Sample records for modified jadad scale

  1. The quality of reporting of randomized controlled trials of traditional Chinese medicine: a survey of 13 randomly selected journals from mainland China.

    PubMed

    Wang, Gang; Mao, Bing; Xiong, Ze-Yu; Fan, Tao; Chen, Xiao-Dong; Wang, Lei; Liu, Guan-Jian; Liu, Jia; Guo, Jia; Chang, Jing; Wu, Tai-Xiang; Li, Ting-Qian

    2007-07-01

    The number of randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) is increasing. However, there have been few systematic assessments of the quality of reporting of these trials. This study was undertaken to evaluate the quality of reporting of RCTs in TCM journals published in mainland China from 1999 to 2004. Thirteen TCM journals were randomly selected by stratified sampling of the approximately 100 TCM journals published in mainland China. All issues of the selected journals published from 1999 to 2004 were hand-searched according to guidelines from the Cochrane Centre. All reviewers underwent training in the evaluation of RCTs at the Chinese Centre of Evidence-based Medicine. A comprehensive quality assessment of each RCT was completed using a modified version of the Consolidated Standards of Reporting Trials (CONSORT) checklist (total of 30 items) and the Jadad scale. Disagreements were resolved by consensus. Seven thousand four hundred twenty-two RCTs were identified. The proportion of published RCTs relative to all types of published clinical trials increased significantly over the period studied, from 18.6% in 1999 to 35.9% in 2004 (P < 0.001). The mean (SD) Jadad score was 1.03 (0.61) overall. One RCT had a Jadad score of 5 points; 14 had a score of 4 points; and 102 had a score of 3 points. The mean (SD) Jadad score was 0.85 (0.53) in 1999 (746 RCTs) and 1.20 (0.62) in 2004 (1634 RCTs). Across all trials, 39.4% of the items on the modified CONSORT checklist were reported, which was equivalent to 11.82 (5.78) of the 30 items. Some important methodologic components of RCTs were incompletely reported, such as sample-size calculation (reported in 1.1% of RCTs), randomization sequence (7.9%), allocation concealment (0.3 %), implementation of the random-allocation sequence (0%), and analysis of intention to treat (0%). The findings of this study indicate that the quality of reporting of RCTs of TCM has improved, but remains poor.

  2. Quality of randomized controlled trials published in the International Urogynecology Journal 2007-2016.

    PubMed

    Kim, Kyu Shik; Chung, Jae Hoon; Jo, Jung Ki; Kim, Jae Heon; Kim, Seungjun; Cho, Jeoung Man; Cho, Hee Ju; Choi, Hong Yong; Lee, Seung Wook

    2018-07-01

    Randomized controlled trials (RCTs) provide the best quality clinical evidence. The aim of this study was to assess the quality of RCTs published by the International Urogynecology Journal (IUJ) in 2007-2016. RCTs in original articles were extracted from PubMed and IUJ homepage. Change in RCT quality over time was assessed with Jadad and van Tulder scales and Cochrane Collaboration's risk of bias tool (CCRBT). Jadad scores of 3-5 or van Tulder scores of >5 indicated high-quality RCTs. The effect on RCT quality of including funding source and institutional review board (IRB) approval statements and describing the intervention was assessed. In addition, changes in RCT topics over time were assessed. Annual RCT frequencies did not change significantly (6.7-15.7%): 36.1% and 25.7% described blinding and allocation concealment, respectively. Both tended to increase between 2013 and 2016, particularly 2013 and 2014. Funding statement inclusion (39.1% overall) and intervention description (78.2% overall) tended to increase steadily. IRB statement inclusion (60.4% overall) increased significantly (p < 0.01). Jadad scores and van Tulder rose significantly until 2014 (p < 0.01). Frequencies of high-quality RCTs tended to rise. CCRBT indicated that RCTs with a low risk of bias tended to increase until 2014. However, from 2015, Jadad scores, van Tulder, and CCRBT the low risk tended to decreased. RCTs with funding and IRB approval statements had higher Jadad and van Tulder scores than unfunded RCTs (p < 0.01 and p < 0.01, respectively). Intervention description did not associate with better quality. RCT quality improved over time, but a dip in quality was observed in 2015-2016 because of decreased blinding and allocation concealment.

  3. Inter-rater and test–retest reliability of quality assessments by novice student raters using the Jadad and Newcastle–Ottawa Scales

    PubMed Central

    Oremus, Carolina; Hall, Geoffrey B C; McKinnon, Margaret C

    2012-01-01

    Introduction Quality assessment of included studies is an important component of systematic reviews. Objective The authors investigated inter-rater and test–retest reliability for quality assessments conducted by inexperienced student raters. Design Student raters received a training session on quality assessment using the Jadad Scale for randomised controlled trials and the Newcastle–Ottawa Scale (NOS) for observational studies. Raters were randomly assigned into five pairs and they each independently rated the quality of 13–20 articles. These articles were drawn from a pool of 78 papers examining cognitive impairment following electroconvulsive therapy to treat major depressive disorder. The articles were randomly distributed to the raters. Two months later, each rater re-assessed the quality of half of their assigned articles. Setting McMaster Integrative Neuroscience Discovery and Study Program. Participants 10 students taking McMaster Integrative Neuroscience Discovery and Study Program courses. Main outcome measures The authors measured inter-rater reliability using κ and the intraclass correlation coefficient type 2,1 or ICC(2,1). The authors measured test–retest reliability using ICC(2,1). Results Inter-rater reliability varied by scale question. For the six-item Jadad Scale, question-specific κs ranged from 0.13 (95% CI −0.11 to 0.37) to 0.56 (95% CI 0.29 to 0.83). The ranges were −0.14 (95% CI −0.28 to 0.00) to 0.39 (95% CI −0.02 to 0.81) for the NOS cohort and −0.20 (95% CI −0.49 to 0.09) to 1.00 (95% CI 1.00 to 1.00) for the NOS case–control. For overall scores on the six-item Jadad Scale, ICC(2,1)s for inter-rater and test–retest reliability (accounting for systematic differences between raters) were 0.32 (95% CI 0.08 to 0.52) and 0.55 (95% CI 0.41 to 0.67), respectively. Corresponding ICC(2,1)s for the NOS cohort were −0.19 (95% CI −0.67 to 0.35) and 0.62 (95% CI 0.25 to 0.83), and for the NOS case–control, the ICC(2,1)s were 0.46 (95% CI −0.13 to 0.92) and 0.83 (95% CI 0.48 to 0.95). Conclusions Inter-rater reliability was generally poor to fair and test–retest reliability was fair to excellent. A pilot rating phase following rater training may be one way to improve agreement. PMID:22855629

  4. Inter-rater and test-retest reliability of quality assessments by novice student raters using the Jadad and Newcastle-Ottawa Scales.

    PubMed

    Oremus, Mark; Oremus, Carolina; Hall, Geoffrey B C; McKinnon, Margaret C

    2012-01-01

    Quality assessment of included studies is an important component of systematic reviews. The authors investigated inter-rater and test-retest reliability for quality assessments conducted by inexperienced student raters. Student raters received a training session on quality assessment using the Jadad Scale for randomised controlled trials and the Newcastle-Ottawa Scale (NOS) for observational studies. Raters were randomly assigned into five pairs and they each independently rated the quality of 13-20 articles. These articles were drawn from a pool of 78 papers examining cognitive impairment following electroconvulsive therapy to treat major depressive disorder. The articles were randomly distributed to the raters. Two months later, each rater re-assessed the quality of half of their assigned articles. McMaster Integrative Neuroscience Discovery and Study Program. 10 students taking McMaster Integrative Neuroscience Discovery and Study Program courses. The authors measured inter-rater reliability using κ and the intraclass correlation coefficient type 2,1 or ICC(2,1). The authors measured test-retest reliability using ICC(2,1). Inter-rater reliability varied by scale question. For the six-item Jadad Scale, question-specific κs ranged from 0.13 (95% CI -0.11 to 0.37) to 0.56 (95% CI 0.29 to 0.83). The ranges were -0.14 (95% CI -0.28 to 0.00) to 0.39 (95% CI -0.02 to 0.81) for the NOS cohort and -0.20 (95% CI -0.49 to 0.09) to 1.00 (95% CI 1.00 to 1.00) for the NOS case-control. For overall scores on the six-item Jadad Scale, ICC(2,1)s for inter-rater and test-retest reliability (accounting for systematic differences between raters) were 0.32 (95% CI 0.08 to 0.52) and 0.55 (95% CI 0.41 to 0.67), respectively. Corresponding ICC(2,1)s for the NOS cohort were -0.19 (95% CI -0.67 to 0.35) and 0.62 (95% CI 0.25 to 0.83), and for the NOS case-control, the ICC(2,1)s were 0.46 (95% CI -0.13 to 0.92) and 0.83 (95% CI 0.48 to 0.95). Inter-rater reliability was generally poor to fair and test-retest reliability was fair to excellent. A pilot rating phase following rater training may be one way to improve agreement.

  5. Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000-2013.

    PubMed

    Lozano López, C; Mesa Jiménez, J; de la Hoz Aizpurúa, J L; Pareja Grande, J; Fernández de Las Peñas, C

    2016-01-01

    To study the efficacy of manual therapy in the treatment of tension-type headache (TTH) by assessing the quality of randomized control trials (RCTs) published from the year 2000 to April 2013. A search was performed in the following databases: MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO and OVID. An analysis was made of RCT including patients with TTH receiving any manual therapy, and assessing outcome measures including the intensity, and frequency or duration of the headache. Two independent referees reviewed the methodological quality of RCTs using the Jadad scale. Data from the studies were extracted by two different reviewers. A total of fourteen RCTs were selected. Twelve studies showed acceptable quality (Jadad scale ≥3), and the remaining 2 had low quality (Jadad=2). The studies showed positive results, including reduction in headache intensity and/or frequency, reduction of medication consumption, and improvement in quality of life. The effectiveness of manual therapy for TTH cannot be completely assessed due to the heterogeneity in study design, outcome measures, and different treatments. Nevertheless, the results suggest patients with TTH receiving manual therapies showed better progress than those receiving conventional treatment or placebo. Further studies of high quality using manual therapy protocols, and also including standardized outcome measures, are now needed to clarify the efficacy of manual therapy in the management of TTH. Copyright © 2013 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Reporting Quality Assessment of Randomized Controlled Trials Published in Nephrology Urology Monthly Journal.

    PubMed

    Mehrazmay, Alireza; Karambakhsh, Alireza; Salesi, Mahmood

    2015-07-01

    Randomized controlled trials (RCTs) are important tools for evidence-based health care decisions. It is, therefore, important that they be conducted and reported with the highest possible standards. The aim of this study was to evaluate the reporting quality of the RCTs published in nephrology urology monthly journal and to examine whether there was a change over time in the reporting quality. The quality of each report was assessed using the Consolidated Standards of Reporting Trials (CONSORT) 2010 Statement checklist and a 5-point quality assessment instrument, i.e. the Jadad scale. Eighteen (14 Iranian and 4 non-Iranian) RCTs were published from 2012 to 2014 on topics including renal stone (16.6%), hemodialysis and transplantation (38.8%), and prostate conditions (11.1%). Interventions comprised surgery, drugs, and teaching method in 7 (38 %), 10 (55%), and 1 (5%) of them, respectively. According to the CONSORT checklist, the weakest reported items were registration number, identification as a randomized trial in the title, and settings and locations where the data were collected. The mean Jadad score of the reports was 2.72 ± 1.36 (54% of their maximum possible total score). According to the Jadad and CONSORT scales, there was an increase in the quality of reporting from 2012 to 2014. This assessment shows low reporting quality scores in reports. Training courses for researchers, using standard reporting tools (e.g. CONSORT 2010 Statement checklist), and consultation with methodologists can improve the quality of published RCTs.

  7. Intervention randomized controlled trials involving wrist and shoulder arthroscopy: a systematic review

    PubMed Central

    2014-01-01

    Background Although arthroscopy of upper extremity joints was initially a diagnostic tool, it is increasingly used for therapeutic interventions. Randomized controlled trials (RCTs) are considered the gold standard for assessing treatment efficacy. We aimed to review the literature for intervention RCTs involving wrist and shoulder arthroscopy. Methods We performed a systematic review for RCTs in which at least one arm was an intervention performed through wrist arthroscopy or shoulder arthroscopy. PubMed and Cochrane Library databases were searched up to December 2012. Two researchers reviewed each article and recorded the condition treated, randomization method, number of randomized participants, time of randomization, outcomes measures, blinding, and description of dropouts and withdrawals. We used the modified Jadad scale that considers the randomization method, blinding, and dropouts/withdrawals; score 0 (lowest quality) to 5 (highest quality). The scores for the wrist and shoulder RCTs were compared with the Mann–Whitney test. Results The first references to both wrist and shoulder arthroscopy appeared in the late 1970s. The search found 4 wrist arthroscopy intervention RCTs (Kienböck’s disease, dorsal wrist ganglia, volar wrist ganglia, and distal radius fracture; first 3 compared arthroscopic with open surgery). The median number of participants was 45. The search found 50 shoulder arthroscopy intervention RCTs (rotator cuff tears 22, instability 14, impingement 9, and other conditions 5). Of these, 31 compared different arthroscopic treatments, 12 compared arthroscopic with open treatment, and 7 compared arthroscopic with nonoperative treatment. The median number of participants was 60. The median modified Jadad score for the wrist RCTs was 0.5 (range 0–1) and for the shoulder RCTs 3.0 (range 0–5) (p = 0.012). Conclusion Despite the increasing use of wrist arthroscopy in the treatment of various wrist disorders the efficacy of arthroscopically performed wrist interventions has been studied in only 4 randomized studies compared to 50 randomized studies of significantly higher quality assessing interventions performed through shoulder arthroscopy. PMID:25059881

  8. A systematic review of the therapeutic effects of Reiki.

    PubMed

    vanderVaart, Sondra; Gijsen, Violette M G J; de Wildt, Saskia N; Koren, Gideon

    2009-11-01

    Reiki is an ancient form of Japanese healing. While this healing method is widely used for a variety of psychologic and physical symptoms, evidence of its effectiveness is scarce and conflicting. The purpose of this systematic review was to try to evaluate whether Reiki produces a significant treatment effect. Studies were identified using an electronic search of Medline, EMBASE, Cochrane Library, and Google Scholar. Quality of reporting was evaluated using a modified CONSORT Criteria for Herbal Interventions, while methodological quality was assessed using the Jadad Quality score. Two (2) researchers selected articles based on the following features: placebo or other adequate control, clinical investigation on humans, intervention using a Reiki practitioner, and published in English. They independently extracted data on study design, inclusion criteria, type of control, sample size, result, and nature of outcome measures. The modified CONSORT Criteria indicated that all 12 trials meeting the inclusion criteria were lacking in at least one of the three key areas of randomization, blinding, and accountability of all patients, indicating a low quality of reporting. Nine (9) of the 12 trials detected a significant therapeutic effect of the Reiki intervention; however, using the Jadad Quality score, 11 of the 12 studies ranked "poor." The serious methodological and reporting limitations of limited existing Reiki studies preclude a definitive conclusion on its effectiveness. High-quality randomized controlled trials are needed to address the effectiveness of Reiki over placebo.

  9. Methodological quality of randomised controlled trials in burns care. A systematic review.

    PubMed

    Danilla, Stefan; Wasiak, Jason; Searle, Susana; Arriagada, Cristian; Pedreros, Cesar; Cleland, Heather; Spinks, Anneliese

    2009-11-01

    To evaluate the methodological quality of published randomised controlled trials (RCTs) in burn care treatment and management. Using a predetermined search strategy we searched Ovid MEDLINE (1950 to January 2008) database to identify all English RCTs related to burn care. Full text studies identified were reviewed for key demographic and methodological characteristics. Methodological trial quality was assessed using the Jadad scale. A total of 257 studies involving 14,535 patients met the inclusion criteria. The median Jadad score was 2 (out of a best possible score of 5). Information was given in the introduction and discussion sections of most RCTs, although insufficient detail was provided on randomisation, allocation concealment, and blinding. The number of RCTs increased between 1950 and 2008 (Spearman's rho=0.6129, P<0.001), although the reporting quality did not improve over the same time period (P=0.1896) and was better in RCTs with larger sample sizes (median Jadad score, 4 vs. 2 points, P<0.0001). Methodological quality did not correlate with journal impact factor (P=0.2371). The reporting standards of RCTs are highly variable and less than optimal in most cases. The advent of evidence-based medicine heralds a new approach to burns care and systematic steps are needed to improve the quality of RCTs in this field. Identifying and reviewing the existing number of RCTs not only highlights the need for burn clinicians to conduct more trials, but may also encourage burn health clinicians to consider the importance of conducting trials that follow appropriate, evidence-based standards.

  10. Effectiveness of Manual Therapy Combined With Physical Therapy in Treatment of Patellofemoral Pain Syndrome: Systematic Review.

    PubMed

    Espí-López, Gemma Victoria; Arnal-Gómez, Anna; Balasch-Bernat, Mercè; Inglés, Marta

    2017-06-01

    The purpose of this study was to conduct a review of randomized controlled trials (RCTs) to determine the treatment effectiveness of the combination of manual therapy (MT) with other physical therapy techniques. Systematic searches of scientific literature were undertaken on PubMed and the Cochrane Library (2004-2014). The following terms were used: "patellofemoral pain syndrome," "physical therapy," "manual therapy," and "manipulation." RCTs that studied adults diagnosed with patellofemoral pain syndrome (PFPS) treated by MT and physical therapy approaches were included. The quality of the studies was assessed by the Jadad Scale. Five RCTs with an acceptable methodological quality (Jadad ≥ 3) were selected. The studies indicated that MT combined with physical therapy has some effect on reducing pain and improving function in PFPS, especially when applied on the full kinetic chain and when strengthening hip and knee muscles. The different combinations of MT and physical therapy programs analyzed in this review suggest that giving more emphasis to proximal stabilization and full kinetic chain treatments in PFPS will help better alleviation of symptoms.

  11. The effectiveness of the problem-based learning teaching model for use in introductory Chinese undergraduate medical courses: a systematic review and meta-analysis.

    PubMed

    Zhang, Yanqi; Zhou, Liang; Liu, Xiaoyu; Liu, Ling; Wu, Yazhou; Zhao, Zengwei; Yi, Dali; Yi, Dong

    2015-01-01

    Although the problem-based learning (PBL) emerged in 1969 and was soon widely applied internationally, the rapid development in China only occurred in the last 10 years. This study aims to compare the effect of PBL and lecture-based learning (LBL) on student course examination results for introductory Chinese undergraduate medical courses. Randomized and nonrandomized controlled trial studies on PBL use in Chinese undergraduate medical education were retrieved through PubMed, the Excerpta Medica Database (EMBASE), Chinese National Knowledge Infrastructure (CNKI) and VIP China Science and Technology Journal Database (VIP-CSTJ) with publication dates from 1st January 1966 till 31 August 2014. The pass rate, excellence rate and examination scores of course examination were collected. Methodological quality was evaluated based on the modified Jadad scale. The I-square statistic and Chi-square test of heterogeneity were used to assess the statistical heterogeneity. Overall RRs or SMDs with their 95% CIs were calculated in meta-analysis. Meta-regression and subgroup meta-analyses were also performed based on comparators and other confounding factors. Funnel plots and Egger's tests were performed to assess degrees of publication bias. The meta-analysis included 31studies and 4,699 subjects. Fourteen studies were of high quality with modified Jadad scores of 4 to 6, and 17 studies were of low quality with scores of 1 to 3. Relative to the LBL model, the PBL model yielded higher course examination pass rates [RR = 1.09, 95%CI (1.03, 1.17)], excellence rates [RR = 1.66, 95%CI (1.33, 2.06)] and examination scores [SMD = 0.82, 95%CI (0.63, 1.01)]. The meta-regression results show that course type was the significant confounding factor that caused heterogeneity in the examination-score meta-analysis (t = 0.410, P<0.001). The examination score SMD in "laboratory course" subgroup [SMD = 2.01, 95% CI: (1.50, 2.52)] was higher than that in "theory course" subgroup [SMD = 0.72, 95% CI: (0.56, 0.89)]. PBL teaching model application in introductory undergraduate medical courses can increase course examination excellence rates and scores in Chinese medical education system. It is more effective when applied to laboratory courses than to theory-based courses.

  12. The Effectiveness of the Problem-Based Learning Teaching Model for Use in Introductory Chinese Undergraduate Medical Courses: A Systematic Review and Meta-Analysis

    PubMed Central

    Zhang, Yanqi; Zhou, Liang; Liu, Xiaoyu; Liu, Ling; Wu, Yazhou; Zhao, Zengwei; Yi, Dali; Yi, Dong

    2015-01-01

    Background Although the problem-based learning (PBL) emerged in 1969 and was soon widely applied internationally, the rapid development in China only occurred in the last 10 years. This study aims to compare the effect of PBL and lecture-based learning (LBL) on student course examination results for introductory Chinese undergraduate medical courses. Methods Randomized and nonrandomized controlled trial studies on PBL use in Chinese undergraduate medical education were retrieved through PubMed, the Excerpta Medica Database (EMBASE), Chinese National Knowledge Infrastructure (CNKI) and VIP China Science and Technology Journal Database (VIP-CSTJ) with publication dates from 1st January 1966 till 31 August 2014. The pass rate, excellence rate and examination scores of course examination were collected. Methodological quality was evaluated based on the modified Jadad scale. The I-square statistic and Chi-square test of heterogeneity were used to assess the statistical heterogeneity. Overall RRs or SMDs with their 95% CIs were calculated in meta-analysis. Meta-regression and subgroup meta-analyses were also performed based on comparators and other confounding factors. Funnel plots and Egger’s tests were performed to assess degrees of publication bias. Results The meta-analysis included 31studies and 4,699 subjects. Fourteen studies were of high quality with modified Jadad scores of 4 to 6, and 17 studies were of low quality with scores of 1 to 3. Relative to the LBL model, the PBL model yielded higher course examination pass rates [RR = 1.09, 95%CI (1.03, 1.17)], excellence rates [RR = 1.66, 95%CI (1.33, 2.06)] and examination scores [SMD = 0.82, 95%CI (0.63, 1.01)]. The meta-regression results show that course type was the significant confounding factor that caused heterogeneity in the examination-score meta-analysis (t = 0.410, P<0.001). The examination score SMD in “laboratory course” subgroup [SMD = 2.01, 95% CI: (1.50, 2.52)] was higher than that in “theory course” subgroup [SMD = 0.72, 95% CI: (0.56, 0.89)]. Conclusions PBL teaching model application in introductory undergraduate medical courses can increase course examination excellence rates and scores in Chinese medical education system. It is more effective when applied to laboratory courses than to theory-based courses. PMID:25822653

  13. Trends in the number and the quality of trial protocols involving children submitted to a French Institutional Review Board.

    PubMed

    Gautier, Isabelle; Janiaud, Perrine; Rollet, Nelly; André, Nicolas; Tsimaratos, Michel; Cornu, Catherine; Malik, Salma; Gentile, Stéphanie; Kassaï, Behrouz

    2017-08-23

    There is a great need for high quality clinical research for children. The European Pediatric Regulation aimed to improve the quality of clinical trials in order to increase the availability of treatments for children. The main purpose of this study was to assess the evolution of both the number and the quality of pediatric trial protocols that were submitted to a French Institutional Review Board (IRB00009118) before and after the initiation of the EU Pediatric Regulation. All protocols submitted to the IRB00009118 between 2003 and 2014 and conducting research on subjects under eighteen years of age were eligible. The quality of randomized clinical trials was assessed according to the guidelines developed by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network and ranked using the Jadad score. Out of 622 protocols submitted to the Institutional Review Board (IRB), 21% (133/622) included children. Among these 133 pediatric protocols, the number of submitted pediatric protocols doubled between the two studied periods. From 2003 to 2008, 47 protocols including 21 institutionally sponsored were submitted to the IRB and from 2009 until 2014, 86 protocols including 48 institutionally sponsored were submitted. No significant trend was observed on the quality of RCTs. The overall median score of RCTs on the Jadad scale was high (3.5), 70.0% of protocols had a Jadad score ≥ 3, and 30.0% had a score < 3. Following the EU Pediatric Regulation, the number of pediatric protocols submitted to the IRB00009118 tends to increase, but no change was noticed regarding their quality.

  14. Quantity and quality assessment of randomized controlled trials on orthodontic practice in PubMed.

    PubMed

    Shimada, Tatsuo; Takayama, Hisako; Nakamura, Yoshiki

    2010-07-01

    To find current high-quality evidence for orthodontic practice within a reasonable time, we tested the performance of a PubMed search. PubMed was searched using publication type randomized controlled trial and medical subject heading term "orthodontics" for articles published between 2003 and 2007. The PubMed search results were compared with those from a hand search of four orthodontic journals to determine the sensitivity of PubMed search. We evaluated the precision of the PubMed search result and assessed the quality of individual randomized controlled trials using the Jadad scale. Sensitivity and precision were 97.46% and 58.12%, respectively. In PubMed, of the 277 articles retrieved, 161 (58.12%) were randomized controlled trials on orthodontic practice, and 115 of the 161 articles (71.42%) were published in four orthodontic journals: American Journal of Orthodontics and Dentofacial Orthopedics, The Angle Orthodontist, the European Journal of Orthodontics, and the Journal of Orthodontics. Assessment by the Jadad scale revealed 60 high-quality randomized controlled trials on orthodontic practice, of which 45 (75%) were published in these four journals. PubMed is a highly desirable search engine for evidence-based orthodontic practice. To stay current and get high-quality evidence, it is reasonable to look through four orthodontic journals: American Journal of Orthodontics and Dentofacial Orthopedics, The Angle Orthodontist, the European Journal of Orthodontics, and the Journal of Orthodontics.

  15. Nonantibiotic prophylaxis for recurrent urinary tract infections: a systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Beerepoot, M A J; Geerlings, S E; van Haarst, E P; van Charante, N Mensing; ter Riet, G

    2013-12-01

    Increasing antimicrobial resistance has stimulated interest in nonantibiotic prophylaxis of recurrent urinary tract infections. We assessed the effectiveness, tolerability and safety of nonantibiotic prophylaxis in adults with recurrent urinary tract infections. MEDLINE®, EMBASE™, the Cochrane Library and reference lists of relevant reviews were searched to April 2013 for relevant English language citations. Two reviewers selected randomized controlled trials that met the predefined criteria for population, interventions and outcomes. The difference in the proportions of patients with at least 1 urinary tract infection was calculated for individual studies, and pooled risk ratios were calculated using random and fixed effects models. Adverse event rates were also extracted. The Jadad score was used to assess risk of bias (0 to 2-high risk and 3 to 5-low risk). We identified 5,413 records and included 17 studies with data for 2,165 patients. The oral immunostimulant OM-89 decreased the rate of urinary tract infection recurrence (4 trials, sample size 891, median Jadad score 3, RR 0.61, 95% CI 0.48-0.78) and had a good safety profile. The vaginal vaccine Urovac® slightly reduced urinary tract infection recurrence (3 trials, sample size 220, Jadad score 3, RR 0.81, 95% CI 0.68-0.96) and primary immunization followed by booster immunization increased the time to reinfection. Vaginal estrogens showed a trend toward preventing urinary tract infection recurrence (2 trials, sample size 201, Jadad score 2.5, RR 0.42, 95% CI 0.16-1.10) but vaginal irritation occurred in 6% to 20% of women. Cranberries decreased urinary tract infection recurrence (2 trials, sample size 250, Jadad score 4, RR 0.53, 95% CI 0.33-0.83) as did acupuncture (2 open label trials, sample size 165, Jadad score 2, RR 0.48, 95% CI 0.29-0.79). Oral estrogens and lactobacilli prophylaxis did not decrease the rate of urinary tract infection recurrence. The evidence of the effectiveness of the oral immunostimulant OM-89 is promising. Although sometimes statistically significant, pooled findings for the other interventions should be considered tentative until corroborated by more research. Large head-to-head trials should be performed to optimally inform clinical decision making. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

    PubMed Central

    Stapelmann, Henrike; Türp, Jens C

    2008-01-01

    Background The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs), tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint. Methods We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007). The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs) was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database. Results Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG) investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4) or with bruxism alone (Kavaklı 2006, Jadad score: 2); in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3), a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5) no difference was found. In one RCT (Shankland 2002, Jadad score: 1), patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion. Conclusion Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a patient will be compliant with follow-up appointments. The NTI-tss bite splint may be justified when a reduction of jaw closer muscle activity (e.g., jaw clenching or tooth grinding) is desired, or as an emergency device in patients with acute temporomandibular pain and, possibly, restricted jaw opening. PMID:18662411

  17. Effects of auditory cues on gait initiation and turning in patients with Parkinson's disease.

    PubMed

    Gómez-González, J; Martín-Casas, P; Cano-de-la-Cuerda, R

    2016-12-08

    To review the available scientific evidence about the effectiveness of auditory cues during gait initiation and turning in patients with Parkinson's disease. We conducted a literature search in the following databases: Brain, PubMed, Medline, CINAHL, Scopus, Science Direct, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Library Plus, CENTRAL, Trip Database, PEDro, DARE, OTseeker, and Google Scholar. We included all studies published between 2007 and 2016 and evaluating the influence of auditory cues on independent gait initiation and turning in patients with Parkinson's disease. The methodological quality of the studies was assessed with the Jadad scale. We included 13 studies, all of which had a low methodological quality (Jadad scale score≤2). In these studies, high-intensity, high-frequency auditory cues had a positive impact on gait initiation and turning. More specifically, they 1) improved spatiotemporal and kinematic parameters; 2) decreased freezing, turning duration, and falls; and 3) increased gait initiation speed, muscle activation, and gait speed and cadence in patients with Parkinson's disease. We need studies of better methodological quality to establish the Parkinson's disease stage in which auditory cues are most beneficial, as well as to determine the most effective type and frequency of the auditory cue during gait initiation and turning in patients with Parkinson's disease. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Hamstring autograft versus soft-tissue allograft in anterior cruciate ligament reconstruction: a systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Cvetanovich, Gregory L; Mascarenhas, Randy; Saccomanno, Maristella F; Verma, Nikhil N; Cole, Brian J; Bush-Joseph, Charles A; Bach, Bernard R

    2014-12-01

    To compare outcomes of anterior cruciate ligament (ACL) reconstruction with hamstring autograft versus soft-tissue allograft by systematic review and meta-analysis. A systematic review of randomized controlled studies comparing hamstring autograft with soft-tissue allograft in ACL reconstruction was performed. Studies were identified by strict inclusion and exclusion criteria. Descriptive statistics were reported. Where possible, the data were pooled and a meta-analysis was performed using RevMan software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Dichotomous data were reported as risk ratios, whereas continuous data were reported as standardized mean differences and 95% confidence intervals. Heterogeneity was assessed by use of I(2) for each meta-analysis. Study methodologic quality was analyzed with the Modified Coleman Methodology Score and Jadad scale. Five studies with 504 combined patients (251 autograft and 253 allograft; 374 male and 130 female patients) with a mean age of 29.9 ± 2.2 years were included. The allografts used were fresh-frozen hamstring, irradiated hamstring, mixture of fresh-frozen and cryopreserved hamstring, fresh-frozen tibialis anterior, and fresh-frozen Achilles tendon grafts without bone blocks. The mean follow-up period was 47.4 ± 26.9 months, with a mean follow-up rate of 83.3% ± 8.6%. Two studies found a longer operative time with autograft than with allograft (77.1 ± 2.0 minutes v 59.9 ± 0.9 minutes, P = .008). Meta-analysis showed no statistically significant differences between autografts and allografts for any outcome measures (P > .05 for all tests). One study found significantly greater laxity for irradiated allograft than for autograft. The methodologic quality of the 5 studies was poor, with a mean Modified Coleman Methodology Score of 54.4 ± 6.9 and mean Jadad score of 1.6 ± 1.5. On the basis of this systematic review and meta-analysis of 5 randomized controlled trials, there is no statistically significant difference in outcome between patients undergoing ACL reconstruction with hamstring autograft and those undergoing ACL reconstruction with soft-tissue allograft. These results may not extrapolate to younger patient populations. The methodology of the available randomized controlled trials comparing hamstring autograft and soft-tissue allograft is poor. Level II, systematic review of Level I and II studies. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. RANDOMIZED CONTROLLED TRIALS IN ORTHOPEDICS AND TRAUMATOLOGY: SYSTEMATIC ANALYSIS ON THE NATIONAL EVIDENCE

    PubMed Central

    de Moraes, Vinícius Ynoe; Moreira, Cesar Domingues; Tamaoki, Marcel Jun Sugawara; Faloppa, Flávio; Belloti, Joao Carlos

    2015-01-01

    Objective: To assess whether there has been any improvement in the quality and quantity of randomized controlled trials (RCTs) in nationally published journals through the application of standardized and validated scores. Methods: We electronically selected all RCTs published in the two indexed Brazilian journals that focus on orthopedics, over the period 2000-2009: Acta Ortopédica Brasileira (AOB) and Revista Brasileira de Ortopedia (RBO). These RCTs were identified and scored by two independent researchers in accordance with the Jadad scale and the Cochrane Bone, Joint and Muscle Trauma Group score. The studies selected were grouped as follows: 1) publication period (2000-2004 or 2004-2009); 2) journal of publication (AOB or RBO). Results: Twenty-two papers were selected: 10 from AOB and 12 from RBO. No statistically significant differences were found between the proportions (nRCT/nTotal of published papers) of RCTs published in the two journals (p = 0.458), or in the Jadad score (p = 0.722) and Cochrane score (p = 0.630). Conclusion: The relative quality and quantity of RCTs in the journals analyzed were similar. There was a trend towards improvement of quality, but there was no increase in the number of RCTs between the two periods analyzed. PMID:27026971

  20. Meta-analysis of clinical trials on traditional Chinese herbal medicine for treatment of persistent allergic rhinitis.

    PubMed

    Wang, Shijun; Tang, Qiaofei; Qian, Wei; Fan, Yu

    2012-05-01

    Chinese herbal medicine (CHM) has been used for the prevention and treatment of persistent allergic rhinitis (PAR), but results are still equivocal. This study was to assess the clinical effectiveness of CHM in patients with PAR. Databases searched included articles published in the Cochrane library, MEDLINE, EMBASE, China National Knowledge Infrastructure, and Wanfang database from 1999 to 2011. The studies included were randomized controlled trials (RCTs) comparing CHM to placebo if they included patients with PAR. The main outcomes were the changes in the standardized mean difference (SMD) of nasal symptom scores and total serum IgE level. Methodological quality was assessed by the modified Jadad's scale. Seven RCTs with 533 patients were identified and analyzed. In the meta-analysis, CHM reduced the total nasal symptom scores compared to placebo (SMD, -1.82; 95% confidence interval [CI], -3.03 to -0.62; P = 0.003). The effect estimate was in favor of the CHM intervention (SMD, -1.09; 95% CI, -2.74 to 0.55) in reducing the total serum IgE level, although this was not significant (P = 0.19). CHM interventions appear to have beneficial effects in patients with PAR. However, the published efficacy studies are too small to draw firm conclusion. © 2012 John Wiley & Sons A/S.

  1. Effects of electroconvulsive therapy on cognitive functioning in patients with depression: protocol for a systematic review and meta-analysis

    PubMed Central

    McNeely, Heather; Losier, Bruno; Parlar, Melissa; King, Matthew; Hasey, Gary; Fervaha, Gagan; Graham, Allyson C; Gregory, Caitlin; Hanford, Lindsay; Nazarov, Anthony; Restivo, Maria; Tatham, Erica; Truong, Wanda; Hall, Geoffrey B C; Lanius, Ruth; McKinnon, Margaret

    2015-01-01

    Introduction Depression is the leading cause of disability worldwide, affecting approximately 350 million people. Evidence indicates that only 60–70% of persons with major depressive disorder who tolerate antidepressants respond to first-line drug treatment; the remainder become treatment resistant. Electroconvulsive therapy (ECT) is considered an effective therapy in persons with treatment-resistant depression. The use of ECT is controversial due to concerns about temporary cognitive impairment in the acute post-treatment period. We will conduct a meta-analysis to examine the effects of ECT on cognition in persons with depression. Methods This systematic review and meta-analysis has been registered with PROSPERO (registration number: CRD42014009100). We developed our methods following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. We are searching MEDLINE, PsychINFO, EMBASE, CINAHL and Cochrane from the date of database inception to the end of October 2014. We are also searching the reference lists of published reviews and evidence reports for additional citations. Comparative studies (randomised controlled trials, cohort and case–control) published in English will be included in the meta-analysis. Three clinical neuropsychologists will group the cognitive tests in each included article into a set of mutually exclusive cognitive subdomains. The risk of bias of randomised controlled trials will be assessed using the Jadad scale. We will supplement the Jadad scale with additional questions based on the Cochrane risk of bias tool. The risk of bias of cohort and case–control studies will be assessed using the Newcastle-Ottawa Scale. We will employ the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess the strength of evidence. Statistical analysis Separate meta-analyses will be conducted for each ECT treatment modality and cognitive subdomain using Comprehensive Meta-Analysis V.2.0. PMID:25762234

  2. Assessments of the quality of randomized controlled trials published in International Journal of Urology from 1994 to 2011.

    PubMed

    Cho, Hee Ju; Chung, Jae Hoon; Jo, Jung Ki; Kang, Dong Hyuk; Cho, Jeong Man; Yoo, Tag Keun; Lee, Seung Wook

    2013-12-01

    Randomized controlled trials are one of the most reliable resources for assessing the effectiveness and safety of medical treatments. Low quality randomized controlled trials carry a large bias that can ultimately impair the reliability of their conclusions. The present study aimed to evaluate the quality of randomized controlled trials published in International Journal of Urology by using multiple quality assessment tools. Randomized controlled trials articles published in International Journal of Urology were found using the PubMed MEDLINE database, and qualitative analysis was carried out with three distinct assessment tools: the Jadad scale, the van Tulder scale and the Cochrane Collaboration Risk of Bias Tool. The quality of randomized controlled trials was analyzed by publication year, type of subjects, intervention, presence of funding and whether an institutional review board reviewed the study. A total of 68 randomized controlled trial articles were published among a total of 1399 original articles in International Journal of Urology. Among these randomized controlled trials, 10 (2.70%) were from 1994 to 1999, 23 (4.10%) were from 2000 to 2005 and 35 (4.00%) were from 2006 to 2011 (P = 0.494). On the assessment with the Jadad and van Tulder scale, the numbers and percentage of high quality randomized controlled trials increased over time. The studies that had institutional review board reviews, funding resources or that were carried out in multiple institutions had an increased percentage of high quality articles. The numbers and percentage of high-quality randomized controlled trials published in International Journal of Urology have increased over time. Furthermore, randomized controlled trials with funding resources, institutional review board reviews or carried out in multiple institutions have been found to be of higher quality compared with others not presenting these features. © 2013 The Japanese Urological Association.

  3. Effects of electroconvulsive therapy on cognitive functioning in patients with depression: protocol for a systematic review and meta-analysis.

    PubMed

    Oremus, Carolina; Oremus, Mark; McNeely, Heather; Losier, Bruno; Parlar, Melissa; King, Matthew; Hasey, Gary; Fervaha, Gagan; Graham, Allyson C; Gregory, Caitlin; Hanford, Lindsay; Nazarov, Anthony; Restivo, Maria; Tatham, Erica; Truong, Wanda; Hall, Geoffrey B C; Lanius, Ruth; McKinnon, Margaret

    2015-03-11

    Depression is the leading cause of disability worldwide, affecting approximately 350 million people. Evidence indicates that only 60-70% of persons with major depressive disorder who tolerate antidepressants respond to first-line drug treatment; the remainder become treatment resistant. Electroconvulsive therapy (ECT) is considered an effective therapy in persons with treatment-resistant depression. The use of ECT is controversial due to concerns about temporary cognitive impairment in the acute post-treatment period. We will conduct a meta-analysis to examine the effects of ECT on cognition in persons with depression. This systematic review and meta-analysis has been registered with PROSPERO (registration number: CRD42014009100). We developed our methods following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. We are searching MEDLINE, PsychINFO, EMBASE, CINAHL and Cochrane from the date of database inception to the end of October 2014. We are also searching the reference lists of published reviews and evidence reports for additional citations. Comparative studies (randomised controlled trials, cohort and case-control) published in English will be included in the meta-analysis. Three clinical neuropsychologists will group the cognitive tests in each included article into a set of mutually exclusive cognitive subdomains. The risk of bias of randomised controlled trials will be assessed using the Jadad scale. We will supplement the Jadad scale with additional questions based on the Cochrane risk of bias tool. The risk of bias of cohort and case-control studies will be assessed using the Newcastle-Ottawa Scale. We will employ the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess the strength of evidence. Separate meta-analyses will be conducted for each ECT treatment modality and cognitive subdomain using Comprehensive Meta-Analysis V.2.0. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Could ginseng-based medicines be better than nitrates in treating ischemic heart disease? A systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Jia, Yongliang; Zhang, Shikai; Huang, Fangyi; Leung, Siu-wai

    2012-06-01

    Ginseng-based medicines and nitrates are commonly used in treating ischemic heart disease (IHD) angina pectoris in China. Hundreds of randomized controlled trials (RCTs) reported in Chinese language claimed that ginseng-based medicines can relieve the symptoms of IHD. This study provides the first PRISMA-compliant systematic review with sensitivity and subgroup analyses to evaluate the RCTs comparing the efficacies of ginseng-based medicines and nitrates in treating ischemic heart disease, particularly angina pectoris. Past RCTs published up to 2010 on ginseng versus nitrates in treating IHD for 14 or more days were retrieved from major English and Chinese databases, including PubMed, Science Direct, Cochrane Library, WangFang Data, and Chinese National Knowledge Infrastructure. The qualities of included RCTs were assessed with Jadad scale, a refined Jadad scale called M scale, CONSORT 2010 checklist, and Cochrane risk of bias tool. Meta-analysis was performed on the primary outcomes including the improvement of symptoms and electrocardiography (ECG). Subgroup analysis, sensitivity analysis, and meta-regression were performed to evaluate the effects of study characteristics of RCTs, including quality, follow-up periods, and efficacy definitions on the overall effect size of ginseng. Eighteen RCTs with 1549 participants were included. Overall odds ratios for comparing ginseng-based medicines with nitrates were 3.00 (95% CI: 2.27-3.96) in symptom improvement (n=18) and 1.61 (95% CI: 1.20-2.15) in ECG improvement (n=10). Subgroup analysis, sensitivity analysis, and meta-regression found no significant difference in overall effects among all study characteristics, indicating that the overall effects were stable. The meta-analysis of 18 eligible RCTs demonstrates moderate evidence that ginseng is more effective than nitrates for treating angina pectoris. However, further RCTs for higher quality, longer follow-up periods, lager sample size, multi-center/country, and are still required to verify the efficacy. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  5. CONSORT in China: past development and future direction.

    PubMed

    Song, Tian-Jiao; Leng, Hou-Fu; Zhong, Linda Ld; Wu, Tai-Xiang; Bian, Zhao-Xiang

    2015-06-01

    The Consolidated Standards of Reporting Trials (CONSORT) Statement was published in 1996, and first introduced to China in 2001. Although CONSORT has been widely accepted in high-quality international journals, we still need to have more investigation on how many Chinese journals have adopted the CONSORT Statement, and whether the quality of reporting has improved. A systematic search of the "Instructions to authors" in all Chinese medical journals in China Academic Journals (CAJ) Full-text Database was conducted up to February 2012 and only 7 journals officially listed the requirements of the CONSORT Statement. The research articles about randomized controlled trials (RCTs) published in 2002, 2004, 2006, 2008, and 2010 from journals which had specifically adopted the CONSORT Statement, and from 30 top journals based on the Chinese Science Citation Index (CSCI) 2011 as the control group, were identified. The quality of both cohorts of articles was assessed using the revised CONSORT Checklist and Jadad scale. A total of 1221 Chinese medical journals was identified. Only seven journals stated clearly in the "Instructions to authors" that authors should adopt the CONSORT requirement in the clinical trial paper. None of these journals is among the control group in the CSCI 2011. In the selected years, a total of 171 articles from 7 journals which had adopted CONSORT and 232 articles in the control were identified as including RCT trials. The average scores according to the revised CONSORT Checklist were 29.47 for the CONSORT-adopting journals and 25.57 for the control group; while the average scores based on the Jadad scale were 2.53 for CONSORT-adopting journals and 1.97 for the control group. Few journals among Chinese medical journals have adopted the CONSORT Statement. The overall quality of RCT reports in the 7 journals which have adopted CONSORT was better than those in the top 30 journals which have not adopted CONSORT. The quality of RCT reports in Chinese journals needs further improvement, and the CONSORT Statement could be a very helpful guideline.

  6. Randomized controlled trials and neuro-oncology: should alternative designs be considered?

    PubMed

    Mansouri, Alireza; Shin, Samuel; Cooper, Benjamin; Srivastava, Archita; Bhandari, Mohit; Kondziolka, Douglas

    2015-09-01

    Deficiencies in design and reporting of randomized controlled trials (RCTs) hinders interpretability and critical appraisal. The reporting quality of recent RCTs in neuro-oncology was analyzed to assess adequacy of design and reporting. The MEDLINE and EMBASE databases were searched to identify non-surgical RCTs (years 2005-2014, inclusive). The CONSORT and Jadad scales were used to assess the quality of design/reporting. Studies published in 2005-2010 were compared as a cohort against studies published in 2011-2014, in terms of general characteristics and reporting quality. A PRECIS-based scale was used to designate studies on the pragmatic-explanatory continuum. Spearman's test was used to assess correlations. Regression analysis was used to assess associations. Overall 68 RCTs were identified. Studies were often chemotherapy-based (n = 41 studies) focusing upon high grade gliomas (46 %) and metastases (41 %) as the top pathologies. Multi-center trials (71 %) were frequent. The overall median CONSORT and Jadad scores were 34.5 (maximum 44) and 2 (maximum 5), respectively; these scores were similar in radiation and chemotherapy-based trials. Major areas of deficiency pertained to allocation concealment, implementation of methods, and blinding whereby less than 20 % of articles fulfilled all criteria. Description of intervention, random sequence generation, and the details regarding recruitment were also deficient; less than 50 % of studies fulfilled all criteria. Description of sample size calculations and blinding improved in later published cohorts. Journal impact factor was significantly associated with higher quality (p = 0.04). Large academic consortia, multi-center designs, ITT analysis, collaboration with biostatisticians, larger sample sizes, and studies with pragmatic objectives were more likely to achieve positive primary outcomes on univariate analysis; none of these variables were significant on multivariate analysis. Deficiencies in the quality of design/reporting of RCTs in neuro-oncology persist. Quality improvement is necessary. Consideration of alternative strategies should be considered.

  7. Current status of evidence-based sports medicine.

    PubMed

    Harris, Joshua D; Cvetanovich, Gregory; Erickson, Brandon J; Abrams, Geoffrey D; Chahal, Jaskarndip; Gupta, Anil K; McCormick, Frank M; Bach, Bernard R

    2014-03-01

    The purpose of this investigation is to determine the proportion of sports medicine studies that are labeled as Level I Evidence in 5 journals and compare the quality of surgical and nonsurgical studies using simple quality assessment tools (Consolidated Standards of Reporting Trials [CONSORT] and Jadad). By use of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines over the prior 2 years in the top 5 (citation and impact factor based) sports medicine journals, only Level I Evidence studies were eligible for inclusion and were analyzed. All study types (therapeutic, prognostic, diagnostic, and economic) were analyzed. Study quality was assessed with the level of evidence, Jadad score, and CONSORT 2010 guidelines. Study demographic data were compared among journals and between surgical and nonsurgical studies by use of χ(2), 1-way analysis of variance, and 2-sample Z tests. We analyzed 190 Level I Evidence studies (10% of eligible studies) (119 randomized controlled trials [RCTs]). Therapeutic, nonsurgical, single-center studies from the United States were the most common studies published. Sixty-two percent of studies reported a financial conflict of interest. The knee was the most common body part studied, and track-and-field/endurance sports were the most common sports analyzed. Significant differences (P < .05) were shown in Jadad and CONSORT scores among the journals reviewed. Overall, the Jadad and CONSORT scores were 2.71 and 77%, respectively. No differences (P > .05) were shown among journals based on the proportion of Level I studies or appropriate randomization. Significant strengths and limitations of RCTs were identified. This study showed that Level I Evidence and RCTs comprise 10% and 6% of contemporary sports medicine literature, respectively. Therapeutic, nonsurgical, single-center studies are the most common publications with Level I Evidence. Significant differences across sports medicine journals were found in study quality. Surgical studies appropriately described randomization, blinding, and patient enrollment significantly more than nonsurgical studies. Level I, systematic review of Level I studies. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  8. Effects of Exercise on Select Biomarkers and Associated Outcomes in Chronic Pain Conditions: Systematic Review.

    PubMed

    Kawi, Jennifer; Lukkahatai, Nada; Inouye, Jillian; Thomason, Diane; Connelly, Kirsten

    2016-03-01

    Chronic pain is highly prevalent. Current management is challenged by lack of validated objective measures like biological markers. Clinical pain studies employing exercise interventions have evaluated biomarkers; however, it is unclear how exercise impacts biomarkers involved in pain pathways and whether these markers are associated with relevant pain-related outcomes. This systematic review evaluates data from clinical studies employing exercise interventions in chronic musculoskeletal nonmalignant pain conditions in which biomarkers in pain pathways were measured. Published research studies from several databases were examined using the Jadad Scale for assessing the quality of clinical studies. Twelve research studies were reviewed. Jadad scores ranged from 5 to 11 out of 13 points. Inflammatory markers were most commonly measured followed by neurotransmitter-related genes and metabolite-detecting genes. After exercise interventions, changes in biomarkers involved in neurotransmission and inflammation suggest a hypoalgesic exercise effect. Significant biomarker associations were found with pain intensity, fatigue, depression, anxiety, and quality of life. However, there were varying methodologies in the studies reviewed. It remains a question whether biomarkers can be used as objective measures for risk assessment, diagnosis, or evaluation or as surrogate endpoints in chronic pain. Adequate sample sizes, optimal exercise dose determination, study replications, and longitudinal research studies with consistent methodologies are warranted. Regardless, the potential translational value of biomarkers in chronic pain is evident. Advancing nursing research in biomarkers is vital for moving the nursing discipline and clinical chronic pain practice forward. Developing a biobehavioral perspective in chronic pain is also necessary for comprehensive management. © The Author(s) 2015.

  9. The use of ginger (Zingiber officinale) for the treatment of pain: a systematic review of clinical trials.

    PubMed

    Terry, Rohini; Posadzki, Paul; Watson, Leala K; Ernst, Edzard

    2011-12-01

      Zingiber officinale (Z. officinale), commonly known as ginger, has been widely used traditionally for a variety of medicinal purposes, one of which is for the treatment of pain. The aim of this systematic review was to evaluate the evidence from all human participant clinical trials that have assessed the efficacy of ginger for the treatment of any type of pain.   Following a protocol, multiple databases were sought using comprehensive search strategies for Z. officinale and pain together with a trial filter for randomized or controlled clinical trials. Trials testing the efficacy of Z. officinale, used as a sole oral treatment against a comparison condition in human adults suffering from any pain condition, were included.   Seven published articles, reporting a total of eight trials (481 participants), were included in the review. Six trials (two for osteoarthritis, one for dysmenorrhea, and three for experimentally induced acute muscle pain) found that the use of Z. officinale reduced subjective pain reports. The methodological quality of the included articles was variable. When assessed using the Jadad scale, which allows a score of between 0 and 5 to be given, included articles obtained Jadad ratings ranging from 2 to 5.   Due to a paucity of well-conducted trials, evidence of the efficacy of Z. officinale to treat pain remains insufficient. However, the available data provide tentative support for the anti-inflammatory role of Z. officinale constituents, which may reduce the subjective experience of pain in some conditions such as osteoarthritis. Further rigorous trials therefore seem to be warranted. Wiley Periodicals, Inc.

  10. Effectiveness of empowerment-based self-management interventions on patients with chronic metabolic diseases: a systematic review and meta-analysis.

    PubMed

    Kuo, Chia-Chi; Lin, Chiu-Chu; Tsai, Fu-Mian

    2014-10-01

    Management of chronic metabolic diseases has recently become an important global health issue. Extensive research on empowerment-based self-management interventions (EBSMIs) for patients with chronic metabolic diseases has been conducted, but no systematic review has evaluated their effects. To evaluate the effects of EBSMIs on patients with chronic metabolic diseases. A systematic review and meta-analysis was conducted. Five electronic databases (Airiti Library, CINAHL, Cochrane Library, PubMed/ MEDLINE, and Index of Taiwan Periodical Literature System) were searched from the earliest year available to October 2012. Controlled trials about the effectiveness of interventions on patients with chronic metabolic diseases were included. Each study was appraised by three reviewers and assigned a level of evidence based on the modified Jadad scale. Extracted data were entered and analyzed using Review Manager 5.2. Nineteen studies were reviewed. Most studies showed that EBSMIs improved patients' hemoglobin A1c test (HbA1c) (p < .00001), waist circumference (p = .02), and empowerment level (p = .004). Four studies compared the effect on body weight and body mass index, but the overall effect was not significant (p = .33 and .73, respectively). Five studies compared the effect on self-efficacy, four of which indicated significant increase. However, the overall effect on self-efficacy was not compared because studies used different scales. EBSMIs improved HbA1c test results, waist circumference, self-efficacy, and empowerment level in patients with chronic metabolic diseases. When implementing the EBSMIs, healthcare institutions need to provide training programs related to empowerment from which health professionals can acquire competence in patient empowerment. Moreover, healthcare leaders should assess and overcome barriers (e.g., time, manpower, cost, etc.) to implementing EBSMIs in clinical settings. © 2014 Sigma Theta Tau International.

  11. A systematic review of physical therapy interventions for patients with anorexia and bulemia nervosa.

    PubMed

    Vancampfort, Davy; Vanderlinden, Johan; De Hert, Marc; Soundy, Andrew; Adámkova, Milena; Skjaerven, Liv Helvik; Catalán-Matamoros, Daniel; Lundvik Gyllensten, Amanda; Gómez-Conesa, Antonia; Probst, Michel

    2014-01-01

    The purpose of this systematic review was to summarise the evidence from randomised controlled trials examining the effectiveness of physical therapy compared with care as usual or a wait-list condition on eating pathology and on physiological and psychological parameters in patients with anorexia and bulimia nervosa. EMBASE, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and The Cochrane Library were searched from their inception until February, 2013. Articles were eligible if they utilised a randomised controlled trial design, compared physical therapy with a placebo condition, control intervention, or standard care and included patients with anorexia and bulimia nervosa. The methodological quality was assessed with the Jadad scale. Eight randomised controlled trials involving 213 patients (age range: 16-36 years) met all selection criteria. Three of the 8 included studies were of strong methodological quality (Jadad score≥3). Major methodological weaknesses were attrition and selection bias. The main results demonstrate that aerobic and resistance training result in significantly increased muscle strength, body mass index and body fat percentage in anorexia patients. In addition, aerobic exercise, yoga, massage and basic body awareness therapy significantly lowered scores of eating pathology and depressive symptoms in both anorexia and bulimia nervosa patients. No adverse effects were reported. The paucity and heterogeneity of available studies limits overall conclusions and highlights the need for further research. Implications for Rehabilitation Supervised physical therapy might increase weight in anorexia nervosa patients. Aerobic exercise, massage, basic body awareness therapy and yoga might reduce eating pathology in patients with anorexia and bulimia nervosa. Aerobic exercise, yoga and basic body awareness therapy might improve mental and physical quality of life in patients with an eating disorder.

  12. Spinal cord stimulation for chronic pain.

    PubMed

    Mailis-Gagnon, A; Furlan, A D; Sandoval, J A; Taylor, R

    2004-01-01

    Spinal cord stimulation (SCS) is a form of therapy used to treat certain types of chronic pain. It involves an electrical generator that delivers pulses to a targeted spinal cord area. The leads can be implanted by laminectomy or percutaneously and the source of power is supplied by an implanted battery or by an external radio-frequency transmitter. The exact mechanism of action of SCS is poorly understood. To assess the efficacy and effectiveness of spinal cord stimulation in relieving certain kinds of pain, as well as the complications and adverse effects of this procedure. We searched MEDLINE and EMBASE to September 2003; the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 3, 2003); textbooks and reference lists in retrieved articles. We also contacted experts in the field of pain and the main manufacturer of the stimulators. We included trials with a control group, either randomized controlled trials (RCTs) or non-randomized controlled clinical trials (CCTs), that assessed spinal cord stimulation for chronic pain. Two independent reviewers selected the studies, assessed study quality and extracted the data. One of the assessors of methodological quality was blinded to authors, dates and journals. The data were analysed using qualitative methods (best evidence synthesis). Two RCTs (81 patients in total) met our inclusion criteria. One was judged as being of high quality (score of 3 on Jadad scale) and the other of low quality (score of 1 on Jadad scale). One trial included patients with Complex Regional Pain Syndrome Type I (reflex sympathetic dystrophy) and the other patients with Failed Back Surgery Syndrome. The follow-up periods varied from 6 to 12 months. Both studies reported that SCS was effective, however, meta-analysis was not undertaken because of the small number of patients and the heterogeneity of the study population. Although there is limited evidence in favour of SCS for Failed Back Surgery Syndrome and Complex Regional Pain Syndrome Type I, more trials are needed to confirm whether SCS is an effective treatment for certain types of chronic pain. In addition, there needs to be a debate about trial designs that will provide the best evidence for assessing this type of intervention.

  13. Standards for reporting randomized controlled trials in medical informatics: a systematic review of CONSORT adherence in RCTs on clinical decision support

    PubMed Central

    Berntsen, G; Lassen, K; Bellika, J G; Wootton, R; Lindsetmo, R O

    2011-01-01

    Introduction The Consolidated Standards for Reporting Trials (CONSORT) were published to standardize reporting and improve the quality of clinical trials. The objective of this study is to assess CONSORT adherence in randomized clinical trials (RCT) of disease specific clinical decision support (CDS). Methods A systematic search was conducted of the Medline, EMBASE, and Cochrane databases. RCTs on CDS were assessed against CONSORT guidelines and the Jadad score. Result 32 of 3784 papers identified in the primary search were included in the final review. 181 702 patients and 7315 physicians participated in the selected trials. Most trials were performed in primary care (22), including 897 general practitioner offices. RCTs assessing CDS for asthma (4), diabetes (4), and hyperlipidemia (3) were the most common. Thirteen CDS systems (40%) were implemented in electronic medical records, and 14 (43%) provided automatic alerts. CONSORT and Jadad scores were generally low; the mean CONSORT score was 30.75 (95% CI 27.0 to 34.5), median score 32, range 21–38. Fourteen trials (43%) did not clearly define the study objective, and 11 studies (34%) did not include a sample size calculation. Outcome measures were adequately identified and defined in 23 (71%) trials; adverse events or side effects were not reported in 20 trials (62%). Thirteen trials (40%) were of superior quality according to the Jadad score (≥3 points). Six trials (18%) reported on long-term implementation of CDS. Conclusion The overall quality of reporting RCTs was low. There is a need to develop standards for reporting RCTs in medical informatics. PMID:21803926

  14. The relationship between external and internal validity of randomized controlled trials: A sample of hypertension trials from China.

    PubMed

    Zhang, Xin; Wu, Yuxia; Ren, Pengwei; Liu, Xueting; Kang, Deying

    2015-10-30

    To explore the relationship between the external validity and the internal validity of hypertension RCTs conducted in China. Comprehensive literature searches were performed in Medline, Embase, Cochrane Central Register of Controlled Trials (CCTR), CBMdisc (Chinese biomedical literature database), CNKI (China National Knowledge Infrastructure/China Academic Journals Full-text Database) and VIP (Chinese scientific journals database) as well as advanced search strategies were used to locate hypertension RCTs. The risk of bias in RCTs was assessed by a modified scale, Jadad scale respectively, and then studies with 3 or more grading scores were included for the purpose of evaluating of external validity. A data extract form including 4 domains and 25 items was used to explore relationship of the external validity and the internal validity. Statistic analyses were performed by using SPSS software, version 21.0 (SPSS, Chicago, IL). 226 hypertension RCTs were included for final analysis. RCTs conducted in university affiliated hospitals (P < 0.001) or secondary/tertiary hospitals (P < 0.001) were scored at higher internal validity. Multi-center studies (median = 4.0, IQR = 2.0) were scored higher internal validity score than single-center studies (median = 3.0, IQR = 1.0) (P < 0.001). Funding-supported trials had better methodological quality (P < 0.001). In addition, the reporting of inclusion criteria also leads to better internal validity (P = 0.004). Multivariate regression indicated sample size, industry-funding, quality of life (QOL) taken as measure and the university affiliated hospital as trial setting had statistical significance (P < 0.001, P < 0.001, P = 0.001, P = 0.006 respectively). Several components relate to the external validity of RCTs do associate with the internal validity, that do not stand in an easy relationship to each other. Regarding the poor reporting, other possible links between two variables need to trace in the future methodological researches.

  15. A systematic review of the effect of daily panty liner use on the vulvovaginal environment.

    PubMed

    Pontes, Ana C; Amaral, Rose L G; Giraldo, Paulo C; Beghini, Joziani; Giraldo, Helena P D; Cordeiro, Etienne S

    2014-10-01

    Whether panty liners predispose to vulvovaginitis is unclear. To clarify the effects of the use of panty liners on the female genital tract. Several electronic databases (including PubMed and Embase) were searched to identify studies published in English before May 3, 2012. Case-control studies, randomized controlled trials, and cohort studies comparing young women who did and did not use panty liners in the intermenstrual period were included. The quality of the studies was assessed using the Newcastle-Ottawa Scale or the Jadad Scale. Data from suitable studies were extracted for analysis. Five articles met the inclusion criteria. Four studies-all of which included only healthy women-found no significant clinical implications arising from the use of panty liners. The fifth study was of women with recurrent candidiasis and showed that use of panty liners was associated with new candidiasis episodes. The intermenstrual use of panty liners does not seem to have a negative effect on the vulvovaginal area. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Efficacy and safety of bisphosphonates in management of low bone density in inflammatory bowel disease

    PubMed Central

    Yao, Liwei; Wang, Haiqing; Dong, Wenwei; Liu, Zhenxin; Mao, Haijiao

    2017-01-01

    Abstract This study aims to determine whether bisphosphonates are safe, as well as effective against bone mineral loss in inflammatory bowel disease (IBD). A computerized search of electronic databases from 1966 to 2016 was performed. Randomized controlled trials (RCTs) were included in this review to evaluate the role of bisphosphonates in the management of osteoporosis in IBD patients. A revised 7-point Jadad scale was used to evaluate the quality of each study. Overall, 13 RCTs and 923 patients met the inclusion criteria of this meta-analysis. The result showed that bisphosphonates decreased bone mass density (BMD) loss at the lumbar spine (P = 0.0002), reduced the risk of new fractures (P = 0.01), and retained the similar adverse events (P = 0.86). Bisphosphonates may provide protection and safety against bone mineral loss in IBD patients. PMID:28099343

  17. Efficacy and safety of bisphosphonates in management of low bone density in inflammatory bowel disease: A meta-analysis.

    PubMed

    Yao, Liwei; Wang, Haiqing; Dong, Wenwei; Liu, Zhenxin; Mao, Haijiao

    2017-01-01

    This study aims to determine whether bisphosphonates are safe, as well as effective against bone mineral loss in inflammatory bowel disease (IBD). A computerized search of electronic databases from 1966 to 2016 was performed. Randomized controlled trials (RCTs) were included in this review to evaluate the role of bisphosphonates in the management of osteoporosis in IBD patients. A revised 7-point Jadad scale was used to evaluate the quality of each study. Overall, 13 RCTs and 923 patients met the inclusion criteria of this meta-analysis. The result showed that bisphosphonates decreased bone mass density (BMD) loss at the lumbar spine (P = 0.0002), reduced the risk of new fractures (P = 0.01), and retained the similar adverse events (P = 0.86). Bisphosphonates may provide protection and safety against bone mineral loss in IBD patients.

  18. Systematic review of peer education intervention programmes among individuals with type 2 diabetes.

    PubMed

    Gatlin, Tricia K; Serafica, Reimund; Johnson, Michael

    2017-12-01

    To systematically review published randomised controlled trials of peer education interventions among adults with type 2 diabetes. Systematic reviews have shown mixed results for peer support interventions to improve diabetes self-management. Given the effectiveness of diabetes education by healthcare professionals, peer education interventions may be a useful alternative approach. This review addressed that gap. Systematic review. A systematic search of published randomised controlled trials between 2006-2016 was conducted using the keywords diabetes, type 2 diabetes, randomised controlled trials, self-management, peer education and peer support. The methodological quality of each study was assessed using the Jadad scale. Seven studies were included in the final review, and the Jadad scores ranged from 8-10 of a possible 13 points. There was no consistent design, setting, or outcome measurement among the studies. There were two types of peer education interventions compared to traditional diabetes education: face-to-face or a combination of face-to-face and telephone/texting. The most common clinical outcome measure was HbA1c. Two of six studies showed statistically significant improvement in HbA1c between intervention and control groups. An increase in diabetes knowledge was also statistically significant in two of five studies. Peer education could be successful in improving clinical outcomes. No evidence was found indicating that healthcare provider education was superior in regard to clinical knowledge or behavioural or psychological outcome measures than peer education. HbA1c was statistically significantly lower in some peer education groups compared to control groups. There is evidence that peer education can be useful in achieving positive clinical outcomes such as decreasing HbA1c levels and increasing diabetes knowledge. A certified diabetes educator or a trained healthcare professional should not be overlooked though when using peer educators. © 2017 John Wiley & Sons Ltd.

  19. The reporting quality of randomized controlled trials in orthodontics.

    PubMed

    Lempesi, Evangelia; Koletsi, Despina; Fleming, Padhraig S; Pandis, Nikolaos

    2014-06-01

    Accurate trial reporting facilitates evaluation and better use of study results. The objective of this article is to investigate the quality of reporting of randomized controlled trials (RCTs) in leading orthodontic journals, and to explore potential predictors of improved reporting. The 50 most recent issues of 4 leading orthodontic journals until November 2013 were electronically searched. Reporting quality assessment was conducted using the modified CONSORT statement checklist. The relationship between potential predictors and the modified CONSORT score was assessed using linear regression modeling. 128 RCTs were identified with a mean modified CONSORT score of 68.97% (SD = 11.09). The Journal of Orthodontics (JO) ranked first in terms of completeness of reporting (modified CONSORT score 76.21%, SD = 10.1), followed by American Journal of Orthodontics and Dentofacial Orthopedics (AJODO) (73.05%, SD = 10.1). Journal of publication (AJODO: β = 10.08, 95% CI: 5.78, 14.38; JO: β = 16.82, 95% CI: 11.70, 21.94; EJO: β = 7.21, 95% CI: 2.69, 11.72 compared to Angle), year of publication (β = 0.98, 95% CI: 0.28, 1.67 for each additional year), region of authorship (Europe: β = 5.19, 95% CI: 1.30, 9.09 compared to Asia/other), statistical significance (significant: β = 3.10, 95% CI: 0.11, 6.10 compared to non-significant) and methodologist involvement (involvement: β = 5.60, 95% CI: 1.66, 9.54 compared to non-involvement) were all significant predictors of improved modified CONSORT scores in the multivariable model. Additionally, median overall Jadad score was 2 (IQR = 2) across journals, with JO (median = 3, IQR = 1) and AJODO (median = 3, IQR = 2) presenting the highest score values. The reporting quality of RCTs published in leading orthodontic journals is considered suboptimal in various CONSORT areas. This may have a bearing in trial result interpretation and use in clinical decision making and evidence- based orthodontic treatment interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Effect of psycho-educational interventions on quality of life in patients with implantable cardioverter defibrillators: a meta-analysis of randomized controlled trials.

    PubMed

    Kao, Chi-Wen; Chen, Miao-Yi; Chen, Ting-Yu; Lin, Pai-Hui

    2016-09-30

    Implantable cardioverter defibrillators (ICD) were developed for primary and secondary prevention of sudden cardiac death. However, ICD recipients' mortality is significantly predicted by their quality of life (QOL). The aim of this meta-analysis was to evaluate the effects of psycho-educational interventions on QOL in patients with ICDs. We systematically searched PubMed, Medline, Cochrane Library, and CINAHL through April 2015 and references of relevant articles. Studies were reviewed if they met following criteria: (1) randomized controlled trial, (2) participants were adults with an ICD, and (3) data were sufficient to evaluate the effect of psychological or educational interventions on QOL measured by the SF-36 or SF-12. Studies were independently selected and their data were extracted by two reviewers. Study quality was evaluated using a modified Jadad scale. The meta-analysis was conducted using the Cochrane Collaboration's Review Manager Software Package (RevMan 5). Study heterogeneity was assessed by Q statistics and I 2 statistic. Depending on heterogeneity, data were pooled across trials using fixed-effect or random-effect modeling. Seven randomized controlled trials fulfilled the inclusion and exclusion criteria, and included 1017 participants. The psycho-educational interventions improved physical component summary (PCS) scores in the intervention groups more than in control groups (mean difference 2.08, 95 % CI 0.86 to 3.29, p < 0.001), but did not significantly affect mental component summary (MCS) scores (mean difference 0.84, 95 % CI -1.68 to 3.35, p = 0.52). Our meta-analysis demonstrates that psycho-educational interventions improved the physical component, but not the mental component of QOL in patients with ICDs.

  1. Is lavender an anxiolytic drug? A systematic review of randomised clinical trials.

    PubMed

    Perry, R; Terry, R; Watson, L K; Ernst, E

    2012-06-15

    Lavender (Lavandula angustifolia) is often recommended for stress/anxiety relief and believed to possess anxiolytic effects. To critically evaluate the efficacy/effectiveness of lavender for the reduction of stress/anxiety. Seven electronic databases were searched to identify all relevant studies. All methods of lavender administration were included. Data extraction and the assessment of the methodological quality of all included trials were conducted by two independent reviewers. Fifteen RCTs met the inclusion criteria. Two trials scored 4 points on the 5-point Jadad scale, the remaining 13 scored two or less. Results from seven trials appeared to favour lavender over controls for at least one relevant outcome. Methodological issues limit the extent to which any conclusions can be drawn regarding the efficacy/effectiveness of lavender. The best evidence suggests that oral lavender supplements may have some therapeutic effects. However, further independent replications are needed before firm conclusions can be drawn. Copyright © 2012 Elsevier GmbH. All rights reserved.

  2. Effect of Fruit Juice on Glucose Control and Insulin Sensitivity in Adults: A Meta-Analysis of 12 Randomized Controlled Trials

    PubMed Central

    Mi, Mantian; Wang, Jian

    2014-01-01

    Background Diabetes mellitus has become a worldwide health problem. Whether fruit juice is beneficial in glycemic control is still inconclusive. This study aimed to synthesize evidence from randomized controlled trials on fruit juice in relationship to glucose control and insulin sensitivity. Methods A strategic literature search of PubMed, EMBASE, and the Cochrane Library (updated to March, 2014) was performed to retrieve the randomized controlled trials that evaluated the effects of fruit juice on glucose control and insulin sensitivity. Study quality was assessed using the Jadad scale. Weighted mean differences were calculated for net changes in the levels of fasting glucose, fasting insulin, hemoglobin A1c (HbA1c), and homeostatic model assessment of insulin resistance (HOMA-IR) using fixed- or random-effects model. Prespecified subgroup and sensitivity analyses were performed to explore the potential heterogeneity. Results Twelve trials comprising a total of 412 subjects were included in the current meta-analysis. The numbers of these studies that reported the data on fasting glucose, fasting insulin, HbA1c and HOMA-IR were 12, 5, 3 and 3, respectively. Fruit juice consumption did not show a significant effect on fasting glucose and insulin concentrations. The net change was 0.79 mg/dL (95% CI: −1.44, 3.02 mg/dL; P = 0.49) for fasting glucose concentrations and −0.74 µIU/ml (95% CI: −2.62, 1.14 µIU/ml; P = 0.44) for fasting insulin concentrations in the fixed-effects model. Subgroup analyses further suggested that the effect of fruit juice on fasting glucose concentrations was not influenced by population region, baseline glucose concentration, duration, type of fruit juice, glycemic index of fruit juice, fruit juice nutrient constitution, total polyphenols dose and Jadad score. Conclusion This meta-analysis showed that fruit juice may have no overall effect on fasting glucose and insulin concentrations. More RCTs are warranted to further clarify the association between fruit juice and glycemic control. PMID:24743260

  3. Photodynamic therapy for chronic periodontitis.

    PubMed

    Herrera, David

    2011-01-01

    Medline, Embase, The Cochrane Oral Health Group's Trials Register, CENTRAL, UK National Research Register, ISI Proceedings, hand search of relevant journals for 2000-2008. References from selected articles and contact with authors. Randomised controlled trials in any language comparing scaling and root planing (SRP) alone and SRP with PDT in patients with chronic periodontitis, with a mean follow up of at least 12 weeks. The primary outcome measure was the change in clinical attachment loss (CAL). Secondary outcomes were changes in probing depth (PD) and gingival recession (GR). Data were extracted by a single reviewer using a standard extraction form. Quality was assessed using both the Jadad scale and the allocation concealment component of the Cochrane risk of bias tool. Meta-analysis was conducted using the random effects model. Heterogeneity was assessed using the chi-squared-based Q statistic method and Higgins' I(2) test. Four trials with 101 participants were included. The risk of bias of these trials was considered to be moderate. The mean difference in CAL at 12 weeks was 0.29 mm (95% CI 0.08-0.50, p=0.007). Heterogeneity was high using both the Chi(2) and I(2) tests. The review suggests there may be a minor improvement in clinical attachment loss at 12 weeks. It is unclear whether this is a clinically meaningful improvement.

  4. Operative versus nonoperative treatment for acute Achilles tendon rupture: a meta-analysis based on current evidence.

    PubMed

    Jiang, Nan; Wang, Bowei; Chen, Anfu; Dong, Fu; Yu, Bin

    2012-04-01

    The aim of this study was to evaluate, in a meta-analysis, the clinical effectiveness of operative treatment for acute Achilles tendon rupture (AATR) compared with nonoperative treatment. We systematically searched six electronic databases (Medline, Embase, Clinical Ovid, BIOSIS and Cochrane registry of controlled clinical trials) to identify randomised controlled trials (RCTs) in which operative treatment was compared with nonoperative treatment for AATR from 1980 to 2011. Trial quality was assessed using the modified Jadad scale. The data was using fixed-effects and random-effects models with mean differences and risk ratios for continuous and dichotomous variables, respectively. Ten RCTs with a total of 894 patients were screened. The results showed that operative was superior to nonoperative treatment regarding lower risk of re-rupture (P = 0.002) and shorter time for sick leave (P = 0.009) but inferior to nonoperative treatment regarding complication risks (P = 0.004). No significant difference was identified between the two methods regarding the number of patients who successfully returned to pre-injury sports (P = 0.30). Subgroup analyses revealed significant differences in relation to scar adhesion (P < 0.00001), superficial infection (P = 0.05), and sensibility disturbance (P = 0.0003). However, no significant differences were found between the two interventions in relation to deep infection (P = 0.22), deep vein thrombosis (DVT) (P = 0.14), and extreme Achilles tendon lengthening (P = 0.31). Little consensus was obtained in the functional recovery from current trials as a result of an inconsistent assessment system. Compared with conservative treatment, operative treatment can effectively reduce the risk of re-rupture but increase the probability of complications. The increased complication risk may be associated with open repair surgery. However, no sufficient evidence is available from current studies to support the belief that operation may lead to better functional recovery.

  5. Is reflexology an effective intervention? A systematic review of randomised controlled trials.

    PubMed

    Ernst, Edzard

    2009-09-07

    To evaluate the evidence for and against the effectiveness of reflexology for treating any medical condition. Six electronic databases were searched from their inception to February 2009 to identify all relevant randomised controlled trials (RCTs). No language restrictions were applied. RCTs of reflexology delivered by trained reflexologists to patients with specific medical conditions. Condition studied, study design and controls, primary outcome measures, follow-up, and main results were extracted. 18 RCTs met all the inclusion criteria. The studies examined a range of conditions: anovulation, asthma, back pain, dementia, diabetes, cancer, foot oedema in pregnancy, headache, irritable bowel syndrome, menopause, multiple sclerosis, the postoperative state and premenstrual syndrome. There were > 1 studies for asthma, the postoperative state, cancer palliation and multiple sclerosis. Five RCTs yielded positive results. Methodological quality was evaluated using the Jadad scale. The methodological quality was often poor, and sample sizes were generally low. Most higher-quality trials did not generate positive findings. The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition.

  6. Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials.

    PubMed

    Bellemare, Steven; Hartling, Lisa; Wiebe, Natasha; Russell, Kelly; Craig, William R; McConnell, Don; Klassen, Terry P

    2004-04-15

    Despite treatment recommendations from various organizations, oral rehydration therapy (ORT) continues to be underused, particularly by physicians in high-income countries. We conducted a systematic review of randomised controlled trials (RCTs) to compare ORT and intravenous therapy (IVT) for the treatment of dehydration secondary to acute gastroenteritis in children. RCTs were identified through MEDLINE, EMBASE, CENTRAL, authors and references of included trials, pharmaceutical companies, and relevant organizations. Screening and inclusion were performed independently by two reviewers in order to identify randomised or quasi-randomised controlled trials comparing ORT and IVT in children with acute diarrhea and dehydration. Two reviewers independently assessed study quality using the Jadad scale and allocation concealment. Data were extracted by one reviewer and checked by a second. The primary outcome measure was failure of rehydration. We analyzed data using standard meta-analytic techniques. The quality of the 14 included trials ranged from 0 to 3 (Jadad score); allocation concealment was unclear in all but one study. Using a random effects model, there was no significant difference in treatment failures (risk difference [RD] 3%; 95% confidence intervals [CI]: 0, 6). The Mantel-Haenzsel fixed effects model gave a significant difference between treatment groups (RD 4%; 95% CI: 2, 5) favoring IVT. Based on the four studies that reported deaths, there were six in the IVT groups and two in ORT. There were no significant differences in total fluid intake at six and 24 hours, weight gain, duration of diarrhea, or hypo/hypernatremia. Length of stay was significantly shorter for the ORT group (weighted mean difference [WMD] -1.2 days; 95% CI: -2.4,-0.02). Phlebitis occurred significantly more often with IVT (number needed to treat [NNT] 33; 95% CI: 25,100); paralytic ileus occurred more often with ORT (NNT 33; 95% CI: 20,100). These results may not be generalizable to children with persistent vomiting. There were no clinically important differences between ORT and IVT in terms of efficacy and safety. For every 25 children (95% CI: 20, 50) treated with ORT, one would fail and require IVT. The results support existing practice guidelines recommending ORT as the first course of treatment in appropriate children with dehydration secondary to gastroenteritis.

  7. Acupuncture for neck disorders.

    PubMed

    Trinh, K V; Graham, N; Gross, A R; Goldsmith, C H; Wang, E; Cameron, I D; Kay, T

    2006-07-19

    Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are the perceptions of benefits. Acupuncture has been used as an alternative to more traditional treatments for musculoskeletal pain. This review summarizes the most current scientific evidence on the effectiveness of acupuncture for acute, subacute and chronic neck pain. To determine the effects of acupuncture for individuals with neck pain. We searched CENTRAL (2006, issue 1) and MEDLINE, EMBASE, MANTIS, CINAHL from their beginning to February 2006. We searched reference lists and the acupuncture database TCMLARS in China. Any published trial using randomized (RCT) or quasi-randomized (quasi-RCT) assignment to the intervention groups, either in full text or abstract form, were included. Two reviewers made independent decisions for each step of the review: article inclusion, data abstraction and assessment of trial methodological quality. Study quality was assessed using the Jadad criteria. Consensus was used to resolve disagreements. When clinical heterogeneity was absent, we combined studies using random-effects meta-analysis models. We did not find any trials that examined the effects of acupuncture for acute or subacute pain, but we found 10 trials that examined acupuncture treatments for chronic neck pain. Overall, methodological quality had a mean of 2.3/5 on the Jadad Scale. For chronic mechanical neck disorders, there was moderate evidence that acupuncture was more effective for pain relief than some types of sham controls, measured immediately post-treatment. There was moderate evidence that acupuncture was more effective than inactive, sham treatments measured immediately post-treatment and at short-term follow-up (pooled standardized mean difference (SMD) -0.37, 95% confidence interval (CI) -0.61 to -0.12). There was limited evidence that acupuncture was more effective than massage at short-term follow-up. For chronic neck disorders with radicular symptoms, there was moderate evidence that acupuncture was more effective than a wait-list control at short-term follow-up. There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment. There is moderate evidence that those who received acupuncture reported less pain at short term follow-up than those on a waiting list. There is also moderate evidence that acupuncture is more effective than inactive treatments for relieving pain post-treatment and this is maintained at short-term follow-up.

