a fast-tracking dome, a suite of visible wide-band filters, and a time-delay integration (TDI) capable camera, MCAT is capable of multiple observing modes ranging from tracking cataloged debris targets to surveying the overall debris environment. Access to the United Kingdom Infrared Telescope (UKIRT) will extend our spectral coverage into the near- (0.8-5 micrometers) and mid- to far-infrared (8-25 micrometers) regime. UKIRT is a 3.8m telescope located on Mauna Kea on the Big Island of Hawaii. At nearly 14,000-feet and above the atmospheric inversion layer, this is one of the premier astronomical sites in the world and is an ideal setting for an infrared telescope. An unprecedented one-third of this telescope's time has been allocated to collect orbital debris data for NASA's ODPO over a 2-year period. UKIRT has several instruments available to obtain low-resolution spectroscopy in both the near-IR and the mid/far-IR. Infrared spectroscopy is ideal for constraining the material types, albedos and sizes of debris targets, and potentially gaining insight into reddening effects caused by space weathering. In addition, UKIRT will be used to acquire broadband photometric imaging at GEO with the Wide Field Camera (WFCAM) for studying known objects of interest as well as collecting data in survey-mode to discover new targets. Results from the first stage of the debris campaign will be presented. The

  7. Predicting Academic Performance at a Predominantly Black Medical School.

    ERIC Educational Resources Information Center

    Johnson, Davis G.; And Others

    1986-01-01

    The validity of the Medical College Admission (MCAT), undergraduate grade-point average (GPA), and "competitiveness" of undergraduate college in predicting the performance of students at a predominantly black college of medicine was examined. No differences between men and women were found in the validity of MCAT scores and GPA.…

  8. Cloning and characterization of the mouse alpha1C/A-adrenergic receptor gene and analysis of an alpha1C promoter in cardiac myocytes: role of an MCAT element that binds transcriptional enhancer factor-1 (TEF-1).

    PubMed

    O'Connell, T D; Rokosh, D G; Simpson, P C

    2001-05-01

    alpha1-Adrenergic receptor (AR) subtypes in the heart are expressed by myocytes but not by fibroblasts, a feature that distinguishes alpha1-ARs from beta-ARs. Here we studied myocyte-specific expression of alpha1-ARs, focusing on the subtype alpha1C (also called alpha1A), a subtype implicated in cardiac hypertrophic signaling in rat models. We first cloned the mouse alpha1C-AR gene, which consisted of two exons with an 18 kb intron, similar to the alpha1B-AR gene. The receptor coding sequence was >90% homologous to that of rat and human. alpha1C-AR transcription in mouse heart was initiated from a single Inr consensus sequence at -588 from the ATG; this and a putative polyadenylation sequence 8.5 kb 3' could account for the predominant 11 kb alpha1C mRNA in mouse heart. A 5'-nontranscribed fragment of 4.4 kb was active as a promoter in cardiac myocytes but not in fibroblasts. Promoter activity in myocytes required a single muscle CAT (MCAT) element, and this MCAT bound in vitro to recombinant and endogenous transcriptional enhancer factor-1. Thus, alpha1C-AR transcription in cardiac myocytes shares MCAT dependence with other cardiac-specific genes, including the alpha- and beta-myosin heavy chains, skeletal alpha-actin, and brain natriuretic peptide. However, the mouse alpha1C gene was not transcribed in the neonatal heart and was not activated by alpha1-AR and other hypertrophic agonists in rat myocytes, and thus differed from other MCAT-dependent genes and the rat alpha1C gene.

  9. Distribution of Total Depressive Symptoms Scores and Each Depressive Symptom Item in a Sample of Japanese Employees.

    PubMed

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Yamada, Hiroshi; Miyake, Hirotsugu; Furukawa, Toshiaki A; Furukaw, Toshiaki A

    2016-01-01

    In a previous study, we reported that the distribution of total depressive symptoms scores according to the Center for Epidemiologic Studies Depression Scale (CES-D) in a general population is stable throughout middle adulthood and follows an exponential pattern except for at the lowest end of the symptom score. Furthermore, the individual distributions of 16 negative symptom items of the CES-D exhibit a common mathematical pattern. To confirm the reproducibility of these findings, we investigated the distribution of total depressive symptoms scores and 16 negative symptom items in a sample of Japanese employees. We analyzed 7624 employees aged 20-59 years who had participated in the Northern Japan Occupational Health Promotion Centers Collaboration Study for Mental Health. Depressive symptoms were assessed using the CES-D. The CES-D contains 20 items, each of which is scored in four grades: "rarely," "some," "much," and "most of the time." The descriptive statistics and frequency curves of the distributions were then compared according to age group. The distribution of total depressive symptoms scores appeared to be stable from 30-59 years. The right tail of the distribution for ages 30-59 years exhibited a linear pattern with a log-normal scale. The distributions of the 16 individual negative symptom items of the CES-D exhibited a common mathematical pattern which displayed different distributions with a boundary at "some." The distributions of the 16 negative symptom items from "some" to "most" followed a linear pattern with a log-normal scale. The distributions of the total depressive symptoms scores and individual negative symptom items in a Japanese occupational setting show the same patterns as those observed in a general population. These results show that the specific mathematical patterns of the distributions of total depressive symptoms scores and individual negative symptom items can be reproduced in an occupational population.

  10. High cancer-specific expression of mesothelin (MSLN) is attributable to an upstream enhancer containing a transcription enhancer factor dependent MCAT motif.

    PubMed

    Hucl, Tomas; Brody, Jonathan R; Gallmeier, Eike; Iacobuzio-Donahue, Christine A; Farrance, Iain K; Kern, Scott E

    2007-10-01

    Identification of genes with cancer-specific overexpression offers the potential to efficiently discover cancer-specific activities in an unbiased manner. We apply this paradigm to study mesothelin (MSLN) overexpression, a nearly ubiquitous, diagnostically and therapeutically useful characteristic of pancreatic cancer. We identified an 18-bp upstream enhancer, termed CanScript, strongly activating transcription from an otherwise weak tissue-nonspecific promoter and operating selectively in cells having aberrantly elevated cancer-specific MSLN transcription. Introducing mutations into CanScript showed two functionally distinct sites: an Sp1-like site and an MCAT element. Gel retardation and chromatin immunoprecipitation assays showed the MCAT element to be bound by transcription enhancer factor (TEF)-1 (TEAD1) in vitro and in vivo. The presence of TEF-1 was required for MSLN protein overexpression as determined by TEF-1 knockdown experiments. The cancer specificity seemed to be provided by a putative limiting cofactor of TEF-1 that could be outcompeted by exogenous TEF-1 only in a MSLN-overexpressing cell line. A CanScript concatemer offered enhanced activity. These results identify a TEF family member as a major regulator of MSLN overexpression, a fundamental characteristic of pancreatic and other cancers, perhaps due to an upstream and highly frequent aberrant cellular activity. The CanScript sequence represents a modular element for cancer-specific targeting, potentially suitable for nearly a third of human malignancies.

  11. Prairie View A&M/Baylor College of Medicine SMART Summer Undergraduate Prostate Cancer Research Project

    DTIC Science & Technology

    2008-04-01

    prepares to take the MCAT and GRE exams and apply for MD/Ph.D. and DO/Ph.D, programs. 2007 Participants Alem Tewoldeberhan was accepted to the...apply to medical school. Mark Williams, II intends to work as a technician while he improves his MCAT score and applies to medical school. Mark

  12. The chinese version of achilles tendon total rupture score: cross-cultural adaptation, reliability and validity.

    PubMed

    Cui, Jin; Jia, Zhenyu; Zhi, Xin; Li, Xiaoqun; Zhai, Xiao; Cao, Liehu; Weng, Weizong; Zhang, Jun; Wang, Lin; Chen, Xiao; Su, Jiacan

    2017-01-05

    The Achilles tendon Total Rupture Score (ATRS), which is originally developed in 2007 in Swedish, is the only patient-reported outcome measure (PROM) for specific outcome assessment of an Achilles tendon rupture.Purpose of this study is to translate and cross-culturally adapt Achilles tendon Total Rupture Score (ATRS) into simplified Chinese, and primarily evaluate the responsiveness, reliability and validity. International recognized guideline which was designed by Beaton was followed to make the translation of ATRS from English into simplified Chinese version (CH-ATRS). A prospective cohort study was carried out for the cross-cultural adaptation. There were 112 participants included into the study. Psychometric properties including floor and ceiling effects, Cronbach's alpha, intraclass correlation coefficient, effect size, standard response mean, and construct validity were tested. The mean scores of CH-ATRS are 57.42 ± 13.70. No sign of floor or ceiling effect was found of CH-ATRS. High level of internal consistency was supported by the value of Cronbach's alpha (0.893). ICC (0.979, 95%CI: 0.984-0.993) was high to indicate the high test-retest reliability. Great responsive ness was proved with the high absolute value of ES and SRM (0.84 and 8.98, respectively). The total CH-ATRS score had very good correlation with physical function and body pain subscales of SF-36 (r = -0.758 and r = -0.694, respectively, p < 0.001), while poor correlation with vitality and role physical subscales of SF-36 (r = -0.033 and r = -0.025, respectively, p ≥ 0.05), which supported construct validity of CH-ATRS. This Chinese version of Achilles tendon Total Rupture Score (CH-ATRS) can be used as a reliable and valid instrument for Achilles tendon rupture assessing in Chinese-speaking population. Level of evidence II.

  13. Modernizing quality of life assessment: development of a multidimensional computerized adaptive questionnaire for patients with schizophrenia.

    PubMed

    Michel, Pierre; Baumstarck, Karine; Lancon, Christophe; Ghattas, Badih; Loundou, Anderson; Auquier, Pascal; Boyer, Laurent

    2018-04-01

    Quality of life (QoL) is still assessed using paper-based and fixed-length questionnaires, which is one reason why QoL measurements have not been routinely implemented in clinical practice. Providing new QoL measures that combine computer technology with modern measurement theory may enhance their clinical use. The aim of this study was to develop a QoL multidimensional computerized adaptive test (MCAT), the SQoL-MCAT, from the fixed-length SQoL questionnaire for patients with schizophrenia. In this multicentre cross-sectional study, we collected sociodemographic information, clinical characteristics (i.e., duration of illness, the PANSS, and the Calgary Depression Scale), and quality of life (i.e., SQoL). The development of the SQoL-CAT was divided into three stages: (1) multidimensional item response theory (MIRT) analysis, (2) multidimensional computerized adaptive test (MCAT) simulations with analyses of accuracy and precision, and (3) external validity. Five hundred and seventeen patients participated in this study. The MIRT analysis found that all items displayed good fit with the multidimensional graded response model, with satisfactory reliability for each dimension. The SQoL-MCAT was 39% shorter than the fixed-length SQoL questionnaire and had satisfactory accuracy (levels of correlation >0.9) and precision (standard error of measurement <0.55 and root mean square error <0.3). External validity was confirmed via correlations between the SQoL-MCAT dimension scores and symptomatology scores. The SQoL-MCAT is the first computerized adaptive QoL questionnaire for patients with schizophrenia. Tailored for patient characteristics and significantly shorter than the paper-based version, the SQoL-MCAT may improve the feasibility of assessing QoL in clinical practice.

  14. Prairie View A&M/Baylor College of Medicine SMART Summer Undergraduate Prostate Cancer Research Project

    DTIC Science & Technology

    2009-04-01

    August, 2007 and is working as a technician while he prepares to take the MCAT and GRE exams and apply for MD/Ph.D. and DO/Ph.D. programs. 2007...degree and is working as a technician while he improves his MCAT score and applies to medical school. Mark was selected for significant PVAMU leadership

  15. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population.

    PubMed

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A; Ono, Yutaka

    2016-01-01

    Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items). The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an exponential mathematical pattern.

  16. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

    PubMed Central

    Kawasaki, Yohei; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A.; Ono, Yutaka

    2016-01-01

    Background Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Methods Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items). The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. Results The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. Discussion The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an exponential mathematical

  17. Cost-benefit comparison of the Oxford Knee score and the American Knee Society score in measuring outcome of total knee arthroplasty.

    PubMed

    Medalla, Greg Anthony; Moonot, Pradeep; Peel, Tamlyn; Kalairajah, Yegappan; Field, Richard E

    2009-06-01

    The American Knee Society score (AKSS) and the Oxford Knee score (OKS) are validated outcome measures for evaluation of total knee arthroplasties (TKAs). We investigated whether patient self-assessment using the OKS offers a viable alternative to clinical review using the AKSS. Preoperative, 2-year, 5-year, and 10-year postoperative OKS and AKSS were reviewed from TKA patients. The scores were analyzed using the Pearson correlation. There was good correlation of OKS and AKSS at 2 years. This implies that patient self-assessment is a viable screening tool to identify which patients require clinical review, at 2 years, after TKA. However, the moderate correlation at 5 and 10 years indicates that clinical evaluation remains necessary at these time points.

  18. Towards a contemporary, comprehensive scoring system for determining technical outcomes of hybrid percutaneous chronic total occlusion treatment: The RECHARGE score.

    PubMed

    Maeremans, Joren; Spratt, James C; Knaapen, Paul; Walsh, Simon; Agostoni, Pierfrancesco; Wilson, William; Avran, Alexandre; Faurie, Benjamin; Bressollette, Erwan; Kayaert, Peter; Bagnall, Alan J; Smith, Dave; McEntegart, Margaret B; Smith, William H T; Kelly, Paul; Irving, John; Smith, Elliot J; Strange, Julian W; Dens, Jo

    2018-02-01

    This study sought to create a contemporary scoring tool to predict technical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) from patients treated by hybrid operators with differing experience levels. Current scoring systems need regular updating to cope with the positive evolutions regarding materials, techniques, and outcomes, while at the same time being applicable for a broad range of operators. Clinical and angiographic characteristics from 880 CTO-PCIs included in the REgistry of CrossBoss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE) were analyzed by using a derivation and validation set (2:1 ratio). Variables significantly associated with technical failure in the multivariable analysis were incorporated in the score. Subsequently, the discriminatory capacity was assessed and the validation set was used to compare with the J-CTO score and PROGRESS scores. Technical success in the derivation and validation sets was 83% and 85%, respectively. Multivariate analysis identified six parameters associated with technical failure: blunt stump (beta coefficient (b) = 1.014); calcification (b = 0.908); tortuosity ≥45° (b = 0.964); lesion length 20 mm (b = 0.556); diseased distal landing zone (b = 0.794), and previous bypass graft on CTO vessel (b = 0.833). Score variables remained significant after bootstrapping. The RECHARGE score showed better discriminatory capacity in both sets (area-under-the-curve (AUC) = 0.783 and 0.711), compared to the J-CTO (AUC = 0.676) and PROGRESS (AUC = 0.608) scores. The RECHARGE score is a novel, easy-to-use tool for assessing the risk for technical failure in hybrid CTO-PCI and has the potential to perform well for a broad community of operators. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Beyond the Total Score: A Preliminary Investigation into the Types of Phonological Awareness Errors Made by First Graders

    ERIC Educational Resources Information Center

    Hayward, Denyse V.; Annable, Caitlin D.; Fung, Jennifer E.; Williamson, Robert D.; Lovell-Johnston, Meridith A.; Phillips, Linda M.

    2017-01-01

    Current phonological awareness assessment procedures consider only the total score a child achieves. Such an approach may result in children who achieve the same total score receiving the same instruction even though the configuration of their errors represent fundamental knowledge differences. The purpose of this study was to develop a tool for…

  20. Macroscopic cartilage repair scoring of defect fill, integration and total points correlate with corresponding items in histological scoring systems - a study in adult sheep.

    PubMed

    Goebel, L; Orth, P; Cucchiarini, M; Pape, D; Madry, H

    2017-04-01

    To correlate osteochondral repair assessed by validated macroscopic scoring systems with established semiquantitative histological analyses in an ovine model and to test the hypothesis that important macroscopic individual categories correlate with their corresponding histological counterparts. In the weight-bearing portion of medial femoral condyles (n = 38) of 19 female adult Merino sheep (age 2-4 years; weight 70 ± 20 kg) full-thickness chondral defects were created (size 4 × 8 mm; International Cartilage Repair Society (ICRS) grade 3C) and treated with Pridie drilling. After sacrifice, 1520 blinded macroscopic observations from three observers at 2-3 time points including five different macroscopic scoring systems demonstrating all grades of cartilage repair where correlated with corresponding categories from 418 blinded histological sections. Categories "defect fill" and "total points" of different macroscopic scoring systems correlated well with their histological counterparts from the Wakitani and Sellers scores (all P ≤ 0.001). "Integration" was assessed in both histological scoring systems and in the macroscopic ICRS, Oswestry and Jung scores. Here, a significant relationship always existed (0.020 ≤ P ≤ 0.049), except for Wakitani and Oswestry (P = 0.054). No relationship was observed for the "surface" between histology and macroscopy (all P > 0.05). Major individual morphological categories "defect fill" and "integration", and "total points" of macroscopic scoring systems correlate with their corresponding categories in elementary and complex histological scoring systems. Thus, macroscopy allows to precisely predict key histological aspects of articular cartilage repair, underlining the specific value of macroscopic scoring for examining cartilage repair. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  1. SF-36 total score as a single measure of health-related quality of life: Scoping review

    PubMed Central

    Lins, Liliane; Carvalho, Fernando Martins

    2016-01-01

    According to the 36-Item Short Form Health Survey questionnaire developers, a global measure of health-related quality of life such as the “SF-36 Total/Global/Overall Score” cannot be generated from the questionnaire. However, studies keep on reporting such measure. This study aimed to evaluate the frequency and to describe some characteristics of articles reporting the SF-36 Total/Global/Overall Score in the scientific literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was adapted to a scoping review. We performed searches in PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library databases for articles using such scores. We found 172 articles published between 1997 and 2015; 110 (64.0%) of them were published from 2010 onwards; 30.0% appeared in journals with Impact Factor 3.00 or greater. Overall, 129 (75.0%) out of the 172 studies did not specify the method for calculating the “SF-36 Total Score”; 13 studies did not specify their methods but referred to the SF-36 developers’ studies or others; and 30 articles used different strategies for calculating such score, the most frequent being arithmetic averaging of the eight SF-36 domains scores. We concluded that the “SF-36 Total/Global/Overall Score” has been increasingly reported in the scientific literature. Researchers should be aware of this procedure and of its possible impacts upon human health. PMID:27757230

  2. Student performance on levels 1 and 2-CE of COMLEX-USA: do elective upper-level undergraduate science courses matter?

    PubMed

    Wong, Stanley K; Ramirez, Juan R; Helf, Scott C

    2009-11-01

    The effect of a variety of preadmission variables, including the number of elective preadmission upper-level science courses, on academic achievement is not well established. To investigate the relationship between number of preadmission variables and overall student academic achievement in osteopathic medical school. Academic records of osteopathic medical students in the 2008 and 2009 graduating classes of Western University of Health Sciences College of Osteopathic Medicine of the Pacific in Pomona, California, were analyzed. Multivariate linear regression analyses were performed to identify predictors of academic achievement based on Medical College Admission Test (MCAT) subscores, undergraduate grade point average (GPA), GPA in medical school basic science (preclinical GPA) and clinical clerkship (clinical GPA), and scores on the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 and Level 2-Cognitive Evaluation (CE). Records of 358 osteopathic medical students were evaluated. Analysis of beta coefficients suggested that undergraduate science GPA was the most important predictor of overall student academic achievement (P<.01). Biological sciences MCAT subscore was a more modest but still statistically significant predictor of preclinical GPA and COMLEX-USA Level 1 score (P<.01). Physical sciences MCAT subscore was also a statistically significant predictor of preclinical GPA, and verbal reasoning MCAT subscore was a statistically significant predictor of COMLEX-USA Level 2-CE score (both P<.01). Women had statistically significantly higher preclinical GPA and COMLEX-USA Level 2-CE scores than men (P<.05). Differences in some outcome variables were also associated with racial-ethnic background and age. Number of preadmission elective upper-level science courses taken by students before matriculation was not significantly correlated with any academic achievement variable. Although undergraduate science GPA and MCAT biological

  3. French adaptation of the new Knee Society Scoring System for total knee arthroplasty.

    PubMed

    Debette, C; Parratte, S; Maucort-Boulch, D; Blanc, G; Pauly, V; Lustig, S; Servien, E; Neyret, P; Argenson, J N

    2014-09-01

    In November 2011, the Knee Society published its new KSS score to evaluate objective clinical data and also patient expectations, satisfaction and knee function during various physical activities before and after total knee arthroplasty (TKA). We undertook the French cross-cultural adaptation of this scoring system according to current recommendations. The French version of the new KSS score is a consistent, feasible, reliable and discriminating score. Eighty patients with knee osteoarthritis were recruited from two centers: one group of 40 patients had a TKA indication, while the other group of 40 patients had an indication for conservative treatment. After the new KSS score was translated and back-translated, it was compared to three other validated instruments (KOOS, AMIQUAL and SF-12) to determine construct validity, discriminating power, feasibility in terms of response rate and existence of floor or ceiling effect, internal consistency with Chronbach's alpha and reliability based on reproducibility and sensitivity to change (responsiveness). Due to missing data, two cases were eliminated. We found that the score could discriminate between groups; it had a nearly 100% response rate, a ceiling effect in the "expectations" domain, satisfactory Chronbach's alpha, excellent reproducibility and good responsiveness. These results confirm that the French version of the new KSS score is reliable, feasible, discriminating, consistent and responsive. The novelty of this scoring system resides in the "expectations" and "satisfaction" domains, its availability as a self-assessment questionnaire and the evaluation of function during various activities. Level III. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. Prematriculation variables associated with suboptimal outcomes for the 1994 – 1999 cohort of U.S. medical-school matriculants

    PubMed Central

    Andriole, Dorothy A.; Jeffe, Donna B.

    2010-01-01

    Context The relationship between increasing numbers and diversity of medical-school enrollees and the US physician workforce size and composition has not been described. Objective Identify demographic and pre-matriculation factors associated with medical-school matriculants’ outcomes. Design, Setting, and Participants De-identified data for the 1994–1999 national cohort of 97445 matriculants, followed through March 2, 2009 to graduation or withdrawal/dismissal, were analyzed using multivariable logistic regression to identify factors associated with suboptimal outcomes. Main Outcome Measures Academic withdrawal/dismissal, non-academic withdrawal/dismissal, and graduation without first-attempt passing scores on United States Medical Licensing Examination (USMLE) Step 1 and/or Step 2CK, each compared with graduation with first-attempt passing scores on both examinations. Results Of 84018 (86.2%) matriculants, 74494 (88.7%) graduated with first-attempt passing scores on Step 1 and Step 2CK, 6743 (8.0%) graduated without first-attempt passing scores on Step 1 and/or Step 2CK, 1049 (1.2%) withdrew/were dismissed for academic reasons, and 1732 (2.1%) withdrew/were dismissed for non-academic reasons. Variables associated with greater likelihood of graduation without first-attempt passing scores on Step 1 and/or Step 2CK and of academic withdrawal/dismissal included Medical College Admission Test (MCAT) scores (MCAT 18–20 [2.9% of sample]: adjusted odds ratio [OR]=13.06, 95% confidence interval [95% CI]=11.56–14.76 and OR=11.08, 95% CI=8.50–14.45, respectively; MCAT 21–23 [5.6%]: OR=7.52, 95% CI=6.79–8.33 and OR=5.97, 95% CI=4.68–7.62; MCAT 24–26 [13.9%]: OR=4.27, 95% CI=3.92–4.65 and OR=3.56, CI=2.88–4.40) each compared with MCAT>29; Asian/Pacific Islander ([18.2%]: OR=2.15, 95% CI=2.00–2.32 and OR=1.69, 95% CI = 1.37–2.09) or underrepresented minority ([14.9%]: OR=2.30, 95% CI=2.13–2.48 and OR=2.96, 95% CI=2.48–3.54) compared with white race

  5. Class-Wide Access to a Commercial Step 1 Question Bank During Preclinical Organ-Based Modules: A Pilot Project.

    PubMed

    Baños, James H; Pepin, Mark E; Van Wagoner, Nicholas

    2018-03-01

    The authors examined the usefulness of a commercially available Step 1 question bank as a formative academic support tool throughout organ-based modules in an integrated preclinical medical curriculum. The authors also determined the extent to which correlation between question bank utilization and academic metrics varied with Medical College Admission Test (MCAT) scores. In 2015, a cohort of 185 first-year medical students at University of Alabama School of Medicine were provided with 18-month full access to a commercially available Step 1 question bank of over 2,100 items throughout organ-based modules, although there were no requirements for use. Data on student use of the question bank were collected via an online administrative portal. Relationships between question bank utilization and academic outcomes including exams, module grades, and United States Medical Licensing Examination (USMLE) Step 1 were determined using multiple linear regression. MCAT scores and number of items attempted in the question bank significantly predicted all academic measures, with question bank utilization as the stronger predictor. The association between question bank utilization and academic outcome was stronger for individuals with lower MCAT scores. The findings elucidate a novel academic support mechanism that, for some programs, may help bridge the gap between holistic and mission-based admissions practices and a residency match process that places a premium on USMLE exam scores. Distributed formative use of USMLE Step 1 practice questions may be of value as an academic support tool that benefits all students, but particularly those entering with lower MCAT scores.

  6. Reliability and validation of the Dutch Achilles tendon Total Rupture Score.

    PubMed

    Opdam, K T M; Zwiers, R; Wiegerinck, J I; Kleipool, A E B; Haverlag, R; Goslings, J C; van Dijk, C N

    2018-03-01

    Patient-reported outcome measures (PROMs) have become a cornerstone for the evaluation of the effectiveness of treatment. The Achilles tendon Total Rupture Score (ATRS) is a PROM for outcome and assessment of an Achilles tendon rupture. The aim of this study was to translate the ATRS to Dutch and evaluate its reliability and validity in the Dutch population. A forward-backward translation procedure was performed according to the guidelines of cross-cultural adaptation process. The Dutch ATRS was evaluated for reliability and validity in patients treated for a total Achilles tendon rupture from 1 January 2012 to 31 December 2014 in one teaching hospital and one academic hospital. Reliability was assessed by the intraclass correlation coefficients (ICC), Cronbach's alpha and minimal detectable change (MDC). We assessed construct validity by calculation of Spearman's rho correlation coefficient with domains of the Foot and Ankle Outcome Score (FAOS), Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A) and Numeric Rating Scale (NRS) for pain in rest and during running. The Dutch ATRS had a good test-retest reliability (ICC = 0.852) and a high internal consistency (Cronbach's alpha = 0.96). MDC was 30.2 at individual level and 3.5 at group level. Construct validity was supported by 75 % of the hypothesized correlations. The Dutch ATRS had a strong correlation with NRS for pain during running (r = -0.746) and all the five subscales of the Dutch FAOS (r = 0.724-0.867). There was a moderate correlation with the VISA-A-NL (r = 0.691) and NRS for pain in rest (r = -0.580). The Dutch ATRS shows an adequate reliability and validity and can be used in the Dutch population for measuring the outcome of treatment of a total Achilles tendon rupture and for research purposes. Diagnostic study, Level I.

  7. Inter-Rater Reliability of Total Body Score-A Scale for Quantification of Corpse Decomposition.

    PubMed

    Nawrocka, Marta; Frątczak, Katarzyna; Matuszewski, Szymon

    2016-05-01

    The degree of body decomposition can be quantified using Total Body Score (TBS), a scale frequently used in taphonomic or entomological studies of decomposition. Here, the inter-rater reliability of the scale is analyzed. The study was made on 120 laymen, which were trained in the use of the scale. Participants scored decomposition of pig carcasses from photographs. It was found that the scale, when used by different people, gives homogeneous results irrespective of the user qualifications (the Krippendorff's alfa for all participants was 0.818). The study also indicated that carcasses in advanced decomposition receive significantly less accurate scores. Moreover, it was found that scores for cadavers in mosaic decomposition (i.e., representing signs of at least two stages of decomposition) are less accurate. These results demonstrate that the scale may be regarded as inter-rater reliable. Some propositions for refinement of the scale were also discussed. © 2016 American Academy of Forensic Sciences.

  8. Associations of medical student personality and health/wellness characteristics with their medical school performance across the curriculum.

    PubMed

    Haight, Scott J; Chibnall, John T; Schindler, Debra L; Slavin, Stuart J

    2012-04-01

    To assess the relationships of cognitive and noncognitive performance predictors to medical student preclinical and clinical performance indicators across medical school years 1 to 3 and to evaluate the association of psychological health/wellness factors with performance. In 2010, the authors conducted a cross-sectional, correlational, retrospective study of all 175 students at the Saint Louis University School of Medicine who had just completed their third (first clinical) year. Students were asked to complete assessments of personality, stress, anxiety, depression, social support, and community cohesion. Performance measures included total Medical College Admission Test (MCAT) score, preclinical academic grades, National Board of Medical Examiners subject exam scores, United States Medical Licensing Examination Step 1 score, clinical evaluations, and Humanism in Medicine Honor Society nominations. A total of 152 students (87%) participated. MCAT scores predicted cognitive performance indicators (academic tests), whereas personality variables (conscientiousness, extraversion, empathy) predicted noncognitive indicators (clinical evaluations, humanism nominations). Conscientiousness predicted all clinical skills, extraversion predicted clinical skills reflecting interpersonal behavior, and empathy predicted motivation. Health/wellness variables had limited associations with performance. In multivariate analyses that included control for shelf exam scores, conscientiousness predicted clinical evaluations, and extraversion and empathy predicted humanism nominations. This study identified two sets of skills (cognitive, noncognitive) used during medical school, with minimal overlap across the types of performance (e.g., exam performance versus clinical interpersonal skills) they predict. Medical school admission and evaluation efforts may need to be modified to reflect the importance of personality and other noncognitive factors.

  9. NASA's Newest Orbital Debris Ground-based Telescope Assets: MCAT and UKIRT

    NASA Astrophysics Data System (ADS)

    Lederer, S.; Frith, J.; Pace, L. F.; Cowardin, H. M.; Hickson, P.; Glesne, T.; Maeda, R.; Buckalew, B.; Nishimoto, D.; Douglas, D.; Stansbery, E. G.

    2014-09-01

    NASAs Orbital Debris Program Office (ODPO) will break ground on Ascension Island in 2014 to build the newest optical (0.30 1.06 microns) ground-based telescope asset dedicated to the study of orbital debris. The Meter Class Autonomous Telescope (MCAT) is a 1.3m optical telescope designed to track objects in orbits ranging from Low Earth Orbit (LEO) to Geosynchronous Earth Orbit (GEO). Ascension Island is located in the South Atlantic Ocean, offering longitudinal sky coverage not afforded by the Ground-based Electro-Optical Deep Space Surveillance (GEODSS) network. With a fast-tracking dome, a suite of visible wide-band filters, and a time-delay integration (TDI) capable camera, MCAT is capable of multiple observing modes ranging from tracking cataloged debris targets to surveying the overall debris environment. Access to the United Kingdom Infrared Telescope (UKIRT) will extend our spectral coverage into the near- (0.8-5 micron) and mid- to far-infrared (8-25 micron) regime. UKIRT is a 3.8m telescope located on Mauna Kea on the Big Island of Hawaii. At nearly 14,000-feet and above the atmospheric inversion layer, this is one of the premier astronomical sites in the world and is an ideal setting for an infrared telescope. An unprecedented one-third of this telescopes time has been allocated to collect orbital debris data for NASAs ODPO over a 2-year period. UKIRT has several instruments available to obtain low-resolution spectroscopy in both the near-IR and the mid/far-IR. Infrared spectroscopy is ideal for constraining the material types, albedos and sizes of debris targets, and potentially gaining insight into reddening effects caused by space weathering. In addition, UKIRT will be used to acquire broadband photometric imaging at GEO with the Wide Field Camera (WFCAM) for studying known objects of interest as well as collecting data in survey-mode to discover new targets. Results from the first stage of the debris campaign will be presented. The combination of

  10. Can Combined Bypass Surgery at Middle Cerebral Artery Territory Save Anterior Cerebral Artery Territory in Adult Moyamoya Disease?

    PubMed

    Cho, Won-Sang; Kim, Jeong Eun; Paeng, Jin Chul; Suh, Minseok; Kim, Yong-Il; Kang, Hyun-Seung; Son, Young Je; Bang, Jae Seung; Oh, Chang Wan

    2017-03-01

    Patients with moyamoya disease are frequently encountered with improved symptoms related to anterior cerebral artery territory (ACAt) and middle cerebral artery territory (MCAt) after bypass surgery at MCAt. To evaluate hemodynamic changes in MCAt and ACAt after bypass surgery in adult moyamoya disease. Combined bypass surgery was performed on 140 hemispheres in 126 patients with MCAt symptoms. Among them, 87 hemispheres (62.1%) accompanied preoperative ACAt symptoms. Clinical, hemodynamic, and angiographic states were evaluated preoperatively and approximately 6 months after surgery. Preoperative symptoms resolved in 127 MCAt (90.7%) and 82 ACAt (94.3%). Hemodynamic analysis of total patients showed a significant improvement in MCAt basal perfusion and reservoir capacity ( P < .001 and P = .002, respectively) and ACAt basal perfusion ( P = .001). In a subgroup analysis, 82 hemispheres that completely recovered from preoperative ACAt symptoms showed a significant improvement in MCAt basal perfusion and reservoir capacity ( P < .001 and P = .05, respectively) and ACAt basal perfusion ( P = .04). Meanwhile, 53 hemispheres that had never experienced ACAt symptoms significantly improved MCAt basal perfusion and reservoir capacity ( P < .001 and P = .05, respectively); however, no ACAt changes were observed. A qualitative angiographic analysis demonstrated a higher trend of leptomeningeal formation from MCAt to ACAt in the former subgroup ( P = .05). During follow-up, no ACAt infarctions were observed. Combined bypass surgery at MCAt resulted in hemodynamic improvements in ACAt and MCAt, especially in patients with preoperative ACAt symptoms. Copyright © 2017 by the Congress of Neurological Surgeons

  11. A quality study of family-centered care coordination to improve care for children undergoing tracheostomy and the quality of life for their caregivers.

    PubMed

    Hartnick, Christopher; Diercks, Gillian; De Guzman, Vanessa; Hartnick, Elizabeth; Van Cleave, Jeanne; Callans, Kevin

    2017-08-01

    Approximately 4000 U.S. children undergo tracheostomy yearly [1], and these surgeries often result in hospital re-admissions that have definite cost and caregiver burdens due to complications that are avoidable with proper training and support. To assess the impact of a Family-Centered Care Coordination (FCCC) program on the quality of care received by children undergoing tracheostomy and their caregivers. Caregivers of children undergoing tracheostomies from January 2012 to January 2013 and then a different set of caregivers of children undergoing tracheostomies from January 2015 to January 2016 completed both the Pediatric Tracheostomy Health Status Instrument (PTHSI) 1 month after discharge and the Medical Complications Associated with Pediatric Tracheostomy (MCAT) questionnaire 6 months after initial tracheostomy. To assess complication rates, these same sets of caregivers were asked to complete the MCAT and only those who provided complete medical data for all 6 months were included for comparative analysis. The PTHSI and MCAT were administered at Massachusetts Eye and Ear in a hospital setting. Ten caregivers of children undergoing tracheostomies completed the PTHSI before FCCC program implementation and12 caregivers then completed the PTHSI after FCCC implementation. For each of the 2 groups, 5 caregivers provided complete data on the MCAT questionnaires. FCCC is a collection of programs, policies, and tools designed to ensure safe transition home for children undergoing tracheostomies, reduce re-admission rates, and minimize "caregiver burden". The PTHSI is a validated caregiver quality of life instrument that was supplemented by the MCAT which records post-discharge medical issues following tracheostomy that relate specifically to the tracheotomy placement. The time to first follow-up appointment decreased from 6.4 weeks (SD = 1.52) to 6 days (SD = 0.18) with FCCC implementation. The total MCAT scores decreased from 15.2 (SD = 1.1) to 1.3 (SD = 1

  12. Relationship of admissions variables and college of osteopathic medicine variables to performance on COMLEX-USA level 3.

    PubMed

    Baker, Helen H; Shuman, Victoria L; Ridpath, Lance C; Pence, Lorenzo L; Fisk, Robert M; Boisvert, Craig S

    2015-02-01

    New accreditation standards require that all US colleges of osteopathic medicine (COMs) publically report the first-time pass rates of graduates on the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 3. Little is known about the extent to which admissions variables or COM performance measures relate to Level 3 performance. To examine the relationship of admissions variables and COM performance to scores on Level 3 and to assess whether a relationship existed between Level 3 scores and sex, curriculum track, year of graduation, and residency specialty in the first postgraduate year. Data were analyzed from 4 graduating classes (2008-2011) of the West Virginia School of Osteopathic Medicine in Lewisburg. Relationships were examined between first-attempt scores on COMLEX-USA Level 3 and Medical College Admission Test (MCAT) scores; undergraduate grade point averages (GPAs); GPAs in COM year 1, year 2, and clinical rotation years (years 3 and 4); and first-attempt scores on COMLEX-USA Level 1, Level 2-Cognitive Evaluation, and Level 2-Performance Evaluation. Of the 556 graduates during this 4-year period, COMLEX-USA Level 3 scores were available for 552 graduates (99.3%). No statistically significant differences were found in Level 3 scores based on sex, curriculum track, graduating class, or residency specialty. The strongest relationship between Level 3 scores and any admissions variable was with total MCAT score, which accounted for 4.2% of the variation in Level 3 scores. The strongest relationship between Level 3 scores and COM year performance measures was with year 2 GPA, which accounted for 35.4% of the variation in Level 3 scores. Level 1 scores accounted for 38.5% of the variation in Level 3 scores, and Level 2-Cognitive Evaluation scores accounted for the greatest percentage of variation (45.7%). The correlation of Level 3 scores with passing the Level 2-Performance Evaluation on the first attempt was not statistically

  13. Effect of Intraoperative Dexamethasone on Pain Scores and Narcotic Consumption in Patients Undergoing Total Knee Arthroplasty.

    PubMed

    Samona, Jason; Cook, Carrie; Krupa, Kyle; Swatsell, Krystle; Jackson, Andrew; Dukes, Chase; Martin, Sidney

    2017-02-01

    To examine whether the addition of intravenous dexamethasone during total knee arthroplasty (TKA) would be effective at reducing postoperative pain scores and postoperative opioid consumption. A total of 102 patients undergoing TKA were placed into two groups: 55 subjects received intraoperative dexamethasone 8 mg intravenously (treatment group) and 47 did not receive dexamethasone at any time during the perioperative period. Comparison was made using the 0-10 numeric pain rating scale and the amount of opioids used in each group. Patients who received dexamethasone required significantly less oral opioids compared to the control group. Pain scores at 24 h post-surgery were significantly less for the dexamethasone group compared to the control group. There was no difference between groups in regards to patient-controlled analgesic dose or pain scores in the post-anesthesia care unit, at 12 or 48 h post-surgery. A single dose of dexamethasone given intraoperatively significantly decreased oral narcotic consumption and decreased pain scores 24 h postoperatively. Dexamethasone appears to be a safe modality to use to control pain in patients undergoing TKA. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  14. Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement.

    PubMed

    Qi, A; Lin, C; Zhou, A; Du, J; Jia, X; Sun, L; Zhang, G; Zhang, L; Liu, M

    2016-01-01

    This study aimed to determine whether psychological factors affect health-related quality of life (HRQL) and recovery of knee function in total knee replacement (TKR) patients. A total of 119 TKR patients (male: 38; female: 81) completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), Eysenck Personality Questionnaire-revised (EPQR-S), Knee Society Score (KSS), and HRQL (SF-36). At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05). SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001). Preoperative Physical Component Summary Scale (PCS) and Mental Component Summary Scale (MCS) scores were negatively associated with extraversion (E score) (B=-0.986 and -0.967, respectively, both P<0.05). Postoperative PCS and State Anxiety Inventory (SAI) scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05). Postoperative MCS, SAI, Trait Anxiety Inventory (TAI), and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05). The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05), but positively associated with the E score (B=0.215, P<0.05). The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05). In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions.

  15. The Relationship Between Total Neuropathy Score-reduced, Neuropathy Symptoms and Function

    NASA Astrophysics Data System (ADS)

    Abulhaija, Ashraf

    Chemotherapy Induced Peripheral Neuropathy (CIPN) is a common problem among cancer patients who receive a wide range of chemotherapy. This problem causes a decline in quality of life and increased disabilities. CIPN assessment instruments are either subjective, objective, or a combination of both. So far, there is no agreement on the best way for assessment. The goal of this study was to explore the relationships among subjective and objective CIPN assessment instruments. Specifically, this study aimed to 1) evaluate the relationship between the Total Neuropathy Score-reduced (mainly objective) and patients' function, as measured by the interference scale of the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (subjective); and 2) evaluate the relationship between the Total Neuropathy Score-reduced and neuropathy symptom experience, as measured by the symptom experience scale of the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (Subjective). To achieve those aims, a secondary data analysis for 56 participants who participated in a study entitled: Group Acupuncture for Treatment of Neuropathy from Chemotherapy was done. After Pearson correlations were calculated, the study found that there is a positive, weak relationship between the TNSr and the symptom experience scale of the CIPNAT(r=0.34). A positive, week relationship was found between the TNSr and the interference with activity scale of the CIPNAT(r=0.28). These results suggest that objective and subjective assessment are not highly correlated, and likely measure different aspects of CIPN. A comprehensive assessment approach is needed for decision making in the clinical oncology setting.

  16. Shifting the Curve: Fostering Academic Success in a Diverse Student Body.

    PubMed

    Elks, Martha L; Herbert-Carter, Janice; Smith, Marjorie; Klement, Brenda; Knight, Brandi Brandon; Anachebe, Ngozi F

    2018-01-01

    Diversity in the health care workforce is key to achieving health equity. Although U.S. medical schools have worked to increase the matriculation and academic success of underrepresented minority (URM) students (African Americans, Latinos, others), they have had only limited success. Lower standardized test scores, including on the Medical College Admission Test (MCAT), have been a barrier to matriculation for many URM applicants. Lower subsequent standardized exam scores, including on the United States Medical Licensing Exam Step 1, also have been an impediment to students' progress, with mean scores for URM students lagging behind those for others. Faculty at the Morehouse School of Medicine developed and implemented interventions to enhance the academic success of their URM students (about 75% are African American, and 5% are from other URM groups). To assess the outcomes of this work, the authors analyzed the MCAT scores and subsequent Step 1 scores of students in the graduating classes of 2009-2014. They also reviewed course evaluations, Graduation Questionnaires, and student and faculty interviews and focus groups. Students' Step 1 scores exceeded those expected based on their MCAT scores. This success was due to three key elements: (1) milieu and mentoring, (2) structure and content of the curriculum, and (3) monitoring. A series of mixed-method studies are planned to better discern the core elements of faculty-student relationships that are key to students' success. Lower test scores are not a fixed attribute; with the elements described, success is attainable for all students.

  17. Total knee arthroplasty: good agreement of clinical severity scores between patients and consultants.

    PubMed

    Ebinesan, Ananthan D; Sarai, Bhupinder S; Walley, Gayle; Bridgman, Stephen; Maffulli, Nicola

    2006-07-31

    Nearly 20,000 patients per year in the UK receive total knee arthroplasty (TKA). One of the problems faced by the health services of many developed countries is the length of time patients spend waiting for elective treatment. We therefore report the results of a study in which the Salisbury Priority Scoring System (SPSS) was used by both the surgeon and their patients to ascertain whether there were differences between the surgeon generated and patient generated Salisbury Priority Scores. The Salisbury Priority Scoring System (SPSS) was used to assign relative priority to patients with knee osteoarthritis as part of a randomised controlled trial comparing the standard medial parapatellar approach versus the sub-vastus approach in TKA. The operating surgeons and each patient completed the SPSS at the same pre-assessment clinic. The SPSS assesses four criteria, namely progression of disease, pain or distress, disability or dependence on others, and loss of usual occupation. Crosstabs and agreement measures (Cohen's kappa) were performed. Overall, the four SPSS criteria showed a kappa value of 0.526, 0.796, 0.813, and 0.820, respectively, showing moderate to very good agreement between the patient and the operating consultant. Male patients showed better agreement than female patients. The Salisbury Priority Scoring System is a good means of assessing patients' needs in relation to elective surgery, with high agreement between the patient and the operating surgeon.

  18. USSTRIDE program is associated with competitive Black and Latino student applicants to medical school.

    PubMed

    Campbell, Kendall M; Berne-Anderson, Thesla; Wang, Aihua; Dormeus, Guy; Rodríguez, José E

    2014-01-01

    We compared MCAT scores, grade point averages (GPAs), and medical school acceptance rates of Black and Latino students in an outreach program called Undergraduate Science Students Together Reaching Instructional Diversity and Excellence (USSTRIDE) to non-USSTRIDE students. We hypothesized that Black and Latino participants in USSTRIDE had higher acceptance rates to medical school, higher MCAT scores, and college GPAs when compared to other Black and Latino medical school applicants from our institution. The academic performance (GPAs and MCAT scores) and acceptance and matriculation rate data on all Black and Latino Florida State University applicants to any medical school from 2008 to 2012 were collected from the AIS/AMCAS database and separated into two comparison groups (USSTRIDE vs. Non-USSTRIDE). Independent sample T-tests and chi-square analysis, Cohen's D test, and odds ratios were determined. Average science GPA was 3.47 for USSTRIDE students (n=55) and 3.45 for non-USSTRIDE students (n=137, p=0.68, d=0.0652). Average cumulative GPA was 3.57 for USSTRIDE students and 3.54 for non-USSTRIDE students (p=0.45, d=0.121). Average MCAT score was 23 for USSTRIDE students and 25 for non-USSTRIDE students (p=0.02, d=0.378). Twenty-three percent of accepted USSTRIDE students and 29% of accepted non-USSTRIDE students had multiple acceptances (p=0.483, OR 1.38, 95% CI 0.52-3.88). Forty-nine percent of non-USSTRIDE students and 75% of USSTRIDE students matriculated in medical school (p=0.001, OR 3.13 95% CI 1.51-6.74). About 78.6% of USSTRIDE students matriculated at FSU's medical school compared to 36.2% of non-USSTRIDE students (p<0.01). USSTRIDE and non-USSTRIDE students had similar science and cumulative GPAs. USSTRIDE students' MCAT scores were lower but acceptance rates to medical school were higher. Participation in USSTRIDE is associated with increased acceptance rates for Black and Latino students to our medical school. This finding is true for other medical

  19. Medical School Applicant Characteristics Associated With Performance in Multiple Mini-Interviews Versus Traditional Interviews: A Multi-Institutional Study.

    PubMed

    Henderson, Mark C; Kelly, Carolyn J; Griffin, Erin; Hall, Theodore R; Jerant, Anthony; Peterson, Ellena M; Rainwater, Julie A; Sousa, Francis J; Wofsy, David; Franks, Peter

    2017-10-31

    To examine applicant characteristics associated with multi mini-interview (MMI) or traditional interview (TI) performance at five California public medical schools. Of the five California Longitudinal Evaluation of Admissions Practices (CA-LEAP) consortium schools, three used TIs and two used MMIs. Schools provided the following retrospective data on all 2011-2013 admissions cycle interviewees: age, gender, race/ethnicity (under-represented in medicine [UIM] or not), self-identified disadvantaged (DA) status, undergraduate GPA, Medical College Admission Test (MCAT) score, and interview score (standardized as z-score, mean = 0, SD = 1). Adjusted linear regression analyses, stratified by interview type, examined associations with interview performance. The 4,993 applicants who completed 7,516 interviews included 931 (18.6%) UIM and 962 (19.3%) DA individuals; 3,226 (64.6%) had one interview. Mean age was 24.4 (SD = 2.7); mean GPA and MCAT score were 3.72 (SD = 0.22) and 33.6 (SD = 3.7), respectively. Older age, female gender, and number of prior interviews were associated with better performance on both MMIs and TIs. Higher GPA was associated with lower MMI scores (z-score, per unit GPA = -0.26, 95% CI [-0.45, -0.06]), but unrelated to TI scores. DA applicants had higher TI scores (z-score = 0.17, 95% CI [0.07, 0.28]), but lower MMI scores (z-score = -0.18, 95% CI [-0.28, -.08]) than non-DA applicants. Neither UIM status nor MCAT score were associated with interview performance. These findings have potentially important workforce implications, particularly regarding DA applicants, and illustrate the need for other multi-institutional studies of medical school admissions processes.

  20. Shifting the Curve: Fostering Academic Success in a Diverse Student Body

    PubMed Central

    Herbert-Carter, Janice; Smith, Marjorie; Klement, Brenda; Knight, Brandi Brandon; Anachebe, Ngozi F.

    2018-01-01

    Problem Diversity in the health care workforce is key to achieving health equity. Although U.S. medical schools have worked to increase the matriculation and academic success of underrepresented minority (URM) students (African Americans, Latinos, others), they have had only limited success. Lower standardized test scores, including on the Medical College Admission Test (MCAT), have been a barrier to matriculation for many URM applicants. Lower subsequent standardized exam scores, including on the United States Medical Licensing Exam Step 1, also have been an impediment to students’ progress, with mean scores for URM students lagging behind those for others. Approach Faculty at the Morehouse School of Medicine developed and implemented interventions to enhance the academic success of their URM students (about 75% are African American, and 5% are from other URM groups). To assess the outcomes of this work, the authors analyzed the MCAT scores and subsequent Step 1 scores of students in the graduating classes of 2009–2014. They also reviewed course evaluations, Graduation Questionnaires, and student and faculty interviews and focus groups. Outcomes Students’ Step 1 scores exceeded those expected based on their MCAT scores. This success was due to three key elements: (1) milieu and mentoring, (2) structure and content of the curriculum, and (3) monitoring. Next Steps A series of mixed-method studies are planned to better discern the core elements of faculty–student relationships that are key to students’ success. Lower test scores are not a fixed attribute; with the elements described, success is attainable for all students. PMID:28678099

  1. Higher forgotten joint score for fixed-bearing than for mobile-bearing total knee arthroplasty.

    PubMed

    Thienpont, E; Zorman, D

    2016-08-01

    To compare the postoperative subjective outcome for fixed- and mobile-bearing total knee arthroplasty (TKA) by using the forgotten joint score (FJS-12), a new patient-reported outcome score of 12 questions evaluating the potential of a patient to forget about his operated joint. The hypothesis of this study was that a mobile-bearing TKA would have a higher level of forgotten joint than a fixed-bearing model of the same design. A retrospective cohort study was conducted in 100 patients who underwent TKA at least 1 year [mean (SD) 18 (5) months] before with either a fixed-bearing (N = 50) or a mobile-bearing (N = 50) TKA from the same implant family. Clinical outcome was evaluated with the knee society score and patient-reported outcome with the forgotten joint score. No difference was observed for demographics in between both study groups. The mean (SD) postoperative FJS-12 for the fixed-bearing TKA was 71 (28) compared to a mean (SD) of 56.5 (30) for the mobile-bearing TKA. The clinical relevance of the present retrospective study is that it shows for the first time a significant difference between fixed- and mobile-bearing TKA by using a new patient-reported outcome score. The hypothesis that mobile-bearing TKA would have a higher degree of forgotten joint than a fixed-bearing TKA could not be confirmed. A level I prospective study should be set up to objectivise these findings. IV.

  2. Can the pre-operative Western Ontario and McMaster score predict patient satisfaction following total hip arthroplasty?

    PubMed

    Rogers, B A; Alolabi, B; Carrothers, A D; Kreder, H J; Jenkinson, R J

    2015-02-01

    In this study we evaluated whether pre-operative Western Ontario and McMaster Universities (WOMAC) osteoarthritis scores can predict satisfaction following total hip arthroplasty (THA). Prospective data for a cohort of patients undergoing THA from two large academic centres were collected, and pre-operative and one-year post-operative WOMAC scores and a 25-point satisfaction questionnaire were obtained for 446 patients. Satisfaction scores were dichotomised into either improvement or deterioration. Scatter plots and Spearman's rank correlation coefficient were used to describe the association between pre-operative WOMAC and one-year post-operative WOMAC scores and patient satisfaction. Satisfaction was compared using receiver operating characteristic (ROC) analysis against pre-operative, post-operative and δ WOMAC scores. We found no relationship between pre-operative WOMAC scores and one-year post-operative WOMAC or satisfaction scores, with Spearman's rank correlation coefficients of 0.16 and -0.05, respectively. The ROC analysis showed areas under the curve (AUC) of 0.54 (pre-operative WOMAC), 0.67 (post-operative WOMAC) and 0.43 (δ WOMAC), respectively, for an improvement in satisfaction. We conclude that the pre-operative WOMAC score does not predict the post-operative WOMAC score or patient satisfaction after THA, and that WOMAC scores can therefore not be used to prioritise patient care. ©2015 The British Editorial Society of Bone & Joint Surgery.

  3. Prediction of soil stability and erosion in semiarid regions using numerical hydrological model (MCAT) and airborne hyperspectral imagery

    NASA Astrophysics Data System (ADS)

    Brook, Anna; Wittenberg, Lea

    2015-04-01

    Long-term environmental monitoring is addressed to identify physical and biological changes and progresses taking place in the ecosystem. This basic action of landscape monitoring is an essential part of the systematic long-term surveillance, aiming to evaluate, assess and predict the spatial change and progresses. Indeed, it provides a context for wide range of diverse studies and research frameworks from regional or global scale. Spatial-temporal trends and changes at various scales (massive to less certain) require establishing consistent baseline data over time. One of the spatial cases of landscape monitoring is dedicated to soil formation and pedological progresses. It is previously acknowledged that changes in soil affect the functionality of the environment, so monitoring changes recently become important cause considerable resources in areas such as environmental management, sustainability services, and protecting the environment healthy. Given the above, it can be concluded that monitoring changes in the base for sustainable development. The hydrological response of bare soils and watersheds in semiarid regions to intense rainfall events is known to be complex due to multiply physical and structural impacts and feedbacks. As a result, the comprehensive evaluations of mathematical models including detailed consideration of uncertainties in the modeling of hydrological and environmental systems are of increasing importance. The presented method incorporates means of remote sensing data, hydrological and climate data and implementing dedicated and integrative Monte Carlo Analysis Toolbox (MCAT) model for semiarid region. Complexity of practical models to represent spatial systems requires an extensive understanding of the spatial phenomena, while providing realistic balance of sensitivity and corresponding uncertainty levels. Nowadays a large number of dedicated mathematical models applied to assess environmental hydrological process. Among the most

  4. New semi-quantitative 123I-MIBG estimation method compared with scoring system in follow-up of advanced neuroblastoma: utility of total MIBG retention ratio versus scoring method.

    PubMed

    Sano, Yuko; Okuyama, Chio; Iehara, Tomoko; Matsushima, Shigenori; Yamada, Kei; Hosoi, Hajime; Nishimura, Tsunehiko

    2012-07-01

    The purpose of this study is to evaluate a new semi-quantitative estimation method using (123)I-MIBG retention ratio to assess response to chemotherapy for advanced neuroblastoma. Thirteen children with advanced neuroblastoma (International Neuroblastoma Risk Group Staging System: stage M) were examined for a total of 51 studies with (123)I-MIBG scintigraphy (before and during chemotherapy). We proposed a new semi-quantitative method using MIBG retention ratio (count obtained with delayed image/count obtained with early image with decay correction) to estimate MIBG accumulation. We analyzed total (123)I-MIBG retention ratio (TMRR: total body count obtained with delayed image/total body count obtained with early image with decay correction) and compared with a scoring method in terms of correlation with tumor markers. TMRR showed significantly higher correlations with urinary catecholamine metabolites before chemotherapy (VMA: r(2) = 0.45, P < 0.05, HVA: r(2) = 0.627, P < 0.01) than MIBG score (VMA: r(2) = 0.19, P = 0.082, HVA: r(2) = 0.25, P = 0.137). There were relatively good correlations between serial change of TMRR and those of urinary catecholamine metabolites (VMA: r(2) = 0.274, P < 0.001, HVA: r(2) = 0.448, P < 0.0001) compared with serial change of MIBG score and those of tumor markers (VMA: r(2) = 0.01, P = 0.537, HVA: 0.084, P = 0.697) during chemotherapy for advanced neuroblastoma. TMRR could be a useful semi-quantitative method for estimating early response to chemotherapy of advanced neuroblastoma because of its high correlation with urine catecholamine metabolites.

  5. Mitochondrial catalase overexpressed transgenic mice are protected against lung fibrosis in part via preventing alveolar epithelial cell mitochondrial DNA damage.

    PubMed

    Kim, Seok-Jo; Cheresh, Paul; Jablonski, Renea P; Morales-Nebreda, Luisa; Cheng, Yuan; Hogan, Erin; Yeldandi, Anjana; Chi, Monica; Piseaux, Raul; Ridge, Karen; Michael Hart, C; Chandel, Navdeep; Scott Budinger, G R; Kamp, David W

    2016-12-01

    Alveolar epithelial cell (AEC) injury and mitochondrial dysfunction are important in the development of lung fibrosis. Our group has shown that in the asbestos exposed lung, the generation of mitochondrial reactive oxygen species (ROS) in AEC mediate mitochondrial DNA (mtDNA) damage and apoptosis which are necessary for lung fibrosis. These data suggest that mitochondrial-targeted antioxidants should ameliorate asbestos-induced lung. To determine whether transgenic mice that express mitochondrial-targeted catalase (MCAT) have reduced lung fibrosis following exposure to asbestos or bleomycin and, if so, whether this occurs in association with reduced AEC mtDNA damage and apoptosis. Crocidolite asbestos (100µg/50µL), TiO 2 (negative control), bleomycin (0.025 units/50µL), or PBS was instilled intratracheally in 8-10 week-old wild-type (WT - C57Bl/6J) or MCAT mice. The lungs were harvested at 21d. Lung fibrosis was quantified by collagen levels (Sircol) and lung fibrosis scores. AEC apoptosis was assessed by cleaved caspase-3 (CC-3)/Surfactant protein C (SFTPC) immunohistochemistry (IHC) and semi-quantitative analysis. AEC (primary AT2 cells from WT and MCAT mice and MLE-12 cells) mtDNA damage was assessed by a quantitative PCR-based assay, apoptosis was assessed by DNA fragmentation, and ROS production was assessed by a Mito-Sox assay. Compared to WT, crocidolite-exposed MCAT mice exhibit reduced pulmonary fibrosis as measured by lung collagen levels and lung fibrosis score. The protective effects in MCAT mice were accompanied by reduced AEC mtDNA damage and apoptosis. Similar findings were noted following bleomycin exposure. Euk-134, a mitochondrial SOD/catalase mimetic, attenuated MLE-12 cell DNA damage and apoptosis. Finally, compared to WT, asbestos-induced MCAT AT2 cell ROS production was reduced. Our finding that MCAT mice have reduced pulmonary fibrosis, AEC mtDNA damage and apoptosis following exposure to asbestos or bleomycin suggests an important role

  6. Mitochondrial catalase overexpressed transgenic mice are protected against lung fibrosis in part via preventing alveolar epithelial cell mitochondrial DNA damage

    PubMed Central

    Kim, Seok-Jo; Cheresh, Paul; Jablonski, Renea P.; Morales-Nebreda, Luisa; Cheng, Yuan; Hogan, Erin; Yeldandi, Anjana; Chi, Monica; Piseaux, Raul; Ridge, Karen; Hart, C. Michael; Chandel, Navdeep; Budinger, G.R. Scott; Kamp, David W.

    2018-01-01

    Rationale Alveolar epithelial cell (AEC) injury and mitochondrial dysfunction are important in the development of lung fibrosis. Our group has shown that in the asbestos exposed lung, the generation of mitochondrial reactive oxygen species (ROS) in AEC mediate mitochondrial DNA (mtDNA) damage and apoptosis which are necessary for lung fibrosis. These data suggest that mitochondrial-targeted antioxidants should ameliorate asbestos-induced lung. Objective To determine whether transgenic mice that express mitochondrial-targeted catalase (MCAT) have reduced lung fibrosis following exposure to asbestos or bleomycin and, if so, whether this occurs in association with reduced AEC mtDNA damage and apoptosis. Methods Crocidolite asbestos (100 μg/50 μL), TiO2 (negative control), bleomycin (0.025 units/50 μL), or PBS was instilled intratracheally in 8–10 week-old wild-type (WT - C57Bl/6 J) or MCAT mice. The lungs were harvested at 21 d. Lung fibrosis was quantified by collagen levels (Sircol) and lung fibrosis scores. AEC apoptosis was assessed by cleaved caspase-3 (CC-3)/Surfactant protein C (SFTPC) immunohistochemistry (IHC) and semi-quantitative analysis. AEC (primary AT2 cells from WT and MCAT mice and MLE-12 cells) mtDNA damage was assessed by a quantitative PCR-based assay, apoptosis was assessed by DNA fragmentation, and ROS production was assessed by a Mito-Sox assay. Results Compared to WT, crocidolite-exposed MCAT mice exhibit reduced pulmonary fibrosis as measured by lung collagen levels and lung fibrosis score. The protective effects in MCAT mice were accompanied by reduced AEC mtDNA damage and apoptosis. Similar findings were noted following bleomycin exposure. Euk-134, a mitochondrial SOD/catalase mimetic, attenuated MLE-12 cell DNA damage and apoptosis. Finally, compared to WT, asbestos-induced MCAT AT2 cell ROS production was reduced. Conclusions Our finding that MCAT mice have reduced pulmonary fibrosis, AEC mtDNA damage and apoptosis following exposure

  7. Mediterranean diet score and total and cardiovascular mortality in Eastern Europe: the HAPIEE study.

    PubMed

    Stefler, Denes; Malyutina, Sofia; Kubinova, Ruzena; Pajak, Andrzej; Peasey, Anne; Pikhart, Hynek; Brunner, Eric J; Bobak, Martin

    2017-02-01

    Mediterranean-type dietary pattern has been associated with lower risk of cardiovascular (CVD) and other chronic diseases, primarily in Southern European populations. We examined whether Mediterranean diet score (MDS) is associated with total, CVD, coronary heart disease (CHD) and stroke mortality in a prospective cohort study in three Eastern European populations. A total of 19,333 male and female participants of the Health Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study in the Czech Republic, Poland and the Russian Federation were included in the analysis. Diet was assessed by food frequency questionnaire, and MDS was derived from consumption of nine groups of food using absolute cut-offs. Mortality was ascertained by linkage with death registers. Over the median follow-up time of 7 years, 1314 participants died. The proportion of participants with high adherence to Mediterranean diet was low (25 %). One standard deviation (SD) increase in the MDS (equivalent to 2.2 point increase in the score) was found to be inversely associated with death from all causes (HR, 95 % CI 0.93, 0.88-0.98) and CVD (0.90, 0.81-0.99) even after multivariable adjustment. Inverse but statistically not significant link was found for CHD (0.90, 0.78-1.03) and stroke (0.87, 0.71-1.07). The MDS effects were similar in each country cohort. Higher adherence to the Mediterranean diet was associated with reduced risk of total and CVD deaths in these large Eastern European urban populations. The application of MDS with absolute cut-offs appears suitable for non-Mediterranean populations.

