A Review on the Applications of Crowdsourcing in Human Pathology.

PubMed

Alialy, Roshanak; Tavakkol, Sasan; Tavakkol, Elham; Ghorbani-Aghbologhi, Amir; Ghaffarieh, Alireza; Kim, Seon Ho; Shahabi, Cyrus

2018-01-01

The advent of the digital pathology has introduced new avenues of diagnostic medicine. Among them, crowdsourcing has attracted researchers' attention in the recent years, allowing them to engage thousands of untrained individuals in research and diagnosis. While there exist several articles in this regard, prior works have not collectively documented them. We, therefore, aim to review the applications of crowdsourcing in human pathology in a semi-systematic manner. We first, introduce a novel method to do a systematic search of the literature. Utilizing this method, we, then, collect hundreds of articles and screen them against a predefined set of criteria. Furthermore, we crowdsource part of the screening process, to examine another potential application of crowdsourcing. Finally, we review the selected articles and characterize the prior uses of crowdsourcing in pathology.

Selection of the open pit mining cut-off grade strategy under price uncertainty using a risk based multi-criteria ranking system / Wybór strategii określania warunku opłacalności wydobycia w kopalniach odkrywkowych w warunkach niepewności cen w oparciu o wielokryterialny system rankingowy z uwzględnieniem czynników ryzyka

NASA Astrophysics Data System (ADS)

Azimi, Yousue; Osanloo, Montza; Esfahanipour, Akbar

2012-12-01

Cut-off Grade Strategy (COGS) is a concept that directly influences the financial, technical, economic, environmental, and legal issues in relation to exploitation of a mineral resource. A decision making system is proposed to select the best technically feasible COGS under price uncertainty. In the proposed system both the conventional discounted cash flow and modern simulation based real option valuations are used to evaluate the alternative strategies. Then the conventional expected value criterion and a multiple criteria ranking system were used to rank the strategies based on the two valuation methods. In the multiple criteria ranking system besides the expected value other stochastic orders expressing abilities of strategies in producing extra profits, minimizing losses and achieving the predefined goals of the exploitation strategy are considered. Finally, the best strategy is selected based on the overall average rank of strategies through all ranking systems. The proposed system was examined using the data of Sungun Copper Mine. To assess the merits of the alternatives better, ranking process was done at both high (prevailing economic condition) and low price conditions. Ranking results revealed that at different price conditions and valuation methods, different results would be obtained. It is concluded that these differences are due to the different behavior of the embedded option to close the mine early, which is more likely to be exercised under low price condition rather than high price condition. The proposed system would enhance the quality of decision making process by providing a more informative and certain platform for project evaluation.

Examining the Concept of Choice in Sexual Health Interventions for Young People

ERIC Educational Resources Information Center

Spencer, Grace; Doull, Marion; Shoveller, Jean A.

2014-01-01

Concepts of choice are often drawn upon within sexual health promotion discourses to encourage young people to take "responsibility" for and promote their own sexual health and reproductive control. A systematic literature search using predefined inclusion criteria identified peer-reviewed articles focusing on sexual health interventions…

International law's effects on health and its social determinants: protocol for a systematic review, meta-analysis, and meta-regression analysis.

PubMed

Hoffman, Steven J; Hughsam, Matthew; Randhawa, Harkanwal; Sritharan, Lathika; Guyatt, Gordon; Lavis, John N; Røttingen, John-Arne

2016-04-16

In recent years, there have been numerous calls for global institutions to develop and enforce new international laws. International laws are, however, often blunt instruments with many uncertain benefits, costs, risks of harm, and trade-offs. Thus, they are probably not always appropriate solutions to global health challenges. Given these uncertainties and international law's potential importance for improving global health, the paucity of synthesized evidence addressing whether international laws achieve their intended effects or whether they are superior in comparison to other approaches is problematic. Ten electronic bibliographic databases were searched using predefined search strategies, including MEDLINE, Global Health, CINAHL, Applied Social Sciences Index and Abstracts, Dissertations and Theses, International Bibliography of Social Sciences, International Political Science Abstracts, Social Sciences Abstracts, Social Sciences Citation Index, PAIS International, and Worldwide Political Science Abstracts. Two reviewers will independently screen titles and abstracts using predefined inclusion criteria. Pairs of reviewers will then independently screen the full-text of articles for inclusion using predefined inclusion criteria and then independently extract data and assess risk of bias for included studies. Where feasible, results will be pooled through subgroup analyses, meta-analyses, and meta-regression techniques. The findings of this review will contribute to a better understanding of the expected benefits and possible harms of using international law to address different kinds of problems, thereby providing important evidence-informed guidance on when and how it can be effectively introduced and implemented by countries and global institutions. PROSPERO CRD42015019830.

Quality of life among adult patients with neurofibromatosis 1, neurofibromatosis 2 and schwannomatosis: a systematic review of the literature.

PubMed

Vranceanu, Ana-Maria; Merker, Vanessa L; Park, Elyse; Plotkin, Scott R

2013-09-01

The aim of this study was to review the literature on quality of life among adult patients with neurofibromatosis 1, neurofibromatosis 2 and schwannomatosis, and to identify the specific aspects of quality of life that were studied and reported in this population. We also set out to report predictors of quality of life. Published research reports were included if they described quality of life in this population and met methodological quality according to a list of predefined criteria. Eight studies (7 in NF1, 1 in NF2, 0 in schwannomatosis), conducted between 2001 and 2013, met inclusion criteria. The methodological quality of the eight studies was mostly high according to ratings by predefined criteria. Most studies reported that patients with NF experience decreased quality of life when compared to the general population. Visibility and disease severity were strong predictors of skin-specific quality of life in NF1 patients. However, the majority of findings regarding predictors of quality of life were weak or inconclusive. Given the decreased quality of life in NF patients, it is important to examine more comprehensively the psychosocial factors in this population, especially in patients with NF2 and schwannomatosis. Mind body interventions that address these domains may provide comprehensive and efficacious long term treatment.

Depression in the workplace: a systematic review of evidence-based prevention strategies.

PubMed

Dietrich, Sandra; Deckert, Stefanie; Ceynowa, Martin; Hegerl, Ulrich; Stengler, Katarina

2012-01-01

Depression is one of the most common mental disorders, causing enormous personal and economic burden. In its early stages, however, it is the most manageable of mental disorders. The workplace, where a large proportion of the adult population can be reached, might be a good setting for prevention interventions that target depression directly. Identify evidence-based indicated/secondary prevention strategies for depression in the workplace. Systematic review of articles published until February 2010 using PubMed, EbscoHost and the Cochrane Library. Studies were selected based on different inclusion criteria, such as diagnosis of depression with validated screening instruments and presence of a control group. A total of 9,173 articles were found. One evaluated intervention study in the workplace met all inclusion criteria (French APRAND programme). The intervention, which combined the provision of diagnosis and psychoeducation, had a positive effect on people with depression, with a significant trend towards chances of recovery or remission after 1 year. The remaining studies did not meet the predefined inclusion criteria of this systematic review. The findings are quite sobering given the high prevalence of depression and the individual and societal burden caused by it. More tailor-made interventions in the workplace targeting depression directly are needed.

Bladder Cancer Recovery Pathways: A Systematic Review

PubMed Central

Maloney, Ian; Parker, Daniel C.; Cookson, Michael S.; Patel, Sanjay

2017-01-01

Background: Enhanced recovery pathways, also known as fast-track protocols, have been adopted since the early 2000s by various surgical specialties with the goal of improving patient outcomes and reducing the cost burden of major surgery on the health care system. Objective: To review the scientific literature on the origin of enhanced recovery pathways, track the contemporary utilization of such practices for patients undergoing radical cystectomy, and analyze the available data regarding their effect on morbidity, mortality, and treatment cost. Methods: A literature search of multiple electronic databases was undertaken. Manuscripts including patients undergoing radical cystectomy were chosen based on predefined criteria with an emphasis on randomized controlled trials and cohort studies. Strength of evidence for each study that met inclusion criteria was assessed based on the risk of bias, consistency, directness, and precision. Results: Database searches resulted in 1,236 potentially relevant articles. A total of 485 articles were selected for full-text dual review and 106 studies in 52 publications met the inclusion criteria. Conclusion: The utilization of enhanced recovery pathways with the goal of improving overall patient morbidity and mortality is well supported in the literature, however standardization of implementation and adherence across institutions is lacking, and their direct efficacy on reducing preventable treatment related expenditures is unconfirmed. PMID:29152551

Diagnostic performance of semi-quantitative and quantitative stress CMR perfusion analysis: a meta-analysis.

PubMed

van Dijk, R; van Assen, M; Vliegenthart, R; de Bock, G H; van der Harst, P; Oudkerk, M

2017-11-27

Stress cardiovascular magnetic resonance (CMR) perfusion imaging is a promising modality for the evaluation of coronary artery disease (CAD) due to high spatial resolution and absence of radiation. Semi-quantitative and quantitative analysis of CMR perfusion are based on signal-intensity curves produced during the first-pass of gadolinium contrast. Multiple semi-quantitative and quantitative parameters have been introduced. Diagnostic performance of these parameters varies extensively among studies and standardized protocols are lacking. This study aims to determine the diagnostic accuracy of semi- quantitative and quantitative CMR perfusion parameters, compared to multiple reference standards. Pubmed, WebOfScience, and Embase were systematically searched using predefined criteria (3272 articles). A check for duplicates was performed (1967 articles). Eligibility and relevance of the articles was determined by two reviewers using pre-defined criteria. The primary data extraction was performed independently by two researchers with the use of a predefined template. Differences in extracted data were resolved by discussion between the two researchers. The quality of the included studies was assessed using the 'Quality Assessment of Diagnostic Accuracy Studies Tool' (QUADAS-2). True positives, false positives, true negatives, and false negatives were subtracted/calculated from the articles. The principal summary measures used to assess diagnostic accuracy were sensitivity, specificity, andarea under the receiver operating curve (AUC). Data was pooled according to analysis territory, reference standard and perfusion parameter. Twenty-two articles were eligible based on the predefined study eligibility criteria. The pooled diagnostic accuracy for segment-, territory- and patient-based analyses showed good diagnostic performance with sensitivity of 0.88, 0.82, and 0.83, specificity of 0.72, 0.83, and 0.76 and AUC of 0.90, 0.84, and 0.87, respectively. In per territory analysis our results show similar diagnostic accuracy comparing anatomical (AUC 0.86(0.83-0.89)) and functional reference standards (AUC 0.88(0.84-0.90)). Only the per territory analysis sensitivity did not show significant heterogeneity. None of the groups showed signs of publication bias. The clinical value of semi-quantitative and quantitative CMR perfusion analysis remains uncertain due to extensive inter-study heterogeneity and large differences in CMR perfusion acquisition protocols, reference standards, and methods of assessment of myocardial perfusion parameters. For wide spread implementation, standardization of CMR perfusion techniques is essential. CRD42016040176 .

COPD, emphysema and the onset of lung cancer. A systematic review.

PubMed

Mouronte-Roibás, Cecilia; Leiro-Fernández, Virginia; Fernández-Villar, Alberto; Botana-Rial, Maribel; Ramos-Hernández, Cristina; Ruano-Ravina, Alberto

2016-11-28

Chronic Obstructive Pulmonary Disease (COPD) and emphysema have been described as possible risk factors for lung cancer. We aim to assess the relationship between COPD, emphysema and the onset of lung cancer. We have developed a systematic review of the published literature in order to systematically analyze the scientific evidence available on this association, applying predefined inclusion and exclusion criteria. 11 Studies were included. Both COPD and emphysema seem to increase the risk of developing lung cancer, being this risk higher for smokers with heavier tobacco consumption. These results emphasize the need for physicians to perform spirometries in current and former smokers and lung image tests when needed in order to identify COPD and emphysema and thus select patients at higher risk of developing lung cancer. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Distributed Space Mission Design for Earth Observation Using Model-Based Performance Evaluation

NASA Technical Reports Server (NTRS)

Nag, Sreeja; LeMoigne-Stewart, Jacqueline; Cervantes, Ben; DeWeck, Oliver

2015-01-01

Distributed Space Missions (DSMs) are gaining momentum in their application to earth observation missions owing to their unique ability to increase observation sampling in multiple dimensions. DSM design is a complex problem with many design variables, multiple objectives determining performance and cost and emergent, often unexpected, behaviors. There are very few open-access tools available to explore the tradespace of variables, minimize cost and maximize performance for pre-defined science goals, and therefore select the most optimal design. This paper presents a software tool that can multiple DSM architectures based on pre-defined design variable ranges and size those architectures in terms of predefined science and cost metrics. The tool will help a user select Pareto optimal DSM designs based on design of experiments techniques. The tool will be applied to some earth observation examples to demonstrate its applicability in making some key decisions between different performance metrics and cost metrics early in the design lifecycle.

Adaptive model training system and method

DOEpatents

Bickford, Randall L; Palnitkar, Rahul M; Lee, Vo

2014-04-15

An adaptive model training system and method for filtering asset operating data values acquired from a monitored asset for selectively choosing asset operating data values that meet at least one predefined criterion of good data quality while rejecting asset operating data values that fail to meet at least the one predefined criterion of good data quality; and recalibrating a previously trained or calibrated model having a learned scope of normal operation of the asset by utilizing the asset operating data values that meet at least the one predefined criterion of good data quality for adjusting the learned scope of normal operation of the asset for defining a recalibrated model having the adjusted learned scope of normal operation of the asset.

Adaptive model training system and method

DOEpatents

Bickford, Randall L; Palnitkar, Rahul M

2014-11-18

An adaptive model training system and method for filtering asset operating data values acquired from a monitored asset for selectively choosing asset operating data values that meet at least one predefined criterion of good data quality while rejecting asset operating data values that fail to meet at least the one predefined criterion of good data quality; and recalibrating a previously trained or calibrated model having a learned scope of normal operation of the asset by utilizing the asset operating data values that meet at least the one predefined criterion of good data quality for adjusting the learned scope of normal operation of the asset for defining a recalibrated model having the adjusted learned scope of normal operation of the asset.

Preliminary experience of a PDCA-cycle and quality management based training curriculum for rat liver transplantation.

PubMed

Jin, Hao; Huang, Hai; Dong, Wei; Sun, Jian; Liu, Anding; Deng, Meihong; Dirsch, Olaf; Dahmen, Uta

2012-08-01

As repeatedly operating rat liver transplantation (LTx) until animals survive is inefficient in respect to time and use of living animals, we developed a new training concept. METHODS AND CONCEPTS: Training was divided into four phases: pretraining-phase, basic-microsurgical-training phase, advanced-microsurgical-training phases, and expert-microsurgical-training phase. Two "productivity-phases" were introduced right after the basic- and advanced-microsurgical-training phases, respectively, to allow the trainee to accumulate experience and to be scientifically productive before proceeding to a more complex procedure. PDCA cycles and quality criteria were employed to control the learning-process and the surgical quality. Predefined quality criteria included survival rate, intraoperative, postoperative, and histologic parameters. Three trainees participated in the LTx training and achieved their first survival record within 4-10 operations. All of them completely mastered the LTx in fewer procedures (31, 60 and 26 procedures) as reported elsewhere, and the more complex arterialized or partial LTx were mastered by trainee A and B in additional 9 and 13 procedures, respectively. Fast progress was possible due to a high number of training in the 2 Productivity-phases. The stepwise and PDCA-based training program increased the efficiency of LTx training, whereas the constant application and development of predefined quality criteria guaranteed the quality of microsurgery. Copyright © 2012 Elsevier Inc. All rights reserved.

Assessment of posaconazole salvage therapy in chronic pulmonary aspergillosis by using predefined response criteria.

PubMed

Rodriguez-Goncer, Isabel; Harris, Chris; Kosmidis, Chris; Muldoon, Eavan G; Newton, Pippa J; Denning, David W

2018-06-12

Chronic pulmonary aspergillosis (CPA) is a progressive infection that destroys lung tissue in non-immunocompromised patients. First line therapies for CPA (itraconazole and/or voriconazole) are often curtailed due to toxicity or the development of drug resistance. Posaconazole is a potential alternative for these patients. Use of posaconazole was funded by the NHS Highly Specialised National Commissioners on an individual basis for patients who failed or did not tolerate first line therapy; those who met predefined criteria for improvement at 4 and 6 months (weight gain and/or improvement in St George's Respiratory Questionnaire) continued posaconazole long-term. We recorded response, failure, discontinuation rates, and adverse events. Seventy-eight patients received posaconazole as salvage therapy. Thirty-four (44%) achieved targets for continuation of therapy. Fourteen (18%) failed therapy; 5 (36%) patients did not achieve clinical targets at 4 or 6 months of assessment and 9 (64%) developed clinical and/or radiological failure. Twenty-eight (36%) discontinued their trial early; 8 (29%) died and 20 (71%) had significant side effects. One patient was non-compliant and another was lost to follow up. Establishing criteria for therapeutic success offered a clear, safe and sustainable method of identifying patients who benefit from additional therapy, and minimised continuation of ineffective therapy in those who did not. Copyright © 2018. Published by Elsevier B.V.

Identifying Novel Phenotypes of Vulnerability and Resistance to Activity-Based Anorexia in Adolescent Female Rats

PubMed Central

Barbarich-Marsteller, Nicole C.; Underwood, Mark D.; Foltin, Richard W.; Myers, Michael M.; Walsh, B. Timothy; Barrett, Jeffrey S.; Marsteller, Douglas A.

2018-01-01

Objective Activity-based anorexia is a translational rodent model that results in severe weight loss, hyperactivity, and voluntary self-starvation. The goal of our investigation was to identify vulnerable and resistant phenotypes of activity-based anorexia in adolescent female rats. Method Sprague-Dawley rats were maintained under conditions of restricted access to food (N = 64; or unlimited access, N = 16) until experimental exit, predefined as a target weight loss of 30–35% or meeting predefined criteria for animal health. Nonlinear mixed effects statistical modeling was used to describe wheel running behavior, time to event analysis was used to assess experimental exit, and a regressive partitioning algorithm was used to classify phenotypes. Results Objective criteria were identified for distinguishing novel phenotypes of activity-based anorexia, including a vulnerable phenotype that conferred maximal hyperactivity, minimal food intake, and the shortest time to experimental exit, and a resistant phenotype that conferred minimal activity and the longest time to experimental exit. Discussion The identification of objective criteria for defining vulnerable and resistant phenotypes of activity-based anorexia in adolescent female rats provides an important framework for studying the neural mechanisms that promote vulnerability to or protection against the development of self-starvation and hyperactivity during adolescence. Ultimately, future studies using these novel phenotypes may provide important translational insights into the mechanisms that promote these maladaptive behaviors characteristic of anorexia nervosa. PMID:23853140

Identifying novel phenotypes of vulnerability and resistance to activity-based anorexia in adolescent female rats.

PubMed

Barbarich-Marsteller, Nicole C; Underwood, Mark D; Foltin, Richard W; Myers, Michael M; Walsh, B Timothy; Barrett, Jeffrey S; Marsteller, Douglas A

2013-11-01

Activity-based anorexia is a translational rodent model that results in severe weight loss, hyperactivity, and voluntary self-starvation. The goal of our investigation was to identify vulnerable and resistant phenotypes of activity-based anorexia in adolescent female rats. Sprague-Dawley rats were maintained under conditions of restricted access to food (N = 64; or unlimited access, N = 16) until experimental exit, predefined as a target weight loss of 30-35% or meeting predefined criteria for animal health. Nonlinear mixed effects statistical modeling was used to describe wheel running behavior, time to event analysis was used to assess experimental exit, and a regressive partitioning algorithm was used to classify phenotypes. Objective criteria were identified for distinguishing novel phenotypes of activity-based anorexia, including a vulnerable phenotype that conferred maximal hyperactivity, minimal food intake, and the shortest time to experimental exit, and a resistant phenotype that conferred minimal activity and the longest time to experimental exit. The identification of objective criteria for defining vulnerable and resistant phenotypes of activity-based anorexia in adolescent female rats provides an important framework for studying the neural mechanisms that promote vulnerability to or protection against the development of self-starvation and hyperactivity during adolescence. Ultimately, future studies using these novel phenotypes may provide important translational insights into the mechanisms that promote these maladaptive behaviors characteristic of anorexia nervosa. Copyright © 2013 Wiley Periodicals, Inc.

Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia.

PubMed

Lopez, Benjamin C; Hamlyn, Peter J; Zakrzewska, Joanna M

2004-04-01

There are no randomized controlled trials comparing retrogasserian percutaneous radiofrequency thermocoagulation, glycerol rhizolysis, balloon compression of the gasserian ganglion, and stereotactic radiosurgery, nor are there systematic reviews using predefined quality criteria. The objective of this study was to systematically identify all of the studies reporting outcomes and complications of ablative techniques for treatment of trigeminal neuralgia, from the development of electronic databases, and to evaluate them with predefined quality criteria. Inclusion criteria for the outcome analysis included thorough demographic documentation, defined diagnostic and outcome criteria, a minimum of 30 patients treated and median/mean follow-up times of 12 months, not more than 20% of patients lost to follow-up monitoring, Kaplan-Meier actuarial analysis of individual procedures, less than 10% of patients retreated because of failure or early recurrence, and a minimal dose of 70 Gy for stereotactic radiosurgery. High-quality studies with no actuarial analysis were used for the evaluation of complications. Of 175 studies identified, 9 could be used to evaluate rates of complete pain relief on a yearly basis and 22 could be used to evaluate complications. In mixed series, radiofrequency thermocoagulation offered higher rates of complete pain relief, compared with glycerol rhizolysis and stereotactic radiosurgery, although it demonstrated the greatest number of complications. Radiofrequency thermocoagulation offers the highest rates of complete pain relief, although further data on balloon microcompression are required. It is essential that uniform outcome measures and actuarial methods be universally adopted for the reporting of surgical results. Randomized controlled trials are required to reliably evaluate new surgical techniques.

Older adults' perceptions of ageing and their health and functioning: a systematic review of observational studies.

PubMed

Warmoth, Krystal; Tarrant, Mark; Abraham, Charles; Lang, Iain A

2016-07-01

Many older people perceive ageing negatively, describing it in terms of poor or declining health and functioning. These perceptions may be related to older adults' health. The aim of this review was to synthesise existing research on the relationship between older adults' perceptions of ageing and their health and functioning. A systematic search was conducted of five electronic databases (ASSIA, CINAHL, IBSS, MEDLINE and PsycINFO). Citations within identified reports were also searched. Observational studies were included if they included perceptions of ageing and health-related measures involving participants aged 60 years and older. Study selection, data extraction and quality appraisal were conducted using predefined criteria. Twenty-eight reports met the criteria for inclusion. Older adults' perceptions of ageing were assessed with a variety of measures. Perceptions were related to health and functioning across seven health domains: memory and cognitive performance, physical and physiological performance, medical conditions and outcomes, disability, care-seeking, self-rated health, quality of life and death. How ageing is perceived by older adults is related to their health and functioning in multiple domains. However, higher quality and longitudinal studies are needed to further investigate this relationship.

Systematic overview and critical appraisal of meta-analyses of interventions in intensive care medicine.

PubMed

Koster, T M; Wetterslev, J; Gluud, C; Keus, F; van der Horst, I C C

2018-05-24

Meta-analysed intervention effect estimates are perceived to represent the highest level of evidence. However, such effects and the randomized clinical trials which are included in them need critical appraisal before the effects can be trusted. Critical appraisal of a predefined set of all meta-analyses on interventions in intensive care medicine to assess their quality and assessed the risks of bias in those meta-analyses having the best quality. We conducted a systematic search to select all meta-analyses of randomized clinical trials on interventions used in intensive care medicine. Selected meta-analyses were critically appraised for basic scientific criteria, (1) presence of an available protocol, (2) report of a full search strategy, and (3) use of any bias risk assessment of included trials. All meta-analyses which qualified these criteria were scrutinized by full "Risk of Bias in Systematic Reviews" ROBIS evaluation of 4 domains of risks of bias, and a "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" PRISMA evaluation. We identified 467 meta-analyses. A total of 56 meta-analyses complied with these basic scientific criteria. We scrutinized the risks of bias in the 56 meta-analyses by full ROBIS evaluation and a PRISMA evaluation. Only 4 meta-analyses scored low risk of bias in all the 4 ROBIS domains and 41 meta-analyses reported all 27 items of the PRISMA checklist. In contrast with what might be perceived as the highest level of evidence only 0.9% of all meta-analyses were judged to have overall low risk of bias. © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

A comparison of selected public health criteria in milk from milk-shops and from a national distributor.

PubMed

O'Ferrall-Berndt, M More

2003-06-01

Selected public health criteria of pasteurised milk available to the consumer from milk-shops in a pre-defined area of Pretoria compared with a national distributor's milk was evaluated. Of the 135 milk samples purchased from milk-shops, 87% were not fit for human consumption on the basis of the minimum standards prescribed in the Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act 54 of1972). The national distributor's milk (n = 79) did not contain any pathogens, toxins nor inhibitory substances and passed all the criteria laid down in the Act. Even though milk-shop milk was sold as having been pasteurised, 38.5% of samples were alkaline phosphatase positive, indicating probable inadequate pasteurisation. Milk-shop milk quality varied between milk-shops and between sampling days and differed significantly (P < 0.05) from the national distributor's milk. Total aerobic plate and coliform counts were generally high for all milk-shop milk samples. Somatic cell counts of milk-shop milk differed significantly (P < 0.05) from the national distributor's milk. Escherichia coli was detected in 1 ml of 17% of milk-shop milk, 95% of which originated from milk which was alkaline phosphatase positive. Salmonella spp. could not be detected in 1 ml in any of the E. coli-positive milk tested. Staphylococcus aureus was isolated from 40% of milk-shop milk samples, and S. aureus enterotoxins from 7.8% of 51 cultures. Inhibitory substances were detected in 54.1% of milk-shop milk. The presence of inhibitory substances and the isolation of E. coli and S. aureus (some of which were able to produce enterotoxins) indicated potentially unsafe milk and poses a serious public health risk to consumers.

Band excitation method applicable to scanning probe microscopy

DOEpatents

Jesse, Stephen [Knoxville, TN; Kalinin, Sergei V [Knoxville, TN

2010-08-17

Methods and apparatus are described for scanning probe microscopy. A method includes generating a band excitation (BE) signal having finite and predefined amplitude and phase spectrum in at least a first predefined frequency band; exciting a probe using the band excitation signal; obtaining data by measuring a response of the probe in at least a second predefined frequency band; and extracting at least one relevant dynamic parameter of the response of the probe in a predefined range including analyzing the obtained data. The BE signal can be synthesized prior to imaging (static band excitation), or adjusted at each pixel or spectroscopy step to accommodate changes in sample properties (adaptive band excitation). An apparatus includes a band excitation signal generator; a probe coupled to the band excitation signal generator; a detector coupled to the probe; and a relevant dynamic parameter extractor component coupled to the detector, the relevant dynamic parameter extractor including a processor that performs a mathematical transform selected from the group consisting of an integral transform and a discrete transform.

Band excitation method applicable to scanning probe microscopy

DOEpatents

Jesse, Stephen; Kalinin, Sergei V

2013-05-28

Methods and apparatus are described for scanning probe microscopy. A method includes generating a band excitation (BE) signal having finite and predefined amplitude and phase spectrum in at least a first predefined frequency band; exciting a probe using the band excitation signal; obtaining data by measuring a response of the probe in at least a second predefined frequency band; and extracting at least one relevant dynamic parameter of the response of the probe in a predefined range including analyzing the obtained data. The BE signal can be synthesized prior to imaging (static band excitation), or adjusted at each pixel or spectroscopy step to accommodate changes in sample properties (adaptive band excitation). An apparatus includes a band excitation signal generator; a probe coupled to the band excitation signal generator; a detector coupled to the probe; and a relevant dynamic parameter extractor component coupled to the detector, the relevant dynamic parameter extractor including a processor that performs a mathematical transform selected from the group consisting of an integral transform and a discrete transform.

Reasons (Not) to Spend a Few Billions More on EHRs: How Human Factors Research Can Help

PubMed Central

Aimé, X.