  8. Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials

    PubMed Central

    Bellemare, Steven; Hartling, Lisa; Wiebe, Natasha; Russell, Kelly; Craig, William R; McConnell, Don; Klassen, Terry P

    2004-01-01

    Background Despite treatment recommendations from various organizations, oral rehydration therapy (ORT) continues to be underused, particularly by physicians in high-income countries. We conducted a systematic review of randomised controlled trials (RCTs) to compare ORT and intravenous therapy (IVT) for the treatment of dehydration secondary to acute gastroenteritis in children. Methods RCTs were identified through MEDLINE, EMBASE, CENTRAL, authors and references of included trials, pharmaceutical companies, and relevant organizations. Screening and inclusion were performed independently by two reviewers in order to identify randomised or quasi-randomised controlled trials comparing ORT and IVT in children with acute diarrhea and dehydration. Two reviewers independently assessed study quality using the Jadad scale and allocation concealment. Data were extracted by one reviewer and checked by a second. The primary outcome measure was failure of rehydration. We analyzed data using standard meta-analytic techniques. Results The quality of the 14 included trials ranged from 0 to 3 (Jadad score); allocation concealment was unclear in all but one study. Using a random effects model, there was no significant difference in treatment failures (risk difference [RD] 3%; 95% confidence intervals [CI]: 0, 6). The Mantel-Haenzsel fixed effects model gave a significant difference between treatment groups (RD 4%; 95% CI: 2, 5) favoring IVT. Based on the four studies that reported deaths, there were six in the IVT groups and two in ORT. There were no significant differences in total fluid intake at six and 24 hours, weight gain, duration of diarrhea, or hypo/hypernatremia. Length of stay was significantly shorter for the ORT group (weighted mean difference [WMD] -1.2 days; 95% CI: -2.4,-0.02). Phlebitis occurred significantly more often with IVT (number needed to treat [NNT] 33; 95% CI: 25,100); paralytic ileus occurred more often with ORT (NNT 33; 95% CI: 20,100). These results may not be generalizable to children with persistent vomiting. Conclusion There were no clinically important differences between ORT and IVT in terms of efficacy and safety. For every 25 children (95% CI: 20, 50) treated with ORT, one would fail and require IVT. The results support existing practice guidelines recommending ORT as the first course of treatment in appropriate children with dehydration secondary to gastroenteritis. PMID:15086953

  9. Surrogate outcomes are associated with low methodological quality of studies of rheumatoid arthritis treated with antitumour necrosis factor agents: a systematic review.

    PubMed

    Nobre, Moacyr Roberto Cuce; da Costa, Frnanda Marques

    2012-02-01

    Surrogate endpoints may be used as substitutes for, but often do not predict clinically relevant events. Objective To assess the methodological quality of articles that present their conclusions based on clinically relevant or surrogate outcomes in a systematic review of randomised trials and cohort studies of patients with rheumatoid arthritis treated with antitumour necrosis factor (TNF) agents. PubMed, Embase and Cochrane databases were searched. The Jadad score, the percentage of Consolidated Standards Of Reporting Trials (CONSORT) statement items adequately reported and levels-of-evidence (Center for Evidence-based Medicine, Oxford) were used in a descriptive synthesis. Among 88 articles appraised, 27 had surrogate endpoints, mainly radiographic, and 44 were duplicate publications; 74% of articles with surrogate and 39% of articles with clinical endpoints (p=0.006). Fewer articles with surrogate endpoints represented a high level of evidence (Level 1b, 33% vs 62%, p=0.037) and the mean percentage of CONSORT statement items met was also lower for articles with surrogate endpoints (62.5 vs 70.7, p=0.026). Although fewer articles with surrogate endpoints were randomised trials (63% vs 74%, p=0.307) and articles with surrogate endpoints had lower Jadad scores (3.0 vs 3.2, p=0.538), these differences were not statistically significant. Studies of anti-TNF agents that report surrogate outcomes are of lesser methodological quality. As such, inclusion of such studies in evidence syntheses may bias results.

  10. A meta-analysis of efficacy of Morus alba Linn. to improve blood glucose and lipid profile.

    PubMed

    Phimarn, Wiraphol; Wichaiyo, Kittisak; Silpsavikul, Khuntawan; Sungthong, Bunleu; Saramunee, Kritsanee

    2017-06-01

    The previous studies have reported the Morus alba may improve blood glucose and lipid profile. The evidence from these studies is not consistent. This meta-analysis was to evaluate efficacy of products derived from M. alba on blood glucose and lipid levels. Literature was reviewed via international database (PubMed, PubMed Central, ScienceDirect, and SciSearch) and Thai databases. Thirteen RCTs with high quality, assessed by Jadad score, were included. M. alba expressed a significant reduction in postprandial glucose (PPG) at 30 min (MD -1.04, 95 % CI -1.36, -0.73), 60 min (MD -0.87, 95 % CI -1.27, -0.48) and 90 min (MD -0.55, 95 % CI -0.87, -0.22). The difference was not found in the levels of other glycaemic (FBS, HbA1C, or HOMA-IR) and lipidaemic (TC, TG, LDL, or HDL) markers. Serious adverse effects were found neither in the control nor in the group received M. alba. Products derived from M. alba can effectively contribute to the reduction in PPG levels, but large-scale RCTs would be informative.

  11. Do workplace physical activity interventions improve mental health outcomes?

    PubMed

    Chu, A H Y; Koh, D; Moy, F M; Müller-Riemenschneider, F

    2014-06-01

    Mental health is an important issue in the working population. Interventions to improve mental health have included physical activity. To review evidence for the effectiveness of workplace physical activity interventions on mental health outcomes. A literature search was conducted for studies published between 1990 and August 2013. Inclusion criteria were physical activity trials, working populations and mental health outcomes. Study quality was assessed using the Jadad scale. Of 3684 unique articles identified, 17 met all selection criteria, including 13 randomized controlled trials, 2 comparison trials and 2 controlled trials. Studies were grouped into two key intervention areas: physical activity and yoga exercise. Of eight high-quality trials, two provided strong evidence for a reduction in anxiety, one reported moderate evidence for an improvement in depression symptoms and one provided limited evidence on relieving stress. The remaining trials did not provide evidence on improved mental well-being. Workplace physical activity and yoga programmes are associated with a significant reduction in depressive symptoms and anxiety, respectively. Their impact on stress relief is less conclusive. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. State of the evidence: Cannabinoids and cancer pain-A systematic review.

    PubMed

    Tateo, Sydney

    2017-02-01

    Cannabinoids are widely used to alleviate intractable symptoms such as pain, nausea, and muscle spasticity. The purpose of this review was to ascertain the current state of the science regarding use of cannabinoids for cancer pain. Four electronic databases were searched for randomized control trials of cannabinoids and cancer pain. Studies included examined the analgesic effects of cannabinoids for cancer pain. Methodological quality was assessed using the Jadad scale. Eight randomized control trials met the inclusion criteria for review. Most trials found analgesic effects from cannabinoids when compared to placebo, although not all associations reached statistical significance. The analgesic effects of cannabinoids were also limited by dose-dependent side effects. Side effects most commonly reported were changes in cognition, sedation, and dizziness. There is evidence that cannabinoids are effective adjuvants for cancer pain not completely relieved by opioid therapy, but there is a dearth of high-quality studies to support a stronger conclusion. Cannabinoids appear to be safe in low and medium doses. Methodological limitations of the trials limited the ability to make sound conclusions. Further research is warranted before efficacy, safety, and utility of cannabinoids for cancer pain can be determined. ©2016 American Association of Nurse Practitioners.

  13. A qualitative systematic review of head-to-head randomized controlled trials of oral analgesics in neuropathic pain

    PubMed Central

    Watson, C Peter N; Gilron, Ian; Sawynok, Jana

    2010-01-01

    BACKGROUND: Neuropathic pain (NP) encompasses many difficult-to-treat disorders. There are few head-to-head, comparative, randomized controlled trials (RCTs) of drugs for NP in different analgesic categories, or of different drugs within a category, despite many placebo-controlled RCTs for individual agents. Well-designed head-to-head comparative trials are an effective way to determine the relative efficacy and safety of a new drug. OBJECTIVE: To perform a systematic review of head-to-head RCTs of oral analgesics in NP. METHODS: A systematic review of RCTs involving NP patients was performed, of which head-to-head comparative trials were selected. Reference lists from published systematic reviews were searched. These studies were rated according to the Jadad scale for quality. RESULTS AND CONCLUSIONS: Twenty-seven such trials were identified. Seventeen were comparisons of different analgesics, and 10 were of different drugs within an analgesic class. Important information was obtained about the relative efficacy and safety of drugs in different categories and within a category. Some significant differences between active treatments were reported. Trial inadequacies were identified. More and improved head-to-head RCTs are needed to inform clinical choices. PMID:20577657

  14. [Effectiveness of non-pharmacological interventions in the quality of life of caregivers of Alzheimer].

    PubMed

    Amador-Marín, Bárbara; Guerra-Martín, María Dolores

    Explore the effectiveness of non-pharmacological interventions to improve the quality of life of family caregivers of Alzheimer's patients. We conducted a systematic review, in pairs, in the following databases: PubMed, Scopus, CINAHL, PsycINFO, WOS, Cochrane Library, IME, Cuiden Plus and Dialnet. Inclusion criteria were: 1. Studies published between 2010-2015. 2. Language: English, Portuguese and Spanish. 3. Randomized controlled clinical trials. 4. Score greater than or equal to 3 on the Jadad scale. 13 studies were included. Four performed a psychosocial intervention with family caregivers, three psychotherapeutic, two psychoeducational, two multicomponent, one educational and another with mutual support groups. The tools to assess quality of life: three studies used the Health Status Questionnaire (HSQ), three EuroQol-5D (two only used the EVA), two health questionnaire SF-36, two WHOQOL-BREF, two Quality of Life SF-12 and one Perceived Quality of Life Scale (PQoL). Regarding the effectiveness of non-pharmacological interventions, five studies obtained favorable results in the quality of life after psychotherapeutic interventions and community-type multicomponent training. The diversity of non-pharmacological interventions used and contents, differences in the number of sessions and hours, and variability of valuation tools used to measure quality of life of family caregivers, leads us to reflect on the appropriateness to standardize criteria, for the sake to improve clinical practice. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. What is the effect of matrices on cartilage repair? A systematic review.

    PubMed

    Wylie, James D; Hartley, Melissa K; Kapron, Ashley L; Aoki, Stephen K; Maak, Travis G

    2015-05-01

    Articular cartilage has minimal endogenous ability to undergo repair. Multiple chondral restoration strategies have been attempted with varied results. The purpose of our review was to determine: (1) Does articular chondrocyte transplantation or matrix-assisted articular chondrocyte transplantation provide better patient-reported outcomes scores, MRI morphologic measurements, or histologic quality of repair tissue compared with microfracture in prospective comparative studies of articular cartilage repair; and (2) which available matrices for matrix-assisted articular chondrocyte transplantation show the best patient-reported outcomes scores, MRI morphologic measurements, or histologic quality of repair tissue? We conducted a systematic review of PubMed, CINAHL, and MEDLINE from March 2004 to February 2014 using keywords determined to be important for articular cartilage repair, including "cartilage", "chondral", "cell source", "chondrocyte", "matrix", "augment", "articular", "joint", "repair", "treatment", "regeneration", and "restoration" to find articles related to cell-based articular cartilage repair of the knee. The articles were reviewed by two authors (JDW, MKH), our study exclusion criteria were applied, and articles were determined to be relevant (or not) to the research questions. The Methodological Index for Nonrandomized Studies (MINORS) scale was used to judge the quality of nonrandomized manuscripts used in this review and the Jadad score was used to judge the quality of randomized trials. Seventeen articles were reviewed for the first research question and 83 articles were reviewed in the second research question from 301 articles identified in the original systematic search. The average MINORS score was 9.9 (62%) for noncomparative studies and 16.1 (67%) for comparative studies. The average Jadad score was 2.3 for the randomized studies. Articular chondrocyte transplantation shows better patient-reported outcomes at 5 years in patients without chronic symptoms preoperatively compared with microfracture (p = 0.026). Matrix-assisted articular chondrocyte transplantation consistently showed improved patient-reported functional outcomes compared with microfracture (p values ranging from < 0.001 to 0.029). Hyalograft C(®) (Anika Therapeutics Inc, Bedford, MA, USA) and Chondro-gide(®) (Genzyme Biosurgery, Kastrup, Denmark) are the matrices with the most published evidence in the literature, but no studies comparing different matrices met our inclusion criteria, because the literature consists only of uncontrolled case series. Matrix-assisted articular chondrocyte transplantation leads to better patient-reported outcomes in cartilage repair compared with microfracture; however, future prospective research is needed comparing different matrices to determine which products optimize cartilage repair. Level IV, therapeutic study.

  16. Is intramedullary fixation of displaced midshaft clavicle fracture superior to plate fixation? Evidence from a systematic review of discordant meta-analyses.

    PubMed

    Xu, Bin; Lin, Yongsheng; Wang, Zhihong; Cao, Junming; Yang, Yipeng; Xia, Hehuan; Zhang, Yingze

    2017-07-01

    An increasing number of meta-analyses comparing intramedullary fixation (IF) with plate fixation (PF) for displaced midshaft clavicle fracture have been reported, but the inconsistent results obtained might confuse decision-making. We systematically reviewed discordant meta-analyses for assisting the decision-maker in interpreting and selecting amongst discordant meta-analyses and providing surgical recommendations for displaced midshaft clavicle fracture according to currently best available evidence. Meta-analyses on IF and PF for displaced midshaft clavicle fracture were identified by searching PubMed, Emabase and the Cochrane Library. A review of meta-analysis quality and data extraction was individually conducted by two reviewers. The meta-analysis providing the best available evidence was identified using the Jadad decision algorithm. Nine studies were included, five of which were of Level-II evidence and four of which were of Level-III evidence. These meta-analyses scored from 6 to 10 according to the Assessment of Multiple Systematic Reviews instrument. With respect to the Jadad decision algorithm, the best meta-analysis was chosen depending upon publication characteristics and methodology of primary studies, language restrictions, and whether data on individual patients were analysed. A meta-analysis incorporating more randomised controlled trials was eventually selected. The best available evidence indicated that the differences between IF and PF were not significant in terms of shoulder function or the rate of treatment failure. However, IF significantly decreased the operative time and the rate of non-operative complications, especially the rate of infection. Based on the best available evidence, IF may be superior to PF for treating displaced midshaft clavicle fracture. Copyright © 2017. Published by Elsevier Ltd.

  17. Surgical Versus Conservative Intervention for Acute Achilles Tendon Rupture: A PRISMA-Compliant Systematic Review of Overlapping Meta-Analyses.

    PubMed

    Zhang, Hao; Tang, Hao; He, Qianyun; Wei, Qiang; Tong, Dake; Wang, Chuangfeng; Wu, Dajiang; Wang, Guangchao; Zhang, Xin; Ding, Wenbin; Li, Di; Ding, Chen; Liu, Kang; Ji, Fang

    2015-11-01

    Although many meta-analyses comparing surgical intervention with conservative treatment have been conducted for acute Achilles tendon rupture, discordant conclusions are shown. This study systematically reviewed the overlapping meta-analyses relating to surgical versus conservative intervention of acute Achilles tendon rupture to assist decision makers select among conflicting meta-analyses, and to offer intervention recommendations based on the currently best evidence.Multiple databases were comprehensively searched for meta-analyses comparing surgical with conservative treatment of acute Achilles tendon rupture. Meta-analyses only comprising randomized controlled trials (RCTs) were included. Two authors independently evaluated the meta-analysis quality and extracted data. The Jadad decision algorithm was applied to ascertain which meta-analysis offered the best evidence.A total of 9 meta-analyses were included. Only RCTs were determined as Level-II evidence. The scores of Assessment of Multiple Systematic Reviews (AMSTAR) ranged from 5 to 10 (median 7). A high-quality meta-analysis with more RCTs was selected according to the Jadad decision algorithm. This study found that when functional rehabilitation was used, conservative intervention was equal to surgical treatment regarding the incidence of rerupture, range of motion, calf circumference, and functional outcomes, while reducing the incidence of other complications. Where functional rehabilitation was not performed, conservative intervention could significantly increase rerupture rate.Conservative intervention may be preferred for acute Achilles tendon rupture at centers offering functional rehabilitation, because it shows a similar rerupture rate with a lower risk of other complications when compared with surgical treatment. However, surgical treatment should be considered at centers without functional rehabilitation as this can reduce the incidence of rerupture.

  18. Inter-Rater Reliability of the Modified Ashworth Scale and Modified Modified Ashworth Scale in Assessing Poststroke Elbow Flexor Spasticity

    ERIC Educational Resources Information Center

    Kaya, Taciser; Goksel Karatepe, Altinay; Gunaydin, Rezzan; Koc, Aysegul; Altundal Ercan, Ulku

    2011-01-01

    The Modified Ashworth Scale (MAS) is commonly used in clinical practice for grading spasticity. However, it was modified recently by omitting grade "1+" of the MAS and redefining grade "2". The aim of this study was to investigate the inter-rater reliability of MAS and modified MAS (MMAS) for the assessment of poststroke elbow flexor spasticity.…

  19. Effect of vitamin D supplementation on patients with systemic lupus erythematosus: a systematic review.

    PubMed

    Sousa, Joyce Ramalho; Rosa, Érica Patrícia Cunha; Nunes, Ivone Freires de Oliveira Costa; Carvalho, Cecilia Maria Resende Gonçalves de

    The objective of this systematic review was to analyze clinical trials carried out for the investigation of the effect of vitamin D supplementation on systemic lupus erythematosus. The research was performed from August to September 2016, without limits regarding year of publication, restriction of gender, age, and ethnicity. For the guiding question, the PICO strategy was employed. To evaluate the quality of the publications the PRISMA protocol and Jadad scale were used. The risk of bias analysis of the clinical trials was performed using the Cochrane collaboration tool. After the process of article selection and removal of duplicates, four articles were identified as eligible. The results of three studies showed a positive effect of supplementation on disease activity reduction and significant improvement in levels of inflammatory markers, fatigue, and endothelial function. Only one study showed no improvement in disease activity after supplementation. Moreover, all studies showed an increase in serum vitamin D levels. The data from this review provide evidence on the benefits of vitamin D supplementation in patients with lupus and vitamin D insufficiency/deficiency. However, it is still necessary to elucidate whether vitamin D acts in the protection against this metabolic disorder, as well as the standardization of the type, dose and time of vitamin D supplementation. Copyright © 2017. Published by Elsevier Editora Ltda.

  20. Review of Clinical Pharmacology of Aloe vera L. in the Treatment of Psoriasis.

    PubMed

    Miroddi, Marco; Navarra, Michele; Calapai, Fabrizio; Mancari, Ferdinando; Giofrè, Salvatore Vincenzo; Gangemi, Sebastiano; Calapai, Gioacchino

    2015-05-01

    Aloe vera L., is a plant used worldwide as folk remedy for the treatment of various ailments, including skin disorders. Its gel is present in cosmetics, medicinal products and food supplements. Psoriasis, an immune-mediated chronic inflammatory disease, involving mainly the skin, affects about the 2-3% of general population. Conventional pharmacological treatments for psoriasis can have limited effectiveness and can cause adverse reactions. For this reason often psoriatic patients look for alternative treatments based on natural products containing Aloe vera. We conducted a systematic review of clinical trials assessing effectiveness and safety of aloe for the treatment of psoriasis. Clinical studies published in English were considered; a total of four clinical trials met inclusion criteria. Studies were also evaluated by using the Jadad scale and Consort Statement in Reporting Clinical trials of Herbal Medicine Intervention. Quality and methodological accuracy of considered studies varied considerably, and some crucial information to reproduce clinical results was missing. We conclude that administration of aloe as cutaneous treatment is generally well tolerated, as no serious side effects were reported. Results on the effectiveness of Aloe vera are contradictory; our analysis reveals the presence of methodological gaps preventing to reach final conclusions. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Dietary interventions, lifestyle changes, and dietary supplements in preventing gestational diabetes mellitus: a literature review.

    PubMed

    Facchinetti, Fabio; Dante, Giulia; Petrella, Elisabetta; Neri, Isabella

    2014-11-01

    Gestational diabetes mellitus (GDM) is associated with increased rates of fetal morbidity and mortality, both during the pregnancy and in the postnatal life. Current treatment of GDM includes diet with or without medications, but this management is expensive and poorly cost-effective for the health care systems. Strategies to prevent such condition would be preferable with respect to its treatment. The aim of this literature review was to evaluate studies reporting the efficacy of the most used approaches to prevent GDM as well as evidences of efficacy and safety of dietary supplementations. Systematic literature searches were performed in electronic databases, covering the period January 1983 to April 2014. Randomized controlled clinical trials were included. Quality of the articles was evaluated with the Jadad scale. We did not evaluate those articles that were already entered in the most recent systematic reviews, and we completed the research with the trials published thereafter. Of 55 articles identified, 15 randomized controlled trials were eligible. Quality and heterogeneity of the studies cannot allow firm conclusions. Anyway, trials in which only intake or expenditure has been targeted mostly reported negative results. On the contrary, combined lifestyle programs including diet control (orienting food intake, restricting energy intake) associated with moderate but continuous physical activity exhibit better efficacy in reducing GDM prevalence. The results from dietary supplements with myoinositol or probiotics are promising. The actual evidences provide enough arguments for implementing large-scale, high-quality randomized controlled trials looking at the possible benefits of these new approaches for preventing GDM.

  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. Assessing the psychometric properties of two food addiction scales.

    PubMed

    Lemeshow, Adina R; Gearhardt, Ashley N; Genkinger, Jeanine M; Corbin, William R

    2016-12-01

    While food addiction is well accepted in popular culture and mainstream media, its scientific validity as an addictive behavior is still under investigation. This study evaluated the reliability and validity of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale using data from two community-based convenience samples. We assessed the internal and test-retest reliability of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale, and estimated the sensitivity and negative predictive value of the Modified Yale Food Addiction Scale using the Yale Food Addiction Scale as the benchmark. We calculated Cronbach's alphas and 95% confidence intervals (CIs) for internal reliability and Cohen's Kappa coefficients and 95% CIs for test-retest reliability. Internal consistency (n=232) was marginal to good, ranging from α=0.63 to 0.84. The test-retest reliability (n=45) for food addiction diagnosis was substantial, with Kappa=0.73 (95% CI, 0.48-0.88) (Yale Food Addiction Scale) and 0.79 (95% CI, 0.66-1.00) (Modified Yale Food Addiction Scale). Sensitivity and negative predictive value for classifying food addiction status were excellent: compared to the Yale Food Addiction Scale, the Modified Yale Food Addiction Scale's sensitivity was 92.3% (95% CI, 64%-99.8%), and the negative predictive value was 99.5% (95% CI, 97.5%-100%). Our analyses suggest that the Modified Yale Food Addiction Scale may be an appropriate substitute for the Yale Food Addiction Scale when a brief measure is needed, and support the continued use of both scales to investigate food addiction. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Physiotherapy intervention in Alzheimer's disease: systematic review and meta-analysis.

    PubMed

    Zhu, Xi-Chen; Yu, Yang; Wang, Hui-Fu; Jiang, Teng; Cao, Lei; Wang, Chong; Wang, Jun; Tan, Chen-Chen; Meng, Xiang-Fei; Tan, Lan; Yu, Jin-Tai

    2015-01-01

    Many studies reported that physiotherapy interventions are available to treat Alzheimer's disease (AD), but the efficacy remains uncertain. To evaluate the effectiveness of physiotherapy intervention on AD. The data sources were searched from literature databases, journals, and reference lists from 1 January 1990 to the end of 1 April 2014. Randomized and non-randomized controlled trials with physiotherapy intervention were included in our meta-analysis. Jadad score and Newcastle-Ottawa scale were used to assess the quality of included trials. Outcome measures were cognition function, physical function, activity of daily life (ADL) and neuropsychiatric inventory (NPI). 23 trials met the inclusion standard finally. Significant changes were seen in cognitive function: Mini-Mental State Examination score (weighted mean difference (WMD): 1.84, 95% confidence interval (CI): [0.76, to, 2.93], p < 0.0001), and verbal fluency (standard mean difference (SMD): 0.34, 95% CI: [0.01 to 0.66], p = 0.04). Other outcomes are also significant, they were timed up and go test (SMD: 0.56, 95% CI: [0.30 to 0.83], p < 0.0001), berg functional balance scale (SMD: 1.11, 95% CI: [0.37 to 1.84], p = 0.003), 6-min walk distance test (SMD: 141.45, 95% CI: [11.72 to 271.18], p = 0.03), ADL (SMD: 0.78, 95% CI: [0.33 to 1.23], p = 0.0007) and NPI (SMD: -0.69, 95% CI: [-1.31 to -0.07], p = 0.03). The available data indicate that physiotherapy intervention may have benefits in AD. However, current data are not definitive; more carefully designed and conducted observational studies are needed to definitively establish that whether physiotherapy intervention can effectively alleviate symptoms of AD.

  5. Treatment effects of massage therapy in depressed people: a meta-analysis.

    PubMed

    Hou, Wen-Hsuan; Chiang, Pai-Tsung; Hsu, Tun-Yen; Chiu, Su-Ying; Yen, Yung-Chieh

    2010-07-01

    To systematically investigate the treatment effects of massage therapy in depressed people by incorporating data from recent studies. A meta-analysis of randomized controlled trials (RCTs) of massage therapy in depressed people was conducted using published studies from PubMed, EMBASE, PsycINFO, and CINAHL electronic database from inception until July 2008. The terms used for the search were derived from medical subheading term (MeSH) massage combined with MeSH depression. Hand searching was also checked for bibliographies of relevant articles. Retrieval articles were constrained to RCTs/clinical trials and human subjects. No language restrictions were imposed. We included 17 studies containing 786 persons from 246 retrieved references. Trials with other intervention, combined therapy, and massage on infants or pregnant women were excluded. Two reviewers independently performed initial screen and assessed quality indicators by Jadad scale. Data were extracted on publication year, participant characteristics, and outcomes by another single reviewer. All trials showed positive effect of massage therapy on depressed people. Seventeen RCTs were of moderate quality, with a mean quality score of 6.4 (SD = 0.85). The pooled standardized mean difference in fixed- and random-effects models were 0.76 (95% CI, 0.61-0.91) and 0.73 (95% CI, 0.52-0.93), respectively. Both indicated significant effectiveness in the treatment group compared with the control group. The variance between these studies revealed possible heterogeneity (tau(2) = 0.06, Cochran chi-squared(16) = 25.77, P = .06). Massage therapy is significantly associated with alleviated depressive symptoms. However, standardized protocols of massage therapy, various depression rating scales, and target populations in further studies are suggested. (c) Copyright 2010 Physicians Postgraduate Press, Inc.

  6. Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials.

    PubMed

    Fernández-San-Martín, Maria Isabel; Masa-Font, Roser; Palacios-Soler, Laura; Sancho-Gómez, Pilar; Calbó-Caldentey, Cristina; Flores-Mateo, Gemma

    2010-06-01

    Insomnia is an often seen primary health care problem. Valerian might be an alternative treatment with fewer secondary effects. The aim of this study is to evaluate its effectiveness on insomnia through a meta-analysis of published literature. Search for randomized clinical trials (RCTs) of Valerian preparations compared with a placebo on Medline, the Cochrane Library, Embase and Biosis. sleep-quality improvement (SQ, yes/no), sleep-quality improvement quantified through visual analogical scales (SQS) and the latency time (LT) in minutes until getting to sleep. Three meta-analyses were carried out using inverse-variance weighted random effects models. Heterogeneity was determined with the Q-statistic and was explored through a sub-groups analysis. Publication bias was evaluated using the funnel plot. Eighteen RCTs were selected; eight had a score of 5 on Jadad's scale. The mean differences in LT between the Valerian and placebo treatment groups was 0.70 min (95% CI, -3.44 to 4.83); the standardized mean differences between the groups measured with SQS was -0.02 (95% CI, -0.35 to 0.31); treatment with Valerian showed a relative risk of SQ of 1.37 (95% CI, 1.05-1.78) compared with the placebo group. There was heterogeneity in the three meta-analyses, but it diminished in the sub groups analysis. No publication bias was detected. The qualitative dichotomous results suggest that valerian would be effective for a subjective improvement of insomnia, although its effectiveness has not been demonstrated with quantitative or objective measurements. We recommend future investigations oriented toward improving insomnia with other more promising treatments. Copyright 2010 Elsevier B.V. All rights reserved.

  7. Health education via mobile text messaging for glycemic control in adults with type 2 diabetes: a systematic review and meta-analysis.

    PubMed

    Saffari, Mohsen; Ghanizadeh, Ghader; Koenig, Harold G

    2014-12-01

    Diabetes type 2 is an increasing problem worldwide that may be managed through education. Text-messaging using a cell phone can assist with self-care. The aim of this study was to systematically review the impact of education through mobile text-messaging on glycemic control. The design was a systematic review with meta-analysis. Five electronic databases were searched to access English studies involving a randomized controlled trial design that used text-messaging educational interventions in patients with type 2 diabetes during an 11-year period (2003-2013). Studies were evaluated using a quality assessment scale adapted from Jadad scale and Cochrane handbook. Extraction of data was carried out by two reviewers. A random-effect model with a standardized mean difference and Hedges's g indices was used for conducting the meta-analysis. Subgroup analyses were conducted and a Funnel plot was used to examine publication bias. Ten studies overall were identified that fulfilled inclusion criteria, involving a total of 960 participants. The mean age of the sample was 52.8 years and majority were females. Data were heterogeneous (I(2)=67.6). Analyses suggested a publication bias based on Egger's regression (P<0.05). HbA1c was reduced significantly in experimental groups compared to control groups (P<0.001). The effect size for glycemic control in studies that used text-messaging only was 44%. For studies that used both text-messaging and Internet, the effect size was 86%. Mobile text-messaging for educating Type 2 diabetics appears to be effective on glycemic control. Further investigations on mobile applications to achieve educational goals involving other diseases are recommended. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  8. Emergency department-based interventions for women suffering domestic abuse: a critical literature review.

    PubMed

    Ansari, Sereena; Boyle, Adrian

    2017-02-01

    Domestic abuse represents a serious public health and human rights concern. Interventions to reduce the risk of abuse include staff training and standardized documentation improving detection and adherence to referral pathways. Interventional studies have been conducted in primary care, maternity and outpatient settings. Women disclosing abuse in emergency departments differ from women attending other healthcare settings, and it is unclear whether these interventions can be transferred to the emergency care setting. This review examines interventional studies to evaluate the effectiveness of emergency department-based interventions in reducing domestic abuse-related morbidity. Medline, EMBASE, CINAHL, PsycINFO and Cochrane Library were searched, according to prespecified selection criteria. Study quality was assessed using the Jadad scale. Of 273 search results, nine were eligible for review. Interventions involving staff training demonstrated benefits in subjective measures, such as staff knowledge regarding abuse, but no changes in clinical practice, based on detection and referral rates. When staff training was implemented in conjunction with supporting system changes - for example, standardized documentation for assessment and referral - clinically relevant improvements were noted. Interventions centred around staff training are insufficient to bring about improvements in the management and, thus, outcome of patients suffering abuse. Instead, system changes, such as standardized documentation and referral pathways, supported by training, may bring about beneficial changes. It remains uncertain whether surrogate outcomes employed by most studies translate to changes in abuse-related morbidity: the ultimate goal.

  9. [Current situation and existing problems of acupuncture for primary hypertension].

    PubMed

    Zhang, Lili; Wei, Pengfei; Chen, Shaozong

    2018-03-12

    To analyze the present situation and existing problems of acupuncture for primary hypertension (PH) based on clinical research literature in recent 20 years. The clinical research literature regarding acupuncture for PH were searched from China National Knowledge Infrastructure (CNKI), VIP data network (VIP) and Wanfang database from 1997 through 2016; a total of 218 papers met the inclusive criteria. Microsoft Excel and Apriori algorithm of SPSS Clementine software were applied to analyze the data. The main acupoints of acupuncture for PH were Taichong (LR 3), Quchi (LI 11), Zusanli (ST 36) and Hegu (LI 4), but its support degree was only 12.21%. 127 papers were randomized controlled trials, accounting for 58.26%. 158 papers had clear diagnostic criteria, accounting for 72.48%. 138 papers had clear efficacy evaluation criteria, accounting for 63.30%. Only 5.05% of the papers were classified as high-quality literature by using Jadad scale. In recent 20 years, some rules existed in acupoint selection for PH, but the support degree was low so it could not accurately guide clinical treatment. Although the clinical literature quality of acupuncture for PH was gradually increasing, the proportion of high-quality literature was low, therefore modern medical research model and foreign similar research should be followed to design a more rigorous trial protocol. As a result, the quality of clinical research is increased to provide reference for future clinical treatment.

  10. Ziconotide Monotherapy: A Systematic Review of Randomised Controlled Trials

    PubMed Central

    Brookes, Morag E.; Eldabe, Sam; Batterham, Alan

    2017-01-01

    INTRODUCTION Chronic neuropathic pain is difficult to treat and is often refractory to most modalities of treatment. Ziconotide is a novel, potent, non-opioid, calcium channel blocking agent which has been shown in clinical trials to be effective in treating chronic neuropathic pain. METHODS EMBASE, MEDLINE, CINAHL Plus and Web of Science electronic databases were searched for English language studies. Reference sections of articles were examined for further papers and the manufacturer of ziconotide was contacted for further unpublished data. Three randomised controlled trials in ziconotide monotherapy were included and subjected to a random effects meta-analysis. RESULTS All three studies used the similar main outcome measure (visual analogue scale of pain intensity; VASPI) and were therefore comparable. A Jadad score was performed for each paper. Frequent serious adverse events (SAEs) were observed which resulted in two of the studies revising the protocol. The meta-analysis revealed a pooled odds ratio (responders on ziconotide vs. placebo) of 2.77 (95% CI, 1.37 to 5.59). DISCUSSION The results suggest that ziconotide is beneficial for pain reduction in chronic neuropathic pain. However, there remain some methodological issues that may call into question the validity of the results. It is evident that more work needs to be conducted to further validate the efficacy of ziconotide and to discover new areas of use. PMID:26861472

  11. Role of Fiber in Symptomatic Uncomplicated Diverticular Disease: A Systematic Review

    PubMed Central

    Carabotti, Marilia; Annibale, Bruno; Severi, Carola; Lahner, Edith

    2017-01-01

    Symptomatic uncomplicated diverticular disease (SUDD) is a syndrome characterized by recurrent abdominal symptoms in patients with colonic diverticula. There is some evidence that a high-fiber diet or supplemental fibers may reduce symptoms in SUDD patients and a high-fiber diet is commonly suggested for these patients. This systematic review aims to update the evidence on the efficacy of fiber treatment in SUDD, in terms of a reduction in symptoms and the prevention of acute diverticulitis. According to PRISMA, we identified studies on SUDD patients treated with fibers (PubMed and Scopus). The quality of these studies was evaluated by the Jadad scale. The main outcome measures were a reduction of abdominal symptoms and the prevention of acute diverticulitis. Nineteen studies were included, nine with dietary fiber and 10 with supplemental fiber, with a high heterogeneity concerning the quantity and quality of fibers employed. Single studies suggest that fibers, both dietary and supplemental, could be beneficial in SUDD, even if the quality is very low, with just one study yielding an optimal score. The presence of substantial methodological limitations, the heterogeneity of the therapeutic regimens employed, and the lack of ad hoc designed studies, did not permit a summary of the outcome measure. Thus, the benefit of dietary or supplemental fiber in SUDD patients still needs to be established. PMID:28230737

  12. The use of modified scaling factors in the design of high-power, non-linear, transmitting rod-core antennas

    NASA Astrophysics Data System (ADS)

    Jordan, Jared Williams; Dvorak, Steven L.; Sternberg, Ben K.

    2010-10-01

    In this paper, we develop a technique for designing high-power, non-linear, transmitting rod-core antennas by using simple modified scale factors rather than running labor-intensive numerical models. By using modified scale factors, a designer can predict changes in magnetic moment, inductance, core series loss resistance, etc. We define modified scale factors as the case when all physical dimensions of the rod antenna are scaled by p, except for the cross-sectional area of the individual wires or strips that are used to construct the core. This allows one to make measurements on a scaled-down version of the rod antenna using the same core material that will be used in the final antenna design. The modified scale factors were derived from prolate spheroidal analytical expressions for a finite-length rod antenna and were verified with experimental results. The modified scaling factors can only be used if the magnetic flux densities within the two scaled cores are the same. With the magnetic flux density constant, the two scaled cores will operate with the same complex permeability, thus changing the non-linear problem to a quasi-linear problem. We also demonstrate that by holding the number of turns times the drive current constant, while changing the number of turns, the inductance and core series loss resistance change by the number of turns squared. Experimental measurements were made on rod cores made from varying diameters of black oxide, low carbon steel wires and different widths of Metglas foil. Furthermore, we demonstrate that the modified scale factors work even in the presence of eddy currents within the core material.

  13. [The Effects of Auditory Hallucination Simulation on Empathy, Knowledge, Social Distance, and Attitudes Toward Patients With Mental Illness Among Undergraduate Students: A Systemic Review and Meta-Analysis].

    PubMed

    Lee, Ming-Feng; Lin, Ching-Lan Esther

    2017-10-01

    The negative attitudes of the general public toward mental illness frequently influence the integration of mental illness patients into the community. Auditory hallucination simulation may be considered as a creative teaching strategy to improve the attitudes of learners toward mental illness. However, the empirical effects of auditory hallucination simulation to change the negative attitudes toward mental illness remains uncertain. To compare and analyze, using a systematic review and meta-analysis, the effectiveness of auditory hallucination simulation in improving empathy, knowledge, social distance, and attitudes toward mental illness in undergraduates. A search using the keywords "auditory hallucination" and "simulation" and the 4 outcome indicators of empathy, knowledge, social distance, and attitudes toward mental illness was conducted to identify related articles published between 2008 and 2016 in 6 Chinese and English electronic databases, including Cochrane Library, EBSCO-CINAHL, MEDLINE, PsycINFO, PubMed, and Airiti Library. Research quality was appraised using the Modified Jadad Scale (MJS), the Oxford Centre for Evidence-Based Medicine Level of Evidence (OCEBM LoE), and the Cochrane Risk of Bias tool. Eleven studies were recruited, and 7 studies with sufficient data were included in the meta-analysis. The meta-analysis showed that hallucination simulation significantly improved the empathy and knowledge of participants, with respective effect sizes of 0.63 (95% CI [0.21, 1.05]) and 0.69 (95% CI [0.43-0.94]). However, this intervention also increased social distance, with an effect size of 0.60 (95% CI [0.01, 1.19]), and did not change attitudes toward mental illness significantly, with an effect size of 0.33 (95% CI [-0.11, 0.77]). Auditory hallucination simulation is an effective teaching strategy for improving the empathy and knowledge of undergraduates. However, related evidence for the effects of social distance and attitudes toward mental illness need to be further strengthened. Most of the extant research on this subject was conducted in the United States and Australia and was of moderate quality. Future studies should use sufficiently rigorous research designs to explore the safety issues and the effectiveness of the auditory hallucination simulation intervention in different countries and ethnic populations.

  14. Early Versus Delayed Motion After Rotator Cuff Repair: A Systematic Review of Overlapping Meta-analyses.

    PubMed

    Houck, Darby A; Kraeutler, Matthew J; Schuette, Hayden B; McCarty, Eric C; Bravman, Jonathan T

    2017-10-01

    Previous meta-analyses have been conducted to compare outcomes of early versus delayed motion after rotator cuff repair. To conduct a systematic review of overlapping meta-analyses comparing early versus delayed motion rehabilitation protocols after rotator cuff repair to determine which meta-analyses provide the best available evidence. Systematic review. A systematic review was performed by searching PubMed and Cochrane Library databases. Search terms included "rotator cuff repair," "early passive motion," "immobilization," "rehabilitation protocol," and "meta-analysis." Results were reviewed to determine study eligibility. Patient outcomes and structural healing were extracted from these meta-analyses. Meta-analysis quality was assessed using the Oxman-Guyatt and Quality of Reporting of Meta-analyses (QUOROM) systems. The Jadad decision algorithm was then used to determine which meta-analyses provided the best level of evidence. Seven meta-analyses containing a total of 5896 patients met the eligibility criteria (1 Level I evidence, 4 Level II evidence, 2 Level III evidence). None of these meta-analyses found immobilization to be superior to early motion; however, most studies suggested that early motion would increase range of motion (ROM), thereby reducing time of recovery. Three of these studies suggested that tear size contributed to the choice of rehabilitation to ensure proper healing of the shoulder. A study by Chan et al in 2014 received the highest QUOROM and Oxman-Guyatt scores, and therefore this meta-analysis appeared to have the highest level of evidence. Additionally, a study by Riboh and Garrigues in 2014 was selected as the highest quality study in this systematic review according to the Jadad decision algorithm. The current, best available evidence suggests that early motion improves ROM after rotator cuff repair but increases the risk of rotator cuff retear. Lower quality meta-analyses indicate that tear size may provide a better strategy in determining the correct rehabilitation protocol.

  15. Assessing the Psychometric Properties of Two Food Addiction Scales

    PubMed Central

    Lemeshow, Adina; Gearhardt, Ashley; Genkinger, Jeanine; Corbin, William R.

    2016-01-01

    Background While food addiction is well accepted in popular culture and mainstream media, its scientific validity as an addictive behavior is still under investigation. This study evaluated the reliability and validity of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale using data from two community-based convenience samples. Methods We assessed the internal and test-retest reliability of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale, and estimated the sensitivity and negative predictive value of the Modified Yale Food Addiction Scale using the Yale Food Addiction Scale as the benchmark. We calculated Cronbach’s alphas and 95% confidence intervals (CIs) for internal reliability and Cohen’s Kappa coefficients and 95% CIs for test-retest reliability. Results Internal consistency (n=232) was marginal to good, ranging from α=0.63 to 0.84. The test-retest reliability (n=45) for food addiction diagnosis was substantial, with Kappa=0.73 (95% CI, 0.48–0.88) (Yale Food Addiction Scale) and 0.79 (95% CI, 0.66–1.00) (Modified Yale Food Addiction Scale). Sensitivity and negative predictive value for classifying food addiction status were excellent: compared to the Yale Food Addiction Scale, the Modified Yale Food Addiction Scale’s sensitivity was 92.3% (95% CI, 64%–99.8%), and the negative predictive value was 99.5% (95% CI, 97.5%–100%). Conclusions Our analyses suggest that the Modified Yale Food Addiction Scale may be an appropriate substitute for the Yale Food Addiction Scale when a brief measure is needed, and support the continued use of both scales to investigate food addiction. PMID:27623221

  16. Reliability and validity analysis of modified Nursing Stress Scale for Indian population.

    PubMed

    Pathak, Vasundhara; Chakraborty, Tania; Mukhopadhyay, Suman

    2013-01-01

    The original Nursing Stress Scale (NSS) was structurally modified according to results of factorial analysis and a new scale was named as modified nursing stress scale (MNSS). This is the first study to modify and validate NSS for Indian nursing population. Factorial analysis showed different factor loading for two subscales and items were shifted according to their loading to provide a more meaningful structure. After relocation of Items 13, 14, and 15 into first factor, this factor was renamed as "emotional and painful conditions of patients" to provide a more appropriate name to the first factor. Items 24, 25, 26, 27, 28, and 29 were found to be distributed under two different factors; one of these two was renamed as "unpredictable changes" and another retained its original name (i.e., workload). This distribution was also supported by rational analysis. All other items were distributed under factors as in the original scale. Rest of the validity assessment was done with the modified scale. Thus, with minor changes in structure, the scale was found to have better content validity.

  17. Measuring AT Usability with the Modified System Usability Scale (SUS).

    PubMed

    Friesen, Emma L

    2017-01-01

    The modified System Usability Scale (SUS) is a widely used generic measure of product usability. This study concerns the usability of mobile shower commodes using correlations between the SUS and AT device-specific measures. Results suggest the modified SUS, and corresponding adjective-anchored rating scale, are appropriate for measuring MSC usability, and have potential for use with other AT devices.

  18. Safety and immunogenicity of prepandemic H5N1 influenza vaccines: a systematic review of the literature.

    PubMed

    Prieto-Lara, Elisa; Llanos-Méndez, Aurora

    2010-06-11

    A systematic review was performed to assess the safety and immunogenicity of the prepandemic H5N1 influenza vaccines licensed so far. A bibliographic search according to the COSI protocol was carried out and 8 of 235 potentially relevant publications were selected. Quality assessment was defined with both CASP and Jadad checklists. Taken together, the results from the present systematic review suggest that the inactivated split-virion formulation that includes a low antigen dose (3.8 microg) and an oil-in-water emulsion-based adjuvant, represents the best option in the case of a pandemic, due to its antigen-sparing capacity and its favorable safety profile. (c) 2010 Elsevier Ltd. All rights reserved.

  19. Trying to optimise the German version of the OPTION scale regarding the dyadic aspect of shared decision making.

    PubMed

    Keller, H; Hirsch, O; Müller-Engelmann, M; Heinzel-Gutenbrunner, M; Krones, T; Donner-Banzhoff, N

    2013-01-01

    The OPTION scale ("observing patient involvement in decision making") assesses the extent to which clinicians involve patients in decisions across a range of situations in clinical practice. It so far just covers physician behavior. We intended to modify the scoring of the OPTION scale to incorporate active patient behavior in consultations. Modification was done on scoring level, attempting a dyadic, relationship-centred approach in that high ratings can be evoked also by the behaviour of active patients. The German version of the OPTION scale was compared with a modified version by analysing video recordings of primary care consultations dealing with cardiovascular prevention. Fifteen general practitioners provided 40 videotaped consultations. Videos were analysed by two rater pairs and two experts in shared decision making (SDM). Reliability measures of the modified version were lower than those of the original scale. Significant associations of the dichotomised scale with the expert SDM rating as well as with physicians' expertise in SDM were only found for the modified OPTION scale. Receiver Operating Characteristic (ROC) analyses confirmed a valid differentiation between the presence of SDM (yes/no) on total score level, even though the cut-off point was quite low. Standard deviations of the single items in the modified version were higher compared to the original OPTION scale, while the means of total scores were similar. The original OPTION scale is physician-centered and neglects the activity and a possible self-involvement of the patient. Our modified instruction was able to capture the dyadic element partially. The development of a separate dyadic instrument might be more promising.

  20. SLEEVE GASTRECTOMY IN PATIENTS WITH MORBID OBESITY AND HIV.

    PubMed

    Pinto, José Máximo Costa; Lima, Marianna Gomes Cavalcanti Leite de; Almeida, Ana Luiza Melo Cavalcanti de; Sousa, Marcelo Gonçalves

    It is estimated that there are nearly 40 million people with the human immunodeficiency virus (HIV) worldwide. Due to the advent of antiretroviral drugs, it has been observed increasing in obesity and metabolic rates among patients undergoing treatment. Thus, numerous surgical therapies for weight loss are proposed for continuous improvement in health of patients with HIV, being the vertical gastrectomy an option for intact intestinal transit. To evaluate the applicability of the vertical gastrectomy in patients with morbid obesity and HIV. Was conducted a systematic review of the literature, in the electronic databases Scopus, Pubmed, Cinahl, Scielo, Cochrane and Lilacs, from 1998 to 2015. MeSH headings used in data collection were "Gastrectomy" and "Morbid obesity" being combined with the descriptor "HIV". Were found 2148 articles in Scopus, 1234 in PubMed and 784 in Cinahl. The articles were analyzed by the Jadad Quality Scale, being reduced to 40 articles, subsequently reassessed using an elaborated form by the Critical Appraisal Skills Programme (CASP), reaching 12 articles in the end. It was found that vertical gastrectomy constitutes a safe and effective method, with low mortality and low rate of postoperative complications, being recommended as surgical technique in patients with obesity, HIV and comorbidities. Estima-se que haja quase 40 milhões de pessoas com o vírus da imunodeficiência adquirida (HIV) no mundo. Com o advento dos antirretrovirais, observou-se aumento da obesidade e de taxas metabólicas nos pacientes em tratamento. Assim, inúmeras terapias cirúrgicas para a perda de peso estão sendo estudadas para a melhoria contínua da saúde dos pacientes com HIV, sendo a gastrectomia vertical uma opção de trânsito íntegro. Avaliar a aplicabilidade da gastrectomia vertical em pacientes com obesidade mórbida e HIV. Foi realizada revisão sistemática de literatura, de artigos publicados nas bases eletrônicas de dados Scopus, Pubmed, Cinahl, Scielo, Cochrane e Lilacs, no período de 1998 a 2015. Os descritores do MeSH utilizados na coleta dos dados foram "Gastrectomia" e "Obesidade mórbida", sendo combinados com o descritor "HIV". Foram encontrados 2.148 artigos na Scopus, 1.234 no Pubmed e 784 na Cinahl. Os artigos foram analisados pela Escala de Qualidade de Jadad, reduzindo para um total de 40 artigos, os quais foram posteriormente reavaliados, utilizando um formulário elaborado pelo Critical Appraisal Skills Programme (CASP), chegando ao montante de 12 artigos ao final. Verificou-se que a gastrectomia vertical constitui método seguro e eficaz, apresentando baixa morbimortalidade e baixo índice de complicações pós-operatórias, sendo técnica cirúrgica segura para uso em pacientes com obesidade, HIV e comorbidades.

  1. A new multiscale model to describe a modified Hall-Petch relation at different scales for nano and micro materials

    NASA Astrophysics Data System (ADS)

    Fadhil, Sadeem Abbas; Alrawi, Aoday Hashim; Azeez, Jazeel H.; Hassan, Mohsen A.

    2018-04-01

    In the present work, a multiscale model is presented and used to modify the Hall-Petch relation for different scales from nano to micro. The modified Hall-Petch relation is derived from a multiscale equation that determines the cohesive energy between the atoms and their neighboring grains. This brings with it a new term that was originally ignored even in the atomistic models. The new term makes it easy to combine all other effects to derive one modified equation for the Hall-Petch relation that works for all scales together, without the need to divide the scales into two scales, each scale with a different equation, as it is usually done in other works. Due to that, applying the new relation does not require a previous knowledge of the grain size distribution. This makes the new derived relation more consistent and easier to be applied for all scales. The new relation is used to fit the data for Copper and Nickel and it is applied well for the whole range of grain sizes from nano to micro scales.

  2. Hypnotherapy for insomnia: a systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Lam, Tak-Ho; Chung, Ka-Fai; Yeung, Wing-Fai; Yu, Branda Yee-Man; Yung, Kam-Ping; Ng, Tommy Ho-Yee

    2015-10-01

    To examine the efficacy and safety of hypnotherapy for insomnia as compared to placebo, pharmacological or non-pharmacological intervention, or no treatment. A systematic search on major electronic databases was conducted up until March 2014. Inclusion criteria are: (1) randomized controlled trials (RCTs) or quasi-RCTs; (2) intervention targeted at improving sleep; (3) hypnosis as an intervention; and (4) English language articles. Sleep diary variable is the primary outcome measure. Six RCTs of hypnotherapy and seven on autogenic training or guided imagery, comprising 502 subjects, were included. Eleven of the 13 studies had low methodological quality, as indicated by a modified Jadad score below 3, and high risks of bias in blinding and design of the control interventions. No adverse events related to hypnosis were reported, though seldom investigated. Meta-analyses found hypnotherapy significantly shortened sleep latency compared to waitlist (standardized mean difference, SMD=-0.88, 95% confidence interval (CI): -1.56, -0.19, P=0.01, I(2)=15%), but no difference compared to sham intervention (SMD: -1.08, 95% CI: -3.15, 0.09, P=0.31, I(2)=90%). Similar results were found for autogenic training or guided imagery (SMD with waitlist=-1.16, 95% CI: -1.92, -0.40, P=0.003, I(2)=0%; SMD with sham intervention=-0.50, 95% CI: -1.19, 0.19, P=0.15, I(2)=0%). Generalizability of the positive results is doubtful due to the relatively small sample size and methodological limitations. Future studies with larger sample size and better study design and methodology are called for. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. The Impact of Biologics and Tofacitinib on Cardiovascular Risk Factors and Outcomes in Patients with Rheumatic Disease: A Systematic Literature Review.

    PubMed

    Nurmohamed, Michael; Choy, Ernest; Lula, Sadiq; Kola, Blerina; DeMasi, Ryan; Accossato, Paola

    2018-05-01

    Rheumatic diseases are autoimmune, inflammatory diseases often associated with cardiovascular (CV) disease, a major cause of mortality in these patients. In recent years, treatment with biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs), either as monotherapy or in combination with other drugs, have become the standard of treatment. In this systematic literature review, we evaluated the effect of treatment with biologic or tofacitinib on the CV risk and outcomes in these patients. A systematic search was performed in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews for articles reporting on CV risk and events in patients with rheumatic disease treated with a biologic agent or tofacitinib. Articles identified were subjected to two levels of screening. Articles that passed the first level based on title and abstract were assessed on full-text evaluation. The quality of randomized clinical trials was assessed by Jadad scoring system and the quality of the other studies and abstracts was assessed using the Downs and Black instrument. The data extracted included study design, baseline patient characteristics, and measurements of CV risk and events. Of the 5722 articles identified in the initial search, screening yielded 105 unique publications from 90 unique studies (33 clinical trials, 39 prospective cohort studies, and an additional 18 retrospective studies) that reported CV risk outcomes. A risk of bias analysis for each type of report indicated that they were of good or excellent quality. Importantly, despite some limitations in data reported, there were no indications of significant increase in adverse CV events or risk in response to treatment with the agents evaluated. Treatment with biologic or tofacitinib appears to be well-tolerated with respect to CV outcomes in these patients.

  4. Connotations of pixel-based scale effect in remote sensing and the modified fractal-based analysis method

    NASA Astrophysics Data System (ADS)

    Feng, Guixiang; Ming, Dongping; Wang, Min; Yang, Jianyu

    2017-06-01

    Scale problems are a major source of concern in the field of remote sensing. Since the remote sensing is a complex technology system, there is a lack of enough cognition on the connotation of scale and scale effect in remote sensing. Thus, this paper first introduces the connotations of pixel-based scale and summarizes the general understanding of pixel-based scale effect. Pixel-based scale effect analysis is essentially important for choosing the appropriate remote sensing data and the proper processing parameters. Fractal dimension is a useful measurement to analysis pixel-based scale. However in traditional fractal dimension calculation, the impact of spatial resolution is not considered, which leads that the scale effect change with spatial resolution can't be clearly reflected. Therefore, this paper proposes to use spatial resolution as the modified scale parameter of two fractal methods to further analyze the pixel-based scale effect. To verify the results of two modified methods (MFBM (Modified Windowed Fractal Brownian Motion Based on the Surface Area) and MDBM (Modified Windowed Double Blanket Method)); the existing scale effect analysis method (information entropy method) is used to evaluate. And six sub-regions of building areas and farmland areas were cut out from QuickBird images to be used as the experimental data. The results of the experiment show that both the fractal dimension and information entropy present the same trend with the decrease of spatial resolution, and some inflection points appear at the same feature scales. Further analysis shows that these feature scales (corresponding to the inflection points) are related to the actual sizes of the geo-object, which results in fewer mixed pixels in the image, and these inflection points are significantly indicative of the observed features. Therefore, the experiment results indicate that the modified fractal methods are effective to reflect the pixel-based scale effect existing in remote sensing data and it is helpful to analyze the observation scale from different aspects. This research will ultimately benefit for remote sensing data selection and application.

  5. Comparison of Marginal Bone Loss Between Implants with Internal and External Connections: A Systematic Review.

    PubMed

    Palacios-Garzón, Natalia; Mauri-Obradors, Elisabeth; Roselló-LLabrés, Xavier; Estrugo-Devesa, Albert; Jané-Salas, Enric; López-López, José

    The objective of this systematic review was to compare the loss of marginal bone between implants with internal and external connections by analyzing results reported in studies published after 2010. A literature search in MEDLINE with the keywords "dental implant connections, external internal implant connection, bone loss implant designs, internal and external connection implant studies in humans" was conducted. Clinical trials on human beings, comparing both connections and published in English, from 2010 to 2016 were selected. Their methodologic quality was assessed using the Jadad scale. From the initial search, 415 articles were obtained; 32 were chosen as potentially relevant based on their titles and abstracts. Among them, only 10 finally met the inclusion criteria. A total of 1,523 patients with 3,965 implants were analyzed. Six out of 10 studies observed that internal connections showed significantly less bone loss compared with external connections. The remaining four articles did not find statistically significant differences between the two connections. According to this systematic review and considering its limitation due to the degree of heterogeneity between the included studies, both internal and external connections present high survival rates. To assess whether marginal bone loss differs significantly between the two connections, more homogenous clinical studies are needed with identical implant characteristics, larger samples, and longer follow-up periods. Studies included in this review and characterized by long-term follow-ups showed that the external connection is a reliable connection on a long-term basis.

  6. High Agreement and High Prevalence: The Paradox of Cohen's Kappa.

    PubMed

    Zec, Slavica; Soriani, Nicola; Comoretto, Rosanna; Baldi, Ileana

    2017-01-01

    Cohen's Kappa is the most used agreement statistic in literature. However, under certain conditions, it is affected by a paradox which returns biased estimates of the statistic itself. The aim of the study is to provide sufficient information which allows the reader to make an informed choice of the correct agreement measure, by underlining some optimal properties of Gwet's AC1 in comparison to Cohen's Kappa, using a real data example. During the process of literature review, we have asked a panel of three evaluators to come up with a judgment on the quality of 57 randomized controlled trials assigning a score to each trial using the Jadad scale. The quality was evaluated according to the following dimensions: adopted design, randomization unit, type of primary endpoint. With respect to each of the above described features, the agreement between the three evaluators has been calculated using Cohen's Kappa statistic and Gwet's AC1 statistic and, finally, the values have been compared with the observed agreement. The values of the Cohen's Kappa statistic would lead to believe that the agreement levels for the variables Unit, Design and Primary Endpoints are totally unsatisfactory. The AC1 statistic, on the contrary, shows plausible values which are in line with the respective values of the observed concordance. We conclude that it would always be appropriate to adopt the AC1 statistic, thus bypassing any risk of incurring the paradox and drawing wrong conclusions about the results of agreement analysis.

  7. Xp11.2 Translocation renal cell carcinomas have a poorer prognosis than non-Xp11.2 translocation carcinomas in children and young adults: a meta-analysis.

    PubMed

    Qiu Rao; Bing Guan; Zhou, Xiao-jun

    2010-12-01

    Renal cell carcinomas (RCCs) in children and adolescents are much rarer than in adults. In this age group, Xp11.2 translocation RCCs were the most common subtype of pediatric RCCs. Information regarding the clinical behavior of pediatric RCCs remains controversial because of their relatively rare incidence. The authors aimed to perform a systematic review and meta-analysis to better define the biological features of pediatric RCCs. Eligible studies were identified through multiple search strategies. Studies were assessed for quality using the Jadad Quality Scale. Data were collected comparing overall survival (OS), disease-free survival (DFS), and stage in patients with TFE3 + pediatric RCCs and TFE3 - RCCs. A total of 4 studies were included for meta-analysis, and pooled odds ratios (ORs) with 95% confidence interval (CI) were calculated. The meta-analysis outcomes showed that TFE3 + pediatric RCCs were significantly associated with poorer outcomes (OS and DFS) and a higher stage (III/IV) than TFE3 - RCCs (pooled ORs for each group: 4.59 [95% CI = 1.46-14.42] for OS; 5.79 [95% CI = 1.85-18.16] for DFS; and 5.89 [95% CI = 2.23-15.52] for stage). This result was also confirmed by OS and DFS curves (P = .005 and P = .001). Xp11.2 translocation carcinomas appear to have a poorer prognosis than non-Xp11.2 translocation carcinomas in children and young adults.

  8. Herbal treatments for alleviating premenstrual symptoms: a systematic review.

    PubMed

    Dante, Giulia; Facchinetti, Fabio

    2011-03-01

    Premenstrual syndrome (PMS) is a condition of cyclical and recurrent physical and psychological discomfort occurring 1 to 2 weeks before menstrual period. More severe psychological symptoms have been described for the premenstrual dysphoric disorder (PMDD). No single treatment is universally recognised as effective and many patients often turn to therapeutic approaches outside of conventional medicine. This systematic review is aimed at analysing the effects of herb remedies in the above conditions. Systematic literature searches were performed in electronic databases, covering the period January 1980 to September 2010. Randomised controlled clinical trials (RCTs) were included. Papers quality was evaluated with the Jadad' scale. A further evaluation of PMS/PMDD diagnostic criteria was also done. Of 102 articles identified, 17 RCTs were eligible and 10 of them were included. The heterogeneity of population included, study design and outcome presentation refrained from a meta-analysis. Vitex agnus castus was the more investigated remedy (four trials, about 500 women), and it was reported to consistently ameliorate PMS better than placebo. Single trials also support the use of either Gingko biloba or Crocus sativus. On the contrary, neither evening primrose oil nor St. John's Wort show an effect different than placebo. None of the herbs was associated with major health risks, although the reduced number of tested patients does not allow definitive conclusions on safety. Some herb remedies seem useful for the treatment of PMS. However, more RCTs are required to account for the heterogeneity of the syndrome.

  9. Effectiveness of Platinum-Based Treatment for Triple Negative Metastatic Breast Cancer: a Meta-Analysis

    PubMed

    Kaya, Vildan; Yildirim, Mustafa; Yazici, Gozde; Gunduz, Seyda; Bozcuk, Hakan; Paydas, Semra

    2018-05-26

    Background: Triple-negative breast cancer (TNBC) is a sub-group of breast cancers with a particularly poor prognosis. The results of studies investigating the role of platinum-based chemotherapy (PBC) in metastatic TNBC (mTNBC) have been conflicting. In this meta-analysis, our aim was to assess the effectiveness of PBCs for mTNBCs. Methods: The PubMed, Cochrane Controlled Trials Register Databases, and EBSCOhost databases were accessed. The English language was used as the search language and only human studies were included. The Newcastle–Ottawa Quality Assessment Scale and the Jadad scoring system were used to evaluate the quality of the included randomized controlled studies. Results: Seven studies and 1,571 patients were included in this meta-analysis. The pooled hazard ratio (HR) for overall survival (OS), evaluated on the basis of six studies, showed the use of PBC regimes to be related to OS in mTNBCs (HR 0.620; 95% CI 0.513-0.749; p:<0.001). Four studies containing HR and abstract statistics used for HR calculation were included in the meta-analysis for progression-free survival (PFS). The pooled HR again indicated a significant relation (HR, 0.628; 95% CI, 0.501-0.786; p:<0.001). Conclusions: In this meta-analysis, we confirmed that PBC regimes provide OS and PFS advantages compared to non-PBC regimes. The use of PBC regimes could be a good choice in mTNBC patients for better quality of life and survival. Creative Commons Attribution License

  10. Treatment of Non-neurogenic Overactive Bladder with OnabotulinumtoxinA: Systematic Review and Meta-analysis of Prospective, Randomized, Placebo-controlled Clinical Trials.

    PubMed

    Arruda, Raquel Martins; Takano, Claudia Cristina; Girão, Manoel João Batista Castelo; Haddad, Jorge Milhem; Aleixo, Gabriel Francisco; Castro, Rodrigo Aquino

    2018-04-01

    We performed a systematic review and meta-analysis of randomized placebo-controlled trials that studied non-neurogenic overactive bladder patients who were treated with 100 units of onabotulinumtoxinA or placebo. The primary purpose of our study was to evaluate the clinical effectiveness with regard to urinary urgency, urinary frequency, nocturia, and incontinence episodes. Our secondary purpose consisted of evaluating the adverse effects. Our initial search yielded 532 entries. Of these, seven studies met all the inclusion criteria (prospective, randomized, placebo-controlled studies, ≥ 3 points on the Jadad scale) and were selected for analysis. For all primary endpoints, the toxin was more effective than placebo ( p  < 0.0001; 95% confidence interval [95CI]), namely: urgency (mean difference = -2.07; 95CI = [-2.55-1.58]), voiding frequency (mean difference = -1.64; 95CI = [-2.10-1.18]), nocturia (mean difference = -0.25; 95CI = [-0.39-0.11]) and incontinence episodes (mean difference = -2.06; 95CI= [-2.60-1.52]). The need for intermittent catheterization and the occurrence of urinary tract infection (UTI) were more frequent in patients treated with onabotulinumtoxinA than in patients treated with placebo ( p  < 0.0001). Compared with placebo, onabotulinumtoxinA had significantly and clinically relevant reductions in overactive bladder symptoms and is associated with higher incidence of intermittent catheterization and UTI. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

  11. Prophylaxis for mucositis induced by ambulatory chemotherapy: systematic review.

    PubMed

    Manzi, Natália de Melo; Silveira, Renata Cristina de Campos Pereira; dos Reis, Paula Elaine Diniz

    2016-04-01

    The aim of this study was to perform a systematic review of clinical trials covering interventions used as prophylaxis for oral mucositis induced by ambulatory antineoplastic chemotherapy. Oral mucositis in patients undergoing chemotherapy is a side effect that can impact the quality of treatment and can interfere with eating and therapeutic adherence. Quantitative systematic review. Relevant databases were searched, from January 2002-July 2013, by using the combination of the keywords mucositis, stomatitis, neoplasms, antineoplastic agents, drug therapy, prevention and control and chemotherapy. Two researchers independently read the titles and abstracts from every cross-reference. The quality of the included studies was analysed by the Jadad Scale and the Cochrane Collaboration Risk of Bias Tool. Data were extracted from the selected studies with a data collection form developed specifically for this purpose. Of the 23 controlled clinical trials that were identified in this study, five articles evaluated the use of oral cryotherapy to prevent oral mucositis and three studies analysed the prophylactic use of glutamine. Interventions of protocols for oral care, palifermin, allopurinol and chlorhexidine were evaluated by two articles each. Interventions of zinc sulphate, amifostine, chewing gum, sucralfate, recombination human intestinal trefoil factor, kefir and vitamin E were evaluated by one article each. There is strong evidence that cryotherapy can prevent oral mucositis arising from ambulatory treatment with 5-flurouracil chemotherapy. Other interventions, although showing positive results in preventing oral mucositis, require further study to confirm their conclusions. © 2015 John Wiley & Sons Ltd.

  12. Efficacy and safety of immunomodulatory drugs in patients with anterior uveitis

    PubMed Central

    Gómez-Gómez, Alejandro; Loza, Estíbaliz; Rosario, Maria Piedad; Espinosa, Gerard; de Morales, José M. García Ruiz; Herreras, Jose M.; Muñoz-Fernández, Santiago; Cordero-Coma, Miguel

    2017-01-01

    Abstract Background: To assess the efficacy and safety of immunomodulatory drugs in patients with noninfectious anterior uveitis (AU). Methods: Systematic review of studies were retrieved from Medline (1961 to March 2016), Embase (1961 to March 2016), and Cochrane Library (up to March 2016), and a complementary hand search was also performed. The selection criteria were as follows: (population) noninfectious AU patients, adults; (intervention) immunomodulatory drugs (any dose, regimen, route of administration, duration of treatment); (outcome) control of inflammation, steroid-sparing effect, AU flares, adverse events, and so on; (study design) systematic literature reviews, randomized controlled trials, and observational studies. The study quality was assessed using the Jadad scale and according to The Oxford Centre for Evidence-based Medicine (update 2009). Results: We included 13 studies of moderate-poor quality, with a mean duration from 5 months to 20 years, and number of AU patients ranging from 9 to 274. Patient's demographic and clinical characteristics were very heterogeneous. In most cases, uveitis anatomic classification criteria and outcomes definitions were unclear. Some of the studies only included AU patients with a systemic disease associated, mostly spondyloarthritis, others, mixed populations (idiopathic and systemic disease associated patients), and in some articles this data is not described. We found that methotrexate, cyclosporine A, azathioprine, adalimumab, and golimumab might prevent AU flares, improve ocular inflammation and visual acuity, and decrease systemic steroids doses. Conclusions: Although there is a lack of robust evidence, methotrexate, cyclosporine A, azathioprine, adalimumab, and golimumab might be effective in AU patients. PMID:29049193

  13. Medicinal plants for primary dysmenorrhoea: A systematic review.

    PubMed

    Pellow, Janice; Nienhuis, Chantelle

    2018-04-01

    Primary dysmenorrhoea is a common complaint experienced by many females in their reproductive years. The use of medicinal plants in the treatment of various gynaecological conditions is on the increase, despite the limited evidence available regarding efficacy and safety of their use. The aim of this systematic review was to synthesise the most recent evidence relating to the treatment of primary dysmenorrhoea with medicinal plants. A thorough database search was conducted using defined search terms, and randomised controlled trials (RCTs) published in English between 2008 and 2016, pertaining to the use of medicinal plants (single use) for the treatment of primary dysmenorrhoea, were assessed. Studies evaluating dysmenorrhoeal pain and associated symptoms as a primary or secondary outcome were considered and assessed by two reviewers independently of each other, using the JADAD scale and the Cochrane risk of bias tool,. 22 RCTs were included in the review; 9 were placebo-controlled trials and 13 were comparative studies to pharmacological treatment or nutritional supplements. Most of the evaluated medicinal plants showed evidence of efficacy in relieving menstrual pain in at least one RCT. The low or unclear quality of the majority of these studies however warrants caution in interpreting these results. This review adds to the knowledge-base on the use of these medicinal plants in the treatment of primary dysmenorrhoea. Further research is needed before definitive conclusions can be made regarding the efficacy and safety of the use of these medicinal plants. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Efficacy and safety of immunomodulatory drugs in patients with anterior uveitis: A systematic literature review.

    PubMed

    Gómez-Gómez, Alejandro; Loza, Estíbaliz; Rosario, Maria Piedad; Espinosa, Gerard; Morales, José M García Ruiz de; Herreras, Jose M; Muñoz-Fernández, Santiago; Cordero-Coma, Miguel

    2017-10-01

    To assess the efficacy and safety of immunomodulatory drugs in patients with noninfectious anterior uveitis (AU). Systematic review of studies were retrieved from Medline (1961 to March 2016), Embase (1961 to March 2016), and Cochrane Library (up to March 2016), and a complementary hand search was also performed. The selection criteria were as follows: (population) noninfectious AU patients, adults; (intervention) immunomodulatory drugs (any dose, regimen, route of administration, duration of treatment); (outcome) control of inflammation, steroid-sparing effect, AU flares, adverse events, and so on; (study design) systematic literature reviews, randomized controlled trials, and observational studies. The study quality was assessed using the Jadad scale and according to The Oxford Centre for Evidence-based Medicine (update 2009). We included 13 studies of moderate-poor quality, with a mean duration from 5 months to 20 years, and number of AU patients ranging from 9 to 274. Patient's demographic and clinical characteristics were very heterogeneous. In most cases, uveitis anatomic classification criteria and outcomes definitions were unclear. Some of the studies only included AU patients with a systemic disease associated, mostly spondyloarthritis, others, mixed populations (idiopathic and systemic disease associated patients), and in some articles this data is not described. We found that methotrexate, cyclosporine A, azathioprine, adalimumab, and golimumab might prevent AU flares, improve ocular inflammation and visual acuity, and decrease systemic steroids doses. Although there is a lack of robust evidence, methotrexate, cyclosporine A, azathioprine, adalimumab, and golimumab might be effective in AU patients.

  15. Speech Compensation for Time-Scale-Modified Auditory Feedback

    ERIC Educational Resources Information Center

    Ogane, Rintaro; Honda, Masaaki

    2014-01-01

    Purpose: The purpose of this study was to examine speech compensation in response to time-scale-modified auditory feedback during the transition of the semivowel for a target utterance of /ija/. Method: Each utterance session consisted of 10 control trials in the normal feedback condition followed by 20 perturbed trials in the modified auditory…

  16. Modified Light Duty AM2 Capability Assessment

    DTIC Science & Technology

    The Modified Light -Duty AM2 matting was designed specifically for lightweight, remote-piloted aircraft (RPA) applications. An in- depth study was... Ratio (CBR) of 6. To understand the full potential of the Modified Light -Duty AM2, a full- scale evaluation was performed with contingency C-17 and...stir welding for use in fabrication of the lightweight RPA matting in conjunction with a full- scale test on the Modified Light -Duty AM2 matting system

  17. A Visual Analog Scale to assess anxiety in children during anesthesia induction (VAS-I): Results supporting its validity in a sample of day care surgery patients.

    PubMed

    Berghmans, Johan M; Poley, Marten J; van der Ende, Jan; Weber, Frank; Van de Velde, Marc; Adriaenssens, Peter; Himpe, Dirk; Verhulst, Frank C; Utens, Elisabeth

    2017-09-01

    The modified Yale Preoperative Anxiety Scale is widely used to assess children's anxiety during induction of anesthesia, but requires training and its administration is time-consuming. A Visual Analog Scale, in contrast, requires no training, is easy-to-use and quickly completed. The aim of this study was to evaluate a Visual Analog Scale as a tool to assess anxiety during induction of anesthesia and to determine cut-offs to distinguish between anxious and nonanxious children. Four hundred and one children (1.5-16 years) scheduled for daytime surgery were included. Children's anxiety during induction was rated by parents and anesthesiologists on a Visual Analog Scale and by a trained observer on the modified Yale Preoperative Anxiety Scale. Psychometric properties assessed were: (i) concurrent validity (correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores); (ii) construct validity (differences between subgroups according to the children's age and the parents' anxiety as assessed by the State-Trait Anxiety Inventory); (iii) cross-informant agreement using Bland-Altman analysis; (iv) cut-offs to distinguish between anxious and nonanxious children (reference: modified Yale Preoperative Anxiety Scale ≥30). Correlations between parents' and anesthesiologists' Visual Analog Scale and modified Yale Preoperative Anxiety Scale scores were strong (0.68 and 0.73, respectively). Visual Analog Scale scores were higher for children ≤5 years compared to children aged ≥6. Visual Analog Scale scores of children of high-anxious parents were higher than those of low-anxious parents. The mean difference between parents' and anesthesiologists' Visual Analog Scale scores was 3.6, with 95% limits of agreement (-56.1 to 63.3). To classify anxious children, cut-offs for parents (≥37 mm) and anesthesiologists (≥30 mm) were established. The present data provide preliminary data for the validity of a Visual Analog Scale to assess children's anxiety during induction. © 2017 John Wiley & Sons Ltd.

  18. Further evidence for the reliability and validity of the Modified Dental Anxiety Scale.

    PubMed

    Humphris, G M; Freeman, R; Campbell, J; Tuutti, H; D'Souza, V

    2000-12-01

    To gain further evidence of the psychometric properties of the Modified Dental Anxiety Scale. Dental admission clinics. Consecutive sampling, cross-sectional survey. Patients (n = 800) in four cities (Belfast, Northern Ireland; Helsinki, Finland; Jyväskylä, Finland and Dubai, UAE). Questionnaire booklet handed to patients, attending clinics, for completion following an invitation by the researcher to be included in the study. Modified Dental Anxiety Scale (MDAS), together with further questions concerning dental attendance and nervousness about dental procedures. Overall 9.3 per cent of patients indicated high dental anxiety. MDAS showed high levels of internal consistency, and good construct validity. The relationship of dental anxiety with age was similar to previous reports and showed lowered anxiety levels in older patients. Data from three countries has supported the psychometric properties of this modified and brief dental anxiety scale.

  19. Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis.

    PubMed

    Borrelli, Francesca; Colalto, Cristiano; Delfino, Domenico V; Iriti, Marcello; Izzo, Angelo A

    2018-04-01

    Erectile dysfunction (ED) is a common condition that significantly affects quality of life and interpersonal relationships. Our objective was to perform a systematic review and meta-analysis to evaluate the efficacy of herbal dietary supplements in the treatment of ED. We searched five databases to identify randomized controlled trials (RCTs) that evaluated the clinical efficacy of herbal medicines in ED. Quality was assessed and risk of bias was estimated using the Jadad score and the Cochrane risk-of-bias tool. In total, 24 RCTs, including 2080 patients with ED, were identified. Among these, 12 evaluated monopreparations (five ginseng [n = 399], three saffron [n = 397], two Tribulus terrestris [n = 202], and one each Pinus pinaster [n = 21] and Lepidium meyenii [n = 50]), seven evaluated formulations (n = 544), and five investigated dietary supplements in combination with pure compounds (n = 410). Ginseng significantly improved erectile function (International Index of Erectile Function [IIEF]-5 score: 140 ginseng, 96 placebo; standardized mean difference [SMD] 0.43; 95% confidence interval [CI] 0.15-0.70; P < 0.01; I 2  = 0), P. pinaster and L. meyenii showed very preliminary positive results, and saffron and T. terrestris treatment produced mixed results. Several herbal formulations were associated with a decrease of IIEF-5 or IIEF-15, although the results were preliminary. The quality of the included studies varied, with only seven having a prevalent low risk of bias. The median methodological quality Jadad score was three out of a maximum of five. Adverse events were recorded in 19 of 24 trials, with no significant differences between placebo and verum in placebo-controlled studies. Encouraging evidence suggests that ginseng may be an effective herbal treatment for ED. However, further, larger, and high-quality studies are required before firm conclusions can be drawn. Promising (although very preliminary) results have also been generated for some herbal formulations. Overall, more research in the field, adhering to the CONSORT statement extension for reporting trials, is justified before the use of herbal products in ED can be recommended.

  20. Therapeutic effects of Lactobacillus in treating irritable bowel syndrome: a meta-analysis.

    PubMed

    Tiequn, Bian; Guanqun, Chao; Shuo, Zhang

    2015-01-01

    As the lack of reliable treatment for irritable bowel syndrome (IBS) prompts interest in the development of new therapies, we aimed to systematically evaluate the effect of Lactobacillus in treating this disease. We searched MEDLIINE, PubMed, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials for the period from 1966 to August 2013 for double-blind, placebo-controlled trials investigating the efficacy of Lactobacillus treatment in the management of IBS. The studies were screened for inclusion based on randomization, controls and reported measurable outcomes. We used the Jadad score to assess the quality of the articles. The STATA 11.0 and Revman 5.0 software packages were used for the meta-analysis. The STATA 11.0 software program was also used to assess indicators of publication bias according to Begg's and Egger's tests. Six randomized, placebo-controlled clinical trials met the criteria and were included in the meta-analysis. The Jadad score of the articles was >3, and three articles were of high quality. We analyzed the heterogeneity of the studies and found no heterogeneity in the meta-analysis. In the forest plot, the diamond was on the right side of the vertical line and did not intersect with the line. The pooled relative risk for clinical improvement with Lactobacillus treatment was 7.69 (95% confidence interval: 2.33-25.43, p=0.0008). For adults, the pooled relative risk for clinical improvement with Lactobacillus treatment was 17.62 (95% confidence interval: 5.12-60.65, p<0.00001). For children, the pooled relative risk for clinical improvement with Lactobacillus treatment was 3.71 (95% confidence interval:1.05-13.11, p=0.04). Using the STATA 10.0 and Revman 5.0 software programs, we confirmed that Lactobacillus exhibited significant efficacy in treating IBS. Compared with the placebo, Lactobacillus treatment was found to be associated with a significantly higher rate of treatment responders in the overall population with IBS, without any side effects. As to limitations of the analysis, additional research is needed.

  1. Influence of Study Design on Outcomes Following Reflexology Massage: An Integrative and Critical Review of Interventional Studies.

    PubMed

    McVicar, Andrew; Greenwood, Christina; Ellis, Carol; LeForis, Chantelle

    2016-09-01

    Interpretation of the efficacy of reflexology is hindered by inconsistent research designs and complicated by professional views that criteria of randomized controlled trials (RCTs)are not ideal to research holistic complementary and alternative medicine practice. The influence of research designs on study outcomes is not known. This integrative review sought to evaluate this possibility. Thirty-seven interventional studies (2000-2014) were identified; they had RCT or non-RCT design and compared reflexology outcomes against a control/comparison group. Viability of integrating RCT and non-RCT studies into a single database was first evaluated by appraisal of 16 reporting fields related to study setting and objectives, sample demographics, methodologic design, and treatment fidelity and assessment against Jadad score quality criteria for RCTs. For appraisal, the database was stratified into RCT/non-RCT or Jadad score of 3 or more or less than 3. Deficits in reporting were identified for blind assignment of participants, dropout/completion rate, and School of Reflexology. For comparison purposes, these fields were excluded from subsequent analysis for evidence of association between design fields and of fields with study outcomes. Thirty-one studies applied psychometric tools and 20 applied biometric tools (14 applied both). A total of 116 measures were used. Type of measure was associated with study objectives (p < 0.001; chi-square), in particular of psychometric measures with a collated "behavioral/cognitive" objective. Significant outcomes were more likely (p < 0.001; chi-square) for psychometric than for biometric measures. Neither type of outcome was associated with choice of RCT or non-RCT method, but psychometric responses were associated (p = 0.007) with a nonmassage control strategy. The review supports psychometric responses to reflexology when study design uses a nonmassage control strategy. Findings suggest that an evaluation of outcomes against sham reflexology massage and other forms of massage, as well as a narrower focus of study objective, may clarify whether there is a relationship between study design and efficacy of reflexology.

  2. Preparation, characterization, and scale-up of ketoconazole with enhanced dissolution and bioavailability.

    PubMed

    Elder, Edmund J; Evans, Jonathan C; Scherzer, Brian D; Hitt, James E; Kupperblatt, Gary B; Saghir, Shakil A; Markham, Dan A

    2007-07-01

    Many new molecular entities targeted for pharmaceutical applications face serious development challenges because of poor water solubility. Although particle engineering technologies such as controlled precipitation have been shown to enhance aqueous dissolution and bioavailability of poorly water soluble active pharmaceutical ingredients, the data available are the results of laboratory-scale experiments. These technologies must be evaluated at larger scale to ensure that the property enhancement is scalable and that the modified drugs can be processed on conventional equipment. In experiments using ketoconazole as the model drug, the controlled precipitation process was shown to produce kg-scale modified drug powder with enhanced dissolution comparable to that of lab-scale powder. Ketoconazole was demonstrated to be stable throughout the controlled precipitation process, with a residual methanol level below the ICH limit. The modified crystalline powder can be formulated, and then compressed using conventional high-speed tableting equipment, and the resulting tablets showed bioavailability more than double that of commercial tablets. When appropriately protected from moisture, both the modified powder and tablets prepared from the modified powder showed no change in dissolution performance for at least 6 months following storage at accelerated conditions and for at least 18 months following storage at room temperature.