  8. Fat scoring: Sources of variability

    USGS Publications Warehouse

    Krementz, D.G.; Pendleton, G.W.

    1990-01-01

    Fat scoring is a widely used nondestructive method of assessing total body fat in birds. This method has not been rigorously investigated. We investigated inter- and intraobserver variability in scoring as well as the predictive ability of fat scoring using five species of passerines. Between-observer variation in scoring was variable and great at times. Observers did not consistently score species higher or lower relative to other observers nor did they always score birds with more total body fat higher. We found that within-observer variation was acceptable but was dependent on the species being scored. The precision of fat scoring was species-specific and for most species, fat scores accounted for less than 50% of the variation in true total body fat. Overall, we would describe fat scoring as a fairly precise method of indexing total body fat but with limited reliability among observers.

  9. Acute Radiation Syndrome Severity Score System in Mouse Total-Body Irradiation Model.

    PubMed

    Ossetrova, Natalia I; Ney, Patrick H; Condliffe, Donald P; Krasnopolsky, Katya; Hieber, Kevin P

    2016-08-01

    Radiation accidents or terrorist attacks can result in serious consequences for the civilian population and for military personnel responding to such emergencies. The early medical management situation requires quantitative indications for early initiation of cytokine therapy in individuals exposed to life-threatening radiation doses and effective triage tools for first responders in mass-casualty radiological incidents. Previously established animal (Mus musculus, Macaca mulatta) total-body irradiation (γ-exposure) models have evaluated a panel of radiation-responsive proteins that, together with peripheral blood cell counts, create a multiparametic dose-predictive algorithm with a threshold for detection of ~1 Gy from 1 to 7 d after exposure as well as demonstrate the acute radiation syndrome severity score systems created similar to the Medical Treatment Protocols for Radiation Accident Victims developed by Fliedner and colleagues. The authors present a further demonstration of the acute radiation sickness severity score system in a mouse (CD2F1, males) TBI model (1-14 Gy, Co γ-rays at 0.6 Gy min) based on multiple biodosimetric endpoints. This includes the acute radiation sickness severity Observational Grading System, survival rate, weight changes, temperature, peripheral blood cell counts and radiation-responsive protein expression profile: Flt-3 ligand, interleukin 6, granulocyte-colony stimulating factor, thrombopoietin, erythropoietin, and serum amyloid A. Results show that use of the multiple-parameter severity score system facilitates identification of animals requiring enhanced monitoring after irradiation and that proteomics are a complementary approach to conventional biodosimetry for early assessment of radiation exposure, enhancing accuracy and discrimination index for acute radiation sickness response categories and early prediction of outcome.

  10. Validation of use of subsets of teeth when applying the total mouth periodontal score (TMPS) system in dogs.

    PubMed

    Harvey, Colin E; Laster, Larry; Shofer, Frances S

    2012-01-01

    A total mouth periodontal score (TMPS) system in dogs has been described previously. Use of buccal and palatal/lingual surfaces of all teeth requires observation and recording of 120 gingivitis scores and 120 periodontitis scores. Although the result is a reliable, repeatable assessment of the extent of periodontal disease in the mouth, observing and recording 240 data points is time-consuming. Using data from a previously reported study of periodontal disease in dogs, correlation analysis was used to determine whether use of any of seven different subsets of teeth can generate TMPS subset gingivitis and periodontitis scores that are highly correlated with TMPS all-site, all-teeth scores. Overall, gingivitis scores were less highly correlated than periodontitis scores. The minimal tooth set with a significant intra-class correlation (> or = 0.9 of means of right and left sides) for both gingivitis scores and attachment loss measurements consisted of the buccal surface of the maxillary third incisor canine, third premolar fourth premolar; and first molar teeth; and, the mandibular canine, third premolar, fourth premolar and first molar teeth on one side (9 teeth, 15 root sites). Use of this subset of teeth, which reduces the number of data points per dog from 240 to 30 for gingivitis and periodontitis at each scoring episode, is recommended when calculating the gingivitis and periodontitis scores using the TMPS system.

  11. Do Press Ganey Scores Correlate With Total Knee Arthroplasty-Specific Outcome Questionnaires in Postsurgical Patients?

    PubMed

    Chughtai, Morad; Patel, Nirav K; Gwam, Chukwuweike U; Khlopas, Anton; Bonutti, Peter M; Delanois, Ronald E; Mont, Michael A

    2017-09-01

    The purpose of this study was to assess whether Center for Medicaid and Medicare services-implemented satisfaction (Press Ganey [PG]) survey results correlate with established total knee arthroplasty (TKA) assessment tools. Data from 736 patients who underwent TKA and received a PG survey between November 2009 and January 2015 were analyzed. The PG survey overall hospital rating scores were correlated with standardized validated outcome assessment tools for TKA (Short form-12 and 36 Health Survey; Knee Society Score; Western Ontario and McMaster Universities Arthritis Index; University of California, Los Angeles; and visual analog scale) at a mean follow-up of 1154 days post-TKA. There was no correlation between PG survey overall hospital rating score and the above-mentioned outcome assessment tools. Our study shows that there is no statistically significant relationship between established arthroplasty assessment tools and the PG overall hospital rating. Therefore, PG surveys may not be an appropriate tool to determine reimbursement for orthopedists performing TKAs. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Predictive relationship of osteopathic manual medicine grades and COMLEX-USA Level 1 total scores and osteopathic principles and practice subscores.

    PubMed

    Lewis, Drew D; Johnson, Mary T; Finnerty, Edward P

    2014-06-01

    Osteopathic manual medicine (OMM) encompasses hands-on diagnosis and treatment as part of patient care. The area of osteopathic principles and practice (OPP) is considered a core competency for students and practitioners of this medical tradition. The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) is a useful tool for assessing candidates' competency. To examine the relationship of COMLEX-USA Level 1 total scores and OPP subscores with OMM course grades, and to determine if these grades are predictive of COMLEX-USA Level 1 OPP performance. The authors collected data-COMLEX-USA Level 1 total and OPP subscores, OMM grades (written, practical, and total for first and second academic years), sex, and age-for a cohort of osteopathic medical students at a single institution, and these data were then analyzed by means of correlation analysis. Records were obtained from a second-year class of osteopathic medical students (N=217). The authors' analysis of total scores and OPP subscores on COMLEX-USA Level 1 yielded a statistically significant correlation with all variables. Although the correlations were moderate, second-year written examination grades showed the strongest association with the COMLEX-USA Level 1 OPP subscores (r=0.530) and total scores (r=0.566). Performance in the second-year OMM written examination could identify students potentially at risk for poor performance on COMLEX-USA Level 1. © 2014 The American Osteopathic Association.

  13. Fall Risk Score at the Time of Discharge Predicts Readmission Following Total Joint Arthroplasty.

    PubMed

    Ravi, Bheeshma; Nan, Zhang; Schwartz, Adam J; Clarke, Henry D

    2017-07-01

    Readmission among Medicare recipients is a leading driver of healthcare expenditure. To date, most predictive tools are too coarse for direct clinical application. Our objective in this study is to determine if a pre-existing tool to identify patients at increased risk for inpatient falls, the Hendrich Fall Risk Score, could be used to accurately identify Medicare patients at increased risk for readmission following arthroplasty, regardless of whether the readmission was due to a fall. This study is a retrospective cohort study. We identified 2437 Medicare patients who underwent a primary elective total joint arthroplasty (TJA) of the hip or knee for osteoarthritis between 2011 and 2014. The Hendrich Fall Risk score was recorded for each patient preoperatively and postoperatively. Our main outcome measure was hospital readmission within 30 days of discharge. Of 2437 eligible TJA recipients, there were 226 (9.3%) patients who had a score ≥6. These patients were more likely to have an unplanned readmission (unadjusted odds ratio 2.84, 95% confidence interval 1.70-4.76, P < .0001), were more likely to have a length of stay >3 days (49.6% vs 36.6%, P = .0001), and were less likely to be sent home after discharge (20.8% vs 35.8%, P < .0001). The effect of a score ≥6 on readmission remained significant (adjusted odds ratio 2.44, 95% confidence interval 1.44-4.13, P = .0009) after controlling for age, paralysis, and the presence of a major psychiatric disorder. Increased Hendrich fall risk score after TJA is strongly associated with unplanned readmission. Application of this tool will allow hospitals to identify these patients and plan their discharge. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Association between Diet-Quality Scores, Adiposity, Total Cholesterol and Markers of Nutritional Status in European Adults: Findings from the Food4Me Study.

    PubMed

    Fallaize, Rosalind; Livingstone, Katherine M; Celis-Morales, Carlos; Macready, Anna L; San-Cristobal, Rodrigo; Navas-Carretero, Santiago; Marsaux, Cyril F M; O'Donovan, Clare B; Kolossa, Silvia; Moschonis, George; Walsh, Marianne C; Gibney, Eileen R; Brennan, Lorraine; Bouwman, Jildau; Manios, Yannis; Jarosz, Miroslaw; Martinez, J Alfredo; Daniel, Hannelore; Saris, Wim H M; Gundersen, Thomas E; Drevon, Christian A; Gibney, Michael J; Mathers, John C; Lovegrove, Julie A

    2018-01-06

    Diet-quality scores (DQS), which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI; Alternate Healthy Eating Index, AHEI; MedDietScore, MDS; PREDIMED Mediterranean Diet Score, P-MDS; Dutch Healthy Diet-Index, DHDI) and markers of metabolic health (anthropometry, objective physical activity levels (PAL), and dried blood spot total cholesterol (TC), total carotenoids, and omega-3 index) in the Food4Me cohort, using regression analysis. Dietary intake was assessed using a validated Food Frequency Questionnaire. Participants ( n = 1480) were adults recruited from seven European Union (EU) countries. Overall, women had higher HEI and AHEI than men ( p < 0.05), and scores varied significantly between countries. For all DQS, higher scores were associated with lower body mass index, lower waist-to-height ratio and waist circumference, and higher total carotenoids and omega-3-index ( p trends < 0.05). Higher HEI, AHEI, DHDI, and P-MDS scores were associated with increased daily PAL, moderate and vigorous activity, and reduced sedentary behaviour ( p trend < 0.05). We observed no association between DQS and TC. To conclude, higher DQS, which reflect better dietary patterns, were associated with markers of better nutritional status and metabolic health.

  15. Genetic evaluation of the total hip score of four populous breeds of dog, as recorded by the New Zealand Veterinary Association Hip Dysplasia Scheme (1991-2011).

    PubMed

    Soo, M; Sneddon, N W; Lopez-Villalobos, N; Worth, A J

    2015-03-01

    To use estimated breeding value (EBV) analysis to investigate the genetic trend of the total hip score (to assess canine hip dysplasia) in four populous breeds of dogs using the records from the New Zealand Veterinary Association (NZVA) Canine Hip Dysplasia Scheme database (1991 to 2011). Estimates of heritability and EBV for the NZVA total hip score of individual dogs from the German Shepherd, Labrador Retriever, Golden Retriever and Rottweiler breeds were obtained using restricted maximum likelihood procedures with a within-breed linear animal model. The model included the fixed effects of gender, birth year, birth season, age at scoring and the random effect of animal. The pedigree file included animals recorded between 1990 and 2011. A total of 2,983 NZVA hip score records, from a pedigree of 3,172 animals, were available for genetic evaluation. Genetic trends of the NZVA total hip score were calculated as the regression coefficient of the EBV (weighted by reliabilities) on year of birth. The estimates of heritability for hip score were 0.32 (SE 0.08) in German Shepherd, 0.37 (SE 0.08) in Labrador Retriever, 0.29 (SE 0.08) in Golden Retriever and 0.52 (SE 0.18) in Rottweiler breeds. Genetic trend analysis revealed that only the German Shepherd breed exhibited a genetic trend towards better hip conformation over time, with a decline of 0.13 (SE 0.04) NZVA total hip score units per year (p<0.001). The genetic trends of total hip score for the remaining three breeds were not significantly different from zero (p>0.1). Despite moderate heritability of the NZVA total hip score, there has not been substantial improvement of this trait for the four breeds analysed in the study period. Greater improvement in reducing the prevalence of canine hip dysplasia may be possible if screening were to be compulsory as a requirement for registration of pedigree breeding stock, greater selection pressure were to be applied and selection of breeding stock made on the basis on an

  16. Should efforts in favor of medical student diversity be focused during admissions or farther upstream?

    PubMed

    Reiter, Harold I; Lockyer, Jocelyn; Ziola, Barry; Courneya, Carol-Ann; Eva, Kevin

    2012-04-01

    Traditional medical school admissions assessment tools may be limiting diversity. This study investigates whether the Multiple Mini-Interview (MMI) is diversity-neutral and, if so, whether applying it with greater weight would dilute the anticipated negative impact of diversity-limiting admissions measures. Interviewed applicants to six medical schools in 2008 and 2009 underwent MMI. Predictor variables of MMI scores, grade point average (GPA), and Medical College Admission Test (MCAT) scores were correlated with diversity measures of age, gender, size of community of origin, income level, and self-declared aboriginal status. A subset of the data was then combined with variable weight assigned to predictor variables to determine whether weighting during the applicant selection process would affect diversity among chosen applicants. MMI scores were unrelated to gender, size of community of origin, and income level. They correlated positively with age and negatively with aboriginal status. GPA and MCAT correlated negatively with age and aboriginal status, GPA correlated positively with income level, and MCAT correlated positively with size of community of origin. Even extreme combinations of MMI and GPA weightings failed to increase diversity among applicants who would be selected on the basis of weighted criteria. MMI could not neutralize the diversity-limiting properties of academic scores as selection criteria to interview. Using academic scores in this way causes range restriction, counteracting attempts to enhance diversity using downstream admissions selection measures such as MMI. Diversity efforts should instead be focused upstream. These results lend further support for the development of pipeline programs.

  17. Use of the Liverpool Elbow Score as a postal questionnaire for the assessment of outcome after total elbow arthroplasty.

    PubMed

    Ashmore, Alexander M; Gozzard, Charles; Blewitt, Neil

    2007-01-01

    The Liverpool Elbow Score (LES) is a newly developed, validated elbow-specific score. It consists of a patient-answered questionnaire (PAQ) and a clinical assessment. The purpose of this study was to determine whether the PAQ portion of the LES could be used independently as a postal questionnaire for the assessment of outcome after total elbow arthroplasty and to correlate the LES and the Mayo Elbow Performance Score (MEPS). A series of 51 total elbow replacements were reviewed by postal questionnaire. Patients then attended the clinic for assessment by use of both the LES and the MEPS. There was an excellent response rate to the postal questionnaire (98%), and 44 elbows were available for clinical review. Good correlation was shown between the LES and the MEPS (Spearman correlation coefficient, 0.84; P < .001) and between the PAQ portion of the LES and the MEPS (Spearman correlation coefficient, 0.76; P < .001). We conclude that there is good correlation between the LES PAQ component and the MEPS, suggesting that outcome assessment is possible by postal questionnaire.

  18. Age and Preoperative Knee Society Score Are Significant Predictors of Outcomes Among Asians Following Total Knee Arthroplasty.

    PubMed

    Bin Abd Razak, Hamid Rahmatullah; Tan, Chuen-Seng; Chen, Yongqiang Jerry Delphi; Pang, Hee-Nee; Tay, Keng-Jin Darren; Chin, Pak-Lin; Chia, Shi-Lu; Lo, Ngai-Nung; Yeo, Seng-Jin

    2016-05-04

    The ability to predict patients' functional outcomes will add value to preoperative counseling. The purpose of this study was to evaluate predictors of good outcomes following total knee arthroplasty (TKA) among Asian patients. Registry data from 2006 to 2010 were extracted. The Oxford Knee Score (OKS) and the Short Form (SF)-36 physical component summary (PCS) were used to evaluate outcomes. A "good outcome" was defined as an improvement in scores of greater than or equal to the minimal clinically important difference (MCID) in the primary analysis. The MCID for the OKS was 5, and the MCID for the PCS was 10. For the sensitivity analyses, a "good outcome" was defined as an OKS of <30 and a PCS score of >50. Clinical variables were used to develop a multiple logistic regression model for a good outcome following total knee arthroplasty at 5 years. Follow-up data were available for 3,062 patients who underwent primary TKA (mean age of 66.4 years; 79.5% female). Eighty-five percent had a good outcome on the basis of the OKS and 83%, on the basis of the SF-36 PCS. Age and preoperative Knee Society score (KSS) were found to be significant predictors. When outcomes were assessed by the MCID, lesser age and lower (worse) preoperative KSS predicted a good outcome at 5 years. When outcomes were assessed by absolute criteria (postoperative scores measured against OKS and PCS thresholds), a higher (better) preoperative KSS predicted a good outcome at 5 years. Body mass index, preoperative flexion range, SF-36 mental component summary (MCS) score, mechanical alignment, sex, education level, ethnicity, operative side, number of comorbidities, type of anesthesia, and type of implant were found not to be significant predictors. The majority of Asian patients with osteoarthritis had good outcomes according to the MCID criterion and benefitted from primary TKA. On the basis of our findings, we believe that older patients with a lower (worse) preoperative KSS can be informed that

  19. Simulating patient-specific heart shape and motion using SPECT perfusion images with the MCAT phantom

    NASA Astrophysics Data System (ADS)

    Faber, Tracy L.; Garcia, Ernest V.; Lalush, David S.; Segars, W. Paul; Tsui, Benjamin M.

    2001-05-01

    The spline-based Mathematical Cardiac Torso (MCAT) phantom is a realistic software simulation designed to simulate single photon emission computed tomographic (SPECT) data. It incorporates a heart model of known size and shape; thus, it is invaluable for measuring accuracy of acquisition, reconstruction, and post-processing routines. New functionality has been added by replacing the standard heart model with left ventricular (LV) epicaridal and endocardial surface points detected from actual patient SPECT perfusion studies. LV surfaces detected from standard post-processing quantitation programs are converted through interpolation in space and time into new B-spline models. Perfusion abnormalities are added to the model based on results of standard perfusion quantification. The new LV is translated and rotated to fit within existing atria and right ventricular models, which are scaled based on the size of the LV. Simulations were created for five different patients with myocardial infractions who had undergone SPECT perfusion imaging. Shape, size, and motion of the resulting activity map were compared visually to the original SPECT images. In all cases, size, shape and motion of simulated LVs matched well with the original images. Thus, realistic simulations with known physiologic and functional parameters can be created for evaluating efficacy of processing algorithms.

  20. Transgenic Mouse Model for Reducing Oxidative Damage in Bone

    NASA Technical Reports Server (NTRS)

    Schreurs, A.-S.; Torres, S.; Truong, T.; Kumar, A.; Alwood, J. S.; Limoli, C. L.; Globus, R. K.

    2014-01-01

    Exposure to musculoskeletal disuse and radiation result in bone loss; we hypothesized that these catabolic treatments cause excess reactive oxygen species (ROS), and thereby alter the tight balance between bone resorption by osteoclasts and bone formation by osteoblasts, culminating in bone loss. To test this, we used transgenic mice which over-express the human gene for catalase, targeted to mitochondria (MCAT). Catalase is an anti-oxidant that converts the ROS hydrogen peroxide into water and oxygen. MCAT mice were shown previously to display reduced mitochondrial oxidative stress and radiosensitivity of the CNS compared to wild type controls (WT). As expected, MCAT mice expressed the transgene in skeletal tissue, and in marrow-derived osteoblasts and osteoclast precursors cultured ex vivo, and also showed greater catalase activity compared to wildtype (WT) mice (3-6 fold). Colony expansion in marrow cells cultured under osteoblastogenic conditions was 2-fold greater in the MCAT mice compared to WT mice, while the extent of mineralization was unaffected. MCAT mice had slightly longer tibiae than WT mice (2%, P less than 0.01), although cortical bone area was slightly lower in MCAT mice than WT mice (10%, p=0.09). To challenge the skeletal system, mice were treated by exposure to combined disuse (2 wk Hindlimb Unloading) and total body irradiation Cs(137) (2 Gy, 0.8 Gy/min), then bone parameters were analyzed by 2-factor ANOVA to detect possible interaction effects. Treatment caused a 2-fold increase (p=0.015) in malondialdehyde levels of bone tissue (ELISA) in WT mice, but had no effect in MCAT mice. These findings indicate that the transgene conferred protection from oxidative damage caused by treatment. Unexpected differences between WT and MCAT mice emerged in skeletal responses to treatment.. In WT mice, treatment did not alter osteoblastogenesis, cortical bone area, moment of inertia, or bone perimeter, whereas in MCAT mice, treatment increased these

  1. Impact of the Occlusion Duration on the Performance of J-CTO Score in Predicting Failure of Percutaneous Coronary Intervention for Chronic Total Occlusion.

    PubMed

    de Castro-Filho, Antonio; Lamas, Edgar Stroppa; Meneguz-Moreno, Rafael A; Staico, Rodolfo; Siqueira, Dimytri; Costa, Ricardo A; Braga, Sergio N; Costa, J Ribamar; Chamié, Daniel; Abizaid, Alexandre

    2017-06-01

    The present study examined the association between Multicenter CTO Registry in Japan (J-CTO) score in predicting failure of percutaneous coronary intervention (PCI) correlating with the estimated duration of chronic total occlusion (CTO). The J-CTO score does not incorporate estimated duration of the occlusion. This was an observational retrospective study that involved all consecutive procedures performed at a single tertiary-care cardiology center between January 2009 and December 2014. A total of 174 patients, median age 59.5 years (interquartile range [IQR], 53-65 years), undergoing CTO-PCI were included. The median estimated occlusion duration was 7.5 months (IQR, 4.0-12.0 months). The lesions were classified as easy (score = 0), intermediate (score = 1), difficult (score = 2), and very difficult (score ≥3) in 51.1%, 33.9%, 9.2%, and 5.7% of the patients, respectively. Failure rate significantly increased with higher J-CTO score (7.9%, 20.3%, 50.0%, and 70.0% in groups with J-CTO scores of 0, 1, 2, and ≥3, respectively; P<.001). There was no significant difference in success rate according to estimated duration of occlusion (P=.63). Indeed, J-CTO score predicted failure of CTO-PCI independently of the estimated occlusion duration (P=.24). Areas under receiver-operating characteristic curves were computed and it was observed that for each occlusion time period, the discriminatory capacity of the J-CTO score in predicting CTO-PCI failure was good, with a C-statistic >0.70. The estimated duration of occlusion had no influence on the J-CTO score performance in predicting failure of PCI in CTO lesions. The probability of failure was mainly determined by grade of lesion complexity.

  2. Differences of wells scores accuracy, caprini scores and padua scores in deep vein thrombosis diagnosis

    NASA Astrophysics Data System (ADS)

    Gatot, D.; Mardia, A. I.

    2018-03-01

    Deep Vein Thrombosis (DVT) is the venous thrombus in lower limbs. Diagnosis is by using venography or ultrasound compression. However, these examinations are not available yet in some health facilities. Therefore many scoring systems are developed for the diagnosis of DVT. The scoring method is practical and safe to use in addition to efficacy, and effectiveness in terms of treatment and costs. The existing scoring systems are wells, caprini and padua score. There have been many studies comparing the accuracy of this score but not in Medan. Therefore, we are interested in comparative research of wells, capriniand padua score in Medan.An observational, analytical, case-control study was conducted to perform diagnostic tests on the wells, caprini and padua score to predict the risk of DVT. The study was at H. Adam Malik Hospital in Medan.From a total of 72 subjects, 39 people (54.2%) are men and the mean age are 53.14 years. Wells score, caprini score and padua score has a sensitivity of 80.6%; 61.1%, 50% respectively; specificity of 80.65; 66.7%; 75% respectively, and accuracy of 87.5%; 64.3%; 65.7% respectively.Wells score has better sensitivity, specificity and accuracy than caprini and padua score in diagnosing DVT.

  3. Understanding the Relationship Between 3-Month and 2-Year Pain and Function Scores After Total Knee Arthroplasty for Osteoarthritis.

    PubMed

    Gandhi, Rajiv; Mahomed, Nizar N; Cram, Peter; Perruccio, Anthony V

    2018-05-01

    Research to understand predictors of poor outcomes after total knee arthroplasty (TKA) has largely focused on presurgery factors. We examined whether pain and function 3-month postsurgery were predictive of longer-term outcomes ascertained 2 years after TKA. Western Ontario McMaster University Osteoarthritis Index pain and physical function scores (scaled 0-20 and 0-68; higher = worse) were recorded pre-TKA and 3, 12, and 24 months post-TKA. A sequential series of regression models was used to examine the relative contribution of baseline score and baseline to 3-month and 3 to 12-month change score to explaining variability (R 2 ) in 2-year pain and function scores, with consideration for presurgery covariates. Data from 560 patients were analyzed. Mean pain and function scores improved significantly presurgery to 2 years postsurgery; 10-4 and 33-16 (P < .001), respectively. Considerable variability in 2-year scores was observed. Overall, 80.3% and 79.9% of changes in pain and function scores over the 2 years occurred within the first 3 months. Change over these 3 months explained the greatest proportion of variability in 2-year scores, 16% and 23% for pain and function, respectively. The influences of these early changes were similar to those of baseline status. Changes in patient-reported pain and function occurring within the first 3 months post-TKA strongly determine pain and function status at 2 years. Research to identify pre-/intra-/early postoperative factors associated with change in this early postoperative period that may be amenable to modification or used to better inform education and decision-making is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Estimating the Reliability of a Test Battery Composite or a Test Score Based on Weighted Item Scoring

    ERIC Educational Resources Information Center

    Feldt, Leonard S.

    2004-01-01

    In some settings, the validity of a battery composite or a test score is enhanced by weighting some parts or items more heavily than others in the total score. This article describes methods of estimating the total score reliability coefficient when differential weights are used with items or parts.

  5. A Commentary on the Use of Cut-Scores to Increase the Emphasis of Non-Cognitive Variables in Medical School Admissions

    ERIC Educational Resources Information Center

    Kreiter, Clarence D.

    2007-01-01

    The academic performance consequences of relying solely on non-cognitive factors for selecting applicants above a GPA and MCAT threshold have not been fully considered in the literature. This commentary considers the impact of using a "threshold approach" on academic performance as assessed with the USMLE Step 1.

  6. Pattern analysis of total item score and item response of the Kessler Screening Scale for Psychological Distress (K6) in a nationally representative sample of US adults

    PubMed Central

    Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Yutaka, Ono; Furukawa, Toshiaki A.

    2017-01-01

    Background Several recent studies have shown that total scores on depressive symptom measures in a general population approximate an exponential pattern except for the lower end of the distribution. Furthermore, we confirmed that the exponential pattern is present for the individual item responses on the Center for Epidemiologic Studies Depression Scale (CES-D). To confirm the reproducibility of such findings, we investigated the total score distribution and item responses of the Kessler Screening Scale for Psychological Distress (K6) in a nationally representative study. Methods Data were drawn from the National Survey of Midlife Development in the United States (MIDUS), which comprises four subsamples: (1) a national random digit dialing (RDD) sample, (2) oversamples from five metropolitan areas, (3) siblings of individuals from the RDD sample, and (4) a national RDD sample of twin pairs. K6 items are scored using a 5-point scale: “none of the time,” “a little of the time,” “some of the time,” “most of the time,” and “all of the time.” The pattern of total score distribution and item responses were analyzed using graphical analysis and exponential regression model. Results The total score distributions of the four subsamples exhibited an exponential pattern with similar rate parameters. The item responses of the K6 approximated a linear pattern from “a little of the time” to “all of the time” on log-normal scales, while “none of the time” response was not related to this exponential pattern. Discussion The total score distribution and item responses of the K6 showed exponential patterns, consistent with other depressive symptom scales. PMID:28289560

  7. Relationship between lower urinary tract symptoms and cardiovascular risk scores including Framingham risk score and ACC/AHA risk score.

    PubMed

    Lee, Bora; Lee, Sang Wook; Kang, Hye Rim; Kim, Dae In; Sun, Hwa Yeon; Kim, Jae Heon

    2018-01-01

    This study attempted to investigate the association between lower urinary tract symptoms (LUTS) and cardiovascular disease (CVD) risk using International Prostate Symptom Score (IPSS) and CVD risk scores and to overcome the limitations of previous relevant studies. A total of 2994 ostensibly healthy males, who participated in a voluntary health check in a health promotion center from January 2010 to December 2014, were reviewed. CVD risk scores were calculated using Framingham risk score and American College of Cardiology (ACC)/American Heart Association (AHA) score. Correlation and multivariate logistic regression analysis to predict the CVD risk severity were performed. Correlation between total IPSS with CVD risk scores demonstrated significant positive associations, which showed higher correlation with ACC/AHA score than the Framingham score (r = 0.18 vs 0.09, respectively). For ACC/AHA score, the partial correlation after adjustment of body mass index (BMI) showed significant positive correlations between all LUTS parameters and PSA. For the Framingham score, all variables, except IPSS Q2 and IPSS Q6, showed significant positive correlations. After adjustment of BMI, prostate volume and PSA, only the severe LUTS group showed significant relationship with intermediate-high CVD risk severity, as compared with normal LUTS group (OR = 2.97, 95%CI (1.35-6.99)). Using two validated CVD risk calculators, we observed that LUTS is closely associated with future CVD risk. To predict the intermediate-high CVD risk severity, severe LUTS was a sentinel sign, the presence of which warrants the importance of an earlier screening for CVD. © 2017 Wiley Periodicals, Inc.

  8. How often is the office visit needed? Predicting total knee arthroplasty revision risk using pain/function scores.

    PubMed

    Hightower, Charles D; Hightower, Lisa S; Tatman, Penny J; Morgan, Patrick M; Gioe, Terence; Singh, Jasvinder A

    2016-08-24

    Most patients have favorable outcomes after primary total knee arthroplasty (TKA). Well-validated methods to predict the risk of poor outcomes have not been developed or implemented. Several patients have annual clinic visits despite well-funcitoning TKA, as a routine practice, to detect early failure requiring revision surgery. It is not known whether assessment of pain and function can be used as a predictive tool for early failure and revision to guide practice. Our objective was to determine whether pain and function can predict revision after TKA. We retrospectively studied data from a large prospectively gathered TKA registry to examine changes in outcome scores for primary TKAs undergoing revision compared to those not requiring revision to determine the factors that are predictive for revision. Of the 1,012 patients, 721 had had a single-sided primary TKA and had American Knee Society (AKS) Scores for three or more visits. 46 patients underwent revision, 23 acutely (fracture, traumatic component failure or acute infection) and 23 for latent causes (late implant loosening, progressive osteolysis, or pain and indolent infection). Mean age was 70 years for the non-revision patients, and 64 years for those revised. Both AKS Clinical and AKS Function Scores for non-revised patients were higher than in revision patients, higher in acute revision compared to latent revision patients. Significant predictors of revision surgery were preoperative, 3- and 15-month postoperative AKS Clinical Scores and 3-month AKS Function Scores. At 15-month post-TKA, a patient with a low calculated probability of revision, 32 % or less, was unlikely to require revision surgery with a negative predictive value of 99 %. Time dependent interval evaluation post-TKA with the AKS outcome scores may provide the ability to assign risk of revision to patients at the 15-month follow-up visit. If these findings can be replicated using a patient-reported measure, a virtual follow-up with

  9. The Achilles tendon total rupture score: a study of responsiveness, internal consistency and convergent validity on patients with acute Achilles tendon ruptures

    PubMed Central

    2012-01-01

    Background The Achilles tendon Total Rupture Score was developed by a research group in 2007 in response to the need for a patient reported outcome measure for this patient population. Beyond this original development paper, no further validation studies have been published. Consequently the purpose of this study was to evaluate internal consistency, convergent validity and responsiveness of this newly developed patient reported outcome measure within patients who have sustained an isolated acute Achilles tendon rupture. Methods Sixty-four eligible patients with an acute rupture of their Achilles tendon completed the Achilles tendon Total Rupture Score alongside two further patient reported outcome measures (Disability Rating Index and EQ 5D). These were completed at baseline, six weeks, three months, six months and nine months post injury. The Achilles tendon Total Rupture Score was evaluated for internal consistency, using Cronbach's alpha, convergent validity, through correlation analysis and responsiveness, by analysing floor and ceiling effects and calculating its relative efficiency in comparison to the Disability Rating Index and EQ 5D scores. Results The Achilles tendon Total Rupture Score demonstrated high internal consistency (Cronbachs alpha > 0.8) and correlated significantly (p < 0.001) with the Disability Rating Index at five time points (pre-injury, six weeks, three, six and nine months) with correlation coefficients between -0.5 and -0.9. However, the confidence intervals were wide. Furthermore, the ability of the new score to detect clinically important changes over time (responsiveness) was shown to be greater than the Disability Rating Index and EQ 5D. Conclusions A universally accepted outcome measure is imperative to allow comparisons to be made across practice. This is the first study to evaluate aspects of validity of this newly developed outcome measure, outside of the developing centre. The ATRS demonstrated high internal consistency and

  10. Trends Plus: U.S. Medical School Applicants, Matriculants, Graduates 1992.

    ERIC Educational Resources Information Center

    Association of American Medical Colleges, Washington, DC.

    This report provides statistical data and charts concerning trends in undergraduate medical education over the past decade. It presents trends in grade point averages (GPAs); in Medical College Admission Test (MCAT) scores for premedical school applicants and matriculants; and provides information on applicant and matriculant characteristics,…

  11. Effectiveness of a Formal Post-Baccalaureate Pre-Medicine Program for Underrepresented Minority Students.

    ERIC Educational Resources Information Center

    Giordani, Bruno; Edwards, Amy S.; Segal, Stuart S.; Gillum, Linda H.; Lindsay, Angela; Johnson, Nakia

    2001-01-01

    Assessed the effectiveness of an intense, year-long experience of course work, research, and personal development for underrepresented minority students before medical school. Program participants demonstrated competency in the first year of medical school consistent with traditional students even though they had lower MCAT scores and college…

  12. Predicting Admission of Minorities into Medical School.

    ERIC Educational Resources Information Center

    Lynch, Kathleen Bodisch; Woode, Moses K.

    A study identifying the relationships between quantitative academic characteristics--specifically, grade point average (GPA) and MCAT scores--and admission into medical school for minorities is presented. Explanations are proposed for contradictory findings related to this question that have appeared in literature. Data from 58 minority student…

  13. The pre-health collection within MedEdPORTAL's iCollaborative: helping faculty prepare students for the competencies in the new MCAT(2015) exam.

    PubMed

    Jakubowski, Henry V; Zapanta, Laura S

    2013-01-01

    To help faculty prepare and revise courses in all the disciplines represented in the MCAT(2015) , the American Association of Medical Colleges, through its MedEdPORTAL's iCollaborative, has established the Pre-health Collection, a repository of reviewed web resources that are openly and freely available to faculty, and indirectly through them to students. The Pre-health Collection initiative makes use of the Internet to centralize teaching resources and to help faculty at institutions with fewer available resources to incorporate high quality teaching material specifically reviewed to assist students in obtaining the required pre-health competencies. As biochemistry competencies are increasingly represented in the new exam, it is important to grow the number of quality teaching resources for biochemistry within the portal and to develop a community of users and contributors. A description of the Pre-Health Collection and mechanisms for contributions are presented. Copyright © 2013 International Union of Biochemistry and Molecular Biology, Inc.

  14. MCAT to XCAT: The Evolution of 4-D Computerized Phantoms for Imaging Research: Computer models that take account of body movements promise to provide evaluation and improvement of medical imaging devices and technology.

    PubMed

    Paul Segars, W; Tsui, Benjamin M W

    2009-12-01

    Recent work in the development of computerized phantoms has focused on the creation of ideal "hybrid" models that seek to combine the realism of a patient-based voxelized phantom with the flexibility of a mathematical or stylized phantom. We have been leading the development of such computerized phantoms for use in medical imaging research. This paper will summarize our developments dating from the original four-dimensional (4-D) Mathematical Cardiac-Torso (MCAT) phantom, a stylized model based on geometric primitives, to the current 4-D extended Cardiac-Torso (XCAT) and Mouse Whole-Body (MOBY) phantoms, hybrid models of the human and laboratory mouse based on state-of-the-art computer graphics techniques. This paper illustrates the evolution of computerized phantoms toward more accurate models of anatomy and physiology. This evolution was catalyzed through the introduction of nonuniform rational b-spline (NURBS) and subdivision (SD) surfaces, tools widely used in computer graphics, as modeling primitives to define a more ideal hybrid phantom. With NURBS and SD surfaces as a basis, we progressed from a simple geometrically based model of the male torso (MCAT) containing only a handful of structures to detailed, whole-body models of the male and female (XCAT) anatomies (at different ages from newborn to adult), each containing more than 9000 structures. The techniques we applied for modeling the human body were similarly used in the creation of the 4-D MOBY phantom, a whole-body model for the mouse designed for small animal imaging research. From our work, we have found the NURBS and SD surface modeling techniques to be an efficient and flexible way to describe the anatomy and physiology for realistic phantoms. Based on imaging data, the surfaces can accurately model the complex organs and structures in the body, providing a level of realism comparable to that of a voxelized phantom. In addition, they are very flexible. Like stylized models, they can easily be

  15. Item usage in a multidimensional computerized adaptive test (MCAT) measuring health-related quality of life.

    PubMed

    Paap, Muirne C S; Kroeze, Karel A; Terwee, Caroline B; van der Palen, Job; Veldkamp, Bernard P

    2017-11-01

    Examining item usage is an important step in evaluating the performance of a computerized adaptive test (CAT). We study item usage for a newly developed multidimensional CAT which draws items from three PROMIS domains, as well as a disease-specific one. The multidimensional item bank used in the current study contained 194 items from four domains: the PROMIS domains fatigue, physical function, and ability to participate in social roles and activities, and a disease-specific domain (the COPD-SIB). The item bank was calibrated using the multidimensional graded response model and data of 795 patients with chronic obstructive pulmonary disease. To evaluate the item usage rates of all individual items in our item bank, CAT simulations were performed on responses generated based on a multivariate uniform distribution. The outcome variables included active bank size and item overuse (usage rate larger than the expected item usage rate). For average θ-values, the overall active bank size was 9-10%; this number quickly increased as θ-values became more extreme. For values of -2 and +2, the overall active bank size equaled 39-40%. There was 78% overlap between overused items and active bank size for average θ-values. For more extreme θ-values, the overused items made up a much smaller part of the active bank size: here the overlap was only 35%. Our results strengthen the claim that relatively short item banks may suffice when using polytomous items (and no content constraints/exposure control mechanisms), especially when using MCAT.

  16. Nursing activities score.

    PubMed

    Miranda, Dinis Reis; Nap, Raoul; de Rijk, Angelique; Schaufeli, Wilmar; Iapichino, Gaetano

    2003-02-01

    The instruments used for measuring nursing workload in the intensive care unit (e.g., Therapeutic Intervention Scoring System-28) are based on therapeutic interventions related to severity of illness. Many nursing activities are not necessarily related to severity of illness, and cost-effectiveness studies require the accurate evaluation of nursing activities. The aim of the study was to determine the nursing activities that best describe workload in the intensive care unit and to attribute weights to these activities so that the score describes average time consumption instead of severity of illness. To define by consensus a list of nursing activities, to determine the average time consumption of these activities by use of a 1-wk observational cross-sectional study, and to compare these results with those of the Therapeutic Intervention Scoring System-28. A total of 99 intensive care units in 15 countries. Consecutive admissions to the intensive care units. Daily recording of nursing activities at a patient level and random multimoment recording of these activities. A total of five new items and 14 subitems describing nursing activities in the intensive care unit (e.g., monitoring, care of relatives, administrative tasks) were added to the list of therapeutic interventions in Therapeutic Intervention Scoring System-28. Data from 2,041 patients (6,451 nursing days and 127,951 multimoment recordings) were analyzed. The new activities accounted for 60% of the average nursing time; the new scoring system (Nursing Activities Score) explained 81% of the nursing time (vs. 43% in Therapeutic Intervention Scoring System-28). The weights in the Therapeutic Intervention Scoring System-28 are not derived from the use of nursing time. Our study suggests that the Nursing Activities Score measures the consumption of nursing time in the intensive care unit. These results should be validated in independent databases.

  17. Clinical characteristics and predictive factors of myasthenic crisis after thymectomy.

    PubMed

    Nam, Tai-Seung; Lee, Seung-Han; Kim, Byeong-Chae; Choi, Kang-Ho; Kim, Joon-Tae; Kim, Myeong-Kyu; Cho, Ki-Hyun; Lee, Min-Cheol

    2011-09-01

    The aims of this study were to assess the clinical characteristics of myasthenic crisis after thymectomy (MCAT) and to identify predictors affecting the occurrence of MCAT. Of 66 patients with myasthenia gravis (MG), MCAT occurred in 20 patients (30.3%). The median time interval from thymectomy to MCAT was 3.4 months. MCAT occurred in 65.0% of patients within the first 6 months of a thymectomy, and 35.0% after 6 months. A second MCAT occurred in nine (45.0%) patients who survived the first MCAT, and in seven (50.0%) of 14 patients with a history of a preoperative myasthenic crisis before thymectomy (MCBT). A history of MCBT, and clinical factors reflecting perioperative clinical severity at thymectomy, including preoperative Osserman's grade, bulbar symptoms, use of immunosuppressants, pulmonary function, and postoperative delayed ventilator weaning, were significantly correlated with the occurrence of MCAT on univariate analysis. However, a history of MCBT was the only independent factor affecting the occurrence of MCAT on multivariate logistic regression analysis (odds ratio, 17.9; 95% confidence interval, 4.019-79.873; p<0.001). Thus, the occurrence of MCAT may be correlated only with a history of MCBT rather than with factors reflecting perioperative clinical severity. MG patients with a history of MCBT are more susceptible to MCAT, particularly within the first 6 months of thymectomy. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Correlation of a single assessment numeric evaluation (SANE) rating with modified Cincinnati knee rating system and IKDC subjective total scores for patients after ACL reconstruction or knee arthroscopy.

    PubMed

    Shelbourne, K Donald; Barnes, Adam F; Gray, Tinker

    2012-11-01

    Limited studies exist regarding how well a single assessment numeric evaluation (SANE) rating correlates with validated knee surveys. To determine whether a SANE rating correlates positively with the International Knee Documentation Committee (IKDC) and the modified Cincinnati Knee Rating System (CKRS) total scores after knee surgery. Cohort study (Diagnosis); Level of evidence, 2. Patients undergoing either anterior cruciate ligament (ACL) reconstruction or knee arthroscopy were prospectively given subjective evaluations yearly after surgery between January 2000 and June 2011. Subjective evaluations were obtained using modified CKRS and IKDC subjective knee surveys and a SANE rating. Interclass correlation coefficient was used to determine the correlation of the SANE rating to the survey total scores. Bland-Altman method was used to access precision and limits of agreement between scores. In addition, the data were analyzed according to sex and age categories (<18, 18-24, 25-40, >40 years). A total of 11,939 surveys were collected from 3209 patients (mean, 3.7 surveys/person; range, 1-22) after ACL reconstruction with a mean survey age of 35.2 ± 11.9 years (range, 13-72). A total of 4615 surveys were collected from 1813 patients (mean, 2.6 surveys/person; range, 1-17) after knee arthroscopy with a mean survey age of 47.4 ± 14.6 years (range, 11-88). For patients who underwent ACL reconstruction, the SANE rating had a moderate positive correlation of 0.66 to the total survey scores. For patients who underwent knee arthroscopies, the SANE rating had a strong positive correlation of 0.74 to total scores. There was minimal difference in correlations based on age group or sex. Bland-Altman analysis showed that the limits of agreement between the SANE score and the 2 surveys were met for at least 94% of patients in both patient groups. The SANE ratings exhibited moderate to strong positive correlations with the modified CKRS and IKDC subjective surveys after ACL

  19. Effects of comprehensive educational reforms on academic success in a diverse student body.

    PubMed

    Lieberman, Steven A; Ainsworth, Michael A; Asimakis, Gregory K; Thomas, Lauree; Cain, Lisa D; Mancuso, Melodee G; Rabek, Jeffrey P; Zhang, Ni; Frye, Ann W

    2010-12-01

    Calls for medical curriculum reform and increased student diversity in the USA have seen mixed success: performance outcomes following curriculum revisions have been inconsistent and national matriculation of under-represented minority (URM) students has not met aspirations. Published innovations in curricula, academic support and pipeline programmes usually describe isolated interventions that fail to affect curriculum-level outcomes. United States Medical Licensing Examination (USMLE) Step 1 performance and graduation rates were analysed for three classes of medical students before (matriculated 1995-1997, n=517) and after (matriculated 2003-2005, n=597) implementing broad-based reforms in our education system. The changes in pipeline recruitment and preparation programmes, instructional methods, assessment systems, academic support and board preparation were based on sound educational principles and best practices. Post-reform classes were diverse with respect to ethnicity (25.8% URM students), gender (51.8% female), and Medical College Admissions Test (MCAT) score (range 20-40; 24.1% scored ≤ 25). Mean±standard deviation MCAT scores were minimally changed (from 27.2±4.7 to 27.8±3.6). The Step 1 failure rate decreased by 69.3% and mean score increased by 14.0 points (effect size: d=0.67) overall. Improvements were greater among women (failure rate decreased by 78.9%, mean score increased by 15.6 points; d=0.76) and URM students (failure rate decreased by 76.5%, mean score increased by 14.6 points; d=0.74), especially African-American students (failure rate decreased by 93.6%, mean score increased by 20.8 points; d=1.12). Step 1 scores increased across the entire MCAT range. Four- and 5-year graduation rates increased by 7.1% and 5.8%, respectively. The effect sizes in these performance improvements surpassed those previously reported for isolated interventions in curriculum and student support. This success is likely to have resulted from the broad

  20. Concurrent Validity of LibQUAL+[TM] Scores: What Do LibQUAL+[TM] Scores Measure?

    ERIC Educational Resources Information Center

    Thompson, Bruce; Cook, Colleen; Kyrillidou, Martha

    2005-01-01

    The present study investigated the validity of LibQUAL+[TM] scores, and specifically how total and subscale LibQUAL+[TM] scores are associated with self-reported, library-related satisfaction and outcomes scores. Participants included 88,664 students and faculty who completed the American English (n[AE] = 69,494) or the British English (n[BE] =…

  1. Assessing Personal Qualities in Medical School Admissions.

    ERIC Educational Resources Information Center

    Albanese, Mark A.; Snow, Mikel H.; Skochelak, Susan E.; Huggett, Kathryn N.; Farrell, Philip M.

    2003-01-01

    Analyzes the challenges to using academic measures (MCAT scores and GPAs) as thresholds for medical school admissions and, for applicants exceeding the threshold, using personal qualities for admission decisions; reviews the literature on using the medical school interview and other admission data to assess personal qualities of applicants;…

  2. Characterizing the Survey Strategy and Initial Orbit Determination Abilities of the NASA MCAT Telescope for Geosynchronous Orbital Debris Environmental Studies

    NASA Astrophysics Data System (ADS)

    Frith, J.; Barker, E.; Cowardin, H.; Buckalew, B.; Anz-Meador, P.; Lederer, S.

    The National Aeronautics and Space Administration (NASA) Orbital Debris Program Office (ODPO) recently commissioned the Meter Class Autonomous Telescope (MCAT) on Ascension Island with the primary goal of obtaining population statistics of the geosynchronous (GEO) orbital debris environment. To help facilitate this, studies have been conducted using MCAT’s known and projected capabilities to estimate the accuracy and timeliness in which it can survey the GEO environment, including collected weather data and the proposed observational data collection cadence. To optimize observing cadences and probability of detection, on-going work using a simulated GEO debris population sampled at various cadences are run through the Constrained Admissible Region Multi Hypotheses Filter (CAR-MHF). The orbits computed from the results are then compared to the simulated data to assess MCAT’s ability to determine accurately the orbits of debris at various sample rates. The goal of this work is to discriminate GEO and near-GEO objects from GEO transfer orbit objects that can appear as GEO objects in the environmental models due to the short arc observation and an assumed circular orbit. The specific methods and results are presented here.

  3. Cross cultural adaptation of the Achilles tendon Total Rupture Score with reliability, validity and responsiveness evaluation.

    PubMed

    Carmont, Michael R; Silbernagel, Karin Grävare; Nilsson-Helander, Katarina; Mei-Dan, Omer; Karlsson, Jon; Maffulli, Nicola

    2013-06-01

    The Achilles tendon Total Rupture Score (ATRS) was developed because of the need for a reliable, valid and sensitive instrument to evaluate symptoms and their effects on physical activity in patients following either conservative or surgical management of an Achilles tendon rupture. Prior to using the score in larger randomized trial in an English-speaking population, we decided to perform reliability, validity and responsiveness evaluations of the English version of the ATRS. Even though the score was published in English, the actual English version has not be validated and compared to the results of the Swedish version. From 2009 to 2010, all patients who received treatment for Achilles tendon rupture were followed up using the English version of the ATRS. Patients were asked to complete the score at 3, 6 and 12 months following treatment for Achilles tendon rupture. The ATRS was completed on arrival in the outpatient clinic and again following consultation. The outcomes of 49 (13 female and 36 male) patients were assessed. The mean (SD) age was 49 (12) years, and 27 patients had treatment for a left-sided rupture, 22 the right. All patients received treatment for ruptured Achilles tendons: 38 acute percutaneous repair, 1 open repair, 5 an Achilles tendon reconstruction using a Peroneus Brevis tendon transfer for delayed presentation, 1 gracilis augmented repair for re-rupture and 4 non-operative treatment for mid-portion rupture. The English version of ATRS was shown to have overall excellent reliability (ICC = 0.986). There was no significant difference between the results with the English version and the Swedish version when compared at the 6-month- or 12-month (n.s.) follow-up appointments. The effect size was 0.93. The minimal detectable change was 6.75 points. The ATRS was culturally adapted to English and shown to be a reliable, valid and responsive method of testing functional outcome following an Achilles tendon rupture.

  4. Serum antibody response to Moraxella catarrhalis proteins OMP CD, OppA, Msp22, Hag, and PilA2 after nasopharyngeal colonization and acute otitis media in children.

    PubMed

    Ren, Dabin; Almudevar, Anthony L; Murphy, Timothy F; Lafontaine, Eric R; Campagnari, Anthony A; Luke-Marshall, Nicole; Casey, Janet R; Pichichero, Michael E

    2015-10-26

    There is no licensed vaccine for Moraxella catarrhalis (Mcat), which is a prominent bacterium causing acute otitis media (AOM) in children and lower respiratory tract infections in adults. Nasopharyngeal (NP) colonization caused by respiratory bacteria results in natural immunization of the host. To identify Mcat antigens as vaccine candidates, we evaluated the development of naturally induced antibodies to 5 Mcat surface proteins in children 6-30 months of age during Mcat NP colonization and AOM. Human serum IgG against the recombinant Mcat proteins, outer membrane protein (OMP) CD, oligopeptide permease (Opp)A, hemagglutinin (Hag), Moraxella surface protein (Msp)22, and PilA clade 2 (PilA2) was quantitated by using an ELISA assay. There were 223 Mcat NP colonization episodes documented in 111 (60%) of 184 children in the study. Thirty five Mcat AOM episodes occurred in 30 (16%) of 184 children. All 5 Mcat candidate vaccine antigens evaluated stimulated a significant rise in serum IgG levles over time from 6 to 36 months of age (P<0.001), with a rank order as follows: Msp22=OppA>OMP CD=Hag=PilA2. Children with no detectable Mcat NP colonization showed a higher serum IgG level against OppA, Hag, and Msp22 compared to those with Mcat NP colonization (P<0.05). Individual data showed that some children responded to AOM with an antibody increase to one or more of the studied Mcat proteins but some children failed to respond. Serum antibody to Mcat candidate vaccine proteins OMP CD, OppA, Msp22, Hag, and PilA2 increased with age in naturally immunized children age 6-30 months following Mcat NP colonization and AOM. High antibody levels against OppA, Msp22, and Hag correlated with reduced carriage. The results support further investigation of these vaccine candidates in protecting against Mcat colonization and infection. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Serum antibody response to Moraxella catarrhalis proteins OMP CD, OppA, Msp22, Hag, and PilA2 after nasopharyngeal colonization and acute otitis media in children

    PubMed Central

    Ren, Dabin; Almudevar, Anthony L.; Murphy, Timothy F.; Lafontaine, Eric R.; Campagnari, Anthony A.; Luke-Marshall, Nicole; Casey, Janet R.; Pichichero, Michael E.

    2015-01-01

    Background There is no licensed vaccine for Moraxella catarrhalis (Mcat), which is a prominent bacterium causing acute otitis media (AOM) in children and lower respiratory tract infections in adults. Nasopharyngeal (NP) colonization caused by respiratory bacteria results in natural immunization of the host. To identify Mcat antigens as vaccine candidates, we evaluated the development of naturally induced antibodies to 5 Mcat surface proteins in children 6–30 months of age during Mcat NP colonization and AOM. Methods Human serum IgG against the recombinant Mcat proteins, outer membrane protein (OMP) CD, oligopeptide permease (Opp)A, hemagglutinin (Hag), Moraxella surface protein (Msp)22, and PilA clade 2 (PilA2) was quantitated by using an ELISA assay. Results There were 223 Mcat NP colonization episodes documented in 111 (60%) of 184 children in the study. Thirty five Mcat AOM episodes occurred in 30 (16%) of 184 children. All 5 Mcat candidate vaccine antigens evaluated stimulated a significant rise in serum IgG levles over time from 6 to 36 months of age (P < 0.001), with a rank order as follows: Msp22 = OppA > OMP CD = Hag = PilA2. Children with no detectable Mcat NP colonization showed a higher serum IgG level against OppA, Hag, and Msp22 compared to those with Mcat NP colonization (P < 0.05). Individual data showed that some children responded to AOM with an antibody increase to one or more of the studied Mcat proteins but some children failed to respond. Conclusions Serum antibody to Mcat candidate vaccine proteins OMP CD, OppA, Msp22, Hag, and PilA2 increased with age in naturally immunized children age 6–30 months following Mcat NP colonization and AOM. High antibody levels against OppA, Msp22, and Hag correlated with reduced carriage. The results support further investigation of these vaccine candidates in protecting against Mcat colonization and infection. PMID:26392013

  6. Can the presence of an infection be predicted before a revision total hip arthroplasty? Preliminary study to establish an infection score.

    PubMed

    Jenny, J-Y; Adamczewski, B; De Thomasson, E; Godet, J; Bonfait, H; Delaunay, C

    2016-04-01

    The diagnosis of periprosthetic joint infection can be challenging, in part because there is no universal diagnostic test. Current recommendations include several diagnostic criteria, and are mainly based on the results of deep microbiological samples; however, these only provide a diagnosis after surgery. A predictive infection score would improve the management of revision arthroplasty cases. The purpose of this study was to define a composite infection score using standard clinical, radiological and laboratory data that can be used to predict whether an infection is present before a total hip arthroplasty (THA) revision procedure. The infection score will make it possible to differentiate correctly between infected and non-infected patients in 75% of cases. One hundred and four records from patients who underwent THA revision for any reason were analysed retrospectively: 43 with infection and 61 without infection. There were 54 men and 50 women with an average age of 70±12 years (range 30-90). A univariate analysis was performed to look for individual discriminating factors between the data in the medical records of infected and non-infected patients. A multivariate analysis subsequently integrated these factors together. A composite score was defined and its diagnostic effectiveness was evaluated as the percentage of correctly classified records, along with its sensitivity and specificity. The score consisted of the following individually weighed factors: body mass index, presence of diabetes, mechanical complication, wound healing disturbance and fever. This composite infection score was able to distinguish correctly between the infected patients (positive score) and non-infected patients (negative score) in 78% of cases; the sensitivity was 57% and the specificity 93%. Once this score is evaluated prospectively, it could be an important tool for defining the medical - surgical strategy during THA revision, no matter the reason for revision. Level IV

  7. Healthy Eating Index--2005 total and component scores for adults aged 20 and over: National Health and Nutrition Examination Survey, 2003-2004.

    PubMed

    Ervin, R Bethene

    2011-12-13

    This report provides Healthy Eating Index-2005 (HEI-2005) scores for adults aged 20 and over, by sex, age groups, race and ethnicity, and level of education in the 2003-2004 National Health and Nutrition Examination Survey (NHANES 2003-2004). The analytic sample consisted of 4,448 adults aged 20 and over from NHANES 2003-2004. The Day 1 dietary recall was used to estimate the HEI-2005 scores. Food and nutrient intakes were assessed on a density basis. The population's mean usual HEI-2005 component and total scores were calculated using a population ratio method based on programs written by the U.S. Department of Agriculture's Center for Nutrition Policy and Promotion. A two-tailed t-test was used to test significant differences between sexes, age and race, and ethnic groups and levels of education. Statistical hypotheses were tested at the p < 0.05 level of significance using a t statistic. The t-value at 0.975 with 15 degrees of freedom was 2.131. The Bonferroni method of adjustment was used to adjust the critical value for the family of pairwise comparisons for age, race and ethnicity, and education. Adults were below the maximum standard for all the HEI-2005 component scores except for total grains and meat and beans. Females and the oldest age group were more successful in meeting the Dietary Guidelines for Americans 2005 recommendations for the fruit and vegetable components and discretionary calories, and had a slightly higher overall diet quality score than their counterparts. Adults with more than a high school education more closely complied with the recommendations for many of the components compared with those with less education. No one racial and ethnic group stood out as having the highest HEI-2005 scores across most of the components. These results demonstrate that adults continue to fall short in meeting the Dietary Guidelines for Americans 2005 recommendations, and that sociodemographic characteristics influence their food choices and overall diet

  8. Analysis of Factors that Predict Clinical Performance in Medical School

    ERIC Educational Resources Information Center

    White, Casey B.; Dey, Eric L.; Fantone, Joseph C.

    2009-01-01

    Academic achievement indices including GPAs and MCAT scores are used to predict the spectrum of medical student academic performance types. However, use of these measures ignores two changes influencing medical school admissions: student diversity and affirmative action, and an increased focus on communication skills. To determine if GPA and MCAT…

  9. How Much Do Medical Students Know about Physical Income?

    ERIC Educational Resources Information Center

    Nicholson, Sean

    2005-01-01

    A comparative study of medical students who estimated physicians' income during their first and fourth years of study throws up interesting results. The medical students typically overestimated physician income by 25% on an average, with differences marked by age, women, older students, students with high MCAT scores. Final year students'…

  10. The Effect of Repeaters on Equating

    ERIC Educational Resources Information Center

    Kim, HeeKyoung; Kolen, Michael J.

    2010-01-01

    Test equating might be affected by including in the equating analyses examinees who have taken the test previously. This study evaluated the effect of including such repeaters on Medical College Admission Test (MCAT) equating using a population invariance approach. Three-parameter logistic (3-PL) item response theory (IRT) true score and…

  11. A Comparison of D. O. and M. D. Student Performance

    ERIC Educational Resources Information Center

    Stachnik, Thomas J.; Simons, Ronald C.

    1977-01-01

    Performances of students from two medical colleges, one allopathic (M.D.) and one osteopathic (D.O.), at Michigan State University in a first course in psychiatry are compared. The M.D. students had scored significantly higher on the MCAT, but there was no difference in psychiatry course performance. (Author/LBH)

  12. Key performance indicators score (KPIs-score) based on clinical and laboratorial parameters can establish benchmarks for internal quality control in an ART program.

    PubMed

    Franco, José G; Petersen, Claudia G; Mauri, Ana L; Vagnini, Laura D; Renzi, Adriana; Petersen, Bruna; Mattila, M C; Comar, Vanessa A; Ricci, Juliana; Dieamant, Felipe; Oliveira, João Batista A; Baruffi, Ricardo L R

    2017-06-01

    KPIs have been employed for internal quality control (IQC) in ART. However, clinical KPIs (C-KPIs) such as age, AMH and number of oocytes collected are never added to laboratory KPIs (L-KPIs), such as fertilization rate and morphological quality of the embryos for analysis, even though the final endpoint is the evaluation of clinical pregnancy rates. This paper analyzed if a KPIs-score strategy with clinical and laboratorial parameters could be used to establish benchmarks for IQC in ART cycles. In this prospective cohort study, 280 patients (36.4±4.3years) underwent ART. The total KPIs-score was obtained by the analysis of age, AMH (AMH Gen II ELISA/pre-mixing modified, Beckman Coulter Inc.), number of metaphase-II oocytes, fertilization rates and morphological quality of the embryonic lot. The total KPIs-score (C-KPIs+L-KPIs) was correlated with the presence or absence of clinical pregnancy. The relationship between the C-KPIs and L-KPIs scores was analyzed to establish quality standards, to increase the performance of clinical and laboratorial processes in ART. The logistic regression model (LRM), with respect to pregnancy and total KPIs-score (280 patients/102 clinical pregnancies), yielded an odds ratio of 1.24 (95%CI = 1.16-1.32). There was also a significant difference (p<0.0001) with respect to the total KPIs-score mean value between the group of patients with clinical pregnancies (total KPIs-score=20.4±3.7) and the group without clinical pregnancies (total KPIs-score=15.9±5). Clinical pregnancy probabilities (CPP) can be obtained using the LRM (prediction key) with the total KPIs-score as a predictor variable. The mean C-KPIs and L-KPIs scores obtained in the pregnancy group were 11.9±2.9 and 8.5±1.7, respectively. Routinely, in all cases where the C-KPIs score was ≥9, after the procedure, the L-KPIs score obtained was ≤6, a revision of the laboratory procedure was performed to assess quality standards. This total KPIs-score could set up

  13. STONE score versus Guy's Stone Score - prospective comparative evaluation for success rate and complications in percutaneous nephrolithotomy

    PubMed Central

    Kumar, Ujwal; Tomar, Vinay; Yadav, Sher Singh; Priyadarshi, Shivam; Vyas, Nachiket; Agarwal, Neeraj; Dayal, Ram

    2018-01-01

    Purpose: The aim of the current study was to compare Guy's score and STONE score in predicting the success and complication rate of percutaneous nephrolithotomy (PCNL). Materials and Methods: A total of 445 patients were included in the study between July 2015 and December 2016. The patients were given STONE score and Guy's Stone Score (GSS) grades based on CT scan done preoperatively and intra- and post-operative complications were graded using the modified Clavien grading system. The PCNL were done by a standard technique in prone positions. Results: The success rate in our study was 86.29% and both the GSS and STONE score were significantly associated with a success rate of the procedure. Both the scoring systems correlated with operative time and postoperative hospital stay. Of the total cases, 102 patients (22.92%) experienced complications. A correlation between STONE score stratified into low, moderate, and high nephrolithometry score risk groups (low scores 4–5, moderate scores 6–8, high scores 9–13), and complication was also found (P = 0.04) but not between the GSS and complication rate (P = 0.054). Conclusion: Both GSS and STONE scores are equally effective in predicting success rate of the procedure. PMID:29416280

  14. Corrective 111 In Capromab Pendetide SPECT Image Reconstruction Methods for Improved Detection of Recurrent Prostate Cancer

    DTIC Science & Technology

    2006-06-01

    Lalush, and T. BMW, Modeling Respiratory Mechanics in the MCAT and 30 Spline-Based MCAT Phantoms. IEEE Trans Nucl Sci., 2001. 38. Segars, W.P., D.S...Lalush, and B.M.W. Tsui. Modeling Respiratory Mechanics in the MCAT and Spline-Based MCAT Phantoms. in Conference Record of the 1999 IEEE Nuclear

  15. Developing a burn injury severity score (BISS): adding age and total body surface area burned to the injury severity score (ISS) improves mortality concordance.

