Importance of multi-modal approaches to effectively identify cataract cases from electronic health records

PubMed Central

Rasmussen, Luke V; Berg, Richard L; Linneman, James G; McCarty, Catherine A; Waudby, Carol; Chen, Lin; Denny, Joshua C; Wilke, Russell A; Pathak, Jyotishman; Carrell, David; Kho, Abel N; Starren, Justin B

2012-01-01

Objective There is increasing interest in using electronic health records (EHRs) to identify subjects for genomic association studies, due in part to the availability of large amounts of clinical data and the expected cost efficiencies of subject identification. We describe the construction and validation of an EHR-based algorithm to identify subjects with age-related cataracts. Materials and methods We used a multi-modal strategy consisting of structured database querying, natural language processing on free-text documents, and optical character recognition on scanned clinical images to identify cataract subjects and related cataract attributes. Extensive validation on 3657 subjects compared the multi-modal results to manual chart review. The algorithm was also implemented at participating electronic MEdical Records and GEnomics (eMERGE) institutions. Results An EHR-based cataract phenotyping algorithm was successfully developed and validated, resulting in positive predictive values (PPVs) >95%. The multi-modal approach increased the identification of cataract subject attributes by a factor of three compared to single-mode approaches while maintaining high PPV. Components of the cataract algorithm were successfully deployed at three other institutions with similar accuracy. Discussion A multi-modal strategy incorporating optical character recognition and natural language processing may increase the number of cases identified while maintaining similar PPVs. Such algorithms, however, require that the needed information be embedded within clinical documents. Conclusion We have demonstrated that algorithms to identify and characterize cataracts can be developed utilizing data collected via the EHR. These algorithms provide a high level of accuracy even when implemented across multiple EHRs and institutional boundaries. PMID:22319176

Derivation and external validation of a case mix model for the standardized reporting of 30-day stroke mortality rates.

PubMed

Bray, Benjamin D; Campbell, James; Cloud, Geoffrey C; Hoffman, Alex; James, Martin; Tyrrell, Pippa J; Wolfe, Charles D A; Rudd, Anthony G

2014-11-01

Case mix adjustment is required to allow valid comparison of outcomes across care providers. However, there is a lack of externally validated models suitable for use in unselected stroke admissions. We therefore aimed to develop and externally validate prediction models to enable comparison of 30-day post-stroke mortality outcomes using routine clinical data. Models were derived (n=9000 patients) and internally validated (n=18 169 patients) using data from the Sentinel Stroke National Audit Program, the national register of acute stroke in England and Wales. External validation (n=1470 patients) was performed in the South London Stroke Register, a population-based longitudinal study. Models were fitted using general estimating equations. Discrimination and calibration were assessed using receiver operating characteristic curve analysis and correlation plots. Two final models were derived. Model A included age (<60, 60-69, 70-79, 80-89, and ≥90 years), National Institutes of Health Stroke Severity Score (NIHSS) on admission, presence of atrial fibrillation on admission, and stroke type (ischemic versus primary intracerebral hemorrhage). Model B was similar but included only the consciousness component of the NIHSS in place of the full NIHSS. Both models showed excellent discrimination and calibration in internal and external validation. The c-statistics in external validation were 0.87 (95% confidence interval, 0.84-0.89) and 0.86 (95% confidence interval, 0.83-0.89) for models A and B, respectively. We have derived and externally validated 2 models to predict mortality in unselected patients with acute stroke using commonly collected clinical variables. In settings where the ability to record the full NIHSS on admission is limited, the level of consciousness component of the NIHSS provides a good approximation of the full NIHSS for mortality prediction. © 2014 American Heart Association, Inc.

Automated Student Aid Processing: The Challenge and Opportunity.

ERIC Educational Resources Information Center

St. John, Edward P.

1985-01-01

To utilize automated technology for student aid processing, it is necessary to work with multi-institutional offices (student aid, admissions, registration, and business) and to develop automated interfaces with external processing systems at state and federal agencies and perhaps at need-analysis organizations and lenders. (MLW)

Examining Evidence for External and Consequential Validity of the First Term General Chemistry Exam from the ACS Examinations Institute

ERIC Educational Resources Information Center

Lewis, Scott E.

2014-01-01

Validity of educational research instruments and student assessments has appropriately become a growing interest in the chemistry education research community. Of particular concern is an attention to the consequences to students that result from the interpretation of assessment scores and whether those consequences are swayed by invalidity within…

Prediction of pelvic organ prolapse using an artificial neural network.

PubMed

Robinson, Christopher J; Swift, Steven; Johnson, Donna D; Almeida, Jonas S

2008-08-01

The objective of this investigation was to test the ability of a feedforward artificial neural network (ANN) to differentiate patients who have pelvic organ prolapse (POP) from those who retain good pelvic organ support. Following institutional review board approval, patients with POP (n = 87) and controls with good pelvic organ support (n = 368) were identified from the urogynecology research database. Historical and clinical information was extracted from the database. Data analysis included the training of a feedforward ANN, variable selection, and external validation of the model with an independent data set. Twenty variables were used. The median-performing ANN model used a median of 3 (quartile 1:3 to quartile 3:5) variables and achieved an area under the receiver operator curve of 0.90 (external, independent validation set). Ninety percent sensitivity and 83% specificity were obtained in the external validation by ANN classification. Feedforward ANN modeling is applicable to the identification and prediction of POP.

Biomarkers for Early Detection of Clinically Relevant Prostate Cancer: A Multi-Institutional Validation Trial

DTIC Science & Technology

2017-10-01

been shown in many studies to improve predictive accuracy for cancer on initial biopsy,3,7-9 and to be correlated with more aggressive cancer at...our multi-center, prospectively accrued prostate cancer active surveillance cohort – the Canary Prostate Active Surveillance Study (PASS). We are in...objective of the study is to utilize analytically validated assays that take into account tumor heterogeneity to measure biomarkers in specimens that were

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.

Multi-institutional evaluation of end-to-end protocol for IMRT/VMAT treatment chains utilizing conventional linacs.

PubMed

Loughery, Brian; Knill, Cory; Silverstein, Evan; Zakjevskii, Viatcheslav; Masi, Kathryn; Covington, Elizabeth; Snyder, Karen; Song, Kwang; Snyder, Michael

2018-03-20

We conducted a multi-institutional assessment of a recently developed end-to-end monthly quality assurance (QA) protocol for external beam radiation therapy treatment chains. This protocol validates the entire treatment chain against a baseline to detect the presence of complex errors not easily found in standard component-based QA methods. Participating physicists from 3 institutions ran the end-to-end protocol on treatment chains that include Imaging and Radiation Oncology Core (IROC)-credentialed linacs. Results were analyzed in the form of American Association of Physicists in Medicine (AAPM) Task Group (TG)-119 so that they may be referenced by future test participants. Optically stimulated luminescent dosimeter (OSLD), EBT3 radiochromic film, and A1SL ion chamber readings were accumulated across 10 test runs. Confidence limits were calculated to determine where 95% of measurements should fall. From calculated confidence limits, 95% of measurements should be within 5% error for OSLDs, 4% error for ionization chambers, and 4% error for (96% relative gamma pass rate) radiochromic film at 3% agreement/3 mm distance to agreement. Data were separated by institution, model of linac, and treatment protocol (intensity-modulated radiation therapy [IMRT] vs volumetric modulated arc therapy [VMAT]). A total of 97% of OSLDs, 98% of ion chambers, and 93% of films were within the confidence limits; measurements were found outside these limits by a maximum of 4%, < 1%, and < 1%, respectively. Data were consistent despite institutional differences in OSLD reading equipment and radiochromic film calibration techniques. Results from this test may be used by clinics for data comparison. Areas of improvement were identified in the end-to-end protocol that can be implemented in an updated version. The consistency of our data demonstrates the reproducibility and ease-of-use of such tests and suggests a potential role for their use in broad end-to-end QA initiatives. Copyright © 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

Predicting Blunt Cerebrovascular Injury in Pediatric Trauma: Validation of the “Utah Score”

PubMed Central

Ravindra, Vijay M.; Bollo, Robert J.; Sivakumar, Walavan; Akbari, Hassan; Naftel, Robert P.; Limbrick, David D.; Jea, Andrew; Gannon, Stephen; Shannon, Chevis; Birkas, Yekaterina; Yang, George L.; Prather, Colin T.; Kestle, John R.

2017-01-01

Abstract Risk factors for blunt cerebrovascular injury (BCVI) may differ between children and adults, suggesting that children at low risk for BCVI after trauma receive unnecessary computed tomography angiography (CTA) and high-dose radiation. We previously developed a score for predicting pediatric BCVI based on retrospective cohort analysis. Our objective is to externally validate this prediction score with a retrospective multi-institutional cohort. We included patients who underwent CTA for traumatic cranial injury at four pediatric Level I trauma centers. Each patient in the validation cohort was scored using the “Utah Score” and classified as high or low risk. Before analysis, we defined a misclassification rate <25% as validating the Utah Score. Six hundred forty-five patients (mean age 8.6 ± 5.4 years; 63.4% males) underwent screening for BCVI via CTA. The validation cohort was 411 patients from three sites compared with the training cohort of 234 patients. Twenty-two BCVIs (5.4%) were identified in the validation cohort. The Utah Score was significantly associated with BCVIs in the validation cohort (odds ratio 8.1 [3.3, 19.8], p < 0.001) and discriminated well in the validation cohort (area under the curve 72%). When the Utah Score was applied to the validation cohort, the sensitivity was 59%, specificity was 85%, positive predictive value was 18%, and negative predictive value was 97%. The Utah Score misclassified 16.6% of patients in the validation cohort. The Utah Score for predicting BCVI in pediatric trauma patients was validated with a low misclassification rate using a large, independent, multicenter cohort. Its implementation in the clinical setting may reduce the use of CTA in low-risk patients. PMID:27297774

Adaptive tracking control of leader-following linear multi-agent systems with external disturbances

NASA Astrophysics Data System (ADS)

Lin, Hanquan; Wei, Qinglai; Liu, Derong; Ma, Hongwen

2016-10-01

In this paper, the consensus problem for leader-following linear multi-agent systems with external disturbances is investigated. Brownian motions are used to describe exogenous disturbances. A distributed tracking controller based on Riccati inequalities with an adaptive law for adjusting coupling weights between neighbouring agents is designed for leader-following multi-agent systems under fixed and switching topologies. In traditional distributed static controllers, the coupling weights depend on the communication graph. However, coupling weights associated with the feedback gain matrix in our method are updated by state errors between neighbouring agents. We further present the stability analysis of leader-following multi-agent systems with stochastic disturbances under switching topology. Most traditional literature requires the graph to be connected all the time, while the communication graph is only assumed to be jointly connected in this paper. The design technique is based on Riccati inequalities and algebraic graph theory. Finally, simulations are given to show the validity of our method.

Validity of the SAT® for Predicting First-Year Grades: 2009 SAT Validity Sample. Statistical Report No. 2012-2

ERIC Educational Resources Information Center

Patterson, Brian F.; Mattern, Krista D.

2009-01-01

In an effort to continuously monitor the validity of the SAT for predicting first-year college grades, the College Board has continued its multi-year effort to recruit four-year colleges and universities (henceforth, "institutions") to provide data on the cohorts of first-time, first-year students entering in the fall semester beginning…

External and semi-internal controls for PCR amplification of homologous sequences in mixed templates.

PubMed

Kalle, Elena; Gulevich, Alexander; Rensing, Christopher

2013-11-01

In a mixed template, the presence of homologous target DNA sequences creates environments that almost inevitably give rise to artifacts and biases during PCR. Heteroduplexes, chimeras, and skewed template-to-product ratios are the exclusive attributes of mixed template PCR and never occur in a single template assay. Yet, multi-template PCR has been used without appropriate attention to quality control and assay validation, in spite of the fact that such practice diminishes the reliability of results. External and internal amplification controls became obligatory elements of good laboratory practice in different PCR assays. We propose the inclusion of an analogous approach as a quality control system for multi-template PCR applications. The amplification controls must take into account the characteristics of multi-template PCR and be able to effectively monitor particular assay performance. This study demonstrated the efficiency of a model mixed template as an adequate external amplification control for a particular PCR application. The conditions of multi-template PCR do not allow implementation of a classic internal control; therefore we developed a convenient semi-internal control as an acceptable alternative. In order to evaluate the effects of inhibitors, a model multi-template mix was amplified in a mixture with DNAse-treated sample. Semi-internal control allowed establishment of intervals for robust PCR performance for different samples, thus enabling correct comparison of the samples. The complexity of the external and semi-internal amplification controls must be comparable with the assumed complexity of the samples. We also emphasize that amplification controls should be applied in multi-template PCR regardless of the post-assay method used to analyze products. © 2013 Elsevier B.V. All rights reserved.

Language Policy and Language Governance: A Case-Study of Irish Language Legislation

ERIC Educational Resources Information Center

Walsh, John

2012-01-01

In this paper, it is argued that the existing conceptual framework of "language policy" should be expanded to include perspectives from the emerging field of "language governance", as the latter pays attention to the multi-faceted internal and external contexts in which institutions and organisations seek to develop language…

Major Decisions: Motivations for Selecting a Major, Satisfaction, and Belonging

ERIC Educational Resources Information Center

Soria, Krista M.; Stebleton, Michael

2013-01-01

In this paper, we analyzed the relationship between students' motivations for choosing academic majors and their satisfaction and sense of belonging on campus. Based on a multi-institutional survey of students who attended large, public, research universities in 2009, the results suggest that external extrinsic motivations for selecting a major…

Abstract for 1999 Rational Software User Conference

NASA Technical Reports Server (NTRS)

Dunphy, Julia; Rouquette, Nicolas; Feather, Martin; Tung, Yu-Wen

1999-01-01

We develop spacecraft fault-protection software at NASA/JPL. Challenges exemplified by our task: 1) high-quality systems - need for extensive validation & verification; 2) multi-disciplinary context - involves experts from diverse areas; 3) embedded systems - must adapt to external practices, notations, etc.; and 4) development pressures - NASA's mandate of "better, faster, cheaper".

A Multi-Institution Look at College Students Seeking Counseling: Nature and Severity of Concerns

ERIC Educational Resources Information Center

Krumrei, Elizabeth J.; Newton, Fred B.; Kim, Eunhee

2010-01-01

This study provides information about students seeking counseling (N = 3,844) at 9 institutions of higher education. The K-PIRS, an empirically validated measure, was used to assess 7 problem areas (mood difficulties, learning problems, food concerns, interpersonal conflicts, career uncertainties, self-harm indicators, and addiction issues).…

Target analyte quantification by isotope dilution LC-MS/MS directly referring to internal standard concentrations--validation for serum cortisol measurement.

PubMed

Maier, Barbara; Vogeser, Michael

2013-04-01

Isotope dilution LC-MS/MS methods used in the clinical laboratory typically involve multi-point external calibration in each analytical series. Our aim was to test the hypothesis that determination of target analyte concentrations directly derived from the relation of the target analyte peak area to the peak area of a corresponding stable isotope labelled internal standard compound [direct isotope dilution analysis (DIDA)] may be not inferior to conventional external calibration with respect to accuracy and reproducibility. Quality control samples and human serum pools were analysed in a comparative validation protocol for cortisol as an exemplary analyte by LC-MS/MS. Accuracy and reproducibility were compared between quantification either involving a six-point external calibration function, or a result calculation merely based on peak area ratios of unlabelled and labelled analyte. Both quantification approaches resulted in similar accuracy and reproducibility. For specified analytes, reliable analyte quantification directly derived from the ratio of peak areas of labelled and unlabelled analyte without the need for a time consuming multi-point calibration series is possible. This DIDA approach is of considerable practical importance for the application of LC-MS/MS in the clinical laboratory where short turnaround times often have high priority.

Embedding Engaged Learning in High Enrollment Lecture-Based Classes

ERIC Educational Resources Information Center

Lund Dean, Kathy; Wright, Sarah

2017-01-01

Engaged learning opportunities have become powerful foundations upon which students build lifelong skills and organizational capacities. Research has empirically validated the long-term positive learning impacts of active and experiential learning opportunities for students. As such, institutional administrators and external stakeholders have…

Development plan for the External Hazards Experimental Group. Light Water Reactor Sustainability Program

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

Coleman, Justin Leigh; Smith, Curtis Lee; Burns, Douglas Edward

This report describes the development plan for a new multi-partner External Hazards Experimental Group (EHEG) coordinated by Idaho National Laboratory (INL) within the Risk-Informed Safety Margin Characterization (RISMC) technical pathway of the Light Water Reactor Sustainability Program. Currently, there is limited data available for development and validation of the tools and methods being developed in the RISMC Toolkit. The EHEG is being developed to obtain high-quality, small- and large-scale experimental data validation of RISMC tools and methods in a timely and cost-effective way. The group of universities and national laboratories that will eventually form the EHEG (which is ultimately expectedmore » to include both the initial participants and other universities and national laboratories that have been identified) have the expertise and experimental capabilities needed to both obtain and compile existing data archives and perform additional seismic and flooding experiments. The data developed by EHEG will be stored in databases for use within RISMC. These databases will be used to validate the advanced external hazard tools and methods.« less

Failure of Colorectal Surgical Site Infection Predictive Models Applied to an Independent Dataset: Do They Add Value or Just Confusion?

PubMed

Bergquist, John R; Thiels, Cornelius A; Etzioni, David A; Habermann, Elizabeth B; Cima, Robert R

2016-04-01

Colorectal surgical site infections (C-SSIs) are a major source of postoperative morbidity. Institutional C-SSI rates are modeled and scrutinized, and there is increasing movement in the direction of public reporting. External validation of C-SSI risk prediction models is lacking. Factors governing C-SSI occurrence are complicated and multifactorial. We hypothesized that existing C-SSI prediction models have limited ability to accurately predict C-SSI in independent data. Colorectal resections identified from our institutional ACS-NSQIP dataset (2006 to 2014) were reviewed. The primary outcome was any C-SSI according to the ACS-NSQIP definition. Emergency cases were excluded. Published C-SSI risk scores: the National Nosocomial Infection Surveillance (NNIS), Contamination, Obesity, Laparotomy, and American Society of Anesthesiologists (ASA) class (COLA), Preventie Ziekenhuisinfecties door Surveillance (PREZIES), and NSQIP-based models were compared with receiver operating characteristic (ROC) analysis to evaluate discriminatory quality. There were 2,376 cases included, with an overall C-SSI rate of 9% (213 cases). None of the models produced reliable and high quality C-SSI predictions. For any C-SSI, the NNIS c-index was 0.57 vs 0.61 for COLA, 0.58 for PREZIES, and 0.62 for NSQIP: all well below the minimum "reasonably" predictive c-index of 0.7. Predictions for superficial, deep, and organ space SSI were similarly poor. Published C-SSI risk prediction models do not accurately predict C-SSI in our independent institutional dataset. Application of externally developed prediction models to any individual practice must be validated or modified to account for institution and case-mix specific factors. This questions the validity of using externally or nationally developed models for "expected" outcomes and interhospital comparisons. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Prediction of Large Vessel Occlusions in Acute Stroke: National Institute of Health Stroke Scale Is Hard to Beat.

PubMed

Vanacker, Peter; Heldner, Mirjam R; Amiguet, Michael; Faouzi, Mohamed; Cras, Patrick; Ntaios, George; Arnold, Marcel; Mattle, Heinrich P; Gralla, Jan; Fischer, Urs; Michel, Patrik

2016-06-01

Endovascular treatment for acute ischemic stroke with a large vessel occlusion was recently shown to be effective. We aimed to develop a score capable of predicting large vessel occlusion eligible for endovascular treatment in the early hospital management. Retrospective, cohort study. Two tertiary, Swiss stroke centers. Consecutive acute ischemic stroke patients (1,645 patients; Acute STroke Registry and Analysis of Lausanne registry), who had CT angiography within 6 and 12 hours of symptom onset, were categorized according to the occlusion site. Demographic and clinical information was used in logistic regression analysis to derive predictors of large vessel occlusion (defined as intracranial carotid, basilar, and M1 segment of middle cerebral artery occlusions). Based on logistic regression coefficients, an integer score was created and validated internally and externally (848 patients; Bernese Stroke Registry). None. Large vessel occlusions were present in 316 patients (21%) in the derivation and 566 (28%) in the external validation cohort. Five predictors added significantly to the score: National Institute of Health Stroke Scale at admission, hemineglect, female sex, atrial fibrillation, and no history of stroke and prestroke handicap (modified Rankin Scale score, < 2). Diagnostic accuracy in internal and external validation cohorts was excellent (area under the receiver operating characteristic curve, 0.84 both). The score performed slightly better than National Institute of Health Stroke Scale alone regarding prediction error (Wilcoxon signed rank test, p < 0.001) and regarding discriminatory power in derivation and pooled cohorts (area under the receiver operating characteristic curve, 0.81 vs 0.80; DeLong test, p = 0.02). Our score accurately predicts the presence of emergent large vessel occlusions, which are eligible for endovascular treatment. However, incorporation of additional demographic and historical information available on hospital arrival provides minimal incremental predictive value compared with the National Institute of Health Stroke Scale alone.

'It'll Look Good on Your Personal Statement': Self-Marketing amongst University Applicants in the United Kingdom

ERIC Educational Resources Information Center

Shuker, Lucie

2014-01-01

"Selling yourself" through personal statements and interviews is now a standard practice for university applicants. This article draws on a multi-case-study research project to report on the self-marketing orientations of students within three 16-19 institutions in England. These orientations (active/passive; internal/external;…

Experimental and Quasi-Experimental Design.

ERIC Educational Resources Information Center

Cottrell, Edward B.

With an emphasis on the problems of control of extraneous variables and threats to internal and external validity, the arrangement or design of experiments is discussed. The purpose of experimentation in an educational institution, and the principles governing true experimentation (randomization, replication, and control) are presented, as are…

Incremental Validity and Informant Effect from a Multi-Method Perspective: Assessing Relations between Parental Acceptance and Children’s Behavioral Problems

PubMed Central

Izquierdo-Sotorrío, Eva; Holgado-Tello, Francisco P.; Carrasco, Miguel Á.

2016-01-01

This study examines the relationships between perceived parental acceptance and children’s behavioral problems (externalizing and internalizing) from a multi-informant perspective. Using mothers, fathers, and children as sources of information, we explore the informant effect and incremental validity. The sample was composed of 681 participants (227 children, 227 fathers, and 227 mothers). Children’s (40% boys) ages ranged from 9 to 17 years (M = 12.52, SD = 1.81). Parents and children completed both the Parental Acceptance Rejection/Control Questionnaire (PARQ/Control) and the check list of the Achenbach System of Empirically Based Assessment (ASEBA). Statistical analyses were based on the correlated uniqueness multitrait-multimethod matrix (model MTMM) by structural equations and different hierarchical regression analyses. Results showed a significant informant effect and a different incremental validity related to which combination of sources was considered. A multi-informant perspective rather than a single one increased the predictive value. Our results suggest that mother–father or child–father combinations seem to be the best way to optimize the multi-informant method in order to predict children’s behavioral problems based on perceived parental acceptance. PMID:27242582

Incremental Validity and Informant Effect from a Multi-Method Perspective: Assessing Relations between Parental Acceptance and Children's Behavioral Problems.

PubMed

Izquierdo-Sotorrío, Eva; Holgado-Tello, Francisco P; Carrasco, Miguel Á

2016-01-01

This study examines the relationships between perceived parental acceptance and children's behavioral problems (externalizing and internalizing) from a multi-informant perspective. Using mothers, fathers, and children as sources of information, we explore the informant effect and incremental validity. The sample was composed of 681 participants (227 children, 227 fathers, and 227 mothers). Children's (40% boys) ages ranged from 9 to 17 years (M = 12.52, SD = 1.81). Parents and children completed both the Parental Acceptance Rejection/Control Questionnaire (PARQ/Control) and the check list of the Achenbach System of Empirically Based Assessment (ASEBA). Statistical analyses were based on the correlated uniqueness multitrait-multimethod matrix (model MTMM) by structural equations and different hierarchical regression analyses. Results showed a significant informant effect and a different incremental validity related to which combination of sources was considered. A multi-informant perspective rather than a single one increased the predictive value. Our results suggest that mother-father or child-father combinations seem to be the best way to optimize the multi-informant method in order to predict children's behavioral problems based on perceived parental acceptance.

Verification and validation of an advanced model of heat and mass transfer in the protective clothing

NASA Astrophysics Data System (ADS)

Łapka, Piotr; Furmański, Piotr

2018-04-01

The paper presents verification and validation of an advanced numerical model of heat and moisture transfer in the multi-layer protective clothing and in components of the experimental stand subjected to either high surroundings temperature or high radiative heat flux emitted by hot objects. The developed model included conductive-radiative heat transfer in the hygroscopic porous fabrics and air gaps as well as conductive heat transfer in components of the stand. Additionally, water vapour diffusion in the pores and air spaces as well as phase transition of the bound water in the fabric fibres (sorption and desorption) were accounted for. All optical phenomena at internal or external walls were modelled and the thermal radiation was treated in the rigorous way, i.e., semi-transparent absorbing, emitting and scattering fabrics with the non-grey properties were assumed. The air was treated as transparent. Complex energy and mass balances as well as optical conditions at internal or external interfaces were formulated in order to find values of temperatures, vapour densities and radiation intensities at these interfaces. The obtained highly non-linear coupled system of discrete equations was solved by the Finite Volume based in-house iterative algorithm. The developed model passed discretisation convergence tests and was successfully verified against the results obtained applying commercial software for simplified cases. Then validation was carried out using experimental measurements collected during exposure of the protective clothing to high radiative heat flux emitted by the IR lamp. Satisfactory agreement of simulated and measured temporal variation of temperature at external and internal surfaces of the multi-layer clothing was attained.

External validation of urinary PCA3-based nomograms to individually predict prostate biopsy outcome.

PubMed

Auprich, Marco; Haese, Alexander; Walz, Jochen; Pummer, Karl; de la Taille, Alexandre; Graefen, Markus; de Reijke, Theo; Fisch, Margit; Kil, Paul; Gontero, Paolo; Irani, Jacques; Chun, Felix K-H

2010-11-01

Prior to safely adopting risk stratification tools, their performance must be tested in an external patient cohort. To assess accuracy and generalizability of previously reported, internally validated, prebiopsy prostate cancer antigen 3 (PCA3) gene-based nomograms when applied to a large, external, European cohort of men at risk of prostate cancer (PCa). Biopsy data, including urinary PCA3 score, were available for 621 men at risk of PCa who were participating in a European multi-institutional study. All patients underwent a ≥10-core prostate biopsy. Biopsy indication was based on suspicious digital rectal examination, persistently elevated prostate-specific antigen level (2.5-10 ng/ml) and/or suspicious histology (atypical small acinar proliferation of the prostate, >/= two cores affected by high-grade prostatic intraepithelial neoplasia in first set of biopsies). PCA3 scores were assessed using the Progensa assay (Gen-Probe Inc, San Diego, CA, USA). According to the previously reported nomograms, different PCA3 score codings were used. The probability of a positive biopsy was calculated using previously published logistic regression coefficients. Predicted outcomes were compared to the actual biopsy results. Accuracy was calculated using the area under the curve as a measure of discrimination; calibration was explored graphically. Biopsy-confirmed PCa was detected in 255 (41.1%) men. Median PCA3 score of biopsy-negative versus biopsy-positive men was 20 versus 48 in the total cohort, 17 versus 47 at initial biopsy, and 37 versus 53 at repeat biopsy (all p≤0.002). External validation of all four previously reported PCA3-based nomograms demonstrated equally high accuracy (0.73-0.75) and excellent calibration. The main limitations of the study reside in its early detection setting, referral scenario, and participation of only tertiary-care centers. In accordance with the original publication, previously developed PCA3-based nomograms achieved high accuracy and sufficient calibration. These novel nomograms represent robust tools and are thus generalizable to European men at risk of harboring PCa. Consequently, in presence of a PCA3 score, these nomograms may be safely used to assist clinicians when prostate biopsy is contemplated. Copyright © 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Social Capital and Stability Operations

DTIC Science & Technology

2008-03-26

defined as an instantiated set of informal values or norms that permit cooperation between two or more individuals, is the sine qua non of stable... multi -dimensional research, and editorial opinions, relate to the means (resources) by which to accomplish stability operations: unified action...development phase requires weaning indigenous institutions from reliance on external assistance. Fukuyama asserts that this is hard for three reasons

External vibration multi-directional ultrasound shearwave elastography (EVMUSE): application in liver fibrosis staging.

PubMed

Zhao, Heng; Song, Pengfei; Meixner, Duane D; Kinnick, Randall R; Callstrom, Matthew R; Sanchez, William; Urban, Matthew W; Manduca, Armando; Greenleaf, James F; Chen, Shigao

2014-11-01

Shear wave speed can be used to assess tissue elasticity, which is associated with tissue health. Ultrasound shear wave elastography techniques based on measuring the propagation speed of the shear waves induced by acoustic radiation force are becoming promising alternatives to biopsy in liver fibrosis staging. However, shear waves generated by such methods are typically very weak. Therefore, the penetration may become problematic, especially for overweight or obese patients. In this study, we developed a new method called external vibration multi-directional ultrasound shearwave elastography (EVMUSE), in which external vibration from a loudspeaker was used to generate a multi-directional shear wave field. A directional filter was then applied to separate the complex shear wave field into several shear wave fields propagating in different directions. A 2-D shear wave speed map was reconstructed from each individual shear wave field, and a final 2-D shear wave speed map was constructed by compounding these individual wave speed maps. The method was validated using two homogeneous phantoms and one multi-purpose tissue-mimicking phantom. Ten patients undergoing liver magnetic resonance elastography (MRE) were also studied with EVMUSE to compare results between the two methods. Phantom results showed EVMUSE was able to quantify tissue elasticity accurately with good penetration. In vivo EVMUSE results were well correlated with MRE results, indicating the promise of using EVMUSE for liver fibrosis staging.

External Vibration Multi-directional Ultrasound Shearwave Elastography (EVMUSE): Application in Liver Fibrosis Staging

PubMed Central

Zhao, Heng; Song, Pengfei; Meixner, Duane D.; Kinnick, Randall R.; Callstrom, Matthew R.; Sanchez, William; Urban, Matthew W.; Manduca, Armando; Greenleaf, James F.

2014-01-01

Shear wave speed can be used to assess tissue elasticity, which is associated with tissue health. Ultrasound shear wave elastography techniques based on measuring the propagation speed of the shear waves induced by acoustic radiation force are becoming promising alternatives to biopsy in liver fibrosis staging. However, shear waves generated by such methods are typically very weak. Therefore, the penetration may become problematic, especially for overweight or obese patients. In this study, we developed a new method called External Vibration Multi-directional Ultrasound Shearwave Elastography (EVMUSE), in which external vibration from a loudspeaker was used to generate a multi-directional shear wave field. A directional filter was then applied to separate the complex shear wave field into several shear wave fields propagating in different directions. A two-dimensional (2D) shear wave speed map was reconstructed from each individual shear wave field, and a final 2D shear wave speed map was constructed by compounding these individual wave speed maps. The method was validated using two homogeneous phantoms and one multi-purpose tissue-mimicking phantom. Ten patients undergoing liver Magnetic Resonance Elastography (MRE) were also studied with EVMUSE to compare results between the two methods. Phantom results showed EVMUSE was able to quantify tissue elasticity accurately with good penetration. In vivo EVMUSE results were well correlated with MRE results, indicating the promise of using EVMUSE for liver fibrosis staging. PMID:25020066

The Community of Inquiry Instrument: Validation and Results in Online Health Care Disciplines

ERIC Educational Resources Information Center

Carlon, S.; Bennett-Woods, D.; Berg, B.; Claywell, L.; LeDuc, K.; Marcisz, N.; Mulhall, M.; Noteboom, T.; Snedden, T.; Whalen, K.; Zenoni, L.

2012-01-01

This descriptive study using survey design sought to establish the efficacy of the Community of Inquiry instrument utilized in a study published by Shea and Bidjerano in 2009 exploring an online community of business students in a multi-institutional study. The current study sought to validate the instrument with a population of students in three…

Development and validation of the Bullying and Cyberbullying Scale for Adolescents: A multi-dimensional measurement model.

PubMed

Thomas, Hannah J; Scott, James G; Coates, Jason M; Connor, Jason P

2018-05-03

Intervention on adolescent bullying is reliant on valid and reliable measurement of victimization and perpetration experiences across different behavioural expressions. This study developed and validated a survey tool that integrates measurement of both traditional and cyber bullying to test a theoretically driven multi-dimensional model. Adolescents from 10 mainstream secondary schools completed a baseline and follow-up survey (N = 1,217; M age  = 14 years; 66.2% male). The Bullying and cyberbullying Scale for Adolescents (BCS-A) developed for this study comprised parallel victimization and perpetration subscales, each with 20 items. Additional measures of bullying (Olweus Global Bullying and the Forms of Bullying Scale [FBS]), as well as measures of internalizing and externalizing problems, school connectedness, social support, and personality, were used to further assess validity. Factor structure was determined, and then, the suitability of items was assessed according to the following criteria: (1) factor interpretability, (2) item correlations, (3) model parsimony, and (4) measurement equivalence across victimization and perpetration experiences. The final models comprised four factors: physical, verbal, relational, and cyber. The final scale was revised to two 13-item subscales. The BCS-A demonstrated acceptable concurrent and convergent validity (internalizing and externalizing problems, school connectedness, social support, and personality), as well as predictive validity over 6 months. The BCS-A has sound psychometric properties. This tool establishes measurement equivalence across types of involvement and behavioural forms common among adolescents. An improved measurement method could add greater rigour to the evaluation of intervention programmes and also enable interventions to be tailored to subscale profiles. © 2018 The British Psychological Society.

Market Orientation and Its Measurement in Universities

ERIC Educational Resources Information Center

Niculescu, Mihai; Xu, Bing; Hampton, Gerald M.; Peterson, Robin T.

2013-01-01

Historically, the measurement of market orientation has proved to be difficult, due to the low external validity of the concept. Existing scales exhibit acceptable properties in measuring market orientation in business organizations, but are less accurate in the context of higher education institutions. This paper compares the performance of three…

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

Chen, X; Wang, J; Hu, W

Purpose: The Varian RapidPlan™ is a commercial knowledge-based optimization process which uses a set of clinically used treatment plans to train a model that can predict individualized dose-volume objectives. The purpose of this study is to evaluate the performance of RapidPlan to generate intensity modulated radiation therapy (IMRT) plans for cervical cancer. Methods: Totally 70 IMRT plans for cervical cancer with varying clinical and physiological indications were enrolled in this study. These patients were all previously treated in our institution. There were two prescription levels usually used in our institution: 45Gy/25 fractions and 50.4Gy/28 fractions. 50 of these plans weremore » selected to train the RapidPlan model for predicting dose-volume constraints. After model training, this model was validated with 10 plans from training pool(internal validation) and additional other 20 new plans(external validation). All plans used for the validation were re-optimized with the original beam configuration and the generated priorities from RapidPlan were manually adjusted to ensure that re-optimized DVH located in the range of the model prediction. DVH quantitative analysis was performed to compare the RapidPlan generated and the original manual optimized plans. Results: For all the validation cases, RapidPlan based plans (RapidPlan) showed similar or superior results compared to the manual optimized ones. RapidPlan increased the result of D98% and homogeneity in both two validations. For organs at risk, the RapidPlan decreased mean doses of bladder by 1.25Gy/1.13Gy (internal/external validation) on average, with p=0.12/p<0.01. The mean dose of rectum and bowel were also decreased by an average of 2.64Gy/0.83Gy and 0.66Gy/1.05Gy,with p<0.01/ p<0.01and p=0.04/<0.01 for the internal/external validation, respectively. Conclusion: The RapidPlan model based cervical cancer plans shows ability to systematically improve the IMRT plan quality. It suggests that RapidPlan has great potential to make the treatment planning process more efficient.« less

Toward Data-Driven Radiology Education-Early Experience Building Multi-Institutional Academic Trainee Interpretation Log Database (MATILDA).

PubMed

Chen, Po-Hao; Loehfelm, Thomas W; Kamer, Aaron P; Lemmon, Andrew B; Cook, Tessa S; Kohli, Marc D

2016-12-01

The residency review committee of the Accreditation Council of Graduate Medical Education (ACGME) collects data on resident exam volume and sets minimum requirements. However, this data is not made readily available, and the ACGME does not share their tools or methodology. It is therefore difficult to assess the integrity of the data and determine if it truly reflects relevant aspects of the resident experience. This manuscript describes our experience creating a multi-institutional case log, incorporating data from three American diagnostic radiology residency programs. Each of the three sites independently established automated query pipelines from the various radiology information systems in their respective hospital groups, thereby creating a resident-specific database. Then, the three institutional resident case log databases were aggregated into a single centralized database schema. Three hundred thirty residents and 2,905,923 radiologic examinations over a 4-year span were catalogued using 11 ACGME categories. Our experience highlights big data challenges including internal data heterogeneity and external data discrepancies faced by informatics researchers.

[Quantitative method for simultaneous assay of four coumarins with one marker in Fraxini Cortex].

PubMed

Feng, Weihong; Wang, Zhimin; Zhang, Qiwei; Liu, Limei; Wang, Jinyu; Yang, Fei

2011-07-01

To establish a new quantitative method for simultaneous determination of multi-coumarins in Fraxini Cortex by using one chemical reference substance, and validate its feasibilities. The new quality evaluation method, quantitative analysis of multi-components by singer-marker (QAMS), was established and validated with Fraxini Cortex. Four main coumarins were selected as analytes to evaluate the quality and their relative correlation factors (RCF) were determined by HPLC-DAD. Within the linear range, the values of RCF at 340 nm of aesculin to asculetin, fraxin and fraxetin were 1.771, 0.799, 1.409, respectively. And the contents of aesculin in samples of Fraxini Cortex were authentically determined by the external standard method, and the contents of the three other coumarins were calculated by their RCF. The contents of these four coumarins in all samples were also determined by the external standard method. Within a certain range, the RCF had a good reproducibility (RSD 2.5%-3.9%). Significant differences were not observed between the quantitative results of two methods. It is feasible and suitable to evaluate the quality of Fraxini Cortex and its Yinpian by QAMS.

A General Formulation for Robust and Efficient Integration of Finite Differences and Phase Unwrapping on Sparse Multidimensional Domains

NASA Astrophysics Data System (ADS)

Costantini, Mario; Malvarosa, Fabio; Minati, Federico

2010-03-01

Phase unwrapping and integration of finite differences are key problems in several technical fields. In SAR interferometry and differential and persistent scatterers interferometry digital elevation models and displacement measurements can be obtained after unambiguously determining the phase values and reconstructing the mean velocities and elevations of the observed targets, which can be performed by integrating differential estimates of these quantities (finite differences between neighboring points).In this paper we propose a general formulation for robust and efficient integration of finite differences and phase unwrapping, which includes standard techniques methods as sub-cases. The proposed approach allows obtaining more reliable and accurate solutions by exploiting redundant differential estimates (not only between nearest neighboring points) and multi-dimensional information (e.g. multi-temporal, multi-frequency, multi-baseline observations), or external data (e.g. GPS measurements). The proposed approach requires the solution of linear or quadratic programming problems, for which computationally efficient algorithms exist.The validation tests obtained on real SAR data confirm the validity of the method, which was integrated in our production chain and successfully used also in massive productions.

GIFT-Cloud: A data sharing and collaboration platform for medical imaging research.

PubMed

Doel, Tom; Shakir, Dzhoshkun I; Pratt, Rosalind; Aertsen, Michael; Moggridge, James; Bellon, Erwin; David, Anna L; Deprest, Jan; Vercauteren, Tom; Ourselin, Sébastien

2017-02-01

Clinical imaging data are essential for developing research software for computer-aided diagnosis, treatment planning and image-guided surgery, yet existing systems are poorly suited for data sharing between healthcare and academia: research systems rarely provide an integrated approach for data exchange with clinicians; hospital systems are focused towards clinical patient care with limited access for external researchers; and safe haven environments are not well suited to algorithm development. We have established GIFT-Cloud, a data and medical image sharing platform, to meet the needs of GIFT-Surg, an international research collaboration that is developing novel imaging methods for fetal surgery. GIFT-Cloud also has general applicability to other areas of imaging research. GIFT-Cloud builds upon well-established cross-platform technologies. The Server provides secure anonymised data storage, direct web-based data access and a REST API for integrating external software. The Uploader provides automated on-site anonymisation, encryption and data upload. Gateways provide a seamless process for uploading medical data from clinical systems to the research server. GIFT-Cloud has been implemented in a multi-centre study for fetal medicine research. We present a case study of placental segmentation for pre-operative surgical planning, showing how GIFT-Cloud underpins the research and integrates with the clinical workflow. GIFT-Cloud simplifies the transfer of imaging data from clinical to research institutions, facilitating the development and validation of medical research software and the sharing of results back to the clinical partners. GIFT-Cloud supports collaboration between multiple healthcare and research institutions while satisfying the demands of patient confidentiality, data security and data ownership. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

The Open Systems University and Organizational Intelligence.

ERIC Educational Resources Information Center

Counelis, James Steve

The open systems model of the university defines the function of institutional research to be a cybernetic one. The internal and external reality-testing function is a vital duty and a moral charge. Though policy makers and educational practitioners can carry on for a considerable length of time with organizational intelligence of low validity,…

Multiple Score Comparison: a network meta-analysis approach to comparison and external validation of prognostic scores.

PubMed

Haile, Sarah R; Guerra, Beniamino; Soriano, Joan B; Puhan, Milo A

2017-12-21

Prediction models and prognostic scores have been increasingly popular in both clinical practice and clinical research settings, for example to aid in risk-based decision making or control for confounding. In many medical fields, a large number of prognostic scores are available, but practitioners may find it difficult to choose between them due to lack of external validation as well as lack of comparisons between them. Borrowing methodology from network meta-analysis, we describe an approach to Multiple Score Comparison meta-analysis (MSC) which permits concurrent external validation and comparisons of prognostic scores using individual patient data (IPD) arising from a large-scale international collaboration. We describe the challenges in adapting network meta-analysis to the MSC setting, for instance the need to explicitly include correlations between the scores on a cohort level, and how to deal with many multi-score studies. We propose first using IPD to make cohort-level aggregate discrimination or calibration scores, comparing all to a common comparator. Then, standard network meta-analysis techniques can be applied, taking care to consider correlation structures in cohorts with multiple scores. Transitivity, consistency and heterogeneity are also examined. We provide a clinical application, comparing prognostic scores for 3-year mortality in patients with chronic obstructive pulmonary disease using data from a large-scale collaborative initiative. We focus on the discriminative properties of the prognostic scores. Our results show clear differences in performance, with ADO and eBODE showing higher discrimination with respect to mortality than other considered scores. The assumptions of transitivity and local and global consistency were not violated. Heterogeneity was small. We applied a network meta-analytic methodology to externally validate and concurrently compare the prognostic properties of clinical scores. Our large-scale external validation indicates that the scores with the best discriminative properties to predict 3 year mortality in patients with COPD are ADO and eBODE.

Backstepping Design of Adaptive Neural Fault-Tolerant Control for MIMO Nonlinear Systems.

PubMed

Gao, Hui; Song, Yongduan; Wen, Changyun

In this paper, an adaptive controller is developed for a class of multi-input and multioutput nonlinear systems with neural networks (NNs) used as a modeling tool. It is shown that all the signals in the closed-loop system with the proposed adaptive neural controller are globally uniformly bounded for any external input in . In our control design, the upper bound of the NN modeling error and the gains of external disturbance are characterized by unknown upper bounds, which is more rational to establish the stability in the adaptive NN control. Filter-based modification terms are used in the update laws of unknown parameters to improve the transient performance. Finally, fault-tolerant control is developed to accommodate actuator failure. An illustrative example applying the adaptive controller to control a rigid robot arm shows the validation of the proposed controller.In this paper, an adaptive controller is developed for a class of multi-input and multioutput nonlinear systems with neural networks (NNs) used as a modeling tool. It is shown that all the signals in the closed-loop system with the proposed adaptive neural controller are globally uniformly bounded for any external input in . In our control design, the upper bound of the NN modeling error and the gains of external disturbance are characterized by unknown upper bounds, which is more rational to establish the stability in the adaptive NN control. Filter-based modification terms are used in the update laws of unknown parameters to improve the transient performance. Finally, fault-tolerant control is developed to accommodate actuator failure. An illustrative example applying the adaptive controller to control a rigid robot arm shows the validation of the proposed controller.

Structural exploration for the refinement of anticancer matrix metalloproteinase-2 inhibitor designing approaches through robust validated multi-QSARs

NASA Astrophysics Data System (ADS)

Adhikari, Nilanjan; Amin, Sk. Abdul; Saha, Achintya; Jha, Tarun

2018-03-01

Matrix metalloproteinase-2 (MMP-2) is a promising pharmacological target for designing potential anticancer drugs. MMP-2 plays critical functions in apoptosis by cleaving the DNA repair enzyme namely poly (ADP-ribose) polymerase (PARP). Moreover, MMP-2 expression triggers the vascular endothelial growth factor (VEGF) having a positive influence on tumor size, invasion, and angiogenesis. Therefore, it is an urgent need to develop potential MMP-2 inhibitors without any toxicity but better pharmacokinetic property. In this article, robust validated multi-quantitative structure-activity relationship (QSAR) modeling approaches were attempted on a dataset of 222 MMP-2 inhibitors to explore the important structural and pharmacophoric requirements for higher MMP-2 inhibition. Different validated regression and classification-based QSARs, pharmacophore mapping and 3D-QSAR techniques were performed. These results were challenged and subjected to further validation to explain 24 in house MMP-2 inhibitors to judge the reliability of these models further. All these models were individually validated internally as well as externally and were supported and validated by each other. These results were further justified by molecular docking analysis. Modeling techniques adopted here not only helps to explore the necessary structural and pharmacophoric requirements but also for the overall validation and refinement techniques for designing potential MMP-2 inhibitors.

A Contemporary Prostate Biopsy Risk Calculator Based on Multiple Heterogeneous Cohorts.

PubMed

Ankerst, Donna P; Straubinger, Johanna; Selig, Katharina; Guerrios, Lourdes; De Hoedt, Amanda; Hernandez, Javier; Liss, Michael A; Leach, Robin J; Freedland, Stephen J; Kattan, Michael W; Nam, Robert; Haese, Alexander; Montorsi, Francesco; Boorjian, Stephen A; Cooperberg, Matthew R; Poyet, Cedric; Vertosick, Emily; Vickers, Andrew J

2018-05-16

Prostate cancer prediction tools provide quantitative guidance for doctor-patient decision-making regarding biopsy. The widely used online Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) utilized data from the 1990s based on six-core biopsies and outdated grading systems. We prospectively gathered data from men undergoing prostate biopsy in multiple diverse North American and European institutions participating in the Prostate Biopsy Collaborative Group (PBCG) in order to build a state-of-the-art risk prediction tool. We obtained data from 15 611 men undergoing 16 369 prostate biopsies during 2006-2017 at eight North American institutions for model-building and three European institutions for validation. We used multinomial logistic regression to estimate the risks of high-grade prostate cancer (Gleason score ≥7) on biopsy based on clinical characteristics, including age, prostate-specific antigen, digital rectal exam, African ancestry, first-degree family history, and prior negative biopsy. We compared the PBCG model to the PCPTRC using internal cross-validation and external validation on the European cohorts. Cross-validation on the North American cohorts (5992 biopsies) yielded the PBCG model area under the receiver operating characteristic curve (AUC) as 75.5% (95% confidence interval: 74.2-76.8), a small improvement over the AUC of 72.3% (70.9-73.7) for the PCPTRC (p<0.0001). However, calibration and clinical net benefit were far superior for the PBCG model. Using a risk threshold of 10%, clinical use of the PBCG model would lead to the equivalent of 25 fewer biopsies per 1000 patients without missing any high-grade cancers. Results were similar on external validation on 10 377 European biopsies. The PBCG model should be used in place of the PCPTRC for prediction of prostate biopsy outcome. A contemporary risk tool for outcomes on prostate biopsy based on the routine clinical risk factors is now available for informed decision-making. Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Risk score to predict gastrointestinal bleeding after acute ischemic stroke.

PubMed

Ji, Ruijun; Shen, Haipeng; Pan, Yuesong; Wang, Penglian; Liu, Gaifen; Wang, Yilong; Li, Hao; Singhal, Aneesh B; Wang, Yongjun

2014-07-25

Gastrointestinal bleeding (GIB) is a common and often serious complication after stroke. Although several risk factors for post-stroke GIB have been identified, no reliable or validated scoring system is currently available to predict GIB after acute stroke in routine clinical practice or clinical trials. In the present study, we aimed to develop and validate a risk model (acute ischemic stroke associated gastrointestinal bleeding score, the AIS-GIB score) to predict in-hospital GIB after acute ischemic stroke. The AIS-GIB score was developed from data in the China National Stroke Registry (CNSR). Eligible patients in the CNSR were randomly divided into derivation (60%) and internal validation (40%) cohorts. External validation was performed using data from the prospective Chinese Intracranial Atherosclerosis Study (CICAS). Independent predictors of in-hospital GIB were obtained using multivariable logistic regression in the derivation cohort, and β-coefficients were used to generate point scoring system for the AIS-GIB. The area under the receiver operating characteristic curve (AUROC) and the Hosmer-Lemeshow goodness-of-fit test were used to assess model discrimination and calibration, respectively. A total of 8,820, 5,882, and 2,938 patients were enrolled in the derivation, internal validation and external validation cohorts. The overall in-hospital GIB after AIS was 2.6%, 2.3%, and 1.5% in the derivation, internal, and external validation cohort, respectively. An 18-point AIS-GIB score was developed from the set of independent predictors of GIB including age, gender, history of hypertension, hepatic cirrhosis, peptic ulcer or previous GIB, pre-stroke dependence, admission National Institutes of Health stroke scale score, Glasgow Coma Scale score and stroke subtype (Oxfordshire). The AIS-GIB score showed good discrimination in the derivation (0.79; 95% CI, 0.764-0.825), internal (0.78; 95% CI, 0.74-0.82) and external (0.76; 95% CI, 0.71-0.82) validation cohorts. The AIS-GIB score was well calibrated in the derivation (P = 0.42), internal (P = 0.45) and external (P = 0.86) validation cohorts. The AIS-GIB score is a valid clinical grading scale to predict in-hospital GIB after AIS. Further studies on the effect of the AIS-GIB score on reducing GIB and improving outcome after AIS are warranted.

External validation and comparison of two nomograms predicting the probability of Gleason sum upgrading between biopsy and radical prostatectomy pathology in two patient populations: a retrospective cohort study.

PubMed

Utsumi, Takanobu; Oka, Ryo; Endo, Takumi; Yano, Masashi; Kamijima, Shuichi; Kamiya, Naoto; Fujimura, Masaaki; Sekita, Nobuyuki; Mikami, Kazuo; Hiruta, Nobuyuki; Suzuki, Hiroyoshi

2015-11-01

The aim of this study is to validate and compare the predictive accuracy of two nomograms predicting the probability of Gleason sum upgrading between biopsy and radical prostatectomy pathology among representative patients with prostate cancer. We previously developed a nomogram, as did Chun et al. In this validation study, patients originated from two centers: Toho University Sakura Medical Center (n = 214) and Chibaken Saiseikai Narashino Hospital (n = 216). We assessed predictive accuracy using area under the curve values and constructed calibration plots to grasp the tendency for each institution. Both nomograms showed a high predictive accuracy in each institution, although the constructed calibration plots of the two nomograms underestimated the actual probability in Toho University Sakura Medical Center. Clinicians need to use calibration plots for each institution to correctly understand the tendency of each nomogram for their patients, even if each nomogram has a good predictive accuracy. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

SU-F-P-13: NRG Oncology Medical Physics Manpower Survey Quantifying Support Demands for Multi Institutional Clinical Trials

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

Monroe, J; Case Western Reserve University; Boparai, K

Purpose: A survey was taken by NRG Oncology to assess Full Time Equivalent (FTE) contributions to multi institutional clinical trials by medical physicists.No current quantification of physicists’ efforts in FTE units associated with clinical trials is available. The complexity of multi-institutional trials increases with new technologies and techniques. Proper staffing may directly impact the quality of trial data and outcomes. The demands on physics time supporting clinical trials needs to be assessed. Methods: The NRG Oncology Medical Physicist Subcommittee created a sixteen question survey to obtain this FTE data. IROC Houston distributed the survey to their list of 1802 contactmore » physicists. Results: After three weeks, 363 responded (20.1% response). 187 (51.5%) institutions reporting external beam participation were processed. There was a wide range in number of protocols active and supported at each institution. Of the 187 clinics, 134 (71.7%) participate in 0 to 10 trials, 28 (15%) in 11 to 20 trials, 10 (5.3%) in 21 to 30 trials, 9 (4.8%) had 40 to 75 trials. On average, physicist spent 2.7 hours (SD: 6.0) per week supervising or interacting with clinical trial staff. 1.25 hours (SD: 3.37), 1.83 hours (SD: 4.13), and 0.64 hours(SD: 1.13) per week were spent on patient simulation, reviewing treatment plans, and maintaining a DICOM server, respectively. For all protocol credentialing activities, physicist spent an average of 37.05 hours (SD: 96.94) yearly. To support dosimetrists, clinicians, and therapists, physicist spend on average 2.07 hours (SD: 3.52) per week just reading protocols. Physicist attended clinical trial meetings for on average 1.13 hours (SD: 1.85) per month. Conclusion: Responding physicists spend a nontrivial amount of time: 8.8 hours per week (0.22 FTE) supporting, on average, 9 active multi-institutional clinical trials.« less

A Multi-institutional Comparison of Adrenal Venous Sampling in Patients with Primary Aldosteronism: Caution Advised if Successful Bilateral Adrenal Vein Sampling is Not Achieved.

PubMed

Wang, Tracy S; Kline, Greg; Yen, Tina W; Yin, Ziyan; Liu, Ying; Rilling, William; So, Benny; Findling, James W; Evans, Douglas B; Pasieka, Janice L

2018-02-01

In patients with primary aldosteronism (PA), adrenal venous sampling (AVS) is recommended to differentiate between unilateral (UNI) or bilateral (BIL) adrenal disease. A recent study suggested that lateralization could be predicted, based on the ratio of aldosterone/cortisol levels (A/C) between the left adrenal vein (LAV) and inferior vena cava (IVC), with a 100% positive predictive value (PPV). This study aimed to validate those findings utilizing a larger, multi-institutional cohort. A retrospective review was performed of patients with PA who underwent AVS from 2 tertiary-care institutions. Laterality was predicted by an A/C ratio of >3:1 between the dominant and non-dominant adrenal. AVS results were compared to LAV/IVC ratios utilizing the published criteria (Lt ≥ 5.5; Rt ≤ 0.5). Of 222 patients, 124 (57%) had UNI and 98 (43%) had BIL disease based on AVS. AVS and LAV/IVC findings were concordant for laterality in 141 (64%) patients (69 UNI, 72 BIL). Using only the LAV/IVC ratio, 54 (24%) patients with UNI disease on AVS who underwent successful surgery would have been assumed to have BAH unless AVS was repeated, and 24 (11%) patients with BIL disease on AVS may have been incorrectly offered surgery (PPV 70%). Based on median LAV/IVC ratios (left 5.26; right 0.31; BIL 2.84), no LAV/IVC ratio accurately predicted laterality. This multi-institutional study of patients with both UNI and BIL PA failed to validate the previously reported PPV of LAV/IVC ratio for lateralization. Caution should be used in interpreting incomplete AVS data to differentiate between UNI versus BIL disease and strong consideration given to repeat AVS prior to adrenalectomy.

The Validity of the Multi-Informant Approach to Assessing Child and Adolescent Mental Health

PubMed Central

De Los Reyes, Andres; Augenstein, Tara M.; Wang, Mo; Thomas, Sarah A.; Drabick, Deborah A.G.; Burgers, Darcy E.; Rabinowitz, Jill

2015-01-01

Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for “best practices” in using and interpreting multi-informant assessments in clinical work and research. This paper has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. PMID:25915035

Biomarkers for Early Detection of Clinically Relevant Prostate Cancer. A Multi-Institutional Validation Trial

DTIC Science & Technology

2016-10-01

Study (PASS). We are in the process of evaluating these three biomarker panels in tissue, blood, and urine samples with well annotated clinical and...impacting both the initial choice of therapy and decision-making during AS. The objective of the study is to utilize analytically validated assays that...predict reclassification from Gleason 6 cancer to Gleason 7 or greater. The analysis plan was determined before specimens were selected for the study

Biomarkers for Early Detection of Clinically Relevant Prostate Cancer. A Multi-Institutional Validation Trial

DTIC Science & Technology

2016-10-01

Study (PASS). We are in the process of evaluating these three biomarker panels in tissue, blood, and urine samples with well annotated clinical and...choice of therapy and decision-making during AS. The objective of the study is to utilize analytically validated assays that take into account tumor...Gleason 6 cancer to Gleason 7 or greater. The analysis plan was determined before specimens were selected for the study , and included 7 breaking

Validation of the Economic and Health Outcomes Model of Type 2 Diabetes Mellitus (ECHO-T2DM).

PubMed

Willis, Michael; Johansen, Pierre; Nilsson, Andreas; Asseburg, Christian

2017-03-01

The Economic and Health Outcomes Model of Type 2 Diabetes Mellitus (ECHO-T2DM) was developed to address study questions pertaining to the cost-effectiveness of treatment alternatives in the care of patients with type 2 diabetes mellitus (T2DM). Naturally, the usefulness of a model is determined by the accuracy of its predictions. A previous version of ECHO-T2DM was validated against actual trial outcomes and the model predictions were generally accurate. However, there have been recent upgrades to the model, which modify model predictions and necessitate an update of the validation exercises. The objectives of this study were to extend the methods available for evaluating model validity, to conduct a formal model validation of ECHO-T2DM (version 2.3.0) in accordance with the principles espoused by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the Society for Medical Decision Making (SMDM), and secondarily to evaluate the relative accuracy of four sets of macrovascular risk equations included in ECHO-T2DM. We followed the ISPOR/SMDM guidelines on model validation, evaluating face validity, verification, cross-validation, and external validation. Model verification involved 297 'stress tests', in which specific model inputs were modified systematically to ascertain correct model implementation. Cross-validation consisted of a comparison between ECHO-T2DM predictions and those of the seminal National Institutes of Health model. In external validation, study characteristics were entered into ECHO-T2DM to replicate the clinical results of 12 studies (including 17 patient populations), and model predictions were compared to observed values using established statistical techniques as well as measures of average prediction error, separately for the four sets of macrovascular risk equations supported in ECHO-T2DM. Sub-group analyses were conducted for dependent vs. independent outcomes and for microvascular vs. macrovascular vs. mortality endpoints. All stress tests were passed. ECHO-T2DM replicated the National Institutes of Health cost-effectiveness application with numerically similar results. In external validation of ECHO-T2DM, model predictions agreed well with observed clinical outcomes. For all sets of macrovascular risk equations, the results were close to the intercept and slope coefficients corresponding to a perfect match, resulting in high R 2 and failure to reject concordance using an F test. The results were similar for sub-groups of dependent and independent validation, with some degree of under-prediction of macrovascular events. ECHO-T2DM continues to match health outcomes in clinical trials in T2DM, with prediction accuracy similar to other leading models of T2DM.

VizieR Online Data Catalog: Planck Sunyaev-Zeldovich sources (PSZ2) (Planck+, 2016)

NASA Astrophysics Data System (ADS)

Planck Collaboration; Ade, P. A. R.; Aghanim, N.; Arnaud, M.; Ashdown, M.; Aumont, J.; Baccigalupi, C.; Banday, A. J.; Barreiro, R. B.; Barrena, R.; Bartlett, J. G.; Bartolo, N.; Battaner, E.; Battye, R.; Benabed, K.; Benoit, A.; Benoit-Levy, A.; Bernard, J.-P.; Bersanelli, M.; Bielewicz, P.; Bikmaev, I.; Bohringer, H.; Bonaldi, A.; Bonavera, L.; Bond, J. R.; Borrill, J.; Bouchet, F. R.; Bucher, M.; Burenin, R.; Burigana, C.; Butler, R. C.; Calabrese, E.; Cardoso, J.-F.; Carvalho, P.; Catalano, A.; Challinor, A.; Chamballu, A.; Chary, R.-R.; Chiang, H. C.; Chon, G.; Christensen, P. R.; Clements, D. L.; Colombi, S.; Colombo, L. P. L.; Combet, C.; Comis, B.; Couchot, F.; Coulais, A.; Crill, B. P.; Curto, A.; Cuttaia, F.; Dahle, H.; Danese, L.; Davies, R. D.; Davis, R. J.; de Bernardis, P.; De Rosa, A.; de Zotti, G.; Delabrouille, J.; Desert, F.-X.; Dickinson, C.; Diego, J. M.; Dolag, K.; Dole, H.; Donzelli, S.; Dore, O.; Douspis, M.; Ducout, A.; Dupac, X.; Efstathiou, G.; Eisenhardt, P. R. M.; Elsner, F.; Ensslin, T. A.; Eriksen, H. K.; Falgarone, E.; Fergusson, J.; Feroz, F.; Ferragamo, A.; Finelli, F.; Forni, O.; Frailis, M.; Fraisse, A. A.; Franceschi, E.; Frejsel, A.; Galeotta, S.; Galli, S.; Ganga, K.; Genova-Santos, R. T.; Giard, M.; Giraud-Heraud, Y.; Gjerlow, E.; Gonzalez-Nuevo, J.; Gorski, K. M.; Grainge, K. J. B.; Gratton, S.; Gregorio, A.; Gruppuso, A.; Gudmundsson, J. E.; Hansen, F. K.; Hanson, D.; Harrison, D. L.; Hempel, A.; Henrot-Versille, S.; Hernandez-Monteagudo, C.; Herranz, D.; Hildebrandt, S. R.; Hivon, E.; Hobson, M.; Holmes, W. A.; Hornstrup, A.; Hovest, W.; Huffenberger, K. M.; Hurier, G.; Jaffe, A. H.; Jaffe, T. R.; Jin, T.; Jones, W. C.; Juvela, M.; Keihanen, E.; Keskitalo, R.; Khamitov, I.; Kisner, T. S.; Kneissl, R.; Knoche, J.; Kunz, M.; Kurki-Suonio, H.; Lagache, G.; Lamarre, J.-M.; Lasenby, A.; Lattanzi, M.; Lawrence, C. R.; Leonardi, R.; Lesgourgues, J.; Levrier, F.; Liguori, M.; Lilje, P. B.; Linden-Vornle, M.; Lopez-Caniego, M.; Lubin, P. M.; Macias-Perez, J. F.; Maggio, G.; Maino, D.; Mak, D. S. Y.; Mandolesi, N.; Mangilli, A.; Martin, P. G.; Martinez-Gonzalez, E.; Masi, S.; Matarrese, S.; Mazzotta, P.; McGehee, P.; Mei, S.; Melchiorri, A.; Melin, J.-B.; Mendes, L.; Mennella, A.; Migliaccio, M.; Mitra, S.; Miville-Deschenes, M.-A.; Moneti, A.; Montier, L.; Morgante, G.; Mortlock, D.; Moss, A.; Munshi, D.; Murphy, J. A.; Naselsky, P.; Nastasi, A.; Nati, F.; Natoli, P.; Netterfield, C. B.; Norgaard-Nielsen, H. U.; Noviello, F.; Novikov, D.; Novikov, I.; Olamaie, M.; Oxborrow, C. A.; Paci, F.; Pagano, L.; Pajot, F.; Paoletti, D.; Pasian, F.; Patanchon, G.; Pearson, T. J.; Perdereau, O.; Perotto, L.; Perrott, Y. C.; Perrotta, F.; Pettorino, V.; Piacentini, F.; Piat, M.; Pierpaoli, E.; Pietrobon, D.; Plaszczynski, S.; Pointecouteau, E.; Polenta, G.; Pratt, G. W.; Prezeau, G.; Prunet, S.; Puget, J.-L.; Rachen, J. P.; Reach, W. T.; Rebolo, R.; Reinecke, M.; Remazeilles, M.; Renault, C.; Renzi, A.; Ristorcelli, I.; Rocha, G.; Rosset, C.; Rossetti, M.; Roudier, G.; Rozo, E.; Rubino-Martin, J. A.; Rumsey, C.; Rusholme, B.; Rykoff, E. S.; Sandri, M.; Santos, D.; Saunders, R. D. E.; Savelainen, M.; Savini, G.; Schammel, M. P.; Scott, D.; Seiffert, M. D.; Shellard, E. P. S.; Shimwell, T. W.; Spence, R. L. D.; Stanford, S. A.; Stern, D.; Stolyarov, V.; Stompor, R.; Streblyanska, A.; Sudiwala, R.; Sunyaev, R.; Sutton, D.; Suur-Uski, A.-S.; Sygnet, J.-F.; Tauber, J. A.; Terenzi, L.; Toffolatti, L.; Tomasi, M.; Tramonte, D.; Tristram, M.; Tucci, M.; Tuovinen, J.; Umana, G.; Valenziano, L.; Valiviita, J.; van Tent, B.; Vielva, P.; Villa, F.; Wade, L. A.; Wandelt, B. D.; Wehus, I. K.; White, S. D. M.; Wright, E. L.; Yvon, D.; Zacchei, A.; Zonca, A.

2017-01-01

Three pipelines are used to detect SZ clusters: two independent implementations of the Matched Multi-Filter (MMF1 and MMF3), and PowellSnakes (PwS). The main catalogue is constructed as the union of the catalogues from the three detection methods. The completeness and reliability of the catalogues have been assessed through internal and external validation as described in section 4 of the paper. (5 data files).

External validity of the pediatric cardiac quality of life inventory

PubMed Central

Marino, Bradley S.; Drotar, Dennis; Cassedy, Amy; Davis, Richard; Tomlinson, Ryan S.; Mellion, Katelyn; Mussatto, Kathleen; Mahony, Lynn; Newburger, Jane W.; Tong, Elizabeth; Cohen, Mitchell I.; Helfaer, Mark A.; Kazak, Anne E.; Wray, Jo; Wernovsky, Gil; Shea, Judy A.; Ittenbach, Richard

2012-01-01

Purpose The Pediatric Cardiac Quality of Life Inventory (PCQLI) is a disease-specific, health-related quality of life (HRQOL) measure for pediatric heart disease (HD). The purpose of this study was to demonstrate the external validity of PCQLI scores. Methods The PCQLI development site (Development sample) and six geographically diverse centers in the United States (Composite sample) recruited pediatric patients with acquired or congenital HD. Item response option variability, scores [Total (TS); Disease Impact (DI) and Psychosocial Impact (PI) subscales], patterns of correlation, and internal consistency were compared between samples. Results A total of 3,128 patients and parent participants (1,113 Development; 2,015 Composite) were analyzed. Response option variability patterns of all items in both samples were acceptable. Inter-sample score comparisons revealed no differences. Median item–total (Development, 0.57; Composite, 0.59) and item–subscale (Development, DI 0.58, PI 0.59; Composite, DI 0.58, PI 0.56) correlations were moderate. Subscale–subscale (0.79 for both samples) and subscale–total (Development, DI 0.95, PI 0.95; Composite, DI 0.95, PI 0.94) correlations and internal consistency (Development, TS 0.93, DI 0.90, PI 0.84; Composite, TS 0.93, DI 0.89, PI 0.85) were high in both samples. Conclusion PCQLI scores are externally valid across the US pediatric HD population and may be used for multi-center HRQOL studies. PMID:21188538

Forensic Science Research and Development at the National Institute of Justice: Opportunities in Applied Physics

NASA Astrophysics Data System (ADS)

Dutton, Gregory

Forensic science is a collection of applied disciplines that draws from all branches of science. A key question in forensic analysis is: to what degree do a piece of evidence and a known reference sample share characteristics? Quantification of similarity, estimation of uncertainty, and determination of relevant population statistics are of current concern. A 2016 PCAST report questioned the foundational validity and the validity in practice of several forensic disciplines, including latent fingerprints, firearms comparisons and DNA mixture interpretation. One recommendation was the advancement of objective, automated comparison methods based on image analysis and machine learning. These concerns parallel the National Institute of Justice's ongoing R&D investments in applied chemistry, biology and physics. NIJ maintains a funding program spanning fundamental research with potential for forensic application to the validation of novel instruments and methods. Since 2009, NIJ has funded over 179M in external research to support the advancement of accuracy, validity and efficiency in the forensic sciences. An overview of NIJ's programs will be presented, with examples of relevant projects from fluid dynamics, 3D imaging, acoustics, and materials science.

Irreversibility and entropy production in transport phenomena, IV: Symmetry, integrated intermediate processes and separated variational principles for multi-currents

NASA Astrophysics Data System (ADS)

Suzuki, Masuo

2013-10-01

The mechanism of entropy production in transport phenomena is discussed again by emphasizing the role of symmetry of non-equilibrium states and also by reformulating Einstein’s theory of Brownian motion to derive entropy production from it. This yields conceptual reviews of the previous papers [M. Suzuki, Physica A 390 (2011) 1904; 391 (2012) 1074; 392 (2013) 314]. Separated variational principles of steady states for multi external fields {Xi} and induced currents {Ji} are proposed by extending the principle of minimum integrated entropy production found by the present author for a single external field. The basic strategy of our theory on steady states is to take in all the intermediate processes from the equilibrium state to the final possible steady states in order to study the irreversible physics even in the steady states. As an application of this principle, Gransdorff-Prigogine’s evolution criterion inequality (or stability condition) dXP≡∫dr∑iJidXi≤0 is derived in the stronger form dQi≡∫drJidXi≤0 for individual force Xi and current Ji even in nonlinear responses which depend on all the external forces {Xk} nonlinearly. This is called “separated evolution criterion”. Some explicit demonstrations of the present general theory to simple electric circuits with multi external fields are given in order to clarify the physical essence of our new theory and to realize the condition of its validity concerning the existence of the solutions of the simultaneous equations obtained by the separated variational principles. It is also instructive to compare the two results obtained by the new variational theory and by the old scheme based on the instantaneous entropy production. This seems to be suggestive even to the energy problem in the world.

Validation of the Survey of Pre-Service Teachers' Knowledge of Teaching and Technology: A Multi-Institutional Sample

ERIC Educational Resources Information Center

Ritzhaupt, Albert D.; Huggins-Manley, Anne Corinne; Ruggles, Krista; Wilson, Matthew

2016-01-01

The TPACK (technological pedagogical content knowledge) framework (Mishra & Koehler, 2006) has gained tremendous momentum from within the educational technology community. Specifically, much discourse has focused on how to measure this multidimensional construct to further define the contours of the framework and potentially make some…

Expectation-Based Efficiency and Quality Improvements in Research Administration: Multi-Institutional Case Studies

ERIC Educational Resources Information Center

Saha, Dhanonjoy C.; Ahmed, Abrar; Hanumandla, Shailaja

2011-01-01

Conventional wisdom may support the presumed notion that higher expectations increase efficiency and improve quality. However, this claim may only be validated when workers are equipped with appropriate tools, training, and a conducive work environment. This study implements various interventions, observes outcomes, and analyzes data collected in…

Motivation Filtering on a Multi-Institution Assessment of General College Outcomes

ERIC Educational Resources Information Center

Steedle, Jeffrey T.

2014-01-01

Possible lack of motivation is a perpetual concern when tests have no stakes attached to performance. Specifically, the validity of test score interpretations may be compromised when examinees are unmotivated to exert their best efforts. Motivation filtering, a procedure that filters out apparently unmotivated examinees, was applied to the…

Mentoring Students: Conceptualizing and Validating the Multi-Dimensions of a Support System

ERIC Educational Resources Information Center

Nora, Amaury; Crisp, Gloria

2008-01-01

Many students do not receive the adequate academic and social support during their enrollment in a higher education institution that could positively impact their abilities to succeed in college (Astin, 1984; Hurtado & Carter, 1997; Nora, 1987; Pascarella & Terenzini, 1991). These support systems can be viewed as providing a holistic mentoring…

Biomarkers for Early Detection of Clinically Relevant Prostate Cancer: A Multi-Institutional Validation Trial

DTIC Science & Technology

2017-10-01

mRNA and has been shown in many studies to improve predictive accuracy for cancer on initial biopsy,3,7-9 and to be correlated with more aggressive... Study (PASS). We are in the process of evaluating these three biomarker panels in tissue, blood, and urine samples with well annotated clinical and...during AS. The objective of the study is to utilize analytically validated assays that take into account tumor heterogeneity to measure biomarkers in

[Development of methods and instruments for external quality assurance in inpatient parent-child rehabilitation and prevention].

PubMed

Neuderth, S; Lukasczik, M; Musekamp, G; Gerlich, C; Saupe-Heide, M; Löbmann, R; Vogel, H

2013-02-01

There so far is no standardized program for external quality assurance in inpatient parent-child prevention and rehabilitation in Germany. Therefore, instruments and methods of external quality assurance were developed and evaluated on behalf of the federal-level health insurance institutions. On the level of structure quality, a modular questionnaire for assessing structural features of rehabilitation/prevention centers, basic and allocation criteria as well as a checklist for visitations were developed. Structural data were collected in a nationwide survey of parent-child prevention and rehabilitation centers. Process and outcome quality data were collected in n=38 centers. Process quality was assessed using multiple methods (process-related structural features, case-related routine documentation, and incident-related patient questionnaires). Outcome quality was measured via patient questionnaires (n=1 799 patients). We used a multi-level modelling approach by adjusting relevant confounders on institutional and patient levels. The methods, instruments and analyzing procedures developed for measuring quality on the level of structure, processes and outcomes were adjusted in cooperation with all relevant stakeholders. Results are exemplarily presented for all quality assurance tools. For most of the risk-adjusted outcome parameters, we found no significant differences between institutions. For the first time, a comprehensive, standardized and generally applicable set of methods and instruments for routine use in comparative quality measurement of inpatient parent-child prevention and rehabilitation is available. However, it should be considered that the very heterogeneous field of family-oriented measures can not be covered entirely by an external quality assurance program. Therefore, methods and instruments have to be adapted continuously to the specifics of this area of health care and to new developments. © Georg Thieme Verlag KG Stuttgart · New York.

The validity of the multi-informant approach to assessing child and adolescent mental health.