  3. A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity.

    PubMed

    Pandyan, A D; Johnson, G R; Price, C I; Curless, R H; Barnes, M P; Rodgers, H

    1999-10-01

    The Ashworth Scale and the modified Ashworth Scale are the primary clinical measures of spast city. A prerequisite for using any scale is a knowledge of its characteristics and limitations, as these will play a part in analysing and interpreting the data. Despite the current emphasis on treating spasticity, clinicians rarely measure it. To determine the validity and the reliability of the Ashworth and modified Ashworth Scales. A theoretical analysis following a structured literature review (key words: Ashworth; Spasticity; Measurement) of 40 papers selected from the BIDS-EMBASE, First Search and Medline databases. The application of both scales would suggest that confusion exists on their characteristics and limitations as measures of spasticity. Resistance to passive movement is a complex measure that will be influenced by many factors, only one of which could be spasticity. The Ashworth Scale (AS) can be used as an ordinal level measure of resistance to passive movement, but not spasticity. The modified Ashworth Scale (MAS) will need to be treated as a nominal level measure of resistance to passive movement until the ambiguity between the '1' and '1+' grades is resolved. The reliability of the scales is better in the upper limb. The AS may be more reliable than the MAS. There is a need to standardize methods to apply these scales in clinical practice and research.

  4. The effects of asking a fertility intention question in primary care settings: a systematic review protocol.

    PubMed

    Henning, Paul A; Burgess, Carolyne K; Jones, Heidi E; Norman, Wendy V

    2017-01-19

    Planning for pregnancy has been associated with reduced unwanted pregnancies and improved pregnancy outcomes. Despite the benefits of planned pregnancy, there are no guideline recommendations on routine counseling regarding pregnancy intention in primary care settings. The objective of the systematic review is to determine the effectiveness of incorporating questions of pregnancy intention into primary care. A systematic search of the literature will be conducted for any studies comparing questions of pregnancy intention in primary care settings with no intervention or a control intervention. Types of studies will include randomized controlled trials, non-randomized trials, and observation studies. Participants will include patients of reproductive age presenting to primary health care settings. Interventions will include any assessment of fertility intention and follow-up care compared with a control group or no intervention. Outcomes will include quantitative data with rates for contraceptive uptake, and any pregnancy related outcome. Databases (Ovid MEDLINE; Pubmed; CINAHL; EMBASE; CDR/DARE databases; Web of Science; ISRCTN registry; Clinicaltrials.gov; Cochrane Library) will be searched from the year 2000 to current. Screening of identified articles and data extraction will be conducted in duplicate by two independent reviewers. Methodological quality will be assessed using the Jadad scale. Methodological quality of observational and non-randomized trials will be assessed using the Newcastle-Ottawa scale. Discrepancies will be resolved by consensus or by consulting a third author. Meta-analyses will be performed if appropriate. Determining the effect of including questions of pregnancy intention into primary care can provide evidence for the development of clinical practice guidelines and inform primary care providers if this simple and low-cost intervention should be routinely employed. This review will also identify any gaps in the current literature on this topic and provide direction for future research in this area of study. Systematic Review Registration: PROSPERO CRD42015019726.

  5. Applying Rasch Model and Generalizability Theory to Study Modified-Angoff Cut Scores

    ERIC Educational Resources Information Center

    Arce, Alvaro J.; Wang, Ze

    2012-01-01

    The traditional approach to scale modified-Angoff cut scores transfers the raw cuts to an existing raw-to-scale score conversion table. Under the traditional approach, cut scores and conversion table raw scores are not only seen as interchangeable but also as originating from a common scaling process. In this article, we propose an alternative…

  6. Development of a fragile X syndrome (FXS) knowledge scale: towards a modified multidimensional measure of informed choice for FXS population carrier screening.

    PubMed

    Ames, Alice G; Jaques, Alice; Ukoumunne, Obioha C; Archibald, Alison D; Duncan, Rony E; Emery, Jon; Metcalfe, Sylvia A

    2015-02-01

    Genetic carrier screening is increasingly possible for many conditions, but it is important to ensure decisions are informed. The multidimensional measure of informed choice (MMIC) is a quantitative instrument developed to evaluate informed choice in prenatal screening for Down syndrome, measuring knowledge, attitudes and uptake. To apply the MMIC in other screening settings, the knowledge scale must be modified. To develop and validate a modified MMIC knowledge scale for use with women undergoing carrier screening for fragile X syndrome (FXS). Responses to MMIC items were collected through questionnaires as part of a FXS carrier screening pilot study in a preconception setting in Melbourne, Australia. Ten knowledge scale items were developed using a modified Delphi technique. Cronbach's alpha and factor analysis were used to validate the new FXS knowledge scale. We summarized the knowledge, attitudes and informed choice status based on the modified MMIC. Two hundred and eighty-five women were recruited, 241 eligible questionnaires were complete for analysis. The FXS knowledge scale items measured one salient construct and were internally consistent (alpha = 0.70). 71% (172/241) of participants were classified as having good knowledge, 70% (169/241) had positive attitudes and 27% (65/241) made an informed choice to accept or decline screening. We present the development of a knowledge scale as part of a MMIC to evaluate informed choice in population carrier screening for FXS. This can be used as a template by other researchers to develop knowledge scales for other conditions for use in the MMIC. © 2012 John Wiley & Sons Ltd.

  7. Modified dispersion relations, inflation, and scale invariance

    NASA Astrophysics Data System (ADS)

    Bianco, Stefano; Friedhoff, Victor Nicolai; Wilson-Ewing, Edward

    2018-02-01

    For a certain type of modified dispersion relations, the vacuum quantum state for very short wavelength cosmological perturbations is scale-invariant and it has been suggested that this may be the source of the scale-invariance observed in the temperature anisotropies in the cosmic microwave background. We point out that for this scenario to be possible, it is necessary to redshift these short wavelength modes to cosmological scales in such a way that the scale-invariance is not lost. This requires nontrivial background dynamics before the onset of standard radiation-dominated cosmology; we demonstrate that one possible solution is inflation with a sufficiently large Hubble rate, for this slow roll is not necessary. In addition, we also show that if the slow-roll condition is added to inflation with a large Hubble rate, then for any power law modified dispersion relation quantum vacuum fluctuations become nearly scale-invariant when they exit the Hubble radius.

  8. Surface modification to prevent oxide scale spallation

    DOEpatents

    Stephens, Elizabeth V; Sun, Xin; Liu, Wenning; Stevenson, Jeffry W; Surdoval, Wayne; Khaleel, Mohammad A

    2013-07-16

    A surface modification to prevent oxide scale spallation is disclosed. The surface modification includes a ferritic stainless steel substrate having a modified surface. A cross-section of the modified surface exhibits a periodic morphology. The periodic morphology does not exceed a critical buckling length, which is equivalent to the length of a wave attribute observed in the cross section periodic morphology. The modified surface can be created using at least one of the following processes: shot peening, surface blasting and surface grinding. A coating can be applied to the modified surface.

  9. Acceptable Tolerances for Matching Icing Similarity Parameters in Scaling Applications

    NASA Technical Reports Server (NTRS)

    Anderson, David N.

    2003-01-01

    This paper reviews past work and presents new data to evaluate how changes in similarity parameters affect ice shapes and how closely scale values of the parameters should match reference values. Experimental ice shapes presented are from tests by various researchers in the NASA Glenn Icing Research Tunnel. The parameters reviewed are the modified inertia parameter (which determines the stagnation collection efficiency), accumulation parameter, freezing fraction, Reynolds number, and Weber number. It was demonstrated that a good match of scale and reference ice shapes could sometimes be achieved even when values of the modified inertia parameter did not match precisely. Consequently, there can be some flexibility in setting scale droplet size, which is the test condition determined from the modified inertia parameter. A recommended guideline is that the modified inertia parameter be chosen so that the scale stagnation collection efficiency is within 10 percent of the reference value. The scale accumulation parameter and freezing fraction should also be within 10 percent of their reference values. The Weber number based on droplet size and water properties appears to be a more important scaling parameter than one based on model size and air properties. Scale values of both the Reynolds and Weber numbers need to be in the range of 60 to 160 percent of the corresponding reference values. The effects of variations in other similarity parameters have yet to be established.

  10. Effects of raloxifene on cognition, mental health, sleep and sexual function in menopausal women: a systematic review of randomized controlled trials.

    PubMed

    Yang, Z D; Yu, J; Zhang, Q

    2013-08-01

    Raloxifene has been used as therapy for osteoporosis and ER(+) breast cancer prevention in menopausal women. However, its effects on cognition and climacteric syndrome are controversial. This study reviews the relevant studies and reaches a comprehensive conclusion. We retrieved thirteen electronic databases, read the titles and abstracts to exclude ineligible articles, and then read the full text and references to form a basis for decisions using the inclusion criteria. If full text was not available, we asked the author for a copy of the article. After the data were extracted and recorded, the research quality was evaluated by two authors using the Jadad score and Cochrane handbook. We found seven eligible studies. The design, evaluated items, questionnaires and scales were heterogeneous. The design quality was fair as evaluated by the Cochrane Handbook. We found that 60 mg/day raloxifene could improve verbal memory, and 120 mg/day raloxifene produced a 33% decrease in the risk of mild cognitive impairment and also lowered the risk of Alzheimer's disease. There was not enough evidence to state if raloxifene had any effect on depression, anxiety, sleep, sexual function, vasomotor symptoms, but significantly worsened menstrual symptoms. Raloxifene may have some benefit for cognition, but it is not significant effect on anxiety, depression, sleep, sexual function, vasomotor symptoms and worsens menstrual symptoms. This drug is safe for treating osteoporosis and preventing breast cancer in menopausal women, but it is not suitable for patients who have any arterial stenosis or thrombophilia. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Effects of psychological interventions for patients with osteoarthritis: a systematic review and meta-analysis.

    PubMed

    Zhang, Lijuan; Fu, Ting; Zhang, Qiuxiang; Yin, Rulan; Zhu, Li; He, Yan; Fu, Wenting; Shen, Biyu

    2018-01-01

    The aim of this study was to determine the effects of psychological interventions (e.g. cognitive restructuring, relaxation) on physiological and psychological health in osteoarthritis patients. A systematic literature search was done using PubMed, Embase, PsycINFO, Web of Science, China National Knowledge Infrastructure, and Wanfang Database through November 2016. Studies were included if they used a randomized controlled trial designed to explore the effects of psychological interventions in osteoarthritis patients. Two independent authors assessed the methodological quality of the trials using criteria outlined by Jadad et al. Meta-analysis was done with the Revman5.0. Twelve randomized controlled trials, including 1307 osteoarthritis patients, met the study inclusion criteria. Meta-analysis showed that psychological interventions could reduce the levels of pain [standard mean difference (SMD) -0.28, 95% CI -0.48, -0.08, P-value 0.005)] and fatigue (SMD -0.18, 95% CI -0.34, -0.01, P-value 0.04). In addition, psychological interventions significantly improved osteoarthritis patients' self-efficacy (SMD 0.58, 95% CI 0.40, 0.75, P-value 0.00) and pain coping (MD 1.64, 95% CI 0.03, 3.25, P-value 0.05). Although the effects on physical function, anxiety, depression, psychological disability were in the expected direction, they were not statistically significant. In conclusion, the role of psychological interventions in the management of osteoarthritis remains equivocal. Some encouraging results were seen with regard to pain, pain coping, self-efficacy, and fatigue. We believe that more methodologically rigorous large-scale randomized controlled trials are necessary to answer this study question.

  12. Long-acting insulin analogues for type 1 diabetes: An overview of systematic reviews and meta-analysis of randomized controlled trials.

    PubMed

    Laranjeira, Fernanda O; de Andrade, Keitty R C; Figueiredo, Ana C M G; Silva, Everton N; Pereira, Mauricio G

    2018-01-01

    The comparison between long acting insulin analogues (LAIA) and human insulin (NPH) has been investigated for decades, with many randomized controlled trials (RCTs) and systematic reviews giving mixed results. This overlapping and contradictory evidence has increased uncertainty on coverage decisions at health systems level. To conduct an overview of systematic reviews and update existing reviews, preparing new meta-analysis to determine whether LAIA are effective for T1D patients compared to NPH. We identified systematic reviews of RCTs that evaluated the efficacy of LAIA glargine or detemir, compared to NPH insulin for T1D, assessing glycated hemoglobin (A1C) and hypoglycemia. Data sources included Pubmed, Cochrane Library, EMBASE and hand-searching. The methodological quality of studies was independently assessed by two reviewers, using AMSTAR and Jadad scale. We found 11 eligible systematic reviews that contained a total of 25 relevant clinical trials. Two reviewers independently abstracted data. We found evidence that LAIA are efficacious compared to NPH, with estimates showing a reduction in nocturnal hypoglycemia episodes (RR 0.66; 95% CI 0.57; 0.76) and A1C (95% CI 0.23; 0.12). No significance was found related to severe hypoglycemia (RR 0.94; 95% CI 0.71; 1.24). This study design has allowed us to carry out the most comprehensive assessment of RCTs on this subject, filling a gap in diabetes research. Our paper addresses a question that is important not only for decision makers but also for clinicians.

  13. The comprehensive summary of surgical versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Cheng, Ji; Gao, Jinbo; Shuai, Xiaoming; Wang, Guobin; Tao, Kaixiong

    2016-06-28

    Bariatric surgery has emerged as a competitive strategy for obese patients. However, its comparative efficacy against non-surgical treatments remains ill-defined, especially among nonseverely obese crowds. Therefore, we implemented a systematic review and meta-analysis in order for an academic addition to current literatures. Literatures were retrieved from databases of PubMed, Web of Science, EMBASE and Cochrane Library. Randomized trials comparing surgical with non-surgical therapies for obesity were included. A Revised Jadad's Scale and Risk of Bias Summary were employed for methodological assessment. Subgroups analysis, sensitivity analysis and publication bias assessment were respectively performed in order to find out the source of heterogeneity, detect the outcome stability and potential publication bias. 25 randomized trials were eligibly included, totally comprising of 1194 participants. Both groups displayed well comparability concerning baseline parameters (P > 0.05). The pooled results of primary endpoints (weight loss and diabetic remission) revealed a significant advantage among surgical patients rather than those receiving non-surgical treatments (P < 0.05). Furthermore, except for certain cardiovascular indicators, bariatric surgery was superior to conventional arms in terms of metabolic secondary parameters (P < 0.05). Additionally, the pooled outcomes were confirmed to be stable by sensitivity analysis. Although Egger's test (P < 0.01) and Begg's test (P<0.05) had reported the presence of publication bias among included studies, "Trim-and-Fill" method verified that the pooled outcomes remained stable. Bariatric surgery is a better therapeutic option for weight loss, irrespective of follow-up duration, surgical techniques and obesity levels.

  14. Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: a review on latest evidence.

    PubMed

    Karagülle, Mine; Karagülle, Müfit Zeki

    2015-02-01

    In most European countries, balneotherapy and spa therapy are widely prescribed by physicians and preferred by European citizens for the treatment of musculoskeletal problems including chronic low back pain (LBP). We aimed to review and evaluate the recent evidence on the effectiveness of balneotherapy and spa therapy for patients with LBP. We comprehensively searched data bases for randomized controlled trials (RCTs) published in English between July 2005 and December 2013. We identified all trials testing balneotherapy or spa therapy for LBP that reported that the sequence of allocation was randomized. We finally included total of eight RCTs: two on balneotherapy and six on spa therapy. All reviewed trials reported that balneotherapy was superior in long term to tap water therapy in relieving pain and improving function and that spa therapy combining balneotherapy with mud pack therapy and/or exercise therapy, physiotherapy, and/or education was effective in the management of low back pain and superior or equally effective to the control treatments in short and long terms. We used Jadad scale to grade the methodological quality. Only three out of total eight had a score of above 3 indicating the good quality. The data from the RCTs indicates that overall evidence on effectiveness of balneotherapy and spa therapy in LBP is encouraging and reflects the consistency of previous evidence. However, the overall quality of trials is generally low. Better quality RCTs (well designed, conducted, and reported) are needed testing short- and long-term effects for relieving chronic back pain and proving broader beneficial effects.

  15. Transcranial Direct Current Stimulation in Epilepsy.

    PubMed

    San-Juan, Daniel; Morales-Quezada, León; Orozco Garduño, Adolfo Josué; Alonso-Vanegas, Mario; González-Aragón, Maricarmen Fernández; Espinoza López, Dulce Anabel; Vázquez Gregorio, Rafael; Anschel, David J; Fregni, Felipe

    2015-01-01

    Transcranial direct current stimulation (tDCS) is an emerging non-invasive neuromodulation therapy in epilepsy with conflicting results in terms of efficacy and safety. Review the literature about the efficacy and safety of tDCS in epilepsy in humans and animals. We searched studies in PubMed, MedLine, Scopus, Web of Science and Google Scholar (January 1969 to October 2013) using the keywords 'transcranial direct current stimulation' or 'tDCS' or 'brain polarization' or 'galvanic stimulation' and 'epilepsy' in animals and humans. Original articles that reported tDCS safety and efficacy in epileptic animals or humans were included. Four review authors independently selected the studies, extracted data and assessed the methodological quality of the studies using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines and Jadad Scale. A meta-analysis was not possible due to methodological, clinical and statistical heterogeneity of included studies. We analyzed 9 articles with different methodologies (3 animals/6 humans) with a total of 174 stimulated individuals; 109 animals and 65 humans. In vivo and in vitro animal studies showed that direct current stimulation can successfully induce suppression of epileptiform activity without neurological injury and 4/6 (67%) clinical studies showed an effective decrease in epileptic seizures and 5/6 (83%) reduction of inter-ictal epileptiform activity. All patients tolerated tDCS well. tDCS trials have demonstrated preliminary safety and efficacy in animals and patients with epilepsy. Further larger studies are needed to define the best stimulation protocols and long-term follow-up. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. The Use of Herbal Medicine in Alzheimer's Disease—A Systematic Review

    PubMed Central

    dos Santos-Neto, Leopoldo Luiz; de Vilhena Toledo, Maria Alice; Medeiros-Souza, Patrícia; de Souza, Gustavo Almeida

    2006-01-01

    The treatments of choice in Alzheimer's disease (AD) are cholinesterase inhibitors and NMDA-receptor antagonists, although doubts remain about the therapeutic effectiveness of these drugs. Herbal medicine products have been used in the treatment of Behavioral and Psychological Symptoms of Dementia (BPSD) but with various responses. The objective of this article was to review evidences from controlled studies in order to determine whether herbs can be useful in the treatment of cognitive disorders in the elderly. Randomized controlled studies assessing AD in individuals older than 65 years were identified through searches of MEDLINE, LILACS, Cochrane Library, dissertation Abstract (USA), ADEAR (Alzheimer's Disease Clinical Trials Database), National Research Register, Current Controlled trials, Centerwatch Trials Database and PsychINFO Journal Articles. The search combined the terms Alzheimer disease, dementia, cognition disorders, Herbal, Phytotherapy. The crossover results were evaluated by the Jadad's measurement scale. The systematic review identified two herbs and herbal formulations with therapeutic effects for the treatment of AD: Melissa officinalis, Salvia officinalis and Yi-Gan San and BDW (Ba Wei Di Huang Wan). Ginkgo biloba was identified in a meta-analysis study. All five herbs are useful for cognitive impairment of AD. M. officinalis and Yi-Gan San are also useful in agitation, for they have sedative effects. These herbs and formulations have demonstrated good therapeutic effectiveness but these results need to be compared with those of traditional drugs. Further large multicenter studies should be conducted in order to test the cost-effectiveness of these herbs for AD and the impact in the control of cognitive deterioration. PMID:17173107

  17. The effect of high-polyphenol extra virgin olive oil on cardiovascular risk factors: a systematic review and meta-analysis.

    PubMed

    George, Elena S; Marshall, Skye; Mayr, Hannah L; Trakman, Gina L; Tatucu-Babet, Oana A; Lassemillante, Annie-Claude M; Bramley, Andrea; Reddy, Anjana J; Forsyth, Adrienne; Tierney, Audrey C; Thomas, Colleen J; Itsiopoulos, Catherine; Marx, Wolfgang

    2018-04-30

    The polyphenol fraction of extra-virgin olive oil may be partly responsible for its cardioprotective effects. The aim of this systematic review and meta-analysis was to evaluate the effect of high versus low polyphenol olive oil on cardiovascular disease (CVD) risk factors in clinical trials. In accordance with PRISMA guidelines, CINAHL, PubMed, Embase and Cochrane databases were systematically searched for relevant studies. Randomized controlled trials that investigated markers of CVD risk (e.g. outcomes related to cholesterol, inflammation, oxidative stress) were included. Risk of bias was assessed using the Jadad scale. A meta-analysis was conducted using clinical trial data with available CVD risk outcomes. Twenty-six studies were included. Compared to low polyphenol olive oil, high polyphenol olive oil significantly improved measures of malondialdehyde (MD: -0.07µmol/L [95%CI: -0.12, -0.02µmol/L]; I 2 : 88%; p = 0.004), oxidized LDL (SMD: -0.44 [95%CI: -0.78, -0.10µmol/L]; I 2 : 41%; P = 0.01), total cholesterol (MD 4.5mg/dL [95%CI: -6.54, -2.39mg/dL]; p<0.0001) and HDL cholesterol (MD 2.37mg/dL [95%CI: 0.41, 5.04mg/dL]; p = 0.02). Subgroup analyses and individual studies reported additional improvements in inflammatory markers and blood pressure. Most studies were rated as having low-to-moderate risk of bias. High polyphenol oils confer some CVD-risk reduction benefits; however, further studies with longer duration and in non-Mediterranean populations are required.

  18. Sequential vs simultaneous revascularization in patients undergoing liver transplantation: A meta-analysis.

    PubMed

    Wang, Jia-Zhong; Liu, Yang; Wang, Jin-Long; Lu, Le; Zhang, Ya-Fei; Lu, Hong-Wei; Li, Yi-Ming

    2015-06-14

    We undertook this meta-analysis to investigate the relationship between revascularization and outcomes after liver transplantation. A literature search was performed using MeSH and key words. The quality of the included studies was assessed using the Jadad Score and the Newcastle-Ottawa Scale. Heterogeneity was evaluated by the χ(2) and I (2) tests. The risk of publication bias was assessed using a funnel plot and Egger's test, and the risk of bias was assessed using a domain-based assessment tool. A sensitivity analysis was conducted by reanalyzing the data using different statistical approaches. Six studies with a total of 467 patients were included. Ischemic-type biliary lesions were significantly reduced in the simultaneous revascularization group compared with the sequential revascularization group (OR = 4.97, 95%CI: 2.45-10.07; P < 0.00001), and intensive care unit (ICU) days were decreased (MD = 2.00, 95%CI: 0.55-3.45; P = 0.007) in the simultaneous revascularization group. Although warm ischemia time was prolonged in simultaneous revascularization group (MD = -25.84, 95%CI: -29.28-22.40; P < 0.00001), there were no significant differences in other outcomes between sequential and simultaneous revascularization groups. Assessment of the risk of bias showed that the methods of random sequence generation and blinding might have been a source of bias. The sensitivity analysis strengthened the reliability of the results of this meta-analysis. The results of this study indicate that simultaneous revascularization in liver transplantation may reduce the incidence of ischemic-type biliary lesions and length of stay of patients in the ICU.

  19. The Relationship between Symptom Relief and Psychosocial Functional Improvement during Acute Electroconvulsive Therapy for Patients with Major Depressive Disorder.

    PubMed

    Lin, Ching-Hua; Yang, Wei-Cheng

    2017-07-01

    We aimed to compare the degree of symptom relief to psychosocial functional (abbreviated as "functional") improvement and explore the relationships between symptom relief and functional improvement during acute electroconvulsive therapy for patients with major depressive disorder. Major depressive disorder inpatients (n=130) requiring electroconvulsive therapy were recruited. Electroconvulsive therapy was generally performed for a maximum of 12 treatments. Symptom severity, using the 17-item Hamilton Depression Rating Scale, and psychosocial functioning (abbreviated as "functioning"), using the Modified Work and Social Adjustment Scale, were assessed before electroconvulsive therapy, after every 3 electroconvulsive therapy treatments, and after the final electroconvulsive therapy. Both 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale scores were converted to T-score units to compare the degrees of changes between depressive symptoms and functioning after electroconvulsive therapy. Structural equation modeling was used to test the relationships between 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale during acute electroconvulsive therapy. One hundred sixteen patients who completed at least the first 3 electroconvulsive therapy treatments entered the analysis. Reduction of 17-item Hamilton Depression Rating Scale T-scores was significantly greater than that of Modified Work and Social Adjustment Scale T-scores at assessments 2, 3, 4, and 5. The model analyzed by structural equation modeling satisfied all indices of goodness-of-fit (chi-square = 32.882, P =.107, TLI = 0.92, CFI = 0.984, RMSEA = 0.057). The 17-item Hamilton Depression Rating Scale change did not predict subsequent Modified Work and Social Adjustment Scale change. Functioning improved less than depressive symptoms during acute electroconvulsive therapy. Symptom reduction did not predict subsequent functional improvement. Depressive symptoms and functional impairment are distinct domains and should be assessed independently to accurately reflect the effectiveness of electroconvulsive therapy. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  20. The Modified HZ Conjugate Gradient Algorithm for Large-Scale Nonsmooth Optimization.

    PubMed

    Yuan, Gonglin; Sheng, Zhou; Liu, Wenjie

    2016-01-01

    In this paper, the Hager and Zhang (HZ) conjugate gradient (CG) method and the modified HZ (MHZ) CG method are presented for large-scale nonsmooth convex minimization. Under some mild conditions, convergent results of the proposed methods are established. Numerical results show that the presented methods can be better efficiency for large-scale nonsmooth problems, and several problems are tested (with the maximum dimensions to 100,000 variables).

  1. Modified Moral Distress Scale (MDS-11): Validation Study Among Italian Nurses.

    PubMed

    Badolamenti, Sondra; Fida, Roberto; Biagioli, Valentina; Caruso, Rosario; Zaghini, Francesco; Sili, Alessandro; Rea, Teresa

    2017-01-01

    Moral distress (MD) has significant implications on individual and organizational health. However there is a lack of an instrument to assess it among Italian nurses. The main aim of this study was to validate a brief instrument to assess MD, developed from the Corley's Moral Distress Scale (MDS). The modified MDS scale was subjected to content and cultural validity. The scale was administered to 347 nurses. Psychometric analysis were performed to assess construct validity. The scale consists of 11 items, investigating MD in nursing practice in different clinical settings. The dimensionality of the scale was investigated through exploratory factor analysis (EFA), which showed a two-dimensional structure labeled futility and potential damage. The futility refers to feelings of powerlessness and ineffectiveness in some clinical situations; the potential damage dimension captures feelings of powerlessness when nurses are forced to tolerate or perform perceived abusive clinical proceedings. Nurses who experienced higher MD, were more lilely to experience burnout. The modified MDS showed good psychometric properties, and it is valid and reliable for assessing moral distress among Italian nurses. Hence, the modified MDS allows to monitor the distress experienced by nurses and it is an important contribution to the scientific community and all those dealing with well-being of health workers.

  2. Measuring Poverty in Southern India: A Comparison of Socio-Economic Scales Evaluated against Childhood Stunting.

    PubMed

    Kattula, Deepthi; Venugopal, Srinivasan; Velusamy, Vasanthakumar; Sarkar, Rajiv; Jiang, Victoria; S, Mahasampath Gowri; Henry, Ankita; Deosaran, Jordanna Devi; Muliyil, Jayaprakash; Kang, Gagandeep

    2016-01-01

    Socioeconomic status (SES) scales measure poverty, wealth and economic inequality in a population to guide appropriate economic and public health policies. Measurement of poverty and comparison of material deprivation across nations is a challenge. This study compared four SES scales which have been used locally and internationally and evaluated them against childhood stunting, used as an indicator of chronic deprivation, in urban southern India. A door-to-door survey collected information on socio-demographic indicators such as education, occupation, assets, income and living conditions in a semi-urban slum area in Vellore, Tamil Nadu in southern India. A total of 7925 households were categorized by four SES scales-Kuppuswamy scale, Below Poverty Line scale (BPL), the modified Kuppuswamy scale, and the multidimensional poverty index (MDPI) and the level of agreement compared between scales. Logistic regression was used to test the association of SES scales with stunting. The Kuppuswamy, BPL, MDPI and modified Kuppuswamy scales classified 7.1%, 1%, 5.5%, and 55.3% of families as low SES respectively, indicating conservative estimation of low SES by the BPL and MDPI scales in comparison with the modified Kuppuswamy scale, which had the highest sensitivity (89%). Children from low SES classified by all scales had higher odds of stunting, but the level of agreement between scales was very poor ranging from 1%-15%. There is great non-uniformity between existing SES scales and cautious interpretation of SES scales is needed in the context of social, cultural, and economic realities.

  3. Chromium and reactive element modified aluminide diffusion coatings on superalloys - Environmental testing

    NASA Technical Reports Server (NTRS)

    Bianco, Robert; Rapp, Robert A.; Smialek, James L.

    1993-01-01

    The high temperature performance of reactive element (RE)-doped and Cr/RE-modified aluminide diffusion coatings on commercial Ni-base alloy substrates was determined. In isothermal oxidation at 1100 C in air, RE-doped aluminide coatings on IN 713LC substrates formed a continuous slow-growing n-Al2O3 scale after 44 hrs of exposure. The coatings were protected by either an outer ridge Al2O3 scale with an inner compact Al2O3 scale rich in RE or by a continuous compact scale without any noticeable cracks or flaws. The cyclic oxidation behavior of Cr/RE-modified aluminide coatings on Rene 80 and IN 713LC alloys and of RE-doped aluminide coatings on IN 713LC alloys at 1100 C in static air was determined. Pack powder entrapment from the powder contacting (PC) process detracted significantly from the overall cyclic oxidation performance. Type I hot corrosion behavior of Cr/RE-modified aluminide coatings on Rene 80 and Mar-M247 alloy substrates at 900 C in a catalyzed 0.1 percent SO3/O3 gas mixture was determined. The modified coatings produced from the PC arrangement provided significantly better resistance to hot corrosion attack than commercial low-activity aluminide coatings produced by the above pack arrangement.

  4. Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior Outcomes Compared With Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review of Overlapping Meta-analyses.

    PubMed

    Campbell, Kirk A; Saltzman, Bryan M; Mascarenhas, Randy; Khair, M Michael; Verma, Nikhil N; Bach, Bernard R; Cole, Brian J

    2015-11-01

    The aims of this study were (1) to perform a systematic review of meta-analyses evaluating platelet-rich plasma (PRP) injection in the treatment of knee joint cartilage degenerative pathology, (2) to provide a framework for analysis and interpretation of the best available evidence to provide recommendations for use (or lack thereof) of PRP in the setting of knee osteoarthritis (OA), and (3) to identify literature gaps where continued investigation would be suggested. Literature searches were performed for meta-analyses examining use of PRP versus corticosteroids, hyaluronic acid, oral nonsteroidal anti-inflammatory drugs, or placebo. Clinical data were extracted, and meta-analysis quality was assessed. The Jadad algorithm was applied to determine meta-analyses that provided the highest level of evidence. Three meta-analyses met the eligibility criteria and ranged in quality from Level II to Level IV evidence. All studies compared outcomes of treatment with intra-articular platelet-rich plasma (IA-PRP) versus control (intra-articular hyaluronic acid or intra-articular placebo). Use of PRP led to significant improvements in patient outcomes at 6 months after injection, and these improvements were seen starting at 2 months and were maintained for up to 12 months. It is unclear if the use of multiple PRP injections, the double-spinning technique, or activating agents leads to better outcomes. Patients with less radiographic evidence of arthritis benefit more from PRP treatment. The use of multiple PRP injections may increase the risk of self-limited local adverse reactions. After application of the Jadad algorithm, 3 concordant high-quality meta-analyses were selected and all showed that IA-PRP provided clinically relevant improvements in pain and function compared with the control treatment. IA-PRP is a viable treatment for knee OA and has the potential to lead to symptomatic relief for up to 12 months. There appears to be an increased risk of local adverse reactions after multiple PRP injections. IA-PRP offers better symptomatic relief to patients with early knee degenerative changes, and its use should be considered in patients with knee OA. Level IV, systematic review of Level II through IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. 2'-modified nucleosides for site-specific labeling of oligonucleotides

    NASA Technical Reports Server (NTRS)

    Krider, Elizabeth S.; Miller, Jeremiah E.; Meade, Thomas J.

    2002-01-01

    We report the synthesis of 2'-modified nucleosides designed specifically for incorporating labels into oligonucleotides. Conversion of these nucleosides to phosphoramidite and solid support-bound derivatives proceeds in good yield. Large-scale synthesis of 11-mer oligonucleotides possessing the 2'-modified nucleosides is achieved using these derivatives. Thermal denaturation studies indicate that the presence of 2'-modified nucleosides in 11-mer duplexes has minimal destabilizing effects on the duplex structure when the nucleosides are placed at the duplex termini. The powerful combination of phosphoramidite and support-bound derivatives of 2'-modified nucleosides affords the large-scale preparation of an entirely new class of oligonucleotides. The ability to synthesize oligonucleotides containing label attachment sites at 3', intervening, and 5' locations of a duplex is a significant advance in the development of oligonucleotide conjugates.

  6. A Modified Radiosurgery-Based Arteriovenous Malformation Grading Scale and Its Correlation With Outcomes

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

    Wegner, Rodney E.; Oysul, Kaan; Pollock, Bruce E.

    Purpose: The Pittsburgh radiosurgery-based arteriovenous malformation (AVM) grading scale was developed to predict patient outcomes after radiosurgery and was later modified with location as a two-tiered variable (deep vs. other). The purpose of this study was to test the modified radiosurgery-based AVM score in a separate set of AVM patients managed with radiosurgery. Methods and Materials: The AVM score is calculated as follows: AVM score = (0.1)(volume, cc) + (0.02)(age, years) + (0.5)(location; frontal/temporal/parietal/occipital/intraventricular/corpus callosum/cerebellar = 0, basal ganglia/thalamus/brainstem = 1). Testing of the modified system was performed on 293 patients having AVM radiosurgery from 1992 to 2004 at themore » University of Pittsburgh with dose planning based on a combination of stereotactic angiography and MRI. The median patient age was 38 years, the median AVM volume was 3.3 cc, and 57 patients (19%) had deep AVMs. The median modified AVM score was 1.25. The median patient follow-up was 39 months. Results: The modified AVM scale correlated with the percentage of patients with AVM obliteration without new deficits ({<=}1.00, 62%; 1.01-1.50, 51%; 1.51-2.00, 53%; and >2.00, 32%; F = 11.002, R{sup 2} = 0.8117, p = 0.001). Linear regression also showed a statistically significant correlation between outcome and dose prescribed to the margin (F = 25.815, p <0.001). Conclusions: The modified radiosurgery-based AVM grading scale using location as a two-tiered variable correlated with outcomes when tested on a cohort of patients who underwent both angiography and MRI for dose planning. This system can be used to guide choices among observation, endovascular, surgical, and radiosurgical management strategies for individual AVM patients.« less

  7. Lexical Testing and the Reliability of the Modified Vocabulary Knowledge Scale

    ERIC Educational Resources Information Center

    Tan, Debbita; Pandian, Ambigapathy; Jaganathan, Paramaswari

    2016-01-01

    This paper highlights some of the vocabulary tests available, and reports the reliability of the modified Vocabulary Knowledge Scale (VKS) (Rosszell, 2007). Although there is no consensus as to what actually constitutes vocabulary knowledge, the notion that it is made up of receptive knowledge (words recognised or known when seen or heard) and…

  8. Teacher Efficacy and Preservice Teachers: A Construct Validation.

    ERIC Educational Resources Information Center

    Kushner, Susan N.

    A construct validation of a modified version of a teacher efficiency scale was conducted to establish its use with preservice teachers. The scale adapted by A. E. Woolfolk and W. K. Hoy from one constructed by S. Gibson and M. H. Dembo, which contained 12 personal efficacy (PE) and 6 general teaching efficacy (TE) items, was further modified for…

  9. Assessing Psychological Need Satisfaction in Exercise Contexts: Issues of Score Invariance, Item Modification, and Context

    ERIC Educational Resources Information Center

    Gunnell, Katie E.; Wilson, Philip M.; Zumbo, Bruno D.; Mack, Diane E.; Crocker, Peter R. E.

    2012-01-01

    The researchers examined if scores from the original Psychological Need Satisfaction in Exercise Scale (Wilson, Rogers, Rodgers, & Wild, 2006) were invariant from a modified version specific to physical activity and then examined measurement invariance of scores across groups on the modified scale. Three groups were examined: (a) Students/staff…

  10. COLA with scale-dependent growth: applications to screened modified gravity models

    NASA Astrophysics Data System (ADS)

    Winther, Hans A.; Koyama, Kazuya; Manera, Marc; Wright, Bill S.; Zhao, Gong-Bo

    2017-08-01

    We present a general parallelized and easy-to-use code to perform numerical simulations of structure formation using the COLA (COmoving Lagrangian Acceleration) method for cosmological models that exhibit scale-dependent growth at the level of first and second order Lagrangian perturbation theory. For modified gravity theories we also include screening using a fast approximate method that covers all the main examples of screening mechanisms in the literature. We test the code by comparing it to full simulations of two popular modified gravity models, namely f(R) gravity and nDGP, and find good agreement in the modified gravity boost-factors relative to ΛCDM even when using a fairly small number of COLA time steps.

  11. Extraction of Carbon Dioxide and Hydrogen from Seawater by an Electrochemical Acidification Cell. Part 4. Electrode Compartments of Cell Modified and Tested in Scaled-Up Mobile Unit

    DTIC Science & Technology

    2013-09-03

    Electrochemical Acidification Cell Part IV: Electrode Compartments of Cell Modified and Tested in Scaled-Up Mobile Unit September 3, 2013 Approved for public...OF ABSTRACT Extraction of Carbon Dioxide and Hydrogen from Seawater by an Electrochemical Acidification Cell Part IV: Electrode Compartments of Cell...Electrochemical acidification cell Carbon dioxide Hydrogen Polarity reversal An electrochemical acidification cell was scaled-up and integrated into a

  12. Scaling of Counter-Current Imbibition Process in Low-Permeability Porous Media, TR-121

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

    Kvoscek, A.R.; Zhou, D.; Jia, L.

    2001-01-17

    This project presents the recent work on imaging imbibition in low permeability porous media (diatomite) with X-ray completed tomography. The viscosity ratio between nonwetting and wetting fluids is varied over several orders of magnitude yielding different levels of imbibition performance. Also performed is mathematical analysis of counter-current imbibition processes and development of a modified scaling group incorporating the mobility ratio. This modified group is physically based and appears to improve scaling accuracy of countercurrent imbibition significantly.

  13. Measuring Poverty in Southern India: A Comparison of Socio-Economic Scales Evaluated against Childhood Stunting

    PubMed Central

    Kattula, Deepthi; Venugopal, Srinivasan; Velusamy, Vasanthakumar; Sarkar, Rajiv; Jiang, Victoria; S., Mahasampath Gowri; Henry, Ankita; Deosaran, Jordanna Devi; Muliyil, Jayaprakash; Kang, Gagandeep

    2016-01-01

    Introduction Socioeconomic status (SES) scales measure poverty, wealth and economic inequality in a population to guide appropriate economic and public health policies. Measurement of poverty and comparison of material deprivation across nations is a challenge. This study compared four SES scales which have been used locally and internationally and evaluated them against childhood stunting, used as an indicator of chronic deprivation, in urban southern India. Methods A door-to-door survey collected information on socio-demographic indicators such as education, occupation, assets, income and living conditions in a semi-urban slum area in Vellore, Tamil Nadu in southern India. A total of 7925 households were categorized by four SES scales—Kuppuswamy scale, Below Poverty Line scale (BPL), the modified Kuppuswamy scale, and the multidimensional poverty index (MDPI) and the level of agreement compared between scales. Logistic regression was used to test the association of SES scales with stunting. Findings The Kuppuswamy, BPL, MDPI and modified Kuppuswamy scales classified 7.1%, 1%, 5.5%, and 55.3% of families as low SES respectively, indicating conservative estimation of low SES by the BPL and MDPI scales in comparison with the modified Kuppuswamy scale, which had the highest sensitivity (89%). Children from low SES classified by all scales had higher odds of stunting, but the level of agreement between scales was very poor ranging from 1%-15%. Conclusion There is great non-uniformity between existing SES scales and cautious interpretation of SES scales is needed in the context of social, cultural, and economic realities. PMID:27490200

  14. The modified Memorial Symptom Assessment Scale Short Form: a modified response format and rational scoring rules.

    PubMed

    Sharp, J L; Gough, K; Pascoe, M C; Drosdowsky, A; Chang, V T; Schofield, P

    2018-07-01

    The Memorial Symptom Assessment Scale Short Form (MSAS-SF) is a widely used symptom assessment instrument. Patients who self-complete the MSAS-SF have difficulty following the two-part response format, resulting in incorrectly completed responses. We describe modifications to the response format to improve useability, and rational scoring rules for incorrectly completed items. The modified MSAS-SF was completed by 311 women in our Peer and Nurse support Trial to Assist women in Gynaecological Oncology; the PeNTAGOn study. Descriptive statistics were used to summarise completion of the modified MSAS-SF, and provide symptom statistics before and after applying the rational scoring rules. Spearman's correlations with the Functional Assessment for Cancer Therapy-General (FACT-G) and Hospital Anxiety and Depression Scale (HADS) were assessed. Correct completion of the modified MSAS-SF items ranged from 91.5 to 98.7%. The rational scoring rules increased the percentage of useable responses on average 4% across all symptoms. MSAS-SF item statistics were similar with and without the scoring rules. The pattern of correlations with FACT-G and HADS was compatible with prior research. The modified MSAS-SF was useable for self-completion and responses demonstrated validity. The rational scoring rules can minimise loss of data from incorrectly completed responses. Further investigation is recommended.

  15. Rituximab as first choice for patients with refractory rheumatoid arthritis: cost-effectiveness analysis in Iran based on a systematic review and meta-analysis.

    PubMed

    Ahmadiani, Saeed; Nikfar, Shekoufeh; Karimi, Somayeh; Jamshidi, Ahmad Reza; Akbari-Sari, Ali; Kebriaeezadeh, Abbas

    2016-09-01

    The aim of this study was to evaluate the effectiveness and cost-effectiveness of using rituximab as first line for patients with refractory rheumatoid arthritis in comparison with continuing conventional DMARDs, from a perspective of health service governors. A systematic review was implemented through searching PubMed, Scopus and Cochrane Library. Quality assessment was performed by Jadad scale. After meta-analysis of ACR index results, QALY gain was calculated through mapping ACR index to HAQ and utility index. To measure the direct and indirect medical costs, a set of interviews with patients were applied. Thirty-two patients were selected from three referral rheumatology clinics in Tehran with definite diagnosis of refractory rheumatoid arthritis in the year before and treatment regimen of either rituximab or DMARDs within last year. Incremental cost-effectiveness ratio was calculated for base case and scenario of generic rituximab. Threefold of GDP per capita was considered as threshold of cost-effectiveness. Four studies were eligible to be considered in this systematic review. Total risk differences of 0.3 for achieving ACR20 criteria, 0.21 for ACR50 and 0.1 for ACR70 were calculated. Also mean of total medical costs of patients for 24 weeks were $3985 in rituximab group and $932 for DMARDs group. Thus, the incremental cost per QALY ratio will be $45,900-$70,223 in base case and $32,386-$49,550 for generic scenario. Rituximab for treatment of patients with refractory rheumatoid arthritis is not considered as cost-effective in Iran in none of the scenarios.

  16. Fiber and prebiotic supplementation in enteral nutrition: A systematic review and meta-analysis

    PubMed Central

    Kamarul Zaman, Mazuin; Chin, Kin-Fah; Rai, Vineya; Majid, Hazreen Abdul

    2015-01-01

    AIM: To investigate fiber and prebiotic supplementation of enteral nutrition (EN) for diarrhea, fecal microbiota and short-chain fatty acids (SCFAs). METHODS: MEDLINE, EMBASE, Cochrane Library, CINAHL, Academic Search Premier, and Web of Science databases were searched for human experimental and observational cohort studies conducted between January 1990 and June 2014. The keywords used for the literature search were fiber, prebiotics and enteral nutrition. English language studies with adult patient populations on exclusive EN were selected. Abstracts and/or full texts of selected studies were reviewed and agreed upon by two independent researchers for inclusion in the meta-analysis. Tools used for the quality assessment were Jadad Scale and the Scottish Intercollegiate Guidelines Network Critical Appraisal of the Medical Literature. RESULTS: A total of 456 possible articles were retrieved, and 430 were excluded due to lack of appropriate data. Of the 26 remaining studies, only eight investigated the effects of prebiotics. Results of the meta-analysis indicated that overall, fiber reduces diarrhea in patients receiving EN (OR = 0.47; 95%CI: 0.29-0.77; P = 0.02). Subgroup analysis revealed a positive effect of fiber supplementation in EN towards diarrhea in stable patients (OR = 0.31; 95%CI: 0.19-0.51; P < 0.01), but not in critically ill patients (OR = 0.89; 95%CI: 0.41-1.92; P = 0.77). Prebiotic supplementation in EN does not improve the incidence of diarrhea despite its manipulative effect on bifidobacteria concentrations and SCFA in healthy humans. In addition, the effect of fiber and/or prebiotic supplementation towards fecal microbiota and SCFA remain disputable. CONCLUSION: Fiber helps minimize diarrhea in patients receiving EN, particularly in non-critically ill patients. However, the effect of prebiotics in moderating diarrhea is inconclusive. PMID:25954112

  17. Contemporary meta-analysis of short-term probiotic consumption on gastrointestinal transit.

    PubMed

    Miller, Larry E; Zimmermann, Angela K; Ouwehand, Arthur C

    2016-06-07

    To determine the efficacy of probiotic supplementation on intestinal transit time (ITT) in adults and to identify factors that influence these outcomes. We conducted a systematic review of randomized controlled trials of probiotic supplementation that measured ITT in adults. Study quality was assessed using the Jadad scale. A random effects meta-analysis was performed with standardized mean difference (SMD) of ITT between probiotic and control groups as the primary outcome. Meta-regression and subgroup analyses examined the impact of moderator variables on SMD of ITT. A total of 15 clinical trials with 17 treatment effects representing 675 subjects were included in this analysis. Probiotic supplementation was moderately efficacious in decreasing ITT compared to control, with an SMD of 0.38 (95%CI: 0.23-0.53, P < 0.001). Subgroup analyses demonstrated statistically greater reductions in ITT with probiotics in subjects with vs without constipation (SMD: 0.57 vs 0.22, P < 0.01) and in studies with high vs low study quality (SMD: 0.45 vs 0.00, P = 0.01). Constipation (R (2) = 38%, P < 0.01), higher study quality (R (2) = 31%, P = 0.01), older age (R (2) = 27%, P = 0.02), higher percentage of female subjects (R (2) = 26%, P = 0.02), and fewer probiotic strains (R (2) = 20%, P < 0.05) were predictive of decreased ITT with probiotics in meta-regression. Medium to large treatment effects were identified with B. lactis HN019 (SMD: 0.67, P < 0.001) and B. lactis DN-173 010 (SMD: 0.54, P < 0.01) while other probiotic strains yielded negligible reductions in ITT relative to control. Probiotic supplementation is moderately efficacious for reducing ITT in adults. Probiotics were most efficacious in constipated subjects, when evaluated in high-quality studies, and with certain probiotic strains.

  18. Effects of Hypotensive Anesthesia on Reducing Intraoperative Blood Loss, Duration of Operation, and Quality of Surgical Field During Orthognathic Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    PubMed

    Lin, Susie; McKenna, Samuel J; Yao, Chuan-Fong; Chen, Yu-Ray; Chen, Chit

    2017-01-01

    The objective of this study was to evaluate the efficacy of hypotensive anesthesia in reducing intraoperative blood loss, decreasing operation time, and improving the quality of the surgical field during orthognathic surgery. A systematic review and meta-analysis of randomized controlled trials addressing these issues were carried out. An electronic database search was performed. The risk of bias was evaluated with the Jadad Scale and Delphi List. The inverse variance statistical method and a random-effects model were used. Ten randomized controlled trials were included for analysis. Our meta-analysis indicated that hypotensive anesthesia reduced intraoperative blood loss by a mean of about 169 mL. Hypotensive anesthesia was not shown to reduce the operation time for orthognathic surgery, but it did improve the quality of the surgical field. Subgroup analysis indicated that for blood loss in double-jaw surgery, the weighted mean difference favored the hypotensive group, with a reduction in blood loss of 175 mL, but no statistically significant reduction in blood loss was found for anterior maxillary osteotomy. If local anesthesia with epinephrine was used in conjunction with hypotensive anesthesia, the reduction in intraoperative blood loss was increased to 254.93 mL. Hypotensive anesthesia was effective in reducing blood loss and improving the quality of the surgical field, but it did not reduce the operation time for orthognathic surgery. The use of local anesthesia in conjunction with hypotensive general anesthesia further reduced the amount of intraoperative blood loss for orthognathic surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Study types and reliability of Real World Evidence compared with experimental evidence used in Polish reimbursement decision-making processes.

    PubMed

    Wilk, N; Wierzbicka, N; Skrzekowska-Baran, I; Moćko, P; Tomassy, J; Kloc, K

    2017-04-01

    The aim of this study was to identify the relationship and impact between Real World Evidence (RWE) and experimental evidence (EE) in Polish decision-making processes for the drugs from selected Anatomical Therapeutic Chemical (ATC) groups. Descriptive study. A detailed analysis was performed for 58 processes from five ATC code groups in which RWE for effectiveness, or effectiveness and safety were cited in Agency for Health Technology Assessment and Tariff System's (AOTMiT) documents published between January 2012 and September 2015: Verification Analysis of AOTMiT, Statement of the Transparency Council of AOTMiT, and Recommendation of the President of AOTMiT. In 62% of the cases, RWE supported the EE and confirmed its main conclusions. The majority of studies in the EE group showed to be RCTs (97%), and the RWE group included mainly cohort studies (89%). There were more studies without a control group within RWE compared with the EE group (10% vs 1%). Our results showed that EE are more often assessed using Jadad, NICE or NOS scale by AOTMiT compared with RWE (93% vs 48%). When the best evidence within a given decision-making process is analysed, half of RWE and two-thirds of EE are considered high quality evidence. RWE plays an important role in the decision-making processes on public funding of drugs in Poland, contributing to nearly half (45%) of all the evidence considered. There exist such processes in which the proportion of RWE is dominant, with one process showing RWE as the only evidence presented. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Review of existing experimental approaches for the clinical evaluation of the benefits of plant food supplements on cardiovascular function.

    PubMed

    Meoni, Paolo; Restani, Patrizia; Mancama, Dalu T

    2013-06-01

    We conducted a survey of the National Centre for Biotechnology Information (NCBI) PubMed database to identify methods most commonly used for the evaluation of the effect of plant food supplements on the cardiovascular system and their relevance to the regulatory status of these products. Particularly, our search strategy was aimed at the selection of studies concerning the clinical evaluation of the beneficial effects of the most commonly studied plant food supplements acting on the cardiovascular system. Following the screening of 3839 papers for inclusion criteria, 48 published reports were retained for this review. Most studies included in this review used a double blind controlled design, and evaluated the effect of plant food supplements on individuals affected by a disease of the cardiovascular system. The majority of the studies were found to be of low methodological quality on the Jadad scale, mainly because of inadequate reporting of adverse events and of patient withdrawals. In comparison, measures used for the evaluation of benefits included mostly cardiovascular risk factors as recommended in international guidelines and in accordance with principles laid down for the evaluation of health claims in food. The risk factors most frequently evaluated belonged to the category of "lipid function and levels", "heart function" and "blood pressure". For the absolute majority of the studies, the study period did not exceed one month. This review highlights critical factors to be considered in the design of studies evaluating the health effects of plant food supplements on the cardiovascular system. Between others, the inclusion of healthy individuals, better reporting and description of the characteristics of the product used could improve the quality and relevance of these studies.

  1. Systematic review of herbs and dietary supplements for glycemic control in diabetes.

    PubMed

    Yeh, Gloria Y; Eisenberg, David M; Kaptchuk, Ted J; Phillips, Russell S

    2003-04-01

    To conduct a systematic review of the published literature on the efficacy and safety of herbal therapies and vitamin/mineral supplements for glucose control in patients with diabetes. We conducted an electronic literature search of MEDLINE, OLDMEDLINE, Cochrane Library Database, and HealthSTAR, from database inception to May 2002, in addition to performing hand searches and consulting with experts in the field. Available clinical studies published in the English language that used human participants and examined glycemic control were included. Data were extracted in a standardized manner, and two independent investigators assessed methodological quality of randomized controlled trials using the Jadad scale. A total of 108 trials examining 36 herbs (single or in combination) and 9 vitamin/mineral supplements, involving 4,565 patients with diabetes or impaired glucose tolerance, met the inclusion criteria and were analyzed. There were 58 controlled clinical trials involving individuals with diabetes or impaired glucose tolerance (42 randomized and 16 nonrandomized trials). Most studies involved patients with type 2 diabetes. Heterogeneity and the small number of studies per supplement precluded formal meta-analyses. Of these 58 trials, the direction of the evidence for improved glucose control was positive in 76% (44 of 58). Very few adverse effects were reported. There is still insufficient evidence to draw definitive conclusions about the efficacy of individual herbs and supplements for diabetes; however, they appear to be generally safe. The available data suggest that several supplements may warrant further study. The best evidence for efficacy from adequately designed randomized controlled trials (RCTs) is available for Coccinia indica and American ginseng. Chromium has been the most widely studied supplement. Other supplements with positive preliminary results include Gymnema sylvestre, Aloe vera, vanadium, Momordica charantia, and nopal.

  2. Meta-analysis of randomized controlled trials on cognitive effects of Bacopa monnieri extract.

    PubMed

    Kongkeaw, Chuenjid; Dilokthornsakul, Piyameth; Thanarangsarit, Phurit; Limpeanchob, Nanteetip; Norman Scholfield, C

    2014-01-01

    Bacopa monnieri has a long history in Ayurvedic medicine for neurological and behavioral defects. To assess its efficacy in improving cognitive function. MEDLINE, EMBASE, CINAHL, AMED, Cochrane Central of clinical trial, WHO registry, Thai Medical Index, Index Medicus Siriraj library and www.clinicaltrial.gov were searched from the inception date of each database to June 2013 using scientific and common synonyms of Bacopa monnieri, cognitive performance or memory. The reference lists of retrieved articles were also reviewed. Randomized, placebo controlled human intervention trials on chronic ≥ 12 weeks dosing of standardized extracts of Bacopa monnieri without any co-medication were included in this study. The methodological quality of studies was assessed using Cochrane's risk of bias assessment and Jadad's quality scales. The weighted mean difference and 95% confidence interval (95% CI) were performed using the random-effects model of the Dersimonian-Laird method. Nine studies met the inclusion criteria using 518 subjects. Overall quality of all included trials was low risk of bias and quality of reported information was high. Meta-analysis of 437 eligible subjects showed improved cognition by shortened Trail B test (-17.9 ms; 95% CI -24.6 to -11.2; p<0.001) and decreased choice reaction time (10.6 ms; 95% CI -12.1 to -9.2; p<0.001). This meta-analysis suggests that Bacopa monnieri has the potential to improve cognition, particularly speed of attention but only a large well designed 'head-to-head' trial against an existing medication will provide definitive data on its efficacy on healthy or dementia patients using a standardized preparation. © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Effects of Lumbar Fusion Surgery with ISOBAR Devices Versus Posterior Lumbar Interbody Fusion Surgery on Pain and Disability in Patients with Lumbar Degenerative Diseases: A Meta-Analysis.

    PubMed

    Su, Shu-Fen; Wu, Meng-Shan; Yeh, Wen-Ting; Liao, Ying-Chin

    2018-06-01

    Purpose/Aim: Lumbar degenerative diseases (LDDs) cause pain and disability and are treated with lumbar fusion surgery. The aim of this study was to evaluate the efficacy of lumbar fusion surgery with ISOBAR devices versus posterior lumbar interbody fusion (PLIF) surgery for alleviating LDD-associated pain and disability. We performed a literature review and meta-analysis conducted in accordance with Cochrane methodology. The analysis included Group Reading Assessment and Diagnostic Evaluation assessments, Jadad Quality Score evaluations, and Risk of Bias in Non-randomized Studies of Interventions assessments. We searched PubMed, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, ProQuest, the Airiti Library, and the China Academic Journals Full-text Database for relevant randomized controlled trials and cohort studies published in English or Chinese between 1997 and 2017. Outcome measures of interest included general pain, lower back pain, and disability. Of the 18 studies that met the inclusion criteria, 16 examined general pain (802 patients), 5 examined lower back pain (274 patients), and 15 examined disability (734 patients). General pain, lower back pain, and disability scores were significantly lower after lumbar fusion surgery with ISOBAR devices compared to presurgery. Moreover, lumbar fusion surgery with ISOBAR devices was more effective than PLIF for decreasing postoperative disability, although it did not provide any benefit in terms of general pain or lower back pain. Lumbar fusion surgery with ISOBAR devices alleviates general pain, lower back pain, and disability in LDD patients and is superior to PLIF for reducing postoperative disability. Given possible publication bias, we recommend further large-scale studies.

  4. A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis.

    PubMed

    Bjordal, Jan Magnus; Bensadoun, Rene-Jean; Tunèr, Jan; Frigo, Lucio; Gjerde, Kjersti; Lopes-Martins, Rodrigo Ab

    2011-08-01

    The purpose of this study is to review the effects of low-level laser therapy (LLLT) in the prevention and treatment of cancer therapy-induced oral mucositis (OM). A systematic review and meta-analysis of randomised placebo-controlled trials of LLLT performed during chemotherapy or radiation therapy in head and neck cancer patients. We found 11 randomised placebo-controlled trials with a total of 415 patients; methodological quality was acceptable at 4.10 (SD ± 0.74) on the 5-point Jadad scale. The relative risk (RR) for developing OM was significantly (p = 0.02) reduced after LLLT compared with placebo LLLT (RR = 2.03 (95% CI, 1.11 to 3.69)). This preventive effect of LLLT improved to RR = 2.72 (95% CI, 1.98 to 3.74) when only trials with adequate doses above 1 J were included. For treatment of OM ulcers, the number of days with OM grade 2 or worse was significantly reduced after LLLT to 4.38 (95% CI, 3.35 to 5.40) days less than placebo LLLT. Oral mucositis severity was also reduced after LLLT with a standardised mean difference of 1.33 (95% CI, 0.68 to 1.98) over placebo LLLT. All studies registered possible side-effects, but they were not significantly different from placebo LLLT. There is consistent evidence from small high-quality studies that red and infrared LLLT can partly prevent development of cancer therapy-induced OM. LLLT also significantly reduced pain, severity and duration of symptoms in patients with cancer therapy-induced OM.

  5. Sequential vs simultaneous revascularization in patients undergoing liver transplantation: A meta-analysis

    PubMed Central

    Wang, Jia-Zhong; Liu, Yang; Wang, Jin-Long; Lu, Le; Zhang, Ya-Fei; Lu, Hong-Wei; Li, Yi-Ming

    2015-01-01

    AIM: We undertook this meta-analysis to investigate the relationship between revascularization and outcomes after liver transplantation. METHODS: A literature search was performed using MeSH and key words. The quality of the included studies was assessed using the Jadad Score and the Newcastle-Ottawa Scale. Heterogeneity was evaluated by the χ2 and I2 tests. The risk of publication bias was assessed using a funnel plot and Egger’s test, and the risk of bias was assessed using a domain-based assessment tool. A sensitivity analysis was conducted by reanalyzing the data using different statistical approaches. RESULTS: Six studies with a total of 467 patients were included. Ischemic-type biliary lesions were significantly reduced in the simultaneous revascularization group compared with the sequential revascularization group (OR = 4.97, 95%CI: 2.45-10.07; P < 0.00001), and intensive care unit (ICU) days were decreased (MD = 2.00, 95%CI: 0.55-3.45; P = 0.007) in the simultaneous revascularization group. Although warm ischemia time was prolonged in simultaneous revascularization group (MD = -25.84, 95%CI: -29.28-22.40; P < 0.00001), there were no significant differences in other outcomes between sequential and simultaneous revascularization groups. Assessment of the risk of bias showed that the methods of random sequence generation and blinding might have been a source of bias. The sensitivity analysis strengthened the reliability of the results of this meta-analysis. CONCLUSION: The results of this study indicate that simultaneous revascularization in liver transplantation may reduce the incidence of ischemic-type biliary lesions and length of stay of patients in the ICU. PMID:26078582

  6. Impact of vitamin D supplementation on the outcome of tuberculosis treatment: a systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Xia, Jingyan; Shi, Liyun; Zhao, Lifang; Xu, Feng

    2014-01-01

    Vitamin D supplementation is believed to be beneficial in the treatment of patients with tuberculosis (TB), however, results from clinical trials have been inconclusive. We performed a systematic literature search across MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Springer, EBSCO, ProQuest, HighWire Press, and Web of Science, published as of December 2013. We individually inspected citations and extracted data independently. We estimated pooled risk ratios (RR) and 95% confidence intervals (CI) using random-effect models. We also assessed risk of bias using the Jadad scale and the quality of the evidence using GRADE. We included all randomized controlled trials comparing vitamin D with or without standard TB therapy or placebo. A total of five studies were analyzed in our meta analysis covering 841 newly-diagnosed TB cases. Patients receiving vitamin D supplementation had a 39% reduced risk of sputum smear or culture positive after six weeks of anti-TB treatment than those in the control group, although this is not statistically significant (pooled RR 0.61, 95% CI 0.24 to 1.56, P = 0.30). Apart from an increased serum vitamin D level in the supplement group after eight weeks of treatment there was no evidence of any additional adverse effects related to vitamin D. The meta analysis results indicate that vitamin D supplementation does not seem to have any beneficial effect in the treatment of TB. Future rigorous randomized controlled trials are needed to explore whether the supplementation of vitamin D could shorten treatment duration and to confirm whether the polymorphisms of vitamin D receptor have any potentially beneficial effect.

  7. Does improving sleep lead to better mental health? A protocol for a meta-analytic review of randomised controlled trials.

    PubMed

    Scott, Alexander J; Webb, Thomas L; Rowse, Georgina

    2017-09-18

    Sleep and mental health go hand-in-hand, with many, if not all, mental health problems being associated with problems sleeping. Although sleep has been traditionally conceptualised as a secondary consequence of mental health problems, contemporary views prescribe a more influential, causal role of sleep in the formation and maintenance of mental health problems. One way to evaluate this assertion is to examine the extent to which interventions that improve sleep also improve mental health. Randomised controlled trials (RCTs) describing the effects of interventions designed to improve sleep on mental health will be identified via a systematic search of four bibliographic databases (in addition to a search for unpublished literature). Hedges' g and associated 95% CIs will be computed from means and SDs where possible. Following this, meta-analysis will be used to synthesise the effect sizes from the primary studies and investigate the impact of variables that could potentially moderate the effects. The Jadad scale for reporting RCTs will be used to assess study quality and publication bias will be assessed via visual inspection of a funnel plot and Egger's test alongside Orwin's fail-safe n . Finally, mediation analysis will be used to investigate the extent to which changes in outcomes relating to mental health can be attributed to changes in sleep quality. This study requires no ethical approval. The findings will be submitted for publication in a peer-reviewed journal and promoted to relevant stakeholders. CRD42017055450. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Meta-analysis of structured triglyceride versus other lipid emulsions for parenteral nutrition.

    PubMed

    Zhu, Mengbai; Li, Xueliang

    2013-06-01

    Structured triglyceride (STG) is a new emulsion synthesized from long-chain fatty acids and medium-chain fatty acids bound to the same glycerol backbone. We performed a meta-analysis to examine the safety, efficacy, and tolerability of STG for parenteral nutrition. We searched MEDLINE, EMBASE, and the Chinese Biomedicine Database, with the last search done in May 2012. Only randomized controlled trials in humans published in Chinese or English were included. Search terms included structured triglyceride and structural lipid. Methodologic quality was evaluated using the Jadad Scale. Meta-analysis was conducted using Review Manager 5.0.24 to calculate the weighted mean difference (WMD) and standardized mean difference (SMD) with 95% confidence intervals. Twenty-one studies (833 participants) published in English or Chinese were included in the analysis. STG significantly affected plasma triglycerides (WMD = -0.15; 95% confidence interval [CI], -0.29 to -0.01; P = 0.04), plasma glycerol (WMD = 0.21; 95% CI, 0.01-0.41; P = 0.04), free fatty acids (WMD = 0.21; 95% CI, 0.03-0.39; P = 0.02), nitrogen balance (SMD = 1.13; 95% CI, 0.26-1.99; P = 0.01), AST (WMD = -5.97; 95% CI, -7.17 to -4.76; P < 0.00001), and glucose (WMD = -0.18; 95% CI, -0.30 to -0.06; P = 004), but not respiratory quotient, resting energy expenditure, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, bilirubin, cholesterol, serum creatinine, or vital signs. STG is rapidly metabolized without harming the liver, and positively affects nitrogen balance. STG is at least as safe and effective for parenteral nutrition as other triglycerides. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. The 11-item Medication Adherence Reasons Scale: reliability and factorial validity among patients with hypertension in Malaysian primary healthcare settings

    PubMed Central

    Shima, Razatul; Farizah, Hairi; Majid, Hazreen Abdul

    2015-01-01

    INTRODUCTION The aim of this study was to assess the reliability and validity of a modified Malaysian version of the Medication Adherence Reasons Scale (MAR-Scale). METHODS In this cross-sectional study, the 15-item MAR-Scale was administered to 665 patients with hypertension who attended one of the four government primary healthcare clinics in the Hulu Langat and Klang districts of Selangor, Malaysia, between early December 2012 and end-March 2013. The construct validity was examined in two phases. Phase I consisted of translation of the MAR-Scale from English to Malay, a content validity check by an expert panel, a face validity check via a small preliminary test among patients with hypertension, and exploratory factor analysis (EFA). Phase II involved internal consistency reliability calculations and confirmatory factor analysis (CFA). RESULTS EFA verified five existing factors that were previously identified (i.e. issues with medication management, multiple medications, belief in medication, medication availability, and the patient’s forgetfulness and convenience), while CFA extracted four factors (medication availability issues were not extracted). The final modified MAR-Scale model, which had 11 items and a four-factor structure, provided good evidence of convergent and discriminant validities. Cronbach’s alpha coefficient was > 0.7, indicating good internal consistency of the items in the construct. The results suggest that the modified MAR-Scale has good internal consistencies and construct validity. CONCLUSION The validated modified MAR-Scale (Malaysian version) was found to be suitable for use among patients with hypertension receiving treatment in primary healthcare settings. However, the comprehensive measurement of other factors that can also lead to non-adherence requires further exploration. PMID:25902719

  10. The 11-item Medication Adherence Reasons Scale: reliability and factorial validity among patients with hypertension in Malaysian primary healthcare settings.

    PubMed

    Shima, Razatul; Farizah, Hairi; Majid, Hazreen Abdul

    2015-08-01

    The aim of this study was to assess the reliability and validity of a modified Malaysian version of the Medication Adherence Reasons Scale (MAR-Scale). In this cross-sectional study, the 15-item MAR-Scale was administered to 665 patients with hypertension who attended one of the four government primary healthcare clinics in the Hulu Langat and Klang districts of Selangor, Malaysia, between early December 2012 and end-March 2013. The construct validity was examined in two phases. Phase I consisted of translation of the MAR-Scale from English to Malay, a content validity check by an expert panel, a face validity check via a small preliminary test among patients with hypertension, and exploratory factor analysis (EFA). Phase II involved internal consistency reliability calculations and confirmatory factor analysis (CFA). EFA verified five existing factors that were previously identified (i.e. issues with medication management, multiple medications, belief in medication, medication availability, and the patient's forgetfulness and convenience), while CFA extracted four factors (medication availability issues were not extracted). The final modified MAR-Scale model, which had 11 items and a four-factor structure, provided good evidence of convergent and discriminant validities. Cronbach's alpha coefficient was > 0.7, indicating good internal consistency of the items in the construct. The results suggest that the modified MAR-Scale has good internal consistencies and construct validity. The validated modified MAR-Scale (Malaysian version) was found to be suitable for use among patients with hypertension receiving treatment in primary healthcare settings. However, the comprehensive measurement of other factors that can also lead to non-adherence requires further exploration.

  11. ECT Has Greater Efficacy Than Fluoxetine in Alleviating the Burden of Illness for Patients with Major Depressive Disorder: A Taiwanese Pooled Analysis

    PubMed Central

    Huang, Chun-Jen; Chen, Cheng-Chung

    2018-01-01

    Abstract Background The burden of major depressive disorder includes suffering due to symptom severity, functional impairment, and quality of life deficits. The aim of this study was to compare the differences between electroconvulsive therapy and pharmacotherapy in reducing such burdens. Methods This was a pooled analysis study including 2 open-label trials for major depressive disorder inpatients receiving either standard bitemporal and modified electroconvulsive therapy with a maximum of 12 sessions or 20 mg/d of fluoxetine for 6 weeks. Symptom severity, functioning, and quality of life were assessed using the 17-item Hamilton Rating Scale for Depression, the Modified Work and Social Adjustment Scale, and SF-36. Side effects following treatment, including subjective memory impairment, nausea/vomiting, and headache, were recorded. The differences between these 2 groups in 17-item Hamilton Rating Scale for Depression, Modified Work and Social Adjustment Scale, quality of life, side effects, and time to response (at least a 50% reduction of 17-item Hamilton Rating Scale for Depression) and remission (17-item Hamilton Rating Scale for Depression ≤7) following treatment were analyzed. Results Electroconvulsive therapy (n=116) showed a significantly greater reduction in 17-item Hamilton Rating Scale for Depression, Modified Work and Social Adjustment Scale, and quality of life deficits and had significantly shorter time to response/remission than fluoxetine (n=126). However, the electroconvulsive therapy group was more likely to experience subjective memory impairment and headache. Conclusions Compared with fluoxetine, electroconvulsive therapy was more effective in alleviating the burden of major depressive disorder and had a substantially increased speed of response/remission in the acute phase. Increased education and information about electroconvulsive therapy for clinicians, patients, and their families and the general public is warranted. PMID:29228200

  12. Sensitivity of the Modified Children's Yale-Brown Obsessive Compulsive Scale to Detect Change: Results from Two Multi-Site Trials

    ERIC Educational Resources Information Center

    Scahill, Lawrence; Sukhodolsky, Denis G.; Anderberg, Emily; Dimitropoulos, Anastasia; Dziura, James; Aman, Michael G.; McCracken, James; Tierney, Elaine; Hallett, Victoria; Katz, Karol; Vitiello, Benedetto; McDougle, Christopher

    2016-01-01

    Repetitive behavior is a core feature of autism spectrum disorder. We used 8-week data from two federally funded, multi-site, randomized trials with risperidone conducted by the Research Units on Pediatric Psychopharmacology Autism Network to evaluate the sensitivity of the Children's Yale-Brown Obsessive Compulsive Scale modified for autism…

  13. Feasibility and Reliability of the Modified Berg Balance Scale in Persons with Severe Intellectual and Visual Disabilities

    ERIC Educational Resources Information Center

    Waninge, A.; van Wijck, R.; Steenbergen, B.; van der Schans, C. P.

    2011-01-01

    Background: The purpose of this study was to determine the feasibility and reliability of the modified Berg Balance Scale (mBBS) in persons with severe intellectual and visual disabilities (severe multiple disabilities, SMD) assigned Gross Motor Function Classification System (GMFCS) grades I and II. Method: Thirty-nine participants with SMD and…

  14. Standard Setting in a Small Scale OSCE: A Comparison of the Modified Borderline-Group Method and the Borderline Regression Method

    ERIC Educational Resources Information Center

    Wood, Timothy J.; Humphrey-Murto, Susan M.; Norman, Geoffrey R.

    2006-01-01

    When setting standards, administrators of small-scale OSCEs often face several challenges, including a lack of resources, a lack of available expertise in statistics, and difficulty in recruiting judges. The Modified Borderline-Group Method is a standard setting procedure that compensates for these challenges by using physician examiners and is…

  15. Cross-cultural validation of the National Eye Institute Visual Function Questionnaire.

    PubMed

    Mollazadegan, Kaziwe; Huang, Jinhai; Khadka, Jyoti; Wang, Qinmei; Yang, Feng; Gao, Rongrong; Pesudovs, Konrad

    2014-05-01

    To assess the native and the previously Rasch-modified National Eye Institute Visual Function Questionnaire (NEI VFQ) scales in a Chinese population. Eye Hospital of Wenzhou Medical University, Wenzhou, China. Questionnaire development. Patients on the waiting list for cataract surgery completed the 39-item NEI VFQ (NEI VFQ-39). Rasch analysis was performed in 3 steps as follows: (1) Assess the psychometric properties of the original NEI VFQ. (2) Reassess the previously proposed Rasch-modified NEI VFQ scales by Pesudovs et al. (2010) in Chinese populations. (3) Compare the scores of previously recommended scales of the NEI VFQ with new Rasch-modified scales of the same questionnaire using Bland-Altman plots. Four hundred thirty-five patients (median age 70 years; range 35 to 90 years) completed the NEI VFQ-39. Response categories for 4 question types were dysfunctional and therefore repaired. The original NEI VFQ-39 and NEI VFQ-25 showed good measurement precision. However, both versions showed multidimensionality, misfitting items, suboptimum targeting, and nonfunctioning subscales. Using the previously proposed Rasch-modified scales of the NEI VFQ yielded valid measurement of each construct in the 39-item and 25-item questionnaire. Comparison between the earlier proposed NEI VFQ scales and the new versions developed in this population showed good agreement. The original NEI VFQ was once again found to be flawed. The previously proposed Rasch-analyzed versions of the NEI VFQ and the new Chinese versions showed good agreement. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  16. Phosphate Removal using Modified Bayoxide®E33 Adsorption Media

    EPA Science Inventory

    The adsorption of phosphate onto modified Bayoxide® E33 (E33) and underlying mechanisms were comparatively investigated by batch kinetics, sorption isotherms, rapid small scale column tests, and material characterization. Synthesis of modified E33 was conducted by the addition of...

  17. The modified polyconic projection for the IMW.

    USGS Publications Warehouse

    Snyder, J.P.

    1982-01-01

    The modified polyconic map projection designed by Lallemand and adopted for the International Map of the World between 1909 and 1962 has two meridians and two parallels which are true to scale. Constructed geometrically in the past, forward and inverse coordinate transformations may be calculated analytically in order to transfer data from existing quadrangles to other maps. The equations for these transformations are derived and used to calculate representative tables of coordinates and scale factors. Although the projection is neither equal-area nor conformal, scale does not vary more than 0.06% throughout the quadrangle.-Author

  18. The Interrater Reliability of the Modified Gait Abnormality Rating Scale for Use with People with Intellectual Disability

    ERIC Educational Resources Information Center

    Hale, Leigh; McIlraith, Lucy; Miller, Clare; Stanley-Clarke, Terri; George, Rebecca

    2010-01-01

    Background: Researching falls in persons with ID is limited by difficulties in applying standardised balance outcome measures. The modified Gait Abnormality Rating Scale (GARS-M), developed to identify falls risk in older adults, requires only that the participant walks and thus may be a feasible falls research tool to use with people with ID. In…

  19. Assessment of the Reliability and Validity of a Stress Questionnaire for Pharmacy Administration Graduate Students

    ERIC Educational Resources Information Center

    Konduri, Niranjan; Gupchup, Gireesh V.; Borrego, Matthew E.; Worley-Louis, Marcia

    2006-01-01

    The purpose of this study was to test and assess the reliability and validity of a modified stress scale in a sample of pharmacy graduate students. The modified stress scale was used as part of a larger, nationwide, study whose aim was to investigate the association of stress, perceived academic success and health-related quality of life among…

  20. Reconstruction scenario in modified Horava-Lifshitz F( R) gravity with well-known scale factors

    NASA Astrophysics Data System (ADS)

    Jawad, Abdul; Rani, Shamaila

    2015-05-01

    In this paper, we analyze the behavior of pilgrim dark energy with G-O cutoff scale in modified Horava-Lifshitz F( R) gravity through correspondence scenario. We consider three well-known scale factors in which one scale factor describes the unification of matter dominated and accelerated phases and others are intermediate and bouncing forms. We obtain the models for these scale factors and obtain increasing behavior with the passage of time. We also extract equation of state parameter corresponding to these models. We observe that this parameter shows transition from phantom towards quintessence by crossing the phantom divide line in all cases. We also give comparison of our results of equation of state parameter with observational constraints.

  1. Dark energy and modified gravity in the Effective Field Theory of Large-Scale Structure

    NASA Astrophysics Data System (ADS)

    Cusin, Giulia; Lewandowski, Matthew; Vernizzi, Filippo

    2018-04-01

    We develop an approach to compute observables beyond the linear regime of dark matter perturbations for general dark energy and modified gravity models. We do so by combining the Effective Field Theory of Dark Energy and Effective Field Theory of Large-Scale Structure approaches. In particular, we parametrize the linear and nonlinear effects of dark energy on dark matter clustering in terms of the Lagrangian terms introduced in a companion paper [1], focusing on Horndeski theories and assuming the quasi-static approximation. The Euler equation for dark matter is sourced, via the Newtonian potential, by new nonlinear vertices due to modified gravity and, as in the pure dark matter case, by the effects of short-scale physics in the form of the divergence of an effective stress tensor. The effective fluid introduces a counterterm in the solution to the matter continuity and Euler equations, which allows a controlled expansion of clustering statistics on mildly nonlinear scales. We use this setup to compute the one-loop dark-matter power spectrum.

  2. Results of tests performed on the Acoustic Quiet Flow Facility Three-Dimensional Model Tunnel: Report on the Modified D.S.M.A. Design

    NASA Technical Reports Server (NTRS)

    Barna, P. S.

    1996-01-01

    Numerous tests were performed on the original Acoustic Quiet Flow Facility Three-Dimensional Model Tunnel, scaled down from the full-scale plans. Results of tests performed on the original scale model tunnel were reported in April 1995, which clearly showed that this model was lacking in performance. Subsequently this scale model was modified to attempt to possibly improve the tunnel performance. The modifications included: (a) redesigned diffuser; (b) addition of a collector; (c) addition of a Nozzle-Diffuser; (d) changes in location of vent-air. Tests performed on the modified tunnel showed a marked improvement in performance amounting to a nominal increase of pressure recovery in the diffuser from 34 percent to 54 percent. Results obtained in the tests have wider application. They may also be applied to other tunnels operating with an open test section not necessarily having similar geometry as the model under consideration.

  3. Feasibility, Test-Retest Reliability, and Interrater Reliability of the Modified Ashworth Scale and Modified Tardieu Scale in Persons with Profound Intellectual and Multiple Disabilities

    ERIC Educational Resources Information Center

    Waninge, A.; Rook, R. A.; Dijkhuizen, A.; Gielen, E.; van der Schans, C. P.

    2011-01-01

    Caregivers of persons with profound intellectual and multiple disabilities (PIMD) often describe the quality of the daily movements of these persons in terms of flexibility or stiffness. Objective outcome measures for flexibility and stiffness are muscle tone or level of spasticity. Two instruments used to grade muscle tone and spasticity are the…

  4. Is the Modified Tardieu Scale in Semi-Standing Position Better Associated with Knee Extension and Hamstring Activity in Terminal Swing than the Supine Tardieu?

    ERIC Educational Resources Information Center

    Faber, Irene R.; Nienhuis, Bart; Rijs, Nique P. A. M.; Geurts, Alexander C. H.; Duysens, Jacques

    2008-01-01

    The aim of this study was to investigate whether the modified Tardieu scale (MTS) in a semi-standing position, used for the assessment of hamstrings spasticity, was better associated with knee extension and hamstrings activity in terminal swing than the MTS in a supine position in children with cerebral palsy (CP). Seven children diagnosed with…

  5. Observations on the oxidation of Mn-modified Ni-base Haynes 230 alloy under SOFC exposure conditions

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

    Yang, Z Gary; Xia, Gordon; Stevenson, Jeffry W.