    PubMed

    Cassidy, J Tristan; Phillips, Michael; Fatovich, Daniel; Duke, Janine; Edgar, Dale; Wood, Fiona

    2014-08-01

    There is limited research validating the injury severity score (ISS) in burns. We examined the concordance of ISS with burn mortality. We hypothesized that combining age and total body surface area (TBSA) burned to the ISS gives a more accurate mortality risk estimate. Data from the Royal Perth Hospital Trauma Registry and the Royal Perth Hospital Burns Minimum Data Set were linked. Area under the receiver operating characteristic curve (AUC) measured concordance of ISS with mortality. Using logistic regression models with death as the dependent variable we developed a burn-specific injury severity score (BISS). There were 1344 burns with 24 (1.8%) deaths, median TBSA 5% (IQR 2-10), and median age 36 years (IQR 23-50). The results show ISS is a good predictor of death for burns when ISS≤15 (OR 1.29, p=0.02), but not for ISS>15 (ISS 16-24: OR 1.09, p=0.81; ISS 25-49: OR 0.81, p=0.19). Comparing the AUCs adjusted for age, gender and cause, ISS of 84% (95% CI 82-85%) and BISS of 95% (95% CI 92-98%), demonstrated superior performance of BISS as a mortality predictor for burns. ISS is a poor predictor of death in severe burns. The BISS combines ISS with age and TBSA and performs significantly better than the ISS. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  16. Anesthesia Technique and Mortality after Total Hip or Knee Arthroplasty: A Retrospective, Propensity Score-matched Cohort Study.

    PubMed

    Perlas, Anahi; Chan, Vincent W S; Beattie, Scott

    2016-10-01

    This propensity score-matched cohort study evaluates the effect of anesthetic technique on a 30-day mortality after total hip or knee arthroplasty. All patients who had hip or knee arthroplasty between January 1, 2003, and December 31, 2014, were evaluated. The principal exposure was spinal versus general anesthesia. The primary outcome was 30-day mortality. Secondary outcomes were (1) perioperative myocardial infarction; (2) a composite of major adverse cardiac events that includes cardiac arrest, myocardial infarction, or newly diagnosed arrhythmia; (3) pulmonary embolism; (4) major blood loss; (5) hospital length of stay; and (6) operating room procedure time. A propensity score-matched-pair analysis was performed using a nonparsimonious logistic regression model of regional anesthetic use. We identified 10,868 patients, of whom 8,553 had spinal anesthesia and 2,315 had general anesthesia. Ninety-two percent (n = 2,135) of the patients who had general anesthesia were matched to similar patients who did not have general anesthesia. In the matched cohort, the 30-day mortality rate was 0.19% (n = 4) in the spinal anesthesia group and 0.8% (n = 17) in the general anesthesia group (risk ratio, 0.42; 95% CI, 0.21 to 0.83; P = 0.0045). Spinal anesthesia was also associated with a shorter hospital length of stay (5.7 vs. 6.6 days; P < 0.001). The results of this observational, propensity score-matched cohort study suggest a strong association between spinal anesthesia and lower 30-day mortality, as well as a shorter hospital length of stay, after elective joint replacement surgery.

  17. An Investigation into the Relationships Between Cloze Test Scores and Informal Reading Inventory Scores of Fifth Grade Pupils.

    ERIC Educational Resources Information Center

    Walter, Richard Barry

    This study investigated the relationship between instructional level scores as determined by a cloze test and instructional level scores as determined by an informal reading inventory (IRI). Fifty male and 50 female subjects were randomly selected from the total fifth grade population of five schools chosen from a total of 22 midwestern elementary…

  18. Mitochondrial proteome remodelling in pressure overload-induced heart failure: the role of mitochondrial oxidative stress

    PubMed Central

    Dai, Dao-Fu; Hsieh, Edward J.; Liu, Yonggang; Chen, Tony; Beyer, Richard P.; Chin, Michael T.; MacCoss, Michael J.; Rabinovitch, Peter S.

    2012-01-01

    Aims We investigate the role of mitochondrial oxidative stress in mitochondrial proteome remodelling using mouse models of heart failure induced by pressure overload. Methods and results We demonstrate that mice overexpressing catalase targeted to mitochondria (mCAT) attenuate pressure overload-induced heart failure. An improved method of label-free unbiased analysis of the mitochondrial proteome was applied to the mouse model of heart failure induced by transverse aortic constriction (TAC). A total of 425 mitochondrial proteins were compared between wild-type and mCAT mice receiving TAC or sham surgery. The changes in the mitochondrial proteome in heart failure included decreased abundance of proteins involved in fatty acid metabolism, an increased abundance of proteins in glycolysis, apoptosis, mitochondrial unfolded protein response and proteolysis, transcription and translational control, and developmental processes as well as responses to stimuli. Overexpression of mCAT better preserved proteins involved in fatty acid metabolism and attenuated the increases in apoptotic and proteolytic enzymes. Interestingly, gene ontology analysis also showed that monosaccharide metabolic processes and protein folding/proteolysis were only overrepresented in mCAT but not in wild-type mice in response to TAC. Conclusion This is the first study to demonstrate that scavenging mitochondrial reactive oxygen species (ROS) by mCAT not only attenuates most of the mitochondrial proteome changes in heart failure, but also induces a subset of unique alterations. These changes represent processes that are adaptive to the increased work and metabolic requirements of pressure overload, but which are normally inhibited by overproduction of mitochondrial ROS. PMID:22012956

  19. Mitochondria-targeted catalase reduces abnormal APP processing, amyloid β production and BACE1 in a mouse model of Alzheimer's disease: implications for neuroprotection and lifespan extension.

    PubMed

    Mao, Peizhong; Manczak, Maria; Calkins, Marcus J; Truong, Quang; Reddy, Tejaswini P; Reddy, Arubala P; Shirendeb, Ulziibat; Lo, Herng-Hsiang; Rabinovitch, Peter S; Reddy, P Hemachandra

    2012-07-01

    The purpose of this study was to investigate the protective effects of the mitochondria-targeted antioxidant catalase (MCAT) and lifespan extension in mice that express amyloid beta (Aβ). Using immunoblotting and immunostaining analyses, we measured the production of full-length amyloid precursor protein (APP), soluble APPα, C-terminal fragments CTF99 and CTF83, monomeric and oligomeric Aβ, Aβ deposits and beta site amyloid precursor protein cleaving enzyme 1 (BACE1), in different stages of disease progression in MCAT/AβPP and AβPP mice. Using quantitative reverse transcriptase polymerase chain reaction and immunostaining analyses, we studied the expression of catalase, BACE1, the Alzheimer's disease (AD) markers, synaptophysin, APP, neprilysin, insulin-degrading enzyme and transthyretin in MCAT, AβPP, MCAT/AβPP and wild-type (WT) mice. Using the high pressure liquid chromatography analysis of 8-hydroxy-2-deoxyguanosine, we measured oxidative DNA damage in the cerebral cortical tissues from MCAT, AβPP, MCAT/AβPP and WT mice. We found that the AβPP transgenic mice that carried the human MCAT gene lived 5 months longer than did the AβPP mice. We also found that the overexpression of MCAT in the brain sections from the MCAT/AβPP transgenic mice significantly correlated with a reduction in the levels of full-length APP, CTF99, BACE1, Aβ levels (40 and 42), Aβ deposits and oxidative DNA damage relative to the brain sections from the AβPP mice. Interestingly, we found significantly increased levels of soluble APPα and CTF83 in the MCAT/AβPP mice, relative to the AβPP mice. These data provide direct evidence that oxidative stress plays a primary role in AD etiopathology and that in MCAT mice express Aβ, MCAT prevents abnormal APP processing, reduces Aβ levels and enhances Aβ-degrading enzymes in mice at different ages, corresponding to different stages of disease progression. These findings indicate that mitochondria-targeted molecules may be an

  20. Mitochondria-targeted catalase reduces abnormal APP processing, amyloid β production and BACE1 in a mouse model of Alzheimer's disease: implications for neuroprotection and lifespan extension

    PubMed Central

    Mao, Peizhong; Manczak, Maria; Calkins, Marcus J.; Truong, Quang; Reddy, Tejaswini P.; Reddy, Arubala P.; Shirendeb, Ulziibat; Lo, Herng-Hsiang; Rabinovitch, Peter S.; Reddy, P. Hemachandra

    2012-01-01

    The purpose of this study was to investigate the protective effects of the mitochondria-targeted antioxidant catalase (MCAT) and lifespan extension in mice that express amyloid beta (Aβ). Using immunoblotting and immunostaining analyses, we measured the production of full-length amyloid precursor protein (APP), soluble APPα, C-terminal fragments CTF99 and CTF83, monomeric and oligomeric Aβ, Aβ deposits and beta site amyloid precursor protein cleaving enzyme 1 (BACE1), in different stages of disease progression in MCAT/AβPP and AβPP mice. Using quantitative reverse transcriptase polymerase chain reaction and immunostaining analyses, we studied the expression of catalase, BACE1, the Alzheimer's disease (AD) markers, synaptophysin, APP, neprilysin, insulin-degrading enzyme and transthyretin in MCAT, AβPP, MCAT/AβPP and wild-type (WT) mice. Using the high pressure liquid chromatography analysis of 8-hydroxy-2-deoxyguanosine, we measured oxidative DNA damage in the cerebral cortical tissues from MCAT, AβPP, MCAT/AβPP and WT mice. We found that the AβPP transgenic mice that carried the human MCAT gene lived 5 months longer than did the AβPP mice. We also found that the overexpression of MCAT in the brain sections from the MCAT/AβPP transgenic mice significantly correlated with a reduction in the levels of full-length APP, CTF99, BACE1, Aβ levels (40 and 42), Aβ deposits and oxidative DNA damage relative to the brain sections from the AβPP mice. Interestingly, we found significantly increased levels of soluble APPα and CTF83 in the MCAT/AβPP mice, relative to the AβPP mice. These data provide direct evidence that oxidative stress plays a primary role in AD etiopathology and that in MCAT mice express Aβ, MCAT prevents abnormal APP processing, reduces Aβ levels and enhances Aβ-degrading enzymes in mice at different ages, corresponding to different stages of disease progression. These findings indicate that mitochondria-targeted molecules may be an

  1. The utility of the Total Neuropathy Score as an instrument to assess neuropathy severity in chronic kidney disease: A validation study.

    PubMed

    Issar, Tushar; Arnold, Ria; Kwai, Natalie C G; Pussell, Bruce A; Endre, Zoltan H; Poynten, Ann M; Kiernan, Matthew C; Krishnan, Arun V

    2018-05-01

    To demonstrate construct validity of the Total Neuropathy Score (TNS) in assessing peripheral neuropathy in subjects with chronic kidney disease (CKD). 113 subjects with CKD and 40 matched controls were assessed for peripheral neuropathy using the TNS. An exploratory factor analysis was conducted and internal consistency of the scale was evaluated using Cronbach's alpha. Construct validity of the TNS was tested by comparing scores between case and control groups. Factor analysis revealed valid item correlations and internal consistency of the TNS was good with a Cronbach's alpha of 0.897. Subjects with CKD scored significantly higher on the TNS (CKD: median, 6, interquartile range, 1-13; controls: median, 0, interquartile range, 0-1; p < 0.001). Subgroup analysis revealed construct validity was maintained for subjects with stages 3-5 CKD with and without diabetes. The TNS is a valid measure of peripheral neuropathy in patients with CKD. The TNS is the first neuropathy scale to be formally validated in patients with CKD. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  2. DoD Biometrics Collaboration Forum 25-27 Jan 2011. Event Report

    DTIC Science & Technology

    2011-03-01

    GS-15 Level Staffing Marine Corps Action Tracking System ( MCATS ) Entered Staffing 21 December 2010 HQ USMC Receiving Staff Comments GO...SES Level Staffing MCATS TBD HQ USMC Assistant Commandant of the TBD HQ USMC 2011 DoD Biometrics Collaboration Forum Event Report 13...O-6/GS-15 Staffing MCATS Late March 2011 HQ USMC GO/SES Staffing MCATS Early April 2011 HQ USMC ACMC Signature TBD HQ USMC USMC

  3. The ERICE-score: the new native cardiovascular score for the low-risk and aged Mediterranean population of Spain.

    PubMed

    Gabriel, Rafael; Brotons, Carlos; Tormo, M José; Segura, Antonio; Rigo, Fernando; Elosua, Roberto; Carbayo, Julio A; Gavrila, Diana; Moral, Irene; Tuomilehto, Jaakko; Muñiz, Javier

    2015-03-01

    In Spain, data based on large population-based cohorts adequate to provide an accurate prediction of cardiovascular risk have been scarce. Thus, calibration of the EuroSCORE and Framingham scores has been proposed and done for our population. The aim was to develop a native risk prediction score to accurately estimate the individual cardiovascular risk in the Spanish population. Seven Spanish population-based cohorts including middle-aged and elderly participants were assembled. There were 11800 people (6387 women) representing 107915 person-years of follow-up. A total of 1214 cardiovascular events were identified, of which 633 were fatal. Cox regression analyses were conducted to examine the contributions of the different variables to the 10-year total cardiovascular risk. Age was the strongest cardiovascular risk factor. High systolic blood pressure, diabetes mellitus and smoking were strong predictive factors. The contribution of serum total cholesterol was small. Antihypertensive treatment also had a significant impact on cardiovascular risk, greater in men than in women. The model showed a good discriminative power (C-statistic=0.789 in men and C=0.816 in women). Ten-year risk estimations are displayed graphically in risk charts separately for men and women. The ERICE is a new native cardiovascular risk score for the Spanish population derived from the background and contemporaneous risk of several Spanish cohorts. The ERICE score offers the direct and reliable estimation of total cardiovascular risk, taking in consideration the effect of diabetes mellitus and cardiovascular risk factor management. The ERICE score is a practical and useful tool for clinicians to estimate the total individual cardiovascular risk in Spain. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  4. Transgenic Mouse Model for Reducing Oxidative Damage in Bone

    NASA Technical Reports Server (NTRS)

    Schreurs, Ann-Sofie; Torres, S.; Truong, T.; Moyer, E. L.; Kumar, A.; Tahimic, Candice C. G.; Alwood, J. S.; Limoli, C. L.; Globus, R. K.

    2016-01-01

    Bone loss can occur due to many challenges such age, radiation, microgravity, and Reactive Oxygen Species (ROS) play a critical role in bone resorption by osteoclasts (Bartell et al. 2014). We hypothesize that suppression of excess ROS in skeletal cells, both osteoblasts and osteoclasts, regulates skeletal growth and remodeling. To test our hypothesis, we used transgenic mCAT mice which overexpress the human anti-oxidant catalase gene targeted to the mitochondria, the main site for endogenous ROS production. mCAT mice have a longer life-span than wildtype controls and have been used to study various age-related disorders. To stimulate remodeling, 16 week old mCAT mice or wildtype mice were exposed to treatment (hindlimb-unloading and total body-irradiation) or sham treatment conditions (control). Tissues were harvested 2 weeks later for skeletal analysis (microcomputed tomography), biochemical analysis (gene expression and oxidative damage measurements), and ex vivo bone marrow derived cell culture (osteoblastogenesis and osteoclastogenesis). mCAT mice expressed the transgene and displayed elevated catalase activity in skeletal tissue and marrow-derived osteoblasts and osteoclasts grown ex vivo. In addition, when challenged with treatment, bone tissues from wildtype mice showed elevated levels of malondialdehyde (MDA), indicating oxidative damage) whereas mCAT mice did not. Correlation analysis revealed that increased catalase activity significantly correlated with decreased MDA levels and that increased oxidative damage correlated with decreased percent bone volume (BVTV). In addition, ex-vivo cultured osteoblast colony growth correlated with catalase activity in the osteoblasts. Thus, we showed that these transgenic mice can be used as a model to study the relationship between markers of oxidative damage and skeletal properties. mCAT mice displayed reduced BVTV and trabecular number relative to wildtype mice, as well as increased structural model index in the

  5. Older medical students' performances at McGill University.

    PubMed

    Feil, D; Kristian, M; Mitchell, N

    1998-01-01

    To compare admission data and academic performances of medical students younger and older than 25, and to qualify older students' experiences and perceptions in medical school. The authors reviewed 1988-1991 data for applications to the McGill University Faculty of Medicine. Data included GPAs and MCAT scores, as well as ratings for reference letters, autobiographical statements, and interviews. For those same years, the authors measured students' academic performances in the preclinical and clinical years. The authors compared the data by students' age: "younger" students, aged 17 to 24; and "older" students, aged 25 and above. All enrolled students took the Derogatis Stress Profile, and the older students participated in focus groups. The older applicants had lower GPAs and MCAT scores, but higher interview and reference letter ratings. For older accepted students, basic science course scores were lower than those of younger students, but clinical scores did not differ significantly between the groups. The two groups had similar stress levels, although older students tested lower in driven behavior, relaxation potential, attitude posture, and hostility. In focus groups, the older students spoke of learning style differences, loss of social support, and loss of professional identity. Different scores in admission criteria suggest that McGill uses different standards to select older medical students. Older students admitted under different criteria, however, do just as well as do younger students by their clinical years. A broad-based study of admission criteria and outcomes for the older student population is warranted.

  6. Total Score Reliability in Large-Scale Writing Assessment.

    ERIC Educational Resources Information Center

    Bunch, Michael B.; Littlefair, Wendy

    A total of 2,000 essays written by 1,000 students was submitted to generalizability analyses for domain-referenced tests. Each student had written one essay on each of two prompts representing two models of discourse. Each essay was read by six readers and judged on a scale of from 1 to 4. No reader read essays from both prompts. Reader agreement…

  7. The Effect of Smoking on Thirty-Day Postoperative Complications After Total Joint Arthroplasty: A Propensity Score-Matched Analysis.

    PubMed

    Sahota, Shawn; Lovecchio, Francis; Harold, Ryan E; Beal, Matthew D; Manning, David W

    2018-01-01

    Total joint arthroplasty (TJA) is a highly successful treatment, but is burdensome to the national healthcare budget. National quality initiatives seek to reduce costly complications. Smoking's role in perioperative complication after TJA is less well known. This study aims to identify smoking's independent contribution to the risk of short-term complication after TJA. All patients undergoing primary TJA between 2011 and 2012 were selected from the American College of Surgeon's National Surgical Quality Improvement Program's database. Outcomes of interest included rates of readmission, reoperation, mortality, surgical complications, and medical complications. To eliminate confounders between smokers and nonsmokers, a propensity score was used to generate a 1:1 match between groups. A total of 1251 smokers undergoing TJA met inclusion criteria. Smokers in the combined total hip and knee arthroplasty cohort had higher 30-day readmission (4.8% vs 3.2%, P = .041), were more likely to have a surgical complication (odds ratio 1.84, 95% confidence interval 1.21-2.80), and had a higher rate of deep surgical site infection (SSI) (1.1% vs 0.2%, P = .007). Analysis of total hip arthroplasty only revealed that smokers had higher rates of deep SSI (1.3% vs 0.2%, P = .038) and higher readmission rate (4.3% vs 2.2%, P = .034). Analysis of total knee arthroplasty only revealed greater surgical complications (2.8% vs 1.2%, P = .048) and superficial SSI (1.8% vs 0.2%, P = .002) in smokers. Smoking in TJA is associated with higher rates of SSI, surgical complications, and readmission. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Harnessing Macroscopic Forces in Catalysis

    DTIC Science & Technology

    2009-11-09

    Figure 1. Schematic representation of biasing reaction selectivity via mechanocatalysis. A catalyst, “ mcat ”, is embedded in an elastomeric support...Deformation of the elastomeric support transfers mechanical stress to mcat . Under stress-free conditions, mcat catalyzes the transformation of reactant

  9. Impact of totally laparoscopic combined management of colorectal cancer with synchronous hepatic metastases on severity of complications: a propensity-score-based analysis.

    PubMed

    Ratti, Francesca; Catena, Marco; Di Palo, Saverio; Staudacher, Carlo; Aldrighetti, Luca

    2016-11-01

    Thanks to widespread diffusion of minimally invasive approach in the setting of both colorectal and hepatic surgeries, the interest in combined resections for colorectal cancer and synchronous liver metastases (SCLM) by totally laparoscopic approach (TLA) has increased. Aim of this study was to compare outcome of combined resections for SCLM performed by TLA or by open approach, in a propensity-score-based study. All 25 patients undergoing combined TLA for SCLM at San Raffaele Hospital in Milano were compared in a case-matched analysis with 25 out of 91 patients undergoing totally open approach (TOA group). Groups were matched with 1:2 ratio using propensity scores based on covariates representing disease severity. Main endpoints were postoperative morbidity and long-term outcome. The Modified Accordion Severity Grading System was used to quantify complications. The groups resulted comparable in terms of patients and disease characteristics. The TLA group, as compared to the TOA group, had lower blood loss (350 vs 600 mL), shorter postoperative stay (9 vs 12 days), lower postoperative morbidity index (0.14 vs 0.20) and severity score for complicated patients (0.60 vs 0.85). Colonic anastomosis leakage had the highest fractional complication burden in both groups. In spite of comparable long-term overall survival, the TLA group had better recurrence-free survival. TLA for combined resections is feasible, and its indications can be widened to encompass a larger population of patients, provided its benefits in terms of reduced overall risk and severity of complications, rapid functional recovery and favorable long-term outcomes.

  10. Stringently Defined Otitis Prone Children Demonstrate Deficient Naturally Induced Mucosal Antibody Response to Moraxella catarrhalis Proteins

    PubMed Central

    Ren, Dabin; Murphy, Timothy F.; Lafontaine, Eric R.; Pichichero, Michael E.

    2017-01-01

    Moraxella catarrhalis (Mcat) is a prominent mucosal pathogen causing acute otitis media (AOM). We studied Mcat nasopharyngeal (NP) colonization, AOM frequency and mucosal antibody responses to four vaccine candidate Mcat proteins: outer membrane protein (OMP) CD, oligopeptide permease (Opp) A, hemagglutinin (Hag), and Pilin A clade 2 (PilA2) from stringently defined otitis prone (sOP) children, who experience the greatest burden of disease, compared to non-otitis prone (NOP) children. sOP children had higher NP colonization of Mcat (30 vs. 22%, P = 0.0003) and Mcat-caused AOM rates (49 vs. 24%, P < 0.0001) than NOP children. Natural acquisition of mucosal antibodies to Mcat proteins OMP CD (IgG, P < 0.0001), OppA (IgG, P = 0.018), Hag (IgG and IgA, both P < 0.0001), and PilA2 (IgA, P < 0.0001) was lower in sOP than NOP children. Higher levels of mucosal IgG to Hag (P = 0.039) and PilA2 (P = 0.0076), and IgA to OMP CD (P = 0.010), OppA (P = 0.030), and PilA2 (P = 0.043) were associated with lower carriage of Mcat in NOP but not sOP children. Higher levels of mucosal IgG to OMP CD (P = 0.0070) and Hag (P = 0.0003), and IgA to Hag (P = 0.0067) at asymptomatic colonization than those at onset of AOM were associated with significantly lower rate of Mcat NP colonization progressing to AOM in NOP compared to sOP children (3 vs. 26%, P < 0.0001). In conclusion, sOP children had a diminished mucosal antibody response to Mcat proteins, which was associated with higher frequencies of asymptomatic NP colonization and NP colonization progressing to Mcat-caused AOM. Enhancing Mcat antigen-specific mucosal immune responses to levels higher than achieved by natural exposure will be necessary to prevent AOM in sOP children. PMID:28848555

  11. Rasch-Transformed Total Neuropathy Score clinical version (RT-TNSc(©) ) in patients with chemotherapy-induced peripheral neuropathy.

    PubMed

    Binda, Davide; Cavaletti, Guido; Cornblath, David R; Merkies, Ingemar S J

    2015-09-01

    Composite scales such as the Total Neuropathy Score clinical version (TNSc(©) ) have been widely used to measure neurological impairment in a standardized manner but they have been criticized due to their ordinal setting having no fixed unit. This study aims to improve impairment assessment in patients with chemotherapy-induced peripheral neuropathy (CIPN) by subjecting TNSc(©) records to Rasch analyses. In particular, we wanted to investigate the influence of factors affecting the use of the TNSc(©) in clinical practice. TNSc(©) has 7 domains (sensory, motor, autonomic, pin-prick, vibration, strength, and deep tendon reflexes [DTR]) each being scored 0-4. Data obtained in 281 patients with stable CIPN were subjected to Rasch analyses to determine the fit to the model. The TNSc(©) did not meet Rasch model's expectations primarily because of misfit statistics in autonomic and DTR domains. Removing these two, acceptable model fit and uni-dimensionality were obtained. However, disordered thresholds (vibration and strength) and item bias (mainly cultural) were still seen, but these findings were kept to balance the assessment range of the Rasch-Transformed TNSc(©) (RT-TNSc(©) ). Acceptable reliability findings were also obtained. A 5-domains RT-TNSc(©) may be a more proper assessment tool in patients with CIPN. Future studies are needed to examine its responsive properties. © 2015 Peripheral Nerve Society.

  12. Mitochondrial-Targeted Catalase Protects Against High-Fat Diet-Induced Muscle Insulin Resistance by Decreasing Intramuscular Lipid Accumulation.

    PubMed

    Lee, Hui-Young; Lee, Jae Sung; Alves, Tiago; Ladiges, Warren; Rabinovitch, Peter S; Jurczak, Michael J; Choi, Cheol Soo; Shulman, Gerald I; Samuel, Varman T

    2017-08-01

    We explored the role of reactive oxygen species (ROS) in the pathogenesis of muscle insulin resistance. We assessed insulin action in vivo with a hyperinsulinemic-euglycemic clamp in mice expressing a mitochondrial-targeted catalase (MCAT) that were fed regular chow (RC) or a high-fat diet (HFD) or underwent an acute infusion of a lipid emulsion. RC-fed MCAT mice were similar to littermate wild-type (WT) mice. However, HFD-fed MCAT mice were protected from diet-induced insulin resistance. In contrast, an acute lipid infusion caused muscle insulin resistance in both MCAT and WT mice. ROS production was decreased in both HFD-fed and lipid-infused MCAT mice and cannot explain the divergent response in insulin action. MCAT mice had subtly increased energy expenditure and muscle fat oxidation with decreased intramuscular diacylglycerol (DAG) accumulation, protein kinase C-θ (PKCθ) activation, and impaired insulin signaling with HFD. In contrast, the insulin resistance with the acute lipid infusion was associated with increased muscle DAG content in both WT and MCAT mice. These studies suggest that altering muscle mitochondrial ROS production does not directly alter the development of lipid-induced insulin resistance. However, the altered energy balance in HFD-fed MCAT mice protected them from DAG accumulation, PKCθ activation, and impaired muscle insulin signaling. © 2017 by the American Diabetes Association.

  13. An eight-year study of online lecture use in a medical gross anatomy and embryology course.

    PubMed

    Nieder, Gary L; Borges, Nicole J

    2012-01-01

    Online lectures have been used in lieu of live lectures in our gross anatomy and embryology course for the past eight years. We examined patterns of online lecture use by our students and related that use to academic entry measures, gender and examination performance. Detailed access records identified by student were available from server logs. Total views per page of lecture material increased over the first six years, then decreased markedly between years seven and eight, possibly due to the recent availability of alternate forms of lecture audio. Lecture use peaked in midafternoon and again in the evening, although some use was seen at all hours. Usage was highest at midweek and lowest on Fridays as might be expected. Individual student's use varied widely from rates equivalent to less than one viewing/page to more than three viewings per page. Overall use by male students was greater than that of females and gender-specific differences in the daily pattern were seen. Lecture use was correlated to the Medical College Admission Test(®) (MCAT(®)) Verbal Reasoning and Physical Sciences scores but not to composite MCAT scores or undergraduate grade point average. Overall use appeared to be driven by scheduled team-based learning (TBL) sessions and major examinations. Specific subsets of lecture material were most often viewed before related TBL sessions and again during review for examinations. A small but significant correlation between lecture use and examination and course performance was seen, specifically in the male student population. These findings, along with earlier observations, suggest that varied use of online lectures is attributable to multiple factors. Copyright © 2012 American Association of Anatomists.

  14. Mitochondrial targeted catalase suppresses invasive breast cancer in mice.

    PubMed

    Goh, Jorming; Enns, Linda; Fatemie, Soroosh; Hopkins, Heather; Morton, John; Pettan-Brewer, Christina; Ladiges, Warren

    2011-05-23

    Treatment of invasive breast cancer has an alarmingly high rate of failure because effective targets have not been identified. One potential target is mitochondrial generated reactive oxygen species (ROS) because ROS production has been associated with changes in substrate metabolism and lower concentration of anti-oxidant enzymes in tumor and stromal cells and increased metastatic potential. Transgenic mice expressing a human catalase gene (mCAT) were crossed with MMTV-PyMT transgenic mice that develop metastatic breast cancer. All mice (33 mCAT positive and 23 mCAT negative) were terminated at 110 days of age, when tumors were well advanced. Tumors were histologically assessed for invasiveness, proliferation and metastatic foci in the lungs. ROS levels and activation status of p38 MAPK were determined. PyMT mice expressing mCAT had a 12.5 per cent incidence of high histological grade primary tumor invasiveness compared to a 62.5 per cent incidence in PyMT mice without mCAT. The histological grade correlated with incidence of metastasis with 56 per cent of PyMT mice positive for mCAT showing evidence of pulmonary metastasis compared to 85.4 per cent of PyMT mice negative for mCAT with pulmonary metastasis (p ≤ 0.05). PyMT tumor cells expressing mCAT had lower ROS levels and were more resistant to hydrogen peroxide-induced oxidative stress than wild type tumor cells, suggesting that mCAT has the potential of quenching intracellular ROS and subsequent invasive behavior. The metastatic tumor burden in PyMT mice expressing mCAT was 0.1 mm2/cm2 of lung tissue compared with 1.3 mm2/cm2 of lung tissue in PyMT mice expressing the wild type allele (p ≤ 0.01), indicating that mCAT could play a role in mitigating metastatic tumor progression at a distant organ site. Expression of mCAT in the lungs increased resistance to hydrogen peroxide-induced oxidative stress that was associated with decreased activation of p38MAPK suggesting ROS signaling is dependent on p38MAPK for

  15. Local Infiltration Analgesia With Liposomal Bupivacaine Improves Pain Scores and Reduces Opioid Use After Total Knee Arthroplasty: Results of a Randomized Controlled Trial.

    PubMed

    Mont, Michael A; Beaver, Walter B; Dysart, Stanley H; Barrington, John W; Del Gaizo, Daniel J

    2018-01-01

    Local infiltration analgesia (LIA) with liposomal bupivacaine (LB) in patients undergoing total knee arthroplasty (TKA) has yielded mixed results. The PILLAR study, which was designed to minimize limitations associated with previous studies, compared the effects of LIA with or without LB on pain scores, opioid consumption, including proportion of opioid-free patients, time to first opioid rescue, and safety after primary unilateral TKA. Patients (N = 140) were randomized to LIA with LB 266 mg/20 mL (admixed with bupivacaine HCl 0.5%, 20 mL) or LIA with bupivacaine HCl 0.5%, 20 mL. Standardized infiltration techniques and a standardized multimodal pain management protocol were used. The coprimary efficacy endpoints were area under the curve (AUC) of visual analog scale pain intensity scores 12-48 hours (AUC 12-48 ) postsurgery and total opioid consumption 0-48 hours postsurgery. Mean AUC 12-48 of visual analog scale pain intensity score was 180.8 with LB and 209.3 without LB (least squares [LS] mean treatment difference -26.88, P = .0381). LS mean total opioid consumption 0-48 hours postsurgery was 18.7 mg with and 84.9 mg without LB (LS ratio 0.220, P = .0048). Significant differences in favor of LB were observed for the percentage of opioid-free patients (P < .01) and time to first opioid rescue (P = .0230). Treatments were similarly well tolerated. This study provides data on LIA with LB administered using optimal techniques specific to TKA. In this setting, LIA with LB significantly improved postsurgical pain, opioid consumption, and time to first opioid rescue, with more opioid-free patients and no unexpected safety concerns. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Complex versus Simple Modeling for DIF Detection: When the Intraclass Correlation Coefficient (?) of the Studied Item Is Less Than the ? of the Total Score

    ERIC Educational Resources Information Center

    Jin, Ying; Myers, Nicholas D.; Ahn, Soyeon

    2014-01-01

    Previous research has demonstrated that differential item functioning (DIF) methods that do not account for multilevel data structure could result in too frequent rejection of the null hypothesis (i.e., no DIF) when the intraclass correlation coefficient (?) of the studied item was the same as the ? of the total score. The current study extended…

  17. Stringently Defined Otitis Prone Children Demonstrate Deficient Naturally Induced Mucosal Antibody Response to Moraxella catarrhalis Proteins.

    PubMed

    Ren, Dabin; Murphy, Timothy F; Lafontaine, Eric R; Pichichero, Michael E

    2017-01-01

    Moraxella catarrhalis ( Mcat ) is a prominent mucosal pathogen causing acute otitis media (AOM). We studied Mcat nasopharyngeal (NP) colonization, AOM frequency and mucosal antibody responses to four vaccine candidate Mcat proteins: outer membrane protein (OMP) CD, oligopeptide permease (Opp) A, hemagglutinin (Hag), and Pilin A clade 2 (PilA2) from stringently defined otitis prone (sOP) children, who experience the greatest burden of disease, compared to non-otitis prone (NOP) children. sOP children had higher NP colonization of Mcat (30 vs. 22%, P  = 0.0003) and Mcat -caused AOM rates (49 vs. 24%, P  < 0.0001) than NOP children. Natural acquisition of mucosal antibodies to Mcat proteins OMP CD (IgG, P  < 0.0001), OppA (IgG, P  = 0.018), Hag (IgG and IgA, both P  < 0.0001), and PilA2 (IgA, P  < 0.0001) was lower in sOP than NOP children. Higher levels of mucosal IgG to Hag ( P  = 0.039) and PilA2 ( P  = 0.0076), and IgA to OMP CD ( P  = 0.010), OppA ( P  = 0.030), and PilA2 ( P  = 0.043) were associated with lower carriage of Mcat in NOP but not sOP children. Higher levels of mucosal IgG to OMP CD ( P  = 0.0070) and Hag ( P  = 0.0003), and IgA to Hag ( P  = 0.0067) at asymptomatic colonization than those at onset of AOM were associated with significantly lower rate of Mcat NP colonization progressing to AOM in NOP compared to sOP children (3 vs. 26%, P  < 0.0001). In conclusion, sOP children had a diminished mucosal antibody response to Mcat proteins, which was associated with higher frequencies of asymptomatic NP colonization and NP colonization progressing to Mcat -caused AOM. Enhancing Mcat antigen-specific mucosal immune responses to levels higher than achieved by natural exposure will be necessary to prevent AOM in sOP children.

  18. Clinical risk scoring for predicting non-alcoholic fatty liver disease in metabolic syndrome patients (NAFLD-MS score).

    PubMed

    Saokaew, Surasak; Kanchanasuwan, Shada; Apisarnthanarak, Piyaporn; Charoensak, Aphinya; Charatcharoenwitthaya, Phunchai; Phisalprapa, Pochamana; Chaiyakunapruk, Nathorn

    2017-10-01

    Non-alcoholic fatty liver disease (NAFLD) can progress from simple steatosis to hepatocellular carcinoma. None of tools have been developed specifically for high-risk patients. This study aimed to develop a simple risk scoring to predict NAFLD in patients with metabolic syndrome (MetS). A total of 509 patients with MetS were recruited. All were diagnosed by clinicians with ultrasonography-confirmed whether they were patients with NAFLD. Patients were randomly divided into derivation (n=400) and validation (n=109) cohort. To develop the risk score, clinical risk indicators measured at the time of recruitment were built by logistic regression. Regression coefficients were transformed into item scores and added up to a total score. A risk scoring scheme was developed from clinical predictors: BMI ≥25, AST/ALT ≥1, ALT ≥40, type 2 diabetes mellitus and central obesity. The scoring scheme was applied in validation cohort to test the performance. The scheme explained, by area under the receiver operating characteristic curve (AuROC), 76.8% of being NAFLD with good calibration (Hosmer-Lemeshow χ 2 =4.35; P=.629). The positive likelihood ratio of NAFLD in patients with low risk (scores below 3) and high risk (scores 5 and over) were 2.32 (95% CI: 1.90-2.82) and 7.77 (95% CI: 2.47-24.47) respectively. When applied in validation cohort, the score showed good performance with AuROC 76.7%, and illustrated 84%, and 100% certainty in low- and high-risk groups respectively. A simple and non-invasive scoring scheme of five predictors provides good prediction indices for NAFLD in MetS patients. This scheme may help clinicians in order to take further appropriate action. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Examining Critical Thinking Skills in Family Medicine Residents.

    PubMed

    Ross, David; Schipper, Shirley; Westbury, Chris; Linh Banh, Hoan; Loeffler, Kim; Allan, G Michael; Ross, Shelley

    2016-02-01

    Our objective was to determine the relationship between critical thinking skills and objective measures of academic success in a family medicine residency program. This prospective observational cohort study was set in a large Canadian family medicine residency program. Intervention was the California Critical Thinking Skills Test (CCTST), administered at three points in residency: upon entry, at mid-point, and at graduation. Results from the CCTST, Canadian Residency Matching Service file, and interview scores were compared to other measures of academic performance (Medical Colleges Admission Test [MCAT] and College of Family Physicians of Canada [CCFP] certification examination results). For participants (n=60), significant positive correlations were found between critical thinking skills and performance on tests of knowledge. For the MCAT, CCTST scores correlated positively with full scores (n=24, r=0.57) as well as with each section score (verbal reasoning: r=0.59; physical sciences: r=0.64; biological sciences: r=0.54). For CCFP examination, CCTST correlated reliably with both sections (n=49, orals: r=0.34; short answer: r=0.47). Additionally, CCTST was a better predictor of performance on the CCFP exam than was the interview score at selection into the residency program (Fisher's r-to-z test, z=2.25). Success on a critical thinking skills exam was found to predict success on family medicine certification examinations. Given that critical thinking skills appear to be stable throughout residency training, including an assessment of critical thinking in the selection process may help identify applicants more likely to be successful on final certification exam.

  20. Mitochondrial-targeted catalase is good for the old mouse proteome, but not for the young: 'reverse' antagonistic pleiotropy?

    PubMed

    Basisty, Nathan; Dai, Dao-Fu; Gagnidze, Arni; Gitari, Lemuel; Fredrickson, Jeanne; Maina, Yvonne; Beyer, Richard P; Emond, Mary J; Hsieh, Edward J; MacCoss, Michael J; Martin, George M; Rabinovitch, Peter S

    2016-08-01

    Reactive oxygen species (ROS) are highly reactive oxygen-containing molecules associated with aging and a broad spectrum of pathologies. We have previously shown that transgenic expression of the antioxidant enzyme catalase targeted to the mitochondria (mCAT) in mice reduces ROS, attenuates age-related disease, and increases lifespan. However, it has been increasingly recognized that ROS also has beneficial roles in signaling, hormesis, stress response, and immunity. We therefore hypothesized that mCAT might be beneficial only when ROS approaches pathological levels in older age and might not be advantageous at a younger age when basal ROS is low. We analyzed abundance and turnover of the global proteome in hearts and livers of young (4 month) and old (20 month) mCAT and wild-type (WT) mice. In old hearts and livers of WT mice, protein half-lives were reduced compared to young, while in mCAT mice the reverse was observed; the longest half-lives were seen in old mCAT mice and the shortest in young mCAT. Protein abundance of old mCAT hearts recapitulated a more youthful proteomic expression profile (P-value < 0.01). However, young mCAT mice partially phenocopied the older wild-type proteome (P-value < 0.01). Age strongly interacts with mCAT, consistent with antagonistic pleiotropy in the reverse of the typical direction. These findings underscore the contrasting roles of ROS in young vs. old mice and indicate the need for better understanding of the interaction between dose and age in assessing the efficacy of therapeutic interventions in aging, including mitochondrial antioxidants. © 2016 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

  1. Quantitative structure-activity relationship analysis of the pharmacology of para-substituted methcathinone analogues.

    PubMed

    Bonano, J S; Banks, M L; Kolanos, R; Sakloth, F; Barnier, M L; Glennon, R A; Cozzi, N V; Partilla, J S; Baumann, M H; Negus, S S

    2015-05-01

    Methcathinone (MCAT) is a potent monoamine releaser and parent compound to emerging drugs of abuse including mephedrone (4-CH3 MCAT), the para-methyl analogue of MCAT. This study examined quantitative structure-activity relationships (QSAR) for MCAT and six para-substituted MCAT analogues on (a) in vitro potency to promote monoamine release via dopamine and serotonin transporters (DAT and SERT, respectively), and (b) in vivo modulation of intracranial self-stimulation (ICSS), a behavioural procedure used to evaluate abuse potential. Neurochemical and behavioural effects were correlated with steric (Es ), electronic (σp ) and lipophilic (πp ) parameters of the para substituents. For neurochemical studies, drug effects on monoamine release through DAT and SERT were evaluated in rat brain synaptosomes. For behavioural studies, drug effects were tested in male Sprague-Dawley rats implanted with electrodes targeting the medial forebrain bundle and trained to lever-press for electrical brain stimulation. MCAT and all six para-substituted analogues increased monoamine release via DAT and SERT and dose- and time-dependently modulated ICSS. In vitro selectivity for DAT versus SERT correlated with in vivo efficacy to produce abuse-related ICSS facilitation. In addition, the Es values of the para substituents correlated with both selectivity for DAT versus SERT and magnitude of ICSS facilitation. Selectivity for DAT versus SERT in vitro is a key determinant of abuse-related ICSS facilitation by these MCAT analogues, and steric aspects of the para substituent of the MCAT scaffold (indicated by Es ) are key determinants of this selectivity. © 2014 The British Pharmacological Society.

  2. Quantitative structure–activity relationship analysis of the pharmacology of para-substituted methcathinone analogues

    PubMed Central

    Bonano, J S; Banks, M L; Kolanos, R; Sakloth, F; Barnier, M L; Glennon, R A; Cozzi, N V; Partilla, J S; Baumann, M H; Negus, S S

    2015-01-01

    Background and Purpose Methcathinone (MCAT) is a potent monoamine releaser and parent compound to emerging drugs of abuse including mephedrone (4-CH3 MCAT), the para-methyl analogue of MCAT. This study examined quantitative structure–activity relationships (QSAR) for MCAT and six para-substituted MCAT analogues on (a) in vitro potency to promote monoamine release via dopamine and serotonin transporters (DAT and SERT, respectively), and (b) in vivo modulation of intracranial self-stimulation (ICSS), a behavioural procedure used to evaluate abuse potential. Neurochemical and behavioural effects were correlated with steric (Es), electronic (σp) and lipophilic (πp) parameters of the para substituents. Experimental Approach For neurochemical studies, drug effects on monoamine release through DAT and SERT were evaluated in rat brain synaptosomes. For behavioural studies, drug effects were tested in male Sprague-Dawley rats implanted with electrodes targeting the medial forebrain bundle and trained to lever-press for electrical brain stimulation. Key Results MCAT and all six para-substituted analogues increased monoamine release via DAT and SERT and dose- and time-dependently modulated ICSS. In vitro selectivity for DAT versus SERT correlated with in vivo efficacy to produce abuse-related ICSS facilitation. In addition, the Es values of the para substituents correlated with both selectivity for DAT versus SERT and magnitude of ICSS facilitation. Conclusions and Implications Selectivity for DAT versus SERT in vitro is a key determinant of abuse-related ICSS facilitation by these MCAT analogues, and steric aspects of the para substituent of the MCAT scaffold (indicated by Es) are key determinants of this selectivity. PMID:25438806

  3. Can computer assistance improve the clinical and functional scores in total knee arthroplasty?

    PubMed

    Hernández-Vaquero, Daniel; Suarez-Vazquez, Abelardo; Iglesias-Fernandez, Susana

    2011-12-01

    Surgical navigation in TKA facilitates better alignment; however, it is unclear whether improved alignment alters clinical evolution and midterm and long-term complication rates. We determined the alignment differences between patients with standard, manual, jig-based TKAs and patients with navigation-based TKAs, and whether any differences would modify function, implant survival, and/or complications. We retrospectively reviewed 97 patients (100 TKAs) undergoing TKAs for minimal preoperative deformities. Fifty TKAs were performed with an image-free surgical navigation system and the other 50 with a standard technique. We compared femoral angle (FA), tibial angle (TA), and femorotibial angle (FTA) and determined whether any differences altered clinical or functional scores, as measured by the Knee Society Score (KSS), or complications. Seventy-three patients (75 TKAs) had a minimum followup of 8 years (mean, 8.3 years; range, 8-9.1 years). All patients included in the surgical navigation group had a FTA between 177° and 182º. We found no differences in the KSS or implant survival between the two groups and no differences in complication rates, although more complications occurred in the standard technique group (seven compared with two in the surgical navigation group). In the midterm, we found no difference in functional and clinical scores or implant survival between TKAs performed with and without the assistance of a navigation system. Level II, therapeutic study. See the Guidelines online for a complete description of levels of evidence.

  4. Diet Quality Scores of Australian Adults Who Have Completed the Healthy Eating Quiz.

    PubMed

    Williams, Rebecca L; Rollo, Megan E; Schumacher, Tracy; Collins, Clare E

    2017-08-15

    Higher scores obtained using diet quality and variety indices are indicators of more optimal food and nutrient intakes and lower chronic disease risk. The aim of this paper is to describe the overall diet quality and variety in a sample of Australian adults who completed an online diet quality self-assessment tool, the Healthy Eating Quiz. The Healthy Eating Quiz takes approximately five minutes to complete online and computes user responses into a total diet quality score (out of a maximum of 73 points) and then categorizes them into the following groups: 'needs work' (<33), 'getting there' (33-38), 'excellent' (39-46), or 'outstanding' (47+). There was a total of 93,252 first-time respondents, of which 76% were female. Over 80% of respondents were between 16-44 years of age. The mean total score was 34.1 ± 9.7 points. Females had a higher total score than males ( p < 0.001) and vegetarians had higher total scores than non-vegetarians ( p < 0.001). Healthy eating quiz scores were higher in those aged 45-75 years compared to 16-44 years ( p < 0.001). When comparing Socioeconomic Indices for Areas deciles, those most disadvantaged had a lower total score than those least disadvantaged ( p < 0.001). Repeat measures showed that those who scored lowest (needs work) in their first completion increased their total score by 3.2 ± 7.4 at their second completion ( p < 0.001). While the Healthy Eating Quiz data indicates that individuals receiving feedback on how to improve their score can improve their diet quality, there is a need for further nutrition promotion interventions in Australian adults.

  5. Mitochondrial targeted catalase suppresses invasive breast cancer in mice

    PubMed Central

    2011-01-01

    Background Treatment of invasive breast cancer has an alarmingly high rate of failure because effective targets have not been identified. One potential target is mitochondrial generated reactive oxygen species (ROS) because ROS production has been associated with changes in substrate metabolism and lower concentration of anti-oxidant enzymes in tumor and stromal cells and increased metastatic potential. Methods Transgenic mice expressing a human catalase gene (mCAT) were crossed with MMTV-PyMT transgenic mice that develop metastatic breast cancer. All mice (33 mCAT positive and 23 mCAT negative) were terminated at 110 days of age, when tumors were well advanced. Tumors were histologically assessed for invasiveness, proliferation and metastatic foci in the lungs. ROS levels and activation status of p38 MAPK were determined. Results PyMT mice expressing mCAT had a 12.5 per cent incidence of high histological grade primary tumor invasiveness compared to a 62.5 per cent incidence in PyMT mice without mCAT. The histological grade correlated with incidence of metastasis with 56 per cent of PyMT mice positive for mCAT showing evidence of pulmonary metastasis compared to 85.4 per cent of PyMT mice negative for mCAT with pulmonary metastasis (p ≤ 0.05). PyMT tumor cells expressing mCAT had lower ROS levels and were more resistant to hydrogen peroxide-induced oxidative stress than wild type tumor cells, suggesting that mCAT has the potential of quenching intracellular ROS and subsequent invasive behavior. The metastatic tumor burden in PyMT mice expressing mCAT was 0.1 mm2/cm2 of lung tissue compared with 1.3 mm2/cm2 of lung tissue in PyMT mice expressing the wild type allele (p ≤ 0.01), indicating that mCAT could play a role in mitigating metastatic tumor progression at a distant organ site. Expression of mCAT in the lungs increased resistance to hydrogen peroxide-induced oxidative stress that was associated with decreased activation of p38MAPK suggesting ROS signaling

  6. An interim report on the MCAT Essay Pilot Project.

    PubMed

    Koenig, J A; Mitchell, K J

    1988-01-01

    Results from four pilot administrations of the Medical College Admission Test essay question are reported. Analyses focused on (a) the performance characteristics of sample groups differentiated by gender, size of hometown, race/ethnicity, and dominant language; (b) the relationships between essay scores and academic/demographic characteristics; and (c) the reliability of one 45-minute versus two 30-minute essays. No differences were found for examinees grouped by gender and size of home community. Mean differences among the racial/ethnic groups were explained largely by reading level differences. Differences in essay performance by language group were large and unexplained by reading level differences. No relationship was found between the essay score and the academic/demographic characteristics. Reliability estimates for two 30-minute essays were higher than for one 45-minute essay; however, the 30-minute period yielded writing of poorer quality. Test-retest reliabilities for the 45-minute topics will remain the focus of future studies as will performance by examinees for whom English is a second language. The impact of the essay on the selection process will also be assessed.

  7. Test-retest reliability at the item level and total score level of the Norwegian version of the Spinal Cord Injury Falls Concern Scale (SCI-FCS).

    PubMed

    Roaldsen, Kirsti Skavberg; Måøy, Åsa Blad; Jørgensen, Vivien; Stanghelle, Johan Kvalvik

    2016-05-01

    Translation of the Spinal Cord Injury Falls Concern Scale (SCI-FCS), and investigation of test-retest reliability on item-level and total-score-level. Translation, adaptation and test-retest study. A specialized rehabilitation setting in Norway. Fifty-four wheelchair users with a spinal cord injury. The median age of the cohort was 49 years, and the median number of years after injury was 13. Interventions/measurements: The SCI-FCS was translated and back-translated according to guidelines. Individuals answered the SCI-FCS twice over the course of one week. We investigated item-level test-retest reliability using Svensson's rank-based statistical method for disagreement analysis of paired ordinal data. For relative reliability, we analyzed the total-score-level test-retest reliability with intraclass correlation coefficients (ICC2.1), the standard error of measurement (SEM), and the smallest detectable change (SDC) for absolute reliability/measurement-error assessment and Cronbach's alpha for internal consistency. All items showed satisfactory percentage agreement (≥69%) between test and retest. There were small but non-negligible systematic disagreements among three items; we recovered an 11-13% higher chance for a lower second score. There was no disagreement due to random variance. The test-retest agreement (ICC2.1) was excellent (0.83). The SEM was 2.6 (12%), and the SDC was 7.1 (32%). The Cronbach's alpha was high (0.88). The Norwegian SCI-FCS is highly reliable for wheelchair users with chronic spinal cord injuries.

  8. A social and academic enrichment program promotes medical school matriculation and graduation for disadvantaged students.

    PubMed

    Keith, L; Hollar, D

    2012-07-01

    This study assessed the impact of a pre-medical pipeline program on successful completion of medical school and the capacity of this program to address achievement gaps experienced by disadvantaged students. The University of North Carolina (USA) Medical Education Development (MED) program provides intensive academic and test skills preparation for admission to medical, dental, and other allied health professions schools. This retrospective study evaluated the academic progress of a longitudinal sample of 1738 disadvantaged college students who completed MED between 1974 and 2001. Data sources included MED participant data, medical school admissions data for the host school, aggregate data from the Association of American Medical Colleges (AAMC), and individual MED participant data from AAMC. Methods of analysis utilized Chi-square, independent samples t test, and logistic regression to examine associations between factors. Of the 935 students in MED from 1974 to 2001, who had indicated an interest in medical school, 887 (94.9%) successfully matriculated and 801 (85.7%) successfully earned the MD degree. Using logistic regression, factors that were significantly correlated with earning the medical degree included the student's race, college undergraduate total and science grade point averages, with Hispanic, African American, and Native American participants earning the medical degree at rates comparable to Caucasian participants. MED students successfully earned the MD degree despite having significantly lower Medical College Admissions Test (MCAT) scores and undergraduate grade point averages compared to all United States medical school applicants: MCAT scores had little relationship with student's success. These findings suggest that an intensive, nine-week, pre-medical academic enrichment program that incorporates confidence-building and small-group tutoring and peer support activities can build a foundation on which disadvantaged students can successfully earn

  9. Coronary Risk Factor Scoring as a Guide for Counseling

    NASA Technical Reports Server (NTRS)

    Fleck, R. L.

    1971-01-01

    A risk factor scoring system for early detection, possible prediction, and counseling to coronary heart disease patients is discussed. Scoring data include dynamic EKG, cholesterol levels, triglycerine content, total lipid level, total phospolipid levels, and electrophoretic patterns. Results indicate such a system is effective in identifying high risk subjects, but that the ability to predict exceeds the ability to prevent heart disease or its complications.

  10. Treatment of multiple adjacent Miller class I and II gingival recessions with a Modified Coronally Advanced Tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: a randomized, controlled clinical trial.

    PubMed

    Aroca, Sofia; Molnár, Bálint; Windisch, Péter; Gera, István; Salvi, Giovanni E; Nikolidakis, Dimitris; Sculean, Anton

    2013-07-01

    A newly developed collagen matrix (CM) of porcine origin has been shown to represent a potential alternative to palatal connective tissue grafts (CTG) for the treatment of single Miller Class I and II gingival recessions when used in conjunction with a coronally advanced flap (CAF). However, at present it remains unknown to what extent CM may represent a valuable alternative to CTG in the treatment of Miller Class I and II multiple adjacent gingival recessions (MAGR). The aim of this study was to compare the clinical outcomes following treatment of Miller Class I and II MAGR using the modified coronally advanced tunnel technique (MCAT) in conjunction with either CM or CTG. Twenty-two patients with a total of 156 Miller Class I and II gingival recessions were included in this study. Recessions were randomly treated according to a split-mouth design by means of MCAT + CM (test) or MCAT + CTG (control). The following measurements were recorded at baseline (i.e. prior to surgery) and at 12 months: Gingival Recession Depth (GRD), Probing Pocket Depth (PD), Clinical Attachment Level (CAL), Keratinized Tissue Width (KTW), Gingival Recession Width (GRW) and Gingival Thickness (GT). GT was measured 3-mm apical to the gingival margin. Patient acceptance was recorded using a Visual Analogue Scale (VAS). The primary outcome variable was Complete Root Coverage (CRC), secondary outcomes were Mean Root Coverage (MRC), change in KTW, GT, patient acceptance and duration of surgery. Healing was uneventful in both groups. No adverse reactions at any of the sites were observed. At 12 months, both treatments resulted in statistically significant improvements of CRC, MRC, KTW and GT compared with baseline (p < 0.05). CRC was found at 42% of test sites and at 85% of control sites respectively (p < 0.05). MRC measured 71 ± 21% mm at test sites versus 90 ± 18% mm at control sites (p < 0.05). Mean KTW measured 2.4 ± 0.7 mm at test sites versus 2.7 ± 0.8 mm at

  11. The Retrograde of Shipping Containers from Afghanistan

    DTIC Science & Technology

    2013-04-01

    detention costs; however, many are still marked with carrier identification markings. To mitigate the problem, Mobile Container Assistance Teams ( MCATs ...comply with the USCENTCOM letter of instruction, the MCATs inventoried containers and locations in theater, with the intent to return carrier...Expeditionary Disposal Remediation Team (EDRT) out to the COPs and FOBs to linkup with MCATs , and the unit CCO to assess all excess containers.96

  12. Alternative Payment Models Should Risk-Adjust for Conversion Total Hip Arthroplasty: A Propensity Score-Matched Study.

    PubMed

    McLawhorn, Alexander S; Schairer, William W; Schwarzkopf, Ran; Halsey, David A; Iorio, Richard; Padgett, Douglas E

    2017-12-06

    For Medicare beneficiaries, hospital reimbursement for nonrevision hip arthroplasty is anchored to either diagnosis-related group code 469 or 470. Under alternative payment models, reimbursement for care episodes is not further risk-adjusted. This study's purpose was to compare outcomes of primary total hip arthroplasty (THA) vs conversion THA to explore the rationale for risk adjustment for conversion procedures. All primary and conversion THAs from 2007 to 2014, excluding acute hip fractures and cancer patients, were identified in the National Surgical Quality Improvement Program database. Conversion and primary THA patients were matched 1:1 using propensity scores, based on preoperative covariates. Multivariable logistic regressions evaluated associations between conversion THA and 30-day outcomes. A total of 2018 conversions were matched to 2018 primaries. There were no differences in preoperative covariates. Conversions had longer operative times (148 vs 95 minutes, P < .001), more transfusions (37% vs 17%, P < .001), and longer length of stay (4.4 vs 3.1 days, P < .001). Conversion THA had increased odds of complications (odds ratio [OR] 1.75; 95% confidence interval [CI] 1.37-2.24), deep infection (OR 4.21; 95% CI 1.72-10.28), discharge to inpatient care (OR 1.52; 95% CI 1.34-1.72), and death (OR 2.39; 95% CI 1.04-5.47). Readmission odds were similar. Compared with primary THA, conversion THA is associated with more complications, longer length of stay, and increased discharge to continued inpatient care, implying greater resource utilization for conversion patients. As reimbursement models shift toward bundled payment paradigms, conversion THA appears to be a procedure for which risk adjustment is appropriate. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Stapler Esophageal Closure During Total Laryngectomy.

    PubMed

    Ismi, Onur; Unal, Murat; Vayisoglu, Yusuf; Yesilova, Mesut; Helvaci, Ilter; Gorur, Kemal; Ozcan, Cengiz

    2017-01-01

    Mechanical esophageal closure with stapler during total laryngectomy has been used by various authors to decrease the surgical time and pharyngocutaneous fistula (PCF) rates. In a few of the studies, surgical site infection (SSI) rates are mentioned and none of the studies emphasize the effect of decreased surgical time on postoperative cardiovascular and cerebrovascular complications. In this study, the authors compared the PCF rates, SSI rates, operation times between 30 mechanical stapler and 40 manual esophageal closure during total laryngectomy for laryngeal cancer patients. National Nasocomial Infections Surveillance system (NNISS) scores were recorded and compared between groups. Total laryngectomy and total operation times were lower in the stapler group patients (P < 0.001 for total laryngectomy time, P = 0.024 for total operation time). There were lower rates of pharyngocutaneous fistula (P = 0.032), surgical site infection (P = 0.019), and NNISS scores (P = 0.009) in the stapler group. There was no statistically significant difference between groups regarding postoperative systemic complications (P = 0.451). In conclusion, stapler esophageal closure decreases operation time, PCF, SSI rates, and NNISS scores but not the systemic complication rates. Comorbid illnesses and prolonged surgical time are risk factors for postoperative systemic complications in total laryngectomy patients, but patients with additional illnesses must not encourage the surgeon to use stapler for decreasing postoperative systemic complications.