PubMed

De Los Reyes, Andres; Augenstein, Tara M; Wang, Mo; Thomas, Sarah A; Drabick, Deborah A G; Burgers, Darcy E; Rabinowitz, Jill

2015-07-01

Child and adolescent patients may display mental health concerns within some contexts and not others (e.g., home vs. school). Thus, understanding the specific contexts in which patients display concerns may assist mental health professionals in tailoring treatments to patients' needs. Consequently, clinical assessments often include reports from multiple informants who vary in the contexts in which they observe patients' behavior (e.g., patients, parents, teachers). Previous meta-analyses indicate that informants' reports correlate at low-to-moderate magnitudes. However, is it valid to interpret low correspondence among reports as indicating that patients display concerns in some contexts and not others? We meta-analyzed 341 studies published between 1989 and 2014 that reported cross-informant correspondence estimates, and observed low-to-moderate correspondence (mean internalizing: r = .25; mean externalizing: r = .30; mean overall: r = .28). Informant pair, mental health domain, and measurement method moderated magnitudes of correspondence. These robust findings have informed the development of concepts for interpreting multi-informant assessments, allowing researchers to draw specific predictions about the incremental and construct validity of these assessments. In turn, we critically evaluated research on the incremental and construct validity of the multi-informant approach to clinical child and adolescent assessment. In so doing, we identify crucial gaps in knowledge for future research, and provide recommendations for "best practices" in using and interpreting multi-informant assessments in clinical work and research. This article has important implications for developing personalized approaches to clinical assessment, with the goal of informing techniques for tailoring treatments to target the specific contexts where patients display concerns. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Study of premixing phase of steam explosion with JASMINE code in ALPHA program

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

Moriyama, Kiyofumi; Yamano, Norihiro; Maruyama, Yu

Premixing phase of steam explosion has been studied in ALPHA Program at Japan Atomic Energy Research Institute (JAERI). An analytical model to simulate the premixing phase, JASMINE (JAERI Simulator for Multiphase Interaction and Explosion), has been developed based on a multi-dimensional multi-phase thermal hydraulics code MISTRAL (by Fuji Research Institute Co.). The original code was extended to simulate the physics in the premixing phenomena. The first stage of the code validation was performed by analyzing two mixing experiments with solid particles and water: the isothermal experiment by Gilbertson et al. (1992) and the hot particle experiment by Angelini et al.more » (1993) (MAGICO). The code predicted reasonably well the experiments. Effectiveness of the TVD scheme employed in the code was also demonstrated.« less

Development and External Validation of a Prognostic Nomogram for Metastatic Uveal Melanoma

PubMed Central

Valpione, Sara; Moser, Justin C.; Parrozzani, Raffaele; Bazzi, Marco; Mansfield, Aaron S.; Mocellin, Simone; Pigozzo, Jacopo; Midena, Edoardo; Markovic, Svetomir N.; Aliberti, Camillo; Campana, Luca G.; Chiarion-Sileni, Vanna

2015-01-01

Background Approximately 50% of patients with uveal melanoma (UM) will develop metastatic disease, usually involving the liver. The outcome of metastatic UM (mUM) is generally poor and no standard therapy has been established. Additionally, clinicians lack a validated prognostic tool to evaluate these patients. The aim of this work was to develop a reliable prognostic nomogram for clinicians. Patients and Methods Two cohorts of mUM patients, from Veneto Oncology Institute (IOV) (N=152) and Mayo Clinic (MC) (N=102), were analyzed to develop and externally validate, a prognostic nomogram. Results The median survival of mUM was 17.2 months in the IOV cohort and 19.7 in the MC cohort. Percentage of liver involvement (HR 1.6), elevated levels of serum LDH (HR 1.6), and a WHO performance status=1 (HR 1.5) or 2–3 (HR 4.6) were associated with worse prognosis. Longer disease-free interval from diagnosis of UM to that of mUM conferred a survival advantage (HR 0.9). The nomogram had a concordance probability of 0.75 (SE .006) in the development dataset (IOV), and 0.80 (SE .009) in the external validation (MC). Nomogram predictions were well calibrated. Conclusions The nomogram, which includes percentage of liver involvement, LDH levels, WHO performance status and disease free-interval accurately predicts the prognosis of mUM and could be useful for decision-making and risk stratification for clinical trials. PMID:25780931

The NASA Astrobiology Institute: early history and organization.

PubMed

Blumberg, Baruch S

2003-01-01

The NASA Astrobiology Institute (NAI) was established as a means to advance the field of astrobiology by providing a multidisciplinary, multi-institution, science-directed program, executed by universities, research institutes, and NASA and other government laboratories. The scientific community and NASA defined the science content at several workshops as summarized in the NASA Astrobiology Roadmap. Teams were chosen nationwide, following the recommendations of external review groups, and the research program began in 1998. There are now 16 national Teams and five international affiliated and associated astrobiology institutions. The NAI has attracted an outstanding group of scientific groups and individuals. The Institute facilitates the involvement of the scientists in its scientific and management vision. Its goal is to support basic research and allow the scientists the freedom to select their projects and alter them as indicated by new research. Additional missions include the education of the public, the involvement of students who will be the astrobiologists of future generations, and the development of a culture of collaboration in NAI, a "virtual institute," spread across many sites nationally and internationally.

The NASA Astrobiology Institute: early history and organization

NASA Technical Reports Server (NTRS)

Blumberg, Baruch S.

2003-01-01

The NASA Astrobiology Institute (NAI) was established as a means to advance the field of astrobiology by providing a multidisciplinary, multi-institution, science-directed program, executed by universities, research institutes, and NASA and other government laboratories. The scientific community and NASA defined the science content at several workshops as summarized in the NASA Astrobiology Roadmap. Teams were chosen nationwide, following the recommendations of external review groups, and the research program began in 1998. There are now 16 national Teams and five international affiliated and associated astrobiology institutions. The NAI has attracted an outstanding group of scientific groups and individuals. The Institute facilitates the involvement of the scientists in its scientific and management vision. Its goal is to support basic research and allow the scientists the freedom to select their projects and alter them as indicated by new research. Additional missions include the education of the public, the involvement of students who will be the astrobiologists of future generations, and the development of a culture of collaboration in NAI, a "virtual institute," spread across many sites nationally and internationally.

Prediction of new brain metastases after radiosurgery: validation and analysis of performance of a multi-institutional nomogram.

PubMed

Ayala-Peacock, Diandra N; Attia, Albert; Braunstein, Steve E; Ahluwalia, Manmeet S; Hepel, Jaroslaw; Chung, Caroline; Contessa, Joseph; McTyre, Emory; Peiffer, Ann M; Lucas, John T; Isom, Scott; Pajewski, Nicholas M; Kotecha, Rupesh; Stavas, Mark J; Page, Brandi R; Kleinberg, Lawrence; Shen, Colette; Taylor, Robert B; Onyeuku, Nasarachi E; Hyde, Andrew T; Gorovets, Daniel; Chao, Samuel T; Corso, Christopher; Ruiz, Jimmy; Watabe, Kounosuke; Tatter, Stephen B; Zadeh, Gelareh; Chiang, Veronica L S; Fiveash, John B; Chan, Michael D

2017-11-01

Stereotactic radiosurgery (SRS) without whole brain radiotherapy (WBRT) for brain metastases can avoid WBRT toxicities, but with risk of subsequent distant brain failure (DBF). Sole use of number of metastases to triage patients may be an unrefined method. Data on 1354 patients treated with SRS monotherapy from 2000 to 2013 for new brain metastases was collected across eight academic centers. The cohort was divided into training and validation datasets and a prognostic model was developed for time to DBF. We then evaluated the discrimination and calibration of the model within the validation dataset, and confirmed its performance with an independent contemporary cohort. Number of metastases (≥8, HR 3.53 p = 0.0001), minimum margin dose (HR 1.07 p = 0.0033), and melanoma histology (HR 1.45, p = 0.0187) were associated with DBF. A prognostic index derived from the training dataset exhibited ability to discriminate patients' DBF risk within the validation dataset (c-index = 0.631) and Heller's explained relative risk (HERR) = 0.173 (SE = 0.048). Absolute number of metastases was evaluated for its ability to predict DBF in the derivation and validation datasets, and was inferior to the nomogram. A nomogram high-risk threshold yielding a 2.1-fold increased need for early WBRT was identified. Nomogram values also correlated to number of brain metastases at time of failure (r = 0.38, p < 0.0001). We present a multi-institutionally validated prognostic model and nomogram to predict risk of DBF and guide risk-stratification of patients who are appropriate candidates for radiosurgery versus upfront WBRT.

Development of a compact filament-discharge multi-cusp H- ion source.

PubMed

Jia, XianLu; Zhang, TianJue; Zheng, Xia; Qin, JiuChang

2012-02-01

A 14 MeV medical cyclotron with the external ion source has been designed and is being constructed at China Institute of Atomic Energy. The H(-) ion will be accelerated by this machine and the proton beam will be extracted by carbon strippers in dual opposite direction. The compact multi-cusp H(-) ion source has been developed for the cyclotron. The 79.5 mm long ion source is 48 mm in diameter, which is consisting of a special shape filament, ten columns of permanent magnets providing a multi-cusp field, and a three-electrode extraction system. So far, the 3 mA∕25 keV H(-) beam with an emittance of 0.3 π mm mrad has been obtained from the ion source. The paper gives the design details and the beam test results. Further experimental study is under way and an extracted beam of 5 mA is expected.

Evaluating Outcomes of High Fidelity Simulation Curriculum in a Community College Nursing Program

ERIC Educational Resources Information Center

Denlea, Gregory Richard

2017-01-01

This study took place at a Wake Technical Community College, a multi-campus institution in Raleigh, North Carolina. An evaluation of the return on investment in high fidelity simulation used by an associate degree of nursing program was conducted with valid and reliable instruments. The study demonstrated that comparable student outcomes are…

TU-AB-BRA-06: BEST IN PHYSICS (JOINT IMAGING-THERAPY): An MRI Compatible Externally and Internally Deformable Lung Motion Phantom for Multi-Modality IGRT

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

Sabouri, P; Sawant, A; Arai, T

Purpose: MRI has become an attractive tool for tumor motion management. Current MR-compatible phantoms are only capable of reproducing translational motion. This study describes the construction and validation of a more realistic, MRI-compatible lung phantom that is deformable internally as well as externally. We demonstrate a radiotherapy application of this phantom by validating the geometric accuracy of the open-source deformable image registration software NiftyReg (UCL, UK). Methods: The outer shell of a commercially-available dynamic breathing torso phantom was filled with natural latex foam with eleven water tubes. A rigid foam cut-out served as the diaphragm. A high-precision programmable, in-house, MRI-compatiblemore » motion platform was used to drive the diaphragm. The phantom was imaged on a 3T scanner (Philips, Ingenia). Twenty seven tumor traces previously recorded from lung cancer patients were programmed into the phantom and 2D+t image sequences were acquired using a sparse-sampling sequence k-t BLAST (accn=3, resolution=0.66×0.66×5mm3; acquisition-time=110ms/slice). The geometric fidelity of the MRI-derived trajectories was validated against those obtained via fluoroscopy using the on board kV imager on a Truebeam linac. NiftyReg was used to perform frame by frame deformable image registration. The location of each marker predicted by using NiftyReg was compared with the values calculated by intensity-based segmentation on each frame. Results: In all cases, MR trajectories were within 1 mm of corresponding fluoroscopy trajectories. RMSE between centroid positions obtained from segmentation with those obtained by NiftyReg varies from 0.1 to 0.21 mm in the SI direction and 0.08 to 0.13 mm in the LR direction showing the high accuracy of deformable registration. Conclusion: We have successfully designed and demonstrated a phantom that can accurately reproduce deformable motion under a variety of imaging modalities including MRI, CT and x-ray fluodoscopy, making it an invaluable research tool for validating novel motion management strategies. This work was partially supported through research funding from National Institutes of Health (R01CA169102).« less

Reconceptualising the external validity of discrete choice experiments.

PubMed

Lancsar, Emily; Swait, Joffre

2014-10-01

External validity is a crucial but under-researched topic when considering using discrete choice experiment (DCE) results to inform decision making in clinical, commercial or policy contexts. We present the theory and tests traditionally used to explore external validity that focus on a comparison of final outcomes and review how this traditional definition has been empirically tested in health economics and other sectors (such as transport, environment and marketing) in which DCE methods are applied. While an important component, we argue that the investigation of external validity should be much broader than a comparison of final outcomes. In doing so, we introduce a new and more comprehensive conceptualisation of external validity, closely linked to process validity, that moves us from the simple characterisation of a model as being or not being externally valid on the basis of predictive performance, to the concept that external validity should be an objective pursued from the initial conceptualisation and design of any DCE. We discuss how such a broader definition of external validity can be fruitfully used and suggest innovative ways in which it can be explored in practice.

Multi-centre audit of VMAT planning and pre-treatment verification.

PubMed

Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

2017-08-01

We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

External Validation of a Case-Mix Adjustment Model for the Standardized Reporting of 30-Day Stroke Mortality Rates in China.

PubMed

Yu, Ping; Pan, Yuesong; Wang, Yongjun; Wang, Xianwei; Liu, Liping; Ji, Ruijun; Meng, Xia; Jing, Jing; Tong, Xu; Guo, Li; Wang, Yilong

2016-01-01

A case-mix adjustment model has been developed and externally validated, demonstrating promise. However, the model has not been thoroughly tested among populations in China. In our study, we evaluated the performance of the model in Chinese patients with acute stroke. The case-mix adjustment model A includes items on age, presence of atrial fibrillation on admission, National Institutes of Health Stroke Severity Scale (NIHSS) score on admission, and stroke type. Model B is similar to Model A but includes only the consciousness component of the NIHSS score. Both model A and B were evaluated to predict 30-day mortality rates in 13,948 patients with acute stroke from the China National Stroke Registry. The discrimination of the models was quantified by c-statistic. Calibration was assessed using Pearson's correlation coefficient. The c-statistic of model A in our external validation cohort was 0.80 (95% confidence interval, 0.79-0.82), and the c-statistic of model B was 0.82 (95% confidence interval, 0.81-0.84). Excellent calibration was reported in the two models with Pearson's correlation coefficient (0.892 for model A, p<0.001; 0.927 for model B, p = 0.008). The case-mix adjustment model could be used to effectively predict 30-day mortality rates in Chinese patients with acute stroke.

Development and validation of a cost-utility model for Type 1 diabetes mellitus.

PubMed

Wolowacz, S; Pearson, I; Shannon, P; Chubb, B; Gundgaard, J; Davies, M; Briggs, A

2015-08-01

To develop a health economic model to evaluate the cost-effectiveness of new interventions for Type 1 diabetes mellitus by their effects on long-term complications (measured through mean HbA1c ) while capturing the impact of treatment on hypoglycaemic events. Through a systematic review, we identified complications associated with Type 1 diabetes mellitus and data describing the long-term incidence of these complications. An individual patient simulation model was developed and included the following complications: cardiovascular disease, peripheral neuropathy, microalbuminuria, end-stage renal disease, proliferative retinopathy, ketoacidosis, cataract, hypoglycemia and adverse birth outcomes. Risk equations were developed from published cumulative incidence data and hazard ratios for the effect of HbA1c , age and duration of diabetes. We validated the model by comparing model predictions with observed outcomes from studies used to build the model (internal validation) and from other published data (external validation). We performed illustrative analyses for typical patient cohorts and a hypothetical intervention. Model predictions were within 2% of expected values in the internal validation and within 8% of observed values in the external validation (percentages represent absolute differences in the cumulative incidence). The model utilized high-quality, recent data specific to people with Type 1 diabetes mellitus. In the model validation, results deviated less than 8% from expected values. © 2014 Research Triangle Institute d/b/a RTI Health Solutions. Diabetic Medicine © 2014 Diabetes UK.

Towards a model-based patient selection strategy for proton therapy: External validation of photon-derived Normal Tissue Complication Probability models in a head and neck proton therapy cohort

PubMed Central

Blanchard, P; Wong, AJ; Gunn, GB; Garden, AS; Mohamed, ASR; Rosenthal, DI; Crutison, J; Wu, R; Zhang, X; Zhu, XR; Mohan, R; Amin, MV; Fuller, CD; Frank, SJ

2017-01-01

Objective To externally validate head and neck cancer (HNC) photon-derived normal tissue complication probability (NTCP) models in patients treated with proton beam therapy (PBT). Methods This prospective cohort consisted of HNC patients treated with PBT at a single institution. NTCP models were selected based on the availability of data for validation and evaluated using the leave-one-out cross-validated area under the curve (AUC) for the receiver operating characteristics curve. Results 192 patients were included. The most prevalent tumor site was oropharynx (n=86, 45%), followed by sinonasal (n=28), nasopharyngeal (n=27) or parotid (n=27) tumors. Apart from the prediction of acute mucositis (reduction of AUC of 0.17), the models overall performed well. The validation (PBT) AUC and the published AUC were respectively 0.90 versus 0.88 for feeding tube 6 months post-PBT; 0.70 versus 0.80 for physician rated dysphagia 6 months post-PBT; 0.70 versus 0.80 for dry mouth 6 months post-PBT; and 0.73 versus 0.85 for hypothyroidism 12 months post-PBT. Conclusion While the drop in NTCP model performance was expected in PBT patients, the models showed robustness and remained valid. Further work is warranted, but these results support the validity of the model-based approach for treatment selection for HNC patients. PMID:27641784

Multi-institutional validation of a novel textural analysis tool for preoperative stratification of suspected thyroid tumors on diffusion-weighted MRI.

PubMed

Brown, Anna M; Nagala, Sidhartha; McLean, Mary A; Lu, Yonggang; Scoffings, Daniel; Apte, Aditya; Gonen, Mithat; Stambuk, Hilda E; Shaha, Ashok R; Tuttle, R Michael; Deasy, Joseph O; Priest, Andrew N; Jani, Piyush; Shukla-Dave, Amita; Griffiths, John

2016-04-01

Ultrasound-guided fine needle aspirate cytology fails to diagnose many malignant thyroid nodules; consequently, patients may undergo diagnostic lobectomy. This study assessed whether textural analysis (TA) could noninvasively stratify thyroid nodules accurately using diffusion-weighted MRI (DW-MRI). This multi-institutional study examined 3T DW-MRI images obtained with spin echo echo planar imaging sequences. The training data set included 26 patients from Cambridge, United Kingdom, and the test data set included 18 thyroid cancer patients from Memorial Sloan Kettering Cancer Center (New York, New York, USA). Apparent diffusion coefficients (ADCs) were compared over regions of interest (ROIs) defined on thyroid nodules. TA, linear discriminant analysis (LDA), and feature reduction were performed using the 21 MaZda-generated texture parameters that best distinguished benign and malignant ROIs. Training data set mean ADC values were significantly different for benign and malignant nodules (P = 0.02) with a sensitivity and specificity of 70% and 63%, respectively, and a receiver operator characteristic (ROC) area under the curve (AUC) of 0.73. The LDA model of the top 21 textural features correctly classified 89/94 DW-MRI ROIs with 92% sensitivity, 96% specificity, and an AUC of 0.97. This algorithm correctly classified 16/18 (89%) patients in the independently obtained test set of thyroid DW-MRI scans. TA classifies thyroid nodules with high sensitivity and specificity on multi-institutional DW-MRI data sets. This method requires further validation in a larger prospective study. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.

A Generalizable Framework for Multi-Scale Auditing of Digital Learning Provision in Higher Education

ERIC Educational Resources Information Center

Ross, Samuel R. P-J.; Volz, Veronica; Lancaster, Matthew K.; Divan, Aysha

2018-01-01

It is increasingly important that higher education institutions be able to audit and evaluate the scope and efficacy of their digital learning resources across various scales. To date there has been little effort to address this need for a validated, appropriate, and simple-to-execute method that will facilitate such an audit, whether it be at the…

Australian validation of the Cancer of the Prostate Risk Assessment Post-Surgical score to predict biochemical recurrence after radical prostatectomy.

PubMed

Beckmann, Kerri; O'Callaghan, Michael; Vincent, Andrew; Roder, David; Millar, Jeremy; Evans, Sue; McNeil, John; Moretti, Kim

2018-03-01

The Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) score is a simple post-operative risk assessment tool predicting disease recurrence after radical prostatectomy, which is easily calculated using available clinical data. To be widely useful, risk tools require multiple external validations. We aimed to validate the CAPRA-S score in an Australian multi-institutional population, including private and public settings and reflecting community practice. The study population were all men on the South Australian Prostate Cancer Clinical Outcomes Collaborative Database with localized prostate cancer diagnosed during 1998-2013, who underwent radical prostatectomy without adjuvant therapy (n = 1664). Predictive performance was assessed via Kaplan-Meier and Cox proportional regression analyses, Harrell's Concordance index, calibration plots and decision curve analysis. Biochemical recurrence occurred in 342 (21%) cases. Five-year recurrence-free probabilities for CAPRA-S scores indicating low (0-2), intermediate (3-5) and high risk were 95, 79 and 46%, respectively. The hazard ratio for CAPRA-S score increments was 1.56 (95% confidence interval 1.49-1.64). The Concordance index for 5-year recurrence-free survival was 0.77. The calibration plot showed good correlation between predicted and observed recurrence-free survival across scores. Limitations include the retrospective nature and small numbers with higher CAPRA-S scores. The CAPRA-S score is an accurate predictor of recurrence after radical prostatectomy in our cohort, supporting its utility in the Australian setting. This simple tool can assist in post-surgical selection of patients who would benefit from adjuvant therapy while avoiding morbidity among those less likely to benefit. © 2017 Royal Australasian College of Surgeons.

A Gene Signature to Determine Metastatic Behavior in Thymomas

PubMed Central

Gökmen-Polar, Yesim; Wilkinson, Jeff; Maetzold, Derek; Stone, John F.; Oelschlager, Kristen M.; Vladislav, Ioan Tudor; Shirar, Kristen L.; Kesler, Kenneth A.; Loehrer, Patrick J.; Badve, Sunil

2013-01-01

Purpose Thymoma represents one of the rarest of all malignancies. Stage and completeness of resection have been used to ascertain postoperative therapeutic strategies albeit with limited prognostic accuracy. A molecular classifier would be useful to improve the assessment of metastatic behaviour and optimize patient management. Methods qRT-PCR assay for 23 genes (19 test and four reference genes) was performed on multi-institutional archival primary thymomas (n = 36). Gene expression levels were used to compute a signature, classifying tumors into classes 1 and 2, corresponding to low or high likelihood for metastases. The signature was validated in an independent multi-institutional cohort of patients (n = 75). Results A nine-gene signature that can predict metastatic behavior of thymomas was developed and validated. Using radial basis machine modeling in the training set, 5-year and 10-year metastasis-free survival rates were 77% and 26% for predicted low (class 1) and high (class 2) risk of metastasis (P = 0.0047, log-rank), respectively. For the validation set, 5-year metastasis-free survival rates were 97% and 30% for predicted low- and high-risk patients (P = 0.0004, log-rank), respectively. The 5-year metastasis-free survival rates for the validation set were 49% and 41% for Masaoka stages I/II and III/IV (P = 0.0537, log-rank), respectively. In univariate and multivariate Cox models evaluating common prognostic factors for thymoma metastasis, the nine-gene signature was the only independent indicator of metastases (P = 0.036). Conclusion A nine-gene signature was established and validated which predicts the likelihood of metastasis more accurately than traditional staging. This further underscores the biologic determinants of the clinical course of thymoma and may improve patient management. PMID:23894276

External validation of a published nomogram for prediction of brain metastasis in patients with extra-cerebral metastatic breast cancer and risk regression analysis.

PubMed

Genre, Ludivine; Roché, Henri; Varela, Léonel; Kanoun, Dorra; Ouali, Monia; Filleron, Thomas; Dalenc, Florence

2017-02-01

Survival of patients with metastatic breast cancer (MBC) suffering from brain metastasis (BM) is limited and this event is usually fatal. In 2010, the Graesslin's nomogram was published in order to predict subsequent BM in patients with breast cancer (BC) with extra-cerebral metastatic disease. This model aims to select a patient population at high risk for BM and thus will facilitate the design of prevention strategies and/or the impact of early treatment of BM in prospective clinical studies. Nomogram external validation was retrospectively applied to patients with BC and later BM between January 2005 and December 2012, treated in our institution. Moreover, risk factors of BM appearance were studied by Fine and Gray's competing risk analysis. Among 492 patients with MBC, 116 developed subsequent BM. Seventy of them were included for the nomogram validation. The discrimination is good (area under curve = 0.695 [95% confidence interval, 0.61-0.77]). Risk factors of BM appearance are: human epidermal growth factor receptor 2 (HER2) overexpression/amplification, triple-negative BC and number of extra-cerebral metastatic sites (>1). With a competing risk model, we highlight the nomogram interest for HER2+ tumour subgroup exclusively. Graesslin's nomogram external validation demonstrates exportability and reproducibility. Importantly, the competing risk model analysis provides additional information for the design of prospective trials concerning the early diagnosis of BM and/or preventive treatment on high risk patients with extra-cerebral metastatic BC. Copyright © 2016 Elsevier Ltd. All rights reserved.

External Validation of the Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale Score for Predicting Pneumonia After Stroke Using Data From the China National Stroke Registry.

PubMed

Zhang, Runhua; Ji, Ruijun; Pan, Yuesong; Jiang, Yong; Liu, Gaifen; Wang, Yilong; Wang, Yongjun

2017-05-01

Pneumonia is an important risk factor for mortality and morbidity after stroke. The Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) score was shown to be a useful tool for predicting stroke-associated pneumonia based on UK multicenter cohort study. We aimed to externally validate the score using data from the China National Stroke Registry (CNSR). Eligible patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) in the CNSR from 2007 to 2008 were included. The area under the receiver operating characteristic (AUC) curve was used to evaluate discrimination. The Hosmer-Lemeshow goodness of fit test and Pearson correlation coefficient were performed to assess calibration of the model. A total of 19,333 patients (AIS = 14400; ICH = 4933) were included and the overall pneumonia rate was 12.7%. The AUC was .76 (95% confidence interval [CI]: .75-.78) for the subgroup of AIS and .70 (95% CI: .68-.72) for the subgroup of ICH. The Hosmer-Lemeshow test showed the ISAN score with the good calibration for AIS and ICH (P = .177 and .405, respectively). The plot of observed versus predicted pneumonia rates suggested higher correlation for patients with AIS than with ICH (Pearson correlation coefficient = .99 and .83, respectively). The ISAN score was a useful tool for predicting in-hospital pneumonia after acute stroke, especially for patients with AIS. Further validations need to be done in different populations. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

The integral inventory for depression, a new, self-rated clinimetric instrument for the emotional and painful dimensions in major depressive disorder.

PubMed

Dueñas, Héctor; Lara, Carmen; Walton, Richard J; Granger, Renee E; Dossenbach, Martin; Raskin, Joel

2011-09-01

To assess the reliability and validity of the Integral Inventory for Depression (IID) scale using post hoc analyses of data from a multi-country study (ClinicalTrials.gov: NCT00561509) of patients with major depressive disorder (MDD). Patients (N = 1629) completed the IID (comprising two separate dimensions for emotional and physically painful symptoms; maximum score of 65) and a reference scale (16-item Quick Inventory of Depressive Symptomatology Self-Report) at baseline and at follow-up (8 and 24 weeks). Physicians rated MDD symptoms using the Clinical Global Impressions of Severity scale at each visit. Inter-item correlation, internal consistency, external validity, factor structure, and exploratory analysis of an optimal severity cut-off point were assessed. The IID displayed two distinct dimensions (i.e. painful and emotional) with little item redundancy and good internal consistency (Cronbach's α > 0.83 at each visit). The IID displayed good external validity (Pearson's correlations coefficients >0.60 at each visit) and statistically significant agreement (McNemar's test; P < 0.001 at follow-up) with the reference scale. Results suggest that a cut-off score of ≤24 had adequate precision (>80%) to identify patients with and without moderate MDD. Results suggest that the IID may be a reliable and valid tool for assessing emotional and painful symptoms of MDD.

Analysis of 2000 cases treated with gamma knife surgery: validating eligibility criteria for a prospective multi-institutional study of stereotactic radiosurgery alone for treatment of patients with 1-10 brain metastases (JLGK0901) in Japan

PubMed Central

Higuchi, Yoshinori; Nagano, Osamu; Sato, Yasunori; Yamamoto, Masaaki; Ono, Junichi; Saeki, Naokatsu; Miyakawa, Akifumi; Hirai, Tatsuo

2012-01-01

Objective The Japan Leksell Gamma Knife (JLGK) Society has conducted a prospective multi-institute study (JLGK0901, UNIN000001812) for selected patients in order to prove the effectiveness of stereotactic radiosurgery (SRS) alone using the gamma knife (GK) for 1-10 brain lesions. Herein, we verify the validity of 5 major patient selection criteria for the JLGK0901 trial. Materials and Methods Between 1998 and 2010, 2246 consecutive cases with 10352 brain metastases treated with GK were analyzed to determine the validity of the following 5 major JLGK0901 criteria; 1) 1-10 brain lesions, 2) less than 10 cm3 volume of the largest tumor, 3) no more than 15 cm3 total tumor volume, 4) no cerebrospinal fluid (CSF) dissemination, 5) Karnofsky performance status (KPS) score ≥70. Results For cases with >10 brain metastases, salvage treatments for new lesions were needed more frequently. The tumor control rate for lesions larger than 10 cm3 was significantly lower than that of tumors <10 cm3. Overall, neurological and qualitative survivals (OS, NS, QS) of cases with >15 cm3 total tumor volume or positive magnetic resonance imaging findings of CSF were significantly poorer. Outcomes in cases with KPS <70 were significantly poorer in terms of OS. Conclusion Our retrospective results of 2246 GK-treated cases verified the validity of the 5 major JLGK0901 criteria. The inclusion criteria for the JLGK0901 study are appearently good indications for SRS. PMID:29296339

A new multi-domain method based on an analytical control surface for linear and second-order mean drift wave loads on floating bodies

NASA Astrophysics Data System (ADS)

Liang, Hui; Chen, Xiaobo

2017-10-01

A novel multi-domain method based on an analytical control surface is proposed by combining the use of free-surface Green function and Rankine source function. A cylindrical control surface is introduced to subdivide the fluid domain into external and internal domains. Unlike the traditional domain decomposition strategy or multi-block method, the control surface here is not panelized, on which the velocity potential and normal velocity components are analytically expressed as a series of base functions composed of Laguerre function in vertical coordinate and Fourier series in the circumference. Free-surface Green function is applied in the external domain, and the boundary integral equation is constructed on the control surface in the sense of Galerkin collocation via integrating test functions orthogonal to base functions over the control surface. The external solution gives rise to the so-called Dirichlet-to-Neumann [DN2] and Neumann-to-Dirichlet [ND2] relations on the control surface. Irregular frequencies, which are only dependent on the radius of the control surface, are present in the external solution, and they are removed by extending the boundary integral equation to the interior free surface (circular disc) on which the null normal derivative of potential is imposed, and the dipole distribution is expressed as Fourier-Bessel expansion on the disc. In the internal domain, where the Rankine source function is adopted, new boundary integral equations are formulated. The point collocation is imposed over the body surface and free surface, while the collocation of the Galerkin type is applied on the control surface. The present method is valid in the computation of both linear and second-order mean drift wave loads. Furthermore, the second-order mean drift force based on the middle-field formulation can be calculated analytically by using the coefficients of the Fourier-Laguerre expansion.

Measuring Diversity and Inclusion in Academic Medicine: The Diversity Engagement Survey (DES)

PubMed Central

Person, Sharina D.; Jordan, C. Greer; Allison, Jeroan J.; Fink Ogawa, Lisa M.; Castillo-Page, Laura; Conrad, Sarah; Nivet, Marc A.; Plummer, Deborah L.

2018-01-01

Purpose To produce a physician and scientific workforce capable of delivering high quality, culturally competent health care and research, academic medical centers must assess their capacity for diversity and inclusion and respond to identified opportunities. Thus, the Diversity Engagement Survey (DES) is presented as a diagnostic and benchmarking tool. Method The 22-item DES connects workforce engagement theory with inclusion and diversity constructs. Face and content validity were established based on decades of previous work to promote institutional diversity. The survey was pilot tested at a single academic medical center and subsequently administered at 13 additional academic medical centers. Cronbach alphas assessed internal consistency and Confirmatory Factor Analysis (CFA) established construct validity. Criterion validity was assessed by observed separation in scores for groups traditionally recognized to have less workforce engagement. Results The sample consisted of 13,694 individuals at 14 medical schools from across the U.S. who responded to the survey administered between 2011– 2012. The Cronbach alphas for inclusion and engagement factors (range: 0.68 to 0.85), CFA fit indices, and item correlations with latent constructs, indicated an acceptable model fit and that questions measured the intended concepts. DES scores clearly distinguished higher and lower performing institutions. The DES detected important disparities for black, women, and those who did not have heterosexual orientation. Conclusions This study demonstrated that the DES is a reliable and valid instrument for internal assessment and evaluation or external benchmarking of institutional progress in building inclusion and engagement. PMID:26466376

Rapid detection of frozen-then-thawed minced beef using multispectral imaging and Fourier transform infrared spectroscopy.

PubMed

Ropodi, Athina I; Panagou, Efstathios Z; Nychas, George-John E

2018-01-01

In recent years, fraud detection has become a major priority for food authorities, as fraudulent practices can have various economic and safety consequences. This work explores ways of identifying frozen-then-thawed minced beef labeled as fresh in a rapid, large-scale and cost-effective way. For this reason, freshly-ground beef was purchased from seven separate shops at different times, divided in fifteen portions and placed in Petri dishes. Multi-spectral images and FTIR spectra of the first five were immediately acquired while the remaining were frozen (-20°C) and stored for 7 and 32days (5 samples for each time interval). Samples were thawed and subsequently subjected to similar data acquisition. In total, 105 multispectral images and FTIR spectra were collected which were further analyzed using partial least-squares discriminant analysis and support vector machines. Two meat batches (30 samples) were reserved for independent validation and the remaining five batches were divided in training and test set (75 samples). Results showed 100% overall correct classification for test and external validation MSI data, while FTIR data yielded 93.3 and 96.7% overall correct classification for FTIR test set and external validation set respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

Urology Residents' Experience and Attitude Toward Surgical Simulation: Presenting our 4-Year Experience With a Multi-institutional, Multi-modality Simulation Model.

PubMed

Chow, Alexander K; Sherer, Benjamin A; Yura, Emily; Kielb, Stephanie; Kocjancic, Ervin; Eggener, Scott; Turk, Thomas; Park, Sangtae; Psutka, Sarah; Abern, Michael; Latchamsetty, Kalyan C; Coogan, Christopher L

2017-11-01

To evaluate the Urological resident's attitude and experience with surgical simulation in residency education using a multi-institutional, multi-modality model. Residents from 6 area urology training programs rotated through simulation stations in 4 consecutive sessions from 2014 to 2017. Workshops included GreenLight photovaporization of the prostate, ureteroscopic stone extraction, laparoscopic peg transfer, 3-dimensional laparoscopy rope pass, transobturator sling placement, intravesical injection, high definition video system trainer, vasectomy, and Urolift. Faculty members provided teaching assistance, objective scoring, and verbal feedback. Participants completed a nonvalidated questionnaire evaluating utility of the workshop and soliciting suggestions for improvement. Sixty-three of 75 participants (84%) (postgraduate years 1-6) completed the exit questionnaire. Median rating of exercise usefulness on a scale of 1-10 ranged from 7.5 to 9. On a scale of 0-10, cumulative median scores of the course remained high over 4 years: time limit per station (9; interquartile range [IQR] 2), faculty instruction (9, IQR 2), ease of use (9, IQR 2), face validity (8, IQR 3), and overall course (9, IQR 2). On multivariate analysis, there was no difference in rating of domains between postgraduate years. Sixty-seven percent (42/63) believe that simulation training should be a requirement of Urology residency. Ninety-seven percent (63/65) viewed the laboratory as beneficial to their education. This workshop model is a valuable training experience for residents. Most participants believe that surgical simulation is beneficial and should be a requirement for Urology residency. High ratings of usefulness for each exercise demonstrated excellent face validity provided by the course. Copyright © 2017 Elsevier Inc. All rights reserved.

External Validation of a Case-Mix Adjustment Model for the Standardized Reporting of 30-Day Stroke Mortality Rates in China

PubMed Central

Yu, Ping; Pan, Yuesong; Wang, Yongjun; Wang, Xianwei; Liu, Liping; Ji, Ruijun; Meng, Xia; Jing, Jing; Tong, Xu; Guo, Li; Wang, Yilong

2016-01-01

Background and Purpose A case-mix adjustment model has been developed and externally validated, demonstrating promise. However, the model has not been thoroughly tested among populations in China. In our study, we evaluated the performance of the model in Chinese patients with acute stroke. Methods The case-mix adjustment model A includes items on age, presence of atrial fibrillation on admission, National Institutes of Health Stroke Severity Scale (NIHSS) score on admission, and stroke type. Model B is similar to Model A but includes only the consciousness component of the NIHSS score. Both model A and B were evaluated to predict 30-day mortality rates in 13,948 patients with acute stroke from the China National Stroke Registry. The discrimination of the models was quantified by c-statistic. Calibration was assessed using Pearson’s correlation coefficient. Results The c-statistic of model A in our external validation cohort was 0.80 (95% confidence interval, 0.79–0.82), and the c-statistic of model B was 0.82 (95% confidence interval, 0.81–0.84). Excellent calibration was reported in the two models with Pearson’s correlation coefficient (0.892 for model A, p<0.001; 0.927 for model B, p = 0.008). Conclusions The case-mix adjustment model could be used to effectively predict 30-day mortality rates in Chinese patients with acute stroke. PMID:27846282

Phase II Trial of Combined High-Dose-Rate Brachytherapy and External Beam Radiotherapy for Adenocarcinoma of the Prostate: Preliminary Results of RTOG 0321

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

Hsu, I-Chow, E-mail: ihsu@radonc.ucsf.ed; Bae, Kyounghwa; Shinohara, Katsuto

2010-11-01

Purpose: To estimate the rate of late Grade 3 or greater genitourinary (GU) and gastrointestinal (GI) adverse events (AEs) after treatment with external beam radiotherapy and prostate high-dose-rate (HDR) brachytherapy. Methods and Materials: Each participating institution submitted computed tomography-based HDR brachytherapy dosimetry data electronically for credentialing and for each study patient. Patients with locally confined Stage T1c-T3b prostate cancer were eligible for the present study. All patients were treated with 45 Gy in 25 fractions using external beam radiotherapy and one HDR implant delivering 19 Gy in two fractions. All AEs were graded according to the Common Terminology Criteria formore » Adverse Events, version 3.0. Late GU/GI AEs were defined as those occurring >9 months from the start of the protocol treatment, in patients with {>=}18 months of potential follow-up. Results: A total of 129 patients from 14 institutions were enrolled in the present study. Of the 129 patients, 125 were eligible, and AE data were available for 112 patients at analysis. The pretreatment characteristics of the patients were as follows: Stage T1c-T2c, 91%; Stage T3a-T3b, 9%; prostate-specific antigen level {<=}10 ng/mL, 70%; prostate-specific antigen level >10 but {<=}20 ng/mL, 30%; and Gleason score 2-6, 10%; Gleason score 7, 72%; and Gleason score 8-10, 18%. At a median follow-up of 29.6 months, three acute and four late Grade 3 GU/GI AEs were reported. The estimated rate of late Grade 3-5 GU and GI AEs at 18 months was 2.56%. Conclusion: This is the first prospective, multi-institutional trial of computed tomography-based HDR brachytherapy and external beam radiotherapy. The technique and doses used in the present study resulted in acceptable levels of AEs.« less

Multi-Disciplinary Analysis and Optimization Frameworks

NASA Technical Reports Server (NTRS)

Naiman, Cynthia Gutierrez

2009-01-01

Since July 2008, the Multidisciplinary Analysis & Optimization Working Group (MDAO WG) of the Systems Analysis Design & Optimization (SAD&O) discipline in the Fundamental Aeronautics Program s Subsonic Fixed Wing (SFW) project completed one major milestone, Define Architecture & Interfaces for Next Generation Open Source MDAO Framework Milestone (9/30/08), and is completing the Generation 1 Framework validation milestone, which is due December 2008. Included in the presentation are: details of progress on developing the Open MDAO framework, modeling and testing the Generation 1 Framework, progress toward establishing partnerships with external parties, and discussion of additional potential collaborations

TROPHI: development of a tool to measure complex, multi-factorial patient handling interventions.

PubMed

Fray, Mike; Hignett, Sue

2013-01-01

Patient handling interventions are complex and multi-factorial. It has been difficult to make comparisons across different strategies due to the lack of a comprehensive outcome measurement method. The Tool for Risk Outstanding in Patient Handling Interventions (TROPHI) was developed to address this gap by measuring outcomes and comparing performance across interventions. Focus groups were held with expert patient handling practitioners (n = 36) in four European countries (Finland, Italy, Portugal and the UK) to identify preferred outcomes to be measured for interventions. A systematic literature review identified 598 outcome measures; these were critically appraised and the most appropriate measurement tool was selected for each outcome. TROPHI was evaluated in the four EU countries (eight sites) and by an expert panel (n = 16) from the European Panel of Patient Handling Ergonomics for usability and practical application. This final stage added external validity to the research by exploring transferability potential and presenting the data and analysis to allow respondent (participant) validation. Patient handling interventions are complex and multi-factorial and it has been difficult to make comparisons due to the lack of a comprehensive outcome measurement method. The Tool for Risk Outstanding in Patient Handling Interventions (TROPHI) was developed to address this gap by measuring outcomes to compare performance across interventions.

Embedded wisdom or rooted problems? Aid workers' perspectives on local social and political infrastructure in post-tsunami Aceh.

PubMed

Daly, Patrick

2015-04-01

This paper analyses the role of local social, cultural, and political institutions in post-disaster reconstruction projects. It contends that such institutions are important considerations within community-driven reconstruction initiatives, but are often viewed with ambivalence by external aid organisations. This paper draws upon in-depth qualitative interviews with aid workers involved in the post-tsunami reconstruction in Aceh, Indonesia, to establish: (i) what roles community institutions were suited to play in the reconstruction; (ii) what were the limitations of community institutions when engaging with external aid agencies; (iii) how did external aid agencies engage with local community institutions; and (iv) how did external aid agencies perceive community institutions. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

Potential Collaborative Research topics with Korea’s Agency for Defense Development

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

Farrar, Charles R.; Todd, Michael D.

2012-08-23

This presentation provides a high level summary of current research activities at the Los Alamos National Laboratory (LANL)-University of California Jacobs School of Engineering (UCSD) Engineering Institute that will be presented at Korea's Agency for Defense Development (ADD). These research activities are at the basic engineering science level with different level of maturity ranging from initial concepts to field proof-of-concept demonstrations. We believe that all of these activities are appropriate for collaborative research activities with ADD subject to approval by each institution. All the activities summarized herein have the common theme that they are multi-disciplinary in nature and typically involvedmore » the integration of high-fidelity predictive modeling, advanced sensing technologies and new development in information technology. These activities include: Wireless Sensor Systems, Swarming Robot sensor systems, Advanced signal processing (compressed sensing) and pattern recognition, Model Verification and Validation, Optimal/robust sensor system design, Haptic systems for large-scale data processing, Cyber-physical security for robots, Multi-source energy harvesting, Reliability-based approaches to damage prognosis, SHMTools software development, and Cyber-physical systems advanced study institute.« less

Simulations of Turbulent Flows with Strong Shocks and Density Variations: Final Report

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

Sanjiva Lele

2012-10-01

The target of this SciDAC Science Application was to develop a new capability based on high-order and high-resolution schemes to simulate shock-turbulence interactions and multi-material mixing in planar and spherical geometries, and to study Rayleigh-Taylor and Richtmyer-Meshkov turbulent mixing. These fundamental problems have direct application in high-speed engineering flows, such as inertial confinement fusion (ICF) capsule implosions and scramjet combustion, and also in the natural occurrence of supernovae explosions. Another component of this project was the development of subgrid-scale (SGS) models for large-eddy simulations of flows involving shock-turbulence interaction and multi-material mixing, that were to be validated with the DNSmore » databases generated during the program. The numerical codes developed are designed for massively-parallel computer architectures, ensuring good scaling performance. Their algorithms were validated by means of a sequence of benchmark problems. The original multi-stage plan for this five-year project included the following milestones: 1) refinement of numerical algorithms for application to the shock-turbulence interaction problem and multi-material mixing (years 1-2); 2) direct numerical simulations (DNS) of canonical shock-turbulence interaction (years 2-3), targeted at improving our understanding of the physics behind the combined two phenomena and also at guiding the development of SGS models; 3) large-eddy simulations (LES) of shock-turbulence interaction (years 3-5), improving SGS models based on the DNS obtained in the previous phase; 4) DNS of planar/spherical RM multi-material mixing (years 3-5), also with the two-fold objective of gaining insight into the relevant physics of this instability and aiding in devising new modeling strategies for multi-material mixing; 5) LES of planar/spherical RM mixing (years 4-5), integrating the improved SGS and multi-material models developed in stages 3 and 5. This final report is outlined as follows. Section 2 shows an assessment of numerical algorithms that are best suited for the numerical simulation of compressible flows involving turbulence and shock phenomena. Sections 3 and 4 deal with the canonical shock-turbulence interaction problem, from the DNS and LES perspectives, respectively. Section 5 considers the shock-turbulence inter-action in spherical geometry, in particular, the interaction of a converging shock with isotropic turbulence as well as the problem of the blast wave. Section 6 describes the study of shock-accelerated mixing through planar and spherical Richtmyer-Meshkov mixing as well as the shock-curtain interaction problem In section 7 we acknowledge the different interactions between Stanford and other institutions participating in this SciDAC project, as well as several external collaborations made possible through it. Section 8 presents a list of publications and presentations that have been generated during the course of this SciDAC project. Finally, section 9 concludes this report with the list of personnel at Stanford University funded by this SciDAC project.« less

External validation of the Cardiff model of information sharing to reduce community violence: natural experiment.

PubMed

Boyle, Adrian A; Snelling, Katrina; White, Laura; Ariel, Barak; Ashelford, Lawrence

2013-12-01

Community violence is a substantial problem for the NHS. Information sharing of emergency department data with community safety partnerships (CSP) has been associated with substantial reductions in assault attendances in emergency departments supported by academic institutions. We sought to validate these findings in a setting not supported by a public health or academic structure. We instituted anonymous data sharing with the police to reduce community violence, and increased involvement with the local CSP. We measured the effectiveness of this approach with routinely collected data at the emergency department and the police. We used police data from 2009, and emergency department data from 2000. Initially, the number of assault patients requiring emergency department treatment rose after we initiated data sharing. After improving the data flows, the number of assault patients fell back to the predata-sharing level. There was no change in the number of hospital admissions during the study period. There were decreases in the numbers of violent crimes against the person, with and without injury, recorded by the police. We have successfully implemented data sharing in our institution without the support of an academic institution. This has been associated with reductions in violent crime, but it is not clear whether this association is causal.

Numerical modelling of multi-vane expander operating conditions in ORC system

NASA Astrophysics Data System (ADS)

Rak, Józef; Błasiak, Przemysław; Kolasiński, Piotr

2017-11-01

Multi-vane expanders are positive displacement volumetric machines which are nowadays considered for application in micro-power domestic ORC systems as promising alternative to micro turbines and other volumetric expanders. The multi-vane expander features very simple design, low gas flow capacity, low expansion ratios, an advantageous ratio of the power output to the external dimensions and are insensitive to the negative influence of the gas-liquid mixture expansion. Moreover, the multi-vane expander can be easily hermetically sealed, which is one of the key issues in the ORC system design. A literature review indicates that issues concerning the application of multi-vane expanders in such systems, especially related to operating of multi-vane expander with different low-boiling working fluids, are innovative, not fully scientifically described and have the potential for practical implementation. In this paper the results of numerical investigations on multi-vane expander operating conditions are presented. The analyses were performed on three-dimensional numerical model of the expander in ANSYS CFX software. The numerical model of the expander was validated using the data obtained from the experiment carried out on a lab test-stand. Then a series of computational analysis were performed using expanders' numerical model in order to determine its operating conditions under various flow conditions of different working fluids.

External validation of leukocytosis and neutrophilia as a prognostic marker in anal carcinoma treated with definitive chemoradiation.

PubMed

Schernberg, Antoine; Huguet, Florence; Moureau-Zabotto, Laurence; Chargari, Cyrus; Rivin Del Campo, Eleonor; Schlienger, Michel; Escande, Alexandre; Touboul, Emmanuel; Deutsch, Eric

2017-07-01

To validate the prognostic value of leukocyte disorders in anal squamous cell carcinoma (SCC) patients receiving definitive concurrent chemoradiation. Bi-institutional clinical records from consecutive patients treated between 2001 and 2015 with definitive chemoradiation for anal SCC were retrospectively reviewed. Prognostic value of pretreatment leukocyte disorders was examined, with focus on patterns of relapse and survival. Leukocytosis and neutrophilia were defined as leukocyte or neutrophil count exceeding 10G/L and 7G/L, respectively. We identified 133 patients, treated in two institutions. Eight% and 7% displayed baseline leukocytosis and neutrophilia, respectively. Estimated 3-year overall survival (OS) and progression-free survival (PFS) were 88% and 77%, respectively. In univariate analysis, both leukocytosis and neutrophilia were associated with worse OS, PFS (p<0.01), locoregional control (LRC) and Distant Metastasis Control (DMC) (p<0.05), also after stratification by each institution. In multivariate analysis, leukocytosis and neutrophilia remained as independent risk factors associated with poorer OS, PFS, LRC and DMC (p<0.05). This study validates leukocytosis and neutrophilia as independent prognostic factors in anal SCC patients treated with definitive chemoradiation. Although prospective confirmation is warranted, it is suggested that the leukocyte and neutrophil count parameters are clinically relevant biomarkers to be considered for further clinical investigations. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessing Security Cooperation: Improving Methods to Maximize Effects

DTIC Science & Technology

2013-03-01

Carl Builder notes, “Institutional and personal interest are not intrinsically bad; but they may be made so if they are always cloaked in altruism and...cooperation professional may be able to lay the groundwork for validating or disqualifying actions based on both countable metrics and anecdotal...Pre-decisional Working Draft), (Washington DC: Multi-Agency, July 31, 2012), 37. 6 Carl H. Builder , The Masks of War: American Military Styles in

Development of ProCaRS Clinical Nomograms for Biochemical Failure-free Survival Following Either Low-Dose Rate Brachytherapy or Conventionally Fractionated External Beam Radiation Therapy for Localized Prostate Cancer

PubMed Central

Warner, Andrew; Pickles, Tom; Crook, Juanita; Martin, Andre-Guy; Souhami, Luis; Catton, Charles; Lukka, Himu

2015-01-01

Purpose: Although several clinical nomograms predictive of biochemical failure-free survival (BFFS) for localized prostate cancer exist in the medical literature, making valid comparisons can be challenging due to variable definitions of biochemical failure, the disparate distribution of prognostic factors, and received treatments in patient populations. The aim of this investigation was to develop and validate clinically-based nomograms for 5-year BFFS using the ASTRO II “Phoenix” definition for two patient cohorts receiving low-dose rate (LDR) brachytherapy or conventionally fractionated external beam radiation therapy (EBRT) from a large Canadian multi-institutional database. Methods and Materials: Patients were selected from the GUROC (Genitourinary Radiation Oncologists of Canada) Prostate Cancer Risk Stratification (ProCaRS) database if they received (1) LDR brachytherapy ≥ 144 Gy (n=4208) or (2) EBRT ≥ 70 Gy  (n=822). Multivariable Cox regression analysis for BFFS was performed separately for each cohort and used to generate clinical nomograms predictive of 5-year BFFS. Nomograms were validated using calibration plots of nomogram predicted probability versus observed probability via Kaplan-Meier estimates. Results: Patients receiving LDR brachytherapy had a mean age of 64 ± 7 years, a mean baseline PSA of 6.3 ± 3.0 ng/mL, 75% had a Gleason 6, and 15% had a Gleason 7, whereas patients receiving EBRT had a mean age of 70 ± 6 years, a mean baseline PSA of 11.6 ± 10.7 ng/mL, 30% had a Gleason 6, 55% had a Gleason 7, and 14% had a Gleason 8-10. Nomograms for 5-year BFFS included age, use and duration of androgen deprivation therapy (ADT), baseline PSA, T stage, and Gleason score for LDR brachytherapy and an ADT (months), baseline PSA, Gleason score, and biological effective dose (Gy) for EBRT. Conclusions: Clinical nomograms examining 5-year BFFS were developed for patients receiving either LDR brachytherapy or conventionally fractionated EBRT and may assist clinicians in predicting an outcome. Future work should be directed at examining the role of additional prognostic factors, comorbidities, and toxicity in predicting survival outcomes. PMID:26180700

External validation of the ability of the DRAGON score to predict outcome after thrombolysis treatment.

PubMed

Ovesen, C; Christensen, A; Nielsen, J K; Christensen, H

2013-11-01

Easy-to-perform and valid assessment scales for the effect of thrombolysis are essential in hyperacute stroke settings. Because of this we performed an external validation of the DRAGON scale proposed by Strbian et al. in a Danish cohort. All patients treated with intravenous recombinant plasminogen activator between 2009 and 2011 were included. Upon admission all patients underwent physical and neurological examination using the National Institutes of Health Stroke Scale along with non-contrast CT scans and CT angiography. Patients were followed up through the Outpatient Clinic and their modified Rankin Scale (mRS) was assessed after 3 months. Three hundred and three patients were included in the analysis. The DRAGON scale proved to have a good discriminative ability for predicting highly unfavourable outcome (mRS 5-6) (area under the curve-receiver operating characteristic [AUC-ROC]: 0.89; 95% confidence interval [CI] 0.81-0.96; p<0.001) and good outcome (mRS 0-2) (AUC-ROC: 0.79; 95% CI 0.73-0.85; p<0.001). When only patients with M1 occlusions were selected the DRAGON scale provided good discriminative capability (AUC-ROC: 0.89; 95% CI 0.78-1.0; p=0.003) for highly unfavourable outcome. We confirmed the validity of the DRAGON scale in predicting outcome after thrombolysis treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

A metabolic fingerprinting approach based on selected ion flow tube mass spectrometry (SIFT-MS) and chemometrics: A reliable tool for Mediterranean origin-labeled olive oils authentication.

PubMed

Bajoub, Aadil; Medina-Rodríguez, Santiago; Ajal, El Amine; Cuadros-Rodríguez, Luis; Monasterio, Romina Paula; Vercammen, Joeri; Fernández-Gutiérrez, Alberto; Carrasco-Pancorbo, Alegría

2018-04-01

Selected Ion flow tube mass spectrometry (SIFT-MS) in combination with chemometrics was used to authenticate the geographical origin of Mediterranean virgin olive oils (VOOs) produced under geographical origin labels. In particular, 130 oil samples from six different Mediterranean regions (Kalamata (Greece); Toscana (Italy); Meknès and Tyout (Morocco); and Priego de Córdoba and Baena (Spain)) were considered. The headspace volatile fingerprints were measured by SIFT-MS in full scan with H 3 O + , NO + and O 2 + as precursor ions and the results were subjected to chemometric treatments. Principal Component Analysis (PCA) was used for preliminary multivariate data analysis and Partial Least Squares-Discriminant Analysis (PLS-DA) was applied to build different models (considering the three reagent ions) to classify samples according to the country of origin and regions (within the same country). The multi-class PLS-DA models showed very good performance in terms of fitting accuracy (98.90-100%) and prediction accuracy (96.70-100% accuracy for cross validation and 97.30-100% accuracy for external validation (test set)). Considering the two-class PLS-DA models, the one for the Spanish samples showed 100% sensitivity, specificity and accuracy in calibration, cross validation and external validation; the model for Moroccan oils also showed very satisfactory results (with perfect scores for almost every parameter in all the cases). Copyright © 2017 Elsevier Ltd. All rights reserved.

Contributions of the SDR Task Network tool to Calibration and Validation of the NPOESS Preparatory Project instruments

NASA Astrophysics Data System (ADS)

Feeley, J.; Zajic, J.; Metcalf, A.; Baucom, T.

2009-12-01

The National Polar-orbiting Operational Environmental Satellite System (NPOESS) Preparatory Project (NPP) Calibration and Validation (Cal/Val) team is planning post-launch activities to calibrate the NPP sensors and validate Sensor Data Records (SDRs). The IPO has developed a web-based data collection and visualization tool in order to effectively collect, coordinate, and manage the calibration and validation tasks for the OMPS, ATMS, CrIS, and VIIRS instruments. This tool is accessible to the multi-institutional Cal/Val teams consisting of the Prime Contractor and Government Cal/Val leads along with the NASA NPP Mission team, and is used for mission planning and identification/resolution of conflicts between sensor activities. Visualization techniques aid in displaying task dependencies, including prerequisites and exit criteria, allowing for the identification of a critical path. This presentation will highlight how the information is collected, displayed, and used to coordinate the diverse instrument calibration/validation teams.

Can Findings from Randomized Controlled Trials of Social Skills Training in Autism Spectrum Disorder Be Generalized? The Neglected Dimension of External Validity

ERIC Educational Resources Information Center

Jonsson, Ulf; Olsson, Nora Choque; Bölte, Sven

2016-01-01

Systematic reviews have traditionally focused on internal validity, while external validity often has been overlooked. In this study, we systematically reviewed determinants of external validity in the accumulated randomized controlled trials of social skills group interventions for children and adolescents with autism spectrum disorder. We…

External Validity, Internal Validity, and Organizational Reality: A Response to Robert L. Cardy (Commentary).

ERIC Educational Resources Information Center

Steinfatt, Thomas M.

1991-01-01

Responds to an article in the same issue of this journal which defends the applied value of laboratory studies to managers. Agrees that external validity is often irrelevant, and maintains that the problem of making inferences from any subject sample in management communication is one that demands internal, not external, validity. (SR)

The GPM Ground Validation Program: Pre to Post-Launch

NASA Astrophysics Data System (ADS)

Petersen, W. A.

2014-12-01

NASA GPM Ground Validation (GV) activities have transitioned from the pre to post-launch era. Prior to launch direct validation networks and associated partner institutions were identified world-wide, covering a plethora of precipitation regimes. In the U.S. direct GV efforts focused on use of new operational products such as the NOAA Multi-Radar Multi-Sensor suite (MRMS) for TRMM validation and GPM radiometer algorithm database development. In the post-launch, MRMS products including precipitation rate, types and data quality are being routinely generated to facilitate statistical GV of instantaneous and merged GPM products. To assess precipitation column impacts on product uncertainties, range-gate to pixel-level validation of both Dual-Frequency Precipitation Radar (DPR) and GPM microwave imager data are performed using GPM Validation Network (VN) ground radar and satellite data processing software. VN software ingests quality-controlled volumetric radar datasets and geo-matches those data to coincident DPR and radiometer level-II data. When combined MRMS and VN datasets enable more comprehensive interpretation of ground-satellite estimation uncertainties. To support physical validation efforts eight (one) field campaigns have been conducted in the pre (post) launch era. The campaigns span regimes from northern latitude cold-season snow to warm tropical rain. Most recently the Integrated Precipitation and Hydrology Experiment (IPHEx) took place in the mountains of North Carolina and involved combined airborne and ground-based measurements of orographic precipitation and hydrologic processes underneath the GPM Core satellite. One more U.S. GV field campaign (OLYMPEX) is planned for late 2015 and will address cold-season precipitation estimation, process and hydrology in the orographic and oceanic domains of western Washington State. Finally, continuous direct and physical validation measurements are also being conducted at the NASA Wallops Flight Facility multi-radar, gauge and disdrometer facility located in coastal Virginia. This presentation will summarize the evolution of the NASA GPM GV program from pre to post-launch eras and highlight early evaluations of GPM satellite datasets.

Predicting ionizing radiation exposure using biochemically-inspired genomic machine learning.

PubMed

Zhao, Jonathan Z L; Mucaki, Eliseos J; Rogan, Peter K

2018-01-01

Background: Gene signatures derived from transcriptomic data using machine learning methods have shown promise for biodosimetry testing. These signatures may not be sufficiently robust for large scale testing, as their performance has not been adequately validated on external, independent datasets. The present study develops human and murine signatures with biochemically-inspired machine learning that are strictly validated using k-fold and traditional approaches. Methods: Gene Expression Omnibus (GEO) datasets of exposed human and murine lymphocytes were preprocessed via nearest neighbor imputation and expression of genes implicated in the literature to be responsive to radiation exposure (n=998) were then ranked by Minimum Redundancy Maximum Relevance (mRMR). Optimal signatures were derived by backward, complete, and forward sequential feature selection using Support Vector Machines (SVM), and validated using k-fold or traditional validation on independent datasets. Results: The best human signatures we derived exhibit k-fold validation accuracies of up to 98% ( DDB2 ,  PRKDC , TPP2 , PTPRE , and GADD45A ) when validated over 209 samples and traditional validation accuracies of up to 92% ( DDB2 ,  CD8A ,  TALDO1 ,  PCNA ,  EIF4G2 ,  LCN2 ,  CDKN1A ,  PRKCH ,  ENO1 ,  and PPM1D ) when validated over 85 samples. Some human signatures are specific enough to differentiate between chemotherapy and radiotherapy. Certain multi-class murine signatures have sufficient granularity in dose estimation to inform eligibility for cytokine therapy (assuming these signatures could be translated to humans). We compiled a list of the most frequently appearing genes in the top 20 human and mouse signatures. More frequently appearing genes among an ensemble of signatures may indicate greater impact of these genes on the performance of individual signatures. Several genes in the signatures we derived are present in previously proposed signatures. Conclusions: Gene signatures for ionizing radiation exposure derived by machine learning have low error rates in externally validated, independent datasets, and exhibit high specificity and granularity for dose estimation.

Consensus oriented fuzzified decision support for oil spill contingency management.

PubMed

Liu, Xin; Wirtz, Kai W

2006-06-30

Studies on multi-group multi-criteria decision-making problems for oil spill contingency management are in their infancy. This paper presents a second-order fuzzy comprehensive evaluation (FCE) model to resolve decision-making problems in the area of contingency management after environmental disasters such as oil spills. To assess the performance of different oil combat strategies, second-order FCE allows for the utilization of lexical information, the consideration of ecological and socio-economic criteria and the involvement of a variety of stakeholders. On the other hand, the new approach can be validated by using internal and external checks, which refer to sensitivity tests regarding its internal setups and comparisons with other methods, respectively. Through a case study, the Pallas oil spill in the German Bight in 1998, it is demonstrated that this approach can help decision makers who search for an optimal strategy in multi-thread contingency problems and has a wider application potential in the field of integrated coastal zone management.

Associations between Medical Student Empathy and Personality: A Multi-Institutional Study

PubMed Central

Costa, Patrício; Alves, Raquel; Neto, Isabel; Marvão, Pedro; Portela, Miguel; Costa, Manuel João

2014-01-01

Background More empathetic physicians are more likely to achieve higher patient satisfaction, adherence to treatments, and health outcomes. In the context of medical education, it is thus important to understand how personality might condition the empathetic development of medical students. Single institutional evidence shows associations between students' personality and empathy. This multi-institutional study aimed to assess such associations across institutions, looking for personality differences between students with high empathy and low empathy levels. Methods Participants were 472 students from three medical schools in Portugal. They completed validated adaptations to Portuguese of self-report measures of the NEO-Five Factor Inventory(NEO-FFI) and the Jefferson Scale of Physician Empathy(JSPE-spv). Students were categorized into two groups: “Bottom” (low empathy, N = 165) and “Top” (high empathy, N = 169) according to their empathy JSPE-spv total score terciles. Correlation analysis, binary logistic regression analysis and ROC curve analysis were conducted. Results A regression model with gender, age and university had a predictive power (pseudo R2) for belonging to the top or bottom group of 6.4%. The addition of personality dimensions improved the predictive power to 16.8%. Openness to experience and Agreeableness were important to predict top or bottom empathy scores when gender, age and university were considered.” Based on the considered predictors the model correctly classified 69.3% of all students. Conclusions The present multi-institutional cross-sectional study in Portugal revealed across-school associations between the Big5 dimensions Agreeableness and Openness to experience and the empathy of medical students and that personality made a significant contribution to identify the more empathic students. Therefore, medical schools may need to pay attention to the personality of medical students to understand how to enhance the empathy of medical students. PMID:24637613

External model validation of binary clinical risk prediction models in cardiovascular and thoracic surgery.

PubMed

Hickey, Graeme L; Blackstone, Eugene H

2016-08-01

Clinical risk-prediction models serve an important role in healthcare. They are used for clinical decision-making and measuring the performance of healthcare providers. To establish confidence in a model, external model validation is imperative. When designing such an external model validation study, thought must be given to patient selection, risk factor and outcome definitions, missing data, and the transparent reporting of the analysis. In addition, there are a number of statistical methods available for external model validation. Execution of a rigorous external validation study rests in proper study design, application of suitable statistical methods, and transparent reporting. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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

Baumann, Brian C.; Bosch, Walter R.; Bahl, Amit

Purpose: To develop multi-institutional consensus clinical target volumes (CTVs) and organs at risk (OARs) for male and female bladder cancer patients undergoing adjuvant radiation therapy (RT) in clinical trials. Methods and Materials: We convened a multidisciplinary group of bladder cancer specialists from 15 centers and 5 countries. Six radiation oncologists and 7 urologists participated in the development of the initial contours. The group proposed initial language for the CTVs and OARs, and each radiation oncologist contoured them on computed tomography scans of a male and female cystectomy patient with input from ≥1 urologist. On the basis of the initial contouring, themore » group updated its CTV and OAR descriptions. The cystectomy bed, the area of greatest controversy, was contoured by another 6 radiation oncologists, and the cystectomy bed contouring language was again updated. To determine whether the revised language produced consistent contours, CTVs and OARs were redrawn by 6 additional radiation oncologists. We evaluated their contours for level of agreement using the Landis-Koch interpretation of the κ statistic. Results: The group proposed that patients at elevated risk for local-regional failure with negative margins should be treated to the pelvic nodes alone (internal/external iliac, distal common iliac, obturator, and presacral), whereas patients with positive margins should be treated to the pelvic nodes and cystectomy bed. Proposed OARs included the rectum, bowel space, bone marrow, and urinary diversion. Consensus language describing the CTVs and OARs was developed and externally validated. The revised instructions were found to produce consistent contours. Conclusions: Consensus descriptions of CTVs and OARs were successfully developed and can be used in clinical trials of adjuvant radiation therapy for bladder cancer.« less

Long-term Follow-up Results of a Multi-institutional Phase 2 Study of Concurrent Chemoradiation Therapy for Locally Advanced Cervical Cancer in East and Southeast Asia

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

Kato, Shingo, E-mail: s_kato@saitama-med.ac.jp; National Institute of Radiological Sciences of Japan, Chiba; Ohno, Tatsuya

2013-09-01

Purpose: To report the long-term survival and toxicity of a multi-institutional phase 2 study of concurrent chemoradiation therapy (CCRT) for locally advanced cervical cancer in east and southeast Asia. Methods and Materials: Ten institutions from 8 Asian countries participated in the study. Between April 2003 and March 2006, 120 patients (60 with bulky stage IIB and 60 with stage IIIB) were treated with CCRT. Radiation therapy consisted of pelvic external beam radiation therapy and either high-dose-rate or low-dose-rate intracavitary brachytherapy. Five cycles of weekly cisplatin (40 mg/m{sup 2}) were administered during the course of radiation therapy. Treatment results were evaluatedmore » by the rates of local control, overall survival, and late toxicities. Results: Median follow-up was 63.7 months, and the follow-up rate at 5 years was 98%. The 5-year local control and overall survival rates for all patients were 76.8% and 55.1%, respectively. The 5-year rates of major late toxicities of the rectum and bladder were 7.9% and 0%, respectively. Conclusions: The long-term results have suggested that CCRT is safe and effective for patients with locally advanced cervical cancer in east and southeast Asia. However, further efforts are needed to improve overall survival.« less

Spatial variation of the physical conditions of molecular gas in galaxies

NASA Technical Reports Server (NTRS)

Jackson, James M.; Eckart, Andreas; Wild, Wolfgang; Genzel, Reinhard; Harris, Andrew I.; Downes, Dennis; Jaffe, D. T.; Ho, Paul T. P.

1990-01-01

Multi-line studies of CO-12, CO-13, C-18O, HCN, and HCO(+) at 3 mm, 1.3 mm, and 0.8 mm using the Institute for Radio Astronomy in the Millimeter range (IRAM) 30 m telescope, with the IRAM superconductor insulator superconductor (SIS) receivers and the Max Planck Institute for External Physics (MPE) 350 GHz SIS receiver, show that the densities and temperatures of molecular gas in external galaxies change significantly with position. CO-12 measures the densities and temperature of diffuse interclump molecular gas, but not the bulk of the molecular gas. Simple one-component models, with or without external heating, cannot account for the weakness of the CO-12 J = 3 to 2 line relative to J = 2 to 1 and J = 1 to 0. CO-12 does not trace the bulk of the molecular gas, and optical depth effects obviate a straightforward interpretation of CO-12 data. Instead, researchers turned to the optically thin CO isotopes and other molecular species. Isotopic CO lines measure the bulk of the molecular gas, and HCN and HCO(+) pick out denser regions. Researchers find a warm ridge of gas in IC 342 (Eckart et al. 1989), denser gas in the starburst nucleus of IC 342, and a possible hot-spot in NGC 2903. In IC 342, NGC 2146, and NGC 6764, the CO-13 J = 2 to 1 line is subthermally populated, implying gas densities less than or equal to 10(exp 4) cm(-3).

External validation of the MRI-DRAGON score: early prediction of stroke outcome after intravenous thrombolysis.

PubMed

Turc, Guillaume; Aguettaz, Pierre; Ponchelle-Dequatre, Nelly; Hénon, Hilde; Naggara, Olivier; Leclerc, Xavier; Cordonnier, Charlotte; Leys, Didier; Mas, Jean-Louis; Oppenheim, Catherine

2014-01-01

The aim of our study was to validate in an independent cohort the MRI-DRAGON score, an adaptation of the (CT-) DRAGON score to predict 3-month outcome in acute ischemic stroke patients undergoing MRI before intravenous thrombolysis (IV-tPA). We reviewed consecutive (2009-2013) anterior circulation stroke patients treated within 4.5 hours by IV-tPA in the Lille stroke unit (France), where MRI is the first-line pretherapeutic work-up. We assessed the discrimination and calibration of the MRI-DRAGON score to predict poor 3-month outcome, defined as modified Rankin Score >2, using c-statistic and the Hosmer-Lemeshow test, respectively. We included 230 patients (mean ±SD age 70.4±16.0 years, median [IQR] baseline NIHSS 8 [5]-[14]; poor outcome in 78(34%) patients). The c-statistic was 0.81 (95%CI 0.75-0.87), and the Hosmer-Lemeshow test was not significant (p = 0.54). The MRI-DRAGON score showed good prognostic performance in the external validation cohort. It could therefore be used to inform the patient's relatives about long-term prognosis and help to identify poor responders to IV-tPA alone, who may be candidates for additional therapeutic strategies, if they are otherwise eligible for such procedures based on the institutional criteria.

Multi-center evaluation of analytical performance of the Beckman Coulter AU5822 chemistry analyzer.

PubMed

Zimmerman, M K; Friesen, L R; Nice, A; Vollmer, P A; Dockery, E A; Rankin, J D; Zmuda, K; Wong, S H

2015-09-01

Our three academic institutions, Indiana University, Northwestern Memorial Hospital, and Wake Forest, were among the first in the United States to implement the Beckman Coulter AU5822 series chemistry analyzers. We undertook this post-hoc multi-center study by merging our data to determine performance characteristics and the impact of methodology changes on analyte measurement. We independently completed performance validation studies including precision, linearity/analytical measurement range, method comparison, and reference range verification. Complete data sets were available from at least one institution for 66 analytes with the following groups: 51 from all three institutions, and 15 from 1 or 2 institutions for a total sample size of 12,064. Precision was similar among institutions. Coefficients of variation (CV) were <10% for 97%. Analytes with CVs >10% included direct bilirubin and digoxin. All analytes exhibited linearity over the analytical measurement range. Method comparison data showed slopes between 0.900-1.100 for 87.9% of the analytes. Slopes for amylase, tobramycin and urine amylase were <0.8; the slope for lipase was >1.5, due to known methodology or standardization differences. Consequently, reference ranges of amylase, urine amylase and lipase required only minor or no modification. The four AU5822 analyzers independently evaluated at three sites showed consistent precision, linearity, and correlation results. Since installations, the test results had been well received by clinicians from all three institutions. Copyright © 2015. Published by Elsevier Inc.

Biomarkers for Early Detection of Clinically Relevant Prostate Cancer: A Multi-Institutional Validation Trial

DTIC Science & Technology

2015-10-01

Suzanne Kolb 12 Project Role: Project Coordinator Researcher Identifier (e.g. ORCID ID): N/A Nearest person month worked: 5 person months...Contribution to Project: Ms. Kolb works under the direction of Drs. Lin and Newcomb to fulfill daily fiscal and administrative functions of the...program. She monitors subaward budgets, provides logistical support. Ms. Kolb works closely with the PASS Deputy Director to maintain IRB files

Biomarkers for Early Detection of Clinically Relevant Prostate Cancer: A Multi-Institutional Validation Trial

DTIC Science & Technology

2015-10-01

Name: Suzanne Kolb 12 Project Role: Project Coordinator Researcher Identifier (e.g. ORCID ID): N/A Nearest person month worked: 5 person...months Contribution to Project: Ms. Kolb works under the direction of Drs. Lin and Newcomb to fulfill daily fiscal and administrative functions of the...program. She monitors subaward budgets, provides logistical support. Ms. Kolb works closely with the PASS Deputy Director to maintain IRB files

Predicting introductory programming performance: A multi-institutional multivariate study

NASA Astrophysics Data System (ADS)

Bergin, Susan; Reilly, Ronan

2006-12-01

A model for predicting student performance on introductory programming modules is presented. The model uses attributes identified in a study carried out at four third-level institutions in the Republic of Ireland. Four instruments were used to collect the data and over 25 attributes were examined. A data reduction technique was applied and a logistic regression model using 10-fold stratified cross validation was developed. The model used three attributes: Leaving Certificate Mathematics result (final mathematics examination at second level), number of hours playing computer games while taking the module and programming self-esteem. Prediction success was significant with 80% of students correctly classified. The model also works well on a per-institution level. A discussion on the implications of the model is provided and future work is outlined.

A Qualitative Comparison of Susceptibility and Behavior in Recreational and Occupational Risk Environments: Implications for Promoting Health and Safety.