2014-01-01

Summary Objectives To select best medical informatics research works published in 2013 on electronic health record (EHR) adoption, design, and impact, from the perspective of human factors and organizational issues (HFOI). Methods We selected 2,764 papers by querying PubMed (Mesh and TIAB) as well as using a manual search. Papers were evaluated based on pre-defined exclusion and inclusion criteria from their title, keywords, and abstract to select 15 candidate best papers, finally reviewed by 4 external reviewers using a standard evaluation grid. Results Five papers were selected as best papers to illustrate how human factors approaches can improve EHR adoption and design. Among other contributions, these works: (i) make use of the observational and analysis methodologies of social and cognitive sciences to understand clinicians’ attitudes towards EHRs, EHR use patterns, and impact on care processes, workflows, information exchange, and coordination of care; (ii) take into account macro- (environmental) and meso- (organizational) level factors to analyze EHR adoption or lack thereof; (iii) highlight the need for qualitative studies to analyze the unexpected side effects of EHRs on cognitive and work processes as well as the persistent use of paper. Conclusion Selected papers tend to demonstrate that HFOI approaches and methodologies are essential to bridge the gap between EHR systems and end users, and to reduce regularly reported adoption failures and unexpected consequences. PMID:25123727

Reasons (not) to Spend a Few Billions More on EHRs: How Human Factors Research Can Help.

PubMed

Declerck, G; Aimé, X

2014-08-15

To select best medical informatics research works published in 2013 on electronic health record (EHR) adoption, design, and impact, from the perspective of human factors and organizational issues (HFOI). We selected 2,764 papers by querying PubMed (Mesh and TIAB) as well as using a manual search. Papers were evaluated based on pre-defined exclusion and inclusion criteria from their title, keywords, and abstract to select 15 candidate best papers, finally reviewed by 4 external reviewers using a standard evaluation grid. Five papers were selected as best papers to illustrate how human factors approaches can improve EHR adoption and design. Among other contributions, these works: (i) make use of the observational and analysis methodologies of social and cognitive sciences to understand clinicians' attitudes towards EHRs, EHR use patterns, and impact on care processes, workflows, information exchange, and coordination of care; (ii) take into account macro- (environmental) and meso- (organizational) level factors to analyze EHR adoption or lack thereof; (iii) highlight the need for qualitative studies to analyze the unexpected side effects of EHRs on cognitive and work processes as well as the persistent use of paper. Selected papers tend to demonstrate that HFOI approaches and methodologies are essential to bridge the gap between EHR systems and end users, and to reduce regularly reported adoption failures and unexpected consequences.

A Study on the Basic Criteria for Selecting Heterogeneity Parameters of F18-FDG PET Images.

PubMed

Forgacs, Attila; Pall Jonsson, Hermann; Dahlbom, Magnus; Daver, Freddie; D DiFranco, Matthew; Opposits, Gabor; K Krizsan, Aron; Garai, Ildiko; Czernin, Johannes; Varga, Jozsef; Tron, Lajos; Balkay, Laszlo

2016-01-01

Textural analysis might give new insights into the quantitative characterization of metabolically active tumors. More than thirty textural parameters have been investigated in former F18-FDG studies already. The purpose of the paper is to declare basic requirements as a selection strategy to identify the most appropriate heterogeneity parameters to measure textural features. Our predefined requirements were: a reliable heterogeneity parameter has to be volume independent, reproducible, and suitable for expressing quantitatively the degree of heterogeneity. Based on this criteria, we compared various suggested measures of homogeneity. A homogeneous cylindrical phantom was measured on three different PET/CT scanners using the commonly used protocol. In addition, a custom-made inhomogeneous tumor insert placed into the NEMA image quality phantom was imaged with a set of acquisition times and several different reconstruction protocols. PET data of 65 patients with proven lung lesions were retrospectively analyzed as well. Four heterogeneity parameters out of 27 were found as the most attractive ones to characterize the textural properties of metabolically active tumors in FDG PET images. These four parameters included Entropy, Contrast, Correlation, and Coefficient of Variation. These parameters were independent of delineated tumor volume (bigger than 25-30 ml), provided reproducible values (relative standard deviation< 10%), and showed high sensitivity to changes in heterogeneity. Phantom measurements are a viable way to test the reliability of heterogeneity parameters that would be of interest to nuclear imaging clinicians.

A Study on the Basic Criteria for Selecting Heterogeneity Parameters of F18-FDG PET Images

PubMed Central

Forgacs, Attila; Pall Jonsson, Hermann; Dahlbom, Magnus; Daver, Freddie; D. DiFranco, Matthew; Opposits, Gabor; K. Krizsan, Aron; Garai, Ildiko; Czernin, Johannes; Varga, Jozsef; Tron, Lajos; Balkay, Laszlo

2016-01-01

Textural analysis might give new insights into the quantitative characterization of metabolically active tumors. More than thirty textural parameters have been investigated in former F18-FDG studies already. The purpose of the paper is to declare basic requirements as a selection strategy to identify the most appropriate heterogeneity parameters to measure textural features. Our predefined requirements were: a reliable heterogeneity parameter has to be volume independent, reproducible, and suitable for expressing quantitatively the degree of heterogeneity. Based on this criteria, we compared various suggested measures of homogeneity. A homogeneous cylindrical phantom was measured on three different PET/CT scanners using the commonly used protocol. In addition, a custom-made inhomogeneous tumor insert placed into the NEMA image quality phantom was imaged with a set of acquisition times and several different reconstruction protocols. PET data of 65 patients with proven lung lesions were retrospectively analyzed as well. Four heterogeneity parameters out of 27 were found as the most attractive ones to characterize the textural properties of metabolically active tumors in FDG PET images. These four parameters included Entropy, Contrast, Correlation, and Coefficient of Variation. These parameters were independent of delineated tumor volume (bigger than 25–30 ml), provided reproducible values (relative standard deviation< 10%), and showed high sensitivity to changes in heterogeneity. Phantom measurements are a viable way to test the reliability of heterogeneity parameters that would be of interest to nuclear imaging clinicians. PMID:27736888

Validation of Standardized Questionnaires Evaluating Symptoms of Depression in Rheumatoid Arthritis Patients: Approaches to Screening for a Frequent Yet Underrated Challenge.

PubMed

Englbrecht, Matthias; Alten, Rieke; Aringer, Martin; Baerwald, Christoph G; Burkhardt, Harald; Eby, Nancy; Fliedner, Gerhard; Gauger, Bettina; Henkemeier, Ulf; Hofmann, Michael W; Kleinert, Stefan; Kneitz, Christian; Krueger, Klaus; Pohl, Christoph; Roske, Anne-Eve; Schett, Georg; Schmalzing, Marc; Tausche, Anne-Kathrin; Peter Tony, Hans; Wendler, Joerg

2017-01-01

To validate standard self-report questionnaires for depression screening in patients with rheumatoid arthritis (RA) and compare these measures to one another and to the Montgomery-Åsberg Depression Rating Scale (MADRS), a standardized structured interview. In 9 clinical centers across Germany, depressive symptomatology was assessed in 262 adult RA patients at baseline (T0) and at 12 ± 2 weeks followup (T1) using the World Health Organization 5-Item Well-Being Index (WHO-5), the Patient Health Questionnaire (PHQ-9), and the Beck Depression Inventory II (BDI-II). The construct validity of these depression questionnaires (using convergent and discriminant validity) was evaluated using Spearman's correlations at both time points. The test-retest reliability of the questionnaires was evaluated in RA patients who had not undergone a psychotherapeutic intervention or received antidepressants between T0 and T1. The sensitivity and the specificity of the questionnaires were calculated using the results of the MADRS, a structured interview, as the gold standard. According to Spearman's correlation coefficients, all questionnaires met convergent validity criteria (ρ > |0.50|), with the BDI-II performing best, while correlations with age and disease activity for all questionnaires met the criteria for discriminant validity (ρ < |0.50|). The only questionnaire to meet the predefined retest reliability criterion (ρ ≥ 0.70) was the BDI-II (r s  = 0.77), which also achieved the best results for both sensitivity and specificity (>80%) when using the MADRS as the gold standard. The BDI-II best met the predefined criteria, and the PHQ-9 met most of the validity criteria, with lower sensitivity and specificity. © 2016, American College of Rheumatology.

Using a community-based definition of poverty for targeting poor households for premium subsidies in the context of a community health insurance in Burkina Faso.

PubMed

Savadogo, Germain; Souarès, Aurelia; Sié, Ali; Parmar, Divya; Bibeau, Gilles; Sauerborn, Rainer

2015-02-06

One of the biggest challenges in subsidizing premiums of poor households for community health insurance is the identification and selection of these households. Generally, poverty assessments in developing countries are based on monetary terms. The household is regarded as poor if its income or consumption is lower than a predefined poverty cut-off. These measures fail to recognize the multi-dimensional character of poverty, ignoring community members' perception and understanding of poverty, leaving them voiceless and powerless in the identification process. Realizing this, the steering committee of Nouna's health insurance devised a method to involve community members to better define 'perceived' poverty, using this as a key element for the poor selection. The community-identified poor were then used to effectively target premium subsidies for the insurance scheme. The study was conducted in the Nouna's Health District located in northwest Burkina Faso. Participants in each village were selected to take part in focus-group discussions (FGD) organized in 41 villages and 7 sectors of Nouna's town to discuss criteria and perceptions of poverty. The discussions were audio recorded, transcribed and analyzed in French using the software NVivo 9. From the FGD on poverty and the subjective definitions and perceptions of the community members, we found that poverty was mainly seen as scarcity of basic needs, vulnerability, deprivation of capacities, powerlessness, voicelessness, indecent living conditions, and absence of social capital and community networks for support in times of need. Criteria and poverty groups as described by community members can be used to identify poor who can then be targeted for subsidies. Policies targeting the poorest require the establishment of effective selection strategies. These policies are well-conditioned by proper identification of the poor people. Community perceptions and criteria of poverty are grounded in reality, to better appreciate the issue. It is crucial to take these perceptions into account in undertaking community development actions which target the poor. For most community-based health insurance schemes with limited financial resources, using a community-based definition of poverty in the targeting of the poorest might be a less costly alternative.

Constraints on grip selection in hemiparetic cerebral palsy: effects of lesional side, end-point accuracy, and context.

PubMed

Steenbergen, Bert; Meulenbroek, Ruud G J; Rosenbaum, David A

2004-04-01

This study was concerned with selection criteria used for grip planning in adolescents with left or right hemiparetic cerebral palsy. In the first experiment, we asked participants to pick up a pencil and place the tip in a pre-defined target region. We varied the size of the target to test the hypothesis that increased end-point precision demands would favour the use of a grip that affords end-state comfort. In the second experiment, we studied grip planning in three task contexts that were chosen to let us test the hypothesis that a more functional task context would likewise promote the end-state comfort effect. When movements were performed with the impaired hand, we found that participants with right hemiparesis (i.e., left brain damage) aimed for postural comfort at the start rather than at the end of the object-manipulation phase in both experiments. By contrast, participants with left hemiparesis (i.e., right brain damage) did not favour a particular selection criterion with the impaired hand in the first experiment, but aimed for postural comfort at the start in the second experiment. When movements were performed with the unimpaired hand, grip selection criteria again differed for right and left hemiparetic participants. Participants with right hemiparesis did not favour a particular selection criterion with the unimpaired hand in the first experiment and only showed the end-state comfort effect in the most functional tasks of the second experiment. By contrast, participants with left hemiparesis showed the end-state comfort effect in all conditions of both experiments. These data suggest that the left hemisphere plays a special role in action planning, as has been recognized before, and that one of the deficits accompanying left brain damage is a deficit in forward movement planning, which has not been recognized before. Our findings have both theoretical and clinical implications.

Early Supported Discharge/Hospital At Home For Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Review and Meta-Analysis.

PubMed

Echevarria, Carlos; Brewin, Karen; Horobin, Hazel; Bryant, Andrew; Corbett, Sally; Steer, John; Bourke, Stephen C

2016-08-01

A systematic review and meta-analysis was performed to assess the safety, efficacy and cost of Early Supported Discharge (ESD) and Hospital at Home (HAH) compared to Usual Care (UC) for patients with acute exacerbation of COPD (AECOPD). The structure of ESD/HAH schemes was reviewed, and analyses performed assuming return to hospital during the acute period (prior to discharge from home treatment) was, and was not, considered a readmission. The pre-defined search strategy completed in November 2014 included electronic databases (Medline, Embase, Amed, BNI, Cinahl and HMIC), libraries, current trials registers, national organisations, key respiratory journals, key author contact and grey literature. Randomised controlled trials (RCTs) comparing ESD/HAH to UC in patients admitted with AECOPD, or attending the emergency department and triaged for admission, were included. Outcome measures were mortality, all-cause readmissions to 6 months and cost. Eight RCTs were identified; seven reported mortality and readmissions. The structure of ESD/HAH schemes, particularly selection criteria applied and level of support provided, varied considerably. Compared to UC, ESD/HAH showed a trend towards lower mortality (RRMH = 0.66; 95% CI 0.40-1.09, p = 0.10). If return to hospital during the acute period was not considered a readmission, ESD/HAH was associated with fewer readmissions (RRMH = 0.74, 95% CI: 0.60-0.90, p = 0.003), but if considered a readmission, the benefit was lost (RRMH = 0.84; 95% CI 0.69-1.01, p = 0.07). Costs were lower for ESD/HAH than UC. ESD/HAH is safe in selected patients with an AECOPD. Further research is required to define optimal criteria to guide patient selection and models of care.

Defining the "proven technology" technical criterion in the reactor technology assessment for Malaysia's nuclear power program

NASA Astrophysics Data System (ADS)

Anuar, Nuraslinda; Kahar, Wan Shakirah Wan Abdul; Manan, Jamal Abdul Nasir Abd

2015-04-01

Developing countries that are considering the deployment of nuclear power plants (NPPs) in the near future need to perform reactor technology assessment (RTA) in order to select the most suitable reactor design. The International Atomic Energy Agency (IAEA) reported in the Common User Considerations (CUC) document that "proven technology" is one of the most important technical criteria for newcomer countries in performing the RTA. The qualitative description of five desired features for "proven technology" is relatively broad and only provides a general guideline to its characterization. This paper proposes a methodology to define the "proven technology" term according to a specific country's requirements using a three-stage evaluation process. The first evaluation stage screens the available technologies in the market against a predefined minimum Technology Readiness Level (TRL) derived as a condition based on national needs and policy objectives. The result is a list of technology options, which are then assessed in the second evaluation stage against quantitative definitions of CUC desired features for proven technology. The potential technology candidates produced from this evaluation is further narrowed down to obtain a list of proven technology candidates by assessing them against selected risk criteria and the established maximum allowable total score using a scoring matrix. The outcome of this methodology is the proven technology candidates selected using an accurate definition of "proven technology" that fulfills the policy objectives, national needs and risk, and country-specific CUC desired features of the country that performs this assessment. A simplified assessment for Malaysia is carried out to demonstrate and suggest the use of the proposed methodology. In this exercise, ABWR, AP1000, APR1400 and EPR designs assumed the top-ranks of proven technology candidates according to Malaysia's definition of "proven technology".

A Systematic Review of Electromyography Studies in Normal Shoulders to Inform Postoperative Rehabilitation Following Rotator Cuff Repair.

PubMed

Edwards, Peter K; Ebert, Jay R; Littlewood, Chris; Ackland, Tim; Wang, Allan

2017-12-01

Study Design Systematic review. Background Electromyography (EMG) has previously been used to guide postoperative rehabilitation progression following rotator cuff repair to prevent deleterious loading of early surgical repair. Objective To review the current literature investigating EMG during rehabilitation exercises in normal shoulders, and to identify exercises that meet a cut point of 15% maximal voluntary isometric contraction (MVIC) or less and are unlikely to result in excessive loading in the early postoperative stages. Methods An electronic search of MEDLINE via Ovid, Embase, CINAHL, SPORTDiscus, PubMed, and the Cochrane Library for all years up to June 2016 was performed. Studies were selected in relation to predefined selection criteria. Pooled mean MVICs were reported and classified as low (0%-15% MVIC), low to moderate (16%-20% MVIC), moderate (21%-40% MVIC), high (41%-60% MVIC), and very high (greater than 60% MVIC). Results A search identified 2159 studies. After applying the selection criteria, 20 studies were included for quality assessment, data extraction, and data synthesis. In total, 43 exercises spanning passive range of motion, active-assisted range of motion, and strengthening exercises were evaluated. Out of 13 active-assisted exercises, 9 were identified as suitable (15% MVIC or less) to load the supraspinatus and 10 as suitable to load the infraspinatus early after surgery. All exercises were placed in a theoretical-continuum model, by which general recommendations could be made for prescription in patients post rotator cuff repair. Conclusion This review identified passive and active-assisted exercises that may be appropriate in the early stages after rotator cuff repair. J Orthop Sports Phys Ther 2017;47(12):931-944. Epub 13 Jul 2017. doi:10.2519/jospt.2017.7271.

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

Anuar, Nuraslinda, E-mail: nuraslinda@uniten.edu.my; Kahar, Wan Shakirah Wan Abdul, E-mail: shakirah@tnb.com.my; Manan, Jamal Abdul Nasir Abd

Developing countries that are considering the deployment of nuclear power plants (NPPs) in the near future need to perform reactor technology assessment (RTA) in order to select the most suitable reactor design. The International Atomic Energy Agency (IAEA) reported in the Common User Considerations (CUC) document that “proven technology” is one of the most important technical criteria for newcomer countries in performing the RTA. The qualitative description of five desired features for “proven technology” is relatively broad and only provides a general guideline to its characterization. This paper proposes a methodology to define the “proven technology” term according to amore » specific country’s requirements using a three-stage evaluation process. The first evaluation stage screens the available technologies in the market against a predefined minimum Technology Readiness Level (TRL) derived as a condition based on national needs and policy objectives. The result is a list of technology options, which are then assessed in the second evaluation stage against quantitative definitions of CUC desired features for proven technology. The potential technology candidates produced from this evaluation is further narrowed down to obtain a list of proven technology candidates by assessing them against selected risk criteria and the established maximum allowable total score using a scoring matrix. The outcome of this methodology is the proven technology candidates selected using an accurate definition of “proven technology” that fulfills the policy objectives, national needs and risk, and country-specific CUC desired features of the country that performs this assessment. A simplified assessment for Malaysia is carried out to demonstrate and suggest the use of the proposed methodology. In this exercise, ABWR, AP1000, APR1400 and EPR designs assumed the top-ranks of proven technology candidates according to Malaysia’s definition of “proven technology”.« less

Eleven-Year Retrospective Report of Super-Selective Venous Sampling for the Evaluation of Recurrent or Persistent Hyperparathyroidism in 32 Patients.

PubMed

Habibollahi, Peiman; Shin, Benjamin; Shamchi, Sara P; Wachtel, Heather; Fraker, Douglas L; Trerotola, Scott O

2018-01-01

Parathyroid venous sampling (PAVS) is usually reserved for patients with persistent or recurrent hyperparathyroidism after parathyroidectomy with inconclusive noninvasive imaging studies. A retrospective study was performed to evaluate the diagnostic efficacy of super-selective PAVS (SSVS) in patients needing revision neck surgery with inconclusive imaging. Patients undergoing PAVS between 2005 and 2016 due to persistent or recurrent hyperparathyroidism following surgery were reviewed. PAVS was performed in all patients using super-selective technique. Single-value measurements within central neck veins performed as part of super-selective PAVS were used to simulate selective venous sampling (SVS) and allow for comparison to data, which might be obtained in a non-super-selective approach. 32 patients (mean age 51 ± 15 years; 8 men and 24 women) met inclusion and exclusion criteria. The sensitivity and positive predictive value (PPV) of SSVS for localizing the source of elevated PTH to a limited area in the neck or chest was 96 and 84%, respectively. Simulated SVS, on the other hand, had a sensitivity of 28% and a PPV of 89% based on the predefined gold standard. SSVS had a significantly higher sensitivity compared to simulated SVS (p < 0.001). SSVS is highly effective in localizing the source of hyperparathyroidism in patients undergoing revision surgery for hyperparathyroidism in whom noninvasive imaging studies are inconclusive. SSVS data had also markedly higher sensitivity for localizing disease in these patients compared to simulated SVS.

Systematic review of scope and quality of electronic patient record data in primary care

PubMed Central

Thiru, Krish; Hassey, Alan; Sullivan, Frank

2003-01-01

Objective To systematically review measures of data quality in electronic patient records (EPRs) in primary care. Design Systematic review of English language publications, 1980-2001. Data sources Bibliographic searches of medical databases, specialist medical informatics databases, conference proceedings, and institutional contacts. Study selection Studies selected according to a predefined framework for categorising review papers. Data extraction Reference standards and measurements used to judge quality. Results Bibliographic searches identified 4589 publications. After primary exclusions 174 articles were classified, 52 of which met the inclusion criteria for review. Selected studies were primarily descriptive surveys. Variability in methods prevented meta-analysis of results. Forty eight publications were concerned with diagnostic data, 37 studies measured data quality, and 15 scoped EPR quality. Reliability of data was assessed with rate comparison. Measures of sensitivity were highly dependent on the element of EPR data being investigated, while the positive predictive value was consistently high, indicating good validity. Prescribing data were generally of better quality than diagnostic or lifestyle data. Conclusion The lack of standardised methods for assessment of quality of data in electronic patient records makes it difficult to compare results between studies. Studies should present data quality measures with clear numerators, denominators, and confidence intervals. Ambiguous terms such as “accuracy” should be avoided unless precisely defined. PMID:12750210

Development of a Knowledge-Based System Approach for Decision Making in Construction Projects

DTIC Science & Technology

1992-05-01

a generic model for an administrative facility and medical facility with predefined fixed building systems based on Air Force criteria and past...MAINTENANCE HANGAR (MEDIUM BAY) CORROSION CONTROL HANGAR (HIGH BAY) FUEL SYSTEM MAINTENANCE HANGAR (MEDIUM BAY) MEDICAL MODEL 82 Table 5-1--continued...BUILDING SUPPORT MEDICAL LOGISTICS MEDICAL TOTAL 85 Table 5-2--continued MISSILE ASSEMBLY AND MAINTENANCE BUILDING TOTAL MISSILE LOADING AND UNLOADING

Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage

PubMed Central

Pinna, Roberto; Campus, Guglielmo; Cumbo, Enzo; Mura, Ida; Milia, Egle

2015-01-01

Background The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient’s quality of life. Purpose To analyze the literature of actual management strategies for radiation-induced hypofunction and xerostomia in HNC patients. Methods MEDLINE/PubMed and the Cochrane Library databases were electronically evaluated for articles published from January 1, 1970, to June 30, 2013. Two reviewers independently screened and included papers according to the predefined selection criteria. Results Sixty-one articles met the inclusion criteria. The systematic review of the literature suggests that the most suitable methods for managing the clinical and pathophysiological consequences of HNC radiotherapy might be the pharmacological approach, for example, through the use of cholinergic agonists when residual secretory capacity is still present, and the use of salivary substitutes. In addition, a modified diet and the patient’s motivation to enhance oral hygiene can lead to a significant improvement. Conclusion Radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia. PMID:25691810

Association between extra- and intracranial calcifications of the internal carotid artery: a CBCT imaging study.

PubMed

Damaskos, S; Aartman, I H A; Tsiklakis, K; van der Stelt, P; Berkhout, W E R

2015-01-01

This study aimed to evaluate the association between the extracranial and intracranial calcification depiction of the internal carotid artery (ICA), incidentally found in CBCT examinations in adults, and to discuss the conspicuous clinical implications. Out of a series of 1085 CBCT examinations, 705 CBCT scans were selected according to pre-defined criteria. The extra- and intracranial calcifications depicted along the course of the ICA were documented according to a comprehensive set of descriptive criteria. In total, 799 findings were detected, 60.1% (n = 480) were intracranially and 39.9% (n = 319) were extracranially allocated. The χ(2) test showed associations between all variables (p < 0.001). Also, most of the combinations of variables showed statistically significant results in the McNemar's test (p < 0.001). We found that a significant correlation exists between extra- and intracranial calcifications of the ICA. It is clear that in cases of the presence of a calcification in the ICA extracranially, the artery's intracranial portion has an increased risk of showing the same findings. CBCT imaging is widely used as a diagnostic tool, thus, our results contribute to the identification of a subgroup of patients who should undergo further medical evaluation of the atherosclerosis of the ICAs.

Impacts of a participatory approach to assess sustainable sewage treatment technologies for urban fringe of Surat city in India.

PubMed

Vashi, A N; Shah, N C

2008-01-01

This paper describes the assessment of the sustainability of a number of different sewage treatment technologies by means of a multi-criteria, participatory method for a scattered settlement of urban fringe of Surat. The special efforts have been made for the broad participation to achieve stronger democracy, better quality of the end product, and a more effective process. The mere participation of technocrats and bureaucrats certainly lead to the greater efficiency in working methods. However, the ultimate goal of sustainable developments of such technologies could not be reached in absence of democratic participation and social learning. Keeping this important aspect in view for assessment of sustainability, the detailed study was conducted in the presence of policy makers and stakeholders, academicians, technical experts, finance managers and NGO, to find out sustainability criteria and indicators for three different sewage treatment technologies: (A) Conventional Activated Sludge Process (B) Extended Aeration System, and (C) Upflow Anaerobic Sludge Blanket (UASB) Reactor followed by Aerated Lagoon and Polishing Pond. Technologies were compared according to four criteria subdivided into twenty operational indicators. Criteria and indicators were evaluated as in a weighted-scale matrix. In India, sustainability criteria used in this type of comparisons are often restricted to a limited set of environmental impacts and financial costs but in this study additional criteria were evaluated including economic, social, and technical aspects. Based on the values assigned by the panel, the Sustainability Index (SI) was calculated for each technology. According to the SI and a predefined scale, sustainability was medium for options A and B, whereas high for option C. The purpose of this study is to provide a basis for the selection of a particular technology based on a rational and democratic assessment of its contribution to sustainability in the local and global context. IWA Publishing 2008.

Quality of life and recreational cannabis use.

PubMed

Goldenberg, Matthew; IsHak, Waguih William; Danovitch, Itai

2017-01-01

Cannabis is now the most commonly used illicit drug in the United States and use is increasing. Frequent cannabis use has been associated with adverse social and health effects. We sought to evaluate the relationship between recreational cannabis use and Quality of Life (QoL), a person-centered measure that characterizes the overall sense of health and wellbeing. We hypothesized that QoL would be unchanged or increased among recreational cannabis users, who did not meet criteria for a Cannabis Use Disorder (CUD) and that QoL would be lower among those who met criteria for a CUD. We conducted a systematic review, employing guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The results were categorized into tables and identified trends. Fourteen studies met our pre-defined selection criteria. The studies were heterogeneous and their quality was low. With one exception, we did not identify any population for whom cannabis use was associated with improved QoL. QoL was lower in persons who used cannabis heavily, or who met criteria for CUD. However, this association was inconsistent and the magnitude was weaker than the relationship between QoL and use of other addictive substances (including tobacco and illicit drugs). In this systematic review, heavy cannabis use or CUD was associated with reduced QoL. It is unknown whether reduced QoL drives cannabis use, or whether cannabis use can lead to reduced QoL. Prospective studies are needed to evaluate the causal relationship between cannabis and QoL. Furthering the understanding of the relationship between cannabis and QoL can inform public policy, prevention efforts, outcomes, and an objective understanding of the effects of cannabis users. (Am J Addict 2017;26:8-25). © 2016 American Academy of Addiction Psychiatry.

The potential of real-time fMRI neurofeedback for stroke rehabilitation: A systematic review.

PubMed

Wang, Tianlu; Mantini, Dante; Gillebert, Celine R

2017-09-18

Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback aids the modulation of neural functions by training self-regulation of brain activity through operant conditioning. This technique has been applied to treat several neurodevelopmental and neuropsychiatric disorders, but its effectiveness for stroke rehabilitation has not been examined yet. Here, we systematically review the effectiveness of rt-fMRI neurofeedback training in modulating motor and cognitive processes that are often impaired after stroke. Based on predefined search criteria, we selected and examined 33 rt-fMRI neurofeedback studies, including 651 healthy individuals and 15 stroke patients in total. The results of our systematic review suggest that rt-fMRI neurofeedback training can lead to a learned modulation of brain signals, with associated changes at both the neural and the behavioural level. However, more research is needed to establish how its use can be optimized in the context of stroke rehabilitation. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Evaluation of Subjective Measurement Systems with Focus on Workmanship Scratches and Characterization

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

Fitzgerald, Jesse

2011-02-24

The presence of workmanship defects at the Kansas City Plant (KCP) is not a new problem nor is it an easy one to remedy. The lack of well defined parameters, subjective evaluations, and operator dependency makes this problem difficult to analyze. At the time of project assignment, workmanship defects comprised approximately 50% of all non-conformance reports for internally produced products. Not all of these non-conformances result in product rejections, thus inferring that inconsistency in evaluations were present. The purpose of this study was to identify a method for evaluating an operator’s ability to properly characterize subjective defects. Since the scopemore » of the project was limited to no funding, scratch depth was selected as the only criteria to evaluate. It was determined that the introduction of a reference standard coupled with a predefined gate-sorting technique approved by the customer can statistically improve an operators ability to perform subjective evaluations.« less

An improved PRoPHET routing protocol in delay tolerant network.