  14. A method to score radiographic change in psoriatic arthritis.

    PubMed

    Wassenberg, S; Fischer-Kahle, V; Herborn, G; Rau, R

    2001-06-01

    Radiographic features of psoriatic arthritis (PsA) are very characteristic and differ from those observed in rheumatoid arthritis, especially in two aspects: 1) the distribution of affected joints (i.e. DIP joints), 2) the presence of destructive changes and bone proliferation at the same time. A scoring method for PsA, therefore, has to account for these characteristics of PsA. To develop, describe and validate a method for scoring radiographic changes in patients with PsA. Forty joints of the hands and feet are scored for destruction and proliferation. In the destruction score (DS) grading on a 0-5 scale is based on the amount of joint surface destruction: 0 = normal, 1 = one or more erosions with an interruption of the cortical plate of > 1 mm with destruction of the total joint surface up to 10%, 2 = 11-25%, 3 = 26-50%, 4 = 51-75%, 5 = > 75% joint surface destruction. The proliferation score (PS) sums up any kind of bony proliferation typical for PsA; graded 0-4: 0 = normal, 1 = bony proliferation of 1-2 mm or bone growth < 25% of the original size (diameter), 2 = bony proliferation 2-3 mm or bone growth 25-50%, 3 = bony proliferation > 3 mm or bone growth > 50%, 4 = bony ankylosis. The DS (0-200) and the PS (0-160) can be summed up to the total score (0-360). VALIDATION OF THE METHOD: To validate the method x-rays of 20 patients with active PsA taken 3 years apart were read twice in pairs, knowing the chronological order but not knowing demographic, clinical or laboratory data of the patients. The data were analyzed with a hierarchical analysis of variance model. There was good agreement between the first and the second reading of the same rater and between the two raters regarding the destruction score. The agreement regarding the proliferation score was lower but still acceptable. The reliability of the method to describe change over time--relation of progression (intra-patient variance) to the measurement error (inter-rater variance)--was 3.9 for the DS, 2

  15. Advancing the efficiency and efficacy of patient reported outcomes with multivariate computer adaptive testing.

    PubMed

    Morris, Scott; Bass, Mike; Lee, Mirinae; Neapolitan, Richard E

    2017-09-01

    The Patient Reported Outcomes Measurement Information System (PROMIS) initiative developed an array of patient reported outcome (PRO) measures. To reduce the number of questions administered, PROMIS utilizes unidimensional item response theory and unidimensional computer adaptive testing (UCAT), which means a separate set of questions is administered for each measured trait. Multidimensional item response theory (MIRT) and multidimensional computer adaptive testing (MCAT) simultaneously assess correlated traits. The objective was to investigate the extent to which MCAT reduces patient burden relative to UCAT in the case of PROs. One MIRT and 3 unidimensional item response theory models were developed using the related traits anxiety, depression, and anger. Using these models, MCAT and UCAT performance was compared with simulated individuals. Surprisingly, the root mean squared error for both methods increased with the number of items. These results were driven by large errors for individuals with low trait levels. A second analysis focused on individuals aligned with item content. For these individuals, both MCAT and UCAT accuracies improved with additional items. Furthermore, MCAT reduced the test length by 50%. For the PROMIS Emotional Distress banks, neither UCAT nor MCAT provided accurate estimates for individuals at low trait levels. Because the items in these banks were designed to detect clinical levels of distress, there is little information for individuals with low trait values. However, trait estimates for individuals targeted by the banks were accurate and MCAT asked substantially fewer questions. By reducing the number of items administered, MCAT can allow clinicians and researchers to assess a wider range of PROs with less patient burden. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  16. Clinical score and arterial oxygen saturation in children with wheezing associated respiratory illness (WARI).

    PubMed

    Sritippayawan, S; Deerojanawong, J; Prapphal, N

    2000-10-01

    To determine the correlation between clinical score (based on respiratory rate, chest wall retractions, air entry, wheezing, consciousness and audible wheezing) and arterial oxygen saturation (SaO2: measured by pulse oximetry) as well as the most appropriate total score for predicting hypoxemia (SaO2 < or = 95%) in children diagnosed to have wheezing associated respiratory illness (WARI). 70 children (1 month-5 years old) hospitalized in the Department of Pediatrics, Chulalongkorn Hospital with the diagnosis of WARI from January 1, 1996 to December 31, 1996 were studied. Half of them were diagnosed to have acute lower respiratory tract infection (LRI) with wheezing while the remainder had reactive airway disease (RAD). Cross sectional, analytical study. In each group of patients, the clinical score and SaO2 were assessed by the same pediatrician throughout the study. The correlation between the clinical signs and SaO2 as well as the cut off point of total score for predicting hypoxemia were analyzed. The sensitivity, specificity and accuracy of that total score in predicting hypoxemia were also calculated. In both groups of patients (acute LRI with wheezing and RAD group), the clinical signs correlated with SaO2 were wheezing (rs = -0.67 and -0.47 respectively) and chest wall retractions (rs = -0.57 and -0.59 respectively). Total score was also correlated with SaO2 (rs = -0.68 and -0.5 respectively). The cut off point of total score in predicting hypoxemia was 4 providing 80 per cent sensitivity in both groups with accuracy 74.3 per cent and 80 per cent respectively. This clinical score may be used to assess the severity of hypoxemia in WARI patients. Wheezing, chest wall retractions and total score correlated well with SaO2. The total score > 4 was most appropriate in predicting hypoxemia in both children with RAD and wheezing associated with LRI.

  17. The S.A.C.S. (Satisfaction-Anatomy-Continence-Safety) score for evaluating pelvic organ prolapse surgery: a proposal for an outcome-based scoring system.

    PubMed

    Mearini, Luigi; Zucchi, Alessandro; Nunzi, Elisabetta; Di Biase, Manuel; Bini, Vittorio; Costantini, Elisabetta

    2015-07-01

    To date, there is no overall consensus on the definition of cure after surgery for pelvic organ prolapse (POP). The aim of the study was to design and test the scoring system S.A.C.S. (Satisfaction-Anatomy-Continence-Safety) to assess and compare the outcomes of POP repair. A total of 233 women underwent open sacrocolpopexy. The S.A.C.S. outcome scoring system was scheduled at 24 months of follow-up, and each component was detected according to: Satisfaction by mean of Patient Global Improvement Inventory scale, Anatomy by mean of POP Quantification system and bulge symptom, Continence by mean of pad use, and Safety by mean of the Clavien-Dindo classification of surgical complications. Each component produced a binary nominal categorical variable (1 or 0), with a total score of 4 representing cure. As a comparative tool, patients answered a simple yes/no question: "If you had to undergo surgery all over again, would you still do it?". The degree of concordance was estimated using Cohen's Kappa test. According to the S.A.C.S. scoring system, only 160 patients (68.6 %) reached the maximum score of cure. Sensitivity of the S.A.C.S. score was 74.1 %, specificity was 90 %, total diagnostic capacity was 75.5 %. The S.A.C.S. score internal consistency was good; the k-coefficient was higher for the satisfaction component of the score (k = 0.560). This study proposes an original, simple post-operative scoring system integrating satisfaction, anatomy, continence, and safety reports for patients undergoing surgery for POP, providing a complete, although perfectible, method to accurately report outcomes in all clinical scenarios.

  18. Stable expression and purification of a functional processed Fab' fragment from a single nascent polypeptide in CHO cells expressing the mCAT-1 retroviral receptor.

    PubMed

    Camper, Nicolas; Byrne, Teresa; Burden, Roberta E; Lowry, Jenny; Gray, Breena; Johnston, James A; Migaud, Marie E; Olwill, Shane A; Buick, Richard J; Scott, Christopher J

    2011-09-30

    Monoclonal antibodies and derivative formats such as Fab' fragments are used in a broad range of therapeutic, diagnostic and research applications. New systems and methodologies that can improve the production of these proteins are consequently of much interest. Here we present a novel approach for the rapid production of processed Fab' fragments in a CHO cell line that has been engineered to express the mouse cationic amino acid transporter receptor 1 (mCAT-1). This facilitated the introduction of the target antibody gene through retroviral transfection, rapidly producing stable expression. Using this system, we designed a single retroviral vector construct for the expression of a target Fab' fragment as a single polypeptide with a furin cleavage site and a FMDV 2A self-cleaving peptide introduced to bridge the light and truncated heavy chain regions. The introduction of these cleavage motifs ensured equimolar expression and processing of the heavy and light domains as exemplified by the production of an active chimeric Fab' fragment against the Fas receptor, routinely expressed in 1-2mg/L yield in spinner-flask cell cultures. These results demonstrate that this method could have application in the facile production of bioactive Fab' fragments. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Performance of third-year primary-care-track students in an integrated curriculum at Case Western Reserve University.

    PubMed

    Lewin, L O; Papp, K K; Hodder, S L; Workings, M G; Wolfe, L; Glover, P; Headrick, L A

    1999-01-01

    In 1994, Case Western Reserve University School of Medicine established a Primary Care Track (PCT) with an integrated curriculum as part of The Robert Wood Johnson Foundation's Generalist Physician Initiative. This study compared the performance of the first cohort of students to participate in the PCT third year with that of their classmates and determined student attitudes toward their experiences. The performances of 24 PCT and 81 traditional students on the Medical School Admissions Test (MCAT) and the United States Medical Licensure Examination (USMLE) Step 1 and 2 were compared using analysis of variance. Grades on the six core clerkships were compared using chi-square analysis. Performances of the PCT students and a subset of traditional students on the generalist school's objective structured clinical exam (OSCE) were compared using multivariate analysis. The students reported their perceptions on a questionnaire. The traditional students had significantly higher scores on the physical science section of the MCAT and on the USMLE Step 1, but at the end of year three, their USMLE Step 2 scores did not differ. Grade distributions in the core clerkships did not differ, except in psychiatry, where the PCT students received honors significantly more often. The PCT students had a lower mean score on the internal medicine National Board of Medicine Examiners shelf exam but performed better on the generalist OSCE exam. A majority of PCT students reported that they would choose the integrated third year again and recommend it to others.

  20. Container Management: A Necessary Strategy for Improved Efficiencies

    DTIC Science & Technology

    2013-03-01

    and carrier-owned containers under the USTRANSCOM USC or other applicable contract.21 Re-organize mobile container assessment teams ( MCAT ) with...warrant officer or field grade officers in charge. The MCATs are a great concept, but when a team shows up with a young Captain or Lieutenant and a...and a master sergeant or sergeant major on the MCAT , they will be more effective and better supported. Plenty of quality field grade Logistics Corps

  1. Anterior knee pain following total knee replacement correlates with the OARSI score of the cartilage of the patella.

    PubMed

    Metsna, Vahur; Vorobjov, Sigrid; Lepik, Katrin; Märtson, Aare

    2014-08-01

    Attempts to relate patellar cartilage involvement to anterior knee pain (AKP) have yielded conflicting results. We determined whether the condition of the cartilage of the patella at the time of knee replacement, as assessed by the OARSI score, correlates with postsurgical AKP. We prospectively studied 100 patients undergoing knee arthroplasty. At surgery, we photographed and biopsied the articular surface of the patella, leaving the patella unresurfaced. Following determination of the microscopic grade of the patellar cartilage lesion and the stage by analyzing the intraoperative photographs, we calculated the OARSI score. We interviewed the patients 1 year after knee arthroplasty using the HSS patella score for diagnosis of AKP. 57 of 95 patients examined had AKP. The average OARSI score of painless patients was 13 (6-20) and that of patients with AKP was 15 (6-20) (p = 0.04). Patients with OARSI scores of 13-24 had 50% higher risk of AKP (prevalence ratio = 1.5, 95% CI: 1.0-2.3) than patients with OARSI scores of 0-12. The depth and extent of the cartilage lesion of the knee-cap should be considered when deciding between the various options for treatment of the patella during knee replacement.

  2. Targeted overexpression of mitochondrial catalase prevents radiation-induced cognitive dysfunction.

    PubMed

    Parihar, Vipan K; Allen, Barrett D; Tran, Katherine K; Chmielewski, Nicole N; Craver, Brianna M; Martirosian, Vahan; Morganti, Josh M; Rosi, Susanna; Vlkolinsky, Roman; Acharya, Munjal M; Nelson, Gregory A; Allen, Antiño R; Limoli, Charles L

    2015-01-01

    Radiation-induced disruption of mitochondrial function can elevate oxidative stress and contribute to the metabolic perturbations believed to compromise the functionality of the central nervous system. To clarify the role of mitochondrial oxidative stress in mediating the adverse effects of radiation in the brain, we analyzed transgenic (mitochondrial catalase [MCAT]) mice that overexpress human catalase localized to the mitochondria. Compared with wild-type (WT) controls, overexpression of the MCAT transgene significantly decreased cognitive dysfunction after proton irradiation. Significant improvements in behavioral performance found on novel object recognition and object recognition in place tasks were associated with a preservation of neuronal morphology. While the architecture of hippocampal CA1 neurons was significantly compromised in irradiated WT mice, the same neurons in MCAT mice did not exhibit extensive and significant radiation-induced reductions in dendritic complexity. Irradiated neurons from MCAT mice maintained dendritic branching and length compared with WT mice. Protected neuronal morphology in irradiated MCAT mice was also associated with a stabilization of radiation-induced variations in long-term potentiation. Stabilized synaptic activity in MCAT mice coincided with an altered composition of the synaptic AMPA receptor subunits GluR1/2. Our findings provide the first evidence that neurocognitive sequelae associated with radiation exposure can be reduced by overexpression of MCAT, operating through a mechanism involving the preservation of neuronal morphology. Our article documents the neuroprotective properties of reducing mitochondrial reactive oxygen species through the targeted overexpression of catalase and how this ameliorates the adverse effects of proton irradiation in the brain.

  3. Clinical use of the ABO-Scoring Index: reliability and subtraction frequency.

    PubMed

    Lieber, William S; Carlson, Sean K; Baumrind, Sheldon; Poulton, Donald R

    2003-10-01

    This study tested the reliability and subtraction frequency of the study model-scoring system of the American Board of Orthodontists (ABO). We used a sample of 36 posttreatment study models that were selected randomly from six different orthodontic offices. Intrajudge and interjudge reliability was calculated using nonparametric statistics (Spearman rank coefficient, Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests). We found differences ranging from 3 to 6 subtraction points (total score) for intrajudge scoring between two sessions. For overall total ABO score, the average correlation was .77. Intrajudge correlation was greatest for occlusal relationships and least for interproximal contacts. Interjudge correlation for ABO score averaged r = .85. Correlation was greatest for buccolingual inclination and least for overjet. The data show that some judges, on average, were much more lenient than others and that this resulted in a range of total scores between 19.7 and 27.5. Most of the deductions were found in the buccal segments and most were related to the second molars. We present these findings in the context of clinicians preparing for the ABO phase III examination and for orthodontists in their ongoing evaluation of clinical results.

  4. Outcomes of Total Knee Arthroplasty in Patients With Poliomyelitis.

    PubMed

    Gan, Zhi-Wei Jonathan; Pang, Hee Nee

    2016-11-01

    We report our experience with outcomes of poliomyelitis in the Asian population. Sixteen total knee replacements in 14 patients with polio-affected knees were followed up for at least 18 months. Follow-up assessment included scoring with the American Knee Society Score (AKSS), Oxford knee score, and Short Form 36 Health Survey scores. The mean AKSS improved from 25.59 preoperatively to 82.94 at 24 months, with greater improvement in the knee score. The mean Oxford knee score improved from 40.82 preoperatively to 20.53 at 24 months. The mean AKSS pain score rose from 2.35 to 47.66 at 24 months. The Short Form 36 Health Survey physical functioning and bodily pain scores improved for all patients. Primary total knee arthroplasty of poliomyelitis-affected limbs shows good outcomes, improving quality of life, and decreasing pain. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. A Comparison Study of Item Exposure Control Strategies in MCAT

    ERIC Educational Resources Information Center

    Mao, Xiuzhen; Ozdemir, Burhanettin; Wang, Yating; Xiu, Tao

    2016-01-01

    Four item selection indexes with and without exposure control are evaluated and compared in multidimensional computerized adaptive testing (CAT). The four item selection indices are D-optimality, Posterior expectation Kullback-Leibler information (KLP), the minimized error variance of the linear combination score with equal weight (V1), and the…

  6. Lower Bounds to the Reliabilities of Factor Score Estimators.

    PubMed

    Hessen, David J

    2016-10-06

    Under the general common factor model, the reliabilities of factor score estimators might be of more interest than the reliability of the total score (the unweighted sum of item scores). In this paper, lower bounds to the reliabilities of Thurstone's factor score estimators, Bartlett's factor score estimators, and McDonald's factor score estimators are derived and conditions are given under which these lower bounds are equal. The relative performance of the derived lower bounds is studied using classic example data sets. The results show that estimates of the lower bounds to the reliabilities of Thurstone's factor score estimators are greater than or equal to the estimates of the lower bounds to the reliabilities of Bartlett's and McDonald's factor score estimators.

  7. Peritumoral Artery Scoring System: a Novel Scoring System to Predict Renal Function Outcome after Laparoscopic Partial Nephrectomy.

    PubMed

    Zhang, Ruiyun; Wu, Guangyu; Huang, Jiwei; Shi, Oumin; Kong, Wen; Chen, Yonghui; Xu, Jianrong; Xue, Wei; Zhang, Jin; Huang, Yiran

    2017-06-06

    The present study aimed to assess the impact of peritumoral artery characteristics on renal function outcome prediction using a novel Peritumoral Artery Scoring System based on computed tomography arteriography. Peritumoral artery characteristics and renal function were evaluated in 220 patients who underwent laparoscopic partial nephrectomy and then validate in 51 patients with split and total glomerular filtration rate (GFR). In particular, peritumoral artery classification and diameter were measured to assign arteries into low, moderate, and high Peritumoral Artery Scoring System risk categories. Univariable and multivariable logistic regression analyses were then used to determine risk factors for major renal functional decline. The Peritumoral Artery Scoring System and four other nephrometry systems were compared using receiver operating characteristic curve analysis. The Peritumoral Artery Scoring System was significantly superior to the other systems for predicting postoperative renal function decline (p < 0.001). In receiver operating characteristic analysis, our category system was a superior independent predictor of estimated glomerular filtration rate (eGFR) decline (area-under-the-curve = 0.865, p < 0.001) and total GFR decline (area-under-the-curve = 0.796, p < 0.001), and split GFR decline (area-under-the-curve = 0.841, p < 0.001). Peritumoral artery characteristics were independent predictors of renal function outcome after laparoscopic partial nephrectomy.

  8. A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores.

    PubMed

    Sattin, Davide; Lovaglio, Piergiorgio; Brenna, Greta; Covelli, Venusia; Rossi Sebastiano, Davide; Duran, Dunja; Minati, Ludovico; Giovannetti, Ambra Mara; Rosazza, Cristina; Bersano, Anna; Nigri, Anna; Ferraro, Stefania; Leonardi, Matilde

    2017-09-01

    The study compared the metric characteristics (discriminant capacity and factorial structure) of two different methods for scoring the items of the Coma Recovery Scale-Revised and it analysed scale scores collected using the standard assessment procedure and a new proposed method. Cross sectional design/methodological study. Inpatient, neurological unit. A total of 153 patients with disorders of consciousness were consecutively enrolled between 2011 and 2013. All patients were assessed with the Coma Recovery Scale-Revised using standard (rater 1) and inverted (rater 2) procedures. Coma Recovery Scale-Revised score, number of cognitive and reflex behaviours and diagnosis. Regarding patient assessment, rater 1 using standard and rater 2 using inverted procedures obtained the same best scores for each subscale of the Coma Recovery Scale-Revised for all patients, so no clinical (and statistical) difference was found between the two procedures. In 11 patients (7.7%), rater 2 noted that some Coma Recovery Scale-Revised codified behavioural responses were not found during assessment, although higher response categories were present. A total of 51 (36%) patients presented the same Coma Recovery Scale-Revised scores of 7 or 8 using a standard score, whereas no overlap was found using the modified score. Unidimensionality was confirmed for both score systems. The Coma Recovery Scale Modified Score showed a higher discriminant capacity than the standard score and a monofactorial structure was also supported. The inverted assessment procedure could be a useful evaluation method for the assessment of patients with disorder of consciousness diagnosis.

  9. Comparing the Scoring of Human Decomposition from Digital Images to Scoring Using On-site Observations.

    PubMed

    Dabbs, Gretchen R; Bytheway, Joan A; Connor, Melissa

    2017-09-01

    When in forensic casework or empirical research in-person assessment of human decomposition is not possible, the sensible substitution is color photographic images. To date, no research has confirmed the utility of color photographic images as a proxy for in situ observation of the level of decomposition. Sixteen observers scored photographs of 13 human cadavers in varying decomposition stages (PMI 2-186 days) using the Total Body Score system (total n = 929 observations). The on-site TBS was compared with recorded observations from digital color images using a paired samples t-test. The average difference between on-site and photographic observations was -0.20 (t = -1.679, df = 928, p = 0.094). Individually, only two observers, both students with <1 year of experience, demonstrated TBS statistically significantly different than the on-site value, suggesting that with experience, observations of human decomposition based on digital images can be substituted for assessments based on observation of the corpse in situ, when necessary. © 2017 American Academy of Forensic Sciences.

  10. The Motivated Strategies for Learning Questionnaire: score validity among medicine residents.

    PubMed

    Cook, David A; Thompson, Warren G; Thomas, Kris G

    2011-12-01

    The Motivated Strategies for Learning Questionnaire (MSLQ) purports to measure motivation using the expectancy-value model. Although it is widely used in other fields, this instrument has received little study in health professions education. The purpose of this study was to evaluate the validity of MSLQ scores. We conducted a validity study evaluating the relationships of MSLQ scores to other variables and their internal structure (reliability and factor analysis). Participants included 210 internal medicine and family medicine residents participating in a web-based course on ambulatory medicine at an academic medical centre. Measurements included pre-course MSLQ scores, pre- and post-module motivation surveys, post-module knowledge test and post-module Instructional Materials Motivation Survey (IMMS) scores. Internal consistency was universally high for all MSLQ items together (Cronbach's α = 0.93) and for each domain (α ≥ 0.67). Total MSLQ scores showed statistically significant positive associations with post-test knowledge scores. For example, a 1-point rise in total MSLQ score was associated with a 4.4% increase in post-test scores (β = 4.4; p < 0.0001). Total MSLQ scores showed moderately strong, statistically significant associations with several other measures of effort, motivation and satisfaction. Scores on MSLQ domains demonstrated associations that generally aligned with our hypotheses. Self-efficacy and control of learning belief scores demonstrated the strongest domain-specific relationships with knowledge scores (β = 2.9 for both). Confirmatory factor analysis showed a borderline model fit. Follow-up exploratory factor analysis revealed the scores of five factors (self-efficacy, intrinsic interest, test anxiety, extrinsic goals, attribution) demonstrated psychometric and predictive properties similar to those of the original scales. Scores on the MSLQ are reliable and predict meaningful outcomes. However, the factor structure suggests a

  11. Total Joint Arthroplasty and the Risk of Myocardial Infarction - A General Population, Propensity Score-Matched Cohort Study

    PubMed Central

    Lu, Na; Misra, Devyani; Neogi, Tuhina; Choi, Hyon K.; Zhang, Yuqing

    2015-01-01

    Background We sought to replicate recent findings that total knee arthroplasty (TKA) or total hip arthroplasty (THA) surgery substantially reduces the risk of serious cardiovascular events among osteoarthritis patients in a UK general population. Methods We conducted a time-stratified propensity score-matched cohort study for the outcome of myocardial infarction (MI). The study population included individuals aged ≥50 years who had a Readcode diagnosis of knee osteoarthritis (to evaluate TKA) or hip osteoarthritis (to evaluate THA) between January 2000 and December 2012. Results Among 13,849 patients who underwent TKA and 13,849 matched non-TKA controls 306 and 286 developed MI during the follow-up, respectively. During the first postoperative month, the risk of MI was substantially increased among TKA group compared with non-TKA group (hazard ratio 8.75; 95% CI, 3.11–24.62), and then gradually declined during the subsequent follow-up. The HR of the entire follow-up was 0.98 (95% CI, 0.82–1.18). The corresponding HRs for THA (n=6,063) compared with non-THA were 4.33 (95% CI, 1.24–15.21) and 0.87 (95% CI, 0.66–1.15), respectively. Using venous thromboembolism as a positive control outcome, both the first month and overall HRs of MI were substantially increased for TKA and for THA, respectively. Conclusion These findings provide the first general population-based evidence that TKA and THA among osteoarthritis patients are associated with a substantially increased risk of MI during the immediate postoperative period. However, its overall long-term impact was null, unlike the risk of venous thromboembolism that remained years after the procedure. PMID:26331443

  12. Targeted Overexpression of Mitochondrial Catalase Prevents Radiation-Induced Cognitive Dysfunction

    PubMed Central

    Parihar, Vipan K.; Allen, Barrett D.; Tran, Katherine K.; Chmielewski, Nicole N.; Craver, Brianna M.; Martirosian, Vahan; Morganti, Josh M.; Rosi, Susanna; Vlkolinsky, Roman; Acharya, Munjal M.; Nelson, Gregory A.; Allen, Antiño R.

    2015-01-01

    Abstract Aims: Radiation-induced disruption of mitochondrial function can elevate oxidative stress and contribute to the metabolic perturbations believed to compromise the functionality of the central nervous system. To clarify the role of mitochondrial oxidative stress in mediating the adverse effects of radiation in the brain, we analyzed transgenic (mitochondrial catalase [MCAT]) mice that overexpress human catalase localized to the mitochondria. Results: Compared with wild-type (WT) controls, overexpression of the MCAT transgene significantly decreased cognitive dysfunction after proton irradiation. Significant improvements in behavioral performance found on novel object recognition and object recognition in place tasks were associated with a preservation of neuronal morphology. While the architecture of hippocampal CA1 neurons was significantly compromised in irradiated WT mice, the same neurons in MCAT mice did not exhibit extensive and significant radiation-induced reductions in dendritic complexity. Irradiated neurons from MCAT mice maintained dendritic branching and length compared with WT mice. Protected neuronal morphology in irradiated MCAT mice was also associated with a stabilization of radiation-induced variations in long-term potentiation. Stabilized synaptic activity in MCAT mice coincided with an altered composition of the synaptic AMPA receptor subunits GluR1/2. Innovation: Our findings provide the first evidence that neurocognitive sequelae associated with radiation exposure can be reduced by overexpression of MCAT, operating through a mechanism involving the preservation of neuronal morphology. Conclusion: Our article documents the neuroprotective properties of reducing mitochondrial reactive oxygen species through the targeted overexpression of catalase and how this ameliorates the adverse effects of proton irradiation in the brain. Antioxid. Redox Signal. 22, 78–91. PMID:24949841

  13. Serum antibody response to Moraxella catarrhalis proteins in stringently defined otitis prone children.

    PubMed

    Ren, Dabin; Almudevar, Anthony L; Murphy, Timothy F; Lafontaine, Eric R; Campagnari, Anthony A; Luke-Marshall, Nicole; Pichichero, Michael E

    2017-07-26

    Moraxella catarrhalis (Mcat) is a frequent pathogen of acute otitis media (AOM) in young children. Here we prospectively assessed naturally-induced serum antibodies to four Mcat vaccine candidate proteins in stringently defined otitis prone (sOP) and non-otitis prone (NOP) children age 6-36months old following nasopharyngeal (NP) colonization, at onset of AOM and convalescence from AOM. Serum IgG and IgM antibody against recombinant Mcat proteins, oligopeptide permease A (OppA), outer membrane protein (OMP) CD, hemagglutinin (Hag), and PilA clade 2 (PilA2), were quantitated by ELISA. During NP colonization by Mcat all four antigens were immunogenic in both sOP and NOP children. However, sOP children had lower antibody responses than NOP children across age 6-36months, similar to our findings for protein vaccine candidates of Streptococcus pneumoniae (Spn) and Nontypeable Haemophilus influenzae (NTHi). sOP children displayed a later and lower peak of antibody rise than NOP children for all four antigens during NP colonization of Mcat. The age-dependent increase of antibody ranked as OppA>Hag5-9>OMP CD>PilA2 in both sOP and NOP children. Lower serum antibody levels to the Mcat antigens were measured in sOP compared to NOP children at the onset of AOM. We did not find a consistent significant increase of antibody at the convalescence phase after an AOM event. sOP children is a highly vulnerable population that mount lower serum antibody responses to Mcat candidate vaccine proteins compared to NOP children during asymptomatic NP carriage and at onset of AOM. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Correlation of Head Impacts to Change in Balance Error Scoring System Scores in Division I Men's Lacrosse Players.

    PubMed

    Miyashita, Theresa L; Diakogeorgiou, Eleni; Marrie, Kaitlyn

    Investigation into the effect of cumulative subconcussive head impacts has yielded various results in the literature, with many supporting a link to neurological deficits. Little research has been conducted on men's lacrosse and associated balance deficits from head impacts. (1) Athletes will commit more errors on the postseason Balance Error Scoring System (BESS) test. (2) There will be a positive correlation to change in BESS scores and head impact exposure data. Prospective longitudinal study. Level 3. Thirty-four Division I men's lacrosse players (age, 19.59 ± 1.42 years) wore helmets instrumented with a sensor to collect head impact exposure data over the course of a competitive season. Players completed a BESS test at the start and end of the competitive season. The number of errors from pre- to postseason increased during the double-leg stance on foam ( P < 0.001), tandem stance on foam ( P = 0.009), total number of errors on a firm surface ( P = 0.042), and total number of errors on a foam surface ( P = 0.007). There were significant correlations only between the total errors on a foam surface and linear acceleration ( P = 0.038, r = 0.36), head injury criteria ( P = 0.024, r = 0.39), and Gadd Severity Index scores ( P = 0.031, r = 0.37). Changes in the total number of errors on a foam surface may be considered a sensitive measure to detect balance deficits associated with cumulative subconcussive head impacts sustained over the course of 1 lacrosse season, as measured by average linear acceleration, head injury criteria, and Gadd Severity Index scores. If there is microtrauma to the vestibular system due to repetitive subconcussive impacts, only an assessment that highly stresses the vestibular system may be able to detect these changes. Cumulative subconcussive impacts may result in neurocognitive dysfunction, including balance deficits, which are associated with an increased risk for injury. The development of a strategy to reduce total number of head

  15. 2D and 3D MOCART scoring systems assessed by 9.4 T high-field MRI correlate with elementary and complex histological scoring systems in a translational model of osteochondral repair.

    PubMed

    Goebel, L; Zurakowski, D; Müller, A; Pape, D; Cucchiarini, M; Madry, H

    2014-10-01

    To compare the 2D and 3D MOCART system obtained with 9.4 T high-field magnetic resonance imaging (MRI) for the ex vivo analysis of osteochondral repair in a translational model and to correlate the data with semiquantitative histological analysis. Osteochondral samples representing all levels of repair (sheep medial femoral condyles; n = 38) were scanned in a 9.4 T high-field MRI. The 2D and adapted 3D MOCART systems were used for grading after point allocation to each category. Each score was correlated with corresponding reconstructions between both MOCART systems. Data were next correlated with corresponding categories of an elementary (Wakitani) and a complex (Sellers) histological scoring system as gold standards. Correlations between most 2D and 3D MOCART score categories were high, while mean total point values of 3D MOCART scores tended to be 15.8-16.1 points higher compared to the 2D MOCART scores based on a Bland-Altman analysis. "Defect fill" and "total points" of both MOCART scores correlated with corresponding categories of Wakitani and Sellers scores (all P ≤ 0.05). "Subchondral bone plate" also correlated between 3D MOCART and Sellers scores (P < 0.001). Most categories of the 2D and 3D MOCART systems correlate, while total scores were generally higher using the 3D MOCART system. Structural categories "total points" and "defect fill" can reliably be assessed by 9.4 T MRI evaluation using either system, "subchondral bone plate" using the 3D MOCART score. High-field MRI is valuable to objectively evaluate osteochondral repair in translational settings. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  16. Spinal appearance questionnaire: factor analysis, scoring, reliability, and validity testing.

    PubMed

    Carreon, Leah Y; Sanders, James O; Polly, David W; Sucato, Daniel J; Parent, Stefan; Roy-Beaudry, Marjolaine; Hopkins, Jeffrey; McClung, Anna; Bratcher, Kelly R; Diamond, Beverly E

    2011-08-15

    Cross sectional. This study presents the factor analysis of the Spinal Appearance Questionnaire (SAQ) and its psychometric properties. Although the SAQ has been administered to a large sample of patients with adolescent idiopathic scoliosis (AIS) treated surgically, its psychometric properties have not been fully evaluated. This study presents the factor analysis and scoring of the SAQ and evaluates its psychometric properties. The SAQ and the Scoliosis Research Society-22 (SRS-22) were administered to AIS patients who were being observed, braced or scheduled for surgery. Standard demographic data and radiographic measures including Lenke type and curve magnitude were also collected. Of the 1802 patients, 83% were female; with a mean age of 14.8 years and mean initial Cobb angle of 55.8° (range, 0°-123°). From the 32 items of the SAQ, 15 loaded on two factors with consistent and significant correlations across all Lenke types. There is an Appearance (items 1-10) and an Expectations factor (items 12-15). Responses are summed giving a range of 5 to 50 for the Appearance domain and 5 to 20 for the Expectations domain. The Cronbach's α was 0.88 for both domains and Total score with a test-retest reliability of 0.81 for Appearance and 0.91 for Expectations. Correlations with major curve magnitude were higher for the SAQ Appearance and SAQ Total scores compared to correlations between the SRS Appearance and SRS Total scores. The SAQ and SRS-22 Scores were statistically significantly different in patients who were scheduled for surgery compared to those who were observed or braced. The SAQ is a valid measure of self-image in patients with AIS with greater correlation to curve magnitude than SRS Appearance and Total score. It also discriminates between patients who require surgery from those who do not.

  17. Walk Score(TM), Perceived Neighborhood Walkability, and walking in the US.

    PubMed

    Tuckel, Peter; Milczarski, William

    2015-03-01

    To investigate both the Walk Score(TM) and a self-reported measure of neighborhood walkability ("Perceived Neighborhood Walkability") as estimators of transport and recreational walking among Americans. The study is based upon a survey of a nationally-representative sample of 1224 American adults. The survey gauged walking for both transport and recreation and included a self-reported measure of neighborhood walkability and each respondent's Walk Score(TM). Binary logistic and linear regression analyses were performed on the data. The Walk Score(TM) is associated with walking for transport, but not recreational walking nor total walking. Perceived Neighborhood Walkability is associated with transport, recreational and total walking. Perceived Neighborhood Walkability captures the experiential nature of walking more than the Walk Score(TM).

  18. A comparison of three developmental stage scoring systems.

    PubMed

    Dawson, Theo Linda

    2002-01-01

    In social psychological research the stage metaphor has fallen into disfavor due to concerns about bias, reliability, and validity. To address some of these issues, I employ a multidimensional partial credit analysis comparing moral judgment interviews scored with the Standard Issue Scoring System (SISS) (Colby and Kohlberg, 1987b), evaluative reasoning interviews scored with the Good Life Scoring System (GLSS) (Armon, 1984b), and Good Education interviews scored with the Hierarchical Complexity Scoring System (HCSS) (Commons, Danaher, Miller, and Dawson, 2000). A total of 209 participants between the ages of 5 and 86 were interviewed. The multidimensional model reveals that even though the scoring systems rely upon different criteria and the data were collected using different methods and scored by different teams of raters, the SISS, GLSS, and HCSS all appear to measure the same latent variable. The HCSS exhibits more internal consistency than the SISS and GLSS, and solves some methodological problems introduced by the content dependency of the SISS and GLSS. These results and their implications are elaborated.

  19. Relating tumor score to hematology in green turtles with fibropapillomatosis in Hawaii

    USGS Publications Warehouse

    Work, Thierry M.; Balazs, George H.

    1999-01-01

    The relationship between hematologic status and severity of tumor affliction in green turtles (Chelonia mydas) with fibropapillomatosis (FP) was examined. During 1 wk periods in July 1997 and July 1998, we bled 108 free-ranging green turtles from Pala'au (Molokai, Hawaii, USA) where FP is endemic. Blood was analyzed for hematocrit, estimated total solids, total white blood cell (WBC) count and differential WBC count. Each turtle was assigned a subjective tumor score ranging from 0 (no visible external tumors) to 3 (heavily tumored) that indicated the severity of FP. There was a progressive increase in monocytes and a decrease in all other hematologic parameters except heterophils and total numbers of white blood cells as tumor score increased. These data indicate that tumor score can relate to physiologic status of green turtles afflicted with FP, and that tumor score is a useful field monitor of severity of FP in this species.

  20. Evaluation of modified Alvarado scoring system and RIPASA scoring system as diagnostic tools of acute appendicitis.

    PubMed

    Shuaib, Abdullah; Shuaib, Ali; Fakhra, Zainab; Marafi, Bader; Alsharaf, Khalid; Behbehani, Abdullah

    2017-01-01

    Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed with the goal of reducing the negative appendectomy rate to 5%-10%. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system was established in 2008 specifically for Asian populations. The aim of this study was to compare the modified Alvarado with the RIPASA scoring system in Kuwait population. This study included 180 patients who underwent appendectomies and were documented as having "acute appendicitis" or "abdominal pain" in the operating theatre logbook (unit B) from November 2014 to March 2016. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, predicted negative appendectomy and receiver operating characteristic (ROC) curve of the modified Alvarado and RIPASA scoring systems were derived using SPSS statistical software. A total of 136 patients were included in this study according to our criteria. The cut-off threshold point of the modified Alvarado score was set at 7.0, which yielded a sensitivity of 82.8% and a specificity of 56%. The PPV was 89.3% and the NPV was 42.4%. The cut-off threshold point of the RIPASA score was set at 7.5, which yielded a 94.5% sensitivity and an 88% specificity. The PPV was 97.2% and the NPV was 78.5%. The predicted negative appendectomy rates were 10.7% and 2.2% for the modified Alvarado and RIPASA scoring systems, respectively. The negative appendectomy rate decreased significantly, from 18.4% to 10.7% for the modified Alvarado, and to 2.2% for the RIPASA scoring system, which was a significant difference (P<0.001) for both scoring systems. Based on the results of this study, the RIPASA score is a simple scoring system with better sensitivity and specificity than the modified Alvarado scoring system in Asian populations. It consists of 14

  1. Predictive values of D-dimer assay, GRACE scores and TIMI scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction

    PubMed Central

    Satilmisoglu, Muhammet Hulusi; Ozyilmaz, Sinem Ozbay; Gul, Mehmet; Ak Yildirim, Hayriye; Kayapinar, Osman; Gokturk, Kadir; Aksu, Huseyin; Erkanli, Korhan; Eksik, Abdurrahman

    2017-01-01

    Purpose To determine the predictive values of D-dimer assay, Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Patients and methods A total of 234 patients (mean age: 57.2±11.7 years, 75.2% were males) hospitalized with NSTEMI were included. Data on D-dimer assay, GRACE and TIMI risk scores were recorded. Logistic regression analysis was conducted to determine the risk factors predicting increased mortality. Results Median D-dimer levels were 349.5 (48.0–7,210.0) ng/mL, the average TIMI score was 3.2±1.2 and the GRACE score was 90.4±27.6 with high GRACE scores (>118) in 17.5% of patients. The GRACE score was correlated positively with both the D-dimer assay (r=0.215, P=0.01) and TIMI scores (r=0.504, P=0.000). Multivariate logistic regression analysis revealed that higher creatinine levels (odds ratio =18.465, 95% confidence interval: 1.059–322.084, P=0.046) constituted the only significant predictor of increased mortality risk with no predictive values for age, D-dimer assay, ejection fraction, glucose, hemoglobin A1c, sodium, albumin or total cholesterol levels for mortality. Conclusion Serum creatinine levels constituted the sole independent determinant of mortality risk, with no significant values for D-dimer assay, GRACE or TIMI scores for predicting the risk of mortality in NSTEMI patients. PMID:28408834

  2. Mitochondrial antioxidative capacity regulates muscle glucose uptake in the conscious mouse: effect of exercise and diet.

    PubMed

    Kang, Li; Lustig, Mary E; Bonner, Jeffrey S; Lee-Young, Robert S; Mayes, Wesley H; James, Freyja D; Lin, Chien-Te; Perry, Christopher G R; Anderson, Ethan J; Neufer, P Darrell; Wasserman, David H

    2012-10-15

    The objective of this study was to test the hypothesis that exercise-stimulated muscle glucose uptake (MGU) is augmented by increasing mitochondrial reactive oxygen species (mtROS) scavenging capacity. This hypothesis was tested in genetically altered mice fed chow or a high-fat (HF) diet that accelerates mtROS formation. Mice overexpressing SOD2 (sod2(Tg)), mitochondria-targeted catalase (mcat(Tg)), and combined SOD2 and mCAT (mtAO) were used to increase mtROS scavenging. mtROS was assessed by the H(2)O(2) emitting potential (JH(2)O(2)) in muscle fibers. sod2(Tg) did not decrease JH(2)O(2) in chow-fed mice, but decreased JH(2)O(2) in HF-fed mice. mcat(Tg) and mtAO decreased JH(2)O(2) in both chow- and HF-fed mice. In parallel, the ratio of reduced to oxidized glutathione (GSH/GSSG) was unaltered in sod2(Tg) in chow-fed mice, but was increased in HF-fed sod2(Tg) and both chow- and HF-fed mcat(Tg) and mtAO. Nitrotyrosine, a marker of NO-dependent, reactive nitrogen species (RNS)-induced nitrative stress, was decreased in both chow- and HF-fed sod2(Tg), mcat(Tg), and mtAO mice. This effect was not changed with exercise. Kg, an index of MGU was assessed using 2-[(14)C]-deoxyglucose during exercise. In chow-fed mice, sod2(Tg), mcat(Tg), and mtAO increased exercise Kg compared with wild types. Exercise Kg was also augmented in HF-fed sod2(Tg) and mcat(Tg) mice but unchanged in HF-fed mtAO mice. In conclusion, mtROS scavenging is a key regulator of exercise-mediated MGU and this regulation depends on nutritional state.

  3. Co-colonization by Haemophilus influenzae with Streptococcus pneumoniae enhances pneumococcal-specific antibody response in young children.

    PubMed

    Xu, Qingfu; Pichichero, Michael E

    2014-02-03

    Streptococcus pneumoniae (Spn), Haemophilus influenzae (Hi) and Moraxella catarrhalis (Mcat) are common bacterial pathogens of respiratory infections and common commensal microbes in the human nasopharynx (NP). The effect of interactions among theses bacteria during co-colonization of the NP on the host immune response has not been evaluated. The objective of this study was to assess the impact of co-colonization by Hi or Mcat on the systemic antibody response to vaccine protein candidate antigens of Spn and similarly the impact of co-colonization by Spn and Mcat on antibody responses to Hi vaccine protein candidate antigens. Serum samples were collected from healthy children at 6, 9, 15, 18, and 24 months of age when they were colonized with Spn, Hi, Mcat or their combinations. Quantitative ELISA was used to determine serum IgA and IgG against three Spn antigens and three Hi antigens, and as well as whole cells of non-typeable (NT) Spn and Hi. NP colonization by Spn increased serum IgA and IgG titers against Spn antigens PhtD, PcpA and PlyD and whole cells of NTSpn, and co-colonization of Hi or Mcat with Spn resulted in further increases of serum pneumococcal-specific antibody levels. NP colonization by Hi increased serum IgA and IgG titers against Hi antigens P6, Protein D and OMP26 and whole cells of NTHi, but co-colonization of Spn or Mcat with Hi did not result in further increase of serum NTHi-specific antibody levels. Co-colonization of Hi or Mcat with Spn enhances serum antibody response to NTSpn whole cells and Spn vaccine candidate antigens PhtD, PcPA and PlyD1. Co-colonization appears to variably modulate pathogen species-specific host adaptive immune response. Published by Elsevier Ltd.

  4. Regulation of malonyl-CoA-acyl carrier protein transacylase network in umbilical cord blood affected by intrauterine hyperglycemia.

    PubMed

    Zhang, Yong; Ye, Jianping; Fan, Jianxia

    2017-09-26

    Gestational diabetes mellitus (GDM) has been shown to be associated with high risk of diabetes in offspring. However, the mechanisms involved in the insulin resistance in offspring are still unclear. Mitochondrial dysfunction is related with insulin resistance. In mitochondria, malonyl-CoA-acyl carrier protein transacylase (MCAT) is the key enzyme of mitochondrial fatty acid synthesis and is estimated to contribute to insulin resistance. In this study, we aimed to examine the role of MCAT and its network in the umbilical cord blood in GDM-induced offspring insulin resistance. We isolated lymphocytes from umbilical cord vein blood in 6 GDM patients and 6 controls and examined the differences of RNA by RNA sequencing. qRT-PCR and western blot were used to measure mRNA and protein changes. Bisulfite genomic sequencing PCR was applied to detect DNA methylation. We found more than 400 genes were differentially regulated in the lymphocytes of umbilical cord blood from GDM patients and these genes were mainly enriched in immune system and endocrine system, which relate to mitochondrial dysfunction and insulin resistance. MCAT closely related with PTPN1 (Protein Tyrosine Phosphatase, Non-Receptor Type1) and STAT5A (Signal Transducer And Activator of Transcription 5A), which were all increased in umbilical cord blood from GDM patients. Increase in MCAT may be due to decreased MCAT DNA methylation. MCAT and its network with PTPN1, STAT5A are regulated in umbilical cord blood affected by maternal intrauterine hyperglycemia.

  5. Best Design for Multidimensional Computerized Adaptive Testing With the Bifactor Model

    PubMed Central

    Seo, Dong Gi; Weiss, David J.

    2015-01-01

    Most computerized adaptive tests (CATs) have been studied using the framework of unidimensional item response theory. However, many psychological variables are multidimensional and might benefit from using a multidimensional approach to CATs. This study investigated the accuracy, fidelity, and efficiency of a fully multidimensional CAT algorithm (MCAT) with a bifactor model using simulated data. Four item selection methods in MCAT were examined for three bifactor pattern designs using two multidimensional item response theory models. To compare MCAT item selection and estimation methods, a fixed test length was used. The Ds-optimality item selection improved θ estimates with respect to a general factor, and either D- or A-optimality improved estimates of the group factors in three bifactor pattern designs under two multidimensional item response theory models. The MCAT model without a guessing parameter functioned better than the MCAT model with a guessing parameter. The MAP (maximum a posteriori) estimation method provided more accurate θ estimates than the EAP (expected a posteriori) method under most conditions, and MAP showed lower observed standard errors than EAP under most conditions, except for a general factor condition using Ds-optimality item selection. PMID:29795848

  6. Continued Inpatient Care After Primary Total Knee Arthroplasty Increases 30-Day Post-Discharge Complications: A Propensity Score-Adjusted Analysis.

    PubMed

    McLawhorn, Alexander S; Fu, Michael C; Schairer, William W; Sculco, Peter K; MacLean, Catherine H; Padgett, Douglas E

    2017-09-01

    Discharge destination, either home or skilled care facility, after total knee arthroplasty (TKA) may be associated with significant variation in postacute care outcomes. The purpose of this study was to characterize the 30-day postdischarge outcomes after primary TKA relative to discharge destination. All primary unilateral TKAs performed for osteoarthritis from 2011-2014 were identified in the National Surgical Quality Improvement Program database. Propensity scores based on predischarge characteristics were used to adjust for selection bias in discharge destination. Propensity-adjusted multivariable logistic regressions were used to examine associations between discharge destination and postdischarge complications. Among 101,256 primary TKAs identified, 70,628 were discharged home and 30,628 to skilled care facilities. Patients discharged to facilities were more frequently were female, older, higher body mass index class, higher Charlson comorbidity index and American Society of Anesthesiologists scores, had predischarge complications, received general anesthesia, and classified as nonindependent preoperatively. Propensity adjustment accounted for this selection bias. Patients discharged to skilled care facilities after TKA had higher odds of any major complication (odds ratio = 1.25; 95% confidence interval, 1.13-1.37) and readmission (odds ratio = 1.81; 95% confidence interval, 1.50-2.18). Skilled care was associated with increased odds for respiratory, septic, thromboembolic, and urinary complications. Associations with death, cardiac, and wound complications were not significant. After controlling for predischarge characteristics, discharge to skilled care facilities vs home after primary TKA is associated with higher odds of numerous complications and unplanned readmission. These results support coordination of care pathways to facilitate home discharge after hospitalization for TKA whenever possible. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. T56. AN EXPLORATORY ANALYSIS CONVERTING SCORES BETWEEN THE PANSS AND BNSS

    PubMed Central

    Kott, Alan; Daniel, David

    2018-01-01

    Abstract Background The Brief Negative Symptom Scale is a relatively new instrument designed specifically to measure the negative symptoms in schizophrenia. Recently more clinical trials include the BNSS scale as a secondary or exploratory outcome, typically along with the PANSS. In the current analysis we aimed at establishing the equations that would allow conversion between the BNSS scale total score and the PANSS negative subscale and PANSS negative factors score as well as conversion equations between the expressive deficits and avolition/apathy factors of the scales. (Kirkpatrick, 2011; Strauss, 2012) Methods Data from 518 schizophrenia clinical trials subjects with both PANSS and BNSS data available were used. Regression analyses predicting the BNSS total score with the PANSS negative subscale score, and the BNSS total score with the PANSS Negative factor (NFS) score were performed on data from all subjects. Regression analyses predicting the BNSS avolition/apathy factor (items 1, 2, 3, 5, 6, 7, and 8) with the PANSS avolition/apathy factor (items N2, N4 and G16) and the BNSS expressive deficits factor (items 4, 9, 10, 11, 12, and 13)with the expressive deficits factor (items N1, N3, N6, G5, G7, and G13)of the PANSS were performed on a sample of 318 subjects with individual BNSS item scores available. In addition to estimating the equations we as well calculated the Pearson’s correlations between the scales. Results The PANSS and BNSS avolition/apathy factors were highly correlated (r=0.70) as were the expressive deficit factors r=0.83). The following equations predicting the BNSS total score were obtained from regression analyses performed on 2,560 data points: BNSS_total = -11.64 + 2.10*PANSS_negative_subscale BNSS_total = -9.26 + 2.11*PANSS_NFS The following equations predicting the BNSS factor scores from the PANSS factor scores were obtained from regression analyses performed on 1,634 data points: BNSS_avolition/apathy = -2.40 + 2.38 * PANSS

  8. The Relation between Factor Score Estimates, Image Scores, and Principal Component Scores

    ERIC Educational Resources Information Center

    Velicer, Wayne F.

    1976-01-01

    Investigates the relation between factor score estimates, principal component scores, and image scores. The three methods compared are maximum likelihood factor analysis, principal component analysis, and a variant of rescaled image analysis. (RC)

  9. Percutaneous Coronary Revascularization for Chronic Total Occlusions: A Novel Predictive Score of Technical Failure Using Advanced Technologies.

    PubMed

    Galassi, Alfredo R; Boukhris, Marouane; Azzarelli, Salvatore; Castaing, Marine; Marzà, Francesco; Tomasello, Salvatore D

    2016-05-09

    The aims of this study were to describe the 10-year experience of a single operator dedicated to chronic total occlusion (CTO) and to establish a model for predicting technical failure. During the last decade, the interest in percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) has increased, allowing the improvement of success rate. One thousand nineteen patients with CTO underwent 1,073 CTO procedures performed by a single CTO-dedicated operator. The study population was subdivided into 2 groups by time period: period 1 (January 2005 to December 2009, n = 378) and period 2 (January 2010 to December 2014, n = 641). Observations were randomly assigned to a derivation set and a validation set (in a 2:1 ratio). A prediction score was established by assigning points for each independent predictor of technical failure in the derivation set according to the beta coefficient and summing all points accrued. Lesions attempted in period 2 were more complex in comparison with those in period 1. Compared with period 1, both technical and clinical success rates significantly improved (from 87.8% to 94.4% [p = 0.001] and from 77.6% to 89.9% [p < 0.001], respectively). A prediction score for technical failure including age ≥75 years (1 point), ostial location (1 point), and collateral filling Rentrop grade <2 (2 points) was established, stratifying procedures into 4 difficulty groups: easy (0), intermediate (1), difficult (2), and very difficult (3 or 4), with decreasing technical success rates. In derivation and validation sets, areas under the curve were comparable (0.728 and 0.772, respectively). With growing expertise, the success rate has increased despite increasing complexity of attempted lesions. The established model predicted the probability of technical failure and thus might be applied to grading the difficulty of CTO procedures. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights

  10. Controlled Hydrogen Peroxide Decomposition for a Solid Oxide Fuel Cell (SOFC) Oxidant Source with a Microreactor Model

    DTIC Science & Technology

    2007-10-01

    established assuming first order kinetics weighted via an inputted catalyst mass, Mcat (equation 2). catrxn MCk *−=22OHr (2) The...H2O2 (0-50%w/w) solution heat capacity(J/kg*K) M cat Mcat 0.03 Mass of Catalyst (g) Deffhh2o 7.85E-10 Average effective diffusivity of H2O2 into... Mcat *c Rate Law for Elementary 1st Order Irreversible Reaction (mol/((s*m^3)) r H2O rtb -rt Rate Law for Elementary 1st Order Irreversible Reaction

  11. Novel Semiquantitative Bone Marrow Oedema Score and Fracture Score for the Magnetic Resonance Imaging Assessment of the Active Charcot Foot in Diabetes

    PubMed Central

    Meacock, L.; Donaldson, Ana; Isaac, A.; Briody, A.; Ramnarine, R.; Edmonds, M. E.; Elias, D. A.

    2017-01-01

    There are no accepted methods to grade bone marrow oedema (BMO) and fracture on magnetic resonance imaging (MRI) scans in Charcot osteoarthropathy. The aim was to devise semiquantitative BMO and fracture scores on foot and ankle MRI scans in diabetic patients with active osteoarthropathy and to assess the agreement in using these scores. Three radiologists assessed 45 scans (Siemens Avanto 1.5T, dedicated foot and ankle coil) and scored independently twenty-two bones (proximal phalanges, medial and lateral sesamoids, metatarsals, tarsals, distal tibial plafond, and medial and lateral malleoli) for BMO (0—no oedema, 1—oedema < 50% of bone volume, and 2—oedema > 50% of bone volume) and fracture (0—no fracture, 1—fracture, and 2—collapse/fragmentation). Interobserver agreement and intraobserver agreement were measured using multilevel modelling and intraclass correlation (ICC). The interobserver agreement for the total BMO and fracture scores was very good (ICC = 0.83, 95% confidence intervals (CI) 0.76, 0.91) and good (ICC = 0.62; 95% CI 0.48, 0.76), respectively. The intraobserver agreement for the total BMO and fracture scores was good (ICC = 0.78, 95% CI 0.6, 0.95) and fair to moderate (ICC = 0.44; 95% CI 0.14, 0.74), respectively. The proposed BMO and fracture scores are reliable and can be used to grade the extent of bone damage in the active Charcot foot. PMID:29230422

  12. Using Neuropsychological Process Scores to Identify Subtle Cognitive Decline and Predict Progression to Mild Cognitive Impairment.

    PubMed

    Thomas, Kelsey R; Edmonds, Emily C; Eppig, Joel; Salmon, David P; Bondi, Mark W

    2018-05-26

    We previously operationally-defined subtle cognitive decline (SCD) in preclinical Alzheimer's disease (AD) using total scores on neuropsychological (NP) tests. NP process scores (i.e., provide information about how a total NP score was achieved) may be a useful tool for identifying early cognitive inefficiencies prior to objective impairment seen in mild cognitive impairment (MCI) and dementia. We aimed to integrate process scores into the SCD definition to identify stages of SCD and improve early detection of those at risk for decline. Cognitively "normal" participants from the Alzheimer's Disease Neuroimaging Initiative were classified as "early" SCD (E-SCD; >1 SD below mean on 2 process scores or on 1 process score plus 1 NP total score), "late" SCD (L-SCD; existing SCD criteria of >1 SD below norm-adjusted mean on 2 NP total scores in different domains), or "no SCD" (NC). Process scores considered in the SCD criteria were word-list intrusion errors, retroactive interference, and learning slope. Cerebrospinal fluid AD biomarkers were used to examine pathologic burden across groups. E-SCD and L-SCD progressed to MCI 2.5-3.4 times faster than the NC group. Survival curves for E-SCD and L-SCD converged at 7-8 years after baseline. The combined (E-SCD+L-SCD) group had improved sensitivity to detect progression to MCI relative to L-SCD only. AD biomarker positivity increased across NC, SCD, and MCI groups. Process scores can be integrated into the SCD criteria to allow for increased sensitivity and earlier identification of cognitively normal older adults at risk for decline prior to frank impairment on NP total scores.

  13. Modified Balance Error Scoring System (M-BESS) test scores in athletes wearing protective equipment and cleats.

    PubMed

    Azad, Aftab Mohammad; Al Juma, Saad; Bhatti, Junaid Ahmad; Delaney, J Scott

    2016-01-01

    Balance testing is an important part of the initial concussion assessment. There is no research on the differences in Modified Balance Error Scoring System (M-BESS) scores when tested in real world as compared to control conditions. To assess the difference in M-BESS scores in athletes wearing their protective equipment and cleats on different surfaces as compared to control conditions. This cross-sectional study examined university North American football and soccer athletes. Three observers independently rated athletes performing the M-BESS test in three different conditions: (1) wearing shorts and T-shirt in bare feet on firm surface (control); (2) wearing athletic equipment with cleats on FieldTurf; and (3) wearing athletic equipment with cleats on firm surface. Mean M-BESS scores were compared between conditions. 60 participants were recruited: 39 from football (all males) and 21 from soccer (11 males and 10 females). Average age was 21.1 years (SD=1.8). Mean M-BESS scores were significantly lower (p<0.001) for cleats on FieldTurf (mean=26.3; SD=2.0) and for cleats on firm surface (mean=26.6; SD=2.1) as compared to the control condition (mean=28.4; SD=1.5). Females had lower scores than males for cleats on FieldTurf condition (24.9 (SD=1.9) vs 27.3 (SD=1.6), p=0.005). Players who had taping or bracing on their ankles/feet had lower scores when tested with cleats on firm surface condition (24.6 (SD=1.7) vs 26.9 (SD=2.0), p=0.002). Total M-BESS scores for athletes wearing protective equipment and cleats standing on FieldTurf or a firm surface are around two points lower than M-BESS scores performed on the same athletes under control conditions.

  14. Modified Balance Error Scoring System (M-BESS) test scores in athletes wearing protective equipment and cleats

    PubMed Central

    Azad, Aftab Mohammad; Al Juma, Saad; Bhatti, Junaid Ahmad; Delaney, J Scott

    2016-01-01

    Background Balance testing is an important part of the initial concussion assessment. There is no research on the differences in Modified Balance Error Scoring System (M-BESS) scores when tested in real world as compared to control conditions. Objective To assess the difference in M-BESS scores in athletes wearing their protective equipment and cleats on different surfaces as compared to control conditions. Methods This cross-sectional study examined university North American football and soccer athletes. Three observers independently rated athletes performing the M-BESS test in three different conditions: (1) wearing shorts and T-shirt in bare feet on firm surface (control); (2) wearing athletic equipment with cleats on FieldTurf; and (3) wearing athletic equipment with cleats on firm surface. Mean M-BESS scores were compared between conditions. Results 60 participants were recruited: 39 from football (all males) and 21 from soccer (11 males and 10 females). Average age was 21.1 years (SD=1.8). Mean M-BESS scores were significantly lower (p<0.001) for cleats on FieldTurf (mean=26.3; SD=2.0) and for cleats on firm surface (mean=26.6; SD=2.1) as compared to the control condition (mean=28.4; SD=1.5). Females had lower scores than males for cleats on FieldTurf condition (24.9 (SD=1.9) vs 27.3 (SD=1.6), p=0.005). Players who had taping or bracing on their ankles/feet had lower scores when tested with cleats on firm surface condition (24.6 (SD=1.7) vs 26.9 (SD=2.0), p=0.002). Conclusions Total M-BESS scores for athletes wearing protective equipment and cleats standing on FieldTurf or a firm surface are around two points lower than M-BESS scores performed on the same athletes under control conditions. PMID:27900181

  15. Scoring Methods for Building Genotypic Scores: An Application to Didanosine Resistance in a Large Derivation Set

    PubMed Central

    Houssaini, Allal; Assoumou, Lambert; Miller, Veronica; Calvez, Vincent; Marcelin, Anne-Geneviève; Flandre, Philippe

    2013-01-01

    Background Several attempts have been made to determine HIV-1 resistance from genotype resistance testing. We compare scoring methods for building weighted genotyping scores and commonly used systems to determine whether the virus of a HIV-infected patient is resistant. Methods and Principal Findings Three statistical methods (linear discriminant analysis, support vector machine and logistic regression) are used to determine the weight of mutations involved in HIV resistance. We compared these weighted scores with known interpretation systems (ANRS, REGA and Stanford HIV-db) to classify patients as resistant or not. Our methodology is illustrated on the Forum for Collaborative HIV Research didanosine database (N = 1453). The database was divided into four samples according to the country of enrolment (France, USA/Canada, Italy and Spain/UK/Switzerland). The total sample and the four country-based samples allow external validation (one sample is used to estimate a score and the other samples are used to validate it). We used the observed precision to compare the performance of newly derived scores with other interpretation systems. Our results show that newly derived scores performed better than or similar to existing interpretation systems, even with external validation sets. No difference was found between the three methods investigated. Our analysis identified four new mutations associated with didanosine resistance: D123S, Q207K, H208Y and K223Q. Conclusions We explored the potential of three statistical methods to construct weighted scores for didanosine resistance. Our proposed scores performed at least as well as already existing interpretation systems and previously unrecognized didanosine-resistance associated mutations were identified. This approach could be used for building scores of genotypic resistance to other antiretroviral drugs. PMID:23555613

  16. Modifications of the National Early Warning Score for patients with chronic respiratory disease.

    PubMed

    Pedersen, N E; Rasmussen, L S; Petersen, J A; Gerds, T A; Østergaard, D; Lippert, A

    2018-02-01

    The National Early Warning Score (NEWS) uses physiological variables to detect deterioration in hospitalized patients. However, patients with chronic respiratory disease may have abnormal variables not requiring interventions. We studied how the Capital Region of Denmark NEWS Override System (CROS), the Chronic Respiratory Early Warning Score (CREWS) and the Salford NEWS (S-NEWS) affected NEWS total scores and NEWS performance. In an observational study, we included patients with chronic respiratory disease. The frequency of use of CROS and the NEWS total score changes caused by CROS, CREWS and S-NEWS were described. NEWS, CROS, CREWS and S-NEWS were compared using 48-h mortality and intensive care unit (ICU) admission within 48 h as outcomes. We studied 11,266 patients during 25,978 admissions; the use of CROS lowered NEWS total scores in 40% of included patients. CROS, CREWS and S-NEWS had lower sensitivities than NEWS for 48-h mortality and ICU admission. Specificities and PPV were higher. CROS, CREWS and S-NEWS downgraded, respectively, 51.5%, 44.9% and 32.8% of the NEWS total scores from the 'mandatory doctor presence' and 'immediate doctor presence and specialist consultation' total score intervals to lower intervals. Capital Region of Denmark NEWS Override System was frequently used in patients with chronic respiratory disease. CROS, CREWS and S-NEWS reduced sensitivity for 48-h mortality and ICU admission. Using the methodology prevalent in the NEWS literature, we cannot conclude on the safety of these systems. Future prospective studies should investigate the balance between detection rate and alarm fatigue of different systems, or use controlled designs and patient-centred outcomes. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. Configural Scoring of Simulator Sickness, Cybersickness and Space Adaptation Syndrome: Similarities and Differences?