PubMed

Haas, Emily Joy; Mattson, Marifran

2016-06-01

Although internal factors that influence risk are frequently studied to understand human behavior, external factors, including social, cultural, and institutional factors, should be better utilized to inform ways to efficiently target, tailor, and promote safety messaging to at-risk populations. Semi-structured interviews obtained data from 37 motorcyclists and 18 mineworkers about their risk perceptions and behaviors within their respective dynamic environments. A comparative thematic analysis revealed information about external factors that influence risk perceptions and behaviors. Results support the importance of qualitative approaches for assessing and targeting individuals' risk perceptions and behaviors. In addition, segmenting at-risk subgroups within target populations and tailoring messages for these at-risk groups is critical for safety behavior modification. Practitioners should utilize strategic, culture-centric risk communication that takes into account external factors when determining when, who, and what to communicate via health promotion activities to more accurately disseminate valid, empathetic, and engaging communication with a higher level of fidelity.

10-Year Coronary Heart Disease Risk Prediction Using Coronary Artery Calcium and Traditional Risk Factors: Derivation in the MESA (Multi-Ethnic Study of Atherosclerosis) With Validation in the HNR (Heinz Nixdorf Recall) Study and the DHS (Dallas Heart Study).

PubMed

McClelland, Robyn L; Jorgensen, Neal W; Budoff, Matthew; Blaha, Michael J; Post, Wendy S; Kronmal, Richard A; Bild, Diane E; Shea, Steven; Liu, Kiang; Watson, Karol E; Folsom, Aaron R; Khera, Amit; Ayers, Colby; Mahabadi, Amir-Abbas; Lehmann, Nils; Jöckel, Karl-Heinz; Moebus, Susanne; Carr, J Jeffrey; Erbel, Raimund; Burke, Gregory L

2015-10-13

Several studies have demonstrated the tremendous potential of using coronary artery calcium (CAC) in addition to traditional risk factors for coronary heart disease (CHD) risk prediction. However, to date, no risk score incorporating CAC has been developed. The goal of this study was to derive and validate a novel risk score to estimate 10-year CHD risk using CAC and traditional risk factors. Algorithm development was conducted in the MESA (Multi-Ethnic Study of Atherosclerosis), a prospective community-based cohort study of 6,814 participants age 45 to 84 years, who were free of clinical heart disease at baseline and followed for 10 years. MESA is sex balanced and included 39% non-Hispanic whites, 12% Chinese Americans, 28% African Americans, and 22% Hispanic Americans. External validation was conducted in the HNR (Heinz Nixdorf Recall Study) and the DHS (Dallas Heart Study). Inclusion of CAC in the MESA risk score offered significant improvements in risk prediction (C-statistic 0.80 vs. 0.75; p < 0.0001). External validation in both the HNR and DHS studies provided evidence of very good discrimination and calibration. Harrell's C-statistic was 0.779 in HNR and 0.816 in DHS. Additionally, the difference in estimated 10-year risk between events and nonevents was approximately 8% to 9%, indicating excellent discrimination. Mean calibration, or calibration-in-the-large, was excellent for both studies, with average predicted 10-year risk within one-half of a percent of the observed event rate. An accurate estimate of 10-year CHD risk can be obtained using traditional risk factors and CAC. The MESA risk score, which is available online on the MESA web site for easy use, can be used to aid clinicians when communicating risk to patients and when determining risk-based treatment strategies. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Validation of nomograms for overall survival, cancer-specific survival, and recurrence in carcinoma of the major salivary glands.

PubMed

Hay, Ashley; Migliacci, Jocelyn; Zanoni, Daniella Karassawa; Patel, Snehal; Yu, Changhong; Kattan, Michael W; Ganly, Ian

2018-05-01

The purpose of this study was to investigate the performance of the Memorial Sloan Kettering Cancer Center salivary carcinoma nomograms predicting overall survival, cancer-specific survival, and recurrence with an external validation dataset. The validation dataset comprised 123 patients treated between 2010 and 2015 at our institution. They were evaluated by assessing discrimination (concordance index [C-index]) and calibration (plotting predicted vs actual probabilities for quintiles). The validation cohort (n = 123) showed some differences to the original cohort (n = 301). The validation cohort had less high-grade cancers (P = .006), less lymphovascular invasion (LVI; P < .001) and shorter follow-up of 19 months versus 45.6 months. Validation showed a C-index of 0.833 (95% confidence interval [CI] 0.758-0.908), 0.807 (95% CI 0.717-0.898), and 0.844 (95% CI 0.768-0.920) for overall survival, cancer-specific survival, and recurrence, respectively. The 3 salivary gland nomograms performed well using a contemporary validation dataset, despite limitations related to sample size, follow-up, and differences in clinical and pathology characteristics between the original and validation cohorts. © 2018 Wiley Periodicals, Inc.

Test-Analysis Correlation for Space Shuttle External Tank Foam Impacting RCC Wing Leading Edge Component Panels

NASA Technical Reports Server (NTRS)

Lyle, Karen H.

2008-01-01

The Space Shuttle Columbia Accident Investigation Board recommended that NASA develop, validate, and maintain a modeling tool capable of predicting the damage threshold for debris impacts on the Space Shuttle Reinforced Carbon-Carbon (RCC) wing leading edge and nosecap assembly. The results presented in this paper are one part of a multi-level approach that supported the development of the predictive tool used to recertify the shuttle for flight following the Columbia Accident. The assessment of predictive capability was largely based on test analysis comparisons for simpler component structures. This paper provides comparisons of finite element simulations with test data for external tank foam debris impacts onto 6-in. square RCC flat panels. Both quantitative displacement and qualitative damage assessment correlations are provided. The comparisons show good agreement and provided the Space Shuttle Program with confidence in the predictive tool.

The prototype design of most powerful exoplanet tracker based on LAMOST

NASA Astrophysics Data System (ADS)

Zhang, Kai; Zhu, Yongtian; Wang, Lei

2010-07-01

Chinese national science project-LAMOST successfully received its official blessing in June, 2009. Its aperture is about 4m, and its focal plane of 1.75m in diameter, corresponding to a 5° field of view, can accommodate as many as 4000 optical fibers, and feed 16 multi-object low-medium resolution spectrometers (LRS). In addition, a new technique called External Dispersed Interferometry (EDI) is successfully used to enhance the accuracy of radial velocity measurement by heterodyning an interference spectrum with absorption lines. For further enhancing the survey power of LAMOST, a major astronomical project, Multi-object Exoplanet Survey System (MESS) based on this advanced technique, is being developed by Nanjing Institute of Astronomical Optics and Technology (NIAOT) and National Astronomical Observatories of China (NAOC), and funded by Joint Fund of Astronomy, which is set up by National Natural Sciences Foundation of China (NSFC) and Chinese Academy of Sciences (CAS). This system is composed of a multi-object fixed delay Michelson interferometer (FDMI) and a multi-object medium resolution spectrometer (R=5000). In this paper, a prototype design of FDMI is given, including optical system and mechanical structure.

Impact of Multi-GNSS Observations on Precise Orbit Determination and Precise Point Positioning Solutions

NASA Astrophysics Data System (ADS)

Amiri, N.; Bertiger, W. I.; Lu, W.; Miller, M. A.; David, M. W.; Ries, P.; Romans, L.; Sibois, A. E.; Sibthorpe, A.; Sakumura, C.

2017-12-01

Impact of Multi-GNSS Observations on Precise Orbit Determination and Precise Point Positioning Solutions Authors: Nikta Amiri, Willy Bertiger, Wenwen Lu, Mark Miller, David Murphy, Paul Ries, Larry Romans, Carly Sakumura, Aurore Sibois, Anthony Sibthorpe All at the Jet Propulsion Laboratory, California Institute of Technology Multiple Global Navigation Satellite Systems (GNSS) are now in various stages of completion. The four current constellations (GPS, GLONASS, BeiDou, Galileo) comprise more than 80 satellites as of July 2017, with 120 satellites expected to be available when all four constellations become fully operational. We investigate the impact of simultaneous observations to these four constellations on global network precise orbit determination (POD) solutions, and compare them to available sets of orbit and clock products submitted to the Multi-GNSS Experiment (MGEX). Using JPL's GipsyX software, we generate orbit and clock products for the four constellations. The resulting solutions are evaluated based on a number of metrics including day-to-day internal and external orbit and/or clock overlaps and estimated constellation biases. Additionally, we examine estimated station positions obtained from precise point positioning (PPP) solutions by comparing results generated from multi-GNSS and GPS-only orbit and clock products.

Identifying natural compounds as multi-target-directed ligands against Alzheimer's disease: an in silico approach.

PubMed

Ambure, Pravin; Bhat, Jyotsna; Puzyn, Tomasz; Roy, Kunal

2018-04-23

Alzheimer's disease (AD) is a multi-factorial disease, which can be simply outlined as an irreversible and progressive neurodegenerative disorder with an unclear root cause. It is a major cause of dementia in old aged people. In the present study, utilizing the structural and biological activity information of ligands for five important and mostly studied vital targets (i.e. cyclin-dependant kinase 5, β-secretase, monoamine oxidase B, glycogen synthase kinase 3β, acetylcholinesterase) that are believed to be effective against AD, we have developed five classification models using linear discriminant analysis (LDA) technique. Considering the importance of data curation, we have given more attention towards the chemical and biological data curation, which is a difficult task especially in case of big data-sets. Thus, to ease the curation process we have designed Konstanz Information Miner (KNIME) workflows, which are made available at http://teqip.jdvu.ac.in/QSAR_Tools/ . The developed models were appropriately validated based on the predictions for experiment derived data from test sets, as well as true external set compounds including known multi-target compounds. The domain of applicability for each classification model was checked based on a confidence estimation approach. Further, these validated models were employed for screening of natural compounds collected from the InterBioScreen natural database ( https://www.ibscreen.com/natural-compounds ). Further, the natural compounds that were categorized as 'actives' in at least two classification models out of five developed models were considered as multi-target leads, and these compounds were further screened using the drug-like filter, molecular docking technique and then thoroughly analyzed using molecular dynamics studies. Finally, the most potential multi-target natural compounds against AD are suggested.

A Successful Model of Collaborative Undergraduate Research: A Multi-Faculty, Multi-Project, Multi-Institution Team Approach

ERIC Educational Resources Information Center

Woodzicka, Julie A.; Ford, Thomas E.; Caudill, Abbie; Ohanmamooreni, Alyna

2015-01-01

A collaborative research grant from the National Science Foundation allowed the first two authors to provide students at primarily undergraduate institutions with a multi-faculty, multi-institution team research experience. Teams of undergraduate students at Western Carolina University and Washington and Lee University collaborated with one…

Predictive Model and Methodology for Heat Treatment Distortion Final Report CRADA No. TC-298-92

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

Nikkel, D. J.; McCabe, J.

This project was a multi-lab, multi-partner CRADA involving LLNL, Los Alamos National Laboratory, Sandia National Laboratories, Oak Ridge National Laboratory, Martin Marietta Energy Systems and the industrial partner, The National Center of Manufacturing Sciences (NCMS). A number of member companies of NCMS participated including General Motors Corporation, Ford Motor Company, The Torrington Company, Gear Research, the Illinois Institute of Technology Research Institute, and Deformation Control Technology •. LLNL was the lead laboratory for metrology technology used for validation of the computational tool/methodology. LLNL was also the lead laboratory for the development of the software user interface , for the computationalmore » tool. This report focuses on the participation of LLNL and NCMS. The purpose of the project was to develop a computational tool/methodology that engineers would use to predict the effects of heat treatment on the _size and shape of industrial parts made of quench hardenable alloys. Initially, the target application of the tool was gears for automotive power trains.« less

Top-forms of leading singularities in nonplanar multi-loop amplitudes

NASA Astrophysics Data System (ADS)

Chen, Baoyi; Chen, Gang; Cheung, Yeuk-Kwan E.; Xie, Ruofei; Xin, Yuan

2018-02-01

The on-shell diagram is a very important tool in studying scattering amplitudes. In this paper we discuss the on-shell diagrams without external BCFW bridges. We introduce an extra step of adding an auxiliary external momentum line. Then we can decompose the on-shell diagrams by removing external BCFW bridges to a planar diagram whose top-form is well known now. The top-form of the on-shell diagram with the auxiliary line can be obtained by adding the BCFW bridges in an inverse order as discussed in our former paper (Chen et al. in Eur Phys J C 77(2):80 2017). To get the top-form of the original diagram, the soft limit of the auxiliary line is needed. We obtain the evolution rule for the Grassmannian integral and the geometry constraint in the soft limit. This completes the top-form description of leading singularities in nonplanar scattering amplitudes of N=4 Super Yang-Mills (SYM), which is valid for arbitrary higher-loops and beyond the Maximally-Helicity-Violation (MHV) amplitudes.

Temporal and external validation of a prediction model for adverse outcomes among inpatients with diabetes.

PubMed

Adderley, N J; Mallett, S; Marshall, T; Ghosh, S; Rayman, G; Bellary, S; Coleman, J; Akiboye, F; Toulis, K A; Nirantharakumar, K

2018-06-01

To temporally and externally validate our previously developed prediction model, which used data from University Hospitals Birmingham to identify inpatients with diabetes at high risk of adverse outcome (mortality or excessive length of stay), in order to demonstrate its applicability to other hospital populations within the UK. Temporal validation was performed using data from University Hospitals Birmingham and external validation was performed using data from both the Heart of England NHS Foundation Trust and Ipswich Hospital. All adult inpatients with diabetes were included. Variables included in the model were age, gender, ethnicity, admission type, intensive therapy unit admission, insulin therapy, albumin, sodium, potassium, haemoglobin, C-reactive protein, estimated GFR and neutrophil count. Adverse outcome was defined as excessive length of stay or death. Model discrimination in the temporal and external validation datasets was good. In temporal validation using data from University Hospitals Birmingham, the area under the curve was 0.797 (95% CI 0.785-0.810), sensitivity was 70% (95% CI 67-72) and specificity was 75% (95% CI 74-76). In external validation using data from Heart of England NHS Foundation Trust, the area under the curve was 0.758 (95% CI 0.747-0.768), sensitivity was 73% (95% CI 71-74) and specificity was 66% (95% CI 65-67). In external validation using data from Ipswich, the area under the curve was 0.736 (95% CI 0.711-0.761), sensitivity was 63% (95% CI 59-68) and specificity was 69% (95% CI 67-72). These results were similar to those for the internally validated model derived from University Hospitals Birmingham. The prediction model to identify patients with diabetes at high risk of developing an adverse event while in hospital performed well in temporal and external validation. The externally validated prediction model is a novel tool that can be used to improve care pathways for inpatients with diabetes. Further research to assess clinical utility is needed. © 2018 Diabetes UK.

Differences in the use of outsourcing in public and private institutions providing medical services.

PubMed

Czerw, Aleksandra I; Kowalska, Mariola; Religioni, Urszula

2014-06-29

The costs of health care in Poland are continuously increasing. Thus, almost every institution providing medical services aims at their limitation. One of the costs rationalisation methods in the health care sector is outsourcing. The study was conducted in 153 randomly selected institutions providing medical activities. The tool was a questionnaire, available via a web browser. Over 30% of public institutions identified the need for financial savings, as the main reason for outsourcing the cleaning function. Among private institutions, the dominant reason for this is too high maintenance cost of the cleaning staff (less than 40% of responses). The huge number of medical institutions use the services of an external company for laundering. Over 30% of public institutions identified as the most common reason for separation of functions laundering lack of resources to upgrade and modernize facilities. Less than 27% of public institutions indicate too high costs of kitchen staff as the main reason for ordering function of feeding. Another reason is the need for financial savings (22% response rate). Some institutions indicate a desire to focus on key areas (20% of responses) and lack of financial resources to upgrade and modernize the kitchen (20% response rate). Public and private institutions exercise control over the quality and method performed by an external service (71% of public institutions and 59% of private institutions). Private institutions often informally exercise external control (difference confirmed - Fisher's exact test). Less than 90% of public institutions indicated satisfaction with the services provided by external companies. The adaptation of outsourcing in medical facilities leads to financial efficiency improvement. Through the separation of some medical functions and entrusting their realisation to external companies, medical institutions can focus on their basic activity that is the provision of health services.

Consistency of clinical biomechanical measures between three different institutions: implications for multi-center biomechanical and epidemiological research.

PubMed

Myer, Gregory D; Wordeman, Samuel C; Sugimoto, Dai; Bates, Nathaniel A; Roewer, Benjamin D; Medina McKeon, Jennifer M; DiCesare, Christopher A; Di Stasi, Stephanie L; Barber Foss, Kim D; Thomas, Staci M; Hewett, Timothy E

2014-05-01

Multi-center collaborations provide a powerful alternative to overcome the inherent limitations to single-center investigations. Specifically, multi-center projects can support large-scale prospective, longitudinal studies that investigate relatively uncommon outcomes, such as anterior cruciate ligament injury. This project was conceived to assess within- and between-center reliability of an affordable, clinical nomogram utilizing two-dimensional video methods to screen for risk of knee injury. The authors hypothesized that the two-dimensional screening methods would provide good-to-excellent reliability within and between institutions for assessment of frontal and sagittal plane biomechanics. Nineteen female, high school athletes participated. Two-dimensional video kinematics of the lower extremity during a drop vertical jump task were collected on all 19 study participants at each of the three facilities. Within-center and between-center reliability were assessed with intra- and inter-class correlation coefficients. Within-center reliability of the clinical nomogram variables was consistently excellent, but between-center reliability was fair-to-good. Within-center intra-class correlation coefficient for all nomogram variables combined was 0.98, while combined between-center inter-class correlation coefficient was 0.63. Injury risk screening protocols were reliable within and repeatable between centers. These results demonstrate the feasibility of multi-site biomechanical studies and establish a framework for further dissemination of injury risk screening algorithms. Specifically, multi-center studies may allow for further validation and optimization of two-dimensional video screening tools. 2b.

A new framework to enhance the interpretation of external validation studies of clinical prediction models.

PubMed

Debray, Thomas P A; Vergouwe, Yvonne; Koffijberg, Hendrik; Nieboer, Daan; Steyerberg, Ewout W; Moons, Karel G M

2015-03-01

It is widely acknowledged that the performance of diagnostic and prognostic prediction models should be assessed in external validation studies with independent data from "different but related" samples as compared with that of the development sample. We developed a framework of methodological steps and statistical methods for analyzing and enhancing the interpretation of results from external validation studies of prediction models. We propose to quantify the degree of relatedness between development and validation samples on a scale ranging from reproducibility to transportability by evaluating their corresponding case-mix differences. We subsequently assess the models' performance in the validation sample and interpret the performance in view of the case-mix differences. Finally, we may adjust the model to the validation setting. We illustrate this three-step framework with a prediction model for diagnosing deep venous thrombosis using three validation samples with varying case mix. While one external validation sample merely assessed the model's reproducibility, two other samples rather assessed model transportability. The performance in all validation samples was adequate, and the model did not require extensive updating to correct for miscalibration or poor fit to the validation settings. The proposed framework enhances the interpretation of findings at external validation of prediction models. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Scaling view by the Virtual Nature Systems

NASA Astrophysics Data System (ADS)

Klenov, Valeriy

2010-05-01

The Virtual Nature System is irreplaceable for research and evaluation for governing processes on the Earth. Processes on the Earth depends on external exogenous and endogenous influences, and on own dynamics of the Actual Nature Systems (ANS). To select part of the actors is impossible without take in account factor of the Time, factor for information safety during the Time. The stochastic nature of external influences and stochastic pattern for dynamics of Nature systems complicates evaluation of 2D threat of disasters. These are multi-layer, multi-scale, and multi-driven structures of surface processes. Their spatial-temporal overlapping of them generates relatively stable structure of river basins and of river net. Dynamics of processes in river basins results in remove of the former sediments and levels, and in displace of erosion/sedimentation pattern, in destroy and dissipation for a memory the ANS. This complex process results in the Information Loss Law (ILL) in the ANS, which gradually cut off own Past. This view on the GeoDynamics appeared after long time field measurements thousands of terrace levels, hundreds of terrace ranks, and terrace complexes in river basins (Klenov, 1986, 2004). Action of the ILL leads to blanks in natural records, which are non-linearly increasing to the Past, and in appearance of false trends in the records. This temporal barrier prevents evaluation of the history. The way to view spatial-temporal dynamics of the ANS is creation for the portrait Virtual Nature Systems, as acting doubles of the actual nature systems (ANS). Exogenous and endogenous influences are governing drivers of the ANS and of corresponding VNS. The VNS is necessary for research of spatial-temporal GeoDynamics. Unfortunately, the ILL is working not only for the Past, but also restrict ‘view' the Future. It is because of future drivers are yet unknown with necessary exactness, and due high sensitivity of nature systems to external pressure. However, a time for validation of the VNS is short to receive non distorted records, but it provides satisfactory validation of the VNS, and provides satisfactory evaluation for stochastic patterns of disasters (floods and debris flows). The VNS gives a chance to divide exogenous (climatic) from tectonic influences. This property is invaluable for monitoring and scenarios of land use, engineering, and other human activity, under simultaneous climatic and tectonic impacts, for evaluation of threat's areas and tracks. The continually measured stochastic spatial-temporal interception of external impacts (storms, precipitations, of tectonic distorts, earthquakes, and others), does not make problems for the VNS (acting by observed records), and by imply the Moving Digital Earth (MDE) technology (by immediate reforming of external drivers to natural processes). It is a goal for the VNS and MDE, which becomes possible by remote sensing, by powerful computers, and by fast communications. The VNS/MDE presents corresponding mapping for processes in any area. Instead of problems of scaling the current task is to provide necessary spatial resolution of the basic multi-layer Matrix of variables and parameters. Problems are in procedures for filling up of large multi-layer M, quick computing and mapping of large areas. The scaling depends on a task. The acceptable spatial resolution of the Matrix must perceive in view to hazardous processes with acceptable in resolution. During the VNS practice were evaluated any imagined combines of exogenous-endogenous impacts (from linear to circle distort, blocks, volcanoes, earthquakes, and others, in a variety of scales from local to sub-continental. The single principle for choose a scale is that spatial resolution (cell size) should not ignore important details of the Earth. For the Rhine Basin was computed influence of small smooth tectonic distorts in a large area. It was resulted in essential change for pattern of erosion/sedimentation on a land, and in Coastal Zone. For small basis were computed scenarios for complex tectonic distorts, earthquakes, resulted in decreasing of soil/rock resistance and in sharp increasing of catastrophic debris flows and flash floods. Any scenarios are possible for the verified/validated VNS. The VNS is valuable for any area, and the MDE has a skill for mapping the soon Future, and for mapping of threats' areas and tracks.

External Validity of a Risk Stratification Score Predicting Early Distant Brain Failure and Salvage Whole Brain Radiation Therapy After Stereotactic Radiosurgery for Brain Metastases.

PubMed

Press, Robert H; Boselli, Danielle M; Symanowski, James T; Lankford, Scott P; McCammon, Robert J; Moeller, Benjamin J; Heinzerling, John H; Fasola, Carolina E; Burri, Stuart H; Patel, Kirtesh R; Asher, Anthony L; Sumrall, Ashley L; Curran, Walter J; Shu, Hui-Kuo G; Crocker, Ian R; Prabhu, Roshan S

2017-07-01

A scoring system using pretreatment factors was recently published for predicting the risk of early (≤6 months) distant brain failure (DBF) and salvage whole brain radiation therapy (WBRT) after stereotactic radiosurgery (SRS) alone. Four risk factors were identified: (1) lack of prior WBRT; (2) melanoma or breast histologic features; (3) multiple brain metastases; and (4) total volume of brain metastases <1.3 cm 3 , with each factor assigned 1 point. The purpose of this study was to assess the validity of this scoring system and its appropriateness for clinical use in an independent external patient population. We reviewed the records of 247 patients with 388 brain metastases treated with SRS between 2010 at 2013 at Levine Cancer Institute. The Press (Emory) risk score was calculated and applied to the validation cohort population, and subsequent risk groups were analyzed using cumulative incidence. The low-risk (LR) group had a significantly lower risk of early DBF than did the high-risk (HR) group (22.6% vs 44%, P=.004), but there was no difference between the HR and intermediate-risk (IR) groups (41.2% vs 44%, P=.79). Total lesion volume <1.3 cm 3  (P=.004), malignant melanoma (P=.007), and multiple metastases (P<.001) were validated as predictors for early DBF. Prior WBRT and breast cancer histologic features did not retain prognostic significance. Risk stratification for risk of early salvage WBRT were similar, with a trend toward an increased risk for HR compared with LR (P=.09) but no difference between IR and HR (P=.53). The 3-level Emory risk score was shown to not be externally valid, but the model was able to stratify between 2 levels (LR and not-LR [combined IR and HR]) for early (≤6 months) DBF. These results reinforce the importance of validating predictive models in independent cohorts. Further refinement of this scoring system with molecular information and in additional contemporary patient populations is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

Development and external validation of nomograms to predict the risk of skeletal metastasis at the time of diagnosis and skeletal metastasis-free survival in nasopharyngeal carcinoma.

PubMed

Yang, Lin; Xia, Liangping; Wang, Yan; He, Shasha; Chen, Haiyang; Liang, Shaobo; Peng, Peijian; Hong, Shaodong; Chen, Yong

2017-09-06

The skeletal system is the most common site of distant metastasis in nasopharyngeal carcinoma (NPC); various prognostic factors have been reported for skeletal metastasis, though most studies have focused on a single factor. We aimed to establish nomograms to effectively predict skeletal metastasis at initial diagnosis (SMAD) and skeletal metastasis-free survival (SMFS) in NPC. A total of 2685 patients with NPC who received bone scintigraphy (BS) and/or 18F-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and 2496 patients without skeletal metastasis were retrospectively assessed to develop individual nomograms for SMAD and SMFS. The models were validated externally using separate cohorts of 1329 and 1231 patients treated at two other institutions. Five independent prognostic factors were included in each nomogram. The SMAD nomogram had a significantly higher c-index than the TNM staging system (training cohort, P = 0.005; validation cohort, P < 0.001). The SMFS nomogram had significantly higher c-index values in the training and validation sets than the TNM staging system (P < 0.001 and P = 0.005, respectively). Three proposed risk stratification groups were created using the nomograms, and enabled significant discrimination of SMFS for each risk group. The prognostic nomograms established in this study enable accurate stratification of distinct risk groups for skeletal metastasis, which may improve counseling and facilitate individualized management of patients with NPC.

Keynote address: Reinventing fire: Physics + markets = energy solutions

NASA Astrophysics Data System (ADS)

Lovins, Amory B.

2015-03-01

Rocky Mountain Institute's multi-year, 61-author, peer-reviewed Reinventing Fire synthesis showed how the U.S. can realistically run a 2.6× bigger U.S. economy in 2050 with no oil, coal, or nuclear energy, one-third less natural gas, tripled efficiency, and 74% renewable supplies (80% for electricity). This transition, at historically reasonable rates, could be led by business for profit, applying normal rates of return, with some innovative subnational and administrative policies but no Acts of Congress. Excluding carbon emissions and all other externalities, the net present value would be 5 trillion more favorable than business-as-usual, averaging a 14% Internal Rate of Return.

Probabilistic Approaches for Multi-Hazard Risk Assessment of Structures and Systems

NASA Astrophysics Data System (ADS)

Kwag, Shinyoung

Performance assessment of structures, systems, and components for multi-hazard scenarios has received significant attention in recent years. However, the concept of multi-hazard analysis is quite broad in nature and the focus of existing literature varies across a wide range of problems. In some cases, such studies focus on hazards that either occur simultaneously or are closely correlated with each other. For example, seismically induced flooding or seismically induced fires. In other cases, multi-hazard studies relate to hazards that are not dependent or correlated but have strong likelihood of occurrence at different times during the lifetime of a structure. The current approaches for risk assessment need enhancement to account for multi-hazard risks. It must be able to account for uncertainty propagation in a systems-level analysis, consider correlation among events or failure modes, and allow integration of newly available information from continually evolving simulation models, experimental observations, and field measurements. This dissertation presents a detailed study that proposes enhancements by incorporating Bayesian networks and Bayesian updating within a performance-based probabilistic framework. The performance-based framework allows propagation of risk as well as uncertainties in the risk estimates within a systems analysis. Unlike conventional risk assessment techniques such as a fault-tree analysis, a Bayesian network can account for statistical dependencies and correlations among events/hazards. The proposed approach is extended to develop a risk-informed framework for quantitative validation and verification of high fidelity system-level simulation tools. Validation of such simulations can be quite formidable within the context of a multi-hazard risk assessment in nuclear power plants. The efficiency of this approach lies in identification of critical events, components, and systems that contribute to the overall risk. Validation of any event or component on the critical path is relatively more important in a risk-informed environment. Significance of multi-hazard risk is also illustrated for uncorrelated hazards of earthquakes and high winds which may result in competing design objectives. It is also illustrated that the number of computationally intensive nonlinear simulations needed in performance-based risk assessment for external hazards can be significantly reduced by using the power of Bayesian updating in conjunction with the concept of equivalent limit-state.

78 FR 75581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... Mental Health Parity and Addiction Equity Act of 2008; Technical Amendment to External Review for Multi... for the Federal external review process under section 2719(b)(2) of the PHS Act and paragraph (d) of...

Validation of psychoanalytic theories: towards a conceptualization of references.

PubMed

Zachrisson, Anders; Zachrisson, Henrik Daae

2005-10-01

The authors discuss criteria for the validation of psychoanalytic theories and develop a heuristic and normative model of the references needed for this. Their core question in this paper is: can psychoanalytic theories be validated exclusively from within psychoanalytic theory (internal validation), or are references to sources of knowledge other than psychoanalysis also necessary (external validation)? They discuss aspects of the classic truth criteria correspondence and coherence, both from the point of view of contemporary psychoanalysis and of contemporary philosophy of science. The authors present arguments for both external and internal validation. Internal validation has to deal with the problems of subjectivity of observations and circularity of reasoning, external validation with the problem of relevance. They recommend a critical attitude towards psychoanalytic theories, which, by carefully scrutinizing weak points and invalidating observations in the theories, reduces the risk of wishful thinking. The authors conclude by sketching a heuristic model of validation. This model combines correspondence and coherence with internal and external validation into a four-leaf model for references for the process of validating psychoanalytic theories.

Multi-method Assessment of Psychopathy in Relation to Factors of Internalizing and Externalizing from the Personality Assessment Inventory: The Impact of Method Variance and Suppressor Effects

PubMed Central

Blonigen, Daniel M.; Patrick, Christopher J.; Douglas, Kevin S.; Poythress, Norman G.; Skeem, Jennifer L.; Lilienfeld, Scott O.; Edens, John F.; Krueger, Robert F.

2010-01-01

Research to date has revealed divergent relations across factors of psychopathy measures with criteria of internalizing (INT; anxiety, depression) and externalizing (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings across distinct measures of psychopathy. Using a large correctional sample, the current study employed a multi-method approach to psychopathy assessment (self-report, interview/file review) to explore convergent and discriminant relations between factors of psychopathy measures and latent criteria of INT and EXT derived from the Personality Assessment Inventory (PAI; L. Morey, 2007). Consistent with prediction, scores on the affective-interpersonal factor of psychopathy were negatively associated with INT and negligibly related to EXT, whereas scores on the social deviance factor exhibited positive associations (moderate and large, respectively) with both INT and EXT. Notably, associations were highly comparable across the psychopathy measures when accounting for method variance (in the case of EXT) and when assessing for suppressor effects (in the case of INT). Findings are discussed in terms of implications for clinical assessment and evaluation of the validity of interpretations drawn from scores on psychopathy measures. PMID:20230156

Reproducibility of preclinical animal research improves with heterogeneity of study samples

PubMed Central

Vogt, Lucile; Sena, Emily S.; Würbel, Hanno

2018-01-01

Single-laboratory studies conducted under highly standardized conditions are the gold standard in preclinical animal research. Using simulations based on 440 preclinical studies across 13 different interventions in animal models of stroke, myocardial infarction, and breast cancer, we compared the accuracy of effect size estimates between single-laboratory and multi-laboratory study designs. Single-laboratory studies generally failed to predict effect size accurately, and larger sample sizes rendered effect size estimates even less accurate. By contrast, multi-laboratory designs including as few as 2 to 4 laboratories increased coverage probability by up to 42 percentage points without a need for larger sample sizes. These findings demonstrate that within-study standardization is a major cause of poor reproducibility. More representative study samples are required to improve the external validity and reproducibility of preclinical animal research and to prevent wasting animals and resources for inconclusive research. PMID:29470495

Applying Theory across Settings, Behaviors and Populations: Translational Challenges and Opportunities

PubMed Central

Mermelstein, Robin J.; Revenson, Tracey A.

2013-01-01

Basic social psychological theories have much to contribute to our understanding of health problems and health-related behaviors and may provide potential avenues for intervention development. However, for these theories to have broader reach and applicability to the field of health psychology, more work needs to be done in integrating contexts into these theories and addressing more specifically their application across settings, behaviors, and populations. We argue that integration of these theories into a broader multi-disciplinary and multi-level ecological framework is needed to enhance their translation into real-world applications. To enhance this translation, we make several recommendations, including breaking down silos between disciplinary perspectives and enhancing bidirectional communication and translation; analyzing boundary conditions of theories; expanding research approaches to move outside the laboratory and maintain a focus on external validity; and conducting efficacy testing of theories with meaningful, relevant endpoints. PMID:23646843

Mode switching in a multi-wavelength distributed feedback quantum cascade laser using an external micro-cavity

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

Sidler, Meinrad; Institute for Quantum Electronics, ETH Zurich, Wolfgang-Pauli-Strasse 16, 8093 Zurich; Rauter, Patrick

2014-02-03

We demonstrate a multi-wavelength distributed feedback (DFB) quantum cascade laser (QCL) operating in a lensless external micro-cavity and achieve switchable single-mode emission at three distinct wavelengths selected by the DFB grating, each with a side-mode suppression ratio larger than 30 dB. Discrete wavelength tuning is achieved by modulating the feedback experienced by each mode of the multi-wavelength DFB QCL, resulting from a variation of the external cavity length. This method also provides a post-fabrication control of the lasing modes to correct for fabrication inhomogeneities, in particular, related to the cleaved facets position.

Development of efficiency indicators of operating room management for multi-institutional comparisons.

PubMed

Tanaka, Masayuki; Lee, Jason; Ikai, Hiroshi; Imanaka, Yuichi

2013-04-01

The efficiency of a hospital's operating room (OR) management can affect its overall profitability. However, existing indicators that assess OR management efficiency do not take into account differences in hospital size, manpower and functional characteristics, thereby rendering them unsuitable for multi-institutional comparisons. The aim of this study was to develop indicators of OR management efficiency that would take into account differences in hospital size and manpower, which may then be applied to multi-institutional comparisons. Using administrative data from 224 hospitals in Japan from 2008 to 2010, we performed four multiple linear regression analyses at the hospital level, in which the dependent variables were the number of operations per OR per month, procedural fees per OR per month, total utilization times per OR per month and total fees per OR per month for each of the models. The expected values of these four indicators were produced using multiple regression analysis results, adjusting for differences in hospital size and manpower, which are beyond the control of process owners' management. However, more than half of the variations in three of these four indicators were shown to be explained by differences in hospital size and manpower. Using the ratio of observed to expected values (OE ratio), as well as the difference between the two values (OE difference) allows hospitals to identify weaknesses in efficiency with more validity when compared to unadjusted indicators. The new indicators may support the improvement and sustainment of a high-quality health care system. © 2012 Blackwell Publishing Ltd.

Multi-Institution Research Centers: Planning and Management Challenges

ERIC Educational Resources Information Center

Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

2016-01-01

Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

Stretchable Dual-Capacitor Multi-Sensor for Touch-Curvature-Pressure-Strain Sensing.

PubMed

Jin, Hanbyul; Jung, Sungchul; Kim, Junhyung; Heo, Sanghyun; Lim, Jaeik; Park, Wonsang; Chu, Hye Yong; Bien, Franklin; Park, Kibog

2017-09-07

We introduce a new type of multi-functional capacitive sensor that can sense several different external stimuli. It is fabricated only with polydimethylsiloxane (PDMS) films and silver nanowire electrodes by using selective oxygen plasma treatment method without photolithography and etching processes. Differently from the conventional single-capacitor multi-functional sensors, our new multi-functional sensor is composed of two vertically-stacked capacitors (dual-capacitor). The unique dual-capacitor structure can detect the type and strength of external stimuli including curvature, pressure, strain, and touch with clear distinction, and it can also detect the surface-normal directionality of curvature, pressure, and touch. Meanwhile, the conventional single-capacitor sensor has ambiguity in distinguishing curvature and pressure and it can detect only the strength of external stimulus. The type, directionality, and strength of external stimulus can be determined based on the relative capacitance changes of the two stacked capacitors. Additionally, the logical flow reflected on a tree structure with its branches reaching the direction and strength of the corresponding external stimulus unambiguously is devised. This logical flow can be readily implemented in the sensor driving circuit if the dual-capacitor sensor is commercialized actually in the future.

External validity of a hierarchical dimensional model of child and adolescent psychopathology: Tests using confirmatory factor analyses and multivariate behavior genetic analyses.

PubMed

Waldman, Irwin D; Poore, Holly E; van Hulle, Carol; Rathouz, Paul J; Lahey, Benjamin B

2016-11-01

Several recent studies of the hierarchical phenotypic structure of psychopathology have identified a General psychopathology factor in addition to the more expected specific Externalizing and Internalizing dimensions in both youth and adult samples and some have found relevant unique external correlates of this General factor. We used data from 1,568 twin pairs (599 MZ & 969 DZ) age 9 to 17 to test hypotheses for the underlying structure of youth psychopathology and the external validity of the higher-order factors. Psychopathology symptoms were assessed via structured interviews of caretakers and youth. We conducted phenotypic analyses of competing structural models using Confirmatory Factor Analysis and used Structural Equation Modeling and multivariate behavior genetic analyses to understand the etiology of the higher-order factors and their external validity. We found that both a General factor and specific Externalizing and Internalizing dimensions are necessary for characterizing youth psychopathology at both the phenotypic and etiologic levels, and that the 3 higher-order factors differed substantially in the magnitudes of their underlying genetic and environmental influences. Phenotypically, the specific Externalizing and Internalizing dimensions were slightly negatively correlated when a General factor was included, which reflected a significant inverse correlation between the nonshared environmental (but not genetic) influences on Internalizing and Externalizing. We estimated heritability of the general factor of psychopathology for the first time. Its moderate heritability suggests that it is not merely an artifact of measurement error but a valid construct. The General, Externalizing, and Internalizing factors differed in their relations with 3 external validity criteria: mother's smoking during pregnancy, parent's harsh discipline, and the youth's association with delinquent peers. Multivariate behavior genetic analyses supported the external validity of the 3 higher-order factors by suggesting that the General, Externalizing, and Internalizing factors were correlated with peer delinquency and parent's harsh discipline for different etiologic reasons. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Prediction of risk of recurrence of venous thromboembolism following treatment for a first unprovoked venous thromboembolism: systematic review, prognostic model and clinical decision rule, and economic evaluation.

PubMed

Ensor, Joie; Riley, Richard D; Jowett, Sue; Monahan, Mark; Snell, Kym Ie; Bayliss, Susan; Moore, David; Fitzmaurice, David

2016-02-01

Unprovoked first venous thromboembolism (VTE) is defined as VTE in the absence of a temporary provoking factor such as surgery, immobility and other temporary factors. Recurrent VTE in unprovoked patients is highly prevalent, but easily preventable with oral anticoagulant (OAC) therapy. The unprovoked population is highly heterogeneous in terms of risk of recurrent VTE. The first aim of the project is to review existing prognostic models which stratify individuals by their recurrence risk, therefore potentially allowing tailored treatment strategies. The second aim is to enhance the existing research in this field, by developing and externally validating a new prognostic model for individual risk prediction, using a pooled database containing individual patient data (IPD) from several studies. The final aim is to assess the economic cost-effectiveness of the proposed prognostic model if it is used as a decision rule for resuming OAC therapy, compared with current standard treatment strategies. Standard systematic review methodology was used to identify relevant prognostic model development, validation and cost-effectiveness studies. Bibliographic databases (including MEDLINE, EMBASE and The Cochrane Library) were searched using terms relating to the clinical area and prognosis. Reviewing was undertaken by two reviewers independently using pre-defined criteria. Included full-text articles were data extracted and quality assessed. Critical appraisal of included full texts was undertaken and comparisons made of model performance. A prognostic model was developed using IPD from the pooled database of seven trials. A novel internal-external cross-validation (IECV) approach was used to develop and validate a prognostic model, with external validation undertaken in each of the trials iteratively. Given good performance in the IECV approach, a final model was developed using all trials data. A Markov patient-level simulation was used to consider the economic cost-effectiveness of using a decision rule (based on the prognostic model) to decide on resumption of OAC therapy (or not). Three full-text articles were identified by the systematic review. Critical appraisal identified methodological and applicability issues; in particular, all three existing models did not have external validation. To address this, new prognostic models were sought with external validation. Two potential models were considered: one for use at cessation of therapy (pre D-dimer), and one for use after cessation of therapy (post D-dimer). Model performance measured in the external validation trials showed strong calibration performance for both models. The post D-dimer model performed substantially better in terms of discrimination (c = 0.69), better separating high- and low-risk patients. The economic evaluation identified that a decision rule based on the final post D-dimer model may be cost-effective for patients with predicted risk of recurrence of over 8% annually; this suggests continued therapy for patients with predicted risks ≥ 8% and cessation of therapy otherwise. The post D-dimer model performed strongly and could be useful to predict individuals' risk of recurrence at any time up to 2-3 years, thereby aiding patient counselling and treatment decisions. A decision rule using this model may be cost-effective for informing clinical judgement and patient opinion in treatment decisions. Further research may investigate new predictors to enhance model performance and aim to further externally validate to confirm performance in new, non-trial populations. Finally, it is essential that further research is conducted to develop a model predicting bleeding risk on therapy, to manage the balance between the risks of recurrence and bleeding. This study is registered as PROSPERO CRD42013003494. The National Institute for Health Research Health Technology Assessment programme.

Development of a Curriculum on the Child With Medical Complexity: Filling a Gap When Few Practice Guidelines Exist.

PubMed

Shah, Neha H; Anspacher, Melanie; Davis, Aisha; Bhansali, Priti

2015-01-01

Pediatric hospitalists are increasingly involved in the clinical management of children with medical complexity (CMC), specifically those with neurologic impairment and technology dependence. Clinical care guidelines and educational resources on management of the diseases and devices prevalent in CMC are scarce. The objective of this study was to develop and evaluate a web-based curriculum on care of CMC for hospitalists at our institution using a novel approach to validate educational content. Junior faculty collaborated with senior hospitalist peer mentors to create multimedia learning modules on highly-desired topics as determined by needs assessment. Module authors were encouraged to work with subspecialty experts from within the institution and to submit their modules for external peer review. Pilot study participants were asked to complete all modules, associated knowledge tests, and evaluations over a 4-month period. Sixteen of 33 eligible hospitalists completed the curriculum and associated assessments. High scores with respect to satisfaction were seen across all modules. There was a significant increase in posttest knowledge scores (P < 0.001) with sustained retention at 6 months posttest (P < 0.013). Participants were most likely to make changes to their teaching and clinical practice based on participation in this curriculum. We used a novel approach for content development in this curriculum that incorporated consultation with experts and external peer review, resulting in improved knowledge, high satisfaction, and behavior change. Our approach may be a useful method to improve content validity for educational resources on topics that do not have established clinical care guidelines.

Characteristics and external validity of the German Health Risk Institute (HRI) Database.

PubMed

Andersohn, Frank; Walker, Jochen

2016-01-01

The aim of this study was to describe characteristics and external validity of the German Health Risk Institute (HRI) Database. The HRI Database is an anonymized healthcare database with longitudinal data from approximately six Mio Germans. In addition to demographic information (gender, age, region of residence), data on persistence of insurants over time, hospitalization rates, mortality rates and drug prescription rates were extracted from the HRI database for 2013. Corresponding national reference data were obtained from official sources. The proportion of men and women was similar in the HRI Database and Germany, but the database population was slightly younger (mean 40.4 vs 43.7 years). The proportion of insurants living in the eastern part of Germany was lower in the HRI Database (10.1% vs 19.7%). There was good accordance to German reference data with respect to hospitalization rates, overall mortality rate and prescription rates for the 20 most often reimbursed drug classes, with the overall burden of morbidity being slightly lower in the HRI database. From insurants insured on 1 January 2009 (N = 6.2 Mio), a total of 70.6% survived and remained continuously insured with the same statutory health insurance until 31 December 2013. This proportion increased to 77.5% if only insurants ≥40 years were considered. There was good overall accordance of the HRI database and the German population in terms of measures of morbidity, mortality and drug usage. Persistence of insurants with the database over time was high, indicating suitability of the data source for longitudinal epidemiological analyses. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluation of diagnostic tools that tertiary teachers can apply to profile their students' conceptions

NASA Astrophysics Data System (ADS)

Schultz, Madeleine; Lawrie, Gwendolyn A.; Bailey, Chantal H.; Bedford, Simon B.; Dargaville, Tim R.; O'Brien, Glennys; Tasker, Roy; Thompson, Christopher D.; Williams, Mark; Wright, Anthony H.

2017-03-01

A multi-institution collaborative team of Australian chemistry education researchers, teaching a total of over 3000 first year chemistry students annually, has explored a tool for diagnosing students' prior conceptions as they enter tertiary chemistry courses. Five core topics were selected and clusters of diagnostic items were assembled linking related concepts in each topic together. An ordered multiple choice assessment strategy was adopted to enable provision of formative feedback to students through combination of the specific distractors that they chose. Concept items were either sourced from existing research instruments or developed by the project team. The outcome is a diagnostic tool consisting of five topic clusters of five concept items that has been delivered in large introductory chemistry classes at five Australian institutions. Statistical analysis of data has enabled exploration of the composition and validity of the instrument including a comparison between delivery of the complete 25 item instrument with subsets of five items, clustered by topic. This analysis revealed that most items retained their validity when delivered in small clusters. Tensions between the assembly, validation and delivery of diagnostic instruments for the purposes of acquiring robust psychometric research data versus their pragmatic use are considered in this study.

A multiparametric magnetic resonance imaging-based risk model to determine the risk of significant prostate cancer prior to biopsy.

PubMed

van Leeuwen, Pim J; Hayen, Andrew; Thompson, James E; Moses, Daniel; Shnier, Ron; Böhm, Maret; Abuodha, Magdaline; Haynes, Anne-Maree; Ting, Francis; Barentsz, Jelle; Roobol, Monique; Vass, Justin; Rasiah, Krishan; Delprado, Warick; Stricker, Phillip D

2017-12-01

To develop and externally validate a predictive model for detection of significant prostate cancer. Development of the model was based on a prospective cohort including 393 men who underwent multiparametric magnetic resonance imaging (mpMRI) before biopsy. External validity of the model was then examined retrospectively in 198 men from a separate institution whom underwent mpMRI followed by biopsy for abnormal prostate-specific antigen (PSA) level or digital rectal examination (DRE). A model was developed with age, PSA level, DRE, prostate volume, previous biopsy, and Prostate Imaging Reporting and Data System (PIRADS) score, as predictors for significant prostate cancer (Gleason 7 with >5% grade 4, ≥20% cores positive or ≥7 mm of cancer in any core). Probability was studied via logistic regression. Discriminatory performance was quantified by concordance statistics and internally validated with bootstrap resampling. In all, 393 men had complete data and 149 (37.9%) had significant prostate cancer. While the variable model had good accuracy in predicting significant prostate cancer, area under the curve (AUC) of 0.80, the advanced model (incorporating mpMRI) had a significantly higher AUC of 0.88 (P < 0.001). The model was well calibrated in internal and external validation. Decision analysis showed that use of the advanced model in practice would improve biopsy outcome predictions. Clinical application of the model would reduce 28% of biopsies, whilst missing 2.6% significant prostate cancer. Individualised risk assessment of significant prostate cancer using a predictive model that incorporates mpMRI PIRADS score and clinical data allows a considerable reduction in unnecessary biopsies and reduction of the risk of over-detection of insignificant prostate cancer at the cost of a very small increase in the number of significant cancers missed. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

GPM Ground Validation: Pre to Post-Launch Era

NASA Astrophysics Data System (ADS)

Petersen, Walt; Skofronick-Jackson, Gail; Huffman, George

2015-04-01

NASA GPM Ground Validation (GV) activities have transitioned from the pre to post-launch era. Prior to launch direct validation networks and associated partner institutions were identified world-wide, covering a plethora of precipitation regimes. In the U.S. direct GV efforts focused on use of new operational products such as the NOAA Multi-Radar Multi-Sensor suite (MRMS) for TRMM validation and GPM radiometer algorithm database development. In the post-launch, MRMS products including precipitation rate, accumulation, types and data quality are being routinely generated to facilitate statistical GV of instantaneous (e.g., Level II orbit) and merged (e.g., IMERG) GPM products. Toward assessing precipitation column impacts on product uncertainties, range-gate to pixel-level validation of both Dual-Frequency Precipitation Radar (DPR) and GPM microwave imager data are performed using GPM Validation Network (VN) ground radar and satellite data processing software. VN software ingests quality-controlled volumetric radar datasets and geo-matches those data to coincident DPR and radiometer level-II data. When combined MRMS and VN datasets enable more comprehensive interpretation of both ground and satellite-based estimation uncertainties. To support physical validation efforts eight (one) field campaigns have been conducted in the pre (post) launch era. The campaigns span regimes from northern latitude cold-season snow to warm tropical rain. Most recently the Integrated Precipitation and Hydrology Experiment (IPHEx) took place in the mountains of North Carolina and involved combined airborne and ground-based measurements of orographic precipitation and hydrologic processes underneath the GPM Core satellite. One more U.S. GV field campaign (OLYMPEX) is planned for late 2015 and will address cold-season precipitation estimation, process and hydrology in the orographic and oceanic domains of western Washington State. Finally, continuous direct and physical validation measurements are also being conducted at the NASA Wallops Flight Facility multi-radar, gauge and disdrometer facility located in coastal Virginia. This presentation will summarize the evolution of the NASA GPM GV program from pre to post-launch eras and place focus on evaluation of year-1 post-launch GPM satellite datasets including Level II GPROF, DPR and Combined algorithms, and Level III IMERG products.

Differences in the use of outsourcing in public and private institutions providing medical services

PubMed Central

Kowalska, Mariola; Religioni, Urszula

2014-01-01

Introduction The costs of health care in Poland are continuously increasing. Thus, almost every institution providing medical services aims at their limitation. One of the costs rationalisation methods in the health care sector is outsourcing. Material and methods The study was conducted in 153 randomly selected institutions providing medical activities. The tool was a questionnaire, available via a web browser. Results Over 30% of public institutions identified the need for financial savings, as the main reason for outsourcing the cleaning function. Among private institutions, the dominant reason for this is too high maintenance cost of the cleaning staff (less than 40% of responses). The huge number of medical institutions use the services of an external company for laundering. Over 30% of public institutions identified as the most common reason for separation of functions laundering lack of resources to upgrade and modernize facilities. Less than 27% of public institutions indicate too high costs of kitchen staff as the main reason for ordering function of feeding. Another reason is the need for financial savings (22% response rate). Some institutions indicate a desire to focus on key areas (20% of responses) and lack of financial resources to upgrade and modernize the kitchen (20% response rate). Public and private institutions exercise control over the quality and method performed by an external service (71% of public institutions and 59% of private institutions). Private institutions often informally exercise external control (difference confirmed – Fisher's exact test). Less than 90% of public institutions indicated satisfaction with the services provided by external companies. Conclusions The adaptation of outsourcing in medical facilities leads to financial efficiency improvement. Through the separation of some medical functions and entrusting their realisation to external companies, medical institutions can focus on their basic activity that is the provision of health services. PMID:25097595

External Validation of Bifactor Model of ADHD: Explaining Heterogeneity in Psychiatric Comorbidity, Cognitive Control, and Personality Trait Profiles within DSM-IV ADHD

ERIC Educational Resources Information Center

Martel, Michelle M.; Roberts, Bethan; Gremillion, Monica; von Eye, Alexander; Nigg, Joel T.

2011-01-01

The current paper provides external validation of the bifactor model of ADHD by examining associations between ADHD latent factor/profile scores and external validation indices. 548 children (321 boys; 302 with ADHD), 6 to 18 years old, recruited from the community participated in a comprehensive diagnostic procedure. Mothers completed the Child…

Selecting and Improving Quasi-Experimental Designs in Effectiveness and Implementation Research.

PubMed

Handley, Margaret A; Lyles, Courtney R; McCulloch, Charles; Cattamanchi, Adithya

2018-04-01

Interventional researchers face many design challenges when assessing intervention implementation in real-world settings. Intervention implementation requires holding fast on internal validity needs while incorporating external validity considerations (such as uptake by diverse subpopulations, acceptability, cost, and sustainability). Quasi-experimental designs (QEDs) are increasingly employed to achieve a balance between internal and external validity. Although these designs are often referred to and summarized in terms of logistical benefits, there is still uncertainty about (a) selecting from among various QEDs and (b) developing strategies to strengthen the internal and external validity of QEDs. We focus here on commonly used QEDs (prepost designs with nonequivalent control groups, interrupted time series, and stepped-wedge designs) and discuss several variants that maximize internal and external validity at the design, execution and implementation, and analysis stages.

MUC1 Expression by Immunohistochemistry Is Associated with Adverse Pathologic Features in Prostate Cancer: A Multi-Institutional Study.

PubMed

Eminaga, Okyaz; Wei, Wei; Hawley, Sarah J; Auman, Heidi; Newcomb, Lisa F; Simko, Jeff; Hurtado-Coll, Antonio; Troyer, Dean A; Carroll, Peter R; Gleave, Martin E; Lin, Daniel W; Nelson, Peter S; Thompson, Ian M; True, Lawrence D; McKenney, Jesse K; Feng, Ziding; Fazli, Ladan; Brooks, James D

2016-01-01

The uncertainties inherent in clinical measures of prostate cancer (CaP) aggressiveness endorse the investigation of clinically validated tissue biomarkers. MUC1 expression has been previously reported to independently predict aggressive localized prostate cancer. We used a large cohort to validate whether MUC1 protein levels measured by immunohistochemistry (IHC) predict aggressive cancer, recurrence and survival outcomes after radical prostatectomy independent of clinical and pathological parameters. MUC1 IHC was performed on a multi-institutional tissue microarray (TMA) resource including 1,326 men with a median follow-up of 5 years. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazard models and the Log-rank test. The presence of MUC1 expression was significantly associated with extracapsular extension and higher Gleason score, but not with seminal vesicle invasion, age, positive surgical margins or pre-operative serum PSA levels. In univariable analyses, positive MUC1 staining was significantly associated with a worse recurrence free survival (RFS) (HR: 1.24, CI 1.03-1.49, P = 0.02), although not with disease specific survival (DSS, P>0.5). On multivariable analyses, the presence of positive surgical margins, extracapsular extension, seminal vesicle invasion, as well as higher pre-operative PSA and increasing Gleason score were independently associated with RFS, while MUC1 expression was not. Positive MUC1 expression was not independently associated with disease specific survival (DSS), but was weakly associated with overall survival (OS). In our large, rigorously designed validation cohort, MUC1 protein expression was associated with adverse pathological features, although it was not an independent predictor of outcome after radical prostatectomy.

An empirical assessment of validation practices for molecular classifiers

PubMed Central

Castaldi, Peter J.; Dahabreh, Issa J.

2011-01-01

Proposed molecular classifiers may be overfit to idiosyncrasies of noisy genomic and proteomic data. Cross-validation methods are often used to obtain estimates of classification accuracy, but both simulations and case studies suggest that, when inappropriate methods are used, bias may ensue. Bias can be bypassed and generalizability can be tested by external (independent) validation. We evaluated 35 studies that have reported on external validation of a molecular classifier. We extracted information on study design and methodological features, and compared the performance of molecular classifiers in internal cross-validation versus external validation for 28 studies where both had been performed. We demonstrate that the majority of studies pursued cross-validation practices that are likely to overestimate classifier performance. Most studies were markedly underpowered to detect a 20% decrease in sensitivity or specificity between internal cross-validation and external validation [median power was 36% (IQR, 21–61%) and 29% (IQR, 15–65%), respectively]. The median reported classification performance for sensitivity and specificity was 94% and 98%, respectively, in cross-validation and 88% and 81% for independent validation. The relative diagnostic odds ratio was 3.26 (95% CI 2.04–5.21) for cross-validation versus independent validation. Finally, we reviewed all studies (n = 758) which cited those in our study sample, and identified only one instance of additional subsequent independent validation of these classifiers. In conclusion, these results document that many cross-validation practices employed in the literature are potentially biased and genuine progress in this field will require adoption of routine external validation of molecular classifiers, preferably in much larger studies than in current practice. PMID:21300697

Validation of EncephalApp, Smartphone-Based Stroop Test, for the Diagnosis of Covert Hepatic Encephalopathy.

PubMed

Bajaj, Jasmohan S; Heuman, Douglas M; Sterling, Richard K; Sanyal, Arun J; Siddiqui, Muhammad; Matherly, Scott; Luketic, Velimir; Stravitz, R Todd; Fuchs, Michael; Thacker, Leroy R; Gilles, HoChong; White, Melanie B; Unser, Ariel; Hovermale, James; Gavis, Edith; Noble, Nicole A; Wade, James B

2015-10-01

Detection of covert hepatic encephalopathy (CHE) is difficult, but point-of-care testing could increase rates of diagnosis. We aimed to validate the ability of the smartphone app EncephalApp, a streamlined version of Stroop App, to detect CHE. We evaluated face validity, test-retest reliability, and external validity. Patients with cirrhosis (n = 167; 38% with overt HE [OHE]; mean age, 55 years; mean Model for End-Stage Liver Disease score, 12) and controls (n = 114) were each given a paper and pencil cognitive battery (standard) along with EncephalApp. EncephalApp has Off and On states; results measured were OffTime, OnTime, OffTime+OnTime, and number of runs required to complete 5 off and on runs. Thirty-six patients with cirrhosis underwent driving simulation tests, and EncephalApp results were correlated with results. Test-retest reliability was analyzed in a subgroup of patients. The test was performed before and after transjugular intrahepatic portosystemic shunt placement, and before and after correction for hyponatremia, to determine external validity. All patients with cirrhosis performed worse on paper and pencil and EncephalApp tests than controls. Patients with cirrhosis and OHE performed worse than those without OHE. Age-dependent EncephalApp cutoffs (younger or older than 45 years) were set. An OffTime+OnTime value of >190 seconds identified all patients with CHE with an area under the receiver operator characteristic value of 0.91; the area under the receiver operator characteristic value was 0.88 for diagnosis of CHE in those without OHE. EncephalApp times correlated with crashes and illegal turns in driving simulation tests. Test-retest reliability was high (intraclass coefficient, 0.83) among 30 patients retested 1-3 months apart. OffTime+OnTime increased significantly (206 vs 255 seconds, P = .007) among 10 patients retested 33 ± 7 days after transjugular intrahepatic portosystemic shunt placement. OffTime+OnTime decreased significantly (242 vs 225 seconds, P = .03) in 7 patients tested before and after correction for hyponatremia (126 ± 3 to 132 ± 4 meq/L, P = .01) 10 ± 5 days apart. A smartphone app called EncephalApp has good face validity, test-retest reliability, and external validity for the diagnosis of CHE. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

Validation of a scenario-based assessment of critical thinking using an externally validated tool.

PubMed

Buur, Jennifer L; Schmidt, Peggy; Smylie, Dean; Irizarry, Kris; Crocker, Carlos; Tyler, John; Barr, Margaret

2012-01-01

With medical education transitioning from knowledge-based curricula to competency-based curricula, critical thinking skills have emerged as a major competency. While there are validated external instruments for assessing critical thinking, many educators have created their own custom assessments of critical thinking. However, the face validity of these assessments has not been challenged. The purpose of this study was to compare results from a custom assessment of critical thinking with the results from a validated external instrument of critical thinking. Students from the College of Veterinary Medicine at Western University of Health Sciences were administered a custom assessment of critical thinking (ACT) examination and the externally validated instrument, California Critical Thinking Skills Test (CCTST), in the spring of 2011. Total scores and sub-scores from each exam were analyzed for significant correlations using Pearson correlation coefficients. Significant correlations between ACT Blooms 2 and deductive reasoning and total ACT score and deductive reasoning were demonstrated with correlation coefficients of 0.24 and 0.22, respectively. No other statistically significant correlations were found. The lack of significant correlation between the two examinations illustrates the need in medical education to externally validate internal custom assessments. Ultimately, the development and validation of custom assessments of non-knowledge-based competencies will produce higher quality medical professionals.

Quantifying climate changes of the Common Era for Finland

NASA Astrophysics Data System (ADS)

Luoto, Tomi P.; Nevalainen, Liisa

2017-10-01

In this study, we aim to quantify summer air temperatures from sediment records from Southern, Central and Northern Finland over the past 2000 years. We use lake sediment archives to estimate paleotemperatures applying fossil Chironomidae assemblages and the transfer function approach. The used enhanced Chironomidae-based temperature calibration set was validated in a 70-year high-resolution sediment record against instrumentally measured temperatures. Since the inferred and observed temperatures showed close correlation, we deduced that the new calibration model is reliable for reconstructions beyond the monitoring records. The 700-year long temperature reconstructions from three sites at multi-decadal temporal resolution showed similar trends, although they had differences in timing of the cold Little Ice Age (LIA) and the initiation of recent warming. The 2000-year multi-centennial reconstructions from three different sites showed resemblance with each other having clear signals of the Medieval Climate Anomaly (MCA) and LIA, but with differences in their timing. The influence of external forcing on climate of the southern and central sites appeared to be complex at the decadal scale, but the North Atlantic Oscillation (NAO) was closely linked to the temperature development of the northern site. Solar activity appears to be synchronous with the temperature fluctuations at the multi-centennial scale in all the sites. The present study provides new insights into centennial and decadal variability in air temperature dynamics in Northern Europe and on the external forcing behind these trends. These results are particularly useful in comparing regional responses and lags of temperature trends between different parts of Scandinavia.

Development of Decision Support Formulas for the Prediction of Bladder Outlet Obstruction and Prostatic Surgery in Patients With Lower Urinary Tract Symptom/Benign Prostatic Hyperplasia: Part II, External Validation and Usability Testing of a Smartphone App.

PubMed

Choo, Min Soo; Jeong, Seong Jin; Cho, Sung Yong; Yoo, Changwon; Jeong, Chang Wook; Ku, Ja Hyeon; Oh, Seung-June

2017-04-01

We aimed to externally validate the prediction model we developed for having bladder outlet obstruction (BOO) and requiring prostatic surgery using 2 independent data sets from tertiary referral centers, and also aimed to validate a mobile app for using this model through usability testing. Formulas and nomograms predicting whether a subject has BOO and needs prostatic surgery were validated with an external validation cohort from Seoul National University Bundang Hospital and Seoul Metropolitan Government-Seoul National University Boramae Medical Center between January 2004 and April 2015. A smartphone-based app was developed, and 8 young urologists were enrolled for usability testing to identify any human factor issues of the app. A total of 642 patients were included in the external validation cohort. No significant differences were found in the baseline characteristics of major parameters between the original (n=1,179) and the external validation cohort, except for the maximal flow rate. Predictions of requiring prostatic surgery in the validation cohort showed a sensitivity of 80.6%, a specificity of 73.2%, a positive predictive value of 49.7%, and a negative predictive value of 92.0%, and area under receiver operating curve of 0.84. The calibration plot indicated that the predictions have good correspondence. The decision curve showed also a high net benefit. Similar evaluation results using the external validation cohort were seen in the predictions of having BOO. Overall results of the usability test demonstrated that the app was user-friendly with no major human factor issues. External validation of these newly developed a prediction model demonstrated a moderate level of discrimination, adequate calibration, and high net benefit gains for predicting both having BOO and requiring prostatic surgery. Also a smartphone app implementing the prediction model was user-friendly with no major human factor issue.

Multiple QSAR models, pharmacophore pattern and molecular docking analysis for anticancer activity of α, β-unsaturated carbonyl-based compounds, oxime and oxime ether analogues

NASA Astrophysics Data System (ADS)

Masand, Vijay H.; El-Sayed, Nahed N. E.; Bambole, Mukesh U.; Quazi, Syed A.

2018-04-01

Multiple discrete quantitative structure-activity relationships (QSARs) models were constructed for the anticancer activity of α, β-unsaturated carbonyl-based compounds, oxime and oxime ether analogues with a variety of substituents like sbnd Br, sbnd OH, -OMe, etc. at different positions. A big pool of descriptors was considered for QSAR model building. Genetic algorithm (GA), available in QSARINS-Chem, was executed to choose optimum number and set of descriptors to create the multi-linear regression equations for a dataset of sixty-nine compounds. The newly developed five parametric models were subjected to exhaustive internal and external validation along with Y-scrambling using QSARINS-Chem, according to the OECD principles for QSAR model validation. The models were built using easily interpretable descriptors and accepted after confirming statistically robustness with high external predictive ability. The five parametric models were found to have R2 = 0.80 to 0.86, R2ex = 0.75 to 0.84, and CCCex = 0.85 to 0.90. The models indicate that frequency of nitrogen and oxygen atoms separated by five bonds from each other and internal electronic environment of the molecule have correlation with the anticancer activity.

Long-Term Survival Prediction for Coronary Artery Bypass Grafting: Validation of the ASCERT Model Compared With The Society of Thoracic Surgeons Predicted Risk of Mortality.

PubMed

Lancaster, Timothy S; Schill, Matthew R; Greenberg, Jason W; Ruaengsri, Chawannuch; Schuessler, Richard B; Lawton, Jennifer S; Maniar, Hersh S; Pasque, Michael K; Moon, Marc R; Damiano, Ralph J; Melby, Spencer J

2018-05-01

The recently developed American College of Cardiology Foundation-Society of Thoracic Surgeons (STS) Collaboration on the Comparative Effectiveness of Revascularization Strategy (ASCERT) Long-Term Survival Probability Calculator is a valuable addition to existing short-term risk-prediction tools for cardiac surgical procedures but has yet to be externally validated. Institutional data of 654 patients aged 65 years or older undergoing isolated coronary artery bypass grafting between 2005 and 2010 were reviewed. Predicted survival probabilities were calculated using the ASCERT model. Survival data were collected using the Social Security Death Index and institutional medical records. Model calibration and discrimination were assessed for the overall sample and for risk-stratified subgroups based on (1) ASCERT 7-year survival probability and (2) the predicted risk of mortality (PROM) from the STS Short-Term Risk Calculator. Logistic regression analysis was performed to evaluate additional perioperative variables contributing to death. Overall survival was 92.1% (569 of 597) at 1 year and 50.5% (164 of 325) at 7 years. Calibration assessment found no significant differences between predicted and actual survival curves for the overall sample or for the risk-stratified subgroups, whether stratified by predicted 7-year survival or by PROM. Discriminative performance was comparable between the ASCERT and PROM models for 7-year survival prediction (p < 0.001 for both; C-statistic = 0.815 for ASCERT and 0.781 for PROM). Prolonged ventilation, stroke, and hospital length of stay were also predictive of long-term death. The ASCERT survival probability calculator was externally validated for prediction of long-term survival after coronary artery bypass grafting in all risk groups. The widely used STS PROM performed comparably as a predictor of long-term survival. Both tools provide important information for preoperative decision making and patient counseling about potential outcomes after coronary artery bypass grafting. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

WHOI and SIO (I): Next Steps toward Multi-Institution Archiving of Shipboard and Deep Submergence Vehicle Data

NASA Astrophysics Data System (ADS)

Detrick, R. S.; Clark, D.; Gaylord, A.; Goldsmith, R.; Helly, J.; Lemmond, P.; Lerner, S.; Maffei, A.; Miller, S. P.; Norton, C.; Walden, B.

2005-12-01

The Scripps Institution of Oceanography (SIO) and the Woods Hole Oceanographic Institution (WHOI) have joined forces with the San Diego Supercomputer Center to build a testbed for multi-institutional archiving of shipboard and deep submergence vehicle data. Support has been provided by the Digital Archiving and Preservation program funded by NSF/CISE and the Library of Congress. In addition to the more than 92,000 objects stored in the SIOExplorer Digital Library, the testbed will provide access to data, photographs, video images and documents from WHOI ships, Alvin submersible and Jason ROV dives, and deep-towed vehicle surveys. An interactive digital library interface will allow combinations of distributed collections to be browsed, metadata inspected, and objects displayed or selected for download. The digital library architecture, and the search and display tools of the SIOExplorer project, are being combined with WHOI tools, such as the Alvin Framegrabber and the Jason Virtual Control Van, that have been designed using WHOI's GeoBrowser to handle the vast volumes of digital video and camera data generated by Alvin, Jason and other deep submergence vehicles. Notions of scalability will be tested, as data volumes range from 3 CDs per cruise to 200 DVDs per cruise. Much of the scalability of this proposal comes from an ability to attach digital library data and metadata acquisition processes to diverse sensor systems. We are able to run an entire digital library from a laptop computer as well as from supercomputer-center-size resources. It can be used, in the field, laboratory or classroom, covering data from acquisition-to-archive using a single coherent methodology. The design is an open architecture, supporting applications through well-defined external interfaces maintained as an open-source effort for community inclusion and enhancement.

Signatures of subacute potentially catastrophic illness in the intensive care unit: model development and validation

PubMed Central

Moss, Travis J.; Lake, Douglas E.; Forrest Calland, J; Enfield, Kyle B; Delos, John B.; Fairchild, Karen D.; Randall Moorman, J.

2016-01-01

Objective Patients in intensive care units are susceptible to subacute, potentially catastrophic illnesses such as respiratory failure, sepsis, and hemorrhage that present as severe derangements of vital signs. More subtle physiologic signatures may be present before clinical deterioration, when treatment might be more effective. We performed multivariate statistical analyses of bedside physiologic monitoring data to identify such early, subclinical signatures of incipient life-threatening illness. Design We report a study of model development and validation of a retrospective observational cohort using resampling (TRIPOD Type 1b internal validation), and a study of model validation using separate data (Type 2b internal/external validation). Setting University of Virginia Health System (Charlottesville), a tertiary-care, academic medical center. Patients Critically ill patients consecutively admitted between January 2009 and June 2015 to either the neonatal, surgical/trauma/burn, or medical intensive care units with available physiologic monitoring data. Interventions None. Measurements and Main Results We analyzed 146 patient-years of vital sign and electrocardiography waveform time series from the bedside monitors of 9,232 ICU admissions. Calculations from 30-minute windows of the physiologic monitoring data were made every 15 minutes. Clinicians identified 1,206 episodes of respiratory failure leading to urgent, unplanned intubation, sepsis, or hemorrhage leading to multi-unit transfusions from systematic, individual chart reviews. Multivariate models to predict events up to 24 hours prior had internally-validated C-statistics of 0.61 to 0.88. In adults, physiologic signatures of respiratory failure and hemorrhage were distinct from each other but externally consistent across ICUs. Sepsis, on the other hand, demonstrated less distinct and inconsistent signatures. Physiologic signatures of all neonatal illnesses were similar. Conclusions Subacute, potentially catastrophic illnesses in 3 diverse ICU populations have physiologic signatures that are detectable in the hours preceding clinical detection and intervention. Detection of such signatures can draw attention to patients at highest risk, potentially enabling earlier intervention and better outcomes. PMID:27452809

Signatures of Subacute Potentially Catastrophic Illness in the ICU: Model Development and Validation.

PubMed

Moss, Travis J; Lake, Douglas E; Calland, J Forrest; Enfield, Kyle B; Delos, John B; Fairchild, Karen D; Moorman, J Randall

2016-09-01

Patients in ICUs are susceptible to subacute potentially catastrophic illnesses such as respiratory failure, sepsis, and hemorrhage that present as severe derangements of vital signs. More subtle physiologic signatures may be present before clinical deterioration, when treatment might be more effective. We performed multivariate statistical analyses of bedside physiologic monitoring data to identify such early subclinical signatures of incipient life-threatening illness. We report a study of model development and validation of a retrospective observational cohort using resampling (Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis type 1b internal validation) and a study of model validation using separate data (type 2b internal/external validation). University of Virginia Health System (Charlottesville), a tertiary-care, academic medical center. Critically ill patients consecutively admitted between January 2009 and June 2015 to either the neonatal, surgical/trauma/burn, or medical ICUs with available physiologic monitoring data. None. We analyzed 146 patient-years of vital sign and electrocardiography waveform time series from the bedside monitors of 9,232 ICU admissions. Calculations from 30-minute windows of the physiologic monitoring data were made every 15 minutes. Clinicians identified 1,206 episodes of respiratory failure leading to urgent unplanned intubation, sepsis, or hemorrhage leading to multi-unit transfusions from systematic individual chart reviews. Multivariate models to predict events up to 24 hours prior had internally validated C-statistics of 0.61-0.88. In adults, physiologic signatures of respiratory failure and hemorrhage were distinct from each other but externally consistent across ICUs. Sepsis, on the other hand, demonstrated less distinct and inconsistent signatures. Physiologic signatures of all neonatal illnesses were similar. Subacute potentially catastrophic illnesses in three diverse ICU populations have physiologic signatures that are detectable in the hours preceding clinical detection and intervention. Detection of such signatures can draw attention to patients at highest risk, potentially enabling earlier intervention and better outcomes.

External review for promotion and tenure in schools of nursing.

PubMed

Reilly, L; Carlisle, J; Mikan, K; Goldsmith, M

1996-10-01

To obtain information about external review for tenure and/or promotion, the faculty affairs committee in a large nursing program located in the southeastern United States conducted a survey among programs that award a doctoral degree in nursing. Research questions focused on general tenure and promotion policies, policies and procedures regarding the use of external review, and perceived advantages and disadvantages of external review. A 22-item survey was sent to 53 institutions with a total of 34 usable surveys being returned. Findings revealed that a majority of the schools used external review, especially for tenure decisions and promotion to the associate and professor rank. Promotion and tenure criteria from individual schools were usually sent to reviewers along with the candidates' curriculum vitae and manuscripts. Candidates usually participated in the selection of external reviewers, but contact with reviewers was usually instituted by the administration within the institution. It was also felt that the advantage of external review far outweighed any disadvantages.

Subtyping attention-deficit/hyperactivity disorder using temperament dimensions: toward biologically based nosologic criteria.