    2005-07-01

    The commercial Ni-base Haynes 230 alloy (Ni-Cr-Mo-W-Mn) was modified with two increased levels of Mn (1 and 2 wt per cent) and evaluated for its oxidation resistance under simulated SOFC interconnect exposure conditions. Oxidation rate, oxide morphology, oxide conductivity and thermal expansion were measured and compared with commercial Haynes 230. It was observed that additions of higher levels of Mn to the bulk alloy facilitated the formation of a bi-layered oxide scale that was comprised of an outer M3O4 (M=Mn, Cr, Ni) spinel-rich layer at the oxide – gas interface over a Cr2O3-rich sub-layer at the metal – oxide interface.more » The modified alloys showed higher oxidation rates and the formation of thicker oxide scales compared to the base alloy. The formation of a spinel-rich top layer improved the scale conductivity, especially during the early stages of the oxidation, but the higher scale growth rate resulted in an increase in the area-specific electrical resistance over time. Due to their face-centered cubic crystal structure, both commercial and modified alloys demonstrated a coefficient of thermal expansion that was higher than that of typical anode-supported and electrolyte-supported SOFCs.« less

  6. Efficacy and Safety of Medicinal Plants or Related Natural Products for Fibromyalgia: A Systematic Review

    PubMed Central

    de Souza Nascimento, Simone; DeSantana, Josimari Melo; Ribeiro, Êurica Adélia Nogueira; da Silva, Daniel Lira; Araújo-Júnior, João Xavier; da Silva Almeida, Jackson Roberto Guedes; Bonjardim, Leonardo Rigoldi; de Souza Araújo, Adriano Antunes; Quintans-Júnior, Lucindo José

    2013-01-01

    To assess the effects of medicinal plants (MPs) or related natural products (RNPs) on fibromyalgia (FM) patients, we evaluate the possible benefits and advantages of MP or RNP for the treatment of FM based on eight randomized placebo-controlled trials (RCTs) involving 475 patients. The methodological quality of all studies included was determined according to JADAD and “Risk of Bias” with the criteria in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Evidence suggests significant benefits of MP or RNP in sleep disruption, pain, depression, joint stiffness, anxiety, physical function, and quality of life. Our results demonstrated that MP or RNP had significant effects on improving the symptoms of FM compared to conventional drug or placebo; longer tests are required to determine the duration of the treatment and characterize the long-term safety of using MP, thus suggesting effective alternative therapies in the treatment of pain with minimized side effects. PMID:23861696

  7. Nursing Intervention on the Compliance of Hemodialysis Patients with End-Stage Renal Disease: A Meta-Analysis.

    PubMed

    Wang, Jing; Yue, Peng; Huang, Jing; Xie, Xiaodong; Ling, Yunhua; Jia, Li; Xiong, Yunjin; Sun, Fang

    2018-01-01

    Dialysis is imperative for patients with end-stage renal disease (ESRD); however, compliance ensures its efficacy. Nursing intervention has been considered to improve compliance. This meta-analysis is aimed at exploring the effects of nursing intervention on dialysis compliance. A search was performed in the PubMed, Cochrane, and Embase databases for relevant original research articles. Studies were included or excluded based on the simultaneous consideration of quality as ranked by Jadad score and the compliance with predefined selection criteria. A total of 817 participants were included. The results showed that nursing intervention led to significantly higher compliance with dialysis than in standard care. A pilot analysis evidenced that different intervention strategies, including educational, cognitive, and behavioral approaches, had limited effects on dialysis compliance. Nursing intervention is beneficial for raising dialysis compliance, providing evidence of the need to strengthen nursing care for ESRD patients administered with dialysis in daily clinical practice. © 2017 S. Karger AG, Basel.

  8. Nutrition and physical activity educational intervention on CHD risk factors: a systematic review study.

    PubMed

    Rahmati Najarkolaei, Fatemeh; Ghaffarpasand, Eiman; Gholami Fesharaki, Mohammad; Jonaidi Jafari, Nematollah

    2015-01-01

    Fast growing epidemic of chronic diseases causes many health challenges over the world. Regarding reported pros and cons, the aim of the current study is to review the effect of nutrition and physical educational intervention in decreasing cardiovascular risk factors. In this review study, searching has done through the English and Persian databases. Articles with other languages, lack of important information, and score 3 or less in the JADAD standard checklist were exluded from the study. In the primary search, 194 articles have been found.Through four stages of secondary search and further evaluation, 43 articles were selected. These articles were published between 1989 to 2013. According to these findings, the majority of articles showed a positive effect of nutrition and physical activity educational interventions on cardiovascular risk factors- blood cholesterol, systolic and diastolic blood pressure, as well as smoking cigarette in high risk patients. These results, suggest the necessity of continiuting nutrition and physical educational intervention for individuals with cardiovascular risk factors.

  9. Aromatherapy: a systematic review.

    PubMed

    Cooke, B; Ernst, E

    2000-06-01

    Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological quality of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect. Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials.

  10. Aromatherapy: a systematic review.

    PubMed Central

    Cooke, B; Ernst, E

    2000-01-01

    Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological quality of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect. Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials. PMID:10962794

  11. Ginkgo biloba for prevention of dementia: a systematic review and meta-analysis.

    PubMed

    Charemboon, Thammanard; Jaisin, Kankamol

    2015-05-01

    To determine the efficacy of Ginkgo biloba for the prevention of dementia in individuals without dementia. English databases including Medline, Embase, Cochrane Library and PsycINFO, were searched, and randomized double-blind controlled studies comparing Ginkgo biloba with placebo in prevention of dementia were considered. Two trials met inclusion criteria. Methodological quality was assessed using the Jadad criteria. Meta-analysis of the two trials involving 5,889 participants indicated no significant difference in dementia rate between Ginkgo biloba and the placebo (347/2,951 vs. 330/2,938, odds ratio = 1.05, 95% CI 0.89-1.23) and there was no considerable heterogeneity between the trials. The two studies revealed no statistically significant differences in the rate of serious adverse effect between Ginko biloba and the placebo. There is no convincing evidence from this review that demonstrated Ginkgo biloba in late-life can prevent the development of dementia. Using it for this indication is not suggested at present.

  12. Examining the bleeding incidences associated with targeted therapies used in metastatic renal cell carcinoma.

    PubMed

    Crist, MacKenzie; Hansen, Elizabeth; Chablani, Lipika; Guancial, Elizabeth

    2017-12-01

    A systematic review was conducted to illustrate the bleeding risks associated with targeted therapies used in the treatment of metastatic renal cell carcinoma (mRCC). Eligible studies included phase II, III, or IV clinical trials using pazopanib, sunitinib, cabozantinib, lenvatinib, everolimus, temsirolimus, bevacizumab, axitinib, and/or sorafenib in the setting of mRCC. Types of bleeding event(s), bleeding event frequency, and incidence of thrombocytopenia were collected from the relevant articles. ClinicalTrials.gov was also searched for incidence of "Serious bleeding adverse effects" reported in these trials. The incidences of bleeding events ranged from 1 to 36%, and incidences of thrombocytopenia ranged from 2 to 78%. Available serious bleeding adverse events ranged from 1 to 7%. The highest percentage of bleeding incidences were seen with bevacizumab, while the lowest percentage of bleeding incidences were seen with axitinib. All of the included trials were of high quality per Jadad scoring. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Reducing calories, fat, saturated fat and sodium in restaurant menu items: Effects on consumer acceptance

    PubMed Central

    Patel, Anjali A.; Lopez, Nanette V.; Lawless, Harry T.; Njike, Valentine; Beleche, Mariana; Katz, David L.

    2016-01-01

    OBJECTIVE This study assessed consumer acceptance of reductions of calories, fat, saturated fat, and sodium to current restaurant recipes. METHODS Twenty-four menu items, from six restaurant chains, were slightly modified and moderately modified by reducing targeted ingredients. Restaurant customers (n=1,838) were recruited for a taste test and were blinded to the recipe version as well as the purpose of the study. Overall consumer acceptance was measured using a 9-point hedonic (like/dislike) scale, likelihood to purchase scale, Just-About-Right (JAR) 5-point scale, penalty analysis and alienation analysis. RESULTS Overall, modified recipes of 19 menu items were scored similar to (or better than) their respective current versions. Eleven menu items were found to be acceptable at the slightly modified recipe version and eight menu items were found to be acceptable at the moderately modified recipe version. Acceptable ingredient reductions resulted in a reduction of up to 26% in calories and a reduction of up to 31% in sodium per serving. CONCLUSIONS The majority of restaurant menu items with small reductions of calories, fat, saturated fat and sodium were acceptable. Given the frequency of eating foods away from home, these reductions could be effective in creating dietary improvements for restaurant diners. PMID:27891828

  14. Reducing calories, fat, saturated fat, and sodium in restaurant menu items: Effects on consumer acceptance.

    PubMed

    Patel, Anjali A; Lopez, Nanette V; Lawless, Harry T; Njike, Valentine; Beleche, Mariana; Katz, David L

    2016-12-01

    To assess consumer acceptance of reductions of calories, fat, saturated fat, and sodium to current restaurant recipes. Twenty-four menu items, from six restaurant chains, were slightly modified and moderately modified by reducing targeted ingredients. Restaurant customers (n = 1,838) were recruited for a taste test and were blinded to the recipe version as well as the purpose of the study. Overall consumer acceptance was measured using a 9-point hedonic (like/dislike) scale, likelihood to purchase scale, Just-About-Right (JAR) 5-point scale, penalty analysis, and alienation analysis. Overall, modified recipes of 19 menu items were scored similar to (or better than) their respective current versions. Eleven menu items were found to be acceptable in the slightly modified recipe version, and eight menu items were found to be acceptable in the moderately modified recipe version. Acceptable ingredient modifications resulted in a reduction of up to 26% in calories and a reduction of up to 31% in sodium per serving. The majority of restaurant menu items with small reductions of calories, fat, saturated fat, and sodium were acceptable. Given the frequency of eating foods away from home, these reductions could be effective in creating dietary improvements for restaurant diners. © 2016 The Obesity Society.

  15. Adhesive taping vs. daily manual muscle stretching and splinting after botulinum toxin type A injection for wrist and fingers spastic overactivity in stroke patients: a randomized controlled trial.

    PubMed

    Santamato, Andrea; Micello, Maria Francesca; Panza, Francesco; Fortunato, Francesca; Picelli, Alessandro; Smania, Nicola; Logroscino, Giancarlo; Fiore, Pietro; Ranieri, Maurizio

    2015-01-01

    To compare the effectiveness of two procedures increasing the botulinum toxin type A effect for wrist and finger flexor spasticity after stroke. A single-blind randomized trial. Seventy patients with upper limb post-stroke spasticity. Adults with wrist and finger flexor muscles spasticity after stroke were submitted to botulinum toxin type A therapy. After the treatment, the subjects injected were randomly divided into two groups and submitted to adhesive taping (Group A) or daily muscle manual stretching, passive articular mobilization of wrist and fingers, and palmar splint (Group B) for 10 days. We measured spasticity with Modified Ashworth Scale, related disability with Disability Assessment Scale, and fingers position at rest. The measurements were done at baseline, after two weeks, and after one month from the treatment session. After two weeks, subjects in Group A reported a significantly greater decrease in spasticity scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.3±0.6 vs. 2.1±0.6; Modified Ashworth Scale wrist: 1.7 ±0.6 vs. 2.3 ±0.8), and after one month in spasticity and disability scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.9 ±0.7 vs. 2.5 ±0.6; Modified Ashworth Scale wrist: 2.0 ±0.7 vs. 2.6 ±0.6; Disability Assessment Scale: 1.6 ±0.7 vs. 2.1 ±0.7) compared with Group B subjects. Subjects in Group A reported also a significantly improved fingers position at rest compared with Group B subjects after two weeks (2.8 ±0.9 vs. 2.1 ±0.7) and one month (2.3 ±0.7 vs. 1.5 ±0.6). Adhesive taping of wrist and finger flexor muscles appeared to enhance the effect of botulinum toxin type A therapy more than daily manual muscle stretching combined with passive articular mobilization and palmar splint. © The Author(s) 2014.

  16. Cascade model for fluvial geomorphology

    NASA Technical Reports Server (NTRS)

    Newman, W. I.; Turcotte, D. L.

    1990-01-01

    Erosional landscapes are generally scale invariant and fractal. Spectral studies provide quantitative confirmation of this statement. Linear theories of erosion will not generate scale-invariant topography. In order to explain the fractal behavior of landscapes a modified Fourier series has been introduced that is the basis for a renormalization approach. A nonlinear dynamical model has been introduced for the decay of the modified Fourier series coefficients that yield a fractal spectra. It is argued that a physical basis for this approach is that a fractal (or nearly fractal) distribution of storms (floods) continually renews erosional features on all scales.

  17. Full-Scale Hydrodynamic Evaluation of a Modified Navy J4F-2 Amphibian with a 0.425-Scale XP5M-1 Hull Bottom. TED No. NACA DE325

    NASA Technical Reports Server (NTRS)

    Land, Norman S.; Elliott, John M.; Christopher, Kenneth W.

    1949-01-01

    An investigation was made to evaluate the hydrodynamic qualities of a 0.425-scale model of the Navy XP5M-1 hull, which was installed on a modified Navy J4F-2 amphibian. Longitudinal and directional stability during take-off and landing, low-speed maneuverability, spray characteristics, and take-off performance were investigated. The behavior of the airplane in moderately rough water was also observed. The opinions of three pilots have been correlated with the data.

  18. ECT Has Greater Efficacy Than Fluoxetine in Alleviating the Burden of Illness for Patients with Major Depressive Disorder: A Taiwanese Pooled Analysis.

    PubMed

    Lin, Ching-Hua; Huang, Chun-Jen; Chen, Cheng-Chung

    2018-01-01

    The burden of major depressive disorder includes suffering due to symptom severity, functional impairment, and quality of life deficits. The aim of this study was to compare the differences between electroconvulsive therapy and pharmacotherapy in reducing such burdens. This was a pooled analysis study including 2 open-label trials for major depressive disorder inpatients receiving either standard bitemporal and modified electroconvulsive therapy with a maximum of 12 sessions or 20 mg/d of fluoxetine for 6 weeks. Symptom severity, functioning, and quality of life were assessed using the 17-item Hamilton Rating Scale for Depression, the Modified Work and Social Adjustment Scale, and SF-36. Side effects following treatment, including subjective memory impairment, nausea/vomiting, and headache, were recorded. The differences between these 2 groups in 17-item Hamilton Rating Scale for Depression, Modified Work and Social Adjustment Scale, quality of life, side effects, and time to response (at least a 50% reduction of 17-item Hamilton Rating Scale for Depression) and remission (17-item Hamilton Rating Scale for Depression ≤7) following treatment were analyzed. Electroconvulsive therapy (n=116) showed a significantly greater reduction in 17-item Hamilton Rating Scale for Depression, Modified Work and Social Adjustment Scale, and quality of life deficits and had significantly shorter time to response/remission than fluoxetine (n=126). However, the electroconvulsive therapy group was more likely to experience subjective memory impairment and headache. Compared with fluoxetine, electroconvulsive therapy was more effective in alleviating the burden of major depressive disorder and had a substantially increased speed of response/remission in the acute phase. Increased education and information about electroconvulsive therapy for clinicians, patients, and their families and the general public is warranted. © The Author(s) 2017. Published by Oxford University Press on behalf of CINP.

  19. Stroke Location Is an Independent Predictor of Cognitive Outcome.

    PubMed

    Munsch, Fanny; Sagnier, Sharmila; Asselineau, Julien; Bigourdan, Antoine; Guttmann, Charles R; Debruxelles, Sabrina; Poli, Mathilde; Renou, Pauline; Perez, Paul; Dousset, Vincent; Sibon, Igor; Tourdias, Thomas

    2016-01-01

    On top of functional outcome, accurate prediction of cognitive outcome for stroke patients is an unmet need with major implications for clinical management. We investigated whether stroke location may contribute independent prognostic value to multifactorial predictive models of functional and cognitive outcomes. Four hundred twenty-eight consecutive patients with ischemic stroke were prospectively assessed with magnetic resonance imaging at 24 to 72 hours and at 3 months for functional outcome using the modified Rankin Scale and cognitive outcome using the Montreal Cognitive Assessment (MoCA). Statistical maps of functional and cognitive eloquent regions were derived from the first 215 patients (development sample) using voxel-based lesion-symptom mapping. We used multivariate logistic regression models to study the influence of stroke location (number of eloquent voxels from voxel-based lesion-symptom mapping maps), age, initial National Institutes of Health Stroke Scale and stroke volume on modified Rankin Scale and MoCA. The second part of our cohort was used as an independent replication sample. In univariate analyses, stroke location, age, initial National Institutes of Health Stroke Scale, and stroke volume were all predictive of poor modified Rankin Scale and MoCA. In multivariable analyses, stroke location remained the strongest independent predictor of MoCA and significantly improved the prediction compared with using only age, initial National Institutes of Health Stroke Scale, and stroke volume (area under the curve increased from 0.697-0.771; difference=0.073; 95% confidence interval, 0.008-0.155). In contrast, stroke location did not persist as independent predictor of modified Rankin Scale that was mainly driven by initial National Institutes of Health Stroke Scale (area under the curve going from 0.840 to 0.835). Similar results were obtained in the replication sample. Stroke location is an independent predictor of cognitive outcome (MoCA) at 3 months post stroke. © 2015 American Heart Association, Inc.

  20. Phase of Illness in palliative care: Cross-sectional analysis of clinical data from community, hospital and hospice patients.

    PubMed

    Mather, Harriet; Guo, Ping; Firth, Alice; Davies, Joanna M; Sykes, Nigel; Landon, Alison; Murtagh, Fliss Em

    2018-02-01

    Phase of Illness describes stages of advanced illness according to care needs of the individual, family and suitability of care plan. There is limited evidence on its association with other measures of symptoms, and health-related needs, in palliative care. The aims of the study are as follows. (1) Describe function, pain, other physical problems, psycho-spiritual problems and family and carer support needs by Phase of Illness. (2) Consider strength of associations between these measures and Phase of Illness. Secondary analysis of patient-level data; a total of 1317 patients in three settings. Function measured using Australia-modified Karnofsky Performance Scale. Pain, other physical problems, psycho-spiritual problems and family and carer support needs measured using items on Palliative Care Problem Severity Scale. Australia-modified Karnofsky Performance Scale and Palliative Care Problem Severity Scale items varied significantly by Phase of Illness. Mean function was highest in stable phase (65.9, 95% confidence interval = 63.4-68.3) and lowest in dying phase (16.6, 95% confidence interval = 15.3-17.8). Mean pain was highest in unstable phase (1.43, 95% confidence interval = 1.36-1.51). Multinomial regression: psycho-spiritual problems were not associated with Phase of Illness ( χ 2  = 2.940, df = 3, p = 0.401). Family and carer support needs were greater in deteriorating phase than unstable phase (odds ratio (deteriorating vs unstable) = 1.23, 95% confidence interval = 1.01-1.49). Forty-nine percent of the variance in Phase of Illness is explained by Australia-modified Karnofsky Performance Scale and Palliative Care Problem Severity Scale. Phase of Illness has value as a clinical measure of overall palliative need, capturing additional information beyond Australia-modified Karnofsky Performance Scale and Palliative Care Problem Severity Scale. Lack of significant association between psycho-spiritual problems and Phase of Illness warrants further investigation.

  1. HOLLOTRON switch for megawatt lightweight space inverters

    NASA Technical Reports Server (NTRS)

    Poeschel, R. L.; Goebel, D. M.; Schumacher, R. W.

    1991-01-01

    The feasibility of satisfying the switching requirements for a megawatt ultralight inverter system using HOLLOTRON switch technology was determined. The existing experimental switch hardware was modified to investigate a coaxial HOLLOTRON switch configuration and the results were compared with those obtained for a modified linear HOLLOTRON configuration. It was concluded that scaling the HOLLOTRON switch to the current and voltage specifications required for a megawatt converter system is indeed feasible using a modified linear configuration. The experimental HOLLOTRON switch operated at parameters comparable to the scaled coaxial HOLLOTRON. However, the linear HOLLOTRON data verified the capability for meeting all the design objectives simultaneously including current density (greater than 2 A/sq cm), voltage (5 kV), switching frequency (20 kHz), switching time (300 ns), and forward voltage drop (less than or equal to 20 V). Scaling relations were determined and a preliminary design was completed for an engineering model linear HOLLOTRON switch to meet the megawatt converter system specifications.

  2. Revised multicultural perspective index and measures of depression, life satisfaction, shyness, and self-esteem.

    PubMed

    Mowrer, Robert R; Parker, Keesha N

    2004-12-01

    In a 2002 publication, Mowrer and McCarver reported weak but significant correlations (r =.24) between scores on the Multicultural Perspective Index and scores on Neugarten, Havighurst, and Tobin's 1961 Life Satisfaction Index-A and the Life Satisfaction Scale developed in 1985 by Diener, Emmons, Larsen, and Griffin. Using 382 undergraduate students the present study reduced the Index from 42 to 29 items based on each item's correlation with total items. An additional 104 undergraduate students then completed the modified 29-item version, Rosenberg's Self-esteem Scale, Cheek and Buss's Shyness Scale, the Self-rating Depression Scale by Zung, and the Neugarten, et al. Life Satisfaction Index-A. Scores on the modified Index were negatively correlated with those on the Depression and Shyness scales and positively correlated with scores on the Self-esteem and Life Satisfaction scales (p< .05).

  3. Modified Baryonic Dynamics: two-component cosmological simulations with light sterile neutrinos

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

    Angus, G.W.; Gentile, G.; Diaferio, A.

    2014-10-01

    In this article we continue to test cosmological models centred on Modified Newtonian Dynamics (MOND) with light sterile neutrinos, which could in principle be a way to solve the fine-tuning problems of the standard model on galaxy scales while preserving successful predictions on larger scales. Due to previous failures of the simple MOND cosmological model, here we test a speculative model where the modified gravitational field is produced only by the baryons and the sterile neutrinos produce a purely Newtonian field (hence Modified Baryonic Dynamics). We use two-component cosmological simulations to separate the baryonic N-body particles from the sterile neutrinomore » ones. The premise is to attenuate the over-production of massive galaxy cluster halos which were prevalent in the original MOND plus light sterile neutrinos scenario. Theoretical issues with such a formulation notwithstanding, the Modified Baryonic Dynamics model fails to produce the correct amplitude for the galaxy cluster mass function for any reasonable value of the primordial power spectrum normalisation.« less

  4. Using 4+ to grade near-normal muscle strength does not improve agreement.

    PubMed

    O'Neill, Søren; Jaszczak, Sofie Louise Thomsen; Steffensen, Anne Katrine Søndergaard; Debrabant, Birgit

    2017-01-01

    Manual assessment of muscle strength is often graded using the ordinal Medical Research Council (MRC) scale. The scale has a number of inherent weaknesses, including poorly defined limits between grades '4' and '5' and very large differences in the span of muscle strength encompassed by each of the six grades. It is not necessarily obvious how to convert a manual muscle test finding into an MRC grade. Several modifications which include intermediate grades have been suggested to improve the MRC scale and the current study examines whether agreement improves and variation in ratings decrease, with an intermediate grade between '4' and '5', in circumstances where such a grade would seem appropriate. The present study examined the hypothesis, that a modified MRC-scale which included the commonly used '4+' option, resulted in greater agreement between clinicians compared to the standard MRC-scale. A questionnaire containing five simple clinical cases were distributed to a large convenience sample of chiropractors in Northern Europe, with instructions to grade the described muscle strength findings using the MRC scale. The scale was adapted (with/without an intermediate '4+' grade) depending on the preference of the individual respondent. The cases were designed in such a way as to suggest a muscle weakness in the grey area between '4' and '5', i.e. grade '4+' on the modified MRC scale. A total of 225 questionnaires were returned (7% response rate). The average percentage agreement (across cases) in the standard MRC group was 64% [range 51%: 73%] (grade '4' in all cases). In the modified MRC group, the corresponding findings was 48% [38%: 74%] (grade '4' or '4+' in all cases). The mean average deviation analogue in the standard MRC group was 0.34 (range 0.34: 0.40), compared to 0.51 (range 0.39: 0.73) in the modified MRC group, indicating greater dispersion of scores in the modified MRC group. The Fleiss kappa was 0.02 ( p  < 0.001) and 0.13 ( p  < 0.001), respectively. Contrary to the original hypothesis, introduction of a '4+' grade did not clearly improve agreement or variability of ratings, despite eliminating the physical muscle testing by providing written descriptions of test findings and specifically designing these to suggest a weakness of grade '4+'.

  5. Is Local Viscosupplementation Injection Clinically Superior to Other Therapies in the Treatment of Osteoarthritis of the Knee: A Systematic Review of Overlapping Meta-analyses.

    PubMed

    Campbell, Kirk A; Erickson, Brandon J; Saltzman, Bryan M; Mascarenhas, Randy; Bach, Bernard R; Cole, Brian J; Verma, Nikhil N

    2015-10-01

    To conduct a systematic review of overlapping meta-analyses comparing treatment of knee osteoarthritis (OA) with intra-articular viscosupplementation (intra-articular hyaluronic acid [IA-HA]) versus oral nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular corticosteroids (IA-corticosteroids), intra-articular platelet-rich plasma (IA-PRP), or intra-articular placebo (IA-placebo) to determine which meta-analyses provide the best current evidence and identify potential causes of discordance. Literature searches were performed for meta-analyses examining use of IA-HA versus NSAIDs, IA-corticosteroids, IA-PRP, or IA-placebo. Clinical data were extracted, and meta-analysis quality was assessed. The Jadad algorithm was applied to determine which meta-analyses provided the highest level of evidence. Fourteen meta-analyses met the eligibility criteria and ranged in quality from Level I to IV evidence. In studies reporting patient numbers, there were a total of 20,049 patients: 13,698 receiving IA-HA, 355 receiving NSAIDs, 294 receiving IA-corticosteroids, and 5,702 receiving IA-placebo. Ten studies examined the effects of IA-HA versus IA-placebo; of these, 5 found that IA-HA improved pain and 4 found that IA-HA improved function. No clinically relevant differences in the efficacy of IA-HA versus NSAIDs regarding pain and function were found. Regarding IA-HA versus IA-PRP, IA-HA improved knee function at 2 and 6 months after injection but the effects were less robust than those of IA-PRP. Regarding IA-HA versus IA-corticosteroids, the positive effects of IA-HA were greater at 5 to 13 weeks and persisted for up to 26 weeks. After application of the Jadad algorithm, 2 concordant high-quality meta-analyses were selected and both showed that IA-HA provided clinically relevant improvements in pain and function compared with IA-placebo. This systematic review of overlapping meta-analyses comparing IA-HA with other nonoperative treatment modalities for knee OA shows that the current highest level of evidence suggests that IA-HA is a viable option for knee OA. Its use results in improvements in knee pain and function that can persist for up to 26 weeks. IA-HA has a good safety profile, and its use should be considered in patients with early knee OA. Level IV, systematic review of Level I to IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. Validation of modified forms of the PedsQL generic core scales and cancer module scales for adolescents and young adults (AYA) with cancer or a blood disorder.

    PubMed

    Ewing, Jane E; King, Madeleine T; Smith, Narelle F

    2009-03-01

    To validate two health-related quality of life (HRQOL) measures, the PedsQL Generic Core and Cancer Module adolescent forms (13-18 years), after modification for 16-25-year-old adolescents and young adults (AYA) with cancer or a blood disorder. AYA patients and nominated proxies were recruited from three Sydney hospitals. Modified forms were administered by telephone or in clinics/wards. Analyses included correlations, factor analysis, and analysis of variance of known-groups (defined by the Memorial Symptom Assessment Scale). Eighty-eight patients and 79 proxies completed questionnaires. Factor structures consistent with those of the unmodified forms confirmed construct validity. Cronbach's alpha ranged 0.81-0.98. Inter-scale correlations were as hypothesized, confirming discriminant validity. Statistically significant differences between groups with mild, moderate, and severe symptoms (P < 0.05) confirmed clinical validity. These modified forms provide reliable and valid measures of HRQOL in AYA with cancer or a blood disorder, suitable for clinical trials, research, and practice.

  8. Modifying patch-scale connectivity to initiate landscape change: An experimental approach to link scale

    USDA-ARS?s Scientific Manuscript database

    Nonlinear interactions and feedbacks across spatial and temporal scales are common features of biological and physical systems. These emergent behaviors often result in surprises that challenge the ability of scientists to understand and predict system behavior at one scale based on information at f...

  9. An Integrated Scale for Measuring an Organizational Learning System

    ERIC Educational Resources Information Center

    Jyothibabu, C.; Farooq, Ayesha; Pradhan, Bibhuti Bhusan

    2010-01-01

    Purpose: The purpose of this paper is to develop an integrated measurement scale for an organizational learning system by capturing the learning enablers, learning results and performance outcome in an organization. Design/methodology/approach: A new measurement scale was developed by integrating and modifying two existing scales, identified…

  10. Development of Capstone Project Attitude Scales

    ERIC Educational Resources Information Center

    Bringula, Rex P.

    2015-01-01

    This study attempted to develop valid and reliable Capstone Project Attitude Scales (CPAS). Among the scales reviewed, the Modified Fennema-Shermann Mathematics Attitude Scales was adapted in the construction of the CPAS. Usefulness, Confidence, and Gender View were the three subscales of the CPAS. Four hundred sixty-three students answered the…

  11. Renormalization group scale-setting from the action—a road to modified gravity theories

    NASA Astrophysics Data System (ADS)

    Domazet, Silvije; Štefančić, Hrvoje

    2012-12-01

    The renormalization group (RG) corrected gravitational action in Einstein-Hilbert and other truncations is considered. The running scale of the RG is treated as a scalar field at the level of the action and determined in a scale-setting procedure recently introduced by Koch and Ramirez for the Einstein-Hilbert truncation. The scale-setting procedure is elaborated for other truncations of the gravitational action and applied to several phenomenologically interesting cases. It is shown how the logarithmic dependence of the Newton's coupling on the RG scale leads to exponentially suppressed effective cosmological constant and how the scale-setting in particular RG-corrected gravitational theories yields the effective f(R) modified gravity theories with negative powers of the Ricci scalar R. The scale-setting at the level of the action at the non-Gaussian fixed point in Einstein-Hilbert and more general truncations is shown to lead to universal effective action quadratic in the Ricci tensor.

  12. Assessment of sedation level for endoscopic retrograde cholangiopancreatography - a prospective validation study.

    PubMed

    Jokelainen, Jarno; Mustonen, Harri; Kylänpää, Leena; Udd, Marianne; Lindström, Outi; Pöyhiä, Reino

    2018-03-01

    There is no consensus on how to assess the depth of sedation for endoscopic retrograde cholangiopancreatography (ERCP). This study was carried out in order to evaluate different methods of assessment of depth of sedation: bispectral index (BiS), modified Richmond Agitation/Sedation Scale (mRASS), modified Ramsay Sedation Scale (mRSS) and modified Observer Assessment of Alertness and Sedation (mOAAS) and their applicability to clinical practice. Two hundred patients were recruited. Sedation was given by standard clinical practice using propofol sedation or patient controlled sedation. Sedation was assessed on all patients using the above-mentioned methods. BiS was considered the reference point for sedation scales. Cronbach's alpha was calculated to determine the consistency of different scales in respect to each other and prediction probability and Spearman's correlation coefficients of sedation scales were calculated to show the relationship between sedation scales and BiS. All scales showed high reliability with overall Cronbach's alpha 0.943. Dropping scales suggested better consistency between mOAAS, mRSS and mRASS than with BiS. Spearman's correlation and prediction probability showed similar results with all tested scales: mOAAS (0.695, 0.739), mRSS (0.673, 0.735), mRASS (0.683, 0.738), p < .01 for all scales. All tested methods were found to be reliable in the assessment of the depth of sedation when compared with each other. However, mRASS, mRSS and mOAAS require the patient to respond to verbal or tactile stimulus, which may impair execution of ERCP, whereas BiS information is collected directly from electroencephalogram and thus may be preferable in clinical setting.

  13. Searching for modified growth patterns with tomographic surveys

    NASA Astrophysics Data System (ADS)

    Zhao, Gong-Bo; Pogosian, Levon; Silvestri, Alessandra; Zylberberg, Joel

    2009-04-01

    In alternative theories of gravity, designed to produce cosmic acceleration at the current epoch, the growth of large scale structure can be modified. We study the potential of upcoming and future tomographic surveys such as Dark Energy Survey (DES) and Large Synoptic Survey Telescope (LSST), with the aid of cosmic microwave background (CMB) and supernovae data, to detect departures from the growth of cosmic structure expected within general relativity. We employ parametric forms to quantify the potential time- and scale-dependent variation of the effective gravitational constant and the differences between the two Newtonian potentials. We then apply the Fisher matrix technique to forecast the errors on the modified growth parameters from galaxy clustering, weak lensing, CMB, and their cross correlations across multiple photometric redshift bins. We find that even with conservative assumptions about the data, DES will produce nontrivial constraints on modified growth and that LSST will do significantly better.

  14. Attitudes towards genetically modified and organic foods.

    PubMed

    Saher, Marieke; Lindeman, Marjaana; Hursti, Ulla-Kaisa Koivisto

    2006-05-01

    Finnish students (N=3261) filled out a questionnaire on attitudes towards genetically modified and organic food, plus the rational-experiential inventory, the magical thinking about food and health scale, Schwartz's value survey and the behavioural inhibition scale. In addition, they reported their eating of meat. Structural equation modelling of these measures had greater explanatory power for attitudes towards genetically modified (GM) foods than for attitudes towards organic foods (OF). GM attitudes were best predicted by natural science education and magical food and health beliefs, which mediated the influence of thinking styles. Positive attitudes towards organic food, on the other hand, were more directly related to such individual differences as thinking styles and set of values. The results of the study indicate that OF attitudes are rooted in more fundamental personal attributes than GM attitudes, which are embedded in a more complex but also in a more modifiable network of characteristics.

  15. Effects of glucose concentration on osteogenic differentiation of type II diabetes mellitus rat bone marrow-derived mesenchymal stromal cells on a nano-scale modified titanium.

    PubMed

    Yamawaki, I; Taguchi, Y; Komasa, S; Tanaka, A; Umeda, M

    2017-08-01

    Diabetes mellitus (DM) is a common disease worldwide. Patients with DM have an increased risk of losing their teeth compared with other individuals. Dental implants are a standard of care for treating partial or full edentulism, and various implant surface treatments have recently been developed to increase dental implant stability. However, some studies have reported that DM reduces osseointegration and the success rate of dental implants. The purpose of this study was to determine the effects of high glucose levels for hard tissue formation on a nano-scale modified titanium surface. Titanium disks were heated at 600°C for 1 h after treatment with or without 10 m NaOH solution. All disks were incubated with type II DM rat bone marrow-derived mesenchymal stromal cells before exposure to one of four concentrations of glucose (5.5, 8.0, 12.0 or 24.0 mm). The effect of different glucose concentrations on bone marrow-derived mesenchymal stromal cell osteogenesis and inflammatory cytokines on the nano-scale modified titanium surface was evaluated. Alkaline phosphatase activity decreased with increasing glucose concentration. In contrast, osteocalcin production and calcium deposition were significantly decreased at 8.0 mm glucose, but increased with glucose concentrations over 8.0 mm. Differences in calcium/phosphate ratio associated with the various glucose concentrations were similar to osteocalcin production and calcium deposition. Inflammatory cytokines were expressed at high glucose concentrations, but the nano-scale modified titanium surface inhibited the effect of high glucose concentrations. High glucose concentration increased hard tissue formation, but the quality of the mineralized tissue decreased. Furthermore, the nano-scale modified titanium surface increased mineralized tissue formation and anti-inflammation, but the quality of hard tissue was dependent on glucose concentration. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. The Effects of Scaling Tennis Equipment on the Forehand Groundstroke Performance of Children

    PubMed Central

    Larson, Emma J.; Guggenheimer, Joshua D.

    2013-01-01

    The modifications that have taken place within youth sports have made games, such as basketball, soccer, or tennis, easier for children to play. The purpose of this study was to determine the effects low compression (LC) tennis balls and scaled tennis courts had on the forehand groundstroke performance of children. The forehand groundstroke performances of eight subjects’ (8.10 ± 0.74 yrs) using LC tennis balls were measured on a scaled tennis court and standard compression balls (SC) on a standard court. Forehand groundstroke performance was assessed by the ForeGround test which measures Velocity Precision Success Index (VPS) and Velocity Precision Index (VP). Participants attempted three different forehand rally patterns on two successive days, using LC balls on the 18.3m court one day and SC balls on the 23.8m court the other. When using LC balls, participants’ recorded higher overall VPS performance scores (p < 0.001) for each non-error stroke as well as higher VP scores (p = 0.01). The results of this study confirmed that the use of modified balls and modified court size may increase the control, velocity and overall success rate of the tennis forehand groundstroke of children. Key Points This study observed the effects of modified tennis balls and court had on the forehand groundstroke performance in children. Modified ball compression and modified court size can increase control, velocity and overall success of tennis performance. Children will have more success learning the game of tennis using modified equipment than using standard equipment. PMID:24149812

  17. Decreasing Neuroscience Anxiety in an Introductory Neuroscience Course: An Analysis Using Data from a Modified Science Anxiety Scale

    PubMed Central

    Birkett, Melissa; Shelton, Kerisa

    2011-01-01

    To determine whether participation in a neuroscience course reduced neuroscience anxiety, a modified version of the Science Anxiety Scale was administered to students at the beginning and end of an introductory course. Neuroscience anxiety scores were significantly reduced at the end of the course and correlated with higher final grades. Reduced neuroscience anxiety did not correlate with reduced science anxiety, suggesting that neuroscience anxiety is a distinct subtype of anxiety. PMID:23626491

  18. Effect of the Modified Glasgow Coma Scale Score Criteria for Mild Traumatic Brain Injury on Mortality Prediction: Comparing Classic and Modified Glasgow Coma Scale Score Model Scores of 13

    PubMed Central

    Mena, Jorge Humberto; Sanchez, Alvaro Ignacio; Rubiano, Andres M.; Peitzman, Andrew B.; Sperry, Jason L.; Gutierrez, Maria Isabel; Puyana, Juan Carlos

    2011-01-01

    Objective The Glasgow Coma Scale (GCS) classifies Traumatic Brain Injuries (TBI) as Mild (14–15); Moderate (9–13) or Severe (3–8). The ATLS modified this classification so that a GCS score of 13 is categorized as mild TBI. We investigated the effect of this modification on mortality prediction, comparing patients with a GCS of 13 classified as moderate TBI (Classic Model) to patients with GCS of 13 classified as mild TBI (Modified Model). Methods We selected adult TBI patients from the Pennsylvania Outcome Study database (PTOS). Logistic regressions adjusting for age, sex, cause, severity, trauma center level, comorbidities, and isolated TBI were performed. A second evaluation included the time trend of mortality. A third evaluation also included hypothermia, hypotension, mechanical ventilation, screening for drugs, and severity of TBI. Discrimination of the models was evaluated using the area under receiver operating characteristic curve (AUC). Calibration was evaluated using the Hoslmer-Lemershow goodness of fit (GOF) test. Results In the first evaluation, the AUCs were 0.922 (95 %CI, 0.917–0.926) and 0.908 (95 %CI, 0.903–0.912) for classic and modified models, respectively. Both models showed poor calibration (p<0.001). In the third evaluation, the AUCs were 0.946 (95 %CI, 0.943 – 0.949) and 0.938 (95 %CI, 0.934 –0.940) for the classic and modified models, respectively, with improvements in calibration (p=0.30 and p=0.02 for the classic and modified models, respectively). Conclusion The lack of overlap between ROC curves of both models reveals a statistically significant difference in their ability to predict mortality. The classic model demonstrated better GOF than the modified model. A GCS of 13 classified as moderate TBI in a multivariate logistic regression model performed better than a GCS of 13 classified as mild. PMID:22071923

  19. Generation of Artificial Ionospheric Irregularities in the Midlatitude Ionosphere Modified by High-Power High-Frequency X-Mode Radio Waves

    NASA Astrophysics Data System (ADS)

    Frolov, V. L.; Bolotin, I. A.; Komrakov, G. P.; Pershin, A. V.; Vertogradov, G. G.; Vertogradov, V. G.; Vertogradova, E. G.; Kunitsyn, V. E.; Padokhin, A. M.; Kurbatov, G. A.; Akchurin, A. D.; Zykov, E. Yu.

    2014-11-01

    We consider the properties of the artificial ionospheric irregularities excited in the ionospheric F 2 region modified by high-power high-frequency X-mode radio waves. It is shown that small-scale (decameter) irregularities are not generated in the midlatitude ionosphere. The intensity of irregularities with the scales l ⊥ ≈50 m to 3 km is severalfold weaker compared with the case where the irregularities are excited by high-power O-mode radio waves. The intensity of the larger-scale irregularities is even stronger attenuated. It is found that the generation of large-scale ( l ⊥ ≈5-10 km) artificial ionospheric irregularities is enhanced at the edge of the directivity pattern of a beam of high-power radio waves.

  20. A Brazilian Portuguese cross-cultural adaptation of the modified JOA scale for myelopathy.

    PubMed

    Pratali, Raphael R; Smith, Justin S; Motta, Rodrigo L N; Martins, Samuel M; Motta, Marcel M; Rocha, Ricardo D; Herrero, Carlos Fernando P S

    2017-02-01

    To develop a version of the modified Japanese Orthopaedic Association (mJOA) scale that had been translated into Portuguese and cross-culturally adapted for the Brazilian population. The well-established process of forward-backward translation was employed along with cross-cultural adaptation. Three bilingual translators (English and native Portuguese) performed the forward translation of the mJOA scale from English to Portuguese based on iterative discussions used to reach a consensus translation. The translated version of the mJOA scale was then back-translated into English by a native English-speaking translator unaware of the concepts involved with the mJOA scale. The original mJOA scale and the back-translated version were compared by a native North American neurosurgeon, and as they were considered equivalent, the final version of the mJOA scale that had been translated into Portuguese and cross-culturally adapted was defined. To facilitate global and cross-cultural comparisons of the severity of cervical myelopathy, this study presents a version of the mJOA scale that was translated into Portuguese and cross-culturally adapted for the Brazilian population.

  1. Necessity of dark matter in modified Newtonian dynamics within galactic scales.

    PubMed

    Ferreras, Ignacio; Sakellariadou, Mairi; Yusaf, Muhammad Furqaan

    2008-01-25

    To test modified Newtonian dynamics (MOND) on galactic scales, we study six strong gravitational lensing early-type galaxies from the CASTLES sample. Comparing the total mass (from lensing) with the stellar mass content (from a comparison of photometry and stellar population synthesis), we conclude that strong gravitational lensing on galactic scales requires a significant amount of dark matter, even within MOND. On such scales a 2 eV neutrino cannot explain the excess of matter in contrast with recent claims to explain the lensing data of the bullet cluster. The presence of dark matter is detected in regions with a higher acceleration than the characteristic MOND scale of approximately 10(-10) m/s(2). This is a serious challenge to MOND unless lensing is qualitatively different [possibly to be developed within a covariant, such as Tensor-Vector-Scalar (TeVeS), theory].

  2. Stop Using the Modified Work APGAR to Measure Job Satisfaction

    PubMed Central

    Mielenz, Thelma J.; DeVellis, Robert F.; Battie, Michele C.; Carey, Timothy S.

    2011-01-01

    Background. The psychometric properties of the Modified Work APGAR (MWA) scale are not established, yet researchers use this scale as an overall measure of job satisfaction. Objective. Perform psychometric analyses on the MWA scale using data from two populations. Methods. A landmark occupational cohort and a clinical cohort are populations with low back pain studied. The first five items of the MWA scale measure social support from coworkers, one item measures dissatisfaction with job tasks, and the sixth item measures lack of social support from a supervisor. Exploratory principal components analyses were conducted in both cohorts. Results. In both cohorts, the first five items of the MWA scale loaded consistently onto one factor, social support from coworkers subscale. Conclusions. Unless researchers are interested in measuring social support from coworkers only, future studies should use other reliable and valid instruments to measure a broad range of psychosocial work characteristics. PMID:22191021

  3. Psychometric testing of the modified Care Dependency Scale among hospitalized school-aged children in Germany.

    PubMed

    Tork, Hanan; Lohrmann, Christa; Dassen, Theo

    2008-03-01

    The objectives of this study were to examine the psychometric properties of the modified Care Dependency Scale in a pediatric setting and to explore the extent of dependency of school-aged children regarding their self-care. The data were collected from 130 hospitalized children, aged 6-12 years. The reliability was determined by Cronbach's alpha, which showed a high level of consistency. The subsequent inter-rater reliability revealed moderate-to-substantial agreement. The criterion-related validity was tested by comparing the sum scores of the Care Dependency Scale for Paediatrics and the Visual Analog Scale. Factor analysis was used to investigate the construct validity and resulted in a one-factor solution. In conclusion, this study provides evidence that the Care Dependency Scale for Paediatrics is a valid and reliable measure that offers a comprehensive assessment from a nursing perspective and enables nurses to help children acquire independence.

  4. Continuous micron-scaled rope engineering using a rotating multi-nozzle electrospinning emitter

    NASA Astrophysics Data System (ADS)

    Zhang, Chunchen; Gao, Chengcheng; Chang, Ming-Wei; Ahmad, Zeeshan; Li, Jing-Song

    2016-10-01

    Electrospinning (ES) enables simple production of fibers for broad applications (e.g., biomedical engineering, energy storage, and electronics). However, resulting structures are predominantly random; displaying significant disordered fiber entanglement, which inevitably gives rise to structural variations and reproducibility on the micron scale. Surface and structural features on this scale are critical for biomaterials, tissue engineering, and pharmaceutical sciences. In this letter, a modified ES technique using a rotating multi-nozzle emitter is developed and utilized to fabricate continuous micron-scaled polycaprolactone (PCL) ropes, providing control on fiber intercalation (twist) and structural order. Micron-scaled ropes comprising 312 twists per millimeter are generated, and rope diameter and pitch length are regulated using polymer concentration and process parameters. Electric field simulations confirm vector and distribution mechanisms, which influence fiber orientation and deposition during the process. The modified fabrication system provides much needed control on reproducibility and fiber entanglement which is crucial for electrospun biomedical materials.

  5. Measuring quality of life in low-income, Spanish-speaking Puerto Ricans with type 2 diabetes residing in the mainland U.S.

    PubMed

    Lemon, Stephenie C; Rosal, Milagros C; Welch, Garry

    2011-11-01

    This study assessed the psychometric properties of the Audit of Diabetes-Dependent Quality of Life (ADDQoL) modified for low-income, low-education, Spanish-speaking Puerto Ricans with type 2 diabetes residing in the northeastern United States. Cross-sectional data from 226 patients were analyzed. Scale modifications included simplification of instructions, question wording and response format, and oral administration. Reliability was assessed with Cronbach's alpha coefficient and internal structure by exploratory factor analysis. Criterion validity was assessed using correlation analysis and linear and logistic regression models assessing the association of the ADDQoL with standardized physical health status, mental health status, depression, and comorbidity indices. Two ADDQoL items were dropped. The modified scale had excellent internal consistency and supported the original scale factor structure. Criterion validity results supported the validity of this measure. The modified ADDQoL showed psychometric properties that support its use in low-income, Spanish-speaking Puerto Ricans with type 2 diabetes who reside in mainland U.S.

  6. Modified constraint-induced therapy for children with hemiplegic cerebral palsy: a randomized trial.

    PubMed

    Wallen, Margaret; Ziviani, Jenny; Naylor, Olivia; Evans, Ruth; Novak, Iona; Herbert, Robert D

    2011-12-01

    Conventional constraint-based therapies are intensive and demanding to implement, particularly for children. Modified forms of constraint-based therapies that are family-centred may be more acceptable and feasible for families of children with cerebral palsy (CP)-but require rigorous evaluation using randomized trials. The aim of this study was to determine the effects of modified constraint-induced therapy compared with intensive occupational therapy on activities of daily living and upper limb outcomes in children with hemiplegic CP. In this assessor-blinded pragmatic randomized trial, 50 children (27 males, 23 females; age range 19 mo-7 y 10 mo) with hemiplegic CP were randomized using a concealed allocation procedure to one of two 8-week interventions: intensive occupational therapy (n = 25), or modified constraint-induced therapy (n = 25). Manual Ability Classification System (MACS) levels of the participants were, level I n = 2, II n = 37, III n = 8, and level IV n = 1; Gross Motor Function Classification System (GMFCS) levels were, level I n = 33, level II n = 15, and level III n = 1. Participants were recruited through three specialist CP centres in Australia and randomized between January 2008 and April 2010. Children randomized to modified constraint-induced therapy wore a mitt on the unaffected hand for 2 hours each day, during which time the children participated in targeted therapy. The primary outcome was the Canadian Occupational Performance Measure (COPM--measured on a 10-point scale) at completion of therapy. Other outcome measures were Goal Attainment Scaling, Assisting Hand Assessment, Pediatric Motor Activity Log, Modified Ashworth Scale, Modified Tardieu Scale, and a parent questionnaire. Assessments were carried out at 10 weeks and 6 months following randomization. All participants were included in the analysis. Between-group differences for all outcomes were neither clinically important nor statistically significant. The mean difference in COPM was 0.3 (95% confidence interval [CI] -0.8 to 1.4; p=0.61) and mean difference in COPM satisfaction was 0.1 (95% CI -1.1 to 1.2; p=0.90). Minor adverse events were reported by five of the 25 participants in the modified constraint-induced therapy group and by one of the 25 in the intensive occupational therapy group. All adverse events were related to participants' lack of acceptance of therapy. Modified constraint-induced therapy is no more effective than intensive occupational therapy for improving completion of activities of daily living or upper limb function in children with hemiplegic CP. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

  7. Pharmacological Treatment of Painful HIV-Associated Sensory Neuropathy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

    PubMed Central

    Phillips, Tudor J. C.; Cherry, Catherine L.; Cox, Sarah; Marshall, Sarah J.; Rice, Andrew S. C.

    2010-01-01

    Background Significant pain from HIV-associated sensory neuropathy (HIV-SN) affects ∼40% of HIV infected individuals treated with antiretroviral therapy (ART). The prevalence of HIV-SN has increased despite the more widespread use of ART. With the global HIV prevalence estimated at 33 million, and with infected individuals gaining increased access to ART, painful HIV-SN represents a large and expanding world health problem. There is an urgent need to develop effective pain management strategies for this condition. Method and Findings Objective: To evaluate the clinical effectiveness of analgesics in treating painful HIV-SN. Design: Systematic review and meta-analysis. Data sources: Medline, Cochrane central register of controlled trials, www.clinicaltrials.gov, www.controlled-trials.com and the reference lists of retrieved articles. Selection criteria: Prospective, double-blinded, randomised controlled trials (RCTs) investigating the pharmacological treatment of painful HIV-SN with sufficient quality assessed using a modified Jadad scoring method. Review methods: Four authors assessed the eligibility of articles for inclusion. Agreement of inclusion was reached by consensus and arbitration. Two authors conducted data extraction and analysis. Dichotomous outcome measures (≥30% and ≥50% pain reduction) were sought from RCTs reporting interventions with statistically significant efficacies greater than placebo. These data were used to calculate RR and NNT values. Results Of 44 studies identified, 19 were RCTs. Of these, 14 fulfilled the inclusion criteria. Interventions demonstrating greater efficacy than placebo were smoked cannabis NNT 3.38 95%CI(1.38 to 4.10), topical capsaicin 8%, and recombinant human nerve growth factor (rhNGF). No superiority over placebo was reported in RCTs that examined amitriptyline (100mg/day), gabapentin (2.4g/day), pregabalin (1200mg/day), prosaptide (16mg/day), peptide-T (6mg/day), acetyl-L-carnitine (1g/day), mexilitine (600mg/day), lamotrigine (600mg/day) and topical capsaicin (0.075% q.d.s.). Conclusions Evidence of efficacy exists only for capsaicin 8%, smoked cannabis and rhNGF. However,rhNGF is clinically unavailable and smoked cannabis cannot be recommended as routine therapy. Evaluation of novel management strategies for painful HIV-SN is urgently needed. PMID:21203440

  8. Combined versus single application of tranexamic acid in total knee and hip arthroplasty: A meta-analysis of randomized controlled trials.

    PubMed

    Peng Zhang, M M; Jifeng Li, M M; Xiao Wang, M M

    2017-07-01

    To compare the efficacy and safety of the combined application of both intravenous and topical tranexamic acid versus the single use of either application in patients with total knee and hip arthroplasty. Potentially relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect and the Cochrane Library. Patients undergoing primary total knee and hip arthroplasty were included in our studies, with an experimental group that received combined intravenous and topical application of tranexamic acid and a control group that received a single application of tranexamic acid or normal saline. The primary outcomes were total blood loss, hemoglobin decline and transfusion requirements. The secondary outcomes were length of stay, operation time and tranexamic acid-related adverse effects, such as superficial infection, deep vein thrombosis or pulmonary embolism. Modified Jadad scores were used to assess the quality of the included randomized controlled trials (RCTs). The data was pooled using RevMan 5.3. After testing for heterogeneity across studies, the data were aggregated using random-effects modeling when appropriate. We have registered the trial at http://www.researchregistry.com. Six RCTs that included 704 patients met the inclusion criteria. The present meta-analysis indicated significant differences existed in the total blood loss (MD = -134.65, 95% CI: -191.66 to -77.64, P < 0.0001), postoperative hemoglobin level (MD = 0.74, 95% CI: 0.39 to 1.10, P < 0.0001), drainage volume (MD = -40.19, 95% CI: -55.95 to -24.43, P < 0.00001) and transfusion rate (RD = -0.07, 95% CI: -0.11 to -0.03, P = 0.0004) between groups. Combined administration of tranexamic acid in total knee and hip arthroplasty was associated with significantly reduced total blood loss, postoperative hemoglobin decline, drainage volume, and transfusion requirements. Based on the limitations of current meta-analysis, well-designed, high-quality RCTs with long-term follow-up are still required. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  9. Phase of Illness in palliative care: Cross-sectional analysis of clinical data from community, hospital and hospice patients

    PubMed Central

    Mather, Harriet; Guo, Ping; Firth, Alice; Davies, Joanna M; Sykes, Nigel; Landon, Alison; Murtagh, Fliss EM

    2017-01-01

    Background: Phase of Illness describes stages of advanced illness according to care needs of the individual, family and suitability of care plan. There is limited evidence on its association with other measures of symptoms, and health-related needs, in palliative care. Aims: The aims of the study are as follows. (1) Describe function, pain, other physical problems, psycho-spiritual problems and family and carer support needs by Phase of Illness. (2) Consider strength of associations between these measures and Phase of Illness. Design and setting: Secondary analysis of patient-level data; a total of 1317 patients in three settings. Function measured using Australia-modified Karnofsky Performance Scale. Pain, other physical problems, psycho-spiritual problems and family and carer support needs measured using items on Palliative Care Problem Severity Scale. Results: Australia-modified Karnofsky Performance Scale and Palliative Care Problem Severity Scale items varied significantly by Phase of Illness. Mean function was highest in stable phase (65.9, 95% confidence interval = 63.4–68.3) and lowest in dying phase (16.6, 95% confidence interval = 15.3–17.8). Mean pain was highest in unstable phase (1.43, 95% confidence interval = 1.36–1.51). Multinomial regression: psycho-spiritual problems were not associated with Phase of Illness (χ2 = 2.940, df = 3, p = 0.401). Family and carer support needs were greater in deteriorating phase than unstable phase (odds ratio (deteriorating vs unstable) = 1.23, 95% confidence interval = 1.01–1.49). Forty-nine percent of the variance in Phase of Illness is explained by Australia-modified Karnofsky Performance Scale and Palliative Care Problem Severity Scale. Conclusion: Phase of Illness has value as a clinical measure of overall palliative need, capturing additional information beyond Australia-modified Karnofsky Performance Scale and Palliative Care Problem Severity Scale. Lack of significant association between psycho-spiritual problems and Phase of Illness warrants further investigation. PMID:28812945

  10. Differential memory in the earth's magnetotail

    NASA Technical Reports Server (NTRS)

    Burkhart, G. R.; Chen, J.

    1991-01-01

    The process of 'differential memory' in the earth's magnetotail is studied in the framework of the modified Harris magnetotail geometry. It is verified that differential memory can generate non-Maxwellian features in the modified Harris field model. The time scales and the potentially observable distribution functions associated with the process of differential memory are investigated, and it is shown that non-Maxwelllian distributions can evolve as a test particle response to distribution function boundary conditions in a Harris field magnetotail model. The non-Maxwellian features which arise from distribution function mapping have definite time scales associated with them, which are generally shorter than the earthward convection time scale but longer than the typical Alfven crossing time.

  11. The theory of n-scales

    NASA Astrophysics Data System (ADS)

    Dündar, Furkan Semih

    2018-01-01

    We provide a theory of n-scales previously called as n dimensional time scales. In previous approaches to the theory of time scales, multi-dimensional scales were taken as product space of two time scales [1, 2]. n-scales make the mathematical structure more flexible and appropriate to real world applications in physics and related fields. Here we define an n-scale as an arbitrary closed subset of ℝn. Modified forward and backward jump operators, Δ-derivatives and Δ-integrals on n-scales are defined.

  12. Road to MOND: A novel perspective

    NASA Astrophysics Data System (ADS)

    Milgrom, Mordehai

    2015-08-01

    Accepting that galactic mass discrepancies are due to modified dynamics, I show why it is specifically the Modified Newtonian dynamics (MOND) paradigm that is pointed to cogently. MOND is thus discussed here as a special case of a larger class of modified dynamics theories whereby galactic systems with large mass discrepancies are described by scale-invariant dynamics. This is a novel presentation that uses more recent, after-the-fact insights and data (largely predicted beforehand by MOND). Starting from a purist set of tenets, I follow the path that leads specifically to the MOND basic tenets. The main signposts are as follows: (i) Space-time scale invariance underlies the dynamics of systems with large mass discrepancies. (ii) In these dynamics, G must be replaced by a single "scale-invariant" gravitational constant, Q0 (in MOND, Q0=A0=G a0, where a0 is MOND's acceleration constant). (iii) Universality of free fall points to the constant q0≡Q0/G as the boundary between the G -controlled, standard dynamics, and the Q0-controlled, scale-invariant dynamics (in MOND, q0=a0). (iv) Data clinch the case for q0 being an acceleration (MOND).

  13. Psychometric validation of the household food insecurity access scale among Inuit pregnant women from Northern Quebec

    PubMed Central

    Teh, Lisa; Pirkle, Catherine; Fillion, Myriam

    2017-01-01

    Background Globally, food insecurity is a major public health concern. In North America, it is particularly prevalent in certain sub-groups, including Indigenous communities. Although many Indigenous and remote communities harvest and share food, most food security assessment tools focus on economic access. This study describes the psychometric evaluation of a modified Household Food Insecurity Access Scale (HFIAS), developed for mixed economies, to assess food insecurity among pregnant Inuit women. Methods The HFIAS was administered to 130 pregnant women in Nunavik (Arctic region of Quebec), Canada. Data were fit to a Rasch Rating Scale Model (RSM) to determine the discrimination ability of the HFIAS. Person parameter (Theta) estimates were calculated based on the RSM to provide a more accurate scoring system of the modified HFIAS for this population. Theta values were compared to known correlates of food insecurity. Results Comparative fit indices showed preference for a modified version of the HFIAS over the original. Theta values displayed a continuum of severity estimates and those values indicating greater food insecurity were consistently linked to known correlates of food insecurity. Participants living in households with more than 1 hunter (Theta = -.45) or more than 1 fisher (Theta = -.43) experienced less food insecurity than those with no hunters (Theta = .48) or fishers (Theta = .49) in their household. The RSM indicated the scale showed good discriminatory ability. Subsequent analyses indicated that most scale items pertain to the classification of a household as moderately food insecure. Conclusions The modified HFIAS shows potential for measuring food insecurity among pregnant women in Nunavik. This is an efficient instrument that can inform interventions targeting health conditions impacting groups that obtain food through both monetary and non-monetary means. PMID:28614392

  14. Psychometric validation of the household food insecurity access scale among Inuit pregnant women from Northern Quebec.

    PubMed

    Teh, Lisa; Pirkle, Catherine; Furgal, Chris; Fillion, Myriam; Lucas, Michel

    2017-01-01

    Globally, food insecurity is a major public health concern. In North America, it is particularly prevalent in certain sub-groups, including Indigenous communities. Although many Indigenous and remote communities harvest and share food, most food security assessment tools focus on economic access. This study describes the psychometric evaluation of a modified Household Food Insecurity Access Scale (HFIAS), developed for mixed economies, to assess food insecurity among pregnant Inuit women. The HFIAS was administered to 130 pregnant women in Nunavik (Arctic region of Quebec), Canada. Data were fit to a Rasch Rating Scale Model (RSM) to determine the discrimination ability of the HFIAS. Person parameter (Theta) estimates were calculated based on the RSM to provide a more accurate scoring system of the modified HFIAS for this population. Theta values were compared to known correlates of food insecurity. Comparative fit indices showed preference for a modified version of the HFIAS over the original. Theta values displayed a continuum of severity estimates and those values indicating greater food insecurity were consistently linked to known correlates of food insecurity. Participants living in households with more than 1 hunter (Theta = -.45) or more than 1 fisher (Theta = -.43) experienced less food insecurity than those with no hunters (Theta = .48) or fishers (Theta = .49) in their household. The RSM indicated the scale showed good discriminatory ability. Subsequent analyses indicated that most scale items pertain to the classification of a household as moderately food insecure. The modified HFIAS shows potential for measuring food insecurity among pregnant women in Nunavik. This is an efficient instrument that can inform interventions targeting health conditions impacting groups that obtain food through both monetary and non-monetary means.

  15. A collaborative sequential meta-analysis of individual patient data from randomized trials of endovascular therapy and tPA vs. tPA alone for acute ischemic stroke: ThRombEctomy And tPA (TREAT) analysis: statistical analysis plan for a sequential meta-analysis performed within the VISTA-Endovascular collaboration.

    PubMed

    MacIsaac, Rachael L; Khatri, Pooja; Bendszus, Martin; Bracard, Serge; Broderick, Joseph; Campbell, Bruce; Ciccone, Alfonso; Dávalos, Antoni; Davis, Stephen M; Demchuk, Andrew; Diener, Hans-Christoph; Dippel, Diederik; Donnan, Geoffrey A; Fiehler, Jens; Fiorella, David; Goyal, Mayank; Hacke, Werner; Hill, Michael D; Jahan, Reza; Jauch, Edward; Jovin, Tudor; Kidwell, Chelsea S; Liebeskind, David; Majoie, Charles B; Martins, Sheila Cristina Ouriques; Mitchell, Peter; Mocco, J; Muir, Keith W; Nogueira, Raul; Saver, Jeffrey L; Schonewille, Wouter J; Siddiqui, Adnan H; Thomalla, Götz; Tomsick, Thomas A; Turk, Aquilla S; White, Philip; Zaidat, Osama; Lees, Kennedy R

    2015-10-01

    Endovascular treatment has been shown to restore blood flow effectively. Second-generation medical devices such as stent retrievers are now showing overwhelming efficacy in clinical trials, particularly in conjunction with intravenous recombinant tissue plasminogen activator. This statistical analysis plan utilizing a novel, sequential approach describes a prospective, individual patient data analysis of endovascular therapy in conjunction with intravenous recombinant tissue plasminogen activator agreed upon by the Thrombectomy and Tissue Plasminogen Activator Collaborative Group. This protocol will specify the primary outcome for efficacy, as 'favorable' outcome defined by the ordinal distribution of the modified Rankin Scale measured at three-months poststroke, but with modified Rankin Scales 5 and 6 collapsed into a single category. The primary analysis will aim to answer the questions: 'what is the treatment effect of endovascular therapy with intravenous recombinant tissue plasminogen activator compared to intravenous tissue plasminogen activator alone on full scale modified Rankin Scale at 3 months?' and 'to what extent do key patient characteristics influence the treatment effect of endovascular therapy?'. Key secondary outcomes include effect of endovascular therapy on death within 90 days; analyses of modified Rankin Scale using dichotomized methods; and effects of endovascular therapy on symptomatic intracranial hemorrhage. Several secondary analyses will be considered as well as expanding patient cohorts to intravenous recombinant tissue plasminogen activator-ineligible patients, should data allow. This collaborative meta-analysis of individual participant data from randomized trials of endovascular therapy vs. control in conjunction with intravenous thrombolysis will demonstrate the efficacy and generalizability of endovascular therapy with intravenous thrombolysis as a concomitant medication. © 2015 World Stroke Organization.

  16. Service Quality Assessment Scale (SQAS): An Instrument for Evaluating Service Quality of Health-Fitness Clubs

    ERIC Educational Resources Information Center

    Lam, Eddie T. C.; Zhang, James J.; Jensen, Barbara E.

    2005-01-01

    This study was designed to develop the Service Quality Assessment Scale to evaluate the service quality of health-fitness clubs. Through a review of literature, field observations, interviews, modified application of the Delphi technique, and a pilot study, a preliminary scale with 46 items was formulated. The preliminary scale was administered to…

  17. Validation of the Modified Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE) Questionnaire: A Prospective Analysis of Facial Plastic and Reconstructive Surgery Procedures.

    PubMed

    Oliver, Jeremie D; Menapace, Deanna; Younes, Ahmed; Recker, Chelsey; Hamilton, Grant; Friedman, Oren

    2018-02-01

    Although periorbital edema and ecchymosis are commonly encountered after facial plastic and reconstructive surgery procedures, there is currently no validated grading scale to qualify these findings. In this study, the modified "Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE)" questionnaire is used as a grading scale for patients undergoing facial plastic surgery procedures. This article aims to validate a uniform grading scale for periorbital edema and ecchymosis using the modified SPREE questionnaire in the postoperative period. This is a prospective study including 82 patients at two different routine postoperative visits (second and seventh postoperative days), wherein the staff and resident physicians, physician assistants (PAs), patients, and any accompanying adults were asked to use the modified SPREE questionnaire to score edema and ecchymosis of each eye of the patient who had undergone a plastic surgery procedure. Interrater and intrarater agreements were then examined. Cohen's kappa coefficient was calculated to measure intrarater and interrater agreement between health care professionals (staff physicians and resident physicians); staff physicians and PAs; and staff physicians, patients, and accompanying adults. Good to excellent agreement was identified between staff physicians and resident physicians as well as between staff physicians and PAs. There was, however, poor agreement between staff physicians, patients, and accompanying adults. In addition, excellent agreement was found for intraobserver reliability during same-day visits. The modified SPREE questionnaire is a validated grading system for use by health care professionals to reliably rate periorbital edema and ecchymosis in the postoperative period. Validation of the modified SPREE questionnaire may improve ubiquity in medical literature reporting and related outcomes reporting in future. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. Validation of a modified table to map the 1998 Abbreviated Injury Scale to the 2008 scale and the use of adjusted severities.

    PubMed

    Tohira, Hideo; Jacobs, Ian; Mountain, David; Gibson, Nick; Yeo, Allen; Ueno, Masato; Watanabe, Hiroaki

    2011-12-01

    The Abbreviated Injury Scale 2008 (AIS 2008) is the most recent injury coding system. A mapping table from a previous AIS 98 to AIS 2008 is available. However, AIS 98 codes that are unmappable to AIS 2008 codes exist in this table. Furthermore, some AIS 98 codes can be mapped to multiple candidate AIS 2008 codes with different severities. We aimed to modify the original table to adjust the severities and to validate these changes. We modified the original table by adding links from unmappable AIS 98 codes to AIS 2008 codes. We applied the original table and our modified table to AIS 98 codes for major trauma patients. We also assigned candidate codes with different severities the weighted averages of their severities as an adjusted severity. The proportion of cases whose injury severity scores (ISSs) were computable were compared. We also compared the agreement of the ISS and New ISS (NISS) between manually determined AIS 2008 codes (MAN) and mapped codes by using our table (MAP) with unadjusted or adjusted severities. All and 72.3% of cases had their ISSs computed by our modified table and the original table, respectively. The agreement between MAN and MAP with respect to the ISS and NISS was substantial (intraclass correlation coefficient = 0.939 for ISS and 0.943 for NISS). Using adjusted severities, the agreements of the ISS and NISS improved to 0.953 (p = 0.11) and 0.963 (p = 0.007), respectively. Our modified mapping table seems to allow more ISSs to be computed than the original table. Severity scores exhibited substantial agreement between MAN and MAP. The use of adjusted severities improved these agreements further.

  19. Clinical outcomes and repair integrity after arthroscopic full-thickness rotator cuff repair: suture-bridge versus double-row modified Mason-Allen technique.

    PubMed

    Lee, Kwang Won; Yang, Dae Suk; Lee, Gyu Sang; Ma, Chang Hyun; Choy, Won Sik

    2018-05-23

    This retrospective study compared the clinical and radiologic outcomes of patients who underwent arthroscopic rotator cuff repairs by the suture-bridge and double-row modified Mason-Allen techniques. From January 2012 to May 2013, 76 consecutive cases of full-thickness rotator cuff tear, 1 to 4 cm in the sagittal plane, for which arthroscopic rotator cuff repair was performed, were included. The suture-bridge technique was used in 37 consecutive shoulders; and the double-row modified Mason-Allen technique, in 39 consecutive shoulders. Clinical outcomes at a minimum of 2 years (mean, 35.7 months) were evaluated postoperatively using the visual analog scale; University of California, Los Angeles Shoulder Scale; American Shoulder and Elbow Surgeons Subjective Shoulder Scale; and Constant score. Postoperative cuff integrity was evaluated at a mean of 17.7 months by magnetic resonance imaging. At the final follow-up, the clinical outcomes improved in both groups (all P < .001) but with no significant differences between the 2 groups (all P > .05). The retear rate was 18.9% in the shoulders subjected to suture-bridge repair and 12.8% in the double-row modified Mason-Allen group; the difference was not significant (P = .361). Despite the presence of fewer suture anchors, the patients who underwent double-row modified Mason-Allen repair had comparable shoulder functional outcomes and a comparable retear rate with those who underwent suture-bridge repair. Therefore, the double-row modified Mason-Allen repair technique can be considered an effective treatment for patients with medium- to large-sized full-thickness rotator cuff tears. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  20. A parametrisation of modified gravity on nonlinear cosmological scales

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

    Lombriser, Lucas, E-mail: llo@roe.ac.uk

    2016-11-01

    Viable modifications of gravity on cosmological scales predominantly rely on screening mechanisms to recover Einstein's Theory of General Relativity in the Solar System, where it has been well tested. A parametrisation of the effects of such modifications in the spherical collapse model is presented here for the use of modelling the modified nonlinear cosmological structure. The formalism allows an embedding of the different screening mechanisms operating in scalar-tensor theories through large values of the gravitational potential or its first or second derivatives as well as of linear suppression effects or more general transitions between modified and Einstein gravity limits. Eachmore » screening or suppression mechanism is parametrised by a time, mass, and environment dependent screening scale, an effective modified gravitational coupling in the fully unscreened limit that can be matched to linear theory, the exponent of a power-law radial profile of the screened coupling, determined by derivatives, symmetries, and potentials in the scalar field equation, and an interpolation rate between the screened and unscreened limits. Along with generalised perturbative methods, the parametrisation may be used to formulate a nonlinear extension to the linear parametrised post-Friedmannian framework to enable generalised tests of gravity with the wealth of observations from the nonlinear cosmological regime.« less

  1. 15 CFR 970.514 - Scale requiring application procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Scale requiring application procedures. 970.514 Section 970.514 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade... § 970.514 Scale requiring application procedures. (a) A proposal by the Administrator to modify a term...

  2. Robust Alternatives to the Standard Deviation in Processing of Physics Experimental Data

    NASA Astrophysics Data System (ADS)

    Shulenin, V. P.

    2016-10-01

    Properties of robust estimations of the scale parameter are studied. It is noted that the median of absolute deviations and the modified estimation of the average Gini differences have asymptotically normal distributions and bounded influence functions, are B-robust estimations, and hence, unlike the estimation of the standard deviation, are protected from the presence of outliers in the sample. Results of comparison of estimations of the scale parameter are given for a Gaussian model with contamination. An adaptive variant of the modified estimation of the average Gini differences is considered.

  3. Results of dynamic stability tests conducted on a .012 scale model modified 089 B shuttle orbiter in the AEDC-VKF tunnel B at a Mach number of 8.0 (LA42)

    NASA Technical Reports Server (NTRS)

    Vaughn, J. E.; Daviet, J. T.

    1975-01-01

    Experimental aerodynamic investigations were conducted on a .012 scale model of a NASA/Langley modified version of the Rockwell 089B Space Shuttle Orbiter. Using the forced oscillation test technique, dynamic stability derivatives were measured in the pitch, yaw and roll planes at a Mach number of 8 over an angle of attack range from -4 deg to 28 deg. Plotted and tabulated results are presented.

  4. Handbook: Approaches for the Remediation of Federal Facility Sites Contaminated with Explosive or Radioactive Wastes

    DTIC Science & Technology

    1993-09-01

    ash, and incinerator fly ash in modified sulfur cement and Portland cement waste forms ................................. 70 6-10 Drawing of full-scale...6-17 Economic analysis of encapsulating sodium nitrate at Rocky Flats Plant ..................... 74 6-18 Portland cement and modified sulfur cement...environment. DP-1629. Savannah and modified sulfur cement encapsulation. Both methods River Laboratory, Aiken, South Carolina. have advantages over

  5. Elaboration of highly hydrophobic polymeric surface--a potential strategy to reduce the adhesion of pathogenic bacteria?

    PubMed

    Poncin-Epaillard, F; Herry, J M; Marmey, P; Legeay, G; Debarnot, D; Bellon-Fontaine, M N

    2013-04-01

    Different polymeric surfaces have been modified in order to reach a high hydrophobic character, indeed the superhydrophobicity property. For this purpose, polypropylene and polystyrene have been treated by RF or μwaves CF4 plasma with different volumes, the results were compared according to the density of injected power. The effect of pretreatment such as mechanical abrasion or plasma activation was also studied. The modified surfaces were shown as hydrophobic, or even superhydrophobic depending of defects density. They were characterized by measurement of wettability and roughness at different scales, i.e. macroscopic, mesoscopic and atomic. It has been shown that a homogeneous surface at the macroscopic scale could be heterogeneous at lower mesoscopic scale. This was associated with the crystallinity of the material. The bioadhesion tests were performed with Gram positive and negative pathogenic strains: Listeria monocytogenes, Pseudomonas aeruginosa and Hafnia alvei. They have demonstrated an antibacterial efficiency of very hydrophobic and amorphous PS treated for all strains tested and a strain-dependent efficiency with modified PP surface being very heterogeneous at the mesoscopic scale. Thus, these biological results pointed out not only the respective role of the surface chemistry and topography in bacterial adhesion, but also the dependence on the peaks and valley distribution at bacteria dimension scale. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Tensor-vector-scalar-modified gravity: from small scale to cosmology.

    PubMed

    Bekenstein, Jacob D

    2011-12-28

    The impressive success of the standard cosmological model has suggested to many that its ingredients are all that one needs to explain galaxies and their systems. I summarize a number of known problems with this programme. They might signal the failure of standard gravity theory on galaxy scales. The requisite hints as to the alternative gravity theory may lie with the modified Newtonian dynamics (MOND) paradigm, which has proved to be an effective summary of galaxy phenomenology. A simple nonlinear modified gravity theory does justice to MOND at the non-relativistic level, but cannot be consistently promoted to relativistic status. The obstacles were first side-stepped with the formulation of tensor-vector-scalar theory (TeVeS), a covariant-modified gravity theory. I review its structure, its MOND and Newtonian limits, and its performance in the face of galaxy phenomenology. I also summarize features of TeVeS cosmology and describe the confrontation with data from strong and weak gravitational lensing.

  7. High-z objects and cold dark matter cosmogonies - Constraints on the primordial power spectrum on small scales

    NASA Technical Reports Server (NTRS)

    Kashlinsky, A.

    1993-01-01

    Modified cold dark matter (CDM) models were recently suggested to account for large-scale optical data, which fix the power spectrum on large scales, and the COBE results, which would then fix the bias parameter, b. We point out that all such models have deficit of small-scale power where density fluctuations are presently nonlinear, and should then lead to late epochs of collapse of scales M between 10 exp 9 - 10 exp 10 solar masses and (1-5) x 10 exp 14 solar masses. We compute the probabilities and comoving space densities of various scale objects at high redshifts according to the CDM models and compare these with observations of high-z QSOs, high-z galaxies and the protocluster-size object found recently by Uson et al. (1992) at z = 3.4. We show that the modified CDM models are inconsistent with the observational data on these objects. We thus suggest that in order to account for the high-z objects, as well as the large-scale and COBE data, one needs a power spectrum with more power on small scales than CDM models allow and an open universe.

  8. Xuebijing in the treatment of patients with sepsis.

    PubMed

    Shi, Heng; Hong, Yun; Qian, Jianfang; Cai, Xiaofang; Chen, Shanwen

    2017-02-01

    There are more than 18 million patients diagnosed with sepsis every year. In China, Xuebijing (XBJ) injection is a traditional medicine that is widely used in the treatment of sepsis. However, the efficacy of XBJ in treatment of randomized controlled trials (RCTs) remains unclear. This meta-analysis was to evaluate the clinical efficacy of XBJ based on randomized case-control studies. PubMed, Cochrane, Embase, Wanfang, CNKI, and WeiPu (VIP) databases were searched to identify all the relative randomized case-control. The latest research was done in June, 2016. Relative risks (RR), weighted mean difference (WMD) along with 95% confidence interval (95%CI) were used to analyze the main outcomes. Statistical analysis was performed using STATA 10.0 (TX, USA). The qualities of the involved articles were accessed by the Jadad scale. Forty-nine randomized case-control studies met the inclusion and exclusion criteria, with 1861 patients in the control group and 2023 patients in the XBJ group. Compared with the conventional therapy, XBJ injection could significantly reduce the APACHE-IIscore (WMD: -3.70, 95%CI: -4.31-[-3.09]), PCT (WMD: -1.26μg/L, 95%CI: -1.63μg/L-[-0.88μg/L]), WBC (WMD: -1.48×10 9 /L, 95%CI: -2.03×10 9 /L-[-0.94×10 9 /L]), CRP (WMD: -24.38mg/L, 95%CI:-30.49mg/L-[-18.26mg/L]), NEU (WMD: -4.68, 95%CI: -8.32-[-1.04]), T 0 (WMD: -0.50, 95%CI: -0.92-[-0.07]). The 28-day mortality of the XBJ group was significantly lower than the control group (RR: 0.51; 95%CI: 0.44-0.59). XBJ injection has a significant clinical efficacy in the therapy of patients with sepsis. However, there is a need for more randomized, lager-sample size, high-quality, and multicenter studies to confirm the extract efficacy of XBJ injection. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. An empirical study using permutation-based resampling in meta-regression

    PubMed Central

    2012-01-01

    Background In meta-regression, as the number of trials in the analyses decreases, the risk of false positives or false negatives increases. This is partly due to the assumption of normality that may not hold in small samples. Creation of a distribution from the observed trials using permutation methods to calculate P values may allow for less spurious findings. Permutation has not been empirically tested in meta-regression. The objective of this study was to perform an empirical investigation to explore the differences in results for meta-analyses on a small number of trials using standard large sample approaches verses permutation-based methods for meta-regression. Methods We isolated a sample of randomized controlled clinical trials (RCTs) for interventions that have a small number of trials (herbal medicine trials). Trials were then grouped by herbal species and condition and assessed for methodological quality using the Jadad scale, and data were extracted for each outcome. Finally, we performed meta-analyses on the primary outcome of each group of trials and meta-regression for methodological quality subgroups within each meta-analysis. We used large sample methods and permutation methods in our meta-regression modeling. We then compared final models and final P values between methods. Results We collected 110 trials across 5 intervention/outcome pairings and 5 to 10 trials per covariate. When applying large sample methods and permutation-based methods in our backwards stepwise regression the covariates in the final models were identical in all cases. The P values for the covariates in the final model were larger in 78% (7/9) of the cases for permutation and identical for 22% (2/9) of the cases. Conclusions We present empirical evidence that permutation-based resampling may not change final models when using backwards stepwise regression, but may increase P values in meta-regression of multiple covariates for relatively small amount of trials. PMID:22587815

  10. [Patients' perspective and economic variables as objectives in clinical trials: added value to clinical parameters].

    PubMed

    Bovaira-García, M J; Soler-Company, E

    2012-01-01

    Patient-reported outcome (PRO) measures complement traditional biomedical outcome measures. The purpose of this study was to evaluate the use of PRO measures including health-related quality of life (HRQoL) questionnaires as a measurement of efficacy and the frequency of inclusion of economic variables related to direct and indirect costs in the design of clinical trials and phase IV observational studies. Moreover, for the trials quality score were measured, and if there were any relationship between the quality study design score and the PRO inclusion. Retrospective observational study of the clinical trials and phase IV observational studies approved by a Clinical Research Ethics Committee (2008-2010). We gathered data concerning general aspects including medical specialty, pathology, methodological quality based on Jadad scale (0-5), inclusion of PRO and economic variables. For clinical trials including HRQoL measurements, we analysed the type of questionnaire in use. Where there were no HRQoL measurements, we analysed if their inclusion would have been proper or not. A total of 70 protocols (59 CTs and 11 phase IV observational studies) were analysed; 37 (52.8%) included PRO measures, and 3 protocols (4.3%) used them as a primary endpoint. Data analysis by therapeutic area showed that PRO measures were most commonly studied in the fields of endocrinology, neurology, digestive diseases, and cardiology. The average quality score for the trials was 2.8. The trials with more PRO inclusion in their end points had a significantly higher quality score. Only 13 (22%) clinical trials and 2 (18.2%) phase IV observational studies included economic variables. The emergence of economic variables in clinical trials and phase IV observational studies evaluated was low, however, more than half of the revised protocols have included PRO measures, reflecting the importance of these parameters in the assessment of the effectiveness of drug treatments, although its use is still not systematic. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  11. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials.