    NASA Technical Reports Server (NTRS)

    Kennedy, Robert S.; Drexler, Julie M.; Compton, Daniel E.; Stanney, Kay M.; Lanham, Susan; Harm, Deborah L.

    2001-01-01

    From a survey of ten U.S. Navy flight simulators a large number (N > 1,600 exposures) of self-reports of motion sickness symptomatology were obtained. Using these data, scoring algorithms were derived, which permit examination of groups of individuals that can be scored either for 1) their total sickness experience in a particular device; or, 2) according to three separable symptom clusters which emerged from a Factor Analysis. Scores from this total score are found to be proportional to other global motion sickness symptom checklist scores with which they correlate (r = 0.82). The factors that surfaced from the analysis include clusters of symptoms referable as nausea, oculomotor disturbances, and disorientation (N, 0, and D). The factor scores may have utility in differentiating the source of symptoms in different devices. The present chapter describes our experience with the use of both of these types of scores and illustrates their use with examples from flight simulators, space sickness and virtual environments.

  18. Prognostic Value of AIMS65 Score in Cirrhotic Patients with Upper Gastrointestinal Bleeding.

    PubMed

    Gaduputi, Vinaya; Abdulsamad, Molham; Tariq, Hassan; Rafeeq, Ahmed; Abbas, Naeem; Kumbum, Kavitha; Chilimuri, Sridhar

    2014-01-01

    Introduction. Unlike Rockall scoring system, AIMS65 is based only on clinical and laboratory features. In this study we investigated the correlation between the AIMS65 score and Endoscopic Rockall score, in cirrhotic and noncirrhotic patients. Methods. This is a retrospective study of patients admitted with overt UGIB and undergoing esophagogastroduodenoscopy (EGD). AIMS65 and Rockall scores were calculated at the time of admission. We investigated the correlation between both scores along with stigmata of bleed seen on endoscopy. Results. A total of 1255 patients were studied. 152 patients were cirrhotic while 1103 patients were noncirrhotic. There was significant correlation between AIMS65 and Total Rockall scores in patients of both groups. There was significant correlation between AIMS65 score and Endoscopic Rockall score in noncirrhotics but not cirrhotics. AIMS65 scores in both cirrhotic and noncirrhotic groups were significantly higher in patients who died from UGIB than in patients who did not. Conclusion. We observed statistically significant correlation between AIMS65 score and length of hospitalization and mortality in noncirrhotic patients. We found that AIMS65 score paralleled the endoscopic grading of lesion causing UGIB in noncirrhotics. AIMS65 score correlated only with mortality but not the length of hospitalization or endoscopic stigmata of bleed in cirrhotics.

  19. Does Parsonnet scoring model predict mortality following adult cardiac surgery in India?

    PubMed

    Srilata, Moningi; Padhy, Narmada; Padmaja, Durga; Gopinath, Ramachandran

    2015-01-01

    To validate the Parsonnet scoring model to predict mortality following adult cardiac surgery in Indian scenario. A total of 889 consecutive patients undergoing adult cardiac surgery between January 2010 and April 2011 were included in the study. The Parsonnet score was determined for each patient and its predictive ability for in-hospital mortality was evaluated. The validation of Parsonnet score was performed for the total data and separately for the sub-groups coronary artery bypass grafting (CABG), valve surgery and combined procedures (CABG with valve surgery). The model calibration was performed using Hosmer-Lemeshow goodness of fit test and receiver operating characteristics (ROC) analysis for discrimination. Independent predictors of mortality were assessed from the variables used in the Parsonnet score by multivariate regression analysis. The overall mortality was 6.3% (56 patients), 7.1% (34 patients) for CABG, 4.3% (16 patients) for valve surgery and 16.2% (6 patients) for combined procedures. The Hosmer-Lemeshow statistic was <0.05 for the total data and also within the sub-groups suggesting that the predicted outcome using Parsonnet score did not match the observed outcome. The area under the ROC curve for the total data was 0.699 (95% confidence interval 0.62-0.77) and when tested separately, it was 0.73 (0.64-0.81) for CABG, 0.79 (0.63-0.92) for valve surgery (good discriminatory ability) and only 0.55 (0.26-0.83) for combined procedures. The independent predictors of mortality determined for the total data were low ejection fraction (odds ratio [OR] - 1.7), preoperative intra-aortic balloon pump (OR - 10.7), combined procedures (OR - 5.1), dialysis dependency (OR - 23.4), and re-operation (OR - 9.4). The Parsonnet score yielded a good predictive value for valve surgeries, moderate predictive value for the total data and for CABG and poor predictive value for combined procedures.

  20. Association between sleep stages and hunger scores in 36 children.

    PubMed

    Arun, R; Pina, P; Rubin, D; Erichsen, D

    2016-10-01

    Childhood obesity is a growing health challenge. Recent studies show that children with late bedtime and late awakening are more obese independent of total sleep time. In adolescents and adults, a delayed sleep phase has been associated with higher caloric intake. Furthermore, an adult study showed a positive correlation between REM sleep and energy balance. This relationship has not been demonstrated in children. However, it may be important as a delayed sleep phase would increase the proportion of REM sleep. This study investigated the relationship between hunger score and sleep physiology in a paediatric population. Thirty-six patients referred for a polysomnogram for suspected obstructive sleep apnoea were enrolled in the study. Sleep stages were recorded as part of the polysomnogram. Hunger scores were obtained using a visual analogue scale. Mean age was 9.6 ± 3.5 years. Mean hunger scores were 2.07 ± 2.78. Hunger scores were positively correlated with percentage of total rapid eye movement (REM) sleep (r = 0.438, P < 0.01) and REM sleep duration in minutes (r = 0.471, P < 0.05). Percentage slow wave sleep (SWS) was negatively correlated with hunger score (r = -0.360, P < 0.05). There were no correlations between age, sex, body mass index percentiles, apnoea-hypopnoea index, total sleep time, sleep efficiency, sleep onset latency, stage 2 sleep duration and hunger scores. These findings suggest that delayed bedtime, which increases the proportion of REM sleep and decreases the proportion of SWS, results in higher hunger levels in children. © 2015 World Obesity.

  1. Extended X-ray Absorption Fine Structure Study of Bond Constraints in Ge-Sb-Te Alloys

    DTIC Science & Technology

    2011-02-07

    Ray Absorption Spectroscopy, or EXAFS. Using the spectroscopic capabilities provided by the MCAT line at the Advanced Photon Source at Argonne...Absorption Spectroscopy, or EXAFS. Using the spectroscopic capabilities provided by the MCAT line at the Advanced Photon Source at Argonne National

  2. Aerospace Systems Technical Research Operation Services (ASTROS) Industry Day (Briefing Charts)

    DTIC Science & Technology

    2014-07-01

    Integrated Motor Life Management AFM 315E – Green Propellant MCAT – Missile Component Advanced Tech EP – Electric Propulsion Distribution A...service life estimate •Distribution A: Approved for public release; unlimited distribution 23 MCAT (Motor Component Assessment Technology) What are

  3. A diagnostic scoring system for myxedema coma.

    PubMed

    Popoveniuc, Geanina; Chandra, Tanu; Sud, Anchal; Sharma, Meeta; Blackman, Marc R; Burman, Kenneth D; Mete, Mihriye; Desale, Sameer; Wartofsky, Leonard

    2014-08-01

    To develop diagnostic criteria for myxedema coma (MC), a decompensated state of extreme hypothyroidism with a high mortality rate if untreated, in order to facilitate its early recognition and treatment. The frequencies of characteristics associated with MC were assessed retrospectively in patients from our institutions in order to derive a semiquantitative diagnostic point scale that was further applied on selected patients whose data were retrieved from the literature. Logistic regression analysis was used to test the predictive power of the score. Receiver operating characteristic (ROC) curve analysis was performed to test the discriminative power of the score. Of the 21 patients examined, 7 were reclassified as not having MC (non-MC), and they were used as controls. The scoring system included a composite of alterations of thermoregulatory, central nervous, cardiovascular, gastrointestinal, and metabolic systems, and presence or absence of a precipitating event. All 14 of our MC patients had a score of ≥60, whereas 6 of 7 non-MC patients had scores of 25 to 50. A total of 16 of 22 MC patients whose data were retrieved from the literature had a score ≥60, and 6 of 22 of these patients scored between 45 and 55. The odds ratio per each score unit increase as a continuum was 1.09 (95% confidence interval [CI], 1.01 to 1.16; P = .019); a score of 60 identified coma, with an odds ratio of 1.22. The area under the ROC curve was 0.88 (95% CI, 0.65 to 1.00), and the score of 60 had 100% sensitivity and 85.71% specificity. A score ≥60 in the proposed scoring system is potentially diagnostic for MC, whereas scores between 45 and 59 could classify patients at risk for MC.

  4. The Autism Diagnostic Observation Schedule, Toddler Module: Standardized Severity Scores

    PubMed Central

    Esler, Amy N.; Bal, Vanessa Hus; Guthrie, Whitney; Wetherby, Amy; Weismer, Susan Ellis; Lord, Catherine

    2016-01-01

    Standardized calibrated severity scores (CSS) have been created for Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) Modules 1–4 as a metric of the relative severity of autism-specific behaviors. Total and domain CSS were created for the Toddler Module to facilitate comparison to other modules. Analyses included 388 children with ASD age 12 to 30 months and were replicated on 435 repeated assessments from 127 children with ASD. Compared to raw scores, associations between total and domain CSS and participant characteristics were reduced in the original sample. Verbal IQ effects on Social Affect-CSS were not reduced in the replication sample. Toddler Module CSS increases comparability of ADOS-2 scores across modules and allows studies of symptom trajectories to extend to earlier ages. PMID:25832801

  5. Color Preference and MMPI Scores of Alcohol and Drug Addicts.

    ERIC Educational Resources Information Center

    Cernovsky, Zdenek

    1986-01-01

    Inpatients (n=67) treated for alcohol and drug abuse were administered the MMPI (Minnesota Multiphasic Personality Inventory) and Luescher Color Test (LCT). Patients showed more preference for brown than did normal adults and also obtained higher (i.e., presumably more pathological) scores on Luescher's total score scale and compensation scale.…

  6. Calcium scoring with dual-energy CT in men and women: an anthropomorphic phantom study

    NASA Astrophysics Data System (ADS)

    Li, Qin; Liu, Songtao; Myers, Kyle; Gavrielides, Marios A.; Zeng, Rongping; Sahiner, Berkman; Petrick, Nicholas

    2016-03-01

    This work aimed to quantify and compare the potential impact of gender differences on coronary artery calcium scoring with dual-energy CT. An anthropomorphic thorax phantom with four synthetic heart vessels (diameter 3-4.5 mm: female/male left main and left circumflex artery) were scanned with and without female breast plates. Ten repeat scans were acquired in both single- and dual-energy modes and reconstructed at six reconstruction settings: two slice thicknesses (3 mm, 0.6 mm) and three reconstruction algorithms (FBP, IR3, IR5). Agatston and calcium volume scores were estimated from the reconstructed data using a segmentation-based approach. Total calcium score (summation of four vessels), and male/female calcium scores (summation of male/female vessels scanned in phantom without/with breast plates) were calculated accordingly. Both Agatston and calcium volume scores were found comparable between single- and dual-energy scans (Pearson r= 0.99, p<0.05). The total calcium scores were larger for the thinner slice thickness. Among the scores obtained from the three reconstruction algorithms, FBP yielded the highest and IR5 yielded the lowest scores. The total calcium scores from the phantom without breast plates were significantly larger than those from the phantom with breast plates, and the difference increased with the stronger denoising in iterative algorithm and with thicker slices. Both gender-based anatomical differences and vessel size impacted the calcium scores. The calcium volume scores tended to be underestimated when the vessels were smaller. These findings are valuable for understanding inconsistencies between women and men in calcium scoring, and for standardizing imaging protocols for improved gender-specific calcium scoring.

  7. Regulation of malonyl-CoA-acyl carrier protein transacylase network in umbilical cord blood affected by intrauterine hyperglycemia

    PubMed Central

    Zhang, Yong; Ye, Jianping; Fan, Jianxia

    2017-01-01

    Background Gestational diabetes mellitus (GDM) has been shown to be associated with high risk of diabetes in offspring. However, the mechanisms involved in the insulin resistance in offspring are still unclear. Mitochondrial dysfunction is related with insulin resistance. In mitochondria, malonyl-CoA-acyl carrier protein transacylase (MCAT) is the key enzyme of mitochondrial fatty acid synthesis and is estimated to contribute to insulin resistance. In this study, we aimed to examine the role of MCAT and its network in the umbilical cord blood in GDM-induced offspring insulin resistance. Methods We isolated lymphocytes from umbilical cord vein blood in 6 GDM patients and 6 controls and examined the differences of RNA by RNA sequencing. qRT-PCR and western blot were used to measure mRNA and protein changes. Bisulfite genomic sequencing PCR was applied to detect DNA methylation. Results We found more than 400 genes were differentially regulated in the lymphocytes of umbilical cord blood from GDM patients and these genes were mainly enriched in immune system and endocrine system, which relate to mitochondrial dysfunction and insulin resistance. MCAT closely related with PTPN1 (Protein Tyrosine Phosphatase, Non-Receptor Type1) and STAT5A (Signal Transducer And Activator of Transcription 5A), which were all increased in umbilical cord blood from GDM patients. Increase in MCAT may be due to decreased MCAT DNA methylation. Conclusion MCAT and its network with PTPN1, STAT5A are regulated in umbilical cord blood affected by maternal intrauterine hyperglycemia. PMID:29088862

  8. Automated Trait Scores for "TOEFL"® Writing Tasks. Research Report. ETS RR-15-14

    ERIC Educational Resources Information Center

    Attali, Yigal; Sinharay, Sandip

    2015-01-01

    The "e-rater"® automated essay scoring system is used operationally in the scoring of "TOEFL iBT"® independent and integrated tasks. In this study we explored the psychometric added value of reporting four trait scores for each of these two tasks, beyond the total e-rater score.The four trait scores are word choice, grammatical…

  9. The ASVAB (Armed Services Vocational Aptitude Battery) Score Scales. 1980 and World War II

    DTIC Science & Technology

    1986-07-01

    TABLE B-3 ASVAB 14 (A, B, & C) MECHANICAL & CRAFTS (MC) COMPOSITE PERCENTILE NORMS BY SEX AND GRADE Females Grade Males Total Standard Grade...COMPOSITE PERCENTILE NORMS BY SEX AND GRADE Females Grade Males Total Standard Grade Grade Standard Score 11th 12th nth 12th nth 12th Score 24 24...Standard Scores. B-8 TABLE B-3 ASVAB 14 (A. B,&C) ELECTRONIC & ELECTRICAL (EE) COMPOSITE PERCENTILE NORMS BY SEX AND GRADE Females Grade Males

  10. Revisiting the utility of technical performance scores following tetralogy of Fallot repair.

    PubMed

    Lodin, Daud; Mavrothalassitis, Orestes; Haberer, Kim; Sunderji, Sherzana; Quek, Ruben G W; Peyvandi, Shabnam; Moon-Grady, Anita; Karamlou, Tara

    2017-08-01

    Although an important quality metric, current technical performance scores may not be generalizable and may omit operative factors that influence outcomes. We examined factors not included in current technical performance scores that may contribute to increased postoperative length of stay, major complications, and cost after primary repair of tetralogy of Fallot. This is a retrospective single site study of patients younger than age 2 years with tetralogy of Fallot undergoing complete repair between 2007 and 2015. Medical record data and discharge echocardiograms were reviewed to ascertain component and composite technical performance scores. Primary outcomes included postoperative length of stay, major complications, and total hospital costs. Multivariable logistic and linear regression identified determinants of each outcome. Patient population (n = 115) had a median postoperative length of stay of 8 days (interquartile range, 6-10 days), and a median total cost of $71,147. Major complications occurred in 33 patients (29%) with 1 death. Technical performance scores assigned were optimum in 28 patients (25%), adequate in 59 patients (52%), and inadequate in 26 patients (23%). Neither technical performance score components nor composite scores were associated with increased postoperative length of stay. Optimum or adequate repairs versus inadequate had equal risk of a complication (P = .79), and equivalent mean total cost ($100,000 vs $187,000; P = .25). Longer cardiopulmonary bypass time per 1-minute increase (P < .01) was associated with longer postoperative length of stay and reintervention (P = .02). The need to return to bypass also increased total cost (P < .01). Current tetralogy of Fallot technical performance scores were not associated with selected outcomes in our postoperative population. Although returning to bypass and bypass length are not included as components in the current score, these are important factors influencing

  11. Dutch validation of the low anterior resection syndrome score.

    PubMed

    Hupkens, B J P; Breukink, S O; Olde Reuver Of Briel, C; Tanis, P J; de Noo, M E; van Duijvendijk, P; van Westreenen, H L; Dekker, J W T; Chen, T Y T; Juul, T

    2018-04-21

    The aim of this study was to validate the Dutch translation of the low anterior resection syndrome (LARS) score in a population of Dutch rectal cancer patients. Patients who underwent surgery for rectal cancer received the LARS score questionnaire, a single quality of life (QoL) category question and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire. A subgroup of patients received the LARS score twice to assess the test-retest reliability. A total of 165 patients were included in the analysis, identified in six Dutch centres. The response rate was 62.0%. The percentage of patients who reported 'major LARS' was 59.4%. There was a high proportion of patients with a perfect or moderate fit between the QoL category question and the LARS score, showing a good convergent validity. The LARS score was able to discriminate between patients with or without neoadjuvant radiotherapy (P = 0.003), between total and partial mesorectal excision (P = 0.008) and between age groups (P = 0.039). There was a statistically significant association between a higher LARS score and an impaired function on the global QoL subscale and the physical, role, emotional and social functioning subscales of the EORTC QLQ-C30 questionnaire. The test-retest reliability of the LARS score was good, with an interclass correlation coefficient of 0.79. The good psychometric properties of the Dutch version of the LARS score are comparable overall to the earlier validations in other countries. Therefore, the Dutch translation can be considered to be a valid tool for assessing LARS in Dutch rectal cancer patients. Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Ireland.

  12. A Comparative Study of Online Item Calibration Methods in Multidimensional Computerized Adaptive Testing

    ERIC Educational Resources Information Center

    Chen, Ping

    2017-01-01

    Calibration of new items online has been an important topic in item replenishment for multidimensional computerized adaptive testing (MCAT). Several online calibration methods have been proposed for MCAT, such as multidimensional "one expectation-maximization (EM) cycle" (M-OEM) and multidimensional "multiple EM cycles"…

  13. Physics and the revised Medical College Admission Test

    NASA Astrophysics Data System (ADS)

    Hilborn, Robert C.

    2014-05-01

    Physics has played an important role in the preparation of future physicians and other health professionals for more than 100 years. Almost all pre-health students take a year of college-level physics as part of their preparation for medical, dental, and pharmacy school. In particular, the widely-used Medical College Admission Test (MCAT) contains a significant number of questions that require physics knowledge and skills. This paper describes the changes in the MCAT to be implemented in 2015, the role of physics in the revised MCAT, and implications for introductory physics courses for the life sciences.

  14. Significant correlation of comprehensive Aristotle score with total cardiac output during the early postoperative period after the Norwood procedure.

    PubMed

    Li, Jia; Zhang, Gencheng; Holtby, Helen; Cai, Sally; Walsh, Mark; Caldarone, Christopher A; Van Arsdell, Glen S

    2008-07-01

    The comprehensive Aristotle score has been proposed as an individualized measure of the complexity of a given surgical procedure and has been reported to significantly correlate with postoperative morbidity and mortality after the Norwood procedure. An important factor leading to postoperative morbidity and mortality is low cardiac output. We studied the correlation between the comprehensive Aristotle score and cardiac output (CO) in infants after the Norwood procedure. Respiratory mass spectrometry was used to continuously measure systemic oxygen consumption (VO(2)) in 22 infants for 72 hours postoperatively. Arterial, superior vena caval and pulmonary venous blood gases were measured at 2 to 4 hour intervals to calculate CO. The comprehensive Aristotle score was collected. Hospital mortality was 4.5%. The comprehensive Aristotle score ranged from 14.5 to 23.5 and negatively correlated with CO (P = 0.027). Among the patient-adjusted factors, myocardial dysfunction (n = 10), mechanical ventilation to treat cardiorespiratory failure (n = 9) and atrioventricular valve regurgitation (n = 4) (P = 0.01) negatively correlated with CO (P = 0.06 to 0.07). Aortic atresia (n = 9) was associated with a lower CO (P = 0.01) for the first 24 hours which linearly increased overtime (P = 0.0001). No correlation was found between CO and other factors (P > 0.3 for all). Comprehensive Aristotle score significantly negatively correlates with CO after the Norwood procedure. A preoperative estimation of the comprehensive Aristotle score, particularly in association with myocardial dysfunction, mechanical ventilation to treat cardiorespiratory failure, atrioventricular valve regurgitation and aortic atresia may help to anticipate a high postoperative morbidity with low cardiac output syndrome.

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

    PubMed

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

    2010-04-01

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

  16. An evaluation of the association between an antimicrobial stewardship score and antimicrobial usage

    PubMed Central

    Pakyz, Amy L.; Moczygemba, Leticia R.; Wang, Hui; Stevens, Michael P.; Edmond, Michael B.

    2015-01-01

    Objectives To determine whether an antimicrobial stewardship ‘intensity’ score predicts hospital antimicrobial usage. Methods An antimicrobial stewardship score for 44 academic medical centres was developed that comprised two main categories: resources (antimicrobial stewardship programme personnel and automated surveillance software) and strategies (preauthorization, audit with intervention and feedback, education, guidelines and clinical pathways, parenteral to oral therapy programmes, de-escalation of therapy, antimicrobial order forms and dose optimization). Multiple regression analyses were used to assess whether the composite score and also the categories were associated with either total or antimicrobial stewardship programme-target antimicrobial use as measured in days of therapy. Results The mean antimicrobial stewardship programme score was 55 (SD 21); the total composite score was not significantly associated with total or target antimicrobial use [estimate –0.49 (95% CI –2.30 to 0.89)], while the category strategies was significantly and negatively associated with target antimicrobial use [–5.91 (95% CI –9.51 to –2.31)]. Conclusions The strategy component of a score developed to measure the intensity of antimicrobial stewardship was associated with the amount of antimicrobials used. Thus, the number and types of strategies employed by antimicrobial stewardship programmes may be of particular importance in programme effectiveness. PMID:25614043

  17. Factors that impact expectations before total knee arthroplasty.

    PubMed

    Hepinstall, Matthew S; Rutledge, John R; Bornstein, Lindsey J; Mazumdar, Madhu; Westrich, Geoffrey H

    2011-09-01

    This study examined the effect of patient attributes on expectations before total knee arthroplasty (TKA). A total of 1943 patients completed an Expectations Survey before TKA. Demographics, surgical history, baseline Medical Outcomes Study Short Form 36 (SF-36) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Lower Extremity Activity Scale score were obtained. On univariate analysis, expectations (mean score, 77.6) correlated with SF-36 General Health, age, SF-36 Vitality, KOOS Quality-of-Life, and Lower Extremity Activity Scale. Living alone and history of joint arthroplasty were associated with significantly lower expectations, whereas male sex and white race were associated with higher expectations. On multivariate regression analysis, age, living situation, history of joint arthroplasty, SF-36 General Health, and KOOS Quality-of-Life remained significant predictors of expectations. Our results suggest that high, possibly unrealistic, expectations of TKA are common and should be moderated to maintain patient satisfaction. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Insertion of targeting domains into the envelope glycoprotein of Moloney murine leukemia virus (MoMLV)-based vectors modulates the route of mCAT-1-mediated viral entry.

    PubMed

    Viejo-Borbolla, A; Pizzato, M; Blair, E D; Schulz, T F

    2005-03-01

    Several groups have inserted targeting domains into the envelope glycoprotein (Env) of Moloney murine leukemia virus (MoMLV) in an attempt to produce targeted retroviral vectors for human gene therapy. While binding of these modified Envs to the target molecule expressed on the surface of human cells was observed, specific high-titer infection of human cells expressing the target molecule was not achieved. Here we investigate the initial steps in the entry process of targeted MoMLV vectors both in murine and human cells expressing the MoMLV receptor, the mouse cationic amino acid transporter-1 (mCAT-1). We show that insertion of a small ligand targeted to E-selectin and of a single chain antibody (scFv) targeted to folate-binding protein (FBP) into the N-terminus of MoMLV Env results in the reduction of the infectivity and the kinetics of entry of the MoMLV vectors. The use of soluble receptor-binding domain (sRBD), bafilomycin A1 (BafA1) and methyl-beta-cyclodextrin (MbetaC) increase the infectivity of the MoMLV vectors targeted to FBP (MoMLV-FBP) suggesting that the scFv targeted to FBP increases the threshold for fusion and might re-route entry of the targeted MoMLV-FBP vector towards an endocytic, non-productive pathway.

  19. Validation of the Sepsis Severity Score Compared with Updated Severity Scores in Predicting Hospital Mortality in Sepsis Patients.

    PubMed

    Khwannimit, Bodin; Bhurayanontachai, Rungsun; Vattanavanit, Veerapong

    2017-06-01

    Recently, the Sepsis Severity Score (SSS) was constructed to predict mortality in sepsis patients. The aim of this study was to compare performance of the SSS with the Acute Physiology and Chronic Health Evaluation (APACHE) II-IV, Simplified Acute Physiology Score (SAPS) II, and SAPS 3 scores in predicting hospital outcome in sepsis patients. A retroprospective analysis was conducted in the medical intensive care unit of a tertiary university hospital. A total of 913 patients were enrolled; 476 of these patients (52.1%) had septic shock. The median SSS was 80 (range 20-137). The SSS presented good discrimination with an area under the receiver operating characteristic curve (AUC) of 0.892. However, the AUC of the SSS did not differ significantly from that of APACHE II (P = 0.07), SAPS II (P = 0.06), and SAPS 3 (P = 0.11). The APACHE IV score showed the best discrimination with an AUC of 0.948 and the overall performance by a Brier score of 0.096. The AUC of the APACHE IV score was statistically greater than the SSS, APACHE II, SAPS II, and SAPS 3 (P <0.0001 for all) and APACHE III (P = 0.0002). The calibration of all scores was poor with the Hosmer-Lemeshow goodness-of-fit H test <0.05. The SSS provided as good discrimination as the APACHE II, SAPS II, and SAPS 3 scores. However, the APACHE IV score had the best discrimination and overall performance in our sepsis patients. The SSS needs to be adapted and modified with new parameters to improve its performance.

  20. Noise reduction technology reduces radiation dose in chronic total occlusions percutaneous coronary intervention: a propensity score-matched analysis.

    PubMed

    Maccagni, Davide; Benincasa, Susanna; Bellini, Barbara; Candilio, Luciano; Poletti, Enrico; Carlino, Mauro; Colombo, Antonio; Azzalini, Lorenzo

    2018-03-23

    Chronic total occlusions (CTO) percutaneous coronary intervention (PCI) is associated with high radiation dose. Our study aim was to evaluate the impact of the implementation of a noise reduction technology (NRT) on patient radiation dose during CTO PCI. A total of 187 CTO PCIs performed between February 2016 and May 2017 were analyzed according to the angiographic systems utilized: Standard (n = 60) versus NRT (n = 127). Propensity score matching (PSM) was performed to control for differences in baseline characteristics. Primary endpoints were Cumulative Air Kerma at Interventional Reference Point (AK at IRP), which correlates with patient's tissue reactions; and Kerma Area Product (KAP), a surrogate measure of patient's risk of stochastic radiation effects. An Efficiency Index (defined as fluoroscopy time/AK at IRP) was calculated for each procedure. Image quality was evaluated using a 5-grade Likert-like scale. After PSM, n = 55 pairs were identified. Baseline and angiographic characteristics were well matched between groups. Compared to the Standard system, NRT was associated with lower AK at IRP [2.38 (1.80-3.66) vs. 3.24 (2.04-5.09) Gy, p = 0.035], a trend towards reduction for KAP [161 (93-244) vs. 203 (136-363) Gycm 2 , p = 0.069], and a better Efficiency Index [16.75 (12.73-26.27) vs. 13.58 (9.92-17.63) min/Gy, p = 0.003]. Image quality was similar between the two groups (4.39 ± 0.53 Standard vs. 4.34 ± 0.47 NRT, p = 0.571). In conclusion, compared with a Standard system, the use of NRT in CTO PCI is associated with lower patient radiation dose and similar image quality.

  1. Bronchiolitis Score of Sant Joan de Déu: BROSJOD Score, validation and usefulness.

    PubMed

    Balaguer, Mònica; Alejandre, Carme; Vila, David; Esteban, Elisabeth; Carrasco, Josep L; Cambra, Francisco José; Jordan, Iolanda

    2017-04-01

    To validate the bronchiolitis score of Sant Joan de Déu (BROSJOD) and to examine the previously defined scoring cutoff. Prospective, observational study. BROSJOD scoring was done by two independent physicians (at admission, 24 and 48 hr). Internal consistency of the score was assessed using Cronbach's α. To determine inter-rater reliability, the concordance correlation coefficient estimated as an intraclass correlation coefficient (CCC) and limits of agreement estimated as the 90% total deviation index (TDI) were estimated. An expert opinion was used to classify patients according to clinical severity. A validity analysis was conducted comparing the 3-level classification score to that expert opinion. Volume under the surface (VUS), predictive values, and probability of correct classification (PCC) were measured to assess discriminant validity. About 112 patients were recruited, 62 of them (55.4%) males. Median age: 52.5 days (IQR: 32.75-115.25). The admission Cronbach's α was 0.77 (CI95%: 0.71; 0.82) and at 24 hr it was 0.65 (CI95%: 0.48; 0.7). The inter-rater reliability analysis was: CCC at admission 0.96 (95%CI 0.94-0.97), at 24 h 0.77 (95%CI 0.65-0.86), and at 48 hr 0.94 (95%CI 0.94-0.97); TDI 90%: 1.6, 2.9, and 1.57, respectively. The discriminant validity at admission: VUS of 0.8 (95%CI 0.70-0.90), at 24 h 0.92 (95%CI 0.85-0.99), and at 48 hr 0.93 (95%CI 0.87-0.99). The predictive values and PCC values were within 38-100% depending on the level of clinical severity. There is a high inter-rater reliability, showing the BROSJOD score to be reliable and valid, even when different observers apply it. Pediatr Pulmonol. 2017;52:533-539. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Translation and validation of the new version of the Knee Society Score - The 2011 KS Score - into Brazilian Portuguese.

    PubMed

    Silva, Adriana Lucia Pastore E; Croci, Alberto Tesconi; Gobbi, Riccardo Gomes; Hinckel, Betina Bremer; Pecora, José Ricardo; Demange, Marco Kawamura

    2017-01-01

    Translation, cultural adaptation, and validation of the new version of the Knee Society Score - The 2011 KS Score - into Brazilian Portuguese and verification of its measurement properties, reproducibility, and validity. In 2012, the new version of the Knee Society Score was developed and validated. This scale comprises four separate subscales: (a) objective knee score (seven items: 100 points); (b) patient satisfaction score (five items: 40 points); (c) patient expectations score (three items: 15 points); and (d) functional activity score (19 items: 100 points). A total of 90 patients aged 55-85 years were evaluated in a clinical cross-sectional study. The pre-operative translated version was applied to patients with TKA referral, and the post-operative translated version was applied to patients who underwent TKA. Each patient answered the same questionnaire twice and was evaluated by two experts in orthopedic knee surgery. Evaluations were performed pre-operatively and three, six, or 12 months post-operatively. The reliability of the questionnaire was evaluated using the intraclass correlation coefficient (ICC) between the two applications. Internal consistency was evaluated using Cronbach's alpha. The ICC found no difference between the means of the pre-operative, three-month, and six-month post-operative evaluations between sub-scale items. The Brazilian Portuguese version of The 2011 KS Score is a valid and reliable instrument for objective and subjective evaluation of the functionality of Brazilian patients who undergo TKA and revision TKA.

  3. The BRICS (Bronchiectasis Radiologically Indexed CT Score): A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis.

    PubMed

    Bedi, Pallavi; Chalmers, James D; Goeminne, Pieter C; Mai, Cindy; Saravanamuthu, Pira; Velu, Prasad Palani; Cartlidge, Manjit K; Loebinger, Michael R; Jacob, Joe; Kamal, Faisal; Schembri, Nicola; Aliberti, Stefano; Hill, Uta; Harrison, Mike; Johnson, Christopher; Screaton, Nicholas; Haworth, Charles; Polverino, Eva; Rosales, Edmundo; Torres, Antoni; Benegas, Michael N; Rossi, Adriano G; Patel, Dilip; Hill, Adam T

    2018-05-01

    The goal of this study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. The Bronchiectasis Radiologically Indexed CT Score (BRICS) was devised based on a multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was then externally validated in six centers in 302 patients. A total of 184 high-resolution CT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percent predicted FEV 1 , sputum purulence, and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with the disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. The BRICS was developed with these two parameters. The receiver operating-characteristic curve values for BRICS in the derivation cohort were 0.79 for percent predicted FEV 1 , 0.71 for sputum purulence, and 0.75 for hospital admissions per year; these values were 0.81, 0.70, and 0.70, respectively, in the validation cohort. Sputum free neutrophil elastase activity was significantly elevated in the group with emphysema on CT imaging. A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and postinfective bronchiectasis. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  4. Correlation of Visual Prostate Symptom Score with International Prostate Symptom Score and Uroflowmetry Parameters in Nepalese Male Patients with Lower Urinary Tract Symptoms.

    PubMed

    Bhomi, K K; Subedi, N; Panta, P P

    2017-01-01

    International prostate symptom score is a validated questionnaire used to evaluate the lower urinary tract symptoms in benign prostatic hyperplasia. Visual prostate symptom score is a new simplified symptom score with pictograms to evaluate the same. We evaluated the correlation of visual prostate symptom score with international prostate symptom score and uroflowmetry parameters in Nepalese male patients with lower urinary tract symptoms. Male patients aged ≥40 years attending the Urology clinic were enrolled in the study. They were given international prostate symptom score and visual prostate symptom score questionnaires to complete providing assistance whenever needed. Demographic data, examination findings and uroflowmetry parameters were noted. Correlation and regression analysis was used to identify correlation of the two scoring systems and uroflowmetry parameters. Among the 66 patients enrolled, only 10 (15.15%) patients were able to understand English language. There was a statistically significant correlation between total visual prostate symptom score and international prostate symptom score (r= 0.822; P<0.01). The correlations between individual scores of the two scoring systems related to force of urinary stream, frequency, nocturia and quality of life were also statistically significant. There was also a statistically significant correlation of both scores with maximum flow rate and average flow rate. There is a statistically significant correlation of visual prostate symptom score with international prostate symptom score and uroflowmetry parameters. IPSS can be replaced with simple VPSS in evaluation of lower urinary tract symptoms in elderly male patients.

  5. Modeling relationships between traditional preadmission measures and clinical skills performance on a medical licensure examination.

    PubMed

    Roberts, William L; Pugliano, Gina; Langenau, Erik; Boulet, John R

    2012-08-01

    Medical schools employ a variety of preadmission measures to select students most likely to succeed in the program. The Medical College Admission Test (MCAT) and the undergraduate college grade point average (uGPA) are two academic measures typically used to select students in medical school. The assumption that presently used preadmission measures can predict clinical skill performance on a medical licensure examination was evaluated within a validity argument framework (Kane 1992). A hierarchical generalized linear model tested relationships between the log-odds of failing a high-stakes medical licensure performance examination and matriculant academic and non-academic preadmission measures, controlling for student-and school-variables. Data includes 3,189 matriculants from 22 osteopathic medical schools tested in 2009-2010. Unconditional unit-specific model expected average log-odds of failing the examination across medical schools is -3.05 (se = 0.11) or 5%. Student-level estimated coefficients for MCAT Verbal Reasoning scores (0.03), Physical Sciences scores (0.05), Biological Sciences scores (0.04), uGPA(science) (0.07), and uGPA(non-science) (0.26) lacked association with the log-odds of failing the COMLEX-USA Level 2-PE, controlling for all other predictors in the model. Evidence from this study shows that present preadmission measures of academic ability are not related to later clinical skill performance. Given that clinical skill performance is an important part of medical practice, selection measures should be developed to identify students who will be successful in communication and be able to demonstrate the ability to systematically collect a medical history, perform a physical examination, and synthesize this information to diagnose and manage patient conditions.

  6. All-cause mortality in asymptomatic persons with extensive Agatston scores above 1000.

    PubMed

    Patel, Jaideep; Blaha, Michael J; McEvoy, John W; Qadir, Sadia; Tota-Maharaj, Rajesh; Shaw, Leslee J; Rumberger, John A; Callister, Tracy Q; Berman, Daniel S; Min, James K; Raggi, Paolo; Agatston, Arthur A; Blumenthal, Roger S; Budoff, Matthew J; Nasir, Khurram

    2014-01-01

    Risk assessment in the extensive calcified plaque phenotype has been limited by small sample size. We studied all-cause mortality rates among asymptomatic patients with markedly elevated Agatston scores > 1000. We studied a clinical cohort of 44,052 asymptomatic patients referred for coronary calcium scans. Mean follow-up was 5.6 years (range, 1-13 years). All-cause mortality rates were calculated after stratifying by Agatston score (0, 1-1000, 1001-1500, 1500-2000, and >2000). A multivariable Cox regression model adjusting for self-reported traditional risk factors was created to assess the relative mortality hazard of Agatston scores 1001 to 1500, 1501 to 2000, and >2000. With the use of post-estimation modeling, we assessed for the presence of an upper threshold of risk with high Agatston scores. A total of 1593 patients (4% of total population) had Agatston score > 1000. There was a continuous graded decrease in estimated 10-year survival across increasing Agatston score, continuing when Agatston score > 1000 (Agatston score 1001-1500, 78%; Agatston score 1501-2000, 74%; Agatston score > 2000, 51%). After multivariable adjustment, Agatston scores 1001 to 1500, 1501 to 2000, and >2000 were associated with an 8.05-, 7.45-, and 13.26-fold greater mortality risk, respectively, than for Agatston score of 0. Compared with Agatston score 1001 to 1500, Agatston score 1501 to 2000 had a similar all-cause mortality risk, whereas Agatston score > 2000 had an increased relative risk (Agatston score 1501-2000: hazard ratio [HR], 1.01 [95% CI, 0.67-1.51]; Agatston score > 2000: HR, 1.79 [95% CI, 1.30-2.46]). Graphical assessment of the predicted survival model suggests no upper threshold for risk associated with calcified plaque in coronary arteries. Increasing calcified plaque in coronary arteries continues to predict a graded decrease in survival among patients with extensive Agatston score > 1000 with no apparent upper threshold. Published by Elsevier Inc.

  7. The Glasgow Prognostic Score, an inflammation based prognostic score, predicts survival in patients with hepatocellular carcinoma

    PubMed Central

    2013-01-01

    Background Elevated Glasgow Prognostic Score (GPS) has been related to poor prognosis in patients with hepatocellular carcinoma (HCC) undergoing surgical resection or receiving sorafenib. The aim of this study was to investigate the prognostic value of GPS in patients with various stages of the disease and with different liver functional status. Methods One hundred and fifty patients with newly diagnosed HCC were prospectively evaluated. Patients were divided according to their GPS scores. Univariate and multivariate analyses were performed to identify clinicopathological variables associated with overall survival; the identified variables were then compared with those of other validated staging systems. Results Elevated GPS were associated with increased asparate aminotransferase (P<0.0001), total bilirubin (P<0.0001), decreased albumin (P<0.0001), α-fetoprotein (P=0.008), larger tumor diameter (P=0.003), tumor number (P=0.041), vascular invasion (P=0.0002), extra hepatic metastasis (P=0.02), higher Child-Pugh scores (P<0.0001), and higher Cancer Liver Italian Program scores (P<0.0001). On multivariate analysis, the elevated GPS was independently associated with worse overall survival. Conclusions Our results demonstrate that the GPS can serve as an independent marker of poor prognosis in patients with HCC in various stages of disease and different liver functional status. PMID:23374755

  8. Cross-cultural adaptation and validation of the Japanese version of the new Knee Society Scoring System for osteoarthritic knee with total knee arthroplasty.

    PubMed

    Hamamoto, Yosuke; Ito, Hiromu; Furu, Moritoshi; Ishikawa, Masahiro; Azukizawa, Masayuki; Kuriyama, Shinichi; Nakamura, Shinichiro; Matsuda, Shuichi

    2015-09-01

    The purposes of this study were to translate the new Knee Society Score (KSS) into Japanese and to evaluate the construct and content validity, test-retest reliability, and internal consistency of the Japanese version of the new KSS. The Japanese version of the KSS was developed according to cross-cultural guidelines by using the "translation-back translation" method to ensure content validity. KSS data were then obtained from patients who had undergone total knee arthroplasty (TKA). The psychometric properties evaluated were as follows: for feasibility, response rate, and floor and ceiling effects; for construct validity, internal consistency using Cronbach's alpha, and correlations with quality of life. Construct validity was evaluated by using Spearman's correlation coefficient to quantify the correlation between the KSS and the Japanese version of the Oxford 12-item Knee Score or Short Form 36 Health Survey (SF-36) questionnaires. The Japanese version of the KSS was sent to 93 consecutive osteoarthritic patients who underwent primary TKA in our institution. Fifty-five patients completed the questionnaires and were included in this study. Neither a floor nor ceiling effect was observed. The reliability proved excellent in the majority of domains, with intraclass correlation coefficients of 0.65-0.88. Internal consistency, assessed by Cronbach's alpha, was good to excellent for all domains (0.78-0.94). All of the four domains of the KSS correlated significantly with the Oxford 12-item Knee Score. The activity and satisfaction domains of the KSS correlated significantly with all and the majority of subscales of the SF-36, respectively, whereas symptoms and expectation domains showed significant correlations only with bodily pain and vitality subscales and with the physical function, bodily pain, and vitality subscales, respectively. The Japanese version of the new KSS is a valid, reliable, and responsive instrument to capture subjective aspects of the functional

  9. Evaluating a grading change at UCSD school of medicine: pass/fail grading is associated with decreased performance on preclinical exams but unchanged performance on USMLE step 1 scores.

    PubMed

    McDuff, Susan G R; McDuff, DeForest; Farace, Jennifer A; Kelly, Carolyn J; Savoia, Maria C; Mandel, Jess

    2014-06-30

    To assess the impact of a change in preclerkship grading system from Honors/Pass/Fail (H/P/F) to Pass/Fail (P/F) on University of California, San Diego (UCSD) medical students' academic performance. Academic performance of students in the classes of 2011 and 2012 (constant-grading classes) were collected and compared with performance of students in the class of 2013 (grading-change class) because the grading policy at UCSD SOM was changed for the class of 2013, from H/P/F during the first year (MS1) to P/F during the second year (MS2). For all students, data consisted of test scores from required preclinical courses from MS1 and MS2 years, and USMLE Step 1 scores. Linear regression analysis controlled for other factors that could be predictive of student performance (i.e., MCAT scores, undergraduate GPA, age, gender, etc.) in order to isolate the effect of the changed grading policy on academic performance. The change in grading policy in the MS2 year only, without any corresponding changes to the medical curriculum, presents a unique natural experiment with which to cleanly evaluate the effect of P/F grading on performance outcomes. After controlling for other factors, the grading policy change to P/F grading in the MS2 year had a negative impact on second-year grades relative to first-year grades (the constant-grading classes performed 1.65% points lower during their MS2 year compared to the MS1 year versus 3.25% points lower for the grading-change class, p < 0.0001), but had no observable impact on USMLE Step 1 scores. A change in grading from H/P/F grading to P/F grading was associated with decreased performance on preclinical examinations but no decrease in performance on the USMLE Step 1 examination. These results are discussed in the broader context of the multitude of factors that should be considered in assessing the merits of various grading systems, and ultimately the authors recommend the continuation of pass-fail grading at UCSD School of Medicine.

  10. Evaluating a grading change at UCSD school of medicine: pass/fail grading is associated with decreased performance on preclinical exams but unchanged performance on USMLE step 1 scores

    PubMed Central

    2014-01-01

    Background To assess the impact of a change in preclerkship grading system from Honors/Pass/Fail (H/P/F) to Pass/Fail (P/F) on University of California, San Diego (UCSD) medical students’ academic performance. Methods Academic performance of students in the classes of 2011 and 2012 (constant-grading classes) were collected and compared with performance of students in the class of 2013 (grading-change class) because the grading policy at UCSD SOM was changed for the class of 2013, from H/P/F during the first year (MS1) to P/F during the second year (MS2). For all students, data consisted of test scores from required preclinical courses from MS1 and MS2 years, and USMLE Step 1 scores. Linear regression analysis controlled for other factors that could be predictive of student performance (i.e., MCAT scores, undergraduate GPA, age, gender, etc.) in order to isolate the effect of the changed grading policy on academic performance. The change in grading policy in the MS2 year only, without any corresponding changes to the medical curriculum, presents a unique natural experiment with which to cleanly evaluate the effect of P/F grading on performance outcomes. Results After controlling for other factors, the grading policy change to P/F grading in the MS2 year had a negative impact on second-year grades relative to first-year grades (the constant-grading classes performed 1.65% points lower during their MS2 year compared to the MS1 year versus 3.25% points lower for the grading-change class, p < 0.0001), but had no observable impact on USMLE Step 1 scores. Conclusions A change in grading from H/P/F grading to P/F grading was associated with decreased performance on preclinical examinations but no decrease in performance on the USMLE Step 1 examination. These results are discussed in the broader context of the multitude of factors that should be considered in assessing the merits of various grading systems, and ultimately the authors recommend the continuation of pass

  11. Automated Interior Lighting Design Software for Base Civil Engineers.

    DTIC Science & Technology

    1987-09-01

    1085 OPEN "I". #1, "A:MAINTCAT.INF" 1090 FOR ^=I TO 6 1i95 FOR B=l TO ? 1100 INPUT#I, MCAT $,A,B) 1105 NEXT B 1110 NEXT A 1115 CLOSE #1 112: REM 125...34 5415(1 PRINT 54155 FOR A=I TO 6 541,0 PRINT TAB󈧏 A; TAB(27) ’,A+61; TAB(45) ICAT$(A,I); TABt63) MCAT $(A,2, 54165 NEXT A 54170 PRINT :PRINT :PRINT...54305 54195 REM 542ry’) CLS 54205 PRINT :FRINT 54210 PRINT TAB(28) "MAINTENANCE CATEGORY EXAMPLE" 54215 PRINT 54:26 PRINT TAB(35i *CATEGORY " MCAT $(B

  12. A Genomic Score Prognostic of Outcome in Trauma Patients

    PubMed Central

    Warren, H Shaw; Elson, Constance M; Hayden, Douglas L; Schoenfeld, David A; Cobb, J Perren; Maier, Ronald V; Moldawer, Lyle L; Moore, Ernest E; Harbrecht, Brian G; Pelak, Kimberly; Cuschieri, Joseph; Herndon, David N; Jeschke, Marc G; Finnerty, Celeste C; Brownstein, Bernard H; Hennessy, Laura; Mason, Philip H; Tompkins, Ronald G

    2009-01-01

    Traumatic injuries frequently lead to infection, organ failure, and death. Health care providers rely on several injury scoring systems to quantify the extent of injury and to help predict clinical outcome. Physiological, anatomical, and clinical laboratory analytic scoring systems (Acute Physiology and Chronic Health Evaluation [APACHE], Injury Severity Score [ISS]) are utilized, with limited success, to predict outcome following injury. The recent development of techniques for measuring the expression level of all of a person’s genes simultaneously may make it possible to develop an injury scoring system based on the degree of gene activation. We hypothesized that a peripheral blood leukocyte gene expression score could predict outcome, including multiple organ failure, following severe blunt trauma. To test such a scoring system, we measured gene expression of peripheral blood leukocytes from patients within 12 h of traumatic injury. cRNA derived from whole blood leukocytes obtained within 12 h of injury provided gene expression data for the entire genome that were used to create a composite gene expression score for each patient. Total blood leukocytes were chosen because they are active during inflammation, which is reflective of poor outcome. The gene expression score combines the activation levels of all the genes into a single number which compares the patient’s gene expression to the average gene expression in uninjured volunteers. Expression profiles from healthy volunteers were averaged to create a reference gene expression profile which was used to compute a difference from reference (DFR) score for each patient. This score described the overall genomic response of patients within the first 12 h following severe blunt trauma. Regression models were used to compare the association of the DFR, APACHE, and ISS scores with outcome. We hypothesized that patients with a total gene response more different from uninjured volunteers would tend to have poorer

  13. Preliminary Investigation of the 1991 Medical College Admission Test Factor Structure.

    ERIC Educational Resources Information Center

    Li, Weichang; Mitchell, Karen J.

    A substantially revised Medical College Admission Test (MCAT) was introduced in spring 1991. The new examination is designed to assess critical thinking skills, basic concepts and problem solving facility in science, and writing skills. This paper reports preliminary findings on the factor structure of the revised MCAT, which consists of four…

  14. Development and implementation of a competency-based clinical evaluation tool for midwifery education.

    PubMed

    Woeber, Kate

    2018-07-01

    The learning goals and evaluation strategies of competency-based midwifery programs must be explicit and well-defined. In the US, didactic learning is evaluated through a standardized certification examination, but standardized clinical competence evaluation is lacking. The Midwifery Competency Assessment Tool (MCAT) has been adapted from the International Confederation of Midwives' (ICM) "Essential Competencies" and from the American College of Nurse-Midwives' (ACNM) "Core Competencies", with student self-evaluation based on Benner's Novice-to-Expert theory. The MCAT allows for the measurement and monitoring of competence development in all domains of full-scope practice over the course of the midwifery program. Strengths of the MCAT are that it provides clear learning goals and performance evaluations for students, ensures and communicates content mapping across a curriculum, and highlights strengths and gaps in clinical opportunities at individual clinical sites and for entire programs. Challenges of the MCAT lie in balancing the number of competency items to be measured with the tedium of form completion, in ensuring the accuracy of student self-evaluation, and in determining "adequate" competence achievement when particular clinical opportunities are limited. Use of the MCAT with competency-based clinical education may facilitate a more standardized approach to clinical evaluation, as well as a more strategic approach to clinical site development and use. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Automated Trait Scores for "GRE"® Writing Tasks. Research Report. ETS RR-15-15

    ERIC Educational Resources Information Center

    Attali, Yigal; Sinharay, Sandip

    2015-01-01

    The "e-rater"® automated essay scoring system is used operationally in the scoring of the argument and issue tasks that form the Analytical Writing measure of the "GRE"® General Test. For each of these tasks, this study explored the value added of reporting 4 trait scores for each of these 2 tasks over the total e-rater score.…

  16. Student-directed retrieval practice is a predictor of medical licensing examination performance.

    PubMed

    Deng, Francis; Gluckstein, Jeffrey A; Larsen, Douglas P

    2015-12-01

    A large body of evidence indicates that retrieval practice (test-enhanced learning) and spaced repetition increase long-term information retention. Implementation of these strategies in medical curricula is unfortunately limited. However, students may choose to apply them autonomously when preparing for high-stakes, cumulative assessments, such as the United States Medical Licensing Examination Step 1. We examined the prevalence of specific self-directed methods of testing, with or without spaced repetition, among preclinical students and assessed the relationship between these methods and licensing examination performance. Seventy-two medical students at one institution completed a survey concerning their use of user-generated (Anki) or commercially-available (Firecracker) flashcards intended for spaced repetition and of boards-style multiple-choice questions (MCQs). Other information collected included Step 1 score, past academic performance (Medical College Admission Test [MCAT] score, preclinical grades), and psychological factors that may have affected exam preparation or performance (feelings of depression, burnout, and test anxiety). All students reported using practice MCQs (mean 3870, SD 1472). Anki and Firecracker users comprised 31 and 49 % of respondents, respectively. In a multivariate regression model, significant independent predictors of Step 1 score included MCQs completed (unstandardized beta coefficient [B] = 2.2 × 10 - 3 , p < 0.001), unique Anki flashcards seen (B = 5.9 × 10 - 4 , p = 0.024), second-year honours (B = 1.198, p = 0.002), and MCAT score (B = 1.078, p = 0.003). Test anxiety was a significant negative predictor (B= - 1.986, p < 0.001). Unique Firecracker flashcards seen did not predict Step 1 score. Each additional 445 boards-style practice questions or 1700 unique Anki flashcards was associated with an additional point on Step 1 when controlling for other academic and psychological

  17. Deriving Stopping Rules for Multidimensional Computerized Adaptive Testing

    ERIC Educational Resources Information Center

    Wang, Chun; Chang, Hua-Hua; Boughton, Keith A.

    2013-01-01

    Multidimensional computerized adaptive testing (MCAT) is able to provide a vector of ability estimates for each examinee, which could be used to provide a more informative profile of an examinee's performance. The current literature on MCAT focuses on the fixed-length tests, which can generate less accurate results for those examinees whose…

  18. REANALYZING THE MODIFIED FERRIMAN-GALLWEY SCORE: IS THERE A SIMPLER METHOD FOR ASSESSING THE EXTENT OF HIRSUTISM?

    PubMed Central

    Cook, Heather; Brennan, Kathleen; Azziz, Ricardo

    2011-01-01

    Objective To determine whether assessing the extent of terminal hair growth in a subset of the traditional 9 areas included in the modified Ferriman-Gallwey (mFG) score can serve as a simpler predictor of total body hirsutism when compared to the full scoring system, and to determine if this new model can accurately distinguish hirsute from non-hirsute women. Design Cross-sectional analysis Setting Two tertiary care academic referral centers. Patients 1951 patients presenting for symptoms of androgen excess. Interventions History and physical examination, including mFG score. Main Outcome Measures Total body hirsutism. Results A regression model using all nine body areas indicated that the combination of upper abdomen, lower abdomen and chin was the best predictor of the total full mFG score. Using this subset of three body areas is accurate in distinguishing true hirsute from non-hirsute women when defining true hirsutism as mFG>7. Conclusion Scoring terminal hair growth only on the chin and abdomen can serve as a simple, yet reliable predictor of total body hirsutism when compared to full body scoring using the traditional mFG system. PMID:21924716

  19. Is there a relation between priapism occurring after penile doppler ultrasonography and international erectile function index score and erection hardness score levels?

    PubMed Central

    Sönmez, Mehmet Giray; Öztürk, Ahmet

    2017-01-01

    Objective The relation between Erection Hardness Score (EHS) and The International Erectile Function Index (IIEF) Questionnaire- Erectile Function Domain Score (IIEF-EF score) used in erectile dysfunction (ED) evaluation and the prevalence of priapism after penile Doppler ultrasonography (PDU) was examined in this study. Material and methods A total of 62 patients who had PDU were included in the study. Patients were divided into two groups; there were 33 patients in IIEF-EF score ≤10, EHS <2 group (Group 1) and 29 patients in IIEF-EF score >10, EHS ≥2 group (Group 2). The two groups separated according to their scores were compared for age, body mass index (BMI), prevalence of priapism, vascular comorbidities and duration of erection. Results When compared to Group 2, median age, rate of vascular comorbidities rate and BMI were detected to be higher in Group 1 with IIEF-EF score ≤10 and EHS <2. But contrary to age and rate of vascular comorbidities (p=0.035, p=0.049 respectively), higher BMI was detected to be statistically insignificant (p=0.093). Duration of erection, IIEF-EF score and number of cases with priapism were significantly higher in Group 2 with IIEF-EF score >10 and EHS ≥2 (p<0.001, p=0.027, p=0.049 respectively). Conclusion High IIEF-EF and EHS scores, younger ages and lower rates of vascular comorbidities in patients from whom PDU was demanded increase the prevalence of priapism. PMID:29201505

  20. Is there a relation between priapism occurring after penile doppler ultrasonography and international erectile function index score and erection hardness score levels?

    PubMed

    Sönmez, Mehmet Giray; Öztürk, Ahmet

    2017-12-01

    The relation between Erection Hardness Score (EHS) and The International Erectile Function Index (IIEF) Questionnaire- Erectile Function Domain Score (IIEF-EF score) used in erectile dysfunction (ED) evaluation and the prevalence of priapism after penile Doppler ultrasonography (PDU) was examined in this study. A total of 62 patients who had PDU were included in the study. Patients were divided into two groups; there were 33 patients in IIEF-EF score ≤10, EHS <2 group (Group 1) and 29 patients in IIEF-EF score >10, EHS ≥2 group (Group 2). The two groups separated according to their scores were compared for age, body mass index (BMI), prevalence of priapism, vascular comorbidities and duration of erection. When compared to Group 2, median age, rate of vascular comorbidities rate and BMI were detected to be higher in Group 1 with IIEF-EF score ≤10 and EHS <2. But contrary to age and rate of vascular comorbidities (p=0.035, p=0.049 respectively), higher BMI was detected to be statistically insignificant (p=0.093). Duration of erection, IIEF-EF score and number of cases with priapism were significantly higher in Group 2 with IIEF-EF score >10 and EHS ≥2 (p<0.001, p=0.027, p=0.049 respectively). High IIEF-EF and EHS scores, younger ages and lower rates of vascular comorbidities in patients from whom PDU was demanded increase the prevalence of priapism.

  1. Characteristics of Youth Food Preparation in Low-Income, African American Homes: Associations with Healthy Eating Index Scores

    PubMed Central

    Sattler, Melissa; Hopkins, Laura; Steeves, Elizabeth Anderson; Cristello, Angelica; Hurley, Kristen; McCloskey, Morgan; Gittelsohn, Joel

    2015-01-01

    This study explores food preparation behaviors, including types of food prepared, methods of preparation, and frequency of preparation of low-income urban African American youth ages 9–15 in Baltimore City (n=289) and analyzes a potential association to diet quality as measured through Healthy Eating Index 2010 (HEI) scores. Overall, youth prepared their own food 6.7±0.33 times per week without significant differences between age groups or genders as measured through pairwise comparison of means. Cereal, noodles, and sandwiches were amongst the foods prepared most frequently. Linear regression analysis found youth food preparation frequency was not significantly associated with total HEI (p=0.59), sodium (p=0.58), empty calories (p=0.96), or dairy scores (p=0.12). Younger age was associated with higher total HEI scores (p=0.012) and higher dairy scores (p=0.01) and female gender was associated with higher total HEI scores (p=0.03), higher sodium scores (p=0.03), and lower dairy scores (p=0.008). PMID:25706350

  2. Characteristics of Youth Food Preparation in Low-Income, African American Homes: Associations with Healthy Eating Index Scores.

    PubMed

    Sattler, Melissa; Hopkins, Laura; Anderson Steeves, Elizabeth; Cristello, Angelica; Mccloskey, Morgan; Gittelsohn, Joel; Hurley, Kristen

    2015-01-01

    This study explores food preparation behaviors, including types of food prepared, methods of preparation, and frequency of preparation of low-income urban African American youth ages 9-15 in Baltimore City (n = 289) and analyzes a potential association to diet quality as measured through Healthy Eating Index 2010 (HEI) scores. Overall, the youth prepared their own food 6.7 ± 0.33 times per week without significant differences between age groups or genders as measured through pairwise comparison of means. Cereal, noodles, and sandwiches were amongst the foods prepared most frequently. Linear regression analysis found youth food preparation frequency was not significantly associated with total HEI (p = 0.59), sodium (p = 0.58), empty calories (p = 0.96), or dairy scores (p = 0.12). Younger age was associated with higher total HEI scores (p = 0.012) and higher dairy scores (p = 0.01) and female gender was associated with higher total HEI scores (p = 0.03), higher sodium scores (p = 0.03), and lower dairy scores (p = 0.008).

  3. Use of the Sequential Organ Failure Assessment score for evaluating outcome among obstetric patients admitted to the intensive care unit.

    PubMed

    Jain, Shruti; Guleria, Kiran; Suneja, Amita; Vaid, Neelam B; Ahuja, Sharmila

    2016-03-01

    To evaluate the prognostic value of the Sequential Organ Failure Assessment (SOFA) score among obstetric patients admitted to the intensive care unit (ICU). A prospective study was conducted among 90 consecutive obstetric patients who were admitted to the ICU of Guru Teg Bahadur Hospital, Delhi, India, between October 6, 2010, and December 25, 2011. Maximum SOFA score was calculated for each of the six organ systems. Receiver operating characteristic curves were used to determine critical cutoff values for total, maximum total, and mean total SOFA scores at various time points. Total SOFA score at admission displayed an area under the curve (AUC) of 0.949, a cutoff value of at least 8.5, sensitivity of 86.7%, and specificity of 90.0%. Maximum total SOFA score had an AUC of 0.980, a cutoff value of at least 10.0, sensitivity of 96.7%, and specificity of 90.0%. Mean total SOFA score had an AUC of 0.997, a cutoff value of at least 9.0, sensitivity of 96.7%, and specificity of 96.7%. In terms of discriminatory power for predicting mortality among obstetric patients admitted to the ICU, total SOFA score at admission was the most relevant, simple, and accurate measure. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  4. Genetic scores of smoking behaviour in a Chinese population.

    PubMed

    Yang, Shanshan; He, Yao; Wang, Jianhua; Wang, Yiyan; Wu, Lei; Zeng, Jing; Liu, Miao; Zhang, Di; Jiang, Bin; Li, Xiaoying

    2016-03-07

    This study sought to structure a genetic score for smoking behaviour in a Chinese population. Single-nucleotide polymorphisms (SNPs) from genome-wide association studies (GWAS) were evaluated in a community-representative sample (N = 3,553) of Beijing, China. The candidate SNPs were tested in four genetic models (dominance model, recessive model, heterogeneous codominant model and additive model), and 7 SNPs were selected to structure a genetic score. A total of 3,553 participants (1,477 males and 2,076 females) completed the survey. Using the unweighted score, we found that participants with a high genetic score had a 34% higher risk of trying smoking and a 43% higher risk of SI at ≤ 18 years of age after adjusting for age, gender, education, occupation, ethnicity, body mass index (BMI) and sports activity time. The unweighted genetic scores were chosen to best extrapolate and understand these results. Importantly, genetic score was significantly associated with smoking behaviour (smoking status and SI at ≤ 18 years of age). These results have the potential to guide relevant health education for individuals with high genetic scores and promote the process of smoking control to improve the health of the population.