PubMed

Han, Seung Deok; Chung, Yun Won

2015-01-01

In delay tolerant network (DTN), an end-to-end path is not guaranteed and packets are delivered from a source node to a destination node via store-carry-forward based routing. In DTN, a source node or an intermediate node stores packets in buffer and carries them while it moves around. These packets are forwarded to other nodes based on predefined criteria and finally are delivered to a destination node via multiple hops. In this paper, we improve the dissemination speed of PRoPHET (probability routing protocol using history of encounters and transitivity) protocol by employing epidemic protocol for disseminating message m, if forwarding counter and hop counter values are smaller than or equal to the threshold values. The performance of the proposed protocol was analyzed from the aspect of delivery probability, average delay, and overhead ratio. Numerical results show that the proposed protocol can improve the delivery probability, average delay, and overhead ratio of PRoPHET protocol by appropriately selecting the threshold forwarding counter and threshold hop counter values.

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

PubMed

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

2018-01-01

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

Remote Patient Monitoring via Non-Invasive Digital Technologies: A Systematic Review

PubMed Central

Tran, Melody; Angelaccio, Michele; Arcona, Steve

2017-01-01

Abstract Background: We conducted a systematic literature review to identify key trends associated with remote patient monitoring (RPM) via noninvasive digital technologies over the last decade. Materials and Methods: A search was conducted in EMBASE and Ovid MEDLINE. Citations were screened for relevance against predefined selection criteria based on the PICOTS (Population, Intervention, Comparator, Outcomes, Timeframe, and Study Design) format. We included studies published between January 1, 2005 and September 15, 2015 that used RPM via noninvasive digital technology (smartphones/personal digital assistants [PDAs], wearables, biosensors, computerized systems, or multiple components of the formerly mentioned) in evaluating health outcomes compared to standard of care or another technology. Studies were quality appraised according to Critical Appraisal Skills Programme. Results: Of 347 articles identified, 62 met the selection criteria. Most studies were randomized control trials with older adult populations, small sample sizes, and limited follow-up. There was a trend toward multicomponent interventions (n = 26), followed by smartphones/PDAs (n = 12), wearables (n = 11), biosensor devices (n = 7), and computerized systems (n = 6). Another key trend was the monitoring of chronic conditions, including respiratory (23%), weight management (17%), metabolic (18%), and cardiovascular diseases (16%). Although substantial diversity in health-related outcomes was noted, studies predominantly reported positive findings. Conclusions: This review will help decision makers develop a better understanding of the current landscape of peer-reviewed literature, demonstrating the utility of noninvasive RPM in various patient populations. Future research is needed to determine the effectiveness of RPM via noninvasive digital technologies in delivering patient healthcare benefits and the feasibility of large-scale implementation. PMID:27116181

Defining traumatic brain injury in children and youth using international classification of diseases version 10 codes: a systematic review protocol.

PubMed

Chan, Vincy; Thurairajah, Pravheen; Colantonio, Angela

2013-11-13

Although healthcare administrative data are commonly used for traumatic brain injury research, there is currently no consensus or consistency on using the International Classification of Diseases version 10 codes to define traumatic brain injury among children and youth. This protocol is for a systematic review of the literature to explore the range of International Classification of Diseases version 10 codes that are used to define traumatic brain injury in this population. The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews will be systematically searched. Grey literature will be searched using Grey Matters and Google. Reference lists of included articles will also be searched. Articles will be screened using predefined inclusion and exclusion criteria and all full-text articles that meet the predefined inclusion criteria will be included for analysis. The study selection process and reasons for exclusion at the full-text level will be presented using a PRISMA study flow diagram. Information on the data source of included studies, year and location of study, age of study population, range of incidence, and study purpose will be abstracted into a separate table and synthesized for analysis. All International Classification of Diseases version 10 codes will be listed in tables and the codes that are used to define concussion, acquired traumatic brain injury, head injury, or head trauma will be identified. The identification of the optimal International Classification of Diseases version 10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies. It also allows for comparisons across countries and studies. This protocol is for a review that identifies the range and most common diagnoses used to conduct surveillance for traumatic brain injury in children and youth. This is an important first step in reaching an appropriate definition using International Classification of Diseases version 10 codes and can inform future work on reaching consensus on the codes to define traumatic brain injury for this vulnerable population.

Distal Radius Fractures Do Not Displace following Splint or Cast Removal in the Acute, Postreduction Period: A Prospective, Observational Study.

PubMed

Foster, Brock D; Sivasundaram, Lakshmanan; Heckmann, Nathanael; Pannell, William C; Alluri, Ram K; Ghiassi, Alidad

2017-02-01

Background  Displacement of distal radius fractures has been previously described in the literature; however, little is known about fracture displacement following splint or cast removal at the initial clinic visit following reduction and immobilization. Purpose  The purpose of this study was to evaluate risk factors for fracture displacement following splint or cast removal and physical examination in the acute postinjury period. Methods  All patients with a closed distal radius fracture who presented to our orthopedic hand clinic within 3 weeks of injury were prospectively enrolled in our study. Standard wrist radiographs were obtained prior to splint or cast removal. A second wrist series was obtained following physical exam and application of immobilization at the end of the clinic visit. Radiographic parameters for displacement were measured by two independent reviewers and included dorsal angulation, radial inclination, articular step-off, radial height, and ulnar variance. Displacement was assessed using predefined, radiographic criteria for displacement. Results  A total of 64 consecutive patients were enrolled over a period of 12 weeks. Of these, 37.5% were classified as operative according to American Academy of Orthopaedic Surgeons guidelines and 37.5% met LaFontaine instability criteria. For each fracture, none of the five measurements exceeded the predefined clinically or statistically significant criteria for displacement. Conclusion  Splint removal in the acute postinjury period did not result in distal radius fracture displacement. Clinicians should feel comfortable removing splints and examining underlying soft tissue in the acute setting for patients with distal radius fractures after closed reduction. Level of Evidence  Level II, prospective comparative study.

Tailoring Selective Laser Melting Process Parameters for NiTi Implants

NASA Astrophysics Data System (ADS)

Bormann, Therese; Schumacher, Ralf; Müller, Bert; Mertmann, Matthias; de Wild, Michael

2012-12-01

Complex-shaped NiTi constructions become more and more essential for biomedical applications especially for dental or cranio-maxillofacial implants. The additive manufacturing method of selective laser melting allows realizing complex-shaped elements with predefined porosity and three-dimensional micro-architecture directly out of the design data. We demonstrate that the intentional modification of the applied energy during the SLM-process allows tailoring the transformation temperatures of NiTi entities within the entire construction. Differential scanning calorimetry, x-ray diffraction, and metallographic analysis were employed for the thermal and structural characterizations. In particular, the phase transformation temperatures, the related crystallographic phases, and the formed microstructures of SLM constructions were determined for a series of SLM-processing parameters. The SLM-NiTi exhibits pseudoelastic behavior. In this manner, the properties of NiTi implants can be tailored to build smart implants with pre-defined micro-architecture and advanced performance.

Framework for the quantitative weight-of-evidence analysis of 'omics data for regulatory purposes.

PubMed

Bridges, Jim; Sauer, Ursula G; Buesen, Roland; Deferme, Lize; Tollefsen, Knut E; Tralau, Tewes; van Ravenzwaay, Ben; Poole, Alan; Pemberton, Mark

2017-12-01

A framework for the quantitative weight-of-evidence (QWoE) analysis of 'omics data for regulatory purposes is presented. The QWoE framework encompasses seven steps to evaluate 'omics data (also together with non-'omics data): (1) Hypothesis formulation, identification and weighting of lines of evidence (LoEs). LoEs conjoin different (types of) studies that are used to critically test the hypothesis. As an essential component of the QWoE framework, step 1 includes the development of templates for scoring sheets that predefine scoring criteria with scores of 0-4 to enable a quantitative determination of study quality and data relevance; (2) literature searches and categorisation of studies into the pre-defined LoEs; (3) and (4) quantitative assessment of study quality and data relevance using the respective pre-defined scoring sheets for each study; (5) evaluation of LoE-specific strength of evidence based upon the study quality and study relevance scores of the studies conjoined in the respective LoE; (6) integration of the strength of evidence from the individual LoEs to determine the overall strength of evidence; (7) characterisation of uncertainties and conclusion on the QWoE. To put the QWoE framework in practice, case studies are recommended to confirm the relevance of its different steps, or to adapt them as necessary. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Extra- and intra-cranial arterial calcifications in adults depicted as incidental findings on cone beam CT images.

PubMed

Damaskos, Spyros; Tsiklakis, Kostas; Syriopoulos, Kostas; van der Stelt, Paul

2015-04-01

The aim of this study was to evaluate, retrospectively, the gender- and age-related prevalence of incidentally found calcifications, depicted within the course of the extra- and intra-cranial portion of internal carotid artery (ICA), in cone beam computed tomography (CBCT) examinations in adults, and to assess their clinical significance. Out of a pull of 700 CBCT examinations a total of 484 CBCT scans of adult patients were finally selected according to a set of pre-defined criteria. These were evaluated for arterial calcifications presence within the ICAs course according to gender and age criteria. In total, 492 calcifications were detected: 211 (42.88%) extra-cranial and 281 (57.11%) intra-cranial. Those were recorded in 150 scans (30.99%) and 161 scans (33.26%), respectively. Calcifications, with either extra- or intra-cranial allocation, were found more frequent in males than in females (all p-values < 0.05); also patients who presented with positive findings were older than those without findings (all p-values < 0.05). Furthermore, calcification presence with either extra- or intra-cranial allocation increases with age (all p-values < 0.05). Significant calcification frequencies were found within the ICA's course, in CBCT scans. Moreover, an increased incidence of either extra- or intra-cranial presence of these depictions and its relation to age and gender was documented.

A systematic review of the factors associated with interest in predictive genetic testing for obesity, type II diabetes and heart disease.

PubMed

Collins, J; Ryan, L; Truby, H

2014-10-01

In the future, it may be possible for individuals to take a genetic test to determine their genetic predisposition towards developing lifestyle-related chronic diseases. A systematic review of the literature was undertaken to identify the factors associated with an interest in having predictive genetic testing for obesity, type II diabetes and heart disease amongst unaffected adults. Ovid Medline, PsycINFO and EMBASE online databases were searched using predefined search terms. Publications meeting the inclusion criteria (English language, free-living adult population not selected as a result of their disease diagnosis, reporting interest as an outcome, not related to a single gene inherited disease) were assessed for quality and content. Narrative synthesis of the results was undertaken. From the 2329 publications retrieved, eight studies met the inclusion criteria and were included in the review. Overall, the evidence base was small but of positive quality. Interest was associated with personal attitudes towards disease risk and the provision of information about genetic testing, shaped by perceived risk of disease and expected outcomes of testing. The role of demographic factors was investigated with largely inconclusive findings. Interest in predictive genetic testing for obesity, type II diabetes or heart disease was greatest amongst those who perceived the risk of disease to be high and/or the outcomes of testing to be beneficial. © 2013 The British Dietetic Association Ltd.

Fabrication of High Contact-Density, Flat-Interface Nerve Electrodes for Recording and Stimulation Applications.

PubMed

Dweiri, Yazan M; Stone, Matthew A; Tyler, Dustin J; McCallum, Grant A; Durand, Dominique M

2016-10-04

Many attempts have been made to manufacture multi-contact nerve cuff electrodes that are safe, robust and reliable for long term neuroprosthetic applications. This protocol describes a fabrication technique of a modified cylindrical nerve cuff electrode to meet these criteria. Minimum computer-aided design and manufacturing (CAD and CAM) skills are necessary to consistently produce cuffs with high precision (contact placement 0.51 ± 0.04 mm) and various cuff sizes. The precision in spatially distributing the contacts and the ability to retain a predefined geometry accomplished with this design are two criteria essential to optimize the cuff's interface for selective recording and stimulation. The presented design also maximizes the flexibility in the longitudinal direction while maintaining sufficient rigidity in the transverse direction to reshape the nerve by using materials with different elasticities. The expansion of the cuff's cross sectional area as a result of increasing the pressure inside the cuff was observed to be 25% at 67 mm Hg. This test demonstrates the flexibility of the cuff and its response to nerve swelling post-implant. The stability of the contacts' interface and recording quality were also examined with contacts' impedance and signal-to-noise ratio metrics from a chronically implanted cuff (7.5 months), and observed to be 2.55 ± 0.25 kΩ and 5.10 ± 0.81 dB respectively.

Cost-effectiveness of different strategies for selecting and treating individuals at increased risk of osteoporosis or osteopenia: a systematic review.

PubMed

Müller, Dirk; Pulm, Jannis; Gandjour, Afschin

2012-01-01

To compare cost-effectiveness modeling analyses of strategies to prevent osteoporotic and osteopenic fractures either based on fixed thresholds using bone mineral density or based on variable thresholds including bone mineral density and clinical risk factors. A systematic review was performed by using the MEDLINE database and reference lists from previous reviews. On the basis of predefined inclusion/exclusion criteria, we identified relevant studies published since January 2006. Articles included for the review were assessed for their methodological quality and results. The literature search resulted in 24 analyses, 14 of them using a fixed-threshold approach and 10 using a variable-threshold approach. On average, 70% of the criteria for methodological quality were fulfilled, but almost half of the analyses did not include medication adherence in the base case. The results of variable-threshold strategies were more homogeneous and showed more favorable incremental cost-effectiveness ratios compared with those based on a fixed threshold with bone mineral density. For analyses with fixed thresholds, incremental cost-effectiveness ratios varied from €80,000 per quality-adjusted life-year in women aged 55 years to cost saving in women aged 80 years. For analyses with variable thresholds, the range was €47,000 to cost savings. Risk assessment using variable thresholds appears to be more cost-effective than selecting high-risk individuals by fixed thresholds. Although the overall quality of the studies was fairly good, future economic analyses should further improve their methods, particularly in terms of including more fracture types, incorporating medication adherence, and including or discussing unrelated costs during added life-years. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Dementia training programmes for staff working in general hospital settings - a systematic review of the literature.

PubMed

Scerri, Anthony; Innes, Anthea; Scerri, Charles

2017-08-01

Although literature describing and evaluating training programmes in hospital settings increased in recent years, there are no reviews that summarise these programmes. This review sought to address this, by collecting the current evidence on dementia training programmes directed to staff working in general hospitals. Literature from five databases were searched, based on a number of inclusion criteria. The selected studies were summarised and data was extracted and compared using narrative synthesis based on a set of pre-defined categories. Methodological quality was assessed. Fourteen peer-reviewed studies were identified with the majority being pre-test post-test investigations. No randomised controlled trials were found. Methodological quality was variable with selection bias being the major limitation. There was a great variability in the development and mode of delivery although, interdisciplinary ward based, tailor-made, short sessions using experiential and active learning were the most utilised. The majority of the studies mainly evaluated learning, with few studies evaluating changes in staff behaviour/practices and patients' outcomes. This review indicates that high quality studies are needed that especially evaluate staff behaviours and patient outcomes and their sustainability over time. It also highlights measures that could be used to develop and deliver training programmes in hospital settings.

Men's reflections on participating in cancer rehabilitation: a systematic review of qualitative studies 2000-2013.

PubMed

Handberg, C; Nielsen, C V; Lomborg, K

2014-03-01

This paper aims to report on a systematic review of qualitative studies on men's reflections on participating in cancer rehabilitation. Nine databases were systematically searched to identify qualitative papers published between 2000 and 2013. Papers were selected by pre-defined inclusion criteria and subsequently critically appraised. Key themes were extracted and synthesised. Fifteen papers were selected and represented. Four central themes were identified in the analytical process: 'changed life perspective', 'the masculinity factor', 'a desire to get back to normal' and 'the meaning of work'. Six peripheral themes were identified: 'the meaning of context', 'music', 'physical training', 'religion', 'humour' and 'the unmentionable'. The themes were synthesised into an integrative model representing men's reflections on participating in cancer rehabilitation. We conclude that existing qualitative literature offers insight into men's reflections on cancer rehabilitation and highlights the interrelationship between men's reflections on their changed life perspective, masculinity, orientation towards a normal life and getting back to work. Further research-based knowledge is needed to explore (1) the underlying causes and patterns of the men's needs, preferences and choices in rehabilitation; and (2) the health professional perspective on male cancer rehabilitation. © 2013 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

Induction regimens for transplant-eligible patients with newly diagnosed multiple myeloma: a network meta-analysis of randomized controlled trials

PubMed Central

Zeng, Zi-Hang; Chen, Jia-Feng; Li, Yi-Xuan; Zhang, Ran; Xiao, Ling-Fei; Meng, Xiang-Yu

2017-01-01

Objective The aim of this study was to compare the early efficacy and survivals of induction regimens for transplant-eligible patients with untreated multiple myeloma. Materials and methods A comprehensive literature search in electronic databases was conducted for relevant randomized controlled trials (RCTs). Eligible studies were selected according to the predefined selection criteria, before they were evaluated for methodological quality. Basic characteristics and data for network meta-analysis (NMA) were extracted from included trials and pooled in our meta-analysis. The end points were the overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). Results A total of 14 RCTs that included 4,763 patients were analyzed. The post-induction ORR was higher with bortezomib plus thalidomide plus dexamethasone (VTD) regimens, and VTD was better than the majority of other regimens. For OS, VTD plus cyclophosphamide (VTDC) regimens showed potential superiority over other regimens, but the difference was not statistically significant. The PFS was longer with thalidomide plus doxorubicin plus dexamethasone (TAD) regimens for transplant-eligible patients with newly diagnosed multiple myeloma (NDMM). Conclusion The NMA demonstrated that the VTD, VTDC, and TAD regimens are most beneficial in terms of ORR, OS, and PFS for transplant-eligible patients with NDMM, respectively. PMID:28744159

Selective catalyst reduction light-off strategy

DOEpatents

Gonze, Eugene V [Pinckney, MI

2011-10-18

An emissions control system includes a temperature determination module and an emissions control module. The temperature determination module determines a first temperature of a heater element of a diesel particulate filter (DPF) assembly in an exhaust system and determines a second temperature of a catalyst of the DPF assembly. The emissions control module selectively activates the heater element, selectively initiates a predefined combustion process in an engine based upon the first temperature, and selectively starts a reductant injection process based upon the second temperature.

Robust fixed-time synchronization for uncertain complex-valued neural networks with discontinuous activation functions.

PubMed

Ding, Xiaoshuai; Cao, Jinde; Alsaedi, Ahmed; Alsaadi, Fuad E; Hayat, Tasawar

2017-06-01

This paper is concerned with the fixed-time synchronization for a class of complex-valued neural networks in the presence of discontinuous activation functions and parameter uncertainties. Fixed-time synchronization not only claims that the considered master-slave system realizes synchronization within a finite time segment, but also requires a uniform upper bound for such time intervals for all initial synchronization errors. To accomplish the target of fixed-time synchronization, a novel feedback control procedure is designed for the slave neural networks. By means of the Filippov discontinuity theories and Lyapunov stability theories, some sufficient conditions are established for the selection of control parameters to guarantee synchronization within a fixed time, while an upper bound of the settling time is acquired as well, which allows to be modulated to predefined values independently on initial conditions. Additionally, criteria of modified controller for assurance of fixed-time anti-synchronization are also derived for the same system. An example is included to illustrate the proposed methodologies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Quality of life in maltreated children and adult survivors of child maltreatment: a systematic review.

PubMed

Weber, S; Jud, A; Landolt, M A

2016-02-01

To review data on health-related quality of life (HRQoL) in individuals with childhood trauma, including psychological maltreatment, physical maltreatment, sexual abuse, and neglect. The literature search was conducted with pre-defined keywords using the following electronic bibliographic databases: EMBASE, PubMed, MEDLINE, CINAHL, PsyINFO, PSYNDEX, and Cochrane Database of Systematic Reviews. Further databases were searched for relevant dissertations. Study selection and data extraction were completed by two independent reviewers. The literature search yielded 1568 entries. Nineteen articles met all inclusion criteria and were retained for further analysis. Findings quite consistently showed significant negative associations between child maltreatment and both self- and proxy-rated HRQoL. Effect sizes range from small to large. Number of types of maltreatment and HRQoL were found to be negatively related. Data on HRQoL for maltreated children are still rare. Studies often investigate adult survivors of child maltreatment. Considering HRQoL in children and adolescents who suffered maltreatment would allow the planning of effective interventions and the evaluation of treatments to improve HRQoL of these children.

Cycling with an amputation: A systematic review.

PubMed

Dyer, Bryce

2016-10-01

Cycling with any form of limb amputation has progressed from an activity of leisure or rehabilitation to elite level competition as part of the Paralympic Games programme. While it is often proposed that research into sport with an amputation can be extremely limited, this study intended to identify the volume, type and historical strategy in this area. This study comprises a documented systematic literature review of cycling undertaken with any form of limb amputation. This study used four online search engines to identify relevant peer-reviewed literature. These included SPORTDiscus, CINAHL, Scopus and MEDLINE. Google Scholar was also used as a secondary source. The initial results were then subjected to a set of pre-defined inclusion criteria. The resulting publications were then analysed for content and thematic commonality. The review identified 20 articles which met pre-defined inclusion criteria. The identified peer-reviewed publications were dated from the period 2004 to 2014. Three clear themes emerged from the historical research. There was both a paucity of peer-reviewed literature with respect to cycling with an amputation and the design of adaptive or assistive technology to replace limb loss. However, publications have been rising substantially over the last 5 years. This review study established the historical strategy and content of cycling with an amputation and identified the existing research themes. This will assist in summarising the current level of knowledge and help signpost such work in the future. © The International Society for Prosthetics and Orthotics 2015.

The EORTC module for quality of life in patients with thyroid cancer: phase III.

PubMed

Singer, Susanne; Jordan, Susan; Locati, Laura D; Pinto, Monica; Tomaszewska, Iwona M; Araújo, Cláudia; Hammerlid, Eva; Vidhubala, E; Husson, Olga; Kiyota, Naomi; Brannan, Christine; Salem, Dina; Gamper, Eva M; Arraras, Juan Ignacio; Ioannidis, Georgios; Andry, Guy; Inhestern, Johanna; Grégoire, Vincent; Licitra, Lisa

2017-04-01

The purpose of the study was to pilot-test a questionnaire measuring health-related quality of life (QoL) in thyroid cancer patients to be used with the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire EORTC QLQ-C30. A provisional questionnaire with 47 items was administered to patients treated for thyroid cancer within the last 2 years. Patients were interviewed about time and help needed to complete the questionnaire, and whether they found the items understandable, confusing or annoying. Items were kept in the questionnaire if they fulfilled pre-defined criteria: relevant to the patients, easy to understand, not confusing, few missing values, neither floor nor ceiling effects, and high variance. A total of 182 thyroid cancer patients in 15 countries participated ( n  = 115 with papillary, n  = 31 with follicular, n  = 22 with medullary, n  = 6 with anaplastic, and n  = 8 with other types of thyroid cancer). Sixty-six percent of the patients needed 15 min or less to complete the questionnaire. Of the 47 items, 31 fulfilled the predefined criteria and were kept unchanged, 14 were removed, and 2 were changed. Shoulder dysfunction was mentioned by 5 patients as missing and an item covering this issue was added. To conclude, the EORTC quality of life module for thyroid cancer (EORTC QLQ-THY34) is ready for the final validation phase IV. © 2017 Society for Endocrinology.

Systematic review of return to work after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.

PubMed

Cancelliere, Carol; Kristman, Vicki L; Cassidy, J David; Hincapié, Cesar A; Côté, Pierre; Boyle, Eleanor; Carroll, Linda J; Stålnacke, Britt-Marie; Nygren-de Boussard, Catharina; Borg, Jörgen

2014-03-01

To synthesize the best available evidence on return to work (RTW) after mild traumatic brain injury (MTBI). MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "employment." Reference lists of eligible articles were also searched. Controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to assess RTW or employment outcomes in at least 30 MTBI cases. Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. Evidence was synthesized qualitatively according to modified Scottish Intercollegiate Guidelines Network criteria and prioritized according to design as exploratory or confirmatory. After 77,914 records were screened, 299 articles were found eligible and reviewed; 101 (34%) of these with a low risk of bias were accepted as scientifically admissible, and 4 of these had RTW or employment outcomes. This evidence is preliminary and suggests that most workers RTW within 3 to 6 months after MTBI; MTBI is not a significant risk factor for long-term work disability; and predictors of delayed RTW include a lower level of education (<11y of formal education), nausea or vomiting on hospital admission, extracranial injuries, severe head/bodily pain early after injury, and limited job independence and decision-making latitude. Our findings are based on preliminary evidence with varied patient characteristics and MTBI definitions, thus limiting firm conclusions. More well-designed studies are required to understand RTW and sustained employment after MTBI in the longer term (≥2y post-MTBI). Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Systematic review of prognosis and return to play after sport concussion: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.

PubMed

Cancelliere, Carol; Hincapié, Cesar A; Keightley, Michelle; Godbolt, Alison K; Côté, Pierre; Kristman, Vicki L; Stålnacke, Britt-Marie; Carroll, Linda J; Hung, Ryan; Borg, Jörgen; Nygren-de Boussard, Catharina; Coronado, Victor G; Donovan, James; Cassidy, J David

2014-03-01

To synthesize the best available evidence on prognosis after sport concussion. MEDLINE and other databases were searched (2001-2012) with terms including "craniocerebral trauma" and "sports." Reference lists of eligible articles were also searched. Randomized controlled trials and cohort and case-control studies were selected according to predefined criteria. Studies had to have a minimum of 30 concussion cases. Eligible studies were critically appraised using a modification of the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed and extracted data from accepted studies into evidence tables. Evidence was synthesized qualitatively according to modified SIGN criteria, and studies were categorized as exploratory or confirmatory based on the strength of their design and evidence. After 77,914 records were screened, 52 articles were eligible for this review, and 24 articles (representing 19 studies) with a low risk of bias were accepted. Our findings are based on exploratory studies of predominantly male football players at the high school, collegiate, and professional levels. Most athletes recover within days to a few weeks, and American and Australian professional football players return to play quickly after mild traumatic brain injury. Delayed recovery appears more likely in high school athletes, in those with a history of previous concussion, and in those with a higher number and duration of postconcussion symptoms. The evidence concerning sports concussion course and prognosis is very preliminary, and there is no evidence on the effect of return-to-play guidelines on prognosis. Our findings have implications for further research. Well-designed, confirmatory studies are urgently needed to understand the consequences of sport concussion, including recurrent concussion, across different athletic populations and sports. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Prevalence of Rheumatic Heart Disease in Children and Young Adults in Nicaragua

PubMed Central

Paar, John A.; Berrios, Nubia M.; Rose, John D.; Cáceres, Mercedes; Peña, Rodolfo; Pérez, Wilton; Chen-Mok, Mario; Jolles, Erik; Dale, James B.

2010-01-01

Rheumatic heart disease (RHD) results in morbidity and mortality that is disproportionate among people in developing countries compared to those living in economically developed countries. The global burden of disease is uncertain because most previous studies to determine the prevalence of RHD in children relied on clinical screening criteria that lacked the sensitivity to detect most cases. The present study was performed to determine the prevalence of RHD in children and young adults in León, Nicaragua, an area previously thought to have a high prevalence of RHD. This was an observational study of 3150 children, ages 5–15, and 489 adults, ages 20–35, randomly selected from urban and rural areas of León. Cardiopulmonary exams and echo-Doppler studies were performed on all subjects. Echo-Doppler diagnosis of RHD was based on pre-defined consensus criteria that were developed by a WHO/NIH working group. The overall prevalence of RHD in children was 48/1000 (95% C.I. = 35/1000–60/1000. The prevalence in urban children was 34/1000 and in rural children it was 80/1000. Using more stringent echo-Doppler criteria designed to diagnose definite RHD in adults, the prevalence was 22/1000 (95% C.I.=8/1000–37/1000). In conclusion, the prevalence of RHD among children and adults in this economically disadvantaged population far exceeds previously predicted rates. The findings underscore the potential health and economic burden of acute rheumatic fever and RHD and support the need for more effective measures of prevention, which may include safe, effective and affordable vaccines to prevent the streptococcal infections that trigger the disease. PMID:20538135

Assessment of the Item Selection and Weighting in the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis

PubMed Central

MAHR, ALFRED D.; NEOGI, TUHINA; LAVALLEY, MICHAEL P.; DAVIS, JOHN C.; HOFFMAN, GARY S.; MCCUNE, W. JOSEPH; SPECKS, ULRICH; SPIERA, ROBERT F.; ST.CLAIR, E. WILLIAM; STONE, JOHN H.; MERKEL, PETER A.