    PubMed

    van Die, M Diana; Burger, Henry G; Teede, Helena J; Bone, Kerry M

    2013-05-01

    Vitex agnus-castus L. (chaste tree; chasteberry) is a popular herbal treatment, predominantly used for a range of female reproductive conditions in Anglo-American and European practice. The objective of this systematic review was to evaluate the evidence for the efficacy and safety of Vitex extracts from randomised, controlled trials investigating women's health.Eight databases were searched using Latin and common names for Vitex and phytotherapeutic preparations of the herb as a sole agent, together with filters for randomised, controlled trials or clinical trials. Methodological quality was assessed according to the Cochrane risk of bias and Jadad scales, as well as the proposed elaboration of CONSORT for reporting trials on herbal interventions.Thirteen randomised, controlled trials were identified and twelve are included in this review, of which eight investigated premenstrual syndrome, two premenstrual dysphoric disorder, and two latent hyperprolactinaemia. For premenstrual syndrome, seven of eight trials found Vitex extracts to be superior to placebo (5 of 6 studies), pyridoxine (1), and magnesium oxide (1). In premenstrual dysphoric disorder, one study reported Vitex to be equivalent to fluoxetine, while in the other, fluoxetine outperformed Vitex. In latent hyperprolactinaemia, one trial reported it to be superior to placebo for reducing TRH-stimulated prolactin secretion, normalising a shortened luteal phase, increasing mid-luteal progesterone and 17β-oestradiol levels, while the other found Vitex comparable to bromocriptine for reducing serum prolactin levels and ameliorating cyclic mastalgia. Adverse events with Vitex were mild and generally infrequent. The methodological quality of the included studies varied, but was generally moderate-to-high. Limitations include small sample sizes in some studies, heterogeneity of conditions being treated, and a range of reference treatments.Despite some methodological limitations, the results from randomised, controlled trials to date suggest benefits for Vitex extracts in the treatment of premenstrual syndrome, premenstrual dysphoric disorder and latent hyperprolactinaemia. Further research is recommended, and greater transparency in reporting for future trials. Georg Thieme Verlag KG Stuttgart · New York.

  12. Effectiveness of Knee Injury and Anterior Cruciate Ligament Tear Prevention Programs: A Meta-Analysis

    PubMed Central

    Collins, Jamie E.; Yang, Heidi Y.; Goczalk, Melissa G.; Katz, Jeffrey N.; Losina, Elena

    2015-01-01

    Objective Individuals frequently involved in jumping, pivoting or cutting are at increased risk of knee injury, including anterior cruciate ligament (ACL) tears. We sought to use meta-analytic techniques to establish whether neuromuscular and proprioceptive training is efficacious in preventing knee and ACL injury and to identify factors related to greater efficacy of such programs. Methods We performed a systematic literature search of studies published in English between 1996 and 2014. Intervention efficacy was ascertained from incidence rate ratios (IRRs) weighted by their precision (1/variance) using a random effects model. Separate analyses were performed for knee and ACL injury. We examined whether year of publication, study quality, or specific components of the intervention were associated with efficacy of the intervention in a meta-regression analysis. Results Twenty-four studies met the inclusion criteria and were used in the meta-analysis. The mean study sample was 1,093 subjects. Twenty studies reported data on knee injury in general terms and 16 on ACL injury. Maximum Jadad score was 3 (on a 0–5 scale). The summary incidence rate ratio was estimated at 0.731 (95% CI: 0.614, 0.871) for knee injury and 0.493 (95% CI: 0.285, 0.854) for ACL injury, indicating a protective effect of intervention. Meta-regression analysis did not identify specific intervention components associated with greater efficacy but established that later year of publication was associated with more conservative estimates of intervention efficacy. Conclusion The current meta-analysis provides evidence that neuromuscular and proprioceptive training reduces knee injury in general and ACL injury in particular. Later publication date was associated with higher quality studies and more conservative efficacy estimates. As study quality was generally low, these data suggest that higher quality studies should be implemented to confirm the preventive efficacy of such programs. PMID:26637173

  13. Hypertonic saline or mannitol for treating elevated intracranial pressure in traumatic brain injury: a meta-analysis of randomized controlled trials.

    PubMed

    Gu, Jiajie; Huang, Haoping; Huang, Yuejun; Sun, Haitao; Xu, Hongwu

    2018-06-15

    Hyperosmolar therapy is regarded as the mainstay for treatment of elevated intracranial pressure (ICP) in traumatic brain injury (TBI). This still has been disputed as application of hypertonic saline (HS) or mannitol for treating patients with severe TBI. Thus, this meta-analysis was performed to further compare the advantages and disadvantages of mannitol with HS for treating elevated ICP after TBI. We conducted a systematic search on PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Wan Fang Data, VIP Data, SinoMed, and China National Knowledge Infrastructure (CNKI) databases. Studies were included or not based on the quality assessment by the Jadad scale and selection criteria. Twelve RCTs with 438 patients were enrolled for the meta-analysis. The comparison of HS and mannitol indicated that they were close in field of improving function outcome (RR = 1.17, 95% CI 0.89 to 1.54, p = 0.258) and reducing intracranial pressure (MD = - 0.16, 95% CI: - 0.59 to 0.27, p = 0.473) and mortality (RR = 0.78, 95% CI 0.53 to 1.16, p = 0.216). The pooled relative risk of successful ICP control was 1.06 (95% CI: 1.00 to 1.13, p = 0.044), demonstrating that HS was more effective than mannitol in ICP management. Both serum sodium (WMD = 5.30, 95% CI: 4.37 to 6.22, p < 0.001) and osmolality (WMD = 3.03, 95% CI: 0.18 to 5.88, p = 0.037) were increased after injection of hypertonic saline. The results do not lend a specific recommendation to select hypertonic saline or mannitol as a first-line for the patients with elevated ICP caused by TBI. However, for the refractory intracranial hypertension, hypertonic saline seems to be preferred.

  14. Effectiveness and Factors Determining the Success of Management Programs for Patients With Heart Failure: A Systematic Review and Meta-analysis.

    PubMed

    Oyanguren, Juana; Latorre García, Pedro María; Torcal Laguna, Jesús; Lekuona Goya, Iñaki; Rubio Martín, Susana; Maull Lafuente, Elena; Grandes, Gonzalo

    2016-10-01

    Heart failure management programs reduce hospitalizations. Some studies also show reduced mortality. The determinants of program success are unknown. The aim of the present study was to update our understanding of the reductions in mortality and readmissions produced by these programs, elucidate their components, and identify the factors determining program success. Systematic literature review (1990-2014; PubMed, EMBASE, CINAHL, Cochrane Library) and manual search of relevant journals. The studies were selected by 3 independent reviewers. Methodological quality was evaluated in a blinded manner by an external researcher (Jadad scale). These results were pooled using random effects models. Heterogeneity was evaluated with the I 2 statistic, and its explanatory factors were determined using metaregression analysis. Of the 3914 studies identified, 66 randomized controlled clinical trials were selected (18 countries, 13 535 patients). We determined the relative risks to be 0.88 for death (95% confidence interval [95%CI], 0.81-0.96; P < .002; I 2 , 6.1%), 0.92 for all-cause readmissions (95%CI, 0.86-0.98; P < .011; I 2 , 58.7%), and 0.80 for heart failure readmissions (95%CI, 0.71-0.90; P < .0001; I 2 , 52.7%). Factors associated with program success were implementation after 2001, program location outside the United States, greater baseline use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, a higher number of intervention team members and components, specialized heart failure cardiologists and nurses, protocol-driven education and its assessment, self-monitoring of signs and symptoms, detection of deterioration, flexible diuretic regimen, early care-seeking among patients and prompt health care response, psychosocial intervention, professional coordination, and program duration. We confirm the reductions in mortality and readmissions with heart failure management programs. Their success is associated with various structural and intervention variables. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Is laser acupuncture an effective complementary therapy for obesity management? A systematic review of clinical trials.

    PubMed

    Namazi, Nazli; Khodamoradi, Kajal; Larijani, Bagher; Ayati, Mohammad Hossein

    2017-12-01

    Complementary therapies may increase the success rate of weight loss via a calorie-restricted diet. Acupuncture is a popular complementary therapy for obesity management. To our knowledge, no studies have summarised the effects of laser acupuncture (LA) on obesity. To evaluate the efficacy of LA, in particular with respect to its impact on anthropometric features and appetite in obese adults, by conducting a systematic review of previous clinical trials. We searched PubMed/Medline, Scopus, Web of Science, the Cochrane Library, Embase and Google Scholar electronic databases for papers published through October 2016. All clinical trials in English containing either anthropometric indices or appetite parameters were included. Two reviewers independently examined studies based on a predefined form for data extraction and the Jadad scale for quality assessment in order to minimise bias throughout the evaluation. After screening the papers, seven clinical trials met the criteria and were included in the systematic review. Positive effects of LA therapy were seen in body weight (n=3), body mass index (n=5), waist circumference (n=4), hip circumference (n=3), waist to hip ratio (n=4) and % fat mass (n=3). Appetite parameters were reported in one study, which showed that LA can reduce appetite and increase the sensation of feeling full. Although some studies have indicated beneficial effects for LA on obesity, the lack of evidence with high methodological quality made it impossible to reach a definitive conclusion about the efficacy of LA for obesity management. Further high-quality, randomised, sham-controlled clinical trials with a larger sample size are needed to shed light on the efficacy of LA for obesity management and weight maintenance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Dropout Prevalence and Associated Factors in Randomized Clinical Trials of Adolescents Treated for Depression: Systematic Review and Meta-analysis.

    PubMed

    Rohden, Adriane Isabel; Benchaya, Mariana Canellas; Camargo, Roger Santos; Moreira, Taís de Campos; Barros, Helena M T; Ferigolo, Maristela

    2017-05-01

    Depression currently affects 350 million people, and its prevalence among adolescents is 4% to 8%. Adolescents who abandon antidepressant treatment or drop out of clinical trials are less likely to recover or experience a remission of symptoms because they are not being followed up by a medical team. The objective of this study was to analyze the dropout rates of randomized clinical trials of depressed adolescents receiving treatment with antidepressant drugs and the factors associated with nonadherence by summarizing this information in a systematic review and meta-analysis. Articles were retrieved from MEDLINE, EMBASE, Cochrane, Clinical Trial, PsycINFO, and Web of Science using the MeSH terms "depressive disorder," "randomized trials," and "adolescents." The evaluation of study quality was performed by using the Cochrane Handbook for Systematic Reviews of Interventions and the Jadad scale. The final sample included 50 articles, of which 44 presented dropout rates. The overall dropout prevalence was 23% (95% CI, 20-27; P < 0.0001). Participants aged ≥16 years, those treated with serotonin norepinephrine reuptake inhibitors, and those receiving medication only exhibited the highest dropout prevalence, respectively (33% [95% CI, 27-39], 45% [95% CI, 31-64], and 15% [95% CI, 13-17]). The adverse effects most associated with dropout were attempted suicide followed by mania, skin rash, and headache. Problems relating to clinical trials and family arbitration were also related with dropout. Serotonin/norepinephrine reuptake inhibitor treatment, adolescent age >16 years, and receiving medication were the only factors demonstrating a higher association with dropout rates. Selective serotonin reuptake inhibitors were linked to the lowest prevalence, probably due to fewer perceived problems with related adverse effects and higher efficacy in adolescents. Cognitive-behavioral therapy combined with pharmacotherapy produced a lower nonadherence prevalence; this approach can be an alternative to avoid dropouts and relapse. Prospero identifier: CRD42014013475. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

  17. The Efficacy of Danshen Injection as Adjunctive Therapy in Treating Angina Pectoris: A Systematic Review and Meta-Analysis.

    PubMed

    Shao, Huikai; Li, Mengsi; Chen, Fuchao; Chen, Lianghua; Jiang, Zhengjin; Zhao, Lingguo

    2018-04-01

    During the last 40 years, Danshen injection has been widely used as an adjunctive therapy for angina pectoris in China, but its efficacy is not yet well defined. The objective of this study was to verify the efficacy of Danshen injection as adjunctive therapy in treating angina pectoris. The major databases including PubMed, Cochrane Library, Sino-Med, Medline, Embase, Google Scholar, China National Knowledge Infrastructure, Wanfang Databases, Chinese Scientific Journal Database, Chinese Biomedical Literature Database and the Chinese Science Citation Database were systematically searched for the published randomised controlled trials (RCTs) on Danshen injection until April 2016. Meta-analysis was conducted on the primary outcomes (i.e., the improvements in symptoms and electrocardiography (ECG)). The quality of the included RCTs was evaluated with the M scoring system (the refined Jadad scale). Based on the quality, year of publication and sample size of RCTs, sensitivity analysis and subgroup analysis were performed in this study. Ten RCTs, including 944 anginal patients, were identified in this meta-analysis. Compared with using antianginal agents (β-blockers, calcium antagonists, nitrates, etc.) alone, Danshen injection combined with antianginal agents had a better therapeutic effect in symptom improvement (odds ratio [OR], 3.66; 95% confidence interval [CI]: 2.50-5.36) and in ECG improvement (OR, 3.25; 95% CI: 1.74-6.08). This study showed that Danshen injection as adjunctive therapy seemed to be more effective than antianginal agents alone in treating angina pectoris. However, more evidence is needed to accurately evaluate the efficacy of Danshen injection because of the low methodological quality of the included RCTs. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  18. Association of physical activity with cognition, metacognition and academic performance in children and adolescents: a protocol for systematic review and meta-analysis.

    PubMed

    Álvarez-Bueno, Celia; Pesce, Caterina; Cavero-Redondo, Iván; Sánchez-López, Mairena; Pardo-Guijarro, María Jesús; Martínez-Vizcaíno, Vicente

    2016-06-28

    Schools provide a relevant context for improving children's and adolescents' physical and mental health by increasing physical activity during school hours and/or beyond. The interest in the relationship between physical activity programmes and cognition during development has recently increased, with evidence suggesting a positive association. We present a protocol of systematic reviews and meta-analysis of intervention studies that, by determining the effects of chronic physical exercise on children's and adolescents' cognitive and metacognitive functions, cognitive life skills, academic behaviours and achievement, aims to ensure procedural objectivity and transparency, and maximise the extraction of relevant information to inform policy development. This protocol is guided by Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and by the Cochrane Collaboration Handbook. Databases to be utilised for a thorough selection of the pertinent literature are MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, PsycINFO and ERIC. Selection is proposed to encompass an international and a national publication level, with inclusion of experimental studies written in English or in Spanish, respectively. Also, relevant references included in the selected studies will be considered suitable for review as supplemental sources.We present an integrated approach to the methodological quality assessment of the selected studies, including the Jadad Scale for the assessment of the quality of randomised controlled trials and the Quality Assessment Tool for Quantitative Studies for pre-post studies and non-randomised controlled trials. The pre-post interventions mean differences will be the primary indicator of the intervention outcome. A subgroup analysis is proposed based on cognitive functions and their neural correlates, metacognitive functions and cognitive life skills, academic achievement areas and academic behaviours. PROSPERO CRD42015029913. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Thromboembolism prevention in surgery of digestive cancer.

    PubMed

    Malafaia, Osvaldo; Montagnini, Andre Luís; Luchese, Angélica; Accetta, Antonio Carlos; Zilberstein, Bruno; Malheiros, Carlos Alberto; Jacob, Carlos Eduardo; Quireze-Junior, Claudemiro; Bresciani, Cláudio José Caldas; Kruel, Cleber Dario Pinto; Cecconello, Ivan; Sad, Eduardo Fonseca; Ohana, Jorge Alberto Langbeck; Aguilar-Nascimento, José Eduardo de; Manso, José Eduardo Ferreira; Ribas-Filho, Jurandir Marcondes; Santo, Marco Aurélio; Andreollo, Nelson Adami; Torres, Orlando Jorge Martins; Herman, Paulo; Cuenca, Ronaldo Mafia; Sallum, Rubens Antônio Aissar; Bernardo, Wanderley Marques

    2012-01-01

    The venous thromboembolism is a common complication after surgical treatment in general and, in particular, on the therapeutic management on cancer. Surgery of the digestive tract has been reported to induce this complication. Patients with digestive cancer have substantial increased risk of initial or recurrent thromboembolism. To provide to surgeons working in digestive surgery and general surgery guidance on how to make safe thromboprophylaxis for patients requiring operations in the treatment of their gastrointestinal malignancies. The guideline was based on 15 relevant clinical issues and related to the risk factors, treatment and prognosis of the patient undergoing surgical treatment of cancer on digestive tract. They focused thromboembolic events associated with operations and thromboprophylaxis. The questions were structured using the PICO (Patient, Intervention or Indicator, Comparison and Outcome), allowing strategies to generate evidence on the main primary bases of scientific information (Medline / Pubmed, Embase, Lilacs / Scielo, Cochrane Library, PreMedline via OVID). Evidence manual search was also conducted (BDTD and IBICT). The evidence was recovered from the selected critical evaluation using discriminatory instruments (scores) according to the category of the question: risk, prognosis and therapy (JADAD Randomized Clinical Trials and New Castle Ottawa Scale for studies not randomized). After defining potential studies to support the recommendations, they were selected by the strength of evidence and grade of recommendation according to the classification of Oxford, including the available evidence of greater strength. A total of 53,555 papers by title and / or abstract related to issue were found. Of this total were selected (1st selection) 478 studies that were evaluated as full-text. From them to support the recommendations were included in the consensus 132 papers. The 15 questions could be answered with evidence grade of articles with 31 A, 130 B, 1 C and 0 D. It was possible to prepare safe recommendations as guidance for thromboembolism prophylaxis in operations on the digestive tract malignancies, addressing the most frequent topics of everyday work of digestive and general surgeons.

  20. The dark-baryonic matter mass relation for observational verification in Verlinde's emergent gravity

    NASA Astrophysics Data System (ADS)

    Shen, Jian Qi

    2018-06-01

    Recently, a new interesting idea of origin of gravity has been developed by Verlinde. In this scheme of emergent gravity, where horizon entropy, microscopic de Sitter states and relevant contribution to gravity are involved, an entropy displacement resulting from matter behaves as a memory effect and can be exhibited at sub-Hubble scales, namely, the entropy displacement and its "elastic" response would lead to emergent gravity, which gives rise to an extra gravitational force. Then galactic dark matter effects may origin from such extra emergent gravity. We discuss some concepts in Verlinde's theory of emergent gravity and point out some possible problems or issues, e.g., the gravitational potential caused by Verlinde's emergent apparent dark matter may no longer be continuous in spatial distribution at ordinary matter boundary (such as a massive sphere surface). In order to avoid the unnatural discontinuity of the extra emergent gravity of Verlinde's apparent dark matter, we suggest a modified dark-baryonic mass relation (a formula relating Verlinde's apparent dark matter mass to ordinary baryonic matter mass) within this framework of emergent gravity. The modified mass relation is consistent with Verlinde's result at relatively small scales (e.g., R<3h_{70}^{-1} Mpc). However, it seems that, compared with Verlinde's relation, at large scales (e.g., gravitating systems with R>3h_{70}^{-1} Mpc), the modified dark-baryonic mass relation presented here might be in better agreement with the experimental curves of weak lensing analysis in the recent work of Brouwer et al. Galactic rotation curves are compared between Verlinde's emergent gravity and McGaugh's recent model of MOND (Modified Newtonian Dynamics established based on recent galaxy observations). It can be found that Verlinde rotational curves deviate far from those of McGaugh MOND model when the MOND effect (or emergent dark matter) dominates. Some applications of the modified dark-baryonic mass relation inspired by Verlinde's emergent gravity will be addressed for galactic and solar scales. Potential possibilities to test this dark-baryonic mass relation as well as apparent dark matter effects, e.g., planetary perihelion precession at Solar System scale, will be considered. This may enable to place some constraints on the magnitudes of the MOND characteristic acceleration at the small solar scale.

  1. The Modified Readiness for Interprofessional Learning Scale in Currently Practicing Athletic Trainers

    ERIC Educational Resources Information Center

    Welsch, Lauren A.; Rutledge, Carolyn; Hoch, Johanna M.

    2017-01-01

    Context: Athletic trainers are encouraged to work collaboratively with other health care professionals to improve patient outcomes. Interprofessional education (IPE) experiences for practicing clinicians should be developed to improve interprofessional collaborative practice postcertification. An outcome measure, such as the modified Readiness for…

  2. [The School Refusal Assessment Scale: Psychometric properties and validation of a modified version].

    PubMed

    Knollmann, Martin; Sicking, Alexander; Hebebrand, Johannes; Reissner, Volker

    2017-07-01

    Psychometric properties of the original and a modified version of the «Einschätzungsskala der Schulverweigerung» (German version of the School Refusal Assessment Scale, SRAS; Kearney & Silverman, 1993; Overmeyer et al., 1994) were analyzed in order to identify alternative ways to revise the SRAS/ESV compared to the existing revision SRAS-R (Kearney, 2002). The SRAS/ESV consists of a parent and a child version and measures four functions of school refusal (avoidance of negative affect related to school settings, escape from aversive social or evaluative situations, attention-getting behavior, positive tangible reinforcement). Data from N = 124 (parent version) respectively N = 156 (child version) patients of a specialized psychiatric outpatient unit for children and adolescents with school-avoiding behavior were obtained. Analyzes included characteristics of items and scales, face-, factorial-, and construct-validity (correlations with other questionnaires, e. g., YSR, CBCL were analyzed). Many items seem to measure overall anxiety instead of the functional aspects of school refusal, one item measures expansive behavior. Four factors were obtained, but they did not reflect the assumed structure of the ESV (e. g., overlap of the two avoidance-related scales). Post-hoc-analyzes with a modified version (elimination of several items with problematic content validity) suggested three factors, convergent and discriminative validity of the modified version was confirmed. Because only some of the afore-mentioned problems have been addressed in the revised version (SRAS-R; Kearney, 2002), a new revision and extension of the German version of the questionnaire covering more aspects of school avoidance behavior (e. g., bullying, depression, somatic complaints, psychosocial factors) is discussed.

  3. Voluntary wheel running improves recovery from a moderate spinal cord injury.

    PubMed

    Engesser-Cesar, Christie; Anderson, Aileen J; Basso, D Michele; Edgerton, V R; Cotman, Carl W

    2005-01-01

    Recently, locomotor training has been shown to improve overground locomotion in patients with spinal cord injury (SCI). This has triggered renewed interest in the role of exercise in rehabilitation after SCI. However, there are no mouse models for voluntary exercise and recovery of function following SCI. Here, we report voluntary wheel running improves recovery from a SCI in mice. C57Bl/10 female mice received a 60-kdyne T9 contusion injury with an IH impactor after 3 weeks of voluntary wheel running or 3 weeks of standard single housing conditions. Following a 7-day recovery period, running mice were returned to their running wheels. Weekly open-field behavior measured locomotor recovery using the Basso, Beattie and Bresnahan (BBB) locomotor rating scale and the Basso Mouse Scale (BMS) locomotor rating scale, a scale recently developed specifically for mice. Initial experiments using standard rung wheels show that wheel running impaired recovery, but subsequent experiments using a modified flat-surface wheel show improved recovery with exercise. By 14 days post SCI, the modified flat-surface running group had significantly higher BBB and BMS scores than the sedentary group. A repeated measures ANOVA shows locomotor recovery of modified flat-surface running mice was significantly improved compared to sedentary animals (p < 0.05). Locomotor assessment using a ladder beam task also shows a significant improvement in the modified flat-surface runners (p < 0.05). Finally, fibronectin staining shows no significant difference in lesion size between the two groups. These data represent the first mouse model showing voluntary exercise improves recovery after SCI.

  4. Model-independent constraints on modified gravity from current data and from the Euclid and SKA future surveys

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

    Taddei, Laura; Martinelli, Matteo; Amendola, Luca, E-mail: taddei@thphys.uni-heidelberg.de, E-mail: martinelli@lorentz.leidenuniv.nl, E-mail: amendola@thphys.uni-heidelberg.de

    2016-12-01

    The aim of this paper is to constrain modified gravity with redshift space distortion observations and supernovae measurements. Compared with a standard ΛCDM analysis, we include three additional free parameters, namely the initial conditions of the matter perturbations, the overall perturbation normalization, and a scale-dependent modified gravity parameter modifying the Poisson equation, in an attempt to perform a more model-independent analysis. First, we constrain the Poisson parameter Y (also called G {sub eff}) by using currently available f σ{sub 8} data and the recent SN catalog JLA. We find that the inclusion of the additional free parameters makes the constraintsmore » significantly weaker than when fixing them to the standard cosmological value. Second, we forecast future constraints on Y by using the predicted growth-rate data for Euclid and SKA missions. Here again we point out the weakening of the constraints when the additional parameters are included. Finally, we adopt as modified gravity Poisson parameter the specific Horndeski form, and use scale-dependent forecasts to build an exclusion plot for the Yukawa potential akin to the ones realized in laboratory experiments, both for the Euclid and the SKA surveys.« less

  5. Modifying gravity: you cannot always get what you want.

    PubMed

    Starkman, Glenn D

    2011-12-28

    The combination of general relativity (GR) and the Standard Model of particle physics disagrees with numerous observations on scales from our Solar System up. In the canonical concordance model of Lambda cold dark matter (ΛCDM) cosmology, many of these contradictions between theory and data are removed or alleviated by the introduction of three completely independent new components of stress energy--the inflaton, dark matter and dark energy. Each of these in its turn is meant to have dominated (or to currently dominate) the dynamics of the Universe. There is, until now, no non-gravitational evidence for any of these dark sectors, nor is there evidence (though there may be motivation) for the required extension of the Standard Model. An alternative is to imagine that it is GR that must be modified to account for some or all of these disagreements. Certain coincidences of scale even suggest that one might expect not to make independent modifications of the theory to replace each of the three dark sectors. Because they must address the most different types of data, attempts to replace dark matter with modified gravity are the most controversial. A phenomenological model (or family of models), modified Newtonian dynamics, has, over the last few years, seen several covariant realizations. We discuss a number of challenges that any model that seeks to replace dark matter with modified gravity must face: the loss of Birkhoff's theorem, and the calculational simplifications it implies; the failure to explain clusters, whether static or interacting, and the consequent need to introduce dark matter of some form, whether hot dark matter neutrinos or dark fields that arise in new sectors of the modified gravity theory; the intrusion of cosmological expansion into the modified force law, which arises precisely because of the coincidence in scale between the centripetal acceleration at which Newtonian gravity fails in galaxies and the cosmic acceleration. We conclude with the observation that, although modified gravity may indeed manage to replace dark matter, it is likely to do so by becoming or at least incorporating a dark matter theory itself.

  6. Comparison of NASA-TLX scale, Modified Cooper-Harper scale and mean inter-beat interval as measures of pilot mental workload during simulated flight tasks.

    PubMed

    Mansikka, Heikki; Virtanen, Kai; Harris, Don

    2018-04-30

    The sensitivity of NASA-TLX scale, modified Cooper-Harper (MCH) scale and the mean inter-beat interval (IBI) of successive heart beats, as measures of pilot mental workload (MWL), were evaluated in a flight training device (FTD). Operational F/A-18C pilots flew instrument approaches with varying task loads. Pilots' performance, subjective MWL ratings and IBI were measured. Based on the pilots' performance, three performance categories were formed; high-, medium- and low-performance. Values of the subjective rating scales and IBI were compared between categories. It was found that all measures were able to differentiate most task conditions and there was a strong, positive correlation between NASA-TLX and MCH scale. An explicit link between IBI, NASA-TLX, MCH and performance was demonstrated. While NASA-TLX, MCH and IBI have all been previously used to measure MWL, this study is the first one to investigate their association in a modern FTD, using a realistic flying mission and operational pilots.

  7. A Scale-Invariant Model of Statistical Mechanics and Modified Forms of the First and the Second Laws of Thermodynamics

    NASA Technical Reports Server (NTRS)

    Sohrab, Siavash H.; Pitch, Nancy (Technical Monitor)

    1999-01-01

    A scale-invariant statistical theory of fields is presented that leads to invariant definition of density, velocity, temperature, and pressure, The definition of Boltzmann constant is introduced as k(sub k) = m(sub k)v(sub k)c = 1.381 x 10(exp -23) J x K(exp -1), suggesting that the Kelvin absolute temperature scale is equivalent to a length scale. Two new state variables called the reversible heat Q(sub rev) = TS and the reversible work W(sub rev) = PV are introduced. The modified forms of the first and second law of thermodynamics are presented. The microscopic definition of heat (work) is presented as the kinetic energy due to the random (peculiar) translational, rotational, and pulsational motions. The Gibbs free energy of an element at scale Beta is identified as the total system energy at scale (Beta-1), thus leading to an invariant form of the first law of thermodynamics U(sub Beta) = Q(sub Beta) - W(sub Beta) +N(e3)U(sub Beta-1).

  8. Multidimensional scaling analysis of financial time series based on modified cross-sample entropy methods

    NASA Astrophysics Data System (ADS)

    He, Jiayi; Shang, Pengjian; Xiong, Hui

    2018-06-01

    Stocks, as the concrete manifestation of financial time series with plenty of potential information, are often used in the study of financial time series. In this paper, we utilize the stock data to recognize their patterns through out the dissimilarity matrix based on modified cross-sample entropy, then three-dimensional perceptual maps of the results are provided through multidimensional scaling method. Two modified multidimensional scaling methods are proposed in this paper, that is, multidimensional scaling based on Kronecker-delta cross-sample entropy (MDS-KCSE) and multidimensional scaling based on permutation cross-sample entropy (MDS-PCSE). These two methods use Kronecker-delta based cross-sample entropy and permutation based cross-sample entropy to replace the distance or dissimilarity measurement in classical multidimensional scaling (MDS). Multidimensional scaling based on Chebyshev distance (MDSC) is employed to provide a reference for comparisons. Our analysis reveals a clear clustering both in synthetic data and 18 indices from diverse stock markets. It implies that time series generated by the same model are easier to have similar irregularity than others, and the difference in the stock index, which is caused by the country or region and the different financial policies, can reflect the irregularity in the data. In the synthetic data experiments, not only the time series generated by different models can be distinguished, the one generated under different parameters of the same model can also be detected. In the financial data experiment, the stock indices are clearly divided into five groups. Through analysis, we find that they correspond to five regions, respectively, that is, Europe, North America, South America, Asian-Pacific (with the exception of mainland China), mainland China and Russia. The results also demonstrate that MDS-KCSE and MDS-PCSE provide more effective divisions in experiments than MDSC.

  9. The inter-rater reliability test of the modified Morse Fall Scale among patients ≥ 55 years old in an acute care hospital in Singapore.

    PubMed

    Tang, Wing Sze; Chow, Yeow Leng; Koh, Serena Siew Lin

    2014-02-01

    A prospective, descriptive study was conducted in an acute care hospital in Singapore to determine the inter-rater reliability of the modified Morse Fall Scale by evaluating the degrees of agreement on the ratings of the individual items and overall score between the 'gold standard' assessor and the facility assessors. One hundred and forty-two subjects were recruited during the 1.5 month data collection period. The simple and weighted κ-values were all > 0.8 except for the item 'effects of medications' (κ and κw  = 0.63), and the correlation coefficient (rs  = 0.89) was significantly high at a significance level of < 0.001. The modified Morse Fall Scale was shown to be a reliable fall risk assessment tool having a relative high inter-rater reliability level for the overall score and individual items. This study provides evidence-based psychometric support for the clinical application of this tool. © 2013 Wiley Publishing Asia Pty Ltd.

  10. Evaluation of a modified interview version and of a self-rating version of the Suicide Assessment Scale.

    PubMed

    Niméus, A; Hjalmarsson Ståhlfors, F; Sunnqvist, C; Stanley, B; Träskman-Bendz, L

    2006-10-01

    The Suicide Assessment Scale (SUAS) was constructed to be sensitive to change of suicidality. It was recently found to be predictive of suicide in a group of suicide attempters. The aim of the present study was to evaluate the reliability and validity of a modified interview version of SUAS with defined scores and also a new self-rating version (SUAS-S). The subjects consisted of former inpatients, 42 persons who had been admitted because of a suicide attempt about 12 years ago and 22 control patients. The subjects were rated according to the SUAS, the SUAS-S, as well as the Montgomery Asberg Depression Rating Scale (MADRS). The interrater reliability was found to be high. The SUAS correlated significantly with the MADRS, but the concordance was not consistent, which indicates that the SUAS measures something different from depression. The SUAS-S correlated significantly with the interview-rated SUAS, thus exhibiting good concurrent validity. In summary, both the modified interview version of SUAS and the SUAS-S seem to be valid, reliable and easily used suicide assessment instruments.

  11. Standardized measures for substance use stigma.

    PubMed

    Brown, Seth A

    2011-07-01

    Despite indications that the stigma associated with substance use is high and may play a role in discouraging treatment participation, there is limited research in this area and only a few psychometrically sound measures of substance use stigma exist. The purpose of this study was to formulate and evaluate the psychometric properties of three substance use stigma measures. College students (N=565) completed three measures of substance use stigma that were modified from three established measures of mental illness stigma. Two of the three modified measures (Social Distance Scale for Substance Users and Affect Scale for Substance Users) emerged as having acceptable psychometric properties, whereas one modified measure (Dangerousness Scale for Substance Users) had inadequate psychometric properties. In regard to sex differences, women had significantly higher substance use stigma on the two psychometrically sound measures (p<.01). Perhaps, with standardized measures, there can be greater progress towards better understanding the mechanisms leading to high levels of substance use stigma and ultimately address failures to seek out treatment due to stigma. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  12. Adsorption Behavior of Heat Modified Soybean Oil via Boundary Lubrication Coefficient of Friction Measurements

    USDA-ARS?s Scientific Manuscript database

    The frictional behaviors of soybean oil and heat modified soybean oils with different Gardner scale viscosities as additives in hexadecane have been examined in a boundary lubrication test regime (steel contacts) using Langmuir adsorption model. The free energy of adsorption (delta-Gads) of various...

  13. Genetic Variants in the Bone Morphogenic Protein Gene Family Modify the Association between Residential Exposure to Traffic and Peripheral Arterial Disease

    EPA Science Inventory

    There is a growing literature indicating that genetic variants modify many of the associations between environmental exposures and clinical outcomes, potentially by increasing susceptibility to these exposures. However, genome-scale investigations of these interactions have been ...

  14. Role of modifiers for analytical-scale supercritical fluid extraction of environmental samples

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

    Langenfeld, J.J.; Hawthorne, S.B.; Miller, D.J.

    1994-03-15

    Supercritical fluid extraction (SFE) using eight different CO[sub 2] + organic modifier mixtures and one ternary mixture (CO[sub 2] + methanol/toluene) at two different concentrations (1 and 10% v/v) was performed on two certified reference materials including polychlorinated biphenyls (PCBs) from river sediment and polycyclic aromatic hydrocarbons (PAHs) from urban air particulate matter. The modifier identity was more important than modifier concentration for increasing extraction efficiencies. Acidic/basic modifiers including methanol, acetic acid, and aniline greatly enhanced the extraction of PCBs. Low molecular weight PAHs were best extracted with modifiers including aniline, acetic acid, acetonitrile, methanol/toluene, hexane, and diethylamine. In contrast,more » modifiers capable of dipole-induced dipole interactions and [pi]-[pi] interactions such as toluene, diethylamine, and methylene chloride were the best modifiers to use for SFE of high molecular weight PAHs from air particulates. 37 refs., 6 tabs.« less

  15. Yield stress and scaling of polyelectrolyte multilayer modified suspensions: effect of polyelectrolyte conformation during multilayer assembly.

    PubMed

    Hess, Andreas; Aksel, Nuri

    2013-09-10

    The yield stress of polyelectrolyte multilayer modified suspensions exhibits a surprising dependence on the polyelectrolyte conformation of multilayer films. The rheological data scale onto a universal master curve for each polyelectrolyte conformation as the particle volume fraction, φ, and the ionic strength of the background fluid, I, are varied. It is shown that rough films with highly coiled, brushy polyelectrolytes significantly enhance the yield stress. Moreover, via the ionic strength I of the background fluid, the dynamic yield stress of brushy polyelectrolyte multilayers can be finely adjusted over 2 decades.

  16. Establishing a Scale for Assessing the Social Validity of Skill Building Interventions for Young Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Berger, Natalie I.; Manston, Lauren; Ingersoll, Brooke

    2016-01-01

    This study evaluated the psychometric properties of the Scale of Treatment Perceptions (STP), a measure of treatment acceptability targeting skill-building interventions for Autism Spectrum Disorder (ASD). This scale utilizes a strength-based approach to intervention assessment, and was established by modifying the Behavior Intervention Rating…

  17. Cosmological tests of modified gravity.

    PubMed

    Koyama, Kazuya

    2016-04-01

    We review recent progress in the construction of modified gravity models as alternatives to dark energy as well as the development of cosmological tests of gravity. Einstein's theory of general relativity (GR) has been tested accurately within the local universe i.e. the Solar System, but this leaves the possibility open that it is not a good description of gravity at the largest scales in the Universe. This being said, the standard model of cosmology assumes GR on all scales. In 1998, astronomers made the surprising discovery that the expansion of the Universe is accelerating, not slowing down. This late-time acceleration of the Universe has become the most challenging problem in theoretical physics. Within the framework of GR, the acceleration would originate from an unknown dark energy. Alternatively, it could be that there is no dark energy and GR itself is in error on cosmological scales. In this review, we first give an overview of recent developments in modified gravity theories including f(R) gravity, braneworld gravity, Horndeski theory and massive/bigravity theory. We then focus on common properties these models share, such as screening mechanisms they use to evade the stringent Solar System tests. Once armed with a theoretical knowledge of modified gravity models, we move on to discuss how we can test modifications of gravity on cosmological scales. We present tests of gravity using linear cosmological perturbations and review the latest constraints on deviations from the standard [Formula: see text]CDM model. Since screening mechanisms leave distinct signatures in the non-linear structure formation, we also review novel astrophysical tests of gravity using clusters, dwarf galaxies and stars. The last decade has seen a number of new constraints placed on gravity from astrophysical to cosmological scales. Thanks to on-going and future surveys, cosmological tests of gravity will enjoy another, possibly even more, exciting ten years.

  18. Years of disability-adjusted life gained as a result of thrombolytic therapy for acute ischemic stroke.

    PubMed

    Hong, Keun-Sik; Saver, Jeffrey L

    2010-03-01

    Disability-adjusted life year (DALY) metric reflects years of healthy life lost because of living with disability and years of life lost because of premature mortality. Widely used in epidemiological analyses, DALY has not been applied to acute stroke trials. From previous studies, we derived, for each modified Rankin Scale level, disability weights, disability-linked mortality hazard ratios, and age-specific life expectancies. We then analyzed patient level data from the 2 publicly available National Institute of Neurological Disorders and Stroke (NINDS) recombinant tissue plasminogen activator trials. For each subject, we abstracted age, treatment assignment, and 3-month modified Rankin Scale outcome and calculated the DALYs lost resulting from the qualifying stroke. The disability-linked hazard ratios for premature annual mortality for a modified Rankin Scale score of 0 to 5 were 1.53, 1.52, 2.17, 3.18, 4.55, and 6.55, respectively. In the NINDS recombinant tissue plasminogen activator trials, DALYs (mean+/-SE) lost as a result of the qualifying stroke were substantially less with recombinant tissue plasminogen activator than with placebo (4.64+/-0.17 versus 5.91+/-0.21; P<0.0001), a finding that remained robust after adjustment for baseline prognostic factors. When DALYs gained were apportioned to the 29% of patients experiencing any benefit from lytic therapy, each patient gained an average of 4.4 DALYs. DALY analysis showed greater power than dichotomized modified Rankin Scale analysis in discriminating treatment effects overall and in patients >or=70 years of age. For patients who benefit from treatment, <3-hour thrombolytic therapy adds the equivalent of 4.4 years of healthy life, free of disability. The DALY metric provides a continuous scale that increases statistical power, is intuitively understandable, and is applicable to a wide range of conditions and treatments.

  19. Cellular and molecular modifier pathways in tauopathies: the big picture from screening invertebrate models.

    PubMed

    Hannan, Shabab B; Dräger, Nina M; Rasse, Tobias M; Voigt, Aaron; Jahn, Thomas R

    2016-04-01

    Abnormal tau accumulations were observed and documented in post-mortem brains of patients affected by Alzheimer's disease (AD) long before the identification of mutations in the Microtubule-associated protein tau (MAPT) gene, encoding the tau protein, in a different neurodegenerative disease called Frontotemporal dementia and Parkinsonism linked to chromosome 17 (FTDP-17). The discovery of mutations in the MAPT gene associated with FTDP-17 highlighted that dysfunctions in tau alone are sufficient to cause neurodegeneration. Invertebrate models have been diligently utilized in investigating tauopathies, contributing to the understanding of cellular and molecular pathways involved in disease etiology. An important discovery came with the demonstration that over-expression of human tau in Drosophila leads to premature mortality and neuronal dysfunction including neurodegeneration, recapitulating some key neuropathological features of the human disease. The simplicity of handling invertebrate models combined with the availability of a diverse range of experimental resources make these models, in particular Drosophila a powerful invertebrate screening tool. Consequently, several large-scale screens have been performed using Drosophila, to identify modifiers of tau toxicity. The screens have revealed not only common cellular and molecular pathways, but in some instances the same modifier has been independently identified in two or more screens suggesting a possible role for these modifiers in regulating tau toxicity. The purpose of this review is to discuss the genetic modifier screens on tauopathies performed in Drosophila and C. elegans models, and to highlight the common cellular and molecular pathways that have emerged from these studies. Here, we summarize results of tau toxicity screens providing mechanistic insights into pathological alterations in tauopathies. Key pathways or modifiers that have been identified are associated with a broad range of processes including, but not limited to, phosphorylation, cytoskeleton organization, axonal transport, regulation of cellular proteostasis, transcription, RNA metabolism, cell cycle regulation, and apoptosis. We discuss the utility and application of invertebrate models in elucidating the cellular and molecular functions of novel and uncharacterized disease modifiers identified in large-scale screens as well as for investigating the function of genes identified as risk factors in genome-wide association studies from human patients in the post-genomic era. In this review, we combined and summarized several large-scale modifier screens performed in invertebrate models to identify modifiers of tau toxicity. A summary of the screens show that diverse cellular processes are implicated in the modification of tau toxicity. Kinases and phosphatases are the most predominant class of modifiers followed by components required for cellular proteostasis and axonal transport and cytoskeleton elements. © 2016 International Society for Neurochemistry.

  20. Change in Action: How Infants Learn to Walk down Slopes

    ERIC Educational Resources Information Center

    Gill, Simone V.; Adolph, Karen E.; Vereijken, Beatrix

    2009-01-01

    A critical aspect of perception-action coupling is the ability to modify ongoing actions in accordance with variations in the environment. Infants' ability to modify their gait patterns to walk down shallow and steep slopes was examined at three nested time scales. Across sessions, a microgenetic training design showed rapid improvements after the…

  1. Issues of Spatial and Temporal Scale in Modeling the Effects of Field Operatiions on Soil Properties

    USDA-ARS?s Scientific Manuscript database

    Tillage is an important procedure for modifying the soil environment in order to enhance crop growth and conserve soil and water resources. Process-based models of crop production are widely used in decision support, but few explicitly simulate tillage. The Cropping Systems Model (CSM) was modified ...

  2. ROLE OF CANOPY-SCALE PHOTOCHEMISTRY IN MODIFYING BIOGENIC-ATMOSPHERE EXCHANGE OF REACTIVE TERPENE SPECIES: RESULTS FROM THE CELTIC FIELD STUDY

    EPA Science Inventory

    A one-dimensional canopy model was used to quantify the impact of photochemistry in modifying biosphere-atmosphere exchange of trace gases. Canopy escape efficiencies, defined as the fraction of emission that escapes into the well-mixed boundary layer, were calculated for reactiv...

  3. Depressive Symptoms Negate the Beneficial Effects of Physical Activity on Mortality Risk

    ERIC Educational Resources Information Center

    Lee, Pai-Lin

    2013-01-01

    The aim of this study is to: (1) compare the association between various levels of physical activity (PA) and mortality; and (2) examine the potential modifying effect of depressive symptoms on the PA-mortality associations. Previous large scale randomized studies rarely assess the association in conjunction with modifying effects of depressive…

  4. A Comprehensive Motion Estimation Technique for the Improvement of EIS Methods Based on the SURF Algorithm and Kalman Filter.

    PubMed

    Cheng, Xuemin; Hao, Qun; Xie, Mengdi

    2016-04-07

    Video stabilization is an important technology for removing undesired motion in videos. This paper presents a comprehensive motion estimation method for electronic image stabilization techniques, integrating the speeded up robust features (SURF) algorithm, modified random sample consensus (RANSAC), and the Kalman filter, and also taking camera scaling and conventional camera translation and rotation into full consideration. Using SURF in sub-pixel space, feature points were located and then matched. The false matched points were removed by modified RANSAC. Global motion was estimated by using the feature points and modified cascading parameters, which reduced the accumulated errors in a series of frames and improved the peak signal to noise ratio (PSNR) by 8.2 dB. A specific Kalman filter model was established by considering the movement and scaling of scenes. Finally, video stabilization was achieved with filtered motion parameters using the modified adjacent frame compensation. The experimental results proved that the target images were stabilized even when the vibrating amplitudes of the video become increasingly large.

  5. Separating Dark Physics from Physical Darkness: Minimalist Modified Gravity vs. Dark Energy

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

    Huterer, Dragan; Linder, Eric V.

    The acceleration of the cosmic expansion may be due to a new component of physical energy density or a modification of physics itself. Mapping the expansion of cosmic scales and the growth of large scale structure in tandem can provide insights to distinguish between the two origins. Using Minimal Modified Gravity (MMG) - a single parameter gravitational growth index formalism to parameterize modified gravity theories - we examine the constraints that cosmological data can place on the nature of the new physics. For next generation measurements combining weak lensing, supernovae distances, and the cosmic microwave background we can extend themore » reach of physics to allow for fitting gravity simultaneously with the expansion equation of state, diluting the equation of state estimation by less than 25percent relative to when general relativity is assumed, and determining the growth index to 8percent. For weak lensing we examine the level of understanding needed of quasi- and nonlinear structure formation in modified gravity theories, and the trade off between stronger precision but greater susceptibility to bias as progressively more nonlinear information is used.« less

  6. Separating dark physics from physical darkness: Minimalist modified gravity versus dark energy

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

    Huterer, Dragan; Linder, Eric V.

    The acceleration of the cosmic expansion may be due to a new component of physical energy density or a modification of physics itself. Mapping the expansion of cosmic scales and the growth of large scale structure in tandem can provide insights to distinguish between the two origins. Using Minimal Modified Gravity (MMG) - a single parameter gravitational growth index formalism to parametrize modified gravity theories - we examine the constraints that cosmological data can place on the nature of the new physics. For next generation measurements combining weak lensing, supernovae distances, and the cosmic microwave background we can extend themore » reach of physics to allow for fitting gravity simultaneously with the expansion equation of state, diluting the equation of state estimation by less than 25% relative to when general relativity is assumed, and determining the growth index to 8%. For weak lensing we examine the level of understanding needed of quasi- and nonlinear structure formation in modified gravity theories, and the trade off between stronger precision but greater susceptibility to bias as progressively more nonlinear information is used.« less

  7. Development and psychometric properties of a measure of catheter burden with bladder drainage after pelvic reconstructive surgery.

    PubMed

    Carpenter, Janet S; Heit, Michael; Rand, Kevin L

    2017-04-01

    Catheter burden after pelvic reconstructive surgery is an important patient-reported quality of life outcome in research and clinical practice. However, existing tools focus on long-term catheter users rather than short-term postoperative patients. The study aim was to evaluate the psychometric properties of a modified version of the intermittent self-catheterization questionnaire (ISC-Q) in postoperative pelvic reconstructive patients. After experts convened to discuss and modify the ISC-Q items based on their knowledge of women's experiences and clinical practices, 178 women (108 with transurethral and 70 with suprapubic catheters) completed the modified scale and other measures as part of a larger parent study designed to assess health-related quality of life (HRQoL) following pelvic reconstructive surgery requiring bladder drainage. During psychometric testing, the modified ISC-Q was reduced to six items encompassing two factors: a three-item difficulty of use factor and a 3-item embarrassment factor. The new scale was named the short-term catheter burden questionnaire (STCBQ). The two-factor model was robust in both subsamples. Only scores within and not between subsamples can be meaningfully compared due to a lack of scalar invariance. Correlations among STCBQ total scores, subscores, and a single satisfaction item indicated good construct validity. Correlations with patient demographics provided further information about the scale. The STCBQ is a short, efficient assessment of short-term catheter burden following pelvic reconstructive surgery. The scale can be used as an important patient reported outcome measure in clinical practice and research. Neurourol. Urodynam. 36:1140-1146, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  8. Efficacy and Safety of Individualized Coaching After Stroke: the LAST Study (Life After Stroke): A Pragmatic Randomized Controlled Trial.

    PubMed

    Askim, Torunn; Langhammer, Birgitta; Ihle-Hansen, Hege; Gunnes, Mari; Lydersen, Stian; Indredavik, Bent

    2018-02-01

    The evidence for interventions to prevent functional decline in the long term after stroke is lacking. The aim of this trial was to evaluate the efficacy and safety of an 18-month follow-up program of individualized regular coaching on physical activity and exercise. This was a multicentre, pragmatic, single-blinded, randomized controlled trial. Adults (age ≥18 years) with first-ever or recurrent stroke, community dwelling, with modified Rankin Scale <5, and no serious comorbidities were included 10 to 16 weeks poststroke. The intervention group received individualized regular coaching on physical activity and exercise every month for 18 consecutive months. The control group received standard care. Primary outcome was the Motor Assessment Scale at end of intervention (18-month follow-up). Secondary measures were Barthel index, modified Rankin Scale, item 14 from Berg Balance Scale, Timed Up and Go test, gait speed, 6-minute walk test, and Stroke Impact Scale. Other outcomes were adverse events and compliance to the intervention assessed by training diaries and the International Physical Activity Questionnaire. Three hundred and eighty consenting participants were randomly assigned to individualized coaching (n=186) or standard care (n=194). The mean estimated difference on Motor Assessment Scale in favor of control group was -0.70 points (95% confidence interval, -2.80, 1.39), P =0.512. There were no differences between the groups on Barthel index, modified Rankin Scale, or Berg Balance Scale. The frequency of adverse events was low in both groups. Results from International Physical Activity Questionnaire and training diaries showed increased activity levels but low intensity of the exercise in the intervention group. The regular individualized coaching did not improve maintenance of motor function or the secondary outcomes compared with standard care. The intervention should be regarded as safe. Despite the neutral results, the health costs related to the intervention should be investigated. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01467206. © 2017 American Heart Association, Inc.

  9. Adapting the academic motivation scale for use in pre-tertiary mathematics classrooms

    NASA Astrophysics Data System (ADS)

    Lim, Siew Yee; Chapman, Elaine

    2015-09-01

    The Academic Motivation Scale ( ams) is a comprehensive and widely used instrument for assessing motivation based on the self-determination theory. Currently, no such comprehensive instrument exists to assess the different domains of motivation (stipulated by the self-determination theory) in mathematics education at the pre-tertiary level (grades 11 and 12) in Asia. This study adapted the ams for this use and assessed the properties of the adapted instrument with 1610 students from Singapore. Exploratory and confirmatory factor analyses indicated a five-factor structure for the modified instrument (the three original ams intrinsic subscales collapsed into a single factor). Additionally, the modified instrument exhibited good internal consistency (mean α = .88), and satisfactory test-retest reliability over a 1-month interval (mean r xx = .73). The validity of the modified ams was further demonstrated through correlational analyses among scores on its subscales, and with scores on other instruments measuring mathematics attitudes, anxiety and achievement.

  10. Results of investigations on a 0.004-scale 140C modified configuration space shuttle vehicle orbiter model (74-0) in the NASA/Langley Research Center hypersonic helium tunnel

    NASA Technical Reports Server (NTRS)

    Hawthorne, P. J.

    1975-01-01

    Data obtained during a wind tunnel test of a 0.004-scale 140C modified configuration SSV orbiter are documented. The test was conducted during August 1974 with 80 occupancy hours charged, and all runs were conducted at a nominal Mach number of 20 and at Reynolds numbers of 0.7, 1.0, 1.8, and 1,100,000 based on body length. The complete -140C modified model was tested with various elevon settings at angles of attack from 10 to 50 degrees at zero yaw and from angles of sideslip of -10 to +10 at 35 deg angle of attack. The purpose of this test was to obtain high hypersonic longitudinal and lateral-directional stability and control characteristics of the updated SSV configuration.

  11. Modified coulomb law in a strongly magnetized vacuum.

    PubMed

    Shabad, Anatoly E; Usov, Vladimir V

    2007-05-04

    We study the electric potential of a charge placed in a strong magnetic field B>B(0) approximately 4.4x10(13) G, as modified by the vacuum polarization. In such a field the electron Larmour radius is much less than its Compton length. At the Larmour distances a scaling law occurs, with the potential determined by a magnetic-field-independent function. The scaling regime implies short-range interaction, expressed by the Yukawa law. The electromagnetic interaction regains its long-range character at distances larger than the Compton length, the potential decreasing across B faster than along. Correction to the nonrelativistic ground-state energy of a hydrogenlike atom is found. In the limit B = infinity, the modified potential becomes the Dirac delta function plus a regular background. With this potential the ground-state energy is finite--the best pronounced effect of the vacuum polarization.

  12. Nonlinear analysis of 0-3 polarized PLZT microplate based on the new modified couple stress theory

    NASA Astrophysics Data System (ADS)

    Wang, Liming; Zheng, Shijie

    2018-02-01

    In this study, based on the new modified couple stress theory, the size- dependent model for nonlinear bending analysis of a pure 0-3 polarized PLZT plate is developed for the first time. The equilibrium equations are derived from a variational formulation based on the potential energy principle and the new modified couple stress theory. The Galerkin method is adopted to derive the nonlinear algebraic equations from governing differential equations. And then the nonlinear algebraic equations are solved by using Newton-Raphson method. After simplification, the new model includes only a material length scale parameter. In addition, numerical examples are carried out to study the effect of material length scale parameter on the nonlinear bending of a simply supported pure 0-3 polarized PLZT plate subjected to light illumination and uniform distributed load. The results indicate the new model is able to capture the size effect and geometric nonlinearity.

  13. Homophobia: The Quest for a Valid Scale

    ERIC Educational Resources Information Center

    Lumby, Malcolm E.

    1976-01-01

    Using a modified version of Smith's "homophobic scale," this study examines attitudinal differences between 60 homosexual and 60 heterosexual Caucasian, middle-class males. Although homosexual subjects evidenced a consistent liberal attitude toward sexual behavior in general, many heterosexuals indicated a strong margin of attitudinal…

  14. Modifying your Physics and Astronomy Courses to Incorporate Heliophysics - Some Examples

    NASA Astrophysics Data System (ADS)

    Cebulka, Rebecca; Cox, Amanda; Rodriguez Garrigues, Alvar; Hoshino, Laura; Fitzgerald, Cullen; Montgomery, M.; Al-Rawi, Ahlam N.; Velissaris, Christos; Flitsiyan, Elena

    2016-01-01

    Although physics and astronomy courses include heliophysics topics, students still leave the courses without knowing what heliophysics is and how heliophysics relates to their daily lives. To meet goals of NASA's Living With a Star Program, UCF Physics has modified courses such as SCALE-UP: Electricity and Magnetism for Engineers and Scientists, Astronomy (for non-science majors), and Astrophysics to include heliophysics topics. In this poster, we present the previous labs, the student-modified labs to incorporate heliophysics, and we present student learning statistics.

  15. Fracture behavior of nano-scale rubber-modified epoxies

    NASA Astrophysics Data System (ADS)

    Bacigalupo, Lauren N.

    The primary focus of the first portion of this study is to compare physical and mechanical properties of a model epoxy that has been toughened with one of three different types of rubber-based modifier: a traditional telechelic oligomer (phase separates into micro-size particles), a core-shell latex particle (preformed nano-scale particles) and a triblock copolymer (self-assembles into nano-scale particles). The effect of modifier content on the physical properties of the matrix was determined using several thermal analysis methods, which provided insight into any inherent alterations of the epoxy matrix. Although the primary objective is to study the role of particle size on the fracture toughness, stiffness and strength were also determined since these properties are often reduced in rubber-toughened epoxies. It was found that since the CSR- and SBM-modified epoxies are composed of less rubber, thermal and mechanical properties of the epoxy were better maintained. In order to better understand the fracture behavior and mechanisms of the three types of rubber particles utilized in this study, extensive microscopy analysis was conducted. Scanning transmission electron microscopy (STEM) was used to quantify the volume fraction of particles, transmission optical microscopy (TOM) was used to determine plastic damage zone size, and scanning electron microscopy (SEM) was used to assess void growth in the plastic zone after fracture. By quantifying these characteristics, it was then possible to model the plastic damage zone size as well as the fracture toughness to elucidate the behavior of the rubber-modified epoxies. It was found that localized shear yielding and matrix void growth are the active toughening mechanisms in all rubber-modified epoxies in this study, however, matrix void growth was more prevalent. The second portion of this study investigated the use of three acrylate-based triblocks and four acrylate-based diblocks to modify a model epoxy system. By varying block lengths and the polarity of the epoxy-miscible blocks, a variety of morphologies were generated (such as spherical micelles, layer particles and worm-like micelles). It was found that in some cases, the epoxy-miscible block did not yield domains substantial enough to facilitate increases in toughness. Overall, the thermal and mechanical properties of the acrylate-based triblock- and diblock-modified epoxies were found to be similar to CTBN-modified epoxy, which was used as a control. However, there were properties that were improved with the acrylate-based diblock-modified epoxies when compared to the acrylate-based triblock modified epoxies. Specifically, the viscosity penalty of the diblock-modified epoxies was shown to be a marked improvement over the triblock-modified epoxies, especially given that the fracture toughness values are similar. This reduction in the viscosity penalty becomes an important criterion when considering processing procedures and applications. Additionally, comparing the morphology of the resulting modified-epoxies utilizing atomic force microscopy (AFM) and scanning electron microscopy (SEM) led to a better understanding of the relationship between the particle morphology obtained and the physical properties of the acrylate-based rubber-modified epoxy systems in this research.

  16. Low body temperature does not compromise the treatment effect of alteplase.

    PubMed

    Lees, Jennifer S; Mishra, Nishant K; Saini, Monica; Lyden, Patrick D; Shuaib, Ashfaq

    2011-09-01

    Hypothermia is neuroprotective in ischemic stroke models. The influence of baseline body temperature on outcomes after thrombolytic therapy is unclear. We examined outcomes after alteplase treatment across baseline body temperature for patients with ischemic stroke in data held within the Virtual International Stroke Trials Archive (VISTA; 1998 to 2007). We collated data on age, baseline severity (National Institutes of Health Stroke Scale), and 90-day modified Rankin Scale score on patients presenting with acute ischemic stroke. We compared 90-day modified Rankin Scale score between thrombolyzed and nonthrombolyzed comparators across baseline body temperature. We report age and baseline National Institutes of Health Stroke Scale-adjusted Cochran-Mantel-Haenszel probability value and proportional OR with 95% CI for improved modified Rankin Scale distribution. We report temperature profiles over 72 hours after stroke by treatment group. Rankin data were available for 5586 patients with acute ischemic stroke in VISTA (1980 received alteplase). Age and baseline severity were similar (age 68.0±13.0 years versus 69.9±12.3 years, National Institutes of Health Stroke Scale 14.2±5.2 versus 13.0±5.6). Alteplase was associated with improved outcome (OR, 1.49; 95% CI, 1.35 to 1.65, P<0.0001). Alteplase treatment effect was not associated with baseline temperature (P=0.14). Point estimates showed benefit of alteplase treatment across 35.5°C to 37.5°C but showed a negative trend >37.5°C. Alteplase did not influence temperature profiles over 72 hours after stroke. There is no evidence of influence of body temperature on alteplase treatment response. These results are reassuring that low temperatures across a physiological range do not compromise therapeutic effect of alteplase.

  17. f(R) gravity on non-linear scales: the post-Friedmann expansion and the vector potential

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

    Thomas, D.B.; Bruni, M.; Koyama, K.

    2015-07-01

    Many modified gravity theories are under consideration in cosmology as the source of the accelerated expansion of the universe and linear perturbation theory, valid on the largest scales, has been examined in many of these models. However, smaller non-linear scales offer a richer phenomenology with which to constrain modified gravity theories. Here, we consider the Hu-Sawicki form of f(R) gravity and apply the post-Friedmann approach to derive the leading order equations for non-linear scales, i.e. the equations valid in the Newtonian-like regime. We reproduce the standard equations for the scalar field, gravitational slip and the modified Poisson equation in amore » coherent framework. In addition, we derive the equation for the leading order correction to the Newtonian regime, the vector potential. We measure this vector potential from f(R) N-body simulations at redshift zero and one, for two values of the f{sub R{sub 0}} parameter. We find that the vector potential at redshift zero in f(R) gravity can be close to 50% larger than in GR on small scales for |f{sub R{sub 0}}|=1.289 × 10{sup −5}, although this is less for larger scales, earlier times and smaller values of the f{sub R{sub 0}} parameter. Similarly to in GR, the small amplitude of this vector potential suggests that the Newtonian approximation is highly accurate for f(R) gravity, and also that the non-linear cosmological behaviour of f(R) gravity can be completely described by just the scalar potentials and the f(R) field.« less

  18. A longitudinal evaluation of the Center for Epidemiologic Studies-Depression scale (CES-D) in a Rheumatoid Arthritis Population using Rasch Analysis

    PubMed Central

    Covic, Tanya; Pallant, Julie F; Conaghan, Philip G; Tennant, Alan

    2007-01-01

    Background The aim of this study was to test the internal validity of the total Center for Epidemiologic Studies-Depression (CES-D) scale using Rasch analysis in a rheumatoid arthritis (RA) population. Methods CES-D was administered to 157 patients with RA over three time points within a 12 month period. Rasch analysis was applied using RUMM2020 software to assess the overall fit of the model, the response scale used, individual item fit, differential item functioning (DIF) and person separation. Results Pooled data across three time points was shown to fit the Rasch model with removal of seven items from the original 20-item CES-D scale. It was necessary to rescore the response format from four to three categories in order to improve the scale's fit. Two items demonstrated some DIF for age and gender but were retained within the 13-item CES-D scale. A new cut point for depression score of 9 was found to correspond to the original cut point score of 16 in the full CES-D scale. Conclusion This Rasch analysis of the CES-D in a longstanding RA cohort resulted in the construction of a modified 13-item scale with good internal validity. Further validation of the modified scale is recommended particularly in relation to the new cut point for depression. PMID:17629902

  19. Energy scale of Lorentz violation in Rainbow Gravity

    NASA Astrophysics Data System (ADS)

    Nilsson, Nils A.; Dąbrowski, Mariusz P.

    2017-12-01

    We modify the standard relativistic dispersion relation in a way which breaks Lorentz symmetry-the effect is predicted in a high-energy regime of some modern theories of quantum gravity. We show that it is possible to realise this scenario within the framework of Rainbow Gravity which introduces two new energy-dependent functions f1(E) and f2(E) into the dispersion relation. Additionally, we assume that the gravitational constant G and the cosmological constant Λ also depend on energy E and introduce the scaling function h(E) in order to express this dependence. For cosmological applications we specify the functions f1 and f2 in order to fit massless particles which allows us to derive modified cosmological equations. Finally, by using Hubble+SNIa+BAO(BOSS+Lyman α)+CMB data, we constrain the energy scale ELV to be at least of the order of 1016 GeV at 1 σ which is the GUT scale or even higher 1017 GeV at 3 σ. Our claim is that this energy can be interpreted as the decoupling scale of massless particles from spacetime Lorentz violating effects.

  20. Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP.

    PubMed

    Spearing, M K; Post, R M; Leverich, G S; Brandt, D; Nolen, W

    1997-12-05

    The Clinical Global Impressions Scale (CGI) was modified specifically for use in assessing global illness severity and change in patients with bipolar disorder. Criticisms of the original CGI were addressed by correcting inconsistencies in scaling, identifying time frames for comparison, clarifying definitions of illness severity and change, and separating out assessment of treatment side effects from illness improvement during treatment. A Detailed User's Guide was developed to train clinicians in the use of the new CGI-Bipolar Version (CGI-BP) for rating severity of manic and depressive episodes and the degree of change from the immediately preceding phase and from the worst phase of illness. The revised scale and manual provide a focused set of instructions to facilitate the reliability of these ratings of mania, depression, and overall bipolar illness during treatment of an acute episode or in longer-term illness prophylaxis. Interrater reliability of the scale was demonstrated in preliminary analyses. Thus, the modified CGI-BP is anticipated to be more useful than the original CGI in studies of bipolar disorder.

  1. Social Desirability and Behavior Rating Scales: An Exploratory Study with the Child Behavior Checklist/4-18

    ERIC Educational Resources Information Center

    Merydith, Scott P.; Prout, H. Thompson; Blaha, John

    2003-01-01

    This study investigated the relationship between the Child Behavior Checklist/4-18 (CBCL/4-18) and two modified measures of social desirability, the Marlowe-Crowne Social Desirability Scale and the Edwards Social Desirability Scale with a sample of 65 parents of normal children from grades K-7. Results from correlational and multiple regression…

  2. Multiscale sample entropy and cross-sample entropy based on symbolic representation and similarity of stock markets

    NASA Astrophysics Data System (ADS)

    Wu, Yue; Shang, Pengjian; Li, Yilong

    2018-03-01

    A modified multiscale sample entropy measure based on symbolic representation and similarity (MSEBSS) is proposed in this paper to research the complexity of stock markets. The modified algorithm reduces the probability of inducing undefined entropies and is confirmed to be robust to strong noise. Considering the validity and accuracy, MSEBSS is more reliable than Multiscale entropy (MSE) for time series mingled with much noise like financial time series. We apply MSEBSS to financial markets and results show American stock markets have the lowest complexity compared with European and Asian markets. There are exceptions to the regularity that stock markets show a decreasing complexity over the time scale, indicating a periodicity at certain scales. Based on MSEBSS, we introduce the modified multiscale cross-sample entropy measure based on symbolic representation and similarity (MCSEBSS) to consider the degree of the asynchrony between distinct time series. Stock markets from the same area have higher synchrony than those from different areas. And for stock markets having relative high synchrony, the entropy values will decrease with the increasing scale factor. While for stock markets having high asynchrony, the entropy values will not decrease with the increasing scale factor sometimes they tend to increase. So both MSEBSS and MCSEBSS are able to distinguish stock markets of different areas, and they are more helpful if used together for studying other features of financial time series.

  3. A modified priority list-based MILP method for solving large-scale unit commitment problems

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

    Ke, Xinda; Lu, Ning; Wu, Di

    This paper studies the typical pattern of unit commitment (UC) results in terms of generator’s cost and capacity. A method is then proposed to combine a modified priority list technique with mixed integer linear programming (MILP) for UC problem. The proposed method consists of two steps. At the first step, a portion of generators are predetermined to be online or offline within a look-ahead period (e.g., a week), based on the demand curve and generator priority order. For the generators whose on/off status is predetermined, at the second step, the corresponding binary variables are removed from the UC MILP problemmore » over the operational planning horizon (e.g., 24 hours). With a number of binary variables removed, the resulted problem can be solved much faster using the off-the-shelf MILP solvers, based on the branch-and-bound algorithm. In the modified priority list method, scale factors are designed to adjust the tradeoff between solution speed and level of optimality. It is found that the proposed method can significantly speed up the UC problem with minor compromise in optimality by selecting appropriate scale factors.« less

  4. Testing the interval-level measurement property of multi-item visual analogue scales.

    PubMed

    Krabbe, Paul F M; Stalmeier, Peep F M; Lamers, Leida M; Busschbach, Jan J V

    2006-12-01

    Conditions were studied that may invalidate health-state values derived from the visual analogue scale (VAS). Respondents were asked to place cards with descriptions of EQ-5D health states on a 20 cm EuroQol VAS and modified versions of it, positioning them such that the distances between the states reflect their valuation for these states. Anchor-point bias was examined using the standard EuroQol VAS (n = 212) and a modified version (n = 97) with a different lower anchor. Context bias was examined in another group of respondents (n = 112) who valued three different sets of EQ-5D health states. Marker bias was studied in yet another group of respondents (n = 100) who placed the same EQ-5D states on the standard EuroQol VAS and on a modified VAS without anchors, categories, or measurement markers. No indication for the existence of the anchor-point and the marker bias was found. However, the VAS valuations were significantly affected by the context of the set of health states in the scaling task. Advanced methodologies should be incorporated in VAS valuation studies to deal with the context bias.

  5. The Legacy of Admiral Beaufort

    ERIC Educational Resources Information Center

    Heidorn, Keith

    1978-01-01

    Francis Beaufort was a British naval officer who developed a wind force scale based on the effect of wind strength on frigate sails. Over the years, this scale has been modified, and today it is used internationally to describe the speed of the wind using numerical equivalents. (MA)

  6. 40 CFR 172.45 - Requirement for a notification.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... EXPERIMENTAL USE PERMITS Notification for Certain Genetically Modified Microbial Pesticides § 172.45... plans to conduct small-scale testing of a type of microbial pesticide identified in paragraph (c) of... tests: (1) Small-scale tests that involve an intentional environmental introduction of that microbial...

  7. 40 CFR 172.45 - Requirement for a notification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... EXPERIMENTAL USE PERMITS Notification for Certain Genetically Modified Microbial Pesticides § 172.45... plans to conduct small-scale testing of a type of microbial pesticide identified in paragraph (c) of... tests: (1) Small-scale tests that involve an intentional environmental introduction of that microbial...

  8. 40 CFR 172.45 - Requirement for a notification.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... EXPERIMENTAL USE PERMITS Notification for Certain Genetically Modified Microbial Pesticides § 172.45... plans to conduct small-scale testing of a type of microbial pesticide identified in paragraph (c) of... tests: (1) Small-scale tests that involve an intentional environmental introduction of that microbial...

  9. 40 CFR 172.45 - Requirement for a notification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... EXPERIMENTAL USE PERMITS Notification for Certain Genetically Modified Microbial Pesticides § 172.45... plans to conduct small-scale testing of a type of microbial pesticide identified in paragraph (c) of... tests: (1) Small-scale tests that involve an intentional environmental introduction of that microbial...

  10. A Modified Rule of Thumb for Evaluating Scale Reproducibilities Determined by Electronic Computers

    ERIC Educational Resources Information Center

    Hofmann, Richard J.

    1978-01-01

    The Goodenough technique for determining scale error is compared to the Guttman technique and demonstrated to be more conservative than the Guttman technique. Implications with regard to Guttman's evaluative rule of thumb for evaluating a reproducibility are noted. (Author)

  11. IMPLEMENTATION OF AN URBAN CANOPY PARAMETERIZATION FOR FINE-SCALE SIMULATIONS

    EPA Science Inventory

    The Pennsylvania State University/National Center for Atmospheric Research Mesoscale Model (MM5) (Grell et al. 1994) has been modified to include an urban canopy parameterization (UCP) for fine-scale urban simulations ( 1 - km horizontal grid spacing ). The UCP accounts for dr...

  12. Power Calculations and Placebo Effect for Future Clinical Trials in Progressive Supranuclear Palsy

    PubMed Central

    Stamelou, Maria; Schöpe, Jakob; Wagenpfeil, Stefan; Ser, Teodoro Del; Bang, Jee; Lobach, Iryna Y.; Luong, Phi; Respondek, Gesine; Oertel, Wolfgang H.; Boxer, Adam L.; Höglinger, Günter U.

    2016-01-01

    Background Two recent randomized, placebo-controlled trials of putative disease-modifying agents (davunetide, tideglusib) in progressive supranuclear palsy (PSP) failed to show efficacy, but generated data relevant for future trials. Methods We provide sample size calculations based on data collected in 187 PSP patients assigned to placebo in these trials. A placebo effect was calculated. Results The total PSP-Rating Scale required the least number of patients per group (N = 51) to detect a 50% change in the 1-year progression and 39 when including patients with ≤ 5 years disease duration. The Schwab and England Activities of Daily Living required 70 patients per group and was highly correlated with the PSP-Rating Scale. A placebo effect was not detected in these scales. Conclusions We propose the 1-year PSP-Rating Scale score change as the single primary readout in clinical neuroprotective or disease-modifying trials. The Schwab and England Activities of Daily Living could be used as a secondary outcome. PMID:26948290

  13. Minimal clinically important difference of the Modified Fatigue Impact Scale in Parkinson's disease.

    PubMed

    Kluger, Benzi M; Garimella, Sanjana; Garvan, Cynthia

    2017-10-01

    Fatigue is a common and debilitating symptom of Parkinson's disease (PD) with no evidence-based treatments. While several fatigue scales are partially validated in PD the minimal clinically important difference (MCID) is unknown for any scale but is an important psychometric value to design and interpret therapeutic trials. We thus sought to determine the MCID for the Modified Fatigue Impact Scale (MFIS). This is a secondary data analysis from 94 PD participants in an acupuncture trial for PD fatigue. Standard psychometric approaches were used to establish validity and an anchor-based approach was used to determine the MCID. The MFIS demonstrated good concurrent validity with other outcome measures and high internal consistency. MCIDs values were found to be 13.8, 6.8 and 6.2 for the MFIS total, MFIS cognitive, and MFIS physical subscores respectively. The MFIS is a valid multidimensional measure of fatigue in PD with demonstrable MCID. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Sharply curved turn around duct flow predictions using spectral partitioning of the turbulent kinetic energy and a pressure modified wall law

    NASA Technical Reports Server (NTRS)

    Santi, L. Michael

    1986-01-01

    Computational predictions of turbulent flow in sharply curved 180 degree turn around ducts are presented. The CNS2D computer code is used to solve the equations of motion for two-dimensional incompressible flows transformed to a nonorthogonal body-fitted coordinate system. This procedure incorporates the pressure velocity correction algorithm SIMPLE-C to iteratively solve a discretized form of the transformed equations. A multiple scale turbulence model based on simplified spectral partitioning is employed to obtain closure. Flow field predictions utilizing the multiple scale model are compared to features predicted by the traditional single scale k-epsilon model. Tuning parameter sensitivities of the multiple scale model applied to turn around duct flows are also determined. In addition, a wall function approach based on a wall law suitable for incompressible turbulent boundary layers under strong adverse pressure gradients is tested. Turn around duct flow characteristics utilizing this modified wall law are presented and compared to results based on a standard wall treatment.

  15. Validation of the XDP-MDSP rating scale for the evaluation of patients with X-linked dystonia-parkinsonism.

    PubMed

    Pasco, Paul Matthew D; Jamora, Roland Dominic G; Rosales, Raymond L; Diesta, Cid Czarina E; Ng, Arlene R; Teleg, Rosalia A; Go, Criscely L; Lee, Lillian; Fernandez, Hubert H

    2017-01-01

    X-linked dystonia-parkinsonism(XDP) is a neurodegenerative disorder endemic to the Philippines. A rating scale was developed by the authors under the guidance of the Movement Disorder Society of the Philippines (MDSP) to assess XDP severity and progression, functional impact, and response to treatment in future clinical trials. Our main objective was to validate our new scale, the XDP-MDSP scale. The initial validation process included pragmatic testing to XDP patients followed by a modified Delphi procedure with an international advisory panel of dystonia, parkinsonism and scale development experts. Pearson correlation was used to assess construct validity of our new scale versus the assess construct validity of our new scale versus standard dystonia, parkinsonism, non-motor and functional scales; and also to assess divergent validity against behavioral and cognitive scales. The 37-item XDP-MDSP scale has five parts: I-dystonia, II-parkinsonism, III-non-motor features, IV-ADL, and V-global impression. After initial validation, the scale was administered to 204 XDP patients. Inter-domain correlation for the first four parts was acceptable. The correlation between these domains and the global rating was slightly lower. Correlations between Parts I, II, III, and IV versus standard dystonia, parkinsonism, non-motor and functional scales were acceptable with values ranging from 0.323 to 0.428. For divergent validity, a significant correlation was seen with behavioral scales. No significant correlation was noted with the cognitive scale. The proposed XDP-MDSP scale is internally valid but the global rating subscale may need to be modified or eliminated. While there is convergent validity, divergent validation was successful only on cognitive and not behavioral scales. The frequent co-occurrence of anxiety and depression, and its effect on the motor and functional state, may explain this finding.

  16. Assessing Predictive Validity of Pressure Ulcer Risk Scales- A Systematic Review and Meta-Analysis

    PubMed Central

    PARK, Seong-Hi; LEE, Hea Shoon

    2016-01-01

    Background: The purpose of this study was to present a scientific reason for pressure ulcer risk scales: Cubbin& Jackson modified Braden, Norton, and Waterlow, as a nursing diagnosis tool by utilizing predictive validity of pressure sores. Methods: Articles published between 1966 and 2013 from periodicals indexed in the Ovid Medline, Embase, CINAHL, KoreaMed, NDSL, and other databases were selected using the key word “pressure ulcer”. QUADAS-II was applied for assessment for internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. Results: Seventeen diagnostic studies with high methodological quality, involving 5,185 patients, were included. In the results of the meta-analysis, sROC AUC of Braden, Norton, and Waterflow scale was over 0.7, showing moderate predictive validity, but they have limited interpretation due to significant differences between studies. In addition, Waterlow scale is insufficient as a screening tool owing to low sensitivity compared with other scales. Conclusion: The contemporary pressure ulcer risk scale is not suitable for uninform practice on patients under standardized criteria. Therefore, in order to provide more effective nursing care for bedsores, a new or modified pressure ulcer risk scale should be developed upon strength and weaknesses of existing tools. PMID:27114977

  17. Variables Affecting Secondary School Students' Willingness to Eat Genetically Modified Food Crops

    ERIC Educational Resources Information Center

    Maes, Jasmien; Bourgonjon, Jeroen; Gheysen, Godelieve; Valcke, Martin

    2018-01-01

    A large-scale cross-sectional study (N = 4002) was set up to determine Flemish secondary school students' willingness to eat genetically modified food (WTE) and to link students' WTE to previously identified key variables from research on the acceptance of genetic modification (GM). These variables include subjective and objective knowledge about…

  18. Changes in Quality of Life in Visually Impaired Patients after Low-Vision Rehabilitation

    ERIC Educational Resources Information Center

    Renieri, Giulia; Pitz, Susanne; Pfeiffer, Norbert; Beutel, Manfred E.; Zwerenz, Rudiger

    2013-01-01

    The objective of the study was to assess the impact of low-vision aids on quality of life. Interviews included a modified version of the National Eye Institute Visual Functioning Questionnaire (Modified German NEI VFQ-25), the Hospital Anxiety and Depression Scale, the Mini-Mental State Examination Blind, and Indicators of the Rehabilitation…

  19. Evaluation of potentially modifiable physical factors as predictors of health status in knee osteoarthritis patients referred for physical therapy.

    PubMed

    Gonçalves, Rui Soles; Pinheiro, João Páscoa; Cabri, Jan

    2012-08-01

    The purpose of this cross sectional study was to estimate the contributions of potentially modifiable physical factors to variations in perceived health status in knee osteoarthritis (OA) patients referred for physical therapy. Health status was measured by three questionnaires: Knee injury and Osteoarthritis Outcome Score (KOOS); Knee Outcome Survey - Activities of Daily Living Scale (KOS-ADLS); and Medical Outcomes Study - 36 item Short Form (SF-36). Physical factors were measured by a battery of tests: body mass index (BMI); visual analog scale (VAS) of pain intensity; isometric dynamometry; universal goniometry; step test (ST); timed "up and go" test (TUGT); 20-meter walk test (20MWT); and 6-minute walk test (6MWT). All tests were administered to 136 subjects with symptomatic knee OA (94 females, 42 males; age: 67.2 ± 7.1 years). Multiple stepwise regression analyses revealed that knee muscle strength, VAS of pain intensity, 6MWT, degree of knee flexion and BMI were moderate predictors of health status. In the final models, selected combinations of these potentially modifiable physical factors explained 22% to 37% of the variance in KOOS subscale scores, 40% of the variance in the KOS-ADLS scale score, and 21% to 34% of the variance in physical health SF-36 subscale scores. More research is required in order to evaluate whether therapeutic interventions targeting these potentially modifiable physical factors would improve health status in knee OA patients. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Confirmatory factor analysis and recommendations for improvement of the Autonomy-Preference-Index (API).

    PubMed

    Simon, Daniela; Kriston, Levente; Loh, Andreas; Spies, Claudia; Scheibler, Fueloep; Wills, Celia; Härter, Martin

    2010-09-01

    Validation of the German version of the Autonomy-Preference-Index (API), a measure of patients' preferences for decision making and information seeking. Stepwise confirmatory factor analysis was conducted on a sample of patients (n = 1592) treated in primary care for depression (n = 186), surgical and internal medicine inpatients (n = 811) and patients with minor trauma treated in an emergency department (n = 595). An initial test of the model was done on calculation and validation halves of the sample. Both local and global indexes-of-fit suggested modifications to the scale. The scale was modified and re-tested in the calculation sample and confirmed in the validation sample. Subgroup analyses for age, gender and type of treatment setting were also performed. The confirmatory analysis led to a modified version of the API with better local and global indexes-of-fit for samples of German-speaking patients. Two items of the sub-scale, 'preference for decision-making', and one item of the sub-scale, 'preference for information seeking', showed very low reliability scores and were deleted. Thus, several global indexes-of-fit clearly improved significantly. The modified scale was confirmed on the validation sample with acceptable to good indices of fit. Results of subgroup analyses indicated that no adaptations were necessary. This first confirmatory analysis for a German-speaking population showed that the API was improved by the removal of several items. There were theoretically plausible explanations for this improvement suggesting that the modifications might also be appropriate in English and other language versions.