  5. Evaluation of the Environmental Scoring System in Multiple Child Asthma Intervention Programs in Boston, Massachusetts.

    PubMed

    Dong, Zhao; Nath, Anjali; Guo, Jing; Bhaumik, Urmi; Chin, May Y; Dong, Sherry; Marshall, Erica; Murphy, Johnna S; Sandel, Megan T; Sommer, Susan J; Ursprung, W W Sanouri; Woods, Elizabeth R; Reid, Margaret; Adamkiewicz, Gary

    2018-01-01

    To test the applicability of the Environmental Scoring System, a quick and simple approach for quantitatively measuring environmental triggers collected during home visits, and to evaluate its contribution to improving asthma outcomes among various child asthma programs. We pooled and analyzed data from multiple child asthma programs in the Greater Boston Area, Massachusetts, collected in 2011 to 2016, to examine the association of environmental scores (ES) with measures of asthma outcomes and compare the results across programs. Our analysis showed that demographics were important contributors to variability in asthma outcomes and total ES, and largely explained the differences among programs at baseline. Among all programs in general, we found that asthma outcomes were significantly improved and total ES significantly reduced over visits, with the total Asthma Control Test score negatively associated with total ES. Our study demonstrated that the Environmental Scoring System is a useful tool for measuring home asthma triggers and can be applied regardless of program and survey designs, and that demographics of the target population may influence the improvement in asthma outcomes.

  6. High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes.

    PubMed

    Custer, Aimee; Sufrinko, Alicia; Elbin, R J; Covassin, Tracey; Collins, Micky; Kontos, Anthony

    2016-02-01

    Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined. To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC. Cohort study. High school and collegiate athletic programs. A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0, n = 247) or a high level of baseline symptoms (PCSS score > 18 [top 10% of sample], n = 68). Participants were evaluated at baseline and 2 to 7 days after SRC with the Immediate Post-concussion Assessment and Cognitive Test and PCSS. Outcome measures were Immediate Post-concussion Assessment and Cognitive Test composite scores (verbal memory, visual memory, visual motor processing speed, and reaction time) and total symptom score on the PCSS. The groups were compared using repeated-measures analyses of variance with Bonferroni correction to assess interactions between group and time for symptoms and neurocognitive impairment. The no-symptoms group represented 38% of the original sample, whereas the high-symptoms group represented 11% of the sample. The high-symptoms group experienced a larger decline from preinjury to postinjury than the no-symptoms group in verbal (P = .03) and visual memory (P = .05). However, total concussion-symptom scores increased from preinjury to postinjury for the no-symptoms group (P = .001) but remained stable for the high-symptoms group. Reported baseline symptoms may help identify athletes at risk for worse outcomes after SRC. Clinicians should examine baseline symptom levels to better identify patients for earlier referral and treatment for their

  7. High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes

    PubMed Central

    Custer, Aimee; Sufrinko, Alicia; Elbin, R. J.; Covassin, Tracey; Collins, Micky; Kontos, Anthony

    2016-01-01

    Context:  Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined. Objective:  To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC. Design:  Cohort study. Setting:  High school and collegiate athletic programs. Patients or Other Participants:  A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0, n = 247) or a high level of baseline symptoms (PCSS score > 18 [top 10% of sample], n = 68). Main Outcome Measure(s):  Participants were evaluated at baseline and 2 to 7 days after SRC with the Immediate Post-concussion Assessment and Cognitive Test and PCSS. Outcome measures were Immediate Post-concussion Assessment and Cognitive Test composite scores (verbal memory, visual memory, visual motor processing speed, and reaction time) and total symptom score on the PCSS. The groups were compared using repeated-measures analyses of variance with Bonferroni correction to assess interactions between group and time for symptoms and neurocognitive impairment. Results:  The no-symptoms group represented 38% of the original sample, whereas the high-symptoms group represented 11% of the sample. The high-symptoms group experienced a larger decline from preinjury to postinjury than the no-symptoms group in verbal (P = .03) and visual memory (P = .05). However, total concussion-symptom scores increased from preinjury to postinjury for the no-symptoms group (P = .001) but remained stable for the high-symptoms group. Conclusions:>  Reported baseline symptoms may help identify athletes at risk for worse

  8. Clinical Outcome Score Predicts Adverse Neurodevelopmental Outcome After Infant Heart Surgery.

    PubMed

    Mackie, Andrew S; Vatanpour, Shabnam; Alton, Gwen Y; Dinu, Irina A; Ryerson, Lindsay; Moddemann, Diane M; Thomas Petrie, Julie

    2015-06-01

    The purpose of this study was to determine whether a clinical outcome score derived from early postoperative events is associated with Bayley-III scores at 18 to 24 months among infants undergoing cardiopulmonary bypass surgery. Included were infants aged 6 weeks or less who underwent surgery between 2005 and 2009, all of whom were referred for neurodevelopmental evaluation at 18 to 24 months. We excluded children with chromosomal abnormalities. The prespecified clinical outcome score had a range of 0 to 7. Lower scores indicated a more rapid postoperative recovery. Patients requiring extracorporeal life support were assigned a score of 7. One hundred and ninety-nine subjects were included. Surgical procedures were arterial switch (72), Norwood (60), repair of total anomalous pulmonary venous connection (29), and other (38). Nine subjects had postoperative extracorporeal life support. Mean clinical outcome score in the Norwood group was 4.0 ± 1.4 versus the arterial switch group (2.6 ± 1.5, p < 0.001), total anomalous pulmonary venous connection group (2.8 ± 1.8, p < 0.01), and other group (4.0 ± 1.8, p = not significant). Among children who had a clinical outcome score of 4 or greater, there was a decrease in Bayley-III cognitive score of 5.7 (95% confidence interval: 1.5 to 9.9, p = 0.009), a decrease in language score of 10.0 (95% confidence interval: 4.9 to 15.1, p < 0.001), and a decrease in motor score of 9.7 (95% confidence interval: 4.8 to 14.5, p < 0.001). Time until lactate of 2.0 mmol/L or less and highest 24-hour inotrope score increased with increasing clinical outcome score (p < 0.0001). Clinical outcome scores of 4 or greater were associated with significantly lower Bayley-III scores at 18 to 24 months. This score may be valuable as an endpoint when evaluating novel potential therapies for this high-risk population. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. AZT-induced mitochondrial toxicity: an epigenetic paradigm for dysregulation of gene expression through mitochondrial oxidative stress.

    PubMed

    Koczor, Christopher A; Jiao, Zhe; Fields, Earl; Russ, Rodney; Ludaway, Tomika; Lewis, William

    2015-10-01

    Mitochondrial dysfunction causes oxidative stress and cardiomyopathy. Oxidative stress also is a side effect of dideoxynucleoside antiretrovirals (NRTI) and is observed in NRTI-induced cardiomyopathy. We show here that treatment with the NRTI AZT {1-[(2R,4S,5S)-4-azido-5-(hydroxymethyl)oxolan-2-yl]-5-methylpyrimidine-2,4-dione} modulates cardiac gene expression epigenetically through production of mitochondrially derived reactive oxygen species. Transgenic mice with ubiquitous expression of mitochondrially targeted catalase (MCAT) and C57Bl/6 wild-type mice littermates (WT) were administered AZT (0.22 mg/day po, 35 days), and cardiac DNA and mRNA were isolated. In AZT-treated WT, 95 cardiac genes were differentially expressed compared with vehicle-treated WTs. When MCAT mice were treated with AZT, each of those 95 genes reverted toward the expression of vehicle-treated WTs. In AZT-treated WT hearts, Mthfr [5,10-methylenetetrahydrofolate reductase; a critical enzyme in synthesis of methionine cycle intermediates including S-adenosylmethionine (SAM)], was overexpressed. Steady-state abundance of SAM in cardiac extracts from AZT-treated MCAT mice increased 60% above that of vehicle-treated MCAT. No such change occurred in WT. AZT caused hypermethylation (47%) and hypomethylation (53%) of differentially methylated DNA regions in WT cardiac DNA. AZT-treated MCAT heart DNA exhibited greater hypermethylation (91%) and less hypomethylation (9%) compared with vehicle-treated MCAT controls. The gene encoding protein kinase C-α displayed multifocal epigenetic regulation caused by oxidative stress. Results show that mitochondrially derived oxidative stress in the heart hinders cardiac DNA methylation, alters steady-state abundance of SAM, alters cardiac gene expression, and promotes characteristic pathophysiological changes of cardiomyopathy. This mechanism for NRTI toxicity offers insight into long-term side effects from these commonly used antiviral agents. Copyright

  10. Incorporating Problem-Based Learning Methodology To Prepare for the Medical College Admission Test.

    ERIC Educational Resources Information Center

    Baiyee, William Agbor

    The effectiveness of problem-based learning (PBL) in preparing for the Medical College Admission Test (MCAT) was studied. A 10-week PBL experience was implemented to supplement lecture-based instruction in preparing for the MCAT. Over 2 years, 33 students participated. Participants met for 3 hours in small PBL groups directed by a tutor three…

  11. Could a Laptop Computer plus the Liquid Crystal Display Projector Amount to Improved Multimedia Geoscience Instruction?

    ERIC Educational Resources Information Center

    Chang, C.Y.

    2004-01-01

    In this study, a multimedia computer-aided tutorial (MCAT) on the topic of debris-flow hazards was developed for senior high-school students in Taiwan. The format of the new course is a blend of whole-class presentations, interactive discussions among the teacher and students, and classroom activities using the MCAT software. The whole-class…

  12. The R.I.R.S. scoring system: An innovative scoring system for predicting stone-free rate following retrograde intrarenal surgery.

    PubMed

    Xiao, Yinglong; Li, Deng; Chen, Lei; Xu, Yaoting; Zhang, Dingguo; Shao, Yi; Lu, Jun

    2017-11-21

    To establish and internally validate an innovative R.I.R.S. scoring system that allows urologists to preoperatively estimate the stone-free rate (SFR) after retrograde intrarenal surgery (RIRS). This study included 382 eligible samples from a total 573 patients who underwent RIRS from January 2014 to December 2016. Four reproducible factors in the R.I.R.S. scoring system, including renal stone density, inferior pole stone, renal infundibular length and stone burden, were measured based on preoperative computed tomography of urography to evaluate the possibility of stone clearance after RIRS. The median cumulative diameter of the stones was 14 mm, and the interquartile range was 10 to 21. The SFR on postoperative day 1 in the present cohort was 61.5% (235 of 382), and the final SFR after 1 month was 73.6% (281 of 382). We established an innovative scoring system to evaluate SFR after RIRS using four preoperative characteristics. The range of the R.I.R.S. scoring system was 4 to 10. The overall score showed a great significance of stone-free status (p < 0.001). The area under the receiver operating characteristic curve of the R.I.R.S. scoring system was 0.904. The R.I.R.S. scoring system is associated with SFR after RIRS. This innovative scoring system can preoperatively assess treatment success after intrarenal surgery and can be used for preoperative surgical arrangement and comparisons of outcomes among different centers and within a center over time.

  13. Interpreting Quality of Life after Brain Injury Scores: Cross-Walk with the Short Form-36.

    PubMed

    Wilson, Lindsay; Marsden-Loftus, Isaac; Koskinen, Sanna; Bakx, Wilbert; Bullinger, Monika; Formisano, Rita; Maas, Andrew; Neugebauer, Edmund; Powell, Jane; Sarajuuri, Jaana; Sasse, Nadine; von Steinbuechel, Nicole; von Wild, Klaus; Truelle, Jean-Luc

    2017-01-01

    The Quality of Life after Brain Injury (QOLIBRI) instruments are traumatic brain injury (TBI)-specific assessments of health-related quality of life (HRQoL), with established validity and reliability. The purpose of the study is to help improve the interpretability of the two QOLIBRI summary scores (the QOLIBRI Total score and the QOLBRI Overall Scale [OS] score). An analysis was conducted of 761 patients with TBI who took part in the QOLIBRI validation studies. A cross-walk between QOLIBRI scores and the SF-36 Mental Component Summary norm-based scoring system was performed using geometric mean regression analysis. The exercise supports a previous suggestion that QOLIBRI Total scores <60 indicate low or impaired HRQoL and indicate that the corresponding score on the QOLIBRI-OS is <52. The percentage of cases in the sample that fell into the "impaired HRQoL" category was 36% for the Mental Component Summary, 38% for the QOLIBRI Total, and 39% for the QOLIBRI-OS. Relationships between the QOLIBRI scales and the Glasgow Outcome Scale-Extended (GOSE), as a measure of global function, are presented in the form of means and standard deviations that allow comparison with other studies, and data on age and sex are presented for the QOLIBRI-OS. While bearing in mind the potential imprecision of the comparison, the findings provide a framework for evaluating QOLIBRI summary scores in relation to generic HRQoL that improves their interpretability.

  14. The Pooling-score (P-score): inter- and intra-rater reliability in endoscopic assessment of the severity of dysphagia.

    PubMed

    Farneti, D; Fattori, B; Nacci, A; Mancini, V; Simonelli, M; Ruoppolo, G; Genovese, E

    2014-04-01

    This study evaluated the intra- and inter-rater reliability of the Pooling score (P-score) in clinical endoscopic evaluation of severity of swallowing disorder, considering excess residue in the pharynx and larynx. The score (minimum 4 - maximum 11) is obtained by the sum of the scores given to the site of the bolus, the amount and ability to control residue/bolus pooling, the latter assessed on the basis of cough, raclage, number of dry voluntary or reflex swallowing acts (< 2, 2-5, > 5). Four judges evaluated 30 short films of pharyngeal transit of 10 solid (1/4 of a cracker), 11 creamy (1 tablespoon of jam) and 9 liquid (1 tablespoon of 5 cc of water coloured with methlyene blue, 1 ml in 100 ml) boluses in 23 subjects (10 M/13 F, age from 31 to 76 yrs, mean age 58.56±11.76 years) with different pathologies. The films were randomly distributed on two CDs, which differed in terms of the sequence of the films, and were given to judges (after an explanatory session) at time 0, 24 hours later (time 1) and after 7 days (time 2). The inter- and intra-rater reliability of the P-score was calculated using the intra-class correlation coefficient (ICC; 3,k). The possibility that consistency of boluses could affect the scoring of the films was considered. The ICC for site, amount, management and the P-score total was found to be, respectively, 0.999, 0.997, 1.00 and 0.999. Clinical evaluation of a criterion of severity of a swallowing disorder remains a crucial point in the management of patients with pathologies that predispose to complications. The P-score, derived from static and dynamic parameters, yielded a very high correlation among the scores attributed by the four judges during observations carried out at different times. Bolus consistencies did not affect the outcome of the test: the analysis of variance, performed to verify if the scores attributed by the four judges to the parameters selected, might be influenced by the different consistencies of the boluses

  15. D-score: a search engine independent MD-score.

    PubMed

    Vaudel, Marc; Breiter, Daniela; Beck, Florian; Rahnenführer, Jörg; Martens, Lennart; Zahedi, René P

    2013-03-01

    While peptides carrying PTMs are routinely identified in gel-free MS, the localization of the PTMs onto the peptide sequences remains challenging. Search engine scores of secondary peptide matches have been used in different approaches in order to infer the quality of site inference, by penalizing the localization whenever the search engine similarly scored two candidate peptides with different site assignments. In the present work, we show how the estimation of posterior error probabilities for peptide candidates allows the estimation of a PTM score called the D-score, for multiple search engine studies. We demonstrate the applicability of this score to three popular search engines: Mascot, OMSSA, and X!Tandem, and evaluate its performance using an already published high resolution data set of synthetic phosphopeptides. For those peptides with phosphorylation site inference uncertainty, the number of spectrum matches with correctly localized phosphorylation increased by up to 25.7% when compared to using Mascot alone, although the actual increase depended on the fragmentation method used. Since this method relies only on search engine scores, it can be readily applied to the scoring of the localization of virtually any modification at no additional experimental or in silico cost. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Validity of the Medical College Admission Test for Predicting MD-PhD Student Outcomes

    ERIC Educational Resources Information Center

    Bills, James L.; VanHouten, Jacob; Grundy, Michelle M.; Chalkley, Roger; Dermody, Terence S.

    2016-01-01

    The Medical College Admission Test (MCAT) is a quantitative metric used by MD and MD-PhD programs to evaluate applicants for admission. This study assessed the validity of the MCAT in predicting training performance measures and career outcomes for MD-PhD students at a single institution. The study population consisted of 153 graduates of the…

  17. USMC Identity Operations Strategy

    DTIC Science & Technology

    2011-01-01

    safety, situational awareness and mission accomplishment • Action Officer Staffing – 2-4 November 2010 – USMC IdOps OIPT • MCATS Staffing – 21 December...10 March 2011 • Location: TBD – Enter into MCATS O-6/GS-15 Staffing – Late March 2011 – GO/SES Staffing – Early April 2011 – ACMC Signature – TBD 10

  18. Teaching Physics to Premedical Students

    NASA Astrophysics Data System (ADS)

    Schantz, Hans

    1997-04-01

    The MCAT exam (taken by students seeking entry to medical school) is drastically different from the standard university course test. The MCAT emphasizes reading and analytic skills far more than quantitative analysis, even on the sections that test physics. I describe these differences, and outline an introductory physics curriculum focused to the special needs of pre-medical students.

  19. Does Field Reliability for Static-99 Scores Decrease as Scores Increase?

    PubMed Central

    Rice, Amanda K.; Boccaccini, Marcus T.; Harris, Paige B.; Hawes, Samuel W.

    2015-01-01

    This study examined the field reliability of Static-99 (Hanson & Thornton, 2000) scores among 21,983 sex offenders and focused on whether rater agreement decreased as scores increased. As expected, agreement was lowest for high-scoring offenders. Initial and most recent Static-99 scores were identical for only about 40% of offenders who had been assigned a score of 6 during their initial evaluations, but for more than 60% of offenders who had been assigned a score of 2 or lower. In addition, the size of the difference between scores increased as scores increased, with pairs of scores differing by 2 or more points for about 30% of offenders scoring in the high-risk range. Because evaluators and systems use high Static-99 scores to identify sexual offenders who may require intensive supervision or even postrelease civil commitment, it is important to recognize that there may be more measurement error for high scores than low scores and to consider adopting procedures for minimizing or accounting for measurement error. PMID:24932647

  20. A novel scoring system for predicting adherent placenta in women with placenta previa.

    PubMed

    Tanimura, Kenji; Morizane, Mayumi; Deguchi, Masashi; Ebina, Yasuhiko; Tanaka, Utaru; Ueno, Yoshiko; Kitajima, Kazuhiro; Maeda, Tetsuo; Sugimura, Kazuro; Yamada, Hideto

    2018-04-01

    Placenta previa (PP) is one of the most significant risk factors for adherent placenta (AP). The aim of this study was to evaluate the diagnostic efficacy of a novel scoring system for predicting AP in pregnant women with PP. This prospective cohort study enrolled 175 women with PP. The placenta previa with adherent placenta score (PPAP score) is composed of 2 categories: (1) past history of cesarean section (CS), surgical abortion, and/or uterine surgery; and (2) ultrasonography and magnetic resonance imaging findings. Each category is graded as 0, 1, 2, or 4 points, yielding a total score between 0 and 24. When women with PP had PPAP score ≥8, they were considered to be at a high risk for AP and received placement of preoperative internal iliac artery occlusion balloon catheters. If they were found to have AP during CS, they underwent hysterectomy or placenta removal using advanced bipolar with balloon catheter occlusion. The predictive accuracy of PPAP score was evaluated. In total, 23 of the 175 women with PP were diagnosed as having AP, histopathologically or clinically. Twenty-one of 24 women with PPAP score ≥8 had AP, whereas two of 151 women with PPAP score <8 had AP. The scoring system yielded 91.3% sensitivity, 98.0% specificity, 87.5% positive predictive value, and 98.7% negative predictive value for predicting AP in women with PP. This prospective study demonstrated that PPAP scoring system may be useful for predicting AP in women with PP. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Neurointerventional Treatment in Acute Stroke. Whom to Treat? (Endovascular Treatment for Acute Stroke: Utility of THRIVE Score and HIAT Score for Patient Selection)

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

    Fjetland, Lars, E-mail: lars.fjetland@lyse.net; Roy, Sumit, E-mail: sumit.roy@sus.no; Kurz, Kathinka D., E-mail: kathinka.dehli.kurz@sus.no

    2013-10-15

    Purpose: Intra-arterial therapy (IAT) is used increasingly as a treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. The authors evaluated the Houston IAT (HIAT) and the totaled health risks in vascular events (THRIVE) score, two predicting scores designed to identify patients likely to benefit from IAT. Methods: Fifty-two patients treated at the Stavanger University Hospital with IAT from May 2009 to June 2012 were included in this study. We combined the scores in an additional analysis. We also performed an additional analysis according to high agemore » and evaluated the scores in respect of technical efficacy. Results: Fifty-two patients were evaluated by the THRIVE score and 51 by the HIAT score. We found a strong correlation between the level of predicted risk and the actual clinical outcome (THRIVE p = 0.002, HIAT p = 0.003). The correlations were limited to patients successfully recanalized and to patients <80 years. By combining the scores additional 14.3 % of the patients could be identified as poor candidates for IAT. Both scores were insufficient to identify patients with a good clinical outcome. Conclusions: Both scores showed a strong correlation to poor clinical outcome in patients <80 years. The specificity of the scores could be enhanced by combining them. Both scores were insufficient to identify patients with a good clinical outcome and showed no association to clinical outcome in patients aged {>=}80 years.« less

  2. Ganga hospital open injury score in management of open injuries.

    PubMed

    Rajasekaran, S; Sabapathy, S R; Dheenadhayalan, J; Sundararajan, S R; Venkatramani, H; Devendra, A; Ramesh, P; Srikanth, K P

    2015-02-01

    Open injuries of the limbs offer challenges in management as there are still many grey zones in decision making regarding salvage, timing and type of reconstruction. As a result, there is still an unacceptable rate of secondary amputations which lead to tremendous waste of resources and psychological devastation of the patient and his family. Gustilo Anderson's classification was a major milestone in grading the severity of injury but however suffers from the disadvantages of imprecise definition, a poor interobserver correlation, inability to address the issue of salvage and inclusion of a wide spectrum of injuries in Type IIIb category. Numerous scores such as Mangled Extremity Severity Score, the Predictive Salvage Index, the Limb Salvage Index, Hannover Fracture Scale-97 etc have been proposed but all have the disadvantage of retrospective evaluation, inadequate sample sizes and poor sensitivity and specificity to amputation, especially in IIIb injuries. The Ganga Hospital Open Injury Score (GHOIS) was proposed in 2004 and is designed to specifically address the outcome in IIIb injuries of the tibia without vascular deficit. It evaluates the severity of injury to the three components of the limb--the skin, the bone and the musculotendinous structures separately on a grade from 0 to 5. Seven comorbid factors which influence the treatment and the outcome are included in the score with two marks each. The application of the total score and the individual tissue scores in management of IIIB injuries is discussed. The total score was shown to predict salvage when the value was 14 or less; amputation when the score was 17 and more. A grey zone of 15 and 16 is provided where the decision making had to be made on a case to case basis. The additional value of GHOIS was its ability to guide the timing and type of reconstruction. A skin score of more than 3 always required a flap and hence it indicated the need for an orthoplastic approach from the index procedure. Bone

  3. Extension of the lod score: the mod score.

    PubMed

    Clerget-Darpoux, F

    2001-01-01

    In 1955 Morton proposed the lod score method both for testing linkage between loci and for estimating the recombination fraction between them. If a disease is controlled by a gene at one of these loci, the lod score computation requires the prior specification of an underlying model that assigns the probabilities of genotypes from the observed phenotypes. To address the case of linkage studies for diseases with unknown mode of inheritance, we suggested (Clerget-Darpoux et al., 1986) extending the lod score function to a so-called mod score function. In this function, the variables are both the recombination fraction and the disease model parameters. Maximizing the mod score function over all these parameters amounts to maximizing the probability of marker data conditional on the disease status. Under the absence of linkage, the mod score conforms to a chi-square distribution, with extra degrees of freedom in comparison to the lod score function (MacLean et al., 1993). The mod score is asymptotically maximum for the true disease model (Clerget-Darpoux and Bonaïti-Pellié, 1992; Hodge and Elston, 1994). Consequently, the power to detect linkage through mod score will be highest when the space of models where the maximization is performed includes the true model. On the other hand, one must avoid overparametrization of the model space. For example, when the approach is applied to affected sibpairs, only two constrained disease model parameters should be used (Knapp et al., 1994) for the mod score maximization. It is also important to emphasize the existence of a strong correlation between the disease gene location and the disease model. Consequently, there is poor resolution of the location of the susceptibility locus when the disease model at this locus is unknown. Of course, this is true regardless of the statistics used. The mod score may also be applied in a candidate gene strategy to model the potential effect of this gene in the disease. Since, however, it

  4. Development and Validation of a Disease Severity Scoring Model for Pediatric Sepsis.

    PubMed

    Hu, Li; Zhu, Yimin; Chen, Mengshi; Li, Xun; Lu, Xiulan; Liang, Ying; Tan, Hongzhuan

    2016-07-01

    Multiple severity scoring systems have been devised and evaluated in adult sepsis, but a simplified scoring model for pediatric sepsis has not yet been developed. This study aimed to develop and validate a new scoring model to stratify the severity of pediatric sepsis, thus assisting the treatment of sepsis in children. Data from 634 consecutive patients who presented with sepsis at Children's hospital of Hunan province in China in 2011-2013 were analyzed, with 476 patients placed in training group and 158 patients in validation group. Stepwise discriminant analysis was used to develop the accurate discriminate model. A simplified scoring model was generated using weightings defined by the discriminate coefficients. The discriminant ability of the model was tested by receiver operating characteristic curves (ROC). The discriminant analysis showed that prothrombin time, D-dimer, total bilirubin, serum total protein, uric acid, PaO2/FiO2 ratio, myoglobin were associated with severity of sepsis. These seven variables were assigned with values of 4, 3, 3, 4, 3, 3, 3 respectively based on the standardized discriminant coefficients. Patients with higher scores had higher risk of severe sepsis. The areas under ROC (AROC) were 0.836 for accurate discriminate model, and 0.825 for simplified scoring model in validation group. The proposed disease severity scoring model for pediatric sepsis showed adequate discriminatory capacity and sufficient accuracy, which has important clinical significance in evaluating the severity of pediatric sepsis and predicting its progress.

  5. Validation study of the Forgotten Joint Score-12 as a universal patient-reported outcome measure.

    PubMed

    Matsumoto, Mikio; Baba, Tomonori; Homma, Yasuhiro; Kobayashi, Hideo; Ochi, Hironori; Yuasa, Takahito; Behrend, Henrik; Kaneko, Kazuo

    2015-10-01

    The Forgotten Joint Score-12 (FJS-12) is for patients to forget their artificial joint and is reportedly a useful patient-reported outcome tool for artificial joints. The purpose of this study was to determine whether the FJS-12 is as useful as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) or the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) in Japan. All patients who visited our hospital's hip joint specialists following unilateral THA from August 2013 to July 2014 were evaluated. Medical staff members other than physicians administered three questionnaires. Items evaluated were (1) the reliability of the FJS-12 and (2) correlations between the FJS-12 and the total and subscale scores of the WOMAC or JHEQ. Of 130 patients, 22 were excluded. Cronbach's α coefficient was 0.97 for the FJS-12. The FJS-12 showed a significantly lower score than the WOMAC or JHEQ (p < 0.01). The FJS-12 was moderately correlated with the total WOMAC score (r = 0.522) and its subscale scores for "stiffness" (r = 0.401) and "function" (r = 0.539) and was weakly correlated with the score for "pain" (r = 0.289). The FJS-12 was favorably correlated with the total JHEQ score (r = 0.686) and its subscale scores (r = 0.530-0.643). The FJS-12 was correlated with and showed reliability similar to that of the JHEQ and WOMAC. The FJS-12, which is not affected by culture or lifestyle, may be useful in Japan.

  6. The Effect of English Language on Multiple Choice Question Scores of Thai Medical Students.

    PubMed

    Phisalprapa, Pochamana; Muangkaew, Wayuda; Assanasen, Jintana; Kunavisarut, Tada; Thongngarm, Torpong; Ruchutrakool, Theera; Kobwanthanakun, Surapon; Dejsomritrutai, Wanchai

    2016-04-01

    Universities in Thailand are preparing for Thailand's integration into the ASEAN Economic Community (AEC) by increasing the number of tests in English language. English language is not the native language of Thailand Differences in English language proficiency may affect scores among test-takers, even when subject knowledge among test-takers is comparable and may falsely represent the knowledge level of the test-taker. To study the impact of English language multiple choice test questions on test scores of medical students. The final examination of fourth-year medical students completing internal medicine rotation contains 120 multiple choice questions (MCQ). The languages used on the test are Thai and English at a ratio of 3:1. Individual scores of tests taken in both languages were collected and the effect of English language on MCQ was analyzed Individual MCQ scores were then compared with individual student English language proficiency and student grade point average (GPA). Two hundred ninety five fourth-year medical students were enrolled. The mean percentage of MCQ scores in Thai and English were significantly different (65.0 ± 8.4 and 56.5 ± 12.4, respectively, p < 0.001). The correlation between MCQ scores in Thai and English was fair (Spearman's correlation coefficient = 0.41, p < 0.001). Of 295 students, only 73 (24.7%) students scored higher when being tested in English than in Thai language. Students were classified into six grade categories (A, B+, B, C+, C, and D+), which cumulatively measured total internal medicine rotation performance score plus final examination score. MCQ scores from Thai language examination were more closely correlated with total course grades than were the scores from English language examination (Spearman's correlation coefficient = 0.73 (p < 0.001) and 0.53 (p < 0.001), respectively). The gap difference between MCQ scores in both languages was higher in borderline students than in the excellent student group (11.2 ± 11

  7. A Note on Stochastic Ordering of the Latent Trait Using the Sum of Polytomous Item Scores

    ERIC Educational Resources Information Center

    van der Ark, L. Andries; Bergsma, Wicher P.

    2010-01-01

    In contrast to dichotomous item response theory (IRT) models, most well-known polytomous IRT models do not imply stochastic ordering of the latent trait by the total test score (SOL). This has been thought to make the ordering of respondents on the latent trait using the total test score questionable and throws doubt on the justifiability of using…

  8. The Zhongshan Score

    PubMed Central

    Zhou, Lin; Guo, Jianming; Wang, Hang; Wang, Guomin

    2015-01-01

    Abstract In the zero ischemia era of nephron-sparing surgery (NSS), a new anatomic classification system (ACS) is needed to adjust to these new surgical techniques. We devised a novel and simple ACS, and compared it with the RENAL and PADUA scores to predict the risk of NSS outcomes. We retrospectively evaluated 789 patients who underwent NSS with available imaging between January 2007 and July 2014. Demographic and clinical data were assessed. The Zhongshan (ZS) score consisted of three parameters. RENAL, PADUA, and ZS scores are divided into three groups, that is, high, moderate, and low scores. For operative time (OT), significant differences were seen between any two groups of ZS score and PADUA score (all P < 0.05). For ZS score, patients with moderate and high scores had longer warm ischemia time (WIT) and greater increase in SCr compared with low score (all P < 0.05). What is more, the differences between moderate and high scores classified by ZS score were borderline but trending toward significance in WIT (P = 0.064) and increase in SCr (P = 0.052). Interestingly, RENAL showed no significant difference between moderate and high complexity in OT, WIT, estimated blood loss, and increase in SCr. Compared with patients with a low score of ZS, those with a high or moderate score had 8.1-fold or 3.3-fold higher risk of surgical complications, respectively (all P < 0.05). As for RENAL score, patients with a high or moderate score had 5.7-fold or 1.9-fold higher risk of surgical complications, respectively (all P < 0.05). Patients with a high or moderate score of PADUA had 2.3-fold or 2.8-fold higher risk of surgical complications, respectively (all P < 0.05). In the ROC curve analysis, ZS score had the greatest AUC for surgical complications (AUC = 0.632) and the conversion to radical nephrectomy (AUC = 0.845) (all P < 0.05). In conclusion, the ability of ZS score to predict the surgical complexity and surgical

  9. Cutoff value of Japanese Orthopaedic Association shoulder score in patients with rotator cuff repair: Based on the University of California at Los Angeles shoulder score.

    PubMed

    Imai, Takaki; Gotoh, Masafumi; Tokunaga, Tsuyoshi; Kawakami, Jyunichi; Mitsui, Yasuhiro; Fukuda, Keiji; Ogino, Misa; Okawa, Takahiro; Shiba, Naoto

    2017-05-01

    The Japanese Orthopaedic Association shoulder score cutoff values were calculated in patients with rotator cuff repair using the University of California at Los Angeles shoulder score. Overall, 175 patients with rotator cuff repair were subjects in this study. The University of California at Los Angeles and Japanese Orthopaedic Association shoulder scores were evaluated before surgery and at 3, 6, 9, and 12 months after surgery. The cutoff value of the Japanese Orthopaedic Association shoulder score was determined using the 4-stage criteria of the University of California at Los Angeles shoulder score and a University of California at Los Angeles shoulder score of 28 points, which is the boundary between an excellent/good group and a fair/poor group. Both the JOA shoulder and UCLA shoulder scores showed significant improvement at 6, 9, and 12 months from the preoperative scores (p < 0.0001). There was a strong correlation between the total values of the two scores (r = 0.85, p < 0.0001). The cutoff value of the Japanese Orthopaedic Association shoulder score based on the highest accuracy from receiver operating characteristic curve analysis was 83 points. A Japanese Orthopaedic Association shoulder score cutoff value of 83 was equivalent to a University of California at Los Angeles shoulder score cutoff value of 28 for distinguishing between excellent/good and fair/poor outcomes after rotator cuff repair. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  10. Predicting Outcome in Subarachnoid Hemorrhage (SAH) Utilizing the Full Outline of UnResponsiveness (FOUR) Score.

    PubMed

    Zeiler, F A; Lo, B W Y; Akoth, E; Silvaggio, J; Kaufmann, A M; Teitelbaum, J; West, M

    2017-12-01

    Existing scoring systems for aneurysmal subarachnoid hemorrhage (SAH) patients fail to accurately predict patient outcome. Our goal was to prospectively study the Full Outline of UnResponsiveness (FOUR) score as applied to newly admitted aneurysmal SAH patients. All adult patients presenting to Health Sciences Center in Winnipeg from January 2013 to July 2015 (2.5 year period) with aneurysmal SAH were prospectively enrolled in this study. All patients were followed up to 6 months. FOUR score was calculated upon admission, with repeat calculation at 7 and 14 days. The primary outcomes were: mortality, as well as dichotomized 1- and 6-month Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) values. Sixty-four patients were included, with a mean age of 54.2 years (range 26-85 years). The mean FOUR score upon admission pre- and post-external ventricular drain (EVD) was 10.3 (range 0-16) and 11.1 (range 3-16), respectively. There was a statistically significant association between pre-EVD FOUR score (total, eye, respiratory and motor sub-scores) with mortality, 1-month GOS, and 6-month GOS/mRS (p < 0.05 in all). The day 7 total, eye, respiratory, and motor FOUR scores were associated with mortality, 1-month GOS/mRS, and 6-month GOS/mRS (p < 0.05 in all). The day 14 total, eye, respiratory, and motor FOUR scores were associated with 6-month GOS (p < 0.05 in all). The day 7 cumulative FOUR score was associated with the development of clinical vasospasm (p < 0.05). The FOUR score at admission and day 7 post-SAH is associated with mortality, 1-month GOS/mRS, and 6-month GOS/mRS. The FOUR score at day 14 post-SAH is associated with 6-month GOS. The brainstem sub-score was not associated with 1- or 6-month primary outcomes.

  11. [Toronto clinical scoring system in diabetic peripheral neuropathy].

    PubMed

    Liu, Feng; Mao, Ji-Ping; Yan, Xiang

    2008-12-01

    To evaluate the application value of Toronto clinical scoring system (TCSS) and its grading of neuropathy for diabetic peripheral neuropathy (DPN), and to explore the relationship between TCSS grading of neuropathy and the grading of diabetic nephropathy and diabetic retinopathy. A total of 209 patients of Type 2 diabtes (T2DM) underwent TCSS. Taking electrophysiological examination as a gold standard for diagnosing DPN, We compared the results of TCSS score > or = 6 with electrophysiological examination, and tried to select the optimal cut-off points of TCSS. The corresponding accuracy, sensitivity, and specificity of TCSS score > or = 6 were 76.6%, 77.2%, and 75.6%, respectively.The Youden index and Kappa were 0.53 and 0.52, which implied TCSS score > or = 6 had a moderate consistency with electrophysiological examination. There was a linear positive correlation between TCSS grading of neuropathy and the grading of diabetic nephropathy and diabetic retinopathy (P<0.05). The optimal cut-off point was 5 or 6 among these patients. TCSS is reliable in diagnosing DPN and its grading of neuropathy has clinical value.

  12. [EFFECTIVENESS OF BILATERAL TOTAL HIP AND KNEE ARTHROPLASTY FOR SEVERE INFLAMMATORY ARTHROPATHIES].

    PubMed

    Li, Xin; Li, Heng; Ni, Ming; Li, Xiang; Song, Xinggui; Kong, Xiangpeng; Li, Yucong; Chen, Jiying

    2016-11-08

    To evaluate the application and effectiveness of bilateral total hip arthroplasty and total knee arthroplasty in the treatment of severe inflammatory arthropathies. Between September 2008 and September 2015, 31 patients with severe inflammatory arthropathies were treated with bilateral total hip arthroplasty and total knee arthroplasty. Of 31 cases, 22 were male and 9 were female with an average age of 30 years (range, 20 to 41 years); there were 15 cases of rheumatoid arthritis and 16 cases of ankylosing spondylitis with an average onset age of 14 years (range, 5-28 years); all 4 ankylosed joints were observed in 11 cases, 3 ankylosed joints in 2 cases, 2 ankylosed joints in 6 cases, 1 ankylosed joint in 1 case, and no ankylosed joint in 11 cases. Before operation, the hip range of motion (ROM) value was (17.82±28.18)°, and the knee ROM value score was (26.45±30.18)°; the hip Harris score was 29.64±11.58, and the hospital for special surgery (HSS) score was 27.07±11.04. The patients were grouped and compared in accordance with etiology and ankylosed joint. One-stage arthroplasty was performed in 1 case, two-stage arthroplasty in 22 cases, three-stage arthroplasty in 7 cases, and four-stage arthroplasty in 1 case. The total operation time was 325-776 minutes; the total blood loss was 900-3 900 mL; the total transfusion volume was 2 220-8 070 mL; and the total hospitalization time was 21-65 days. The patients were followed up 12-94 months (mean, 51 months). The hip and knee ROM values, Harris score and HSS score at last follow-up were significantly improved when compared with preoperative ones ( P <0.05). The subjective satisfaction degree was good in 16 cases, moderate in 10 cases, and poor in 5 cases. Periprosthetic infection occurred in 2 cases (3 knees), joint stiffness in 3 cases (6 knees), joint instability in 1 case (1 knee), leg length discrepancy of >2 cm in 2 cases, and flexion deformity of 10° in 1 case (1 knee). The hip and knee ROM values, Harris

  13. Use of allele scores as instrumental variables for Mendelian randomization

    PubMed Central

    Burgess, Stephen; Thompson, Simon G

    2013-01-01

    Background An allele score is a single variable summarizing multiple genetic variants associated with a risk factor. It is calculated as the total number of risk factor-increasing alleles for an individual (unweighted score), or the sum of weights for each allele corresponding to estimated genetic effect sizes (weighted score). An allele score can be used in a Mendelian randomization analysis to estimate the causal effect of the risk factor on an outcome. Methods Data were simulated to investigate the use of allele scores in Mendelian randomization where conventional instrumental variable techniques using multiple genetic variants demonstrate ‘weak instrument’ bias. The robustness of estimates using the allele score to misspecification (for example non-linearity, effect modification) and to violations of the instrumental variable assumptions was assessed. Results Causal estimates using a correctly specified allele score were unbiased with appropriate coverage levels. The estimates were generally robust to misspecification of the allele score, but not to instrumental variable violations, even if the majority of variants in the allele score were valid instruments. Using a weighted rather than an unweighted allele score increased power, but the increase was small when genetic variants had similar effect sizes. Naive use of the data under analysis to choose which variants to include in an allele score, or for deriving weights, resulted in substantial biases. Conclusions Allele scores enable valid causal estimates with large numbers of genetic variants. The stringency of criteria for genetic variants in Mendelian randomization should be maintained for all variants in an allele score. PMID:24062299

  14. [Relative effect per patient (REPP)--outcome groups for total hip replacement and total knee replacement].

    PubMed

    Huber, J; Dabis, E; Zumstein, M D; Hüsler, J

    2013-06-01

    The outcome of orthopaedic surgery such as total hip replacement (THR) or total knee replacement (TKR) is commonly given by the change in mean scores on patient-reported outcome measures (Prom's). This may give the impression that all enrolled patients have experienced an improvement. But the Swedish hip registry and other studies report a reduction of complaints in 80-85 % of patients ("responders"), with the remainder (approximately one in six) remaining unchanged or reporting worse complaints ("non-responders"). According to Cohen, the degree of success in the "responders" group can be subdivided into excellent, good and moderate. For a given treatment, a total of 5 different outcome groups can therefore be defined: excellent, good, moderate, unchanged and worse. Allocation to the groups is based on the "relative effect per patient" (REPP). The REPP is calculated as the base-line score minus the post-treatment score divided by the baseline score. The maximum possible REPP is 1; a REPP of 0 means no effect and a negative REPP means deterioration. Allocation to the outcome groups is as follows: excellent 0.95 to 1 REPP, good 0.5 to 0.95 REPP, moderate over 0.2 to 0.5 REPP, unchanged -0.2 to 0.2 REPP and worse below -0.2 REPP. Our local arthroplasty register was used to evaluate the 1-year outcomes of THR and TKR patients operated between March 2003 and November 2008, using WOMAC scores and EuroQoL scores. Only patients with complete data sets and unilateral THR/TKR were included. The success rate given by the REPP method was compared with that of the "responder rate" method defined by the OMERACT-OARSI criteria. With the WOMAC questionnaire, outcomes were as follows (THR/TKR): excellent 29/14 %, good 51/54 %, moderate 11/13 %, unchanged at 5/12 %, worse 4/7 %. The corresponding values for the EuroQoL were (THR/TKR): excellent 16/6 %, good 41/42 %, moderate 25/28 %, unchanged 12/16 %, worse 6/8 %. For THR, success rates were 92 % using the "responder rate" method

  15. Association of serum total antioxidant capacity and total oxidant status with pain perception in patients with myofacial pain dysfunction.

    PubMed

    Etoz, Osman A; Ataoglu, Hanife; Erel, Ozcan; Celik, Hakim; Herken, Emine Nur; Bayazit, Yildirim Ahmet

    2009-01-01

    We aimed to find out the association of total antioxidant capacity (TAC) and total oxidant status (TOS) with generalized pressure pain thresholds (PPT) of patients with myofacial pain dysfunction (MPD). PPT scores of patients with MPD (n = 37) and healthy individuals (n = 43) were measured on the hypothenar region of the hand using a mechanical algometer. Serum samples were collected and TAC and TOS were measured by novel methods. The TAC of patients was significantly lower than that of the control subjects. The difference between the TOS measurements of patients and control subjects was not significant. The PPT scores of the patients were significantly lower than that of control subjects. There may be an association between serum antioxidant capacity and MPD. Low serum TAC might also be related with pain perception.

  16. Application of the FOUR Score in Intracerebral Hemorrhage Risk Analysis.

    PubMed

    Braksick, Sherri A; Hemphill, J Claude; Mandrekar, Jay; Wijdicks, Eelco F M; Fugate, Jennifer E

    2018-06-01

    The Full Outline of Unresponsiveness (FOUR) Score is a validated scale describing the essentials of a coma examination, including motor response, eye opening and eye movements, brainstem reflexes, and respiratory pattern. We incorporated the FOUR Score into the existing ICH Score and evaluated its accuracy of risk assessment in spontaneous intracerebral hemorrhage (ICH). Consecutive patients admitted to our institution from 2009 to 2012 with spontaneous ICH were reviewed. The ICH Score was calculated using patient age, hemorrhage location, hemorrhage volume, evidence of intraventricular extension, and Glasgow Coma Scale (GCS). The FOUR Score was then incorporated into the ICH Score as a substitute for the GCS (ICH Score FS ). The ability of the 2 scores to predict mortality at 1 month was then compared. In total, 274 patients met the inclusion criteria. The median age was 73 years (interquartile range 60-82) and 138 (50.4%) were male. Overall mortality at 1 month was 28.8% (n = 79). The area under the receiver operating characteristic curve was .91 for the ICH Score and .89 for the ICH Score FS . For ICH Scores of 1, 2, 3, 4, and 5, 1-month mortality was 4.2%, 29.9%, 62.5%, 95.0%, and 100%. In the ICH Score FS model, mortality was 10.7%, 26.5%, 64.5%, 88.9%, and 100% for scores of 1, 2, 3, 4, and 5, respectively. The ICH Score and the ICH Score FS predict 1-month mortality with comparable accuracy. As the FOUR Score provides additional clinical information regarding patient status, it may be a reasonable substitute for the GCS into the ICH Score. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. European conformation and fat scores have no relationship with eating quality.

    PubMed

    Bonny, S P F; Pethick, D W; Legrand, I; Wierzbicki, J; Allen, P; Farmer, L J; Polkinghorne, R J; Hocquette, J-F; Gardner, G E

    2016-06-01

    European conformation and fat grades are a major factor determining carcass value throughout Europe. The relationships between these scores and sensory scores were investigated. A total of 3786 French, Polish and Irish consumers evaluated steaks, grilled to a medium doneness, according to protocols of the ���Meat Standards Australia��� system, from 18 muscles representing 455 local, commercial cattle from commercial abattoirs. A mixed linear effects model was used for the analysis. There was a negative relationship between juiciness and European conformation score. For the other sensory scores, a maximum of three muscles out of a possible 18 demonstrated negative effects of conformation score on sensory scores. There was a positive effect of European fat score on three individual muscles. However, this was accounted for by marbling score. Thus, while the European carcass classification system may indicate yield, it has no consistent relationship with sensory scores at a carcass level that is suitable for use in a commercial system. The industry should consider using an additional system related to eating quality to aid in the determination of the monetary value of carcasses, rewarding eating quality in addition to yield.

  18. Reliability and Validity of Composite Scores from the NIH Toolbox Cognition Battery in Adults

    PubMed Central

    Heaton, Robert K.; Akshoomoff, Natacha; Tulsky, David; Mungas, Dan; Weintraub, Sandra; Dikmen, Sureyya; Beaumont, Jennifer; Casaletto, Kaitlin B.; Conway, Kevin; Slotkin, Jerry; Gershon, Richard

    2014-01-01

    This study describes psychometric properties of the NIH Toolbox Cognition Battery (NIHTB-CB) Composite Scores in an adult sample. The NIHTB-CB was designed for use in epidemiologic studies and clinical trials for ages 3 to 85. A total of 268 self-described healthy adults were recruited at four university-based sites, using stratified sampling guidelines to target demographic variability for age (20–85 years), gender, education, and ethnicity. The NIHTB-CB contains seven computer-based instruments assessing five cognitive sub-domains: Language, Executive Function, Episodic Memory, Processing Speed, and Working Memory. Participants completed the NIHTB-CB, corresponding gold standard validation measures selected to tap the same cognitive abilities, and sociodemographic questionnaires. Three Composite Scores were derived for both the NIHTB-CB and gold standard batteries: “Crystallized Cognition Composite,” “Fluid Cognition Composite,” and “Total Cognition Composite” scores. NIHTB Composite Scores showed acceptable internal consistency (Cronbach’s alphas = 0.84 Crystallized, 0.83 Fluid, 0.77 Total), excellent test–retest reliability (r: 0.86–0.92), strong convergent (r: 0.78–0.90) and discriminant (r: 0.19–0.39) validities versus gold standard composites, and expected age effects (r = 0.18 crystallized, r = − 0.68 fluid, r = − 0.26 total). Significant relationships with self-reported prior school difficulties and current health status, employment, and presence of a disability provided evidence of external validity. The NIH Toolbox Cognition Battery Composite Scores have excellent reliability and validity, suggesting they can be used effectively in epidemiologic and clinical studies. PMID:24960398

  19. Traditional Admissions Variables as Predictors of Minority Students' Performance in Medical School — A Cause for Concern

    PubMed Central

    Johnson, Henry C.; Rosevear, G. Craig

    1977-01-01

    This study explored the relationship between traditional admissions criteria, performance in the first semester of medical school, and performance on the National Board of Medical Examiners' (NBME) Examination, Part 1 for minority medical students, non-minority medical students, and the two groups combined. Correlational analysis and step-wise multiple regression procedures were used as the analysis techniques. A different pattern of admissions variables related to National Board Part 1 performance for the two groups. The General Information section of the Medical College Admission Test (MCAT) contributed the most variance for the minority student group. MCAT-Science contributed the most variance for the non-minority student group. MCATs accounted for a substantial portion of the variance on the National Board examination. PMID:904005

  20. The variability in Oxford hip and knee scores in the preoperative period: is there an ideal time to score?

    PubMed

    Quah, C; Holmes, D; Khan, T; Cockshott, S; Lewis, J; Stephen, A

    2018-01-01

    Background All NHS-funded providers are required to collect and report patient-reported outcome measures for hip and knee arthroplasty. Although there are established guidelines for timing such measures following arthroplasty, there are no specific time-points for collection in the preoperative period. The primary aim of this study was to identify whether there was a significant amount of variability in the Oxford hip and knee scores prior to surgical intervention when completed in the outpatient clinic at the time of listing for arthroplasty or when completed at the preoperative assessment clinic. Methods A prospective cohort study of patients listed for primary hip or knee arthroplasty was conducted. Patients were asked to fill in a preoperative Oxford score in the outpatient clinic at the time of listing. They were then invited to fill in the official outcome measures questionnaire at the preoperative assessment clinic. The postoperative Oxford score was then completed when the patient was seen again at their postoperative follow up in clinic. Results Of the total of 109 patients included in this study period, there were 18 (17%) who had a worse score of 4 or more points difference and 43 (39.4%) who had an improvement of 4 or more points difference when the scores were compared between time of listing at the outpatient and at the preoperative assessment clinic. There was a statistically significant difference (P = 0.0054) in the mean Oxford scores. Conclusions The results of our study suggest that there should be standardisation of timing for completing the preoperative patient-reported outcome measures.

  1. Validating MMI Scores: Are We Measuring Multiple Attributes?

    ERIC Educational Resources Information Center

    Oliver, Tom; Hecker, Kent; Hausdorf, Peter A.; Conlon, Peter

    2014-01-01

    The multiple mini-interview (MMI) used in health professional schools' admission processes is reported to assess multiple non-cognitive constructs such as ethical reasoning, oral communication, or problem evaluation. Though validation studies have been performed with total MMI scores, there is a paucity of information regarding how well MMI…

  2. 25 CFR Appendix A to Subpart C - IRR High Priority Project Scoring Matrix

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...—IRR High Priority Project Scoring Matrix Score 10 5 3 1 0 Accident and fatality rate for candidate route 1 Severe X Moderate Minimal No accidents. Years since last IRR construction project completed... elements Addresses 1 element. 1 National Highway Traffic Safety Board standards. 2 Total funds requested...

  3. College Math Assessment: SAT Scores vs. College Math Placement Scores

    ERIC Educational Resources Information Center

    Foley-Peres, Kathleen; Poirier, Dawn

    2008-01-01

    Many colleges and university's use SAT math scores or math placement tests to place students in the appropriate math course. This study compares the use of math placement scores and SAT scores for 188 freshman students. The student's grades and faculty observations were analyzed to determine if the SAT scores and/or college math assessment scores…

  4. Model for predicting the injury severity score.

    PubMed

    Hagiwara, Shuichi; Oshima, Kiyohiro; Murata, Masato; Kaneko, Minoru; Aoki, Makoto; Kanbe, Masahiko; Nakamura, Takuro; Ohyama, Yoshio; Tamura, Jun'ichi

    2015-07-01

    To determine the formula that predicts the injury severity score from parameters that are obtained in the emergency department at arrival. We reviewed the medical records of trauma patients who were transferred to the emergency department of Gunma University Hospital between January 2010 and December 2010. The injury severity score, age, mean blood pressure, heart rate, Glasgow coma scale, hemoglobin, hematocrit, red blood cell count, platelet count, fibrinogen, international normalized ratio of prothrombin time, activated partial thromboplastin time, and fibrin degradation products, were examined in those patients on arrival. To determine the formula that predicts the injury severity score, multiple linear regression analysis was carried out. The injury severity score was set as the dependent variable, and the other parameters were set as candidate objective variables. IBM spss Statistics 20 was used for the statistical analysis. Statistical significance was set at P  < 0.05. To select objective variables, the stepwise method was used. A total of 122 patients were included in this study. The formula for predicting the injury severity score (ISS) was as follows: ISS = 13.252-0.078(mean blood pressure) + 0.12(fibrin degradation products). The P -value of this formula from analysis of variance was <0.001, and the multiple correlation coefficient (R) was 0.739 (R 2  = 0.546). The multiple correlation coefficient adjusted for the degrees of freedom was 0.538. The Durbin-Watson ratio was 2.200. A formula for predicting the injury severity score in trauma patients was developed with ordinary parameters such as fibrin degradation products and mean blood pressure. This formula is useful because we can predict the injury severity score easily in the emergency department.

  5. Staging Dementia Using Clinical Dementia Rating Scale Sum of Boxes Scores

    PubMed Central

    O'Bryant, Sid E.; Waring, Stephen C.; Cullum, C. Munro; Hall, James; Lacritz, Laura; Massman, Paul J.; Lupo, Philip J.; Reisch, Joan S.; Doody, Rachelle

    2012-01-01

    Background The Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) score is commonly used, although the utility regarding this score in staging dementia severity is not well established. Obiective To investigate the effectiveness of CDRSOB scores in staging dementia severity compared with the global CDR score. Design Retrospective study. Setting Texas Alzheimer's Research Consortium minimum data set cohort. Participants A total of 1577 participants (110 controls, 202 patients with mild cognitive impairment, and 1265 patients with probable Alzheimer disease) were available for analysis. Main Outcome Measures Receiver operating characteristic curves were generated from a derivation sample to determine optimal cutoff scores and ranges, which were then applied to the validation sample. Results Optimal ranges of CDR-SOB scores corresponding to the global CDR scores were 0.5 to 4.0 for a global score of 0.5, 4.5 to 9.0 for a global score of 1.O, 9.5 to 15.5 for a global score of 2.0, and 16.0 to 18.0 for a global score of 3.0. When applied to the validation sample, κ scores ranged from 0.86 to 0.94 (P <.001 for all), with 93.0% of the participants falling within the new staging categories. Conclusions The CDR-SOB score compares well with the global CDR score for dementia staging. Owing to the increased range of values, the CDR-SOB score offers several advantages over the global score, including increased utility in tracking changes within and between stages of dementia severity. Interpretive guidelines for CDR-SOB scores are provided. PMID:18695059

  6. 4H Leukodystrophy: A Brain Magnetic Resonance Imaging Scoring System.

    PubMed

    Vrij-van den Bos, Suzanne; Hol, Janna A; La Piana, Roberta; Harting, Inga; Vanderver, Adeline; Barkhof, Frederik; Cayami, Ferdy; van Wieringen, Wessel N; Pouwels, Petra J W; van der Knaap, Marjo S; Bernard, Geneviève; Wolf, Nicole I

    2017-06-01

    4H (hypomyelination, hypodontia and hypogonadotropic hypogonadism) leukodystrophy (4H) is an autosomal recessive hypomyelinating white matter (WM) disorder with neurologic, dental, and endocrine abnormalities. The aim of this study was to develop and validate a magnetic resonance imaging (MRI) scoring system for 4H. A scoring system (0-54) was developed to quantify hypomyelination and atrophy of different brain regions. Pons diameter and bicaudate ratio were included as measures of cerebral and brainstem atrophy, and reference values were determined using controls. Five independent raters completed the scoring system in 40 brain MRI scans collected from 36 patients with genetically proven 4H. Interrater reliability (IRR) and correlations between MRI scores, age, gross motor function, gender, and mutated gene were assessed. IRR for total MRI severity was found to be excellent (intraclass correlation coefficient: 0.87; 95% confidence interval: 0.80-0.92) but varied between different items with some (e.g., myelination of the cerebellar WM) showing poor IRR. Atrophy increased with age in contrast to hypomyelination scores. MRI scores (global, hypomyelination, and atrophy scores) significantly correlated with clinical handicap ( p  < 0.01 for all three items) and differed between the different genotypes. Our 4H MRI scoring system reliably quantifies hypomyelination and atrophy in patients with 4H, and MRI scores reflect clinical disease severity. Georg Thieme Verlag KG Stuttgart · New York.

  7. Automated Essay Scoring versus Human Scoring: A Comparative Study

    ERIC Educational Resources Information Center

    Wang, Jinhao; Brown, Michelle Stallone

    2007-01-01

    The current research was conducted to investigate the validity of automated essay scoring (AES) by comparing group mean scores assigned by an AES tool, IntelliMetric [TM] and human raters. Data collection included administering the Texas version of the WriterPlacer "Plus" test and obtaining scores assigned by IntelliMetric [TM] and by…

  8. Application of prognostic scores in the STOPAH trial: Discriminant function is no longer the optimal scoring system in alcoholic hepatitis.

    PubMed

    Forrest, Ewan H; Atkinson, Stephen R; Richardson, Paul; Masson, Steven; Ryder, Stephen; Thursz, Mark R; Allison, Michael

    2018-03-01

    'Static' prognostic models in alcoholic hepatitis, using data from a single time point, include the discriminant function (DF), Glasgow alcoholic hepatitis score (GAHS), the age, serum bilirubin, international normalized ratio and serum creatinine (ABIC) score and the model of end-stage liver disease (MELD). 'Dynamic' scores, incorporating evolution of bilirubin at seven days, include the Lille score. The aim of this study was to assess these scores' performance in patients from the STOPAH trial. Predictive performance of scores was assessed by area under the receiver operating curve (AUC). The effect of different therapeutic strategies upon survival was assessed by Kaplan-Meier analysis and tested using the log-rank test. A total of 1,068 patients were studied. The AUCs for the DF were significantly lower than for MELD, ABIC and GAHS for both 28- and 90-day outcomes: 90-day values were 0.670, 0.704, 0.726 and 0.713, respectively. 'Dynamic' scores and change in 'static' scores by Day 7 had similar AUCs. Patients with consistently low 'static' scores had low 28-day mortalities that were not improved with prednisolone (MELD <25: 8.6%; ABIC <6.71: 6.6%; GAHS <9: 5.9%). In patients with high 'static' scores without gastrointestinal bleeding or sepsis, prednisolone reduced 28-day mortality (MELD: 22.2% vs. 28.9%, p = 0.13; ABIC 14.6% vs. 21%, p = 0.02; GAHS 21% vs. 29.3%, p = 0.04). Overall mortality from treating all patients with a DF ≥32 and Lille assessment (90-day mortality 26.8%) was greater than combining newer 'static' and 'dynamic' scores (90-day mortality: MELD/Lille 21.8%; ABIC/Lille 23.7%; GAHS/Lille 20.6%). MELD, ABIC and GAHS are superior to the DF in alcoholic hepatitis. Consistently low scores have a favourable outcome not improved with prednisolone. Combined baseline 'static' and Day 7 scores reduce the number of patients exposed to corticosteroids and improve 90-day outcome. Alcoholic hepatitis is a life-threatening condition. Several

  9. Computer-Assisted Automated Scoring of Polysomnograms Using the Somnolyzer System.

    PubMed

    Punjabi, Naresh M; Shifa, Naima; Dorffner, Georg; Patil, Susheel; Pien, Grace; Aurora, Rashmi N

    2015-10-01

    Manual scoring of polysomnograms is a time-consuming and tedious process. To expedite the scoring of polysomnograms, several computerized algorithms for automated scoring have been developed. The overarching goal of this study was to determine the validity of the Somnolyzer system, an automated system for scoring polysomnograms. The analysis sample comprised of 97 sleep studies. Each polysomnogram was manually scored by certified technologists from four sleep laboratories and concurrently subjected to automated scoring by the Somnolyzer system. Agreement between manual and automated scoring was examined. Sleep staging and scoring of disordered breathing events was conducted using the 2007 American Academy of Sleep Medicine criteria. Clinical sleep laboratories. A high degree of agreement was noted between manual and automated scoring of the apnea-hypopnea index (AHI). The average correlation between the manually scored AHI across the four clinical sites was 0.92 (95% confidence interval: 0.90-0.93). Similarly, the average correlation between the manual and Somnolyzer-scored AHI values was 0.93 (95% confidence interval: 0.91-0.96). Thus, interscorer correlation between the manually scored results was no different than that derived from manual and automated scoring. Substantial concordance in the arousal index, total sleep time, and sleep efficiency between manual and automated scoring was also observed. In contrast, differences were noted between manually and automated scored percentages of sleep stages N1, N2, and N3. Automated analysis of polysomnograms using the Somnolyzer system provides results that are comparable to manual scoring for commonly used metrics in sleep medicine. Although differences exist between manual versus automated scoring for specific sleep stages, the level of agreement between manual and automated scoring is not significantly different than that between any two human scorers. In light of the burden associated with manual scoring, automated

  10. In Vitro Investigation of Crosstalk between Fatty Acid and Polyketide Synthases in the Andrimid Biosynthetic Assembly Line.