2013-01-01

Objective To assess the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG) with respect to its selection and weighting of items. Methods This study used the BVAS/WG data from the Wegener's Granulomatosis Etanercept Trial. The scoring frequencies of the 34 predefined items and any “other” items added by clinicians were calculated. Using linear regression with generalized estimating equations in which the physician global assessment (PGA) of disease activity was the dependent variable, we computed weights for all predefined items. We also created variables for clinical manifestations frequently added as other items, and computed weights for these as well. We searched for the model that included the items and their generated weights yielding an activity score with the highest R2 to predict the PGA. Results We analyzed 2,044 BVAS/WG assessments from 180 patients; 734 assessments were scored during active disease. The highest R2 with the PGA was obtained by scoring WG activity based on the following items: the 25 predefined items rated on ≥5 visits, the 2 newly created fatigue and weight loss variables, the remaining minor other and major other items, and a variable that signified whether new or worse items were present at a specific visit. The weights assigned to the items ranged from 1 to 21. Compared with the original BVAS/WG, this modified score correlated significantly more strongly with the PGA. Conclusion This study suggests possibilities to enhance the item selection and weighting of the BVAS/WG. These changes may increase this instrument's ability to capture the continuum of disease activity in WG. PMID:18512722

Interventions for adults with mild intellectual disabilities and mental ill-health: a systematic review.

PubMed

Osugo, M; Cooper, S-A

2016-06-01

People with intellectual disabilities have very high rates of mental ill health. Standard psychosocial interventions designed for the general population may not be accessible for people with mild intellectual disabilities, and drug usage tends to be modified - 'start low and go slow'. This systematic review aims to synthesise the evidence on psychological, pharmacological and electroconvulsive therapy (ECT) interventions for adults with mild intellectual disabilities and mental ill health. PRISMA guidelines were followed. Medline, Embase, PsycINFO and CINAHL were searched, as was grey literature and reference lists of selected papers. Papers were selected based on pre-defined inclusion and exclusion criteria. A proportion of papers were double reviewed. Data was extracted using a structured table. PROSPERO 2015:CRD42015015218. Initially, 18 949 records were identified. Sixteen studies were finally selected for inclusion; seven on psychological therapies, two on group exercise, five on antipsychotics and two on antidepressants. They do not provide definitive evidence for effectiveness of psychosocial interventions, nor address whether starting low and going slow is wise, or causes sub-optimum therapy. There are few evidence-based interventions for people with mild intellectual disabilities and mental ill-health; existing literature is limited in quantity and quality. Group cognitive-behavioural therapies have some supporting evidence - however, further randomised control trials are required, with longer-term follow-up, and larger sample sizes. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Priority target conditions for algorithms for monitoring children's growth: Interdisciplinary consensus.

PubMed

Scherdel, Pauline; Reynaud, Rachel; Pietrement, Christine; Salaün, Jean-François; Bellaïche, Marc; Arnould, Michel; Chevallier, Bertrand; Piloquet, Hugues; Jobez, Emmanuel; Cheymol, Jacques; Bichara, Emmanuelle; Heude, Barbara; Chalumeau, Martin

2017-01-01

Growth monitoring of apparently healthy children aims at early detection of serious conditions through the use of both clinical expertise and algorithms that define abnormal growth. Optimization of growth monitoring requires standardization of the definition of abnormal growth, and the selection of the priority target conditions is a prerequisite of such standardization. To obtain a consensus about the priority target conditions for algorithms monitoring children's growth. We applied a formal consensus method with a modified version of the RAND/UCLA method, based on three phases (preparatory, literature review, and rating), with the participation of expert advisory groups from the relevant professional medical societies (ranging from primary care providers to hospital subspecialists) as well as parent associations. We asked experts in the pilot (n = 11), reading (n = 8) and rating (n = 60) groups to complete the list of diagnostic classification of the European Society for Paediatric Endocrinology and then to select the conditions meeting the four predefined criteria of an ideal type of priority target condition. Strong agreement was obtained for the 8 conditions selected by the experts among the 133 possible: celiac disease, Crohn disease, craniopharyngioma, juvenile nephronophthisis, Turner syndrome, growth hormone deficiency with pituitary stalk interruption syndrome, infantile cystinosis, and hypothalamic-optochiasmatic astrocytoma (in decreasing order of agreement). This national consensus can be used to evaluate the algorithms currently suggested for growth monitoring. The method used for this national consensus could be re-used to obtain an international consensus.

Decision support for risk prioritisation of environmental health hazards in a UK city.

PubMed

Woods, Mae; Crabbe, Helen; Close, Rebecca; Studden, Mike; Milojevic, Ai; Leonardi, Giovanni; Fletcher, Tony; Chalabi, Zaid

2016-03-08

There is increasing appreciation of the proportion of the health burden that is attributed to modifiable population exposure to environmental health hazards. To manage this avoidable burden in the United Kingdom (UK), government policies and interventions are implemented. In practice, this procedure is interdisciplinary in action and multi-dimensional in context. Here, we demonstrate how Multi Criteria Decision Analysis (MCDA) can be used as a decision support tool to facilitate priority setting for environmental public health interventions within local authorities. We combine modelling and expert elicitation to gather evidence on the impacts and ranking of interventions. To present the methodology, we consider a hypothetical scenario in a UK city. We use MCDA to evaluate and compare the impact of interventions to reduce the health burden associated with four environmental health hazards and rank them in terms of their overall performance across several criteria. For illustrative purposes, we focus on heavy goods vehicle controls to reduce outdoor air pollution, remediation to control levels of indoor radon, carbon monoxide and fitting alarms, and encouraging cycling to target the obesogenic environment. Regional data was included as model evidence to construct a ratings matrix for the city. When MCDA is performed with uniform weights, the intervention of heavy goods vehicle controls to reduce outdoor air pollution is ranked the highest. Cycling and the obesogenic environment is ranked second. We argue that a MCDA based approach provides a framework to guide environmental public health decision makers. This is demonstrated through an online interactive MCDA tool. We conclude that MCDA is a transparent tool that can be used to compare the impact of alternative interventions on a set of pre-defined criteria. In our illustrative example, we ranked the best intervention across the equally weighted selected criteria out of the four alternatives. Further work is needed to test the tool with decision makers and stakeholders.

Suboptimal care and perinatal mortality in ten European regions: methodology and evaluation of an international audit.

PubMed

Richardus, J H; Graafmans, W C; Bergsjø, P; Lloyd, D J; Bakketeig, L S; Bannon, E M; Borkent-Polet, M; Davidson, L L; Defoort, P; Leitão, A Esparteiro; Langhoff-Roos, J; Garcia, A Moral; Papantoniou, N E; Wennergren, M; Amelink-Verburg, M P; Verloove-Vanhorick, S P; Mackenbach, J P

2003-10-01

A European concerted action (the EuroNatal study) investigated differences in perinatal mortality between countries of Europe. This report describes the methods used in the EuroNatal international audit and discusses the validity of the results. Perinatal deaths between 1993 and 1998 in regions of ten European countries were identified. The categories of death chosen for the study were singleton fetal deaths at 28 or more weeks of gestational age, all intrapartum deaths at 28 or more weeks of gestational age and neonatal deaths at 34 or more weeks of gestational age. Deaths with major congenital anomalies were excluded. An international audit panel used explicit criteria to review all cases, which were blinded for region. Subjective interpretation was used in cases of events or interventions where explicit criteria did not exist. Suboptimal factors were identified in the antenatal, intrapartum and neonatal periods, and classified as 'maternal/social', due to 'infrastructure/service organization', or due to 'professional care delivery'. The contribution of each suboptimal factor to the fatal outcome was listed and consensus was reached on a final grade using a procedure that included correspondence and plenary meetings. In all regions combined, 90% of all known or estimated cases in the selected categories were included in the audit. In total, 1619 cases of perinatal death were audited. Consensus was reached in 1543 (95%) cases. In 75% of all cases, the grade was based on explicit criteria. In the remaining cases, consensus was reached within subpanels without reference to predefined criteria. There was reasonable to good agreement between and within subpanels, and within panel members. The international audit procedure proved feasible and led to consistent results. The results that relate to suboptimal care will need to be studied in depth in order to reach conclusions about their implications for assessing the quality of perinatal care in the individual regions.

25 CFR 543.2 - What are the definitions for this part?

Code of Federal Regulations, 2010 CFR

2010-04-01

... II games. Gaming Equipment. All electronic, electro-mechanical, mechanical or other physical... independent audit. Independence is obtained through the organizational reporting relationship, as the internal... that increases by a selectable or predefined amount based on play of a Class II game. Promotional...

Proton Therapy Dose Characterization and Verification

DTIC Science & Technology

2013-10-01

predefined acceptance criteria. The Calypso System accurately localizes LT and LO patients in the IBA proton therapy vault at the University of Pennsylvania...earlier vet>ions of mdioct.’omio 0 lm. Thcrr ’" Jechnkul 1\\Sues ~nd challenge~ tluu mu.~t be ad~ts:led and rrsolvtd pnor lo Ibm nppllculion for do...IOcmatthch«enter) from a Varian l100linc1!r aecdcmtur (llnac) dirr<ltd plll’nllel lo nn EBTI film ~nd wtchtd bCiwttn slit!• of ••.lhd wurcr1 M. The plwuom

Change in Cardiopulmonary Arrest Response in an Anesthesiology Residency: A practice-based learning initiative.

PubMed

Takla, Amgad; Dorotta, Ihab; Staszak, John; Tetzlaff, John E

2007-01-01

Because of increases in the acuity in our patient population, increasing complexity of the care provided and the structure of our residency, we decided to systematically alter our participation in the hospital-wide cardiac arrest system. The need to provide optimum service in an increasingly complex clinical care system was the motivation for change. With substantive input from trainees and practitioners, we created a multi-tier-system of response along with predefined criteria for the anesthesiology response. We report the result of our practice based learning initiative.

Evaluation of a New Grading System for Clinical Skills in Dental Student Clinics.

PubMed

Bodenmann, Aurel D; Bühler, Julia M; Amato, Mauro; Weiger, Ronald; Zitzmann, Nicola U

2017-05-01

Several evaluation systems for clinical exams have been suggested over the years, but no systematic analysis of checklists or criteria-based exam forms has yet been undertaken. The aims of this study were to analyze criteria-based evaluation forms and to identify areas in the teaching process potentially requiring improvements. All evaluation forms introduced in 2012 at the Clinic for Periodontology, Endodontology, and Cariology at the University Center of Dental Medicine in Basel, Switzerland, and applied over a three-year period (n=1,093 in 2015) were analyzed using predefined criteria. The authors investigated how well clinical tasks were examined with the given criteria and which criteria were preferably evaluated with a grading system (0-2) or a yes/no choice. The average final grades ranged from 0.89 (n=92) for gold inlay preparation to 1.76 (n=46) for periodontal treatment. Comments were made in 38.5% (n=356) of all exams, mainly highlighting specific aspects of existing criteria. Overall, 13 criteria out of 66 should be checked instead of graded. This methodological analysis of exam forms assessing tasks in operative dentistry yielded valuable information on areas with potential for improvement in the dental curriculum and the evaluation process. Aspects that require more theoretical background and/or hands-on recommendations from experienced clinicians were identified, and ways of further refining and redesigning the evaluation forms were proposed.

Albumin administration for fluid resuscitation in burn patients: A systematic review and meta-analysis.

PubMed

Eljaiek, Roberto; Heylbroeck, Christophe; Dubois, Marc-Jacques

2017-02-01

The objective was to systematically review the literature summarizing the effect on mortality of albumin compared to non-albumin solutions during the fluid resuscitation phase of burn injured patients. We searched MEDLINE, EMBASE and CENTRAL and the content of two leading journals in burn care, Burns and Journal of Burn Care and Research. Two reviewers independently selected randomized controlled trials comparing albumin vs. non-albumin solutions for the acute resuscitation of patients with >20% body surface area involvement. Reviewers abstracted data independently and assessed methodological quality of the included trials using predefined criteria. A random effects model was used to assess mortality. We identified 164 trials of which, 4 trials involving 140 patients met our inclusion criteria. Overall, the methodological quality of the included trials was fair. We did not find a significant benefit of albumin solutions as resuscitation fluid on mortality in burn patients (relative risk (RR) 1.6; 95% confidence interval (CI), 0.63-4.08). Total volume of fluid infusion during the phase of resuscitation was lower in patients receiving albumin containing solution -1.00ml/kg/%TBSA (total body surface area) (95% CI, -1.42 to -0.58). The pooled estimate demonstrated a neutral effect on mortality in burn patients resuscitated acutely with albumin solutions. Due to limited evidence and uncertainty, an adequately powered, high quality trial could be required to assess the impact of albumin solutions on mortality in burn patients. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

[Invasive fungal infections in children with cancer, neutropenia and fever, in Chile].

PubMed

Lucero, Yalda; Brücher, Roberto; Alvarez, Ana María; Becker, Ana; Cofré, José; Enríquez, Nancy; Payá, Ernesto; Salgado, Carmen; Santolaya, María Elena; Tordecilla, Juan; Varas, Mónica; Villarroel, Milena; Viviani, Tamara; Zubieta, Marcela; O'Ryan, Miguel

2002-10-01

Invasive fungal infections (IFI) cause prolonged hospitalizations and increase the possibility of death among patients with cancer and febrile neutropenia (FN). Up to 10% of febrile neutropenic episodes may be caused by IFI. To estimate the incidence of IFI among a large group of Chilean children with cancer and FN. Clinical and laboratory information was collected from a data base provided by the "Programa Infantil Nacional de Drogas Antineoplásicas" (PINDA) that included 445 FN episodes occurring in five hospitals in Santiago, Chile. This information was used to identify children that presented with signs and symptoms compatible with an IFI. According to predefined criteria based on a literature review, IFI episodes were categorized as "proven", "probable" or "possible". A total of 41/445 episodes (9.2%) were compatible with an IFI of which 4 (0.9%) were proven, 23 (5.2%) probable, and 14 (3.1%) possible. Hospitalization was longer (27 vs 8 days, p < .01), new infectious foci appeared with higher frequency (71 vs 38%, p < .01), and mortality was higher (10 vs 1.6%, p < .001) in children with IFI compatible episodes, when compared to children who did not have an IFI. The estimated incidence of IFI in Chilean children with cancer and FN ranged between 6-9% depending on the stringency of criteria selection used for classification. This estimate is similar to that reported by other studies. The low detection yield of clinically compatible IFI underscores the need of improved diagnosis of fungal infections in this population.

Root resorption of endodontically treated teeth following orthodontic treatment: a meta-analysis.

PubMed

Ioannidou-Marathiotou, Ioulia; Zafeiriadis, Anastasios A; Papadopoulos, Moschos A

2013-09-01

The aim of this meta-analysis was to investigate the effect of orthodontic treatment on root resorption of endodontically treated teeth compared to vital teeth. A literature search was conducted in 18 electronic databases. Review articles and relevant articles were searched for cross-references. Two independent reviewers screened all articles according to predefined inclusion and exclusion criteria and extracted the corresponding data. The pooled estimate of mean difference of root resorption weighted by the fixed-effect model and the corresponding 95 % confidence intervals (CIs) were used to construct a forest plot by implementing the "RevMan 5.1" software. Quality and heterogeneity assessments as well as publication bias evaluation and sensitivity analyses were performed. Inter-reviewer agreement for data selection, data extraction and quality analysis was evaluated by Cohen's kappa. Six out of 1,942 original papers met the inclusion criteria. Four out of six studies were included in the quantitative analysis. Root resorption was less in endodontically treated teeth than in vital teeth (MD = -0.48 mm; 95 % CI = -0.81 to -0.14 mm). The funnel plot indicated no evidence of publication bias, while no data heterogeneity was present (I(2) = 0 %). However, the overall quality of the included studies was considered as "low." Following orthodontic treatment, endodontically treated teeth exhibit relatively less root resorption than teeth with vital pulps. Clinicians should consider orthodontic movement of endodontically treated teeth as a relatively safe clinical procedure.

Datalist: A Value Added Service to Enable Easy Data Selection

NASA Technical Reports Server (NTRS)

Li, Angela; Hegde, Mahabaleshwa; Bryant, Keith; Seiler, Edward; Shie, Chung-Lin; Teng, William; Liu, Zhong; Hearty, Thomas; Shen, Suhung; Kempler, Steven;

Systematic review of the literature and evidence-based recommendations for antibiotic prophylaxis in trauma: results from an Italian consensus of experts.

PubMed

Poole, Daniele; Chieregato, Arturo; Langer, Martin; Viaggi, Bruno; Cingolani, Emiliano; Malacarne, Paolo; Mengoli, Francesca; Nardi, Giuseppe; Nascimben, Ennio; Riccioni, Luigi; Turriziani, Ilaria; Volpi, Annalisa; Coniglio, Carlo; Gordini, Giovanni

2014-01-01

Antibiotic prophylaxis is frequently administered in severe trauma. However, the risk of selecting resistant bacteria, a major issue especially in critical care environments, has not been sufficiently investigated. The aim of the present study was to provide guidelines for antibiotic prophylaxis for four different trauma-related clinical conditions, taking into account the risks of antibiotic-resistant bacteria selection, thus innovating previous guidelines in the field. The MEDLINE database was searched for studies comparing antibiotic prophylaxis to controls (placebo or no antibiotic administration) in four clinical traumatic conditions that were selected on the basis of the traumatic event frequency and/or infection severity. The selected studies focused on the prevention of early ventilator associated pneumonia (VAP) in comatose patients with traumatic brain injury, of meningitis in severe basilar skull fractures, of wound infections in long-bone open fractures. Since no placebo-controlled study was available for deep surgical site-infections prevention in abdominal trauma with enteric contamination, we compared 24-hour and 5-day antibiotic prophylaxis policies. A separate specific research focused on the question of antibiotic-resistant bacteria selection caused by antibiotic prophylaxis, an issue not adequately investigated by the selected studies. Randomised trials, reviews, meta-analyses, observational studies were included. Data extraction was carried out by one author according to a predefined protocol, using an electronic form. The strength of evidence was stratified and recommendations were given according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Uncertain evidence deserving further studies was found for two-dose antibiotic prophylaxis for early VAP prevention in comatose patients. In the other cases the risk of resistant-bacteria selection caused by antibiotic administration for 48 hours or more, outweighed potential benefits. When accounting for antibiotic-resistant bacteria selection we found no evidence in favour of antibiotic prophylaxis lasting two or more days in the studied clinical conditions.

Recording and assessment of evoked potentials with electrode arrays.

PubMed

Miljković, N; Malešević, N; Kojić, V; Bijelić, G; Keller, T; Popović, D B

2015-09-01

In order to optimize procedure for the assessment of evoked potentials and to provide visualization of the flow of action potentials along the motor systems, we introduced array electrodes for stimulation and recording and developed software for the analysis of the recordings. The system uses a stimulator connected to an electrode array for the generation of evoked potentials, an electrode array connected to the amplifier, A/D converter and computer for the recording of evoked potentials, and a dedicated software application. The method has been tested for the assessment of the H-reflex on the triceps surae muscle in six healthy humans. The electrode array with 16 pads was positioned over the posterior aspect of the thigh, while the recording electrode array with 16 pads was positioned over the triceps surae muscle. The stimulator activated all the pads of the stimulation electrode array asynchronously, while the signals were recorded continuously at all the recording sites. The results are topography maps (spatial distribution of evoked potentials) and matrices (spatial visualization of nerve excitability). The software allows the automatic selection of the lowest stimulation intensity to achieve maximal H-reflex amplitude and selection of the recording/stimulation pads according to predefined criteria. The analysis of results shows that the method provides rich information compared with the conventional recording of the H-reflex with regard the spatial distribution.

Effects of Psychosocial Interventions for School-aged Children's Internet Addiction, Self-control and Self-esteem: Meta-Analysis

PubMed Central

Yeun, Young Ran

2016-01-01

Objectives This study was conducted to perform an effect size analysis of psychosocial interventions for internet addiction and to identify the intervention moderators applied to school-aged children. Methods For the meta-analysis, studies were included that were published in English or Korean until January 2015, without limitation in terms of the year. They were retrieved from 11 electronic databases and by manual searches according to predefined inclusion criteria. Results A total of 37 studies were selected, which included 11 treatment conditions and covered a total of 1,490 participants. The effect size estimates showed that psychosocial interventions had a large effect for reducing internet addiction (standardized mean difference [SMD], –1.19; 95% confidence interval [CI], –1.52 to –0.87) and improving self-control (SMD, 0.29; 95% CI, 0.11 to 0.47) and self-esteem (mean difference, 3.58; 95% CI, 2.03 to 5.12). The moderator analyses reveals that group treatments, a selective approach, a long duration, a community setting, or higher school grade had a larger effect. Conclusions The findings of this review suggest that psychosocial intervention may be used to prevent Internet addiction in school-aged children, although further research should be conducted using a randomized controlled trial design or diverse age groups to provide evidence-based recommendations. PMID:27525163

[Screening of adverse childhood experiences in preschoolers: scoping review].

PubMed

Vega-Arce, Maribel; Núñez-Ulloa, Gastón

The aim of the present article was to describe available scientific publications detailing strategies and screening tools for Adverse Childhood Experiences in preschoolers (2 to 5 years of age). A scoping review of the topic was carried out through investigative articles published in peer review journals from January 1998 to June 2017 and indexed in seven international databases (Cochrane Library, EBSCO, PubMed, Science Direct, Springer, Web of Science and Scielo). The articles were selected based on predefined criteria, using limiters and manual screening. Twenty articles published between 1999 and 2017 were selected. The screening of adverse childhood experiences is performed through opportunistic recruitment in a professional context aimed at caregivers and children, which integrates training actions, application of screening tools and reception of identified cases. Screening tools differ between interviews and questionnaires. Furthermore, we report the periodicity of the screening, the behaviors and beliefs of the professionals against it and the barriers to its implementation. This review confirms that the screening of Adverse Childhood Experiences is an emerging topic in the research field. We emphasize the need to systematize and evaluate the strategies and tools for screening Adverse Childhood Experiences, as well as to develop local approaches to respond to the needs of children exposed to adversity. Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Balancing Participation across Students in Large College Classes via Randomized Participation Credit

ERIC Educational Resources Information Center

McCleary, Daniel F.; Aspiranti, Kathleen B.; Foster, Lisa N.; Blondin, Carolyn A.; Gaylon, Charles E.; Yaw, Jared S.; Forbes, Bethany N.; Williams, Robert L.

2011-01-01

The study examines the effects of randomized credit on the percentage of students participating at four predefined levels. Students recorded their comments on specially designed record cards, and days were randomly selected for participation credit. This arrangement balanced participation across students while cutting instructor time for recording…

Novel surgical performance evaluation approximates Standardized Incidence Ratio with high accuracy at simple means.

PubMed

Gabbay, Itay E; Gabbay, Uri

2013-01-01

Excess adverse events may be attributable to poor surgical performance but also to case-mix, which is controlled through the Standardized Incidence Ratio (SIR). SIR calculations can be complicated, resource consuming, and unfeasible in some settings. This article suggests a novel method for SIR approximation. In order to evaluate a potential SIR surrogate measure we predefined acceptance criteria. We developed a new measure - Approximate Risk Index (ARI). "Number Needed for Event" (NNE) is the theoretical number of patients needed "to produce" one adverse event. ARI is defined as the quotient of the group of patients needed for no observed events Ge by total patients treated Ga. Our evaluation compared 2500 surgical units and over 3 million heterogeneous risk surgical patients that were induced through a computerized simulation. Surgical unit's data were computed for SIR and ARI to evaluate compliance with the predefined criteria. Approximation was evaluated by correlation analysis and performance prediction capability by Receiver Operating Characteristics (ROC) analysis. ARI strongly correlates with SIR (r(2) = 0.87, p < 0.05). ARI prediction of excessive risk revealed excellent ROC (Area Under the Curve > 0.9) 87% sensitivity and 91% specificity. ARI provides good approximation of SIR and excellent prediction capability. ARI is simple and cost-effective as it requires thorough risk evaluation of only the adverse events patients. ARI can provide a crucial screening and performance evaluation quality control tool. The ARI method may suit other clinical and epidemiological settings where relatively small fraction of the entire population is affected. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Application of a policy framework for the public funding of drugs for rare diseases.

PubMed

Winquist, Eric; Coyle, Doug; Clarke, Joe T R; Evans, Gerald A; Seager, Christine; Chan, Winnie; Martin, Janet

2014-08-01

In many countries, decisions about the public funding of drugs are preferentially based on the results of randomized trials. For truly rare diseases, such trials are not typically available, and approaches by public payers are highly variable. In view of this, a policy framework intended to fairly evaluate these drugs was developed by the Drugs for Rare Diseases Working Group (DRDWG) at the request of the Ontario Public Drug Programs. To report the initial experience of applying a novel evaluation framework to funding applications for drugs for rare diseases. Retrospective observational cohort study. Clinical effectiveness, costs, funding recommendations, funding approval. Between March 2008 and February 2013, eight drugs were evaluated using the DRDWG framework. The estimated average annual drug cost per patient ranged from 28,000 to 1,200,000 Canadian dollars (CAD). For five drugs, full evaluations were completed, specific funding recommendations were made by the DRDWG, and funding was approved after risk-sharing agreements with the manufacturers were negotiated. For two drugs, the disease indications were determined to be ineligible for consideration. For one drug, there was insufficient natural history data for the disease to provide a basis for recommendation. For the five drugs fully evaluated, 32 patients met the predefined eligibility criteria for funding, and five were denied based on predefined exclusion criteria. The framework improved transparency and consistency for evaluation and public funding of drugs for rare diseases in Ontario. The evaluation process will continue to be iteratively refined as feedback on actual versus expected clinical and economic outcomes is incorporated.

Quality and readability of online patient information regarding sclerotherapy for venous malformations.

PubMed

Pass, Jonathan H; Patel, Amani H; Stuart, Sam; Barnacle, Alex M; Patel, Premal A

2018-05-01

Patients often use the internet as a source of information about their condition and treatments. However, this information is unregulated and varies in quality. To evaluate the readability and quality of online information for pediatric and adult patients and caregivers regarding sclerotherapy for venous malformations. "Venous malformation sclerotherapy" was entered into Google, and results were reviewed until 20 sites that satisfied predefined inclusion criteria were identified. Scientific and non-patient-focused web pages were excluded. Readability was assessed using the Flesch Reading Ease Score and American Medical Association reading difficulty recommendations and quality was assessed using Journal of the American Medical Association standards and assessing if the site displayed HONcode (Health on the Net Code) certification. Assessment of the breadth of relevant information was made using a predefined checklist. Forty-nine search engine results were reviewed before 20 sites were identified for analysis. Average Flesch Reading Ease Score was 44 (range: 24.2-70.1), representing a "fairly difficult" reading level. None of the sites had a Flesch Reading Ease Score meeting the American Medical Association recommendation of 80-90. Only one site met all four Journal of the American Medical Association quality criteria (average: 2.1). None of the sites displayed a HONcode seal. The information most frequently found was: sclerotherapy is performed by radiologists, multiple treatments may be needed and surgery is an alternative treatment. Online information regarding sclerotherapy for venous malformations is heterogeneous in quality and breadth of information, and does not meet readability recommendations for patient information. Radiologists should be aware of and account for this when meeting patients.

Integration of oncology and palliative care: setting a benchmark.

PubMed

Vayne-Bossert, P; Richard, E; Good, P; Sullivan, K; Hardy, J R

2017-10-01

Integration of oncology and palliative care (PC) should be the standard model of care for patients with advanced cancer. An expert panel developed criteria that constitute integration. This study determined whether the PC service within this Health Service, which is considered to be fully "integrated", could be benchmarked against these criteria. A survey was undertaken to determine the perceived level of integration of oncology and palliative care by all health care professionals (HCPs) within our cancer centre. An objective determination of integration was obtained from chart reviews of deceased patients. Integration was defined as >70% of all respondents answered "agree" or "strongly agree" to each indicator and >70% of patient charts supported each criteria. Thirty-four HCPs participated in the survey (response rate 69%). Over 90% were aware of the outpatient PC clinic, interdisciplinary and consultation team, PC senior leadership, and the acceptance of concurrent anticancer therapy. None of the other criteria met the 70% agreement mark but many respondents lacked the necessary knowledge to respond. The chart review included 67 patients, 92% of whom were seen by the PC team prior to death. The median time from referral to death was 103 days (range 0-1347). The level of agreement across all criteria was below our predefined definition of integration. The integration criteria relating to service delivery are medically focused and do not lend themselves to interdisciplinary review. The objective criteria can be audited and serve both as a benchmark and a basis for improvement activities.

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 .