  1. Importance of frailty evaluation in the prediction of the prognosis of patients with chronic subdural hematoma.

    PubMed

    Shimizu, Kiyoharu; Sadatomo, Takashi; Hara, Takeshi; Onishi, Shumpei; Yuki, Kiyoshi; Kurisu, Kaoru

    2018-05-17

    The present study aimed to clarify the relationship between frailty and prognosis of patients with chronic subdural hematoma. This retrospective study involved 211 patients aged ≥65 years with chronic subdural hematoma, who underwent surgery at Higashihiroshima Medical Center, Hiroshima, Japan, between July 2011 and May 2017. The study outcome was the patient's modified Rankin Scale score at 3 months after surgery. A logistic regression analysis was carried out to analyze factors that influenced the outcome. Chronic subdural hematoma patients with frailty had a poorer prognosis than those without (median modified Rankin Scale: 4 and 2, P < 0.001; proportions of patients discharged to home: 35% and 91%, P < 0.001, respectively). After adjusting for patients' background, the patients' modified Rankin Scale scores at 3 months after surgery were found to be associated with age, controlling nutritional status score and recurrence, but not with frailty. However, receiver operating characteristic curves of the model with the Clinical Frailty Scale were more accurately correlated with prognosis than those of the model without this scale (area under the curve 0.98, 95% confidence interval 0.96-0.99; and 0.87, 95% confidence interval 0.82-0.91, respectively.) CONCLUSIONS: Chronic subdural hematoma patients with frailty had poorer prognosis than those without. The evaluation of the presence of frailty on admission can be an important factor in the prediction of the prognosis of chronic subdural hematoma patients. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

  2. Acoustics and Trust of Separate-Flow Exhaust Nozzles With Mixing Devices for High-Bypass-Ratio Engines

    NASA Technical Reports Server (NTRS)

    Saiyed, Naseem H.; Mikkelsen, Kevin L.; Bridges, James E.

    2000-01-01

    The NASA Glenn Research Center recently completed an experimental study to reduce the jet noise from modern turbofan engines. The study concentrated on exhaust nozzle designs for high-bypass-ratio engines. These designs modified the core and fan nozzles individually and simultaneously. Several designs provided an ideal jet noise reduction of over 2.5 EPNdB for the effective perceived noise level (EPNL) metric. Noise data, after correcting for takeoff thrust losses, indicated over a 2.0-EPNdB reduction for nine designs. Individually modifying the fan nozzle did not provide attractive EPNL reductions. Designs in which only the core nozzle was modified provided greater EPNL reductions. Designs in which core and fan nozzles were modified simultaneously provided the greatest EPNL reduction. The best nozzle design had a 2.7-EPNdB reduction (corrected for takeoff thrust loss) with a 0.06-point cruise thrust loss. This design simultaneously employed chevrons on the core and fan nozzles. In comparison with chevrons, tabs appeared to be an inefficient method for reducing jet noise. Data trends indicate that the sum of the thrust losses from individually modifying core and fan nozzles did not generally equal the thrust loss from modifying them simultaneously. Flow blockage from tabs did not scale directly with cruise thrust loss and the interaction between fan flow and the core nozzle seemed to strongly affect noise and cruise performance. Finally, the nozzle configuration candidates for full-scale engine demonstrations are identified.

  3. A thermal scale modeling study for Apollo and Apollo applications, volume 2

    NASA Technical Reports Server (NTRS)

    Shannon, R. L.

    1972-01-01

    The development and demonstration of practical thermal scale modeling techniques applicable to systems involving radiation, conduction, and convection with emphasis on cabin atmosphere/cabin wall thermal interface are discussed. The Apollo spacecraft environment is used as the model. Four possible scaling techniques were considered: (1) modified material preservation, (2) temperature preservation, (3) scaling compromises, and Nusselt number preservation. A thermal mathematical model was developed for use with the Nusselt number preservation technique.

  4. Complementary Spiritist Therapy: Systematic Review of Scientific Evidence

    PubMed Central

    Lucchetti, Giancarlo; Lucchetti, Alessandra L. Granero; Bassi, Rodrigo M.; Nobre, Marlene Rossi Severino

    2011-01-01

    Spiritism is the third most common religion in Brazil, and its therapies have been used by millions worldwide. These therapies are based on therapeutic resources including prayer, laying on of hands, fluidotherapy (magnetized water), charity/volunteering, spirit education/moral values, and disobsession (spirit release therapy). This paper presents a systematic review of the current literature on the relationship among health outcomes and 6 predictors: prayer, laying on of hands, magnetized/fluidic water, charity/volunteering, spirit education (virtuous life and positive affect), and spirit release therapy. All articles were analyzed according to inclusion/exclusion criteria, Newcastle-Ottawa and Jadad score. At present, there is moderate to strong evidence that volunteering and positive affect are linked to better health outcomes. Furthermore, laying on of hands, virtuous life, and praying for oneself also seem to be associated to positive findings. Nevertheless, there is a lack of studies on magnetized water and spirit release therapy. In summary, science is indirectly demonstrating that some of these therapies can be associated to better health outcomes and that other therapies have been overlooked or poorly investigated. Further studies in this field could contribute to the disciplines of Complementary and Alternative Medicine by investigating the relationship between body, mind, and soul/spirit. PMID:21687790

  5. Effect of Medicinal Herbs on Primary Dysmenorrhoea- a Systematic Review

    PubMed Central

    Mirabi, Parvaneh; Alamolhoda, Seideh Hanieh; Esmaeilzadeh, Seddigheh; Mojab, Faraz

    2014-01-01

    Conventional treatment for primary dysmenorrhoea has a failure rate of 20% to 25% and may be contraindicated or not tolerated by some women. Herbal medicine may be a suitable alternative. To determine the efficacy and safety of Iranian herbal medicine for primary dysmenorrhea when compared with placebo, no treatment, and other treatment. Electronic searches of the Cochrane Menstrual Disorders and Dysmenorrhoea Group Register of controlled trials, Scopus, Google Scholar, Medline, Pubmed were performed to identify relevant randomized controlled trials (RCTs). The study abstraction and quality assessment of all studies were undertaken following the detailed descriptions of these categories as described in the JADAD Criteria for Systematic Reviews of Interventions. 25 RCTs involving a total of women were included in the review. The review found promising evidence in the form of RCTs for the use of herbal medicine in the treatment of primary dysmenorrhoea compared with pharmacological treatment. However, the results were limited by methodological flaws. Further rigorous no penetrating placebo-controlled RCTs are warranted. The review found promising evidence supporting the use of herbal medicine for primary dysmenorrhoea; however, results are limited by the poor methodological quality of the included trials. PMID:25276177

  6. Constraining modified gravitational theories by weak lensing with Euclid

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

    Martinelli, Matteo; Calabrese, Erminia; De Bernardis, Francesco

    2011-01-15

    Future proposed satellite missions such as Euclid can offer the opportunity to test general relativity on cosmic scales through mapping of the galaxy weak-lensing signal. In this paper we forecast the ability of these experiments to constrain modified gravity scenarios such as those predicted by scalar-tensor and f(R) theories. We find that Euclid will improve constraints expected from the Planck satellite on these modified theories of gravity by 2 orders of magnitude. We discuss parameter degeneracies and the possible biases introduced by modifications to gravity.

  7. Validation of a modified Bristol stool scale - inter-rater reliability amongst pediatric gastroenterologists

    USDA-ARS?s Scientific Manuscript database

    Stool form and changes in stool form are important criteria in both clinical practice and clinical research. However, descriptions of stool form from both patients and physicians alike may be subjective and objective measurements of stool form are not well developed. Although the Bristol stool scale...

  8. Lesbian and Gay Male Group Identity Attitudes and Self-Esteem: Implications for Counseling.

    ERIC Educational Resources Information Center

    Walters, Karina L.; Simoni, Jane M.

    1993-01-01

    Ninety-six lesbians and gay men completed Rosenberg Self-Esteem Scale and modified version of Racial Identity Attitude Scale. Results indicated moderate inverse relationship between preencounter attitudes and self-esteem and positive relationship between internalization attitudes and self-esteem. Encounter and immersion-emersion attitudes were…

  9. Development and Validation of a Depression Scale for Asian Adolescents

    ERIC Educational Resources Information Center

    Woo, Bernardine S. C.; Chang, W. C.; Fung, Daniel S. S.; Koh, Jessie B. K.; Leong, Joyce S. F.; Kee, Carolyn H. Y.; Seah, Cheryl K. F.

    2004-01-01

    Items covering both core and culture-specific facets of depression were generated based on literature review and clinical experience. They were modified following focus group discussions with depressed adolescents and adolescents in the community. The newly constructed Asian Adolescent Depression Scale (AADS) was administered to a clinical and a…

  10. Scalability study of solid xenon

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

    Yoo, J.; Cease, H.; Jaskierny, W. F.

    2015-04-01

    We report a demonstration of the scalability of optically transparent xenon in the solid phase for use as a particle detector above a kilogram scale. We employed a cryostat cooled by liquid nitrogen combined with a xenon purification and chiller system. A modified {\\it Bridgeman's technique} reproduces a large scale optically transparent solid xenon.

  11. Considering the Use of General and Modified Assessment Items in Computerized Adaptive Testing

    ERIC Educational Resources Information Center

    Wyse, Adam E.; Albano, Anthony D.

    2015-01-01

    This article used several data sets from a large-scale state testing program to examine the feasibility of combining general and modified assessment items in computerized adaptive testing (CAT) for different groups of students. Results suggested that several of the assumptions made when employing this type of mixed-item CAT may not be met for…

  12. Removal of phosphorus using chemically modified lignocellulosic materials

    Treesearch

    James S. Han; N. Hur; B. Choi; Soo-Hong Min

    2003-01-01

    Heavy metals from an acid mine drainage (AMD) site were precipitated on the surface of juniper fiber. The modified fiber was tested in lab-scaled batch and column tests and in the field. Elemental analysis showed that soluble iron species deposited on the fiber act as an inorganic adsorbent for anions. Sorption capacity, determined by fitting results to a Langmuir...

  13. Assessment of Biomarkers Associated with Joint Injury and Subsequent Post-Traumatic Arthritis

    DTIC Science & Technology

    2014-10-01

    using a modified Mankin score, synovial inflammation using a modified synovitis score with semi-quantitative scales, and osteophyte score6-10...Parametric analyses were performed for bone morphological measures and histological assessment. Subchondral bone thickening was significantly increased in...Soder S, Eger W, Diemtar T, Aigner T. Feb 2003. Osteophyte development-- molecular characterization of differentiation stages. Osteoarthritis

  14. Fabrication and surface-modification of implantable microprobes for neuroscience studies

    NASA Astrophysics Data System (ADS)

    Cao, H.; Nguyen, C. M.; Chiao, J. C.

    2012-06-01

    In this work implantable micro-probes for central nervous system (CNS) studies were developed on silicon and polyimide substrates. The probes which contained micro-electrode arrays with different surface modifications were designed for implantation in the CNS. The electrode surfaces were modified with nano-scale structures that could greatly increase the active surface area in order to enhance the electrochemical current outputs while maintaining micro-scale dimensions of the electrodes and probes. The electrodes were made of gold or platinum, and designed with different sizes. The silicon probes were modified by silicon nanowires fabricated with the vapor-liquid-solid mechanism at high temperatures. With polyimide substrates, the nanostructure modification was carried out by applying concentrated gold or silver colloid solutions onto the micro-electrodes at room temperature. The surfaces of electrodes before and after modification were observed by scanning electron microscopy. The silicon nanowire-modified surface was characterized by cyclic voltammetry. Experiments were carried out to investigate the improvement in sensing performance. The modified electrodes were tested with H2O2, electrochemical L-glutamate and dopamine. Comparisons between electrodes with and without nanostructure modification were conducted showing that the modifications have enhanced the signal outputs of the electrochemical neurotransmitter sensors.

  15. Effects of processing parameters on the caffeine extraction yield during decaffeination of black tea using pilot-scale supercritical carbon dioxide extraction technique.

    PubMed

    Ilgaz, Saziye; Sat, Ihsan Gungor; Polat, Atilla

    2018-04-01

    In this pilot-scale study supercritical carbon dioxide (SCCO 2 ) extraction technique was used for decaffeination of black tea. Pressure (250, 375, 500 bar), extraction time (60, 180, 300 min), temperature (55, 62.5, 70 °C), CO 2 flow rate (1, 2, 3 L/min) and modifier quantity (0, 2.5, 5 mol%) were selected as extraction parameters. Three-level and five-factor response surface methodology experimental design with a Box-Behnken type was employed to generate 46 different processing conditions. 100% of caffeine from black tea was removed under two different extraction conditions; one of which was consist of 375 bar pressure, 62.5 °C temperature, 300 min extraction time, 2 L/min CO 2 flow rate and 5 mol% modifier concentration and the other was composed of same temperature, pressure and extraction time conditions with 3 L/min CO 2 flow rate and 2.5 mol% modifier concentration. Results showed that extraction time, pressure, CO 2 flow rate and modifier quantity had great impact on decaffeination yield.

  16. [Utility of diagnostic scales for hereditary non-polyposis colon cancer in the Mexican population].

    PubMed

    Mendoza Sánchez, Andrés; Sobrino Cossio, Sergio; Hernández Guerrero, Angélica; Córdova Pluma, Víctor Hugo; Alonso Lárraga, Octavio; Sánchez del Monte, D r Julio

    2005-01-01

    Hereditary non-polyposis colorectal cancer (HNPCC) represents 2 - 7% of all cancers. Diagnosis is made by means of the Amstedam criteria, or the modified Amsterdam and Bethesda. Aim was to evaluate the clinical application of the diagnostic scales for HNPCC in our population and to determine the clinical characteristics that these patients reveal at the time of diagnosis. A retrospective, cross-sectional study in which patients with colon cancer and less than 50 years of age were evaluated in a period of 3 years. The demographic data, patients and relatives history and the characteristics of the tumor were obtained at the time of diagnosis. We applied the Amsterdam criteria, modified Amsterdam and Bethesda to all the patients. 56 of 210 patients were of 50 younger with an average age of 38.3 years. Among the patients 14.3% had familiar cancer history. In 53.6% the tumor was located in right colon, regardless histology they had mucin component and poor cellular differentiation. Only two patients fulfilled criteria of modified Amsterdam and Amsterdam, and no patient fulfilled the Bethesda criteria. Frequency of CCNPH in our population was 1% by the Amsterdam criteria and modified Amsterdam and 0% by the Bethesda criteria.

  17. Facilitativeness, conflict, demand for approval, self-esteem, and satisfaction with romantic relationships.

    PubMed

    Cramer, Duncan

    2003-01-01

    This study is an examination of the extent to which satisfaction with a main current romantic relationship is associated with negative conflict, demand for approval, self-esteem, and the 3 facilitative conditions of unconditional regard, empathy, and congruence. One or more of these conditions have been proposed as important determinants of relationship satisfaction by various relationship-enhancement approaches such as behavioral marital therapy and cognitive-behavioral marital therapy. College students (86 women and 58 men) completed S. S. Hendrick's (1988) Relationship Satisfaction Scale, a measure of negative conflict formulated by the author, R. G. Jones's (1969) Demand for Approval Scale (modified for a particular relationship), M. Rosenberg's (1965) Self-Esteem Scale, and a shortened modified version of G. T. Barrett-Lennard's (1964) Relationship Inventory. Relationship satisfaction was most strongly related to the level of regard and empathy, which is consistent with approaches to relationships that emphasize empathy training.

  18. A fault diagnosis scheme for planetary gearboxes using modified multi-scale symbolic dynamic entropy and mRMR feature selection

    NASA Astrophysics Data System (ADS)

    Li, Yongbo; Yang, Yuantao; Li, Guoyan; Xu, Minqiang; Huang, Wenhu

    2017-07-01

    Health condition identification of planetary gearboxes is crucial to reduce the downtime and maximize productivity. This paper aims to develop a novel fault diagnosis method based on modified multi-scale symbolic dynamic entropy (MMSDE) and minimum redundancy maximum relevance (mRMR) to identify the different health conditions of planetary gearbox. MMSDE is proposed to quantify the regularity of time series, which can assess the dynamical characteristics over a range of scales. MMSDE has obvious advantages in the detection of dynamical changes and computation efficiency. Then, the mRMR approach is introduced to refine the fault features. Lastly, the obtained new features are fed into the least square support vector machine (LSSVM) to complete the fault pattern identification. The proposed method is numerically and experimentally demonstrated to be able to recognize the different fault types of planetary gearboxes.

  19. Modified circular velocity law

    NASA Astrophysics Data System (ADS)

    Djeghloul, Nazim

    2018-05-01

    A modified circular velocity law is presented for a test body orbiting around a spherically symmetric mass. This law exhibits a distance scale parameter and allows to recover both usual Newtonian behaviour for lower distances and a constant velocity limit at large scale. Application to the Galaxy predicts the known behaviour and also leads to a galactic mass in accordance with the measured visible stellar mass so that additional dark matter inside the Galaxy can be avoided. It is also shown that this circular velocity law can be embedded in a geometrical description of spacetime within the standard general relativity framework upon relaxing the usual asymptotic flatness condition. This formulation allows to redefine the introduced Newtonian scale limit in term of the central mass exclusively. Moreover, a satisfactory answer to the galactic escape speed problem can be provided indicating the possibility that one can also get rid of dark matter halo outside the Galaxy.

  20. Brain modularity controls the critical behavior of spontaneous activity.

    PubMed

    Russo, R; Herrmann, H J; de Arcangelis, L

    2014-03-13

    The human brain exhibits a complex structure made of scale-free highly connected modules loosely interconnected by weaker links to form a small-world network. These features appear in healthy patients whereas neurological diseases often modify this structure. An important open question concerns the role of brain modularity in sustaining the critical behaviour of spontaneous activity. Here we analyse the neuronal activity of a model, successful in reproducing on non-modular networks the scaling behaviour observed in experimental data, on a modular network implementing the main statistical features measured in human brain. We show that on a modular network, regardless the strength of the synaptic connections or the modular size and number, activity is never fully scale-free. Neuronal avalanches can invade different modules which results in an activity depression, hindering further avalanche propagation. Critical behaviour is solely recovered if inter-module connections are added, modifying the modular into a more random structure.

  1. The Modified Abbreviated Math Anxiety Scale: A Valid and Reliable Instrument for Use with Children.

    PubMed

    Carey, Emma; Hill, Francesca; Devine, Amy; Szűcs, Dénes

    2017-01-01

    Mathematics anxiety (MA) can be observed in children from primary school age into the teenage years and adulthood, but many MA rating scales are only suitable for use with adults or older adolescents. We have adapted one such rating scale, the Abbreviated Math Anxiety Scale (AMAS), to be used with British children aged 8-13. In this study, we assess the scale's reliability, factor structure, and divergent validity. The modified AMAS (mAMAS) was administered to a very large ( n = 1746) cohort of British children and adolescents. This large sample size meant that as well as conducting confirmatory factor analysis on the scale itself, we were also able to split the sample to conduct exploratory and confirmatory factor analysis of items from the mAMAS alongside items from child test anxiety and general anxiety rating scales. Factor analysis of the mAMAS confirmed that it has the same underlying factor structure as the original AMAS, with subscales measuring anxiety about Learning and Evaluation in math. Furthermore, both exploratory and confirmatory factor analysis of the mAMAS alongside scales measuring test anxiety and general anxiety showed that mAMAS items cluster onto one factor (perceived to represent MA). The mAMAS provides a valid and reliable scale for measuring MA in children and adolescents, from a younger age than is possible with the original AMAS. Results from this study also suggest that MA is truly a unique construct, separate from both test anxiety and general anxiety, even in childhood.

  2. Generation of Envelope-Modified Baculoviruses for Gene Delivery into Mammalian Cells.

    PubMed

    Hofmann, Christian

    2016-01-01

    Genetically modified baculoviruses can efficiently deliver and express genes in mammalian cells. The major prerequisite for the expression of a gene transferred by baculovirus is its control by a promoter that is active in mammalian cells. This chapter describes methods for producing second generation baculovirus vectors through modification of their envelope. Envelope modified baculoviruses offer additional new applications of the system, such as their use in in vivo gene delivery, targeting, and vaccination. Methods of generating a recombinant baculovirus vector with a modified envelope and its amplification and purification, including technical scale production, are discussed. A variety of notes give clues regarding specific technical procedures. Finally, methods to analyze the virus and transduction procedures are presented.

  3. Environmental factors that influence the location of crop agriculture in the conterminous United States

    USGS Publications Warehouse

    Baker, Nancy T.; Capel, Paul D.

    2011-01-01

    Most crops are grown on land with shallow slope where the temperature, precipitation, and soils are favorable. In areas that are too steep, wet, or dry, landscapes have been modified to allow cultivation. Some of the limitations of the environmental factors that determine the location of agriculture can be overcome through modifications, but others cannot. On a larger-than-field scale, agricultural modifications commonly influence water availability through irrigation and (or) drainage and soil fertility and (or) organic-matter content through amendments such as manure, commercial fertilizer and lime. In general, it is not feasible to modify the other environmental factors, soil texture, soil depth, soil mineralogy, temperature, and terrain at large scales.

  4. Buckling and postbuckling of size-dependent cracked microbeams based on a modified couple stress theory

    NASA Astrophysics Data System (ADS)

    Akbarzadeh Khorshidi, M.; Shariati, M.

    2017-07-01

    The elastic buckling analysis and the static postbuckling response of the Euler-Bernoulli microbeams containing an open edge crack are studied based on a modified couple stress theory. The cracked section is modeled by a massless elastic rotational spring. This model contains a material length scale parameter and can capture the size effect. The von Kármán nonlinearity is applied to display the postbuckling behavior. Analytical solutions of a critical buckling load and the postbuckling response are presented for simply supported cracked microbeams. This parametric study indicates the effects of the crack location, crack severity, and length scale parameter on the buckling and postbuckling behaviors of cracked microbeams.

  5. [Problems associated with age estimation of underage persons who appear in child pornography materials].

    PubMed

    Łabecka, Marzena; Lorkiewicz-Muszyńska, Dorota; Jarzabek-Bielecka, Grazyna

    2011-01-01

    Among opinions issued by the Forensic Medicine Department, Medical Science University in Poznan, in the last six years, there are opinions concerning age estimation in child pornography materials. The issue subject to research is indicating persons under the age of 15 years in pornographic materials, since possession of pornographic materials featuring underage persons is considered a crime and is subject to article 202 of the Penal Code. The estimation of the age of teenagers based on secondary and tertiary sexual characteristics is increasingly more difficult and the available data in professional literature regarding the standard time of development differ among various authors of such studies. In the report, an attempt has been made at determining the agreement regarding different characteristics in the data included in the Tanner's scale, which has been modified to accommodate the research done on persons registered by electronic means. The modified scale, which up to now has been used in research of registered subjects in classified public prosecutors' materials, has been employed in children seen in a pediatric outpatient department. The goal has been a comparison of the outcome of the research to prove its usefulness so that in the future, the modified scale could be used as a research tool in estimation of age of persons appearing in pornography materials. medical forms of 205 children seen in a pediatric outpatient department, based on the scale created by the present authors us and later processed using Excel.

  6. Up-scaling of tannin-based coagulants for wastewater treatment: performance in a water treatment plant.

    PubMed

    Grenda, Kinga; Arnold, Julien; Gamelas, José A F; Rasteiro, Maria G

    2018-06-21

    Tannin extracts from the bark of Acacia mearnsii and wood of Schinopsis balansae, commonly known as Quebracho, were employed. These were modified at laboratory sale via the Mannich aminomethylation with formaldehyde and dimethylamine hydrochloride. Some reaction conditions were varied, namely the formaldehyde dosage and reaction time, while keeping the Mannich solution activation time constant, and their influence on the shear viscosity of the created bio-coagulants was evaluated. The effect of the final pH of the products on their shear viscosity was also analyzed. Up-scaling of the Mannich reaction for tannin from South Africa was performed and the procedure developed at 1-L scale was reproducible in upscaled conditions. One example of a modified South Africa tannin and the modified Quebracho tannin was subsequently selected for the treatment of an industrial wastewater and tested for color and turbidity reduction in jar tests. The effluent treatment was carried out in a single and dual system with cationic synthetic flocculation agents of different charge degree. Good turbidity and decoloration results (93 and 89% reduction, respectively) were obtained with the simultaneous introduction of a cationic, 40% charged polyacrylamide, with minimal dosage (5 ppm) of the latter additive. The tannin-based coagulant from Acacia mearnsii was successfully applied in dual system with cationic polyacrylamide flocculant for industrial wastewater treatment at pilot plant scale. It was shown to satisfactorily treat the water and generate less sludge.

  7. Effects of the sliding rehabilitation machine on balance and gait in chronic stroke patients - a controlled clinical trial.

    PubMed

    Byun, Seung-Deuk; Jung, Tae-Du; Kim, Chul-Hyun; Lee, Yang-Soo

    2011-05-01

    To investigate the effects of a sliding rehabilitation machine on balance and gait in chronic stroke patients. A non-randomized crossover design. Inpatient rehabilitation in a general hospital. Thirty patients with chronic stroke who had medium or high falling risk as determined by the Berg Balance Scale. Participants were divided into two groups and underwent four weeks of training. Group A (n = 15) underwent training with the sliding rehabilitation machine for two weeks with concurrent conventional training, followed by conventional training only for another two weeks. Group B (n = 15) underwent the same training in reverse order. The effect of the experimental period was defined as the sum of changes during training with sliding rehabilitation machine in each group, and the effect of the control period was defined as those during the conventional training only in each group. Functional Ambulation Category, Berg Balance Scale, Six-Minute Walk Test, Timed Up and Go Test, Korean Modified Barthel Index, Modified Ashworth Scale and Manual Muscle Test. Statistically significant improvements were observed in all parameters except Modified Ashworth Scale in the experimental period, but only in Six-Minute Walk Test (P < 0.01) in the control period. There were also statistically significant differences in the degree of change in all parameters in the experimental period as compared to the control period. The sliding rehabilitation machine may be a useful tool for the improvement of balance and gait abilities in chronic stroke patients.

  8. The 2-MEV Scale in the United States: A Measure of Children's Environmental Attitudes Based on the Theory of Ecological Attitude

    ERIC Educational Resources Information Center

    Johnson, Bruce; Manoli, Constantinos C.

    2011-01-01

    The Environmental (2-MEV) Scale questionnaire was developed in Europe to measure adolescents' attitudes and gauge the effectiveness of educational programs. It also formed the basis for the Theory of Ecological Attitudes. In the present four-year study, the 2-MEV Scale was modified for use with 9-12-year-old children in the United States. Initial…

  9. Correlation between physical anomaly and behavioral abnormalities in Down syndrome

    PubMed Central

    Bhattacharyya, Ranjan; Sanyal, Debasish; Roy, Krishna; Bhattacharyya, Sumita

    2010-01-01

    Objective: The minor physical anomaly (MPA) is believed to reflect abnormal development of the CNS. The aim is to find incidence of MPA and its behavioral correlates in Down syndrome and to compare these findings with the other causes of intellectual disability and normal population. Materials and Methods: One-hundred and forty intellectually disabled people attending a tertiary care set-up and from various NGOs are included in the study. The age-matched group from normal population was also studied for comparison. MPA are assessed by using Modified Waldrop scale and behavioral abnormality by Diagnostic assessment scale for severely handicapped (DASH II scale). Results: The Down syndrome group had significantly more MPA than other two groups and most of the MPA is situated in the global head region. There is strong correlation (P < 0.001) between the various grouped items of Modified Waldrop scale. Depression subscale is correlated with anomalies in the hands (P < 0.001), feet and Waldrop total items (P < 0.005). Mania item of DASH II scale is related with anomalies around the eyes (P < 0.001). Self-injurious behavior and total Waldrop score is negatively correlated with global head. Conclusion: Down syndrome group has significantly more MPA and a pattern of correlation between MPA and behavioral abnormalities exists which necessitates a large-scale study. PMID:21559153

  10. Quadrantal multi-scale distribution entropy analysis of heartbeat interval series based on a modified Poincaré plot

    NASA Astrophysics Data System (ADS)

    Huo, Chengyu; Huang, Xiaolin; Zhuang, Jianjun; Hou, Fengzhen; Ni, Huangjing; Ning, Xinbao

    2013-09-01

    The Poincaré plot is one of the most important approaches in human cardiac rhythm analysis. However, further investigations are still needed to concentrate on techniques that can characterize the dispersion of the points displayed by a Poincaré plot. Based on a modified Poincaré plot, we provide a novel measurement named distribution entropy (DE) and propose a quadrantal multi-scale distribution entropy analysis (QMDE) for the quantitative descriptions of the scatter distribution patterns in various regions and temporal scales. We apply this method to the heartbeat interval series derived from healthy subjects and congestive heart failure (CHF) sufferers, respectively, and find that the discriminations between them are most significant in the first quadrant, which implies significant impacts on vagal regulation brought about by CHF. We also investigate the day-night differences of young healthy people, and it is shown that the results present a clearly circadian rhythm, especially in the first quadrant. In addition, the multi-scale analysis indicates that the results of healthy subjects and CHF sufferers fluctuate in different trends with variation of the scale factor. The same phenomenon also appears in circadian rhythm investigations of young healthy subjects, which implies that the cardiac dynamic system is affected differently in various temporal scales by physiological or pathological factors.

  11. Note on a modified return period scale for upper-truncated unbounded flood distributions

    NASA Astrophysics Data System (ADS)

    Bardsley, Earl

    2017-01-01

    Probability distributions unbounded to the right often give good fits to annual discharge maxima. However, all hydrological processes are in reality constrained by physical upper limits, though not necessarily well defined. A result of this contradiction is that for sufficiently small exceedance probabilities the unbounded distributions anticipate flood magnitudes which are impossibly large. This raises the question of whether displayed return period scales should, as is current practice, have some given number of years, such as 500 years, as the terminating rightmost tick-point. This carries the implication that the scale might be extended indefinitely to the right with a corresponding indefinite increase in flood magnitude. An alternative, suggested here, is to introduce a sufficiently high upper truncation point to the flood distribution and modify the return period scale accordingly. The rightmost tick-mark then becomes infinity, corresponding to the upper truncation point discharge. The truncation point is likely to be set as being above any physical upper bound and the return period scale will change only slightly over all practical return periods of operational interest. The rightmost infinity tick point is therefore proposed, not as an operational measure, but rather to signal in flood plots that the return period scale does not extend indefinitely to the right.

  12. Tissue adhesives for simple traumatic lacerations.

    PubMed

    Beam, Joel W

    2008-01-01

    Farion K, Osmond MH, Hartling L, et al. Tissue adhesives for traumatic lacerations in children and adults. Cochrane Database Syst Rev. 2001(4);CD003326. What is the clinical evidence base for tissue adhesives in the management of simple traumatic lacerations? Studies were identified by searches of the following databases: Cochrane Wounds Group Specialized Trials Register (September 2003), Cochrane Central Register of Controlled Trials (CENTRAL) (CDROM 2003, issue 3), MEDLINE (1966 to September 2003, week 1), EMBASE (1988 to 2003, week 36), Web of Science Science Citation Index (1975 to September 13, 2003) and various clinical trials registers (September 2003). Investigators and product manufacturers were contacted to identify additional eligible studies. The search terms included wounds and injuries, laceration, face injury, nose injury, tissue adhesives, and acrylates. Each study fulfilled the following criteria: (1) The study was a randomized controlled trial that compared tissue adhesives with standard wound closure (SWC) (sutures, staples, adhesive strips) or tissue adhesive with tissue adhesive. (2) The wounds were acute, linear lacerations less than 12 hours old, resulting from blunt or sharp trauma. (3) The wound length, width, and depth allowed for approximation of the edges with minimal tension after deep sutures were placed, if required. Studies were included with no language or publication status restriction, with participants of any age recruited in an emergency department, outpatient clinic, walk-in clinic, or other primary care setting. Studies were excluded if the wounds were stellate lacerations, puncture wounds, mammalian bites, infected, heavily contaminated or devitalized, crossing joints or mucocutaneous junctions, in hair-bearing areas, or in patients with keloid formation or chronic illness. The characteristics of the study and participants, interventions, outcome measures, and findings were extracted by one author and verified by a second using a standard form. The primary measure was cosmetic outcome. Secondary measures were pain with the procedure, time to complete the procedure, and complications (erythema, infection, discharge, need for delayed closure, and dehiscence). Studies were divided into 2 groups as follows: group 1, comparisons among tissue adhesives with SWC, and group 2, comparisons among different tissue adhesives. All eligible studies were assessed for methodologic quality independently by 2 investigators using the Jadad Scale, which evaluates randomization, double blinding, withdrawals, and dropouts and is scored on a 5-point (maximum) scale. The data from the tissue adhesive and SWC studies were pooled and analyzed with a random-effects model. The I (2) statistic was used to determine heterogeneity among the studies. chi (2) analysis was performed to compare participant age, wound location, and type of tissue adhesive among the studies. The data from the studies comparing tissue adhesives were pooled and analyzed using a fixed-effects model. The search criteria identified 39 eligible studies, of which 11 met the inclusion criteria. In 10 studies, a tissue adhesive was compared with SWC. Five groups used butylcyanoacrylate, and 5 used octylcyanoacrylate. For SWC, 6 groups used sutures, 2 used adhesive strips, and 2 used a combination of methods, although most used sutures. Six studies were limited to pediatric patients and 2 to adult patients; 2 included patients of any age. Wounds were limited to facial lacerations in 2 pediatric studies and 1 group with patients of any age. Lacerations requiring deep sutures were excluded in 4 studies. One group compared tissue adhesives (butylcyanoacrylate and octylcyanoacrylate) among pediatric patients with facial lacerations not requiring deep sutures. In the 11 included studies, authors of 9 randomized and evaluated 1 laceration per patient, whereas 2 groups included patients with more than 1 laceration. In 1 group, each laceration was independently randomized and evaluated, and the other group randomized the patient and assigned all lacerations to a treatment group (tissue adhesive with SWC or tissue adhesive with tissue adhesive). The sample sizes ranged between 60 and 163 lacerations, and all 11 studies were performed in emergency departments. The primary measure in all included studies was cosmetic outcome. The majority of groups used the Cosmetic Visual Analogue Scale, the Wound Evaluation Score, or a combination of these measures. Three groups measured cosmetic outcome with nonvalidated scoring systems. Assessment time periods were grouped and reported at (1) 5 to 14 days, (2) 1 to 3 months, and (3) 9 to 12 months after wound closure. Secondary outcomes were pain (as noted on visual analogue scale) and time to complete the procedure (as mean number of minutes). The 11 studies scored from 1 to 3 on the Jadad Scale. Adequate allocation concealment was reported in only 1 group. Examining cosmetic outcome, 8 groups (565 lacerations) used the Cosmetic Visual Analogue Scale to compare tissue adhesives and SWC. The authors reported no significant differences in scores at the time periods of 5 to 14 days, 1 to 3 months, and 9 to 12 months. A subgroup analysis showed a significant ( P = .005) superiority of butylcyanoacrylate over SWC at 1 to 3 months. Using the Wound Evaluation Score, 4 studies (364 lacerations) compared tissue adhesives with SWC. No significant differences in cosmetic scores were found at 5 to 14 days, 1 to 3 months, or 9 to 12 months. One group (83 lacerations) compared butylcyanoacrylate with octylcyanoacrylate and reported no significant differences in cosmetic scores using the Cosmetic Visual Analogue Scale at 1 to 3 months and the Wound Evaluation Score at 5 to 14 days and 1 to 3 months. Examining secondary outcomes, 6 groups (570 lacerations) compared tissue adhesives with SWC using the visual analogue scale for pain. Scores reported by parents, patients, physicians, and nurses significantly favored tissue adhesives. In 6 studies (584 lacerations), tissue adhesives were significantly favored over SWC in time to complete the procedure. For complication outcomes, 8 groups (727 lacerations) demonstrated significantly fewer incidences of erythema and an increased risk of dehiscence with tissue adhesives compared with SWC. No significant differences were shown for infection, delayed closure, or discharge. Among 83 lacerations, 1 group compared butylcyanoacrylate with octylcyanoacrylate and reported no significant differences in combined patient-reported and parent-reported visual analogue pain scores, time to complete the procedure, dehiscence, or infection. This review provides evidence that tissue adhesives are an option to SWC (sutures, staples, adhesive strips) for the management of simple traumatic lacerations. Overall, no significant differences were found in cosmetic scores at the reported assessment periods between tissue adhesives and SWC. At 1 to 3 months, a subgroup analysis significantly favored butylcyanoacrylate over SWC. Tissue adhesives significantly lowered the time to complete the procedure, levels of pain, and rate of erythema. However, the data revealed a significant increase in the rate of dehiscence with the use of tissue adhesives when compared with SWC. The low methodologic quality of the evidence should be considered in the interpretation of the findings.

  13. Modified dark matter: Relating dark energy, dark matter and baryonic matter

    NASA Astrophysics Data System (ADS)

    Edmonds, Douglas; Farrah, Duncan; Minic, Djordje; Ng, Y. Jack; Takeuchi, Tatsu

    Modified dark matter (MDM) is a phenomenological model of dark matter, inspired by gravitational thermodynamics. For an accelerating universe with positive cosmological constant (Λ), such phenomenological considerations lead to the emergence of a critical acceleration parameter related to Λ. Such a critical acceleration is an effective phenomenological manifestation of MDM, and it is found in correlations between dark matter and baryonic matter in galaxy rotation curves. The resulting MDM mass profiles, which are sensitive to Λ, are consistent with observational data at both the galactic and cluster scales. In particular, the same critical acceleration appears both in the galactic and cluster data fits based on MDM. Furthermore, using some robust qualitative arguments, MDM appears to work well on cosmological scales, even though quantitative studies are still lacking. Finally, we comment on certain nonlocal aspects of the quanta of modified dark matter, which may lead to novel nonparticle phenomenology and which may explain why, so far, dark matter detection experiments have failed to detect dark matter particles.

  14. Stability domain of alumina thermally grown on Fe-Cr-Al-based model alloys and modified surface layers exposed to oxygen-containing molten Pb

    NASA Astrophysics Data System (ADS)

    Jianu, A.; Fetzer, R.; Weisenburger, A.; Doyle, S.; Bruns, M.; Heinzel, A.; Hosemann, P.; Mueller, G.

    2016-03-01

    The paper gives experimental results concerning the morphology, composition, structure and thickness of the oxide scales grown on Fe-Cr-Al-based bulk alloys during exposure to oxygen-containing molten lead. The results are discussed and compared with former results obtained on Al-containing surface layers, modified by melting with intense pulsed electron beam and exposed to similar conditions. The present and previous results provide the alumina stability domain and also the criterion of the Al/Cr ratio for the formation of a highly protective alumina layer on the surface of Fe-Cr-Al-based alloys and on modified surface layers exposed to molten lead with 10-6 wt.% oxygen at 400-600 °C. The protective oxide scales, grown on alumina-forming Fe-Cr-Al alloys under the given experimental conditions, were transient aluminas, namely, kappa-Al2O3 and theta-Al2O3.

  15. Wind tunnel and ground static tests of a .094 scale powered model of a modified T-39 lift/cruise fan V/STOL research airplane

    NASA Technical Reports Server (NTRS)

    Hunt, D.; Clinglan, J.; Salemann, V.; Omar, E.

    1977-01-01

    Ground static and wind tunnel test of a scale model modified T-39 airplane are reported. The configuration in the nose and replacement of the existing nacelles with tilting lift/cruise fans. The model was powered with three 14 cm diameter tip driven turbopowered simulators. Forces and moments were measured by an internal strain guage balance. Engine simulator thrust and mass flow were measured by calibrated pressure and temperature instrumentation mounted downstream of the fans. The low speed handling qualities and general aerodynamic characteristics of the modified T-39 were defined. Test variables include thrust level and thrust balance, forward speed, model pitch and sideslip angle at forward speeds, model pitch, roll, and ground height during static tests, lift/cruise fan tilt angle, flap and aileron deflection angle, and horizonal stabilizer angle. The effects of removing the landing gear, the lift/cruise fans, and the tail surfaces were also investigated.

  16. Development of modified starch technology (maltodextrin) from commercial tapioca on semi production scale using oil heater dextrinator

    NASA Astrophysics Data System (ADS)

    Triyono, Agus; Cecep Erwan Andriansyah, Raden; Luthfiyanti, Rohmah; Rahman, Taufik

    2017-12-01

    One way to improve functional starch is by modification of starch into dextrin or maltodextrin. Maltodextrin is used in the food industry as a food substitution. Development of enzymatically modified starch technology has been performed with the use of α-amylase at optimum pH of 5.5, temperature 75-85 °C, with enzyme activity of 135 KNU/g. The maltodextrin produced from commercial tapioca has the quality requirements for food according to SNI 1992. The yield of maltodextrin obtained is about 80%. The use of the optimum amount of the α-amylase enzyme is 0.07 % v/w and the substrate amount of tapioca starch is 35%. Analysis of the feasibility of modified starch with the assumption of production scale of 300 kg per day, the economic value of 10 years business, the price of starch is IDR 8,350/kg, from tapioca starch (tapioca) IDR 4,000 - IDR 4,500/kg.

  17. Influence of racial differences on outcomes after thrombolytic therapy in acute ischemic stroke.

    PubMed

    Mishra, Nishant K; Mandava, Pitchaiah; Chen, Christopher; Grotta, James; Lees, Kennedy R; Kent, Thomas A

    2014-07-01

    The National Institutes of Neurological Disorders and Stroke and the European Co-operative Acute Stroke III trials enrolled a largely Caucasian population, but the results are often extrapolated onto non-Caucasians. A limited number of nonrandomized studies have proposed that non-Caucasian patients show differential response to tissue plasminogen activator. We examined if non-Caucasian patients of mixed national origin within the Virtual International Stroke Trials Archives neuroprotection trials responded differently to tissue plasminogen activator compared with Caucasians. We matched patients within each race-subtype for age, baseline National Institutes of Health Stroke Scales, and diabetes status, and excluded outliers. We tested for an interaction of race ethnicity with tissue plasminogen activator on predicting outcomes at α = 0·05. We compared 90-day ordinal outcome (modified Rankin Scale; primary analysis) and dichotomized outcomes (modified Rankin Scale 0-1; modified Rankin Scale 0-2; survival) within individual race ethnicity. One thousand nine hundred forty-six thrombolysed patients (125 Blacks, 39 Asians, and 1821 Caucasians) were matched with 1946 non-thrombolysed patients in each race ethnicity group. Postmatching, there were no imbalances in baseline National Institutes of Health Stroke Scales and age between the groups (P > 0·05). The interaction of tissue plasminogen activator with race ethnicity was nonsignificant in ordinal (P = 0·4) and in dichotomized outcome models (P > 0·05). Ordinal odds for improved outcomes were 1·5 for all patients (P < 0·05). Ordinal odds for Caucasians were 1·5 (P < 0·05); for Blacks, 2·1 (P < 0·05); and for Asians, 1·2 (P > 0·05; 1·6 after 1:2 matching with nonthrombolysed, because of small numbers). Dichotomized functional outcomes improved after thrombolysis overall, in Caucasians, in Blacks (modified Rankin Scale 0-2 only), and in Asians (after 1:2 matching; P > 0·05). Odds for survival were consistent across all groups. These results do not suggest a differential response to tissue plasminogen activator based on race ethnicity. Among Asians, data were particularly sparse, and results should be interpreted with caution. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

  18. Development of the Comprehensive Cervical Dystonia Rating Scale: Methodology

    PubMed Central

    Comella, Cynthia L.; Fox, Susan H.; Bhatia, Kailash P.; Perlmutter, Joel S.; Jinnah, Hyder A.; Zurowski, Mateusz; McDonald, William M.; Marsh, Laura; Rosen, Ami R.; Waliczek, Tracy; Wright, Laura J.; Galpern, Wendy R.; Stebbins, Glenn T.

    2016-01-01

    We present the methodology utilized for development and clinimetric testing of the Comprehensive Cervical Dystonia (CD) Rating scale, or CCDRS. The CCDRS includes a revision of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS-2), a newly developed psychiatric screening tool (TWSTRS-PSYCH), and the previously validated Cervical Dystonia Impact Profile (CDIP-58). For the revision of the TWSTRS, the original TWSTRS was examined by a committee of dystonia experts at a dystonia rating scales workshop organized by the Dystonia Medical Research Foundation. During this workshop, deficiencies in the standard TWSTRS were identified and recommendations for revision of the severity and pain subscales were incorporated into the TWSTRS-2. Given that no scale currently evaluates the psychiatric features of cervical dystonia (CD), we used a modified Delphi methodology and a reiterative process of item selection to develop the TWSTRS-PSYCH. We also included the CDIP-58 to capture the impact of CD on quality of life. The three scales (TWSTRS2, TWSTRS-PSYCH, and CDIP-58) were combined to construct the CCDRS. Clinimetric testing of reliability and validity of the CCDRS are described. The CCDRS was designed to be used in a modular fashion that can measure the full spectrum of CD. This scale will provide rigorous assessment for studies of natural history as well as novel symptom-based or disease-modifying therapies. PMID:27088112

  19. Development of the Comprehensive Cervical Dystonia Rating Scale: Methodology.

    PubMed

    Comella, Cynthia L; Fox, Susan H; Bhatia, Kailash P; Perlmutter, Joel S; Jinnah, Hyder A; Zurowski, Mateusz; McDonald, William M; Marsh, Laura; Rosen, Ami R; Waliczek, Tracy; Wright, Laura J; Galpern, Wendy R; Stebbins, Glenn T

    2015-06-01

    We present the methodology utilized for development and clinimetric testing of the Comprehensive Cervical Dystonia (CD) Rating scale, or CCDRS. The CCDRS includes a revision of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS-2), a newly developed psychiatric screening tool (TWSTRS-PSYCH), and the previously validated Cervical Dystonia Impact Profile (CDIP-58). For the revision of the TWSTRS, the original TWSTRS was examined by a committee of dystonia experts at a dystonia rating scales workshop organized by the Dystonia Medical Research Foundation. During this workshop, deficiencies in the standard TWSTRS were identified and recommendations for revision of the severity and pain subscales were incorporated into the TWSTRS-2. Given that no scale currently evaluates the psychiatric features of cervical dystonia (CD), we used a modified Delphi methodology and a reiterative process of item selection to develop the TWSTRS-PSYCH. We also included the CDIP-58 to capture the impact of CD on quality of life. The three scales (TWSTRS2, TWSTRS-PSYCH, and CDIP-58) were combined to construct the CCDRS. Clinimetric testing of reliability and validity of the CCDRS are described. The CCDRS was designed to be used in a modular fashion that can measure the full spectrum of CD. This scale will provide rigorous assessment for studies of natural history as well as novel symptom-based or disease-modifying therapies.

  20. Twelve-Month Clinical and Quality-of-Life Outcomes in the Interventional Management of Stroke III Trial.

    PubMed

    Palesch, Yuko Y; Yeatts, Sharon D; Tomsick, Thomas A; Foster, Lydia D; Demchuk, Andrew M; Khatri, Pooja; Hill, Michael D; Jauch, Edward C; Jovin, Tudor G; Yan, Bernard; von Kummer, Rüdiger; Molina, Carlos A; Goyal, Mayank; Schonewille, Wouter J; Mazighi, Mikael; Engelter, Stefan T; Anderson, Craig; Spilker, Judith; Carrozzella, Janice; Ryckborst, Karla J; Janis, L Scott; Simpson, Annie; Simpson, Kit N; Broderick, Joseph P

    2015-05-01

    Randomized trials have indicated a benefit for endovascular therapy in appropriately selected stroke patients at 3 months, but data regarding outcomes at 12 months are currently lacking. We compared functional and quality-of-life outcomes at 12 months overall and by stroke severity in stroke patients treated with intravenous tissue-type plasminogen activator followed by endovascular treatment as compared with intravenous tissue-type plasminogen activator alone in the Interventional Management of Stroke III Trial. The key outcome measures were a modified Rankin Scale score ≤2 (functional independence) and the Euro-QoL EQ-5D, a health-related quality-of-life measure. 656 subjects with moderate-to-severe stroke (National Institutes of Health Stroke Scale ≥8) were enrolled at 58 centers in the United States (41 sites), Canada (7), Australia (4), and Europe (6). There was an interaction between treatment group and stroke severity in the repeated measures analysis of modified Rankin Scale ≤2 outcome (P=0.039). In the 204 participants with severe stroke (National Institutes of Health Stroke Scale ≥20), a greater proportion of the endovascular group had a modified Rankin Scale ≤2 (32.5%) at 12 months as compared with the intravenous tissue-type plasminogen activator group (18.6%, P=0.037); no difference was seen for the 452 participants with moderately severe strokes (55.6% versus 57.7%). In participants with severe stroke, the endovascular group had 35.2 (95% confidence interval: 2.1, 73.3) more quality-adjusted-days over 12 months as compared with intravenous tissue-type plasminogen activator alone. Endovascular therapy improves functional outcome and health-related quality-of-life at 12 months after severe ischemic stroke. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00359424. © 2015 American Heart Association, Inc.

  1. The variance of angle-of-arrival fluctuation of partially coherent Gaussian-Schell Model beam propagations in slant atmospheric turbulence

    NASA Astrophysics Data System (ADS)

    Tan, Zhenkun; Ke, Xizheng

    2017-10-01

    The variance of angle-of-arrival fluctuation of the partially coherent Gaussian-Schell Model (GSM) beam propagations in the slant path, based on the extended Huygens-Fresnel principle and the model of atmospheric refraction index structural constant proposed by the international telecommunication union-radio (ITU-R), has been investigated under the modified Hill turbulence model. The expression of that has been obtained. Firstly, the effects of optical wavelength, the inner-and-outer scale of the turbulence and turbulence intensity on the variance of angle-of-arrival fluctuation have been analyzed by comparing with the partially coherent GSM beam and the completely coherent Gaussian beam. Secondly, the variance of angle-of-arrival fluctuation has been compared with the von Karman spectrum and the modified Hill spectrum under the partially coherent GSM beam. Finally, the effects of beam waist radius and partial coherence length on the variance of angle-of-arrival of the collimated (focused) beam have been analyzed under the modified Hill turbulence model. The results show that the influence of the variance of angle-of-arrival fluctuation for the inner scale effect is larger than that of the outer scale effect. The variance of angle-of-arrival fluctuation under the modified Hill spectrum is larger than that of the von Karman spectrum. The influence of the waist radius on the variance of angle-of-arrival for the collimated beam is less than focused the beam. This study will provide a necessary theoretical basis for the experiments of partially coherent GSM beam propagation through atmosphere turbulence.

  2. PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) Scale in Stroke: A Validation Study.

    PubMed

    Katzan, Irene L; Lapin, Brittany

    2018-01-01

    The International Consortium for Health Outcomes Measurement recently included the 10-item PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) scale as part of their recommended Standard Set of Stroke Outcome Measures. Before collection of PROMIS GH is broadly implemented, it is necessary to assess its performance in the stroke population. The objective of this study was to evaluate the psychometric properties of PROMIS GH in patients with ischemic stroke and intracerebral hemorrhage. PROMIS GH and 6 PROMIS domain scales measuring same/similar constructs were electronically collected on 1102 patients with ischemic and hemorrhagic strokes at various stages of recovery from their stroke who were seen in a cerebrovascular clinic from October 12, 2015, through June 2, 2017. Confirmatory factor analysis was performed to evaluate the adequacy of 2-factor structure of component scores. Test-retest reliability and convergent validity of PROMIS GH items and component scores were assessed. Discriminant validity and responsiveness were compared between PROMIS GH and PROMIS domain scales measuring the same or related constructs. Analyses were repeated stratified by stroke subtype and modified Rankin Scale score <2 versus ≥2. There was moderate internal reliability (ordinal α, 0.82-0.88) and marginal model fit for the 2-factor solution for component scores (root mean square error of approximation, 0.11). Convergent validity was good with significant correlations between all PROMIS GH items and PROMIS domain scales ( P <0.001 for all). There was excellent discrimination for all PROMIS GH items and component scores across modified Rankin Scale levels. Good responsiveness (effect size, >0.5) was demonstrated for 8 of the 10 PROMIS GH items. Reliability and validity remained consistent across stroke subtype and disability level (modified Rankin Scale, <2 versus ≥2). PROMIS GH exhibits acceptable performance in patients with stroke. Our findings support International Consortium for Health Outcomes Measurement recommendation to use PROMIS GH as part of the standard set of outcome measures in stroke. © 2017 American Heart Association, Inc.

  3. High temperature oxidation behavior of gamma-nickel+gamma'-nickel aluminum alloys and coatings modified with platinum and reactive elements

    NASA Astrophysics Data System (ADS)

    Mu, Nan

    Materials for high-pressure turbine blades must be able to operate in the high-temperature gases (above 1000°C) emerging from the combustion chamber. Accordingly, the development of nickel-based superalloys has been constantly motivated by the need to have improved engine efficiency, reliability and service lifetime under the harsh conditions imposed by the turbine environment. However, the melting point of nickel (1455°C) provides a natural ceiling for the temperature capability of nickel-based superalloys. Thus, surface-engineered turbine components with modified diffusion coatings and overlay coatings are used. Theses coatings are capable of forming a compact and adherent oxide scale, which greatly impedes the further transport of reactants between the high-temperature gases and the underlying metal and thus reducing attack by the atmosphere. Typically, these coatings contain beta-NiAl as a principal constituent phase in order to have sufficient aluminum content to form an Al2O3 scale at elevated temperatures. The drawbacks to the currently-used beta-based coatings, such as phase instabilities, associated stresses induced by such phase instabilities, and extensive coating/substrate interdiffusion, are major motivations in this study to seek next-generation coatings. The high-temperature oxidation resistance of novel Pt+Hf-modified gamma-Ni+gamma'-Ni 3Al-based alloys and coatings were investigated in this study. Both early-stage and 4-days isothermal oxidation behavior of single-phase gamma-Ni and gamma'-Ni3Al alloys were assessed by examining the weight changes, oxide-scale structures, and elemental concentration profiles through the scales and subsurface alloy regions. It was found that Pt promotes Al 2O3 formation by suppressing the NiO growth on both gamma-Ni and gamma'-Ni3Al single-phase alloys. This effect increases with increasing Pt content. Moreover, Pt exhibits this effect even at lower temperatures (˜970°C) in the very early stage of oxidation. It was also inferred that Pt enhances the diffusive flux of aluminum from the substrate to the scale/alloy interface. Relatively low levels of hafnium addition to Pt-free gamma'-Ni 3Al increased the extent of external NiO formation due to non-protective HfO2 formation. Accordingly, this effect intensified with increasing Hf content from 0.2 to 0.5at.%. The synergistic effect of Pt and Hf co-addition was realized by examining Pt+Hf-modified gamma'-Ni3Al alloys. It was inferred that Pt decreases the chemical activity of Hf so that HfO2 formation could be suppressed with increasing Pt content. Thus, the early-stage Al2O3 formation facilitated by Pt additions and NiO development assisted by Hf additions are the competing scale growth processes that are influenced by the relative contents of Pt and Hf. Large interfacial voids were observed on the gamma'-Ni 3Al alloy after 4-days isothermal oxidation at 1150°C, which could be attributed to the Kirkendall effect. Platinum addition was also found to improve Al2O3-scale adhesion. Pt and Hf effects on two-phase gamma-Ni+gamma'-Ni3Al alloys of compositions Ni-20Al-20Pt-xHf (x ranges from 0 to 0.91) were examined by both thermal gravimetric analyses and cyclic oxidation tests. Scale microstructures were characterized by confocal photo-stimulated microspectroscopy (CPSM), in-lens SEM, and FIB-TEM. Hafnium additions up to about 0.48at.% markedly decreased the weight change of isothermally oxidized Pt-modified gamma+gamma' alloys by forming thinner oxide scales than that on the Hf-free Ni-20Al-20Pt base alloy. This could be attributed to an Al2O3 grain boundary blocking effect imparted by the segregated Hf. However, an over-doped alloy with 0.91at.% Hf exhibited detrimental effect by forming internal HfO 2. It was observed that Hf additions altered the Al2O3 scale microstructure. The most remarkable difference was that the columnar width of the Al2O3 scale grains formed on Ni-20Al-20Pt was much larger than it was on Ni-20Al-20Pt-0.48Hf. Even so, the Hf-doped alloys exhibited much slower scaling kinetics with a correspondingly thinner scale. This behavior could be ascribed to the Hf blocking diffusing paths as it segregated into Al2O3 grain boundaries. Therefore, the Hf-doped scale grew at a lower rate even though it contained more grain boundaries. Accompanied with this scale microstructure modification, Hf additions led to the following two additional effects: (1) Hf delayed the theta→alpha structural transformation of Al2O3; and (2) compressive residual stress in the scale formed on Hf-doped alloys was lower than that on the Hf-free Ni-20Al-20Pt alloy. Guided by the results from the bulk-alloy studies, a feasible method to deposit Pt+Hf-modified gamma+gamma' coatings having overall compositions closely approaching Ni-Al15-20-Pt15-20-Hf was subsequently developed. A key improvement of the application of Pt+Hf-modified gamma-Ni+gamma'-Ni 3Al coatings is the relief of TCP phases generated from coating/substrate interdiffusion. This could be simply attributed to the inherited phase compatibility between gamma+gamma' coatings with Ni-based superalloys. Another important advantage of gamma+gamma' coatings is the exclusion of phase transformations during thermal cycling. The Pt+Hf-modified gamma-Ni+gamma'-Ni3Al coating compositions had a strong dependence on the temperature and time in both pack cementation and post-heat-treatment processes. Meanwhile, coating performance was apparently more sensitive to the Hf content than what was observed with the alloys. Coating performance was also considerable affected by the surface finish and the composition of the superalloy substrate.

  4. Lagrangian Formulation of a Magnetostatic Field in the Presence of a Minimal Length Scale Based on the Kempf Algebra

    NASA Astrophysics Data System (ADS)

    Moayedi, S. K.; Setare, M. R.; Khosropour, B.

    2013-11-01

    In the 1990s, Kempf and his collaborators Mangano and Mann introduced a D-dimensional (β, β‧)-two-parameter deformed Heisenberg algebra which leads to an isotropic minimal length (\\triangle Xi)\\min = \\hbar √ {Dβ +β '}, \\forall i\\in \\{1, 2, ..., D\\}. In this work, the Lagrangian formulation of a magnetostatic field in three spatial dimensions (D = 3) described by Kempf algebra is presented in the special case of β‧ = 2β up to the first-order over β. We show that at the classical level there is a similarity between magnetostatics in the presence of a minimal length scale (modified magnetostatics) and the magnetostatic sector of the Abelian Lee-Wick model in three spatial dimensions. The integral form of Ampere's law and the energy density of a magnetostatic field in the modified magnetostatics are obtained. Also, the Biot-Savart law in the modified magnetostatics is found. By studying the effect of minimal length corrections to the gyromagnetic moment of the muon, we conclude that the upper bound on the isotropic minimal length scale in three spatial dimensions is 4.42×10-19 m. The relationship between magnetostatics with a minimal length and the Gaete-Spallucci nonlocal magnetostatics [J. Phys. A: Math. Theor. 45, 065401 (2012)] is investigated.

  5. The Student Risk Screening Scale for Early Childhood: An Initial Validation Study

    ERIC Educational Resources Information Center

    Lane, Kathleen Lynne; Oakes, Wendy Peia; Menzies, Holly Mariah; Major, Rebecca; Allegra, Laurie; Powers, Lisa; Schatschneider, Chris

    2015-01-01

    We report findings of two exploratory validation studies of a revised instrument: the "Student Risk Screening Scale for Early Childhood" version (SRSS-EC). The SRSS-EC was modified to reflect characteristics of externalizing and internalizing behaviors manifested by preschool-age children. In Study 1, we explored the reliability of…

  6. Psychometric Evidence of SRSS-IE Scores in Middle and High Schools

    ERIC Educational Resources Information Center

    Lane, Kathleen Lynne; Oakes, Wendy Peia; Cantwell, Emily D.; Menzies, Holly Mariah; Schatschneider, Christopher; Lambert, Warren; Common, Eric Alan

    2017-01-01

    We report results of an exploratory validation study of the "Student Risk Screening Scale-Internalizing and Externalizing" (SRSS-IE) applied with the first sample of middle and high school students from nine middle and three high schools from three states. The "Student Risk Screening Scale" (SRSS) was modified to broaden the…

  7. Development and Evaluation of a Chemistry-Specific Version of the Academic Motivation Scale (AMS-Chemistry)

    ERIC Educational Resources Information Center

    Liu, Yujuan; Ferrell, Brent; Barbera, Jack; Lewis, Jennifer E.

    2017-01-01

    Fundamentally concerned with motivation, self-determination theory (SDT) represents a framework of several mini-theories to explore how social context interacts with people's motivational types categorized by degree of regulation internalization. This paper aims to modify an existing theory-based instrument (Academic Motivation Scale, or AMS) and…

  8. Principal Self-Efficacy: Relations with Burnout, Job Satisfaction and Motivation to Quit

    ERIC Educational Resources Information Center

    Federici, Roger A.; Skaalvik, Einar M.

    2012-01-01

    The purpose of this study was to explore relations between principals' self-efficacy, burnout, job satisfaction and principals' motivation to quit. Principal self-efficacy was measured by a recently developed multidimensional scale called the Norwegian Principal Self-Efficacy Scale. Burnout was measured by a modified version of the Maslach Burnout…

  9. Investigating the Mercalli Intensity Scale through "Lived Experience"

    ERIC Educational Resources Information Center

    Jones, Richard

    2012-01-01

    The modified Mercalli (MM) intensity scale is composed of 12 increasing levels of intensity that range from imperceptible shaking to catastrophic destruction and is designated by Roman numerals I through XII. Although qualitative in nature, it can provide a more concrete model for middle and high school students striving to understand the dynamics…

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

    Zhang, Na; Zhang, Peng; Kang, Wei

    Multiscale simulations of fluids such as blood represent a major computational challenge of coupling the disparate spatiotemporal scales between molecular and macroscopic transport phenomena characterizing such complex fluids. In this paper, a coarse-grained (CG) particle model is developed for simulating blood flow by modifying the Morse potential, traditionally used in Molecular Dynamics for modeling vibrating structures. The modified Morse potential is parameterized with effective mass scales for reproducing blood viscous flow properties, including density, pressure, viscosity, compressibility and characteristic flow dynamics of human blood plasma fluid. The parameterization follows a standard inverse-problem approach in which the optimal micro parameters aremore » systematically searched, by gradually decoupling loosely correlated parameter spaces, to match the macro physical quantities of viscous blood flow. The predictions of this particle based multiscale model compare favorably to classic viscous flow solutions such as Counter-Poiseuille and Couette flows. It demonstrates that such coarse grained particle model can be applied to replicate the dynamics of viscous blood flow, with the advantage of bridging the gap between macroscopic flow scales and the cellular scales characterizing blood flow that continuum based models fail to handle adequately.« less

  11. Validation of the Modified Fatigue Impact Scale in mild to moderate traumatic brain injury.

    PubMed

    Schiehser, Dawn M; Delano-Wood, Lisa; Jak, Amy J; Matthews, Scott C; Simmons, Alan N; Jacobson, Mark W; Filoteo, J Vincent; Bondi, Mark W; Orff, Henry J; Liu, Lin

    2015-01-01

    To evaluate the validity of the Modified Fatigue Impact Scale (MFIS) in veterans with a history of mild to moderate traumatic brain injury (TBI). Veterans (N = 106) with mild (92%) or moderate (8%) TBI. Veterans Administration Health System. Factor structure, internal consistency, convergent validity, sensitivity, and specificity of the MFIS were examined. Principal component analysis identified 2 viable MFIS factors: a Cognitive subscale and a Physical/Activities subscale. Item analysis revealed high internal consistency of the MFIS Total scale and subscale items. Strong convergent validity of the MFIS scales was established with 2 Beck Depression Inventory II fatigue items. Receiver operating characteristic curve analysis revealed good to excellent accuracy of the MFIS in classifying fatigued versus nonfatigued individuals. The MFIS is a valid multidimensional measure that can be used to evaluate the impact of fatigue on cognitive and physical functioning in individuals with mild to moderate TBI. The psychometric properties of the MFIS make it useful for evaluating fatigue and provide the potential for improving research on fatigue in this population.

  12. Fully Endoscopic Freehand Evacuation of Spontaneous Supratentorial Intraparenchymal Hemorrhage.

    PubMed

    Angileri, Filippo Flavio; Esposito, Felice; Priola, Stefano Maria; Raffa, Giovanni; Marino, Daniele; Abbritti, Rosaria Viola; Giusa, Maria; Germanò, Antonino; Tomasello, Francesco

    2016-10-01

    A modification of other reported endoscopic techniques for intracerebral clot evacuation is described and illustrated. From January 2014 to December 2014, we operated on 6 patients harboring a spontaneous supratentorial intracerebral hemorrhage using a fully endoscopic freehand technique. Clinical chart and surgical videos were analyzed. Volumetric evaluation of the clot preoperatively and the residual hematoma postoperatively was performed. Clinical outcome was measured using the modified Rankin Scale and Glasgow Outcome Scale. The mean operative time was 96 minutes (range, 72-125 minutes). Clot evacuation was >90% in all patients. No patient experienced rebleeding after surgery. Two patients died. The Glasgow Outcome Scale score at 6 months was 4 in 2 patients, 3 in 2 patients, and 1 (death) in 2 patients. The modified Rankin Scale score at 6 months was 6 (death) in 2 patients, 4 in 2 patients, 3 in 1 patient and 2 in 1 patient. The proposed minimally invasive technique allows a good rate of hematoma evacuation and intraoperative bleeding control. Further studies in large series are needed to confirm the role of this freehand endoscopic technique. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Karolinska Psychodynamic Profile for Sexual Disorders: KAPP-SD. A proposal for a psychodynamic rating scale for sexual disorders.

    PubMed

    Soldati, Lorenzo; Köhl, John; Abraham, Georges; Bianchi Demicheli, Francesco; Wilczek, Alexander

    2015-01-01

    Our first objective in this paper was to review the literature on psychodynamic rating scales of sexual disorders. Our second objective, based on the findings from our review, was to develop a psychodynamic rating scale for people with sexual disorders: the KAPP-SD. We developed the KAPP-SD by modifying an existing psychodynamic rating scale, which assesses stable modes of mental functioning and character traits, the Karolinska Psychodynamic Profile (KAPP). We removed items 13 and 14 of the KAPP and replaced them with three other items-sexual fantasies, conceptions and role of gender identity, and conceptions and role of sexual orientation. These items are part of the assessment of an individual's sexuality and are used to evaluate a person with a sexual disorder psychodynamically. The KAPP-SD, a modified version of the KAPP, can be found in the Appendix. We developed the KAPP-SD in order to help sex therapists make a rigorous psychodynamic evaluation of persons with sexual disorders, which would give information on the prognosis and on the type of treatment to offer.

  14. A Retrospective Analysis of Pressure Ulcer Incidence and Modified Braden Scale Score Risk Classifications.

    PubMed

    Chen, Hong-Lin; Cao, Ying-Juan; Wang, Jing; Huai, Bao-Sha

    2015-09-01

    The Braden Scale is the most widely used pressure ulcer risk assessment in the world, but the currently used 5 risk classification groups do not accurately discriminate among their risk categories. To optimize risk classification based on Braden Scale scores, a retrospective analysis of all consecutively admitted patients in an acute care facility who were at risk for pressure ulcer development was performed between January 2013 and December 2013. Predicted pressure ulcer incidence first was calculated by logistic regression model based on original Braden score. Risk classification then was modified based on the predicted pressure ulcer incidence and compared between different risk categories in the modified (3-group) classification and the traditional (5-group) classification using chi-square test. Two thousand, six hundred, twenty-five (2,625) patients (mean age 59.8 ± 16.5, range 1 month to 98 years, 1,601 of whom were men) were included in the study; 81 patients (3.1%) developed a pressure ulcer. The predicted pressure ulcer incidence ranged from 0.1% to 49.7%. When the predicted pressure ulcer incidence was greater than 10.0% (high risk), the corresponding Braden scores were less than 11; when the predicted incidence ranged from 1.0% to 10.0% (moderate risk), the corresponding Braden scores ranged from 12 to 16; and when the predicted incidence was less than 1.0% (mild risk), the corresponding Braden scores were greater than 17. In the modified classification, observed pressure ulcer incidence was significantly different between each of the 3 risk categories (P less than 0.05). However, in the traditional classification, the observed incidence was not significantly different between the high-risk category and moderate-risk category (P less than 0.05) and between the mild-risk category and no-risk category (P less than 0.05). If future studies confirm the validity of these findings, pressure ulcer prevention protocols of care based on Braden Scale scores can be simplified.

  15. Planning Future Clinical Trials for Machado-Joseph Disease.

    PubMed

    Saute, Jonas Alex Morales; Jardim, Laura Bannach

    2018-01-01

    Spinocerebellar ataxia type 3/Machado-Joseph disease (SCA3/MJD) is an autosomal dominant multiple neurological systems degenerative disorder caused by a CAG repeat expansion at ATXN3 gene. Only a few treatments were evaluated in randomized clinical trials (RCT) in SCA3/MJD patients, with a lack of evidence for both disease-modifying and symptomatic therapies. The present chapter discuss in detail major methodological issues for planning future RCT for SCA3/MJD. There are several potential therapies for SCA3/MJD with encouraging preclinical results. Route of treatment, dosage titration and potential therapy biomarkers might differ among candidate drugs; however, the core study design and protocol will be mostly the same. RCT against placebo group is the best study design to test a disease-modifying therapy; the same cannot be stated for some symptomatic treatments. Main outcomes for future RCT are clinical scales: the Scale for the Assessment and Rating of ataxia (SARA) is currently the instrument of choice to prove efficacy of disease-modifying or symptomatic treatments against ataxia, the most important disease feature. Ataxia quantitative scales or its composite scores can be used as primary outcomes to provide preliminary evidence of efficacy in phase 2 RCT, due to a greater sensitivity to change. Details regarding eligibility criteria, randomization, sample size estimation, duration and type of analysis for both disease modifying and symptomatic treatment trials, were also discussed. Finally, a section anticipates the methodological issues for testing novel drugs when an effective treatment is already available. We conclude emphasizing four points, the first being the need of RCT for a number of different aims in the care of SCA3/MJD. Due to large sample sizes needed to warrant power, RCT for disease-modifying therapies should be multicenter enterprises. There is an urge need for surrogate markers validated for several drug classes. Finally, engagement of at risk or presymptomatic individuals in future trials will enable major advances on treatment research for SCA3/MJD.

  16. Personality assessment of adolescents: an analysis of the Junior Self-Monitoring Scale.

    PubMed

    Howells, G N; Fishfader, V L

    1995-04-01

    The factor structure and reliability of Graziano, Musser, Leone, and Lautenschlager's 1987 Junior Self-monitoring Scale was examined using the responses of 1279 students in Grades 6 to 9. Analyses suggested that the scale contains two main factors which represent Concern for Social Appropriateness and Ability to Modify Self-presentation. We suggest using a 20-item version of the scale (rather than the original 24-item version) to provide increased reliability and that the scale may be more appropriate than the Adolescent Self-monitoring Scale by Pledger for use with younger children because it is easier to read and has abundant situational cues.

  17. Surface diagnostics for scale analysis.

    PubMed

    Dunn, S; Impey, S; Kimpton, C; Parsons, S A; Doyle, J; Jefferson, B

    2004-01-01

    Stainless steel, polymethylmethacrylate and polytetrafluoroethylene coupons were analysed for surface topographical and adhesion force characteristics using tapping mode atomic force microscopy and force-distance microscopy techniques. The two polymer materials were surface modified by polishing with silicon carbide papers of known grade. The struvite scaling rate was determined for each coupon and related to the data gained from the surface analysis. The scaling rate correlated well with adhesion force measurements indicating that lower energy materials scale at a lower rate. The techniques outlined in the paper provide a method for the rapid screening of materials in potential scaling applications.

  18. Application and Testing the Reliability and Validity of a Modified Version of Herek's Attitudes Toward Lesbians and Gay Men Scale in China

    PubMed Central

    Yu, Yong; Xiang, Ying

    2011-01-01

    The present study was the first attempt to test the reliability and validity of Herek's Attitudes Toward Lesbians and Gay Men Scale (ATLG; Herek, 1988) in the Chinese population. Participants (n = 2,391 for the field trials and n = 200 for test–retest reliability) were asked to complete the translated, slightly modified version of the ATLG. The resulting ATLG has a two-dimensional factor structure as well as good validity and reliability in the Chinese culture. ATLG scores followed distinct patterns according sex and level of education that were consistent with previous studies in other populations. The significance of these findings in Chinese culture is discussed. PMID:21294029

  19. Modified interferometric imaging condition for reverse-time migration

    NASA Astrophysics Data System (ADS)

    Guo, Xue-Bao; Liu, Hong; Shi, Ying

    2018-01-01

    For reverse-time migration, high-resolution imaging mainly depends on the accuracy of the velocity model and the imaging condition. In practice, however, the small-scale components of the velocity model cannot be estimated by tomographical methods; therefore, the wavefields are not accurately reconstructed from the background velocity, and the imaging process will generate artefacts. Some of the noise is due to cross-correlation of unrelated seismic events. Interferometric imaging condition suppresses imaging noise very effectively, especially the unknown random disturbance of the small-scale part. The conventional interferometric imaging condition is extended in this study to obtain a new imaging condition based on the pseudo-Wigner distribution function (WDF). Numerical examples show that the modified interferometric imaging condition improves imaging precision.

  20. Measurement of the Differential and Total Thrust and Torque of Six Full-Scale Adjustable-Pitch Propellers

    NASA Technical Reports Server (NTRS)

    Stickle, George W

    1933-01-01

    Force measurements giving total thrust and torque, and propeller slip stream surveys giving differential thrust and torque were simultaneously made on each of six full-scale propellers in the 20-foot propeller-research tunnel of the National Advisory Committee for Aeronautics. They were adjustable-pitch metal propellers 9.5 feet in diameter; three had modified Clark Y blade sections and three had modified RAF-6 blade sections. This report gives the differential thrust and torque and the variation caused by changing the propeller tip speed and the pitch setting. The total thrust and torque obtained from integration of the thrust and torque distribution curves are compared with those obtained by direct force measurements.

  1. Predictive accuracy of risk scales following self-harm: multicentre, prospective cohort study†

    PubMed Central

    Quinlivan, Leah; Cooper, Jayne; Meehan, Declan; Longson, Damien; Potokar, John; Hulme, Tom; Marsden, Jennifer; Brand, Fiona; Lange, Kezia; Riseborough, Elena; Page, Lisa; Metcalfe, Chris; Davies, Linda; O'Connor, Rory; Hawton, Keith; Gunnell, David; Kapur, Nav

    2017-01-01

    Background Scales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking. Aims To evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months. Method A multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm. Scale a priori cut-offs were evaluated using diagnostic accuracy statistics. The area under the curve (AUC) was used to determine optimal cut-offs and compare global accuracy. Results In total, 483 episodes of self-harm were included in the study. The episode-based 6-month repetition rate was 30% (n = 145). Sensitivity ranged from 1% (95% CI 0–5) for the SAD PERSONS scale, to 97% (95% CI 93–99) for the Manchester Self-Harm Rule. Positive predictive values ranged from 13% (95% CI 2–47) for the Modified SAD PERSONS Scale to 47% (95% CI 41–53) for the clinician assessment of risk. The AUC ranged from 0.55 (95% CI 0.50–0.61) for the SAD PERSONS scale to 0.74 (95% CI 0.69–0.79) for the clinician global scale. The remaining scales performed significantly worse than clinician and patient estimates of risk (P<0.001). Conclusions Risk scales following self-harm have limited clinical utility and may waste valuable resources. Most scales performed no better than clinician or patient ratings of risk. Some performed considerably worse. Positive predictive values were modest. In line with national guidelines, risk scales should not be used to determine patient management or predict self-harm. PMID:28302702

  2. Predictive accuracy of risk scales following self-harm: multicentre, prospective cohort study.

    PubMed

    Quinlivan, Leah; Cooper, Jayne; Meehan, Declan; Longson, Damien; Potokar, John; Hulme, Tom; Marsden, Jennifer; Brand, Fiona; Lange, Kezia; Riseborough, Elena; Page, Lisa; Metcalfe, Chris; Davies, Linda; O'Connor, Rory; Hawton, Keith; Gunnell, David; Kapur, Nav

    2017-06-01

    Background Scales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking. Aims To evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months. Method A multisite prospective cohort study was conducted of adults aged 18 years and over referred to liaison psychiatry services following self-harm. Scale a priori cut-offs were evaluated using diagnostic accuracy statistics. The area under the curve (AUC) was used to determine optimal cut-offs and compare global accuracy. Results In total, 483 episodes of self-harm were included in the study. The episode-based 6-month repetition rate was 30% ( n = 145). Sensitivity ranged from 1% (95% CI 0-5) for the SAD PERSONS scale, to 97% (95% CI 93-99) for the Manchester Self-Harm Rule. Positive predictive values ranged from 13% (95% CI 2-47) for the Modified SAD PERSONS Scale to 47% (95% CI 41-53) for the clinician assessment of risk. The AUC ranged from 0.55 (95% CI 0.50-0.61) for the SAD PERSONS scale to 0.74 (95% CI 0.69-0.79) for the clinician global scale. The remaining scales performed significantly worse than clinician and patient estimates of risk ( P <0.001). Conclusions Risk scales following self-harm have limited clinical utility and may waste valuable resources. Most scales performed no better than clinician or patient ratings of risk. Some performed considerably worse. Positive predictive values were modest. In line with national guidelines, risk scales should not be used to determine patient management or predict self-harm. © The Royal College of Psychiatrists 2017.

  3. Coulomb-Gas scaling law for a superconducting Bi(2+y)Sr(2-x-y)La(x)CuO(6+delta) thin films in magnetic fields

    PubMed

    Zhang; Deltour; Zhao

    2000-10-16

    The electrical transport properties of epitaxial superconducting Bi(2+y)Sr(2-x-y)La(x)CuO(6+delta) thin films have been studied in magnetic fields. Using a modified Coulomb-gas scaling law, we can fit all the magnetic field dependent low resistance data with a universal scaling curve, which allows us to determine a relation between the activation energy of the thermally activated flux flow resistance and the characteristic temperature scaling parameters.

  4. Factorial validity of an abbreviated neighborhood environment walkability scale for seniors in the Nurses' Health Study.

    PubMed

    Starnes, Heather A; McDonough, Meghan H; Tamura, Kosuke; James, Peter; Laden, Francine; Troped, Philip J

    2014-10-10

    Using validated measures of individuals' perceptions of their neighborhood built environment is important for accurately estimating effects on physical activity. However, no studies to date have examined the factorial validity of a measure of perceived neighborhood environment among older adults in the United States. The purpose of this measurement study was to test the factorial validity of a version of the Abbreviated Neighborhood Environment Walkability Scale (NEWS-A) modified for seniors in the Nurses' Health Study (NHS). A random sample of 2,920 female nurses (mean age = 73 ± 7 years) in the NHS cohort from California, Massachusetts, and Pennsylvania completed a 36-item modified NEWS-A for seniors. Confirmatory factor analyses were conducted to test measurement models for both the modified NEWS-A for seniors and the original NEWS-A. Internal consistency within factors was examined using Cronbach's alpha. The hypothesized 7-factor measurement model was a poor fit for the modified NEWS-A for seniors. Overall, the best-fitting measurement model was the original 6-factor solution to the NEWS-A. Factors were correlated and internally consistent. This study provided support for the construct validity of the original NEWS-A for assessing perceptions of neighborhood environments in older women in the United States.

  5. Quadratic Frequency Modulation Signals Parameter Estimation Based on Two-Dimensional Product Modified Parameterized Chirp Rate-Quadratic Chirp Rate Distribution.

    PubMed

    Qu, Zhiyu; Qu, Fuxin; Hou, Changbo; Jing, Fulong

    2018-05-19

    In an inverse synthetic aperture radar (ISAR) imaging system for targets with complex motion, the azimuth echo signals of the target are always modeled as multicomponent quadratic frequency modulation (QFM) signals. The chirp rate (CR) and quadratic chirp rate (QCR) estimation of QFM signals is very important to solve the ISAR image defocus problem. For multicomponent QFM (multi-QFM) signals, the conventional QR and QCR estimation algorithms suffer from the cross-term and poor anti-noise ability. This paper proposes a novel estimation algorithm called a two-dimensional product modified parameterized chirp rate-quadratic chirp rate distribution (2D-PMPCRD) for QFM signals parameter estimation. The 2D-PMPCRD employs a multi-scale parametric symmetric self-correlation function and modified nonuniform fast Fourier transform-Fast Fourier transform to transform the signals into the chirp rate-quadratic chirp rate (CR-QCR) domains. It can greatly suppress the cross-terms while strengthening the auto-terms by multiplying different CR-QCR domains with different scale factors. Compared with high order ambiguity function-integrated cubic phase function and modified Lv's distribution, the simulation results verify that the 2D-PMPCRD acquires higher anti-noise performance and obtains better cross-terms suppression performance for multi-QFM signals with reasonable computation cost.

  6. Comparison between suture anchor and transosseous suture for the modified-Broström procedure.

    PubMed

    Cho, Byung-Ki; Kim, Yong-Min; Kim, Dong-Soo; Choi, Eui-Sung; Shon, Hyun-Chul; Park, Kyoung-Jin

    2012-06-01

    This prospective, randomized study was conducted to compare clinical outcomes of the modified Broström procedure using suture anchor or transosseous suture technique for chronic ankle instability. Forty patients were followed for more than 2 years after modified Broström procedure. Twenty procedures using a suture anchor and 20 procedures using a transosseous suture were performed by one surgeon. The clinical evaluation consisted of the Karlsson scale and the Sefton grading system. Talar tilt and anterior talar translation were measured on anterior and varus stress radiographs. The Karlsson scale had improved significantly to 90.8 points in the suture anchor group, and to 89.2 points in the transosseous suture group. According to Sefton grading system, 18 patients (90%) in suture anchor group and 17 patients (85%) in transosseous suture group achieved satisfactory results. The talar tilt angle and anterior talar translation improved significantly to 5.9 degrees and 4.2 mm in suture anchor group, and to 5.4 degrees and 4.1 mm in transosseous suture group, respectively. No significant differences existed in clinical and functional outcomes between the two techniques for ligament reattachment. Both modified Broström procedures using the suture anchor and transosseous suture seem to be effective treatment methods for chronic lateral ankle instability.