    PubMed

    Ishikawa, Fumihiro; Sugimoto, Hiroyasu; Kakeya, Hideaki

    2016-11-17

    Andrimid (Adm) synthase, which belongs to the type II system of enzymes, produces Adm in Pantoea agglomerans. The adm biosynthetic gene cluster lacks canonical acyltransferases (ATs) to load the malonyl group to acyl carrier proteins (ACPs), thus suggesting that a malonyl-CoA ACP transacylase (MCAT) from the fatty acid synthase (FAS) complex provides the essential AT activity in Adm biosynthesis. Here we report that an MCAT is essential for catalysis of the transacylation of malonate from malonyl-CoA to AdmA polyketide synthase (PKS) ACP in vitro. Catalytic self-malonylation of AdmA (PKS ACP) was not observed in reactions without MCAT, although many type II PKS ACPs are capable of catalyzing self-acylation. This lack of self-malonylation was explained by amino acid sequence analysis of the AdmA PKS ACP and the type II PKS ACPs. The results show that MCAT from the organism's FAS complex can provide the missing AT activity in trans, thus suggesting a protein-protein interaction between the fatty acid and polyketide synthases in the Adm assembly line. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Total and Conceptual Vocabulary in Spanish–English Bilinguals From 22 to 30 Months: Implications for Assessment

    PubMed Central

    Core, Cynthia; Hoff, Erika; Rumiche, Rosario; Señor, Melissa

    2015-01-01

    Purpose Vocabulary assessment holds promise as a way to identify young bilingual children at risk for language delay. This study compares 2 measures of vocabulary in a group of young Spanish–English bilingual children to a single-language measure used with monolingual children. Method Total vocabulary and conceptual vocabulary were used to measure mean vocabulary size and growth in 47 Spanish–English bilingually developing children from 22 to 30 months of age based on results from the MacArthur–Bates Communicative Development Inventory (CDI; Fenson et al., 1993) and the Inventario del Desarrollo de Habilidades Comunicativas (Jackson-Maldonado et al., 2003). Bilingual children’s scores of total vocabulary and conceptual vocabulary were compared with CDI scores for a control group of 56 monolingual children. Results The total vocabulary measure resulted in mean vocabulary scores and average rate of growth similar to monolingual growth, whereas conceptual vocabulary scores were significantly smaller and grew at a slower rate than total vocabulary scores. Total vocabulary identified the same proportion of bilingual children below the 25th percentile on monolingual norms as the CDI did for monolingual children. Conclusion These results support the use of total vocabulary as a means of assessing early language development in young bilingual Spanish–English speaking children. PMID:24023382

  12. Total and conceptual vocabulary in Spanish-English bilinguals from 22 to 30 months: implications for assessment.

    PubMed

    Core, Cynthia; Hoff, Erika; Rumiche, Rosario; Señor, Melissa

    2013-10-01

    Vocabulary assessment holds promise as a way to identify young bilingual children at risk for language delay. This study compares 2 measures of vocabulary in a group of young Spanish-English bilingual children to a single-language measure used with monolingual children. Total vocabulary and conceptual vocabulary were used to measure mean vocabulary size and growth in 47 Spanish-English bilingually developing children from 22 to 30 months of age based on results from the MacArthur-Bates Communicative Development Inventory (CDI; Fenson et al., 1993) and the Inventario del Desarrollo de Habilidades Comunicativas ( Jackson-Maldonado et al., 2003). Bilingual children's scores of total vocabulary and conceptual vocabulary were compared with CDI scores for a control group of 56 monolingual children. The total vocabulary measure resulted in mean vocabulary scores and average rate of growth similar to monolingual growth, whereas conceptual vocabulary scores were significantly smaller and grew at a slower rate than total vocabulary scores. Total vocabulary identified the same proportion of bilingual children below the 25th percentile on monolingual norms as the CDI did for monolingual children. These results support the use of total vocabulary as a means of assessing early language development in young bilingual Spanish-English speaking children.

  13. Outcomes of total knee arthroplasty in relation to preoperative patient-reported and radiographic measures: data from the osteoarthritis initiative.

    PubMed

    Kahn, Timothy L; Soheili, Aydin; Schwarzkopf, Ran

    2013-12-01

    Total knee arthroplasty (TKA) is the preferred surgical treatment for end-stage osteoarthritis. However, substantial numbers of patients still experience poor outcomes. Consequently, it is important to identify which patient characteristics are predictive of outcomes in order to guide clinical decisions. Our hypothesis is that preoperative patient-reported outcome measures and radiographic measures may help to predict TKA outcomes. Using cohort data from the Osteoarthritis Initiative, we studied 172 patients who underwent TKA. For each patient, we compiled pre- and postoperative Western Ontario and McMaster University Arthritis Index (WOMAC) scores. Radiographs were measured for knee joint angles, femorotibial angles, anatomical lateral distal femoral angles, and anatomical medial proximal tibial angles; Kellgren and Lawrence (KL) grades were assigned to each compartment of the knee. All studied measurements were compared to WOMAC outcomes. Preoperative WOMAC disability, pain, and total scores were positively associated with postoperative WOMAC total scores (P = .010, P = .010, and P = .009, respectively) and were associated with improvement in WOMAC total scores (P < .001, P < .001, and P < .001, respectively). For radiographic measurements, preoperative joint angles were positively associated with improvements in postoperative WOMAC total scores (P = .044). Combined KL grades (medial and lateral compartments) were negatively correlated with postoperative WOMAC disability and pain scores (P = .045 and P = .044) and were positively correlated with improvements in WOMAC total scores (P = .001). All preoperative WOMAC scores demonstrated positive associations with postoperative WOMAC scores, while among the preoperative radiographic measurements only combined KL grades and joint angles showed any correlation with postoperative WOMAC scores. Higher preoperative KL grades and joint angles were associated with better (lower) postoperative WOMAC scores, demonstrating an

  14. Assessing spelling in kindergarten: further comparison of scoring metrics and their relation to reading skills.

    PubMed

    Clemens, Nathan H; Oslund, Eric L; Simmons, Leslie E; Simmons, Deborah

    2014-02-01

    Early reading and spelling development share foundational skills, yet spelling assessment is underutilized in evaluating early reading. This study extended research comparing the degree to which methods for scoring spelling skills at the end of kindergarten were associated with reading skills measured at the same time as well as at the end of first grade. Five strategies for scoring spelling responses were compared: totaling the number of words spelled correctly, totaling the number of correct letter sounds, totaling the number of correct letter sequences, using a rubric for scoring invented spellings, and calculating the Spelling Sensitivity Score (Masterson & Apel, 2010b). Students (N=287) who were identified at kindergarten entry as at risk for reading difficulty and who had received supplemental reading intervention were administered a standardized spelling assessment in the spring of kindergarten, and measures of phonological awareness, decoding, word recognition, and reading fluency were administered concurrently and at the end of first grade. The five spelling scoring metrics were similar in their strong relations with factors summarizing reading subskills (phonological awareness, decoding, and word reading) on a concurrent basis. Furthermore, when predicting first-grade reading skills based on spring-of-kindergarten performance, spelling scores from all five metrics explained unique variance over the autoregressive effects of kindergarten word identification. The practical advantages of using a brief spelling assessment for early reading evaluation and the relative tradeoffs of each scoring metric are discussed. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  15. The AIMS65 Score Is a Useful Predictor of Mortality in Patients with Nonvariceal Upper Gastrointestinal Bleeding: Urgent Endoscopy in Patients with High AIMS65 Scores

    PubMed Central

    Park, Sun Wook; Song, Young Wook; Tak, Dae Hyun; Ahn, Byung Moo; Kang, Sun Hyung; Moon, Hee Seok; Sung, Jae Kyu; Jeong, Hyun Yong

    2015-01-01

    Background/Aims: To validate the AIMS65 score for predicting mortality of patients with nonvariceal upper gastrointestinal bleeding and to evaluate the effectiveness of urgent (<8 hours) endoscopic procedures in patients with high AIMS65 scores. Methods: This was a 5-year single-center, retrospective study. Nonvariceal, upper gastrointestinal bleeding was assessed by using the AIM65 and Rockall scores. Scores for mortality were assessed by calculating the area under the receiver-operating characteristic curve (AUROC). Patients with high AIMS65 scores (≥2) were allocated to either the urgent or non-urgent endoscopic procedure group. In-hospital mortality, success of endoscopic procedure, recurrence of bleeding, admission period, and dose of transfusion were compared between groups. Results: A total of 634 patients were analyzed. The AIMS65 score successfully predicted mortality (AUROC=0.943; 95% confidence interval [CI], 0.876 to 0.99) and was superior to the Rockall score (AUROC=0.856; 95% CI, 0.743 to 0.969) in predicting mortality. The group with high AIMS65 score included 200 patients. The urgent endoscopic procedure group had reduced hospitalization periods (p<0.05) Conclusions: AIMS65 score may be useful in predicting mortality in patients with nonvariceal upper gastrointestinal bleeding. Urgent endoscopic procedures in patients with high scores may be related to reduced hospitalization periods. PMID:26668799

  16. Exploring a Source of Uneven Score Equity across the Test Score Range

    ERIC Educational Resources Information Center

    Huggins-Manley, Anne Corinne; Qiu, Yuxi; Penfield, Randall D.

    2018-01-01

    Score equity assessment (SEA) refers to an examination of population invariance of equating across two or more subpopulations of test examinees. Previous SEA studies have shown that score equity may be present for examinees scoring at particular test score ranges but absent for examinees scoring at other score ranges. No studies to date have…

  17. Steric parameters, molecular modeling and hydropathic interaction analysis of the pharmacology of para-substituted methcathinone analogues

    PubMed Central

    Sakloth, F; Kolanos, R; Mosier, P D; Bonano, J S; Banks, M L; Partilla, J S; Baumann, M H; Negus, S S; Glennon, R A

    2015-01-01

    Background and Purpose There is growing concern over the abuse of certain psychostimulant methcathinone (MCAT) analogues. This study extends an initial quantitative structure–activity relationship (QSAR) investigation that demonstrated important steric considerations of seven 4- (or para-)substituted analogues of MCAT. Specifically, the steric character (Taft's steric ES) of the 4-position substituent affected in vitro potency to induce monoamine release via dopamine and 5-HT transporters (DAT and SERT) and in vivo modulation of intracranial self-stimulation (ICSS). Here, we have assessed the effects of other steric properties of the 4-position substituents. Experimental Approach Definitive steric parameters that more explicitly focus on the volume, width and length of the MCAT 4-position substituents were assessed. In addition, homology models of human DAT and human SERT based upon the crystallized Drosophila DAT were constructed and docking studies were performed, followed by hydropathic interaction (HINT) analysis of the docking results. Key Results The potency of seven MCAT analogues at DAT was negatively correlated with the volume and maximal width of their 4-position substituents, whereas potency at SERT increased as substituent volume and length increased. SERT/DAT selectivity, as well as abuse-related drug effects in the ICSS procedure, also correlated with the same parameters. Docking solutions offered a means of visualizing these findings. Conclusions and Implications These results suggest that steric aspects of the 4-position substituents of MCAT analogues are key determinants of their action and selectivity, and that the hydrophobic nature of these substituents is involved in their potency at SERT. PMID:25522019

  18. Validity and reliability of the infant breastfeeding assessment tool, the mother baby assessment tool, and the LATCH scoring system.

    PubMed

    Altuntas, Nilgun; Turkyilmaz, Canan; Yildiz, Havva; Kulali, Ferit; Hirfanoglu, Ibrahim; Onal, Esra; Ergenekon, Ebru; Koç, Esin; Atalay, Yıldız

    2014-05-01

    We aimed to evaluate the validity and reliability of the Infant Breastfeeding Assessment Tool (IBFAT), the Mother Baby Assessment (MBA) Tool, and the LATCH scoring system. Mothers who delivered healthy, full-term infants in the Obstetrics & Gynecology Service of Gazi University, Ankara, Turkey, between December 2013 and January 2014 and their infants were included in the study. Forty-six randomly selected breastfeeding sessions were monitored and scored simultaneously by three researchers (Raters 1, 2, and 3) using LATCH, IBFAT, and the MBA Tool. Researchers put the score sheets in an envelope in order to hide them from each other. The compatibility of the scores given by three researchers was assessed by statistical methods. We found positive and significant correlation coefficients between 0.81 to 0.88 for the total MBA score, between 0.90 to 0.95 for the total IBFAT score, and between 0.85 to 0.91 for the total LATCH score. Correlation coefficients testing these three tools ranged from 0.71 to 0.88, with the minimum value being noted for the correlation between LATCH and IBFAT scores and the maximum value being noted for the correlation between LATCH and MBA scores. We found positive and significant correlations between researchers' scores for 46 observations using the three assessment tools. This study showed that these above-mentioned tools were compatible for the assessment of the efficiency of breastfeeding.

  19. Score Distributions of the Balance Outcome Measure for Elder Rehabilitation (BOOMER) in Community-Dwelling Older Adults With Vertebral Fracture.

    PubMed

    Brown, Zachary M; Gibbs, Jenna C; Adachi, Jonathan D; Ashe, Maureen C; Hill, Keith D; Kendler, David L; Khan, Aliya; Papaioannou, Alexandra; Prasad, Sadhana; Wark, John D; Giangregorio, Lora M

    2017-11-28

    We sought to evaluate the Balance Outcome Measure for Elder Rehabilitation (BOOMER) in community-dwelling women 65 years and older with vertebral fracture and to describe score distributions and potential ceiling and floor effects. This was a secondary data analysis of baseline data from the Build Better Bones with Exercise randomized controlled trial using the BOOMER. A total of 141 women with osteoporosis and radiographically confirmed vertebral fracture were included. Concurrent validity and internal consistency were assessed in comparison to the Short Physical Performance Battery (SPPB). Normality and ceiling/floor effects of total BOOMER scores and component test items were also assessed. Exploratory analyses of assistive aid use and falls history were performed. Tests for concurrent validity demonstrated moderate correlation between total BOOMER and SPPB scores. The BOOMER component tests showed modest internal consistency. Substantial ceiling effect and nonnormal score distributions were present among overall sample and those not using assistive aids for total BOOMER scores, although scores were normally distributed for those using assistive aids. The static standing with eyes closed test demonstrated the greatest ceiling effects of the component tests, with 92% of participants achieving a maximal score. While the BOOMER compares well with the SPPB in community-dwelling women with vertebral fractures, researchers or clinicians considering using the BOOMER in similar or higher-functioning populations should be aware of the potential for ceiling effects.

  20. Sixteen years of collaborative learning through active sense-making in physics (CLASP) at UC Davis

    NASA Astrophysics Data System (ADS)

    Potter, Wendell; Webb, David; Paul, Cassandra; West, Emily; Bowen, Mark; Weiss, Brenda; Coleman, Lawrence; De Leone, Charles

    2014-02-01

    This paper describes our large reformed introductory physics course at UC Davis, which bioscience students have been taking since 1996. The central feature of this course is a focus on sense-making by the students during the 5 h per week discussion/labs in which the students take part in activities emphasizing peer-peer discussions, argumentation, and presentations of ideas. The course differs in many fundamental ways from traditionally taught introductory physics courses. After discussing the unique features of CLASP and its implementation at UC Davis, various student outcome measures are presented that show increased performance by students who took the CLASP course compared to students who took a traditionally taught introductory physics course. Measures we use include upper-division GPAs, MCAT scores, FCI gains, and MPEX-II scores.

  1. Mitochondrial catalase suppresses naturally occurring lung cancer in old mice.

    PubMed

    Ge, Xuang; Pettan-Brewer, Christina; Morton, John; Carter, Katrina; Fatemi, Sy; Rabinovitch, Peter; Ladiges, Warren C

    2015-01-01

    Lung cancer is generally difficult to detect until the late stages of disease, when it is much more difficult to treat because of the more aggressive and invasive behavior. Advanced lung cancer is much more common in older adults making it even more challenging to treat. Adenocarcinoma belongs to a category of non-small cell lung cancers, which comprise up to 40% of all lung cancers, and about half of these have an activating K-ras mutation. Because treatment relapses are common, more effective unconventional treatment and prevention methods are needed. In this regard, the antioxidant enzyme catalase targeted to mitochondria (mCAT) has been shown to delay aging and cancer in mice, and the progression of transgenic oncogene and syngeneic tumors was suppressed, helping support the notion that attenuation of mitochondria-generated hydrogen peroxide signaling is associated with an antitumor effect. In order to determine if mCAT has any effect on naturally occurring lung cancer of the adenocarcinoma type in old mice, the tumor incidence and progression were examined in the lungs of old mCAT transgenic and wild-type (WT) mice with a CB6F1 (Balb/c X C57BL/6) background. CB6F1 mice with a WT genotype were found to have a high incidence of adenomas at 24 months of age, which progressed to adenocarcinomas at 32 months of age. CB6F1 mice with the mCAT genotype had significantly reduced incidence and severity of lung tumors at both ages. Fibroblasts isolated from the lungs of old mCAT mice, but not WT mice, were shown to secrete soluble factors that inhibited lung tumor cell growth suggesting that stromal fibroblasts play a role in mediating the antitumor effects of mCAT. The aged CB6F1 mouse, with its high incidence of K-ras mutant lung cancer, is an excellent model to further study the anticancer potential of mitochondria-targeted therapy.

  2. Mitochondrial catalase suppresses naturally occurring lung cancer in old mice

    PubMed Central

    Ge, Xuang; Pettan-Brewer, Christina; Morton, John; Carter, Katrina; Fatemi, Sy; Rabinovitch, Peter; Ladiges, Warren C.

    2015-01-01

    Lung cancer is generally difficult to detect until the late stages of disease, when it is much more difficult to treat because of the more aggressive and invasive behavior. Advanced lung cancer is much more common in older adults making it even more challenging to treat. Adenocarcinoma belongs to a category of non-small cell lung cancers, which comprise up to 40% of all lung cancers, and about half of these have an activating K-ras mutation. Because treatment relapses are common, more effective unconventional treatment and prevention methods are needed. In this regard, the antioxidant enzyme catalase targeted to mitochondria (mCAT) has been shown to delay aging and cancer in mice, and the progression of transgenic oncogene and syngeneic tumors was suppressed, helping support the notion that attenuation of mitochondria-generated hydrogen peroxide signaling is associated with an antitumor effect. In order to determine if mCAT has any effect on naturally occurring lung cancer of the adenocarcinoma type in old mice, the tumor incidence and progression were examined in the lungs of old mCAT transgenic and wild-type (WT) mice with a CB6F1 (Balb/c X C57BL/6) background. CB6F1 mice with a WT genotype were found to have a high incidence of adenomas at 24 months of age, which progressed to adenocarcinomas at 32 months of age. CB6F1 mice with the mCAT genotype had significantly reduced incidence and severity of lung tumors at both ages. Fibroblasts isolated from the lungs of old mCAT mice, but not WT mice, were shown to secrete soluble factors that inhibited lung tumor cell growth suggesting that stromal fibroblasts play a role in mediating the antitumor effects of mCAT. The aged CB6F1 mouse, with its high incidence of K-ras mutant lung cancer, is an excellent model to further study the anticancer potential of mitochondria-targeted therapy. PMID:26400209

  3. Do Neurocognitive SCAT3 Baseline Test Scores Differ Between Footballers (Soccer) Living With and Without Disability? A Cross-Sectional Study.

    PubMed

    Weiler, Richard; van Mechelen, Willem; Fuller, Colin; Ahmed, Osman Hassan; Verhagen, Evert

    2018-01-01

    To determine if baseline Sport Concussion Assessment Tool, third Edition (SCAT3) scores differ between athletes with and without disability. Cross-sectional comparison of preseason baseline SCAT3 scores for a range of England international footballers. Team doctors and physiotherapists supporting England football teams recorded players' SCAT 3 baseline tests from August 1, 2013 to July 31, 2014. A convenience sample of 249 England footballers, of whom 185 were players without disability (male: 119; female: 66) and 64 were players with disability (male learning disability: 17; male cerebral palsy: 28; male blind: 10; female deaf: 9). Between-group comparisons of median SCAT3 total and section scores were made using nonparametric Mann-Whitney-Wilcoxon ranked-sum test. All footballers with disability scored higher symptom severity scores compared with male players without disability. Male footballers with learning disability demonstrated no significant difference in the total number of symptoms, but recorded significantly lower scores on immediate memory and delayed recall compared with male players without disability. Male blind footballers' scored significantly higher for total concentration and delayed recall, and male footballers with cerebral palsy scored significantly higher on balance testing and immediate memory, when compared with male players without disability. Female footballers with deafness scored significantly higher for total concentration and balance testing than female footballers without disability. This study suggests that significant differences exist between SCAT3 baseline section scores for footballers with and without disability. Concussion consensus guidelines should recognize these differences and produce guidelines that are specific for the growing number of athletes living with disability.

  4. Knowing the Score

    ERIC Educational Resources Information Center

    Strouse, Lewis H.

    2009-01-01

    Before rehearsals begin, conductors need to thoroughly study the score. What elements go into a comprehensive score preparation? To learn music scores efficiently, having a detailed and systematic study method helps. The author has developed a score preparation guide that works for directors of bands, choruses, and orchestras, even when there's…

  5. Poor WOMAC scores in contralateral knee negatively impact TKA outcomes: data from the osteoarthritis initiative.

    PubMed

    Kahn, Timothy L; Soheili, Aydin C; Schwarzkopf, Ran

    2014-08-01

    While total knee arthroplasty (TKA) has been shown to have excellent outcomes, a significant proportion of patients experience relatively poor post-operative function. In this study, we test the hypothesis that the level of osteoarthritic symptoms in the contralateral knee at the time of TKA is associated with poorer post-operative outcomes in the operated knee. Using longitudinal cohort data from the Osteoarthritis Initiative (OAI), we included 171 patients who received a unilateral TKA. We compared pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in the contralateral knee to post-operative WOMAC scores in the index knee. Pre-operative contralateral knee WOMAC scores were associated with post-operative index knee WOMAC Total scores, indicating that the health of the pre-operative contralateral knee is a significant factor in TKA outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Prognostic value of FOUR and GCS scores in determining mortality in patients with traumatic brain injury.

    PubMed

    Saika, Amrit; Bansal, Sonia; Philip, Mariamma; Devi, Bhagavatula Indira; Shukla, Dhaval P

    2015-09-01

    The Glasgow Coma Scale (GCS) is considered the gold standard for assessment of unconsciousness in patients with traumatic brain injury (TBI) against which other scales are compared. To overcome the disadvantages of GCS, the Full Outline Of Unresponsiveness (FOUR) score was proposed. We aimed to compare the predictability of FOUR score and GCS for early mortality, after moderate and severe TBI. This is a prospective observational study of patients with moderate and severe TBI. Both FOUR and GCS scores were determined at admission. The primary outcome was mortality at the end of 2 weeks of injury. A total of 138 (117 males) patients were included in the study. Out of these, 17 (12.3 %) patients died within 2 weeks of injury. The mean GCS and FOUR scores were 9.5 (range, 3-13) and 11 (0-16), respectively. The total GCS and FOUR scores were significantly lower in patients who did not survive. At a cut-off score of 7 for FOUR score, the AUC was 0.97, with sensitivity of 97.5 and specificity of 88.2 % (p < 0.0001). For GCS score, AUC was 0.95, with sensitivity of 98.3 % and specificity of 82.4 % with cut-off score of 6 (p < 0.0001). The correlation coefficient was 0.753 (p < 0.001) between the GCS and FOUR scores. The predictive value of the FOUR score on admission of patients with TBI is no better than the GCS score.

  7. CK-MM Polymorphism is Associated With Physical Fitness Test Scores in Military Recruits.

    PubMed

    Sprouse, Courtney; Tosi, Laura L; Gordish-Dressman, Heather; Abdel-Ghani, Mai S; Panchapakesan, Karuna; Niederberger, Brenda; Devaney, Joseph M; Kelly, Karen R

    2015-09-01

    Muscle-specific creatine kinase is thought to play an integral role in maintaining energy homeostasis by providing a supply of creatine phosphate. The genetic variant, rs8111989, contributes to individual differences in physical performance, and thus the purpose of this study was to determine if rs8111989 variant is predictive of Physical Fitness Test (PFT) scores in male, military infantry recruits. DNA was extracted from whole blood, and genotyping was performed in 176 Marines. Relationships between PFT measures (run, sit-ups, and pull-ups) and genotype were determined. Participants with 2 copies of the T allele for rs8111989 variant had higher PFT scores for run time, pull-ups, and total PFT score. Specifically, participants with 2 copies of the TT allele (variant) (n = 97) demonstrated an overall higher total PFT score as compared with those with one copy of the C allele (n = 79) (TT: 250 ± 31 vs. 238 ± 31; p = 0.02), run score (TT: 82 ± 10 vs. 78 ± 11; p = 0.04) and pull-up score (TT: 78 ± 11 vs. 65 ± 21; p = 0.04) or those with the CC/CT genotype. These results demonstrate an association between physical performance measures and genetic variation in the muscle-specific creatine kinase gene (rs8111989). Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  8. Scoring Idiopathic Granulomatous Mastitis: An Effective System for Predicting Recurrence?

    PubMed Central

    Gürel, Bora; Güler, Sertaç Ata; Baran, Mehmet Ali; Erşan, Büşra; Duman, Seda; Utkan, Zafer

    2018-01-01

    Objective Idiopathic granulomatous mastitis is a breast disease without a definitive etiology. There are no definitive classifications, scoring systems or certitudes. The aim of this study is to define the factors related to the recurrence and design a scoring system. Material and Methods Patients who were admitted to the general surgery department with symptoms of granulomatous mastitis were evaluated by ultrasonography and underwent antibiotic therapy. Granulomatous mastitis is diagnosed by core biopsy and treated with steroid therapy. Patients without improvement underwent surgery and were included in the study. In total, 53 patients were included in the study. There were 8 recurrent cases. Factors related with recurrences were defined. Results Number of births over 2, duration of lactation more than 18 months, body mass index greater than 31, having fistula in physical examination, abscess collection in ultrasonographic examination, and luminal inflammation score over 2 were scored as 1. Severity score in recurrent cases were 5.1±0.6 whereas 1.9±1.0 in nonrecurrent cases. Conclusion Granulomatous mastitis score is a tool targeted at predicting the risk of recurrences. The patients with these factors are more prone for recurrences. PMID:29774320

  9. [Prevention and treatment of perioperative period complication of total ankle replacement].

    PubMed

    Liao, Xiang; Gao, Zhizeng; Huang, Shanhu; Yang, Shuhua

    2008-01-01

    To explore the cause of the perioprative period complication of scandinavian total ankle replacement (STAR) and to summarize the experience in the treatment and prevention. From March 1999 to November 2006, 35 patients were given total ankle replacement (TAR) with STAR system. There were 19 males and 16 females with an average age of 50.5 years (27 to 68 years), including 12 cases of posttraumatic arthritis, 8 cases of osteoarthritis and 15 cases of rheumatoid arthritis. All patients had pain of ankle joint, swelling and limitation of joint motion. The disease course was 9-64 months. The curative effect was estimated by Kofoed total ankle scoring system. The mean preoperative ankle score was 29 (6-48); the mean pain score was 18.3 (0-35); the mean function score was 11.7 (6-18); and the mean activity score was 9.2 (3-12). The type of all complications were record, and its cause, prevetion and treatment were analyszed. Thirty-three patients achieved healing by first intention, 2 achieved delayed union because of infection. Twenty-eight patients were followed up 3-80 months (mean 43.5 months). Medial malleolus fracture occurred in 2 cases, unstable ankle joint introversion in 2 cases, limitation of ankle dorsiextension in 1 case and 1 case had hypoesthesia at intermediate dorsal skin of foot and 3rd-5th metatarsal skin without obvious dysfunction; all were treated with symptomatic medication. The postoperative mean ankle score was 85.5 (58-95); the mean pain score was 48.3 (35-50); the mean function score was 20.7 (18-30); the mean activity score was 17.2 (16-20). There were statistically significant differences when compared with preoperative score (P<0.01). The clinical results were excellent in 16 patients, good in 9 patients and fair in 3 patients. The X-ray films showed no loosening and subsidence of prosthesis. Although STAR can retain the functions of the operated joint, it has its special complications. It is important to obey operation principle with

  10. Total knee arthroplasty in limbs affected by poliomyelitis.

    PubMed

    Giori, Nicholas J; Lewallen, David G

    2002-07-01

    Little information is available regarding the results and complications of total knee arthroplasty in limbs affected by poliomyelitis with severe knee degeneration. We performed a retrospective chart and radiograph review of patients with a history of poliomyelitis involving a limb that subsequently underwent primary total knee arthroplasty between 1970 and 2000. Sixteen total knee arthroplasties were performed in limbs affected by poliomyelitis in fifteen patients. Eleven patients were followed for a minimum of two years, one (two knees) died before the minimum two-year follow-up could be completed, and three were followed for less than two years. No patient was lost to follow-up. There were two periprosthetic fractures, one peroneal nerve palsy, one avulsion of the patellar tendon, and four cases of recurrent instability. These complications were related to the poor bone quality, valgus deformity, patella baja, poor musculature, and attenuated soft tissues commonly found in knees affected by poliomyelitis. Knee Society pain and knee scores were improved postoperatively for all nine knees with a two-year follow-up that had had at least antigravity quadriceps strength prior to surgery. However, Knee Society function scores remained at 0 or worsened for six of the eleven knees followed for at least two years, including those with less than antigravity strength, and four of the nine knees with at least antigravity strength. None of the prostheses loosened. Pain and knee scores improved following total knee arthroplasty in patients with a history of poliomyelitis and antigravity quadriceps strength, but there was less pain relief in patients with less than antigravity quadriceps strength. Recurrence of instability and progressive functional deterioration is possible in all knees affected by poliomyelitis that have undergone total knee replacement, but they appear to occur more commonly in more severely affected knees.

  11. Computer-Assisted Automated Scoring of Polysomnograms Using the Somnolyzer System

    PubMed Central

    Punjabi, Naresh M.; Shifa, Naima; Dorffner, Georg; Patil, Susheel; Pien, Grace; Aurora, Rashmi N.

    2015-01-01

    Study Objectives: Manual scoring of polysomnograms is a time-consuming and tedious process. To expedite the scoring of polysomnograms, several computerized algorithms for automated scoring have been developed. The overarching goal of this study was to determine the validity of the Somnolyzer system, an automated system for scoring polysomnograms. Design: The analysis sample comprised of 97 sleep studies. Each polysomnogram was manually scored by certified technologists from four sleep laboratories and concurrently subjected to automated scoring by the Somnolyzer system. Agreement between manual and automated scoring was examined. Sleep staging and scoring of disordered breathing events was conducted using the 2007 American Academy of Sleep Medicine criteria. Setting: Clinical sleep laboratories. Measurements and Results: A high degree of agreement was noted between manual and automated scoring of the apnea-hypopnea index (AHI). The average correlation between the manually scored AHI across the four clinical sites was 0.92 (95% confidence interval: 0.90–0.93). Similarly, the average correlation between the manual and Somnolyzer-scored AHI values was 0.93 (95% confidence interval: 0.91–0.96). Thus, interscorer correlation between the manually scored results was no different than that derived from manual and automated scoring. Substantial concordance in the arousal index, total sleep time, and sleep efficiency between manual and automated scoring was also observed. In contrast, differences were noted between manually and automated scored percentages of sleep stages N1, N2, and N3. Conclusion: Automated analysis of polysomnograms using the Somnolyzer system provides results that are comparable to manual scoring for commonly used metrics in sleep medicine. Although differences exist between manual versus automated scoring for specific sleep stages, the level of agreement between manual and automated scoring is not significantly different than that between any two

  12. Mobile health technology transforms injury severity scoring in South Africa.

    PubMed

    Spence, Richard Trafford; Zargaran, Eiman; Hameed, S Morad; Navsaria, Pradeep; Nicol, Andrew

    2016-08-01

    The burden of data collection associated with injury severity scoring has limited its application in areas of the world with the highest incidence of trauma. Since January 2014, electronic records (electronic Trauma Health Records [eTHRs]) replaced all handwritten records at the Groote Schuur Hospital Trauma Unit in South Africa. Data fields required for Glasgow Coma Scale, Revised Trauma Score, Kampala Trauma Score, Injury Severity Score (ISS), and Trauma Score-Injury Severity Score calculations are now prospectively collected. Fifteen months after implementation of eTHR, the injury severity scores were compared as predictors of mortality on three accounts: (1) ability to discriminate (area under receiver operating curve, ROC); (2) ability to calibrate (observed versus expected ratio, O/E); and (3) feasibility of data collection (rate of missing data). A total of 7460 admissions were recorded by eTHR from April 1, 2014 to July 7, 2015, including 770 severely injured patients (ISS > 15) and 950 operations. The mean age was 33.3 y (range 13-94), 77.6% were male, and the mechanism of injury was penetrating in 39.3% of cases. The cohort experienced a mortality rate of 2.5%. Patient reserve predictors required by the scores were 98.7% complete, physiological injury predictors were 95.1% complete, and anatomic injury predictors were 86.9% complete. The discrimination and calibration of Trauma Score-Injury Severity Score was superior for all admissions (ROC 0.9591 and O/E 1.01) and operatively managed patients (ROC 0.8427 and O/E 0.79). In the severely injured cohort, the discriminatory ability of Revised Trauma Score was superior (ROC 0.8315), but no score provided adequate calibration. Emerging mobile health technology enables reliable and sustainable injury severity scoring in a high-volume trauma center in South Africa. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. The relationship of live animal muscular and skeletal scores, ultrasound measurements and carcass classification scores with carcass composition and value in steers.

    PubMed

    Conroy, S B; Drennan, M J; Kenny, D A; McGee, M

    2009-11-01

    .1 cents/kg. In conclusion, both pre-slaughter live animal scores/measurements and carcass classification scores, explained an appreciable amount of the total variation in carcass meat, fat and bone proportions and carcass value, and a moderate amount of the variation in proportion of high-value meat cuts in the carcass.

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

    PubMed

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

    2015-01-01

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

  15. The Comparative Effectiveness of Different Item Analysis Techniques in Increasing Change Score Reliability.

    ERIC Educational Resources Information Center

    Crocker, Linda M.; Mehrens, William A.

    Four new methods of item analysis were used to select subsets of items which would yield measures of attitude change. The sample consisted of 263 students at Michigan State University who were tested on the Inventory of Beliefs as freshmen and retested on the same instrument as juniors. Item change scores and total change scores were computed for…

  16. An Early Warning Scoring System to Identify Septic Patients in the Prehospital Setting: The PRESEP Score.

    PubMed

    Bayer, Ole; Schwarzkopf, Daniel; Stumme, Christoph; Stacke, Angelika; Hartog, Christiane S; Hohenstein, Christian; Kabisch, Björn; Reichel, Jens; Reinhart, Konrad; Winning, Johannes

    2015-07-01

    The objective was to develop and evaluate an early sepsis detection score for the prehospital setting. A retrospective analysis of consecutive patients who were admitted by emergency medical services (EMS) to the emergency department of the Jena University Hospital was performed. Because potential predictors for sepsis should be based on consensus criteria, the following parameters were extracted from the EMS protocol for further analysis: temperature, heart rate (HR), respiratory rate (RR), oxygen saturation (SaO2 ), Glasgow Coma Scale score, blood glucose, and systolic blood pressure (sBP). Potential predictors were stratified based on inspection of Loess graphs. Backward model selection was performed to select risk factors for the final model. The Prehospital Early Sepsis Detection (PRESEP) score was calculated as the sum of simplified regression weights. Its predictive validity was compared to the Modified Early Warning Score (MEWS), the Robson screening tool, and the BAS 90-30-90. A total of 375 patients were included in the derivation sample; 93 (24.8%) of these had sepsis, including 60 patients with severe sepsis and 12 patients with septic shock. Backward model selection identified temperature, HR, RR, SaO2 , and sBP for inclusion in the PRESEP score. Simplified weights were as follows: temperature > 38°C = 4, temperature < 36°C = 1, HR > 90 beats/min = 2, RR > 22 breaths/min = 1, SaO2 < 92% = 2, and sBP < 90 mm Hg = 2. The cutoff value for a possible existing septic disease based on maximum Youden's index was ≥4 (sensitivity 0.85, specificity 0.86, positive predictive value [PPV] 0.66, and negative predictive value [NPV] 0.95). The area under the receiver operating characteristic curve (AUC) of the PRESEP score was 0.93 (95% confidence interval [CI] = 0.89 to 0.96) and was larger than the AUC of the MEWS (0.93 vs. 0.77, p < 0.001). The PRESEP score surpassed MEWS and BAS 90-60-90 for sensitivity (0.74 and 0.62, respectively), specificity (0.75 and 0

  17. Are the Best Scores the Best Scores for Predicting College Success?

    ERIC Educational Resources Information Center

    Patterson, Brian F.; Mattern, Krista D.; Swerdzewski, Peter

    2012-01-01

    The College Board's SAT[R] Score Choice[TM] policy allows students to choose which set(s) of scores to send to colleges and universities to which they plan to apply. Based on data gathered before the implementation of that policy, the following study evaluated the predictive validity of the various sets of SAT scores. The value of five score sets…

  18. Preformulation considerations for controlled release dosage forms. Part III. Candidate form selection using numerical weighting and scoring.

    PubMed

    Chrzanowski, Frank

    2008-01-01

    Two numerical methods, Decision Analysis (DA) and Potential Problem Analysis (PPA) are presented as alternative selection methods to the logical method presented in Part I. In DA properties are weighted and outcomes are scored. The weighted scores for each candidate are totaled and final selection is based on the totals. Higher scores indicate better candidates. In PPA potential problems are assigned a seriousness factor and test outcomes are used to define the probability of occurrence. The seriousness-probability products are totaled and forms with minimal scores are preferred. DA and PPA have never been compared to the logical-elimination method. Additional data were available for two forms of McN-5707 to provide complete preformulation data for five candidate forms. Weight and seriousness factors (independent variables) were obtained from a survey of experienced formulators. Scores and probabilities (dependent variables) were provided independently by Preformulation. The rankings of the five candidate forms, best to worst, were similar for all three methods. These results validate the applicability of DA and PPA for candidate form selection. DA and PPA are particularly applicable in cases where there are many candidate forms and where each form has some degree of unfavorable properties.

  19. Standardizing ADOS Domain Scores: Separating Severity of Social Affect and Restricted and Repetitive Behaviors

    ERIC Educational Resources Information Center

    Hus, Vanessa; Gotham, Katherine; Lord, Catherine

    2014-01-01

    Standardized Autism Diagnostic Observation Schedule (ADOS) scores provide a measure of autism severity that is less influenced by child characteristics than raw totals (Gotham et al. in "Journal of Autism and Developmental Disorders," 39(5), 693-705 2009). However, these scores combine symptoms from the Social Affect (SA) and Restricted…

  20. Pavement scores synthesis.

    DOT National Transportation Integrated Search

    2009-02-01

    The purpose of this synthesis was to summarize the use of pavement scores by the states, including the : rating methods used, the score scales, and descriptions; if the scores are used for recommending pavement : maintenance and rehabilitation action...

  1. Association of a Controlled Substance Scoring Algorithm with Health Care Costs and Hospitalizations: A Cohort Study.

    PubMed

    Starner, Catherine I; Qiu, Yang; Karaca-Mandic, Pinar; Gleason, Patrick P

    2016-12-01

    Patients often misuse a combination of prescription drugs including opioids; however, the relationship between a controlled substance (CS) score and health outcomes is unknown. To examine the association between a CS scoring algorithm and health care use, specifically total cost of care, hospitalizations, and emergency room (ER) visits. This analysis was a retrospective cohort study using administrative claims data from a large U.S. health insurer. Included in the analysis were 999,852 members with a minimum CS score of 2.5 in the fourth quarter (4Q) of 2012, who were continuously enrolled from January 1, 2012, to December 31, 2013, and who were aged 18 years or older. A CS score was calculated using 4Q 2012 (3 months) prescription claims data and divided into 3 components: (1) number of CS claims, (2) number of unique pharmacies and unique prescribers, and (3) evidence of increasing CS use. The primary outcomes were total cost of care (pharmacy and medical costs), all-cause hospitalizations, and ER visits in 2013. We also quantified what a 1-point change in CS score meant for the primary outcomes. 47% of members had a CS score of 2.5, indicating a single CS claim, and 51% of members had a score between 3 and less than 12. The remaining 2% (20,858 members) had a score of 12 or more. There was a statistically significant and consistently increasing association between the 4Q 2012 CS score and hospitalizations, ER visits, and total costs of care in 2013. A 1-point change in CS score was associated with a $1,488 change in total cost of care, 0.9% change in the hospitalization rate, and 1.5% change in the ER visit rate. There is a linear association between increasing CS score and negative health outcomes. Insurers should consider interventions to lower member CS scores. This study was funded internally by Prime Therapeutics. Starner, Qiu, and Gleason are employees of Prime Therapeutics, a pharmacy benefits management company. Karaca-Mandic is an employee of the

  2. Reliable scar scoring system to assess photographs of burn patients.

    PubMed

    Mecott, Gabriel A; Finnerty, Celeste C; Herndon, David N; Al-Mousawi, Ahmed M; Branski, Ludwik K; Hegde, Sachin; Kraft, Robert; Williams, Felicia N; Maldonado, Susana A; Rivero, Haidy G; Rodriguez-Escobar, Noe; Jeschke, Marc G

    2015-12-01

    Several scar-scoring scales exist to clinically monitor burn scar development and maturation. Although scoring scars through direct clinical examination is ideal, scars must sometimes be scored from photographs. No scar scale currently exists for the latter purpose. We modified a previously described scar scale (Yeong et al., J Burn Care Rehabil 1997) and tested the reliability of this new scale in assessing burn scars from photographs. The new scale consisted of three parameters as follows: scar height, surface appearance, and color mismatch. Each parameter was assigned a score of 1 (best) to 4 (worst), generating a total score of 3-12. Five physicians with burns training scored 120 representative photographs using the original and modified scales. Reliability was analyzed using coefficient of agreement, Cronbach alpha, intraclass correlation coefficient, variance, and coefficient of variance. Analysis of variance was performed using the Kruskal-Wallis test. Color mismatch and scar height scores were validated by analyzing actual height and color differences. The intraclass correlation coefficient, the coefficient of agreement, and Cronbach alpha were higher for the modified scale than those of the original scale. The original scale produced more variance than that in the modified scale. Subanalysis demonstrated that, for all categories, the modified scale had greater correlation and reliability than the original scale. The correlation between color mismatch scores and actual color differences was 0.84 and between scar height scores and actual height was 0.81. The modified scar scale is a simple, reliable, and useful scale for evaluating photographs of burn patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Do Examinees Understand Score Reports for Alternate Methods of Scoring Computer Based Tests?

    ERIC Educational Resources Information Center

    Whittaker, Tiffany A.; Williams, Natasha J.; Dodd, Barbara G.

    2011-01-01

    This study assessed the interpretability of scaled scores based on either number correct (NC) scoring for a paper-and-pencil test or one of two methods of scoring computer-based tests: an item pattern (IP) scoring method and a method based on equated NC scoring. The equated NC scoring method for computer-based tests was proposed as an alternative…

  4. Patients recall worse preoperative pain after shoulder arthroplasty than originally reported: a study of recall accuracy using the American Shoulder and Elbow Surgeons score.

    PubMed

    Lowe, Jeremiah T; Li, Xinning; Fasulo, Sydney M; Testa, Edward J; Jawa, Andrew

    2017-03-01

    Patient-reported outcome measures (PROMs) are valuable tools for quantifying outcomes of orthopedic surgery. However, when baseline scores are not obtained, there is considerable controversy about whether PROMs can be administered retrospectively for patients to recall their preoperative state. We investigated the accuracy of patient recall after total shoulder arthroplasty (TSA) using the American Shoulder and Elbow Surgeons (ASES) assessment score. Recalled ASES scores were collected postoperatively at 6 weeks, 3 months, 6 months, and 12 months from 169 patients who previously completed baseline scores before TSA. The ASES total score was divided into its two subcomponents: functional ability and visual analog scale (VAS) for pain. We compared preoperative and recalled scores for each subcomponent and the total ASES score. Recalled ASES function scores were comparable to corresponding preoperative scores across all time points (analysis of variance, P = .21), but recalled VAS pain was significantly higher at all time points beyond 6 weeks after surgery (P = .0001 at 3 months; P = .005 at 6 months; and P = .001 at 12 months). As a result, the ASES total score was only comparable at 6 weeks after surgery (P = .39) and differed at all time points thereafter. Patients are able to recall preoperative function with considerable accuracy for up to 12 months after TSA. However, beyond 6 weeks postoperatively, patients recall having worse pain than they originally reported, and recalled ASES total scores are unreliable as a result. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  5. [Clinical score to rule out pneumonia due to Mycoplasma pneumoniae].

    PubMed

    Rodríguez de Ita, J; Torres-Quintanilla, A; Paláu-Dávila, L; Silva-Gburek, J C; Ortiz de Elguea-Lizarraga, J; Chávez Caraza, K L; Santos-Guzman, J

    2014-10-01

    The gold standard for the diagnosis of pneumonia secondary to Mycoplasma pneumoniae is the serial measurement of IgM, since an isolated test for IgM has a poor sensitivity of 31.8%. A pneumonia due to Mycoplasma pneumoniae could be of clinically different origins, thus it is possible to perform a clinical score for its early diagnosis. To develop a clinical score in order to rule out a pneumoniae secondary to Mycoplasma pneumoniae. A total of 302 patients from 0 to 18 years-old, with a diagnosis of pneumonia were evaluated and divided into two groups: Mycoplasma positive and Mycoplasma negative. Using different variables in the medical records a clinical score was calculated. Of the 302 cases studied, 34 were classified as Mycoplasma positive and 268 as Mycoplasma negative. The variables relevant to the calculation of the score were age, days with fever, and days with cough, thus providing the CAF (Cough, Age, Fever) score. Ranges were assigned for each variable and points were given for each range. A value greater than or equal to 5 meant a positive score. The CAF score was applied to the 302 cases, resulting in 164 cases of Mycoplasma positive and 138 cases of Mycoplasma negative. The CAF score had a sensitivity of 85% and specificity of 49%. The CAF score had better sensitivity than other clinical diagnostic tools. With a negative predictive value of 96% it is possible to rule out a pneumonia secondary to M. pneumoniae. The study requires a prospective study to verify the usefulness of our score. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  6. Observational scores of dampness and mold associated with measurements of microbial agents and moisture in three public schools

    PubMed Central

    Cho, S. J.; Cox-Ganser, J. M.; Park, J.-H.

    2015-01-01

    We examined associations between observational dampness scores and measurements of microbial agents and moisture in three public schools. A dampness score was created for each room from 4-point-scale scores (0–3) of water damage, water stains, visible mold, moldy odor, and wetness for each of 8 room components (ceiling, walls, windows, floor, ventilation, furniture, floor trench, and pipes), when present. We created mixed microbial exposure indices (MMEIs) for each of 121 rooms by summing decile ranks of 8 analytes (total culturable fungi; total, Gram-negative, and Gram-positive culturable bacteria; ergosterol; (1→3)-β-D-glucan; muramic acid; and endotoxin) in floor dust. We found significant (P ≤ 0.01) linear associations between the dampness score and culturable bacteria (total, Gram-positive, and Gram-negative) and the MMEIs. Rooms with dampness scores greater than 0.25 (median) had significantly (P < 0.05) higher levels of most microbial agents, MMEIs, and relative moisture content than those with lower scores (≤0.25). Rooms with reported recent water leaks had significantly (P < 0.05) higher dampness scores than those with historical or no reported water leaks. This study suggests that observational assessment of dampness and mold using a standardized form may be valuable for identifying and documenting water damage and associated microbial contamination. PMID:25650175

  7. Chronic total coronary occlusion: treatment results.

    PubMed

    Kirk Christensen, Martin; Freeman, Phillip Fischer; Rasmussen, Jeppe Groendal; Villadsen, Anton Boel; Raungaard, Bent; Eggert Jensen, Svend; Thuesen, Leif

    2017-08-01

    To describe the clinical and procedural coronary chronic total occlusion (CTO) treatment results in a Nordic PCI centre during the implementation of a CTO treatment program. In a retrospective registry study, we assessed; (1) indication for the procedure, (2) Canadian Cardiovascular Society angina pectoris score (CCS)/New York Heart Association (NYHA) heart failure score, (3) lesion complexity and (4) adverse events during hospital stay and three months following the index procedure. The study cohort included 503 patients (594 lesions). From 2010 to 2013 96% of procedures were performed with antegrade wire-escalation technique and 4% performed using retrograde techniques, from 2013-2016 the corresponding numbers were 83% and 17.0%. The procedural success rate was 69%, increasing from 64% before to 72% (p = .06) after routinely using the retrograde approach. No individual patient characteristic, lesion variable or score was strongly associated with procedural success or failure. There were 4% serious procedure related complications. In patients with PCI of a CTO lesion only, 87% were in CCS or NYHA functional class ≥2 before the index procedure vs. 22% at follow-up. Routine use of retrograde techniques tended to increase the procedural success rate. Clinical results after three months were acceptable, but the complication rate was higher than for non-CTO PCI. Individual patient and lesion characteristics had a low predictability for procedural success. Therefore, clinical symptoms, objective signs of myocardial ischemia and procedural risk should be focus points in coronary chronic total occlusion treatment strategies.

  8. The PER (Preoperative Esophagectomy Risk) Score: A Simple Risk Score to Predict Short-Term and Long-Term Outcome in Patients with Surgically Treated Esophageal Cancer.

    PubMed

    Reeh, Matthias; Metze, Johannes; Uzunoglu, Faik G; Nentwich, Michael; Ghadban, Tarik; Wellner, Ullrich; Bockhorn, Maximilian; Kluge, Stefan; Izbicki, Jakob R; Vashist, Yogesh K

    2016-02-01

    Esophageal resection in patients with esophageal cancer (EC) is still associated with high mortality and morbidity rates. We aimed to develop a simple preoperative risk score for the prediction of short-term and long-term outcomes for patients with EC treated by esophageal resection. In total, 498 patients suffering from esophageal carcinoma, who underwent esophageal resection, were included in this retrospective cohort study. Three preoperative esophagectomy risk (PER) groups were defined based on preoperative functional evaluation of different organ systems by validated tools (revised cardiac risk index, model for end-stage liver disease score, and pulmonary function test). Clinicopathological parameters, morbidity, and mortality as well as disease-free survival (DFS) and overall survival (OS) were correlated to the PER score. The PER score significantly predicted the short-term outcome of patients with EC who underwent esophageal resection. PER 2 and PER 3 patients had at least double the risk of morbidity and mortality compared to PER 1 patients. Furthermore, a higher PER score was associated with shorter DFS (P < 0.001) and OS (P < 0.001). The PER score was identified as an independent predictor of tumor recurrence (hazard ratio [HR] 2.1; P < 0.001) and OS (HR 2.2; P < 0.001). The PER score allows preoperative objective allocation of patients with EC into different risk categories for morbidity, mortality, and long-term outcomes. Thus, multicenter studies are needed for independent validation of the PER score.

  9. Apgar score

    MedlinePlus

    ... infant cries well, the respiratory score is 2. Heart rate is evaluated by stethoscope. This is the most important assessment: If there is no heartbeat, the infant scores 0 for heart rate. If heart rate is less than 100 ...

  10. [Application of Ocular Trauma Score in Mechanical Ocular Injury in Forensic Medicine].

    PubMed

    Xiang, Jian; Guo, Zhao-ming; Wang, Xu; Yu, Li-li; Liu, Hui

    2015-10-01

    To evaluate the application value for the prognosis of mechanical ocular injury cases using ocular trauma score (OTS). Four hundred and eleven cases of mechanical ocular trauma were retrospectively reviewed. Of the 449 eyes, there were 317 closed globe injury and 132 open globe injury. OTS variables included numerical values as initial visual acuity, rupture, endophthalmitis, perforat- ing or penetrating injury, retinal detachment and relative afferent pupillary block. The differences be- tween the distribution of the final visual acuity and the probability of standard final visual acuity were compared to analyze the correlation between OTS category and final visual acuity. The different types of ocular trauma were compared. Compared with the distribution of final visual acuity in standard OTS score, the ratio in OTS-3 category was statistically different in present study, and no differences were found in other categories. Final visual acuity showed a great linear correlation with OTS category (r = 0.71) and total score (r = 0.73). Compared with closed globe injury, open globe injury was generally associated with lower total score and poorer prognosis. Rupture injury had poorer prognosis compared with penetrating injury. The use of OTS for the patients with ocular trauma can provide re- liable information for the evaluation of prognosis in forensic medicine.

  11. Scoring Systems to Estimate Intracerebral Control and Survival Rates of Patients Irradiated for Brain Metastases;Brain metastases; Radiation therapy; Local control; Survival; Prognostic scores

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

    Rades, Dirk, E-mail: Rades.Dirk@gmx.net; Dziggel, Liesa; Haatanen, Tiina

    2011-07-15

    Purpose: To create and validate scoring systems for intracerebral control (IC) and overall survival (OS) of patients irradiated for brain metastases. Methods and Materials: In this study, 1,797 patients were randomly assigned to the test (n = 1,198) or the validation group (n = 599). Two scoring systems were developed, one for IC and another for OS. The scores included prognostic factors found significant on multivariate analyses. Age, performance status, extracerebral metastases, interval tumor diagnosis to RT, and number of brain metastases were associated with OS. Tumor type, performance status, interval, and number of brain metastases were associated with IC.more » The score for each factor was determined by dividing the 6-month IC or OS rate (given in percent) by 10. The total score represented the sum of the scores for each factor. The score groups of the test group were compared with the corresponding score groups of the validation group. Results: In the test group, 6-month IC rates were 17% for 14-18 points, 49% for 19-23 points, and 77% for 24-27 points (p < 0.0001). IC rates in the validation group were 19%, 52%, and 77%, respectively (p < 0.0001). In the test group, 6-month OS rates were 9% for 15-19 points, 41% for 20-25 points, and 78% for 26-30 points (p < 0.0001). OS rates in the validation group were 7%, 39%, and 79%, respectively (p < 0.0001). Conclusions: Patients irradiated for brain metastases can be given scores to estimate OS and IC. IC and OS rates of the validation group were similar to the test group demonstrating the validity and reproducibility of both scores.« less

  12. Total recognition discriminability in Huntington's and Alzheimer's disease.

    PubMed

    Graves, Lisa V; Holden, Heather M; Delano-Wood, Lisa; Bondi, Mark W; Woods, Steven Paul; Corey-Bloom, Jody; Salmon, David P; Delis, Dean C; Gilbert, Paul E

    2017-03-01

    Both the original and second editions of the California Verbal Learning Test (CVLT) provide an index of total recognition discriminability (TRD) but respectively utilize nonparametric and parametric formulas to compute the index. However, the degree to which population differences in TRD may vary across applications of these nonparametric and parametric formulas has not been explored. We evaluated individuals with Huntington's disease (HD), individuals with Alzheimer's disease (AD), healthy middle-aged adults, and healthy older adults who were administered the CVLT-II. Yes/no recognition memory indices were generated, including raw nonparametric TRD scores (as used in CVLT-I) and raw and standardized parametric TRD scores (as used in CVLT-II), as well as false positive (FP) rates. Overall, the patient groups had significantly lower TRD scores than their comparison groups. The application of nonparametric and parametric formulas resulted in comparable effect sizes for all group comparisons on raw TRD scores. Relative to the HD group, the AD group showed comparable standardized parametric TRD scores (despite lower raw nonparametric and parametric TRD scores), whereas the previous CVLT literature has shown that standardized TRD scores are lower in AD than in HD. Possible explanations for the similarity in standardized parametric TRD scores in the HD and AD groups in the present study are discussed, with an emphasis on the importance of evaluating TRD scores in the context of other indices such as FP rates in an effort to fully capture recognition memory function using the CVLT-II.

  13. [Clinical study on patellar replacement in total knee arthroplasty].

    PubMed

    Bao, Liang; Gao, Zhihui; Shi, Xiaoqiang; Fang, Xiaomin; Jin, Qunhua

    2013-01-01

    To evaluate the influence of patellar replacement on total knee arthroplasty by comparing with non patellar replacement. Between September 2010 and November 2010, 63 patients (63 knees) with osteoarthritis who met the selection criteria and underwent total knee arthroplasty, were randomly divided into 2 groups: patellar replacement in 32 cases (replacement group), non patellar replacement in 31 cases (non patellar replacement group). There was no significant difference in gender, age, disease duration, osteoarthritis grading, the clinical and functional scores of American Knee Society Score (KSS), the patellar tilt angle, tibiofemoral angle, and patellar ligament ratio between 2 groups (P > 0.05), they were comparable. After 6 weeks, 3, 6, and 12 months of operation, clinical and imaging evaluation methods were used to assessment the effectiveness. Primary healing of incision was obtained in all patients of 2 groups. Deep venous thrombosis occurred in 6 cases of replacement group and in 8 cases of non patellar replacement group. All patients were followed up 12 months. The postoperative incidence of anterior knee pain in replacement group was significantly lower than that in non patellar replacement group (P < 0.05) at 3, 6, and 12 months after operation. No significant difference was found in the postoperative KSS clinical score between 2 groups at each time point (P > 0.05). The joint function score of the replacement group was significantly higher than that of the non patellar replacement group at the other time point (P < 0.05) except the score at 6 weeks and 3 months. Significant difference was found in the patella score between 2 groups at 12 months (P < 0.05), but no significant difference at the other time points (P > 0.05). X-ray film showed no patellar fracture and dislocation, or loosening and breakage of internal fixation. At 12 months after operation, the tibiofemoral angle, the patellar ligament ratio, and the patellar tilt angle showed no significant

  14. Scoring systems for outcome prediction in patients with perforated peptic ulcer.

    PubMed

    Thorsen, Kenneth; Søreide, Jon Arne; Søreide, Kjetil

    2013-04-10

    Patients with perforated peptic ulcer (PPU) often present with acute, severe illness that carries a high risk for morbidity and mortality. Mortality ranges from 3-40% and several prognostic scoring systems have been suggested. The aim of this study was to review the available scoring systems for PPU patients, and to assert if there is evidence to prefer one to the other. We searched PubMed for the mesh terms "perforated peptic ulcer", "scoring systems", "risk factors", "outcome prediction", "mortality", "morbidity" and the combinations of these terms. In addition to relevant scores introduced in the past (e.g. Boey score), we included recent studies published between January 2000 and December 2012) that reported on scoring systems for prediction of morbidity and mortality in PPU patients. A total of ten different scoring systems used to predict outcome in PPU patients were identified; the Boey score, the Hacettepe score, the Jabalpur score the peptic ulcer perforation (PULP) score, the ASA score, the Charlson comorbidity index, the sepsis score, the Mannheim Peritonitis Index (MPI), the Acute physiology and chronic health evaluation II (APACHE II), the simplified acute physiology score II (SAPS II), the Mortality probability models II (MPM II), the Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity physical sub-score (POSSUM-phys score). Only four of the scores were specifically constructed for PPU patients. In five studies the accuracy of outcome prediction of different scoring systems was evaluated by receiver operating characteristics curve (ROC) analysis, and the corresponding area under the curve (AUC) among studies compared. Considerable variation in performance both between different scores and between different studies was found, with the lowest and highest AUC reported between 0.63 and 0.98, respectively. While the Boey score and the ASA score are most commonly used to predict outcome for PPU patients, considerable

  15. Scoring systems for outcome prediction in patients with perforated peptic ulcer

    PubMed Central

    2013-01-01

    Background Patients with perforated peptic ulcer (PPU) often present with acute, severe illness that carries a high risk for morbidity and mortality. Mortality ranges from 3-40% and several prognostic scoring systems have been suggested. The aim of this study was to review the available scoring systems for PPU patients, and to assert if there is evidence to prefer one to the other. Material and methods We searched PubMed for the mesh terms “perforated peptic ulcer”, “scoring systems”, “risk factors”, ”outcome prediction”, “mortality”, ”morbidity” and the combinations of these terms. In addition to relevant scores introduced in the past (e.g. Boey score), we included recent studies published between January 2000 and December 2012) that reported on scoring systems for prediction of morbidity and mortality in PPU patients. Results A total of ten different scoring systems used to predict outcome in PPU patients were identified; the Boey score, the Hacettepe score, the Jabalpur score the peptic ulcer perforation (PULP) score, the ASA score, the Charlson comorbidity index, the sepsis score, the Mannheim Peritonitis Index (MPI), the Acute physiology and chronic health evaluation II (APACHE II), the simplified acute physiology score II (SAPS II), the Mortality probability models II (MPM II), the Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity physical sub-score (POSSUM-phys score). Only four of the scores were specifically constructed for PPU patients. In five studies the accuracy of outcome prediction of different scoring systems was evaluated by receiver operating characteristics curve (ROC) analysis, and the corresponding area under the curve (AUC) among studies compared. Considerable variation in performance both between different scores and between different studies was found, with the lowest and highest AUC reported between 0.63 and 0.98, respectively. Conclusion While the Boey score and the ASA score

  16. The value of muscular and skeletal scores in the live animal and carcass classification scores as indicators of carcass composition in cattle.

    PubMed

    Drennan, M J; McGee, M; Keane, M G

    2008-05-01

    4.0 and 2.9 g/kg and decreased bone proportion by 4.9 and 5.2 g/kg in bulls and heifers, respectively. Corresponding values per unit increase in carcass fat score were -11.9 and -9.7 g/kg, 12.4 and 9.9 g/kg, and -0.5 and -0.2 g/kg. Carcass conformation and fat scores explained 0.70 and 0.55 of the total variation in meat yield for bulls and heifers, respectively. It is concluded that live animal muscular scores, and carcass conformation and fat scores, are useful indicators of carcass meat proportion and value.

  17. Scoring Package

    National Institute of Standards and Technology Data Gateway

    NIST Scoring Package (PC database for purchase)   The NIST Scoring Package (Special Database 1) is a reference implementation of the draft Standard Method for Evaluating the Performance of Systems Intended to Recognize Hand-printed Characters from Image Data Scanned from Forms.