PubMed

Karalunas, Sarah L; Fair, Damien; Musser, Erica D; Aykes, Kamari; Iyer, Swathi P; Nigg, Joel T

2014-09-01

Psychiatric nosology is limited by behavioral and biological heterogeneity within existing disorder categories. The imprecise nature of current nosologic distinctions limits both mechanistic understanding and clinical prediction. We demonstrate an approach consistent with the National Institute of Mental Health Research Domain Criteria initiative to identify superior, neurobiologically valid subgroups with better predictive capacity than existing psychiatric categories for childhood attention-deficit/hyperactivity disorder (ADHD). To refine subtyping of childhood ADHD by using biologically based behavioral dimensions (i.e., temperament), novel classification algorithms, and multiple external validators. A total of 437 clinically well-characterized, community-recruited children, with and without ADHD, participated in an ongoing longitudinal study. Baseline data were used to classify children into subgroups based on temperament dimensions and examine external validators including physiological and magnetic resonance imaging measures. One-year longitudinal follow-up data are reported for a subgroup of the ADHD sample to address stability and clinical prediction. Parent/guardian ratings of children on a measure of temperament were used as input features in novel community detection analyses to identify subgroups within the sample. Groups were validated using 3 widely accepted external validators: peripheral physiological characteristics (cardiac measures of respiratory sinus arrhythmia and pre-ejection period), central nervous system functioning (via resting-state functional connectivity magnetic resonance imaging), and clinical outcomes (at 1-year longitudinal follow-up). The community detection algorithm suggested 3 novel types of ADHD, labeled as mild (normative emotion regulation), surgent (extreme levels of positive approach-motivation), and irritable (extreme levels of negative emotionality, anger, and poor soothability). Types were independent of existing clinical demarcations including DSM-5 presentations or symptom severity. These types showed stability over time and were distinguished by unique patterns of cardiac physiological response, resting-state functional brain connectivity, and clinical outcomes 1 year later. Results suggest that a biologically informed temperament-based typology, developed with a discovery-based community detection algorithm, provides a superior description of heterogeneity in the ADHD population than does any current clinical nosologic criteria. This demonstration sets the stage for more aggressive attempts at a tractable, biologically based nosology.

Telling stories and adding scores: Measuring resilience in young children affected by maternal HIV and AIDS.

PubMed

Ebersöhn, Liesel; Eloff, Irma; Finestone, Michelle; Grobler, Adri; Moen, Melanie

2015-01-01

"Telling stories and adding scores: Measuring resilience in young children affected by maternal HIV and AIDS", demonstrates how a concurrent mixed method design assisted cross-cultural comparison and ecological descriptions of resilience in young South African children, as well as validated alternative ways to measure resilience in young children. In a longitudinal randomised control trial, which investigated psychological resilience in mothers and children affected by HIV/AIDS, we combined a qualitative projective story-telling technique (Düss Fable) with quantitative data (Child Behaviour Checklist). The children mostly displayed adaptive resilience-related behaviours, although maladaptive behaviours were present. Participating children use internal (resolve/agency, positive future expectations, emotional intelligence) and external protective resources (material resources, positive institutions) to mediate adaptation. Children's maladaptive behaviours were exacerbated by internal (limited problem-solving skills, negative emotions) and external risk factors (chronic and cumulative adversity).

Use of laser ablation-inductively coupled plasma-time of flight-mass spectrometry to identify the elemental composition of vanilla and determine the geographic origin by discriminant function analysis.

PubMed

Hondrogiannis, Ellen M; Ehrlinger, Erin; Poplaski, Alyssa; Lisle, Meredith

2013-11-27

A total of 11 elements found in 25 vanilla samples from Uganda, Madagascar, Indonesia, and Papua New Guinea were measured by laser ablation-inductively coupled plasma-time-of-flight-mass spectrometry (LA-ICP-TOF-MS) for the purpose of collecting data that could be used to discriminate among the origins. Pellets were prepared of the samples, and elemental concentrations were obtained on the basis of external calibration curves created using five National Institute of Standards and Technology (NIST) standards and one Chinese standard with (13)C internal standardization. These curves were validated using NIST 1573a (tomato leaves) as a check standard. Discriminant analysis was used to successfully classify the vanilla samples by their origin. Our method illustrates the feasibility of using LA-ICP-TOF-MS with an external calibration curve for high-throughput screening of spice screening analysis.

Rice Crop Monitoring Using Microwave and Optical Remotely Sensed Image Data

NASA Astrophysics Data System (ADS)

Suga, Y.; Konishi, T.; Takeuchi, S.; Kitano, Y.; Ito, S.

Hiroshima Institute of Technology HIT is operating the direct down-links of microwave and optical satellite data in Japan This study focuses on the validation for rice crop monitoring using microwave and optical remotely sensed image data acquired by satellites referring to ground truth data such as height of crop ratio of crop vegetation cover and leaf area index in the test sites of Japan ENVISAT-1 ASAR data has a capability to capture regularly and to monitor during the rice growing cycle by alternating cross polarization mode images However ASAR data is influenced by several parameters such as landcover structure direction and alignment of rice crop fields in the test sites In this study the validation was carried out combined with microwave and optical satellite image data and ground truth data regarding rice crop fields to investigate the above parameters Multi-temporal multi-direction descending and ascending and multi-angle ASAR alternating cross polarization mode images were used to investigate rice crop growing cycle LANDSAT data were used to detect landcover structure direction and alignment of rice crop fields corresponding to the backscatter of ASAR As the result of this study it was indicated that rice crop growth can be precisely monitored using multiple remotely sensed data and ground truth data considering with spatial spectral temporal and radiometric resolutions

Multi-actuators vehicle collision avoidance system - Experimental validation

NASA Astrophysics Data System (ADS)

Hamid, Umar Zakir Abdul; Zakuan, Fakhrul Razi Ahmad; Akmal Zulkepli, Khairul; Zulfaqar Azmi, Muhammad; Zamzuri, Hairi; Rahman, Mohd Azizi Abdul; Aizzat Zakaria, Muhammad

2018-04-01

The Insurance Institute for Highway Safety (IIHS) of the United States of America in their reports has mentioned that a significant amount of the road mishaps would be preventable if more automated active safety applications are adopted into the vehicle. This includes the incorporation of collision avoidance system. The autonomous intervention by the active steering and braking systems in the hazardous scenario can aid the driver in mitigating the collisions. In this work, a real-time platform of a multi-actuators vehicle collision avoidance system is developed. It is a continuous research scheme to develop a fully autonomous vehicle in Malaysia. The vehicle is a modular platform which can be utilized for different research purposes and is denominated as Intelligent Drive Project (iDrive). The vehicle collision avoidance proposed design is validated in a controlled environment, where the coupled longitudinal and lateral motion control system is expected to provide desired braking and steering actuation in the occurrence of a frontal static obstacle. Results indicate the ability of the platform to yield multi-actuators collision avoidance navigation in the hazardous scenario, thus avoiding the obstacle. The findings of this work are beneficial for the development of a more complex and nonlinear real-time collision avoidance work in the future.

Future of External Reporting

ERIC Educational Resources Information Center

Powers, Kristina

2015-01-01

This chapter builds on prior chapters and focuses on higher education trends on the horizon and the resulting impact on external reporting for institutional researchers. Three practical recommendations and examples for institutional researchers are also presented.

External and Institutional Factors Affecting Community College Student-Transfer Activity.

ERIC Educational Resources Information Center

Banks, Debra L.

A study was conducted to identify the environmental conditions and relationships between external and institutional conditions that have a significant effect upon student transfer activity. A sample of 78 colleges in 15 states were selected from institutions participating in a national transfer project; 42% were located in Texas or California. The…

External Collaboration Patterns of Research Institutions Using Shared Publications in the Web of Science

ERIC Educational Resources Information Center

Toral, Sergio Luis; Bessis, Nik; Martinez-Torres, Maria del Rocio

2013-01-01

Purpose: During recent decades, research institutions have increased collaboration with other institutions since it is recognized as a good practice that improves their performance. However, they do not usually consider external collaborations as a strategic issue despite their benefits. The purpose of this paper consists of identifying different…

The Necessity of Environmental Scanning Prior to Long-Range Planning Activities at Higher Education Institutions.

ERIC Educational Resources Information Center

Handy, Ty J.

Formal environmental scanning procedures can provide key administrators of higher education institutions with valuable external information regarding both the probability and impact of external trends and forces. Such information may then be used in various strategic planning stages including scenario development, institutional mission and goals…

External validation of a Cox prognostic model: principles and methods

PubMed Central

2013-01-01

Background A prognostic model should not enter clinical practice unless it has been demonstrated that it performs a useful role. External validation denotes evaluation of model performance in a sample independent of that used to develop the model. Unlike for logistic regression models, external validation of Cox models is sparsely treated in the literature. Successful validation of a model means achieving satisfactory discrimination and calibration (prediction accuracy) in the validation sample. Validating Cox models is not straightforward because event probabilities are estimated relative to an unspecified baseline function. Methods We describe statistical approaches to external validation of a published Cox model according to the level of published information, specifically (1) the prognostic index only, (2) the prognostic index together with Kaplan-Meier curves for risk groups, and (3) the first two plus the baseline survival curve (the estimated survival function at the mean prognostic index across the sample). The most challenging task, requiring level 3 information, is assessing calibration, for which we suggest a method of approximating the baseline survival function. Results We apply the methods to two comparable datasets in primary breast cancer, treating one as derivation and the other as validation sample. Results are presented for discrimination and calibration. We demonstrate plots of survival probabilities that can assist model evaluation. Conclusions Our validation methods are applicable to a wide range of prognostic studies and provide researchers with a toolkit for external validation of a published Cox model. PMID:23496923

A nomogram for predicting complications in patients with solid tumours and seemingly stable febrile neutropenia.

PubMed

Fonseca, Paula Jiménez; Carmona-Bayonas, Alberto; García, Ignacio Matos; Marcos, Rosana; Castañón, Eduardo; Antonio, Maite; Font, Carme; Biosca, Mercè; Blasco, Ana; Lozano, Rebeca; Ramchandani, Avinash; Beato, Carmen; de Castro, Eva Martínez; Espinosa, Javier; Martínez-García, Jerónimo; Ghanem, Ismael; Cubero, Jorge Hernando; Manrique, Isabel Aragón; Navalón, Francisco García; Sevillano, Elena; Manzano, Aránzazu; Virizuela, Juan; Garrido, Marcelo; Mondéjar, Rebeca; Arcusa, María Ángeles; Bonilla, Yaiza; Pérez, Quionia; Gallardo, Elena; Del Carmen Soriano, Maria; Cardona, Mercè; Lasheras, Fernando Sánchez; Cruz, Juan Jesús; Ayala, Francisco

2016-05-24

We sought to develop and externally validate a nomogram and web-based calculator to individually predict the development of serious complications in seemingly stable adult patients with solid tumours and episodes of febrile neutropenia (FN). The data from the FINITE study (n=1133) and University of Salamanca Hospital (USH) FN registry (n=296) were used to develop and validate this tool. The main eligibility criterion was the presence of apparent clinical stability, defined as events without acute organ dysfunction, abnormal vital signs, or major infections. Discriminatory ability was measured as the concordance index and stratification into risk groups. The rate of infection-related complications in the FINITE and USH series was 13.4% and 18.6%, respectively. The nomogram used the following covariates: Eastern Cooperative Group (ECOG) Performance Status ⩾2, chronic obstructive pulmonary disease, chronic cardiovascular disease, mucositis of grade ⩾2 (National Cancer Institute Common Toxicity Criteria), monocytes <200/mm(3), and stress-induced hyperglycaemia. The nomogram predictions appeared to be well calibrated in both data sets (Hosmer-Lemeshow test, P>0.1). The concordance index was 0.855 and 0.831 in each series. Risk group stratification revealed a significant distinction in the proportion of complications. With a ⩾116-point cutoff, the nomogram yielded the following prognostic indices in the USH registry validation series: 66% sensitivity, 83% specificity, 3.88 positive likelihood ratio, 48% positive predictive value, and 91% negative predictive value. We have developed and externally validated a nomogram and web calculator to predict serious complications that can potentially impact decision-making in patients with seemingly stable FN.

Non-autonomous multi-rogue waves for spin-1 coupled nonlinear Gross-Pitaevskii equation and management by external potentials.

PubMed

Li, Li; Yu, Fajun

2017-09-06

We investigate non-autonomous multi-rogue wave solutions in a three-component(spin-1) coupled nonlinear Gross-Pitaevskii(GP) equation with varying dispersions, higher nonlinearities, gain/loss and external potentials. The similarity transformation allows us to relate certain class of multi-rogue wave solutions of the spin-1 coupled nonlinear GP equation to the solutions of integrable coupled nonlinear Schrödinger(CNLS) equation. We study the effect of time-dependent quadratic potential on the profile and dynamic of non-autonomous rogue waves. With certain requirement on the backgrounds, some non-autonomous multi-rogue wave solutions exhibit the different shapes with two peaks and dip in bright-dark rogue waves. Then, the managements with external potential and dynamic behaviors of these solutions are investigated analytically. The results could be of interest in such diverse fields as Bose-Einstein condensates, nonlinear fibers and super-fluids.

Diagnosis of acute respiratory distress syndrome by exhaled breath analysis

PubMed Central

2018-01-01

The acute respiratory distress syndrome (ARDS) is a complication of critical illness that is characterized by acute onset, protein rich, pulmonary edema. There is no treatment for ARDS, other than the reduction of additional ventilator induced lung injury. Prediction or earlier recognition of ARDS could result in preventive measurements and might decrease mortality and morbidity. Exhaled breath contains volatile organic compounds (VOCs), a collection of hundreds of small molecules linked to several physiological and pathophysiological processes. Analysis of exhaled breath through gas-chromatography and mass-spectrometry (GC-MS) has resulted in an accurate diagnosis of ARDS in several studies. Most identified markers are linked to lipid peroxidation. Octane is one of the few markers that was validated as a marker of ARDS and is pathophysiologically likely to be increased in ARDS. None of the currently studied breath analysis methods is directly applicable in clinical practice. Two steps have to be taken before any breath test can be allowed into the intensive care unit. External validation in a multi-center study is a prerequisite for any of the candidate breath markers and the breath test should outperform clinical prediction scores. Second, the technology for breath analysis should be adapted so that it is available at a decentralized lab inside the intensive care unit and can be operated by trained nurses, in order to reduce the analysis time. In conclusion, exhaled analysis might be used for the early diagnosis and prediction of ARDS in the near future but several obstacles have to be taken in the coming years. Most of the candidate markers can be linked to lipid peroxidation. Only octane has been validated in a temporal external validation cohort and is, at this moment, the top-ranking breath biomarker for ARDS. PMID:29430450

Positioning and aligning CNTs by external magnetic field to assist localised epoxy cure

NASA Astrophysics Data System (ADS)

Ariu, G.; Hamerton, I.; Ivanov, D.

2016-01-01

This work focuses on the generation of conductive networks through the localised alignment of nano fillers, such as multi-walled carbon nanotubes (MWCNTs). The feasibility of alignment and positioning of functionalised MWCNTs by external DC magnetic fields was investigated. The aim of this manipulation is to enhance resin curing through AC induction heating due to hysteresis losses from the nanotubes. Experimental analyses focused on in-depth assessment of the nanotube functionalisation, processing and characterisation of magnetic, rheological and cure kinetics properties of the MWCNT solution. The study has shown that an external magnetic field has great potential for positioning and alignment of CNTs. The study demonstrated potential for creating well-ordered architectures with an unprecedented level of control of network geometry. Magnetic characterisation indicated cobalt-plated nanotubes to be the most suitable candidate for magnetic alignment due to their high magnetic sensitivity. Epoxy/metal-plated CNT nanocomposite systems were validated by thermal analysis as induction heating mediums. The curing process could therefore be optimised by the use of dielectric resins. This study offers a first step towards the proof of concept of this technique as a novel repair technology.

Hospital acquisitions, parenting styles and management accounting change: An institutional perspective.

PubMed

Dossi, Andrea; Lecci, Francesca; Longo, Francesco; Morelli, Marco

2017-02-01

Many healthcare scholars have applied institutional theories to the study of management accounting systems (MAS) change. However, little attention has been devoted to MAS change within groups. Kostova et al. highlight the limitations of traditional institutional frameworks in studying groups since they are characterised not only by the existence of external institutional environments but also by intra-organisational (meso-level) ones. Given this background, the research question is: how does the meso-level institutional environment affect MAS change in healthcare groups? We use a longitudinal multiple-case study design to understand the role of headquarters in shaping local MAS change. We would expect companies to adopt similar MAS. However, we argue that the relationship between external institutions and MAS change cannot be wholly understood without taking into consideration the role of headquarters. Our analysis shows how hospitals facing the same external institutional environment implement different MAS as a consequence of different parenting styles. From a scientific perspective, our article contributes to broaden traditional institutional theoretical frameworks.

Analysis of model development strategies: predicting ventral hernia recurrence.

PubMed

Holihan, Julie L; Li, Linda T; Askenasy, Erik P; Greenberg, Jacob A; Keith, Jerrod N; Martindale, Robert G; Roth, J Scott; Liang, Mike K

2016-11-01

There have been many attempts to identify variables associated with ventral hernia recurrence; however, it is unclear which statistical modeling approach results in models with greatest internal and external validity. We aim to assess the predictive accuracy of models developed using five common variable selection strategies to determine variables associated with hernia recurrence. Two multicenter ventral hernia databases were used. Database 1 was randomly split into "development" and "internal validation" cohorts. Database 2 was designated "external validation". The dependent variable for model development was hernia recurrence. Five variable selection strategies were used: (1) "clinical"-variables considered clinically relevant, (2) "selective stepwise"-all variables with a P value <0.20 were assessed in a step-backward model, (3) "liberal stepwise"-all variables were included and step-backward regression was performed, (4) "restrictive internal resampling," and (5) "liberal internal resampling." Variables were included with P < 0.05 for the Restrictive model and P < 0.10 for the Liberal model. A time-to-event analysis using Cox regression was performed using these strategies. The predictive accuracy of the developed models was tested on the internal and external validation cohorts using Harrell's C-statistic where C > 0.70 was considered "reasonable". The recurrence rate was 32.9% (n = 173/526; median/range follow-up, 20/1-58 mo) for the development cohort, 36.0% (n = 95/264, median/range follow-up 20/1-61 mo) for the internal validation cohort, and 12.7% (n = 155/1224, median/range follow-up 9/1-50 mo) for the external validation cohort. Internal validation demonstrated reasonable predictive accuracy (C-statistics = 0.772, 0.760, 0.767, 0.757, 0.763), while on external validation, predictive accuracy dipped precipitously (C-statistic = 0.561, 0.557, 0.562, 0.553, 0.560). Predictive accuracy was equally adequate on internal validation among models; however, on external validation, all five models failed to demonstrate utility. Future studies should report multiple variable selection techniques and demonstrate predictive accuracy on external data sets for model validation. Copyright © 2016 Elsevier Inc. All rights reserved.

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 3 2014-07-01 2014-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 3 2013-07-01 2013-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 3 2012-07-01 2012-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

34 CFR 675.34 - Multi-Institutional job location and development programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Multi-Institutional job location and development... (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Job Location and Development Program § 675.34 Multi-Institutional job location and development programs. (a) An...

Simultaneous quantitative analysis of main components in linderae reflexae radix with one single marker.

PubMed

Wang, Li-Li; Zhang, Yun-Bin; Sun, Xiao-Ya; Chen, Sui-Qing

2016-05-08

Establish a quantitative analysis of multi-components by the single marker (QAMS) method for quality evaluation and validate its feasibilities by the simultaneous quantitative assay of four main components in Linderae Reflexae Radix. Four main components of pinostrobin, pinosylvin, pinocembrin, and 3,5-dihydroxy-2-(1- p -mentheneyl)- trans -stilbene were selected as analytes to evaluate the quality by RP-HPLC coupled with a UV-detector. The method was evaluated by a comparison of the quantitative results between the external standard method and QAMS with a different HPLC system. The results showed that no significant differences were found in the quantitative results of the four contents of Linderae Reflexae Radix determined by the external standard method and QAMS (RSD <3%). The contents of four analytes (pinosylvin, pinocembrin, pinostrobin, and Reflexanbene I) in Linderae Reflexae Radix were determined by the single marker of pinosylvin. This fingerprint was the spectra determined by Shimadzu LC-20AT and Waters e2695 HPLC that were equipped with three different columns.

Optimal External Wrench Distribution During a Multi-Contact Sit-to-Stand Task.

PubMed

Bonnet, Vincent; Azevedo-Coste, Christine; Robert, Thomas; Fraisse, Philippe; Venture, Gentiane

2017-07-01

This paper aims at developing and evaluating a new practical method for the real-time estimate of joint torques and external wrenches during multi-contact sit-to-stand (STS) task using kinematics data only. The proposed method allows also identifying subject specific body inertial segment parameters that are required to perform inverse dynamics. The identification phase is performed using simple and repeatable motions. Thanks to an accurately identified model the estimate of the total external wrench can be used as an input to solve an under-determined multi-contact problem. It is solved using a constrained quadratic optimization process minimizing a hybrid human-like energetic criterion. The weights of this hybrid cost function are adjusted and a sensitivity analysis is performed in order to reproduce robustly human external wrench distribution. The results showed that the proposed method could successfully estimate the external wrenches under buttocks, feet, and hands during STS tasks (RMS error lower than 20 N and 6 N.m). The simplicity and generalization abilities of the proposed method allow paving the way of future diagnosis solutions and rehabilitation applications, including in-home use.

[Mission statements of Dutch mental health institutions; the quality of communication with stakeholders].

PubMed

Krol, D G H; de Kruif, J

2013-01-01

As a result of recent reforms in Dutch health care, healthcare providers are having to operate more and more like commercial organisations and adopt some of the rules prevailing in the profit sector. Because missions statements can be an efficient means of useful communication with internal and external stakeholders they can make a useful contribution to the way healthcare institutions are managed and to their status and reputation. Research shows that in view of this the quality of the messages conveyed via mission statements is important. To ascertain which stakeholders are mentioned in the mission statements of Dutch mental healthcare providers and to quantify the quality of the messages conveyed to them via mission statements. We examined the mission statements of 34 mental health providers to find out which stakeholders were included. The message conveyed to the stakeholders was quantified by means of a validated measuring instrument devised specifically for this purpose. Patients were referred to in all mission statements and the quality of the messages conveyed was of higher quality than the messages conveyed to other stakeholders. Other important stakeholders on whom the institutions depended were referred to much less frequently and the quality of sections of text referring to them was definitely inferior. Mission statements frequently serve as management tool for Dutch mental healthcare providers. The potential benefits that these statements could bestow on the providers are not being fully exploited because the standard of communication with several internal and external stakeholders is of poor quality.

Evolution of Precipitation Particle Size Distributions within MC3E Systems and its Impact on Aerosol-Cloud-Precipitation Interactions: Final Report

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

Kollias, Pavlos

2017-08-08

This is a multi-institutional, collaborative project using observations and modeling to study the evolution (e.g. formation and growth) of hydrometeors in continental convective clouds. Our contribution was in data analysis for the generation of high-value cloud and precipitation products and derive cloud statistics for model validation. There are two areas in data analysis that we contributed: i) the development of novel, state-of-the-art dual-wavelength radar algorithms for the retrieval of cloud microphysical properties and ii) the evaluation of large domain, high-resolution models using comprehensive multi-sensor observations. Our research group developed statistical summaries from numerous sensors and developed retrievals of vertical airmore » motion in deep convection.« less

Foreign direct investment, institutional development, and environmental externalities: evidence from China.

PubMed

Wang, Danny T; Chen, Wendy Y

2014-03-15

The question of how foreign direct investment (FDI) affects a host country's natural environment has generated much debate but little consensus. Building on an institution-based theory, this article examines how the institutional development of a host setting affects the degree of FDI-related environmental externalities in China (specifically, industrial sulfur dioxide emissions). With a panel data set of 287 Chinese cities, over the period 2002-2009, this study reveals that FDI in general induces negative environmental externalities. Investments from OECD countries increase sulfur dioxide emissions, whereas FDI from Hong Kong, Macau, and Taiwan shows no significant effect. Institutional development reduces the impacts of FDI across the board. By focusing on the moderating role of institutions, this study sheds new light on the long-debated relationships among FDI, institutions, and the environments of the host countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

External validation of the DHAKA score and comparison with the current IMCI algorithm for the assessment of dehydration in children with diarrhoea: a prospective cohort study.

PubMed

Levine, Adam C; Glavis-Bloom, Justin; Modi, Payal; Nasrin, Sabiha; Atika, Bita; Rege, Soham; Robertson, Sarah; Schmid, Christopher H; Alam, Nur H

2016-10-01

Dehydration due to diarrhoea is a leading cause of child death worldwide, yet no clinical tools for assessing dehydration have been validated in resource-limited settings. The Dehydration: Assessing Kids Accurately (DHAKA) score was derived for assessing dehydration in children with diarrhoea in a low-income country setting. In this study, we aimed to externally validate the DHAKA score in a new population of children and compare its accuracy and reliability to the current Integrated Management of Childhood Illness (IMCI) algorithm. DHAKA was a prospective cohort study done in children younger than 60 months presenting to the International Centre for Diarrhoeal Disease Research, Bangladesh, with acute diarrhoea (defined by WHO as three or more loose stools per day for less than 14 days). Local nurses assessed children and classified their dehydration status using both the DHAKA score and the IMCI algorithm. Serial weights were obtained and dehydration status was established by percentage weight change with rehydration. We did regression analyses to validate the DHAKA score and compared the accuracy and reliability of the DHAKA score and IMCI algorithm with receiver operator characteristic (ROC) curves and the weighted κ statistic. This study was registered with ClinicalTrials.gov, number NCT02007733. Between March 22, 2015, and May 15, 2015, 496 patients were included in our primary analyses. On the basis of our criterion standard, 242 (49%) of 496 children had no dehydration, 184 (37%) of 496 had some dehydration, and 70 (14%) of 496 had severe dehydration. In multivariable regression analyses, each 1-point increase in the DHAKA score predicted an increase of 0·6% in the percentage dehydration of the child and increased the odds of both some and severe dehydration by a factor of 1·4. Both the accuracy and reliability of the DHAKA score were significantly greater than those of the IMCI algorithm. The DHAKA score is the first clinical tool for assessing dehydration in children with acute diarrhoea to be externally validated in a low-income country. Further validation studies in a diverse range of settings and paediatric populations are warranted. National Institutes of Health Fogarty International Center. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

External validation of the DHAKA score and comparison with the current IMCI algorithm for the assessment of dehydration in children with diarrhoea: a prospective cohort study

PubMed Central

Levine, Adam C; Glavis-Bloom, Justin; Modi, Payal; Nasrin, Sabiha; Atika, Bita; Rege, Soham; Robertson, Sarah; Schmid, Christopher H; Alam, Nur H

2016-01-01

Summary Background Dehydration due to diarrhoea is a leading cause of child death worldwide, yet no clinical tools for assessing dehydration have been validated in resource-limited settings. The Dehydration: Assessing Kids Accurately (DHAKA) score was derived for assessing dehydration in children with diarrhoea in a low-income country setting. In this study, we aimed to externally validate the DHAKA score in a new population of children and compare its accuracy and reliability to the current Integrated Management of Childhood Illness (IMCI) algorithm. Methods DHAKA was a prospective cohort study done in children younger than 60 months presenting to the International Centre for Diarrhoeal Disease Research, Bangladesh, with acute diarrhoea (defined by WHO as three or more loose stools per day for less than 14 days). Local nurses assessed children and classified their dehydration status using both the DHAKA score and the IMCI algorithm. Serial weights were obtained and dehydration status was established by percentage weight change with rehydration. We did regression analyses to validate the DHAKA score and compared the accuracy and reliability of the DHAKA score and IMCI algorithm with receiver operator characteristic (ROC) curves and the weighted κ statistic. This study was registered with ClinicalTrials.gov, number NCT02007733. Findings Between March 22, 2015, and May 15, 2015, 496 patients were included in our primary analyses. On the basis of our criterion standard, 242 (49%) of 496 children had no dehydration, 184 (37%) of 496 had some dehydration, and 70 (14%) of 496 had severe dehydration. In multivariable regression analyses, each 1-point increase in the DHAKA score predicted an increase of 0·6% in the percentage dehydration of the child and increased the odds of both some and severe dehydration by a factor of 1·4. Both the accuracy and reliability of the DHAKA score were significantly greater than those of the IMCI algorithm. Interpretation The DHAKA score is the first clinical tool for assessing dehydration in children with acute diarrhoea to be externally validated in a low-income country. Further validation studies in a diverse range of settings and paediatric populations are warranted. Funding National Institutes of Health Fogarty International Center. PMID:27567350

Recurrence patterns and survival endpoints in women with stage II uterine endometrioid carcinoma: a multi-institution study.

PubMed

Elshaikh, Mohamed A; Al-Wahab, Zaid; Mahdi, Haider; Albuquerque, Kevin; Mahan, Meredith; Kehoe, Siobhan M; Ali-Fehmi, Rouba; Rose, Peter G; Munkarah, Adnan R

2015-02-01

There is paucity of data in regard to prognostic factors and outcome of women with 2009 FIGO stage II disease. The objective of this study was to investigate prognostic factors, recurrence patterns and survival endpoints in this group of patients. Data from four academic institutions were analyzed. 130 women were identified with 2009 FIGO stage II. All patients underwent hysterectomy, oophorectomy and lymph node evaluation with or without pelvic and paraaortic lymph node dissections and peritoneal cytology. The Kaplan-Meier approach and Cox regression analysis were used to estimate recurrence-free (RFS), disease-specific (DSS) and overall survival (OS). Median follow-up was 44months. 120 patients (92%) underwent simple hysterectomy, 78% had lymph node dissection and 95% had peritoneal cytology examination. 99 patients (76%) received adjuvant radiation treatment (RT). 5-year RFS, DSS and OS were 77%, 90%, and 72%, respectively. On multivariate analysis of RFS, adjuvant RT, the presence of lymphovascular space invasion (LVSI) and high tumor grades were significant predictors. For DSS, LVSI and high tumor grades were significant predictors while older age and high tumor grade were the only predictors of OS. In this multi-institutional study, disease-specific survival for women with FIGO stage II uterine endometrioid carcinoma is excellent. High tumor grade, lymphovascular space invasion, adjuvant radiation treatment and old age are important prognostic factors. There was no significant difference in the outcome between patients who received vaginal cuff brachytherapy compared to those who received pelvic external beam radiation treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

Siblings versus Parents and Friends: Longitudinal Linkages to Adolescent Externalizing Problems

ERIC Educational Resources Information Center

Defoe, Ivy N.; Keijsers, Loes; Hawk, Skyler T.; Branje, Susan; Dubas, Judith Semon; Buist, Kirsten; Frijns, Tom; van Aken, Marcel A. G.; Koot, Hans M.; van Lier, Pol A. C.; Meeus, Wim

2013-01-01

Background: It is well documented that friends' externalizing problems and negative parent-child interactions predict externalizing problems in adolescence, but relatively little is known about the role of siblings. This four-wave, multi-informant study investigated linkages of siblings' externalizing problems and sibling-adolescent negative…

Using component technology to facilitate external software reuse in ground-based planning systems

NASA Technical Reports Server (NTRS)

Chase, A.

2003-01-01

APGEN (Activity Plan GENerator - 314), a multi-mission planning tool, must interface with external software to vest serve its users. AP-GEN's original method for incorporating external software, the User-Defined library mechanism, has been very successful in allowing APGEN users access to external software functionality.

Influence of energy alternatives and carbon emissions on an institution's green reputation.

PubMed

Komarek, Timothy M; Lupi, Frank; Kaplowitz, Michael D; Thorp, Laurie

2013-10-15

Institutions' reputation for being environmentally friendly or 'green' can come from many sources. This paper examines how the attributes of alternative energy management plans impact an institutions' 'green' reputation by focusing on the interaction between 'external' and 'internal' influences. Some 'external' influences on environmental reputation we studied include the institution's mix of fuels, energy conservation effort, carbon emissions targets, investment time-frame, and program cost. The 'internal' influences on institutions' green reputation we examined include altruism (respondents' concern for the welfare of others) and environmentalism (respondents' concern for the environment). Using a stated-preference conjoint survey, we empirically examine how attributes of alternative energy management plans influence a large, research university's 'green' reputation. Our results show that constituents benefit from their institution's green reputation and that the energy management choices of the institution can significantly influence its perceived green reputation. Furthermore, integrating internal and external influences on reputation can create more informative models and better decision-making. Copyright © 2013 Elsevier Ltd. All rights reserved.

Validation of a Predictive Scoring System for Deep Sternal Wound Infection after Bilateral Internal Thoracic Artery Grafting in a Cohort of French Patients.

PubMed

Perrotti, Andrea; Gatti, Giuseppe; Dorigo, Enrica; Sinagra, Gianfranco; Pappalardo, Aniello; Chocron, Sidney

The Gatti score is a weighted scoring system based on risk factors for deep sternal wound infection (DSWI) that was created in an Italian center to predict DSWI risk after bilateral internal thoracic artery (BITA) grafting. No external evaluation based on validation samples derived from other surgical centers has been performed. The aim of this study is to perform this validation. During 2015, BITA grafts were used as skeletonized conduits in all 255 consecutive patients with multi-vessel coronary disease who underwent isolated coronary bypass surgery at the Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France. Baseline characteristics, operative data, and immediate outcomes of every patient were collected prospectively. A DSWI risk score was assigned to each patient pre-operatively. The discrimination power of both models, pre-operative and combined, of the Gatti score was assessed with the calculation of the area under the receiver operating characteristic curve. Fourteen (5.5%) patients had DSWI. Major differences both as the baseline characteristics of patients and surgical techniques were found between this series and the original series from which the Gatti score was derived. The area under the receiver operating characteristic curve was 0.78 (95% confidence interval: 0.64-0.92) for the pre-operative model and 0.84 (95% confidence interval: 0.69-0.98) for the combined model. The Gatti score has proven to be effective even in a cohort of French patients despite major differences from the original Italian series. Multi-center validation studies must be performed before introducing the score into clinical practice.

Circulation Policies for External Users: A Comparative Study of Public Urban Research Institutions

ERIC Educational Resources Information Center

Weare, William H., Jr.; Stevenson, Matthew

2012-01-01

This article is a study of the policies that govern the use of the university library by external users at Indiana University-Purdue University Indianapolis (IUPUI) and 12 peer institutions used by IUPUI for comparative purposes. A search of each institution's Web site was conducted as well as interviews with circulation librarians and managers.…

Deep Learning to Classify Radiology Free-Text Reports.

PubMed

Chen, Matthew C; Ball, Robyn L; Yang, Lingyao; Moradzadeh, Nathaniel; Chapman, Brian E; Larson, David B; Langlotz, Curtis P; Amrhein, Timothy J; Lungren, Matthew P

2018-03-01

Purpose To evaluate the performance of a deep learning convolutional neural network (CNN) model compared with a traditional natural language processing (NLP) model in extracting pulmonary embolism (PE) findings from thoracic computed tomography (CT) reports from two institutions. Materials and Methods Contrast material-enhanced CT examinations of the chest performed between January 1, 1998, and January 1, 2016, were selected. Annotations by two human radiologists were made for three categories: the presence, chronicity, and location of PE. Classification of performance of a CNN model with an unsupervised learning algorithm for obtaining vector representations of words was compared with the open-source application PeFinder. Sensitivity, specificity, accuracy, and F1 scores for both the CNN model and PeFinder in the internal and external validation sets were determined. Results The CNN model demonstrated an accuracy of 99% and an area under the curve value of 0.97. For internal validation report data, the CNN model had a statistically significant larger F1 score (0.938) than did PeFinder (0.867) when classifying findings as either PE positive or PE negative, but no significant difference in sensitivity, specificity, or accuracy was found. For external validation report data, no statistical difference between the performance of the CNN model and PeFinder was found. Conclusion A deep learning CNN model can classify radiology free-text reports with accuracy equivalent to or beyond that of an existing traditional NLP model. © RSNA, 2017 Online supplemental material is available for this article.

Feasibility of establishing a biosafety level 3 tuberculosis culture laboratory of acceptable quality standards in a resource-limited setting: an experience from Uganda.

PubMed

Ssengooba, Willy; Gelderbloem, Sebastian J; Mboowa, Gerald; Wajja, Anne; Namaganda, Carolyn; Musoke, Philippa; Mayanja-Kizza, Harriet; Joloba, Moses Lutaakome

2015-01-15

Despite the recent innovations in tuberculosis (TB) and multi-drug resistant TB (MDR-TB) diagnosis, culture remains vital for difficult-to-diagnose patients, baseline and end-point determination for novel vaccines and drug trials. Herein, we share our experience of establishing a BSL-3 culture facility in Uganda as well as 3-years performance indicators and post-TB vaccine trials (pioneer) and funding experience of sustaining such a facility. Between September 2008 and April 2009, the laboratory was set-up with financial support from external partners. After an initial procedure validation phase in parallel with the National TB Reference Laboratory (NTRL) and legal approvals, the laboratory registered for external quality assessment (EQA) from the NTRL, WHO, National Health Laboratories Services (NHLS), and the College of American Pathologists (CAP). The laboratory also instituted a functional quality management system (QMS). Pioneer funding ended in 2012 and the laboratory remained in self-sustainability mode. The laboratory achieved internationally acceptable standards in both structural and biosafety requirements. Of the 14 patient samples analyzed in the procedural validation phase, agreement for all tests with NTRL was 90% (P <0.01). It started full operations in October 2009 performing smear microscopy, culture, identification, and drug susceptibility testing (DST). The annual culture workload was 7,636, 10,242, and 2,712 inoculations for the years 2010, 2011, and 2012, respectively. Other performance indicators of TB culture laboratories were also monitored. Scores from EQA panels included smear microscopy >80% in all years from NTRL, CAP, and NHLS, and culture was 100% for CAP panels and above regional average scores for all years with NHLS. Quarterly DST scores from WHO-EQA ranged from 78% to 100% in 2010, 80% to 100% in 2011, and 90 to 100% in 2012. From our experience, it is feasible to set-up a BSL-3 TB culture laboratory with acceptable quality performance standards in resource-limited countries. With the demonstrated quality of work, the laboratory attracted more research groups and post-pioneer funding, which helped to ensure sustainability. The high skilled experts in this research laboratory also continue to provide an excellent resource for the needed national discussion of the laboratory and quality management systems.

A multi-site cognitive task analysis for biomedical query mediation.

PubMed

Hruby, Gregory W; Rasmussen, Luke V; Hanauer, David; Patel, Vimla L; Cimino, James J; Weng, Chunhua

2016-09-01

To apply cognitive task analyses of the Biomedical query mediation (BQM) processes for EHR data retrieval at multiple sites towards the development of a generic BQM process model. We conducted semi-structured interviews with eleven data analysts from five academic institutions and one government agency, and performed cognitive task analyses on their BQM processes. A coding schema was developed through iterative refinement and used to annotate the interview transcripts. The annotated dataset was used to reconstruct and verify each BQM process and to develop a harmonized BQM process model. A survey was conducted to evaluate the face and content validity of this harmonized model. The harmonized process model is hierarchical, encompassing tasks, activities, and steps. The face validity evaluation concluded the model to be representative of the BQM process. In the content validity evaluation, out of the 27 tasks for BQM, 19 meet the threshold for semi-valid, including 3 fully valid: "Identify potential index phenotype," "If needed, request EHR database access rights," and "Perform query and present output to medical researcher", and 8 are invalid. We aligned the goals of the tasks within the BQM model with the five components of the reference interview. The similarity between the process of BQM and the reference interview is promising and suggests the BQM tasks are powerful for eliciting implicit information needs. We contribute a BQM process model based on a multi-site study. This model promises to inform the standardization of the BQM process towards improved communication efficiency and accuracy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Multi-Site Cognitive Task Analysis for Biomedical Query Mediation

PubMed Central

Hruby, Gregory W.; Rasmussen, Luke V.; Hanauer, David; Patel, Vimla; Cimino, James J.; Weng, Chunhua

2016-01-01

Objective To apply cognitive task analyses of the Biomedical query mediation (BQM) processes for EHR data retrieval at multiple sites towards the development of a generic BQM process model. Materials and Methods We conducted semi-structured interviews with eleven data analysts from five academic institutions and one government agency, and performed cognitive task analyses on their BQM processes. A coding schema was developed through iterative refinement and used to annotate the interview transcripts. The annotated dataset was used to reconstruct and verify each BQM process and to develop a harmonized BQM process model. A survey was conducted to evaluate the face and content validity of this harmonized model. Results The harmonized process model is hierarchical, encompassing tasks, activities, and steps. The face validity evaluation concluded the model to be representative of the BQM process. In the content validity evaluation, out of the 27 tasks for BQM, 19 meet the threshold for semi-valid, including 3 fully valid: “Identify potential index phenotype,” “If needed, request EHR database access rights,” and “Perform query and present output to medical researcher”, and 8 are invalid. Discussion We aligned the goals of the tasks within the BQM model with the five components of the reference interview. The similarity between the process of BQM and the reference interview is promising and suggests the BQM tasks are powerful for eliciting implicit information needs. Conclusions We contribute a BQM process model based on a multi-site study. This model promises to inform the standardization of the BQM process towards improved communication efficiency and accuracy. PMID:27435950

Derivation and validation of in-hospital mortality prediction models in ischaemic stroke patients using administrative data.

PubMed

Lee, Jason; Morishima, Toshitaka; Kunisawa, Susumu; Sasaki, Noriko; Otsubo, Tetsuya; Ikai, Hiroshi; Imanaka, Yuichi

2013-01-01

Stroke and other cerebrovascular diseases are a major cause of death and disability. Predicting in-hospital mortality in ischaemic stroke patients can help to identify high-risk patients and guide treatment approaches. Chart reviews provide important clinical information for mortality prediction, but are laborious and limiting in sample sizes. Administrative data allow for large-scale multi-institutional analyses but lack the necessary clinical information for outcome research. However, administrative claims data in Japan has seen the recent inclusion of patient consciousness and disability information, which may allow more accurate mortality prediction using administrative data alone. The aim of this study was to derive and validate models to predict in-hospital mortality in patients admitted for ischaemic stroke using administrative data. The sample consisted of 21,445 patients from 176 Japanese hospitals, who were randomly divided into derivation and validation subgroups. Multivariable logistic regression models were developed using 7- and 30-day and overall in-hospital mortality as dependent variables. Independent variables included patient age, sex, comorbidities upon admission, Japan Coma Scale (JCS) score, Barthel Index score, modified Rankin Scale (mRS) score, and admissions after hours and on weekends/public holidays. Models were developed in the derivation subgroup, and coefficients from these models were applied to the validation subgroup. Predictive ability was analysed using C-statistics; calibration was evaluated with Hosmer-Lemeshow χ(2) tests. All three models showed predictive abilities similar or surpassing that of chart review-based models. The C-statistics were highest in the 7-day in-hospital mortality prediction model, at 0.906 and 0.901 in the derivation and validation subgroups, respectively. For the 30-day in-hospital mortality prediction models, the C-statistics for the derivation and validation subgroups were 0.893 and 0.872, respectively; in overall in-hospital mortality prediction these values were 0.883 and 0.876. In this study, we have derived and validated in-hospital mortality prediction models for three different time spans using a large population of ischaemic stroke patients in a multi-institutional analysis. The recent inclusion of JCS, Barthel Index, and mRS scores in Japanese administrative data has allowed the prediction of in-hospital mortality with accuracy comparable to that of chart review analyses. The models developed using administrative data had consistently high predictive abilities for all models in both the derivation and validation subgroups. These results have implications in the role of administrative data in future mortality prediction analyses. Copyright © 2013 S. Karger AG, Basel.

Interaction of Theory and Practice to Assess External Validity.

PubMed

Leviton, Laura C; Trujillo, Mathew D

2016-01-18

Variations in local context bedevil the assessment of external validity: the ability to generalize about effects of treatments. For evaluation, the challenges of assessing external validity are intimately tied to the translation and spread of evidence-based interventions. This makes external validity a question for decision makers, who need to determine whether to endorse, fund, or adopt interventions that were found to be effective and how to ensure high quality once they spread. To present the rationale for using theory to assess external validity and the value of more systematic interaction of theory and practice. We review advances in external validity, program theory, practitioner expertise, and local adaptation. Examples are provided for program theory, its adaptation to diverse contexts, and generalizing to contexts that have not yet been studied. The often critical role of practitioner experience is illustrated in these examples. Work is described that the Robert Wood Johnson Foundation is supporting to study treatment variation and context more systematically. Researchers and developers generally see a limited range of contexts in which the intervention is implemented. Individual practitioners see a different and often a wider range of contexts, albeit not a systematic sample. Organized and taken together, however, practitioner experiences can inform external validity by challenging the developers and researchers to consider a wider range of contexts. Researchers have developed a variety of ways to adapt interventions in light of such challenges. In systematic programs of inquiry, as opposed to individual studies, the problems of context can be better addressed. Evaluators have advocated an interaction of theory and practice for many years, but the process can be made more systematic and useful. Systematic interaction can set priorities for assessment of external validity by examining the prevalence and importance of context features and treatment variations. Practitioner interaction with researchers and developers can assist in sharpening program theory, reducing uncertainty about treatment variations that are consistent or inconsistent with the theory, inductively ruling out the ones that are harmful or irrelevant, and helping set priorities for more rigorous study of context and treatment variation. © The Author(s) 2016.

Development and validation of a nomogram to estimate the pretest probability of cancer in Chinese patients with solid solitary pulmonary nodules: A multi-institutional study.

PubMed

She, Yunlang; Zhao, Lilan; Dai, Chenyang; Ren, Yijiu; Jiang, Gening; Xie, Huikang; Zhu, Huiyuan; Sun, Xiwen; Yang, Ping; Chen, Yongbing; Shi, Shunbin; Shi, Weirong; Yu, Bing; Xie, Dong; Chen, Chang

2017-11-01

To develop and validate a nomogram to estimate the pretest probability of malignancy in Chinese patients with solid solitary pulmonary nodule (SPN). A primary cohort of 1798 patients with pathologically confirmed solid SPNs after surgery was retrospectively studied at five institutions from January 2014 to December 2015. A nomogram based on independent prediction factors of malignant solid SPN was developed. Predictive performance also was evaluated using the calibration curve and the area under the receiver operating characteristic curve (AUC). The mean age of the cohort was 58.9 ± 10.7 years. In univariate and multivariate analysis, age; history of cancer; the log base 10 transformations of serum carcinoembryonic antigen value; nodule diameter; the presence of spiculation, pleural indentation, and calcification remained the predictive factors of malignancy. A nomogram was developed, and the AUC value (0.85; 95%CI, 0.83-0.88) was significantly higher than other three models. The calibration cure showed optimal agreement between the malignant probability as predicted by nomogram and the actual probability. We developed and validated a nomogram that can estimate the pretest probability of malignant solid SPNs, which can assist clinical physicians to select and interpret the results of subsequent diagnostic tests. © 2017 Wiley Periodicals, Inc.

Quantum dot SOA/silicon external cavity multi-wavelength laser.

PubMed

Zhang, Yi; Yang, Shuyu; Zhu, Xiaoliang; Li, Qi; Guan, Hang; Magill, Peter; Bergman, Keren; Baehr-Jones, Thomas; Hochberg, Michael

2015-02-23

We report a hybrid integrated external cavity, multi-wavelength laser for high-capacity data transmission operating near 1310 nm. This is the first demonstration of a single cavity multi-wavelength laser in silicon to our knowledge. The device consists of a quantum dot reflective semiconductor optical amplifier and a silicon-on-insulator chip with a Sagnac loop mirror and microring wavelength filter. We show four major lasing peaks from a single cavity with less than 3 dB power non-uniformity and demonstrate error-free 4 × 10 Gb/s data transmission.

Assessment of generalizability, applicability and predictability (GAP) for evaluating external validity in studies of universal family-based prevention of alcohol misuse in young people: systematic methodological review of randomized controlled trials.

PubMed

Fernandez-Hermida, Jose Ramon; Calafat, Amador; Becoña, Elisardo; Tsertsvadze, Alexander; Foxcroft, David R

2012-09-01

To assess external validity characteristics of studies from two Cochrane Systematic Reviews of the effectiveness of universal family-based prevention of alcohol misuse in young people. Two reviewers used an a priori developed external validity rating form and independently assessed three external validity dimensions of generalizability, applicability and predictability (GAP) in randomized controlled trials. The majority (69%) of the included 29 studies were rated 'unclear' on the reporting of sufficient information for judging generalizability from sample to study population. Ten studies (35%) were rated 'unclear' on the reporting of sufficient information for judging applicability to other populations and settings. No study provided an assessment of the validity of the trial end-point measures for subsequent mortality, morbidity, quality of life or other economic or social outcomes. Similarly, no study reported on the validity of surrogate measures using established criteria for assessing surrogate end-points. Studies evaluating the benefits of family-based prevention of alcohol misuse in young people are generally inadequate at reporting information relevant to generalizability of the findings or implications for health or social outcomes. Researchers, study authors, peer reviewers, journal editors and scientific societies should take steps to improve the reporting of information relevant to external validity in prevention trials. © 2012 The Authors. Addiction © 2012 Society for the Study of Addiction.

Autonomous quantum to classical transitions and the generalized imaging theorem

NASA Astrophysics Data System (ADS)

Briggs, John S.; Feagin, James M.

2016-03-01

The mechanism of the transition of a dynamical system from quantum to classical mechanics is of continuing interest. Practically it is of importance for the interpretation of multi-particle coincidence measurements performed at macroscopic distances from a microscopic reaction zone. Here we prove the generalized imaging theorem which shows that the spatial wave function of any multi-particle quantum system, propagating over distances and times large on an atomic scale but still microscopic, and subject to deterministic external fields and particle interactions, becomes proportional to the initial momentum wave function where the position and momentum coordinates define a classical trajectory. Currently, the quantum to classical transition is considered to occur via decoherence caused by stochastic interaction with an environment. The imaging theorem arises from unitary Schrödinger propagation and so is valid without any environmental interaction. It implies that a simultaneous measurement of both position and momentum will define a unique classical trajectory, whereas a less complete measurement of say position alone can lead to quantum interference effects.

Autonomous quantum to classical transitions and the generalized imaging theorem

DOE PAGES

Briggs, John S.; Feagin, James M.

2016-03-16

The mechanism of the transition of a dynamical system from quantum to classical mechanics is of continuing interest. Practically it is of importance for the interpretation of multi-particle coincidence measurements performed at macroscopic distances from a microscopic reaction zone. We prove the generalized imaging theorem which shows that the spatial wave function of any multi-particle quantum system, propagating over distances and times large on an atomic scale but still microscopic, and subject to deterministic external fields and particle interactions, becomes proportional to the initial momentum wave function where the position and momentum coordinates define a classical trajectory. Now, the quantummore » to classical transition is considered to occur via decoherence caused by stochastic interaction with an environment. The imaging theorem arises from unitary Schrödinger propagation and so is valid without any environmental interaction. It implies that a simultaneous measurement of both position and momentum will define a unique classical trajectory, whereas a less complete measurement of say position alone can lead to quantum interference effects.« less

Developing a Brief Cross-Culturally Validated Screening Tool for Externalizing Disorders in Children

ERIC Educational Resources Information Center

Zwirs, Barbara W. C.; Burger, Huibert; Schulpen, Tom W. J.; Buitelaar, Jan K.

2008-01-01

The study aims at developing and validating a brief, easy-to-use screening instrument for teachers to predict externalizing disorders in children and recommending them for timely referral. The scores are compared between Dutch and non-Dutch immigrant children and a significant amount of cases for externalizing disorders were identified but sex and…

A multidisciplinary approach to vascular surgery procedure coding improves coding accuracy, work relative value unit assignment, and reimbursement.

PubMed

Aiello, Francesco A; Judelson, Dejah R; Messina, Louis M; Indes, Jeffrey; FitzGerald, Gordon; Doucet, Danielle R; Simons, Jessica P; Schanzer, Andres

2016-08-01

Vascular surgery procedural reimbursement depends on accurate procedural coding and documentation. Despite the critical importance of correct coding, there has been a paucity of research focused on the effect of direct physician involvement. We hypothesize that direct physician involvement in procedural coding will lead to improved coding accuracy, increased work relative value unit (wRVU) assignment, and increased physician reimbursement. This prospective observational cohort study evaluated procedural coding accuracy of fistulograms at an academic medical institution (January-June 2014). All fistulograms were coded by institutional coders (traditional coding) and by a single vascular surgeon whose codes were verified by two institution coders (multidisciplinary coding). The coding methods were compared, and differences were translated into revenue and wRVUs using the Medicare Physician Fee Schedule. Comparison between traditional and multidisciplinary coding was performed for three discrete study periods: baseline (period 1), after a coding education session for physicians and coders (period 2), and after a coding education session with implementation of an operative dictation template (period 3). The accuracy of surgeon operative dictations during each study period was also assessed. An external validation at a second academic institution was performed during period 1 to assess and compare coding accuracy. During period 1, traditional coding resulted in a 4.4% (P = .004) loss in reimbursement and a 5.4% (P = .01) loss in wRVUs compared with multidisciplinary coding. During period 2, no significant difference was found between traditional and multidisciplinary coding in reimbursement (1.3% loss; P = .24) or wRVUs (1.8% loss; P = .20). During period 3, traditional coding yielded a higher overall reimbursement (1.3% gain; P = .26) than multidisciplinary coding. This increase, however, was due to errors by institution coders, with six inappropriately used codes resulting in a higher overall reimbursement that was subsequently corrected. Assessment of physician documentation showed improvement, with decreased documentation errors at each period (11% vs 3.1% vs 0.6%; P = .02). Overall, between period 1 and period 3, multidisciplinary coding resulted in a significant increase in additional reimbursement ($17.63 per procedure; P = .004) and wRVUs (0.50 per procedure; P = .01). External validation at a second academic institution was performed to assess coding accuracy during period 1. Similar to institution 1, traditional coding revealed an 11% loss in reimbursement ($13,178 vs $14,630; P = .007) and a 12% loss in wRVU (293 vs 329; P = .01) compared with multidisciplinary coding. Physician involvement in the coding of endovascular procedures leads to improved procedural coding accuracy, increased wRVU assignments, and increased physician reimbursement. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Multi-mode Intravascular RF Coil for MRI-guided Interventions

PubMed Central

Kurpad, Krishna N.; Unal, Orhan

2011-01-01

Purpose To demonstrate the feasibility of using a single intravascular RF probe connected to the external MRI system via a single coaxial cable to perform active tip tracking and catheter visualization, and high SNR intravascular imaging. Materials and Methods A multi-mode intravascular RF coil was constructed on a 6F balloon catheter and interfaced to a 1.5T MRI scanner via a decoupling circuit. Bench measurements of coil impedances were followed by imaging experiments in saline and phantoms. Results The multi-mode coil behaves as an inductively-coupled transmit coil. Forward looking capability of 6mm is measured. Greater than 3-fold increase in SNR compared to conventional imaging using optimized external coil is demonstrated. Simultaneous active tip tracking and catheter visualization is demonstrated. Conclusions It is feasible to perform 1) active tip tracking, 2) catheter visualization, and 3) high SNR imaging using a single multi-mode intravascular RF coil that is connected to the external system via a single coaxial cable. PMID:21448969

78 FR 47016 - Submission for Review: Request for External Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Request for External Review AGENCY: U.S... External Review. As required by the Paperwork Reduction Act of 1995, (Pub. L. 104-13, 44 U.S.C. chapter 35... the Multi-State Plan Program (MSPP) on March 11, 2013, 78 FR 15560, which outlined an external review...

Work organization in hospital wards and nurses' emotional exhaustion: A multi-method study of observation-based assessment and nurses' self-reports.

PubMed

Stab, Nicole; Hacker, Winfried; Weigl, Matthias

2016-09-01

Ward organization is a major determinant for nurses' well-being on the job. The majority of previous research on this relationship is based on single source methods, which have been criticized as skewed estimations mainly due to subjectivity of the ratings and due to common source bias. To investigate the association of ward organization characteristics and nurses' exhaustion by combining observation-based assessments with nurses' self-reports. Cross-sectional study on 25 wards of four hospitals and 245 nurses. Our multi-method approach to evaluate hospital ward organization consisted of on-site observations with a standardized assessment tool and of questionnaires to evaluate nurses' self-reports and exhaustion. After establishing the reliability of our measures, we applied multi-level regression analyses to determine associations between determinant and outcome variables. We found substantial convergence in ward organization between the observation-based assessments and nurses' self-reports, which supports the validity of our external assessments. Furthermore, two observation-based characteristics, namely participation and patient-focused care, were significantly associated with lower emotional exhaustion among the nurses. Our results suggest that observation-based assessments are a valid and feasible way to assess ward organization in hospitals. Nurses' self-reported as well as observation-based ratings on ward organization were associated with nurses' emotional exhaustion. This is of interest mainly for identifying alternative measures in evaluating nurses' work environments, to inform health promotion activities and to evaluate job redesign intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Demonstrating Experimenter "Ineptitude" as a Means of Teaching Internal and External Validity

ERIC Educational Resources Information Center

Treadwell, Kimberli R.H.

2008-01-01

Internal and external validity are key concepts in understanding the scientific method and fostering critical thinking. This article describes a class demonstration of a "botched" experiment to teach validity to undergraduates. Psychology students (N = 75) completed assessments at the beginning of the semester, prior to and immediately following…

The internal and external validity of the Major Depression Inventory in measuring severity of depressive states.

PubMed

Olsen, L R; Jensen, D V; Noerholm, V; Martiny, K; Bech, P

2003-02-01

We have developed the Major Depression Inventory (MDI), consisting of 10 items, covering the DSM-IV as well as the ICD-10 symptoms of depressive illness. We aimed to evaluate this as a scale measuring severity of depressive states with reference to both internal and external validity. Patients representing the score range from no depression to marked depression on the Hamilton Depression Scale (HAM-D) completed the MDI. Both classical and modern psychometric methods were applied for the evaluation of validity, including the Rasch analysis. In total, 91 patients were included. The results showed that the MDI had an adequate internal validity in being a unidimensional scale (the total score an appropriate or sufficient statistic). The external validity of the MDI was also confirmed as the total score of the MDI correlated significantly with the HAM-D (Pearson's coefficient 0.86, P < or = 0.01, Spearman 0.80, P < or = 0.01). When used in a sample of patients with different states of depression the MDI has an adequate internal and external validity.

The NINDS-Canadian stroke network vascular cognitive impairment neuropsychology protocols in Chinese.

PubMed

Wong, Adrian; Xiong, Yun-yun; Wang, Defeng; Lin, Shi; Chu, Winnie W C; Kwan, Pauline W K; Nyenhuis, David; Black, Sandra E; Wong, Ka Sing Lawrence; Mok, Vincent

2013-05-01

Vascular cognitive impairment (VCI) affects up to half of stroke survivors and predicts poor outcomes. Valid and reliable assessement for VCI is lacking, especially for the Chinese population. In 2005, the National Institute of Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) Harmonisation workshop proposed a set of three neuropsychology protocols for VCI evaluation. This paper is to introduce the protocol design and to report the psychometric properties of the Chinese NINDS-CSN VCI protocols. Fifty patients with mild stroke (mean National Institute of Health Stroke Scale 2.2 (SD=3.2)) and 50 controls were recruited. The NINDS-CSN VCI protocols were adapted into Chinese. We assessed protocols' (1) external validity, defined by how well the protocol summary scores differentiated patients from controls using receiver operating characteristics (ROC) curve analysis; (2) concurrent validity, by correlations with functional measures including Stroke Impact Scale memory score and Chinese Disability Assessment for Dementia; (3) internal consistency; and (4) ease of administration. All three protocols differentiated patients from controls (area under ROC for the three protocols between 0.77 to 0.79, p<0.001), and significantly correlated with the functional measures (Pearson r ranged from 0.37 to 0.51). A cut-off of 19/20 on MMSE identified only one-tenth of patients classified as impaired on the 5-min protocol. Cronbach's α across the four cognitive domains of the 60-min protocol was 0.78 for all subjects and 0.76 for stroke patients. The Chinese NINDS-CSN VCI protocols are valid and reliable for cognitive assessment in Chinese patients with mild stroke.

A nomogram for predicting complications in patients with solid tumours and seemingly stable febrile neutropenia

PubMed Central

Fonseca, Paula Jiménez; Carmona-Bayonas, Alberto; García, Ignacio Matos; Marcos, Rosana; Castañón, Eduardo; Antonio, Maite; Font, Carme; Biosca, Mercè; Blasco, Ana; Lozano, Rebeca; Ramchandani, Avinash; Beato, Carmen; de Castro, Eva Martínez; Espinosa, Javier; Martínez-García, Jerónimo; Ghanem, Ismael; Cubero, Jorge Hernando; Manrique, Isabel Aragón; Navalón, Francisco García; Sevillano, Elena; Manzano, Aránzazu; Virizuela, Juan; Garrido, Marcelo; Mondéjar, Rebeca; Arcusa, María Ángeles; Bonilla, Yaiza; Pérez, Quionia; Gallardo, Elena; del Carmen Soriano, Maria; Cardona, Mercè; Lasheras, Fernando Sánchez; Cruz, Juan Jesús; Ayala, Francisco

2016-01-01

Background: We sought to develop and externally validate a nomogram and web-based calculator to individually predict the development of serious complications in seemingly stable adult patients with solid tumours and episodes of febrile neutropenia (FN). Patients and methods: The data from the FINITE study (n=1133) and University of Salamanca Hospital (USH) FN registry (n=296) were used to develop and validate this tool. The main eligibility criterion was the presence of apparent clinical stability, defined as events without acute organ dysfunction, abnormal vital signs, or major infections. Discriminatory ability was measured as the concordance index and stratification into risk groups. Results: The rate of infection-related complications in the FINITE and USH series was 13.4% and 18.6%, respectively. The nomogram used the following covariates: Eastern Cooperative Group (ECOG) Performance Status ⩾2, chronic obstructive pulmonary disease, chronic cardiovascular disease, mucositis of grade ⩾2 (National Cancer Institute Common Toxicity Criteria), monocytes <200/mm3, and stress-induced hyperglycaemia. The nomogram predictions appeared to be well calibrated in both data sets (Hosmer–Lemeshow test, P>0.1). The concordance index was 0.855 and 0.831 in each series. Risk group stratification revealed a significant distinction in the proportion of complications. With a ⩾116-point cutoff, the nomogram yielded the following prognostic indices in the USH registry validation series: 66% sensitivity, 83% specificity, 3.88 positive likelihood ratio, 48% positive predictive value, and 91% negative predictive value. Conclusions: We have developed and externally validated a nomogram and web calculator to predict serious complications that can potentially impact decision-making in patients with seemingly stable FN. PMID:27187687

External Validity in the Study of Human Development: Theoretical and Methodological Issues

ERIC Educational Resources Information Center

Hultsch, David F.; Hickey, Tom

1978-01-01

An examination of the concept of external validity from two theoretical perspectives: a traditional mechanistic approach and a dialectical organismic approach. Examines the theoretical and methodological implications of these perspectives. (BD)

Adapting Social Neuroscience Measures for Schizophrenia Clinical Trials, Part 1: Ferrying Paradigms Across Perilous Waters

PubMed Central

Green, Michael F.

2013-01-01

Social cognitive impairment is prominent in schizophrenia, and it is closely related to functional outcome. Partly for these reasons, it has rapidly become a target for both training and psychopharmacological interventions. However, there is a paucity of reliable and valid social cognitive endpoints that can be used to evaluate treatment response in clinical trials. Also, clinical studies in schizophrenia have benefited rather little from the surge of activity and knowledge in nonclinical social neuroscience. The National Institute of Mental Health-sponsored study, “Social Cognition and Functioning in Schizophrenia” (SCAF), attempted to address this translational challenge by selecting paradigms from social neuroscience that could be adapted for use in schizophrenia. The project also evaluated the psychometric properties and external validity of the tasks to determine their suitability for multisite clinical trials. This first article in the theme section presents the goals, conceptual background, and rationale for the SCAF project. PMID:24072811

The FORBIO Climate data set for climate analyses

NASA Astrophysics Data System (ADS)

Delvaux, C.; Journée, M.; Bertrand, C.

2015-06-01

In the framework of the interdisciplinary FORBIO Climate research project, the Royal Meteorological Institute of Belgium is in charge of providing high resolution gridded past climate data (i.e. temperature and precipitation). This climate data set will be linked to the measurements on seedlings, saplings and mature trees to assess the effects of climate variation on tree performance. This paper explains how the gridded daily temperature (minimum and maximum) data set was generated from a consistent station network between 1980 and 2013. After station selection, data quality control procedures were developed and applied to the station records to ensure that only valid measurements will be involved in the gridding process. Thereafter, the set of unevenly distributed validated temperature data was interpolated on a 4 km × 4 km regular grid over Belgium. The performance of different interpolation methods has been assessed. The method of kriging with external drift using correlation between temperature and altitude gave the most relevant results.

[Cardiology quality assessment in Germany--pro and contra].

PubMed

von Hodenberg, E; Eder, S; Grunebaum, P; Melichercik, J

2009-10-01

The German National Institute for Quality in Healthcare has also developed a program of external quality assessment in the field of cardiology. Hospitals are committed to collect certain data of diagnostic coronary angiography, percutaneous coronary interventions and pacemaker implantations. If statistical abnormalities are observed a so called structured dialogue is implemented. The responsible physicians of the hospitals are asked to comment possible quality deficits. Appointed members of quality commissions examine the answers and can invite the responsible physicians for interviews or also visit the hospital. However the validity of the quality data is problematic, because audits or check-ups of quality assessment in place are lacking. Therefore the results should not be misused for a comparison or ranking of hospitals with each other. As long as the validity of the quality assessment has not been improved, the results should also not be accessible for other parties, such as health insurances. Georg Thieme Verlag KG Stuttgart, New York.

Effect of modulation p-doping level on multi-state lasing in InAs/InGaAs quantum dot lasers having different external loss

NASA Astrophysics Data System (ADS)

Korenev, V. V.; Savelyev, A. V.; Maximov, M. V.; Zubov, F. I.; Shernyakov, Yu. M.; Kulagina, M. M.; Zhukov, A. E.

2017-09-01

The influence of the modulation p-doping level on multi-state lasing in InAs/InGaAs quantum dot (QD) lasers is studied experimentally for devices having various external losses. It is shown that in the case of short cavities (high external loss), there is an increase in the lasing power component corresponding to the ground-state optical transitions of QDs as the p-doping level grows. However, in the case of long cavities (small external loss), higher dopant concentrations may have an opposite effect on the output power. Based on these observations, an optimal design of laser geometry and an optimal doping level are discussed.

An assessment of the Pacific Regional Cancer Coalition: outcomes and implications of a regional coalition internal and external assessment.

PubMed

Sy, Angela U; Heckert, Karen A; Buenconsejo-Lum, Lee; Hedson, Johnny; Tamang, Suresh; Palafox, Neal

2011-11-01

The Pacific Regional Cancer Coalition (PRCC) provides regional leadership in the U.S. Affiliated Pacific Islands (USAPI) to implement the Regional Comprehensive Control Plan: 2007-2012, and to evaluate its coalition and partnerships. The Pacific Center of Excellence in the Elimination of Disparities (CEED), aims to reduce cancer disparities and conducts evaluation activities relevant to cancer prevention and control in the USAPI. The PRCC Self (internal) and Partner (external) Assessments were conducted to assess coalition functioning, regional and national partnerships, sustainability, and the role of regionalism for integrating all chronic disease prevention and control in the Pacific. Self-administered questionnaires and key informant telephone interviews with PRCC members (N=20), and representatives from regional and national partner organizations were administered (N=26). Validated multi item measures using 5-point scales on coalition and partnership characteristics were used. Chronbach's alphas and averages for the measures were computed. Internal coalition measures: satisfaction (4.2, SD=0.48) communication (4.0, SD=0.56), respect (4.0, SD=0.60) were rated more highly than external partnership measures: resource sharing (3.5, SD=0.74), regionalism (3.9, SD=0.47), use of findings (3.9, SD=0.50). The PRCC specifically identified its level of "collaboration" with external partners including Pacific CEED. External partners identified its partnership with the PRCC in the "coalition" stage. PRCC members and external partners are satisfied with their partnerships. All groups should continue to focus on building collaboration with partners to reflect a truly regional approach to sustain the commitment, the coalitions and the programming to reduce cancer in the USAPI. PRCC and partners should also work together to integrate all chronic disease prevention and control efforts in the Pacific.

Managing an Open Access, Multi-Institutional, International Digital Library: The Digital Library of the Caribbean

ERIC Educational Resources Information Center

Wooldridge, Brooke; Taylor, Laurie; Sullivan, Mark

2009-01-01

Developing an Open Access, multi-institutional, multilingual, international digital library requires robust technological and institutional infrastructures that support both the needs of individual institutions alongside the needs of the growing partnership and ensure continuous communication and development of the shared vision for the digital…

Military-Connected Student Academic Success at 4-Year Institutions: A Multi-Institution Study

ERIC Educational Resources Information Center

Williams-Klotz, Denise N.; Gansemer-Topf, Ann M.

2017-01-01

We examined how the experiences--academic, financial, social, and personal--and relationship factors of military-connected students attending a 4-year institution are associated with their academic success. This multi-institution study highlights the demographic characteristics, experiences, and campus relationships that are associated with…

VISUAL3D - An EIT network on visualization of geomodels

NASA Astrophysics Data System (ADS)

Bauer, Tobias

2017-04-01

When it comes to interpretation of data and understanding of deep geological structures and bodies at different scales then modelling tools and modelling experience is vital for deep exploration. Geomodelling provides a platform for integration of different types of data, including new kinds of information (e.g., new improved measuring methods). EIT Raw Materials, initiated by the EIT (European Institute of Innovation and Technology) and funded by the European Commission, is the largest and strongest consortium in the raw materials sector worldwide. The VISUAL3D network of infrastructure is an initiative by EIT Raw Materials and aims at bringing together partners with 3D-4D-visualisation infrastructure and 3D-4D-modelling experience. The recently formed network collaboration interlinks hardware, software and expert knowledge in modelling visualization and output. A special focus will be the linking of research, education and industry and integrating multi-disciplinary data and to visualize the data in three and four dimensions. By aiding network collaborations we aim at improving the combination of geomodels with differing file formats and data characteristics. This will create an increased competency in modelling visualization and the ability to interchange and communicate models more easily. By combining knowledge and experience in geomodelling with expertise in Virtual Reality visualization partners of EIT Raw Materials but also external parties will have the possibility to visualize, analyze and validate their geomodels in immersive VR-environments. The current network combines partners from universities, research institutes, geological surveys and industry with a strong background in geological 3D-modelling and 3D visualization and comprises: Luleå University of Technology, Geological Survey of Finland, Geological Survey of Denmark and Greenland, TUBA Freiberg, Uppsala University, Geological Survey of France, RWTH Aachen, DMT, KGHM Cuprum, Boliden, Montan Universität Leoben, Slovenian National Building and Civil Engineering Institute, Tallinn University of Technology and Turku University. The infrastructure within the network comprises different types of capturing and visualization hardware, ranging from high resolution cubes, VR walls, VR goggle solutions, high resolution photogrammetry, UAVs, lidar-scanners, and many more.

Outsourcing versus in-house maintenance of medical devices: a longitudinal, empirical study.

PubMed

Miguel-Cruz, Antonio; Rios-Rincón, Adriana; Haugan, Gregory L

2014-03-01

To determine what factors have a significant influence on the performance of medical device maintenance outsourcing, and to determine how the performance of external governance structures differs depending on whether a hospital is private or public. This was a longitudinal study of 590 maintenance transactions at 20 hospitals in Bogotá, Colombia, involving 764 medical devices and 72 maintenance service providers. Maintenance performance data (i.e., turn-around time in hours; TAT) for the service providers (either in-house or outsourced) were primarily collected over a 20-month period, from December 2009-August 2011, by means of a monitoring procedure; then, a hazards model was run. The availability of specific repair parts, in-stock, in the city in which the medical devices were located, had a positive impact on the performance of both internal and external governance structures. Online service also had a positive impact on both, with a stronger positive impact on the performance of internal governance than on that of external governance. For transactions governed by external structures, better performance was seen in private hospitals than in public ones. In public health institutions, internal governance showed better performance than external governance. Both internal and external governance structures showed better performance in private healthcare institutions than in public ones. In public health institutions, internal governance shows better performance than external governance; this suggests that healthcare managers should reconsider the trend to eliminate in-house maintenance service staff in public healthcare institutions.

Assessing Discriminative Performance at External Validation of Clinical Prediction Models

PubMed Central

Nieboer, Daan; van der Ploeg, Tjeerd; Steyerberg, Ewout W.

2016-01-01

Introduction External validation studies are essential to study the generalizability of prediction models. Recently a permutation test, focusing on discrimination as quantified by the c-statistic, was proposed to judge whether a prediction model is transportable to a new setting. We aimed to evaluate this test and compare it to previously proposed procedures to judge any changes in c-statistic from development to external validation setting. Methods We compared the use of the permutation test to the use of benchmark values of the c-statistic following from a previously proposed framework to judge transportability of a prediction model. In a simulation study we developed a prediction model with logistic regression on a development set and validated them in the validation set. We concentrated on two scenarios: 1) the case-mix was more heterogeneous and predictor effects were weaker in the validation set compared to the development set, and 2) the case-mix was less heterogeneous in the validation set and predictor effects were identical in the validation and development set. Furthermore we illustrated the methods in a case study using 15 datasets of patients suffering from traumatic brain injury. Results The permutation test indicated that the validation and development set were homogenous in scenario 1 (in almost all simulated samples) and heterogeneous in scenario 2 (in 17%-39% of simulated samples). Previously proposed benchmark values of the c-statistic and the standard deviation of the linear predictors correctly pointed at the more heterogeneous case-mix in scenario 1 and the less heterogeneous case-mix in scenario 2. Conclusion The recently proposed permutation test may provide misleading results when externally validating prediction models in the presence of case-mix differences between the development and validation population. To correctly interpret the c-statistic found at external validation it is crucial to disentangle case-mix differences from incorrect regression coefficients. PMID:26881753

Assessing Discriminative Performance at External Validation of Clinical Prediction Models.

PubMed

Nieboer, Daan; van der Ploeg, Tjeerd; Steyerberg, Ewout W

2016-01-01

External validation studies are essential to study the generalizability of prediction models. Recently a permutation test, focusing on discrimination as quantified by the c-statistic, was proposed to judge whether a prediction model is transportable to a new setting. We aimed to evaluate this test and compare it to previously proposed procedures to judge any changes in c-statistic from development to external validation setting. We compared the use of the permutation test to the use of benchmark values of the c-statistic following from a previously proposed framework to judge transportability of a prediction model. In a simulation study we developed a prediction model with logistic regression on a development set and validated them in the validation set. We concentrated on two scenarios: 1) the case-mix was more heterogeneous and predictor effects were weaker in the validation set compared to the development set, and 2) the case-mix was less heterogeneous in the validation set and predictor effects were identical in the validation and development set. Furthermore we illustrated the methods in a case study using 15 datasets of patients suffering from traumatic brain injury. The permutation test indicated that the validation and development set were homogenous in scenario 1 (in almost all simulated samples) and heterogeneous in scenario 2 (in 17%-39% of simulated samples). Previously proposed benchmark values of the c-statistic and the standard deviation of the linear predictors correctly pointed at the more heterogeneous case-mix in scenario 1 and the less heterogeneous case-mix in scenario 2. The recently proposed permutation test may provide misleading results when externally validating prediction models in the presence of case-mix differences between the development and validation population. To correctly interpret the c-statistic found at external validation it is crucial to disentangle case-mix differences from incorrect regression coefficients.