Distractor Interference during Smooth Pursuit Eye Movements

ERIC Educational Resources Information Center

Spering, Miriam; Gegenfurtner, Karl R.; Kerzel, Dirk

2006-01-01

When 2 targets for pursuit eye movements move in different directions, the eye velocity follows the vector average (S. G. Lisberger & V. P. Ferrera, 1997). The present study investigates the mechanisms of target selection when observers are instructed to follow a predefined horizontal target and to ignore a moving distractor stimulus. Results show…

Method for the separation of high impact polystyrene (HIPS) and acrylonitrile butadiene styrene (ABS) plastics

DOEpatents

Jody, Bassam J.; Arman, Bayram; Karvelas, Dimitrios E.; Pomykala, Jr., Joseph A.; Daniels, Edward J.

1997-01-01

An improved method is provided for separating acrylonitrile butadiene styrene (ABS) and high impact polystyrene (HIPS) plastics from each other. The ABS and HIPS plastics are shredded to provide a selected particle size. The shredded particles of the ABS and HIPS plastics are applied to a solution having a solution density in a predefined range between 1.055 gm/cm.sup.3 and 1.07 gm/cm.sup.3, a predefined surface tension in a range between 22 dynes/cm to 40 dynes/cm and a pH in the range of 1.77 and 2.05. In accordance with a feature of the invention, the novel method is provided for separating ABS and HIPS, two solid thermoplastics which have similar densities by selectively modifying the effective density of the HIPS using a binary solution with the appropriate properties, such as pH, density and surface tension, such as a solution of acetic acid and water or a quaternary solution having the appropriate density, surface tension, and pH.

Procedure of Partitioning Data Into Number of Data Sets or Data Group - A Review

NASA Astrophysics Data System (ADS)

Kim, Tai-Hoon

The goal of clustering is to decompose a dataset into similar groups based on a objective function. Some already well established clustering algorithms are there for data clustering. Objective of these data clustering algorithms are to divide the data points of the feature space into a number of groups (or classes) so that a predefined set of criteria are satisfied. The article considers the comparative study about the effectiveness and efficiency of traditional data clustering algorithms. For evaluating the performance of the clustering algorithms, Minkowski score is used here for different data sets.

Development of an automated processing and screening system for the space shuttle orbiter flight test data

NASA Technical Reports Server (NTRS)

Mccutchen, D. K.; Brose, J. F.; Palm, W. E.

1982-01-01

One nemesis of the structural dynamist is the tedious task of reviewing large quantities of data. This data, obtained from various types of instrumentation, may be represented by oscillogram records, root-mean-squared (rms) time histories, power spectral densities, shock spectra, 1/3 octave band analyses, and various statistical distributions. In an attempt to reduce the laborious task of manually reviewing all of the space shuttle orbiter wideband frequency-modulated (FM) analog data, an automated processing system was developed to perform the screening process based upon predefined or predicted threshold criteria.

Patient-reported outcome measures in burning mouth syndrome - a review of the literature.

PubMed

Ni Riordain, R; McCreary, C

2013-04-01

Oral Diseases (2013) 19, 230-235 This review aims to investigate the patient-reported outcomes currently used in the burning mouth syndrome literature and to explore whether any standardisation of such measures has taken place. Electronic databases were searched for all types of burning mouth syndrome studies using patient-reported outcome measures. Studies were selected by predefined inclusion criteria. Copies of the papers obtained were thoroughly reviewed. A study-specific data extraction form was used, allowing papers to be reviewed in a standardised manner. The initial literature search yielded a total of 173 citations, 43 of which were deemed suitable for inclusion in this study. Symptom severity and symptomatic relief were reported as a patient-reported outcome measure in 40 of the studies and quantified most commonly using a visual analogue scale. Quality of life was reported in 13 studies included in this review. Depression and/or anxiety was reported in 14 of the studies. As is evident from the variety of questionnaires and instruments used in the evaluation of the impact of burning mouth syndrome on patients' lives, no standardisation of patient outcomes has yet been achieved. © 2012 John Wiley & Sons A/S.

Dignity under threat? A study of the experiences of older people in the United Kingdom.

PubMed

Calnan, Michael; Badcott, David; Woolhead, Gillian

2006-01-01

Theoretical accounts have offered a general understanding of the social significance and importance of dignity and suggest that older age may threaten dignity by structuring and limiting the opportunities for participation and/or social recognition. Micro-sociological research has shown how older people negotiate their identity, in the face of its erosion by the aging body and disability and the domination of health and social care workers. These theoretical approaches inform the study presented here, which explores the meaning and experience of dignity for older people in their daily lives. Older people's accounts were elicited through a series of focus groups with participants living in England and Wales. Participants were selected according to predefined criteria to represent a range of different socio-economic and ethnic backgrounds, levels of fitness, and home circumstances. Personal identity and autonomy were the aspects of dignity most meaningful to the participants, and discussions tended to focus mainly on when personal identity and autonomy were threatened or violated in the context of the provision of health and social care. The authors discuss the extent to which older people's discourse on dignity resonates with the theoretical discourse.

Comprehensive Adolescent Health Programs That Include Sexual and Reproductive Health Services: A Systematic Review

PubMed Central

Parekh, Jenita; Tunçalp, Özge; Turke, Shani; Blum, Robert William

2014-01-01

We systematically reviewed peer-reviewed and gray literature on comprehensive adolescent health (CAH) programs (1998–2013), including sexual and reproductive health services. We screened 36 119 records and extracted articles using predefined criteria. We synthesized data into descriptive characteristics and assessed quality by evidence level. We extracted data on 46 programs, of which 19 were defined as comprehensive. Ten met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia, and Mexico. Three programs displayed rigorous evidence; 5 had strong and 2 had modest evidence. Those with rigorous or strong evidence directly or indirectly influenced adolescent sexual and reproductive health. The long-term impact of many CAH programs cannot be proven because of insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects. PMID:25320876

Evaluation Studies of Robotic Rollators by the User Perspective: A Systematic Review.

PubMed

Werner, Christian; Ullrich, Phoebe; Geravand, Milad; Peer, Angelika; Hauer, Klaus

2016-01-01

Robotic rollators enhance the basic functions of established devices by technically advanced physical, cognitive, or sensory support to increase autonomy in persons with severe impairment. In the evaluation of such ambient assisted living solutions, both the technical and user perspectives are important to prove usability, effectiveness and safety, and to ensure adequate device application. The aim of this systematic review is to summarize the methodology of studies evaluating robotic rollators with focus on the user perspective and to give recommendations for future evaluation studies. A systematic literature search up to December 31, 2014, was conducted based on the Cochrane Review methodology using the electronic databases PubMed and IEEE Xplore. Articles were selected according to the following inclusion criteria: evaluation studies of robotic rollators documenting human-robot interaction, no case reports, published in English language. Twenty-eight studies were identified that met the predefined inclusion criteria. Large heterogeneity in the definitions of the target user group, study populations, study designs and assessment methods was found across the included studies. No generic methodology to evaluate robotic rollators could be identified. We found major methodological shortcomings related to insufficient sample descriptions and sample sizes, and lack of appropriate, standardized and validated assessment methods. Long-term use in habitual environment was also not evaluated. Apart from the heterogeneity, methodological deficits in most of the identified studies became apparent. Recommendations for future evaluation studies include: clear definition of target user group, adequate selection of subjects, inclusion of other assistive mobility devices for comparison, evaluation of the habitual use of advanced prototypes, adequate assessment strategy with established, standardized and validated methods, and statistical analysis of study results. Assessment strategies may additionally focus on specific functionalities of the robotic rollators allowing an individually tailored assessment of innovative features to document their added value. © 2016 S. Karger AG, Basel.

Ascertainment of acute liver injury in two European primary care databases.

PubMed

Ruigómez, A; Brauer, R; Rodríguez, L A García; Huerta, C; Requena, G; Gil, M; de Abajo, Francisco; Downey, G; Bate, A; Tepie, M Feudjo; de Groot, M; Schlienger, R; Reynolds, R; Klungel, O

2014-10-01

The purpose of this study was to ascertain acute liver injury (ALI) in primary care databases using different computer algorithms. The aim of this investigation was to study and compare the incidence of ALI in different primary care databases and using different definitions of ALI. The Clinical Practice Research Datalink (CPRD) in UK and the Spanish "Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria" (BIFAP) were used. Both are primary care databases from which we selected individuals of all ages registered between January 2004 and December 2009. We developed two case definitions of idiopathic ALI using computer algorithms: (i) restrictive definition (definite cases) and (ii) broad definition (definite and probable cases). Patients presenting prior liver conditions were excluded. Manual review of potential cases was performed to confirm diagnosis, in a sample in CPRD (21%) and all potential cases in BIFAP. Incidence rates of ALI by age, sex and calendar year were calculated. In BIFAP, all cases considered definite after manual review had been detected with the computer algorithm as potential cases, and none came from the non-cases group. The restrictive definition of ALI had a low sensitivity but a very high specificity (95% in BIFAP) and showed higher rates of agreement between computer search and manual review compared to the broad definition. Higher incidence rates of definite ALI in 2008 were observed in BIFAP (3.01 (95% confidence interval (CI) 2.13-4.25) per 100,000 person-years than CPRD (1.35 (95% CI 1.03-1.78)). This study shows that it is feasible to identify ALI cases if restrictive selection criteria are used and the possibility to review additional information to rule out differential diagnoses. Our results confirm that idiopathic ALI is a very rare disease in the general population. Finally, the construction of a standard definition with predefined criteria facilitates the timely comparison across databases.

Management of primary Sjögren’s syndrome: recent developments and new classification criteria

PubMed Central

Del Papa, Nicoletta; Vitali, Claudio

2018-01-01

For many years primary Sjögren’s syndrome (pSS) has been considered an orphan disease, since no specific therapies were recognized as being capable of contrasting the development and progression of this disorder. The treatment of oral and ocular features, as well as of the systemic organ involvement, has been entrusted to the joint management of different subspecialty physicians, like ophthalmologists, otolaryngologists, dentists and rheumatologists. These latter subspecialty doctors are usually more involved in the treatment of systemic extraglandular involvement and, to do it, they have long been using the conventional therapies borrowed by the treatment schedules adopted in other systemic autoimmune diseases. The increasing knowledge of the biological pathways that are operative in patients with pSS, and the parallel development of molecular biology technology, have allowed the production and availability of a number of biological agents able to positively act on different disease mechanisms, and thus are candidates for testing in therapeutic trials. Meanwhile, the scientific community has made a great effort to develop new accurate and validated classification criteria and outcome measures to be applied in the selection of patients to be included and monitored in therapeutic studies. Some of the new-generation biotechnological agents have been tested in a number of open-label and randomized controlled trials that have produced in many cases inconclusive or contradictory results. Behind the differences in trial protocols, adopted outcome measures and predefined endpoints, reasons for such unsatisfactory results can be found in the large heterogeneity of clinical subtypes in the examined cohorts. The future challenge for a substantial advancement in the therapeutic approach to pSS could be to identify the pathologic mechanisms, outcome tools and biomarkers that characterize the different subsets of the disease in order to test carefully selected target therapies with the highest probability of success in each different clinical phenotype. PMID:29387177

The Impact of System Factors on Quality and Safety in Arterial Surgery: A Systematic Review.

PubMed

Lear, R; Godfrey, A D; Riga, C; Norton, C; Vincent, C; Bicknell, C D

2017-07-01

A systems approach to patient safety proposes that a wide range of factors contribute to surgical outcome, yet the impact of team, work environment, and organisational factors, is not fully understood in arterial surgery. The aim of this systematic review is to summarize and discuss what is already known about the impact of system factors on quality and safety in arterial surgery. A systematic review of original research papers in English using MEDLINE, Embase, PsycINFO, and Cochrane databases, was performed according to PRISMA guidelines. Independent reviewers selected papers according to strict inclusion and exclusion criteria, and using predefined data fields, extracted relevant data on team, work environment, and organisational factors, and measures of quality and/or safety, in arterial procedures. Twelve papers met the selection criteria. Study endpoints were not consistent between papers, and most failed to report their clinical significance. A variety of tools were used to measure team skills in five papers; only one paper measured the relationship between team factors and patient outcomes. Two papers reported that equipment failures were common and had a significant impact on operating room efficiency. The influence of hospital characteristics on failure-to-rescue rates was tested in one large study, although their conclusions were limited to the American Medicare population. Five papers implemented changes in the patient pathway, but most studies failed to account for potential confounding variables. A small number of heterogenous studies have evaluated the relationship between system factors and quality or safety in arterial surgery. There is some evidence of an association between system factors and patient outcomes, but there is more work to be done to fully understand this relationship. Future research would benefit from consistency in definitions, the use of validated assessment tools, measurement of clinically relevant endpoints, and adherence to national reporting guidelines. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Selective advantage of implementing optimal contributions selection and timescales for the convergence of long-term genetic contributions.

PubMed

Howard, David M; Pong-Wong, Ricardo; Knap, Pieter W; Kremer, Valentin D; Woolliams, John A

2018-05-10

Optimal contributions selection (OCS) provides animal breeders with a framework for maximising genetic gain for a predefined rate of inbreeding. Simulation studies have indicated that the source of the selective advantage of OCS is derived from breeding decisions being more closely aligned with estimates of Mendelian sampling terms ([Formula: see text]) of selection candidates, rather than estimated breeding values (EBV). This study represents the first attempt to assess the source of the selective advantage provided by OCS using a commercial pig population and by testing three hypotheses: (1) OCS places more emphasis on [Formula: see text] compared to EBV for determining which animals were selected as parents, (2) OCS places more emphasis on [Formula: see text] compared to EBV for determining which of those parents were selected to make a long-term genetic contribution (r), and (3) OCS places more emphasis on [Formula: see text] compared to EBV for determining the magnitude of r. The population studied also provided an opportunity to investigate the convergence of r over time. Selection intensity limited the number of males available for analysis, but females provided some evidence that the selective advantage derived from applying an OCS algorithm resulted from greater weighting being placed on [Formula: see text] during the process of decision-making. Male r were found to converge initially at a faster rate than female r, with approximately 90% convergence achieved within seven generations across both sexes. This study of commercial data provides some support to results from theoretical and simulation studies that the source of selective advantage from OCS comes from [Formula: see text]. The implication that genomic selection (GS) improves estimation of [Formula: see text] should allow for even greater genetic gains for a predefined rate of inbreeding, once the synergistic benefits of combining OCS and GS are realised.

A Meta-Analysis of Studies of Treatments for Feline Urine Spraying

PubMed Central

Mills, Daniel S.; Redgate, Sarah E.; Landsberg, Gary M.

2011-01-01

Feline urine spraying inside the home is a common problem behaviour that owners seek advice for from veterinarians. Individual trials relating to a variety of interventions produce variable results, and to date, no consensus on the value of different treatments has emerged. This study therefore aimed to meta-analyse, current data from appropriate published clinical trials that evaluate treatments for feline urine spraying. Inclusion and exclusion criteria for study selection were predefined and methodological quality was assessed by two independent reviewers. Ten studies in nine publications that either evaluated pharmacotherapy or pheromonatherapy (the use of a synthetic analogue of the F3 facial fraction in the cat) were suitable for analysis. There was a significant (P<0.001) association between the use of any intervention and the number of cats that ceased or reduced urine spraying by at least 90%. Analysis by intervention type indicated that fluoxetine, clomipramine and pheromonatherapy may each assist in managing urine spraying beyond a placebo based intervention. This is the first time meta-analytical techniques have been used and reported to evaluate the efficacy of interventions used in veterinary behavioural medicine, and it has established confidence in the value of both conventional treatments (pharmacotherapy) and a more recently developed treatment modality (pheromonatherapy) as an adjunct to the management of this problem. It is suggested that future research into treatment efficacy for this problem uses the benchmark standard of randomised, controlled trials lasting for at least 8 weeks, with the outcome criteria of cessation of feline urine spraying or reduction by at least 90%. PMID:21525994

Non-Adherence in Patients on Peritoneal Dialysis: A Systematic Review

PubMed Central

Griva, Konstadina; Lai, Alden Yuanhong; Lim, Haikel Asyraf; Yu, Zhenli; Foo, Marjorie Wai Yin; Newman, Stanton P.

2014-01-01

Background It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). Methods A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. Results The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6–53% for dialysis exchanges, 3.9–85% for medication, and 14.4–67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. Conclusion Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population. PMID:24586478

The potential role of taxes and subsidies on food in the prevention of obesity in Europe.

PubMed

González-Zapata, Laura Inés; Alvarez-Dardet, Carlos; Millstone, Erik; Clemente-Gómez, Vicente; Holdsworth, Michelle; Ortiz-Moncada, Rocio; Lobstein, Tim; Sarri, Katerina; De Marchi, Bruna; Horvath, Katalin Z

2010-08-01

Obesity implies costs not only for the individual but also for society. The authors explore the opinions of stakeholders on the potential of taxes or subsidies, as measures for tackling obesity in Europe. Structured interviews were conducted using Multicriteria Mapping, a computer-based, decision-support tool, with 189 interviewees drawn from 21 different stakeholder categories across nine members of the EU interviews, to appraise 20 predefined policy options aimed at reducing obesity, including 'taxing obesity-promoting foods' and 'subsidising healthy foods.' A four-step approach involved selecting options, defining criteria, scoring options quantitatively and weighting criteria to provide overall rankings of options. Interviews were recorded and transcribed to yield qualitative data. Compared with other policy options appraised, taxation and subsidies were not favourably received, mainly because they were considered difficult to implement. Overall, trade unions rated both options more favourably than all other stakeholder groups. As anticipated, both options received their lowest scores from representatives of the farming, food processing and advertising industries. Nutritional/obesity advisory experts and public sector caterers gave the most positive ratings to subsidies overall. Along with public health professionals, large commercial retailers were most in favour of taxation. Taxation and subsidies were poorly appraised compared with other policy measures, with stakeholders expressing reservations mainly focussed on the practicalities and cost of introducing such measures. Although applying taxes/subsidies could be useful to combat obesity, the study suggests that most stakeholders still need to be convinced of their viability and acceptability when compared with other measures.

Commercial gaming devices for stroke upper limb rehabilitation: a systematic review.

PubMed

Thomson, Katie; Pollock, Alex; Bugge, Carol; Brady, Marian

2014-06-01

Rehabilitation using commercial gaming devices is a new concept for stroke care. Commercial gaming devices such as Nintendo Wii or Sony PlayStation encourage high repetition of arm movements and are being introduced into some clinical settings. The evidence base for gaming use in rehabilitation is growing rapidly and there is a need to systematically synthesise research. Our review aims to integrate evidence on how gaming is being used, explore patient/therapist experience and synthesise evidence of effectiveness. An integrative systematic review was undertaken searching Cochrane Central Register of Controlled Trials (2013), Medline (2013), Embase (2013) and twelve additional databases. Two review authors independently selected studies based on pre-defined inclusion criteria, extracted data and assessed risk of bias. Nineteen studies including 215 patients met inclusion criteria. Studies were typically small scale feasibility studies using a range of research designs, limiting the ability to reach generalised conclusions. Results have been tabulated (activities of daily living, upper limb function/ movement) and qualitative themes identified. Findings suggest that most patients enjoy using commercial gaming and can tolerate 180 mins per week without significant adverse effects. A trend towards improvement was noted for upper limb function/ movement. Few studies recorded outcomes related to activities of daily living or focused on understanding patients' experiences of this intervention. Commercial gaming can provide high intensity upper limb practice however there is insufficient high quality evidence to reach generalisable conclusions about risks or benefits on activities of daily living or upper limb function/movement. © 2014 The Authors. International Journal of Stroke © 2014 World Stroke Organization.

An application of PSO algorithm for multi-criteria geometry optimization of printed low-pass filters based on conductive periodic structures

NASA Astrophysics Data System (ADS)

Steckiewicz, Adam; Butrylo, Boguslaw

2017-08-01

In this paper we discussed the results of a multi-criteria optimization scheme as well as numerical calculations of periodic conductive structures with selected geometry. Thin printed structures embedded on a flexible dielectric substrate may be applied as simple, cheap, passive low-pass filters with an adjustable cutoff frequency in low (up to 1 MHz) radio frequency range. The analysis of an electromagnetic phenomena in presented structures was realized on the basis of a three-dimensional numerical model of three proposed geometries of periodic elements. The finite element method (FEM) was used to obtain a solution of an electromagnetic harmonic field. Equivalent lumped electrical parameters of printed cells obtained in such manner determine the shape of an amplitude transmission characteristic of a low-pass filter. A nonlinear influence of a printed cell geometry on equivalent parameters of cells electric model, makes it difficult to find the desired optimal solution. Therefore an optimization problem of optimal cell geometry estimation with regard to an approximation of the determined amplitude transmission characteristic with an adjusted cutoff frequency, was obtained by the particle swarm optimization (PSO) algorithm. A dynamically suitable inertia factor was also introduced into the algorithm to improve a convergence to a global extremity of a multimodal objective function. Numerical results as well as PSO simulation results were characterized in terms of approximation accuracy of predefined amplitude characteristics in a pass-band, stop-band and cutoff frequency. Three geometries of varying degrees of complexity were considered and their use in signal processing systems was evaluated.

Cholinesterase inhibitors for patients with Alzheimer's disease: systematic review of randomised clinical trials

PubMed Central

Kaduszkiewicz, Hanna; Zimmermann, Thomas; Beck-Bornholdt, Hans-Peter; van den Bussche, Hendrik

2005-01-01

Objectives Pharmacological treatment of Alzheimer's disease focuses on correcting the cholinergic deficiency in the central nervous system with cholinesterase inhibitors. Three cholinesterase inhibitors are currently recommended: donepezil, rivastigmine, and galantamine. This review assessed the scientific evidence for the recommendation of these agents. Data sources The terms “donepezil”, “rivastigmine”, and “galantamine”, limited by “randomized-controlled-trials” were searched in Medline (1989-November 2004), Embase (1989-November 2004), and the Cochrane Database of Systematic Reviews without restriction for language. Study selection All published, double blind, randomised controlled trials examining efficacy on the basis of clinical outcomes, in which treatment with donepezil, rivastigmine, or galantamine was compared with placebo in patients with Alzheimer's disease, were included. Each study was assessed independently, following a predefined checklist of criteria of methodological quality. Results 22 trials met the inclusion criteria. Follow-up ranged from six weeks to three years. 12 of 14 studies measuring the cognitive outcome by means of the 70 point Alzheimer's disease assessment scale—cognitive subscale showed differences ranging from 1.5 points to 3.9 points in favour of the respective cholinesterase inhibitors. Benefits were also reported from all 12 trials that used the clinician's interview based impression of change scale with input from caregivers. Methodological assessment of all studies found considerable flaws—for example, multiple testing without correction for multiplicity or exclusion of patients after randomisation. Conclusion Because of flawed methods and small clinical benefits, the scientific basis for recommendations of cholinesterase inhibitors for the treatment of Alzheimer's disease is questionable. PMID:16081444

Non-adherence in patients on peritoneal dialysis: a systematic review.

PubMed

Griva, Konstadina; Lai, Alden Yuanhong; Lim, Haikel Asyraf; Yu, Zhenli; Foo, Marjorie Wai Yin; Newman, Stanton P

2014-01-01

It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6-53% for dialysis exchanges, 3.9-85% for medication, and 14.4-67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population.

Site selective generation of sol-gel deposits in layered bimetallic macroporous electrode architectures.

PubMed

Lalo, Hélène; Bon-Saint-Côme, Yémima; Plano, Bernard; Etienne, Mathieu; Walcarius, Alain; Kuhn, Alexander

2012-02-07

The elaboration of an original composite bimetallic macroporous electrode containing a site-selective sol-gel deposit is reported. Regular colloidal crystals, obtained by a modified Langmuir-Blodgett approach, are used as templates for the electrogeneration of the desired metals in the form of a well-defined layered bimetallic porous electrode. This porous matrix shows a spatially modulated electroactivity which is subsequently used as a strategy for targeted electrogeneration of a sol-gel deposit, exclusively in one predefined part of the porous electrode.

Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: the POPE Study

PubMed Central

Koblizek, Vladimir; Milenkovic, Branislava; Barczyk, Adam; Tkacova, Ruzena; Somfay, Attila; Zykov, Kirill; Tudoric, Neven; Kostov, Kosta; Zbozinkova, Zuzana; Svancara, Jan; Sorli, Jurij; Krams, Alvils; Miravitlles, Marc

2017-01-01

Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries; however, there are no data regarding clinical phenotypes of these patients in this region. Participation in the Phenotypes of COPD in Central and Eastern Europe (POPE) study was offered to stable patients with COPD in a real-life setting. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria. Secondary aims included analysis of differences in symptom load, comorbidities and pharmacological treatment. 3362 patients with COPD were recruited in 10 CEE countries. 63% of the population were nonexacerbators, 20.4% frequent exacerbators with chronic bronchitis, 9.5% frequent exacerbators without chronic bronchitis and 6.9% were classified as asthma–COPD overlap. Differences in the distribution of phenotypes between countries were observed, with the highest heterogeneity observed in the nonexacerbator cohort and the lowest heterogeneity observed in the asthma–COPD cohort. There were statistically significant differences in symptom load, lung function, comorbidities and treatment between these phenotypes. The majority of patients with stable COPD in CEE are nonexacerbators; however, there are distinct differences in surrogates of disease severity and therapy between predefined COPD phenotypes. PMID:28495687

Total disc replacement for chronic back pain in the presence of disc degeneration.

PubMed

Jacobs, Wilco; Van der Gaag, Niels A; Tuschel, Alexander; de Kleuver, Marinus; Peul, Wilco; Verbout, A J; Oner, F Cumhur

2012-09-12

In the search for better surgical treatment of chronic low-back pain (LBP) in the presence of disc degeneration, total disc replacement has received increasing attention in recent years. A possible advantage of total disc replacement compared with fusion is maintained mobility at the operated level, which has been suggested to reduce the chance of adjacent segment degeneration. The aim of this systematic review was to assess the effect of total disc replacement for chronic low-back pain in the presence of lumbar disc degeneration compared with other treatment options in terms of patient-centred improvement, motion preservation and adjacent segment degeneration. A comprehensive search in Cochrane Back Review Group (CBRG) trials register, CENTRAL, MEDLINE, EMBASE, BIOSIS, ISI, and the FDA register was conducted. We also checked the reference lists and performed citation tracking of included studies. We included randomised controlled trials (RCTs) comparing total disc replacement with any other intervention for degenerative disc disease. We assessed risk of bias per study using the criteria of the CBRG. Quality of evidence was graded according to the GRADE approach. Two review authors independently selected studies and assessed risk of bias of the studies. Results and upper bounds of confidence intervals were compared against predefined clinically relevant differences. We included 40 publications, describing seven unique RCT's. The follow-up of the studies was 24 months, with only one extended to five years. Five studies had a low risk of bias, although there is a risk of bias in the included studies due to sponsoring and absence of any kind of blinding. One study compared disc replacement against rehabilitation and found a statistically significant advantage in favour of surgery, which, however, did not reach the predefined threshold for clinical relevance. Six studies compared disc replacement against fusion and found that the mean improvement in VAS back pain was 5.2 mm (of 100 mm) higher (two studies, 676 patients; 95% confidence interval (CI) 0.18 to 10.26) with a low quality of evidence while from the same studies leg pain showed no difference. The improvement of Oswestry score at 24 months in the disc replacement group was 4.27 points more than in the fusion group (five studies; 1207 patients; 95% CI 1.85 to 6.68) with a low quality of evidence. Both upper bounds of the confidence intervals for VAS back pain and Oswestry score were below the predefined clinically relevant difference. Choice of control group (circumferential or anterior fusion) did not appear to result in different outcomes. Although statistically significant, the differences between disc replacement and conventional fusion surgery for degenerative disc disease were not beyond the generally accepted clinical important differences with respect to short-term pain relief, disability and Quality of Life. Moreover, these analyses only represent a highly selected population. The primary goal of prevention of adjacent level disease and facet joint degeneration by using total disc replacement, as noted by the manufacturers and distributors, was not properly assessed and not a research question at all. Unfortunately, evidence from observational studies could not be used because of the high risk of bias, while these could have improved external validity assessment of complications in less selected patient groups. Non-randomised studies should however be very clear about patient selection and should incorporate independent, blinded outcome assessment, which was not the case in the excluded studies. Therefore, because we believe that harm and complications may occur after years, we believe that the spine surgery community should be prudent about adopting this technology on a large scale, despite the fact that total disc replacement seems to be effective in treating low-back pain in selected patients, and in the short term is at least equivalent to fusion surgery.

What Influences Recommendations Issued by the Agency for Health Technology Assessment in Poland? A Glimpse Into Decision Makers' Preferences.