  18. A Comparison of Two Scoring Methods for an Automated Speech Scoring System

    ERIC Educational Resources Information Center

    Xi, Xiaoming; Higgins, Derrick; Zechner, Klaus; Williamson, David

    2012-01-01

    This paper compares two alternative scoring methods--multiple regression and classification trees--for an automated speech scoring system used in a practice environment. The two methods were evaluated on two criteria: construct representation and empirical performance in predicting human scores. The empirical performance of the two scoring models…

  19. A Comparison of Repeater Performance on the MCAT: Review Course Participants vs. Non-Participants.

    ERIC Educational Resources Information Center

    Jackson, Evelyn W.; And Others

    The Medical/Dental Education Preparatory Program (MEDPREP) at Southern Illinois University School of Medicine at Carbondale prepares underrepresented minorities for medical school admission. This paper reports on the evaluation of the MEDPREP Summer Review program by the comparison of participant and non-participant score gains on the Medical…

  20. Assessment of interobserver concordance in polysomnography scoring of sleep bruxism☆

    PubMed Central

    Ferraz, Otávio; de Moura Guimarães, Thais; Maluly Filho, Milton; Dal-Fabbro, Cibele; Abraão Crosara Cunha, Thays; Cristina Lotaif, Ana; Cristina Barros Schütz, Teresa; Santos-Silva, Rogério; Tufik, Sergio; Bittencourt, Lia

    2015-01-01

    Introduction Objective evaluation of sleep bruxism (SB) using whole-night polysomnography (PSG) is relevant for diagnostic confirmation. Nevertheless, the PSG electromyogram (EMG) scoring may give rise to controversy, particularly when audiovisual monitoring is not performed. Therefore, the present study assessed the concordance between two independent scorers to visual SB on a PSG performed without audiovisual monitoring. Methods Fifty-six PSG tests were scored from individuals with clinical history and polysomnography criteria of SB. In addition to the protocol of conventional whole-night PSG, electrodes were also placed bilaterally on the masseter and temporal muscles. Visual EMG scoring without audio video monitoring was scored by two independent scorers (Dentist 1 and Dentist 2) according the recommendations formulated in the AASM manual (2007). Kendall Tau correlation was used to assess interobserver concordance relative to variables “total duration of events (seconds), “shortest events”, “longest events” and index in each phasic, tonic or mixed event. Results The correlation was positive and significant relative to all the investigated variables, being T>0.54. Conclusion It was found a good inter-examiner concordance rate in SB scoring in absence of audio video monitoring. PMID:26779318

  1. Team-based learning on a third-year pediatric clerkship improves NBME subject exam blood disorder scores.

    PubMed

    Saudek, Kris; Treat, Robert

    2015-01-01

    Purpose At our institution, speculation amongst medical students and faculty exists as to whether team-based learning (TBL) can improve scores on high-stakes examinations over traditional didactic lectures. Faculty with experience using TBL developed and piloted a required TBL blood disorders (BD) module for third-year medical students on their pediatric clerkship. The purpose of this study is to analyze the BD scores from the NBME subject exams before and after the introduction of the module. Methods We analyzed institutional and national item difficulties for BD items from the NBME pediatrics content area item analysis reports from 2011 to 2014 before (pre) and after (post) the pilot (October 2012). Total scores of 590 NBME subject examination students from examinee performance profiles were analyzed pre/post. t-Tests and Cohen's d effect sizes were used to analyze item difficulties for institutional versus national scores and pre/post comparisons of item difficulties and total scores. Results BD scores for our institution were 0.65 (±0.19) compared to 0.62 (±0.15) nationally (P=0.346; Cohen's d=0.15). The average of post-consecutive BD scores for our students was 0.70(±0.21) compared to examinees nationally [0.64 (±0.15)] with a significant mean difference (P=0.031; Cohen's d=0.43). The difference in our institutions pre [0.65 (±0.19)] and post [0.70 (±0.21)] BD scores trended higher (P=0.391; Cohen's d=0.27). Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national norms. Conclusions Institutional BD scores were higher than national BD scores for both pre and post, with an effect size that tripled from pre to post scores. Institutional BD scores increased after the use of the TBL module, while overall exam scores remained steadily above national

  2. A multicenter study analyzing the relationship of a standardized radiographic scoring system of adolescent idiopathic scoliosis and the Scoliosis Research Society outcomes instrument.

    PubMed

    Wilson, Philip L; Newton, Peter O; Wenger, Dennis R; Haher, Thomas; Merola, Andrew; Lenke, Larry; Lowe, Thomas; Clements, David; Betz, Randy

    2002-09-15

    A multicenter study examining the association between radiographic and outcomes measures in adolescent idiopathic scoliosis. To evaluate the association between an objective radiographic scoring system and patient quality of life measures as determined by the Scoliosis Research Society outcomes instrument. Although surgical correction of scoliosis has been reported to be positively correlated with patient outcomes, studies to date have been unable to demonstrate an association between radiographic measures of deformity and outcomes measures in patients with adolescent idiopathic scoliosis. A standardized radiographic deformity scoring system and the Scoliosis Research Society outcome tool were used prospectively in seven scoliosis centers to collect data on patients with adolescent idiopathic scoliosis. A total of 354 data points for 265 patients consisting of those with nonoperative or preoperative curves >or=10 degrees, as well as those with surgically treated curves, were analyzed. Correlation analysis was performed to identify significant relationships between any of the radiographic measures, the Harms Study Group radiographic deformity scores (total, sagittal, coronal), and the seven Scoliosis Research Society outcome domains (Total Pain, General Self-Image, General Function, Activity, Postoperative Self-Image, Postoperative Function, and Satisfaction) as well as Scoliosis Research Society outcomes instrument total scores. Radiographic measures that were identified as significantly correlated with Scoliosis Research Society outcome scores were then entered into a stepwise regression analysis. The coronal measures of thoracic curve and lumbar curve magnitude were found to be significantly correlated with the Total Pain, General Self-Image, and total Scoliosis Research Society scores (P < 0.0001). The thoracic and upper thoracic curve magnitudes were also correlated with General Function (P < 0.002). The "coronal" subscore as well as the "total" score of the

  3. Evaluation of target scores and benchmarks for the traversal task scenario of the Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) laparoscopy simulator.

    PubMed

    Hackethal, A; Immenroth, M; Bürger, T

    2006-04-01

    The Minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR) simulator is validated for laparoscopy training, but benchmarks and target scores for assessing single tasks are needed. Control data for the MIST-VR traversal task scenario were collected from 61 novices who performed the task 10 times over 3 days (1 h daily). Data were collected on the time taken, error score, economy of movement, and total score. Test differences were analyzed through percentage scores and t-tests for paired samples. Improvement was greatest over tests 1 to 5 (improvement: test(1.2), 38.07%; p = 0.000; test(4.5), 10.66%; p = 0.010): between tests 5 and 10, improvement slowed and scores stabilized. Variation in participants' performance fell steadily over the 10 tests. Trainees should perform at least 10 tests of the traversal task-five to get used to the equipment and task (automation phase; target total score, 95.16) and five to stabilize and consolidate performance (test 10 target total score, 74.11).

  4. Massive Transfusion: The Revised Assessment of Bleeding and Transfusion (RABT) Score.

    PubMed

    Joseph, Bellal; Khan, Muhammad; Truitt, Michael; Jehan, Faisal; Kulvatunyou, Narong; Azim, Asad; Jain, Arpana; Zeeshan, Muhammad; Tang, Andrew; O'Keeffe, Terence

    2018-05-21

    Massive transfusion (MT) is a lifesaving treatment for trauma patients with hemorrhagic shock, assessed by Assessment of Blood Consumption (ABC) Score based on mechanism of injury, systolic blood pressure (SBP), tachycardia, and FAST exam. The aim of this study was to assess the performance of ABC score by replacing hypotension and tachycardia; with Shock Index (SI) > 1.0 and including pelvic fractures. We performed a 2-year (2014-2015) analysis of all high-level trauma activations and excluded patients dead on arrival. The ABC score was calculated using the 4-point score [blunt (0)/penetrating trauma (1), HR ≥ 120 (1), SBP ≤ 90 mmHg (1), and FAST positive (1)]. The Revised Assessment of Bleeding and Transfusion (RABT) score also included 4 points, calculated by replacing HR and SBP with SI > 1.0 and including pelvic fracture. AUROC compared performances of the two scores. A total of 380 patients were included. The overall MT was 27%. Patients receiving MT had higher median ABC scores [1.1 (0-2) vs. 1 (0-2), p = 0.15] and RABT scores [2 (1-3) vs. 1 (0-2), p < 0.001]. The RABT score had better discriminative power (AUROC = 0.828) compared to ABC score (AUROC = 0.617) for predicting the need for MT. Cutoff of RABT score ≥ 2 had a sensitivity of 84% and specificity of 77% for predicting need for MT compared to ABC score with 39% sensitivity and 72% specificity. Replacement of hypotension and tachycardia with a SI > 1.0 and inclusion of pelvic fracture enhanced discrimination of ABC score for predicting the need for MT. The current ABC score would benefit from revision to more appropriately identify patients requiring MT.

  5. Results of a multimodal analgesic trial involving patients with total hip or total knee arthroplasty.

    PubMed

    Skinner, Harry B; Shintani, Ellen Y

    2004-02-01

    The mainstays for pain relief after total hip arthroplasty (THA) and total knee arthroplasty (TKA) have been the opioids, but these medications, though excellent analgesics, have problems limiting their effectiveness. Alternative analgesics have been considered too mild for the pain caused by THA and TKA. These medications have been used in combination, but only in pairs and not in a "stacked modality." Here we report a trial of around-the-clock acetaminophen, rofecoxib, tramadol, and dexamethasone combined with bupivicaine pain pumps and on-demand opioid use (patient-controlled analgesia with morphine). Patients (48 with THA, 54 with TKA) were divided into pain protocol (PP) groups and conventional pain-therapy groups. Important variables were recorded from a chart review. In the PP groups, reductions in opioid use, length of hospital stay (TKA, P=.012), and time on patient-controlled analgesia were significant, as were improvements in pain scores for TKA. In addition, there was a trend in improved pain scores for the PP group with THA. Minor adverse events were similar for the groups, but major medical complications were fewer in the PP group. Preemptive analgesia with multiple non-narcotic medications used in a stacked modality can significantly reduce postoperative pain.

  6. A risk scoring system for prediction of haemorrhagic stroke.

    PubMed

    Zodpey, S P; Tiwari, R R

    2005-01-01

    The present pair-matched case control study was carried out at Government Medical College Hospital, Nagpur, India, a tertiary care hospital with the objective to devise and validate a risk scoring system for prediction of hemorrhagic stroke. The study consisted of 166 hospitalized CT scan proved cases of hemorrhagic stroke (ICD 9, 431-432), and a age and sex matched control per case. The controls were selected from patients who attended the study hospital for conditions other than stroke. On conditional multiple logistic regression five risk factors- hypertension (OR = 1.9. 95% Cl = 1.5-2.5). raised scrum total cholesterol (OR = 2.3, 95% Cl = 1.1-4.9). use of anticoagulants and antiplatelet agents (OR = 3.4, 95% Cl =1.1-10.4). past history of transient ischaemic attack (OR = 8.4, 95% Cl = 2.1- 33.6) and alcohol intake (OR = 2.1, 95% Cl = 1.3-3.6) were significant. These factors were ascribed statistical weights (based on regression coefficients) of 6, 8, 12, 21 and 8 respectively. The nonsignificant factors (diabetes mellitus, physical inactivity, obesity, smoking, type A personality, history of claudication, family history of stroke, history of cardiac diseases and oral contraceptive use in females) were not included in the development of scoring system. ROC curve suggested a total score of 21 to be the best cut-off for predicting haemorrhag stroke. At this cut-off the sensitivity, specificity, positive predictivity and Cohen's kappa were 0.74, 0.74, 0.74 and 0.48 respectively. The overall predictive accuracy of this additive risk scoring system (area under ROC curve by Wilcoxon statistic) was 0.79 (95% Cl = 0.73-0.84). Thus to conclude, if substantiated by further validation, this scorincy system can be used to predict haemorrhagic stroke, thereby helping to devise effective risk factor intervention strategy.

  7. Right-handers have negligibly higher IQ scores than left-handers: Systematic review and meta-analyses.

    PubMed

    Ntolka, Eleni; Papadatou-Pastou, Marietta

    2018-01-01

    The relationship between intelligence and handedness remains a matter of debate. The present study is a systematic review of 36 studies (totaling 66,108 individuals), which have measured full IQ scores in different handedness groups. Eighteen of those studies were further included in three sets of meta-analyses (totaling 20,442 individuals), which investigated differences in standardized mean IQ scores in (i) left-handers, (ii) non-right-handers, and (iii) mixed-handers compared to right-handers. The bulk of the studies included in the systematic review reported no differences in IQ scores between left- and right-handers. In the meta-analyses, statistically significant differences in mean IQ scores were detected between right-handers and left-handers, but were marginal in magnitude (d=-0.07); the data sets were found to be homogeneous. Significance was lost when the largest study was excluded. No differences in mean IQ scores were found between right-handers and non-right-handers as well as between right-handers and mixed-handers. No sex differences were found. Overall, the intelligence differences between handedness groups in the general population are negligible. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Assessment of voice related quality of life and its correlation with socioeconomic status after total laryngectomy.

    PubMed

    Agarwal, Sangeet Kumar; Gogia, Shweta; Agarwal, Alok; Agarwal, Rajiv; Mathur, Ajay Swaroop

    2015-10-01

    After total laryngectomy for laryngeal cancer, the major determinants of QOL is the patient's voice related quality of life (V-RQOL). The primary aim of this study was to assess the V-RQOL and impact of socioeconomic status over it in Indian population by using two validated scales [voice handicap index (VHI) and V-RQOL questionnaires]. Total 104 patients underwent total laryngectomy but 71 were eligible for study. Patients filled the VHI and V-RQOL questionnaires after completion of 1 year of usage of the TEP voice. The socioeconomic status of the patients was calculated according to various domains related to their life and were divided into lower and higher status. A total of 76.1% patients had VHI score between 0 to 30 (minimal voice handicap), 19.7% had score between 31 to 60 (moderate voice handicap) and only 4.2% patients had VHI score more than 61 (serious voice handicap). On V-RQOL scores, 16.9% patients had score between 10 to 15 (excellent), 40.8% patients, between 16 to 20 (very good), 22.5% patients, between 21 and 25 (good voice), 15.5% patients, between 26 and 30 (fair) and only 4.2% patients scored more than 30 with poor quality of voice. Patients with lower socioeconomic group had better V-RQOL than with high socioeconomic group. VHI and V-RQOL scores in our series were superior to other studies due to major population with lower socioeconomic status and better social support which exists in our society.

  9. Tracking tumor biology with radiomics: A systematic review utilizing a radiomics quality score.

    PubMed

    Sanduleanu, Sebastian; Woodruff, Henry C; de Jong, Evelyn E C; van Timmeren, Janna E; Jochems, Arthur; Dubois, Ludwig; Lambin, Philippe

    2018-05-18

    In this review we describe recent developments in the field of radiomics along with current relevant literature linking it to tumor biology. We furthermore explore the methodologic quality of these studies with our in-house radiomics quality scoring (RQS) tool. Finally, we offer our vision on necessary future steps for the development of stable radiomic features and their links to tumor biology. Two authors (S.S. and H.W.) independently performed a thorough systematic literature search and outcome extraction to identify relevant studies published in MEDLINE/PubMed (National Center for Biotechnology Information, NCBI), EMBASE (Ovid) and Web of Science (WoS). Two authors (S.S, H.W) separately and two authors (J.v.T and E.d.J) concordantly scored the articles for their methodology and analyses according to the previously published radiomics quality score (RQS). In summary, a total of 655 records were identified till 25-09-2017 based on the previously specified search terms, from which n = 236 in MEDLINE/PubMed, n = 215 in EMBASE and n = 204 from Web of Science. After determining full article availability and reading the available articles, a total of n = 41 studies were included in the systematic review. The RQS scoring resulted in some discrepancies between the reviewers, e.g. reviewer H.W scored 4 studies ≥50%, reviewer S.S scored 3 studies ≥50% while reviewers J.v.T and E.d.J scored 1 study ≥50%. Up to nine studies were given a quality score of 0%. The majority of studies were scored below 50%. In this study, we performed a systematic literature search linking radiomics to tumor biology. All but two studies (n = 39) revealed that radiomic features derived from ultrasound, CT, PET and/or MR are significantly associated with one or several specific tumor biologic substrates, from somatic mutation status to tumor histopathologic grading and metabolism. Considerable inter-observer differences were found with regard to RQS scoring, while

  10. National Drug Formulary review of statin therapeutic group using the multiattribute scoring tool

    PubMed Central

    Ramli, Azuana; Aljunid, Syed Mohamed; Sulong, Saperi; Md Yusof, Faridah Aryani

    2013-01-01

    Purpose HMG-CoA reductase inhibitors (statins) are extensively used in treating hypercholesterolemia. The statins available in Malaysia include atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and fluvastatin. Over the years, they have accumulated in the National Drug Formulary; hence, the need for review. Effective selection of the best drugs to remain in the formulary can become complex due to the multiple drug attributes involved, and is made worse by the limited time and resources available. The multiattribute scoring tool (MAST) systematizes the evaluation of the drug attributes to facilitate the drug selection process. In this study, a MAST framework was developed to rank the statins based on their utilities or benefits. Methods Published literature on multicriteria decision analysis (MCDA) were studied and five sessions of expert group discussions were conducted to build the MAST framework and to review the evidence. The attributes identified and selected for analysis were efficacy (clinical efficacy, clinical endpoints), safety (drug interactions, serious side effects and documentation), drug applicability (drug strength/formulation, indications, dose frequency, side effects, food–drug interactions, and dose adjustments), and cost. The average weights assigned by the members for efficacy, safety, drug applicability and cost were 32.6%, 26.2%, 24.1%, and 17.1%, respectively. The utility values of the attributes were scored based on the published evidence or/and agreements during the group discussions. The attribute scores were added up to provide the total utility score. Results Using the MAST, the six statins under review were successfully scored and ranked. Atorvastatin scored the highest total utility score (TUS) of 84.48, followed by simvastatin (83.11). Atorvastatin and simvastatin scored consistently high, even before drug costs were included. The low scores on the side effects for atorvastatin were compensated for by the higher

  11. The influence of energy standardisation on the alternate Mediterranean diet score and its association with mortality in the Multiethnic Cohort.

    PubMed

    Shvetsov, Yurii B; Harmon, Brook E; Ettienne, Reynolette; Wilkens, Lynne R; Le Marchand, Loic; Kolonel, Laurence N; Boushey, Carol J

    2016-11-01

    The alternate Mediterranean diet (aMED) score is an adaptation of the original Mediterranean diet score. Raw (aMED) and energy-standardised (aMED-e) versions have been used. How the diet scores and their association with health outcomes differ between the two versions is unclear. We examined differences in participants' total and component scores and compared the association of aMED and aMED-e with all-cause, CVD and cancer mortality. As part of the Multiethnic Cohort, 193 527 men and women aged 45-75 years from Hawaii and Los Angeles completed a baseline FFQ and were followed up for 13-18 years. The association of aMED and aMED-e with mortality was examined using Cox's regression, with adjustment for total energy intake. The correlation between aMED and aMED-e total scores was lower among people with higher BMI. Participants who were older, leaner, more educated and consumed less energy scored higher on aMED-e components compared with aMED, except for the red and processed meat and alcohol components. Men reporting more physical activity scored lower on most aMED-e components compared with aMED, whereas the opposite was observed for the meat component. Higher scores of both aMED and aMED-e were associated with lower risk of all-cause, CVD and cancer mortality. Although individuals may score differently with aMED and aMED-e, both scores show similar reductions in mortality risk for persons scoring high on the index scale. Either version can be used in studies of diet and mortality. Comparisons can be performed across studies using different versions of the score.

  12. Observational scores of dampness and mold associated with measurements of microbial agents and moisture in three public schools.

    PubMed

    Cho, S J; Cox-Ganser, J M; Park, J-H

    2016-04-01

    We examined associations between observational dampness scores and measurements of microbial agents and moisture in three public schools. A dampness score was created for each room from 4-point-scale scores (0-3) of water damage, water stains, visible mold, moldy odor, and wetness for each of 8 room components (ceiling, walls, windows, floor, ventilation, furniture, floor trench, and pipes), when present. We created mixed microbial exposure indices (MMEIs) for each of 121 rooms by summing decile ranks of 8 analytes (total culturable fungi; total, Gram-negative, and Gram-positive culturable bacteria; ergosterol; (1→3)-β-D-glucan; muramic acid; and endotoxin) in floor dust. We found significant (P ≤ 0.01) linear associations between the dampness score and culturable bacteria (total, Gram-positive, and Gram-negative) and the MMEIs. Rooms with dampness scores greater than 0.25 (median) had significantly (P < 0.05) higher levels of most microbial agents, MMEIs, and relative moisture content than those with lower scores (≤0.25). Rooms with reported recent water leaks had significantly (P < 0.05) higher dampness scores than those with historical or no reported water leaks. This study suggests that observational assessment of dampness and mold using a standardized form may be valuable for identifying and documenting water damage and associated microbial contamination. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  13. The Addenbrooke's Cognitive Examination Revised (ACE-R) and its sub-scores: normative values in an Italian population sample.

    PubMed

    Siciliano, Mattia; Raimo, Simona; Tufano, Dario; Basile, Giuseppe; Grossi, Dario; Santangelo, Franco; Trojano, Luigi; Santangelo, Gabriella

    2016-03-01

    The Addenbrooke's Cognitive Examination Revised (ACE-R) is a rapid screening battery, including five sub-scales to explore different cognitive domains: attention/orientation, memory, fluency, language and visuospatial. ACE-R is considered useful in discriminating cognitively normal subjects from patients with mild dementia. The aim of present study was to provide normative values for ACE-R total score and sub-scale scores in a large sample of Italian healthy subjects. Five hundred twenty-six Italian healthy subjects (282 women and 246 men) of different ages (age range 20-93 years) and educational level (from primary school to university) underwent ACE-R and Montreal Cognitive Assessment (MoCA). Multiple linear regression analysis revealed that age and education significantly influenced performance on ACE-R total score and sub-scale scores. A significant effect of gender was found only in sub-scale attention/orientation. From the derived linear equation, a correction grid for raw scores was built. Inferential cut-offs score were estimated using a non-parametric technique and equivalent scores (ES) were computed. Correlation analysis showed a good significant correlation between ACE-R adjusted scores with MoCA adjusted scores (r = 0.612, p < 0.001). The present study provided normative data for the ACE-R in an Italian population useful for both clinical and research purposes.

  14. Scored Discussions.

    ERIC Educational Resources Information Center

    Zola, John

    1992-01-01

    Suggests a classroom strategy to help students learn to analyze and discuss significant issues from history and current policy debates. Describes scored discussions in which small groups of students receive points for participation. Provides an example of a discussion on gold mining. Includes an agenda. Explores uses of scored discussions and…

  15. The NASA/AFRL Meter Class Autonomous Telescope

    NASA Technical Reports Server (NTRS)

    Cowardin, H.; Lederer, S.; Buckalew, B.; Frith, J.; Hickson, P.; Glesne, T.; Anz-Meador, P.; Barker, E.; Stansbery, G.; Kervin, P.

    2016-01-01

    For the past decade, the NASA Orbital Debris Program Office (ODPO) has relied on using various ground-based telescopes in Chile to acquire statistical survey data as well as photometric and spectroscopic data of orbital debris in geosynchronous Earth orbit (GEO). The statistical survey data have been used to supply the Orbital Debris Engineering Model (ORDEM) v.3.0 with debris detections in GEO to better model the environment at altitudes where radar detections are limited. The data produced for the statistical survey ranged from 30 to 40 nights per year, which only accounted for 10% of the possible observing time. Data collection was restricted by ODPO resources and weather conditions. In order to improve the statistical sampling in GEO, as well as observe and sample other orbits, NASA's ODPO with support from the Air Force Research Laboratory (AFRL), has constructed a new observatory dedicated to orbital debris - the Meter Class Autonomous Telescope (MCAT) on Ascension Island. This location provides MCAT with the unique ability to access targets orbiting at an altitude of less than 1,000 km and low inclinations (< 20 deg). This orbital regime currently has little to no coverage by the U.S. Space Surveillance Network. Unlike previous ODPO optical assets, the ability to operate autonomously will allow rapid response observations of break-up events, an observing mode that was only available via radar tasking prior to MCAT's deployment. The primary goal of MCAT is to statistically characterize GEO via daily tasking files uploaded from ODPO. These tasking files define which operating mode to follow, providing the field center, rates, and/or targets to observe over the entire observing period. The system is also capable of tracking fast-moving targets in low Earth orbit (LEO), middle Earth orbit (MEO), as well as highly eccentric orbits like geostationary transfer orbits. On 25 August 2015, MCAT successfully acquired scientific first light, imaging the Bug Nebula and

  16. Unsatisfactory Outcome of Arthrodesis Performed After Septic Failure of Revision Total Knee Arthroplasty

    PubMed Central

    Röhner, Eric; Windisch, Christoph; Nuetzmann, Katy; Rau, Max; Arnhold, Michael; Matziolis, Georg

    2015-01-01

    Background: Periprosthetic infection is one of the most dreaded orthopaedic complications. Current treatment procedures include one-stage or two-stage revision total knee arthroplasty. If the periprosthetic infection is no longer controllable after several revision total knee arthroplasties, many surgeons regard knee arthrodesis as a promising option. The aim of our study was to ascertain whether intramedullary nailing results in the suppression or eradication of an infection and to identify risk factors for persistent infection. Methods: All patients who had undergone intramedullary nailing following septic failure of revision total knee arthroplasty between 1997 and 2013 were included in the study. Pathogens, risk factors predisposing to persistent infection, and the rate of persistent infections were recorded. In addition, a visual analog scale (VAS) and Knee injury Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), Lysholm, Short Form-36 (SF-36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires were completed to assess clinical outcomes and quality of life. Results: Twenty-six patients were included in the study. Thirteen (50%) had a persistent infection requiring additional revision surgery. Nineteen patients (73%) reported persistent pain (VAS score of >3). All scores showed marked impairment of quality of life. Conclusions: Intramedullary nailing following septic failure of revision total knee arthroplasty must be regarded with skepticism, and we cannot recommend it. Repeat revision total knee arthroplasty or amputation should be considered as an alternative in such difficult cases. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. PMID:25695981

  17. Five year survival analysis of an oxidised zirconium total knee arthroplasty.

    PubMed

    Holland, Philip; Santini, Alasdair J A; Davidson, John S; Pope, Jill A

    2013-12-01

    Zirconium total knee arthroplasties theoretically have a low incidence of failure as they are low friction, hard wearing and hypoallergenic. We report the five year survival of 213 Profix zirconium total knee arthroplasties with a conforming all polyethylene tibial component. Data was collected prospectively and multiple strict end points were used. SF12 and WOMAC scores were recorded pre-operatively, at three months, at twelve months, at 3 years and at 5 years. Eight patients died and six were "lost to follow-up". The remaining 199 knees were followed up for five years. The mean WOMAC score improved from 56 to 35 and the mean SF12 physical component score improved from 28 to 34. The five year survival for failure due to implant related reasons was 99.5% (95% CI 97.4-100). This was due to one tibial component becoming loose aseptically in year zero. Our results demonstrate that the Profix zirconium total knee arthroplasty has a low medium term failure rate comparable to the best implants. Further research is needed to establish if the beneficial properties of zirconium improve long term implant survival. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. A comprehensive scoring system to measure healthy community design in land use plans and regulations.

    PubMed

    Maiden, Kristin M; Kaplan, Marina; Walling, Lee Ann; Miller, Patricia P; Crist, Gina

    2017-02-01

    Comprehensive land use plans and their corresponding regulations play a role in determining the nature of the built environment and community design, which are factors that influence population health and health disparities. To determine the level in which a plan addresses healthy living and active design, there is a need for a systematic, reliable and valid method of analyzing and scoring health-related content in plans and regulations. This paper describes the development and validation of a scoring tool designed to measure the strength and comprehensiveness of health-related content found in land use plans and the corresponding regulations. The measures are scored based on the presence of a specific item and the specificity and action-orientation of language. To establish reliability and validity, 42 land use plans and regulations from across the United States were scored January-April 2016. Results of the psychometric analysis indicate the scorecard is a reliable scoring tool for land use plans and regulations related to healthy living and active design. Intraclass correlation coefficients (ICC) scores showed strong inter-rater reliability for total strength and comprehensiveness. ICC scores for total implementation scores showed acceptable consistency among scorers. Cronbach's alpha values for all focus areas were acceptable. Strong content validity was measured through a committee vetting process. The development of this tool has far-reaching implications, bringing standardization of measurement to the field of land use plan assessment, and paving the way for systematic inclusion of health-related design principles, policies, and requirements in land use plans and their corresponding regulations. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. The New York State risk score for predicting in-hospital/30-day mortality following percutaneous coronary intervention.

    PubMed

    Hannan, Edward L; Farrell, Louise Szypulski; Walford, Gary; Jacobs, Alice K; Berger, Peter B; Holmes, David R; Stamato, Nicholas J; Sharma, Samin; King, Spencer B

    2013-06-01

    This study sought to develop a percutaneous coronary intervention (PCI) risk score for in-hospital/30-day mortality. Risk scores are simplified linear scores that provide clinicians with quick estimates of patients' short-term mortality rates for informed consent and to determine the appropriate intervention. Earlier PCI risk scores were based on in-hospital mortality. However, for PCI, a substantial percentage of patients die within 30 days of the procedure after discharge. New York's Percutaneous Coronary Interventions Reporting System was used to develop an in-hospital/30-day logistic regression model for patients undergoing PCI in 2010, and this model was converted into a simple linear risk score that estimates mortality rates. The score was validated by applying it to 2009 New York PCI data. Subsequent analyses evaluated the ability of the score to predict complications and length of stay. A total of 54,223 patients were used to develop the risk score. There are 11 risk factors that make up the score, with risk factor scores ranging from 1 to 9, and the highest total score is 34. The score was validated based on patients undergoing PCI in the previous year, and accurately predicted mortality for all patients as well as patients who recently suffered a myocardial infarction (MI). The PCI risk score developed here enables clinicians to estimate in-hospital/30-day mortality very quickly and quite accurately. It accurately predicts mortality for patients undergoing PCI in the previous year and for MI patients, and is also moderately related to perioperative complications and length of stay. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. The autism diagnostic observation schedule, module 4: revised algorithm and standardized severity scores.

    PubMed

    Hus, Vanessa; Lord, Catherine

    2014-08-01

    The recently published Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) includes revised diagnostic algorithms and standardized severity scores for modules used to assess younger children. A revised algorithm and severity scores are not yet available for Module 4, used with verbally fluent adults. The current study revises the Module 4 algorithm and calibrates raw overall and domain totals to provide metrics of autism spectrum disorder (ASD) symptom severity. Sensitivity and specificity of the revised Module 4 algorithm exceeded 80 % in the overall sample. Module 4 calibrated severity scores provide quantitative estimates of ASD symptom severity that are relatively independent of participant characteristics. These efforts increase comparability of ADOS scores across modules and should facilitate efforts to examine symptom trajectories from toddler to adulthood.

  1. [Eleven-Year Experience with Total Ankle Arthroplasty].

    PubMed

    Popelka, S; Sosna, A; Vavřík, P; Jahoda, D; Barták, V; Landor, I

    2016-01-01

    PURPOSE OF THE STUDY Total joint replacement is one of the options in surgical treatment of advanced ankle arthritis. It allows the ankle to remain mobile but, unfortunately, it does not provide the same longevity as total knee or hip replacements. Therefore, decisions concerning the kind of treatment are very individual and depend on the clinical status and opinion of each patient. MATERIAL AND METHODS A total of 132 total ankle replacements were carried out in the period from 2004 to 2015. The prostheses used included the Ankle Evolutive System (AES) in 52 patients, Mobility Total Ankle System (DePuy) in 24 patients and, recently, Rebalance Total Ankle Replacement implant in 53 patients. Three patients allergic to metal received the Taric prosthesis. Revision arthroplasty using the Hintegra prosthesis was carried out in four patients. The outcome of arthroplasty was evaluated on the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale. Indications for total ankle arthroplasty included post-traumatic arthritis in 83 patients, rheumatoid arthritis in 37 and primary arthritis in 12 patients. There were 78 women and 54 men, with an average age of 55.6 years at the time of surgery. RESULTS The average follow-up was 6.1 years (1-11 years). The average AOFAS score of the whole group increased from 33.2 before surgery to 82.5 after it. The primary indication had an important role. Arthroplasty outcomes were poorer in patients with post-traumatic arthritis than in those with rheumatoid arthritis or primary arthritis. In patients with post-traumatic arthritis, the average AOFAS score rose to 78.6 due to restricted motion of the ankle, and some patients continued to have pain when walking. The average AOFAS score in a total of 49 patients who had rheumatoid arthritis or primary arthritis reached a value of 86.4. Post-operative complications were recorded in ten patients (7.6%) in whom part of the wound was healing by second intention. Ossification was also a

  2. Translation and linguistic validation of the Composite Autonomic Symptom Score COMPASS 31.

    PubMed

    Pierangeli, Giulia; Turrini, Alessandra; Giannini, Giulia; Del Sorbo, Francesca; Calandra-Buonaura, Giovanna; Guaraldi, Pietro; Bacchi Reggiani, Maria Letizia; Cortelli, Pietro

    2015-10-01

    The aim of our study was to translate and to do a linguistic validation of the Composite Autonomic Symptom Score COMPASS 31. COMPASS 31 is a self-assessment instrument including 31 items assessing six domains of autonomic functions: orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor functions. This questionnaire has been created by the Autonomic group of the Mayo Clinic from two previous versions: the Autonomic Symptom Profile (ASP) composed of 169 items and the following COMPASS with 72 items selected from the ASP. We translated the questionnaire by means of a standardized forward and back-translation procedure. Thirty-six subjects, 25 patients with autonomic failure of different aethiologies and 11 healthy controls filled in the COMPASS 31 twice, 4 ± 1 weeks apart, once in Italian and once in English in a randomized order. The test-retest showed a significant correlation between the Italian and the English versions as total score. The evaluation of single domains by means of Pearson correlation when applicable or by means of Spearman test showed a significant correlation between the English and the Italian COMPASS 31 version for all clinical domains except the vasomotor one for the lack of scoring. The comparison between the patients with autonomic failure and healthy control groups showed significantly higher total scores in patients with respect to controls confirming the high sensitivity of COMPASS 31 in revealing autonomic symptoms.

  3. Abuse-Related Neurochemical Effects of Para-Substituted Methcathinone Analogs in Rats: Microdialysis Studies of Nucleus Accumbens Dopamine and Serotonin

    PubMed Central

    Suyama, Julie A.; Sakloth, Farhana; Kolanos, Renata; Glennon, Richard A.; Lazenka, Matthew F.; Negus, S. Stevens

    2016-01-01

    Methcathinone (MCAT) is a monoamine releaser and parent compound to a new class of designer drugs that includes the synthetic cathinones mephedrone and flephedrone. Using MCAT and a series of para-substituted (or 4-substituted) MCAT analogs, it has been previously shown that expression of abuse-related behavioral effects in rats correlates both with the volume of the para substituent and in vitro neurochemical selectivity to promote monoamine release via the dopamine (DA) versus serotonin (5-HT) transporters in rat brain synaptosomes. The present study used in vivo microdialysis to determine the relationship between these previous measures and the in vivo neurochemical selectivity of these compounds to alter nucleus accumbens (NAc) DA and 5-HT levels. Male Sprague-Dawley rats were implanted with bilateral guide cannulae targeting the NAc. MCAT and five para-substituted analogs (4-F, 4-Cl, 4-Br, 4-CH3, and 4-OCH3) produced dose- and time-dependent increases in NAc DA and/or 5-HT levels. Selectivity was determined as the dose required to increase peak 5-HT levels by 250% divided by the dose required to increase peak DA levels by 250%. This measure of in vivo neurochemical selectivity varied across compounds and correlated with 1) in vivo expression of abuse-related behavioral effects (r = 0.89, P = 0.02); 2) in vitro selectivity to promote monoamine release via DA and 5-HT transporters (r = 0.95, P < 0.01); and 3) molecular volume of the para substituent (r = −0.85, P = 0.03). These results support a relationship between these molecular, neurochemical, and behavioral measures and support a role for molecular structure as a determinant of abuse-related neurochemical and behavioral effects of MCAT analogs. PMID:26645638

  4. Multicentre validation of the bedside paediatric early warning system score: a severity of illness score to detect evolving critical illness in hospitalised children

    PubMed Central

    2011-01-01

    Introduction The timely provision of critical care to hospitalised patients at risk for cardiopulmonary arrest is contingent upon identification and referral by frontline providers. Current approaches require improvement. In a single-centre study, we developed the Bedside Paediatric Early Warning System (Bedside PEWS) score to identify patients at risk. The objective of this study was to validate the Bedside PEWS score in a large patient population at multiple hospitals. Methods We performed an international, multicentre, case-control study of children admitted to hospital inpatient units with no limitations on care. Case patients had experienced a clinical deterioration event involving either an immediate call to a resuscitation team or urgent admission to a paediatric intensive care unit. Control patients had no events. The scores ranged from 0 to 26 and were assessed in the 24 hours prior to the clinical deterioration event. Score performance was assessed using the area under the receiver operating characteristic (AUCROC) curve by comparison with the retrospective rating of nurses and the temporal progression of scores in case patients. Results A total of 2,074 patients were evaluated at 4 participating hospitals. The median (interquartile range) maximum Bedside PEWS scores for the 12 hours ending 1 hour before the clinical deterioration event were 8 (5 to 12) in case patients and 2 (1 to 4) in control patients (P < 0.0001). The AUCROC curve (95% confidence interval) was 0.87 (0.85 to 0.89). In case patients, mean scores were 5.3 at 20 to 24 hours and 8.4 at 0 to 4 hours before the event (P < 0.0001). The AUCROC curve (95% CI) of the retrospective nurse ratings was 0.83 (0.81 to 0.86). This was significantly lower than that of the Bedside PEWS score (P < 0.0001). Conclusions The Bedside PEWS score identified children at risk for cardiopulmonary arrest. Scores were elevated and continued to increase in the 24 hours before the clinical deterioration event

  5. Pregabalin Improves Pain Scores in Patients with Fibromyalgia Irrespective of Comorbid Osteoarthritis.

    PubMed

    Argoff, Charles E; Emir, Birol; Whalen, Ed; Ortiz, Marie; Pauer, Lynne; Clair, Andrew

    2016-11-01

    Fibromyalgia (FM) is a chronic pain disorder with patients frequently suffering from comorbid conditions, including osteoarthritis (OA). Data on how FM patients with comorbid OA respond to recommended therapies (such as pregabalin) could help their treatment. This was a pooled exploratory analysis of three randomized placebo-controlled clinical trials of pregabalin in FM patients to assess the impact of comorbid OA on the response to pregabalin. Patients were divided into those with and without comorbid OA. Difference in change in least squares (LS) mean pain score at endpoint (assessed by 0-10 numeric rating scale, controlled for baseline pain score) with pregabalin (300 mg/day and 450 mg/day) vs placebo was assessed. Changes in Patient Global Impression of Change (PGIC) responders and Fibromyalgia Impact Questionnaire (FIQ) total score were also assessed. There were 1665 patients in the analysis set (558, placebo; 552, pregabalin 300 mg/day; 555, pregabalin 450 mg/day), including 296 with comorbid OA. Pregabalin 450 mg/day significantly improved the LS mean (95% confidence interval) difference in pain score vs placebo in patients with (0.99 [0.44, 1.55], P < 0.001), and without (0.64 [0.39, 0.89], P < 0.001) OA. Improvements with pregabalin 300 mg/day with (0.31 [-0.25, 0.86], P = 0.276) and without (0.51 [0.25, 0.76], P < 0.001) OA were not consistently significant. Improvements in PGIC and FIQ total score were observed in patients with and without comorbid OA. FM patients with or without comorbid OA respond to treatment with pregabalin 450mg/day with significant improvements in pain intensity scores. These data could provide guidance to healthcare professionals treating these patients. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Risk-Assessment Score and Patient Optimization as Cost Predictors for Ventral Hernia Repair.

    PubMed

    Saleh, Sherif; Plymale, Margaret A; Davenport, Daniel L; Roth, John Scott

    2018-04-01

    Ventral hernia repair (VHR) is associated with complications that significantly increase healthcare costs. This study explores the associations between hospital costs for VHR and surgical complication risk-assessment scores, need for cardiac or pulmonary evaluation, and smoking or obesity counseling. An IRB-approved retrospective study of patients having undergone open VHR over 3 years was performed. Ventral Hernia Risk Score (VHRS) for surgical site occurrence and surgical site infection, and the Ventral Hernia Working Group grade were calculated for each case. Also recorded were preoperative cardiology or pulmonary evaluations, smoking cessation and weight reduction counseling, and patient goal achievement. Hospital costs were obtained from the cost accounting system for the VHR hospitalization stratified by major clinical cost drivers. Univariate regression analyses were used to compare the predictive power of the risk scores. Multivariable analysis was performed to develop a cost prediction model. The mean cost of index VHR hospitalization was $20,700. Total and operating room costs correlated with increasing CDC wound class, VHRS surgical site infection score, VHRS surgical site occurrence score, American Society of Anesthesiologists class, and Ventral Hernia Working Group (all p < 0.01). The VHRS surgical site infection scores correlated negatively with contribution margin (-280; p < 0.01). Multivariable predictors of total hospital costs for the index hospitalization included wound class, hernia defect size, age, American Society of Anesthesiologists class 3 or 4, use of biologic mesh, and 2+ mesh pieces; explaining 73% of the variance in costs (p < 0.001). Weight optimization significantly reduced direct and operating room costs (p < 0.05). Cardiac evaluation was associated with increased costs. Ventral hernia repair hospital costs are more accurately predicted by CDC wound class than VHR risk scores. A straightforward 6-factor model predicted most cost

  7. Algorithm improvement program nuclide identification algorithm scoring criteria and scoring application.

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

    Enghauser, Michael

    2016-02-01

    The goal of the Domestic Nuclear Detection Office (DNDO) Algorithm Improvement Program (AIP) is to facilitate gamma-radiation detector nuclide identification algorithm development, improvement, and validation. Accordingly, scoring criteria have been developed to objectively assess the performance of nuclide identification algorithms. In addition, a Microsoft Excel spreadsheet application for automated nuclide identification scoring has been developed. This report provides an overview of the equations, nuclide weighting factors, nuclide equivalencies, and configuration weighting factors used by the application for scoring nuclide identification algorithm performance. Furthermore, this report presents a general overview of the nuclide identification algorithm scoring application including illustrative examples.

  8. Trunnionosis: Does Head Size Affect Fretting and Corrosion in Total Hip Arthroplasty?

    PubMed

    Del Balso, Christopher; Teeter, Matthew G; Tan, Sok Chuen; Howard, James L; Lanting, Brent A

    2016-10-01

    Wear and tribocorrosion at the modular head-neck taper interface may be a cause of failure in metal-on-polyethylene total hip arthroplasty (THA). The present investigation endeavored to elucidate the effect of femoral head diameter on fretting and corrosion in retrieved head-neck tapers. A retrieval analysis of THA prostheses in vivo for a minimum of 1 year was performed. Twenty-three femoral heads of 32-mm diameter were matched with 28-mm heads based on time in vivo and head length (-3 mm to +8 mm). All included implants featured a single taper design from a single manufacturer. Fretting and corrosion damage scoring was performed for each implant under stereomicroscopic visualization. Head diameter was observed to affect fretting (P = .01), with 32-mm femoral heads exhibiting greater total fretting scores than 28-mm heads. Fretting damage was greatest (P = .01) in the central concentric zone of the femoral head bore tapers, regardless of head diameter, length, or stem offset. No significant effect on total corrosion scores was observed for any head or stem variable. Retrieved implant total corrosion scores were positively correlated (ρ = 0.51, P < .001) with implantation time. Increased femoral head diameter in THA may produce greater fretting damage owing to and increased head-neck moment arm. There is no associated increase in corrosion with 28-mm and 32-mm heads of this taper design. The longer a THA prosthesis is implanted, the greater the risk of damage due to corrosion. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. The Thompson Encephalopathy Score and Short-Term Outcomes in Asphyxiated Newborns Treated With Therapeutic Hypothermia.

    PubMed

    Thorsen, Patricia; Jansen-van der Weide, Martine C; Groenendaal, Floris; Onland, Wes; van Straaten, Henrika L M; Zonnenberg, Inge; Vermeulen, Jeroen R; Dijk, Peter H; Dudink, Jeroen; Rijken, Monique; van Heijst, Arno; Dijkman, Koen P; Cools, Filip; Zecic, Alexandra; van Kaam, Anton H; de Haan, Timo R

    2016-07-01

    The Thompson encephalopathy score is a clinical score to assess newborns suffering from perinatal asphyxia. Previous studies revealed a high sensitivity and specificity of the Thompson encephalopathy score for adverse outcomes (death or severe disability). Because the Thompson encephalopathy score was developed before the use of therapeutic hypothermia, its value was reassessed. The purpose of this study was to assess the association of the Thompson encephalopathy score with adverse short-term outcomes, defined as death before discharge, development of severe epilepsy, or the presence of multiple organ failure in asphyxiated newborns undergoing therapeutic hypothermia. The study period ranged from November 2010 to October 2014. A total of 12 tertiary neonatal intensive care units participated. Demographic and clinical data were collected from the "PharmaCool" multicenter study, an observational cohort study analyzing pharmacokinetics of medication during therapeutic hypothermia. With multiple logistic regression analyses the association of the Thompson encephalopathy scores with outcomes was studied. Data of 142 newborns were analyzed (male: 86; female: 56). Median Thompson score was 9 (interquartile range: 8 to 12). Median gestational age was 40 weeks (interquartile range 38 to 41), mean birth weight was 3362 grams (standard deviation: 605). All newborns manifested perinatal asphyxia and underwent therapeutic hypothermia. Death before discharge occurred in 23.9% and severe epilepsy in 21.1% of the cases. In total, 59.2% of the patients had multiple organ failure. The Thompson encephalopathy score was not associated with multiple organ failure, but a Thompson encephalopathy score ≥12 was associated with death before discharge (odds ratio: 3.9; confidence interval: 1.3 to 11.2) and with development of severe epilepsy (odds ratio: 8.4; confidence interval: 2.5 to 27.8). The Thompson encephalopathy score is a useful clinical tool, even in cooled asphyxiated

  10. Automated Essay Scoring versus Human Scoring: A Correlational Study

    ERIC Educational Resources Information Center

    Wang, Jinhao; Brown, Michelle Stallone

    2008-01-01

    The purpose of the current study was to analyze the relationship between automated essay scoring (AES) and human scoring in order to determine the validity and usefulness of AES for large-scale placement tests. Specifically, a correlational research design was used to examine the correlations between AES performance and human raters' performance.…

  11. Cross-cultural adaptation and validation of the Turkish version of Oxford hip score.

    PubMed

    Tuğay, Baki Umut; Tuğay, Nazan; Güney, Hande; Hazar, Zeynep; Yüksel, İnci; Atilla, Bülent

    2015-06-01

    The purpose of this study was to translate the Oxford hip score (OHS) into Turkish and to evaluate the psychometric properties by testing the internal consistency, reproducibility, construct validity, and responsiveness in patients with hip osteoarthritis (OA). Oxford hip score was translated and culturally adapted according to the guidelines in the literature. Seventy patients (mean age 61.45 ± 9.29 years) with hip osteoarthritis participated in the study. Patients completed the Turkish Oxford hip score (OHS-TR), the Short-Form 36 (SF-36), and Western Ontario and McMaster Universities Index (WOMAC). Internal consistency was tested using Cronbach's α coefficient. Patients completed OHS-TR questionnaire twice in 7 days for determining the reproducibility. Correlation between the total results of both tests was determined by the Pearson correlation coefficient and intraclass correlation coefficient (ICC). Validity was assessed by calculating the Pearson correlation coefficient between the OHS-TR and WOMAC and SF-36 scores. Floor and ceiling effects were analyzed. The internal consistency was high (Cronbach's α 0.93). The construct validity showed a significant correlation between the OHS-TR and WOMAC and related SF-36 domains (p < 0.001). The ICC's ranged between 0.80 and 0.99. There was no floor or ceiling effect in total OHS-TR score. The OHS-TR questionnaire is valid, reliable, and responsive for the Turkish-speaking patients with hip OA.

  12. Validation of the nursing workload scoring systems "Nursing Activities Score" (NAS), and "Therapeutic Intervention Scoring System For Critically Ill Children" (TISS-C) in a Greek Paediatric Intensive Care Unit.

    PubMed

    Nieri, Alexandra-Stavroula; Manousaki, Kalliopi; Kalafati, Maria; Padilha, Katia Grilio; Stafseth, Siv K; Katsoulas, Theodoros; Matziou, Vasiliki; Giannakopoulou, Margarita

    2018-04-11

    To assess the reliability and validity of the Greek version of Nursing Activities Score (NAS), and Therapeutic Intervention Scoring System for Critically Ill Children (TISS-C) in a Greek Paediatric Intensive Care Unit (PICU). A methodological study was performed in one PICU of the largest Paediatric Hospital in Athens-Greece. The culturally adapted and validated Greek NAS version, enriched according to the Norwegian paediatric one (P-NAS), was used. TISS-C and Norwegian paediatric interventions were translated to Greek language and backwards. Therapeutic Intervention Scoring System (TISS-28) was used as a gold standard. Two independent observers simultaneously recorded 30 daily P-NAS and TISS-C records. Totally, 188 daily P-NAS, TISS-C and TISS-28 reports in a sample of 29 patients have been obtained during 5 weeks. Descriptive statistics, reliability and validity measures were applied using SPSS (ver 22.0) (p ≤ 0.05). Kappa was 0.963 for P-NAS and 0.9895 for TISS-C (p < 0.001) and Intraclass Correlation Coefficient for all scale items of TISS-C was 1.00 (p < 0.001). P-NAS, TISS-28 and TISS-C measurements were significantly correlated (0.680 ≤ rho ≤ 0.743, p < 0.001). The mean score(±SD) for TISS-28, P-NAS and TISS-C was 23.05(±5.72), 58.14(±13.98) and 20.21(±9.66) respectively. These results support the validity of P-NAS and TISS-C scales to be used in Greek PICUs. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. A brief simulation intervention increasing basic science and clinical knowledge.

    PubMed

    Sheakley, Maria L; Gilbert, Gregory E; Leighton, Kim; Hall, Maureen; Callender, Diana; Pederson, David

    2016-01-01

    The United States Medical Licensing Examination (USMLE) is increasing clinical content on the Step 1 exam; thus, inclusion of clinical applications within the basic science curriculum is crucial. Including simulation activities during basic science years bridges the knowledge gap between basic science content and clinical application. To evaluate the effects of a one-off, 1-hour cardiovascular simulation intervention on a summative assessment after adjusting for relevant demographic and academic predictors. This study was a non-randomized study using historical controls to evaluate curricular change. The control group received lecture (n l=515) and the intervention group received lecture plus a simulation exercise (n l+s=1,066). Assessment included summative exam questions (n=4) that were scored as pass/fail (≥75%). USMLE-style assessment questions were identical for both cohorts. Descriptive statistics for variables are presented and odds of passage calculated using logistic regression. Undergraduate grade point ratio, MCAT-BS, MCAT-PS, age, attendance at an academic review program, and gender were significant predictors of summative exam passage. Students receiving the intervention were significantly more likely to pass the summative exam than students receiving lecture only (P=0.0003). Simulation plus lecture increases short-term understanding as tested by a written exam. A longitudinal study is needed to assess the effect of a brief simulation intervention on long-term retention of clinical concepts in a basic science curriculum.

  14. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing.

    PubMed

    van Jonbergen, H P W; Scholtes, V A B; van Kampen, A; Poolman, R W

    2011-08-01

    The efficacy of circumpatellar electrocautery in reducing the incidence of post-operative anterior knee pain is unknown. We conducted a single-centre, outcome-assessor and patient-blinded, parallel-group, randomised, controlled trial to compare circumpatellar electrocautery with no electrocautery in total knee replacement in the absence of patellar resurfacing. Patients requiring knee replacement for primary osteoarthritis were randomly assigned circumpatellar electrocautery (intervention group) or no electrocautery (control group). The primary outcome measure was the incidence of anterior knee pain. A secondary measure was the standardised clinical and patient-reported outcomes determined by the American Knee Society scores and the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. A total of 131 knees received circumpatellar electrocautery and 131 had no electrocautery. The overall incidence of anterior knee pain at follow-up at one year was 26% (20% to 31%), with 19% (12% to 26%) in the intervention group and 32% (24% to 40%) in the control group (p = 0.02). The relative risk reduction from electrocautery was 40% (9% to 61%) and the number needed to treat was 7.7 (4.3 to 41.4). The intervention group had a better mean total WOMAC score at follow-up at one year compared with the control group (16.3 (0 to 77.7) versus 21.6 (0 to 76.7), p = 0.04). The mean post-operative American Knee Society knee scores and function scores were similar in the intervention and control groups (knee score: 92.4 (55 to 100) versus 90.4 (51 to 100), respectively (p = 0.14); function score: 86.5 (15 to 100) versus 84.5 (30 to 100), respectively (p = 0.49)). Our study suggests that in the absence of patellar resurfacing electrocautery around the margin of the patella improves the outcome of total knee replacement.

  15. Development of the Brazilian Portuguese version of the Achilles Tendon Total Rupture Score (ATRS BrP): a cross-cultural adaptation with reliability and construct validity evaluation.

    PubMed

    Zambelli, Roberto; Pinto, Rafael Z; Magalhães, João Murilo Brandão; Lopes, Fernando Araujo Silva; Castilho, Rodrigo Simões; Baumfeld, Daniel; Dos Santos, Thiago Ribeiro Teles; Maffulli, Nicola

    2016-01-01

    There is a need for a patient-relevant instrument to evaluate outcome after treatment in patients with a total Achilles tendon rupture. The purpose of this study was to undertake a cross-cultural adaptation of the Achilles Tendon Total Rupture Score (ATRS) into Brazilian Portuguese, determining the test-retest reliability and construct validity of the instrument. A five-step approach was used in the cross-cultural adaptation process: initial translation (two bilingual Brazilian translators), synthesis of translation, back-translation (two native English language translators), consensus version and evaluation (expert committee), and testing phase. A total of 46 patients were recruited to evaluate the test-retest reproducibility and construct validity of the Brazilian Portuguese version of the ATRS. Test-retest reproducibility was performed by assessing each participant on two separate occasions. The construct validity was determined by the correlation index between the ATRS and the Orthopedic American Foot and Ankle Society (AOFAS) questionnaires. The final version of the Brazilian Portuguese ATRS had the same number of questions as the original ATRS. For the reliability analysis, an ICC(2,1) of 0.93 (95 % CI: 0.88 to 0.96) with SEM of 1.56 points and MDC of 4.32 was observed, indicating excellent reliability. The construct validity showed excellent correlation with R = 0.76 (95 % CI: 0.52 to 0.89, P < 0.001). The ATRS was successfully cross-culturally validated into Brazilian Portuguese. This version was a reliable and valid measure of function in patients who suffered complete rupture of the Achilles Tendon.

  16. Common Clinical Practice versus new PRIM Score in Predicting Coronary Heart Disease Risk

    PubMed Central

    Frikke-Schmidt, Ruth; Tybjærg-Hansen, Anne; Schnohr, Peter; Jensen, Gorm B.; Nordestgaard, Børge G.

    2011-01-01

    Objectives To compare the new Patient Rule Induction Method(PRIM) Score and common clinical practice with the Framingham Point Score for classification of individuals with respect to coronary heart disease(CHD) risk. Methods and Results PRIM Score and the Framingham Point Score were estimated for 11,444 participants from the Copenhagen City Heart Study. Gender specific cumulative incidences and 10 year absolute CHD risks were estimated for subsets defined by age, total cholesterol, high-density lipoprotein(HDL) cholesterol, blood pressure, diabetes and smoking categories. PRIM defined seven mutually exclusive subsets in women and men, with cumulative incidences of CHD from 0.01 to 0.22 in women, and from 0.03 to 0.26 in men. PRIM versus Framingham Point Score found 11% versus 4% of all women, and 31% versus 35% of all men to have 10 year CHD risks >20%. Among women ≥65 years with hypertension and/or with diabetes, 10 year CHD risk >20% was found for 100% with PRIM scoring but for only 18% with the Framingham Point Score. Conclusion Compared to the PRIM Score, common clinical practice with the Framingham Point Score underestimates CHD risk in women, especially in women ≥65 years with hypertension and/or with diabetes. PMID:20728887

  17. Nursing Activities Score: nursing work load in a burns Intensive Care Unit1

    PubMed Central

    Camuci, Marcia Bernadete; Martins, Júlia Trevisan; Cardeli, Alexandrina Aparecida Maciel; Robazzi, Maria Lúcia do Carmo Cruz

    2014-01-01

    Objective to evaluate the nursing work load in a Burns Intensive Care Unit according to the Nursing Activities Score. Method an exploratory, descriptive cross-sectional study with a quantitative approach. The Nursing Activities Score was used for data collection between October 2011 and May 2012, totalling 1,221 measurements, obtained from 50 patients' hospital records. Data for qualitative variables was described in tables; for the quantitative variables, calculations using statistical measurements were used. Results the mean score for the Nursing Activities Score was 70.4% and the median was 70.3%, corresponding to the percentage of the time spent on direct care to the patient in 24 hours. Conclusion the Nursing Activities Score provided information which involves the process of caring for patients hospitalized in a Burns Intensive Care Unit, and indicated that there is a high work load for the nursing team of the sector studied. PMID:26107842

  18. Portsmouth physiological and operative severity score for the Enumeration of Mortality and morbidity scoring system in general surgical practice and identifying risk factors for poor outcome

    PubMed Central

    Tyagi, Ashish; Nagpal, Nitin; Sidhu, D. S.; Singh, Amandeep; Tyagi, Anjali

    2017-01-01

    Background: Estimation of the outcome is paramount in disease stratification and subsequent management in severely ill surgical patients. Risk scoring helps us quantify the prospects of adverse outcome in a patient. Portsmouth-Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) the world over has proved itself as a worthy scoring system and the present study was done to evaluate the feasibility of P-POSSUM as a risk scoring system as a tool in efficacious prediction of mortality and morbidity in our demographic profile. Materials and Methods: Validity of P-POSSUM was assessed prospectively in fifty major general surgeries performed at our hospital from May 2011 to October 2012. Data were collected to obtain P-POSSUM score, and statistical analysis was performed. Results: Majority (72%) of patients was male and mean age was 40.24 ± 18.6 years. Seventy-eight percentage procedures were emergency laparotomies commonly performed for perforation peritonitis. Mean physiological score was 17.56 ± 7.6, and operative score was 17.76 ± 4.5 (total score = 35.3 ± 10.4). The ratio of observed to expected mortality rate was 0.86 and morbidity rate was 0.78. Discussion: P-POSSUM accurately predicted both mortality and morbidity in patients who underwent major surgical procedures in our setup. Thus, it helped us in identifying patients who required preferential attention and aggressive management. Widespread application of this tool can result in better distribution of care among high-risk surgical patients. PMID:28250670

  19. RENZI SCORE FOR OBSTRUCTED DEFECATION SYNDROME - VALIDATION OF THE PORTUGUESE VERSION ACCORDING TO THE COSMIN CHECKLIST.

    PubMed

    Caetano, Ana Celia; Dias, Sara; Santa-Cruz, André; Rolanda, Carla

    2018-01-01

    Recently, the Obstructed Defecation Syndrome score (ODS score) was developed and validated by Renzi to assess clinical staging and to allow evaluation and comparison of the efficacy of treatment of this disorder. Our goal is to validate the Portuguese version of Renzi ODS score, according to the Consensus based Standards for the selection of the Health Measurement Instruments (COSMIN) checklist. Following guidelines for cross-cultural validity, Renzi ODS score was translated into the Portuguese language. Then, a group of patients and healthy controls were invited to fill in the Renzi ODS score at baseline, after 2 weeks and 3 months, respectively. We assessed internal consistency, reliability and measurement error, content and construct validity, responsiveness and interpretability. A total of 113 individuals (77 patients; 36 healthy controls) completed the questionnaire. Seventy and 30 patients repeated the Renzi ODS score after 2 weeks and 3 months respectively. Factor analysis confirmed the unidimensionality of the scale. Cronbach's α coefficient of 0.77 supported item's homogeneity. Weighted quadratic kappa of 0.89 established test-retest reliability. The smallest detectable change at the individual level was 2.66 and at the group level was 0.30. Renzi ODS score and the total (-0.32) and physical (-0.43) SF-36 scores correlated negatively. Patient and control's groups significantly differed (11 points). The change score of Renzi ODS score between baseline and 3 months correlated negatively with the clinical evolution (-0.86). ROC analysis showed minimal important change of 2.00 with AUC 0.97. Neither floor nor ceiling effects were observed. This work validated the Portuguese version of Renzi ODS score. We can now use this reliable, responsive, and interpretable (at the group level) tool to evaluate Portuguese ODS patients.

  20. Metal-on-Metal Total Hip Arthroplasty: Quality of Online Patient Information.

    PubMed

    Crozier-Shaw, Geoff; Queally, Joseph M; Quinlan, John F

    2017-03-01

    Metal-on-metal total hip arthroplasty (THA) has generated much attention in the media because of early failure of certain implant systems. This study assessed the quality, accuracy, and readability of online information on metal-on-metal THA. The search terms "metal-on-metal hip replacement" and "metal hip replacement" were entered into the 3 most popular search engines. Information quality was assessed with the DISCERN score and a specific metal-on-metal THA content score. Accuracy of information was assessed with a customized score. Readability of the websites was assessed with the Flesch-Kincaid grade level score. A total of 61 unique websites were assessed. For 56% of websites, the target audience was patients. Media or medicolegal sources accounted for 44% of websites. As assessed by DISCERN (range, 16-80) and metal-on-metal THA (range, 0-25) scores, quality of the websites was moderate at best (47.1 and 9.6, respectively). Accuracy (range, 0-8) of the information presented also was moderate, with a mean score of 6.6. Media and medicolegal websites had the lowest scores for both quality and accuracy, despite making up the greatest proportion of sites assessed. Only 1 website (2%) had a Flesch-Kincaid grade level at or less than the recommended level of 8th grade. This study found that online information on metal-on-metal THA was of poor quality, often was inaccurate, and was presented at an inappropriately high reading level, particularly for media and medicolegal websites. Health care providers should counsel patients on the quality of information available and recommend appropriate online resources. [Orthopedics. 2017; 40(2):e262-e268.]. Copyright 2016, SLACK Incorporated.