Rice crop growth monitoring using ENVISAT-1/ASAR AP mode

NASA Astrophysics Data System (ADS)

Konishi, Tomohisa; Suga, Yuzo; Omatu, Shigeru; Takeuchi, Shoji; Asonuma, Kazuyoshi

2007-10-01

Hiroshima Institute of Technology (HIT) is operating the direct down-links of microwave and optical earth observation satellite data in Japan. This study focuses on the validation for rice crop monitoring using microwave remotely sensed image data acquired by ENIVISAT-1 referring to ground truth data such as height of rice crop, vegetation cover rate and leaf area index in the test sites of Hiroshima district, the western part of Japan. ENVISAT-1/ASAR data has the capabilities for the monitoring of the rice crop growing cycle by using alternating cross polarization mode images. However, ASAR data is influenced by several parameters such as land cover structure, direction and alignment of rice crop fields in the test sites. In this study, the validation was carried out to be combined with microwave image data and ground truth data regarding rice crop fields to investigate the above parameters. Multi-temporal, multi-direction (descending and ascending) and multi-angle ASAR alternating cross polarization mode images were used to investigate during the rice crop growing cycle. On the other hand, LANDSAT-7/ETM+ data were used to detect land cover structure, direction and alignment of rice crop fields corresponding to the backscatter of ASAR. Finally, the extraction of rice planted area was attempted by using multi-temporal ASAR AP mode data such as VV/VH and HH/HV. As the result of this study, it is clear that the estimated rice planted area coincides with the existing statistical data for area of the rice crop field. In addition, HH/HV is more effective than VV/VH in the rice planted area extraction.

Virtual temporal bone dissection system: OSU virtual temporal bone system: development and testing.

PubMed

Wiet, Gregory J; Stredney, Don; Kerwin, Thomas; Hittle, Bradley; Fernandez, Soledad A; Abdel-Rasoul, Mahmoud; Welling, D Bradley

2012-03-01

The objective of this project was to develop a virtual temporal bone dissection system that would provide an enhanced educational experience for the training of otologic surgeons. A randomized, controlled, multi-institutional, single-blinded validation study. The project encompassed four areas of emphasis: structural data acquisition, integration of the system, dissemination of the system, and validation. Structural acquisition was performed on multiple imaging platforms. Integration achieved a cost-effective system. Dissemination was achieved on different levels including casual interest, downloading of software, and full involvement in development and validation studies. A validation study was performed at eight different training institutions across the country using a two-arm randomized trial where study subjects were randomized to a 2-week practice session using either the virtual temporal bone or standard cadaveric temporal bones. Eighty subjects were enrolled and randomized to one of the two treatment arms; 65 completed the study. There was no difference between the two groups using a blinded rating tool to assess performance after training. A virtual temporal bone dissection system has been developed and compared to cadaveric temporal bones for practice using a multicenter trial. There was no statistical difference between practice on the current simulator compared to practice on human cadaveric temporal bones. Further refinements in structural acquisition and interface design have been identified, which can be implemented prior to full incorporation into training programs and used for objective skills assessment. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Absorption in Sport: A Cross-Validation Study

PubMed Central

Koehn, Stefan; Stavrou, Nektarios A. M.; Cogley, Jeremy; Morris, Tony; Mosek, Erez; Watt, Anthony P.

2017-01-01

Absorption has been identified as readiness for experiences of deep involvement in the task. Conceptually, absorption is a key psychological construct, incorporating experiential, cognitive, and motivational components. Although, no operationalization of the construct has been provided to facilitate research in this area, the purpose of this research was the development and examination of the psychometric properties of a sport-specific measure of absorption that evolved from the use of the modified Tellegen Absorption Scale (MODTAS; Jamieson, 2005) in mainstream psychology. The study aimed to provide evidence of the psychometric properties, reliability, and validity of the Measure of Absorption in Sport Contexts (MASCs). The psychometric examination included a calibration sample from Scotland and a cross-validation sample from Australia using a cross-sectional design. The item pool was developed based on existing items from the modified Tellegen Absorption Scale (Jamieson, 2005). The MODTAS items were reworded and translated into a sport context. The Scottish sample consisted of 292 participants and the Australian sample of 314 participants. Congeneric model testing and confirmatory factor analysis for both samples and multi-group invariance testing across samples was used. In the cross-validation sample the MASC subscales showed acceptable internal consistency and construct reliability (≥0.70). Excellent fit indices were found for the final 18-item, six-factor measure in the cross-validation sample, χ(120)2 = 197.486, p < 0.001; CFI = 0.957; TLI = 0.945; RMSEA = 0.045; SRMR = 0.044. Multi-group invariance testing revealed no differences in item meaning, except for two items. The MASC and the Dispositional Flow Scale-2 showed moderate-to-strong positive correlations in both samples, r = 0.38, p < 0.001 and r = 0.42, p < 0.001, supporting the external validity of the MASC. This article provides initial evidence in support of the psychometric properties, reliability, and validity of the sport-specific measure of absorption. The MASC provides rich research opportunities in sport psychology that can enhance the theoretical understanding between absorption and related constructs and facilitate future intervention studies. PMID:28883802

Space Debris Attitude Simulation - IOTA (In-Orbit Tumbling Analysis)

NASA Astrophysics Data System (ADS)

Kanzler, R.; Schildknecht, T.; Lips, T.; Fritsche, B.; Silha, J.; Krag, H.

Today, there is little knowledge on the attitude state of decommissioned intact objects in Earth orbit. Observational means have advanced in the past years, but are still limited with respect to an accurate estimate of motion vector orientations and magnitude. Especially for the preparation of Active Debris Removal (ADR) missions as planned by ESA's Clean Space initiative or contingency scenarios for ESA spacecraft like ENVISAT, such knowledge is needed. The In-Orbit Tumbling Analysis tool (IOTA) is a prototype software, currently in development within the framework of ESA's “Debris Attitude Motion Measurements and Modelling” project (ESA Contract No. 40000112447), which is led by the Astronomical Institute of the University of Bern (AIUB). The project goal is to achieve a good understanding of the attitude evolution and the considerable internal and external effects which occur. To characterize the attitude state of selected targets in LEO and GTO, multiple observation methods are combined. Optical observations are carried out by AIUB, Satellite Laser Ranging (SLR) is performed by the Space Research Institute of the Austrian Academy of Sciences (IWF) and radar measurements and signal level determination are provided by the Fraunhofer Institute for High Frequency Physics and Radar Techniques (FHR). Developed by Hyperschall Technologie Göttingen GmbH (HTG), IOTA will be a highly modular software tool to perform short- (days), medium- (months) and long-term (years) propagation of the orbit and attitude motion (six degrees-of-freedom) of spacecraft in Earth orbit. The simulation takes into account all relevant acting forces and torques, including aerodynamic drag, solar radiation pressure, gravitational influences of Earth, Sun and Moon, eddy current damping, impulse and momentum transfer from space debris or micro meteoroid impact, as well as the optional definition of particular spacecraft specific influences like tank sloshing, reaction wheel behaviour, magnetic torquer activity and thruster firing. The meaning of IOTA is to provide high accuracy short-term simulations to support observers and potential ADR missions, as well as medium- and long-term simulations to study the significance of the particular internal and external influences on the attitude, especially damping factors and momentum transfer. The simulation will also enable the investigation of the altitude dependency of the particular external influences. IOTA's post-processing modules will generate synthetic measurements for observers and for software validation. The validation of the software will be done by cross-calibration with observations and measurements acquired by the project partners.

CARES: Completely Automated Robust Edge Snapper for carotid ultrasound IMT measurement on a multi-institutional database of 300 images: a two stage system combining an intensity-based feature approach with first order absolute moments

NASA Astrophysics Data System (ADS)

Molinari, Filippo; Acharya, Rajendra; Zeng, Guang; Suri, Jasjit S.

2011-03-01

The carotid intima-media thickness (IMT) is the most used marker for the progression of atherosclerosis and onset of the cardiovascular diseases. Computer-aided measurements improve accuracy, but usually require user interaction. In this paper we characterized a new and completely automated technique for carotid segmentation and IMT measurement based on the merits of two previously developed techniques. We used an integrated approach of intelligent image feature extraction and line fitting for automatically locating the carotid artery in the image frame, followed by wall interfaces extraction based on Gaussian edge operator. We called our system - CARES. We validated the CARES on a multi-institutional database of 300 carotid ultrasound images. IMT measurement bias was 0.032 +/- 0.141 mm, better than other automated techniques and comparable to that of user-driven methodologies. Our novel approach of CARES processed 96% of the images leading to the figure of merit to be 95.7%. CARES ensured complete automation and high accuracy in IMT measurement; hence it could be a suitable clinical tool for processing of large datasets in multicenter studies involving atherosclerosis.pre-

Development and Validation of the Patient Experience with Treatment and Self-Management (PETS): A Patient-Reported Measure of Treatment Burden

PubMed Central

Eton, David T.; Yost, Kathleen J.; Lai, Jin-shei; Ridgeway, Jennifer L.; Egginton, Jason S.; Rosedahl, Jordan K.; Linzer, Mark; Boehm, Deborah H.; Thakur, Azra; Poplau, Sara; Odell, Laura; Montori, Victor M.; May, Carl R.; Anderson, Roger T.

2017-01-01

Purpose The purpose of this study was to develop and validate a new comprehensive patient-reported measure of treatment burden – the Patient Experience with Treatment and Self-Management (PETS). Methods A conceptual framework was used to derive the PETS with items reviewed and cognitively tested with patients. A survey battery, including a pilot version of the PETS, was mailed to 838 multi-morbid patients from two healthcare institutions for validation. Results A total of 332 multi-morbid patients returned completed surveys. Diagnostics supported deletion and consolidation of some items and domains. Confirmatory factor analysis supported a domain model for scaling comprised of 9 factors: medical information, medications, medical appointments, monitoring health, interpersonal challenges, medical/healthcare expenses, difficulty with healthcare services, role/social activity limitations, and physical/mental exhaustion. Scales showed good internal consistency (alpha range: 0.79 – 0.95). Higher PETS scores, indicative of greater treatment burden, were correlated with more distress, less satisfaction with medications, lower self-efficacy, worse physical and mental health, and lower convenience of healthcare (Ps<.001). Patients with lower health literacy, less adherence to medications, and more financial difficulties reported higher PETS scores (Ps<.01). Conclusion A comprehensive patient-reported measure of treatment burden can help to better characterize the impact of treatment and self-management burden on patient well-being and guide care toward minimally disruptive medicine. PMID:27566732

Development and validation of the Patient Experience with Treatment and Self-management (PETS): a patient-reported measure of treatment burden.

PubMed

Eton, David T; Yost, Kathleen J; Lai, Jin-Shei; Ridgeway, Jennifer L; Egginton, Jason S; Rosedahl, Jordan K; Linzer, Mark; Boehm, Deborah H; Thakur, Azra; Poplau, Sara; Odell, Laura; Montori, Victor M; May, Carl R; Anderson, Roger T

2017-02-01

The purpose of this study was to develop and validate a new comprehensive patient-reported measure of treatment burden-the Patient Experience with Treatment and Self-management (PETS). A conceptual framework was used to derive the PETS with items reviewed and cognitively tested with patients. A survey battery, including a pilot version of the PETS, was mailed to 838 multi-morbid patients from two healthcare institutions for validation. A total of 332 multi-morbid patients returned completed surveys. Diagnostics supported deletion and consolidation of some items and domains. Confirmatory factor analysis supported a domain model for scaling comprised of 9 factors: medical information, medications, medical appointments, monitoring health, interpersonal challenges, medical/healthcare expenses, difficulty with healthcare services, role/social activity limitations, and physical/mental exhaustion. Scales showed good internal consistency (α range 0.79-0.95). Higher PETS scores, indicative of greater treatment burden, were correlated with more distress, less satisfaction with medications, lower self-efficacy, worse physical and mental health, and lower convenience of healthcare (Ps < 0.001). Patients with lower health literacy, less adherence to medications, and more financial difficulties reported higher PETS scores (Ps < 0.01). A comprehensive patient-reported measure of treatment burden can help to better characterize the impact of treatment and self-management burden on patient well-being and guide care toward minimally disruptive medicine.

Externalizing disorders: cluster 5 of the proposed meta-structure for DSM-V and ICD-11.

PubMed

Krueger, R F; South, S C

2009-12-01

The extant major psychiatric classifications DSM-IV and ICD-10 are purportedly atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis is greatly enhanced by an understanding of the etiology. In an attempt to group mental disorders on the basis of etiology, five clusters have been proposed. We consider the validity of the fifth cluster, externalizing disorders, within this proposal. We reviewed the literature in relation to 11 validating criteria proposed by the Study Group of the DSM-V Task Force, in terms of the extent to which these criteria support the idea of a coherent externalizing spectrum of disorders. This cluster distinguishes itself by the central role of disinhibitory personality in mental disorders spread throughout sections of the current classifications, including substance dependence, antisocial personality disorder and conduct disorder. Shared biomarkers, co-morbidity and course offer additional evidence for a valid cluster of externalizing disorders. Externalizing disorders meet many of the salient criteria proposed by the Study Group of the DSM-V Task Force to suggest a classification cluster.

Vascular endothelial growth factor receptor-2 (VEGFR-2) inhibitors: development and validation of predictive 3-D QSAR models through extensive ligand- and structure-based approaches

NASA Astrophysics Data System (ADS)

Ragno, Rino; Ballante, Flavio; Pirolli, Adele; Wickersham, Richard B.; Patsilinakos, Alexandros; Hesse, Stéphanie; Perspicace, Enrico; Kirsch, Gilbert

2015-08-01

Vascular endothelial growth factor receptor-2, (VEGFR-2), is a key element in angiogenesis, the process by which new blood vessels are formed, and is thus an important pharmaceutical target. Here, 3-D quantitative structure-activity relationship (3-D QSAR) were used to build a quantitative screening and pharmacophore model of the VEGFR-2 receptors for design of inhibitors with improved activities. Most of available experimental data information has been used as training set to derive optimized and fully cross-validated eight mono-probe and a multi-probe quantitative models. Notable is the use of 262 molecules, aligned following both structure-based and ligand-based protocols, as external test set confirming the 3-D QSAR models' predictive capability and their usefulness in design new VEGFR-2 inhibitors. From a survey on literature, this is the first generation of a wide-ranging computational medicinal chemistry application on VEGFR2 inhibitors.

[The Amsterdam wrist rules: the multicenter prospective derivation and external validation of a clinical decision rule for the use of radiography in acute wrist trauma].

PubMed

Walenkamp, Monique M J; Bentohami, Abdelali; Slaar, Annelie; Beerekamp, M S H Suzan; Maas, Mario; Jager, L C Cara; Sosef, Nico L; van Velde, Romuald; Ultee, Jan M; Steyerberg, Ewout W; Goslings, J C Carel; Schep, Niels W L

2016-01-01

Although only 39% of patients with wrist trauma have sustained a fracture, the majority of patients is routinely referred for radiography. The purpose of this study was to derive and externally validate a clinical decision rule that selects patients with acute wrist trauma in the Emergency Department (ED) for radiography. This multicenter prospective study consisted of three components: (1) derivation of a clinical prediction model for detecting wrist fractures in patients following wrist trauma; (2) external validation of this model; and (3) design of a clinical decision rule. The study was conducted in the EDs of five Dutch hospitals: one academic hospital (derivation cohort) and four regional hospitals (external validation cohort). We included all adult patients with acute wrist trauma. The main outcome was fracture of the wrist (distal radius, distal ulna or carpal bones) diagnosed on conventional X-rays. A total of 882 patients were analyzed; 487 in the derivation cohort and 395 in the validation cohort. We derived a clinical prediction model with eight variables: age; sex, swelling of the wrist; swelling of the anatomical snuffbox, visible deformation; distal radius tender to palpation; pain on radial deviation and painful axial compression of the thumb. The Area Under the Curve at external validation of this model was 0.81 (95% CI: 0.77-0.85). The sensitivity and specificity of the Amsterdam Wrist Rules (AWR) in the external validation cohort were 98% (95% CI: 95-99%) and 21% (95% CI: 15%-28). The negative predictive value was 90% (95% CI: 81-99%). The Amsterdam Wrist Rules is a clinical prediction rule with a high sensitivity and negative predictive value for fractures of the wrist. Although external validation showed low specificity and 100 % sensitivity could not be achieved, the Amsterdam Wrist Rules can provide physicians in the Emergency Department with a useful screening tool to select patients with acute wrist trauma for radiography. The upcoming implementation study will further reveal the impact of the Amsterdam Wrist Rules on the anticipated reduction of X-rays requested, missed fractures, Emergency Department waiting times and health care costs.

Assessing International Opportunities in Higher Education: A Matrix-Based Assessment Tool

ERIC Educational Resources Information Center

Kaufman, Sophie R.; Ekstrom, David N.; Shortridge-Baggett, Lillie M.

2006-01-01

The pressure on academic institutions to develop sustainable programs is felt both internally and externally. Owing to shrinking operating budgets, universities will only support programs that relate directly to their mission and that are financially viable. External expectations come from funding agencies that typically require institutions to be…

The 2018 Definition of Periprosthetic Hip and Knee Infection: An Evidence-Based and Validated Criteria.

PubMed

Parvizi, Javad; Tan, Timothy L; Goswami, Karan; Higuera, Carlos; Della Valle, Craig; Chen, Antonia F; Shohat, Noam

2018-05-01

The introduction of the Musculoskeletal Infection Society (MSIS) criteria for periprosthetic joint infection (PJI) in 2011 resulted in improvements in diagnostic confidence and research collaboration. The emergence of new diagnostic tests and the lessons we have learned from the past 7 years using the MSIS definition, prompted us to develop an evidence-based and validated updated version of the criteria. This multi-institutional study of patients undergoing revision total joint arthroplasty was conducted at 3 academic centers. For the development of the new diagnostic criteria, PJI and aseptic patient cohorts were stringently defined: PJI cases were defined using only major criteria from the MSIS definition (n = 684) and aseptic cases underwent one-stage revision for a noninfective indication and did not fail within 2 years (n = 820). Serum C-reactive protein (CRP), D-dimer, erythrocyte sedimentation rate were investigated, as well as synovial white blood cell count, polymorphonuclear percentage, leukocyte esterase, alpha-defensin, and synovial CRP. Intraoperative findings included frozen section, presence of purulence, and isolation of a pathogen by culture. A stepwise approach using random forest analysis and multivariate regression was used to generate relative weights for each diagnostic marker. Preoperative and intraoperative definitions were created based on beta coefficients. The new definition was then validated on an external cohort of 222 patients with PJI who subsequently failed with reinfection and 200 aseptic patients. The performance of the new criteria was compared to the established MSIS and the prior International Consensus Meeting definitions. Two positive cultures or the presence of a sinus tract were considered as major criteria and diagnostic of PJI. The calculated weights of an elevated serum CRP (>1 mg/dL), D-dimer (>860 ng/mL), and erythrocyte sedimentation rate (>30 mm/h) were 2, 2, and 1 points, respectively. Furthermore, elevated synovial fluid white blood cell count (>3000 cells/μL), alpha-defensin (signal-to-cutoff ratio >1), leukocyte esterase (++), polymorphonuclear percentage (>80%), and synovial CRP (>6.9 mg/L) received 3, 3, 3, 2, and 1 points, respectively. Patients with an aggregate score of greater than or equal to 6 were considered infected, while a score between 2 and 5 required the inclusion of intraoperative findings for confirming or refuting the diagnosis. Intraoperative findings of positive histology, purulence, and single positive culture were assigned 3, 3, and 2 points, respectively. Combined with the preoperative score, a total of greater than or equal to 6 was considered infected, a score between 4 and 5 was inconclusive, and a score of 3 or less was not infected. The new criteria demonstrated a higher sensitivity of 97.7% compared to the MSIS (79.3%) and International Consensus Meeting definition (86.9%), with a similar specificity of 99.5%. This study offers an evidence-based definition for diagnosing hip and knee PJI, which has shown excellent performance on formal external validation. Copyright © 2018 Elsevier Inc. All rights reserved.

External validation of the proposed T and N categories of squamous cell carcinoma of the penis.

PubMed

Al-Najar, Amr; Alkatout, Ibrahim; Al-Sanabani, Sakhr; Korda, Joanna Beate; Hegele, Axel; Bolenz, Christian; Jünemann, Klaus-Peter; Naumann, Carsten Maik

2011-04-01

The aim of this study was to validate recently proposed modifications to the current TNM classification of penile squamous cell carcinoma (PSCC) by using data from four German urological centers. We identified 89 patients treated for histologically confirmed PSCC between 1996 and 2008 and reclassified them according to the proposed TNM staging revisions. The proposed changes restricted T2 to tumoral invasion of the corpus spongiosum, whereas invasion of the corpus cavernosum was considered as T3. No changes were made to T1 and T4. Furthermore, N1 was limited to unilateral and N2 to bilateral inguinal lymph node involvement regardless of their number. Pelvic lymph node involvement and fixed lymph node were considered as N3 tumors. The range of follow up after initial treatment was 1-142 months (mean 38). Node-negative cases following the current classification were 65.2% (30/46), 48.5% (16/33) and 87.5% (7/8) for T1, T2 and T3, respectively. According to the proposed classification, N0 cases were markedly reduced in the T3 group (55.5%, 10/18) and relatively changed in the T2 group (56.5%, 13/23). T4 patients had no negative disease status. The 3-year disease-specific survival (DSS) rates for the proposed categories were 85.4%, 71.6% and 62.4% for T1, T2 and T3, respectively. For the current categories, the 3-year DSS rates were 85.4%, 66.9% and 100% for T1, T2 and T3, respectively. The 3-year DSS of the current N categories was 78.7%, 51% and 13.3% for N1, N2 and N3, respectively. According to the newly proposed categories, the 3-year DSS was 70%, 50% and 13.3% for N1, N2 and N3, respectively. Tumor and nodal staging of the newly proposed TNM classification show a more distinctive survival compared to the current one. However, a multi-institutional validation is still required to further corroborate the proposed modifications. © 2011 The Japanese Urological Association.

The bottom-up approach to integrative validity: a new perspective for program evaluation.

PubMed

Chen, Huey T

2010-08-01

The Campbellian validity model and the traditional top-down approach to validity have had a profound influence on research and evaluation. That model includes the concepts of internal and external validity and within that model, the preeminence of internal validity as demonstrated in the top-down approach. Evaluators and researchers have, however, increasingly recognized that in an evaluation, the over-emphasis on internal validity reduces that evaluation's usefulness and contributes to the gulf between academic and practical communities regarding interventions. This article examines the limitations of the Campbellian validity model and the top-down approach and provides a comprehensive, alternative model, known as the integrative validity model for program evaluation. The integrative validity model includes the concept of viable validity, which is predicated on a bottom-up approach to validity. This approach better reflects stakeholders' evaluation views and concerns, makes external validity workable, and becomes therefore a preferable alternative for evaluation of health promotion/social betterment programs. The integrative validity model and the bottom-up approach enable evaluators to meet scientific and practical requirements, facilitate in advancing external validity, and gain a new perspective on methods. The new perspective also furnishes a balanced view of credible evidence, and offers an alternative perspective for funding. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

[External and internal validity of a multidimensional Locus of control scale of eating attitudes for athletes (LOCSCAS)].

PubMed

Paquet, Y; Scoffier, S; d'Arripe-Longueville, F

2016-10-01

In the field of health psychology, the control has consistently been considered as a protective factor. This protective role has been also highlighted in eating attitudes' domain. However, current studies use the one-dimensional scale of Rotter or the multidimensional health locus of control scale, and no specific eating attitudes' scale in the sport context exists. Moreover, the social influence in previous scales is limited. According to recent works, the purpose of this study was to test the internal and external validity of a multidimensional locus of control scale of eating attitudes for athletes. One hundred and seventy-nine participants were solicited. A confirmatory factorial analysis was conducted in order to test the internal validity of the scale. The scale external validity was tested in relation to eating attitudes. The internal validity of the scale was verified as well as the external validity, which confirmed the importance of taking into consideration social influences. Indeed, the 2 subscales "Trainers, friends" and "Parents, family" are related respectively positively and negatively in eating disorders. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Velocity Model Using the Large-N Seismic Array from the Source Physics Experiment (SPE)

NASA Astrophysics Data System (ADS)

Chen, T.; Snelson, C. M.

2016-12-01

The Source Physics Experiment (SPE) is a multi-institutional, multi-disciplinary project that consists of a series of chemical explosions conducted at the Nevada National Security Site (NNSS). The goal of SPE is to understand the complicated effect of geological structures on seismic wave propagation and source energy partitioning, develop and validate physics-based modeling, and ultimately better monitor low-yield nuclear explosions. A Large-N seismic array was deployed at the SPE site to image the full 3D wavefield from the most recent SPE-5 explosion on April 26, 2016. The Large-N seismic array consists of 996 geophones (half three-component and half vertical-component sensors), and operated for one month, recording the SPE-5 shot, ambient noise, and additional controlled-sources (a large hammer). This study uses Large-N array recordings of the SPE-5 chemical explosion to develop high resolution images of local geologic structures. We analyze different phases of recorded seismic data and construct a velocity model based on arrival times. The results of this study will be incorporated into the large modeling and simulation efforts as ground-truth further validating the models.

PROMIS measures of pain, fatigue, negative affect, physical function, and social function demonstrated clinical validity across a range of chronic conditions.

PubMed

Cook, Karon F; Jensen, Sally E; Schalet, Benjamin D; Beaumont, Jennifer L; Amtmann, Dagmar; Czajkowski, Susan; Dewalt, Darren A; Fries, James F; Pilkonis, Paul A; Reeve, Bryce B; Stone, Arthur A; Weinfurt, Kevin P; Cella, David

2016-05-01

To present an overview of a series of studies in which the clinical validity of the National Institutes of Health's Patient Reported Outcome Measurement Information System (NIH; PROMIS) measures was evaluated, by domain, across six clinical populations. Approximately 1,500 individuals at baseline and 1,300 at follow-up completed PROMIS measures. The analyses reported in this issue were conducted post hoc, pooling data across six previous studies, and accommodating the different designs of the six, within-condition, parent studies. Changes in T-scores, standardized response means, and effect sizes were calculated in each study. When a parent study design allowed, known groups validity was calculated using a linear mixed model. The results provide substantial support for the clinical validity of nine PROMIS measures in a range of chronic conditions. The cross-condition focus of the analyses provided a unique and multifaceted perspective on how PROMIS measures function in "real-world" clinical settings and provides external anchors that can support comparative effectiveness research. The current body of clinical validity evidence for the nine PROMIS measures indicates the success of NIH PROMIS in developing measures that are effective across a range of chronic conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

Monitoring of fetal radiation exposure during pregnancy.

PubMed

Chandra, Venita; Dorsey, Chelsea; Reed, Amy B; Shaw, Palma; Banghart, Dawn; Zhou, Wei

2013-09-01

One unique concern of vascular surgeons and trainees is radiation exposure associated with increased endovascular practice. The safety of childbearing is a particular worry for current and future women in vascular surgery. Little is known regarding actual fetal radiation exposure. This multi-institutional study aimed to evaluate the radiation dosages recorded on fetal dosimeter badges and compare them to external badges worn by the same cohort of women. All women who declared pregnancy with potential radiation exposure were required to wear two radiation monitors at each institution, one outside and the other inside the lead apron. Maternal (external) and fetal monitor dosimeter readings were analyzed. Maternal radiation exposures prior to, during, and postpregnancy were also assessed to determine any associated behavior modification. Eighty-one women declared pregnancy from 2008 to 2011 and 32 had regular radiation exposure during pregnancy. Maternal whole-body exposures ranged from 21-731 mrem. The average fetal dosimeter recordings for the cohort rounded to zero. Only two women had positive fetal dosimeter recordings; one had a single recording of 3 mrem and the other had a single recording of 7 mrem. There was no significant difference between maternal exposures prior to, during, and postpregnancy. Lack of knowledge of fetal radiation exposure has concerned many vascular surgeons, prompting them to wear double lead aprons during pregnancy, and perhaps prevented numerous other women from entering the field. Our study showed negligible radiation exposure on fetal monitoring suggesting that with the appropriate safety precautions, these concerns may be unwarranted. Published by Mosby, Inc.

A novel QSAR model of Salmonella mutagenicity and its application in the safety assessment of drug impurities

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

Valencia, Antoni; Prous, Josep; Mora, Oscar

As indicated in ICH M7 draft guidance, in silico predictive tools including statistically-based QSARs and expert analysis may be used as a computational assessment for bacterial mutagenicity for the qualification of impurities in pharmaceuticals. To address this need, we developed and validated a QSAR model to predict Salmonella t. mutagenicity (Ames assay outcome) of pharmaceutical impurities using Prous Institute's Symmetry℠, a new in silico solution for drug discovery and toxicity screening, and the Mold2 molecular descriptor package (FDA/NCTR). Data was sourced from public benchmark databases with known Ames assay mutagenicity outcomes for 7300 chemicals (57% mutagens). Of these data, 90%more » was used to train the model and the remaining 10% was set aside as a holdout set for validation. The model's applicability to drug impurities was tested using a FDA/CDER database of 951 structures, of which 94% were found within the model's applicability domain. The predictive performance of the model is acceptable for supporting regulatory decision-making with 84 ± 1% sensitivity, 81 ± 1% specificity, 83 ± 1% concordance and 79 ± 1% negative predictivity based on internal cross-validation, while the holdout dataset yielded 83% sensitivity, 77% specificity, 80% concordance and 78% negative predictivity. Given the importance of having confidence in negative predictions, an additional external validation of the model was also carried out, using marketed drugs known to be Ames-negative, and obtained 98% coverage and 81% specificity. Additionally, Ames mutagenicity data from FDA/CFSAN was used to create another data set of 1535 chemicals for external validation of the model, yielding 98% coverage, 73% sensitivity, 86% specificity, 81% concordance and 84% negative predictivity. - Highlights: • A new in silico QSAR model to predict Ames mutagenicity is described. • The model is extensively validated with chemicals from the FDA and the public domain. • Validation tests show desirable high sensitivity and high negative predictivity. • The model predicted 14 reportedly difficult to predict drug impurities with accuracy. • The model is suitable to support risk evaluation of potentially mutagenic compounds.« less

Strengthening research capacity through the medical education partnership initiative: the Mozambique experience

PubMed Central

2013-01-01

Background Since Mozambique’s independence, the major emphasis of its higher educational institutions has been on didactic education. Because of fiscal and human resource constraints, basic and applied research activities have been relatively modest in scope, and priorities have often been set primarily by external collaborators. These factors have compromised the scope and the relevance of locally conducted research and have limited the impact of Mozambique’s universities as major catalysts for national development. Case description We developed a multi-institutional partnership to undertake a comprehensive analysis of the research environment at Mozambique’s major public universities to identify factors that have served as barriers to the development of a robust research enterprise. Based on this analysis, we developed a multifaceted plan to reduce the impact of these barriers and to enhance research capacity within Mozambique. Interventions On the basis of our needs assessment, we have implemented a number of major initiatives within participating institutions to facilitate basic and applied research activities. These have included specialized training programmes, a reorganization of the research administration infrastructure, the development of multiple collaborative research projects that have emphasized local research priorities and a substantial investment in bioinformatics. We have established a research support centre that provides grant development and management services to Mozambique’s public universities and have developed an independent Institutional Review Board for the review of research involving human research subjects. Multiple research projects involving both communicable and non-communicable diseases have been developed and substantial external research support has been obtained to undertake these projects. A sizable investment in biomedical informatics has enhanced both connectivity and access to digital reference material. Active engagement with relevant entities within the Government of Mozambique has aligned institutional development with national priorities. Conclusions Although multiple challenges remain, over the past 3 years significant progress has been made towards establishing conditions within which a broad range of basic, translational and clinical and public health research can be undertaken. Ongoing development of this research enterprise will enhance capacity to address critical locally relevant research questions and will leverage resources to accelerate the development of Mozambique’s national universities. PMID:24304706

External validation of the Cairns Prediction Model (CPM) to predict conversion from laparoscopic to open cholecystectomy.

PubMed

Hu, Alan Shiun Yew; Donohue, Peter O'; Gunnarsson, Ronny K; de Costa, Alan

2018-03-14

Valid and user-friendly prediction models for conversion to open cholecystectomy allow for proper planning prior to surgery. The Cairns Prediction Model (CPM) has been in use clinically in the original study site for the past three years, but has not been tested at other sites. A retrospective, single-centred study collected ultrasonic measurements and clinical variables alongside with conversion status from consecutive patients who underwent laparoscopic cholecystectomy from 2013 to 2016 in The Townsville Hospital, North Queensland, Australia. An area under the curve (AUC) was calculated to externally validate of the CPM. Conversion was necessary in 43 (4.2%) out of 1035 patients. External validation showed an area under the curve of 0.87 (95% CI 0.82-0.93, p = 1.1 × 10 -14 ). In comparison with most previously published models, which have an AUC of approximately 0.80 or less, the CPM has the highest AUC of all published prediction models both for internal and external validation. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Enabling multi-faceted measures of success for protected area management in Trinidad and Tobago.

PubMed

Granderson, Ainka A

2011-08-01

A key challenge has been to define and measure "success" in managing protected areas. A case study was conducted of efforts to evaluate the new protected area management system in Trinidad and Tobago using a participatory approach. The aim of the case study was to (1) examine whether stakeholder involvement better captures the multi-faceted nature of success and (2) identify the role and influence of various stakeholder groups in this process. An holistic and systematic framework was developed with stakeholder input that facilitated the integration of expert and lay knowledge, a broad emphasis on ecological, socio-economic, and institutional aspects, and the use of both quantitative and qualitative data allowing the evaluation to capture the multi-faceted nature and impacts of protected area management. Input from primary stakeholders, such as local communities, was critical as they have a high stake in protected area outcomes. Secondary and external stakeholders, including government agencies, non-governmental organizations, academia and the private sector, were also important in providing valuable technical assistance and serving as mediators. However, a lack of consensus over priorities, politics, and limited stakeholder capacity and data access pose significant barriers to engaging stakeholders to effectively measure the management success of protected areas. Copyright © 2011 Elsevier Ltd. All rights reserved.

External validation of the CAPRA-S score to predict biochemical recurrence, metastasis and mortality after radical prostatectomy in a European cohort.

PubMed

Tilki, Derya; Mandel, Philipp; Schlomm, Thorsten; Chun, Felix K-H; Tennstedt, Pierre; Pehrke, Dirk; Haese, Alexander; Huland, Hartwig; Graefen, Markus; Salomon, Georg

2015-06-01

The CAPRA-S score predicts prostate cancer recurrence based on pathological information from radical prostatectomy. To our knowledge CAPRA-S has never been externally validated in a European cohort. We independently validated CAPRA-S in a single institution European database. The study cohort comprised 14,532 patients treated with radical prostatectomy between January 1992 and August 2012. Prediction of biochemical recurrence, metastasis and cancer specific mortality by CAPRA-S was assessed by Kaplan-Meier analysis and the c-index. CAPRA-S performance to predict biochemical recurrence was evaluated by calibration plot and decision curve analysis. Median followup was 50.8 months (IQR 25.0-96.0). Biochemical recurrence developed in 20.3% of men at a median of 21.2 months (IQR 7.7-44.9). When stratifying patients by CAPRA-S risk group, estimated 5-year biochemical recurrence-free survival was 91.4%, 70.4% and 29.3% in the low, intermediate and high risk groups, respectively. The CAPRA-S c-index to predict biochemical recurrence, metastasis and cancer specific mortality was 0.80, 0.85 and 0.88, respectively. Metastasis developed in 417 men and 196 men died of prostate cancer. The CAPRA-S score was accurate when applied in a European study cohort. It predicted biochemical recurrence, metastasis and cancer specific mortality after radical prostatectomy with a c-index of greater than 0.80. The score can be valuable in regard to decision making for adjuvant therapy. Copyright © 2015. Published by Elsevier Inc.

Assessment of the External Validity of the National Comprehensive Cancer Network and European Society for Medical Oncology Guidelines for Non-Small-Cell Lung Cancer in a Population of Patients Aged 80 Years and Older.

PubMed

Battisti, Nicolò Matteo Luca; Sehovic, Marina; Extermann, Martine

2017-09-01

Non-small-cell lung cancer (NSCLC) is a disease of the elderly, who are under-represented in clinical trials. This challenges the external validity of the evidence base for its management and of current guidelines, that we evaluated in a population of older patients. We retrieved randomized clinical trials (RCTs) supporting the guidelines and identified 18 relevant topics. We matched a cohort of NSCLC patients aged older than 80 years from the Moffitt Cancer Center database with the studies' eligibility criteria to check their qualification for at least 2 studies. Eligibility > 60% was rated full validity, 30% to 60% partial validity, and < 30% limited validity. We obtained data from 760 elderly patients in stage-adjusted groups and collected 244 RCTs from the National Comprehensive Cancer Network (NCCN) and 148 from the European Society for Medical Oncology (ESMO) guidelines. External validity was deemed insufficient for neoadjuvant chemotherapy in stage III disease (27.37% and 25.26% of patients eligible for NCCN and ESMO guidelines, respectively) and use of bevacizumab (13.86% and 16.27% of patients eligible). For ESMO guidelines, it was inadequate regarding double-agent chemotherapy (25.90% of patients eligible), its duration (24.10%) and therapy for Eastern Cooperative Oncology Group performance status 2 patients (17.74%). For NCCN guidelines external validity was lacking for neoadjuvant chemoradiotherapy in stage IIIA disease (25.86% of patients eligible). Our analysis highlighted the effect of RCT eligibility criteria on guidelines' external validity in elderly patients. Eligibility criteria should be carefully considered in trial design and more studies that do not exclude elderly patients should be included in guidelines. Copyright © 2017 Elsevier Inc. All rights reserved.

Developing Enhanced Blood–Brain Barrier Permeability Models: Integrating External Bio-Assay Data in QSAR Modeling

PubMed Central

Wang, Wenyi; Kim, Marlene T.; Sedykh, Alexander

2015-01-01

Purpose Experimental Blood–Brain Barrier (BBB) permeability models for drug molecules are expensive and time-consuming. As alternative methods, several traditional Quantitative Structure-Activity Relationship (QSAR) models have been developed previously. In this study, we aimed to improve the predictivity of traditional QSAR BBB permeability models by employing relevant public bio-assay data in the modeling process. Methods We compiled a BBB permeability database consisting of 439 unique compounds from various resources. The database was split into a modeling set of 341 compounds and a validation set of 98 compounds. Consensus QSAR modeling workflow was employed on the modeling set to develop various QSAR models. A five-fold cross-validation approach was used to validate the developed models, and the resulting models were used to predict the external validation set compounds. Furthermore, we used previously published membrane transporter models to generate relevant transporter profiles for target compounds. The transporter profiles were used as additional biological descriptors to develop hybrid QSAR BBB models. Results The consensus QSAR models have R2=0.638 for fivefold cross-validation and R2=0.504 for external validation. The consensus model developed by pooling chemical and transporter descriptors showed better predictivity (R2=0.646 for five-fold cross-validation and R2=0.526 for external validation). Moreover, several external bio-assays that correlate with BBB permeability were identified using our automatic profiling tool. Conclusions The BBB permeability models developed in this study can be useful for early evaluation of new compounds (e.g., new drug candidates). The combination of chemical and biological descriptors shows a promising direction to improve the current traditional QSAR models. PMID:25862462

External validation of the diffuse intrinsic pontine glioma survival prediction model: a collaborative report from the International DIPG Registry and the SIOPE DIPG Registry.

PubMed

Veldhuijzen van Zanten, Sophie E M; Lane, Adam; Heymans, Martijn W; Baugh, Joshua; Chaney, Brooklyn; Hoffman, Lindsey M; Doughman, Renee; Jansen, Marc H A; Sanchez, Esther; Vandertop, William P; Kaspers, Gertjan J L; van Vuurden, Dannis G; Fouladi, Maryam; Jones, Blaise V; Leach, James

2017-08-01

We aimed to perform external validation of the recently developed survival prediction model for diffuse intrinsic pontine glioma (DIPG), and discuss its utility. The DIPG survival prediction model was developed in a cohort of patients from the Netherlands, United Kingdom and Germany, registered in the SIOPE DIPG Registry, and includes age <3 years, longer symptom duration and receipt of chemotherapy as favorable predictors, and presence of ring-enhancement on MRI as unfavorable predictor. Model performance was evaluated by analyzing the discrimination and calibration abilities. External validation was performed using an unselected cohort from the International DIPG Registry, including patients from United States, Canada, Australia and New Zealand. Basic comparison with the results of the original study was performed using descriptive statistics, and univariate- and multivariable regression analyses in the validation cohort. External validation was assessed following a variety of analyses described previously. Baseline patient characteristics and results from the regression analyses were largely comparable. Kaplan-Meier curves of the validation cohort reproduced separated groups of standard (n = 39), intermediate (n = 125), and high-risk (n = 78) patients. This discriminative ability was confirmed by similar values for the hazard ratios across these risk groups. The calibration curve in the validation cohort showed a symmetric underestimation of the predicted survival probabilities. In this external validation study, we demonstrate that the DIPG survival prediction model has acceptable cross-cohort calibration and is able to discriminate patients with short, average, and increased survival. We discuss how this clinico-radiological model may serve a useful role in current clinical practice.

Sulfate and sulfide sulfur isotopes (δ34S and δ33S) measured by solution and laser ablation MC-ICP-MS: An enhanced approach using external correction

USGS Publications Warehouse

Pribil, Michael; Ridley, William I.; Emsbo, Poul

2015-01-01

Isotope ratio measurements using a multi-collector inductively coupled plasma mass spectrometer (MC-ICP-MS) commonly use standard-sample bracketing with a single isotope standard for mass bias correction for elements with narrow-range isotope systems measured by MC-ICP-MS, e.g. Cu, Fe, Zn, and Hg. However, sulfur (S) isotopic composition (δ34S) in nature can range from at least − 40 to + 40‰, potentially exceeding the ability of standard-sample bracketing using a single sulfur isotope standard to accurately correct for mass bias. Isotopic fractionation via solution and laser ablation introduction was determined during sulfate sulfur (Ssulfate) isotope measurements. An external isotope calibration curve was constructed using in-house and National Institute of Standards and Technology (NIST) Ssulfate isotope reference materials (RM) in an attempt to correct for the difference. The ability of external isotope correction for Ssulfate isotope measurements was evaluated by analyzing NIST and United States Geological Survey (USGS) Ssulfate isotope reference materials as unknowns. Differences in δ34Ssulfate between standard-sample bracketing and standard-sample bracketing with external isotope correction for sulfate samples ranged from 0.72‰ to 2.35‰ over a δ34S range of 1.40‰ to 21.17‰. No isotopic differences were observed when analyzing Ssulfide reference materials over a δ34Ssulfide range of − 32.1‰ to 17.3‰ and a δ33S range of − 16.5‰ to 8.9‰ via laser ablation (LA)-MC-ICP-MS. Here, we identify a possible plasma induced fractionation for Ssulfate and describe a new method using external isotope calibration corrections using solution and LA-MC-ICP-MS.

Fly's Eye GLM Simulator

NASA Image and Video Library

2017-07-27

The Fly’s Eye GLM Simulator (FEGS) is an airborne array of multi-spectral radiometers optimized to measure the optical emission from lightning. The instrument was designed by the Lightning Group in the Earth Science Office at the Marshall Space Flight Center as part of the validation effort for the first Geostationary Lightning Mapper (GLM) onboard GOES-16. From March to May of 2017, FEGS was flown on the NASA Armstrong Flight Research Center ER-2 along with a payload of other instruments during the GOES-16 Validation Flight Campaign. Data collected during the campaign are being analyzed by scientists at NASA and collaborating institutions to test the accuracy of GLM and other GOES-16 instruments. FEGS adds the capability to investigate sub-millisecond lightning energetics to the NASA Airborne Earth Science program. When flown with its complimentary suite of instruments, the FEGS package observes lightning radiation signatures that span from radio frequencies to gamma-ray emission. Learn more about the GOES-16 Validation Flight Campaign here: https://www.youtube.com/watch?v=rCTIk...

Prediction models for successful external cephalic version: a systematic review.

PubMed

Velzel, Joost; de Hundt, Marcella; Mulder, Frederique M; Molkenboer, Jan F M; Van der Post, Joris A M; Mol, Ben W; Kok, Marjolein

2015-12-01

To provide an overview of existing prediction models for successful ECV, and to assess their quality, development and performance. We searched MEDLINE, EMBASE and the Cochrane Library to identify all articles reporting on prediction models for successful ECV published from inception to January 2015. We extracted information on study design, sample size, model-building strategies and validation. We evaluated the phases of model development and summarized their performance in terms of discrimination, calibration and clinical usefulness. We collected different predictor variables together with their defined significance, in order to identify important predictor variables for successful ECV. We identified eight articles reporting on seven prediction models. All models were subjected to internal validation. Only one model was also validated in an external cohort. Two prediction models had a low overall risk of bias, of which only one showed promising predictive performance at internal validation. This model also completed the phase of external validation. For none of the models their impact on clinical practice was evaluated. The most important predictor variables for successful ECV described in the selected articles were parity, placental location, breech engagement and the fetal head being palpable. One model was assessed using discrimination and calibration using internal (AUC 0.71) and external validation (AUC 0.64), while two other models were assessed with discrimination and calibration, respectively. We found one prediction model for breech presentation that was validated in an external cohort and had acceptable predictive performance. This model should be used to council women considering ECV. Copyright © 2015. Published by Elsevier Ireland Ltd.

The Perceived Impact of External Evaluation: The System, Organisation and Individual Levels-Estonian Case

ERIC Educational Resources Information Center

Seema, Riin; Udam, Maiki; Mattisen, Heli; Lauri, Liia

2017-01-01

The purpose of this article is to provide an overview of how the employees of higher education institutions perceive the impact of external evaluations. The study was conducted using the concurrent mixed method and involved 361 employees from Estonian universities and professional higher education institutions. The results indicated that…

Construct, Concurrent and Predictive Validity of the URICA: Data from Two Multi-site Clinical Trials

PubMed Central

Field, Craig A.; Adinoff, Bryon; Harris, T. Robert; Ball, Samuel A.; Carroll, Kathleen M.

2011-01-01

Background A better understanding of how to measure motivation to change and how it relates to behavior change in patients with drug and alcohol dependence would broaden our understanding of the role of motivation in addiction treatment. Methods Two multi-site, randomized clinical trials comparing brief motivational interventions with standard care were conducted in the National Institute on Drug Abuse Clinical Trials Network. Patients with primary drug dependence and alcohol dependence entering outpatient treatment participated in a study of either Motivational Enhancement Therapy (n=431) or Motivational Interviewing (n=423). The construct, concurrent, and predictive validity of two composite measures of motivation to change derived from the University of Rhode Island Change Assessment (URICA): Readiness to Change (RTC) and Committed Action (CA) were evaluated. Results Confirmatory factor analysis confirmed the a priori factor structure of the URICA. RTC was significantly associated with measures of addiction severity at baseline (r=.12-.52, p<.05). Although statistically significant (p<.01), the correlations between treatment outcomes and RTC were low (r=-.15 and -18). Additional analyses did not support a moderating or mediating effect of motivation on treatment retention or substance use. Conclusions The construct validity of the URICA was confirmed separately in a large sample of drug- and alcohol-dependent patients. However, evidence for the predictive validity of composite scores was very limited and there were no moderating or mediating effects of either measure on treatment outcome. Thus, increased motivation to change, as measured by the composite scores of motivation derived from the URICA, does not appear to influence treatment outcome. PMID:19157723

Prognostic impact of KRAS mutation subtypes in 677 patients with metastatic lung adenocarcinomas

PubMed Central

Yu, Helena A.; Sima, Camelia S.; Shen, Ronglai; Kass, Samantha; Gainor, Justin; Shaw, Alice; Hames, Megan; Iams, Wade; Aston, Jonathan; Lovly, Christine M.; Horn, Leora; Lydon, Christine; Oxnard, Geoffrey R.; Kris, Mark G.; Ladanyi, Marc; Riely, Gregory J.

2015-01-01

Background We previously demonstrated that patients with metastatic KRAS mutant lung cancers have a shorter survival compared to patients with KRAS wild type cancers. Recent reports have suggested different clinical outcomes and distinct activated signaling pathways depending on KRAS mutation subtype. To better understand the impact of KRAS mutation subtype, we analyzed data from 677 patients with KRAS mutant metastatic lung cancer. Methods We reviewed all patients with metastatic or recurrent lung cancers found to have KRAS mutations over a 6 year time period. We evaluated the associations between KRAS mutation type, clinical factors, and overall survival in univariate and multivariate analyses. Any significant findings were validated in an external multi-institution patient data set. Results Among 677 patients with KRAS mutant lung cancers (53 at codon 13, 624 at codon 12), there was no difference in overall survival for patients when comparing KRAS transition versus transversion mutations (p=0.99), smoking status (p=0.33) or when comparing specific amino acid substitutions (p=0.20). In our data set, patients with KRAS codon 13 mutant tumors (n=53) had shorter overall survival compared to patients with codon 12 mutant tumors (n=624)( 1.1 vs 1.3 years, respectively, p=0.009), and the findings were confirmed in a multivariate Cox model controlling for age, sex and smoking status (HR 1.52 95% CI 1.11-2.08, p=0.008). In an independent validation set of tumors from 682 patients with stage IV KRAS mutant lung cancers, there was no difference in survival between patients with KRAS codon 13 versus codon 12 mutations (1.0 vs 1.1 years respectively, p=0.41). Conclusions Among individuals with KRAS mutant metastatic lung cancers treated with conventional therapy, there are apparent differences in outcome based on KRAS mutation subtype PMID:25415430

Validity of the Internal-External Scale in its Relationship with Political Position

ERIC Educational Resources Information Center

Silvern, Louise

1975-01-01

Previous studies have shown a relationship between left wing political beliefs and externality on Rotter's Scale. By examining the validity of Rotter's Scale in relation to political position, no evidence was found relating political position to locus of control. (DEP)

AEROSE 2004 - An Interdisciplinary Atmosphere-Ocean Saharan Dust Expedition

NASA Astrophysics Data System (ADS)

Clemente-Colón, P.

2004-05-01

The NOAA Center for Atmospheric Sciences (NCAS) is sponsoring a Trans-Atlantic Saharan Dust AERosol and Ocean Science Expedition (AEROSE) aboard the NOAA Ship Ronald H. Brown in March 2004. The fundamental purpose of this aerosol cruise is to study the impacts and microphysical evolution of Saharan dust aerosol as it is transported across the Atlantic Ocean. The mission encompasses both, atmospheric and oceanographic components. Participating institutions include Howard University, NCAS lead institution, the University of Puerto Rico at Mayagüez, the Canary Institute of Marine Sciences, the Spanish Institute of Oceanography, the Laboratory of Atmospheric Physics Siméon Fongang, the University of Miami Rosenstiel School of Marine and Atmospheric Science, the University of Washington Applied Physics Laboratory, NASA Goddard Space Flight Center, the NOAA Cooperative Institute for Meteorological Satellite Studies at the University of Wisconsin-Madison, NASA Jet Propulsion Laboratory, and the NOAA/NESDIS Office of Research and Applications. This collaboration provides unique atmospheric and oceanic observations across the North Tropical Atlantic during eastward and westward tracks during a period of nearly one month. Characterization of microphysical properties of Saharan dust aerosol is done trough direct observations of mass, size, and particle number distributions, chemical composition, spatial distributions, and air chemistry. Aerosol radiative properties are studied through a suite of sensors that include a Multi-Angle Absorption Photometer (MAAP), the Marine-Atmosphere Emitted Radiance Interferometer (M-AERI), sunphotometers, and an assortment of other radiometers. Characterization of atmospheric conditions is done through a combination of over 250 radiosonde and ozonesonde launches at 3 to 5 hour intervals during the duration of the cruise and in coordination with satellite overpasses. AEROSE is also supporting the collection of bio-optics and oceanographic observations including water sampling, spectroradiometry, and continuous in-water optical measurements using and under-tow undulating instrument aimed at investigate deposition rates of aerosol and the response of oceanographic systems. Additionally, the cruise effort provides complementary in-situ and remote sensing observations that support the validation and improvement of AVHRR SST corrections under tropospheric aerosol conditions, the validation of MODIS aerosol and oceanographic data and products, the validation of AIRS soundings, and the validation of ICESat aerosol observations, among other activities. An overview of the cruise, available datasets, preliminary results, and follow-on research plans are be presented in this paper.

Integration of XNAT/PACS, DICOM, and Research Software for Automated Multi-modal Image Analysis.

PubMed

Gao, Yurui; Burns, Scott S; Lauzon, Carolyn B; Fong, Andrew E; James, Terry A; Lubar, Joel F; Thatcher, Robert W; Twillie, David A; Wirt, Michael D; Zola, Marc A; Logan, Bret W; Anderson, Adam W; Landman, Bennett A

2013-03-29

Traumatic brain injury (TBI) is an increasingly important public health concern. While there are several promising avenues of intervention, clinical assessments are relatively coarse and comparative quantitative analysis is an emerging field. Imaging data provide potentially useful information for evaluating TBI across functional, structural, and microstructural phenotypes. Integration and management of disparate data types are major obstacles. In a multi-institution collaboration, we are collecting electroencephalogy (EEG), structural MRI, diffusion tensor MRI (DTI), and single photon emission computed tomography (SPECT) from a large cohort of US Army service members exposed to mild or moderate TBI who are undergoing experimental treatment. We have constructed a robust informatics backbone for this project centered on the DICOM standard and eXtensible Neuroimaging Archive Toolkit (XNAT) server. Herein, we discuss (1) optimization of data transmission, validation and storage, (2) quality assurance and workflow management, and (3) integration of high performance computing with research software.

Integration of XNAT/PACS, DICOM, and research software for automated multi-modal image analysis

NASA Astrophysics Data System (ADS)

Gao, Yurui; Burns, Scott S.; Lauzon, Carolyn B.; Fong, Andrew E.; James, Terry A.; Lubar, Joel F.; Thatcher, Robert W.; Twillie, David A.; Wirt, Michael D.; Zola, Marc A.; Logan, Bret W.; Anderson, Adam W.; Landman, Bennett A.

2013-03-01

Traumatic brain injury (TBI) is an increasingly important public health concern. While there are several promising avenues of intervention, clinical assessments are relatively coarse and comparative quantitative analysis is an emerging field. Imaging data provide potentially useful information for evaluating TBI across functional, structural, and microstructural phenotypes. Integration and management of disparate data types are major obstacles. In a multi-institution collaboration, we are collecting electroencephalogy (EEG), structural MRI, diffusion tensor MRI (DTI), and single photon emission computed tomography (SPECT) from a large cohort of US Army service members exposed to mild or moderate TBI who are undergoing experimental treatment. We have constructed a robust informatics backbone for this project centered on the DICOM standard and eXtensible Neuroimaging Archive Toolkit (XNAT) server. Herein, we discuss (1) optimization of data transmission, validation and storage, (2) quality assurance and workflow management, and (3) integration of high performance computing with research software.

Integration of XNAT/PACS, DICOM, and Research Software for Automated Multi-modal Image Analysis

PubMed Central

Gao, Yurui; Burns, Scott S.; Lauzon, Carolyn B.; Fong, Andrew E.; James, Terry A.; Lubar, Joel F.; Thatcher, Robert W.; Twillie, David A.; Wirt, Michael D.; Zola, Marc A.; Logan, Bret W.; Anderson, Adam W.; Landman, Bennett A.

2013-01-01

Traumatic brain injury (TBI) is an increasingly important public health concern. While there are several promising avenues of intervention, clinical assessments are relatively coarse and comparative quantitative analysis is an emerging field. Imaging data provide potentially useful information for evaluating TBI across functional, structural, and microstructural phenotypes. Integration and management of disparate data types are major obstacles. In a multi-institution collaboration, we are collecting electroencephalogy (EEG), structural MRI, diffusion tensor MRI (DTI), and single photon emission computed tomography (SPECT) from a large cohort of US Army service members exposed to mild or moderate TBI who are undergoing experimental treatment. We have constructed a robust informatics backbone for this project centered on the DICOM standard and eXtensible Neuroimaging Archive Toolkit (XNAT) server. Herein, we discuss (1) optimization of data transmission, validation and storage, (2) quality assurance and workflow management, and (3) integration of high performance computing with research software. PMID:24386548

Impact of External Cue Validity on Driving Performance in Parkinson's Disease

PubMed Central

Scally, Karen; Charlton, Judith L.; Iansek, Robert; Bradshaw, John L.; Moss, Simon; Georgiou-Karistianis, Nellie

2011-01-01

This study sought to investigate the impact of external cue validity on simulated driving performance in 19 Parkinson's disease (PD) patients and 19 healthy age-matched controls. Braking points and distance between deceleration point and braking point were analysed for red traffic signals preceded either by Valid Cues (correctly predicting signal), Invalid Cues (incorrectly predicting signal), and No Cues. Results showed that PD drivers braked significantly later and travelled significantly further between deceleration and braking points compared with controls for Invalid and No-Cue conditions. No significant group differences were observed for driving performance in response to Valid Cues. The benefit of Valid Cues relative to Invalid Cues and No Cues was significantly greater for PD drivers compared with controls. Trail Making Test (B-A) scores correlated with driving performance for PDs only. These results highlight the importance of external cues and higher cognitive functioning for driving performance in mild to moderate PD. PMID:21789275

Overview of external Nacelle drag and interference drag

NASA Technical Reports Server (NTRS)

Neal, R. D.

1975-01-01

A historical view of multi-jet engine installations is given that emphasizes integration of the powerplant and the airframe in aircraft design for improved reduction in external nacelle drag and interference drag characteristics.

Heart rate variability indicates emotional value during pro-social economic laboratory decisions with large external validity.

PubMed

Fooken, Jonas

2017-03-10

The present study investigates the external validity of emotional value measured in economic laboratory experiments by using a physiological indicator of stress, heart rate variability (HRV). While there is ample evidence supporting the external validity of economic experiments, there is little evidence comparing the magnitude of internal levels of emotional stress during decision making with external stress. The current study addresses this gap by comparing the magnitudes of decision stress experienced in the laboratory with the stress from outside the laboratory. To quantify a large change in HRV, measures observed in the laboratory during decision-making are compared to the difference between HRV during a university exam and other mental activity for the same individuals in and outside of the laboratory. The results outside the laboratory inform about the relevance of laboratory findings in terms of their relative magnitude. Results show that psychologically induced HRV changes observed in the laboratory, particularly in connection with social preferences, correspond to large effects outside. This underscores the external validity of laboratory findings and shows the magnitude of emotional value connected to pro-social economic decisions in the laboratory.

Psychometric properties of the Press Ganey® Outpatient Medical Practice Survey.

PubMed

Presson, Angela P; Zhang, Chong; Abtahi, Amir M; Kean, Jacob; Hung, Man; Tyser, Andrew R

2017-02-10

The Press Ganey® Medical Practice Survey ("Press Ganey® survey") is a patient-reported questionnaire commonly used to measure patient satisfaction with outpatient health care in the United States. Our objective was to evaluate the reliability and validity of the Press Ganey® survey in a single institution setting. We analyzed surveys from 34,503 unique respondents seen by 624 providers from 47 specialties and 94 clinics at the University of Utah in 2013. The University of Utah is a health care system that provides primary through tertiary care for over 200 medical specialties. Surveys were administered online. The Press Ganey® survey consisted of 24 items organized into 6 scales: Access (4 items), Moving Through the Visit (2), Nurse Assistant (2), Care Provider (10), Personal Issues (4) and Overall Assessment (2). Missingness, ceiling and floor rates were summarized. Cronbach's alpha was used to evaluate internal consistency reliability. Confirmatory factor analysis was used to assess convergent and discriminant validities. Missingness was 0.01% for the total score and ranged from 0.8 to 11.4% across items. The ceiling rate was high at 29.3% for the total score, and ranged from 55.4 to 84.1% across items. Floor rates were 0.01% for the total score, and ranged from 0.1 to 2.1% across items. Internal consistency reliability ranged from 0.79 to 0.96, and item-scale correlations ranged from 0.49 to 0.9. Confirmatory factor analysis supported convergent and discriminant validities. The Press Ganey® survey demonstrated suitable psychometric properties for most metrics. However, the high ceiling rate can have a notable impact on quarterly percentile scores within our institution. Multi-institutional studies of the Press Ganey® survey are needed to inform administrative decision making and institution reimbursement decisions based on this survey.

Three-dimensional deformation response of a NiTi shape memory helical-coil actuator during thermomechanical cycling: experimentally validated numerical model

NASA Astrophysics Data System (ADS)

Dhakal, B.; Nicholson, D. E.; Saleeb, A. F.; Padula, S. A., II; Vaidyanathan, R.

2016-09-01

Shape memory alloy (SMA) actuators often operate under a complex state of stress for an extended number of thermomechanical cycles in many aerospace and engineering applications. Hence, it becomes important to account for multi-axial stress states and deformation characteristics (which evolve with thermomechanical cycling) when calibrating any SMA model for implementation in large-scale simulation of actuators. To this end, the present work is focused on the experimental validation of an SMA model calibrated for the transient and cyclic evolutionary behavior of shape memory Ni49.9Ti50.1, for the actuation of axially loaded helical-coil springs. The approach requires both experimental and computational aspects to appropriately assess the thermomechanical response of these multi-dimensional structures. As such, an instrumented and controlled experimental setup was assembled to obtain temperature, torque, degree of twist and extension, while controlling end constraints during heating and cooling of an SMA spring under a constant externally applied axial load. The computational component assesses the capabilities of a general, multi-axial, SMA material-modeling framework, calibrated for Ni49.9Ti50.1 with regard to its usefulness in the simulation of SMA helical-coil spring actuators. Axial extension, being the primary response, was examined on an axially-loaded spring with multiple active coils. Two different conditions of end boundary constraint were investigated in both the numerical simulations as well as the validation experiments: Case (1) where the loading end is restrained against twist (and the resulting torque measured as the secondary response) and Case (2) where the loading end is free to twist (and the degree of twist measured as the secondary response). The present study focuses on the transient and evolutionary response associated with the initial isothermal loading and the subsequent thermal cycles under applied constant axial load. The experimental results for the helical-coil actuator under two different boundary conditions are found to be within error to their counterparts in the numerical simulations. The numerical simulation and the experimental validation demonstrate similar transient and evolutionary behavior in the deformation response under the complex, inhomogeneous, multi-axial stress-state and large deformations of the helical-coil actuator. This response, although substantially different in magnitude, exhibited similar evolutionary characteristics to the simple, uniaxial, homogeneous, stress-state of the isobaric tensile tests results used for the model calibration. There was no significant difference in the axial displacement (primary response) magnitudes observed between Cases (1) and (2) for the number of cycles investigated here. The simulated secondary responses of the two cases evolved in a similar manner when compared to the experimental validation of the respective cases.

Independent external validation of predictive models for urinary dysfunction following external beam radiotherapy of the prostate: Issues in model development and reporting.

PubMed

Yahya, Noorazrul; Ebert, Martin A; Bulsara, Max; Kennedy, Angel; Joseph, David J; Denham, James W

2016-08-01

Most predictive models are not sufficiently validated for prospective use. We performed independent external validation of published predictive models for urinary dysfunctions following radiotherapy of the prostate. Multivariable models developed to predict atomised and generalised urinary symptoms, both acute and late, were considered for validation using a dataset representing 754 participants from the TROG 03.04-RADAR trial. Endpoints and features were harmonised to match the predictive models. The overall performance, calibration and discrimination were assessed. 14 models from four publications were validated. The discrimination of the predictive models in an independent external validation cohort, measured using the area under the receiver operating characteristic (ROC) curve, ranged from 0.473 to 0.695, generally lower than in internal validation. 4 models had ROC >0.6. Shrinkage was required for all predictive models' coefficients ranging from -0.309 (prediction probability was inverse to observed proportion) to 0.823. Predictive models which include baseline symptoms as a feature produced the highest discrimination. Two models produced a predicted probability of 0 and 1 for all patients. Predictive models vary in performance and transferability illustrating the need for improvements in model development and reporting. Several models showed reasonable potential but efforts should be increased to improve performance. Baseline symptoms should always be considered as potential features for predictive models. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

External Stakeholders of Higher Education Institutions in Poland: Their Identification and Significance

ERIC Educational Resources Information Center

Piotrowska-Piatek, Agnieszka

2017-01-01

In the context of the ongoing changes in the management systems of higher education, the issue of higher education institutions' (HEIs) relationships with external stakeholders are of key importance. This article discusses this problem from the perspective of Polish higher education system. The aim of it is to answer the following questions: (1)…

Validating a Local Failure Risk Stratification for Use in Prospective Studies of Adjuvant Radiation Therapy for Bladder Cancer

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

Baumann, Brian C.; He, Jiwei; Hwang, Wei-Ting

Purpose: To inform prospective trials of adjuvant radiation therapy (adj-RT) for bladder cancer after radical cystectomy, a locoregional failure (LF) risk stratification was proposed. This stratification was developed and validated using surgical databases that may not reflect the outcomes expected in prospective trials. Our purpose was to assess sources of bias that may affect the stratification model's validity or alter the LF risk estimates for each subgroup: time bias due to evolving surgical techniques; trial accrual bias due to inclusion of patients who would be ineligible for adj-RT trials because of early disease progression, death, or loss to follow-up shortlymore » after cystectomy; bias due to different statistical methods to estimate LF; and subgrouping bias due to different definitions of the LF subgroups. Methods and Materials: The LF risk stratification was developed using a single-institution cohort (n=442, 1990-2008) and the multi-institutional SWOG 8710 cohort (n=264, 1987-1998) treated with radical cystectomy with or without chemotherapy. We evaluated the sensitivity of the stratification to sources of bias using Fine-Gray regression and Kaplan-Meier analyses. Results: Year of radical cystectomy was not associated with LF risk on univariate or multivariate analysis after controlling for risk group. By use of more stringent inclusion criteria, 26 SWOG patients (10%) and 60 patients from the single-institution cohort (14%) were excluded. Analysis of the remaining patients confirmed 3 subgroups with significantly different LF risks with 3-year rates of 7%, 17%, and 36%, respectively (P<.01), nearly identical to the rates without correcting for trial accrual bias. Kaplan-Meier techniques estimated higher subgroup LF rates than competing risk analysis. The subgroup definitions used in the NRG-GU001 adj-RT trial were validated. Conclusions: These sources of bias did not invalidate the LF risk stratification or substantially change the model's LF estimates.« less

Number of organ dysfunctions predicts mortality in emergency department patients with suspected infection: a multicenter validation study.

PubMed

Jessen, Marie K; Skibsted, Simon; Shapiro, Nathan I

2017-06-01

The aim of this study was to validate the association between number of organ dysfunctions and mortality in emergency department (ED) patients with suspected infection. This study was conducted at two medical care center EDs. The internal validation set was a prospective cohort study conducted in Boston, USA. The external validation set was a retrospective case-control study conducted in Aarhus, Denmark. The study included adult patients (>18 years) with clinically suspected infection. Laboratory results and clinical data were used to assess organ dysfunctions. Inhospital mortality was the outcome measure. Multivariate logistic regression was used to determine the independent mortality odds for number and types of organ dysfunctions. We enrolled 4952 (internal) and 483 (external) patients. The mortality rate significantly increased with increasing number of organ dysfunctions: internal validation: 0 organ dysfunctions: 0.5% mortality, 1: 3.6%, 2: 9.5%, 3: 17%, and 4 or more: 37%; external validation: 2.2, 6.7, 17, 41, and 57% mortality (both P<0.001 for trend). Age-adjusted and comorbidity-adjusted number of organ dysfunctions remained an independent predictor. The effect of specific types of organ dysfunction on mortality was most pronounced for hematologic [odds ratio (OR) 3.3 (95% confidence interval (CI) 2.0-5.4)], metabolic [OR 3.3 (95% CI 2.4-4.6); internal validation], and cardiovascular dysfunctions [OR 14 (95% CI 3.7-50); external validation]. The number of organ dysfunctions predicts sepsis mortality.

Prediction of Multi-Target Networks of Neuroprotective Compounds with Entropy Indices and Synthesis, Assay, and Theoretical Study of New Asymmetric 1,2-Rasagiline Carbamates

PubMed Central

Romero Durán, Francisco J.; Alonso, Nerea; Caamaño, Olga; García-Mera, Xerardo; Yañez, Matilde; Prado-Prado, Francisco J.; González-Díaz, Humberto

2014-01-01

In a multi-target complex network, the links (Lij) represent the interactions between the drug (di) and the target (tj), characterized by different experimental measures (Ki, Km, IC50, etc.) obtained in pharmacological assays under diverse boundary conditions (cj). In this work, we handle Shannon entropy measures for developing a model encompassing a multi-target network of neuroprotective/neurotoxic compounds reported in the CHEMBL database. The model predicts correctly >8300 experimental outcomes with Accuracy, Specificity, and Sensitivity above 80%–90% on training and external validation series. Indeed, the model can calculate different outcomes for >30 experimental measures in >400 different experimental protocolsin relation with >150 molecular and cellular targets on 11 different organisms (including human). Hereafter, we reported by the first time the synthesis, characterization, and experimental assays of a new series of chiral 1,2-rasagiline carbamate derivatives not reported in previous works. The experimental tests included: (1) assay in absence of neurotoxic agents; (2) in the presence of glutamate; and (3) in the presence of H2O2. Lastly, we used the new Assessing Links with Moving Averages (ALMA)-entropy model to predict possible outcomes for the new compounds in a high number of pharmacological tests not carried out experimentally. PMID:25255029

Validity of the Externalizing Spectrum Inventory in a Criminal Offender Sample: Relations with Disinhibitory Psychopathology, Personality, and Psychopathic Features

PubMed Central

Venables, Noah C.; Patrick, Christopher J.

2013-01-01

The Externalizing Spectrum Inventory (ESI; Krueger, Markon, Patrick, Benning, & Kramer, 2007) provides a self-report based method for indexing a range of correlated problem behaviors and traits in the domain of deficient impulse control. The ESI organizes lower-order behaviors and traits of this kind around higher-order factors encompassing general disinhibitory proneness, callous-aggression, and substance abuse. The current study used data from a male prisoner sample (N = 235) to evaluate the validity of ESI total and factor scores in relation to external criterion measures consisting of externalizing disorder symptoms (including child and adult antisocial deviance and substance-related problems) assessed via diagnostic interview, personality traits assessed by self-report, and psychopathic features as assessed by both interview and self-report. Results provide evidence for the validity of the ESI measurement model and point to its potential utility as a referent for research on the neurobiological correlates and etiological bases of externalizing proneness. PMID:21787091

Validity of the Externalizing Spectrum Inventory in a criminal offender sample: relations with disinhibitory psychopathology, personality, and psychopathic features.

PubMed

Venables, Noah C; Patrick, Christopher J

2012-03-01

The Externalizing Spectrum Inventory (ESI; Krueger, Markon, Patrick, Benning, & Kramer, 2007) provides a self-report based method for indexing a range of correlated problem behaviors and traits in the domain of deficient impulse control. The ESI organizes lower order behaviors and traits of this kind around higher order factors encompassing general disinhibitory proneness, callous-aggression, and substance abuse. In the current study, we used data from a male prisoner sample (N = 235) to evaluate the validity of ESI total and factor scores in relation to external criterion measures consisting of externalizing disorder symptoms (including child and adult antisocial deviance and substance-related problems) assessed via diagnostic interviews, personality traits assessed with self-reports, and psychopathic features as assessed with both interviews and self-reports. Results provide evidence for the validity of the ESI measurement model and point to its potential usefulness as a referent for research on the neurobiological correlates and etiological bases of externalizing proneness.

The Amsterdam wrist rules: the multicenter prospective derivation and external validation of a clinical decision rule for the use of radiography in acute wrist trauma.

PubMed

Walenkamp, Monique M J; Bentohami, Abdelali; Slaar, Annelie; Beerekamp, M Suzan H; Maas, Mario; Jager, L Cara; Sosef, Nico L; van Velde, Romuald; Ultee, Jan M; Steyerberg, Ewout W; Goslings, J Carel; Schep, Niels W L

2015-12-18

Although only 39 % of patients with wrist trauma have sustained a fracture, the majority of patients is routinely referred for radiography. The purpose of this study was to derive and externally validate a clinical decision rule that selects patients with acute wrist trauma in the Emergency Department (ED) for radiography. This multicenter prospective study consisted of three components: (1) derivation of a clinical prediction model for detecting wrist fractures in patients following wrist trauma; (2) external validation of this model; and (3) design of a clinical decision rule. The study was conducted in the EDs of five Dutch hospitals: one academic hospital (derivation cohort) and four regional hospitals (external validation cohort). We included all adult patients with acute wrist trauma. The main outcome was fracture of the wrist (distal radius, distal ulna or carpal bones) diagnosed on conventional X-rays. A total of 882 patients were analyzed; 487 in the derivation cohort and 395 in the validation cohort. We derived a clinical prediction model with eight variables: age; sex, swelling of the wrist; swelling of the anatomical snuffbox, visible deformation; distal radius tender to palpation; pain on radial deviation and painful axial compression of the thumb. The Area Under the Curve at external validation of this model was 0.81 (95 % CI: 0.77-0.85). The sensitivity and specificity of the Amsterdam Wrist Rules (AWR) in the external validation cohort were 98 % (95 % CI: 95-99 %) and 21 % (95 % CI: 15 %-28). The negative predictive value was 90 % (95 % CI: 81-99 %). The Amsterdam Wrist Rules is a clinical prediction rule with a high sensitivity and negative predictive value for fractures of the wrist. Although external validation showed low specificity and 100 % sensitivity could not be achieved, the Amsterdam Wrist Rules can provide physicians in the Emergency Department with a useful screening tool to select patients with acute wrist trauma for radiography. The upcoming implementation study will further reveal the impact of the Amsterdam Wrist Rules on the anticipated reduction of X-rays requested, missed fractures, Emergency Department waiting times and health care costs. This study was registered in the Dutch Trial Registry, reference number NTR2544 on October 1(st), 2010.