  7. The effect of modified trampoline training on balance, gait, and falls efficacy of stroke patients

    PubMed Central

    Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

    2015-01-01

    [Purpose] This research was conducted to investigate the effects of modified trampoline training on the balance, gait, and falls efficacy of stroke patients. [Subjects] Twenty-four stroke patients participated in this study. The subjects were randomly allocated to one of two groups: the trampoline group (n=12) or the control group (n=12). [Methods] Both groups participated in conventional physical therapy for thirty minutes per day, three times a week for six weeks. The trampoline group also took part in trampoline training for thirty minutes per day, three times a week for six weeks. We evaluated balance (Berg balance scale, timed up and go test), gait (dynamic gait index), and falls efficacy (falls efficacy scale-K) to confirm the effects of the intervention. [Results] Both the trampoline and the control group showed significant improvements in balance, gait, and falls efficacy compared to before the intervention, and the improvements were significantly greater in the trampoline group than in the control group. [Conclusion] Modified trampoline training resulted in significantly improved balance, dynamic gait, and falls efficacy of stroke patients compared to the control group. These results suggest that modified trampoline training is feasible and effective at improving balance, dynamic gait, and falls efficacy after stroke. PMID:26696696

  8. The effect of modified trampoline training on balance, gait, and falls efficacy of stroke patients.

    PubMed

    Hahn, Joohee; Shin, Seonhae; Lee, Wanhee

    2015-11-01

    [Purpose] This research was conducted to investigate the effects of modified trampoline training on the balance, gait, and falls efficacy of stroke patients. [Subjects] Twenty-four stroke patients participated in this study. The subjects were randomly allocated to one of two groups: the trampoline group (n=12) or the control group (n=12). [Methods] Both groups participated in conventional physical therapy for thirty minutes per day, three times a week for six weeks. The trampoline group also took part in trampoline training for thirty minutes per day, three times a week for six weeks. We evaluated balance (Berg balance scale, timed up and go test), gait (dynamic gait index), and falls efficacy (falls efficacy scale-K) to confirm the effects of the intervention. [Results] Both the trampoline and the control group showed significant improvements in balance, gait, and falls efficacy compared to before the intervention, and the improvements were significantly greater in the trampoline group than in the control group. [Conclusion] Modified trampoline training resulted in significantly improved balance, dynamic gait, and falls efficacy of stroke patients compared to the control group. These results suggest that modified trampoline training is feasible and effective at improving balance, dynamic gait, and falls efficacy after stroke.

  9. Structural Integrity of Normal Appearing White Matter and Sex-Specific Outcomes After Acute Ischemic Stroke.

    PubMed

    Etherton, Mark R; Wu, Ona; Cougo, Pedro; Giese, Anne-Katrin; Cloonan, Lisa; Fitzpatrick, Kaitlin M; Kanakis, Allison S; Boulouis, Gregoire; Karadeli, Hasan H; Lauer, Arne; Rosand, Jonathan; Furie, Karen L; Rost, Natalia S

    2017-12-01

    Women have worse poststroke outcomes than men. We evaluated sex-specific clinical and neuroimaging characteristics of white matter in association with functional recovery after acute ischemic stroke. We performed a retrospective analysis of acute ischemic stroke patients with admission brain MRI and 3- to 6-month modified Rankin Scale score. White matter hyperintensity and acute infarct volume were quantified on fluid-attenuated inversion recovery and diffusion tensor imaging MRI, respectively. Diffusivity anisotropy metrics were calculated in normal appearing white matter contralateral to the acute ischemia. Among 319 patients with acute ischemic stroke, women were older (68.0 versus 62.7 years; P =0.004), had increased incidence of atrial fibrillation (21.4% versus 12.2%; P =0.04), and lower rate of tobacco use (21.1% versus 35.9%; P =0.03). There was no sex-specific difference in white matter hyperintensity volume, acute infarct volume, National Institutes of Health Stroke Scale, prestroke modified Rankin Scale score, or normal appearing white matter diffusivity anisotropy metrics. However, women were less likely to have an excellent outcome (modified Rankin Scale score <2: 49.6% versus 67.0%; P =0.005). In logistic regression analysis, female sex and the interaction of sex with fractional anisotropy, radial diffusivity, and axial diffusivity were independent predictors of functional outcome. Female sex is associated with decreased likelihood of excellent outcome after acute ischemic stroke. The correlation between markers of white matter integrity and functional outcomes in women, but not men, suggests a potential sex-specific mechanism. © 2017 American Heart Association, Inc.

  10. The Impact of Guided Student-Generated Questioning on Chemistry Achievement and Self-Efficacy of Elementary Preservice Teachers

    ERIC Educational Resources Information Center

    Moseley, Christine; Bonner, Emily; Ibey, Marilyn

    2016-01-01

    This study investigated the use of Guided Student-Generated Questioning (GSGQ) as a metacognitive instructional strategy to increase chemistry achievement and self-efficacy of elementary preservice teachers. The Chemistry Self-Efficacy Scale (CSES), modified from the Biology Self-Efficacy Scale (BSES),was used to determine elementary preservice…

  11. Refining the Assessment of Hopelessness: An Improved Way to Look to the Future

    ERIC Educational Resources Information Center

    Fisher, Lauren B.; Overholser, James C.

    2013-01-01

    Despite its high sensitivity, the Beck Hopelessness Scale (BHS) has demonstrated low specificity, has an ambiguous factor structure, and includes inadequate items. The current study examined the psychometric properties of a modified BHS (mBHS) using a Likert scale format that would allow for improved reliability, validity, and clinical utility.…

  12. Modified Attitudes to Psychiatry Scale Created Using Principal-Components Analysis

    ERIC Educational Resources Information Center

    Shankar, Rohit; Laugharne, Richard; Pritchard, Colin; Joshi, Pallavi; Dhar, Romika

    2011-01-01

    Objective: The Attitudes to Psychiatry Scale (APS) is a tool used to assess medical students' attitudes toward psychiatry. This study sought to examine the internal validity of the APS in order to identify dimensions within the questionnaire. Method: Using data collected from 549 medical students from India and Ghana, the authors analyzed 28…

  13. Quantifying the multi-scale response of avifauna to prescribed fire experiments in the southwest United States

    Treesearch

    Brett G. Dickson; Barry R. Noon; Curtis H. Flather; Stephanie Jentsch; William M. Block

    2009-01-01

    Landscape-scale disturbance events, including ecological restoration and fuel reduction activities, can modify habitat and affect relationships between species and their environment. To reduce the risk of uncharacteristic stand-replacing fires in the southwestern United States, land managers are implementing restoration and fuels treatments (e.g., mechanical thinning,...

  14. Meta-Analysis on Randomized Controlled Trials of Vaccines with QS-21 or ISCOMATRIX Adjuvant: Safety and Tolerability

    PubMed Central

    Bigaeva, Emilia; van Doorn, Eva; Liu, Heng; Hak, Eelko

    2016-01-01

    Background and Objectives QS-21 shows in vitro hemolytic effect and causes side effects in vivo. New saponin adjuvant formulations with better toxicity profiles are needed. This study aims to evaluate the safety and tolerability of QS-21 and the improved saponin adjuvants (ISCOM, ISCOMATRIX and Matrix-M™) from vaccine trials. Methods A systematic literature search was conducted from MEDLINE, EMBASE, Cochrane library and Clinicaltrials.gov. We selected for the meta-analysis randomized controlled trials (RCTs) of vaccines adjuvanted with QS-21, ISCOM, ISCOMATRIX or Matrix-M™, which included a placebo control group and reported safety outcomes. Pooled risk ratios (RRs) and their 95% confidence intervals (CIs) were calculated using a random-effects model. Jadad scale was used to assess the study quality. Results Nine RCTs were eligible for the meta-analysis: six trials on QS-21-adjuvanted vaccines and three trials on ISCOMATRIX-adjuvanted, with 907 patients in total. There were no studies on ISCOM or Matrix-M™ adjuvanted vaccines matching the inclusion criteria. Meta-analysis identified an increased risk for diarrhea in patients receiving QS21-adjuvanted vaccines (RR 2.55, 95% CI 1.04–6.24). No increase in the incidence of the reported systemic AEs was observed for ISCOMATRIX-adjuvanted vaccines. QS-21- and ISCOMATRIX-adjuvanted vaccines caused a significantly higher incidence of injection site pain (RR 4.11, 95% CI 1.10–15.35 and RR 2.55, 95% CI 1.41–4.59, respectively). ISCOMATRIX-adjuvanted vaccines also increased the incidence of injection site swelling (RR 3.43, 95% CI 1.08–10.97). Conclusions Our findings suggest that vaccines adjuvanted with either QS-21 or ISCOMATRIX posed no specific safety concern. Furthermore, our results indicate that the use of ISCOMATRIX enables a better systemic tolerability profile when compared to the use of QS-21. However, no better local tolerance was observed for ISCOMATRIX-adjuvanted vaccines in immunized non-healthy subjects. This meta-analysis is limited by the relatively small number of individuals recruited in the included trials, especially in the control groups. PMID:27149269

  15. Meta-Analysis on Randomized Controlled Trials of Vaccines with QS-21 or ISCOMATRIX Adjuvant: Safety and Tolerability.

    PubMed

    Bigaeva, Emilia; Doorn, Eva van; Liu, Heng; Hak, Eelko

    2016-01-01

    QS-21 shows in vitro hemolytic effect and causes side effects in vivo. New saponin adjuvant formulations with better toxicity profiles are needed. This study aims to evaluate the safety and tolerability of QS-21 and the improved saponin adjuvants (ISCOM, ISCOMATRIX and Matrix-M™) from vaccine trials. A systematic literature search was conducted from MEDLINE, EMBASE, Cochrane library and Clinicaltrials.gov. We selected for the meta-analysis randomized controlled trials (RCTs) of vaccines adjuvanted with QS-21, ISCOM, ISCOMATRIX or Matrix-M™, which included a placebo control group and reported safety outcomes. Pooled risk ratios (RRs) and their 95% confidence intervals (CIs) were calculated using a random-effects model. Jadad scale was used to assess the study quality. Nine RCTs were eligible for the meta-analysis: six trials on QS-21-adjuvanted vaccines and three trials on ISCOMATRIX-adjuvanted, with 907 patients in total. There were no studies on ISCOM or Matrix-M™ adjuvanted vaccines matching the inclusion criteria. Meta-analysis identified an increased risk for diarrhea in patients receiving QS21-adjuvanted vaccines (RR 2.55, 95% CI 1.04-6.24). No increase in the incidence of the reported systemic AEs was observed for ISCOMATRIX-adjuvanted vaccines. QS-21- and ISCOMATRIX-adjuvanted vaccines caused a significantly higher incidence of injection site pain (RR 4.11, 95% CI 1.10-15.35 and RR 2.55, 95% CI 1.41-4.59, respectively). ISCOMATRIX-adjuvanted vaccines also increased the incidence of injection site swelling (RR 3.43, 95% CI 1.08-10.97). Our findings suggest that vaccines adjuvanted with either QS-21 or ISCOMATRIX posed no specific safety concern. Furthermore, our results indicate that the use of ISCOMATRIX enables a better systemic tolerability profile when compared to the use of QS-21. However, no better local tolerance was observed for ISCOMATRIX-adjuvanted vaccines in immunized non-healthy subjects. This meta-analysis is limited by the relatively small number of individuals recruited in the included trials, especially in the control groups.

  16. The effects of massage therapy in hospitalized preterm neonates: A systematic review.

    PubMed

    Álvarez, María José; Fernández, Daniel; Gómez-Salgado, Juan; Rodríguez-González, Dolores; Rosón, María; Lapeña, Santiago

    2017-04-01

    The aim of this study was to perform a systematic review to identify, evaluate and summarise studies on the administration of therapeutic massage to preterm neonates during their stay in the NICU, and to assess their methodological quality. systematic review following PRISMA statements guidelines. A comprehensive search was performed including relevant articles between January 2004 and December 2013, using the following electronic databases: Medline, PEDro, Web of Science and Scopus. Two reviewers conducted a review of the selected articles: one evaluated the methodological quality of the studies and performed data extraction and the other performed a cross-check. Divergences of opinion were resolved by discussion with a third reviewer. The studies reviewed implemented a wide variety of interventions and evaluation methods, and therefore it was not possible to perform a meta-analysis. The following data were extracted from each article: year of publication, study design, participants and main measurements of outcomes obtained through the intervention. A non-quantitative synthesis of the extracted data was performed. Level of evidence was graded using the Jadad Scale. A total of 23 articles met the inclusion criteria and were thus included in the review; these presented a methodological quality ranging from 1 to 5 points (with a mean of 3 points). Most studies reported that the administration of various forms of therapeutic massage exerted a beneficial effect on factors related to the growth of preterm infants. The causes indicated by the researchers for these anthropometric benefits included increased vagal activity, increased gastric activity and increased serum insulin levels. Other demonstrated benefits of massage therapy when administered to hospitalised preterm infants included better neurodevelopment, a positive effect on brain development, a reduced risk of neonatal sepsis, a reduction in length of hospital stay and reduced neonatal stress. Although based on a qualitative analysis of heterogeneous data, the present review suggests that a clear benefit is obtained from the administration of massage therapy in hospitalised preterm infants, a finding which should encourage the more generalised use of massotherapy in NICU clinical practice. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. A scaling transformation for classifier output based on likelihood ratio: Applications to a CAD workstation for diagnosis of breast cancer

    PubMed Central

    Horsch, Karla; Pesce, Lorenzo L.; Giger, Maryellen L.; Metz, Charles E.; Jiang, Yulei

    2012-01-01

    Purpose: The authors developed scaling methods that monotonically transform the output of one classifier to the “scale” of another. Such transformations affect the distribution of classifier output while leaving the ROC curve unchanged. In particular, they investigated transformations between radiologists and computer classifiers, with the goal of addressing the problem of comparing and interpreting case-specific values of output from two classifiers. Methods: Using both simulated and radiologists’ rating data of breast imaging cases, the authors investigated a likelihood-ratio-scaling transformation, based on “matching” classifier likelihood ratios. For comparison, three other scaling transformations were investigated that were based on matching classifier true positive fraction, false positive fraction, or cumulative distribution function, respectively. The authors explored modifying the computer output to reflect the scale of the radiologist, as well as modifying the radiologist’s ratings to reflect the scale of the computer. They also evaluated how dataset size affects the transformations. Results: When ROC curves of two classifiers differed substantially, the four transformations were found to be quite different. The likelihood-ratio scaling transformation was found to vary widely from radiologist to radiologist. Similar results were found for the other transformations. Our simulations explored the effect of database sizes on the accuracy of the estimation of our scaling transformations. Conclusions: The likelihood-ratio-scaling transformation that the authors have developed and evaluated was shown to be capable of transforming computer and radiologist outputs to a common scale reliably, thereby allowing the comparison of the computer and radiologist outputs on the basis of a clinically relevant statistic. PMID:22559651

  18. Corrosion Behavior and Durability of Low-Alloy Steel Rebars in Marine Environment

    NASA Astrophysics Data System (ADS)

    Liu, Ming; Cheng, Xuequn; Li, Xiaogang; Yue, Pan; Li, Jun

    2016-11-01

    The corrosion resistance of Cr-modified low-alloy steels and HRB400 carbon steel was estimated using the open-circuit potential, potentiodynamic polarization, electrochemical impedance spectroscopic, and weight loss methods in simulated concrete pore solution. Results show that Cr-modified steels exhibit a higher corrosion resistance with a higher critical chloride level (CTL), lower corrosion current density, and higher impedance than carbon steel. The CTL of the steels significantly reduces with increasing temperature. Weight loss measurement shows that the Cr-modified steels exhibit low corrosion rates and small corrosion pitting. The primary constituents of the corrosion scales are Fe2O3, Fe3O4, β-FeOOH, γ-FeOOH, and α-FeOOH. A large amount of α-FeOOH could be detected in the Cr-modified steel corrosion products. Moreover, the Cr-modified steels demonstrate a higher durability than HRB400 carbon steel.

  19. Association between autonomic dysfunction and fatigue in Parkinson disease.

    PubMed

    Chou, Kelvin L; Gilman, Sid; Bohnen, Nicolaas I

    2017-06-15

    Fatigue is a disabling non-motor symptom in Parkinson disease (PD). We investigated the relationship between autonomic dysfunction and fatigue in PD while accounting for possible confounding factors. 29 subjects with PD (8F/21M; mean age 61.6±5.9; mean disease duration 4.8±3.0years), underwent clinical assessment and completed several non-motor symptom questionnaires, including a modified version of the Mayo Clinic Composite Autonomic Symptom Score (COMPASS) scale and the Fatigue Severity Scale (FSS). The mean modified COMPASS was 21.6±14.2 (range 1.7-44.2) and the mean FSS score was 3.3±1.6 (range 1.0-6.7). There was a significant bivariate relationship between the modified COMPASS and FSS scores (R=0.69, P<0.0001). Stepwise regression analysis was used to assess the specificity of the association between the modified COMPASS and FSS scores while accounting for possible confounder effects from other variables that were significantly associated with autonomic dysfunction. Results showed that the modified COMPASS (R 2 =0.52, F=28.4, P<0.0001) was highly associated with fatigue, followed by ESS (R 2 =0.13, F=8.4, P=0.008) but no other co-variates. Post-hoc analysis exploring the association between the different modified COMPASS autonomic sub-domain scores and FSS scores found significant regressor effects for the orthostatic intolerance (R 2 =0.45, F=21.2, P<0.0001) and secretomotor sub-domains (R 2 =0.09, F=4.8, P=0.04) but not for other autonomic sub-domains. Autonomic dysfunction, in particular orthostatic intolerance, is highly associated with fatigue in PD. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Feasibility, Validity, and Reliability of the Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale for Adults in Inpatients with Severe Obesity

    PubMed Central

    Manzoni, Gian Mauro; Rossi, Alessandro; Marazzi, Nicoletta; Agosti, Fiorenza; De Col, Alessandra; Pietrabissa, Giada; Castelnuovo, Gianluca; Molinari, Enrico; Sartorio, Allessandro

    2018-01-01

    Objective This study was aimed to examine the feasibility, validity, and reliability of the Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL™ MFS) for adult inpatients with severe obesity. Methods 200 inpatients (81% females) with severe obesity (BMI ≥ 35 kg/m2) completed the PedsQL MFS (General Fatigue, Sleep/Rest Fatigue and Cognitive Fatigue domains), the Fatigue Severity Scale, and the Center for Epidemiologic Studies Depression Scale immediately after admission to a 3-week residential body weight reduction program. A randomized subsample of 48 patients re-completed the PedsQL MFS after 3 days. Results Confirmatory factor analysis showed that a modified hierarchical model with two items moved from the Sleep/Rest Fatigue domain to the General Fatigue domain and a second-order latent factor best fitted the data. Internal consistency and test-retest reliabilities were acceptable to high in all scales, and small to high statistically significant correlations were found with all convergent measures, with the exception of BMI. Significant floor effects were found in two scales (Cognitive Fatigue and Sleep/Rest Fatigue). Conclusion The Italian modified PedsQL MFS for adults showed to be a valid and reliable tool for the assessment of fatigue in inpatients with severe obesity. Future studies should assess its discriminant validity as well as its responsiveness to weight reduction. PMID:29402854

  1. The Relationship Between Serum Neuron-Specific Enolase Levels and Severity of Bleeding and Functional Outcomes in Patients With Nontraumatic Subarachnoid Hemorrhage.

    PubMed

    Tawk, Rabih G; Grewal, Sanjeet S; Heckman, Michael G; Rawal, Bhupendra; Miller, David A; Edmonston, Drucilla; Ferguson, Jennifer L; Navarro, Ramon; Ng, Lauren; Brown, Benjamin L; Meschia, James F; Freeman, William D

    2016-04-01

    The value of neuron-specific enolase (NSE) in predicting clinical outcomes has been investigated in a variety of neurological disorders. To investigate the associations of serum NSE with severity of bleeding and functional outcomes in patients with subarachnoid hemorrhage (SAH). We retrospectively reviewed the records of patients with SAH from June 2008 to June 2012. The severity of SAH bleeding at admission was measured radiographically with the Fisher scale and clinically with the Glasgow Coma Scale, Hunt and Hess grade, and World Federation of Neurologic Surgeons scale. Outcomes were assessed with the modified Rankin Scale at discharge. We identified 309 patients with nontraumatic SAH, and 71 had NSE testing. Median age was 54 years (range, 23-87 years), and 44% were male. In multivariable analysis, increased NSE was associated with a poorer Hunt and Hess grade (P = .003), World Federation of Neurologic Surgeons scale score (P < .001), and Glasgow Coma Scale score (P = .003) and worse outcomes (modified Rankin Scale at discharge; P = .001). There was no significant association between NSE level and Fisher grade (P = .81) in multivariable analysis. We found a significant association between higher NSE levels and poorer clinical presentations and worse outcomes. Although it is still early for any relevant clinical conclusions, our results suggest that NSE holds promise as a tool for screening patients at increased risk of poor outcomes after SAH.

  2. 'Ego-dystonicity' in homosexuality: An Indian perspective.

    PubMed

    Maroky, Ami Sebastian; Ratheesh, Aswin; Viswanath, Biju; Math, Suresh Bada; Chandrashekar, Channapatna R; Seshadri, Shekhar P

    2015-06-01

    Homosexual persons are targets of verbal and physical abuse, discrimination and face legal disadvantages in many countries, including India. These external factors could play a role in determining discomfort with their sexuality. We ascertained the association between ego-dystonicity of sexual orientation and indices of perceived acceptance, stigma and awareness of possible normative lifestyles. Fifty-one self-identified adult homosexual men were assessed using online questionnaires that covered information including their socio-demographic details; a Visual Analog Scale (VAS) that measured their degree of discomfort with their sexuality; Reactions to Homosexuality Scale, Perceived Acceptance Scale, Modified China Men Who Have Sex with Men (MSM) Stigma scale; and trait version of the Positive and Negative Affect Scale. The participants were also asked to provide a written narrative of their experiences which influenced their comfort with their sexuality. Discomfort with sexuality significantly correlated with education, acceptance by friends and family, legal disadvantages, awareness and accessibility to non-heteronormative lifestyles and support systems and trait affect. Only acceptance by friends and awareness showed significance on linear regression. Qualitative analyses revealed external attributions for discomfort. Modifying external factors, reducing legal restrictions and improving societal acceptance and support systems could reduce 'ego-dystonicity'. 'Ego-dystonicity' as a determinant for psychiatric classification and intervention needs to be reexamined. © The Author(s) 2014.

  3. Application of fracture toughness scaling models to the ductile-to- brittle transition

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

    Link, R.E.; Joyce, J.A.

    1996-01-01

    An experimental investigation of fracture toughness in the ductile-brittle transition range was conducted. A large number of ASTM A533, Grade B steel, bend and tension specimens with varying crack lengths were tested throughout the transition region. Cleavage fracture toughness scaling models were utilized to correct the data for the loss of constraint in short crack specimens and tension geometries. The toughness scaling models were effective in reducing the scatter in the data, but tended to over-correct the results for the short crack bend specimens. A proposed ASTM Test Practice for Fracture Toughness in the Transition Range, which employs a mastermore » curve concept, was applied to the results. The proposed master curve over predicted the fracture toughness in the mid-transition and a modified master curve was developed that more accurately modeled the transition behavior of the material. Finally, the modified master curve and the fracture toughness scaling models were combined to predict the as-measured fracture toughness of the short crack bend and the tension specimens. It was shown that when the scaling models over correct the data for loss of constraint, they can also lead to non-conservative estimates of the increase in toughness for low constraint geometries.« less

  4. Advection by ocean currents modifies phytoplankton size structure.

    PubMed

    Font-Muñoz, Joan S; Jordi, Antoni; Tuval, Idan; Arrieta, Jorge; Anglès, Sílvia; Basterretxea, Gotzon

    2017-05-01

    Advection by ocean currents modifies phytoplankton size structure at small scales (1-10 cm) by aggregating cells in different regions of the flow depending on their size. This effect is caused by the inertia of the cells relative to the displaced fluid. It is considered that, at larger scales (greater than or equal to 1 km), biological processes regulate the heterogeneity in size structure. Here, we provide observational evidence of heterogeneity in phytoplankton size structure driven by ocean currents at relatively large scales (1-10 km). Our results reveal changes in the phytoplankton size distribution associated with the coastal circulation patterns. A numerical model that incorporates the inertial properties of phytoplankton confirms the role of advection on the distribution of phytoplankton according to their size except in areas with enhanced nutrient inputs where phytoplankton dynamics is ruled by other processes. The observed preferential concentration mechanism has important ecological consequences that range from the phytoplankton level to the whole ecosystem. © 2017 The Author(s).

  5. Therapeutic conversation to improve mood in nursing home residents with Alzheimer's disease.

    PubMed

    Tappen, Ruth M; Williams, Christine L

    2009-10-01

    Few studies have tested strategies to address the mental health needs of individuals with Alzheimer's disease (AD). To test a newly developed, empirically based modified counseling approach, 30 nursing home residents with AD were randomly assigned to a modified counseling (Therapeutic Conversation) treatment group or usual care control group. Mini-Mental State Examination mean scores were 10.60 (SD = 6.99) for the treatment group and 12.26 (SD = 7.43) for the control group. Individual treatment was provided three times per week for 16 weeks. On the posttest, treatment group participants evidenced significantly less negative mood than the control group on the Montgomery-Asberg Depression Rating Scale and the Sadness and Apathy subscales of the Alzheimer's Disease and Related Disorders Mood Scale. The differences approached significance on the Dementia Mood Assessment Scale. Results suggest that a therapeutic counseling approach can be effective in treating the dysphoria commonly found in individuals with AD. Copyright 2009, SLACK Incorporated.

  6. Fate of Large-Scale Structure in Modified Gravity After GW170817 and GRB170817A

    NASA Astrophysics Data System (ADS)

    Amendola, Luca; Kunz, Martin; Saltas, Ippocratis D.; Sawicki, Ignacy

    2018-03-01

    The coincident detection of gravitational waves (GW) and a gamma-ray burst from a merger of neutron stars has placed an extremely stringent bound on the speed of GWs. We showed previously that the presence of gravitational slip (η ) in cosmology is intimately tied to modifications of GW propagation. This new constraint implies that the only remaining viable source of gravitational slip is a conformal coupling to gravity in scalar-tensor theories, while viable vector-tensor theories cannot now generate gravitational slip at all. We discuss structure formation in the remaining viable models, demonstrating that (i) the dark-matter growth rate must now be at least as fast as in general relativity (GR), with the possible exception of that beyond the Horndeski model, and (ii) if there is any scale dependence at all in the slip parameter, it is such that it takes the GR value at large scales. We show a consistency relation that must be violated if gravity is modified.

  7. A modified belief entropy in Dempster-Shafer framework.

    PubMed

    Zhou, Deyun; Tang, Yongchuan; Jiang, Wen

    2017-01-01

    How to quantify the uncertain information in the framework of Dempster-Shafer evidence theory is still an open issue. Quite a few uncertainty measures have been proposed in Dempster-Shafer framework, however, the existing studies mainly focus on the mass function itself, the available information represented by the scale of the frame of discernment (FOD) in the body of evidence is ignored. Without taking full advantage of the information in the body of evidence, the existing methods are somehow not that efficient. In this paper, a modified belief entropy is proposed by considering the scale of FOD and the relative scale of a focal element with respect to FOD. Inspired by Deng entropy, the new belief entropy is consistent with Shannon entropy in the sense of probability consistency. What's more, with less information loss, the new measure can overcome the shortage of some other uncertainty measures. A few numerical examples and a case study are presented to show the efficiency and superiority of the proposed method.

  8. A modified belief entropy in Dempster-Shafer framework

    PubMed Central

    Zhou, Deyun; Jiang, Wen

    2017-01-01

    How to quantify the uncertain information in the framework of Dempster-Shafer evidence theory is still an open issue. Quite a few uncertainty measures have been proposed in Dempster-Shafer framework, however, the existing studies mainly focus on the mass function itself, the available information represented by the scale of the frame of discernment (FOD) in the body of evidence is ignored. Without taking full advantage of the information in the body of evidence, the existing methods are somehow not that efficient. In this paper, a modified belief entropy is proposed by considering the scale of FOD and the relative scale of a focal element with respect to FOD. Inspired by Deng entropy, the new belief entropy is consistent with Shannon entropy in the sense of probability consistency. What’s more, with less information loss, the new measure can overcome the shortage of some other uncertainty measures. A few numerical examples and a case study are presented to show the efficiency and superiority of the proposed method. PMID:28481914

  9. Investigating the Influence of Climate Changes on Rodent Communities at a Regional-Scale (MIS 1-3, Southwestern France)

    PubMed Central

    Royer, Aurélien; Montuire, Sophie; Legendre, Serge; Discamps, Emmanuel; Jeannet, Marcel; Lécuyer, Christophe

    2016-01-01

    Terrestrial ecosystems have continuously evolved throughout the Late Pleistocene and the Holocene, deeply affected by both progressive environmental and climatic modifications, as well as by abrupt and large climatic changes such as the Heinrich or Dansgaard-Oeschger events. Yet, the impacts of these different events on terrestrial mammalian communities are poorly known, as is the role played by potential refugia on geographical species distributions. This study examines community changes in rodents of southwestern France between 50 and 10 ky BP by integrating 94 dated faunal assemblages coming from 37 archaeological sites. This work reveals that faunal distributions were modified in response to abrupt and brief climatic events, such as Heinrich events, without actually modifying the rodent community on a regional scale. However, the succession of events which operated between the Late Pleistocene and the Holocene gradually led to establishing a new rodent community at the regional scale, with intermediate communities occurring between the Bølling and the Allerød. PMID:26789523

  10. Novel mechanisms for self-assembled pattern formation in nanoscopic metal films

    NASA Astrophysics Data System (ADS)

    Kalyanaraman, R.; Trice, J.; Favazza, C.; Thomas, D.; Sureshkumar, R.

    2007-03-01

    Classical hydrodynamic theory of dewetting of spinodally unstable thin films (Vrij, Disc. farad. Soc. 1966) predicts a monotonic increase in patterning length scales with increasing film thickness. We verified this effect for nanoscopic Co metal films following melting by ns laser pulses for thickness regime h<=hc˜8,m (Favazza et al. Nanotechnology, 2006). However, a dramatic change is observed beyond this thickness hc, with length scales decreasing with increasing h. This novel behavior arises from strong thickness dependence of heating by ultrafast laser light resulting in thermocapillary effects, whose magnitude and sign are thickness dependent. We modified the classical theory, according to which the instability occurs when the stabilizing capillary force is overcome by destabilizing attractive long-range interactions, to include thermocapillary effects. The modified theory accurately predicts the experimentally observed trend. This result suggests that a variety of new length scales can be accessed by robust self-assembly via dewetting of metal films under ultrafast light.

  11. Neurotrauma pediatric scales

    PubMed Central

    Alexandru, Vlad Ciurea; Aurelia, Mihaela Sandu; Mihai, Popescu; Stefan, Mircea Iencean; Bogdan, Davidescu

    2008-01-01

    Cranial traumas have different particularities in infants, toddlers, preschool child, school child and teenagers. The assessment of these cases must be individualized according to age. It is completely different in children that in adults. Trauma scales, very useful in grading the severity and predicting outcome in traumatic brain injury, used in adults must be adapted in children. Children have age-related specificity and anatomic particularities, for each of this period of development. Neurotrauma scales, specific for infants and children, such as Pediatric Coma Scale, Children’s Coma Score, Trauma Infant Neurological Score, Glasgow Coma Scale, Liege Scale are reviewed, as well as neurotrauma outcome scales, like Glasgow Outcome Scale, modified Rankin score, KOSCHI score and Barthel Index. The authors present these scales in an exhaustive manner for thoroughgoing pediatric neurotrauma standards. PMID:20108520

  12. Organically modified low-grade kaolin as a secondary containment material for underground storage tanks.

    PubMed

    Moon, Chul-Hwan; Lee, Jai-Young; Oh, Byung-Taek; Choi, Sang-Il

    2007-08-01

    Batch scale reactions were conducted to evaluate the efficacy of modified low-grade kaolin for the treatment of petroleum contaminants. Low-grade kaolin, which has been unvalued as material in the mining process because of its low quality for commercial products, was modified with HDTMA (hexadecyl-trimethylammonium), and its efficiency was compared with that of HDTMA-modified bentonite, which is used as a secondary containment barrier for underground storage tanks. The sorption capacity and hydraulic conductivity of both the HDTMA-modified bentonite and low-grade kaolin were investigated and showed distribution coefficients in the sorption of benzene, toluene, ethylbenzene and xylene ranging between 45.7 and 583.7 and 57.0 and 525.1, respectively. The hydraulic conductivities were 2.53 x 10(-8) and 5.62 x 10(-8) cm/s for the HDTMA-modified bentonite and low-grade kaolin, respectively. These results suggest that HDTMA-modified low-grade kaolin could be used as a hydraulic barrier against advection migration of petroleum contaminants. Simulation of the one-dimensional transport of benzene through a liner made of either one of the compounds was also performed. These results also showed that HDTMA-modified kaolin more effectively retards the transport of benzene.

  13. Large-scale functional RNAi screen in C. elegans identifies genes that regulate the dysfunction of mutant polyglutamine neurons

    PubMed Central

    2012-01-01

    Background A central goal in Huntington's disease (HD) research is to identify and prioritize candidate targets for neuroprotective intervention, which requires genome-scale information on the modifiers of early-stage neuron injury in HD. Results Here, we performed a large-scale RNA interference screen in C. elegans strains that express N-terminal huntingtin (htt) in touch receptor neurons. These neurons control the response to light touch. Their function is strongly impaired by expanded polyglutamines (128Q) as shown by the nearly complete loss of touch response in adult animals, providing an in vivo model in which to manipulate the early phases of expanded-polyQ neurotoxicity. In total, 6034 genes were examined, revealing 662 gene inactivations that either reduce or aggravate defective touch response in 128Q animals. Several genes were previously implicated in HD or neurodegenerative disease, suggesting that this screen has effectively identified candidate targets for HD. Network-based analysis emphasized a subset of high-confidence modifier genes in pathways of interest in HD including metabolic, neurodevelopmental and pro-survival pathways. Finally, 49 modifiers of 128Q-neuron dysfunction that are dysregulated in the striatum of either R/2 or CHL2 HD mice, or both, were identified. Conclusions Collectively, these results highlight the relevance to HD pathogenesis, providing novel information on the potential therapeutic targets for neuroprotection in HD. PMID:22413862

  14. Large-scale functional RNAi screen in C. elegans identifies genes that regulate the dysfunction of mutant polyglutamine neurons.

    PubMed

    Lejeune, François-Xavier; Mesrob, Lilia; Parmentier, Frédéric; Bicep, Cedric; Vazquez-Manrique, Rafael P; Parker, J Alex; Vert, Jean-Philippe; Tourette, Cendrine; Neri, Christian

    2012-03-13

    A central goal in Huntington's disease (HD) research is to identify and prioritize candidate targets for neuroprotective intervention, which requires genome-scale information on the modifiers of early-stage neuron injury in HD. Here, we performed a large-scale RNA interference screen in C. elegans strains that express N-terminal huntingtin (htt) in touch receptor neurons. These neurons control the response to light touch. Their function is strongly impaired by expanded polyglutamines (128Q) as shown by the nearly complete loss of touch response in adult animals, providing an in vivo model in which to manipulate the early phases of expanded-polyQ neurotoxicity. In total, 6034 genes were examined, revealing 662 gene inactivations that either reduce or aggravate defective touch response in 128Q animals. Several genes were previously implicated in HD or neurodegenerative disease, suggesting that this screen has effectively identified candidate targets for HD. Network-based analysis emphasized a subset of high-confidence modifier genes in pathways of interest in HD including metabolic, neurodevelopmental and pro-survival pathways. Finally, 49 modifiers of 128Q-neuron dysfunction that are dysregulated in the striatum of either R/2 or CHL2 HD mice, or both, were identified. Collectively, these results highlight the relevance to HD pathogenesis, providing novel information on the potential therapeutic targets for neuroprotection in HD. © 2012 Lejeune et al; licensee BioMed Central Ltd.

  15. Plasma 8-iso-Prostaglandin F2α, a possible prognostic marker in aneurysmal subarachnoid hemorrhage.

    PubMed

    Pan, De-Sheng; Yan, Min; Hassan, Muhammad; Fang, Ze-Bin; Chen, Man-Tao

    2017-06-01

    8-iso-Prostaglandin F2α (8-iso-PGF2α) is a potential biomarker of oxidative stress. This study clarified whether plasma 8-iso-PGF2α concentrations were affected and its underlying relevance to prognosis in aneurysmal subarachnoid hemorrhage (aSAH). In this prospective, observational study, a total of 170 controls and 170 aSAH patients were enrolled. Plasma 8-iso-PGF2α concentrations were detected using an ELISA. Severity was assessed by World Federation of Neurological Surgeons (WFNS) scale and modified Fisher grading scale. Clinical outcomes included 6-month mortality and poor outcome referred to as Glasgow outcome scale score of 1-3. As compared to controls, admission plasma 8-iso-PGF2α concentrations were significantly enhanced. Increased concentrations of plasma 8-iso-PGF2α correlated with WFNS scores and modified Fisher scores. 8-iso-PGF2α in plasma was an independent predictor for clinical outcomes. Under ROC curve, the predictive values of 8-iso-PGF2α concentrations resembled those of WFNS scores and modified Fisher scores for clinical outcomes. An elevation in plasma 8-iso-PGF2α concentrations is associated with the severity and poor outcome after aSAH, substantializing 8-iso-PGF2α as a potential prognostic biomarker of aSAH. Copyright © 2017. Published by Elsevier B.V.

  16. An illness-specific version of the Revised Illness Perception Questionnaire in patients with atrial fibrillation (AF IPQ-R): Unpacking beliefs about treatment control, personal control and symptom triggers.

    PubMed

    Taylor, Elaina C; O'Neill, Mark; Hughes, Lyndsay D; Moss-Morris, Rona

    2018-04-01

    This study modified the Revised Illness Perception Questionnaire (IPQ-R) in patients with persistent atrial fibrillation (AF). Qualitative interviews and think-aloud techniques informed modification of the IPQ-R to be specific to AF patients. Confirmatory Factor Analysis (CFA) (n = 198) examined the validity of the modified IPQ-R (AF-IPQ-R). Exploratory factor analysis (EFA) examined the new AF-triggers scale. Construct validity examined associations between the AF-IPQ-R, quality of life (QoL) and beliefs about medicines. Test-retest and internal reliability were examined. Interviews indicated that patients viewed triggers of AF rather than initial causes of illness as more applicable. Patients believed specific behaviours such as rest could control AF. Treatment control beliefs related to pharmacological and procedural treatments. These data were used to modify the IPQ-R subscales and to develop a triggers of AF scale. CFA indicated good model fit. EFA of the triggers scale indicated three factors: emotional; health behaviours; and over-exertion triggers. Expected correlations were found between the AF-IPQ-R, QoL and treatment beliefs, evidencing good construct validity. The AF-IPQ-R showed sound psychometric properties. It provides more detailed specification than the IPQ-R of beliefs that may help to understand poor QoL in AF patients, and guidance for future interventions in this area.

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

    Capela, Fabio; Ramazanov, Sabir, E-mail: fc403@cam.ac.uk, E-mail: Sabir.Ramazanov@ulb.ac.be

    At large scales and for sufficiently early times, dark matter is described as a pressureless perfect fluid—dust— non-interacting with Standard Model fields. These features are captured by a simple model with two scalars: a Lagrange multiplier and another playing the role of the velocity potential. That model arises naturally in some gravitational frameworks, e.g., the mimetic dark matter scenario. We consider an extension of the model by means of higher derivative terms, such that the dust solutions are preserved at the background level, but there is a non-zero sound speed at the linear level. We associate this Modified Dust withmore » dark matter, and study the linear evolution of cosmological perturbations in that picture. The most prominent effect is the suppression of their power spectrum for sufficiently large cosmological momenta. This can be relevant in view of the problems that cold dark matter faces at sub-galactic scales, e.g., the missing satellites problem. At even shorter scales, however, perturbations of Modified Dust are enhanced compared to the predictions of more common particle dark matter scenarios. This is a peculiarity of their evolution in radiation dominated background. We also briefly discuss clustering of Modified Dust. We write the system of equations in the Newtonian limit, and sketch the possible mechanism which could prevent the appearance of caustic singularities. The same mechanism may be relevant in light of the core-cusp problem.« less

  18. The Relationship Between Balance Measured With a Modified Bathroom Scale and Falls and Disability in Older Adults: A 6-Month Follow-Up Study

    PubMed Central

    2015-01-01

    Background There are indications that older adults who suffer from poor balance have an increased risk for adverse health outcomes, such as falls and disability. Monitoring the development of balance over time enables early detection of balance decline, which can identify older adults who could benefit from interventions aimed at prevention of these adverse outcomes. An innovative and easy-to-use device that can be used by older adults for home-based monitoring of balance is a modified bathroom scale. Objective The objective of this paper is to study the relationship between balance scores obtained with a modified bathroom scale and falls and disability in a sample of older adults. Methods For this 6-month follow-up study, participants were recruited via physiotherapists working in a nursing home, geriatricians, exercise classes, and at an event about health for older adults. Inclusion criteria were being aged 65 years or older, being able to stand on a bathroom scale independently, and able to provide informed consent. A total of 41 nursing home patients and 139 community-dwelling older adults stepped onto the modified bathroom scale three consecutive times at baseline to measure their balance. Their mean balance scores on a scale from 0 to 16 were calculated—higher scores indicated better balance. Questionnaires were used to study falls and disability at baseline and after 6 months of follow-up. The cross-sectional relationship between balance and falls and disability at baseline was studied using t tests and Spearman rank correlations. Univariate and multivariate logistic regression analyses were conducted to study the relationship between balance measured at baseline and falls and disability development after 6 months of follow-up. Results A total of 128 participants with complete datasets—25.8% (33/128) male—and a mean age of 75.33 years (SD 6.26) were included in the analyses of this study. Balance scores of participants who reported at baseline that they had fallen at least once in the past 6 months were lower compared to nonfallers—8.9 and 11.2, respectively (P<.001). The correlation between mean balance score and disability sum-score at baseline was -.51 (P<.001). No significant associations were found between balance at baseline and falls after 6 months of follow-up. Baseline balance scores were significantly associated with the development of disability after 6 months of follow-up in the univariate analysis—odds ratio (OR) 0.86 (95% CI 0.76-0.98)—but not in the multivariate analysis when correcting for age, gender, baseline disability, and falls at follow-up—OR 0.94 (95% CI 0.79-1.11). Conclusions There is a cross-sectional relationship between balance measured by a modified bathroom scale and falls and disability in older adults. Despite this cross-sectional relationship, longitudinal data showed that balance scores have no predictive value for falls and might only have limited predictive value for disability development after 6 months of follow-up. PMID:26018423

  19. Improvement of the Scintillation-Irregularity Model in WBMOD

    DTIC Science & Technology

    1983-02-28

    satellite over e small s.ction of its orbit . 2-4 IMPLEMENTATION AT AFGWC One of the tasks carried out was to modify the most recent version of WaMOD...influence scintillation strength OSRTN Sets up integral to calculate phase variance, for finite outer scale ROMINT Modified Romberg quadrature integration... orbit calculation, and implc-Nentation of Ln irregularity drift routine based on a recently published model of ionospheric convection st high latitudes

  20. The Effects of a Modified Direct Instruction Procedure on Time Telling for a Third Grade Student with Learning Disabilities with a Brief Comparison of Interesting and Boring Formats

    ERIC Educational Resources Information Center

    Wieber, Adrianne Essex; Evoy, Katie; McLaughlin, T. F.; Derby, K. Mark; Kellogg, Ethyl; Williams, Randy Lee; Peterson, Stephanie Marie; Rinaldi, Lisa

    2017-01-01

    We designed and implemented a modified eight-week Direct Instruction (DI) program intended to teach a third grade student with learning disabilities to tell time. The first objective was to determine whether or not the appearance (interesting or boring) of the worksheet affected performance. These data suggested the use of large-scale clocks and…

  1. Increasing the Thermal Conductivity and Thermal Diffusivity of Asbestos-Reinforced Laminates Through Modification of their Polymer Matrix with Carbon Nanomaterials

    NASA Astrophysics Data System (ADS)

    Danilova-Tret'yak, S. M.; Evseeva, L. E.; Tanaeva, S. A.

    2014-11-01

    Experimental investigations of the thermophysical properties of traditional and modified asbestos-reinforced laminates depending on the type of their carbon nanofiller have been carried out in the range of temperatures from -150 to 150°C. It has been shown that the largest (nearly twofold) increase in the thermal-conductivity and thermal-diffusivity coefficients of the indicated materials is observed when they are modified with a small-scale fraction of a nanofiller (carbon nanotubes). The specific heats of the modified and traditional asbestos-reinforced laminates turned out to be identical, in practice, within the measurement error.

  2. Development of a thermal storage module using modified anhydrous sodium hydroxide

    NASA Technical Reports Server (NTRS)

    Rice, R. E.; Rowny, P. E.

    1980-01-01

    The laboratory scale testing of a modified anhydrous NaOH latent heat storage concept for small solar thermal power systems such as total energy systems utilizing organic Rankine systems is discussed. A diagnostic test on the thermal energy storage module and an investigation of alternative heat transfer fluids and heat exchange concepts are specifically addressed. A previously developed computer simulation model is modified to predict the performance of the module in a solar total energy system environment. In addition, the computer model is expanded to investigate parametrically the incorporation of a second heat exchange inside the module which will vaporize and superheat the Rankine cycle power fluid.

  3. N-Glycopeptide Profiling in Arabidopsis Inflorescence

    DOE PAGES

    Xu, Shou-Ling; Medzihradszky, Katalin F.; Wang, Zhi-Yong; ...

    2016-04-11

    This study presents the first large scale analysis of plant intact glycopeptides. Using wheat germ agglutinin lectin weak affinity chromatography to enrich modified peptides, followed by ETD fragmentation tandem mass spectrometry, glycan compositions on over 1100 glycopeptides from 270 proteins found in Arabidopsis inflorescence tissue were characterized. While some sites were only detected with a single glycan attached, others displayed up to 16 different glycoforms. Among the identified glycopeptides were four modified in non-consensus glycosylation motifs. Finally, while most of the modified proteins are secreted, membrane, ER or Golgi localized proteins, surprisingly N-linked sugars were detected on a protein predictedmore » to be cytosolic or nuclear.« less

  4. Graphene-based room-temperature implementation of a modified Deutsch-Jozsa quantum algorithm.

    PubMed

    Dragoman, Daniela; Dragoman, Mircea

    2015-12-04

    We present an implementation of a one-qubit and two-qubit modified Deutsch-Jozsa quantum algorithm based on graphene ballistic devices working at room temperature. The modified Deutsch-Jozsa algorithm decides whether a function, equivalent to the effect of an energy potential distribution on the wave function of ballistic charge carriers, is constant or not, without measuring the output wave function. The function need not be Boolean. Simulations confirm that the algorithm works properly, opening the way toward quantum computing at room temperature based on the same clean-room technologies as those used for fabrication of very-large-scale integrated circuits.

  5. Decision tree rating scales for workload estimation: Theme and variations

    NASA Technical Reports Server (NTRS)

    Wierwille, W. W.; Skipper, J. H.; Rieger, C. A.

    1984-01-01

    The Modified Cooper-Harper (MCH) scale which is a sensitive indicator of workload in several different types of aircrew tasks was examined. The study determined if variations of the scale might provide greater sensitivity and the reasons for the sensitivity of the scale. The MCH scale and five newly devised scales were examined in two different aircraft simulator experiments in which pilot loading was treated as an independent variable. It is indicated that while one of the new scales may be more sensitive in a given experiment, task dependency is a problem. The MCH scale exhibits consistent senstivity and remains the scale recommended for general use. The MCH scale results are consistent with earlier experiments. The rating scale experiments are reported and the questionnaire results which were directed to obtain a better understanding of the reasons for the relative sensitivity of the MCH scale and its variations are described.

  6. Decision Tree Rating Scales for Workload Estimation: Theme and Variations

    NASA Technical Reports Server (NTRS)

    Wietwille, W. W.; Skipper, J. H.; Rieger, C. A.

    1984-01-01

    The modified Cooper-Harper (MCH) scale has been shown to be a sensitive indicator of workload in several different types of aircrew tasks. The MCH scale was examined to determine if certain variations of the scale might provide even greater sensitivity and to determine the reasons for the sensitivity of the scale. The MCH scale and five newly devised scales were studied in two different aircraft simulator experiments in which pilot loading was treated as an independent variable. Results indicate that while one of the new scales may be more sensitive in a given experiment, task dependency is a problem. The MCH scale exhibits consistent sensitivity and remains the scale recommended for general use. The results of the rating scale experiments are presented and the questionnaire results which were directed at obtaining a better understanding of the reasons for the relative sensitivity of the MCH scale and its variations are described.

  7. Initial Evidence for the Reliability and Validity of the Student Risk Screening Scale for Internalizing and Externalizing Behaviors at the Elementary Level

    ERIC Educational Resources Information Center

    Lane, Kathleen Lynne; Oakes, Wendy P.; Harris, Pamela J.; Menzies, Holly Mariah; Cox, Meredith; Lambert, Warren

    2012-01-01

    We report findings of an exploratory validation study of a revised instrument: the Student Risk Screening Scale-Internalizing and Externalizing (SRSS-IE). The SRSS-IE was modified to include seven additional items reflecting characteristics of internalizing behaviors, with proposed items generated from the current literature base, review of…

  8. Global Self-Esteem and Self-Efficacy Correlates: Relation of Academic Achievement and Self-Esteem among Emirati Students

    ERIC Educational Resources Information Center

    Afari, Ernest; Ward, Graeme; Khine, Myint Swe

    2012-01-01

    We investigated the relationships between global self-esteem, academic self-efficacy and academic performance among a sample of 255 college students in the United Arab Emirates. The widely used Rosenberg's Self-Esteem Scale (RSES; Rosenberg, 1965) and an academic self-efficacy scale, modified from (Jinks and Morgan, 1999) were used to assess…

  9. Seeing the forest for the homogeneous trees: stand-scale resource distributions emerge from tree-scale structure

    Treesearch

    Suzanne Boyden; Rebecca Montgomery; Peter B. Reich; Brian J. Palik

    2012-01-01

    Forest ecosystem processes depend on local interactions that are modified by the spatial pattern of trees and resources. Effects of resource supplies on processes such as regeneration are increasingly well understood, yet we have few tools to compare resource heterogeneity among forests that differ in structural complexity. We used a neighborhood approach to examine...

  10. The American Association on Mental Deficiency-Adaptive Behavior Scale: Allowing Credit for Alternative Means of Communication.

    ERIC Educational Resources Information Center

    Suess, James F.; And Others

    1983-01-01

    Compared were the Adaptive Behavior Scale (ABS) and a modified version of the ABS (which allowed alternative methods of communication such as sign language) with 134 deaf-blind persons, three to 30 years old. Among results were that alternative communication methods had no effect on nine of 10 ABS domains. (Author/MC)

  11. Increased Specificity of Wechsler Adult Intelligence Scale-Third Edition Matrix Reasoning Test Instructions and Time Limits

    ERIC Educational Resources Information Center

    Callens, Andy M.; Atchison, Timothy B.; Engler, Rachel R.

    2009-01-01

    Instructions for the Matrix Reasoning Test (MRT) of the Wechsler Adult Intelligence Scale-Third Edition were modified by explicitly stating that the subtest was untimed or that a per-item time limit would be imposed. The MRT was administered within one of four conditions: with (a) standard administration instructions, (b) explicit instructions…

  12. Measuring Evaluation Fears in Adolescence: Psychometric Validation of the Portuguese Versions of the Fear of Positive Evaluation Scale and the Specific Fear of Negative Evaluation Scale

    ERIC Educational Resources Information Center

    Vagos, Paula; Salvador, Maria do Céu; Rijo, Daniel; Santos, Isabel M.; Weeks, Justin W.; Heimberg, Richard G.

    2016-01-01

    Modified measures of Fear of Negative Evaluation and Fear of Positive Evaluation were examined among Portuguese adolescents. These measures demonstrated replicable factor structure, internal consistency, and positive relationships with social anxiety and avoidance. Gender differences were found. Implications for evaluation and intervention are…

  13. Initialization of high resolution surface wind simulations using NWS gridded data

    Treesearch

    J. Forthofer; K. Shannon; Bret Butler

    2010-01-01

    WindNinja is a standalone computer model designed to provide the user with simulations of surface wind flow. It is deterministic and steady state. It is currently being modified to allow the user to initialize the flow calculation using National Digital Forecast Database. It essentially allows the user to downscale the coarse scale simulations from meso-scale models to...

  14. The Assessment of Anxiety Symptoms in Preschool-Aged Children: The Revised Preschool Anxiety Scale

    ERIC Educational Resources Information Center

    Edwards, Susan L.; Rapee, Ronald M.; Kennedy, Susan J.; Spence, Susan H.

    2010-01-01

    The purpose of this study was to test the validity and factorial structure of a modified version of the Preschool Anxiety Scale (Spence, Rapee, McDonald, & Ingram, 2001). The measure was completed by 764 mothers and 418 fathers of children aged 3 to 5 years. After removing, two items tapping obsessive compulsive symptoms, confirmatory factor…

  15. International Childhood Cancer Cohort Consortium

    Cancer.gov

    An alliance of several large-scale prospective cohort studies of children to pool data and biospecimens from individual cohorts to study various modifiable and genetic factors in relation to cancer risk

  16. Influence of viscosity modifying admixtures on the rheological behavior of cement and mortar pastes

    NASA Astrophysics Data System (ADS)

    Bouras, R.; Kaci, A.; Chaouche, M.

    2012-03-01

    The influence of Viscosity-modifying admixtures (VMA) dosage rate on the steady state rheological properties, including the yield stress, fluid consistency index and flow behaviour index, of cementitious materials is considered experimentally. The investigation is undertaken both at cement paste and mortar scales. It is found that the rheological behaviour of the material is in general dependent upon shear-rate interval considered. At sufficiently low shear-rates the materials exhibit shear-thinning. This behaviour is attributed to flow-induced defloculation of the solid particles and VMA polymer disentanglement and alignment. At relatively high shear-rates the pastes becomes shear-thickening, due to repulsive interactions among the solid particles. There is a qualitative difference between the influence of VMA dosage at cement and mortar scales: at cement scale we obtain a monotonic increase of the yield stress, while at mortar scale there exists an optimum VMA dosage for which the yield stress is a minimum. The flow behaviour index exhibit a maximum in the case of cement pastes and monotonically decreases in the case of mortars. On the other hand, the fluid consistency index presents a minimum for both cement pastes and mortars.

  17. Confirmatory factor analysis for two questionnaires of caregiving in eating disorders

    PubMed Central

    Hibbs, Rebecca; Rhind, Charlotte; Sallis, Hannah; Goddard, Elizabeth; Raenker, Simone; Ayton, Agnes; Bamford, Bryony; Arcelus, Jon; Boughton, Nicky; Connan, Frances; Goss, Ken; Lazlo, Bert; Morgan, John; Moore, Kim; Robertson, David; Schreiber-Kounine, Christa; Sharma, Sonu; Whitehead, Linette; Lacey, Hubert; Schmidt, Ulrike; Treasure, Janet

    2014-01-01

    Objective: Caring for someone diagnosed with an eating disorder (ED) is associated with a high level of burden and psychological distress which can inadvertently contribute to the maintenance of the illness. The Eating Disorders Symptom Impact Scale (EDSIS) and Accommodation and Enabling Scale for Eating Disorders (AESED) are self-report scales to assess elements of caregiving theorised to contribute to the maintenance of an ED. Further validation and confirmation of the factor structures for these scales are necessary for rigorous evaluation of complex interventions which target these modifiable elements of caregiving. Method: EDSIS and AESED data from 268 carers of people with anorexia nervosa (AN), recruited from consecutive admissions to 15 UK inpatient or day patient hospital units, were subjected to confirmatory factor analysis to test model fit by applying the existing factor structures: (a) four-factor structure for the EDSIS and (b) five-factor structure for the AESED. Results: Confirmatory factor analytic results support the existing four-factor and five-factor structures for the EDSIS and the AESED, respectively. Discussion: The present findings provide further validation of the EDSIS and the AESED as tools to assess modifiable elements of caregiving for someone with an ED. PMID:25750785

  18. Parameterizing the Morse Potential for Coarse-Grained Modeling of Blood Plasma

    PubMed Central

    Zhang, Na; Zhang, Peng; Kang, Wei; Bluestein, Danny; Deng, Yuefan

    2014-01-01

    Multiscale simulations of fluids such as blood represent a major computational challenge of coupling the disparate spatiotemporal scales between molecular and macroscopic transport phenomena characterizing such complex fluids. In this paper, a coarse-grained (CG) particle model is developed for simulating blood flow by modifying the Morse potential, traditionally used in Molecular Dynamics for modeling vibrating structures. The modified Morse potential is parameterized with effective mass scales for reproducing blood viscous flow properties, including density, pressure, viscosity, compressibility and characteristic flow dynamics of human blood plasma fluid. The parameterization follows a standard inverse-problem approach in which the optimal micro parameters are systematically searched, by gradually decoupling loosely correlated parameter spaces, to match the macro physical quantities of viscous blood flow. The predictions of this particle based multiscale model compare favorably to classic viscous flow solutions such as Counter-Poiseuille and Couette flows. It demonstrates that such coarse grained particle model can be applied to replicate the dynamics of viscous blood flow, with the advantage of bridging the gap between macroscopic flow scales and the cellular scales characterizing blood flow that continuum based models fail to handle adequately. PMID:24910470

  19. Development of the Portuguese version of the modified Japanese Orthopaedic Association Score: cross-cultural adaptation, reliability, validity and responsiveness.

    PubMed

    Augusto, Mateus Tomaz; Diniz, Juliete Melo; Rolemberg Dantas, Fernando Luiz; Fernandes de Oliveira, Matheus; Rotta, José Marcus; Botelho, Ricardo Vieira

    2018-06-01

    Spondylotic cervical myelopathy (SCM) is a common cause of spinal-related disability in the elderly. The assessment of this disability is a challenging task and depends on the subjective evaluation of the investigator. As a widespread used scale, the modified scale of the Japanese Association of Orthopedics (mJOA) should be translated and culturally adapted in the Brazilian Portuguese language (mJOA-Br) to provide its clinical and research use. This study aims to do translation, transcultural adaptation and validation of the mJOA, into Brazilian Portuguese language. Following the transcultural adaptation model described by Guillemin et al., the scale as translated into Brazilian Portuguese and back-translated to English. Afterwards, questionnaires were applied in consecutive patients with SCM and compared to a control group (without SCM). The final scale was compared to the Brazilian version of Neck Disability Index for validation. Sixty patients were submitted to the translated version of mJOA. There was strong correlation between mJOA-Br scores and NDI scores to evaluate SCM symptoms (R=-0.75). mJOA-Br was considered a valid and reliable tool to evaluate SCM patients. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Genetically modified crops and small-scale farmers: main opportunities and challenges.

    PubMed

    Azadi, Hossein; Samiee, Atry; Mahmoudi, Hossein; Jouzi, Zeynab; Khachak, Parisa Rafiaani; De Maeyer, Philippe; Witlox, Frank

    2016-01-01

    Although some important features of genetically modified (GM) crops such as insect resistance, herbicide tolerance, and drought tolerance might seem to be beneficial for small-scale farmers, the adoption of GM technology by smallholders is still slight. Identifying pros and cons of using this technology is important to understand the impacts of GM crops on these farmers. This article reviews the main opportunities and challenges of GM crops for small-scale farmers in developing countries. The most significant advantages of GM crops include being independent to farm size, environment protection, improvement of occupational health issues, and the potential of bio-fortified crops to reduce malnutrition. Challenges faced by small-scale farmers for adoption of GM crops comprise availability and accessibility of GM crop seeds, seed dissemination and price, and the lack of adequate information. In addition, R&D and production costs in using GM crops make it difficult for these farmers to adopt the use of these crops. Moreover, intellectual property right regulations may deprive resource poor farmers from the advantages of GM technology. Finally, concerns on socio-economic and environment safety issues are also addressed in this paper.

  1. Transverse forces versus modified ashworth scale for upper limb flexion/extension in para-sagittal plane.

    PubMed

    Seth, Nitin; Johnson, Denise; Abdullah, Hussein A

    2017-07-01

    Spasticity is a common impairment following an upper motor neuron lesion in conditions such as stroke and brain injury. A clinical issue is how to best quantify and measure spasticity. Recently, research has been performed to develop new methods of spasticity quantification using various systems. This paper follows up on previous work taking a closer look at the role of transversal forces obtained via rehabilitation robot for motions in the para-sagittal plane. Results from 45 healthy individuals and 40 individuals with acquired brain injury demonstrate that although the passive upper motions are vertical, horizontal forces into and away from the individual's body demonstrate a relationship with the Modified Ashworth Scale. This finding leads the way to new avenues of spasticity quantification and monitoring.

  2. An investigation of stress wave propagation in a shear deformable nanobeam based on modified couple stress theory

    NASA Astrophysics Data System (ADS)

    Akbarzadeh Khorshidi, Majid; Shariati, Mahmoud

    2016-04-01

    This paper presents a new investigation for propagation of stress wave in a nanobeam based on modified couple stress theory. Using Euler-Bernoulli beam theory, Timoshenko beam theory, and Reddy beam theory, the effect of shear deformation is investigated. This nonclassical model contains a material length scale parameter to capture the size effect and the Poisson effect is incorporated in the current model. Governing equations of motion are obtained by Hamilton's principle and solved explicitly. This solution leads to obtain two phase velocities for shear deformable beams in different directions. Effects of shear deformation, material length scale parameter, and Poisson's ratio on the behavior of these phase velocities are investigated and discussed. The results also show a dual behavior for phase velocities against Poisson's ratio.

  3. Nonlinear effective theory of dark energy

    NASA Astrophysics Data System (ADS)

    Cusin, Giulia; Lewandowski, Matthew; Vernizzi, Filippo

    2018-04-01

    We develop an approach to parametrize cosmological perturbations beyond linear order for general dark energy and modified gravity models characterized by a single scalar degree of freedom. We derive the full nonlinear action, focusing on Horndeski theories. In the quasi-static, non-relativistic limit, there are a total of six independent relevant operators, three of which start at nonlinear order. The new nonlinear couplings modify, beyond linear order, the generalized Poisson equation relating the Newtonian potential to the matter density contrast. We derive this equation up to cubic order in perturbations and, in a companion article [1], we apply it to compute the one-loop matter power spectrum. Within this approach, we also discuss the Vainshtein regime around spherical sources and the relation between the Vainshtein scale and the nonlinear scale for structure formation.

  4. Existence of k⁻¹ power-law scaling in the equilibrium regions of wall-bounded turbulence explained by Heisenberg's eddy viscosity.

    PubMed

    Katul, Gabriel G; Porporato, Amilcare; Nikora, Vladimir

    2012-12-01

    The existence of a "-1" power-law scaling at low wavenumbers in the longitudinal velocity spectrum of wall-bounded turbulence was explained by multiple mechanisms; however, experimental support has not been uniform across laboratory studies. This letter shows that Heisenberg's eddy viscosity approach can provide a theoretical framework that bridges these multiple mechanisms and explains the elusiveness of the "-1" power law in some experiments. Novel theoretical outcomes are conjectured about the role of intermittency and very-large scale motions in modifying the k⁻¹ scaling.

  5. A systematic review of selected evidence on developing nursing students' critical thinking through problem-based learning.

    PubMed

    Yuan, Haobin; Williams, Beverly A; Fan, Lin

    2008-08-01

    Rapidly changing developments and expanding roles in healthcare environment requires professional nurses to develop critical thinking. Nursing education strives to facilitate students' critical thinking through the appropriate instructional approaches. Problem-based learning (PBL) is a student-centered approach to learning which enables the students to work cooperatively in small groups for seeking solutions to situations/problems. The systematic review was conducted to provide the available evidence on developing nursing students' critical thinking through PBL. The computerized searches from 1990-2006 in CINAHL, Proquest, Cochrane library, Pubmed etc were performed. All studies which addressed the differences in critical thinking among nursing students in PBL were considered. Two independent reviewers assessed the eligibility of each study, its level of evidence and the methodological quality. As a result, only ten studies were retrieved, they were: one RCT with a Jadad quality score of 3, one nonrandomized control study, two quasi-experimental studies with non-controlled pretest-posttest design, and six descriptive studies. The available evidence in this review did not provide supportive evidence on developing nursing students' critical thinking through PBL. Clearly, there is a need for additional research with larger sample size and high quality to clarify the effects of PBL on critical thinking development within nursing educational context.

  6. Iron and attention deficit/hyperactivity disorder: What is the empirical evidence so far? A systematic review of the literature.

    PubMed

    Cortese, Samuele; Angriman, Marco; Lecendreux, Michel; Konofal, Eric

    2012-10-01

    The authors systematically reviewed evidence on iron status, as well as studies of iron supplementation, in individuals with attention deficit/hyperactivity disorder (ADHD). PubMed, Ovid, EMBASE and Web of Knowledge were searched on 4 July 2012. Quantitative appraisal of trials was performed using Jadad's score. Most (n = 20) of the retrieved studies assessed an index of peripheral iron status (i.e., serum ferritin), with overall mixed results - that is, both significant and nonsignificant association between ADHD symptoms and serum ferritin levels. One MRI study reported significantly lower indices of thalamic iron in ADHD versus comparison subjects. Two trials, an open-label and a pilot randomized placebo-controlled study with high Jaded score (4), showed improvement in some but not all measures of ADHD symptoms. Three studies showed that children with ADHD plus sleep disorders, in particular restless legs syndrome, are at risk of iron deficiency. Finally, two studies suggested that iron deficiency might decrease the effectiveness of psychostimulant treatment. The authors discussed how the field could move from initial research mainly focused on serum ferritin towards a more comprehensive and translational investigation of iron in ADHD, with the potential to inform clinical practice in terms of screening and treating iron deficiency in individuals with ADHD.

  7. Systematic review; Nutritional therapy in gestational diabetes mellitus.

    PubMed

    Thomaz de Lima, Helaine; Lopes Rosado, Eliane; Ribeiro Neves, Paulo Augusto; Corrêa Monteiro Machado, Raphaela; Mello de Oliveira, Larissa; Saunders, Cláudia

    2013-11-01

    Several methods of dietetic counseling can be used in the nutritional therapy in gestational diabetes mellitus (GDM). The main methods are the traditional method (TM) and the carbohydrate counting (CCM). Presenting a systematic review of the literature on the impact of nutritional therapy in GDM, through TM and CCM, evaluating the results for maternal and child health. We searched databases PubMed, Scopus, Web of Science, Lilacs and CAPES Digital Bank of Thesis. The methodological quality of all the studies included was made using the Jadad score. We have found five studies that evaluated the effects of nutritional therapy, through the TM, on the maternal and child health. None study evaluating the CCM was detected in pregnant women with GDM Nutritional therapy given during antenatal care was effective in reducing pregnancy complications (preeclampsia, excessive gestational weight gain, necessity for cesarean delivery, for insulin therapy and for shoulder dystocia), perinatal complications (macrosomia, neonatal hypoglycemia, and birth weight) and also in better glycemic control. The use of nutritional therapy should be highlighted within the antenatal care for pregnant women with GDM, giving the satisfactory results on metabolic control and on pregnancy outcomes. Studies examining the CCM to GDM patients should be conducted to show its effects on maternal and child health.

  8. Assessing a hydrodynamic description for instabilities in highly dissipative, freely cooling granular gases.

    PubMed

    Mitrano, Peter P; Garzó, Vicente; Hilger, Andrew M; Ewasko, Christopher J; Hrenya, Christine M

    2012-04-01

    An intriguing phenomenon displayed by granular flows and predicted by kinetic-theory-based models is the instability known as particle "clustering," which refers to the tendency of dissipative grains to form transient, loose regions of relatively high concentration. In this work, we assess a modified-Sonine approximation recently proposed [Garzó, Santos, and Montanero, Physica A 376, 94 (2007)] for a granular gas via an examination of system stability. In particular, we determine the critical length scale associated with the onset of two types of instabilities--vortices and clusters--via stability analyses of the Navier-Stokes-order hydrodynamic equations by using the expressions of the transport coefficients obtained from both the standard and the modified-Sonine approximations. We examine the impact of both Sonine approximations over a range of solids fraction φ<0.2 for small restitution coefficients e = 0.25-0.4, where the standard and modified theories exhibit discrepancies. The theoretical predictions for the critical length scales are compared to molecular dynamics (MD) simulations, of which a small percentage were not considered due to inelastic collapse. Results show excellent quantitative agreement between MD and the modified-Sonine theory, while the standard theory loses accuracy for this highly dissipative parameter space. The modified theory also remedies a high-dissipation qualitative mismatch between the standard theory and MD for the instability that forms more readily. Furthermore, the evolution of cluster size is briefly examined via MD, indicating that domain-size clusters may remain stable or halve in size, depending on system parameters.

  9. Constructing the Japanese version of the Maslach Burnout Inventory-Student Survey: Confirmatory factor analysis.

    PubMed

    Tsubakita, Takashi; Shimazaki, Kazuyo

    2016-01-01

    To examine the factorial validity of the Maslach Burnout Inventory-Student Survey, using a sample of 2061 Japanese university students majoring in the medical and natural sciences (67.9% male, 31.8% female; Mage  = 19.6 years, standard deviation = 1.5). The back-translated scale used unreversed items to assess inefficacy. The inventory's descriptive properties and Cronbach's alphas were calculated using SPSS software. The present authors compared fit indices of the null, one factor, and default three factor models via confirmatory factor analysis with maximum-likelihood estimation using AMOS software, version 21.0. Intercorrelations between exhaustion, cynicism, and inefficacy were relatively higher than in prior studies. Cronbach's alphas were 0.76, 0.85, and 0.78, respectively. Although fit indices of the hypothesized three factor model did not meet the respective criteria, the model demonstrated better fit than did the null and one factor models. The present authors added four paths between error variables within items, but the modified model did not show satisfactory fit. Subsequent analysis revealed that a bi-factor model fit the data better than did the hypothesized or modified three factor models. The Japanese version of the Maslach Burnout Inventory-Student Survey needs minor changes to improve the fit of its three factor model, but the scale as a whole can be used to adequately assess overall academic burnout in Japanese university students. Although the scale was back-translated, two items measuring exhaustion whose expressions overlapped should be modified, and all items measuring inefficacy should be reversed in order to statistically clarify the factorial difference between the scale's three factors. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.

  10. Autonomic Dysfunction Predicts Clinical Outcomes After Acute Ischemic Stroke: A Prospective Observational Study.

    PubMed

    Xiong, Li; Tian, Ge; Leung, Howan; Soo, Yannie O Y; Chen, Xiangyan; Ip, Vincent H L; Mok, Vincent C T; Chu, Winnie C W; Wong, Ka Sing; Leung, Thomas W H

    2018-01-01

    Central autonomic dysfunction increases stroke morbidity and mortality. We aimed to investigate whether poststroke autonomic dysfunction graded by Ewing battery can predict clinical outcome. In this prospective observational study, we assessed autonomic function of ischemic stroke patients within 7 days from symptom onset by Ewing battery. On the basis of the magnitude of autonomic dysfunction, we stratified patients into significant (definite, severe, or atypical) or minor (normal or early) autonomic function impairment groups and correlated the impairment with the 3-month modified Rankin Scale score (good outcome: modified Rankin Scale score 0≈2; poor outcome: modified Rankin Scale score 3≈6). Among the 150 patients enrolled (mean age, 66.4±9.9 years; 70.7% males), minor autonomic dysfunction was identified in 36 patients (24.0%), and significant autonomic dysfunction was identified in 114 patients (76.0%) based on Ewing battery. In 3 months, a poor functional outcome was found in 32.5% of significant group patients compared with 13.9% in the minor group ( P =0.031). Crude odds ratios of the magnitude of autonomic dysfunction and 3-month unfavorable functional outcome after acute ischemic stroke were 2.979 (95% confidence interval, 1.071-8.284; P =0.036). After adjusting for confounding variables with statistical significance between the 2 functional outcome subgroups identified in univariate analysis (including sex and National Institutes of Health Stroke Scale score on admission), the magnitude of autonomic dysfunction still independently predicted an unfavorable outcome, with an odds ratio of 3.263 (95% confidence interval, 1.141-9.335; P =0.027). Autonomic dysfunction gauged by Ewing battery predicts poor functional outcome after acute ischemic stroke. © 2017 American Heart Association, Inc.

  11. Scale invariance of the η-deformed AdS5 × S5 superstring, T-duality and modified type II equations

    NASA Astrophysics Data System (ADS)

    Arutyunov, G.; Frolov, S.; Hoare, B.; Roiban, R.; Tseytlin, A. A.

    2016-02-01

    We consider the ABF background underlying the η-deformed AdS5 ×S5 sigma model. This background fails to satisfy the standard IIB supergravity equations which indicates that the corresponding sigma model is not Weyl invariant, i.e. does not define a critical string theory in the usual sense. We argue that the ABF background should still define a UV finite theory on a flat 2d world-sheet implying that the η-deformed model is scale invariant. This property follows from the formal relation via T-duality between the η-deformed model and the one defined by an exact type IIB supergravity solution that has 6 isometries albeit broken by a linear dilaton. We find that the ABF background satisfies candidate type IIB scale invariance conditions which for the R-R field strengths are of the second order in derivatives. Surprisingly, we also find that the ABF background obeys an interesting modification of the standard IIB supergravity equations that are first order in derivatives of R-R fields. These modified equations explicitly depend on Killing vectors of the ABF background and, although not universal, they imply the universal scale invariance conditions. Moreover, we show that it is precisely the non-isometric dilaton of the T-dual solution that leads, after T-duality, to modification of type II equations from their standard form. We conjecture that the modified equations should follow from κ-symmetry of the η-deformed model. All our observations apply also to η-deformations of AdS3 ×S3 ×T4and AdS2 ×S2 ×T6models.

  12. Polychaete richness and abundance enhanced in anthropogenically modified estuaries despite high concentrations of toxic contaminants.

    PubMed

    Dafforn, Katherine A; Kelaher, Brendan P; Simpson, Stuart L; Coleman, Melinda A; Hutchings, Pat A; Clark, Graeme F; Knott, Nathan A; Doblin, Martina A; Johnston, Emma L

    2013-01-01

    Ecological communities are increasingly exposed to multiple chemical and physical stressors, but distinguishing anthropogenic impacts from other environmental drivers remains challenging. Rarely are multiple stressors investigated in replicated studies over large spatial scales (>1000 kms) or supported with manipulations that are necessary to interpret ecological patterns. We measured the composition of sediment infaunal communities in relation to anthropogenic and natural stressors at multiple sites within seven estuaries. We observed increases in the richness and abundance of polychaete worms in heavily modified estuaries with severe metal contamination, but no changes in the diversity or abundance of other taxa. Estuaries in which toxic contaminants were elevated also showed evidence of organic enrichment. We hypothesised that the observed response of polychaetes was not a 'positive' response to toxic contamination or a reduction in biotic competition, but due to high levels of nutrients in heavily modified estuaries driving productivity in the water column and enriching the sediment over large spatial scales. We deployed defaunated field-collected sediments from the surveyed estuaries in a small scale experiment, but observed no effects of sediment characteristics (toxic or enriching). Furthermore, invertebrate recruitment instead reflected the low diversity and abundance observed during field surveys of this relatively 'pristine' estuary. This suggests that differences observed in the survey are not a direct consequence of sediment characteristics (even severe metal contamination) but are related to parameters that covary with estuary modification such as enhanced productivity from nutrient inputs and the diversity of the local species pool. This has implications for the interpretation of diversity measures in large-scale monitoring studies in which the observed patterns may be strongly influenced by many factors that covary with anthropogenic modification.

  13. Polychaete Richness and Abundance Enhanced in Anthropogenically Modified Estuaries Despite High Concentrations of Toxic Contaminants

    PubMed Central

    Dafforn, Katherine A.; Kelaher, Brendan P.; Simpson, Stuart L.; Coleman, Melinda A.; Hutchings, Pat A.; Clark, Graeme F.; Knott, Nathan A.; Doblin, Martina A.; Johnston, Emma L.

    2013-01-01

    Ecological communities are increasingly exposed to multiple chemical and physical stressors, but distinguishing anthropogenic impacts from other environmental drivers remains challenging. Rarely are multiple stressors investigated in replicated studies over large spatial scales (>1000 kms) or supported with manipulations that are necessary to interpret ecological patterns. We measured the composition of sediment infaunal communities in relation to anthropogenic and natural stressors at multiple sites within seven estuaries. We observed increases in the richness and abundance of polychaete worms in heavily modified estuaries with severe metal contamination, but no changes in the diversity or abundance of other taxa. Estuaries in which toxic contaminants were elevated also showed evidence of organic enrichment. We hypothesised that the observed response of polychaetes was not a ‘positive’ response to toxic contamination or a reduction in biotic competition, but due to high levels of nutrients in heavily modified estuaries driving productivity in the water column and enriching the sediment over large spatial scales. We deployed defaunated field-collected sediments from the surveyed estuaries in a small scale experiment, but observed no effects of sediment characteristics (toxic or enriching). Furthermore, invertebrate recruitment instead reflected the low diversity and abundance observed during field surveys of this relatively ‘pristine’ estuary. This suggests that differences observed in the survey are not a direct consequence of sediment characteristics (even severe metal contamination) but are related to parameters that covary with estuary modification such as enhanced productivity from nutrient inputs and the diversity of the local species pool. This has implications for the interpretation of diversity measures in large-scale monitoring studies in which the observed patterns may be strongly influenced by many factors that covary with anthropogenic modification. PMID:24098816

  14. Evaluating the potential for site-specific modification of LiDAR DEM derivatives to improve environmental planning-scale wetland identification using Random Forest classification

    NASA Astrophysics Data System (ADS)

    O'Neil, Gina L.; Goodall, Jonathan L.; Watson, Layne T.

    2018-04-01

    Wetlands are important ecosystems that provide many ecological benefits, and their quality and presence are protected by federal regulations. These regulations require wetland delineations, which can be costly and time-consuming to perform. Computer models can assist in this process, but lack the accuracy necessary for environmental planning-scale wetland identification. In this study, the potential for improvement of wetland identification models through modification of digital elevation model (DEM) derivatives, derived from high-resolution and increasingly available light detection and ranging (LiDAR) data, at a scale necessary for small-scale wetland delineations is evaluated. A novel approach of flow convergence modelling is presented where Topographic Wetness Index (TWI), curvature, and Cartographic Depth-to-Water index (DTW), are modified to better distinguish wetland from upland areas, combined with ancillary soil data, and used in a Random Forest classification. This approach is applied to four study sites in Virginia, implemented as an ArcGIS model. The model resulted in significant improvement in average wetland accuracy compared to the commonly used National Wetland Inventory (84.9% vs. 32.1%), at the expense of a moderately lower average non-wetland accuracy (85.6% vs. 98.0%) and average overall accuracy (85.6% vs. 92.0%). From this, we concluded that modifying TWI, curvature, and DTW provides more robust wetland and non-wetland signatures to the models by improving accuracy rates compared to classifications using the original indices. The resulting ArcGIS model is a general tool able to modify these local LiDAR DEM derivatives based on site characteristics to identify wetlands at a high resolution.

  15. Clinical Outcomes of Transplanted Modified Bone Marrow-Derived Mesenchymal Stem Cells in Stroke: A Phase 1/2a Study.

    PubMed

    Steinberg, Gary K; Kondziolka, Douglas; Wechsler, Lawrence R; Lunsford, L Dade; Coburn, Maria L; Billigen, Julia B; Kim, Anthony S; Johnson, Jeremiah N; Bates, Damien; King, Bill; Case, Casey; McGrogan, Michael; Yankee, Ernest W; Schwartz, Neil E

    2016-07-01

    Preclinical data suggest that cell-based therapies have the potential to improve stroke outcomes. Eighteen patients with stable, chronic stroke were enrolled in a 2-year, open-label, single-arm study to evaluate the safety and clinical outcomes of surgical transplantation of modified bone marrow-derived mesenchymal stem cells (SB623). All patients in the safety population (N=18) experienced at least 1 treatment-emergent adverse event. Six patients experienced 6 serious treatment-emergent adverse events; 2 were probably or definitely related to surgical procedure; none were related to cell treatment. All serious treatment-emergent adverse events resolved without sequelae. There were no dose-limiting toxicities or deaths. Sixteen patients completed 12 months of follow-up at the time of this analysis. Significant improvement from baseline (mean) was reported for: (1) European Stroke Scale: mean increase 6.88 (95% confidence interval, 3.5-10.3; P<0.001), (2) National Institutes of Health Stroke Scale: mean decrease 2.00 (95% confidence interval, -2.7 to -1.3; P<0.001), (3) Fugl-Meyer total score: mean increase 19.20 (95% confidence interval, 11.4-27.0; P<0.001), and (4) Fugl-Meyer motor function total score: mean increase 11.40 (95% confidence interval, 4.6-18.2; P<0.001). No changes were observed in modified Rankin Scale. The area of magnetic resonance T2 fluid-attenuated inversion recovery signal change in the ipsilateral cortex 1 week after implantation significantly correlated with clinical improvement at 12 months (P<0.001 for European Stroke Scale). In this interim report, SB623 cells were safe and associated with improvement in clinical outcome end points at 12 months. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01287936. © 2016 American Heart Association, Inc.

  16. Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial.