PubMed

Niewada, Maciej; Polkowska, Małgorzata; Jakubczyk, Michał; Golicki, Dominik

This study aimed to evaluate the factors that are associated with positive (supporting public funding) and negative recommendations of the Agency for Health Technology Assessment in Poland. Two independent analysts reviewed all the recommendations publicly available online before October 7, 2011. For each recommendation, predefined decision rationales, that is, clinical efficacy, safety, cost-effectiveness, and formal aspects, were sought, either advocating or discouraging the public financing. In the analysis, we used descriptive statistics and a logistic regression model so as to identify the association between predefined criteria and the recommendation being positive. We identified 344 recommendations-218 positive (62.8%) and 126 negative (37.2%). Negative recommendations were better justified and also the comments were less ambiguous in accordance with the recommendation (except for clinical efficacy). In general, the specified criteria supported the decision (either positive or negative) in 209 (60.8%), 107 (31.1%), 124 (36.0%), 96 (27.9%), and 61 (17.7%) recommendations, respectively, and ran contrary to the actual decision in the remaining ones. Threshold values for either cost-effectiveness or budget impact distinguishing positive from negative recommendations could not be specified. The following parameters reached statistical significance in logistic regression: clinical efficacy (both explicitly positive and explicitly negative evaluations impacted in opposite directions), lack of impact on hard end points, unfavorable safety profile, cost-effectiveness results, and formal shortcomings (all reduced the probability of a positive recommendation). Decision making of the Agency for Health Technology Assessment in Poland is multicriterial, and its results cannot be easily decomposed into simple associations or easily predicted. Still, efficacy and safety seem to contribute most to final recommendations. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

Gait Retraining With Real-Time Biofeedback to Reduce Knee Adduction Moment: Systematic Review of Effects and Methods Used.

PubMed

Richards, Rosie; van den Noort, Josien C; Dekker, Joost; Harlaar, Jaap

2017-01-01

To review the current literature regarding methods and effects of real-time biofeedback used as a method for gait retraining to reduce knee adduction moment (KAM), with intended application for patients with knee osteoarthritis (KOA). Searches were conducted in MEDLINE, Embase, CINAHL, SPORTDiscus, Web of Science, and Cochrane Central Register of Controlled Trials with the keywords gait, feedback, and knee osteoarthritis from inception to May 2015. Titles and abstracts were screened by 1 individual for studies aiming to reduce KAM. Full-text articles were assessed by 2 individuals against predefined criteria. Data were extracted by 1 individual according to a predefined list, including participant demographics and training methods and effects. Electronic searches resulted in 190 potentially eligible studies, from which 12 met all inclusion criteria. Within-group standardized mean differences (SMDs) for reduction of KAM in healthy controls ranged from .44 to 2.47 and from .29 to .37 in patients with KOA. In patients with KOA, improvements were reported in pain and function, with SMDs ranging from .55 to 1.16. Methods of implementation of biofeedback training varied between studies, but in healthy controls increased KAM reduction was noted with implicit, rather than explicit, instructions. This review suggests that biofeedback gait training is effective primarily for reducing KAM but also for reducing pain and improving function in patients with KOA. The review was limited by the small number of studies featuring patients with KOA and the lack of controlled studies. The results suggest there is value and a need in further researching biofeedback training for reducing KAM. Future studies should include larger cohorts of patients, long-term follow-up, and controlled trials. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Comparative evaluation of topographical data of dental implant surfaces applying optical interferometry and scanning electron microscopy.

PubMed

Kournetas, N; Spintzyk, S; Schweizer, E; Sawada, T; Said, F; Schmid, P; Geis-Gerstorfer, J; Eliades, G; Rupp, F

2017-08-01

Comparability of topographical data of implant surfaces in literature is low and their clinical relevance often equivocal. The aim of this study was to investigate the ability of scanning electron microscopy and optical interferometry to assess statistically similar 3-dimensional roughness parameter results and to evaluate these data based on predefined criteria regarded relevant for a favorable biological response. Four different commercial dental screw-type implants (NanoTite Certain Prevail, TiUnite Brånemark Mk III, XiVE S Plus and SLA Standard Plus) were analyzed by stereo scanning electron microscopy and white light interferometry. Surface height, spatial and hybrid roughness parameters (Sa, Sz, Ssk, Sku, Sal, Str, Sdr) were assessed from raw and filtered data (Gaussian 50μm and 5μm cut-off-filters), respectively. Data were statistically compared by one-way ANOVA and Tukey-Kramer post-hoc test. For a clinically relevant interpretation, a categorizing evaluation approach was used based on predefined threshold criteria for each roughness parameter. The two methods exhibited predominantly statistical differences. Dependent on roughness parameters and filter settings, both methods showed variations in rankings of the implant surfaces and differed in their ability to discriminate the different topographies. Overall, the analyses revealed scale-dependent roughness data. Compared to the pure statistical approach, the categorizing evaluation resulted in much more similarities between the two methods. This study suggests to reconsider current approaches for the topographical evaluation of implant surfaces and to further seek after proper experimental settings. Furthermore, the specific role of different roughness parameters for the bioresponse has to be studied in detail in order to better define clinically relevant, scale-dependent and parameter-specific thresholds and ranges. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Management of postintubation tracheal stenosis: appropriate indications make outcome differences.

PubMed

Melkane, Antoine E; Matar, Nayla E; Haddad, Amine C; Nassar, Michel N; Almoutran, Homère G; Rohayem, Ziad; Daher, Mohammad; Chalouhy, Georges; Dabar, George

2010-01-01

Laryngotracheal stenosis is difficult to treat and its etiologies are multiple; nowadays, the most common ones are postintubation or posttracheostomy stenoses. To provide an algorithm for the management of postintubation laryngotracheal stenoses (PILTS) based on the experience of a tertiary care referral center. A retrospective study was conducted on all patients treated for PILTS over a 10-year period. Patients were divided into a surgically and an endoscopically treated group according to predefined criteria. The characteristics of the two groups were analyzed and the outcomes compared. Thirty-three consecutive patients were included in the study: 14 in the surgically treated group and 19 in the endoscopically treated group. Our candidates for airway surgery were healthy patients presenting with complex tracheal stenoses, subglottic involvement or associated tracheomalacia. The endoscopic candidates were chronically ill patients presenting with simple, strictly tracheal stenoses not exceeding 4 cm in length. Stents were placed if the stenosis was associated with tracheomalacia or exceeded 2 cm in total length. In the surgically treated group, 2/14 patients needed more than one procedure versus 8/19 patients in the endoscopically treated group. At the end of the intervention, 50% of the patients were decannulated in the surgically treated group versus 84.2% in the endoscopically treated group (p = 0.03). However, the decannulation rates at 6 months and the symptomatology at rest and on exertion on the last follow-up visit were comparable in the two groups. Our experience in the management of PILTS demonstrates that both surgery and endoscopy yield excellent functional outcomes if the treatment strategy is based on clear, predefined objective criteria. Copyright 2010 S. Karger AG, Basel.

A systematic review of online resources to support patient decision-making for full-thickness rectal prolapse surgery.

PubMed

Fowler, G E; Baker, D M; Lee, M J; Brown, S R

2017-11-01

The internet is becoming an increasingly popular resource to support patient decision-making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support patient decision-making for full-thickness rectal prolapse surgery. This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch-Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Overall, 95 sources were from Google and the specialist decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch-Kincaid Reading Ease score was higher than recommended for patient education materials (48.8 ± 15.6, range 25.2-85.3). Overall quality of sources supporting patient decision-making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1-5). No sources met minimum decision-making standards (median IPDASi score 5/12 ± 2.01, range 1-8). Currently, easily accessible online health information to support patient decision-making for rectal surgery is of poor quality, difficult to read and does not support shared decision-making. It is recommended that professional bodies and medical professionals seek to develop decision aids to support decision-making for full-thickness rectal prolapse surgery.

Fiber Typing of the Erector Spinae and Multifidus Muscles in Healthy Controls and Back Pain Patients: A Systematic Literature Review.

PubMed

Cagnie, Barbara; Dhooge, Famke; Schumacher, Charline; De Meulemeester, Kayleigh; Petrovic, Mirko; van Oosterwijck, Jessica; Danneels, Lieven

2015-01-01

Understanding the changes in muscle fiber typing is relevant in the context of muscle disorders because it provides information on the metabolic profile and functional capacity. The aim of this study was to systematically review the literature comparing muscle fiber typing in the back muscles of healthy subjects with low back pain (LBP) patients. Predefined keywords regarding muscle fiber typing and back muscles were combined in PubMed and Web of Science electronic search engines from inception to August 2014. Full-text articles were independently screened by 2 independent, blinded researchers. Full texts fulfilling the predefined inclusion criteria were assessed on risk of bias by 2 independent researchers, and relative data were extracted. Data were not pooled because of heterogeneity in biopsy locations and population. From the 214 articles that were identified, 18 met the inclusion criteria. These articles evaluated the muscle fiber type distribution or proportional fiber type area between muscles, muscle layers, men, and women or healthy subjects and LBP patients. Regarding muscle fiber type distribution, findings in healthy subjects and LBP patients show no or inconclusive evidence for intermuscular and interindividual differentiation. Studies evaluating the proportional fiber type area also suggest little intermuscular differentiation but provide plausible evidence that the proportional area occupied by type I fibers is higher in women compared to men. The evidence for differentiation based on the presence of low back pain is conflicting. This study found that the evidence regarding muscle fiber typing in back muscles is either inconclusive or shows little differences. The most plausible evidence exists for differentiation in proportional fiber type area depending on sex. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review.

PubMed

Chan, Vincy; Thurairajah, Pravheen; Colantonio, Angela

2015-02-04

Although healthcare administrative data are commonly used for traumatic brain injury (TBI) research, there is currently no consensus or consistency on the International Classification of Diseases Version 10 (ICD-10) codes used to define TBI among children and youth internationally. This study systematically reviewed the literature to explore the range of ICD-10 codes that are used to define TBI in this population. The identification of the range of ICD-10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies. The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews were systematically searched. Grey literature was searched using Grey Matters and Google. Reference lists of included articles were also searched for relevant studies. Two reviewers independently screened all titles and abstracts using pre-defined inclusion and exclusion criteria. A full text screen was conducted on articles that met the first screen inclusion criteria. All full text articles that met the pre-defined inclusion criteria were included for analysis in this systematic review. A total of 1,326 publications were identified through the predetermined search strategy and 32 articles/reports met all eligibility criteria for inclusion in this review. Five articles specifically examined children and youth aged 19 years or under with TBI. ICD-10 case definitions ranged from the broad injuries to the head codes (ICD-10 S00 to S09) to concussion only (S06.0). There was overwhelming consensus on the inclusion of ICD-10 code S06, intracranial injury, while codes S00 (superficial injury of the head), S03 (dislocation, sprain, and strain of joints and ligaments of head), and S05 (injury of eye and orbit) were only used by articles that examined head injury, none of which specifically examined children and youth. This review provides evidence for discussion on how best to use ICD codes for different goals. This is an important first step in reaching an appropriate definition and can inform future work on reaching consensus on the ICD-10 codes to define TBI for this vulnerable population.

A Low-Cost PC-Based Image Workstation for Dynamic Interactive Display of Three-Dimensional Anatomy

NASA Astrophysics Data System (ADS)

Barrett, William A.; Raya, Sai P.; Udupa, Jayaram K.

1989-05-01

A system for interactive definition, automated extraction, and dynamic interactive display of three-dimensional anatomy has been developed and implemented on a low-cost PC-based image workstation. An iconic display is used for staging predefined image sequences through specified increments of tilt and rotation over a solid viewing angle. Use of a fast processor facilitates rapid extraction and rendering of the anatomy into predefined image views. These views are formatted into a display matrix in a large image memory for rapid interactive selection and display of arbitrary spatially adjacent images within the viewing angle, thereby providing motion parallax depth cueing for efficient and accurate perception of true three-dimensional shape, size, structure, and spatial interrelationships of the imaged anatomy. The visual effect is that of holding and rotating the anatomy in the hand.

Development and implementation of an audit tool for quality control of parenteral nutrition.

PubMed

García-Rodicio, Sonsoles; Abajo, Celia; Godoy, Mercedes; Catalá, Miguel Angel

2009-01-01

The aim of this article is to describe the development of a quality control methodology applied to patients receiving parenteral nutrition (PN) and to present the results obtained over the past 10 years. Development of the audit tool: In 1995, a total of 13 PN quality criteria and their standards were defined based on literature and past experiences. They were applied during 5 different 6-month audits carried out in subsequent years. According to the results of each audit, the criteria with lower validity were eliminated, while others were optimized and new criteria were introduced to complete the monitoring of other areas not previously examined. Currently, the quality control process includes 22 quality criteria and their standards that examine the following 4 different areas: (1) indication and duration of PN; (2) nutrition assessment, adequacy of the nutrition support, and monitoring; (3) metabolic and infectious complications; and (4) global efficacy of the nutrition support regimen. The authors describe the current definition of each criterion and present the results obtained in the 5 audits performed. In the past year, 9 of the 22 criteria reached the predefined standards. The areas detected for further improvements were: indication for PN, nutrition assessment, and management of catheter infections. The definition of quality criteria and their standards is an efficient method of providing a qualitative and quantitative analysis of the clinical care of patients receiving PN. It detects areas for improvement and assists in developing a methodology to work efficiently.

Influence of the intervention of exercise on obese type II diabetes mellitus: A meta-analysis.

PubMed

Zou, Zhichun; Cai, Wei; Cai, Min; Xiao, Mouyuan; Wang, Zhijie

2016-06-01

The study aimed to assess the effect of exercise intervention on the management of obese T2DM patients. The literature retrieval was conducted in relevant databases from their inception to 2015, with predefined searching strategy and selection criteria. The Cochrane Collaboration's tool was utilized to assess the quality of included studies. Weighted mean difference (WMD) with its corresponding 95% CI (confidence interval) was used as the effect size. A subset of 13 eligible studies was selected. Exercise significantly reduced the concentration of high sensitivity C reactive protein (4 months: WMD=-1.03, 95% CI: -1.77 to -0.29, P<0.01), triglyceride (6 months: WMD=-24.75, 95% CI: -27.67 to -21.83, P<0.01), diastolic blood pressure (6 months: WMD=-2.70, 95% CI: -4.12 to -1.28, P=0.0002), systolic blood pressure (WMD=-7.98, 95% CI: -9.87 to -6.08, P<0.01)), HbA1c (4 months: WMD=-0.25, 95% CI: -0.49 to -0.02, P=0.04) and homeostasis model assessment-insulin resistance (3 months: WMD=-0.19, 95% CI: -0.37 to -0.01, P=0.04); and a pronounced increase of HDL-C (12 months: WMD=3.57, 95% CI: 1.92 to 5.21, P<0.01). Exercise was beneficial to obese T2DM patients. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

A systematic review of the effectiveness of taxes on nonalcoholic beverages and high-in-fat foods as a means to prevent obesity trends

PubMed Central

Maniadakis, Nikolaos; Kapaki, Vasiliki; Damianidi, Louiza; Kourlaba, Georgia

2013-01-01

Background As part of the efforts to curb obesity, a new focus seems to be put on taxing foods that are perceived as being associated with obesity (eg, sugar-sweetened beverages and foods high in fat, sugar, and salt content) as a policy instrument to promote healthier diets. Objective To assess the possible effects of such taxation policies by identifying and analyzing all studies which investigate the impact of price increases on consumption, caloric intake, or weight outcomes. Methods Electronic data bases were searched with appropriate terms and their combinations. Thereafter, abstracts were reviewed and studies were selected based on predefined criteria. The characteristics of the selected studies and the results were extracted in a special form and consequently were reviewed and synthesized. Results Price increase may lead to a reduction in consumption of the targeted products, but the subsequent effect on caloric intake may be much smaller. Only a limited number of the identified studies reported weight outcomes, most of which are either insignificant or very small in magnitude to make any improvement in public health. Conclusion The effectiveness of a taxation policy to curb obesity is doubtful and available evidence in most studies is not very straightforward due to the multiple complexities in consumer behavior and the underling substitution effects. There is need to investigate in-depth the potential underlying mechanisms and the relationship between price-increase policies, obesity, and public health outcomes. PMID:24187507

A systematic review of the effectiveness of taxes on nonalcoholic beverages and high-in-fat foods as a means to prevent obesity trends.

PubMed

Maniadakis, Nikolaos; Kapaki, Vasiliki; Damianidi, Louiza; Kourlaba, Georgia

2013-10-22

As part of the efforts to curb obesity, a new focus seems to be put on taxing foods that are perceived as being associated with obesity (eg, sugar-sweetened beverages and foods high in fat, sugar, and salt content) as a policy instrument to promote healthier diets. To assess the possible effects of such taxation policies by identifying and analyzing all studies which investigate the impact of price increases on consumption, caloric intake, or weight outcomes. Electronic data bases were searched with appropriate terms and their combinations. Thereafter, abstracts were reviewed and studies were selected based on predefined criteria. The characteristics of the selected studies and the results were extracted in a special form and consequently were reviewed and synthesized. Price increase may lead to a reduction in consumption of the targeted products, but the subsequent effect on caloric intake may be much smaller. Only a limited number of the identified studies reported weight outcomes, most of which are either insignificant or very small in magnitude to make any improvement in public health. The effectiveness of a taxation policy to curb obesity is doubtful and available evidence in most studies is not very straightforward due to the multiple complexities in consumer behavior and the underling substitution effects. There is need to investigate in-depth the potential underlying mechanisms and the relationship between price-increase policies, obesity, and public health outcomes.

Systematic review of systemic sclerosis-specific instruments for the EULAR Outcome Measures Library: An evolutional database model of validated patient-reported outcomes.

PubMed

Ingegnoli, Francesca; Carmona, Loreto; Castrejon, Isabel

2017-04-01

The EULAR Outcome Measures Library (OML) is a freely available database of validated patient-reported outcomes (PROs). The aim of this study was to provide a comprehensive review of validated PROs specifically developed for systemic sclerosis (SSc) to feed the EULAR OML. A sensitive search was developed in Medline and Embase to identify all validation studies, cohort studies, reviews, or meta-analyses in which the objective were the development or validation of specific PROs evaluating organ involvement, disease activity or damage in SSc. A reviewer screened title and abstracts, selected the studies, and collected data concerning validation using ad hoc forms based on the COSMIN checklist. From 13,140 articles captured, 74 met the predefined criteria. After excluding two instruments as they were unavailable in English the selected 23 studies provided information on seven SSc-specific PROs on different SSc domains: burden of illness (symptom burden index), functional status (Scleroderma Assessment Questionnaire), functional ability (scleroderma Functional Score), Raynaud's phenomenon (Raynaud's condition score), mouth involvement (Mouth Handicap in SSc), gastro-intestinal involvement (University of California Los Angeles-Scleroderma Clinical Trial Consortium Gastro-Intestinal tract 2.0), and skin involvement (skin self-assessment). Each of them is partially validated and has different psychometric requirements. Seven SSc-specific PROs have a minimum validation and were included in the EULAR OML. Further development in the area of disease-specific PROs in SSc is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

Procedure to select test organisms for environmental risk assessment of genetically modified crops in aquatic systems.

PubMed

Hilbeck, Angelika; Bundschuh, Rebecca; Bundschuh, Mirco; Hofmann, Frieder; Oehen, Bernadette; Otto, Mathias; Schulz, Ralf; Trtikova, Miluse

2017-11-01

For a long time, the environmental risk assessment (ERA) of genetically modified (GM) crops focused mainly on terrestrial ecosystems. This changed when it was scientifically established that aquatic ecosystems are exposed to GM crop residues that may negatively affect aquatic species. To assist the risk assessment process, we present a tool to identify ecologically relevant species usable in tiered testing prior to authorization or for biological monitoring in the field. The tool is derived from a selection procedure for terrestrial ecosystems with substantial but necessary changes to adequately consider the differences in the type of ecosystems. By using available information from the Water Framework Directive (2000/60/EC), the procedure can draw upon existing biological data on aquatic systems. The proposed procedure for aquatic ecosystems was tested for the first time during an expert workshop in 2013, using the cultivation of Bacillus thuringiensis (Bt) maize as the GM crop and 1 stream type as the receiving environment in the model system. During this workshop, species executing important ecological functions in aquatic environments were identified in a stepwise procedure according to predefined ecological criteria. By doing so, we demonstrated that the procedure is practicable with regard to its goal: From the initial long list of 141 potentially exposed aquatic species, 7 species and 1 genus were identified as the most suitable candidates for nontarget testing programs. Integr Environ Assess Manag 2017;13:974-979. © 2017 SETAC. © 2017 SETAC.

A validation of the Mobil O Graph (version 12) ambulatory blood pressure monitor.

PubMed

Jones, C R; Taylor, K; Chowienczyk, P; Poston, L; Shennan, A H

2000-08-01

To assess the clinical accuracy of the Mobil O Graph (version 12) ambulatory blood pressure monitor in an adult population. The accuracy of the device was assessed by predefined criteria (British Hypertension Society, BHS) in 85 subjects recruited from the patients and staff in a teaching hospital. A series of same-arm sequential blood pressure measurements were taken: first two observers taking simultaneous mercury readings, followed by a reading with the Mobil O Graph ambulatory monitor. A total of seven readings were taken from each subject in the sitting position. The data were then analysed according to the BHS protocol and the criteria of the Association for the Advancement of Medical Instrumentation (AAMI). The Mobil O Graph ambulatory monitor fulfilled the criteria of the BHS protocol, achieving a grade B for systolic blood pressure (SBP) and a grade A for diastolic blood pressure (DBP). The mean differences were -2+/-8 mmHg for SBP and -2+/-7 mmHg for DBP. The device therefore also passed the AAMI standard (the mean to be within 5+/-8 mmHg). The Mobil O Graph ambulatory monitor performed in a satisfactory manner according to the BHS and the AAMI criteria and can therefore be recommended for clinical use in the general population.

Classifying distinct basal cell carcinoma subtype by means of dermatoscopy and reflectance confocal microscopy.

PubMed

Longo, Caterina; Lallas, Aimilios; Kyrgidis, Athanassios; Rabinovitz, Harold; Moscarella, Elvira; Ciardo, Silvana; Zalaudek, Iris; Oliviero, Margaret; Losi, Amanda; Gonzalez, Salvador; Guitera, Pascale; Piana, Simonetta; Argenziano, Giuseppe; Pellacani, Giovanni

2014-10-01

The current guidelines for the management of basal cell carcinoma (BCC) suggest a different therapeutic approach according to histopathologic subtype. Although dermatoscopic and confocal criteria of BCC have been investigated, no specific studies were performed to evaluate the distinct reflectance confocal microscopy (RCM) aspects of BCC subtypes. To define the specific dermatoscopic and confocal criteria for delineating different BCC subtypes. Dermatoscopic and confocal images of histopathologically confirmed BCCs were retrospectively evaluated for the presence of predefined criteria. Frequencies of dermatoscopic and confocal parameters are provided. Univariate and adjusted odds ratios were calculated. Discriminant analyses were performed to define the independent confocal criteria for distinct BCC subtypes. Eighty-eight BCCs were included. Dermatoscopically, superficial BCCs (n=44) were primarily typified by the presence of fine telangiectasia, multiple erosions, leaf-like structures, and revealed cords connected to the epidermis and epidermal streaming upon RCM. Nodular BCCs (n=22) featured the classic dermatoscopic features and well outlined large basaloid islands upon RCM. Infiltrative BCCs (n=22) featured structureless, shiny red areas, fine telangiectasia, and arborizing vessels on dermatoscopy and dark silhouettes upon RCM. The retrospective design. Dermatoscopy and confocal microscopy can reliably classify different BCC subtypes. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Target assessment for antiparasitic drug discovery

PubMed Central

Frearson, Julie A.; Wyatt, Paul G.; Gilbert, Ian H.; Fairlamb, Alan H.

2010-01-01

Drug discovery is a high-risk, expensive and lengthy process taking at least 12 years and costing upwards of US$500 million per drug to reach the clinic. For neglected diseases, the drug discovery process is driven by medical need and guided by pre-defined target product profiles. Assessment and prioritisation of the most promising targets for entry into screening programmes is crucial for maximising chances of success. Here we describe criteria used in our drug discovery unit for target assessment and introduce the ‘traffic light’ system as a prioritisation and management tool. We hope this brief review will stimulate basic scientists to acquire additional information necessary for drug discovery. PMID:17962072

49 CFR 80.15 - Selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Selection criteria. 80.15 Section 80.15... § 80.15 Selection criteria. (a) The Secretary shall assign weights as indicated to the following eight selection criteria in evaluating and selecting among eligible projects to receive credit assistance: (1) The...

Second Report of the Washington State Advisory Council on Vocational Education: Part I, Findings, Conclusions, Recommendations, and Part II, Commentary and Detailed Survey Results.

ERIC Educational Resources Information Center

Washington State Advisory Council on Vocational Education, Olympia.

To determine the public's attitude relative to vocational education, the Washington State Advisory Council on Vocational Education distributed attitudinal opinionnaires to 2,200 individuals randomly selected from predefined users of vocational education services. The users included: (1) teachers, students, and administrators in public schools,…

Reference set for performance testing of pediatric vaccine safety signal detection methods and systems.

PubMed

Brauchli Pernus, Yolanda; Nan, Cassandra; Verstraeten, Thomas; Pedenko, Mariia; Osokogu, Osemeke U; Weibel, Daniel; Sturkenboom, Miriam; Bonhoeffer, Jan

2016-12-12

Safety signal detection in spontaneous reporting system databases and electronic healthcare records is key to detection of previously unknown adverse events following immunization. Various statistical methods for signal detection in these different datasources have been developed, however none are geared to the pediatric population and none specifically to vaccines. A reference set comprising pediatric vaccine-adverse event pairs is required for reliable performance testing of statistical methods within and across data sources. The study was conducted within the context of the Global Research in Paediatrics (GRiP) project, as part of the seventh framework programme (FP7) of the European Commission. Criteria for the selection of vaccines considered in the reference set were routine and global use in the pediatric population. Adverse events were primarily selected based on importance. Outcome based systematic literature searches were performed for all identified vaccine-adverse event pairs and complemented by expert committee reports, evidence based decision support systems (e.g. Micromedex), and summaries of product characteristics. Classification into positive (PC) and negative control (NC) pairs was performed by two independent reviewers according to a pre-defined algorithm and discussed for consensus in case of disagreement. We selected 13 vaccines and 14 adverse events to be included in the reference set. From a total of 182 vaccine-adverse event pairs, we classified 18 as PC, 113 as NC and 51 as unclassifiable. Most classifications (91) were based on literature review, 45 were based on expert committee reports, and for 46 vaccine-adverse event pairs, an underlying pathomechanism was not plausible classifying the association as NC. A reference set of vaccine-adverse event pairs was developed. We propose its use for comparing signal detection methods and systems in the pediatric population. Published by Elsevier Ltd.

Systematic Review of Retraction Devices for Laparoscopic Surgery.

PubMed

Vargas-Palacios, Armando; Hulme, Claire; Veale, Thomas; Downey, Candice L

2016-02-01

Retraction plays a vital role in optimizing the field of vision in minimal-access surgery. As such, a number of devices have been marketed to aid the surgeon in laparoscopic retraction. This systematic review explores the advantages and disadvantages of the different instruments in order to aid surgeons and their institutions in selecting the appropriate device. Primary outcome measures include operation time, length of stay, use of staff, patient morbidity, ease of use, conversion rates to open surgery, and cost. Systematic literature searches were performed in MEDLINE, EMBASE, The Cochrane Library, Current Controlled Trials, and ClinicalTrials.gov. The search strategy focused on studies testing a retraction device. The selection process was based on a predefined set of inclusion and exclusion criteria. Data were then extracted and analyzed. Out of 1360 papers initially retrieved, 12 articles were selected for data extraction and analysis. A total of 10 instruments or techniques were tested. Devices included the Nathanson's liver retractor, liver suspension tape, the V-List technique, a silicone disk with or without a snake retractor, the Endoloop, the Endograb, a magnetic retractor, the VaroLift, a laparoscope holder, and a retraction sponge. None of the instruments reported were associated with increased morbidity. No studies found increased rates of conversion to open surgery. All articles reported that the tested instruments might spare the use of an assistant during the procedure. It was not possible to determine the impact on length of stay or operation time. Each analyzed device facilitates retraction, providing a good field of view while allowing reduced staff numbers and minimal patient morbidity. Due to economic and environmental advantages, reusable devices may be preferable to disposable instruments, although the choice must be primarily based on clinical judgement. © The Author(s) 2015.