Predicting Overall Survival After Stereotactic Ablative Radiation Therapy in Early-Stage Lung Cancer: Development and External Validation of the Amsterdam Prognostic Model

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

Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com; Department of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario; Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts

Purpose: A prognostic model for 5-year overall survival (OS), consisting of recursive partitioning analysis (RPA) and a nomogram, was developed for patients with early-stage non-small cell lung cancer (ES-NSCLC) treated with stereotactic ablative radiation therapy (SABR). Methods and Materials: A primary dataset of 703 ES-NSCLC SABR patients was randomly divided into a training (67%) and an internal validation (33%) dataset. In the former group, 21 unique parameters consisting of patient, treatment, and tumor factors were entered into an RPA model to predict OS. Univariate and multivariate models were constructed for RPA-selected factors to evaluate their relationship with OS. A nomogrammore » for OS was constructed based on factors significant in multivariate modeling and validated with calibration plots. Both the RPA and the nomogram were externally validated in independent surgical (n=193) and SABR (n=543) datasets. Results: RPA identified 2 distinct risk classes based on tumor diameter, age, World Health Organization performance status (PS) and Charlson comorbidity index. This RPA had moderate discrimination in SABR datasets (c-index range: 0.52-0.60) but was of limited value in the surgical validation cohort. The nomogram predicting OS included smoking history in addition to RPA-identified factors. In contrast to RPA, validation of the nomogram performed well in internal validation (r{sup 2}=0.97) and external SABR (r{sup 2}=0.79) and surgical cohorts (r{sup 2}=0.91). Conclusions: The Amsterdam prognostic model is the first externally validated prognostication tool for OS in ES-NSCLC treated with SABR available to individualize patient decision making. The nomogram retained strong performance across surgical and SABR external validation datasets. RPA performance was poor in surgical patients, suggesting that 2 different distinct patient populations are being treated with these 2 effective modalities.« less

A Public-Private Partnership Develops and Externally Validates a 30-Day Hospital Readmission Risk Prediction Model

PubMed Central

Choudhry, Shahid A.; Li, Jing; Davis, Darcy; Erdmann, Cole; Sikka, Rishi; Sutariya, Bharat

2013-01-01

Introduction: Preventing the occurrence of hospital readmissions is needed to improve quality of care and foster population health across the care continuum. Hospitals are being held accountable for improving transitions of care to avert unnecessary readmissions. Advocate Health Care in Chicago and Cerner (ACC) collaborated to develop all-cause, 30-day hospital readmission risk prediction models to identify patients that need interventional resources. Ideally, prediction models should encompass several qualities: they should have high predictive ability; use reliable and clinically relevant data; use vigorous performance metrics to assess the models; be validated in populations where they are applied; and be scalable in heterogeneous populations. However, a systematic review of prediction models for hospital readmission risk determined that most performed poorly (average C-statistic of 0.66) and efforts to improve their performance are needed for widespread usage. Methods: The ACC team incorporated electronic health record data, utilized a mixed-method approach to evaluate risk factors, and externally validated their prediction models for generalizability. Inclusion and exclusion criteria were applied on the patient cohort and then split for derivation and internal validation. Stepwise logistic regression was performed to develop two predictive models: one for admission and one for discharge. The prediction models were assessed for discrimination ability, calibration, overall performance, and then externally validated. Results: The ACC Admission and Discharge Models demonstrated modest discrimination ability during derivation, internal and external validation post-recalibration (C-statistic of 0.76 and 0.78, respectively), and reasonable model fit during external validation for utility in heterogeneous populations. Conclusions: The ACC Admission and Discharge Models embody the design qualities of ideal prediction models. The ACC plans to continue its partnership to further improve and develop valuable clinical models. PMID:24224068

Validation of Immunohistochemical Assays for Integral Biomarkers in the NCI-MATCH EAY131 Clinical Trial.

PubMed

Khoury, Joseph D; Wang, Wei-Lien; Prieto, Victor G; Medeiros, L Jeffrey; Kalhor, Neda; Hameed, Meera; Broaddus, Russell; Hamilton, Stanley R

2018-02-01

Biomarkers that guide therapy selection are gaining unprecedented importance as targeted therapy options increase in scope and complexity. In conjunction with high-throughput molecular techniques, therapy-guiding biomarker assays based upon immunohistochemistry (IHC) have a critical role in cancer care in that they inform about the expression status of a protein target. Here, we describe the validation procedures for four clinical IHC biomarker assays-PTEN, RB, MLH1, and MSH2-for use as integral biomarkers in the nationwide NCI-Molecular Analysis for Therapy Choice (NCI-MATCH) EAY131 clinical trial. Validation procedures were developed through an iterative process based on collective experience and adaptation of broad guidelines from the FDA. The steps included primary antibody selection; assay optimization; development of assay interpretation criteria incorporating biological considerations; and expected staining patterns, including indeterminate results, orthogonal validation, and tissue validation. Following assay lockdown, patient samples and cell lines were used for analytic and clinical validation. The assays were then approved as laboratory-developed tests and used for clinical trial decisions for treatment selection. Calculations of sensitivity and specificity were undertaken using various definitions of gold-standard references, and external validation was required for the PTEN IHC assay. In conclusion, validation of IHC biomarker assays critical for guiding therapy in clinical trials is feasible using comprehensive preanalytic, analytic, and postanalytic steps. Implementation of standardized guidelines provides a useful framework for validating IHC biomarker assays that allow for reproducibility across institutions for routine clinical use. Clin Cancer Res; 24(3); 521-31. ©2017 AACR . ©2017 American Association for Cancer Research.

Coherent multi-heterodyne spectroscopy using acousto-optic frequency combs.

PubMed

Durán, Vicente; Schnébelin, Cȏme; Guillet de Chatellus, Hugues

2018-05-28

We propose and characterize experimentally a new source of optical frequency combs for performing multi-heterodyne spectrometry. This comb modality is based on a frequency-shifting loop seeded with a continuous-wave (CW) monochromatic laser. The comb lines are generated by successive passes of the CW laser through an acousto-optic frequency shifter. We report the generation of frequency combs with more than 1500 mutually coherent lines, without resorting to non-linear broadening phenomena or external electronic modulation. The comb line spacing is easily reconfigurable from tens of MHz down to the kHz region. We first use a single acousto-optic frequency comb to conduct self-heterodyne interferometry with a high frequency resolution (500 kHz). By increasing the line spacing to 80 MHz, we demonstrate molecular spectroscopy on the sub-millisecond time scale. In order to reduce the detection bandwidth, we subsequently implement an acousto-optic dual-comb spectrometer with the aid of two mutually coherent frequency shifting loops. In each architecture, the potentiality of acousto-optic frequency combs for spectroscopy is validated by spectral measurements of hydrogen cyanide in the near-infrared region.

Detection of Nitrogen Content in Rubber Leaves Using Near-Infrared (NIR) Spectroscopy with Correlation-Based Successive Projections Algorithm (SPA).

PubMed

Tang, Rongnian; Chen, Xupeng; Li, Chuang

2018-05-01

Near-infrared spectroscopy is an efficient, low-cost technology that has potential as an accurate method in detecting the nitrogen content of natural rubber leaves. Successive projections algorithm (SPA) is a widely used variable selection method for multivariate calibration, which uses projection operations to select a variable subset with minimum multi-collinearity. However, due to the fluctuation of correlation between variables, high collinearity may still exist in non-adjacent variables of subset obtained by basic SPA. Based on analysis to the correlation matrix of the spectra data, this paper proposed a correlation-based SPA (CB-SPA) to apply the successive projections algorithm in regions with consistent correlation. The result shows that CB-SPA can select variable subsets with more valuable variables and less multi-collinearity. Meanwhile, models established by the CB-SPA subset outperform basic SPA subsets in predicting nitrogen content in terms of both cross-validation and external prediction. Moreover, CB-SPA is assured to be more efficient, for the time cost in its selection procedure is one-twelfth that of the basic SPA.

Coherent multi-heterodyne spectroscopy using acousto-optic frequency combs

NASA Astrophysics Data System (ADS)

Durán, Vicente; Schnébelin, Cȏme; Guillet de Chatellus, Hugues

2018-05-01

We propose and characterize experimentally a new source of optical frequency combs for performing multi-heterodyne spectrometry. This comb modality is based on a frequency shifting loop seeded with a CW monochromatic laser. The comb lines are generated by successive passes of the CW laser through an acousto-optic frequency shifter. We report the generation of frequency combs with more than 1500 mutually coherent lines, without resorting to non-linear broadening phenomena or external electronic modulation. The comb line spacing is easily reconfigurable from tens of MHz down to the kHz region. We first use a single acousto-optic frequency comb to conduct self-heterodyne interferometry with a high frequency resolution (500 kHz). By increasing the line spacing to 80 MHz, we demonstrate molecular spectroscopy on the sub-millisecond time scale. In order to reduce the detection bandwidth, we subsequently implement an acousto-optic dual-comb spectrometer with the aid of two mutually coherent frequency shifting loops. In each architecture, the potentiality of acousto-optic frequency combs for spectroscopy is validated by spectral measurements of hydrogen cyanide in the near-infrared region.

A series of strategies for solving the shortage of reference standards for multi-components determination of traditional Chinese medicine, Mahoniae Caulis as a case.

PubMed

Wang, Wenguang; Ma, Xiaoli; Guo, Xiaoyu; Zhao, Mingbo; Tu, Pengfei; Jiang, Yong

2015-09-18

In order to solve the bottleneck of reference standards shortage for comprehensive quality control of traditional Chinese medicines (TCMs), a series of strategies, including one single reference standard to determine multi-compounds (SSDMC), quantitative analysis by standardized reference extract (QASRE), and quantitative nuclear magnetic resonance spectroscopy (qNMR) were proposed, and Mahoniae Caulis was selected as an example to develop and validate these methods for simultaneous determination of four alkaloids, columbamine, jatrorrhizine, palmatine, and berberine. Comprehensive comparisons among these methods and with the conventional external standard method (ESM) were carried out. The relative expanded uncertainty of measurement was firstly used to compare their credibility. The results showed that all these three new developed methods can accurately accomplish the quantification by using only one purified reference standard, but each of them has its own advantages and disadvantages as well as the specific application scope, which were also discussed in detail in this paper. Copyright © 2015 Elsevier B.V. All rights reserved.

Energy-Efficient Bioalcohol Recovery by Gel Stripping

NASA Astrophysics Data System (ADS)

Godbole, Rutvik; Ma, Lan; Hedden, Ronald

2014-03-01

Design of energy-efficient processes for recovering butanol and ethanol from dilute fermentations is a key challenge facing the biofuels industry due to the high energy consumption of traditional multi-stage distillation processes. Gel stripping is an alternative purification process by which a dilute alcohol is stripped from the fermentation product by passing it through a packed bed containing particles of a selectively absorbent polymeric gel material. The gel must be selective for the alcohol, while swelling to a reasonable degree in dilute alcohol-water mixtures. To accelerate materials optimization, a combinatorial approach is taken to screen a matrix of copolymer gels having orthogonal gradients in crosslinker concentration and hydrophilicity. Using a combination of swelling in pure solvents, the selectivity and distribution coefficients of alcohols in the gels can be predicted based upon multi-component extensions of Flory-Rehner theory. Predictions can be validated by measuring swelling in water/alcohol mixtures and conducting h HPLC analysis of the external liquid. 95% + removal of butanol from dilute aqueous solutions has been demonstrated, and a mathematical model of the unsteady-state gel stripping process has been developed. NSF CMMI Award 1335082.

A parallel multi-domain solution methodology applied to nonlinear thermal transport problems in nuclear fuel pins

DOE PAGES

Philip, Bobby; Berrill, Mark A.; Allu, Srikanth; ...

2015-01-26

We describe an efficient and nonlinearly consistent parallel solution methodology for solving coupled nonlinear thermal transport problems that occur in nuclear reactor applications over hundreds of individual 3D physical subdomains. Efficiency is obtained by leveraging knowledge of the physical domains, the physics on individual domains, and the couplings between them for preconditioning within a Jacobian Free Newton Krylov method. Details of the computational infrastructure that enabled this work, namely the open source Advanced Multi-Physics (AMP) package developed by the authors are described. The details of verification and validation experiments, and parallel performance analysis in weak and strong scaling studies demonstratingmore » the achieved efficiency of the algorithm are presented. Moreover, numerical experiments demonstrate that the preconditioner developed is independent of the number of fuel subdomains in a fuel rod, which is particularly important when simulating different types of fuel rods. Finally, we demonstrate the power of the coupling methodology by considering problems with couplings between surface and volume physics and coupling of nonlinear thermal transport in fuel rods to an external radiation transport code.« less

New schemes for internally contracted multi-reference configuration interaction

NASA Astrophysics Data System (ADS)

Wang, Yubin; Han, Huixian; Lei, Yibo; Suo, Bingbing; Zhu, Haiyan; Song, Qi; Wen, Zhenyi

2014-10-01

In this work we present a new internally contracted multi-reference configuration interaction (MRCI) scheme by applying the graphical unitary group approach and the hole-particle symmetry. The latter allows a Distinct Row Table (DRT) to split into a number of sub-DRTs in the active space. In the new scheme a contraction is defined as a linear combination of arcs within a sub-DRT, and connected to the head and tail of the DRT through up-steps and down-steps to generate internally contracted configuration functions. The new scheme deals with the closed-shell (hole) orbitals and external orbitals in the same manner and thus greatly simplifies calculations of coupling coefficients and CI matrix elements. As a result, the number of internal orbitals is no longer a bottleneck of MRCI calculations. The validity and efficiency of the new ic-MRCI code are tested by comparing with the corresponding WK code of the MOLPRO package. The energies obtained from the two codes are essentially identical, and the computational efficiencies of the two codes have their own advantages.

Does Rational Selection of Training and Test Sets Improve the Outcome of QSAR Modeling?

EPA Science Inventory

Prior to using a quantitative structure activity relationship (QSAR) model for external predictions, its predictive power should be established and validated. In the absence of a true external dataset, the best way to validate the predictive ability of a model is to perform its s...

Estimates of External Validity Bias When Impact Evaluations Select Sites Nonrandomly

ERIC Educational Resources Information Center

Bell, Stephen H.; Olsen, Robert B.; Orr, Larry L.; Stuart, Elizabeth A.

2016-01-01

Evaluations of educational programs or interventions are typically conducted in nonrandomly selected samples of schools or districts. Recent research has shown that nonrandom site selection can yield biased impact estimates. To estimate the external validity bias from nonrandom site selection, we combine lists of school districts that were…

Postoperative complications following intraoperative radiotherapy in abdominopelvic malignancy: A single institution analysis of 113 consecutive patients.

PubMed

Abdelfatah, Eihab; Page, Andrew; Sacks, Justin; Pierorazio, Phillip; Bivalacqua, Trinity; Efron, Jonathan; Terezakis, Stephanie; Gearhart, Susan; Fang, Sandy; Safar, Bashar; Pawlik, Timothy M; Armour, Elwood; Hacker-Prietz, Amy; Herman, Joseph; Ahuja, Nita

2017-06-01

Intraoperative radiotherapy (IORT) has advantages over external beam radiation therapy (EBRT). Few studies have described side effects associated with its addition. We evaluated our institution's experience with abdominopelvic IORT to assess safety by postoperative complication rates. Prospectively collected IRB-approved database of all patients receiving abdominopelvic IORT (via high dose rate brachytherapy) at Johns Hopkins Hospital between November 2006 and May 2014 was reviewed. Patients were discussed in multidisciplinary conferences. Those selected for IORT were patients for whom curative intent resection was planned for which IORT could improve margin-negative resection and optimize locoregional control. Perioperative complications were classified via Clavien-Dindo scale for postoperative surgical complications. A total of 113 patients were evaluated. Most common diagnosis was sarcoma (50/113, 44%) followed by colorectal cancer (45/113, 40%), most of which were recurrent (84%). There were no perioperative deaths. A total of 57% of patients experienced a complication Grade II or higher: 24% (27/113) Grade II; 27% (30/113) Grade III; 7% (8/113) Grade IV. Wound complications were most common (38%), then gastrointestinal (25%). No radiotherapy variables were significantly associated with complications on uni/multi-variate analysis. Our institution's experience with IORT demonstrated historically expected postoperative complication rates. IORT is safe, with acceptable perioperative morbidity. © 2017 Wiley Periodicals, Inc.

Optimal multi-type sensor placement for response and excitation reconstruction

NASA Astrophysics Data System (ADS)

Zhang, C. D.; Xu, Y. L.

2016-01-01

The need to perform dynamic response reconstruction always arises as the measurement of structural response is often limited to a few locations, especially for a large civil structure. Besides, it is usually very difficult, if not impossible, to measure external excitations under the operation condition of a structure. This study presents an algorithm for optimal placement of multi-type sensors, including strain gauges, displacement transducers and accelerometers, for the best reconstruction of responses of key structural components where there are no sensors installed and the best estimation of external excitations acting on the structure at the same time. The algorithm is developed in the framework of Kalman filter with unknown excitation, in which minimum-variance unbiased estimates of the generalized state of the structure and the external excitations are obtained by virtue of limited sensor measurements. The structural responses of key locations without sensors can then be reconstructed with the estimated generalized state and excitation. The asymptotic stability feature of the filter is utilized for optimal sensor placement. The number and spatial location of the multi-type sensors are determined by adding the optimal sensor which gains the maximal reduction of the estimation error of reconstructed responses. For the given mode number in response reconstruction and the given locations of external excitations, the optimal multi-sensor placement achieved by the proposed method is independent of the type and time evolution of external excitation. A simply-supported overhanging steel beam under multiple types of excitation is numerically studied to demonstrate the feasibility and superiority of the proposed method, and the experimental work is then carried out to testify the effectiveness of the proposed method.

External Accountability of Collaborative Arrangements; A Case Study of a Multi Academy Trust in England

ERIC Educational Resources Information Center

Ehren, Melanie C. M.; Godfrey, David

2017-01-01

This paper explores the impact of external accountability on four mechanisms of network-internal quality control and the properties of (mandated) inter-organizational networks. An explorative case study approach examines the external accountability of a newly established educational network (MAT) and how schools and the Trust are held accountable…

The Multiple Faces of Interparental Conflict: Implications for Cascades of Children’s Insecurity and Externalizing Problems

PubMed Central

Davies, Patrick T.; Hentges, Rochelle F.; Coe, Jesse L.; Martin, Meredith J.; Sturge-Apple, Melissa L.; Cummings, E. Mark

2016-01-01

This multi-study paper examined the relative strength of mediational pathways involving hostile, disengaged, and uncooperative forms of interparental conflict, children’s emotional insecurity, and their externalizing problems across two longitudinal studies. Participants in Study 1 consisted of 243 preschool children (M age = 4.60 years) and their parents, whereas Study 2 consisted of 263 adolescents (M age = 12.62 years) and their parents. Both studies utilized multi-method, multi-informant assessment batteries within a longitudinal design with three measurement occasions. Across both studies, lagged, autoregressive tests of the mediational paths revealed that interparental hostility was a significantly stronger predictor of the prospective cascade of children’s insecurity and externalizing problems than interparental disengagement and low levels of interparental cooperation. Findings further indicated that interparental disengagement was a stronger predictor of the insecurity pathway than was low interparental cooperation for the sample of adolescents in Study 2. Results are discussed in relation to how they inform and advance developmental models of family risk. PMID:27175983

Zygomatic bone shape in intentional cranial deformations: a model for the study of the interactions between skull growth and facial morphology.

PubMed

Ketoff, S; Girinon, F; Schlager, S; Friess, M; Schouman, T; Rouch, P; Khonsari, R H

2017-04-01

Intentional cranial deformations (ICD) were obtained by exerting external mechanical constraints on the skull vault during the first years of life to permanently modify head shape. The repercussions of ICD on the face are not well described in the midfacial region. Here we assessed the shape of the zygomatic bone in different types of ICDs. We considered 14 non-deformed skulls, 19 skulls with antero-posterior deformation, nine skulls with circumferential deformation and seven skulls with Toulouse deformation. The shape of the zygomatic bone was assessed using a statistical shape model after mesh registration. Euclidian distances between mean models and Mahalanobis distances after canonical variate analysis were computed. Classification accuracy was computed using a cross-validation approach. Different ICDs cause specific zygomatic shape modifications corresponding to different degrees of retrusion but the shape of the zygomatic bone alone is not a sufficient parameter for classifying populations into ICD groups defined by deformation types. We illustrate the fact that external mechanical constraints on the skull vault influence midfacial growth. ICDs are a model for the study of the influence of epigenetic factors on craniofacial growth and can help to understand the facial effects of congenital skull malformations such as single or multi-suture synostoses, or of external orthopedic devices such as helmets used to correct deformational plagiocephaly. © 2016 Anatomical Society.

Developing and Validating a Survival Prediction Model for NSCLC Patients Through Distributed Learning Across 3 Countries.

PubMed

Jochems, Arthur; Deist, Timo M; El Naqa, Issam; Kessler, Marc; Mayo, Chuck; Reeves, Jackson; Jolly, Shruti; Matuszak, Martha; Ten Haken, Randall; van Soest, Johan; Oberije, Cary; Faivre-Finn, Corinne; Price, Gareth; de Ruysscher, Dirk; Lambin, Philippe; Dekker, Andre

2017-10-01

Tools for survival prediction for non-small cell lung cancer (NSCLC) patients treated with chemoradiation or radiation therapy are of limited quality. In this work, we developed a predictive model of survival at 2 years. The model is based on a large volume of historical patient data and serves as a proof of concept to demonstrate the distributed learning approach. Clinical data from 698 lung cancer patients, treated with curative intent with chemoradiation or radiation therapy alone, were collected and stored at 2 different cancer institutes (559 patients at Maastro clinic (Netherlands) and 139 at Michigan university [United States]). The model was further validated on 196 patients originating from The Christie (United Kingdon). A Bayesian network model was adapted for distributed learning (the animation can be viewed at https://www.youtube.com/watch?v=ZDJFOxpwqEA). Two-year posttreatment survival was chosen as the endpoint. The Maastro clinic cohort data are publicly available at https://www.cancerdata.org/publication/developing-and-validating-survival-prediction-model-nsclc-patients-through-distributed, and the developed models can be found at www.predictcancer.org. Variables included in the final model were T and N category, age, performance status, and total tumor dose. The model has an area under the curve (AUC) of 0.66 on the external validation set and an AUC of 0.62 on a 5-fold cross validation. A model based on the T and N category performed with an AUC of 0.47 on the validation set, significantly worse than our model (P<.001). Learning the model in a centralized or distributed fashion yields a minor difference on the probabilities of the conditional probability tables (0.6%); the discriminative performance of the models on the validation set is similar (P=.26). Distributed learning from federated databases allows learning of predictive models on data originating from multiple institutions while avoiding many of the data-sharing barriers. We believe that distributed learning is the future of sharing data in health care. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Development and validation of Prediction models for Risks of complications in Early-onset Pre-eclampsia (PREP): a prospective cohort study.

PubMed

Thangaratinam, Shakila; Allotey, John; Marlin, Nadine; Mol, Ben W; Von Dadelszen, Peter; Ganzevoort, Wessel; Akkermans, Joost; Ahmed, Asif; Daniels, Jane; Deeks, Jon; Ismail, Khaled; Barnard, Ann Marie; Dodds, Julie; Kerry, Sally; Moons, Carl; Riley, Richard D; Khan, Khalid S

2017-04-01

The prognosis of early-onset pre-eclampsia (before 34 weeks' gestation) is variable. Accurate prediction of complications is required to plan appropriate management in high-risk women. To develop and validate prediction models for outcomes in early-onset pre-eclampsia. Prospective cohort for model development, with validation in two external data sets. Model development: 53 obstetric units in the UK. Model transportability: PIERS (Pre-eclampsia Integrated Estimate of RiSk for mothers) and PETRA (Pre-Eclampsia TRial Amsterdam) studies. Pregnant women with early-onset pre-eclampsia. Nine hundred and forty-six women in the model development data set and 850 women (634 in PIERS, 216 in PETRA) in the transportability (external validation) data sets. The predictors were identified from systematic reviews of tests to predict complications in pre-eclampsia and were prioritised by Delphi survey. The primary outcome was the composite of adverse maternal outcomes established using Delphi surveys. The secondary outcome was the composite of fetal and neonatal complications. We developed two prediction models: a logistic regression model (PREP-L) to assess the overall risk of any maternal outcome until postnatal discharge and a survival analysis model (PREP-S) to obtain individual risk estimates at daily intervals from diagnosis until 34 weeks. Shrinkage was used to adjust for overoptimism of predictor effects. For internal validation (of the full models in the development data) and external validation (of the reduced models in the transportability data), we computed the ability of the models to discriminate between those with and without poor outcomes ( c -statistic), and the agreement between predicted and observed risk (calibration slope). The PREP-L model included maternal age, gestational age at diagnosis, medical history, systolic blood pressure, urine protein-to-creatinine ratio, platelet count, serum urea concentration, oxygen saturation, baseline treatment with antihypertensive drugs and administration of magnesium sulphate. The PREP-S model additionally included exaggerated tendon reflexes and serum alanine aminotransaminase and creatinine concentration. Both models showed good discrimination for maternal complications, with anoptimism-adjusted c -statistic of 0.82 [95% confidence interval (CI) 0.80 to 0.84] for PREP-L and 0.75 (95% CI 0.73 to 0.78) for the PREP-S model in the internal validation. External validation of the reduced PREP-L model showed good performance with a c -statistic of 0.81 (95% CI 0.77 to 0.85) in PIERS and 0.75 (95% CI 0.64 to 0.86) in PETRA cohorts for maternal complications, and calibrated well with slopes of 0.93 (95% CI 0.72 to 1.10) and 0.90 (95% CI 0.48 to 1.32), respectively. In the PIERS data set, the reduced PREP-S model had a c -statistic of 0.71 (95% CI 0.67 to 0.75) and a calibration slope of 0.67 (95% CI 0.56 to 0.79). Low gestational age at diagnosis, high urine protein-to-creatinine ratio, increased serum urea concentration, treatment with antihypertensive drugs, magnesium sulphate, abnormal uterine artery Doppler scan findings and estimated fetal weight below the 10th centile were associated with fetal complications. The PREP-L model provided individualised risk estimates in early-onset pre-eclampsia to plan management of high- or low-risk individuals. The PREP-S model has the potential to be used as a triage tool for risk assessment. The impacts of the model use on outcomes need further evaluation. Current Controlled Trials ISRCTN40384046. The National Institute for Health Research Health Technology Assessment programme.

Leadership Development Institute: A California Community College Multi-College District Case Study

ERIC Educational Resources Information Center

Leon, Bianca R.

2016-01-01

The purpose of this study is to examine a community college district Grow Your Own (GYO) leadership program in the Western United States, the Multi College Leadership Development Institute (MCLDI). The MCLDI was developed in-house for a multi-campus community college district and offered to interested employees at all position levels with the…

MULTIPLY: Development of a European HSRL Airborne Facility

NASA Astrophysics Data System (ADS)

Binietoglou, Ioannis; Serikov, Ilya; Nicolae, Doina; Amiridis, Vassillis; Belegante, Livio; Boscornea, Andrea; Brugmann, Bjorn; Costa Suros, Montserrat; Hellmann, David; Kokkalis, Panagiotis; Linne, Holger; Stachlewska, Iwona; Vajaiac, Sorin-Nicolae

2016-08-01

MULTIPLY is a novel airborne high spectral resolution lidar (HSRL) currently under development by a consortium of European institutions from Romania, Germany, Greece, and Poland. Its aim is to contribute to calibration and validations activities of the upcoming ESA aerosol sensing missions like ADM-Aeolus, EarthCARE and the Sentinel-3/-4/-5/-5p which include products related to atmospheric aerosols. The effectiveness of these missions depends on independent airborne measurements to develop and test the retrieval methods, and validate mission products following launch. The aim of ESA's MULTIPLY project is to design, develop, and test a multi-wavelength depolarization HSRL for airborne applications. The MULTIPLY lidar will deliver the aerosol extinction and backscatter coefficient profiles at three wavelengths (355nm, 532nm, 1064nm), as well as profiles of aerosol intensive parameters (Ångström exponents, extinction- to-backscatter ratios, and linear particle depolarization ratios).

Development and application of a Controlled Release Facility (CRF) to validate flux quantifying methodologies.

NASA Astrophysics Data System (ADS)

Helmore, Jonathan

2017-04-01

The National Physical Laboratory, the UK's National Measurement Institute, has developed a novel facility capable of replicating the gaseous emission flux characteristics of a variety of real-word scenarios as may be found in small to medium scale industry and agriculture. The Controlled Release Facility (CRF) can be used to challenge conventional remote sensing techniques, as well as validate new Unmanned Aerial Vehicle (UAV) and distributed sensor network based methods, for source identification and flux calculation. The CRF method will be described and the results from three case studies will be discussed: The replication of an operational on-shore shale gas well using emissions of natural gas to atmosphere and measurements using Differential Absorption LIDAR (DIAL); the replication of fugitive volatile organic compounds emissions from a petrochemical unit and measurements using DIAL; and the replication of methane and carbon dioxide emissions from landfill and measurements using both fixed wing and multi-rotor UAVs.

Development and validation of a music performance anxiety inventory for gifted adolescent musicians.

PubMed

Osborne, Margaret S; Kenny, Dianna T

2005-01-01

Music performance anxiety (MPA) is a distressing experience for musicians of all ages, yet the empirical investigation of MPA in adolescents has received little attention to date. No measures specifically targeting MPA in adolescents have been empirically validated. This article presents findings of an initial study into the psychometric properties and validation of the Music Performance Anxiety Inventory for Adolescents (MPAI-A), a new self-report measure of MPA for this group. Data from 381 elite young musicians aged 12-19 years was used to investigate the factor structure, internal reliability, construct and divergent validity of the MPAI-A. Cronbach's alpha for the full measure was .91. Factor analysis identified three factors, which together accounted for 53% of the variance. Construct validity was demonstrated by significant positive relationships with social phobia (measured using the Social Phobia Anxiety Inventory [Beidel, D. C., Turner, S. M., & Morris, T. L. (1995). A new inventory to assess childhood social anxiety and phobia: The Social Phobia and Anxiety Inventory for Children. Psychological Assessment, 7(1), 73-79; Beidel, D. C., Turner, S. M., & Morris, T. L. (1998). Social Phobia and Anxiety Inventory for Children (SPAI-C). North Tonawanda, NY: Multi-Health Systems Inc.]) and trait anxiety (measured using the State Trait Anxiety Inventory [Spielberger, C. D. (1983). State-Trait Anxiety Inventory STAI (Form Y). Palo Alto, CA: Consulting Psychologists Press, Inc.]). The MPAI-A demonstrated convergent validity by a moderate to strong positive correlation with an adult measure of MPA. Discriminant validity was established by a weaker positive relationship with depression, and no relationship with externalizing behavior problems. It is hoped that the MPAI-A, as the first empirically validated measure of adolescent musicians' performance anxiety, will enhance and promote phenomenological and treatment research in this area.

A Psychometric Validation of the Internal and External Motivation to Respond without Prejudice toward People with Disabilities Scale

ERIC Educational Resources Information Center

Pruett, Steven R.; Deiches, Jon; Pfaller, Joseph; Moser, Erin; Chan, Fong

2014-01-01

Objective: To determine the factorial validity of the Internal and External Motivation to Respond without Prejudice toward People with Disabilities Scale (D-IMS/EMS). Design: A quantitative descriptive design using factor analysis. Participants: 233 rehabilitation counseling and rehabilitation services students. Results: Both exploratory and…

ODD and ADHD Symptoms in Ukrainian Children: External Validators and Comorbidity

ERIC Educational Resources Information Center

Drabick, Deborah A. G.; Gadow, Kenneth D.; Carlson, Gabrielle A.; Bromet, Evelyn J.

2004-01-01

Objective: To examine potential external validators for oppositional defiant disorder (ODD) and attention-deficient/hyperactive disorder (ADHD) symptoms in a Ukrainian community-based sample of 600 children age 10 to 12 years old and evaluate the nature of co-occurring ODD and ADHD symptoms using mother- and teacher-defined groups. Method: In…

Maximizing Institutional Research Impact through Building Relationships and Collaborating within the Institution

ERIC Educational Resources Information Center

Kirby, Yvonne Kochera; Floyd, Nancy D.

2015-01-01

Building and maintaining relationships within the institution with shared goals for preserving compliance and presenting an accurate portrait of the institution is critical for effective external reporting. It can also provide immeasurable internal benefit to information stakeholders.

AlzhCPI: A knowledge base for predicting chemical-protein interactions towards Alzheimer's disease.

PubMed

Fang, Jiansong; Wang, Ling; Li, Yecheng; Lian, Wenwen; Pang, Xiaocong; Wang, Hong; Yuan, Dongsheng; Wang, Qi; Liu, Ai-Lin; Du, Guan-Hua

2017-01-01

Alzheimer's disease (AD) is a complicated progressive neurodegeneration disorder. To confront AD, scientists are searching for multi-target-directed ligands (MTDLs) to delay disease progression. The in silico prediction of chemical-protein interactions (CPI) can accelerate target identification and drug discovery. Previously, we developed 100 binary classifiers to predict the CPI for 25 key targets against AD using the multi-target quantitative structure-activity relationship (mt-QSAR) method. In this investigation, we aimed to apply the mt-QSAR method to enlarge the model library to predict CPI towards AD. Another 104 binary classifiers were further constructed to predict the CPI for 26 preclinical AD targets based on the naive Bayesian (NB) and recursive partitioning (RP) algorithms. The internal 5-fold cross-validation and external test set validation were applied to evaluate the performance of the training sets and test set, respectively. The area under the receiver operating characteristic curve (ROC) for the test sets ranged from 0.629 to 1.0, with an average of 0.903. In addition, we developed a web server named AlzhCPI to integrate the comprehensive information of approximately 204 binary classifiers, which has potential applications in network pharmacology and drug repositioning. AlzhCPI is available online at http://rcidm.org/AlzhCPI/index.html. To illustrate the applicability of AlzhCPI, the developed system was employed for the systems pharmacology-based investigation of shichangpu against AD to enhance the understanding of the mechanisms of action of shichangpu from a holistic perspective.

Development and validation of the ExPRESS instrument for primary health care providers' evaluation of external supervision.

PubMed

Schriver, Michael; Cubaka, Vincent Kalumire; Vedsted, Peter; Besigye, Innocent; Kallestrup, Per

2018-01-01

External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. "External supervision: Provider Evaluation of Supervisor Support" (ExPRESS) was developed in 18 steps, primarily in Rwanda. Content validity was optimised using systematic search for related instruments, interviews, translations, and relevance assessments by international supervision experts as well as local experts in Nigeria, Kenya, Uganda and Rwanda. Construct validity and reliability were examined in two separate field tests, the first using exploratory factor analysis and a test-retest design, the second for confirmatory factor analysis. We included 16 items in section A ('The most recent experience with an external supervisor'), and 13 items in section B ('The overall experience with external supervisors'). Item-content validity index was acceptable. In field test I, test-retest had acceptable kappa values and exploratory factor analysis suggested relevant factors in sections A and B used for model hypotheses. In field test II, models were tested by confirmatory factor analysis fitting a 4-factor model for section A, and a 3-factor model for section B. ExPRESS is a promising tool for evaluation of the quality of support of primary health care providers in external supervision of primary health care facilities in resource-constrained settings. ExPRESS may be used as specific feedback to external supervisors to help identify and address gaps in the supervision they provide. Further studies should determine optimal interpretation of scores and the number of respondents needed per supervisor to obtain precise results, as well as test the functionality of section B.

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

PubMed Central

Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2015-01-01

Objectives Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. Methods An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. Results How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. Conclusions The development of hospital leaders’ skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. PMID:26683885

Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries.

PubMed

Burnett, Susan; Mendel, Peter; Nunes, Francisco; Wiig, Siri; van den Bovenkamp, Hester; Karltun, Anette; Robert, Glenn; Anderson, Janet; Vincent, Charles; Fulop, Naomi

2016-04-01

Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands. An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals. How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures. The development of hospital leaders' skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required. © The Author(s) 2015.

Organizational Adaptation to the Rapidly Changing External Environment: A Case Study of Strategic Marketing at Notre Dame College in Ohio

ERIC Educational Resources Information Center

Brown, Shawn M.

2012-01-01

This thesis examined the role of strategic marketing in organizational adaptation to a rapidly changing and competitive external environment among institutions of higher education. Colleges and universities adapt to external pressures as open systems operating within a broader external environment (Bess & Dee, 2008; Keller, 1983). How does…

Granting Credit for College Proficiency and Regents External Degree Examinations in New York State: A Summary of Institutional Policies, 1981-82.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Independent Study and Programs Development.

A guide is presented for students on the policies and practices of public and private New York colleges and universities in regard to granting credit, course waiver, or advanced standing to those who pass the College Proficiency Examinations (CPEs) and the Regents External Degree Examinations (REDEs). A chart indicates, for each institution and…

An Assessment of the Pacific Regional Cancer Coalition: Outcomes and Implications of a Regional Coalition Internal and External Assessment

PubMed Central

Heckert, Karen A; Buenconsejo-Lum, Lee; Hedson, Johnny; Tamang, Suresh; Palafox, Neal

2011-01-01

Significance The Pacific Regional Cancer Coalition Signifi(PRCC) provides regional leadership in the US Affiliated Pacific Islands (USAPI) to implement the Regional Comprehensive Control Plan: 2007–2012, and to evaluate its coalition and partnerships. The Pacific Center of Excellence in the Elimination of Disparities (CEED), aims to reduce cancer disparities and conducts evaluation activities relevant to cancer prevention and control in the USAPI. Purpose The PRCC Self (internal) and Partner (external) Assessments were conducted to assess coalition functioning, regional and national partnerships, sustainability, and the role of regionalism for integrating all chronic disease prevention and control in the Pacific. Methods Self-administered questionnaires and key informant telephone interviews with PRCC members (N=20), and representatives from regional and national partner organizations were administered (N=26). Validated multi item measures using 5-point scales on coalition and partnership characteristics were used. Chronbach's alphas and averages for the measures were computed. Results Internal coalition measures: satisfaction (4.2, SD=0.48) communication (4.0, SD=0.56), respect (4.0, SD=0.60) were rated more highly than external partnership measures: resource sharing (3.5, SD=0.74), regionalism (3.9, SD=0.47), use of findings (3.9, SD=0.50). The PRCC specifically identified its level of “collaboration” with external partners including Pacific CEED. External partners identified its partnership with the PRCC in the “coalition” stage. Principal Conclusions PRCC members and external partners are satisfied with their partnerships. All groups should continue to focus on building collaboration with partners to reflect a truly regional approach to sustain the commitment, the coalitions and the programming to reduce cancer in the USAPI. PRCC and partners should also work together to integrate all chronic disease prevention and control efforts in the Pacific. PMID:22235160

The convergent and discriminant validity of burnout measures in sport: a multi-trait/multi-method analysis.

PubMed

Cresswell, Scott L; Eklund, Robert C

2006-02-01

Athlete burnout research has been hampered by the lack of an adequate measurement tool. The Athlete Burnout Questionnaire (ABQ) and the Maslach Burnout Inventory General Survey (MBI-GS) are two recently developed self-report instruments designed to assess burnout. The convergent and discriminant validity of the ABQ and MBI-GS were assessed through multi-trait/multi-method analysis with a sporting population. Overall, the ABQ and the MBI-GS displayed acceptable convergent validity with matching subscales highly correlated, and satisfactory internal discriminant validity with lower correlations between non-matching subscales. Both scales also indicated an adequate discrimination between the concepts of burnout and depression. These findings add support to previous findings in non-sporting populations that depression and burnout are separate constructs. Based on the psychometric results, construct validity analysis and practical considerations, the results support the use of the ABQ to assess athlete burnout.

External and Other Threats to Institutional Autonomy

ERIC Educational Resources Information Center

Millett, John D.

1977-01-01

Institutional autonomy is discussed in terms of: (1) what functions society expects higher education to perform: (2) the effect of institutional dependence on public financing; and (3) the social importance of higher education. (LBH)

Preoperative Prediction of Node-Negative Disease After Neoadjuvant Chemotherapy in Patients Presenting with Node-Negative or Node-Positive Breast Cancer.

PubMed

Murphy, Brittany L; L Hoskin, Tanya; Heins, Courtney Day N; Habermann, Elizabeth B; Boughey, Judy C

2017-09-01

Axillary node status after neoadjuvant chemotherapy (NAC) influences the axillary surgical staging procedure as well as recommendations regarding reconstruction and radiation. Our aim was to construct a clinical preoperative prediction model to identify the likelihood of patients being node negative after NAC. Using the National Cancer Database (NCDB) from January 2010 to December 2012, we identified cT1-T4c, N0-N3 breast cancer patients treated with NAC. The effects of patient and tumor factors on pathologic node status were assessed by multivariable logistic regression separately for clinically node negative (cN0) and clinically node positive (cN+) disease, and two models were constructed. Model performance was validated in a cohort of NAC patients treated at our institution (January 2013-July 2016), and model discrimination was assessed by estimating the area under the curve (AUC). Of 16,153 NCDB patients, 6659 (41%) were cN0 and 9494 (59%) were cN+. Factors associated with pathologic nodal status and included in the models were patient age, tumor grade, biologic subtype, histology, clinical tumor category, and, in cN+ patients only, clinical nodal category. The validation dataset included 194 cN0 and 180 cN+ patients. The cN0 model demonstrated good discrimination, with an AUC of 0.73 (95% confidence interval [CI] 0.72-0.74) in the NCDB and 0.77 (95% CI 0.68-0.85) in the external validation, while the cN+ patient model AUC was 0.71 (95% CI 0.70-0.72) in the NCDB and 0.74 (95% CI 0.67-0.82) in the external validation. We constructed two models that showed good discrimination for predicting ypN0 status following NAC in cN0 and cN+ patients. These clinically useful models can guide surgical planning after NAC.

Development and validation of the patient evaluation scale (PES) for primary health care in Nigeria.

PubMed

Ogaji, Daprim S; Giles, Sally; Daker-White, Gavin; Bower, Peter

2017-03-01

Questionnaires developed for patient evaluation of the quality of primary care are often focussed on primary care systems in developed countries. Aim To report the development and validation of the patient evaluation scale (PES) designed for use in the Nigerian primary health care context. An iterative process was used to develop and validate the questionnaire using patients attending 28 primary health centres across eight states in Nigeria. The development involved literature review, patient interviews, expert reviews, cognitive testing with patients and waves of quantitative cross-sectional surveys. The questionnaire's content validity, internal structures, acceptability, reliability and construct validity are reported. Findings The full and shortened version of PES with 27 and 18 items, respectively, were developed through these process. The low item non-response from the serial cross-sectional surveys depicts questionnaire's acceptability among the local population. PES-short form (SF) has Cronbach's α of 0.87 and three domains (codenamed 'facility', 'organisation' and 'health care') with Cronbach's αs of 0.78, 0.79 and 0.81, respectively. Items in the multi-dimensional questionnaire demonstrated adequate convergent and discriminant properties. PES-SF scores show significant positive correlation with scores of the full PES and also discriminated population groups in support of a priori hypotheses. The PES and PES-SF contain items that are relevant to the needs of patients in Nigeria. The good measurement properties of the questionnaire demonstrates its potential usefulness for patient-focussed quality improvement activities in Nigeria. There is still need to translate these questionnaires into major languages in Nigeria and assess their validity against external quality criteria.

Steam-air blown bubbling fluidized bed biomass gasification (BFBBG): Multi-scale models and experimental validation

DOE PAGES

Bates, Richard B.; Ghoniem, Ahmed F.; Jablonski, Whitney S.; ...

2017-02-02

During fluidized bed biomass gasification, complex gas-solid mixing patterns and numerous chemical and physical phenomena make identification of optimal operating conditions challenging. In this work, a parametric experimental campaign was carried out alongside the development of a coupled reactor network model which successfully integrates the individually validated sub-models to predict steady-state reactor performance metrics and outputs. The experiments utilized an integrated gasification system consisting of an externally-heated, bench-scale, 4-in., 5 kWth, fluidized bed steam/air blown gasifier fed with woody biomass equipped with a molecular beam mass spectrometer to directly measure tar species. The operating temperature (750-850°C) and air/fuel equivalence ratiomore » (ER = 0-0.157) were independently varied to isolate their effects. Elevating temperature is shown to improve the char gasification rate and reduce tar concentrations. In conclusion, air strongly impacts the composition of tar, accelerating the conversion of lighter polycyclic-aromatic hydrocarbons into soot precursors, while also improving the overall carbon conversion.« less

Improving Institutional Report Card Indicators

ERIC Educational Resources Information Center

McGowan, Veronica

2016-01-01

Institutional report cards are increasingly being used by higher educational institutions to present academic outcomes to external audiences of prospective students and parents, as well as program and institutional evaluators. While some prospective students are served by national transparency measures most users mine information from the…

Merging Hyperspectural Imagery and Multi Scale Modeling for Laser Lethality

DTIC Science & Technology

2016-02-24

standing aluminum films, (2) the effect of the external gas pressure on the flow structures and the mechanisms of the alumina and oxygen transport to...expansion from Al target irradiated by a continuous wave laser into a supersonic external air flow is investigated in kinetic simulations performed for...a broad range of pressure in the external flow. The results of the simulations reveal a significant effect of the external gas pressure on the flow

Illustrating and analyzing the processes of multi-institutional collaboration: Lessons learnt at Howard University Hospital.

PubMed

Malik, Mansoor; Kumari, Suneeta; Manalai, Partam; Hipolito, Maria

2017-05-01

Multi-institutional collaboration offers a promising approach to the dissemination of resources for capacity building and the improvement of the training of new investigators and residents, especially in areas of novel curricular content. Physicians should keep pace with the rapid growth of curricular content in an era of restricted resources. Such collaborations, in which educational entities work together and share resources and infrastructure, have been employed in health care to improve quality of care, capacity building, disparity reduction, and resident training. This paper examines a federally funded multi-institutional collaboration for the project STRIDE (Seek, Treat, Reach to Identify Pretrial Defendants Enhancement) between Yale University, George Mason University (GMU), and Howard University, a Historically Black University. The STRIDE study collaboration focused on mental health, opioid addiction, and infectious disease/HIV among Africans Americans involved in CJS (Criminal Justice System). We discuss some of the challenges and benefits of collaborative research projects conducted at Historically Black Colleges and University (HBCUs) and highlight the educational opportunities created by such collaborations for residents and other trainees, leading to the development of independent investigators through multi-institutional, structured collaborative research. We identify some unique challenges such as substance use, race, stigma, incarceration among participants, and the cultural and power difference between participating institutions, and thereby address these issues and how it impacted the course of the multi-institutional collaborative effort.

Illustrating and analyzing the processes of multi-institutional collaboration: Lessons learnt at Howard University Hospital

PubMed Central

Malik, Mansoor; Kumari, Suneeta; Manalai, Partam; Hipolito, Maria

2017-01-01

Multi-institutional collaboration offers a promising approach to the dissemination of resources for capacity building and the improvement of the training of new investigators and residents, especially in areas of novel curricular content. Physicians should keep pace with the rapid growth of curricular content in an era of restricted resources. Such collaborations, in which educational entities work together and share resources and infrastructure, have been employed in health care to improve quality of care, capacity building, disparity reduction, and resident training. This paper examines a federally funded multi-institutional collaboration for the project STRIDE (Seek, Treat, Reach to Identify Pretrial Defendants Enhancement) between Yale University, George Mason University (GMU), and Howard University, a Historically Black University. The STRIDE study collaboration focused on mental health, opioid addiction, and infectious disease/HIV among Africans Americans involved in CJS (Criminal Justice System). We discuss some of the challenges and benefits of collaborative research projects conducted at Historically Black Colleges and University (HBCUs) and highlight the educational opportunities created by such collaborations for residents and other trainees, leading to the development of independent investigators through multi-institutional, structured collaborative research. We identify some unique challenges such as substance use, race, stigma, incarceration among participants, and the cultural and power difference between participating institutions, and thereby address these issues and how it impacted the course of the multi-institutional collaborative effort. PMID:28966991

Rendezvous with connectivity preservation for multi-robot systems with an unknown leader

NASA Astrophysics Data System (ADS)

Dong, Yi

2018-02-01

This paper studies the leader-following rendezvous problem with connectivity preservation for multi-agent systems composed of uncertain multi-robot systems subject to external disturbances and an unknown leader, both of which are generated by a so-called exosystem with parametric uncertainty. By combining internal model design, potential function technique and adaptive control, two distributed control strategies are proposed to maintain the connectivity of the communication network, to achieve the asymptotic tracking of all the followers to the output of the unknown leader system, as well as to reject unknown external disturbances. It is also worth to mention that the uncertain parameters in the multi-robot systems and exosystem are further allowed to belong to unknown and unbounded sets when applying the second fully distributed control law containing a dynamic gain inspired by high-gain adaptive control or self-tuning regulator.

Development and External Validation of a Melanoma Risk Prediction Model Based on Self-assessed Risk Factors.

PubMed

Vuong, Kylie; Armstrong, Bruce K; Weiderpass, Elisabete; Lund, Eiliv; Adami, Hans-Olov; Veierod, Marit B; Barrett, Jennifer H; Davies, John R; Bishop, D Timothy; Whiteman, David C; Olsen, Catherine M; Hopper, John L; Mann, Graham J; Cust, Anne E; McGeechan, Kevin

2016-08-01

Identifying individuals at high risk of melanoma can optimize primary and secondary prevention strategies. To develop and externally validate a risk prediction model for incident first-primary cutaneous melanoma using self-assessed risk factors. We used unconditional logistic regression to develop a multivariable risk prediction model. Relative risk estimates from the model were combined with Australian melanoma incidence and competing mortality rates to obtain absolute risk estimates. A risk prediction model was developed using the Australian Melanoma Family Study (629 cases and 535 controls) and externally validated using 4 independent population-based studies: the Western Australia Melanoma Study (511 case-control pairs), Leeds Melanoma Case-Control Study (960 cases and 513 controls), Epigene-QSkin Study (44 544, of which 766 with melanoma), and Swedish Women's Lifestyle and Health Cohort Study (49 259 women, of which 273 had melanoma). We validated model performance internally and externally by assessing discrimination using the area under the receiver operating curve (AUC). Additionally, using the Swedish Women's Lifestyle and Health Cohort Study, we assessed model calibration and clinical usefulness. The risk prediction model included hair color, nevus density, first-degree family history of melanoma, previous nonmelanoma skin cancer, and lifetime sunbed use. On internal validation, the AUC was 0.70 (95% CI, 0.67-0.73). On external validation, the AUC was 0.66 (95% CI, 0.63-0.69) in the Western Australia Melanoma Study, 0.67 (95% CI, 0.65-0.70) in the Leeds Melanoma Case-Control Study, 0.64 (95% CI, 0.62-0.66) in the Epigene-QSkin Study, and 0.63 (95% CI, 0.60-0.67) in the Swedish Women's Lifestyle and Health Cohort Study. Model calibration showed close agreement between predicted and observed numbers of incident melanomas across all deciles of predicted risk. In the external validation setting, there was higher net benefit when using the risk prediction model to classify individuals as high risk compared with classifying all individuals as high risk. The melanoma risk prediction model performs well and may be useful in prevention interventions reliant on a risk assessment using self-assessed risk factors.

Environmental Scanning and External Tendencies Affecting American Higher Education.

ERIC Educational Resources Information Center

Montgomery, Bruce A.; Hesse, Martin L.

1990-01-01

The use of environmental scanning to link the external environment to institutional strategic planning is exemplified in Michigan State University's approach. The university's program is described, and in an appended section, 25 external tendencies are presented and related issues, trends, and events outlined. (MSE)

Analysis of internal and external validity criteria for a computerized visual search task: A pilot study.

PubMed

Richard's, María M; Introzzi, Isabel; Zamora, Eliana; Vernucci, Santiago

2017-01-01

Inhibition is one of the main executive functions, because of its fundamental role in cognitive and social development. Given the importance of reliable and computerized measurements to assessment inhibitory performance, this research intends to analyze the internal and external criteria of validity of a computerized conjunction search task, to evaluate the role of perceptual inhibition. A sample of 41 children (21 females and 20 males), aged between 6 and 11 years old (M = 8.49, SD = 1.47), intentionally selected from a private management school of Mar del Plata (Argentina), middle socio-economic level were assessed. The Conjunction Search Task from the TAC Battery, Coding and Symbol Search tasks from Wechsler Intelligence Scale for Children were used. Overall, results allow us to confirm that the perceptual inhibition task form TAC presents solid rates of internal and external validity that make a valid measurement instrument of this process.

[Clinical and empirical findings with the OPD-CA].

PubMed

Winter, Sibylle; Jelen, Anna; Pressel, Christine; Lenz, Klaus; Lehmkuhl, Ulrike

2011-01-01

60 clinical patients (5-17 years) were diagnosed with an interview-manual of OPD-CA (Winter, 2004). For clinical validity a comparison of patients with internal (N=17) and external disorders (N=19) was shown. References for clinical validity resulted from the comparison of the groups, especially for the axes "conflict" and "prerequisites for treatment". Patients with internal disorders showed the conflict desire for care versus autarchy significantly more often than patients with external disorders. On the other hand patients with external disorders displayed the conflict submission versus control significantly more often. Significant differences were also found for the axis "prerequisites for treatment". Patients with internal disorders had better "prerequisites for treatment" in the domains experience of illness and the prerequisites for therapy. For the axes "interpersonal relation", "structure" and "prerequisites for treatment" satisfactory data for validity and reliability were found. The clinical validity points to the usefulness of OPD-CA-manual for psychodynamic diagnostics in childhood and adolescence.

Multi-frequency klystron designed for high efficiency

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

Jensen, Aaron

A multi-frequency klystron has an electron gun which generates a beam, a circuit of bunch-align-collect (BAC) tuned cavities that bunch the beam and amplify an RF signal, a collector where the beam is collected and dumped, and a standard output cavity and waveguide coupled to a window to output RF power at a fundamental mode to an external load. In addition, the klystron has additional bunch-align-collect (BAC) cavities tuned to a higher harmonic frequency, and a harmonic output cavity and waveguide coupled via a window to an additional external load.

Audits for advanced treatment dosimetry

NASA Astrophysics Data System (ADS)

Ibbott, G. S.; Thwaites, D. I.

2015-01-01

Radiation therapy has advanced rapidly over the last few decades, progressing from 3D conformal treatment to image-guided intensity modulated therapy of several different flavors, both 3D and 4D and to adaptive radiotherapy. The use of intensity modulation has increased the complexity of quality assurance and essentially eliminated the physicist's ability to judge the validity of a treatment plan, even approximately, on the basis of appearance and experience. Instead, complex QA devices and procedures are required at the institutional level. Similarly, the assessment of treatment quality through remote and on-site audits also requires greater sophistication. The introduction of 3D and 4D dosimetry into external audit systems must follow, to enable quality assurance systems to perform meaningful and thorough audits.

Approaches to developing the capacity of health policy analysis institutes: a comparative case study.

PubMed

Bennett, Sara; Corluka, Adrijana; Doherty, Jane; Tangcharoensathien, Viroj

2012-03-05

To review and assess (i) the factors that facilitate the development of sustainable health policy analysis institutes in low and middle income countries and (ii) the nature of external support for capacity development provided to such institutes. Comparative case studies of six health policy analysis institutes (3 from Asia and 3 from Africa) were conducted. In each region an NGO institute, an institute linked to government and a university based institute were included. Data collection comprised document review, semi-structured interviews with stakeholders and discussion of preliminary findings with institute staff. The findings are organized around four key themes: (i) Financial resources: three of the institutes had received substantial external grants at start-up, however two of these institutes subsequently collapsed. At all but one institute, reliance upon short term, donor funding, created high administrative costs and unpredictability. (ii) Human resources: the retention of skilled human resources was perceived to be key to institute success but was problematic at all but one institute. In particular staff often moved to better paid positions elsewhere once having acquired necessary skills and experience, leaving remaining senior staff with heavy workloads. (iii) Governance and management: board structures and roles varied according to the nature of institute ownership. Boards made important contributions to organizational capacity through promoting continuity, independence and fund raising. Routine management systems were typically perceived to be strong. (iv) Networks: linkages to policy makers helped promote policy influences. External networks with other research organizations, particularly where these were longer term institutional collaborations helped promote capacity. The development of strong in-country analytical and research capacity to guide health policy development is critical, yet many health policy analysis institutes remain very fragile. A combination of more strategic planning, active recruitment and retention strategies, and longer term, flexible funding, for example through endowments, needs to be promoted. Specific recommendations to funders and institutes are provided.

The Main Concept Analysis in Cantonese Aphasic Oral Discourse: External Validation and Monitoring Chronic Aphasia

ERIC Educational Resources Information Center

Kong, Anthony Pak-Hin

2011-01-01

Purpose: The 1st aim of this study was to further establish the external validity of the main concept (MC) analysis by examining its relationship with the Cantonese Linguistic Communication Measure (CLCM; Kong, 2006; Kong & Law, 2004)--an established quantitative system for narrative production--and the Cantonese version of the Western Aphasia…

External Validity of Childhood Disintegrative Disorder in Comparison with Autistic Disorder

ERIC Educational Resources Information Center

Kurita, Hiroshi; Osada, Hirokazu; Miyake, Yuko

2004-01-01

To examine the external validity of DSM-IV childhood disintegrative disorder (CDD), 10 children (M = 8.2 yrs) with CDD and 152 gender- and age-matched children with autistic disorder (AD) were compared on 24 variables. The CDD children had a significantly higher rate of epilepsy, significantly less uneven intellectual functioning, and a tendency…

Development of land use regression models for nitrogen dioxide, ultrafine particles, lung deposited surface area, and four other markers of particulate matter pollution in the Swiss SAPALDIA regions.

PubMed

Eeftens, Marloes; Meier, Reto; Schindler, Christian; Aguilera, Inmaculada; Phuleria, Harish; Ineichen, Alex; Davey, Mark; Ducret-Stich, Regina; Keidel, Dirk; Probst-Hensch, Nicole; Künzli, Nino; Tsai, Ming-Yi

2016-04-18

Land Use Regression (LUR) is a popular method to explain and predict spatial contrasts in air pollution concentrations, but LUR models for ultrafine particles, such as particle number concentration (PNC) are especially scarce. Moreover, no models have been previously presented for the lung deposited surface area (LDSA) of ultrafine particles. The additional value of ultrafine particle metrics has not been well investigated due to lack of exposure measurements and models. Air pollution measurements were performed in 2011 and 2012 in the eight areas of the Swiss SAPALDIA study at up to 40 sites per area for NO2 and at 20 sites in four areas for markers of particulate air pollution. We developed multi-area LUR models for biannual average concentrations of PM2.5, PM2.5 absorbance, PM10, PMcoarse, PNC and LDSA, as well as alpine, non-alpine and study area specific models for NO2, using predictor variables which were available at a national level. Models were validated using leave-one-out cross-validation, as well as independent external validation with routine monitoring data. Model explained variance (R(2)) was moderate for the various PM mass fractions PM2.5 (0.57), PM10 (0.63) and PMcoarse (0.45), and was high for PM2.5 absorbance (0.81), PNC (0.87) and LDSA (0.91). Study-area specific LUR models for NO2 (R(2) range 0.52-0.89) outperformed combined-area alpine (R (2)  = 0.53) and non-alpine (R (2)  = 0.65) models in terms of both cross-validation and independent external validation, and were better able to account for between-area variability. Predictor variables related to traffic and national dispersion model estimates were important predictors. LUR models for all pollutants captured spatial variability of long-term average concentrations, performed adequately in validation, and could be successfully applied to the SAPALDIA cohort. Dispersion model predictions or area indicators served well to capture the between area variance. For NO2, applying study-area specific models was preferable over applying combined-area alpine/non-alpine models. Correlations between pollutants were higher in the model predictions than in the measurements, so it will remain challenging to disentangle their health effects.

Institutional Mergers in Higher Education: Lessons from International Experience

ERIC Educational Resources Information Center

Harman, Grant; Harman, Kay

2003-01-01

Higher education systems and institutions have used institutional mergers to address a range of different problems, particularly fragmentation amongst non-university institutions, lack of financial and academic viability, pressures for major system restructuring and external competitive threats. While mergers frequently are disruptive, strongly…

5HTTLPR genotype moderates the longitudinal impact of early caregiving on externalizing behavior

PubMed Central

Smyke, Anna T.; Gleason, Mary Margaret; Nelson, Charles A.; Zeanah, Charles H.; Fox, Nathan A; Drury, Stacy S.

2014-01-01

We examined caregiver report of externalizing behavior from 12 to 54 months of age in 102 children randomized to care as usual in institutions or to newly-created high quality foster care. At baseline no differences by group or genotype in externalizing were found. However, changes in externalizing from baseline to 42 months of age were moderated by 5HTTLPR genotype and intervention group, where the slope for s/s individuals differed as a function of intervention group. The slope for individuals carrying the l allele did not significantly differ between groups. At 54 months of age, s/s children in the foster care group had the lowest levels of externalizing behavior, while children with the s/s genotype in the care as usual group demonstrated the highest rates of externalizing behavior. No intervention group differences were found in externalizing behavior among children who carried the l allele. These findings, within a randomized control trial of foster care compared to continued care as usual, indicate that 5HTTLPR genotype moderates the relation between early caregiving environments to predict externalizing behavior in children exposed to early institutional care in a manner most consistent with differential susceptibility. PMID:25640827

Creating Joint Representations of Collaborative Problem Solving with Multi-Touch Technology

ERIC Educational Resources Information Center

Mercier, E.; Higgins, S.

2014-01-01

Multi-touch surfaces have the potential to change the nature of computer-supported collaborative learning, allowing more equitable access to shared digital content. In this paper, we explore how large multi-touch tables can be used by groups of students as an external representation of their group interaction processes. Video data from 24 groups…

Clinical staging and operative reporting for multi-institutional trials in head and neck squamous cell carcinoma.

PubMed

Weymuller, E A

1997-12-01

A Strategic Planning Conference (jointly supported by NCI and NIDCD) was convened to consider potential improvements in surgical patient data for multi-institutional trials. The thesis underlying this project is that inadequacies in staging, pretreatment patient stratification, and the details of surgical resection may have obscured the detection of treatment effect. The goals of this project were multiple: (1) to consider the utility of new clinical stratification variables, (2) to increase the precision of tumor staging, and (3) to improve operative reporting for multi-institutional trials in head and neck cancer. The conference attendees came to a number of important conclusions: (1) TNM status is inadequate for describing head and neck cancer in a multi-institutional trial setting. A detailed anatomic reporting scheme is proposed; (2) comorbidity measures should be included as patient descriptors, especially those that meet the criteria "definitely important and easy to obtain"; (3) surgical reporting in multi-institutional trials should use a format that is compatible with computer analysis and use the same items as the revised (anatomic) staging system; (4) the surgeon should be personally responsible for data coding and should interact directly with the pathologist in marking the surgical specimen; (5) pathologic reporting should use an anatomic template identical to the staging and operative reporting formats.

External validation of type 2 diabetes computer simulation models: definitions, approaches, implications and room for improvement-a protocol for a systematic review.

PubMed

Ogurtsova, Katherine; Heise, Thomas L; Linnenkamp, Ute; Dintsios, Charalabos-Markos; Lhachimi, Stefan K; Icks, Andrea

2017-12-29

Type 2 diabetes mellitus (T2DM), a highly prevalent chronic disease, puts a large burden on individual health and health care systems. Computer simulation models, used to evaluate the clinical and economic effectiveness of various interventions to handle T2DM, have become a well-established tool in diabetes research. Despite the broad consensus about the general importance of validation, especially external validation, as a crucial instrument of assessing and controlling for the quality of these models, there are no systematic reviews comparing such validation of diabetes models. As a result, the main objectives of this systematic review are to identify and appraise the different approaches used for the external validation of existing models covering the development and progression of T2DM. We will perform adapted searches by applying respective search strategies to identify suitable studies from 14 electronic databases. Retrieved study records will be included or excluded based on predefined eligibility criteria as defined in this protocol. Among others, a publication filter will exclude studies published before 1995. We will run abstract and full text screenings and then extract data from all selected studies by filling in a predefined data extraction spreadsheet. We will undertake a descriptive, narrative synthesis of findings to address the study objectives. We will pay special attention to aspects of quality of these models in regard to the external validation based upon ISPOR and ADA recommendations as well as Mount Hood Challenge reports. All critical stages within the screening, data extraction and synthesis processes will be conducted by at least two authors. This protocol adheres to PRISMA and PRISMA-P standards. The proposed systematic review will provide a broad overview of the current practice in the external validation of models with respect to T2DM incidence and progression in humans built on simulation techniques. PROSPERO CRD42017069983 .

ICP-MS Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity ofanalytical data generated through the USEPA Contract Laboratory Program Statement ofWork (SOW) ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

Local irrigation management institutions mediate changes driven by external policy and market pressures in Nepal and Thailand.

PubMed

Bastakoti, Ram C; Shivakoti, Ganesh P; Lebel, Louis

2010-09-01

This article assesses the role of local institutions in managing irrigation water use. Fifty irrigation systems in each country were studied in Nepal and Thailand to compare the influence of local institutions on performance of irrigation systems amid changes in external policy and market pressures. Nepal's new irrigation policy after the re-instatement of multiparty democracy in 1990 emphasized participatory irrigation management transferring the management responsibility from state authorities to water users. The water user associations of traditional farmer-managed irrigation systems were formally recognized by requiring registration with related state authorities. In Thailand also government policies encouraged people's participation in irrigation management. Today water users are directly involved in management of even some large irrigation systems at the level of tertiary canals. Traditional communal irrigation systems in northern Thailand received support for system infrastructure improvement but have faced increased interference from government. In Thailand market development supported diversification in farming practices resulting in increased areas under high water-demanding commercial crops in the dry season. In contrast, the command areas of most irrigation systems in Nepal include cereal-based subsistence farming with only one-third having commercial farming. Cropping intensities are higher in Nepal than in Thailand reflecting, in part, differences in availability of land and management. In both countries local institutions play an important role in maintaining the performance of irrigation systems as external drivers and local contexts change. Local institutions have provided alternative options for irrigation water use by mediating external pressures.

[SIMBO: a Screening Instrument for Identification of Work-Related Disabilities--analyses of construct and prognostic validity].

PubMed

Streibelt, M; Gerwinn, H; Hansmeier, T; Thren, K; Müller-Fahrnow, W

2007-10-01

For a number of years, work-related interventions in medical rehabilitation (MBO) have been developed. Basically, these interventions concentrate on vocational problems of rehabilitees whose health disorders are strongly associated with contextual factors of the environment as well as personal factors. Previous studies showed a close relationship between the success of an intervention and identification of a specific demand. In fact there are several clinical concepts regarding specific demand. But there still is a lack of appropriate instruments for use in identification of occupational challenges. Therefore SIMBO (Screening Instrument for Identification of a Demand for Medical-Vocational Oriented Rehabilitation) has been developed recently. By using a scale for the intensity of work-related problems as well as a cut-off point, SIMBO is able to identify patients with and without a demand for work-related interventions. Analyses relative to construct validity and predictive validity were carried out on two different samples--a multi-clinic sample (patients with musculoskeletal disorders) and a sample from the German statutory pension insurance agency DRV Westfalen (successful applications for medical rehabilitation). In this context the cut-off level discussion is very important. By means of the multi-clinic sample--irrespective of cut-off definition--the SIMBO-decision and the clinical identification of MBO-demand were found to agree in 74-78% of the cases. This corresponds to a maximum adjusted correlation of r=0.59 (phi coefficient). Compared to the external ratings of vocational problems given by DRV staff in handling the applications, however, only little agreement is found (64%, r=0.25). In fact, SIMBO had in 77% (r=0.50) of the cases been able to correctly predict work-related problems to be expected. So the result obtained using this instrument is far better than prediction of these problems in the external ratings by DRV staff (54%, r=0,21). Also, return to work (RTW) in good health after six months can be predicted correctly by SIMBO in 77% of the cases. This means that the probability of RTW in good health is reduced by 90% (Odds Ratio=0.1) if work-related problems had been identified by SIMBO. Concerning its clinical as well as predictive quality, the validity of SIMBO-based ratings of work-related problems has been proven. Further, it has become obvious that SIMBO is suitable as an easy-to-handle tool for identification of a need for vocationally-focused interventions for use by the social insurance agencies which finance rehabilitation. Further interesting questions arise relative to application in different indications as well as potential uses as an outcome instrument.

Influence of healthcare institution managers' proactive approach to communication activities on patient satisfaction.

PubMed

Filipović, Vinka; Cicvarić, Slavica; Stavljanin, Velimir; Damnjanović, Vesna; Radojicić, Zoran; Joksimović, Nevenka Zarkić; Gogić, Aleksandra

2010-04-01

Over the recent years customer satisfaction program as a tool for patient satisfaction has been recognized as an important issue in healthcare services. The aim of this preliminary study was to explore an influence of healthcare institution managers' approach and attitudes to marketing and public relations activities (communication activities), in the context of implementation of customer satisfaction programs, on patient satisfaction. The study was conducted among managers from different state-owned healthcare institutions (healthcare centres, clinics, hospitals) in Serbia. The structured questionnaire form, comprising both open and closed questions, was used as a main research tool. The total number of sent questionnaires was 120; 56 questionnaires were sent back, while 49 of them were valid. It was shown that 42.9% of healthcare institutions apply proactive media approach, and that 35.7% of the organizations have a person who, besides his/her basic engagements, performs activities connected with marketing and public relations. Using Chi-square likelihood ratio test it is confirmed that these activities have a significant role in supporting customer satisfaction program implementation (p < 0.05). The results showed that in 69.4% cases, positive attitude of healthcare institutions managers toward marketing and public relations activities had positive influence on patient satisfaction (p < 0.05). Managers in healthcare sector in Serbia who used proactive approach toward media and who had already institutionalized communication activities with external stakeholders have a positive attitude to implementation of customer satisfaction program. Furthermore, managers' attitude toward communication activities has influence on patient satisfaction.

ICP-AES Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity ofanalytical data generated through the USEPA Contract Laboratory Program (CLP) Statement ofWork (SOW) ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

Trace Volatile Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity ofanalytical data generated through the USEPA Contract Laboratory Program (CLP) Statement ofWork (SOW) ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

Multi-institutional tumor banking: lessons learned from a pancreatic cancer biospecimen repository.

PubMed

Demeure, Michael J; Sielaff, Timothy; Koep, Larry; Prinz, Richard; Moser, A James; Zeh, Herb; Hostetter, Galen; Black, Jodi; Decker, Ardis; Rosewell, Sandra; Bussey, Kimberly J; Von Hoff, Daniel

2010-10-01

Clinically annotated pancreatic cancer samples are needed for progress to be made toward developing more effective treatments for this deadly cancer. As part of a National Cancer Institute-funded program project, we established a biospecimen core to support the research efforts. This article summarizes the key hurdles encountered and solutions we found in the process of developing a successful multi-institution biospecimen repository.

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…

Internal and External Validity of Scores on the Balanced Inventory of Desirable Responding and the Paulhus Deception Scales

ERIC Educational Resources Information Center

Lanyon, Richard I.; Carle, Adam C.

2007-01-01

The internal and external validity of scores on the two-scale Balanced Inventory of Desirable Responding (BIDR) and its recent revision, the Paulhus Deception Scales (PDS), developed to measure two facets of social desirability, were studied with three groups of forensic clients and two groups of college undergraduates (total N = 519). The two…

Single neural adaptive controller and neural network identifier based on PSO algorithm for spherical actuators with 3D magnet array

NASA Astrophysics Data System (ADS)

Yan, Liang; Zhang, Lu; Zhu, Bo; Zhang, Jingying; Jiao, Zongxia

2017-10-01

Permanent magnet spherical actuator (PMSA) is a multi-variable featured and inter-axis coupled nonlinear system, which unavoidably compromises its motion control implementation. Uncertainties such as external load and friction torque of ball bearing and manufacturing errors also influence motion performance significantly. Therefore, the objective of this paper is to propose a controller based on a single neural adaptive (SNA) algorithm and a neural network (NN) identifier optimized with a particle swarm optimization (PSO) algorithm to improve the motion stability of PMSA with three-dimensional magnet arrays. The dynamic model and computed torque model are formulated for the spherical actuator, and a dynamic decoupling control algorithm is developed. By utilizing the global-optimization property of the PSO algorithm, the NN identifier is trained to avoid locally optimal solution and achieve high-precision compensations to uncertainties. The employment of the SNA controller helps to reduce the effect of compensation errors and convert the system to a stable one, even if there is difference between the compensations and uncertainties due to external disturbances. A simulation model is established, and experiments are conducted on the research prototype to validate the proposed control algorithm. The amplitude of the parameter perturbation is set to 5%, 10%, and 15%, respectively. The strong robustness of the proposed hybrid algorithm is validated by the abundant simulation data. It shows that the proposed algorithm can effectively compensate the influence of uncertainties and eliminate the effect of inter-axis couplings of the spherical actuator.

Translation and validation of the German version of the Bournemouth Questionnaire for Neck Pain.

PubMed

Soklic, Marina; Peterson, Cynthia; Humphreys, B Kim

2012-01-25

Clinical outcome measures are important tools to monitor patient improvement during treatment as well as to document changes for research purposes. The short-form Bournemouth questionnaire for neck pain patients (BQN) was developed from the biopsychosocial model and measures pain, disability, cognitive and affective domains. It has been shown to be a valid and reliable outcome measure in English, French and Dutch and more sensitive to change compared to other questionnaires. The purpose of this study was to translate and validate a German version of the Bournemouth questionnaire for neck pain patients. German translation and back translation into English of the BQN was done independently by four persons and overseen by an expert committee. Face validity of the German BQN was tested on 30 neck pain patients in a single chiropractic practice. Test-retest reliability was evaluated on 31 medical students and chiropractors before and after a lecture. The German BQN was then assessed on 102 first time neck pain patients at two chiropractic practices for internal consistency, external construct validity, external longitudinal construct validity and sensitivity to change compared to the German versions of the Neck Disability Index (NDI) and the Neck Pain and Disability Scale (NPAD). Face validity testing lead to minor changes to the German BQN. The Intraclass Correlation Coefficient for the test-retest reliability was 0.99. The internal consistency was strong for all 7 items of the BQN with Cronbach α's of .79 and .80 for the pre and post-treatment total scores. External construct validity and external longitudinal construct validity using Pearson's correlation coefficient showed statistically significant correlations for all 7 scales of the BQN with the other questionnaires. The German BQN showed greater responsiveness compared to the other questionnaires for all scales. The German BQN is a valid and reliable outcome measure that has been successfully translated and culturally adapted. It is shorter, easier to use, and more responsive to change than the NDI and NPAD.

Prediction of multi-target networks of neuroprotective compounds with entropy indices and synthesis, assay, and theoretical study of new asymmetric 1,2-rasagiline carbamates.