    PubMed

    Rasmussen, Rune Skovgaard; Østergaard, Ann; Kjær, Pia; Skerris, Anja; Skou, Christina; Christoffersen, Jane; Seest, Line Skou; Poulsen, Mai Bang; Rønholt, Finn; Overgaard, Karsten

    2016-03-01

    To evaluate if home-based rehabilitation of inpatients improved outcome compared to standard care. Interventional, randomised, safety/efficacy open-label trial. University hospital stroke unit in collaboration with three municipalities. Seventy-one eligible stroke patients (41 women) with focal neurological deficits hospitalised in a stroke unit for more than three days and in need of rehabilitation. Thirty-eight patients were randomised to home-based rehabilitation during hospitalization and for up to four weeks after discharge to replace part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome measures were the modified Barthel-100 Index, Motor Assessment Scale, CT-50 Cognitive Test, EuroQol-5D, Body Mass Index and treatment-associated economy. Thirty-one intervention and 30 control patients completed the study. Patients in the intervention group achieved better modified Rankin Scale score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training in minutes highly correlated with mRS, Barthel, Motor Assessment Scale and EuroQol-5D™ scores (P-values ranging from P<0.00001 to P=0.01). Economical estimations of intervention costs were lower than total costs of standard treatment. Early home-based rehabilitation reduced disability and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective. © The Author(s) 2015.

  17. Scale invariance of the η-deformed AdS 5 × S 5 superstring, T-duality and modified type II equations

    DOE PAGES

    Arutyunov, G.; Frolov, S.; Hoare, B.; ...

    2015-12-23

    We consider the ABF background underlying the η-deformed AdS 5 × S 5 sigma model. This background fails to satisfy the standard IIB supergravity equations which indicates that the corresponding sigma model is not Weyl invariant, i.e. does not define a critical string theory in the usual sense. We argue that the ABF background should still define a UV finite theory on a flat 2d world-sheet implying that the η-deformed model is scale invariant. This property follows from the formal relation via T-duality between the η-deformed model and the one defined by an exact type IIB supergravity solution that hasmore » 6 isometries albeit broken by a linear dilaton. We find that the ABF background satisfies candidate type IIB scale invariance conditions which for the R–R field strengths are of the second order in derivatives. Surprisingly, we also find that the ABF background obeys an interesting modification of the standard IIB supergravity equations that are first order in derivatives of R–R fields. These modified equations explicitly depend on Killing vectors of the ABF background and, although not universal, they imply the universal scale invariance conditions. Moreover, we show that it is precisely the non-isometric dilaton of the T-dual solution that leads, after T-duality, to modification of type II equations from their standard form. We conjecture that the modified equations should follow from κ-symmetry of the η-deformed model. All our observations apply also to η-deformations of AdS 3 × S 3 × T 4 and AdS 2 × S 2 × T 6 models.« less

  18. Impact of a city centre on the dispersal of a regional pollen cloud. Cas of Montréal, Canada.

    NASA Astrophysics Data System (ADS)

    Goyette-Pernot, J.

    2003-04-01

    Highly allergenic ragweed pollen is released into the air in large quantities at the end of every summer in and around Montreal. More than 19% of the city's population experiences hay fever (DSP-Montreal Center, 2000). The aim of this study is to obtain a deeper insight into the manner in which a North American urban area may influence the dispersal of a regional pollen clouds, how it modifies the dispersal and thereby its concentration. Downtown areas provide particular surface characteristics that result in strong disturbances to regional meteorological conditions. Strong pollen concentrations are modified by the passage of fronts and may increase the occurrence of regional-scale pollen peaks. They offer the best conditions for the local dilution of pollen and even the best dynamic conditions for external pollen that reaches Montreal from southern regions. On the contrary, anticyclonic situations seem to offer the best conditions for local production but inhibit dilution on a larger scale. Observations have been made in order to investigate the vertical as well as the regional versus the local and street-level differences in pollen abundance. The aim is to develop an original statistical downscaling technique, inferring pollen concentrations from the largest to the smallest scales. At the regional scale, the emphasis is placed on the typical meteorological conditions or weather types influencing the regional pollen cloud. At the street level, the discussion focuses on whether these prior regional conditions continue to influence the micro-scale pollen diffusion or whether they are themselves modified by the characteristics of the surface. If this were to be the case, then it would be essential to address the issue of how it affects the pollen concentrations at the pedestrian level, with all this may imply in term of public health.

  19. Endovascular Therapy Is Effective and Safe for Patients With Severe Ischemic Stroke: Pooled Analysis of Interventional Management of Stroke III and Multicenter Randomized Clinical Trial of Endovascular Therapy for Acute Ischemic Stroke in the Netherlands Data.

    PubMed

    Broderick, Joseph P; Berkhemer, Olvert A; Palesch, Yuko Y; Dippel, Diederik W J; Foster, Lydia D; Roos, Yvo B W E M; van der Lugt, Aad; Tomsick, Thomas A; Majoie, Charles B L M; van Zwam, Wim H; Demchuk, Andrew M; van Oostenbrugge, Robert J; Khatri, Pooja; Lingsma, Hester F; Hill, Michael D; Roozenbeek, Bob; Jauch, Edward C; Jovin, Tudor G; Yan, Bernard; von Kummer, Rüdiger; Molina, Carlos A; Goyal, Mayank; Schonewille, Wouter J; Mazighi, Mikael; Engelter, Stefan T; Anderson, Craig S; Spilker, Judith; Carrozzella, Janice; Ryckborst, Karla J; Janis, L Scott; Simpson, Kit N

    2015-12-01

    We assessed the effect of endovascular treatment in acute ischemic stroke patients with severe neurological deficit (National Institutes of Health Stroke Scale score, ≥20) after a prespecified analysis plan. The pooled analysis of the Interventional Management of Stroke III (IMS III) and Multicenter Randomized Clinical Trial of Endovascular Therapy for Acute Ischemic Stroke in the Netherlands (MR CLEAN) trials included participants with an National Institutes of Health Stroke Scale score of ≥20 before intravenous tissue-type plasminogen activator (tPA) treatment (IMS III) or randomization (MR CLEAN) who were treated with intravenous tPA ≤3 hours of stroke onset. Our hypothesis was that participants with severe stroke randomized to endovascular therapy after intravenous tPA would have improved 90-day outcome (distribution of modified Rankin Scale scores), when compared with those who received intravenous tPA alone. Among 342 participants in the pooled analysis (194 from IMS III and 148 from MR CLEAN), an ordinal logistic regression model showed that the endovascular group had superior 90-day outcome compared with the intravenous tPA group (adjusted odds ratio, 1.78; 95% confidence interval, 1.20-2.66). In the logistic regression model of the dichotomous outcome (modified Rankin Scale score, 0-2, or functional independence), the endovascular group had superior outcomes (adjusted odds ratio, 1.97; 95% confidence interval, 1.09-3.56). Functional independence (modified Rankin Scale score, ≤2) at 90 days was 25% in the endovascular group when compared with 14% in the intravenous tPA group. Endovascular therapy after intravenous tPA within 3 hours of symptom onset improves functional outcome at 90 days after severe ischemic stroke. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00359424 (IMS III) and ISRCTN10888758 (MR CLEAN). © 2015 American Heart Association, Inc.

  20. Fabrication of aligned magnetic nanoparticles using tobamoviruses.

    PubMed

    Kobayashi, Mime; Seki, Munetoshi; Tabata, Hitoshi; Watanabe, Yuichiro; Yamashita, Ichiro

    2010-03-10

    We used genetically modified tube-shaped tobamoviruses to produce 3 nm aligned magnetic nanoparticles. Amino acid residues facing the central channel of the virus were modified to increase the number of nucleation sites. Energy dispersive X-ray spectroscopy and superconducting quantum interference device analysis suggest that the particles consisted of Co-Pt alloy. The use of tobamovirus mutants is a promising approach to making a variety of components that can be applied to fabricate nanometer-scaled electronic devices.

  1. de Sitter and power-law solutions in some models of modified gravity

    NASA Astrophysics Data System (ADS)

    Zhong, Yi; Elizalde, Emilio

    2016-11-01

    Inspired by some recent works of Lovelock Brans-Dicke (BD) gravity and mimetic gravity, cosmology solutions in extensions of these two modified gravities are investigated. A nonlocal term is added to the Lovelock BD action and Gauss-Bonnet (GB) terms to the mimetic action, correspondingly. de Sitter and power scale factor solutions are then obtained in both theories. They can provide natural new approaches to a more accurate description of the unverse evolution.

  2. Cold Flow Testing of a Modified Subscale Model Exhaust System for a Space Based Laser

    DTIC Science & Technology

    2004-06-01

    Abstract The aim of this research was a continued study of gas-dynamic phenomena that occurred in a set of stacked nozzles as reported by Captains...join the vacuum and test sections. The goals of this research were two fold; first, modify the original scale-model of the stacked cylindrical...Defense Advanced Research Projects Agency (DARPA), in conjunction with the Airborne Laser Laboratory, have studied the use of an Airborne Laser (ABL

  3. Modified ADM1 for modeling free ammonia inhibition in anaerobic acidogenic fermentation with high-solid sludge.

    PubMed

    Bai, Jie; Liu, He; Yin, Bo; Ma, Huijun; Chen, Xinchun

    2017-02-01

    Anaerobic acidogenic fermentation with high-solid sludge is a promising method for volatile fatty acid (VFA) production to realize resource recovery. In this study, to model inhibition by free ammonia in high-solid sludge fermentation, the anaerobic digestion model No. 1 (ADM1) was modified to simulate the VFA generation in batch, semi-continuous and full scale sludge. The ADM1 was operated on the platform AQUASIM 2.0. Three kinds of inhibition forms, e.g., simple inhibition, Monod and non-inhibition forms, were integrated into the ADM1 and tested with the real experimental data for batch and semi-continuous fermentation, respectively. The improved particle swarm optimization technique was used for kinetic parameter estimation using the software MATLAB 7.0. In the modified ADM1, the K s of acetate is 0.025, the k m,ac is 12.51, and the K I_NH3 is 0.02, respectively. The results showed that the simple inhibition model could simulate the VFA generation accurately while the Monod model was the better inhibition kinetics form in semi-continuous fermentation at pH10.0. Finally, the modified ADM1 could successfully describe the VFA generation and ammonia accumulation in a 30m 3 full-scale sludge fermentation reactor, indicating that the developed model can be applicable in high-solid sludge anaerobic fermentation. Copyright © 2016. Published by Elsevier B.V.

  4. Depressive symptoms negate the beneficial effects of physical activity on mortality risk.

    PubMed

    Lee, Pai-Lin

    2013-01-01

    The aim of this study is to: (1) compare the association between various levels of physical activity (PA) and mortality; and (2) examine the potential modifying effect of depressive symptoms on the PA-mortality associations. Previous large scale randomized studies rarely assess the association in conjunction with modifying effects of depressive symptoms. In this study, participants consisted of 624 (mean age = 77.35 years) non-institutionalized elderly from the Americans' Changing Lives Longitudinal Study. Depression was measured using the Center for Epidemiological Studies' Depression Scale. Participants in gardening, walking, and sports were first classified into four PA frequency levels, "never," "rarely," "sometimes," and "often." Those who self-reported "often" engaged in activities of gardening and walking and had reduced odds of mortality of 77% and 83%, adjusted odds ratio (ORadj) = .23 and .17, 95% confidence interval (CI) = .09-.59 and.07-.41 when compared to those who reported "never." However, mortality risk was not linked to sports activity. The modifying effects of depressive symptoms on PA (depressive symptoms x PA) were then tested, PA was not associated with increased risk for mortality for gardening (parameter estimates, PE = -.03 +/- .62, p = .958), and for walking (PE = .04 +/- .57, p = .948). Elderly people who engaged in gardening and walking might have protection effects on later risk of mortality. Depressive symptoms showed negative modifying effects that prevent PA predicting later mortality.

  5. Distensibility and Strength of the Pelvic Floor Muscles of Women in the Third Trimester of Pregnancy

    PubMed Central

    Petricelli, Carla Dellabarba; Resende, Ana Paula Magalhães; Elito Júnior, Julio; Araujo Júnior, Edward; Alexandre, Sandra Maria; Zanetti, Miriam Raquel Diniz; Nakamura, Mary Uchiyama

    2014-01-01

    Objective. The objective of this study was to compare the role of the pelvic floor muscles between nulliparous and multiparous women in the third trimester of pregnancy, by analyzing the relationship between electrical activity (surface electromyography—EMG), vaginal palpation (modified Oxford scale), and perineal distensibility (Epi-no). Methods. This was an observational cross-sectional study on a sample of 60 healthy pregnant women with no cervical dilation, single fetus, gestational age between 35 and 40 weeks, and maternal age ranging from 15 to 40 years. The methods used were bidigital palpation (modified Oxford scale, graded 0–5), surface EMG (electrical activity during maximal voluntary contraction), and perineal distensibility (Epi-no device). The Pearson correlation coefficient (r) was used to analyze the Epi-no values and the surface EMG findings. The Kruskal-Wallis test was used to compare the median values from surface EMG and Epi-no, using the modified Oxford scale scores. Results. Among the 60 patients included in this study, 30 were nulliparous and 30 multiparous. The average maternal age and gestational age were 26.06 (±5.58) and 36.56 (±1.23), respectively. It was observed that nulliparous women had both higher perineal muscle strength (2.53 ± 0.57 versus 2.06 ± 0.64; P = 0.005) and higher electrical activity (45.35 ± 12.24 μV versus 35.79 ± 11.66 μV; P = 0.003), while among the multiparous women, distensibility was higher (19.39 ± 1.92 versus 18.05 ± 2.14; P = 0.013). We observed that there was no correlation between perineal distensibility and electrical activity during maximal voluntary contraction (r = − 0.193; P = 0.140). However, we found a positive relationship between vaginal palpation and surface electromyography (P = 0.008), but none between Epi-no values (P = 0.785). Conclusion. The electrical activity and muscle strength of the pelvic floor muscles of the multiparous women were damaged, in relation to the nulliparous women, while the perineal distensibility was lower in the latter group. There was a positive relationship between surface EMG and the modified Oxford scale. PMID:24877094

  6. Development of the cat-owner relationship scale (CORS).

    PubMed

    Howell, Tiffani J; Bowen, Jonathan; Fatjó, Jaume; Calvo, Paula; Holloway, Anna; Bennett, Pauleen C

    2017-08-01

    Characteristics of the human-animal bond can be influenced by both owner-related and pet-related factors, which likely differ between species. Three studies adapted the Monash Dog-Owner Relationship Scale (MDORS) to permit assessment of human-cat interactions as perceived by the cat's owner. In Study 1293 female cat owners completed a modified version of the MDORS, where 'dog' was replaced with 'cat' for all items. Responses were compared with a matched sample of female dog owners. A partial least squares discriminant analysis revealed systematic differences between cat and dog owners in the Dog (Cat)-Owner Interaction subscale (MDORS subscale 1), but not for Perceived Emotional Closeness or Perceived Costs (Subscales 2 and 3). Study 2 involved analysis of free-text descriptions of cat-owner interactions provided by 61 female cat owners. Text mining identified key words which were used to create additional questions for a new Cat-Owner Interaction subscale. In Study 3, the resulting cat-owner relationship scale (CORS) was tested in a group of 570 cat owners. The main psychometric properties of the scale, including internal consistency and factor structure, were evaluated. We propose that this scale can be used to accurately assess owner perceptions of their relationship with their cat. A modified scale, combining items from the CORS and MDORS (a C/DORS), is also provided for when researchers would find it desirable to compare human-cat and human-dog interactions. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Shame, Catastrophizing, and Negative Partner Responses Are Associated With Lower Sexual and Relationship Satisfaction and More Negative Affect in Men With Peyronie's Disease.

    PubMed

    Davis, Seth; Ferrar, Saskia; Sadikaj, Gentiana; Binik, Yitzchak; Carrier, Serge

    2017-04-03

    Peyronie's disease (PD) has a negative impact on men's sexual functioning and quality of life, but little is known about why some men cope better than others and what the effects of PD are on their relationships. The aims of the present study were to describe negative affect, pain, and relationship and sexual satisfaction in men with PD, and to explore their psychosocial correlates. Participants were 110 men diagnosed with PD. All men completed questionnaires. The main outcome measures were as follows: Global Measure of Sexual Satisfaction, Dyadic Adjustment Scale, McGill Pain Questionnaire, and Negative Affect Scale. The predictor variables were the following: Experience of Shame Scale, Body Esteem Scale, Body Image Self-Consciousness Scale, Index of Male Genital Image, a modified Pain Catastrophizing Scale, and a modified Multidimensional Pain Inventory. Although men with PD had mean sexual/relationship satisfaction and negative affect scores indicating mild impairment, there was a wide range of variation, with 42% to 52% scoring in the clinical range. Catastrophizing was significantly associated with reduced sexual satisfaction and increased negative affect and pain. Shame was also associated with increased negative affect. The significant associations of relationship satisfaction were partner responses and shame. Given the lack of curative treatment in PD, understanding why some men cope better than others may guide therapy. Shame, catastrophizing, and partner responses may be important therapeutic targets.

  8. Feasibility, Validity, and Reliability of the Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale for Adults in Inpatients with Severe Obesity.

    PubMed

    Manzoni, Gian Mauro; Rossi, Alessandro; Marazzi, Nicoletta; Agosti, Fiorenza; De Col, Alessandra; Pietrabissa, Giada; Castelnuovo, Gianluca; Molinari, Enrico; Sartorio, Allessandro

    2018-01-01

    This study was aimed to examine the feasibility, validity, and reliability of the Italian Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL™ MFS) for adult inpatients with severe obesity. 200 inpatients (81% females) with severe obesity (BMI ≥ 35 kg/m2) completed the PedsQL MFS (General Fatigue, Sleep/Rest Fatigue and Cognitive Fatigue domains), the Fatigue Severity Scale, and the Center for Epidemiologic Studies Depression Scale immediately after admission to a 3-week residential body weight reduction program. A randomized subsample of 48 patients re-completed the PedsQL MFS after 3 days. Confirmatory factor analysis showed that a modified hierarchical model with two items moved from the Sleep/Rest Fatigue domain to the General Fatigue domain and a second-order latent factor best fitted the data. Internal consistency and test-retest reliabilities were acceptable to high in all scales, and small to high statistically significant correlations were found with all convergent measures, with the exception of BMI. Significant floor effects were found in two scales (Cognitive Fatigue and Sleep/Rest Fatigue). The Italian modified PedsQL MFS for adults showed to be a valid and reliable tool for the assessment of fatigue in inpatients with severe obesity. Future studies should assess its discriminant validity as well as its responsiveness to weight reduction. © 2018 The Author(s) Published by S. Karger GmbH, Freiburg.

  9. Characterization of modified PVDF membrane by gamma irradiation for non-potable water reuse.

    PubMed

    Lim, Seung Joo; Kim, Tak-Hyun; Shin, In Hwan

    2015-01-01

    Poly(vinylidene fluorine) (PVDF) membranes were grafted by gamma-ray irradiation and were sulfonated by sodium sulfite to modify the surface of the membranes. The characteristics of the modified PVDF membranes were evaluated by the data of Fourier transform infrared (FT-IR), X-ray photoelectron spectroscopy (XPS), field-emission scanning electron microscope (FE-SEM), the contact angle of the membrane surface and the water permeability. From the results of FT-IR, XPS and FE-SEM, it was shown that the modified membranes were successfully grafted by gamma-ray irradiation and were sulfonated. The content of oxygen and sulfur increased with the monomer concentration, while the content of fluorine sharply decreased. The pore size of the modified membranes decreased after gamma-ray irradiation. The contact angle and the water permeability showed that the hydrophilicity of the modified membranes played a role in determining the membrane performance. The feasibility study of the modified PVDF membranes for using non-potable water reuse were carried out using a laboratory-scale microfiltration system. Grey wastewater was used as the influent in the filtration unit, and permeate quality satisfied non-potable water reuse guidelines in the Republic of Korea.

  10. Correlation between mobility assessed by the Modified Rivermead Mobility Index and physical function in stroke patients

    PubMed Central

    Park, Gi-Tae; Kim, Mihyun

    2016-01-01

    [Purpose] The purpose of this study was to investigate the relationship between mobility assessed by the Modified Rivermead Mobility Index and variables associated with physical function in stroke patients. [Subjects and Methods] One hundred stroke patients (35 males and 65 females; age 58.60 ± 13.91 years) participated in this study. Modified Rivermead Mobility Index, muscle strength (manual muscle test), muscle tone (Modified Ashworth Scale), range of motion of lower extremity, sensory function (light touch and proprioception tests), and coordination (heel to shin and lower-extremity motor coordination tests) were assessed. [Results] The Modified Rivermead Mobility Index was correlated with all the physical function variables assessed, except the degree of knee extension. In addition, stepwise linear regression analysis revealed that coordination (heel to shin test) was the explanatory variable closely associated with mobility in stroke patients. [Conclusion] The Modified Rivermead Mobility Index score was significantly correlated with all the physical function variables. Coordination (heel to shin test) was closely related to mobility function. These results may be useful in developing rehabilitation programs for stroke patients. PMID:27630440

  11. Interrelationship of motivation for and perceived constraints to physical activity participation and the well-being of senior center participants

    Treesearch

    Motoko Miyake; Ellen Rodgers

    2009-01-01

    This study investigated the relationship of motivation for and perceived constraints to physical activity (PA) participation and the well-being of senior center participants. A survey instrument made up of modified versions of the Sport Motivation and Perceived Constraints Scales, the Life Satisfaction Index-Z, and the Geriatric Depression Scale was administered at the...

  12. Effects of intermediate-scale wind disturbance on composition, structure, and succession in Quercus stands: Implications for natural disturbance-based silviculture

    Treesearch

    M.M. Cowden; J.L. Hart; C.J. Schweitzer; D.C. Dey

    2014-01-01

    Forest disturbances are discrete events in space and time that disrupt the biophysical environment and impart lasting legacies on forest composition and structure. Disturbances are often classified along a gradient of spatial extent and magnitude that ranges from catastrophic events where most of the overstory is removed to gap-scale events that modify local...

  13. Sex, grade, and course differences in attitudes that are related to cognitive performance in secondary science

    NASA Astrophysics Data System (ADS)

    Levin, James; Seymour Fowler, H.

    The purpose of this study was to collect and analyze data on sexual differences in secondary school students' attitudes towards science. Attitudinal differences were also analyzed for the independent variables of science programs and grade levels. Data were collected from 988 students using a modified version of the Fennema-Sherman Mathematics Attitude Scales to represent attitudes toward science. Reliabilities of the modified science subscales were all high ( > 0.83). Multivariate analysis of variance (MANOVA) was used to analyze the data for the main and interaction effects of the independent variables of sex (male, female), grade level (10th, 11th, 12th), and science program (advanced placement, academic, general, terminal). Significant differences (p < 0.05) were indicated for all main effects (sex, grade, science program). Interaction effects were not found. Mean separations for the various levels of sex, grade, and science program were performed for all attitudinal subscales. Females evidenced a significantly more positive attitude (p 0.01) than males on three subscales: Attitude Toward Success in Science Scale, Science as a Male Domain Scale, and Teacher Scale. Although not significant, males evidenced more positive attitudes on all the remaining five subscales. Eleventh graders evidenced significantly more positive attitudes than tenth graders on all but the Effectance Motivation Scale. Students in 11th grade had more positive attitudes than 12th-grade students on all scales but Science as a Male Domain Scale; however, these differences were not significant. Tenth graders differed significantly from 12th graders on three subscales; Science Usefulness Scale, Confidence in Learning Science Scale, and Teacher Scale. Positive attitudes decreased from advanced placement to terminal programs. Academic students did not differ significantly from general students except on the Father Scale; however, they were significantly different (more positive) from the terminal students for all subscales. General students were also significantly different from terminal students except on the three subscales of Attitudes Toward Success in Science, Science as a Male Domain, and Effectance Motivation.

  14. Modified constraint-induced movement therapy or bimanual occupational therapy following injection of Botulinum toxin-A to improve bimanual performance in young children with hemiplegic cerebral palsy: a randomised controlled trial methods paper

    PubMed Central

    2010-01-01

    Background Use of Botulinum toxin-A (BoNT-A) for treatment of upper limb spasticity in children with cerebral palsy has become routine clinical practice in many paediatric treatment centres worldwide. There is now high-level evidence that upper limb BoNT-A injection, in combination with occupational therapy, improves outcomes in children with cerebral palsy at both the body function/structure and activity level domains of the International Classification of Functioning, Disability and Health. Investigation is now required to establish what amount and specific type of occupational therapy will further enhance functional outcomes and prolong the beneficial effects of BoNT-A. Methods/Design A randomised, controlled, evaluator blinded, prospective parallel-group trial. Eligible participants were children aged 18 months to 6 years, diagnosed with spastic hemiplegic cerebral palsy and who were able to demonstrate selective motor control of the affected upper limb. Both groups received upper limb injections of BoNT-A. Children were randomised to either the modified constraint-induced movement therapy group (experimental) or bimanual occupational therapy group (control). Outcome assessments were undertaken at pre-injection and 1, 3 and 6 months following injection of BoNT-A. The primary outcome measure was the Assisting Hand Assessment. Secondary outcomes included: the Quality of Upper Extremity Skills Test; Pediatric Evaluation of Disability Inventory; Canadian Occupational Performance Measure; Goal Attainment Scaling; Pediatric Motor Activity Log; modified Ashworth Scale and; the modified Tardieu Scale. Discussion The aim of this paper is to describe the methodology of a randomised controlled trial comparing the effects of modified constraint-induced movement therapy (a uni-manual therapy) versus bimanual occupational therapy (a bimanual therapy) on improving bimanual upper limb performance of children with hemiplegic cerebral palsy following upper limb injection of BoNT-A. The paper outlines the background to the study, the study hypotheses, outcome measures and trial methodology. It also provides a comprehensive description of the interventions provided. Trial Registration ACTRN12605000002684 PMID:20602795

  15. Modelling galaxy clustering on small scales to tighten constraints on dark energy and modified gravity

    NASA Astrophysics Data System (ADS)

    Wang, Yun

    2017-01-01

    We present a new approach to measuring cosmic expansion history and growth rate of large-scale structure using the anisotropic two-dimensional galaxy correlation function (2DCF) measured from data; it makes use of the empirical modelling of small-scale galaxy clustering derived from numerical simulations by Zheng et al. We validate this method using mock catalogues, before applying it to the analysis of the CMASS sample from the Sloan Digital Sky Survey Data Release 10 of the Baryon Oscillation Spectroscopic Survey. We find that this method enables accurate and precise measurements of cosmic expansion history and growth rate of large-scale structure. Modelling the 2DCF fully including non-linear effects and redshift space distortions in the scale range of 16-144 h-1 Mpc, we find H(0.57)rs(zd)/c = 0.0459 ± 0.0006, DA(0.57)/rs(zd) = 9.011 ± 0.073, and fg(0.57)σ8(0.57) = 0.476 ± 0.050, which correspond to precisions of 1.3 per cent, 0.8 per cent, and 10.5 per cent, respectively. We have defined rs(zd) to be the sound horizon at the drag epoch computed using a simple integral, fg(z) as the growth rate at redshift z, and σ8(z) as the matter power spectrum normalization on 8 h-1 Mpc scale at z. We find that neglecting the small-scale information significantly weakens the constraints on H(z) and DA(z), and leads to a biased estimate of fg(z). Our results indicate that we can significantly tighten constraints on dark energy and modified gravity by reliably modelling small-scale galaxy clustering.

  16. Assessing health-related quality of life in Japanese children with a chronic condition: validation of the DISABKIDS chronic generic module.

    PubMed

    Sasaki, Hatoko; Kakee, Naoko; Morisaki, Naho; Mori, Rintaro; Ravens-Sieberer, Ulrike; Bullinger, Monika

    2018-05-02

    This study examined the reliability and validity of the Japanese versions of the DISABKIDS-37 generic modules, a tool for assessing the health-related quality of life (HRQOL) of children and adolescents with a chronic condition. The study was conducted using a sample of 123 children/adolescents with a chronic medical condition, aged 8-18 years, and their parents. Focus interviews were performed to ensure content validity after translation. The classical psychometric tests were used to assess reliability and scale intercorrelations. The factor structure was examined with confirmatory factor analysis (CFA). Convergent validity was assessed by the correlation between the total score and the sub-scales of DISABKIDS-37 as well as the total score of KIDSCREEN-10. Both the children/adolescent and parent versions of the score showed good to high internal consistency, and the test-retest reliability correlations were r = 0.91 or above. The CFA revealed that the modified models for all domains were better fit than the original 37 item scale model for both self-report and proxy-report. Moderate to high positive correlations were found for the associations within DISABKIDS-37 sub-scales and between the subscales and total score, except for the treatment sub-scale, which correlated weakly with the remaining sub-scales. The total score of the child-reported version of KIDSCREEN-10 correlated significantly and positively with the total score and all the sub-scales of the child-reported version of DISABKIDS-37 except the Treatment sub-scale in adolescents. The modified models of Japanese version of DISABKIDS generic module were psychometrically robust enough to assess the HRQOL of children with a chronic condition.

  17. Alternative to particle dark matter

    NASA Astrophysics Data System (ADS)

    Khoury, Justin

    2015-01-01

    We propose an alternative to particle dark matter that borrows ingredients of modified Newtonian dynamics (MOND) while adding new key components. The first new feature is a dark matter fluid, in the form of a scalar field with small equation of state and sound speed. This component is critical in reproducing the success of cold dark matter for the expansion history and the growth of linear perturbations, but does not cluster significantly on nonlinear scales. Instead, the missing mass problem on nonlinear scales is addressed by a modification of the gravitational force law. The force law approximates MOND at large and intermediate accelerations, and therefore reproduces the empirical success of MOND at fitting galactic rotation curves. At ultralow accelerations, the force law reverts to an inverse-square law, albeit with a larger Newton's constant. This latter regime is important in galaxy clusters and is consistent with their observed isothermal profiles, provided the characteristic acceleration scale of MOND is mildly varying with scale or mass, such that it is 12 times higher in clusters than in galaxies. We present an explicit relativistic theory in terms of two scalar fields. The first scalar field is governed by a Dirac-Born-Infeld action and behaves as a dark matter fluid on large scales. The second scalar field also has single-derivative interactions and mediates a fifth force that modifies gravity on nonlinear scales. Both scalars are coupled to matter via an effective metric that depends locally on the fields. The form of this effective metric implies the equality of the two scalar gravitational potentials, which ensures that lensing and dynamical mass estimates agree. Further work is needed in order to make both the acceleration scale of MOND and the fraction at which gravity reverts to an inverse-square law explicitly dynamical quantities, varying with scale or mass.

  18. Overland flow connectivity on planar patchy hillslopes - modified percolation theory approaches and combinatorial model of urns

    NASA Astrophysics Data System (ADS)

    Nezlobin, David; Pariente, Sarah; Lavee, Hanoch; Sachs, Eyal

    2017-04-01

    Source-sink systems are very common in hydrology; in particular, some land cover types often generate runoff (e.g. embedded rocks, bare soil) , while other obstruct it (e.g. vegetation, cracked soil). Surface runoff coefficients of patchy slopes/plots covered by runoff generating and obstructing covers (e.g., bare soil and vegetation) depend critically on the percentage cover (i.e. sources/sinks abundance) and decrease strongly with observation scale. The classic mathematical percolation theory provides a powerful apparatus for describing the runoff connectivity on patchy hillslopes, but it ignores strong effect of the overland flow directionality. To overcome this and other difficulties, modified percolation theory approaches can be considered, such as straight percolation (for the planar slopes), quasi-straight percolation and models with limited obstruction. These approaches may explain both the observed critical dependence of runoff coefficients on percentage cover and their scale decrease in systems with strong flow directionality (e.g. planar slopes). The contributing area increases sharply when the runoff generating percentage cover approaches the straight percolation threshold. This explains the strong increase of the surface runoff and erosion for relatively low values (normally less than 35%) of the obstructing cover (e.g., vegetation). Combinatorial models of urns with restricted occupancy can be applied for the analytic evaluation of meaningful straight percolation quantities, such as NOGA's (Non-Obstructed Generating Area) expected value and straight percolation probability. It is shown that the nature of the cover-related runoff scale decrease is combinatorial - the probability for the generated runoff to avoid obstruction in unit area decreases with scale for the non-trivial percentage cover values. The magnitude of the scale effect is found to be a skewed non-monotonous function of the percentage cover. It is shown that the cover-related scale effect becomes less prominent if the obstructing capacity decreases, as generally occurs during heavy rainfalls. The plot width have a moderate positive statistical effect on runoff and erosion coefficients, since wider patchy plots have, on average, a greater normalized contributing area and a higher probability to have runoff of a certain length. The effect of plot width depends by itself on the percentage cover, plot length, and compared width scales. The contributing area uncertainty brought about by cover spatial arrangement is examined, including its dependence on the percentage cover and scale. In general, modified percolation theory approaches and combinatorial models of urns with restricted occupancy may link between critical dependence of runoff on percentage cover, cover-related scale effect, and statistical uncertainty of the observed quantities.

  19. On the saturation of the refractive index structure function. II - Influence of the correlation length on astronomical 'seeing'

    NASA Technical Reports Server (NTRS)

    Venkatakrishnan, P.

    1987-01-01

    A physical length scale in the wavefront corresponding to the parameter (r sub 0) characterizing the loss in detail in a long exposure image is identified, and the influence of the correlation scale of turbulence as r sub 0 approaches this scale is shown. Allowing for the effect of 2-point correlations in the fluctuations of the refractive index, Venkatakrishnan and Chatterjee (1987) proposed a modified law for the phase structure function. It is suggested that the departure of the phase structure function from the 5/3 power law for length scales in the wavefront approaching the correlation scale of turbulence may lead to better 'seeing' at longer wavelengths.

  20. Absence of a fundamental acceleration scale in galaxies

    NASA Astrophysics Data System (ADS)

    Rodrigues, Davi C.; Marra, Valerio; del Popolo, Antonino; Davari, Zahra

    2018-06-01

    Dark matter is currently one of the main mysteries of the Universe. There is much strong indirect evidence that supports its existence, but there is yet no sign of a direct detection1-3. Moreover, at the scale of galaxies, there is tension between the theoretically expected dark matter distribution and its indirectly observed distribution4-7. Therefore, phenomena associated with dark matter have a chance of serving as a window towards new physics. The radial acceleration relation8,9 confirms that a non-trivial acceleration scale a0 can be found from the internal dynamics of several galaxies. The existence of such a scale is not obvious as far as the standard cosmological model is concerned10,11, and it has been interpreted as a possible sign of modified gravity12,13. Here, we consider 193 high-quality disk galaxies and, using Bayesian inference, show that the probability of existence of a fundamental acceleration is essentially 0: the null hypothesis is rejected at more than 10σ. We conclude that a0 is of emergent nature. In particular, the modified Newtonian dynamics theory14-17—a well-known alternative to dark matter based on the existence of a fundamental acceleration scale—or any other theory that behaves like it at galactic scales, is ruled out as a fundamental theory for galaxies at more than 10σ.

  1. Moving beyond perceptions: internalized stigma in the irritable bowel syndrome.

    PubMed

    Taft, T H; Riehl, M E; Dowjotas, K L; Keefer, L

    2014-07-01

    Internalized stigma (IS) is an important construct in the chronic illness literature with implications for several patient reported outcomes. To date, no study exists evaluating IS in patients with the irritable bowel syndrome (IBS). Two hundred and forty three online and clinical participants completed the following questionnaires: the IS scale for mental illness (ISMI; modified for IBS), perceived stigma scale for IBS, NIH-PROMIS Anxiety and Depression Scales, IBS quality of life scale, and the Perceived Health Competence Scale. Demographical and clinical data were also collected. The modified ISMI was reliable and valid in this population. Participants reported both perceived and IS. Alienation was most reported, followed by social withdrawal and discrimination experiences. IS predicted 25-40% of the variance in psychological functioning, quality of life, healthcare utilization, and health competence when controlling for stigma perception and disease variables. IBS patients perceived more stigma from personal relations than healthcare providers. Hispanic participants reported more perceived stigma, indicating there may be cultural differences in IBS-related stigma experience. Symptom severity, disruptiveness, and treatment choices are also implicated in stigma perception and internalization. Patients with IBS report both perceived and IS with alienation most reported. However, IS significantly predicts several patient outcomes when controlling for PS. Cultural and illness traits may influence how stigma is perceived and internalized. Future research is warranted. © 2014 John Wiley & Sons Ltd.

  2. Efficacy and safety of sodium-glucose cotransporter 2 inhibitors in type 2 diabetes: a meta-analysis of randomized controlled trials for 1 to 2years.

    PubMed

    Liu, Xiang-Yang; Zhang, Ning; Chen, Rui; Zhao, Jia-Guo; Yu, Pei

    2015-01-01

    To evaluate the mid long-term efficacy and safety of sodium-glucose cotransporter 2 (SGLT2) inhibitors in adults with type 2 diabetes mellitus (T2DM). Three databases including Pubmed, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) of SGLT2 inhibitors that lasted for at least 52weeks. Two reviewers retrieved the literature and evaluated study quality using the Modified Jadad Score Scale. The outcome measures were pooled using random or fixed effects models. Fourteen articles of 13 RCTs were included in this meta-analysis. Compared to a placebo, the SGLT2 inhibitors significantly reduced glycated hemoglobin (HbA1c) [for 1year result, weighted mean differences (WMDs): -0.491%; 95% confidence intervals (CIs): -0.573 to -0.410; I(2)=39.9%, for 2years result, WMD: -0.503%; 95% CI: -0.742 to -0.265; I(2)=70.7%], fasting plasma glucose (FPG) (for 1year result, WMD: -0.809; 95% CI: -0.858 to -0.761; I(2)=56.4%; for 2years result, WMD: -0.764; 95% CI: -1.026 to -0.501; I(2)=39.4%), body weight (BW) (for 1year result, WMD: -2.477; 95% CI: -2.568 to -2.385; I(2)=0.0%; for 2years result, WMD: -2.990; 95% CI: -3.642 to -2.337; I(2)=0.0%), systolic blood pressure (SBP) (for 1year result, WMD: -2.874; 95% CI: -4.528 to -1.220; I(2)=98.1%; for 2years result, WMD: -7.500; 95% CI: -7.698 to -7.302) and diastolic blood pressure (DBP) (for 1year result, WMD: -1.950; 95% CI: -2.890 to -1.010; I(2)=98.0%; for 2years result, WMD: -2.197; 95% CI: -3.112 to -1.283). Compared to oral antidiabetic drugs (OADs), the SGLT2 inhibitors also reduced HbA1c, FPG, BW, SBP and DBP significantly. Compared to a placebo, the SGLT2 inhibitors increase the risk of hypoglycemia [odds ratios (ORs): 1.214; 95% CI: 1.036 to 1.423; I(2)=47.7%], urinary infection (OR: 1.477; 95% CI: 1.172 to 1.861; I(2)=46.6%) and genital tract infections (OR: 4.196; 95% CI: 2.332 to 7.549; I(2)=52.7%). Compared to OADs, SGLT2 inhibitors showed a remarkable reduction of hypoglycemia incidence (OR: 0.202; 95% CI: 0.059 to 0.691; I(2)=97.8%), but increased the incidence of genital tract infections (OR: 5.715; 95% CI: 4.339 to 7.528; I(2)=0.0%) and urinary infection (OR: 1.192; 95% CI: 0.990 to 1.434; I(2)=45.3%). SGLT2 inhibitors did not decrease estimated glomerular filtration rate (eGFR) when comparing with placebos [(for absolute value change, WMD: 0.629mL/min/1.73m(2); 95% CI: -1.250 to 2.508; I(2)=0.0%); (for percent change, WMD: -2.274%; 95% CI: -5.410 to 0.861; I(2)=54.5%)] and OADs (for percent change, WMD: 0.356%; 95% CI: -0.967 to 1.679; I(2)=0.0%). SGLT2 inhibitors have favorable effects on combating hyperglycemia for mid long-term; likewise, they have additional benefits beyond glycemic control such as reducing body weight and lowering blood pressure. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Reconstructing f(R) modified gravity with dark energy parametrization

    NASA Astrophysics Data System (ADS)

    Morita, Masaaki; Takahashi, Hirotaka

    2014-03-01

    We demonstrate the reconstruction of f(R) modified gravity theory with late-time accelerated cosmic expansion. A second-order differential equation for Lagrangian density is obtained from the field equation, and is solved as a function of the cosmic scale factor in two cases. First we begin with the case of a wCDM cosmological model, in which a dark-energy equation-of-state parameter w is constant, for simplicity. Next we extend the method to a case in which the parameter w is epoch-dependent and is expressed as the Chevallier-Polarski-Linder parametrization. Thus we can represent Lagrangian density of f(R) modified gravity theory in terms of dark energy parameters.

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

    Winther, Hans A.; Koyama, Kazuya; Wright, Bill S.

    We present a general parallelized and easy-to-use code to perform numerical simulations of structure formation using the COLA (COmoving Lagrangian Acceleration) method for cosmological models that exhibit scale-dependent growth at the level of first and second order Lagrangian perturbation theory. For modified gravity theories we also include screening using a fast approximate method that covers all the main examples of screening mechanisms in the literature. We test the code by comparing it to full simulations of two popular modified gravity models, namely f ( R ) gravity and nDGP, and find good agreement in the modified gravity boost-factors relative tomore » ΛCDM even when using a fairly small number of COLA time steps.« less

  5. Performance testing for superpave and structural validation.

    DOT National Transportation Integrated Search

    2012-11-01

    The primary objective of this full-scale accelerated pavement testing was to evaluate the performance of unmodified : and polymer modified asphalt binders and to recommend improved specification tests over existing SUperior : PERforming Asphalt PAVEm...

  6. Beyond δ: Tailoring marked statistics to reveal modified gravity

    NASA Astrophysics Data System (ADS)

    Valogiannis, Georgios; Bean, Rachel

    2018-01-01

    Models which attempt to explain the accelerated expansion of the universe through large-scale modifications to General Relativity (GR), must satisfy the stringent experimental constraints of GR in the solar system. Viable candidates invoke a “screening” mechanism, that dynamically suppresses deviations in high density environments, making their overall detection challenging even for ambitious future large-scale structure surveys. We present methods to efficiently simulate the non-linear properties of such theories, and consider how a series of statistics that reweight the density field to accentuate deviations from GR can be applied to enhance the overall signal-to-noise ratio in differentiating the models from GR. Our results demonstrate that the cosmic density field can yield additional, invaluable cosmological information, beyond the simple density power spectrum, that will enable surveys to more confidently discriminate between modified gravity models and ΛCDM.

  7. Kinetics of biochemical sensing by single cells and populations of cells

    NASA Astrophysics Data System (ADS)

    Saakian, David B.

    2017-10-01

    We investigate the collective stationary sensing using N communicative cells, which involves surface receptors, diffusive signaling molecules, and cell-cell communication messengers. We restrict the scenarios to the signal-to-noise ratios (SNRs) for both strong communication and extrinsic noise only. We modified a previous model [Bialek and Setayeshgar, Proc. Natl. Acad. Sci. USA 102, 10040 (2005), 10.1073/pnas.0504321102] to eliminate the singularities in the fluctuation correlations by considering a uniform receptor distribution over the surface of each cell with a finite radius a . The modified model enables a simple and rigorous mathematical treatment of the collective sensing phenomenon. We then derive the scaling of the SNR for both juxtacrine and autocrine cases in all dimensions. For the optimal locations of the cells in the autocrine case, we find identical scaling for both two and three dimensions.

  8. De Sitter and scaling solutions in a higher-order modified teleparallel theory

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

    Paliathanasis, Andronikos, E-mail: anpaliat@phys.uoa.gr

    The existence and the stability conditions for some exact relativistic solutions of special interest are studied in a higher-order modified teleparallel gravitational theory. The theory with the use of a Lagrange multiplier is equivalent with that of General Relativity with a minimally coupled noncanonical field. The conditions for the existence of de Sitter solutions and ideal gas solutions in the case of vacuum are studied as also the stability criteria. Furthermore, in the presence of matter the behaviour of scaling solutions is given. Finally, we discuss the degrees of freedom of the field equations and we reduce the field equationsmore » in an algebraic equation, where in order to demonstrate our result we show how this noncanonical scalar field can reproduce the Hubble function of Λ-cosmology.« less

  9. Waste management technology development and demonstration programs at Brookhaven National Laboratory

    NASA Technical Reports Server (NTRS)

    Kalb, Paul D.; Colombo, Peter

    1991-01-01

    Two thermoplastic processes for improved treatment of radioactive, hazardous, and mixed wastes were developed from bench scale through technology demonstration: polyethylene encapsulation and modified sulfur cement encapsulation. The steps required to bring technologies from the research and development stage through full scale implementation are described. Both systems result in durable waste forms that meet current Nuclear Regulatory Commission and Environmental Protection Agency regulatory criteria and provide significant improvements over conventional solidification systems such as hydraulic cement. For example, the polyethylene process can encapsulate up to 70 wt pct. nitrate salt, compared with a maximum of about 20 wt pct. for the best hydraulic cement formulation. Modified sulfur cement waste forms containing as much as 43 wt pct. incinerator fly ash were formulated, whereas the maximum quantity of this waste in hydraulic cement is 16 wt pct.

  10. Mixed Messages: Ambiguous Penalty Information in Modified Restaurant Menu Items

    PubMed Central

    Lawless, Harry T.; Patel, Anjali A.; Lopez, Nanette V.

    2016-01-01

    Restaurant menu items from six national or regional brands were modified to reduce fat, saturated fat, sodium and total calories. Twenty-four items were tested with a current recipe, and two modifications (small and moderate reductions) for 72 total products. Approximately 100 consumers tested each product for acceptability as well as for desired levels of tastes/flavor, amounts of key ingredients and texture/consistency using just-about-right (JAR) scales. Penalty analysis was conducted to assess the effects of non-JAR ratings on acceptability scores. Situations arose where JAR ratings and penalty analyses could yield different recommendations, including large groups with low penalties and small groups with high penalties. Opposing groups with moderate to high penalties on opposite sides of the same JAR scale were also seen. Strategies for dealing with these observances are discussed. PMID:27833254

  11. Stochastic modeling of stock price process induced from the conjugate heat equation

    NASA Astrophysics Data System (ADS)

    Paeng, Seong-Hun

    2015-02-01

    Currency can be considered as a ruler for values of commodities. Then the price is the measured value by the ruler. We can suppose that inflation and variation of exchange rate are caused by variation of the scale of the ruler. In geometry, variation of the scale means that the metric is time-dependent. The conjugate heat equation is the modified heat equation which satisfies the heat conservation law for the time-dependent metric space. We propose a new model of stock prices by using the stochastic process whose transition probability is determined by the kernel of the conjugate heat equation. Our model of stock prices shows how the volatility term is affected by inflation and exchange rate. This model modifies the Black-Scholes equation in light of inflation and exchange rate.

  12. On Analytical Solutions of f(R) Modified Gravity Theories in FLRW Cosmologies

    NASA Astrophysics Data System (ADS)

    Domazet, Silvije; Radovanović, Voja; Simonović, Marko; Štefančić, Hrvoje

    2013-02-01

    A novel analytical method for f(R) modified theories without matter in Friedmann-Lemaitre-Robertson-Walker (FLRW) spacetimes is introduced. The equation of motion for the scale factor in terms of cosmic time is reduced to the equation for the evolution of the Ricci scalar R with the Hubble parameter H. The solution of equation of motion for actions of the form of power law in Ricci scalar R is presented with a detailed elaboration of the action quadratic in R. The reverse use of the introduced method is exemplified in finding functional forms f(R), which leads to specified scale factor functions. The analytical solutions are corroborated by numerical calculations with excellent agreement. Possible further applications to the phases of inflationary expansion and late-time acceleration as well as f(R) theories with radiation are outlined.

  13. Cloud microphysics modification with an online coupled COSMO-MUSCAT regional model

    NASA Astrophysics Data System (ADS)

    Sudhakar, D.; Quaas, J.; Wolke, R.; Stoll, J.; Muehlbauer, A. D.; Tegen, I.

    2015-12-01

    Abstract: The quantification of clouds, aerosols, and aerosol-cloud interactions in models, continues to be a challenge (IPCC, 2013). In this scenario two-moment bulk microphysical scheme is used to understand the aerosol-cloud interactions in the regional model COSMO (Consortium for Small Scale Modeling). The two-moment scheme in COSMO has been especially designed to represent aerosol effects on the microphysics of mixed-phase clouds (Seifert et al., 2006). To improve the model predictability, the radiation scheme has been coupled with two-moment microphysical scheme. Further, the cloud microphysics parameterization has been modified via coupling COSMO with MUSCAT (MultiScale Chemistry Aerosol Transport model, Wolke et al., 2004). In this study, we will be discussing the initial result from the online-coupled COSMO-MUSCAT model system with modified two-moment parameterization scheme along with COSP (CFMIP Observational Simulator Package) satellite simulator. This online coupled model system aims to improve the sub-grid scale process in the regional weather prediction scenario. The constant aerosol concentration used in the Seifert and Beheng, (2006) parameterizations in COSMO model has been replaced by aerosol concentration derived from MUSCAT model. The cloud microphysical process from the modified two-moment scheme is compared with stand-alone COSMO model. To validate the robustness of the model simulation, the coupled model system is integrated with COSP satellite simulator (Muhlbauer et al., 2012). Further, the simulations are compared with MODIS (Moderate Resolution Imaging Spectroradiometer) and ISCCP (International Satellite Cloud Climatology Project) satellite products.

  14. Rasch analysis of the hospital anxiety and depression scale among Chinese cataract patients.

    PubMed

    Lin, Xianchai; Chen, Ziyan; Jin, Ling; Gao, Wuyou; Qu, Bo; Zuo, Yajing; Liu, Rongjiao; Yu, Minbin

    2017-01-01

    To analyze the validity of the Hospital Anxiety and Depression Scale (HADS) among Chinese cataract population. A total of 275 participants with unilateral or bilateral cataract were recruited to complete the Chinese version of HADS. The patients' demographic and ophthalmic characteristics were documented. Rasch analysis was conducted to examine the model fit statistics, the thresholds ordering of the polytomous items, targeting, person separation index and reliability, local dependency, unidimentionality, differential item functioning (DIF) and construct validity of the HADS individual and summary measures. Rasch analysis was performed on anxiety and depression subscales as well as HADS-Total score respectively. The items of original HADS-Anxiety, HADS-Depression and HADS-Total demonstrated evidence of misfit of the Rasch model. Removing items A7 for anxiety subscale and rescoring items D14 for depression subscale significantly improved Rasch model fit. A 12-item higher order total scale with further removal of D12 was found to fit the Rasch model. The modified items had ordered response thresholds. No uniform DIF was detected, whereas notable non-uniform DIF in high-ability group was found. The revised cut-off points were given for the modified anxiety and depression subscales. The modified version of HADS with HADS-A and HADS-D as subscale and HADS-T as a higher-order measure is a reliable and valid instrument that may be useful for assessing anxiety and depression states in Chinese cataract population.

  15. Non-pharmacological interventions to promote the sleep of patients after cardiac surgery: a systematic review.

    PubMed

    Machado, Fernanda de Souza; Souza, Regina Claudia da Silva; Poveda, Vanessa Brito; Costa, Ana Lucia Siqueira

    2017-09-12

    to analyze evidence available in the literature concerning non-pharmacological interventions that are effective to treat altered sleep patterns among patients who underwent cardiac surgery. systematic review conducted in the National Library of Medicine-National Institutes of Health, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences Literature, Scopus, Embase, Cumulative Index to Nursing and Allied Health Literature and PsycINFO databases, and also grey literature. ten controlled, randomized clinical trials were included in this review. Non-pharmacological interventions were grouped into three main categories, namely: relaxation techniques, devices or equipment to minimize sleep interruptions and/or induce sleep, and educational strategies. Significant improvement was found in the scores assessing sleep quality among studies testing interventions such as earplugs, sleeping masks, muscle relaxation, posture and relaxation training, white noise, and educational strategies. In regard to the studies' methodological quality, high quality studies as established by Jadad scoring were not found. significant improvement was found among the scores assessing sleep in the studies testing interventions such as earplugs, sleeping masks, muscle relaxation, posture and relaxation training, white noise and music, and educational strategies. analisar as evidências disponíveis, na literatura, sobre as intervenções não farmacológicas, efetivas para o tratamento da alteração do padrão do sono em pacientes submetidos à cirurgia cardíaca. revisão sistemática realizada por meio de busca nas bases de dados National Library of Medicine National Institutes of Health, Cochrane Central Register of Controlled Trials, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Scopus, Embase, Cumulative Index to Nursing and Allied Health Literature e PsycINFO, e na literatura cinzenta. dez ensaios clínicos controlados e randomizados foram incluídos na revisão. Constatou-se que as intervenções não farmacológicas agruparam-se em três categorias principais, a saber: técnicas de relaxamento, dispositivos ou equipamentos para minimizar a interrupção do sono e/ou induzir o sono e estratégias educacionais. Houve melhoria significativa nos escores de avaliação do sono entre os estudos que testaram intervenções como tampões de ouvidos, máscara de olhos, relaxamento muscular, treinamento de postura e relaxamento, produção sonora e estratégia educacional. Em relação à qualidade metodológica dos estudos, não foram encontrados estudos considerados de alta qualidade pelo escore de Jadad. houve melhora significativa nos escores de avaliação do sono em estudos que avaliaram intervenções como tampões de ouvidos, máscara de olhos, relaxamento muscular, treinamento de postura e relaxamento, produção sonora e estratégia educacional. analizar las evidencias disponibles en la literatura sobre las intervenciones no farmacológicas, eficientes para el tratamiento de la alteración del patrón del sueño en pacientes sometidos a una cirugía cardíaca. revisión sistemática realizada mediante búsqueda en las bases de datos de la Librería Nacional de Medicina (National Library of Medicine), de los Institutos Nacionales de la Salud (National Institutes of Health), del Registro Central Cochrane de Ensayos Controlados (Cochrane Central Register of Controlled Trials), de la literatura latinoamericana y del Caribe, en Ciencias de la Salud, Scopus, Embase, Índice Acumulado de Enfermería y Literatura en Ciencias de la Salud, CINAHL (Cumulative Index to Nursing and Allied Health Literature) y PsycINFO, y en la literatura gris. se incluyeron en la revisión diez ensayos clínicos controlados y aleatorizados. Se constató que las intervenciones no farmacológicas se agruparon en tres categorías principales: técnicas de relajación, dispositivos o equipos para minimizar la interrupción del sueño y/o inducirlo, y estrategias educativas. Hubo una mejora significativa en las puntuaciones de la evaluación del sueño entre los estudios que probaron las intervenciones como tapón de oídos, máscara de ojos, relajación muscular, entrenamiento de postura y relajación, producción sonora y estrategia educacional. Con respecto a la calidad metodológica de los estudios, no se hallaron los considerados de alta calidad mediante la puntuación de Jadad. hubo una mejora significativa en las puntuaciones de la evaluación del sueño en los estudios que evaluaron intervenciones como tapones de oídos, máscara de ojos, relajación muscular, entrenamiento de postura y relajación, producción sonora y estrategia educacional.

  16. VALIDATION OF ADULT OMNI PERCEIVED EXERTION SCALES FOR ELLIPTICAL ERGOMETRY12

    PubMed Central

    MAYS, RYAN J.; GOSS, FREDRIC L.; SCHAFER, MARK A.; KIM, KEVIN H.; NAGLE-STILLEY, ELIZABETH F.; ROBERTSON, ROBERT J.

    2012-01-01

    Summary This investigation examined the validity of newly developed Adult OMNI Elliptical Ergometer Ratings of Perceived Exertion Scales. Sixty men and women performed a graded exercise test on an elliptical ergometer. Oxygen consumption (VO2), heart rate (HR) and ratings of perceived exertion were recorded each stage from the Borg 15 Category Scale and two different OMNI scales. One scale employed an elliptical ergometer format of the OMNI Picture System of Perceived Exertion. The second scale modified verbal, numerical, and pictorial descriptors at the low end of the response range. Concurrent and construct validity were established by the positive relation between ratings of perceived exertion from each OMNI scale with VO2, HR and Borg Scale ratings of perceived exertion (men, r = .94–.97; women, r = .93–.98). Validity was established for both OMNI scales, indicating either metric can be used to estimate ratings of perceived exertion during partial weight bearing exercise. PMID:21319623

  17. Characterization of the Auroral Electrojet and the Ambient and Modified D Region for HAARP Using Long-Path VLF Diagnostics

    DTIC Science & Technology

    2001-03-15

    order to characterize the auroral electrojet and the ambient and modified D-region directly above and near the HAARP (High Frequency Active Auroral...near the HAARP facility and along the west coast of Alaska. In addition in order to characterize the auroral electrojet on a continental scale and to...United States and Canada. Data from the complete array of D-region diagnostic systems was acquired during a number of Fall and Spring HAARP campaigns

  18. Development of Low-cost, High Energy-per-unit-area Solar Cell Modules

    NASA Technical Reports Server (NTRS)

    Jones, G. T.; Chitre, S.; Rhee, S. S.

    1978-01-01

    The development of two hexagonal solar cell process sequences, a laserscribing process technique for scribing hexagonal and modified hexagonal solar cells, a large through-put diffusion process, and two surface macrostructure processes suitable for large scale production is reported. Experimental analysis was made on automated spin-on anti-reflective coating equipment and high pressure wafer cleaning equipment. Six hexagonal solar cell modules were fabricated. Also covered is a detailed theoretical analysis on the optimum silicon utilization by modified hexagonal solar cells.

  19. Coherent backscattering of singular beams

    NASA Astrophysics Data System (ADS)

    Schwartz, Chaim; Dogariu, Aristide

    2006-02-01

    The phenomenon of coherent backscattering depends on both the statistical characteristics of a random scattering medium and the correlation features of the incident field. Imposing a wavefront singularity on the incident field offers a unique and very attractive way to modify the field correlations in a deterministic manner. The field correlations are found to act as a path-length filter which modifies the distribution of different contributions to the enhancement cone. This effect is thoroughly discussed and demonstrated experimentally for the case of single scale scattering systems.

  20. A Modified Rodrigues Parameter-based Nonlinear Observer Design for Spacecraft Gyroscope Parameters Estimation

    NASA Astrophysics Data System (ADS)

    Yong, Kilyuk; Jo, Sujang; Bang, Hyochoong

    This paper presents a modified Rodrigues parameter (MRP)-based nonlinear observer design to estimate bias, scale factor and misalignment of gyroscope measurements. A Lyapunov stability analysis is carried out for the nonlinear observer. Simulation is performed and results are presented illustrating the performance of the proposed nonlinear observer under the condition of persistent excitation maneuver. In addition, a comparison between the nonlinear observer and alignment Kalman filter (AKF) is made to highlight favorable features of the nonlinear observer.

  1. Cluster-modified function projective synchronisation of complex networks with asymmetric coupling

    NASA Astrophysics Data System (ADS)

    Wang, Shuguo

    2018-02-01

    This paper investigates the cluster-modified function projective synchronisation (CMFPS) of a generalised linearly coupled network with asymmetric coupling and nonidentical dynamical nodes. A novel synchronisation scheme is proposed to achieve CMFPS in community networks. We use adaptive control method to derive CMFPS criteria based on Lyapunov stability theory. Each cluster of networks is synchronised with target system by state transformation with scaling function matrix. Numerical simulation results are presented finally to illustrate the effectiveness of this method.

  2. Finite length-scale anti-gravity and observations of mass discrepancies in galaxies

    NASA Astrophysics Data System (ADS)

    Sanders, R. H.

    1986-01-01

    The modification of Newtonian attraction suggested by Sanders (1984) contains a repulsive Yukawa component which is characterised by two physical parameters: a coupling constant, α, and a length scale, r0. Although this form of the gravitational potential can result in flat rotation curves for a galaxy (or a point mass) it is not obvious that any modification of gravity associated with a definite length scale can reproduce the observed rotation curves of galaxies covering a wide range of mass and size. Here it is shown that the rotation curves of galaxies ranging in size from 5 to 40 kpc can be reproduced by this modified potential. Moreover, the implied mass-to-light ratios for a larger sample of galaxies are reasonable (one to three) and show no systematic trend with the size of the galaxy. The observed infrared Tully-Fisher law is shown to be consistent with the prediction of this revised gravity. The modified potential permits the X-ray emitting halos observed around elliptical galaxies to be bound without the addition of dark matter.

  3. Modelling of Coke Layer Collapse during Ore Charging in Ironmaking Blast Furnace by DEM

    NASA Astrophysics Data System (ADS)

    Narita, Yoichi; Mio, Hiroshi; Orimoto, Takashi; Nomura, Seiji

    2017-06-01

    A technical issue in an ironmaking blast furnace operation is to realize the optimum layer thickness and the radial distribution of burden (ore and coke) to enhance its efficiency and productivity. When ore particles are charged onto the already-embedded coke layer, the coke layer-collapse phenomenon occurs. The coke layer-collapse phenomenon has a significant effect on the distribution of ore and coke layer thickness in the radial direction. In this paper, the mechanical properties of coke packed bed under ore charging were investigated by the impact-loading test and the large-scale direct shear test. Experimental results show that the coke particle is broken by the impact force of ore charging, and the particle breakage leads to weaken of coke-layer strength. The expression of contact force for coke in Discrete Element Method (DEM) was modified based on the measured data, and it followed by the 1/3-scaled experiment on coke's collapse phenomena. Comparing a simulation by modified model to the 1/3-scaled experiment, they agreed well in the burden distribution.

  4. TPS design for aerobraking at Earth and Mars

    NASA Astrophysics Data System (ADS)

    Williams, S. D.; Gietzel, M. M.; Rochelle, W. C.; Curry, D. M.

    1991-08-01

    An investigation was made to determine the feasibility of using an aerobrake system for manned and unmanned missions to Mars, and to Earth from Mars and lunar orbits. A preliminary thermal protection system (TPS) was examined for five unmanned small nose radius, straight bi-conic vehicles and a scaled up Aeroassist Flight Experiment (AFE) vehicle aerocapturing at Mars. Analyses were also conducted for the scaled up AFE and an unmanned Sample Return Cannister (SRC) returning from Mars and aerocapturing into Earth orbit. Also analyzed were three different classes of lunar transfer vehicles (LTV's): an expendable scaled up modified Apollo Command Module (CM), a raked cone (modified AFT), and three large nose radius domed cylinders. The LTV's would be used to transport personnel and supplies between Earth and the moon in order to establish a manned base on the lunar surface. The TPS for all vehicles analyzed is shown to have an advantage over an all-propulsive velocity reduction for orbit insertion. Results indicate that TPS weight penalties of less than 28 percent can be achieved using current material technology, and slightly less than the most favorable LTV using advanced material technology.

  5. Beyond clay: Towards an improved set of variables for predicting soil organic matter content

    USGS Publications Warehouse

    Rasmussen, Craig; Heckman, Katherine; Wieder, William R.; Keiluweit, Marco; Lawrence, Corey R.; Berhe, Asmeret Asefaw; Blankinship, Joseph C.; Crow, Susan E.; Druhan, Jennifer; Hicks Pries, Caitlin E.; Marin-Spiotta, Erika; Plante, Alain F.; Schadel, Christina; Schmiel, Joshua P.; Sierra, Carlos A.; Thompson, Aaron; Wagai, Rota

    2018-01-01

    Improved quantification of the factors controlling soil organic matter (SOM) stabilization at continental to global scales is needed to inform projections of the largest actively cycling terrestrial carbon pool on Earth, and its response to environmental change. Biogeochemical models rely almost exclusively on clay content to modify rates of SOM turnover and fluxes of climate-active CO2 to the atmosphere. Emerging conceptual understanding, however, suggests other soil physicochemical properties may predict SOM stabilization better than clay content. We addressed this discrepancy by synthesizing data from over 5,500 soil profiles spanning continental scale environmental gradients. Here, we demonstrate that other physicochemical parameters are much stronger predictors of SOM content, with clay content having relatively little explanatory power. We show that exchangeable calcium strongly predicted SOM content in water-limited, alkaline soils, whereas with increasing moisture availability and acidity, iron- and aluminum-oxyhydroxides emerged as better predictors, demonstrating that the relative importance of SOM stabilization mechanisms scales with climate and acidity. These results highlight the urgent need to modify biogeochemical models to better reflect the role of soil physicochemical properties in SOM cycling.

  6. Aerodynamic results of a separation test (CA20) conducted at the Boeing transonic wind tunnel using 0.030-scale models of the configuration 140A/B (modified) SSV orbiter (model no. 45-0) and the Boeing 747 carrier (model no. AX 1319 I-1), volume 1. [wind tunnel tests

    NASA Technical Reports Server (NTRS)

    Dziubala, T.; Esparza, V.; Gillins, R. L.; Petrozzi, M.

    1975-01-01

    A Rockwell built 0.030-scale 45-0 modified Space Shuttle Orbiter Configuration 14?A/B model and a Boeing built 0.030-scale 747 carrier model were tested to provide six component force and moment data for each vehicle in proximity to the other at a matrix of relative positions, attitudes and test conditions (angles of attack and sideslip were varied). Orbiter model support system tare effects were determined for corrections to obtain support-free aerodynamics. In addition to the balance force data, pressures were measured. Pressure orifices were located at the base of the Orbiter, on either side of the vertical blade strut, and at the mid-root chord on either side of the vertical tail. Strain gages were installed on the Boeing 747 vertical tail to indicate buffet onset. Photographs of aerodynamic configurations tested are shown.

  7. Laboratory Study of Homogeneous and Isotropic Turbulence at High Reynolds Number

    NASA Astrophysics Data System (ADS)

    Pecenak, Zachary; Dou, Zhongwang; Yang, Fan; Cao, Lujie; Liang, Zach; Meng, Hui

    2013-11-01

    To study particle dynamics modified by isotropic turbulence at high Reynolds numbers and provide experimental data for DNS validation, we have developed a soccer-ball-shaped truncated icosahedron turbulence chamber with 20 adjoining hexagon surfaces, 12 pentagon surfaces and twenty symettrically displaced fans, which form an enclosed chamber of 1m diameter. We use Particle Image Velocimetry (PIV) technique to characterize the base turbulent flow, using different PIV set ups to capture various characteristic scales of turbulence. Results show that the stationary isotropic turbulence field is a spherical domain with diameter of 40 mm with quasi-zero mean velocities. The maximum rms velocity is ~1.5 m/s, corresponding to a Taylor microscale Re of 450. We extract from the PIV velocity field the whole set of turbulent flow parameters including: turbulent kinetic energy, turbulent intensity, kinetic energy dissipation rate, large eddy length and time scales, the Kolmogorov length, time and velocity scales, Taylor microscale and Re, which are critical to the study of inter-particle statistics modified by turbulence. This research is funded by an NSF grant CBET-0967407.

  8. TCA High Lift Preliminary Assessment

    NASA Technical Reports Server (NTRS)

    Wyatt, G. H.; Polito, R. C.; Yeh, D. T.; Elzey, M. E.; Tran, J. T.; Meredith, Paul T.

    1999-01-01

    This paper presents a TCA (Technology Concept Airplane) High lift Preliminary Assessment. The topics discussed are: 1) Model Description; 2) Data Repeatability; 3) Effect of Inboard L.E. (Leading Edge) Flap Span; 4) Comparison of 14'x22' TCA-1 With NTF (National Transonic Facility) Modified Ref. H; 5) Comparison of 14'x22' and NTF Ref. H Results; 6) Effect of Outboard Sealed Slat on TCA; 7) TCA Full Scale Build-ups; 8) Full Scale L/D Comparisons; 9) TCA Full Scale; and 10) Touchdown Lift Curves. This paper is in viewgraph form.

  9. Quantum mechanics, gravity and modified quantization relations.

    PubMed

    Calmet, Xavier

    2015-08-06

    In this paper, we investigate a possible energy scale dependence of the quantization rules and, in particular, from a phenomenological point of view, an energy scale dependence of an effective [Formula: see text] (reduced Planck's constant). We set a bound on the deviation of the value of [Formula: see text] at the muon scale from its usual value using measurements of the anomalous magnetic moment of the muon. Assuming that inflation has taken place, we can conclude that nature is described by a quantum theory at least up to an energy scale of about 10(16) GeV. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  10. When less is more: validating a brief scale to rate interprofessional team competencies.

    PubMed

    Lie, Désirée A; Richter-Lagha, Regina; Forest, Christopher P; Walsh, Anne; Lohenry, Kevin

    2017-01-01

    There is a need for validated and easy-to-apply behavior-based tools for assessing interprofessional team competencies in clinical settings. The seven-item observer-based Modified McMaster-Ottawa scale was developed for the Team Objective Structured Clinical Encounter (TOSCE) to assess individual and team performance in interprofessional patient encounters. We aimed to improve scale usability for clinical settings by reducing item numbers while maintaining generalizability; and to explore the minimum number of observed cases required to achieve modest generalizability for giving feedback. We administered a two-station TOSCE in April 2016 to 63 students split into 16 newly-formed teams, each consisting of four professions. The stations were of similar difficulty. We trained sixteen faculty to rate two teams each. We examined individual and team performance scores using generalizability (G) theory and principal component analysis (PCA). The seven-item scale shows modest generalizability (.75) with individual scores. PCA revealed multicollinearity and singularity among scale items and we identified three potential items for removal. Reducing items for individual scores from seven to four (measuring Collaboration, Roles, Patient/Family-centeredness, and Conflict Management) changed scale generalizability from .75 to .73. Performance assessment with two cases is associated with reasonable generalizability (.73). Students in newly-formed interprofessional teams show a learning curve after one patient encounter. Team scores from a two-station TOSCE demonstrate low generalizability whether the scale consisted of four (.53) or seven items (.55). The four-item Modified McMaster-Ottawa scale for assessing individual performance in interprofessional teams retains the generalizability and validity of the seven-item scale. Observation of students in teams interacting with two different patients provides reasonably reliable ratings for giving feedback. The four-item scale has potential for assessing individual student skills and the impact of IPE curricula in clinical practice settings. IPE: Interprofessional education; SP: Standardized patient; TOSCE: Team objective structured clinical encounter.

  11. A Numerical Comparison of Barrier and Modified Barrier Methods for Large-Scale Bound-Constrained Optimization

    NASA Technical Reports Server (NTRS)

    Nash, Stephen G.; Polyak, R.; Sofer, Ariela

    1994-01-01

    When a classical barrier method is applied to the solution of a nonlinear programming problem with inequality constraints, the Hessian matrix of the barrier function becomes increasingly ill-conditioned as the solution is approached. As a result, it may be desirable to consider alternative numerical algorithms. We compare the performance of two methods motivated by barrier functions. The first is a stabilized form of the classical barrier method, where a numerically stable approximation to the Newton direction is used when the barrier parameter is small. The second is a modified barrier method where a barrier function is applied to a shifted form of the problem, and the resulting barrier terms are scaled by estimates of the optimal Lagrange multipliers. The condition number of the Hessian matrix of the resulting modified barrier function remains bounded as the solution to the constrained optimization problem is approached. Both of these techniques can be used in the context of a truncated-Newton method, and hence can be applied to large problems, as well as on parallel computers. In this paper, both techniques are applied to problems with bound constraints and we compare their practical behavior.

  12. A robust algorithm for optimisation and customisation of fractal dimensions of time series modified by nonlinearly scaling their time derivatives: mathematical theory and practical applications.

    PubMed

    Fuss, Franz Konstantin

    2013-01-01

    Standard methods for computing the fractal dimensions of time series are usually tested with continuous nowhere differentiable functions, but not benchmarked with actual signals. Therefore they can produce opposite results in extreme signals. These methods also use different scaling methods, that is, different amplitude multipliers, which makes it difficult to compare fractal dimensions obtained from different methods. The purpose of this research was to develop an optimisation method that computes the fractal dimension of a normalised (dimensionless) and modified time series signal with a robust algorithm and a running average method, and that maximises the difference between two fractal dimensions, for example, a minimum and a maximum one. The signal is modified by transforming its amplitude by a multiplier, which has a non-linear effect on the signal's time derivative. The optimisation method identifies the optimal multiplier of the normalised amplitude for targeted decision making based on fractal dimensions. The optimisation method provides an additional filter effect and makes the fractal dimensions less noisy. The method is exemplified by, and explained with, different signals, such as human movement, EEG, and acoustic signals.

  13. A Robust Algorithm for Optimisation and Customisation of Fractal Dimensions of Time Series Modified by Nonlinearly Scaling Their Time Derivatives: Mathematical Theory and Practical Applications

    PubMed Central

    2013-01-01

    Standard methods for computing the fractal dimensions of time series are usually tested with continuous nowhere differentiable functions, but not benchmarked with actual signals. Therefore they can produce opposite results in extreme signals. These methods also use different scaling methods, that is, different amplitude multipliers, which makes it difficult to compare fractal dimensions obtained from different methods. The purpose of this research was to develop an optimisation method that computes the fractal dimension of a normalised (dimensionless) and modified time series signal with a robust algorithm and a running average method, and that maximises the difference between two fractal dimensions, for example, a minimum and a maximum one. The signal is modified by transforming its amplitude by a multiplier, which has a non-linear effect on the signal's time derivative. The optimisation method identifies the optimal multiplier of the normalised amplitude for targeted decision making based on fractal dimensions. The optimisation method provides an additional filter effect and makes the fractal dimensions less noisy. The method is exemplified by, and explained with, different signals, such as human movement, EEG, and acoustic signals. PMID:24151522

  14. [Clinical and radiographic evaluation of a new percutaneous technique for moderate to severe hallux valgus deformity].

    PubMed

    Vélez-de Lachica, J C; Valdez-Jiménez, L A; Inzunza-Sánchez, J M

    2017-01-01

    Hallux valgus is considered the most common musculoskeletal deformity, with a prevalence of 88%. There are more than 130 surgical techniques for its treatment; currently, percutaneous ones are popular; however, they do not take into account the metatarsal-phalangeal correction angle. The aim of this study is to propose a modified technique for the correction of the percutaneous metatarsal-phalangeal and inter-metatarsal angles and to evaluate its clinical and radiological results. An experimental, prospective and longitudinal study in 10 patients with moderate to severe hallux valgus according to the classification of Coughlin and Mann were collected; the results were evaluated with the AOFAS scale at 15, 30, 60 and 90 days. The McBride technique and the technique of percutaneous anchor with the proposed amendment were performed. The AOFAS scale was applied as described, finding a progressive increase of the rating; the average correction of the inter-metatarsal angle was 8.8 degrees and of the metatarsal-phalangeal, 9.12. The modified technique of percutaneous anchor showed clear clinical and radiographic improvements in the short term. Our modified technique is proposed for future projects, including a large sample with long-term follow-up.

  15. Equilibrium properties of blackbody radiation with an ultraviolet energy cut-off

    NASA Astrophysics Data System (ADS)

    Mishra, Dheeraj Kumar; Chandra, Nitin; Vaibhav, Vinay

    2017-10-01

    We study various equilibrium thermodynamic properties of blackbody radiation (i.e. a photon gas) with an ultraviolet energy cut-off. We find that the energy density, specific heat etc. follow usual acoustic phonon dynamics as have been well studied by Debye. Other thermodynamic quantities like pressure, entropy etc. have also been calculated. The usual Stefan-Boltzmann law gets modified. We observe that the values of the thermodynamic quantities with the energy cut-off is lower than the corresponding values in the theory without any such scale. The phase-space measure is also expected to get modified for an exotic spacetime appearing at Planck scale, which in turn leads to the modification of Planck energy density distribution and the Wien's displacement law. We found that the non-perturbative nature of the thermodynamic quantities in the SR limit (for both unmodified and modified cases), due to nonanalyticity of the leading term, is a general feature of the theory accompanied with an ultraviolet energy cut-off. We have also discussed the possible modification in the case of Big Bang and the Stellar objects and have suggested a table top experiment for verification in effective low energy case.

  16. Studies of land-cover, land-use, and biophysical properties of vegetation in the Large Scale Biosphere Atmosphere experiment in Amazonia.

    Treesearch

    Dar A. Robertsa; Michael Keller; Joao Vianei Soares

    2003-01-01

    We summarize early research on land-cover, land-use, and biophysical properties of vegetation from the Large Scale Biosphere Atmosphere (LBA) experiment in Amazoˆnia. LBA is an international research program developed to evaluate regional function and to determine how land-use and climate modify biological, chemical and physical processes there. Remote sensing has...

  17. Efficacy of physical therapy in multiple sclerosis as measured with the modified fatigue impact scale and ambulation index: a retrospective study.

    PubMed

    Brichetto, Giampaolo; Rinaldi, Sara; Spallarossa, Patricio; Battaglia, Mario Alberto; de Carvalho, Maria Laura Lopes

    2013-01-01

    Evaluate the efficacy of outcome measures routinely used in a physical therapy service for Multiple Sclerosis (MS). We performed a retrospective review of 500 medical records of MS patients from the outpatients service of AISM Rehabilitation Centre, Genova, Italy. All records of outpatients followed by AISM Rehabilitation Centre who underwent physical therapy from 2006 to 2008 were evaluated. Modified Fatigue Impact Scale (MFIS) and Ambulation Index (AI) were reviewed for all records at the begin and at the end of the rehabilitation treatment. The number of assessments recorded was 295 in 209 patients. Out of the 209 patients, 133 were female and 76 were male. The mean age was 51.6 ± 11.68 years, the mean Expanded Disability Status Scale (EDSS) score was 4.98 ± 1.79, and 185 patients were ambulatory. In nonambulatory patients neither scale showed a significant increase. In ambulatory patients (275 assessments) significant changes were observed in AI, MFIS total score and subscores. Physical therapy has a positive impact on fatigue, and the MFIS seems to be a good outcome measure in ambulatory patients. The AI and MFIS seem to be not indicated for use in non-ambulatory patients.

  18. The Trunk Impairment Scale - modified to ordinal scales in the Norwegian version.

    PubMed

    Gjelsvik, Bente; Breivik, Kyrre; Verheyden, Geert; Smedal, Tori; Hofstad, Håkon; Strand, Liv Inger

    2012-01-01

    To translate the Trunk Impairment Scale (TIS), a measure of trunk control in patients after stroke, into Norwegian (TIS-NV), and to explore its construct validity, internal consistency, intertester and test-retest reliability. TIS was translated according to international guidelines. The validity study was performed on data from 201 patients with acute stroke. Fifty patients with stroke and acquired brain injury were recruited to examine intertester and test-retest reliability. Construct validity was analyzed with exploratory and confirmatory factor analysis and item response theory, internal consistency with Cronbach's alpha test, and intertester and test-retest reliability with kappa and intraclass correlation coefficient tests. The back-translated version of TIS-NV was validated by the original developer. The subscale Static sitting balance was removed. By combining items from the subscales Dynamic sitting balance and Coordination, six ordinal superitems (testlets) were constructed. The TIS-NV was renamed the modified TIS-NV (TIS-modNV). After modifications the TIS-modNV fitted well to a locally dependent unidimensional item response theory model. It demonstrated good construct validity, excellent internal consistency, and high intertester and test-retest reliability for the total score. This study supports that the TIS-modNV is a valid and reliable scale for use in clinical practice and research.

  19. Confirmation of general relativity on large scales from weak lensing and galaxy velocities.

    PubMed

    Reyes, Reinabelle; Mandelbaum, Rachel; Seljak, Uros; Baldauf, Tobias; Gunn, James E; Lombriser, Lucas; Smith, Robert E

    2010-03-11

    Although general relativity underlies modern cosmology, its applicability on cosmological length scales has yet to be stringently tested. Such a test has recently been proposed, using a quantity, E(G), that combines measures of large-scale gravitational lensing, galaxy clustering and structure growth rate. The combination is insensitive to 'galaxy bias' (the difference between the clustering of visible galaxies and invisible dark matter) and is thus robust to the uncertainty in this parameter. Modified theories of gravity generally predict values of E(G) different from the general relativistic prediction because, in these theories, the 'gravitational slip' (the difference between the two potentials that describe perturbations in the gravitational metric) is non-zero, which leads to changes in the growth of structure and the strength of the gravitational lensing effect. Here we report that E(G) = 0.39 +/- 0.06 on length scales of tens of megaparsecs, in agreement with the general relativistic prediction of E(G) approximately 0.4. The measured value excludes a model within the tensor-vector-scalar gravity theory, which modifies both Newtonian and Einstein gravity. However, the relatively large uncertainty still permits models within f(R) theory, which is an extension of general relativity. A fivefold decrease in uncertainty is needed to rule out these models.

  20. Confirmation of general relativity on large scales from weak lensing and galaxy velocities

    NASA Astrophysics Data System (ADS)

    Reyes, Reinabelle; Mandelbaum, Rachel; Seljak, Uros; Baldauf, Tobias; Gunn, James E.; Lombriser, Lucas; Smith, Robert E.

    2010-03-01

    Although general relativity underlies modern cosmology, its applicability on cosmological length scales has yet to be stringently tested. Such a test has recently been proposed, using a quantity, EG, that combines measures of large-scale gravitational lensing, galaxy clustering and structure growth rate. The combination is insensitive to `galaxy bias' (the difference between the clustering of visible galaxies and invisible dark matter) and is thus robust to the uncertainty in this parameter. Modified theories of gravity generally predict values of EG different from the general relativistic prediction because, in these theories, the `gravitational slip' (the difference between the two potentials that describe perturbations in the gravitational metric) is non-zero, which leads to changes in the growth of structure and the strength of the gravitational lensing effect. Here we report that EG = 0.39+/-0.06 on length scales of tens of megaparsecs, in agreement with the general relativistic prediction of EG~0.4. The measured value excludes a model within the tensor-vector-scalar gravity theory, which modifies both Newtonian and Einstein gravity. However, the relatively large uncertainty still permits models within f() theory, which is an extension of general relativity. A fivefold decrease in uncertainty is needed to rule out these models.

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