Comparison of Risk of Carpal Tunnel Syndrome in Patients with Distal Radius Fractures After 7 Treatments

PubMed Central

Zhao, Huan-Li; Wang, Gui-Bin; Jia, Yue-Qing; Zhu, Shi-Cai; Zhang, Feng-Fang; Liu, Hong-Mei

2015-01-01

Background To compare risk of carpal tunnel syndrome (CTS) in distal radius fracture (DRF) patients after 7 treatments using bridging external fixation (BrEF), non-bridging external fixation (non-BrEF), plaster fixation, K-wire fixation, dorsal plating fixation, volar plating fixation, and dorsal and volar plating by performing a network meta-analysis. Material/Methods An exhaustive search of electronic databases identified randomized controlled trails (RCTs) closely related to our study topic. The published articles were screened, based on predefined inclusion and exclusion criteria, to select high-quality studies for the present network meta-analysis. Data extracted from the selected studies were analyzed using STATA version 12.0 software. Results The literature search and selection process identified 12 eligible RCTs that contained a total of 1370 DRF patients (394 patients with BrEF, 377 patients with non-BrEF, 89 patients with K-wire fixation, 192 patients with plaster fixation, 42 patients with dorsal plating fixation, 152 patients with volar plating fixation, and 124 patients with dorsal and volar plating fixation). Our network meta-analysis results demonstrated no significant differences in CTS risk among the 7 treatments (P>0.05). The value of surface under the cumulative ranking curve (SUCRA), however, suggested that dorsal plating fixation is the optimal treatment, with the lowest risk of CTS in DRF patients (dorsal plating fixation: 89.2%; dorsal and volar plating: 57.8%; plaster fixation: 50.9%; non-BrEF: 50.6%; volar plating fixation: 39.6%; BrEF: 38.4%; K-wire fixation: 23.6%). Conclusions Our network meta-analysis provides evidence that dorsal plating fixation significantly decreases the risk of CTS and could be the method of choice in DRF patients. PMID:26391617

Depression in Aboriginal men in central Australia: adaptation of the Patient Health Questionnaire 9

PubMed Central

2013-01-01

Background While Indigenous Australians are believed to be at a high risk of psychological illness, few screening instruments have been designed to accurately measure this burden. Rather than simply transposing western labels of symptoms, this paper describes the process by which a screening tool for depression was specifically adapted for use across multiple Indigenous Australian communities. Method Potential depression screening instruments were identified and interrogated according to a set of pre-defined criteria. A structured process was then developed which relied on the expertise of five focus groups comprising of members from primary Indigenous language groups in central Australia. First, focus group participants were asked to review and select a screening measure for adaptation. Bi-lingual experts then translated and back translated the language within the selected measure. Focus group participants re-visited the difficult items, explored their meaning and identified potential ways to achieve equivalence of meaning. Results All five focus groups independently selected the Primary Health Questionnaire 9, several key conceptual differences were exposed, largely related to the construction of hopelessness. Together with translated versions of each instrument for each of the five languages, a single, simplified English version for use across heterogeneous settings was negotiated. Importantly, the ‘code’ and specific conceptually equivalent words that could be used for other Indigenous language groups were also developed. Conclusions The extensive process of adaptation used in this study has demonstrated that within the context of Indigenous Australian communities, across multiple language groups, where English is often a third or fourth language, conceptual and linguistic equivalence of psychological constructs can be negotiated. A validation study is now required to assess the adapted instrument’s potential for measuring the burden of disease across all Indigenous Australian populations. PMID:24139186

Identification of Pure-Tone Audiologic Thresholds for Pediatric Cochlear Implant Candidacy: A Systematic Review.

PubMed

de Kleijn, Jasper L; van Kalmthout, Ludwike W M; van der Vossen, Martijn J B; Vonck, Bernard M D; Topsakal, Vedat; Bruijnzeel, Hanneke

2018-05-24

Although current guidelines recommend cochlear implantation only for children with profound hearing impairment (HI) (>90 decibel [dB] hearing level [HL]), studies show that children with severe hearing impairment (>70-90 dB HL) could also benefit from cochlear implantation. To perform a systematic review to identify audiologic thresholds (in dB HL) that could serve as an audiologic candidacy criterion for pediatric cochlear implantation using 4 domains of speech and language development as independent outcome measures (speech production, speech perception, receptive language, and auditory performance). PubMed and Embase databases were searched up to June 28, 2017, to identify studies comparing speech and language development between children who were profoundly deaf using cochlear implants and children with severe hearing loss using hearing aids, because no studies are available directly comparing children with severe HI in both groups. If cochlear implant users with profound HI score better on speech and language tests than those with severe HI who use hearing aids, this outcome could support adjusting cochlear implantation candidacy criteria to lower audiologic thresholds. Literature search, screening, and article selection were performed using a predefined strategy. Article screening was executed independently by 4 authors in 2 pairs; consensus on article inclusion was reached by discussion between these 4 authors. This study is reported according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Title and abstract screening of 2822 articles resulted in selection of 130 articles for full-text review. Twenty-one studies were selected for critical appraisal, resulting in selection of 10 articles for data extraction. Two studies formulated audiologic thresholds (in dB HLs) at which children could qualify for cochlear implantation: (1) at 4-frequency pure-tone average (PTA) thresholds of 80 dB HL or greater based on speech perception and auditory performance subtests and (2) at PTA thresholds of 88 and 96 dB HL based on a speech perception subtest. In 8 of the 18 outcome measures, children with profound HI using cochlear implants performed similarly to children with severe HI using hearing aids. Better performance of cochlear implant users was shown with a picture-naming test and a speech perception in noise test. Owing to large heterogeneity in study population and selected tests, it was not possible to conduct a meta-analysis. Studies indicate that lower audiologic thresholds (≥80 dB HL) than are advised in current national and manufacturer guidelines would be appropriate as audiologic candidacy criteria for pediatric cochlear implantation.

Multi-Criteria Decision Making For Determining A Simple Model of Supplier Selection

NASA Astrophysics Data System (ADS)

Harwati

2017-06-01

Supplier selection is a decision with many criteria. Supplier selection model usually involves more than five main criteria and more than 10 sub-criteria. In fact many model includes more than 20 criteria. Too many criteria involved in supplier selection models sometimes make it difficult to apply in many companies. This research focuses on designing supplier selection that easy and simple to be applied in the company. Analytical Hierarchy Process (AHP) is used to weighting criteria. The analysis results there are four criteria that are easy and simple can be used to select suppliers: Price (weight 0.4) shipment (weight 0.3), quality (weight 0.2) and services (weight 0.1). A real case simulation shows that simple model provides the same decision with a more complex model.

Resin selection criteria for tough composite structures

NASA Technical Reports Server (NTRS)

Chamis, C. C.; Smith, G. T.

1983-01-01

Resin selection criteria are derived using a structured methodology consisting of an upward integrated mechanistic theory and its inverse (top-down structured theory). These criteria are expressed in a "criteria selection space" which are used to identify resin bulk properties for improved composite "toughness". The resin selection criteria correlate with a variety of experimental data including laminate strength, elevated temperature effects and impact resistance.

Interactive autonomy and robotic skills

NASA Technical Reports Server (NTRS)

Kellner, A.; Maediger, B.

1994-01-01

Current concepts of robot-supported operations for space laboratories (payload servicing, inspection, repair, and ORU exchange) are mainly based on the concept of 'interactive autonomy' which implies autonomous behavior of the robot according to predefined timelines, predefined sequences of elementary robot operations and within predefined world models supplying geometrical and other information for parameter instantiation on the one hand, and the ability to override and change the predefined course of activities by human intervention on the other hand. Although in principle a very powerful and useful concept, in practice the confinement of the robot to the abstract world models and predefined activities appears to reduce the robot's stability within real world uncertainties and its applicability to non-predefined parts of the world, calling for frequent corrective interaction by the operator, which in itself may be tedious and time-consuming. Methods are presented to improve this situation by incorporating 'robotic skills' into the concept of interactive autonomy.

45 CFR 1634.9 - Selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Selection criteria. 1634.9 Section 1634.9 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION COMPETITIVE BIDDING FOR GRANTS AND CONTRACTS § 1634.9 Selection criteria. (a) The criteria to be used to select among...

Psoriasis treatment and management - a systematic review of full economic evaluations.

PubMed

Hamilton, M P; Ntais, D; Griffiths, C E M; Davies, L M

2015-03-01

Psoriasis frequently requires lifetime control and current therapies vary significantly in price. High-quality economic evaluations are necessary to determine if higher-cost treatments are value for money. This review aims to identify the cost-effectiveness of psoriasis care (whether more expensive interventions are associated with savings in health care and psoriasis management and/or improve patients' health); assess the level of uncertainty and transferability of this evidence to policy and practice; and, identify future research needs. Searches of electronic databases Embase, MEDLINE and NHS EED for full economic evaluations were conducted in January 2012 (updated April 2014). Included articles were screened, selected and critically appraised using predefined inclusion criteria and data extraction forms: 1355 articles were identified; 37 papers reporting 71 comparisons met the inclusion criteria. Treatments evaluated were systemic (n = 45), topical (n = 22), phototherapies (n = 14) and combination (n = 4). Despite a significant number of recent economic evaluations, the cost-effectiveness of all therapies remains unclear. This uncertainty arises from a diversity in settings, perspective and design. Economic evaluations were constrained by limited availability of high-quality short- and long-term head-to-head comparisons of the effectiveness, safety and adherence of different interventions. The economic evidence is dominated by comparisons of interventions to placebo, with implicit comparisons of different therapies. There is a lack of evaluations of service model innovations to deliver complex packages of care for psoriasis. Primary and secondary integrated clinical and economic research is needed to address the limitations and to identify patient preferences and barriers/facilitators to treatment. © 2014 British Association of Dermatologists.

Use of near-infrared systems for investigations of hemodynamics in human in vivo bone tissue: A systematic review.

PubMed

Meertens, Robert; Casanova, Francesco; Knapp, Karen M; Thorn, Clare; Strain, William David

2018-05-04

A range of technologies using near infrared (NIR) light have shown promise at providing real time measurements of hemodynamic markers in bone tissue in vivo, an exciting prospect given existing difficulties in measuring hemodynamics in bone tissue. This systematic review aimed to evaluate the evidence for this potential use of NIR systems, establishing their potential as a research tool in this field. Major electronic databases including MEDLINE and EMBASE were searched using pre-planned search strategies with broad scope for any in vivo use of NIR technologies in human bone tissue. Following identification of studies by title and abstract screening, full text inclusion was determined by double blind assessment using predefined criteria. Full text studies for inclusion were data extracted using a predesigned proforma and quality assessed. Narrative synthesis was appropriate given the wide heterogeneity of included studies. Eighty-eight full text studies fulfilled the inclusion criteria, 57 addressing laser Doppler flowmetry (56 intra-operatively), 21 near infrared spectroscopy, and 10 photoplethysmography. The heterogeneity of the methodologies included differing hemodynamic markers, measurement protocols, anatomical locations, and research applications, making meaningful direct comparisons impossible. Further, studies were often limited by small sample sizes with potential selection biases, detection biases, and wide variability in results between participants. Despite promising potential in the use of NIR light to interrogate bone circulation, the application of NIR systems in bone requires rigorous assessment of the reproducibility of potential hemodynamic markers and further validation of these markers against alternative physiologically relevant reference standards. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-9, 2018. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Prevalence of Recommendations Made Within Dental Research Articles Using Uncontrolled Intervention or Observational Study Designs.

PubMed

Wilson, M K; Chestnutt, I G

2016-03-01

Evidence to inform clinical practice is reliant on research carried out using appropriate study design. The objectives of this work were to (i) identify the prevalence of articles reporting on human studies using uncontrolled intervention or observational research designs published in peer-reviewed dental journals and (ii) determine the nature of recommendations made by these articles. Six peer-reviewed dental journals were selected. Issues published in January to June 2013 were examined and the types of articles published categorized. Following pre-defined inclusion/exclusion criteria, human studies classified as using uncontrolled intervention or observational research designs were subject to detailed review by two independent investigators, to examine if they presented clinical, policy or research recommendations and if these recommendations were supported by the data presented. 52.9% (n = 156) of studies published during the time period met the inclusion criteria. Studies with uncontrolled intervention or observational research designs comprised a larger proportion of the primary research studies published in the journals with lower impact factors (73.3%; n = 107) compared to the high impact journals (38.9%; n = 49). Analysis showed that 60.9% (n = 95) of the included studies made recommendations for clinical practice/dental policy. In 28.2% (n = 44) of studies, the clinical/policy recommendations made were judged to not be fully supported by the data presented. Many studies published in the current dental literature, which are not considered to produce strong evidence, make recommendations for clinical practice or policy. There were some cases when the recommendations were not fully supported by the data presented. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of Stress Cardiac Magnetic Resonance Imaging on Clinical Care

PubMed Central

McGraw, Sloane; Romano, Simone; Jue, Jennifer; Bauml, Michael A; Chung, Jaehoon; Farzaneh-Far, Afshin

2016-01-01

Given the rising costs of imaging, there is increasing pressure to provide evidence for direct additive impact on clinical care. Appropriate use criteria (AUC) were developed to optimize test-patient selection, and are increasingly used by payers to assess reimbursement. However, these criteria were created by expert consensus with limited systematic validation. The aims of this study were therefore to determine: 1) rates of active clinical change resulting from stress cardiovascular magnetic resonance (CMR) imaging; and 2) whether the AUC can predict these changes. We prospectively enrolled 350 consecutive outpatients referred for stress CMR. Categories of “active changes in clinical care” due to stress CMR were pre-defined. Appropriateness was classified according to the 2013 AUC. Multivariable logistic regression analysis was used to identify factors independently associated with active change. Overall, stress CMR led to an active change in clinical care in about 70% of patients. Rates of change in clinical care did not vary significantly across AUC categories (p=0.767). In a multivariable model adjusting for clinical variables and AUC, only ischemia (OR 6.896, 95% CI 2.637–18.032, p<0.001), known CAD (OR 0.300, 95% CI 0.161–0.559, p<0.001), and age (OR 0.977, 95% CI 0.954–1.000, p=0.050) independently predicted significant clinical change. In conclusion, stress CMR made a significant impact on clinical management, resulting in active change in clinical care in about 70% of patients. AUC categories were not an independent predictor of clinical change. Clinical change was independently associated with presence of ischemia, absence of known CAD, and younger age. PMID:27476576

Strengthening Health Systems of Developing Countries: Inclusion of Surgery in Universal Health Coverage.

PubMed

Okoroh, Juliet S; Chia, Victoria; Oliver, Emily A; Dharmawardene, Marisa; Riviello, Robert

2015-08-01

Universal health coverage (UHC) has its roots in the Universal Declaration of Human Rights and has recently gained momentum. Out-of-pocket payments (OPP) remain a significant barrier to care. There is an increasing global prevalence of non-communicable diseases, many of which are surgically treatable. We sought to provide a comparative analysis of the inclusion of surgical care in operating plans for UHC in low- and middle-income countries (LMIC). We systematically searched PubMed and Google Scholar using pre-defined criteria for articles published in English, Spanish, or French between January 1991 and November 2013. Keywords included "insurance," "OPP," "surgery," "trauma," "cancer," and "congenital anomalies." World Health Organization (WHO), World Bank, and Joint Learning Network for UHC websites were searched for supporting documents. Ministries of Health were contacted to provide further information on the inclusion of surgery. We found 696 articles and selected 265 for full-text review based on our criteria. Some countries enumerated surgical conditions in detail (India, 947 conditions). Other countries mentioned surgery broadly. Obstetric care was most commonly covered (19 countries). Solid organ transplantation was least covered. Cancer care was mentioned broadly, often without specifying the therapeutic modality. No countries were identified where hospitals are required to provide emergency care regardless of insurance coverage. OPP varied greatly between countries. Eighty percent of countries had OPP of 60% or more, making these services, even if partially covered, largely inaccessible. While OPP, delivery, and utilization continue to represent challenges to health care access in many LMICs, the inclusion of surgery in many UHC policies sets an important precedent in addressing a growing global prevalence of surgically treatable conditions. Barriers to access, including inequalities in financial protection in the form of high OPP, remain a fundamental challenge to providing surgical care in LMICs.

Power of treatment success definitions when the Canine Brief Pain Inventory is used to evaluate carprofen treatment for the control of pain and inflammation in dogs with osteoarthritis.

PubMed

Brown, Dorothy Cimino; Bell, Margie; Rhodes, Linda

2013-12-01

To determine the optimal method for use of the Canine Brief Pain Inventory (CBPI) to quantitate responses of dogs with osteoarthritis to treatment with carprofen or placebo. 150 dogs with osteoarthritis. Data were analyzed from 2 studies with identical protocols in which owner-completed CBPIs were used. Treatment for each dog was classified as a success or failure by comparing the pain severity score (PSS) and pain interference score (PIS) on day 0 (baseline) with those on day 14. Treatment success or failure was defined on the basis of various combinations of reduction in the 2 scores when inclusion criteria were set as a PSS and PIS ≥ 1, 2, or 3 at baseline. Statistical analyses were performed to select the definition of treatment success that had the greatest statistical power to detect differences between carprofen and placebo treatments. Defining treatment success as a reduction of ≥ 1 in PSS and ≥ 2 in PIS in each dog had consistently robust power. Power was 62.8% in the population that included only dogs with baseline scores ≥ 2 and 64.7% in the population that included only dogs with baseline scores ≥ 3. The CBPI had robust statistical power to evaluate the treatment effect of carprofen in dogs with osteoarthritis when protocol success criteria were predefined as a reduction ≥ 1 in PIS and ≥ 2 in PSS. Results indicated the CBPI can be used as an outcome measure in clinical trials to evaluate new pain treatments when it is desirable to evaluate success in individual dogs rather than overall mean or median scores in a test population.

Treatment strategies in colorectal cancer patients with initially unresectable liver-only metastases, a study protocol of the randomised phase 3 CAIRO5 study of the Dutch Colorectal Cancer Group (DCCG).

PubMed

Huiskens, Joost; van Gulik, Thomas M; van Lienden, Krijn P; Engelbrecht, Marc R W; Meijer, Gerrit A; van Grieken, Nicole C T; Schriek, Jonne; Keijser, Astrid; Mol, Linda; Molenaar, I Quintus; Verhoef, Cornelis; de Jong, Koert P; Dejong, Kees H C; Kazemier, Geert; Ruers, Theo M; de Wilt, Johanus H W; van Tinteren, Harm; Punt, Cornelis J A

2015-05-06

Colorectal cancer patients with unresectable liver-only metastases may be cured after downsizing of metastases by neoadjuvant systemic therapy. However, the optimal neoadjuvant induction regimen has not been defined, and the lack of consensus on criteria for (un)resectability complicates the interpretation of published results. CAIRO5 is a multicentre, randomised, phase 3 clinical study. Colorectal cancer patients with initially unresectable liver-only metastases are eligible, and will not be selected for potential resectability. The (un)resectability status is prospectively assessed by a central panel consisting of at least one radiologist and three liver surgeons, according to predefined criteria. Tumours of included patients will be tested for RAS mutation status. Patients with RAS wild type tumours will be treated with doublet chemotherapy (FOLFOX or FOLFIRI) and randomised between the addition of either bevacizumab or panitumumab, and patients with RAS mutant tumours will be randomised between doublet chemotherapy (FOLFOX or FOLFIRI) plus bevacizumab or triple chemotherapy (FOLFOXIRI) plus bevacizumab. Radiological evaluation to assess conversion to resectability will be performed by the central panel, at an interval of two months. The primary study endpoint is median progression-free survival. Secondary endpoints are the R0/1 resection rate, median overall survival, response rate, toxicity, pathological response of resected lesions, postoperative morbidity, and correlation of baseline and follow-up evaluation with respect to outcomes by the central panel. CAIRO5 is a prospective multicentre trial that investigates the optimal systemic induction therapy for patients with initially unresectable, liver-only colorectal cancer metastases. CAIRO 5 is registered at European Clinical Trials Database (EudraCT) (2013-005435-24). CAIRO 5 is registered at ClinicalTrials.gov: NCT02162563 , June 10, 2014.

Privacy-Aware Relevant Data Access with Semantically Enriched Search Queries for Untrusted Cloud Storage Services.

PubMed

Pervez, Zeeshan; Ahmad, Mahmood; Khattak, Asad Masood; Lee, Sungyoung; Chung, Tae Choong

2016-01-01

Privacy-aware search of outsourced data ensures relevant data access in the untrusted domain of a public cloud service provider. Subscriber of a public cloud storage service can determine the presence or absence of a particular keyword by submitting search query in the form of a trapdoor. However, these trapdoor-based search queries are limited in functionality and cannot be used to identify secure outsourced data which contains semantically equivalent information. In addition, trapdoor-based methodologies are confined to pre-defined trapdoors and prevent subscribers from searching outsourced data with arbitrarily defined search criteria. To solve the problem of relevant data access, we have proposed an index-based privacy-aware search methodology that ensures semantic retrieval of data from an untrusted domain. This method ensures oblivious execution of a search query and leverages authorized subscribers to model conjunctive search queries without relying on predefined trapdoors. A security analysis of our proposed methodology shows that, in a conspired attack, unauthorized subscribers and untrusted cloud service providers cannot deduce any information that can lead to the potential loss of data privacy. A computational time analysis on commodity hardware demonstrates that our proposed methodology requires moderate computational resources to model a privacy-aware search query and for its oblivious evaluation on a cloud service provider.

Nasal Septal Deviations: A Systematic Review of Classification Systems.

PubMed

Teixeira, Jeffrey; Certal, Victor; Chang, Edward T; Camacho, Macario

2016-01-01

Objective. To systematically review the international literature for internal nasal septal deviation classification systems and summarize them for clinical and research purposes. Data Sources. Four databases (including PubMed/MEDLINE) were systematically searched through December 16, 2015. Methods. Systematic review, adhering to PRISMA. Results. After removal of duplicates, this study screened 952 articles for relevance. A final comprehensive review of 50 articles identified that 15 of these articles met the eligibility criteria. The classification systems defined in these articles included C-shaped, S-shaped, reverse C-shaped, and reverse S-shaped descriptions of the septal deviation in both the cephalocaudal and anteroposterior dimensions. Additional studies reported use of computed tomography and categorized deviation based on predefined locations. Three studies graded the severity of septal deviations based on the amount of deflection. The systems defined in the literature also included an evaluation of nasal septal spurs and perforations. Conclusion. This systematic review ascertained that the majority of the currently published classification systems for internal nasal septal deviations can be summarized by C-shaped or reverse C-shaped, as well as S-shaped or reverse S-shaped deviations in the anteroposterior and cephalocaudal dimensions. For imaging studies, predefined points have been defined along the septum. Common terminology can facilitate future research.

Privacy-Aware Relevant Data Access with Semantically Enriched Search Queries for Untrusted Cloud Storage Services

PubMed Central

Pervez, Zeeshan; Ahmad, Mahmood; Khattak, Asad Masood; Lee, Sungyoung; Chung, Tae Choong

2016-01-01

Privacy-aware search of outsourced data ensures relevant data access in the untrusted domain of a public cloud service provider. Subscriber of a public cloud storage service can determine the presence or absence of a particular keyword by submitting search query in the form of a trapdoor. However, these trapdoor-based search queries are limited in functionality and cannot be used to identify secure outsourced data which contains semantically equivalent information. In addition, trapdoor-based methodologies are confined to pre-defined trapdoors and prevent subscribers from searching outsourced data with arbitrarily defined search criteria. To solve the problem of relevant data access, we have proposed an index-based privacy-aware search methodology that ensures semantic retrieval of data from an untrusted domain. This method ensures oblivious execution of a search query and leverages authorized subscribers to model conjunctive search queries without relying on predefined trapdoors. A security analysis of our proposed methodology shows that, in a conspired attack, unauthorized subscribers and untrusted cloud service providers cannot deduce any information that can lead to the potential loss of data privacy. A computational time analysis on commodity hardware demonstrates that our proposed methodology requires moderate computational resources to model a privacy-aware search query and for its oblivious evaluation on a cloud service provider. PMID:27571421

A green vehicle routing problem with customer satisfaction criteria

NASA Astrophysics Data System (ADS)

Afshar-Bakeshloo, M.; Mehrabi, A.; Safari, H.; Maleki, M.; Jolai, F.

2016-12-01

This paper develops an MILP model, named Satisfactory-Green Vehicle Routing Problem. It consists of routing a heterogeneous fleet of vehicles in order to serve a set of customers within predefined time windows. In this model in addition to the traditional objective of the VRP, both the pollution and customers' satisfaction have been taken into account. Meanwhile, the introduced model prepares an effective dashboard for decision-makers that determines appropriate routes, the best mixed fleet, speed and idle time of vehicles. Additionally, some new factors evaluate the greening of each decision based on three criteria. This model applies piecewise linear functions (PLFs) to linearize a nonlinear fuzzy interval for incorporating customers' satisfaction into other linear objectives. We have presented a mixed integer linear programming formulation for the S-GVRP. This model enriches managerial insights by providing trade-offs between customers' satisfaction, total costs and emission levels. Finally, we have provided a numerical study for showing the applicability of the model.

Neuropsychological impairments predict the clinical course in schizophrenia.

PubMed

Wölwer, Wolfgang; Brinkmeyer, Jürgen; Riesbeck, Mathias; Freimüller, Lena; Klimke, Ansgar; Wagner, Michael; Möller, Hans-Jürgen; Klingberg, Stefan; Gaebel, Wolfgang

2008-11-01

To add to the open question whether cognitive impairments predict clinical outcome in schizophrenia, a sample of 125 first episode patients was assessed at the onset and over one year of controlled long-term treatment within a study of the German Research Network on Schizophrenia. No relapse according to predefined criteria occurred within the first year, but a total of 29 patients fulfilled post-hoc criteria of "clinical deterioration". Impairments in cognitive functioning assessed by the Trail-Making Test B at the onset of long-term treatment differentiated between patients with vs. without later clinical deterioration and proved to be a significant predictor of the clinical course in a regression analysis outperforming initial clinical status as predictor. However, low sensitivity (72%) and specificity (51%) limit possibilities of a transfer to individual predictions. As a linear combination of neuropsychological and psychopathological variables obtained highest predictive validity, such a combination may improve the prediction of the course of schizophrenic disorders and may ultimately lead to a more efficient and comprehensive treatment planning.

e-Screening revolution: A novel approach to developing a delirium screening tool in the intensive care unit.

PubMed

Eeles, Eamonn; Gunn, Hayley; Sutt, Anna-Liisa; Pinsker, Donna; Flaws, Dylan; Jarrett, Paul; Lye, India; Fraser, John F

2018-06-01

Delirium is common in the intensive care unit (ICU), often affecting older patients. A bedside electronic tool has the potential to revolutionise delirium screening. Our group describe a novel approach to the design and development of delirium screening questions for the express purpose of use within an electronic device. Preliminary results are presented. Our group designed a series of tests which targeted the clinical criteria for delirium according to Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5) criteria against predefined requirements, including applicability to older patients. Candidate questions, including tests of attention and awareness, were devised and then refined by an expert multidisciplinary group, including geriatricians. A scoring scheme was constructed, with testing to failure an indicator of delirium. The device was tested in healthy controls, aged 20-80 years, who were recorded as being without delirium. e-Screening for delirium requires a novel approach to instrument design but may revolutionise recognition of delirium in ICU. © 2018 AJA Inc.

Employing the therapeutic operating characteristic (TOC) graph for individualised dose prescription.

PubMed

Hoffmann, Aswin L; Huizenga, Henk; Kaanders, Johannes H A M

2013-03-07

In current practice, patients scheduled for radiotherapy are treated according to 'rigid' protocols with predefined dose prescriptions that do not consider risk-taking preferences of individuals. The therapeutic operating characteristic (TOC) graph is applied as a decision-aid to assess the trade-off between treatment benefit and morbidity to facilitate dose prescription customisation. Historical dose-response data from prostate cancer patient cohorts treated with 3D-conformal radiotherapy is used to construct TOC graphs. Next, intensity-modulated (IMRT) plans are generated by optimisation based on dosimetric criteria and dose-response relationships. TOC graphs are constructed for dose-scaling of the optimised IMRT plan and individualised dose prescription. The area under the TOC curve (AUC) is estimated to measure the therapeutic power of these plans. On a continuous scale, the TOC graph directly visualises treatment benefit and morbidity risk of physicians' or patients' choices for dose (de-)escalation. The trade-off between these probabilities facilitates the selection of an individualised dose prescription. TOC graphs show broader therapeutic window and higher AUCs with increasing target dose heterogeneity. The TOC graph gives patients and physicians access to a decision-aid and read-out of the trade-off between treatment benefit and morbidity risks for individualised dose prescription customisation over a continuous range of dose levels.