PubMed

Romero Durán, Francisco J; Alonso, Nerea; Caamaño, Olga; García-Mera, Xerardo; Yañez, Matilde; Prado-Prado, Francisco J; González-Díaz, Humberto

2014-09-24

In a multi-target complex network, the links (L(ij)) represent the interactions between the drug (d(i)) and the target (t(j)), characterized by different experimental measures (K(i), K(m), IC50, etc.) obtained in pharmacological assays under diverse boundary conditions (c(j)). In this work, we handle Shannon entropy measures for developing a model encompassing a multi-target network of neuroprotective/neurotoxic compounds reported in the CHEMBL database. The model predicts correctly >8300 experimental outcomes with Accuracy, Specificity, and Sensitivity above 80%-90% on training and external validation series. Indeed, the model can calculate different outcomes for >30 experimental measures in >400 different experimental protocolsin relation with >150 molecular and cellular targets on 11 different organisms (including human). Hereafter, we reported by the first time the synthesis, characterization, and experimental assays of a new series of chiral 1,2-rasagiline carbamate derivatives not reported in previous works. The experimental tests included: (1) assay in absence of neurotoxic agents; (2) in the presence of glutamate; and (3) in the presence of H2O2. Lastly, we used the new Assessing Links with Moving Averages (ALMA)-entropy model to predict possible outcomes for the new compounds in a high number of pharmacological tests not carried out experimentally.

Mercury and Cyanide Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity ofanalytical data generated through the USEPA Contract Laboratory Program (CLP) Statement ofWork (SOW) ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

Low/Medium Volatile Data Validation

EPA Pesticide Factsheets

Document designed to offer data reviewers guidance in determining the validity of analytical data generated through the US EPA Contract Laboratory Program Statement of Work ISM01.X Inorganic Superfund Methods (Multi-Media, Multi-Concentration)

Participatory flood vulnerability assessment: a multi-criteria approach

NASA Astrophysics Data System (ADS)

Madruga de Brito, Mariana; Evers, Mariele; Delos Santos Almoradie, Adrian

2018-01-01

This paper presents a participatory multi-criteria decision-making (MCDM) approach for flood vulnerability assessment while considering the relationships between vulnerability criteria. The applicability of the proposed framework is demonstrated in the municipalities of Lajeado and Estrela, Brazil. The model was co-constructed by 101 experts from governmental organizations, universities, research institutes, NGOs, and private companies. Participatory methods such as the Delphi survey, focus groups, and workshops were applied. A participatory problem structuration, in which the modellers work closely with end users, was used to establish the structure of the vulnerability index. The preferences of each participant regarding the criteria importance were spatially modelled through the analytical hierarchy process (AHP) and analytical network process (ANP) multi-criteria methods. Experts were also involved at the end of the modelling exercise for validation. The final product is a set of individual and group flood vulnerability maps. Both AHP and ANP proved to be effective for flood vulnerability assessment; however, ANP is preferred as it considers the dependences among criteria. The participatory approach enabled experts to learn from each other and acknowledge different perspectives towards social learning. The findings highlight that to enhance the credibility and deployment of model results, multiple viewpoints should be integrated without forcing consensus.

3D Simulation of External Flooding Events for the RISMC Pathway

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

Prescott, Steven; Mandelli, Diego; Sampath, Ramprasad

2015-09-01

Incorporating 3D simulations as part of the Risk-Informed Safety Margins Characterization (RISMIC) Toolkit allows analysts to obtain a more complete picture of complex system behavior for events including external plant hazards. External events such as flooding have become more important recently – however these can be analyzed with existing and validated simulated physics toolkits. In this report, we describe these approaches specific to flooding-based analysis using an approach called Smoothed Particle Hydrodynamics. The theory, validation, and example applications of the 3D flooding simulation are described. Integrating these 3D simulation methods into computational risk analysis provides a spatial/visual aspect to themore » design, improves the realism of results, and can prove visual understanding to validate the analysis of flooding.« less

German Translation and Validation of the Cognitive Style Questionnaire Short Form (CSQ-SF-D)

PubMed Central

Huys, Quentin J. M.; Renz, Daniel; Petzschner, Frederike; Berwian, Isabel; Stoppel, Christian; Haker, Helene

2016-01-01

Background The Cognitive Style Questionnaire is a valuable tool for the assessment of hopeless cognitive styles in depression research, with predictive power in longitudinal studies. However, it is very burdensome to administer. Even the short form is still long, and neither this nor the original version exist in validated German translations. Methods The questionnaire was translated from English to German, back-translated and commented on by clinicians. The reliability, factor structure and external validity of an online form of the questionnaire were examined on 214 participants. External validity was measured on a subset of 90 subjects. Results The resulting CSQ-SF-D had good to excellent reliability, both across items and subscales, and similar external validity to the original English version. The internality subscale appeared less robust than other subscales. A detailed analysis of individual item performance suggests that stable results could be achieved with a very short form (CSQ-VSF-D) including only 27 of the 72 items. Conclusions The CSQ-SF-D is a validated and freely distributed translation of the CSQ-SF into German. This should make efficient assessment of cognitive style in German samples more accessible to researchers. PMID:26934499

German Translation and Validation of the Cognitive Style Questionnaire Short Form (CSQ-SF-D).

PubMed

Huys, Quentin J M; Renz, Daniel; Petzschner, Frederike; Berwian, Isabel; Stoppel, Christian; Haker, Helene

2016-01-01

The Cognitive Style Questionnaire is a valuable tool for the assessment of hopeless cognitive styles in depression research, with predictive power in longitudinal studies. However, it is very burdensome to administer. Even the short form is still long, and neither this nor the original version exist in validated German translations. The questionnaire was translated from English to German, back-translated and commented on by clinicians. The reliability, factor structure and external validity of an online form of the questionnaire were examined on 214 participants. External validity was measured on a subset of 90 subjects. The resulting CSQ-SF-D had good to excellent reliability, both across items and subscales, and similar external validity to the original English version. The internality subscale appeared less robust than other subscales. A detailed analysis of individual item performance suggests that stable results could be achieved with a very short form (CSQ-VSF-D) including only 27 of the 72 items. The CSQ-SF-D is a validated and freely distributed translation of the CSQ-SF into German. This should make efficient assessment of cognitive style in German samples more accessible to researchers.

An approach to using heart rate monitoring to estimate the ventilation and load of air pollution exposure.

PubMed

Cozza, Izabela Campos; Zanetta, Dirce Maria Trevisan; Fernandes, Frederico Leon Arrabal; da Rocha, Francisco Marcelo Monteiro; de Andre, Paulo Afonso; Garcia, Maria Lúcia Bueno; Paceli, Renato Batista; Prado, Gustavo Faibischew; Terra-Filho, Mario; do Nascimento Saldiva, Paulo Hilário; de Paula Santos, Ubiratan

2015-07-01

The effects of air pollution on health are associated with the amount of pollutants inhaled which depends on the environmental concentration and the inhaled air volume. It has not been clear whether statistical models of the relationship between heart rate and ventilation obtained using laboratory cardiopulmonary exercise test (CPET) can be applied to an external group to estimate ventilation. To develop and evaluate a model to estimate respiratory ventilation based on heart rate for inhaled load of pollutant assessment in field studies. Sixty non-smoking men; 43 public street workers (public street group) and 17 employees of the Forest Institute (park group) performed a maximum cardiopulmonary exercise test (CPET). Regression equation models were constructed with the heart rate and natural logarithmic of minute ventilation data obtained on CPET. Ten individuals were chosen randomly (public street group) and were used for external validation of the models (test group). All subjects also underwent heart rate register, and particulate matter (PM2.5) monitoring for a 24-hour period. For the public street group, the median difference between estimated and observed data was 0.5 (CI 95% -0.2 to 1.4) l/min and for the park group was 0.2 (CI 95% -0.2 to 1.2) l/min. In the test group, estimated values were smaller than the ones observed in the CPET, with a median difference of -2.4 (CI 95% -4.2 to -1.8) l/min. The mixed model estimated values suggest that this model is suitable for situations in which heart rate is around 120-140bpm. The mixed effect model is suitable for ventilation estimate, with good accuracy when applied to homogeneous groups, suggesting that, in this case, the model could be used in field studies to estimate ventilation. A small but significant difference in the median of external validation estimates was observed, suggesting that the applicability of the model to external groups needs further evaluation. Copyright © 2015 Elsevier B.V. All rights reserved.

Opportunities for Automation of Student Aid Processing in Postsecondary Institutions.

ERIC Educational Resources Information Center

St. John, Edward P.

1986-01-01

An overview of the options and opportunities postsecondary institutions should consider when developing plans for student aid automation is provided. The role of automation in the financial aid office, interfaces with institutional and external systems, alternative approaches to automation, and the need for an institutional strategy for automation…

Characteristics of acute care hospitals with diversity plans and translation services.

PubMed

Moseley, Charles B; Shen, Jay J; Ginn, Gregory O

2011-01-01

Hospitals provide diversity activities for a number of reasons. The authors examined community demand, resource availability, managed care, institutional pressure, and external orientation related variables that were associated with acute care hospital diversity plans and translation services. The authors used multiple logistic regression to analyze the data for 478 hospitals in the 2006 National Inpatient Sample (NIS) dataset that had available data on the racial and ethnic status of their discharges. We also used 2004 and 2006 American Hospital Association (AHA) data to measure the two dependent diversity variables and the other independent variables. We found that resource, managed care, and external orientation variables were associated with having a diversity plan and that resource, managed care, institutional, and external orientation variables were associated with providing translation services. The authors concluded that more evidence for diversity's impact, additional resources, and more institutional pressure may be needed to motivate more hospitals to provide diversity planning and translation services.

Evaluation of globally available precipitation data products as input for water balance models

NASA Astrophysics Data System (ADS)

Lebrenz, H.; Bárdossy, A.

2009-04-01

Subject of this study is the evaluation of globally available precipitation data products, which are intended to be used as input variables for water balance models in ungauged basins. The selected data sources are a) the Global Precipitation Climatology Centre (GPCC), b) the Global Precipitation Climatology Project (GPCP) and c) the Climate Research Unit (CRU), resulting into twelve globally available data products. The data products imply different data bases, different derivation routines and varying resolutions in time and space. For validation purposes, the ground data from South Africa were screened on homogeneity and consistency by various tests and an outlier detection using multi-linear regression was performed. External Drift Kriging was subsequently applied on the ground data and the resulting precipitation arrays were compared to the different products with respect to quantity and variance.

Patterns of Cognitive Strengths and Weaknesses: Identification Rates, Agreement, and Validity for Learning Disabilities Identification

PubMed Central

Miciak, Jeremy; Fletcher, Jack M.; Stuebing, Karla; Vaughn, Sharon; Tolar, Tammy D.

2014-01-01

Purpose Few empirical investigations have evaluated LD identification methods based on a pattern of cognitive strengths and weaknesses (PSW). This study investigated the reliability and validity of two proposed PSW methods: the concordance/discordance method (C/DM) and cross battery assessment (XBA) method. Methods Cognitive assessment data for 139 adolescents demonstrating inadequate response to intervention was utilized to empirically classify participants as meeting or not meeting PSW LD identification criteria using the two approaches, permitting an analysis of: (1) LD identification rates; (2) agreement between methods; and (3) external validity. Results LD identification rates varied between the two methods depending upon the cut point for low achievement, with low agreement for LD identification decisions. Comparisons of groups that met and did not meet LD identification criteria on external academic variables were largely null, raising questions of external validity. Conclusions This study found low agreement and little evidence of validity for LD identification decisions based on PSW methods. An alternative may be to use multiple measures of academic achievement to guide intervention. PMID:24274155

The Multitheoretical List of Therapeutic Interventions - 30 items (MULTI-30).

PubMed

Solomonov, Nili; McCarthy, Kevin S; Gorman, Bernard S; Barber, Jacques P

2018-01-16

To develop a brief version of the Multitheoretical List of Therapeutic Interventions (MULTI-60) in order to decrease completion time burden by approximately half, while maintaining content coverage. Study 1 aimed to select 30 items. Study 2 aimed to examine the reliability and internal consistency of the MULTI-30. Study 3 aimed to validate the MULTI-30 and ensure content coverage. In Study 1, the sample included 186 therapist and 255 patient MULTI ratings, and 164 ratings of sessions coded by trained observers. Internal consistency (Chronbach's alpha and McDonald's omega) was calculated and confirmatory factor analysis was conducted. Psychotherapy experts rated content relevance. Study 2 included a sample of 644 patient and 522 therapist ratings, and 793 codings of psychotherapy sessions. In Study 3, the sample included 33 codings of sessions. A series of regression analyses was conducted to examine replication of previously published findings using the MULTI-30. The MULTI-30 was found valid, reliable, and internally consistent across 2564 ratings examined across the three studies presented. The MULTI-30 a brief and reliable process measure. Future studies are required for further validation.

Increased anatomic severity in appendicitis is associated with outcomes in a South African population.

PubMed

Hernandez, Matthew C; Kong, Victor Y; Aho, Johnathon M; Bruce, John L; Polites, Stephanie F; Laing, Grant L; Zielinski, Martin D; Clarke, Damian L

2017-07-01

Severity of emergency general surgery (EGS) diseases has not been standardized until recently. The American Association for the Surgery of Trauma (AAST) proposed an anatomic severity grading system for EGS diseases to facilitate communication and quality comparisons between providers and hospitals. Previous work has demonstrated validity of the system for appendicitis in the United States. To demonstrate generalizability, we aim to externally validate this grading system in South African patients with appendicitis. Patients with acute appendicitis during 2010 to 2016 were identified at multi-institutional sites within South Africa. Baseline demographics and procedure types were recorded, and AAST grades were assigned based on intraoperative findings. Outcomes included duration of stay, mortality, and Clavien-Dindo complications. Summary statistical univariate and nominal logistic regression analyses were performed to compare AAST grade and outcomes. A total of 1,415 patients with a median (interquartile range) age of 19 years (14-28 years) were included (55% men). One hundred percent underwent appendectomy: 63.5% completed via midline laparotomy, 36.5% via limited incision (31.8% via McBurney incision and 4.7% via laparoscopy). Overall, 30-day mortality rate was 1.4% with an overall complication rate of 44%. Most common complications included surgical site infection (n = 147, 10.4%), pneumonia (n = 105, 7.4%), and renal failure (n = 64, 4.5%). Distribution of AAST grade is as follows: Grade 0 (10, 0.7%), Grade 1 (247, 17.4%), Grade 2 (280, 19.8%), Grade 3 (158, 11.3%), Grade 4 (179, 12.6%), and Grade 5 (541, 38.2%). Increased median (interquartile range) AAST grades were recorded in patients with complications, 5 (3-5) compared with those without (2 [1-3], p = 0.001). Duration of stay was increased for patients with higher AAST grades: 4 and 5 (10.6 ± 5.9 days) versus I and II (3.6 ± 4.3 days; p = 0.001). Area under the receiver operating characteristic analysis to predict presence of any complication based on AAST grade was 0.90. The AAST EGS grading system is valid to predict important clinical outcomes in a South African population with an increased degree of severity on presentation. These results support generalizability of the AAST EGS grading system for appendicitis in a developing nation. Prognostic, level II.

Multi-institutional, prospective, observational study comparing the Gastrografin challenge versus standard treatment in adhesive small bowel obstruction.

PubMed

Zielinski, Martin D; Haddad, Nadeem N; Cullinane, Daniel C; Inaba, Kenji; Yeh, Dante D; Wydo, Salina; Turay, David; Pakula, Andrea; Duane, Therese M; Watras, Jill; Widom, Kenneth A; Cull, John; Rodriguez, Carlos J; Toschlog, Eric A; Sams, Valerie G; Hazelton, Joshua P; Graybill, John Christopher; Skinner, Ruby; Yune, Ji-Ming

2017-07-01

Existing trials studying the use of Gastrografin for management of adhesive small bowel obstruction (SBO) are limited by methodological flaws and small sample sizes. We compared institutional protocols with and without Gastrografin (GG), hypothesizing that a SBO management protocol utilizing GG is associated with lesser rates of exploration, shorter length of stay, and fewer complications. A multi-institutional, prospective, observational study was performed on patients appropriate for GG with adhesive SBO. Exclusion criteria were internal/external hernia, signs of strangulation, history of abdominal/pelvic malignancy, or exploration within the past 6 weeks. Patients receiving GG were compared to patients receiving standard care without GG. Overall, 316 patients were included (58 ± 18 years; 53% male). There were 173 (55%) patients in the GG group (of whom 118 [75%] successfully passed) and 143 patients in the non-GG group. There were no differences in duration of obstipation (1.6 vs. 1.9 days, p = 0.77) or small bowel feces sign (32.9% vs. 25.0%, p = 0.14). Fewer patients in the GG protocol cohort had mesenteric edema on CT (16.3% vs. 29.9%; p = 0.009). There was a lower rate of bowel resection (6.9% vs. 21.0%, p < 0.001) and exploration rate in the GG group (20.8% vs. 44.1%, p < 0.0001). GG patients had a shorter duration of hospital stay (4 IQR 2-7 vs. 5 days IQR 2-12; p = 0.036) and a similar rate of complications (12.5% vs. 17.9%; p = 0.20). Multivariable analysis revealed that GG was independently associated with successful nonoperative management. Patients receiving Gastrografin for adhesive SBO had lower rates of exploration and shorter hospital length of stay compared to patients who did not receive GG. Adequately powered and well-designed randomized trials are required to confirm these findings and establish causality. Therapeutic, level III.

Analysis of the external and internal quantum efficiency of multi-emitter, white organic light emitting diodes

NASA Astrophysics Data System (ADS)

Furno, Mauro; Rosenow, Thomas C.; Gather, Malte C.; Lüssem, Björn; Leo, Karl

2012-10-01

We report on a theoretical framework for the efficiency analysis of complex, multi-emitter organic light emitting diodes (OLEDs). The calculation approach makes use of electromagnetic modeling to quantify the overall OLED photon outcoupling efficiency and a phenomenological description for electrical and excitonic processes. From the comparison of optical modeling results and measurements of the total external quantum efficiency, we obtain reliable estimates of internal quantum yield. As application of the model, we analyze high-efficiency stacked white OLEDs and comment on the various efficiency loss channels present in the devices.

Comparison of genomic-enhanced EPD systems using an external phenotypic database

USDA-ARS?s Scientific Manuscript database

The American Angus Association (AAA) is currently evaluating two methods to incorporate genomic information into their genetic evaluation program: 1) multi-trait incorporation of an externally produced molecular breeding value as an indicator trait (MT) and 2) single-step evaluation with an unweight...

Multi-institutional Prospective Evaluation of Bowel Quality of Life After Prostate External Beam Radiation Therapy Identifies Patient and Treatment Factors Associated With Patient-Reported Outcomes: The PROSTQA Experience

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

Hamstra, Daniel A., E-mail: dhamm@med.umich.edu; Conlon, Anna S.C.; Daignault, Stephanie

Purpose: To evaluate patients treated with external beam radiation therapy as part of the multicenter Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment (PROSTQA), to identify factors associated with posttreatment patient-reported bowel health-related quality of life (HRQOL). Methods and Materials: Pretreatment characteristics and treatment details among 292 men were evaluated using a general linear mixed model for their association with measured HRQOL by the Expanded Prostate Cancer Index Composite instrument through 2 years after enrollment. Results: Bowel HRQOL had a median score of 100 (interquartile range 91.7-100) pretreatment and 95.8 (interquartile range 83.3-100) at 2 years, representing new moderate/bigmore » problems in 11% for urgency, 7% for frequency, 4% for bloody stools, and 8% for an overall bowel problems. Baseline bowel score was the strongest predictor for all 2-year endpoints. In multivariable models, a volume of rectum ≥25% treated to 70 Gy (V70) yielded a clinically significant 9.3-point lower bowel score (95% confidence interval [CI] 16.8-1.7, P=.015) and predicted increased risks for moderate to big fecal incontinence (P=.0008). No other radiation therapy treatment-related variables influenced moderate to big changes in rectal HRQOL. However, on multivariate analyses V70 ≥25% was associated with increases in small, moderate, or big problems with the following: incontinence (3.9-fold; 95% CI 1.1-13.4, P=.03), rectal bleeding (3.6-fold; 95% CI 1.3-10.2, P=.018), and bowel urgency (2.9-fold; 95% CI 1.1-7.6, P=.026). Aspirin use correlated with a clinically significant 4.7-point lower bowel summary score (95% CI 9.0-0.4, P=.03) and an increase in small, moderate, or big problems with bloody stools (2.8-fold; 95% CI 1.2-6.4, P=.018). Intensity modulated radiation therapy was associated with higher radiation therapy doses to the prostate and lower doses to the rectum but did not independently correlate with bowel HRQOL. Conclusion: After contemporary dose-escalated external beam radiation therapy up to 11% of patients have newly identified moderate/big problems with bowel HRQOL 2 years after treatment. Bowel HRQOL is related to baseline function, rectal V70, and aspirin use. Finally, our findings validate the commonly utilized cut-point of rectal V70 ≥25% as having significant impact on patient-reported outcomes.« less

The German Version of the Dutch Eating Behavior Questionnaire: Psychometric Properties, Measurement Invariance, and Population-Based Norms

PubMed Central

Hilbert, Anja; de Zwaan, Martina; Braehler, Elmar; Kersting, Anette

2016-01-01

The Dutch Eating Behavior Questionnaire is an internationally widely used instrument assessing different eating styles that may contribute to weight gain and overweight: emotional eating, external eating, and restraint. This study aimed to evaluate the psychometric properties of the 30-item German version of the DEBQ including its measurement invariance across gender, age, and BMI-status in a representative German population sample. Furthermore, we examined the distribution of eating styles in the general population and provide population-based norms for DEBQ scales. A representative sample of the German general population (N = 2513, age ≥ 14 years) was assessed with the German version of the DEBQ along with information on sociodemographic characteristics and body weight and height. The German version of the DEQB demonstrates good item characteristics and reliability (restraint: α = .92, emotional eating: α = .94, external eating: α = .89). The 3-factor structure of the DEBQ could be replicated in exploratory and confirmatory factor analyses and results of multi-group confirmatory factor analyses supported its metric and scalar measurement invariance across gender, age, and BMI-status. External eating was the most prevalent eating style in the German general population. Women scored higher on emotional and restrained eating scales than men, and overweight individuals scored higher in all three eating styles compared to normal weight individuals. Small differences across age were found for external eating. Norms were provided according to gender, age, and BMI-status. Our findings suggest that the German version of the DEBQ has good reliability and construct validity, and is suitable to reliably measure eating styles across age, gender, and BMI-status. Furthermore, the results demonstrate a considerable variation of eating styles across gender and BMI-status. PMID:27656879

The German Version of the Dutch Eating Behavior Questionnaire: Psychometric Properties, Measurement Invariance, and Population-Based Norms.

PubMed

Nagl, Michaela; Hilbert, Anja; de Zwaan, Martina; Braehler, Elmar; Kersting, Anette

The Dutch Eating Behavior Questionnaire is an internationally widely used instrument assessing different eating styles that may contribute to weight gain and overweight: emotional eating, external eating, and restraint. This study aimed to evaluate the psychometric properties of the 30-item German version of the DEBQ including its measurement invariance across gender, age, and BMI-status in a representative German population sample. Furthermore, we examined the distribution of eating styles in the general population and provide population-based norms for DEBQ scales. A representative sample of the German general population (N = 2513, age ≥ 14 years) was assessed with the German version of the DEBQ along with information on sociodemographic characteristics and body weight and height. The German version of the DEQB demonstrates good item characteristics and reliability (restraint: α = .92, emotional eating: α = .94, external eating: α = .89). The 3-factor structure of the DEBQ could be replicated in exploratory and confirmatory factor analyses and results of multi-group confirmatory factor analyses supported its metric and scalar measurement invariance across gender, age, and BMI-status. External eating was the most prevalent eating style in the German general population. Women scored higher on emotional and restrained eating scales than men, and overweight individuals scored higher in all three eating styles compared to normal weight individuals. Small differences across age were found for external eating. Norms were provided according to gender, age, and BMI-status. Our findings suggest that the German version of the DEBQ has good reliability and construct validity, and is suitable to reliably measure eating styles across age, gender, and BMI-status. Furthermore, the results demonstrate a considerable variation of eating styles across gender and BMI-status.

Initial Evidence for the Reliability and Validity of the Student Risk Screening Scale for Internalizing and Externalizing Behaviors at the Middle School Level

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Oakes, Wendy Peia; Carter, Erik W.; Lambert, Warren E.; Jenkins, Abbie B.

2013-01-01

We reported findings of an exploratory validation study of a revised universal screening instrument: the Student Risk Screening Scale--Internalizing and Externalizing (SRSS-IE) for use with middle school students. Tested initially for use with elementary-age students, the SRSS-IE was adapted to include seven additional items reflecting…

A Validation of the Student Risk Screening Scale for Internalizing and Externalizing Behaviors: Patterns in Rural and Urban Elementary Schools

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Menzies, Holly M.; Oakes, Wendy P.; Lambert, Warren; Cox, Meredith; Hankins, Katy

2012-01-01

We report findings of two studies, one conducted in a rural school district (N = 982) and a second conducted in an urban district (N = 1,079), offering additional evidence of the reliability and validity of a revised instrument, the Student Risk Screening Scale-Internalizing and Externalizing (SRSS-IE), to accurately detect internalizing and…

Multi-task transfer learning deep convolutional neural network: application to computer-aided diagnosis of breast cancer on mammograms

NASA Astrophysics Data System (ADS)

Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Helvie, Mark A.; Cha, Kenny H.; Richter, Caleb D.

2017-12-01

Transfer learning in deep convolutional neural networks (DCNNs) is an important step in its application to medical imaging tasks. We propose a multi-task transfer learning DCNN with the aim of translating the ‘knowledge’ learned from non-medical images to medical diagnostic tasks through supervised training and increasing the generalization capabilities of DCNNs by simultaneously learning auxiliary tasks. We studied this approach in an important application: classification of malignant and benign breast masses. With Institutional Review Board (IRB) approval, digitized screen-film mammograms (SFMs) and digital mammograms (DMs) were collected from our patient files and additional SFMs were obtained from the Digital Database for Screening Mammography. The data set consisted of 2242 views with 2454 masses (1057 malignant, 1397 benign). In single-task transfer learning, the DCNN was trained and tested on SFMs. In multi-task transfer learning, SFMs and DMs were used to train the DCNN, which was then tested on SFMs. N-fold cross-validation with the training set was used for training and parameter optimization. On the independent test set, the multi-task transfer learning DCNN was found to have significantly (p  =  0.007) higher performance compared to the single-task transfer learning DCNN. This study demonstrates that multi-task transfer learning may be an effective approach for training DCNN in medical imaging applications when training samples from a single modality are limited.

Examining the Assessment Literacy of External Examiners

ERIC Educational Resources Information Center

Medland, Emma

2015-01-01

External scrutiny of higher education courses is evident globally, but the use of an external examiner from another institution for the purposes of quality assurance has been a distinguishing feature of UK higher education since the 1830s. However, the changing higher education context has led to mounting criticism of the system and the…

Students' Experience of External Studies. Student Diary Project.

ERIC Educational Resources Information Center

Parer, Michael S.

This study examined students' experiences of external study at Gippsland Institute through the method of student self-report study diaries. Questions which were addressed include: (1) Why are external students taking courses at Gippsland? (2) What do they hope to gain? (3) How do they handle particular study guides and assignment materials? (4)…

Mortality after Spontaneous Subarachnoid Hemorrhage: Causality and Validation of a Prediction Model.

PubMed

Abulhasan, Yasser B; Alabdulraheem, Najayeb; Simoneau, Gabrielle; Angle, Mark R; Teitelbaum, Jeanne

2018-04-01

To evaluate primary causes of death after spontaneous subarachnoid hemorrhage (SAH) and externally validate the HAIR score, a prognostication tool, in a single academic institution. We reviewed all patients with SAH admitted to our neuro-intensive care unit between 2010 and 2016. Univariate and multivariate logistic regressions were performed to identify predictors of in-hospital mortality. The HAIR score predictors were Hunt and Hess grade at treatment decision, age, intraventricular hemorrhage, and rebleeding within 24 hours. Validation of the HAIR score was characterized with the receiver operating curve, the area under the curve, and a calibration plot. Among 434 patients with SAH, in-hospital mortality was 14.1%. Of the 61 mortalities, 54 (88.5%) had a neurologic cause of death or withdrawal of care and 7 (11.5%) had cardiac death. Median time from SAH to death was 6 days. The main causes of death were effect of the initial hemorrhage (26.2%), rebleeding (23%) and refractory cerebral edema (19.7%). Factors significantly associated with in-hospital mortality in the multivariate analysis were age, Hunt and Hess grade, and intracerebral hemorrhage. Maximum lumen size was also a significant risk factor after aneurysmal SAH. The HAIR score had a satisfactory discriminative ability, with an area under the curve of 0.89. The in-hospital mortality is lower than in previous reports, attesting to the continuing improvement of our institutional SAH care. The major causes are the same as in previous reports. Despite a different therapeutic protocol, the HAIR score showed good discrimination and could be a useful tool for predicting mortality. Copyright © 2018 Elsevier Inc. All rights reserved.

Joint multiple fully connected convolutional neural network with extreme learning machine for hepatocellular carcinoma nuclei grading.

PubMed

Li, Siqi; Jiang, Huiyan; Pang, Wenbo

2017-05-01

Accurate cell grading of cancerous tissue pathological image is of great importance in medical diagnosis and treatment. This paper proposes a joint multiple fully connected convolutional neural network with extreme learning machine (MFC-CNN-ELM) architecture for hepatocellular carcinoma (HCC) nuclei grading. First, in preprocessing stage, each grayscale image patch with the fixed size is obtained using center-proliferation segmentation (CPS) method and the corresponding labels are marked under the guidance of three pathologists. Next, a multiple fully connected convolutional neural network (MFC-CNN) is designed to extract the multi-form feature vectors of each input image automatically, which considers multi-scale contextual information of deep layer maps sufficiently. After that, a convolutional neural network extreme learning machine (CNN-ELM) model is proposed to grade HCC nuclei. Finally, a back propagation (BP) algorithm, which contains a new up-sample method, is utilized to train MFC-CNN-ELM architecture. The experiment comparison results demonstrate that our proposed MFC-CNN-ELM has superior performance compared with related works for HCC nuclei grading. Meanwhile, external validation using ICPR 2014 HEp-2 cell dataset shows the good generalization of our MFC-CNN-ELM architecture. Copyright © 2017 Elsevier Ltd. All rights reserved.

QSAR prediction of additive and non-additive mixture toxicities of antibiotics and pesticide.

PubMed

Qin, Li-Tang; Chen, Yu-Han; Zhang, Xin; Mo, Ling-Yun; Zeng, Hong-Hu; Liang, Yan-Peng

2018-05-01

Antibiotics and pesticides may exist as a mixture in real environment. The combined effect of mixture can either be additive or non-additive (synergism and antagonism). However, no effective predictive approach exists on predicting the synergistic and antagonistic toxicities of mixtures. In this study, we developed a quantitative structure-activity relationship (QSAR) model for the toxicities (half effect concentration, EC 50 ) of 45 binary and multi-component mixtures composed of two antibiotics and four pesticides. The acute toxicities of single compound and mixtures toward Aliivibrio fischeri were tested. A genetic algorithm was used to obtain the optimized model with three theoretical descriptors. Various internal and external validation techniques indicated that the coefficient of determination of 0.9366 and root mean square error of 0.1345 for the QSAR model predicted that 45 mixture toxicities presented additive, synergistic, and antagonistic effects. Compared with the traditional concentration additive and independent action models, the QSAR model exhibited an advantage in predicting mixture toxicity. Thus, the presented approach may be able to fill the gaps in predicting non-additive toxicities of binary and multi-component mixtures. Copyright © 2018 Elsevier Ltd. All rights reserved.

Validity, Responsibility, and Aporia

ERIC Educational Resources Information Center

Koro-Ljungberg, Mirka

2010-01-01

In this article, the author problematizes external, objectified, oversimplified, and mechanical approaches to validity in qualitative research, which endorse simplistic and reductionist views of knowledge and data. Instead of promoting one generalizable definition or operational criteria for validity, the author's "deconstructive validity work"…

Review and evaluation of performance measures for survival prediction models in external validation settings.

PubMed

Rahman, M Shafiqur; Ambler, Gareth; Choodari-Oskooei, Babak; Omar, Rumana Z

2017-04-18

When developing a prediction model for survival data it is essential to validate its performance in external validation settings using appropriate performance measures. Although a number of such measures have been proposed, there is only limited guidance regarding their use in the context of model validation. This paper reviewed and evaluated a wide range of performance measures to provide some guidelines for their use in practice. An extensive simulation study based on two clinical datasets was conducted to investigate the performance of the measures in external validation settings. Measures were selected from categories that assess the overall performance, discrimination and calibration of a survival prediction model. Some of these have been modified to allow their use with validation data, and a case study is provided to describe how these measures can be estimated in practice. The measures were evaluated with respect to their robustness to censoring and ease of interpretation. All measures are implemented, or are straightforward to implement, in statistical software. Most of the performance measures were reasonably robust to moderate levels of censoring. One exception was Harrell's concordance measure which tended to increase as censoring increased. We recommend that Uno's concordance measure is used to quantify concordance when there are moderate levels of censoring. Alternatively, Gönen and Heller's measure could be considered, especially if censoring is very high, but we suggest that the prediction model is re-calibrated first. We also recommend that Royston's D is routinely reported to assess discrimination since it has an appealing interpretation. The calibration slope is useful for both internal and external validation settings and recommended to report routinely. Our recommendation would be to use any of the predictive accuracy measures and provide the corresponding predictive accuracy curves. In addition, we recommend to investigate the characteristics of the validation data such as the level of censoring and the distribution of the prognostic index derived in the validation setting before choosing the performance measures.

Predicting herbivore faecal nitrogen using a multispecies near-infrared reflectance spectroscopy calibration.

PubMed

Villamuelas, Miriam; Serrano, Emmanuel; Espunyes, Johan; Fernández, Néstor; López-Olvera, Jorge R; Garel, Mathieu; Santos, João; Parra-Aguado, María Ángeles; Ramanzin, Maurizio; Fernández-Aguilar, Xavier; Colom-Cadena, Andreu; Marco, Ignasi; Lavín, Santiago; Bartolomé, Jordi; Albanell, Elena

2017-01-01

Optimal management of free-ranging herbivores requires the accurate assessment of an animal's nutritional status. For this purpose 'near-infrared reflectance spectroscopy' (NIRS) is very useful, especially when nutritional assessment is done through faecal indicators such as faecal nitrogen (FN). In order to perform an NIRS calibration, the default protocol recommends starting by generating an initial equation based on at least 50-75 samples from the given species. Although this protocol optimises prediction accuracy, it limits the use of NIRS with rare or endangered species where sample sizes are often small. To overcome this limitation we tested a single NIRS equation (i.e., multispecies calibration) to predict FN in herbivores. Firstly, we used five herbivore species with highly contrasting digestive physiologies to build monospecies and multispecies calibrations, namely horse, sheep, Pyrenean chamois, red deer and European rabbit. Secondly, the equation accuracy was evaluated by two procedures using: (1) an external validation with samples from the same species, which were not used in the calibration process; and (2) samples from different ungulate species, specifically Alpine ibex, domestic goat, European mouflon, roe deer and cattle. The multispecies equation was highly accurate in terms of the coefficient of determination for calibration R2 = 0.98, standard error of validation SECV = 0.10, standard error of external validation SEP = 0.12, ratio of performance to deviation RPD = 5.3, and range error of prediction RER = 28.4. The accuracy of the multispecies equation to predict other herbivore species was also satisfactory (R2 > 0.86, SEP < 0.27, RPD > 2.6, and RER > 8.1). Lastly, the agreement between multi- and monospecies calibrations was also confirmed by the Bland-Altman method. In conclusion, our single multispecies equation can be used as a reliable, cost-effective, easy and powerful analytical method to assess FN in a wide range of herbivore species.

A systematic RE-AIM review to assess sugar-sweetened beverage interventions for children and adolescents across the socio-ecological model

PubMed Central

Porter, Kathleen; Estabrooks, Paul; Zoellner, Jamie

2016-01-01

Background Sugar-sweetened beverage (SSB) consumption among children and adolescents is a determinant of childhood obesity. Many programs to reduce consumption across the socio-ecological model report significant positive results; however, the generalizability of the results, including whether reporting differences exist among socio-ecological strategy levels, is unknown. Objectives This systematic review aims to (1) examine the extent to which studies reported internal and external validity indicators defined by RE-AIM (reach, effectiveness, adoption, implementation, maintenance) and (2) assess reporting differences by socio-ecological level: intrapersonal/interpersonal (Level 1), environmental/policy (Level 2), multi-level (Combined Level). Methods Six major databases (PubMed, Web of Science, Cinahl, CAB Abstracts, ERIC, and Agiricola) systematic literature review was conducted to identify studies from 2004–2015 meeting inclusion criteria (targeting children aged 3–12, adolescents 13–17, and young adults 18 years, experimental/quasi-experimental, substantial SSB component). Interventions were categorized by socio-ecological level, and data were extracted using a validated RE-AIM protocol. A one-way ANOVA assessed differences between levels. Results There were 55 eligible studies (N) accepted, including 21 Level 1, 18 Level 2, and 16 Combined Level studies. Thirty-six (65%) were conducted in the USA, 19 (35%) internationally, and 39 (71%) were implemented in schools. Across levels, reporting averages were low for all RE-AIM dimensions (reach=29%, efficacy/effectiveness=45%, adoption=26%, implementation=27%, maintenance=14%). Level 2 studies had significantly lower reporting on reach and effectiveness (10% and 26%, respectively) compared to Level 1 (44%, 57%) or Combined Level studies (31%, 52%) (p<0.001). Adoption, implementation, and maintenance reporting did not vary among levels. Conclusion Interventions to reduce SSB in children and adolescents across the socio-ecological spectrum do not provide the necessary information for dissemination and implementation in community nutrition settings. Future interventions should address both internal and external validity to maximize population impact. PMID:27262383

A posteriori model validation for the temporal order of directed functional connectivity maps.

PubMed

Beltz, Adriene M; Molenaar, Peter C M

2015-01-01

A posteriori model validation for the temporal order of neural directed functional connectivity maps is rare. This is striking because models that require sequential independence among residuals are regularly implemented. The aim of the current study was (a) to apply to directed functional connectivity maps of functional magnetic resonance imaging data an a posteriori model validation procedure (i.e., white noise tests of one-step-ahead prediction errors combined with decision criteria for revising the maps based upon Lagrange Multiplier tests), and (b) to demonstrate how the procedure applies to single-subject simulated, single-subject task-related, and multi-subject resting state data. Directed functional connectivity was determined by the unified structural equation model family of approaches in order to map contemporaneous and first order lagged connections among brain regions at the group- and individual-levels while incorporating external input, then white noise tests were run. Findings revealed that the validation procedure successfully detected unmodeled sequential dependencies among residuals and recovered higher order (greater than one) simulated connections, and that the procedure can accommodate task-related input. Findings also revealed that lags greater than one were present in resting state data: With a group-level network that contained only contemporaneous and first order connections, 44% of subjects required second order, individual-level connections in order to obtain maps with white noise residuals. Results have broad methodological relevance (e.g., temporal validation is necessary after directed functional connectivity analyses because the presence of unmodeled higher order sequential dependencies may bias parameter estimates) and substantive implications (e.g., higher order lags may be common in resting state data).

Development and external validation of a prediction rule for an unfavorable course of late-life depression: A multicenter cohort study.

PubMed

Maarsingh, O R; Heymans, M W; Verhaak, P F; Penninx, B W J H; Comijs, H C

2018-08-01

Given the poor prognosis of late-life depression, it is crucial to identify those at risk. Our objective was to construct and validate a prediction rule for an unfavourable course of late-life depression. For development and internal validation of the model, we used The Netherlands Study of Depression in Older Persons (NESDO) data. We included participants with a major depressive disorder (MDD) at baseline (n = 270; 60-90 years), assessed with the Composite International Diagnostic Interview (CIDI). For external validation of the model, we used The Netherlands Study of Depression and Anxiety (NESDA) data (n = 197; 50-66 years). The outcome was MDD after 2 years of follow-up, assessed with the CIDI. Candidate predictors concerned sociodemographics, psychopathology, physical symptoms, medication, psychological determinants, and healthcare setting. Model performance was assessed by calculating calibration and discrimination. 111 subjects (41.1%) had MDD after 2 years of follow-up. Independent predictors of MDD after 2 years were (older) age, (early) onset of depression, severity of depression, anxiety symptoms, comorbid anxiety disorder, fatigue, and loneliness. The final model showed good calibration and reasonable discrimination (AUC of 0.75; 0.70 after external validation). The strongest individual predictor was severity of depression (AUC of 0.69; 0.68 after external validation). The model was developed and validated in The Netherlands, which could affect the cross-country generalizability. Based on rather simple clinical indicators, it is possible to predict the 2-year course of MDD. The prediction rule can be used for monitoring MDD patients and identifying those at risk of an unfavourable outcome. Copyright © 2018 Elsevier B.V. All rights reserved.

Serotonin transporter linked polymorphic region (5-HTTLPR) genotype moderates the longitudinal impact of early caregiving on externalizing behavior.

PubMed

Brett, Zoë H; Humphreys, Kathryn L; Smyke, Anna T; Gleason, Mary Margaret; Nelson, Charles A; Zeanah, Charles H; Fox, Nathan A; Drury, Stacy S

2015-02-01

We examined caregiver report of externalizing behavior from 12 to 54 months of age in 102 children randomized to care as usual in institutions or to newly created high-quality foster care. At baseline no differences by group or genotype in externalizing were found. However, changes in externalizing from baseline to 42 months of age were moderated by the serotonin transporter linked polymorphic region genotype and intervention group, where the slope for short-short (S/S) individuals differed as a function of intervention group. The slope for individuals carrying the long allele did not significantly differ between groups. At 54 months of age, S/S children in the foster care group had the lowest levels of externalizing behavior, while children with the S/S genotype in the care as usual group demonstrated the highest rates of externalizing behavior. No intervention group differences were found in externalizing behavior among children who carried the long allele. These findings, within a randomized controlled trial of foster care compared to continued care as usual, indicate that the serotonin transporter linked polymorphic region genotype moderates the relation between early caregiving environments to predict externalizing behavior in children exposed to early institutional care in a manner most consistent with differential susceptibility.

NASA’s Universe of Learning: Connecting Scientists, Educators, and Learners

NASA Astrophysics Data System (ADS)

Smith, Denise A.; Lestition, Kathleen; Squires, Gordon K.; Greene, W. M.; Biferno, Anya A.; Cominsky, Lynn R.; Goodman, Irene; Walker, Allyson; Universe of Learning Team

2017-01-01

NASA’s Universe of Learning (UoL) is one of 27 competitively awarded education programs selected by NASA’s Science Mission Directorate (SMD) in its newly restructured education effort. Through these 27 programs, SMD aims to infuse NASA science experts and content more effectively and efficiently into learning environments serving audiences of all ages. UoL is a unique partnership between the Space Telescope Science Institute, Chandra X-ray Center, IPAC at Caltech, Jet Propulsion Laboratory Exoplanet Exploration Program, and Sonoma State University that will connect the scientists, engineers, science, technology and adventure of NASA Astrophysics with audience needs, proven infrastructure, and a network of partners to advance SMD education objectives. External evaluation is provided through a partnership with Goodman Research Group and Cornerstone Evaluation Associates. The multi-institutional team is working to develop and deliver a unified, consolidated and externally evaluated suite of education products, programs, and professional development offerings that spans the full spectrum of NASA Astrophysics, including the Cosmic Origins, Physics of the Cosmos, and Exoplanet Exploration themes. Products and programs focus on out-of-school-time learning environments and include enabling educational use of Astrophysics mission data and offering participatory experiences; creating multimedia and immersive experiences; designing exhibits and community programs; and producing resources for special needs and underserved/underrepresented audiences. The UoL team also works with a network of partners to provide professional learning experiences for informal educators, pre-service educators, and undergraduate instructors. This presentation will provide an overview of the UoL team’s approach to partnering scientists and educators to engage learners in Astrophysics discoveries and data; progress to date; and pathways for science community involvement.

Geographic Information Systems to Assess External Validity in Randomized Trials.

PubMed

Savoca, Margaret R; Ludwig, David A; Jones, Stedman T; Jason Clodfelter, K; Sloop, Joseph B; Bollhalter, Linda Y; Bertoni, Alain G

2017-08-01

To support claims that RCTs can reduce health disparities (i.e., are translational), it is imperative that methodologies exist to evaluate the tenability of external validity in RCTs when probabilistic sampling of participants is not employed. Typically, attempts at establishing post hoc external validity are limited to a few comparisons across convenience variables, which must be available in both sample and population. A Type 2 diabetes RCT was used as an example of a method that uses a geographic information system to assess external validity in the absence of a priori probabilistic community-wide diabetes risk sampling strategy. A geographic information system, 2009-2013 county death certificate records, and 2013-2014 electronic medical records were used to identify community-wide diabetes prevalence. Color-coded diabetes density maps provided visual representation of these densities. Chi-square goodness of fit statistic/analysis tested the degree to which distribution of RCT participants varied across density classes compared to what would be expected, given simple random sampling of the county population. Analyses were conducted in 2016. Diabetes prevalence areas as represented by death certificate and electronic medical records were distributed similarly. The simple random sample model was not a good fit for death certificate record (chi-square, 17.63; p=0.0001) and electronic medical record data (chi-square, 28.92; p<0.0001). Generally, RCT participants were oversampled in high-diabetes density areas. Location is a highly reliable "principal variable" associated with health disparities. It serves as a directly measurable proxy for high-risk underserved communities, thus offering an effective and practical approach for examining external validity of RCTs. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Predicting survival of men with recurrent prostate cancer after radical prostatectomy.

PubMed

Dell'Oglio, Paolo; Suardi, Nazareno; Boorjian, Stephen A; Fossati, Nicola; Gandaglia, Giorgio; Tian, Zhe; Moschini, Marco; Capitanio, Umberto; Karakiewicz, Pierre I; Montorsi, Francesco; Karnes, R Jeffrey; Briganti, Alberto

2016-02-01

To develop and externally validate a novel nomogram aimed at predicting cancer-specific mortality (CSM) after biochemical recurrence (BCR) among prostate cancer (PCa) patients treated with radical prostatectomy (RP) with or without adjuvant external beam radiotherapy (aRT) and/or hormonal therapy (aHT). The development cohort included 689 consecutive PCa patients treated with RP between 1987 and 2011 with subsequent BCR, defined as two subsequent prostate-specific antigen values >0.2 ng/ml. Multivariable competing-risks regression analyses tested the predictors of CSM after BCR for the purpose of 5-year CSM nomogram development. Validation (2000 bootstrap resamples) was internally tested. External validation was performed into a population of 6734 PCa patients with BCR after treatment with RP at the Mayo Clinic from 1987 to 2011. The predictive accuracy (PA) was quantified using the receiver operating characteristic-derived area under the curve and the calibration plot method. The 5-year CSM-free survival rate was 83.6% (confidence interval [CI]: 79.6-87.2). In multivariable analyses, pathologic stage T3b or more (hazard ratio [HR]: 7.42; p = 0.008), pathologic Gleason score 8-10 (HR: 2.19; p = 0.003), lymph node invasion (HR: 3.57; p = 0.001), time to BCR (HR: 0.99; p = 0.03) and age at BCR (HR: 1.04; p = 0.04), were each significantly associated with the risk of CSM after BCR. The bootstrap-corrected PA was 87.4% (bootstrap 95% CI: 82.0-91.7%). External validation of our nomogram showed a good PA at 83.2%. We developed and externally validated the first nomogram predicting 5-year CSM applicable to contemporary patients with BCR after RP with or without adjuvant treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

External validation and clinical utility of a prediction model for 6-month mortality in patients undergoing hemodialysis for end-stage kidney disease.

PubMed

Forzley, Brian; Er, Lee; Chiu, Helen Hl; Djurdjev, Ognjenka; Martinusen, Dan; Carson, Rachel C; Hargrove, Gaylene; Levin, Adeera; Karim, Mohamud

2018-02-01

End-stage kidney disease is associated with poor prognosis. Health care professionals must be prepared to address end-of-life issues and identify those at high risk for dying. A 6-month mortality prediction model for patients on dialysis derived in the United States is used but has not been externally validated. We aimed to assess the external validity and clinical utility in an independent cohort in Canada. We examined the performance of the published 6-month mortality prediction model, using discrimination, calibration, and decision curve analyses. Data were derived from a cohort of 374 prevalent dialysis patients in two regions of British Columbia, Canada, which included serum albumin, age, peripheral vascular disease, dementia, and answers to the "the surprise question" ("Would I be surprised if this patient died within the next year?"). The observed mortality in the validation cohort was 11.5% at 6 months. The prediction model had reasonable discrimination (c-stat = 0.70) but poor calibration (calibration-in-the-large = -0.53 (95% confidence interval: -0.88, -0.18); calibration slope = 0.57 (95% confidence interval: 0.31, 0.83)) in our data. Decision curve analysis showed the model only has added value in guiding clinical decision in a small range of threshold probabilities: 8%-20%. Despite reasonable discrimination, the prediction model has poor calibration in this external study cohort; thus, it may have limited clinical utility in settings outside of where it was derived. Decision curve analysis clarifies limitations in clinical utility not apparent by receiver operating characteristic curve analysis. This study highlights the importance of external validation of prediction models prior to routine use in clinical practice.

Data analysis of the COMPTEL instrument on the NASA gamma ray observatory

NASA Technical Reports Server (NTRS)

Diehl, R.; Bennett, K.; Collmar, W.; Connors, A.; Denherder, J. W.; Hermsen, W.; Lichti, G. G.; Lockwood, J. A.; Macri, J.; Mcconnell, M.

1992-01-01

The Compton imaging telescope (COMPTEL) on the Gamma Ray Observatory (GRO) is a wide field of view instrument. The coincidence measurement technique in two scintillation detector layers requires specific analysis methods. Straightforward event projection into the sky is impossible. Therefore, detector events are analyzed in a multi-dimensional dataspace using a gamma ray sky hypothesis convolved with the point spread function of the instrument in this dataspace. Background suppression and analysis techniques have important implications on the gamma ray source results for this background limited telescope. The COMPTEL collaboration applies a software system of analysis utilities, organized around a database management system. The use of this system for the assistance of guest investigators at the various collaboration sites and external sites is foreseen and allows different detail levels of cooperation with the COMPTEL institutes, dependent on the type of data to be studied.

Copolyimide Surface Modifying Agents for Particle Adhesion Mitigation

NASA Technical Reports Server (NTRS)

Wohl, Christopher J.; Connell, John W.

2011-01-01

Marine biofouling, insect adhesion on aircraft surfaces, microbial contamination of sterile environments, and particle contamination all present unique challenges for which researchers have adopted an array of mitigation strategies. Particulate contamination is of interest to NASA regarding exploration of the Moon, Mars, asteroids, etc.1 Lunar dust compromised seals, clogged filters, abraded visors and space suit surfaces, and was a significant health concern during the Apollo missions.2 Consequently, NASA has instituted a multi-faceted approach to address dust including use of sacrificial surfaces, active mitigation requiring the use of an external energy source, and passive mitigation utilizing materials with an intrinsic resistance to surface contamination. One passive mitigation strategy is modification of a material s surface energy either chemically or topographically. The focus of this paper is the synthesis and evaluation of novel copolyimide materials with surface modifying agents (SMA, oxetanes) enabling controlled variation of surface chemical composition.

Automatic Sleep Stage Determination by Multi-Valued Decision Making Based on Conditional Probability with Optimal Parameters

NASA Astrophysics Data System (ADS)

Wang, Bei; Sugi, Takenao; Wang, Xingyu; Nakamura, Masatoshi

Data for human sleep study may be affected by internal and external influences. The recorded sleep data contains complex and stochastic factors, which increase the difficulties for the computerized sleep stage determination techniques to be applied for clinical practice. The aim of this study is to develop an automatic sleep stage determination system which is optimized for variable sleep data. The main methodology includes two modules: expert knowledge database construction and automatic sleep stage determination. Visual inspection by a qualified clinician is utilized to obtain the probability density function of parameters during the learning process of expert knowledge database construction. Parameter selection is introduced in order to make the algorithm flexible. Automatic sleep stage determination is manipulated based on conditional probability. The result showed close agreement comparing with the visual inspection by clinician. The developed system can meet the customized requirements in hospitals and institutions.

Virtual Coaching for Instructional Leaders: A Multi-Method Investigation of Technology-Enabled External Assistance

ERIC Educational Resources Information Center

Ermeling, Bradley; Tatsui, Timothy; Young, Kelly

2015-01-01

Background: Education reforms over the last several decades have relied heavily on external assistance to help schools increase capacity for improving outcomes, but investing in sustained outside coaching and support is increasingly difficult with diminishing federal, state, and district resources. One under-investigated possibility for…

Externalizing Behavior Trajectories: The Role of Parenting, Sibling Relationships and Child Personality

ERIC Educational Resources Information Center

Meunier, Jean Christophe; Roskam, Isabelle; Stievenart, Marie; van de Moortele, Gaelle; Browne, Dillon T.; Kumar, Aarti

2011-01-01

Based on longitudinal multilevel modeling and using a multi-informant strategy, this study examines trajectories of externalizing problem behavior (EPB) in childhood as predicted by parental behavior (absolute level of parenting [ALP] and parental differential treatment [PDT]), parental self-efficacy (PSE), child personality and sibling…

Evidence for a Multi-Dimensional Latent Structural Model of Externalizing Disorders

ERIC Educational Resources Information Center

Witkiewitz, Katie; King, Kevin; McMahon, Robert J.; Wu, Johnny; Luk, Jeremy; Bierman, Karen L.; Coie, John D.; Dodge, Kenneth A.; Greenberg, Mark T.; Lochman, John E.; Pinderhughes, Ellen E.

2013-01-01

Strong associations between conduct disorder (CD), antisocial personality disorder (ASPD) and substance use disorders (SUD) seem to reflect a general vulnerability to externalizing behaviors. Recent studies have characterized this vulnerability on a continuous scale, rather than as distinct categories, suggesting that the revision of the…

[Scales to measure parents and caretakers satisfaction with the food and nutrition component of Child care Centers].

PubMed

Bernal, Jennifer; Lorenzana, Paulina

2002-06-01

Two Likert-type scales for measuring parents' and caretakers' level of satisfaction with the food and nutrition services offered at childcare multi-centers in a peri-urban community in Caracas, were developed and validated. An intentional sample of 20 parents and caretakers were interviewed within the naturalistic-constructivist perspective, to capture their perceptions of distinct aspects of the food and nutrition components of the program. Categories emerged from the interviews that served to construct the items for two scales that measure level of satisfaction of parents and caretakers with the food and nutrition aspects of the program. To validate the scales, they were applied to 73 parents and 32 caretakers. Factor and multiple components analysis showed that overall, the scales explained 61% and 69% of the variation in level of satisfaction of parents and caretakers respectively. Confiability measured with Alpha Cronbach coefficient was 0.74 and 0.77 for parents' and caretakers' scales respectively. These results reveal scales that have content validity and good reliability. Besides, the scales detect specific aspects of the food and nutrition service that should be reinforced or modified, to make the Child-care Centers program more effective and efficient. External validation of the scales is recommended, since they provide an instrument capable of capturing useful information for monitoring and evaluating the Child-care Centers program nation-wide, from the perspective of program managers and parents of program users.

Local Irrigation Management Institutions Mediate Changes Driven by External Policy and Market Pressures in Nepal and Thailand

NASA Astrophysics Data System (ADS)

Bastakoti, Ram C.; Shivakoti, Ganesh P.; Lebel, Louis

2010-09-01

This article assesses the role of local institutions in managing irrigation water use. Fifty irrigation systems in each country were studied in Nepal and Thailand to compare the influence of local institutions on performance of irrigation systems amid changes in external policy and market pressures. Nepal’s new irrigation policy after the re-instatement of multiparty democracy in 1990 emphasized participatory irrigation management transferring the management responsibility from state authorities to water users. The water user associations of traditional farmer-managed irrigation systems were formally recognized by requiring registration with related state authorities. In Thailand also government policies encouraged people’s participation in irrigation management. Today water users are directly involved in management of even some large irrigation systems at the level of tertiary canals. Traditional communal irrigation systems in northern Thailand received support for system infrastructure improvement but have faced increased interference from government. In Thailand market development supported diversification in farming practices resulting in increased areas under high water-demanding commercial crops in the dry season. In contrast, the command areas of most irrigation systems in Nepal include cereal-based subsistence farming with only one-third having commercial farming. Cropping intensities are higher in Nepal than in Thailand reflecting, in part, differences in availability of land and management. In both countries local institutions play an important role in maintaining the performance of irrigation systems as external drivers and local contexts change. Local institutions have provided alternative options for irrigation water use by mediating external pressures.

An Approach to Find out Students' Motives and Influences on Their Selection of Studies and University: Results from Six Years of Continuous Institutional Research in a Multi-Campus System in Spain

ERIC Educational Resources Information Center

Gallifa, Josep

2009-01-01

This paper presents an institutional research on service quality conducted to analyze the students' motives and influences on their selection of studies and university. The research was carried out by collecting data from first-year students in a multi-campus system where institutions are independent in their recruitment strategies. Results from…

A RE-AIM evaluation of theory-based physical activity interventions.

PubMed

Antikainen, Iina; Ellis, Rebecca

2011-04-01

Although physical activity interventions have been shown to effectively modify behavior, little research has examined the potential of these interventions for adoption in real-world settings. The purpose of this literature review was to evaluate the external validity of 57 theory-based physical activity interventions using the RE-AIM framework. The physical activity interventions included were more likely to report on issues of internal, rather than external validity and on individual, rather than organizational components of the RE-AIM framework, making the translation of many interventions into practice difficult. Furthermore, most studies included motivated, healthy participants, thus reducing the generalizability of the interventions to real-world settings that provide services to more diverse populations. To determine if a given intervention is feasible and effective in translational research, more information should be reported about the factors that affect external validity.

Collaborative Teaching and Learning through Multi-Institutional Integrated Group Projects

ERIC Educational Resources Information Center

Long, Suzanna K.; Carlo, Héctor J.

2013-01-01

This teaching brief describes an innovative multi-institutional initiative through which integrated student groups from different courses collaborate on a common course project. In this integrated group project, students are asked to design a decentralized manufacturing organization for a company that will manufacture industrial Proton-Exchange…

Pathways to Undergraduate Research Experiences: A Multi-Institutional Study

ERIC Educational Resources Information Center

Mahatmya, Duhita; Morrison, Janet; Jones, Rebecca M.; Garner, Pamela W.; Davis, Shannon N.; Manske, Jill; Berner, Nancy; Johnson, Ann; Ditty, Jayna

2017-01-01

The positive impact of undergraduate research experiences on students' post-secondary success is well-documented. However, these conclusions are drawn from undergraduate students who already participate; very little research has explored the pathways by which students enter these experiences. Using data from a multi-institutional survey, we…

34 CFR 675.47 - Multi-institutional work-colleges arrangements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Multi-institutional work-colleges arrangements. 675.47 Section 675.47 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION FEDERAL WORK-STUDY PROGRAMS Work-Colleges Program § 675.47...

Serotonin Transporter Genotype (5HTTLPR) Moderates the Longitudinal Impact of Atypical Attachment on Externalizing Behavior.

PubMed

Humphreys, Kathryn L; Zeanah, Charles H; Nelson, Charles A; Fox, Nathan A; Drury, Stacy S

2015-01-01

To test whether genotype of the serotonin transporter-linked polymorphic region (5HTTLPR) and atypical attachment interact to predict externalizing psychopathology prospectively in a sample of children with a history of early institutional care. Caregiver report of externalizing behavior at 54 months was examined in 105 children initially reared in institutional care and enrolled in the Bucharest Early Intervention Project, a randomized controlled trial of high quality foster care. 5HTTLPR genotype, attachment status at 42 months of age (typical [secure, avoidant, or ambivalent] or atypical [disorganized-controlling, insecure-other]), and their interaction were examined as predictors of externalizing behavior at age 54 months. 5HTTLPR genotype and atypical attachment at age 42 months interacted to predict externalizing behavior at age 54 months. Specifically, children with the s/s genotype with an atypical attachment had the highest externalizing scores. However, s/s children with a typical attachment demonstrated the lowest externalizing scores, even after controlling for intervention group status. There was no association between attachment status and externalizing behavior among children carrying at least 1 copy of the l allele. These findings indicate that genetic variation in the serotonergic system moderates the association between atypical attachment status and externalizing in young children. Our findings suggest that children, as a result of genetic variability in the serotonergic system, demonstrate differential sensitivity to the attachment relationship.

Serotonin Transporter Genotype (5HTTLPR) Moderates the Longitudinal Impact of Atypical Attachment on Externalizing Behavior

PubMed Central

Humphreys, Kathryn L.; Zeanah, Charles H.; Nelson, Charles A.; Fox, Nathan A.; Drury, Stacy S.

2015-01-01

Objective To test whether genotype of the serotonin transporter-linked polymorphic region (5HTTLPR) and atypical attachment interact to predict externalizing psychopathology prospectively in a sample of children with a history of early institutional care. Methods Caregiver report of externalizing behavior at 54 months was examined in 105 children initially reared in institutional care and enrolled in the Bucharest Early Intervention Project, a randomized controlled trial of high quality foster care. 5HTTLPR genotype, attachment status at 42 months of age (typical [secure, avoidant, or ambivalent] or atypical [disorganized-controlling, insecure-other]), as well as their interaction, were examined as predictors of externalizing behavior at age 54 months. Results 5HTTLPR genotype and atypical attachment at age 42 months interacted to predict externalizing behavior at age 54 months. Specifically, children with the s/s genotype with an atypical attachment had the highest externalizing scores. However, s/s children with a typical attachment demonstrated the lowest externalizing scores, even after controlling for intervention group status. There was no association between attachment status and externalizing behavior among children carrying at least one copy of the l allele. Discussion These findings indicate that genetic variation in the serotonergic system moderates the association between atypical attachment status and externalizing in young children. Our findings suggest that children, as a result of genetic variability in the serotonergic system, demonstrate differential sensitivity to the attachment relationship. PMID:25933228

78 FR 20106 - Farm Credit System Insurance Corporation Board; Regular Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-03

... Institutions Presentation of 2012 Audit Results by External Auditor Clifton Larson Allen L.L.P. Executive Session Executive Session of the FCSIC Board Audit Committee with the External Auditor Dated: March 29...

Towards personalized therapy for multiple sclerosis: prediction of individual treatment response.

PubMed

Kalincik, Tomas; Manouchehrinia, Ali; Sobisek, Lukas; Jokubaitis, Vilija; Spelman, Tim; Horakova, Dana; Havrdova, Eva; Trojano, Maria; Izquierdo, Guillermo; Lugaresi, Alessandra; Girard, Marc; Prat, Alexandre; Duquette, Pierre; Grammond, Pierre; Sola, Patrizia; Hupperts, Raymond; Grand'Maison, Francois; Pucci, Eugenio; Boz, Cavit; Alroughani, Raed; Van Pesch, Vincent; Lechner-Scott, Jeannette; Terzi, Murat; Bergamaschi, Roberto; Iuliano, Gerardo; Granella, Franco; Spitaleri, Daniele; Shaygannejad, Vahid; Oreja-Guevara, Celia; Slee, Mark; Ampapa, Radek; Verheul, Freek; McCombe, Pamela; Olascoaga, Javier; Amato, Maria Pia; Vucic, Steve; Hodgkinson, Suzanne; Ramo-Tello, Cristina; Flechter, Shlomo; Cristiano, Edgardo; Rozsa, Csilla; Moore, Fraser; Luis Sanchez-Menoyo, Jose; Laura Saladino, Maria; Barnett, Michael; Hillert, Jan; Butzkueven, Helmut

2017-09-01

Timely initiation of effective therapy is crucial for preventing disability in multiple sclerosis; however, treatment response varies greatly among patients. Comprehensive predictive models of individual treatment response are lacking. Our aims were: (i) to develop predictive algorithms for individual treatment response using demographic, clinical and paraclinical predictors in patients with multiple sclerosis; and (ii) to evaluate accuracy, and internal and external validity of these algorithms. This study evaluated 27 demographic, clinical and paraclinical predictors of individual response to seven disease-modifying therapies in MSBase, a large global cohort study. Treatment response was analysed separately for disability progression, disability regression, relapse frequency, conversion to secondary progressive disease, change in the cumulative disease burden, and the probability of treatment discontinuation. Multivariable survival and generalized linear models were used, together with the principal component analysis to reduce model dimensionality and prevent overparameterization. Accuracy of the individual prediction was tested and its internal validity was evaluated in a separate, non-overlapping cohort. External validity was evaluated in a geographically distinct cohort, the Swedish Multiple Sclerosis Registry. In the training cohort (n = 8513), the most prominent modifiers of treatment response comprised age, disease duration, disease course, previous relapse activity, disability, predominant relapse phenotype and previous therapy. Importantly, the magnitude and direction of the associations varied among therapies and disease outcomes. Higher probability of disability progression during treatment with injectable therapies was predominantly associated with a greater disability at treatment start and the previous therapy. For fingolimod, natalizumab or mitoxantrone, it was mainly associated with lower pretreatment relapse activity. The probability of disability regression was predominantly associated with pre-baseline disability, therapy and relapse activity. Relapse incidence was associated with pretreatment relapse activity, age and relapsing disease course, with the strength of these associations varying among therapies. Accuracy and internal validity (n = 1196) of the resulting predictive models was high (>80%) for relapse incidence during the first year and for disability outcomes, moderate for relapse incidence in Years 2-4 and for the change in the cumulative disease burden, and low for conversion to secondary progressive disease and treatment discontinuation. External validation showed similar results, demonstrating high external validity for disability and relapse outcomes, moderate external validity for cumulative disease burden and low external validity for conversion to secondary progressive disease and treatment discontinuation. We conclude that demographic, clinical and paraclinical information helps predict individual response to disease-modifying therapies at the time of their commencement. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels.

PubMed

Brach, Michael; Nieder, Frank; Nieder, Ulrike; Mechling, Heinz

2009-11-24

There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL), the organisational-institutional level (OIL) and the political-cultural level (PCL). Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. The intervention consisted of (a) two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL), (b) a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL), (c) informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL). Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL), number of groups continued without external financial support (at the end of the project, and after one year) (OIL). Secondary outcome was measured by sensorimotor tests and care-related assessments in the beginning and every 16 weeks (ISL), by qualitative outcome descriptions 12 months after group implementation (OIL) and by analysis of media response and structured interviews with stakeholders, also after 12 months (PCL). Exemplarily, preventive exercise has been established for a neglected target population. The multi-level approach used here seems to be helpful to overcome institutional and individual (attitude) barriers. Current Controlled Trials ISRCTN55213782.

Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA).

PubMed

Tricarico, Pierfrancesco; Tardivo, Stefano; Sotgiu, Giovanni; Moretti, Francesca; Poletti, Piera; Fiore, Alberto; Monturano, Massimo; Mura, Ida; Privitera, Gaetano; Brusaferro, Silvio

2016-08-08

Purpose - The European Union recommendations for patient safety calls for shared clinical risk management (CRM) safety standards able to guide organizations in CRM implementation. The purpose of this paper is to develop a self-evaluation tool to measure healthcare organization performance on CRM and guide improvements over time. Design/methodology/approach - A multi-step approach was implemented including: a systematic literature review; consensus meetings with an expert panel from eight Italian leader organizations to get to an agreement on the first version; field testing to test instrument feasibility and flexibility; Delphi strategy with a second expert panel for content validation and balanced scoring system development. Findings - The self-assessment tool - Clinical Assessment of Risk Management: an INtegrated Approach includes seven areas (governance, communication, knowledge and skills, safe environment, care processes, adverse event management, learning from experience) and 52 standards. Each standard is evaluated according to four performance levels: minimum; monitoring; outcomes; and improvement actions, which resulted in a feasible, flexible and valid instrument to be used throughout different organizations. Practical implications - This tool allows practitioners to assess their CRM activities compared to minimum levels, monitor performance, benchmarking with other institutions and spreading results to different stakeholders. Originality/value - The multi-step approach allowed us to identify core minimum CRM levels in a field where no consensus has been reached. Most standards may be easily adopted in other countries.

Patterns of Sensitivity to Parenting and Peer Environments: Early Temperament and Adolescent Externalizing Behavior.

PubMed

Tung, Irene; Noroña, Amanda N; Morgan, Julia E; Caplan, Barbara; Lee, Steve S; Baker, Bruce L

2018-03-14

Although parenting behavior and friendship quality predict adolescent externalizing behaviors (EBs), individual differences in temperament may differentially affect susceptibility to these factors over time. In a multi-method and multi-informant study of 141 children followed prospectively from toddlerhood to adolescence, we tested the independent and interactive associations of age 3 reactive temperament (e.g., negative emotionality) and age 13 observed parenting (i.e., positive and negative behavior) and friendship (i.e., conflict and warmth), with multi-informant ratings of age 15 aggression and rule-breaking behavior. Negative parenting predicted growth in parent-rated EB, but only for adolescents with early reactive temperament. Temperament did not affect sensitivity to positive parenting or friendship. Results are discussed in the context of differential susceptibility theory and intervention implications for adolescents. © 2018 Society for Research on Adolescence.

The drivers of corporate environment inputs: Based on neo-institution theory evidence from Chinese listed biological and other companies.

PubMed

Guo, Rui; Tao, Lan; Yan, Liang; Chen, Lianfang; Wang, Haijun

2014-09-01

From corporate internal governance structure and external institutional environment, this study uses a legitimacy perspective of intuitional theory to analyze the main influence factors on corporate environmental protection inputs and propose some hypotheses. With the establishment of empirical models, it analyzes the data of 2004-2009 listed biological and other companies in China to test the hypotheses. The findings are concluded that in internal institutional environment, the nature of the controlling shareholder, the proportion of the first shareholder in the ownership structure, the combination of chairman and general manager in board efficiency and the intensity of environmental laws and regulations of the industry in external institutional environment have an significant impact on the behaviors of corporate environmental protection inputs.

Integrated Summary Report: Validation of Two Binding Assays ...

EPA Pesticide Factsheets

This Integrated Summary Report (ISR) summarizes, in a single document, the results from an international multi-laboratory validation study conducted for two in vitro estrogen receptor (ER) binding assays. These assays both use human recombinant estrogen receptor, alpha subtype (hrERα), to identify chemicals that may impact estrogen signaling through binding to the ER. The purpose of the ISR is to support the peer review of the findings obtained during the validation process.The two assays evaluated during this validation process are: The Freyberger-Wilson Assay (FW) using a full length human ER, and The Chemical Evaluation and Research Institute (CERI) Assay using a ligand-binding domain of the human ER.The two assays are mechanistically and functionally similar in that each measures the ability of a test chemical to competitively inhibit binding of [3H]17β-estradiol to the human recombinant ER. The essential elements of the FW and the CERI assays were developed at the laboratories of Bayer Pharma AG, Wuppertal, Germany (Freyberger et al., 2010) and CERI, Tokyo, Japan (Akahori et al., 2008), respectively.The ER competitive binding assay has long been in use, and is a well characterized approach, but historically uses rodent or other animal tissues as a source of the ER. Validation of the FW and CERI assays using human recombinant estrogen receptors ( subtype) will provide an updated alternative for the Agency’s current test guideline (OPPTS 89

An artificial neural network to predict resting energy expenditure in obesity.

PubMed

Disse, Emmanuel; Ledoux, Séverine; Bétry, Cécile; Caussy, Cyrielle; Maitrepierre, Christine; Coupaye, Muriel; Laville, Martine; Simon, Chantal

2017-09-01

The resting energy expenditure (REE) determination is important in nutrition for adequate dietary prescription. The gold standard i.e. indirect calorimetry is not available in clinical settings. Thus, several predictive equations have been developed, but they lack of accuracy in subjects with extreme weight including obese populations. Artificial neural networks (ANN) are useful predictive tools in the area of artificial intelligence, used in numerous clinical fields. The aim of this study was to determine the relevance of ANN in predicting REE in obesity. A Multi-Layer Perceptron (MLP) feed-forward neural network with a back propagation algorithm was created and cross-validated in a cohort of 565 obese subjects (BMI within 30-50 kg m -2 ) with weight, height, sex and age as clinical inputs and REE measured by indirect calorimetry as output. The predictive performances of ANN were compared to those of 23 predictive REE equations in the training set and in two independent sets of 100 and 237 obese subjects for external validation. Among the 23 established prediction equations for REE evaluated, the Harris & Benedict equations recalculated by Roza were the most accurate for the obese population, followed by the USA DRI, Müller and the original Harris & Benedict equations. The final 5-fold cross-validated three-layer 4-3-1 feed-forward back propagation ANN model developed in that study improved precision and accuracy of REE prediction over linear equations (precision = 68.1%, MAPE = 8.6% and RMSPE = 210 kcal/d), independently from BMI subgroups within 30-50 kg m -2 . External validation confirmed the better predictive performances of ANN model (precision = 73% and 65%, MAPE = 7.7% and 8.6%, RMSPE = 187 kcal/d and 200 kcal/d in the 2 independent datasets) for the prediction of REE in obese subjects. We developed and validated an ANN model for the prediction of REE in obese subjects that is more precise and accurate than established REE predictive equations independent from BMI subgroups. For convenient use in clinical settings, we provide a simple ANN-REE calculator available at: https://www.crnh-rhone-alpes.fr/fr/ANN-REE-Calculator. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

p53 predictive value for pT1-2 N0 disease at radical cystectomy.

PubMed

Shariat, Shahrokh F; Lotan, Yair; Karakiewicz, Pierre I; Ashfaq, Raheela; Isbarn, Hendrik; Fradet, Yves; Bastian, Patrick J; Nielsen, Matthew E; Capitanio, Umberto; Jeldres, Claudio; Montorsi, Francesco; Müller, Stefan C; Karam, Jose A; Heukamp, Lukas C; Netto, George; Lerner, Seth P; Sagalowsky, Arthur I; Cote, Richard J

2009-09-01

Approximately 15% to 30% of patients with pT1-2N0M0 urothelial carcinoma of the bladder experience disease progression despite radical cystectomy with curative intent. We determined whether p53 expression would improve the prediction of disease progression after radical cystectomy for pT1-2N0M0 UCB. In a multi-institutional retrospective cohort we identified 324 patients with pT1-2N0M0 urothelial carcinoma of the bladder who underwent radical cystectomy. Analysis focused on a testing cohort of 272 patients and an external validation of 52. Competing risks regression models were used to test the association of variables with cancer specific mortality after accounting for nonbladder cancer caused mortality. In the testing cohort 91 patients (33.5%) had altered p53 expression (p53alt). On multivariate competing risks regression analysis altered p53 achieved independent status for predicting disease recurrence and cancer specific mortality (each p <0.001). Adding p53 increased the accuracy of multivariate competing risks regression models predicting recurrence and cancer specific mortality by 5.7% (62.0% vs 67.7%) and 5.4% (61.6% vs 67.0%), respectively. Alterations in p53 represent a highly promising marker of disease recurrence and cancer specific mortality after radical cystectomy for urothelial carcinoma of the bladder. Analysis confirmed previous findings and showed that considering p53 can result in substantial accuracy gains relative to the use of standard predictors. The value and the level of the current evidence clearly exceed previous proof of the independent predictor status of p53 for predicting recurrence and cancer specific mortality.

Still Balancing Improvement and Accountability? Developments in External Quality Assurance in the Nordic Countries 1996-2006

ERIC Educational Resources Information Center

Dano, Trine; Stensaker, Bjorn

2007-01-01

The role and function of external quality assurance is of great importance for the development of an internal quality culture in higher education. Research has shown that external quality assurance can stimulate but also create obstacles for institutional improvement. To strike a balance between improvement and accountability is, therefore, a key…

34 CFR 690.65 - Transfer student: attendance at more than one institution during an award year.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Grant at one institution subsequently enrolls at a second institution in the same award year, the... valid SAR to the second institution; or (2) The second institution obtains a valid ISIR. (b) The second... Federal Pell Grant only for that portion of the academic year in which a student is enrolled at that...

34 CFR 690.65 - Transfer student: attendance at more than one institution during an award year.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Grant at one institution subsequently enrolls at a second institution in the same award year, the... valid SAR to the second institution; or (2) The second institution obtains a valid ISIR. (b) The second... Federal Pell Grant only for that portion of the academic year in which a student is enrolled at that...

34 CFR 690.65 - Transfer student: attendance at more than one institution during an award year.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Grant at one institution subsequently enrolls at a second institution in the same award year, the... valid SAR to the second institution; or (2) The second institution obtains a valid ISIR. (b) The second... Federal Pell Grant only for that portion of the academic year in which a student is enrolled at that...

34 CFR 690.65 - Transfer student: attendance at more than one institution during an award year.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Grant at one institution subsequently enrolls at a second institution in the same award year, the... valid SAR to the second institution; or (2) The second institution obtains a valid ISIR. (b) The second... Federal Pell Grant only for that portion of the academic year in which a student is enrolled at that...

Effects of cavity dimensions, boundary layer, and temperature on cavity noise with emphasis on benchmark data to validate computational aeroacoustic codes

NASA Technical Reports Server (NTRS)

Ahuja, K. K.; Mendoza, J.

1995-01-01

This report documents the results of an experimental investigation on the response of a cavity to external flowfields. The primary objective of this research was to acquire benchmark of data on the effects of cavity length, width, depth, upstream boundary layer, and flow temperature on cavity noise. These data were to be used for validation of computational aeroacoustic (CAA) codes on cavity noise. To achieve this objective, a systematic set of acoustic and flow measurements were made for subsonic turbulent flows approaching a cavity. These measurements were conducted in the research facilities of the Georgia Tech research institute. Two cavity models were designed, one for heated flow and another for unheated flow studies. Both models were designed such that the cavity length (L) could easily be varied while holding fixed the depth (D) and width (W) dimensions of the cavity. Depth and width blocks were manufactured so that these dimensions could be varied as well. A wall jet issuing from a rectangular nozzle was used to simulate flows over the cavity.

Institutional Research's Role in Strategic Planning

ERIC Educational Resources Information Center

Voorhees, Richard A.

2008-01-01

Institutions that have organized and centralized their data enjoy an obvious advantage in grappling with strategic planning and other issues. As the drumbeat for accountability, planning, and demonstrating effectiveness to internal and external stakeholders intensifies, the stature and importance of institutional research offices on most campuses…

"The Impacts of External Constraints on the Institutional Research Function."

ERIC Educational Resources Information Center

Law, Bill, Ed.

This document contains seventeen presentations delivered at the ninth annual meeting of the Florida Statewide Conference on Institutional Research. Part one contains: (1) "Your Legislative Session--1976"; (2) "Equal Access/Equal Opportunity: Institutions, Students, Politics, and Fairness"; (3) "The Impact of the Equal…

Characteristics Desired in Clinical Data Warehouse for Biomedical Research

PubMed Central

Shin, Soo-Yong; Kim, Woo Sung

2014-01-01

Objectives Due to the unique characteristics of clinical data, clinical data warehouses (CDWs) have not been successful so far. Specifically, the use of CDWs for biomedical research has been relatively unsuccessful thus far. The characteristics necessary for the successful implementation and operation of a CDW for biomedical research have not clearly defined yet. Methods Three examples of CDWs were reviewed: a multipurpose CDW in a hospital, a CDW for independent multi-institutional research, and a CDW for research use in an institution. After reviewing the three CDW examples, we propose some key characteristics needed in a CDW for biomedical research. Results A CDW for research should include an honest broker system and an Institutional Review Board approval interface to comply with governmental regulations. It should also include a simple query interface, an anonymized data review tool, and a data extraction tool. Also, it should be a biomedical research platform for data repository use as well as data analysis. Conclusions The proposed characteristics desired in a CDW may have limited transfer value to organizations in other countries. However, these analysis results are still valid in Korea, and we have developed clinical research data warehouse based on these desiderata. PMID:24872909

A self-scaling, distributed information architecture for public health, research, and clinical care.

PubMed

McMurry, Andrew J; Gilbert, Clint A; Reis, Ben Y; Chueh, Henry C; Kohane, Isaac S; Mandl, Kenneth D

2007-01-01

This study sought to define a scalable architecture to support the National Health Information Network (NHIN). This architecture must concurrently support a wide range of public health, research, and clinical care activities. The architecture fulfils five desiderata: (1) adopt a distributed approach to data storage to protect privacy, (2) enable strong institutional autonomy to engender participation, (3) provide oversight and transparency to ensure patient trust, (4) allow variable levels of access according to investigator needs and institutional policies, (5) define a self-scaling architecture that encourages voluntary regional collaborations that coalesce to form a nationwide network. Our model has been validated by a large-scale, multi-institution study involving seven medical centers for cancer research. It is the basis of one of four open architectures developed under funding from the Office of the National Coordinator of Health Information Technology, fulfilling the biosurveillance use case defined by the American Health Information Community. The model supports broad applicability for regional and national clinical information exchanges. This model shows the feasibility of an architecture wherein the requirements of care providers, investigators, and public health authorities are served by a distributed model that grants autonomy, protects privacy, and promotes participation.

The Development and Piloting of Parallel Scales Measuring External and Internal HIV and Tuberculosis Stigma Among Healthcare Workers in the Free State Province, South Africa.

PubMed

Wouters, Edwin; Rau, Asta; Engelbrecht, Michelle; Uebel, Kerry; Siegel, Jacob; Masquillier, Caroline; Kigozi, Gladys; Sommerland, Nina; Yassi, Annalee

2016-05-15

The dual burden of tuberculosis and human immunodeficiency virus (HIV) is severely impacting the South African healthcare workforce. However, the use of on-site occupational health services is hampered by stigma among the healthcare workforce. The success of stigma-reduction interventions is difficult to evaluate because of a dearth of appropriate scientific tools to measure stigma in this specific professional setting. The current pilot study aimed to develop and test a range of scales measuring different aspects of stigma-internal and external stigma toward tuberculosis as well as HIV-in a South African healthcare setting. The study employed data of a sample of 200 staff members of a large hospital in Bloemfontein, South Africa. Confirmatory factor analysis produced 7 scales, displaying internal construct validity: (1) colleagues' external HIV stigma, (2) colleagues' actions against external HIV stigma, (3) respondent's external HIV stigma, (4) respondent's internal HIV stigma, (5) colleagues' external tuberculosis stigma, (6) respondent's external tuberculosis stigma, and (7) respondent's internal tuberculosis stigma. Subsequent analyses (reliability analysis, structural equation modeling) demonstrated that the scales displayed good psychometric properties in terms of reliability and external construct validity. The study outcomes support the use of the developed scales as a valid and reliable means to measure levels of tuberculosis- and HIV-related stigma among the healthcare workforce in a resource-limited context. Future studies should build on these findings to fine-tune the instruments and apply them to larger study populations across a range of different resource-limited healthcare settings with high HIV and tuberculosis prevalence. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

The Development and Piloting of Parallel Scales Measuring External and Internal HIV and Tuberculosis Stigma Among Healthcare Workers in the Free State Province, South Africa

PubMed Central

Wouters, Edwin; Rau, Asta; Engelbrecht, Michelle; Uebel, Kerry; Siegel, Jacob; Masquillier, Caroline; Kigozi, Gladys; Sommerland, Nina; Yassi, Annalee

2016-01-01

Background The dual burden of tuberculosis and human immunodeficiency virus (HIV) is severely impacting the South African healthcare workforce. However, the use of on-site occupational health services is hampered by stigma among the healthcare workforce. The success of stigma-reduction interventions is difficult to evaluate because of a dearth of appropriate scientific tools to measure stigma in this specific professional setting. Methods The current pilot study aimed to develop and test a range of scales measuring different aspects of stigma—internal and external stigma toward tuberculosis as well as HIV—in a South African healthcare setting. The study employed data of a sample of 200 staff members of a large hospital in Bloemfontein, South Africa. Results Confirmatory factor analysis produced 7 scales, displaying internal construct validity: (1) colleagues’ external HIV stigma, (2) colleagues’ actions against external HIV stigma, (3) respondent’s external HIV stigma, (4) respondent’s internal HIV stigma, (5) colleagues’ external tuberculosis stigma, (6) respondent’s external tuberculosis stigma, and (7) respondent’s internal tuberculosis stigma. Subsequent analyses (reliability analysis, structural equation modeling) demonstrated that the scales displayed good psychometric properties in terms of reliability and external construct validity. Conclusions The study outcomes support the use of the developed scales as a valid and reliable means to measure levels of tuberculosis- and HIV-related stigma among the healthcare workforce in a resource-limited context. Future studies should build on these findings to fine-tune the instruments and apply them to larger study populations across a range of different resource-limited healthcare settings with high HIV and tuberculosis prevalence. PMID:27118854

External Validation of the Acoustic Voice Quality Index Version 03.01 With Extended Representativity.

PubMed

Barsties, Ben; Maryn, Youri

2016-07-01

The Acoustic Voice Quality Index (AVQI) is an objective method to quantify the severity of overall voice quality in concatenated continuous speech and sustained phonation segments. Recently, AVQI was successfully modified to be more representative and ecologically valid because the internal consistency of AVQI was balanced out through equal proportion of the 2 speech types. The present investigation aims to explore its external validation in a large data set. An expert panel of 12 speech-language therapists rated the voice quality of 1058 concatenated voice samples varying from normophonia to severe dysphonia. The Spearman rank-order correlation coefficients (r) were used to measure concurrent validity. The AVQI's diagnostic accuracy was evaluated with several estimates of its receiver operating characteristics (ROC). Finally, 8 of the 12 experts were chosen because of reliability criteria. A strong correlation was identified between AVQI and auditoryperceptual rating (r = 0.815, P = .000). It indicated that 66.4% of the auditory-perceptual rating's variation was explained by AVQI. Additionally, the ROC results showed again the best diagnostic outcome at a threshold of AVQI = 2.43. This study highlights external validation and diagnostic precision of the AVQI version 03.01 as a robust and ecologically valid measurement to objectify voice quality. © The Author(s) 2016.

How feasible is remote 3D dosimetry for MR guided Radiation Therapy (MRgRT)?

NASA Astrophysics Data System (ADS)

Mein, S.; Rankine, L.; Miles, D.; Juang, T.; Cai, B.; Curcuru, A.; Mutic, S.; Fenoli, J.; Adamovics, J.; Li, H.; Oldham, M.

2017-05-01

To develop and apply a remote dosimetry protocol with PRESAGE® radiochromic plastic and optical-CT readout in the validation of MRI guided radiation therapy (MRgRT) treatments (MRIdian® by ViewRay®). Through multi-institutional collaboration we performed PRESAGE® dosimetry studies in 4ml cuvettes to investigate dose-response linearity, MR-compatibility, and energy-independence. An open calibration field and symmetrical 3-field plans were delivered to 10cm diameter PRESAGE® to examine percent depth dose and response uniformity under a magnetic field. Evidence of non-linear dose response led to a large volume PRESAGE® study where small corrections were developed for temporally- and spatially-dependent behaviors observed between irradiation and delayed readout. TG-119 plans were created in the MRIdian® TPS and then delivered to 14.5cm 2kg PRESAGE® dosimeters. Through the domestic investigation of an off-site MRgRT system, a refined 3D remote dosimetry protocol is presented capable of validation of advanced MRgRT radiation treatments.

Research priorities for multi-institutional collaborative research in surgical education.

PubMed

Stefanidis, Dimitrios; Cochran, Amalia; Sevdalis, Nick; Mellinger, John; Phitayakorn, Roy; Sullivan, Maura; Barney, Linda

2015-01-01

Research in surgical education has seen unprecedented growth but originates from single institutions and remains uncoordinated; this study aimed to generate a list of research priorities in surgical educational topics. The membership of the Association for Surgical Education was asked to submit up to 5 research questions concerned with multi-institutional collaborative surgical education research and to identify challenges faced by surgical education researchers. A modified Delphi methodology was used to create the research agenda based on these responses. Surgical educators responded to 3 survey rounds. Categories of submitted questions included teaching methods and curriculum development; assessment and competency; simulation; medical student preparation and selection; impact of work hour restrictions; and faculty development. Participants cited institutional culture and practice variability and lack of institutional review board coordination as common barriers to collaborative research, while identifying extensive planning, frequent communication, and availability of dedicated research coordinators as the most important facilitators. Using a Delphi methodology, a prioritized agenda for multi-institutional surgical education research was developed that may help advance surgeon education. Copyright © 2015 Elsevier Inc. All rights reserved.

The feasibility of sharing simulation-based evaluation scenarios in anesthesiology.

PubMed

Berkenstadt, Haim; Kantor, Gareth S; Yusim, Yakov; Gafni, Naomi; Perel, Azriel; Ezri, Tiberiu; Ziv, Amitai

2005-10-01

We prospectively assessed the feasibility of international sharing of simulation-based evaluation tools despite differences in language, education, and anesthesia practice, in an Israeli study, using validated scenarios from a multi-institutional United States (US) study. Thirty-one Israeli junior anesthesia residents performed four simulation scenarios. Training sessions were videotaped and performance was assessed using two validated scoring systems (Long and Short Forms) by two independent raters. Subjects scored from 37 to 95 (70 +/- 12) of 108 possible points with the "Long Form" and "Short Form" scores ranging from 18 to 35 (28.2 +/- 4.5) of 40 possible points. Scores >70% of the maximal score were achieved by 61% of participants in comparison to only 5% in the original US study. The scenarios were rated as very realistic by 80% of the participants (grade 4 on a 1-4 scale). Reliability of the original assessment tools was demonstrated by internal consistencies of 0.66 for the Long and 0.75 for the Short Form (Cronbach alpha statistic). Values in the original study were 0.72-0.76 for the Long and 0.71-0.75 for the Short Form. The reliability did not change when a revised Israeli version of the scoring was used. Interrater reliability measured by Pearson correlation was 0.91 for the Long and 0.96 for the Short Form (P < 0.01). The high scores for plausibility given to the scenarios and the similar reliability of the original assessment tool support the feasibility of using simulation-based evaluation tools, developed in the US, in Israel. The higher scores achieved by Israeli residents may be related to the fact that most Israeli residents are immigrants with previous training in anesthesia. Simulation-based assessment tools developed in a multi-institutional study in the United States can be used in Israel despite the differences in language, education, and medical system.

Simultaneous measurement of sulfur and lead isotopes in sulfides using nanosecond laser ablation coupled with two multi-collector inductively coupled plasma mass spectrometers

NASA Astrophysics Data System (ADS)

Yuan, Honglin; Liu, Xu; Chen, Lu; Bao, Zhian; Chen, Kaiyun; Zong, Chunlei; Li, Xiao-Chun; Qiu, Johnson Wenhong

2018-04-01

We herein report the coupling of a nanosecond laser ablation system with a large-scale multi-collector inductively coupled plasma mass spectrometer (Nu1700 MC-ICPMS, NP-1700) and a conventional Nu Plasma II MC-ICPMS (NP-II) for the simultaneous laser ablation and determination of in situ S and Pb isotopic compositions of sulfide minerals. We found that the required aerosol distribution between the two spectrometers depended on the Pb content of the sample. For example, for a sulfide containing 100-3000 ppm Pb, the aerosol was distributed between the NP-1700 and the NP-II spectrometers in a 1:1 ratio, while for lead contents >3000 and <100 ppm, these ratios were 5:1 and 1:3, respectively. In addition, S isotopic analysis showed a pronounced matrix effect, so a matrix-matched external standard was used for standard-sample bracketing correction. The NIST NBS 977 (NBS, National Bureau of Standards; NIST, National Institute of Standards & Technology) Tl (thallium) dry aerosol internal standard and the NIST SRM 610 (SRM, standard reference material) external standard were employed to obtain accurate results for the analysis of Pb isotopes. In tandem experiments where airflow conditions were similar to those employed during stand-alone analyses, small changes in the aerosol carrier gas flow did not significantly influence the accurate determination of S and Pb isotope ratios. In addition, careful optimization of the flow ratio of the aerosol carrier (He) and makeup (Ar) gases to match stand-alone analytical conditions allowed comparable S and Pb isotope ratios to be obtained within an error of 2 s analytical uncertainties. Furthermore, the results of tandem analyses obtained using our method were consistent with those of previously reported stand-alone techniques for the S and Pb isotopes of chalcopyrite, pyrite, galena, and sphalerite, thus indicating that this method is suitable for the simultaneous analysis of S and Pb isotopes of natural sulfide minerals, and provides an effective tool to determine S and Pb isotope compositions of sulfides formed through multi-stage deposition routes.

Prognostic models for complete recovery in ischemic stroke: a systematic review and meta-analysis.

PubMed

Jampathong, Nampet; Laopaiboon, Malinee; Rattanakanokchai, Siwanon; Pattanittum, Porjai

2018-03-09

Prognostic models have been increasingly developed to predict complete recovery in ischemic stroke. However, questions arise about the performance characteristics of these models. The aim of this study was to systematically review and synthesize performance of existing prognostic models for complete recovery in ischemic stroke. We searched journal publications indexed in PUBMED, SCOPUS, CENTRAL, ISI Web of Science and OVID MEDLINE from inception until 4 December, 2017, for studies designed to develop and/or validate prognostic models for predicting complete recovery in ischemic stroke patients. Two reviewers independently examined titles and abstracts, and assessed whether each study met the pre-defined inclusion criteria and also independently extracted information about model development and performance. We evaluated validation of the models by medians of the area under the receiver operating characteristic curve (AUC) or c-statistic and calibration performance. We used a random-effects meta-analysis to pool AUC values. We included 10 studies with 23 models developed from elderly patients with a moderately severe ischemic stroke, mainly in three high income countries. Sample sizes for each study ranged from 75 to 4441. Logistic regression was the only analytical strategy used to develop the models. The number of various predictors varied from one to 11. Internal validation was performed in 12 models with a median AUC of 0.80 (95% CI 0.73 to 0.84). One model reported good calibration. Nine models reported external validation with a median AUC of 0.80 (95% CI 0.76 to 0.82). Four models showed good discrimination and calibration on external validation. The pooled AUC of the two validation models of the same developed model was 0.78 (95% CI 0.71 to 0.85). The performance of the 23 models found in the systematic review varied from fair to good in terms of internal and external validation. Further models should be developed with internal and external validation in low and middle income countries.

Finding Erich Jantsch's Five Crucial Innovations: A Study of Four Small Colleges

ERIC Educational Resources Information Center

MacVie, Leah

2017-01-01

Institutions of higher education have faced many challenges over the last few decades. Though many large institutions have the resources needed to respond to these challenges, small institutions have had to be innovative in the ways in which they are adapting. There are similarities between the external challenges that institutions face today and…

Institutional Quality of a Higher Education Institution from the Perspective of Employers

ERIC Educational Resources Information Center

Rodman, Karmen; Biloslavo, Roberto; Bratoz, Silva

2013-01-01

The present paper proposes a theoretical model of institutional quality of a higher education institution (HEI) which, in addition to the internal dimensions of quality, incorporates also the external dimension, i.e. the outcomes dimension. This dimension has been neglected by the quality standards and models examined in our paper. Furthermore,…

Valid and reliable authentic assessment of culminating student performance in the biomedical sciences.

PubMed

Oh, Deborah M; Kim, Joshua M; Garcia, Raymond E; Krilowicz, Beverly L

2005-06-01

There is increasing pressure, both from institutions central to the national scientific mission and from regional and national accrediting agencies, on natural sciences faculty to move beyond course examinations as measures of student performance and to instead develop and use reliable and valid authentic assessment measures for both individual courses and for degree-granting programs. We report here on a capstone course developed by two natural sciences departments, Biological Sciences and Chemistry/Biochemistry, which engages students in an important culminating experience, requiring synthesis of skills and knowledge developed throughout the program while providing the departments with important assessment information for use in program improvement. The student work products produced in the course, a written grant proposal, and an oral summary of the proposal, provide a rich source of data regarding student performance on an authentic assessment task. The validity and reliability of the instruments and the resulting student performance data were demonstrated by collaborative review by content experts and a variety of statistical measures of interrater reliability, including percentage agreement, intraclass correlations, and generalizability coefficients. The high interrater reliability reported when the assessment instruments were used for the first time by a group of external evaluators suggests that the assessment process and instruments reported here will be easily adopted by other natural science faculty.

Robust adaptive fault-tolerant control for leader-follower flocking of uncertain multi-agent systems with actuator failure.

PubMed

Yazdani, Sahar; Haeri, Mohammad

2017-11-01

In this work, we study the flocking problem of multi-agent systems with uncertain dynamics subject to actuator failure and external disturbances. By considering some standard assumptions, we propose a robust adaptive fault tolerant protocol for compensating of the actuator bias fault, the partial loss of actuator effectiveness fault, the model uncertainties, and external disturbances. Under the designed protocol, velocity convergence of agents to that of virtual leader is guaranteed while the connectivity preservation of network and collision avoidance among agents are ensured as well. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

A Multi-Level Approach to Outreach for Geologic Sequestration Projects

USGS Publications Warehouse

Greenberg, S.E.; Leetaru, H.E.; Krapac, I.G.; Hnottavange-Telleen, K.; Finley, R.J.

2009-01-01

Public perception of carbon capture and sequestration (CCS) projects represents a potential barrier to commercialization. Outreach to stakeholders at the local, regional, and national level is needed to create familiarity with and potential acceptance of CCS projects. This paper highlights the Midwest Geological Sequestration Consortium (MGSC) multi-level outreach approach which interacts with multiple stakeholders. The MGSC approach focuses on external and internal communication. External communication has resulted in building regional public understanding of CCS. Internal communication, through a project Risk Assessment process, has resulted in enhanced team communication and preparation of team members for outreach roles. ?? 2009 Elsevier Ltd. All rights reserved.

A novel protein-based prognostic signature improves risk stratification to guide clinical management in early lung adenocarcinoma patients.

PubMed

Martínez-Terroba, Elena; Behrens, Carmen; de Miguel, Fernando J; Agorreta, Jackeline; Monsó, Eduard; Millares, Laura; Sainz, Cristina; Mesa-Guzman, Miguel; Pérez-Gracia, Jose Luis; Lozano, María Dolores; Zulueta, Javier J; Pio, Ruben; Wistuba, Ignacio I; Montuenga, Luis M; Pajares, María J

2018-05-13

Each of the pathological stages (I-IIIa) in which surgically resected non-small cell lung cancer patients are classified conceals hidden biological heterogeneity, manifested in heterogeneous outcomes within each stage. Thus, the finding of robust and precise molecular classifiers to assess individual patient risk is an unmet medical need. Here we identified and validated the clinical utility of a new prognostic signature based on three proteins (BRCA1, QKI and SLC2A1) to stratify early lung adenocarcinoma patients according to their risk of recurrence or death. Patients were staged following the new International Association for the Study of Lung Cancer (IASLC) staging criteria (8 th edition, 2018). A test cohort (n=239) was used to assess the value of this new prognostic index (PI) based on the three proteins. The prognostic signature was developed by Cox regression following stringent statistical criteria (TRIPOD: Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis). The model resulted in a highly significant predictor of five-year outcome for disease-free survival (P<0.001) and overall survival (P<0.001). The prognostic ability of the model was externally validated in an independent multi-institutional cohort of patients (n=114, P=0.021). We also demonstrated that this molecular classifier adds relevant information to the gold standard TNM-based pathological staging with a highly significant improvement of likelihood ratio. We subsequently developed a combined prognostic index (CPI) including both the molecular and the pathological data which improved the risk stratification in both cohorts (P≤0.001). Moreover, the signature may help to select stage I-IIA patients who might benefit from adjuvant chemotherapy. In summary, this protein-based signature accurately identifies those patients with high risk of recurrence and death, and adds further prognostic information to the TNM-based clinical staging, even applying the new IASLC 8 th edition staging criteria. More importantly, it may be a valuable tool for selecting patients for adjuvant therapy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

An external-cavity quantum cascade laser operating near 5.2 µm combined with cavity ring-down spectroscopy for multi-component chemical sensing

NASA Astrophysics Data System (ADS)

Dutta Banik, Gourab; Maity, Abhijit; Som, Suman; Pal, Mithun; Pradhan, Manik

2018-04-01

We report on the performance of a widely tunable continuous wave mode-hop-free external-cavity quantum cascade laser operating at λ ~ 5.2 µm combined with cavity ring-down spectroscopy (CRDS) technique for high-resolution molecular spectroscopy. The CRDS system has been utilized for simultaneous and molecule-specific detection of several environmentally and bio-medically important trace molecular species such as nitric oxide, nitrous oxide, carbonyl sulphide and acetylene (C2H2) at ultra-low concentrations by probing numerous rotationally resolved ro-vibrational transitions in the mid-IR spectral region within a relatively small spectral range of ~0.035 cm-1. This continuous wave external-cavity quantum cascade laser-based multi-component CRDS sensor with high sensitivity and molecular specificity promises applications in environmental sensing as well as non-invasive medical diagnosis through human breath analysis.

A Multi-Level Examination of College and Its Influence on Ecumenical Worldview Development

ERIC Educational Resources Information Center

Mayhew, Matthew J.

2012-01-01

This multi-level, longitudinal study investigated the ecumenical worldview development of 13,932 students enrolled in one of 126 institutions. Results indicated that the final hierarchical linear model, consisting of institution-and-student-level predictors as well as slopes explaining the relationships among some of these predictors, explained…

Multi-Level Strategies in Universities: Coordination, Contestation or Creolisation?

ERIC Educational Resources Information Center

Stensaker, Bjørn; Fumasoli, Tatiana

2017-01-01

In contemporary research-intensive universities, strategies are not only found at the institutional level but also at various sub-levels in the organisation. In principle, such multi-level strategies are assumed to be a means for institutional coordination in the sense that more generic strategic objectives may give room for local adaptation…

Recommendations of the VAC2VAC workshop on the design of multi-centre validation studies.

PubMed

Halder, Marlies; Depraetere, Hilde; Delannois, Frédérique; Akkermans, Arnoud; Behr-Gross, Marie-Emmanuelle; Bruysters, Martijn; Dierick, Jean-François; Jungbäck, Carmen; Kross, Imke; Metz, Bernard; Pennings, Jeroen; Rigsby, Peter; Riou, Patrice; Balks, Elisabeth; Dobly, Alexandre; Leroy, Odile; Stirling, Catrina

2018-03-01

Within the Innovative Medicines Initiative 2 (IMI 2) project VAC2VAC (Vaccine batch to vaccine batch comparison by consistency testing), a workshop has been organised to discuss ways of improving the design of multi-centre validation studies and use the data generated for product-specific validation purposes. Moreover, aspects of validation within the consistency approach context were addressed. This report summarises the discussions and outlines the conclusions and recommendations agreed on by the workshop participants. Copyright © 2018.

Using Transcripts To Validate Institutional Mission: The Role of the Community College in the Postsecondary Experience of a Generation. ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Adelman, Clifford

Information is presented on the use of transcripts to validate institutional mission, proposing that transcript archives can serve as grounds against which the validity of an institution's claimed mission with respect to its primary beneficiaries can be measured. This is done with a focus on the community college. The National Longitudinal Study…

A Strategic Governance Review for Multi-Organizational Systems of Education, Training, and Professional Development.

ERIC Educational Resources Information Center

Daley, Glenn A.; Levy, Dina G.; Kaganoff, Tessa; Augustine, Catherine A.; Benjamin, Roger; Bikson, Tora K.; Gates, Susan M.; Moini, Joy S.

A study was conducted to develop tools for describing and evaluating external governance in the U.S. Department of Defense's (DoD's) multiorganizational system of education, training, and professional development. An exploratory conceptual framework and taxonomy for understanding external governance in the DoD context was developed, and the…

Medical examiner/coroner records: uses and limitations in occupational injury epidemiologic research.

PubMed

Conroy, C; Russell, J C

1990-07-01

Epidemiologic research often relies on existing data, collected for nonepidemiologic reasons, to support studies. Data are obtained from hospital records, police reports, labor reports, death certificates, or other sources. Medical examiner/coroner records are, however, not often used in epidemiologic studies. The National Institute for Occupational Safety and Health's Division of Safety Research has begun using these records in its research program on work-related trauma. Because medical examiners and coroners have the legal authority and responsibility to investigate all externally caused deaths, these records can be used in surveillance of these deaths. Another use of these records is to validate cases identified by other case ascertainment methods, such as death certificates. Using medical examiner/coroner records also allows rapid identification of work-related deaths without waiting several years for mortality data from state offices of vital statistics. Finally, the records are an invaluable data source since they contain detailed information on the nature of the injury, external cause of death, and results of toxicologic testing, which is often not available from other sources. This paper illustrates some of the ways that medical examiner/coroner records are a valuable source of information for epidemiologic studies and makes recommendations to improve their usefulness.

Differential Correlates of Multi-Type Maltreatment among Urban Youth

ERIC Educational Resources Information Center

Arata, Catalina M.; Langhinrichsen-Rohling, Jennifer; Bowers, David; O'Brien, Natalie

2007-01-01

Objective: The aim of this study was to examine the differential effects of multi-types of maltreatment in an adolescent sample. Different combinations of maltreatment (emotional, sexual, physical, neglect) were examined in relation to both negative affect and externalizing symptoms in male and female youth. Method: One thousand four hundred…

Measuring the Perception of the Teachers' Autonomy-Supportive Behavior in Physical Education: Development and Initial Validation of a Multi-Dimensional Instrument

ERIC Educational Resources Information Center

Tilga, Henri; Hein, Vello; Koka, Andre

2017-01-01

This research aimed to develop and validate an instrument to assess the students' perceptions of the teachers' autonomy-supportive behavior by the multi-dimensional scale (Multi-Dimensional Perceived Autonomy Support Scale for Physical Education). The participants were 1,476 students aged 12- to 15-years-old. In Study 1, a pool of 37 items was…

A comparison of single- and multi-site calibration and validation: a case study of SWAT in the Miyun Reservoir watershed, China

NASA Astrophysics Data System (ADS)

Bai, Jianwen; Shen, Zhenyao; Yan, Tiezhu

2017-09-01

An essential task in evaluating global water resource and pollution problems is to obtain the optimum set of parameters in hydrological models through calibration and validation. For a large-scale watershed, single-site calibration and validation may ignore spatial heterogeneity and may not meet the needs of the entire watershed. The goal of this study is to apply a multi-site calibration and validation of the Soil andWater Assessment Tool (SWAT), using the observed flow data at three monitoring sites within the Baihe watershed of the Miyun Reservoir watershed, China. Our results indicate that the multi-site calibration parameter values are more reasonable than those obtained from single-site calibrations. These results are mainly due to significant differences in the topographic factors over the large-scale area, human activities and climate variability. The multi-site method involves the division of the large watershed into smaller watersheds, and applying the calibrated parameters of the multi-site calibration to the entire watershed. It was anticipated that this case study could provide experience of multi-site calibration in a large-scale basin, and provide a good foundation for the simulation of other pollutants in followup work in the Miyun Reservoir watershed and other similar large areas.

Treatment of severe porcine tracheomalacia with a 3-dimensionally printed, bioresorbable, external airway splint

PubMed Central

Zopf, David A.; Flanagan, Colleen L.; Wheeler, Matthew; Hollister, Scott J.; Green, Glenn E.

2015-01-01

Importance The study demonstrates an application for 3-dimensional (3D) printing that may serve as an effective intervention for severe tracheobronchomalacia. Objective A novel 3D printed, bioresorbable airway splint is tested for efficacy in extending survival in an animal model of severe, life-threatening tracheobronchomalacia. Participants Evaluation of an external airway splint for severe, life-threatening tracheobronchomalacia in a porcine animal model. Setting Multi-institutional and multidisciplinary collaboration between biomedical engineering laboratories and an academic animal surgery center. Interventions Experimental analysis of a 3D printed, bioresorbable airway splint is assessed in a porcine animal model of life-threatening tracheobronchomalacia. The open-cylindrical, bellow shaped porous polycaprolactone splint is placed externally and designed to suspend the underlying collapsed airway. Control animals (n=3) undergoing tracheal cartilage division and inner tracheal lumen dissociation and experimental animals (n=3) receiving the same model with overlying placement of the newly developed airway splint were evaluated. Main Outcomes and Measures An animal model for severe, life-threatening tracheobronchomalacia is proposed. Complete or near complete tracheal lumen collapse was observed in each animal with resolution of symptoms in all of the experimental animals after splint placement. Using our severe tracheobronchomalacia animal model, survival was significantly longer in duration in the experimental group receiving the airway splint after model creation when compared to model creation alone (p = 0.0495). Mortality in the experimental group was related to infection. Conclusions A multidisciplinary effort producing a CAD/CAM, bioresorbable tracheobronchial splint was tested in a porcine model of severe tracheomalacia and was found to extend survival. PMID:24232078

COMPUTING THERAPY FOR PRECISION MEDICINE: COLLABORATIVE FILTERING INTEGRATES AND PREDICTS MULTI-ENTITY INTERACTIONS.

PubMed

Regenbogen, Sam; Wilkins, Angela D; Lichtarge, Olivier

2016-01-01

Biomedicine produces copious information it cannot fully exploit. Specifically, there is considerable need to integrate knowledge from disparate studies to discover connections across domains. Here, we used a Collaborative Filtering approach, inspired by online recommendation algorithms, in which non-negative matrix factorization (NMF) predicts interactions among chemicals, genes, and diseases only from pairwise information about their interactions. Our approach, applied to matrices derived from the Comparative Toxicogenomics Database, successfully recovered Chemical-Disease, Chemical-Gene, and Disease-Gene networks in 10-fold cross-validation experiments. Additionally, we could predict each of these interaction matrices from the other two. Integrating all three CTD interaction matrices with NMF led to good predictions of STRING, an independent, external network of protein-protein interactions. Finally, this approach could integrate the CTD and STRING interaction data to improve Chemical-Gene cross-validation performance significantly, and, in a time-stamped study, it predicted information added to CTD after a given date, using only data prior to that date. We conclude that collaborative filtering can integrate information across multiple types of biological entities, and that as a first step towards precision medicine it can compute drug repurposing hypotheses.

COMPUTING THERAPY FOR PRECISION MEDICINE: COLLABORATIVE FILTERING INTEGRATES AND PREDICTS MULTI-ENTITY INTERACTIONS

PubMed Central

REGENBOGEN, SAM; WILKINS, ANGELA D.; LICHTARGE, OLIVIER

2015-01-01

Biomedicine produces copious information it cannot fully exploit. Specifically, there is considerable need to integrate knowledge from disparate studies to discover connections across domains. Here, we used a Collaborative Filtering approach, inspired by online recommendation algorithms, in which non-negative matrix factorization (NMF) predicts interactions among chemicals, genes, and diseases only from pairwise information about their interactions. Our approach, applied to matrices derived from the Comparative Toxicogenomics Database, successfully recovered Chemical-Disease, Chemical-Gene, and Disease-Gene networks in 10-fold cross-validation experiments. Additionally, we could predict each of these interaction matrices from the other two. Integrating all three CTD interaction matrices with NMF led to good predictions of STRING, an independent, external network of protein-protein interactions. Finally, this approach could integrate the CTD and STRING interaction data to improve Chemical-Gene cross-validation performance significantly, and, in a time-stamped study, it predicted information added to CTD after a given date, using only data prior to that date. We conclude that collaborative filtering can integrate information across multiple types of biological entities, and that as a first step towards precision medicine it can compute drug repurposing hypotheses. PMID:26776170

Deeply learnt hashing forests for content based image retrieval in prostate MR images

NASA Astrophysics Data System (ADS)

Shah, Amit; Conjeti, Sailesh; Navab, Nassir; Katouzian, Amin

2016-03-01

Deluge in the size and heterogeneity of medical image databases necessitates the need for content based retrieval systems for their efficient organization. In this paper, we propose such a system to retrieve prostate MR images which share similarities in appearance and content with a query image. We introduce deeply learnt hashing forests (DL-HF) for this image retrieval task. DL-HF effectively leverages the semantic descriptiveness of deep learnt Convolutional Neural Networks. This is used in conjunction with hashing forests which are unsupervised random forests. DL-HF hierarchically parses the deep-learnt feature space to encode subspaces with compact binary code words. We propose a similarity preserving feature descriptor called Parts Histogram which is derived from DL-HF. Correlation defined on this descriptor is used as a similarity metric for retrieval from the database. Validations on publicly available multi-center prostate MR image database established the validity of the proposed approach. The proposed method is fully-automated without any user-interaction and is not dependent on any external image standardization like image normalization and registration. This image retrieval method is generalizable and is well-suited for retrieval in heterogeneous databases other imaging modalities and anatomies.

The Perils of Ignoring Design Effects in Experimental Studies: Lessons from a Mammography Screening Trial

PubMed Central

Glenn, Beth A.; Bastani, Roshan; Maxwell, Annette E.

2013-01-01

Objective Threats to external validity including pretest sensitization and the interaction of selection and an intervention are frequently overlooked by researchers despite their potential to significantly influence study outcomes. The purpose of this investigation was to conduct secondary data analyses to assess the presence of external validity threats in the setting of a randomized trial designed to promote mammography use in a high risk sample of women. Design During the trial, recruitment and intervention implementation took place in three cohorts (with different ethnic composition), utilizing two different designs (pretest-posttest control group design; posttest only control group design). Results Results reveal that the intervention produced different outcomes across cohorts, dependent upon the research design used and the characteristics of the sample. Conclusion These results illustrate the importance of weighing the pros and cons of potential research designs before making a selection and attending more closely to issues of external validity. PMID:23289517

External Validity of the New York University Caregiver Intervention: Key Caregiver Outcomes Across Multiple Demonstration Projects.

PubMed

Fauth, Elizabeth B; Jackson, Mark A; Walberg, Donna K; Lee, Nancy E; Easom, Leisa R; Alston, Gayle; Ramos, Angel; Felten, Kristen; LaRue, Asenath; Mittelman, Mary

2017-06-01

The Administration on Aging funded six New York University Caregiver Intervention (NYUCI) demonstration projects, a counseling/support intervention targeting dementia caregivers and families. Three sites (Georgia, Utah, Wisconsin) pooled data to inform external validity in nonresearch settings. This study (a) assesses collective changes over time, and (b) compares outcomes across sites on caregiver burden, depressive symptoms, satisfaction with social support, family conflict, and quality of life. Data included baseline/preintervention ( N = 294) and follow-up visits (approximately 4, 8, 12 months). Linear mixed models showed that social support satisfaction increased ( p < .05) and family conflict decreased ( p < .05; Cohen's d = 0.49 and 0.35, respectively). Marginally significant findings emerged for quality of life increases ( p = .05) and burden decreases ( p < .10). Depressive symptoms remained stable. Slopes did not differ much by site. NYUCI demonstrated external validity in nonresearch settings across diverse caregiver samples.

The perils of ignoring design effects in experimental studies: lessons from a mammography screening trial.

PubMed

Glenn, Beth A; Bastani, Roshan; Maxwell, Annette E

2013-01-01

Threats to external validity, including pretest sensitisation and the interaction of selection and an intervention, are frequently overlooked by researchers despite their potential to significantly influence study outcomes. The purpose of this investigation was to conduct secondary data analyses to assess the presence of external validity threats in the setting of a randomised trial designed to promote mammography use in a high-risk sample of women. During the trial, recruitment and intervention, implementation took place in three cohorts (with different ethnic composition), utilising two different designs (pretest-posttest control group design and posttest only control group design). Results reveal that the intervention produced different outcomes across cohorts, dependent upon the research design used and the characteristics of the sample. These results illustrate the importance of weighing the pros and cons of potential research designs before making a selection and attending more closely to issues of external validity.

Psychopathy in Bulgaria: The cross-cultural generalizability of the Hare Psychopathy Checklist

PubMed Central

Wilson, Michael J.; Abramowitz, Carolyn; Vasilev, Georgi; Bozgunov, Kiril; Vassileva, Jasmin

2014-01-01

The generalizability of the psychopathy construct to Eastern European cultures has not been well-studied, and no prior studies have evaluated psychopathy in non-offender samples from this population. The current validation study examines the factor structure, internal consistency, and external validity of the Bulgarian translation of the Hare Psychopathy Checklist: Screening Version. Two hundred sixty-two Bulgarian adults from the general community were assessed, of which 185 had a history of substance dependence. Confirmatory factor analysis indicated good fit for the two-, three-, and four-factor models of psychopathy. Zero-order and partial correlation analyses were conducted between the two factors of psychopathy and criterion measures of antisocial behavior, internalizing and externalizing psychopathology, personality traits, addictive disorders and demographic characteristics. Relationships to external variables provided evidence for the convergent and discriminant validity of the psychopathy construct in a Bulgarian community sample. PMID:25313268

External Validation of Bifactor Model of ADHD: Explaining Heterogeneity in Psychiatric Comorbidity, Cognitive Control, and Personality Trait Profiles Within DSM-IV ADHD

PubMed Central

Martel, Michelle M.; Roberts, Bethan; Gremillion, Monica; von Eye, Alexander; Nigg, Joel T.

2011-01-01

The current paper provides external validation of the bifactor model of ADHD by examining associations between ADHD latent factor/profile scores and external validation indices. 548 children (321 boys; 302 with ADHD), 6 to 18 years old, recruited from the community participated in a comprehensive diagnostic procedure. Mothers completed the Child Behavior Checklist, Early Adolescent Temperament Questionnaire, and California Q-Sort. Children completed the Stop and Trail-Making Task. Specific inattention was associated with depression/withdrawal, slower cognitive task performance, introversion, agreeableness, and high reactive control; specific hyperactivity-impulsivity was associated with rule-breaking/aggressive behavior, social problems, errors during set-shifting, extraversion, disagreeableness, and low reactive control. It is concluded that the bifactor model provides better explanation of heterogeneity within ADHD than DSM-IV ADHD symptom counts or subtypes. PMID:21735050

The use of patient factors to improve the prediction of operative duration using laparoscopic cholecystectomy.

PubMed

Thiels, Cornelius A; Yu, Denny; Abdelrahman, Amro M; Habermann, Elizabeth B; Hallbeck, Susan; Pasupathy, Kalyan S; Bingener, Juliane

2017-01-01

Reliable prediction of operative duration is essential for improving patient and care team satisfaction, optimizing resource utilization and reducing cost. Current operative scheduling systems are unreliable and contribute to costly over- and underestimation of operative time. We hypothesized that the inclusion of patient-specific factors would improve the accuracy in predicting operative duration. We reviewed all elective laparoscopic cholecystectomies performed at a single institution between 01/2007 and 06/2013. Concurrent procedures were excluded. Univariate analysis evaluated the effect of age, gender, BMI, ASA, laboratory values, smoking, and comorbidities on operative duration. Multivariable linear regression models were constructed using the significant factors (p < 0.05). The patient factors model was compared to the traditional surgical scheduling system estimates, which uses historical surgeon-specific and procedure-specific operative duration. External validation was done using the ACS-NSQIP database (n = 11,842). A total of 1801 laparoscopic cholecystectomy patients met inclusion criteria. Female sex was associated with reduced operative duration (-7.5 min, p < 0.001 vs. male sex) while increasing BMI (+5.1 min BMI 25-29.9, +6.9 min BMI 30-34.9, +10.4 min BMI 35-39.9, +17.0 min BMI 40 + , all p < 0.05 vs. normal BMI), increasing ASA (+7.4 min ASA III, +38.3 min ASA IV, all p < 0.01 vs. ASA I), and elevated liver function tests (+7.9 min, p < 0.01 vs. normal) were predictive of increased operative duration on univariate analysis. A model was then constructed using these predictive factors. The traditional surgical scheduling system was poorly predictive of actual operative duration (R 2  = 0.001) compared to the patient factors model (R 2  = 0.08). The model remained predictive on external validation (R 2  = 0.14).The addition of surgeon as a variable in the institutional model further improved predictive ability of the model (R 2  = 0.18). The use of routinely available pre-operative patient factors improves the prediction of operative duration during cholecystectomy.

Accelerated hyperfractionated radiotherapy for cervical cancer: multi-institutional prospective study of forum for nuclear cooperation in Asia among eight Asian countries.

PubMed

Ohno, Tatsuya; Nakano, Takashi; Kato, Shingo; Koo, Cho Chul; Chansilpa, Yaowalak; Pattaranutaporn, Pittayapoom; Calaguas, Miriam Joy C; de Los Reyes, Rey H; Zhou, Beibei; Zhou, Juying; Susworo, Raden; Supriana, Nana; Dung, To Anh; Ismail, Fuad; Sato, Sinichiro; Suto, Hisao; Kutsutani-Nakamura, Yuzuru; Tsujii, Hirohiko

2008-04-01

To evaluate the toxicity and efficacy of accelerated hyperfractionated radiotherapy (RT) for locally advanced cervical cancer. A multi-institutional prospective single-arm study was conducted among eight Asian countries. Between 1999 and 2002, 120 patients (64 with Stage IIB and 56 with Stage IIIB) with squamous cell carcinoma of the cervix were treated with accelerated hyperfractionated RT. External beam RT consisted of 30 Gy to the whole pelvis, 1.5 Gy/fraction twice daily, followed by 20 Gy of pelvic RT with central shielding at a dose of 2-Gy fractions daily. A small bowel displacement device was used with the patient in the prone position. In addition to central shielding RT, intracavitary brachytherapy was started. Acute and late morbidities were graded according to the Radiation Therapy Oncology Group and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. The median overall treatment time was 35 days. The median follow-up time for surviving patients was 4.7 years. The 5-year pelvic control and overall survival rate for all patients was 84% and 70%, respectively. The 5-year pelvic control and overall survival rate was 78% and 69% for tumors > or = 6 cm in diameter, respectively. No treatment-related death occurred. Grade 3-4 late toxicities of the small intestine, large intestine, and bladder were observed in 1, 1, and 2 patients, respectively. The 5-year actuarial rate of Grade 3-4 late toxicity at any site was 5%. The results of our study have shown that accelerated hyperfractionated RT achieved sufficient pelvic control and survival without increasing severe toxicity. This treatment could be feasible in those Asian countries where chemoradiotherapy is not available.

Accelerated Hyperfractionated Radiotherapy for Cervical Cancer: Multi-Institutional Prospective Study of Forum for Nuclear Cooperation in Asia Among Eight Asian Countries

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

Ohno, Tatsuya; Nakano, Takashi; Kato, Shingo

2008-04-01

Purpose: To evaluate the toxicity and efficacy of accelerated hyperfractionated radiotherapy (RT) for locally advanced cervical cancer. Methods and Materials: A multi-institutional prospective single-arm study was conducted among eight Asian countries. Between 1999 and 2002, 120 patients (64 with Stage IIB and 56 with Stage IIIB) with squamous cell carcinoma of the cervix were treated with accelerated hyperfractionated RT. External beam RT consisted of 30 Gy to the whole pelvis, 1.5 Gy/fraction twice daily, followed by 20 Gy of pelvic RT with central shielding at a dose of 2-Gy fractions daily. A small bowel displacement device was used with themore » patient in the prone position. In addition to central shielding RT, intracavitary brachytherapy was started. Acute and late morbidities were graded according to the Radiation Therapy Oncology Group and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria. Results: The median overall treatment time was 35 days. The median follow-up time for surviving patients was 4.7 years. The 5-year pelvic control and overall survival rate for all patients was 84% and 70%, respectively. The 5-year pelvic control and overall survival rate was 78% and 69% for tumors {>=}6 cm in diameter, respectively. No treatment-related death occurred. Grade 3-4 late toxicities of the small intestine, large intestine, and bladder were observed in 1, 1, and 2 patients, respectively. The 5-year actuarial rate of Grade 3-4 late toxicity at any site was 5%. Conclusion: The results of our study have shown that accelerated hyperfractionated RT achieved sufficient pelvic control and survival without increasing severe toxicity. This treatment could be feasible in those Asian countries where chemoradiotherapy is not available.« less

GetReal in mathematical modelling: a review of studies predicting drug effectiveness in the real world.

PubMed

Panayidou, Klea; Gsteiger, Sandro; Egger, Matthias; Kilcher, Gablu; Carreras, Máximo; Efthimiou, Orestis; Debray, Thomas P A; Trelle, Sven; Hummel, Noemi

2016-09-01

The performance of a drug in a clinical trial setting often does not reflect its effect in daily clinical practice. In this third of three reviews, we examine the applications that have been used in the literature to predict real-world effectiveness from randomized controlled trial efficacy data. We searched MEDLINE, EMBASE from inception to March 2014, the Cochrane Methodology Register, and websites of key journals and organisations and reference lists. We extracted data on the type of model and predictions, data sources, validation and sensitivity analyses, disease area and software. We identified 12 articles in which four approaches were used: multi-state models, discrete event simulation models, physiology-based models and survival and generalized linear models. Studies predicted outcomes over longer time periods in different patient populations, including patients with lower levels of adherence or persistence to treatment or examined doses not tested in trials. Eight studies included individual patient data. Seven examined cardiovascular and metabolic diseases and three neurological conditions. Most studies included sensitivity analyses, but external validation was performed in only three studies. We conclude that mathematical modelling to predict real-world effectiveness of drug interventions is not widely used at present and not well validated. © 2016 The Authors Research Synthesis Methods Published by John Wiley & Sons Ltd. © 2016 The Authors Research Synthesis Methods Published by John Wiley & Sons Ltd.

Simultaneous quantitative analysis of olmesartan, amlodipine and hydrochlorothiazide in their combined dosage form utilizing classical and alternating least squares based chemometric methods.

PubMed

Darwish, Hany W; Bakheit, Ahmed H; Abdelhameed, Ali S

2016-03-01

Simultaneous spectrophotometric analysis of a multi-component dosage form of olmesartan, amlodipine and hydrochlorothiazide used for the treatment of hypertension has been carried out using various chemometric methods. Multivariate calibration methods include classical least squares (CLS) executed by net analyte processing (NAP-CLS), orthogonal signal correction (OSC-CLS) and direct orthogonal signal correction (DOSC-CLS) in addition to multivariate curve resolution-alternating least squares (MCR-ALS). Results demonstrated the efficiency of the proposed methods as quantitative tools of analysis as well as their qualitative capability. The three analytes were determined precisely using the aforementioned methods in an external data set and in a dosage form after optimization of experimental conditions. Finally, the efficiency of the models was validated via comparison with the partial least squares (PLS) method in terms of accuracy and precision.

Current advances in esophageal cancer proteomics.

PubMed

Uemura, Norihisa; Kondo, Tadashi

2015-06-01

We review the current status of proteomics for esophageal cancer (EC) from a clinician's viewpoint. The ultimate goal of cancer proteomics is the improvement of clinical outcome. The proteome as a functional translation of the genome is a straightforward representation of genomic mechanisms that trigger carcinogenesis. Cancer proteomics has identified the mechanisms of carcinogenesis and tumor progression, detected biomarker candidates for early diagnosis, and provided novel therapeutic targets for personalized treatments. Our review focuses on three major topics in EC proteomics: diagnostics, treatment, and molecular mechanisms. We discuss the major histological differences between EC types, i.e., esophageal squamous cell carcinoma and adenocarcinoma, and evaluate the clinical significance of published proteomics studies, including promising diagnostic biomarkers and novel therapeutic targets, which should be further validated prior to launching clinical trials. Multi-disciplinary collaborations between basic scientists, clinicians, and pathologists should be established for inter-institutional validation. In conclusion, EC proteomics has provided significant results, which after thorough validation, should lead to the development of novel clinical tools and improvement of the clinical outcome for esophageal cancer patients. This article is part of a Special Issue entitled: Medical Proteomics. Copyright © 2014 Elsevier B.V. All rights reserved.

[Prospective multi-institutional analysis according to the "Japanese guidelines for prevention of perioperative infections in urological field"].

PubMed

Wada, Koichiro; Uehara, Shinya; Kira, Shinichiro; Matsumoto, Masahiro; Sho, Takehiko; Kurimura, Yuichiro; Hashimoto, Jiro; Uehara, Teruhisa; Yamane, Takashi; Kanamaru, Sojun; Togo, Yoshikazu; Taoka, Rikiya; Takahashi, Akira; Yamada, Yusuke; Yokomizo, Akira; Yasuda, Mitsuru; Tanaka, Kazushi; Hamasuna, Ryoichi; Takahashi, Satoshi; Hayami, Hiroshi; Watanabe, Toyohiko; Monden, Koichi; Kiyota, Hiroshi; Deguchi, Takashi; Naito, Seiji; Tsukamoto, Taiji; Arakawa, Soichi; Fujisawa, Masato; Yamamoto, Shingo; Kumon, Hiromi; Matsumoto, Tetsuro

2013-05-01

The "Japanese guidelines for prevention of perioperative infections in urological field" was edited by the Japanese Urological Association in 2007. They are the first Japanese guidelines for antimicrobial prophylaxis specifically to prevent perioperative infections in the urological field. We report here the results of a multicenter prospective study conducted to examine the validity and usefulness of these guidelines. The subjects were 513 patients who had undergone urological surgeries between July and September 2008 at 10 nationwide university institutions in the Japanese Society of UTI Cooperative Study Group. These surgeries were transurethral resection of bladder (TURBT), transurethral resection of prostate (TURP), adrenalectomy, nephrectomy, nephroureterectomy, radical prostatectomy and total cystectomy. Analysis was performed on patient information, surgical procedures, types and durations of administration of prophylactic antibiotic agents, and the presence of surgical site infections (SSI) and remote infections (RI). Of 513 patients, 387 (75.4%) were administered prophylactic antibiotic agents according to the guidelines. In these patients, the incidences of SSI and RI were 5.9% and 4.1%, respectively. Multivariate analysis showed that significant factors for SSI were the surgical risk (according to the ASA physical status classification system), diabetes, and operation time, and that the only significant factor for RI was the operation time. More large-scale study and evidences are necessary in order to demonstrate the validity and usefulness of these guidelines.

Impact of early institutionalization on attention mechanisms underlying the inhibition of a planned action.

PubMed

Lamm, Connie; Troller-Renfree, Sonya; Zeanah, Charles H; Nelson, Charles A; Fox, Nathan A

2018-06-14

Institutional rearing is associated with deficits in executive functions, such as inhibitory control, and may contribute to later externalizing behavior problems. In the current study, we explored the impact of institutional rearing on attention in the context of inhibiting a planned action. As part of the Bucharest Early Intervention Project (BEIP), children were randomized to either remain in the institutions in which they lived (Care as Usual Group) or be placed into foster family homes (Foster Care Group). We also recruited age and gender matched never-institutionalized (NIG) children from the Bucharest community. We examined differences in behavioral and Event Related Potentials (ERPs) during a go-no-go task when children were 12 years old. Results revealed that the ever-institutionalized group (CAUG and FCG combined) showed slower reaction times, worse performance accuracy, larger P2 activation, and smaller (less negative) N2 activation than the NIG group. Results of a moderation analysis revealed that children who spent more time in institutions and had small N2s showed more externalizing symptoms. These results have implications for the design of treatment approaches for previously institutionalized children with externalizing behavior problems. Copyright © 2018. Published by Elsevier Ltd.

Multi-year predictability of climate, drought, and wildfire in southwestern North America.

PubMed

Chikamoto, Yoshimitsu; Timmermann, Axel; Widlansky, Matthew J; Balmaseda, Magdalena A; Stott, Lowell

2017-07-26

Past severe droughts over North America have led to massive water shortages and increases in wildfire frequency. Triggering sources for multi-year droughts in this region include randomly occurring atmospheric blocking patterns, ocean impacts on atmospheric circulation, and climate's response to anthropogenic radiative forcings. A combination of these sources translates into a difficulty to predict the onset and length of such droughts on multi-year timescales. Here we present results from a new multi-year dynamical prediction system that exhibits a high degree of skill in forecasting wildfire probabilities and drought for 10-23 and 10-45 months lead time, which extends far beyond the current seasonal prediction activities for southwestern North America. Using a state-of-the-art earth system model along with 3-dimensional ocean data assimilation and by prescribing the external radiative forcings, this system simulates the observed low-frequency variability of precipitation, soil water, and wildfire probabilities in close agreement with observational records and reanalysis data. The underlying source of multi-year predictability can be traced back to variations of the Atlantic/Pacific sea surface temperature gradient, external radiative forcings, and the low-pass filtering characteristics of soils.

International certification in developing countries: the role of internal and external institutional pressure.

PubMed

Fikru, Mahelet G

2014-11-01

This paper examines the different internal and external institutional factors that affect the decision of businesses in developing countries to adopt international certification (IC). Past studies focus on pressure from international laws, the role of multinationals, and businesses mimicking practices of their counterparts in developed countries. This paper finds that, in addition to these external factors, internal factors may have a significant role. Even though environmental regulation is weak in developing countries, governments do not ignore industrial pollution and casualties. They respond by increasing bureaucratic regulations for businesses and this can affect the decision to adopt IC. Furthermore, internal pressure may come from workers' unions that push for a safe and healthy working environment. Published by Elsevier Ltd.

External Correlates of the MMPI-2 Content Component Scales in Mental Health Inpatients

ERIC Educational Resources Information Center

Green, Bradley A.; Handel, Richard W.; Archer, Robert P.

2006-01-01

External correlates of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Content Component Scales were identified using an inpatient sample of 544 adults. The Brief Psychiatric Rating Scale (BPRS) and Symptom Checklist 90-Revised (SCL-90-R) produced correlates of the Content Component Scales, demonstrating external validity with…

External Link Policy | Division of Cancer Prevention

Cancer.gov

The following graphic notice means that you are leaving the DCP Web site: (link is external)This external link provides additional information that is consistent with the intended purpose of DCP.The National Cancer Institute (NCI) cannot attest to the accuracy of a non-federal site.Linking to a non-federal site does not constitute an endorsement by HHS or any of its employees

The Changing Role of External Stakeholders: From Imaginary Friends to Effective Actors or Non-Interfering Friends

ERIC Educational Resources Information Center

Magalhães, António; Veiga, Amélia; Amaral, Alberto

2018-01-01

Recent shifts in university governance have relied on increased autonomy. Within this context, the enhanced role attributed to governance boards at the expense of academic bodies and the role of external stakeholders has gained momentum. With the aim of understanding the extent of the influence of external stakeholders at the institutional level,…

Alternative Fistula Risk Score for Pancreatoduodenectomy (a-FRS): Design and International External Validation.

PubMed

Mungroop, Timothy H; van Rijssen, L Bengt; van Klaveren, David; Smits, F Jasmijn; van Woerden, Victor; Linnemann, Ralph J; de Pastena, Matteo; Klompmaker, Sjors; Marchegiani, Giovanni; Ecker, Brett L; van Dieren, Susan; Bonsing, Bert; Busch, Olivier R; van Dam, Ronald M; Erdmann, Joris; van Eijck, Casper H; Gerhards, Michael F; van Goor, Harry; van der Harst, Erwin; de Hingh, Ignace H; de Jong, Koert P; Kazemier, Geert; Luyer, Misha; Shamali, Awad; Barbaro, Salvatore; Armstrong, Thomas; Takhar, Arjun; Hamady, Zaed; Klaase, Joost; Lips, Daan J; Molenaar, I Quintus; Nieuwenhuijs, Vincent B; Rupert, Coen; van Santvoort, Hjalmar C; Scheepers, Joris J; van der Schelling, George P; Bassi, Claudio; Vollmer, Charles M; Steyerberg, Ewout W; Abu Hilal, Mohammed; Groot Koerkamp, Bas; Besselink, Marc G

2017-12-12

The aim of this study was to develop an alternative fistula risk score (a-FRS) for postoperative pancreatic fistula (POPF) after pancreatoduodenectomy, without blood loss as a predictor. Blood loss, one of the predictors of the original-FRS, was not a significant factor during 2 recent external validations. The a-FRS was developed in 2 databases: the Dutch Pancreatic Cancer Audit (18 centers) and the University Hospital Southampton NHS. Primary outcome was grade B/C POPF according to the 2005 International Study Group on Pancreatic Surgery (ISGPS) definition. The score was externally validated in 2 independent databases (University Hospital of Verona and University Hospital of Pennsylvania), using both 2005 and 2016 ISGPS definitions. The a-FRS was also compared with the original-FRS. For model design, 1924 patients were included of whom 12% developed POPF. Three predictors were strongly associated with POPF: soft pancreatic texture [odds ratio (OR) 2.58, 95% confidence interval (95% CI) 1.80-3.69], small pancreatic duct diameter (per mm increase, OR: 0.68, 95% CI: 0.61-0.76), and high body mass index (BMI) (per kg/m increase, OR: 1.07, 95% CI: 1.04-1.11). Discrimination was adequate with an area under curve (AUC) of 0.75 (95% CI: 0.71-0.78) after internal validation, and 0.78 (0.74-0.82) after external validation. The predictive capacity of a-FRS was comparable with the original-FRS, both for the 2005 definition (AUC 0.78 vs 0.75, P = 0.03), and 2016 definition (AUC 0.72 vs 0.70, P = 0.05). The a-FRS predicts POPF after pancreatoduodenectomy based on 3 easily available variables (pancreatic texture, duct diameter, BMI) without blood loss and pathology, and was successfully validated for both the 2005 and 2016 POPF definition.

Patient-Reported Outcomes After Radiation Therapy in Men With Prostate Cancer: A Systematic Review of Prognostic Tool Accuracy and Validity

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

O'Callaghan, Michael E., E-mail: elspeth.raymond@health.sa.gov.au; Freemasons Foundation Centre for Men's Health, University of Adelaide; Urology Unit, Repatriation General Hospital, SA Health, Flinders Centre for Innovation in Cancer

Purpose: To identify, through a systematic review, all validated tools used for the prediction of patient-reported outcome measures (PROMs) in patients being treated with radiation therapy for prostate cancer, and provide a comparative summary of accuracy and generalizability. Methods and Materials: PubMed and EMBASE were searched from July 2007. Title/abstract screening, full text review, and critical appraisal were undertaken by 2 reviewers, whereas data extraction was performed by a single reviewer. Eligible articles had to provide a summary measure of accuracy and undertake internal or external validation. Tools were recommended for clinical implementation if they had been externally validated and foundmore » to have accuracy ≥70%. Results: The search strategy identified 3839 potential studies, of which 236 progressed to full text review and 22 were included. From these studies, 50 tools predicted gastrointestinal/rectal symptoms, 29 tools predicted genitourinary symptoms, 4 tools predicted erectile dysfunction, and no tools predicted quality of life. For patients treated with external beam radiation therapy, 3 tools could be recommended for the prediction of rectal toxicity, gastrointestinal toxicity, and erectile dysfunction. For patients treated with brachytherapy, 2 tools could be recommended for the prediction of urinary retention and erectile dysfunction. Conclusions: A large number of tools for the prediction of PROMs in prostate cancer patients treated with radiation therapy have been developed. Only a small minority are accurate and have been shown to be generalizable through external validation. This review provides an accessible catalogue of tools that are ready for clinical implementation as well as which should be prioritized for validation.« less

Personalized Prediction of Psychosis: External validation of the NAPLS2 Psychosis Risk Calculator with the EDIPPP project

PubMed Central

Carrión, Ricardo E.; Cornblatt, Barbara A.; Burton, Cynthia Z.; Tso, Ivy F; Auther, Andrea; Adelsheim, Steven; Calkins, Roderick; Carter, Cameron S.; Niendam, Tara; Taylor, Stephan F.; McFarlane, William R.

2016-01-01

Objective In the current issue, Cannon and colleagues, as part of the second phase of the North American Prodrome Longitudinal Study (NAPLS2), report on a risk calculator for the individualized prediction of developing a psychotic disorder in a 2-year period. The present study represents an external validation of the NAPLS2 psychosis risk calculator using an independent sample of subjects at clinical high risk for psychosis collected as part of the Early Detection, Intervention, and Prevention of Psychosis Program (EDIPPP). Methods 176 subjects with follow-up (from the total EDIPPP sample of 210) rated as clinical high-risk (CHR) based on the Structured Interview for Prodromal Syndromes were used to construct a new prediction model with the 6 significant predictor variables in the NAPLS2 psychosis risk calculator (unusual thoughts, suspiciousness, Symbol Coding, verbal learning, social functioning decline, baseline age, and family history). Discrimination performance was assessed with the area under the receiver operating curve (AUC). The NAPLS2 risk calculator was then used to generate a psychosis risk estimate for each case in the external validation sample. Results The external validation model showed good discrimination, with an AUC of 79% (95% CI 0.644–0.937). In addition, the personalized risk generated by the NAPLS calculator provided a solid estimation of the actual conversion outcome in the validation sample. Conclusions In the companion papers in this issue, two independent samples of CHR subjects converge to validate the NAPLS2 psychosis risk calculator. This prediction calculator represents a meaningful step towards early intervention and personalized treatment of psychotic disorders. PMID:27363511

Validation of a new mortality risk prediction model for people 65 years and older in northwest Russia: The Crystal risk score.

PubMed

Turusheva, Anna; Frolova, Elena; Bert, Vaes; Hegendoerfer, Eralda; Degryse, Jean-Marie

2017-07-01

Prediction models help to make decisions about further management in clinical practice. This study aims to develop a mortality risk score based on previously identified risk predictors and to perform internal and external validations. In a population-based prospective cohort study of 611 community-dwelling individuals aged 65+ in St. Petersburg (Russia), all-cause mortality risks over 2.5 years follow-up were determined based on the results obtained from anthropometry, medical history, physical performance tests, spirometry and laboratory tests. C-statistic, risk reclassification analysis, integrated discrimination improvement analysis, decision curves analysis, internal validation and external validation were performed. Older adults were at higher risk for mortality [HR (95%CI)=4.54 (3.73-5.52)] when two or more of the following components were present: poor physical performance, low muscle mass, poor lung function, and anemia. If anemia was combined with high C-reactive protein (CRP) and high B-type natriuretic peptide (BNP) was added the HR (95%CI) was slightly higher (5.81 (4.73-7.14)) even after adjusting for age, sex and comorbidities. Our models were validated in an external population of adults 80+. The extended model had a better predictive capacity for cardiovascular mortality [HR (95%CI)=5.05 (2.23-11.44)] compared to the baseline model [HR (95%CI)=2.17 (1.18-4.00)] in the external population. We developed and validated a new risk prediction score that may be used to identify older adults at higher risk for mortality in Russia. Additional studies need to determine which targeted interventions improve the outcomes of these at-risk individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

Validity of self-assessment in a quality improvement collaborative in Ecuador.

PubMed

Hermida, Jorge; Broughton, Edward I; Miller Franco, Lynne

2011-12-01

Health care quality improvement (QI) efforts commonly use self-assessment to measure compliance with quality standards. This study investigates the validity of self-assessment of quality indicators. Cross sectional. A maternal and newborn care improvement collaborative intervention conducted in health facilities in Ecuador in 2005. Four external evaluators were trained in abstracting medical records to calculate six indicators reflecting compliance with treatment standards. About 30 medical records per month were examined at 12 participating health facilities for a total of 1875 records. The same records had already been reviewed by QI teams at these facilities (self-assessment). Overall compliance, agreement (using the Kappa statistic), sensitivity and specificity were analyzed. We also examined patterns of disagreement and the effect of facility characteristics on levels of agreement. External evaluators reported compliance of 69-90%, while self-assessors reported 71-92%, with raw agreement of 71-95% and Kappa statistics ranging from fair to almost perfect agreement. Considering external evaluators as the gold standard, sensitivity of self-assessment ranged from 90 to 99% and specificity from 48 to 86%. Simpler indicators had fewer disagreements. When disagreements occurred between self-assessment and external valuators, the former tended to report more positive findings in five of six indicators, but this tendency was not of a magnitude to change program actions. Team leadership, understanding of the tools and facility size had no overall impact on the level of agreement. When compared with external evaluation (gold standard), self-assessment was found to be sufficiently valid for tracking QI team performance. Sensitivity was generally higher than specificity. Simplifying indicators may improve validity.

Polychlorinated Biphenyl (PCB) Aroclor Data Validation, SOP No. HW-37A Revision 0; SOM02.2

EPA Pesticide Factsheets

This document is designed to offer the data reviewer guidance in determining the validity of analytical data generated through the USEPA Contract Laboratory Program (CLP) Statement of Work (SOW) for Multi-Media, Multi-Concentration Organics Analysis

Moving from institutional dependence to entrepreneurialism. Creating and funding a collaborative research and practice development position.

PubMed

Darbyshire, Philip; Downes, Maeve; Collins, Carmel; Dyer, Susan

2005-09-01

The paper describes the creation of, the rationale behind and the external funding of a collaborative research-clinical practice development position. The paper also demonstrates the benefits of nursing's collaboration with external funding bodies and the value of moving from our traditional position of assuming that 'the hospital' will always provide. There is a constant refrain that nursing must become more 'research-based' and develop an active research culture. In harsh financial times however, funding for research development is scarce. Nurses can respond to this by bemoaning the lack of money or by taking an entrepreneurial approach, creating innovative project proposals that develop new partnerships and attract external funding. Institutional support for clinical research is often more verbal than financial as most health care systems are experiencing extreme financial stringencies. Nurses need to reconsider the notion that every initiative must automatically be funded by the institution. In this paper we show how in a busy major hospital, clinicians and researchers collaborated to create and fund the kind of innovative research and practice development position that may be impossible to fund through existing budgets. With creativity and determination, nurses can challenge the orthodoxy that they are solely dependent on institutional funding. If there is a clear project vision, a convincing rationale, a strongly argued 'business case' and a passionate and persistent team, then innovative new projects and positions can be realized. Developing clinical focused, practice based research is now a worldwide policy and practice imperative for nurses. Unfortunately, current levels of institutional funding are unlikely to support research promotion positions and initiatives. This paper outlines an approach to securing funding for research initiatives that can create exciting new positions and develop productive partnerships between researchers, clinicians and external agencies.

Scaling view by the Virtual Nature Systems

NASA Astrophysics Data System (ADS)

Klenov, Valeriy

2010-05-01

The Actual Nature Systems (ANS) continually are under spatial-temporal governing external influences from other systems (Meteorology and Geophysics). This influences provide own spatial temporal patterns on the Earth Nature Systems, which reforms these influences by own manner and scales. These at last three systems belong to the Open Non Equilibrium Nature Systems (ONES). The Geophysics and Meteorology Systems are both governing for the ANS on the Earth. They provide as continual energetic pressure and impacts, and direct Extremes from the both systems to the ANS on Earth surface (earthquakes, storms, and others). The Geodynamics of the ANS is under mixing of influence for both systems, on their scales and on dynamics of their spatial-temporal structures, and by own ANS properties, as the ONES. To select influences of external systems on the Earth systems always is among major tasks of the Geomorphology. Mixing of the Systems scales and dynamics provide specific properties for the memory of Earth system. The memory of the ANS has practical value for their multi-purpose management. The knowledge of these properties is the key for research spatial-temporal GeoDynamics and Trends of Earth Nature Systems. Selection of the influences in time and space requires for special tool, requires elaboration and action of the Virtual Nature Systems (VNS), which are enliven computer doubles for analysis Geodynamics of the ANS. The Experience on the VNS enables to assess influence of each and both external factors on the ANS. It is source of knowledge for regional tectonic and climate oscillations, trends, and threats. Research by the VNS for spatial-temporal dynamics and structures of stochastic regimes of governing systems and processes results in stochastic GeoDynamics of environmental processes, in forming of false trends and blanks in natural records. This ‘wild dance' of 2D stochastic patterns and their interaction each other and generates acting structures of river nets, and of river basins, in multi-layer, multi-scale, and multi-driven structures of surface processes. It results in the Information Loss Law for observed memory of the VNS (and of external drivers) which gradually cut off own Past and distort own history. This view on the GeoDynamics appeared after long time field measurements thousand of terrace levels, hundreds of terrace ranks, and many terrace complexes in river basins of all scales - for the purpose to recognize their deforming by climatic and tectonic spatial-temporal influences. The method for following up of terrace levels along valleys was used in the Geomorphology and Geology for a long time, by linking fragments of level to ‘cycles'. It gradually linked them by heights above riverbed. The understanding of this logical mistake was happened (as insight) during observing from upstream a valley. All fragmental levels downstream were good visible, without chances for their correlation ‘by height' or ‘by number'. Instead of link of fragments, this explains process of river valleys' stochastic GeoDynamics by properties of the ONES (I. Prigogine et al., 1984) to generate oscillations. Is only first view, but later it turned to simple mechanic of Information Loss Law action in the GeoInformatics for Nature Systems (Klenov, 1980, et al.). The Information Loss distorts and destroys natural records (sources for data on the Past exogenous and endogenous rivers). This simple equation was received by multiple measures of terrace rank, and other natural records. It explains origin of false trend in natural records, destroys most own history by stochastic dynamics of the ONES. It prevents to restore of nature records as a memory of the Past. Non-disturbed is only small time between the Past and the Future, which looks like a peak between two non-linear losses. The history of Past (of the ANS, and of external drivers) are destroyed by the ANS. The Future becomes none determined due unknown 2D data of future external influences. However, the effect is the reliable Outstripping Monitoring for impending disasters and of other processes with satisfactory exactness. It was proved by direct validations (by use observed records). The conclusions are as follows: The ILL is mechanics for dissipation the Past and indeterminism the Future of the Nature. Moving back along the VNS' Phase Trajectory changes a view on natural records, and is chance to restore history of the ANS and its external drivers.

Institutional Design and the Internationalization of U.S. Postsecondary Education Institutions

ERIC Educational Resources Information Center

Bruce, Gonzalo Raul

2009-01-01

Postsecondary education institutions are increasingly affected by their external environment and more specifically, global forces. Among such forces is the acknowledged global labor market of education, fierce competition between educational systems, and the need for colleges and universities to expand their resource base.In response to such…