Employing the therapeutic operating characteristic (TOC) graph for individualised dose prescription

PubMed Central

2013-01-01

Background In current practice, patients scheduled for radiotherapy are treated according to ‘rigid’ protocols with predefined dose prescriptions that do not consider risk-taking preferences of individuals. The therapeutic operating characteristic (TOC) graph is applied as a decision-aid to assess the trade-off between treatment benefit and morbidity to facilitate dose prescription customisation. Methods Historical dose-response data from prostate cancer patient cohorts treated with 3D-conformal radiotherapy is used to construct TOC graphs. Next, intensity-modulated (IMRT) plans are generated by optimisation based on dosimetric criteria and dose-response relationships. TOC graphs are constructed for dose-scaling of the optimised IMRT plan and individualised dose prescription. The area under the TOC curve (AUC) is estimated to measure the therapeutic power of these plans. Results On a continuous scale, the TOC graph directly visualises treatment benefit and morbidity risk of physicians’ or patients’ choices for dose (de-)escalation. The trade-off between these probabilities facilitates the selection of an individualised dose prescription. TOC graphs show broader therapeutic window and higher AUCs with increasing target dose heterogeneity. Conclusions The TOC graph gives patients and physicians access to a decision-aid and read-out of the trade-off between treatment benefit and morbidity risks for individualised dose prescription customisation over a continuous range of dose levels. PMID:23497640

Antibiotic prophylaxis in transarterial therapy of hepatocellular carcinoma: A meta-analysis

PubMed Central

Wang, Jun; He, Xiao Dong; Zhang, You Cheng

2012-01-01

BACKGROUND: The use of prophylactic antibiotics against postprocedure infection in patients undergoing transarterial therapy for hepatocellular carcinoma is controversial. AIM: To compare the effects of prophylactic antibiotic treatment and no prophylactic antibiotic treatment on infectious complications following transarterial procedures. METHODS: Clinical trials fulfilling predefined selection criteria were identified by searching several bibliographic databases; a meta-analysis was performed where appropriate. RESULTS: Four trials of inadequate quality consisting of 210 patients were included in the analysis. Only one case of possible postprocedure infection in each group was reported. The rate of patients developing fever (RR 0.91 [95% CI 0.61 to 1.35]), changes in peripheral white blood cell count or serum C-reactive protein levels, and the mean length of hospital stay (mean difference 0.20 [95% CI 0.75 to 1.14]) showed no significant intergroup differences between antibiotic and no antibiotic treatment. Furthermore, the results of the present study indicated that the incidence of bacteremia, septicemia, sepsis or hepatic abscess after transarterial therapy was rare. CONCLUSION: Antibiotic prophylaxis in patients undergoing transarterial therapy for hepatocellular carcinoma may not be routinely necessary. However, a more judicious use of antibiotics is recommended for patients who are at an increased risk of infection. Nevertheless, prospective trials on a larger scale are clearly needed. PMID:22312607

Antibiotic prophylaxis in transarterial therapy of hepatocellular carcinoma: a meta-analysis.

PubMed

Wang, Jun; He, Xiao Dong; Zhang, You Cheng

2012-02-01

The use of prophylactic antibiotics against postprocedure infection in patients undergoing transarterial therapy for hepatocellular carcinoma is controversial. To compare the effects of prophylactic antibiotic treatment and no prophylactic antibiotic treatment on infectious complications following transarterial procedures. Clinical trials fulfilling predefined selection criteria were identified by searching several bibliographic databases; a meta-analysis was performed where appropriate. Four trials of inadequate quality consisting of 210 patients were included in the analysis. Only one case of possible postprocedure infection in each group was reported. The rate of patients developing fever (RR 0.91 [95% CI 0.61 to 1.35]), changes in peripheral white blood cell count or serum C-reactive protein levels, and the mean length of hospital stay (mean difference 0.20 [95% CI 0.75 to 1.14]) showed no significant intergroup differences between antibiotic and no antibiotic treatment. Furthermore, the results of the present study indicated that the incidence of bacteremia, septicemia, sepsis or hepatic abscess after transarterial therapy was rare. Antibiotic prophylaxis in patients undergoing transarterial therapy for hepatocellular carcinoma may not be routinely necessary. However, a more judicious use of antibiotics is recommended for patients who are at an increased risk of infection. Nevertheless, prospective trials on a larger scale are clearly needed.

Comparison of commercial analytical techniques for measuring chlorine dioxide in urban desalinated drinking water.

PubMed

Ammar, T A; Abid, K Y; El-Bindary, A A; El-Sonbati, A Z

2015-12-01

Most drinking water industries are closely examining options to maintain a certain level of disinfectant residual through the entire distribution system. Chlorine dioxide is one of the promising disinfectants that is usually used as a secondary disinfectant, whereas the selection of the proper monitoring analytical technique to ensure disinfection and regulatory compliance has been debated within the industry. This research endeavored to objectively compare the performance of commercially available analytical techniques used for chlorine dioxide measurements (namely, chronoamperometry, DPD (N,N-diethyl-p-phenylenediamine), Lissamine Green B (LGB WET) and amperometric titration), to determine the superior technique. The commonly available commercial analytical techniques were evaluated over a wide range of chlorine dioxide concentrations. In reference to pre-defined criteria, the superior analytical technique was determined. To discern the effectiveness of such superior technique, various factors, such as sample temperature, high ionic strength, and other interferences that might influence the performance were examined. Among the four techniques, chronoamperometry technique indicates a significant level of accuracy and precision. Furthermore, the various influencing factors studied did not diminish the technique's performance where it was fairly adequate in all matrices. This study is a step towards proper disinfection monitoring and it confidently assists engineers with chlorine dioxide disinfection system planning and management.

Use of Benzodiazepines in Alzheimer’s Disease: A Systematic Review of Literature

PubMed Central

Defrancesco, Michaela; Marksteiner, Josef; Fleischhacker, W. Wolfgang; Blasko, Imrich

2015-01-01

Background: Benzodiazepines are frequently prescribed in patients with Alzheimer’s disease. Unfortunately, studies evaluating their benefits and risks in these patients are limited. Methods: Clinical trials focusing on the effect of benzodiazepines on cognitive functions, disease progression, behavioral symptoms, sleep disturbances, and the general frequency of benzodiazepine use were included in this review. Published articles from January 1983 to January 2015 were identified using specific search terms in MEDLINE and PubMed Library according to the recommendations of The Strengthening the Reporting of Observational Studies in Epidemiology initiative. Results: Of the 657 articles found, 18 articles met predefined selection criteria and were included in this review (8 on frequency, 5 on cognitive functions, 5 on behavioral and sleep disturbances). The frequency of benzodiazepine use ranged from 8.5% to 20%. Five studies reported accelerated cognitive deterioration in association with benzodiazepine use. Two studies reported clinical efficacy for lorazepam and alprazolam to reduce agitation in Alzheimer’s disease patients. No evidence was found for an improvement of sleep quality using benzodiazepines. Conclusion: This systematic review shows a relatively high prevalence of benzodiazepine use but limited evidence for clinical efficacy in Alzheimer’s disease patients. However, there is a paucity of methodologically high quality controlled clinical trials. Our results underscore a need for randomized controlled trials in this area. PMID:25991652

Services for the Detection and Treatment of Retinopathy of Prematurity in Major Indian Cities: The 11-City 9-State Study.

PubMed

Gilbert, Clare; Shukla, Rajan; Kumar, Rakesh; Khera, Ajay; Murthy, G Vs

2016-11-07

Control of visual loss from retinopathy of prematurity requires high quality neonatal care, and timely screening and treatment of sight-threatening disease. We assessed services for retinopathy of prematurity provided by ophthalmic training institutions in major Indian cities. Eleven cities were purposefully selected and eye-care facilities were evaluated using predefined criteria. Field teams visited these facilities to collect data by interview and observation using structured questionnaires. 30 training institutions were visited (18 public; 12 not-for-profit); 24 (24/30, 80%) provided a service for retinopathy of prematurity in 58 neonatal units (30 public, 28 private). 15/24 (63%) screened in one unit; six (25%) in 2-3 units and three (12%) in >3 units. Not-for-profit facilities (n=9) screened in more units than public facilities (n=15)(mean (range) 4.5 [1-12] vs 1.1 [1-2] units). Indirect ophthalmoscopy by ophthalmologists was the commonest screening modality but only half of these visited the units weekly. Laser was the commonest treatment, but only half treated babies in the neonatal unit. Annual treatments ranged from 1-200 (mean 39). Eye-care services for retinopathy of prematurity need to expand, particularly in the government sector.

[Water pollution and health risks at Yaoundé, Cameroon].

PubMed

Youmbi, Jean Ghislain Tabué; Feumba, Roger; Njitat, Valérie Tsama; de Marsily, Ghislain; Ekodeck, Georges Emmanuel

2013-01-01

The aim of this article consists of developing an ecosystemic approach to collect information about groundwater pollution in order to determine its origin and infer the health risks in Mingoa's watershed through the study of 12 spontaneous settlements. From an environmental point of view, family interviews and direct observations allowed us to inventory springs, wells and latrines, and to collect information. So, we have selected, on the basis of predefined criteria, 21 wells and springs for physico-chemical and bacteriological laboratory analyses. Two hundred children aged less than 5 years were subjected to KOAP examination. A number of 1224 latrines were inventoried, for an average use of 15 people per latrine, producing 913.3 kg/year of excreta. Most of 91% of people use these latrines. The superficial aquifers, connected to the wells and springs, present high values of nitrogen, phosphorous pollutant and fecal contamination indicators (coliforms and fecal streptococcus), which make water inappropriate to human consumption. PCA analysis establishes that water pollution comes mainly from traditional pit latrines. The overall prevalence of diarrhea and parasite infestation was important (=40%). The presence of cysts of Entamoeba histolytica, Ascaris limbricoides, and Entamoeba coli confirms this high prevalence and testify to very approximate hygiene and environment conditions. Copyright © 2013 Académie des sciences. Published by Elsevier SAS. All rights reserved.

Infliximab for Crohn's disease in the Swiss IBD Cohort Study: clinical management and appropriateness.

PubMed

Juillerat, Pascal; Pittet, Valérie; Vader, John-Paul; Burnand, Bernard; Gonvers, Jean-Jacques; de Saussure, Philippe; Mottet, Christian; Seibold, Frank; Rogler, Gerhard; Sagmeister, Markus; Felley, Christian; Michetti, Pierre; Froehlich, Florian

2010-11-01

Antitumor necrosis factor a agents have significantly improved the management of Crohn's disease (CD), but not all patients benefit from this therapy. We used data from the Swiss Inflammatory Bowel Disease Cohort Study and predefined appropriateness criteria to examine the appropriateness of use of infliximab (IFX) in CD patients. EPACT II (European Panel on the Appropriateness of CD Therapy, 2007; www.epact.ch) appropriateness criteria have been developed using a formal explicit panel process combining evidence from the published literature and expert opinion. Questionnaires relating to EPACT II criteria were used at enrollment and follow-up of all Swiss Inflammatory Bowel Disease Cohort Study patients. A step-by-step analysis of all possible indications for IFX therapy in a given patient allowed identification of the most appropriate indication and final classification in a single appropriateness category (appropriate, uncertain, inappropriate). Eight hundred and twenty-one CD patients were prospectively enrolled between November 2006 and March 2009. IFX was administered to 146 patients (18%) at enrollment and was most frequently used for complex fistulizing disease and for the maintenance of remission induced by biological therapy. IFX therapy was considered appropriate in 44%, uncertain in 44%, and inappropriate in 10% of patients. In this cohort, 9 out of 10 indications for IFX therapy were clinically generally acceptable (appropriate or uncertain) according to EPACT II criteria. Uncertain indications resulted mainly from the current more liberal use of IFX in clinical practice as compared with the EPACT II criteria.

Impact of Binding Study Advice on Study Behavior and Pre-University Education Qualification Factors in a Problem-Based Psychology Bachelor Program

ERIC Educational Resources Information Center

de Koning, Björn B.; Loyens, Sofie M. M.; Rikers, Remy M. J. P.; Smeets, Guus; van der Molen, Henk T.

2014-01-01

In the Netherlands, university programs increasingly use the binding study advice (BSA) to select students after the first year. Students with insufficient progress after the first year and who therefore do not conform to pre-defined BSA norms have to quit their program. This study investigated whether the introduction of the BSA is associated…

The Importance of Behavioral Thresholds and Objective Functions in Contaminant Transport Uncertainty Analysis

NASA Astrophysics Data System (ADS)

Sykes, J. F.; Kang, M.; Thomson, N. R.

2007-12-01

The TCE release from The Lockformer Company in Lisle Illinois resulted in a plume in a confined aquifer that is more than 4 km long and impacted more than 300 residential wells. Many of the wells are on the fringe of the plume and have concentrations that did not exceed 5 ppb. The settlement for the Chapter 11 bankruptcy protection of Lockformer involved the establishment of a trust fund that compensates individuals with cancers with payments being based on cancer type, estimated TCE concentration in the well and the duration of exposure to TCE. The estimation of early arrival times and hence low likelihood events is critical in the determination of the eligibility of an individual for compensation. Thus, an emphasis must be placed on the accuracy of the leading tail region in the likelihood distribution of possible arrival times at a well. The estimation of TCE arrival time, using a three-dimensional analytical solution, involved parameter estimation and uncertainty analysis. Parameters in the model included TCE source parameters, groundwater velocities, dispersivities and the TCE decay coefficient for both the confining layer and the bedrock aquifer. Numerous objective functions, which include the well-known L2-estimator, robust estimators (L1-estimators and M-estimators), penalty functions, and dead zones, were incorporated in the parameter estimation process to treat insufficiencies in both the model and observational data due to errors, biases, and limitations. The concept of equifinality was adopted and multiple maximum likelihood parameter sets were accepted if pre-defined physical criteria were met. The criteria ensured that a valid solution predicted TCE concentrations for all TCE impacted areas. Monte Carlo samples are found to be inadequate for uncertainty analysis of this case study due to its inability to find parameter sets that meet the predefined physical criteria. Successful results are achieved using a Dynamically-Dimensioned Search sampling methodology that inherently accounts for parameter correlations and does not require assumptions regarding parameter distributions. For uncertainty analysis, multiple parameter sets were obtained using a modified Cauchy's M-estimator. Penalty functions had to be incorporated into the objective function definitions to generate a sufficient number of acceptable parameter sets. The combined effect of optimization and the application of the physical criteria perform the function of behavioral thresholds by reducing anomalies and by removing parameter sets with high objective function values. The factors that are important to the creation of an uncertainty envelope for TCE arrival at wells are outlined in the work. In general, greater uncertainty appears to be present at the tails of the distribution. For a refinement of the uncertainty envelopes, the application of additional physical criteria or behavioral thresholds is recommended.

Charge patterns as templates for the assembly of layered biomolecular structures.

PubMed

Naujoks, Nicola; Stemmer, Andreas

2006-08-01

Electric fields are used to guide the assembly of biomolecules in predefined geometric patterns on solid substrates. Local surface charges serve as templates to selectively position proteins on thin-film polymeric electret layers, thereby creating a basis for site-directed layered assembly of biomolecular structures. Charge patterns are created using the lithographic capabilities of an atomic force microscope, namely by applying voltage pulses between a conductive tip and the sample. Samples consist of a poly(methyl methacrylate) layer on a p-doped silicon support. Subsequently, the sample is developed in a water-in-oil emulsion, consisting of a dispersed aqueous phase containing biotin-modified immunoglobulinG molecules, and a continuous nonpolar, insulating oil phase. The electrostatic fields cause a net force of (di)electrophoretic nature on the droplet, thereby guiding the proteins to the predefined locations. Due to the functionalization of the immunoglobulinG molecules with biotin-groups, these patterns can now be used to initiate the localized layer-by-layer assembly of biomolecules based on the avidin-biotin mechanism. By binding 40 nm sized biotin-labelled beads to the predefined locations via a streptavidin linker, we verify the functionality of the previously deposited immunoglobulinG-biotin. All assembly steps following the initial deposition of the immunoglobulinG from emulsion can conveniently be conducted in aqueous solutions. Results show that pattern definition is maintained after immersion into aqueous solution.

Identification of multi-criteria for supplier selection in IT project outsourcing

NASA Astrophysics Data System (ADS)

Fusiripong, Prashaya; Baharom, Fauziah; Yusof, Yuhanis

2017-10-01

In the increasing global business competitiveness, most organizations have attempted to determine the suitable external parties to support their core and non-core competency, particularly, in IT project outsourcing. The IT supplier selection is required to apply multi-criteria which comprised tangible criteria and intangible criteria in consider optimal IT supplier. Most researches attempted to identify optimal criteria for selecting IT supplier, however, the criteria cannot be the considered common criteria support the variety of IT outsourcing. Therefore, the study aimed to identify a common set of criteria being used in the various types of IT outsourcing. The common criteria are constructed by multi-criteria and success criteria, which were collected by literature review with comprehensive and comparative approach. Consequently, the researchers are able to identify a common set of criteria adopted in the variety of selection problem IT outsourcing supplier.

Inverse statistics and information content

NASA Astrophysics Data System (ADS)

Ebadi, H.; Bolgorian, Meysam; Jafari, G. R.

2010-12-01

Inverse statistics analysis studies the distribution of investment horizons to achieve a predefined level of return. This distribution provides a maximum investment horizon which determines the most likely horizon for gaining a specific return. There exists a significant difference between inverse statistics of financial market data and a fractional Brownian motion (fBm) as an uncorrelated time-series, which is a suitable criteria to measure information content in financial data. In this paper we perform this analysis for the DJIA and S&P500 as two developed markets and Tehran price index (TEPIX) as an emerging market. We also compare these probability distributions with fBm probability, to detect when the behavior of the stocks are the same as fBm.

Histologic Inflammatory Response to Transvaginal Polypropylene Mesh: A Systematic Review.

PubMed

Thomas, Dominique; Demetres, Michelle; Anger, Jennifer T; Chughtai, Bilal

2018-01-01

To evaluate the inflammatory response following transvaginal implantation of polypropylene (PP) mesh. A comprehensive literature search was performed in the following databases from inception in April 2017: Ovid MEDLINE, Ovid EMBASE, and The Cochrane Library (Wiley). The studies retrieved were screened for eligibility against predefined inclusion and exclusion criteria. Twenty-three articles were included in this review. Following the implantation of PP mesh, there are immediate and local inflammatory responses. PP mesh elicits an inflammatory response that decreases over time; however, no studies documented a complete resolution. Further studies are needed to determine if there is a complete resolution of inflammation or if it persists. Copyright © 2017 Elsevier Inc. All rights reserved.

Allergen immunotherapy for insect venom allergy: protocol for a systematic review.

PubMed

Dhami, Sangeeta; Nurmatov, Ulugbek; Varga, Eva-Maria; Sturm, Gunter; Muraro, Antonella; Akdis, Cezmi A; Antolín-Amérigo, Darío; Bilò, M Beatrice; Bokanovic, Danijela; Calderon, Moises A; Cichocka-Jarosz, Ewa; Elberink, Joanna N G Oude; Gawlik, Radoslaw; Jakob, Thilo; Kosnik, Mitja; Lange, Joanna; Mingomataj, Ervin; Mitsias, Dimitris I; Mosbech, Holger; Pfaar, Oliver; Pitsios, Constantinos; Pravettoni, Valerio; Roberts, Graham; Ruëff, Franziska; Sin, Betül Ayşe; Sheikh, Aziz

2015-01-01

The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guidelines for Allergen Immunotherapy (AIT) for the Management of Insect Venom Allergy. We seek to critically assess the effectiveness, cost-effectiveness and safety of AIT in the management of insect venom allergy. We will undertake a systematic review, which will involve searching international biomedical databases for published, in progress and unpublished evidence. Studies will be independently screened against pre-defined eligibility criteria and critically appraised using established instruments. Data will be descriptively and, if possible and appropriate, quantitatively synthesised. The findings from this review will be used to inform the development of recomendations for EAACI's Guidelines on AIT.

48 CFR 236.602-1 - Selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Selection criteria. 236.602-1 Section 236.602-1 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM... Architect-Engineer Services 236.602-1 Selection criteria. (a) Establish the evaluation criteria before...

Measurement properties of asthma-specific quality-of-life measures: protocol for a systematic review.

PubMed

Apfelbacher, Christian; Paudyal, Priya; Bülbül, Alpaslan; Smith, Helen

2014-07-24

Asthma is a frequent chronic inflammatory disease of the airways, and the assessment of health-related quality of life (HrQoL) is important in both research and routine care. Various asthma-specific measures of HrQoL exist but there is uncertainty which measures are best suited for use in research and routine care. Therefore, the aim of the proposed research is a comprehensive systematic assessment of the measurement properties of the existing measures that were developed to measure asthma-specific quality of life. This study is a systematic review of the measurement properties of asthma-specific measures of health-related quality of life. PubMed and Embase will be searched using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing or comparing measurement properties of asthma-specific HRQL tools. Eligibility assessment and data abstraction will be performed independently by two reviewers. Evidence tables will be generated for study characteristics, instrument characteristics, measurement properties and interpretability. The quality of the measurement properties will be assessed using predefined criteria. Methodological quality of studies will be assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. A best evidence synthesis will be undertaken if more than one study have investigated a particular measurement property. The proposed systematic review will produce a comprehensive assessment of measurement properties of existing measures of asthma-specific health-related quality of life. We also aim to derive recommendations in order to help researchers and practitioners alike in the choice of instrument. PROSPERO registration number: CRD42014010491.

Endomyocardial fibrosis in Sudan: clinical and echocardiographic features

PubMed Central

Khalil, Siddiq Ibrahim; Khalil, Suha; El Tigani, Salma; Saad, Hanan A

2017-01-01

Summary Objective: Endomyocardial fibrosis (EMF) is a rare disease and is often an underdiagnosed and forgotten cardiomyopathy. The objective of this study was to document the current frequency of EMF in Sudan by defining and selecting cases from patients attending the echocardiography laboratory. Additionally we aimed to create an EMF registry for Sudan. Methods: The study started in January 2007 and is on-going. All the patients attending our echocardiography clinics in four different hospitals in Khartoum, Sudan, were included. Transthoracic echocardiography was used as the main diagnostic and selection tool. The diagnosis of EMF was based on predefined criteria and definitions, and was further supported by additional clinical, ECG, laboratory and chest X-ray findings. Results: Out of 4 332 cases studied, 23 (0.5%) were found to have features of EMF. Females constituted 52% and the age range was 24 to 67 years. All patients presented with dyspnoea grades III–IV. Advanced heart failure with gross fluid overload was seen in 54% of cases and ascites was seen in 30%. EMF was biventricular in 53%, left ventricular in 29% and right ventricular in 18% of cases. Apical and ventricular wall fibrosis was found in all cases, followed by atrial enlargement, atrioventricular valve incompetence, ventricular cavity obliteration, restrictive flow pattern and pericardial effusion. Additional echocardiographic features are defined and discussed. Conclusion: Although a rare disease, cases of EMF can be identified in Sudan if a high index of suspicion is observed. New echocardiographic features of ventricular wall layering, endocardial fibrous shelf and endomyocardiopericarial fibrosis were identified and are discussed. PMID:28906536

CARDIOVASCULAR SCREENING OF YOUNG ATHLETES: A REVIEW OF ECONOMIC EVALUATIONS.

PubMed

Gerkens, Sophie; Van Brabandt, Hans; Desomer, Anja; Leonard, Christian; Neyt, Mattias

2017-01-01

Some experts have promoted preparticipative cardiovascular screening programs for young athletes and have claimed that such programs were cost-effective without performing a critical analysis of studies supporting this statement. In this systematic review, a critical assessment of economic evaluations on these programs is performed to determine if they really provide value for money. A systematic review of economic evaluations was performed on December 24, 2014. Web sites of health technology assessment agencies, the Cochrane database of systematic review, the National Health Service Economic Evaluation Database of the Cochrane Library, EMBASE, Medline, Psychinfo, and EconLit were searched to retrieve (reviews of) economic evaluations. No language or time restrictions were imposed and predefined selection criteria were used. Selected studies were critically assessed applying a structured data extraction sheet. Five relevant economic evaluations were critically assessed. Results of these studies were mixed. However, those in favor of screening made (methodological) incorrect choices, of which the most important one was not taking into account a no-screening alternative as comparator. Compared with no screening, other strategies (history and physical examination or history and physical examination plus electrocardiogram) were not considered cost-effective. Results of primary economic evaluations should not be blindly copied without critical assessment. Economic evaluations in this field lack the support of robust evidence. Negative consequences of screening (false positive findings, overtreatment) should also be taken into account and may cause more harm than good. A mass screening of young athletes for cardiovascular diseases does not provide value for money and should be discouraged.

Exposure Matching for Extrapolation of Efficacy in Pediatric Drug Development

PubMed Central

Mulugeta, Yeruk; Barrett, Jeffrey S.; Nelson, Robert; Eshete, Abel Tilahun; Mushtaq, Alvina; Yao, Lynne; Glasgow, Nicole; Mulberg, Andrew E.; Gonzalez, Daniel; Green, Dionna; Florian, Jeffry; Krudys, Kevin; Seo, Shirley; Kim, Insook; Chilukuri, Dakshina; Burckart, Gilbert J.

2017-01-01

During drug development, matching adult systemic exposures of drugs is a common approach for dose selection in pediatric patients when efficacy is partially or fully extrapolated. This is a systematic review of approaches used for matching adult systemic exposures as the basis for dose selection in pediatric trials submitted to the U.S. Food and Drug Administration (FDA) between 1998 and 2012. The trial design of pediatric pharmacokinetic (PK) studies and the pediatric and adult systemic exposure data were obtained from FDA publicly available databases containing reviews of pediatric trials. Exposure matching approaches that were used as the basis for pediatric dose selection were reviewed. The PK data from the adult and pediatric populations were used to quantify exposure agreement between the two patient populations. The main measures were the pediatric PK studies trial design elements and drug systemic exposures (adult and pediatric). There were 31 products (86 trials) with full or partial extrapolation of efficacy with an available PK assessment. Pediatric exposures had a range of mean Cmax and AUC ratios (pediatric/adult) of 0.63-4.19 and 0.36-3.60 respectively. Seven of the 86 trials (8.1%) had a pre-defined acceptance boundary used to match adult exposures. The key PK parameter was consistently predefined for antiviral and anti-infective products. Approaches to match exposure in children and adults varied across products. A consistent approach for systemic exposure matching and evaluating pediatric PK studies is needed to guide future pediatric trials. PMID:27040726

48 CFR 1436.602-1 - Selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Selection criteria. 1436.602-1 Section 1436.602-1 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR SPECIAL...-1 Selection criteria. (a) The CO may include specific evaluation criteria to be used in the...

7 CFR 1948.80 - Planning grant selection criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... financial resources available for such planning; (d) The planning priorities and recommended funding level... 7 Agriculture 13 2010-01-01 2009-01-01 true Planning grant selection criteria. 1948.80 Section... Development Assistance Program § 1948.80 Planning grant selection criteria. The following criteria will be...

[Principles for the evaluation of telemedicine applications: Results of a systematic review and consensus process].

PubMed

Arnold, Katrin; Scheibe, Madlen; Müller, Olaf; Schmitt, Jochen

2016-11-01

The limited number of telemedicine applications being transferred to standard medical care in Germany may to some extent be explained by deficits in the current evaluation practice. Effectiveness and cost effectiveness can only be demonstrated to decision makers and potential users with methodologically sound and fully published evaluations. There is a lack of well-founded and mandatory standards for adequate, comparable evaluations of telemedicine applications. As part of the project CCS Telehealth Eastern Saxony (CCS THOS), a systematic review on evaluation concepts for telemedicine applications (search period until September 2014, databases Medline, Embase, HTA-Database, DARE, NHS EED) as well as an additional selective literature search were conducted. Suggestions for evaluation fundamentals were derived from the results. These suggestions were subjected to a formal consensus process (nominal group process) with relevant stakeholder groups (healthcare payers, healthcare providers, health policy representatives, researchers). 19 papers were included in the systematic review. In accordance with the predefined inclusion criteria, each presented an evaluation concept for telemedicine applications that was based upon a systematic review and/or a consensus process. Via a formal consensus process, the suggestions for evaluation principles derived from the review and the selective literature search (23 papers) resulted in ten agreed evaluation principles. Eight of them were unanimously agreed upon, two were arrived at with one abstention each. The principles enclose criteria for the planning, conduct and reporting of telemedicine evaluations. Adherence to them is obligatory for users of the telemedical infrastructure provided by CCS THOS. Furthermore, right from the beginning the intention was very much for these principles to be seized upon by other projects and initiatives. The agreed evaluation principles for telemedicine applications are the first in Germany to be based both upon evidence and consensus. Due to the methodology of development, they have a strong scientific and health policy legitimation. Therefore, and because of their general applicability, adherence to these principles beyond the context of the telemedicine platform developed within CCS THOS is recommended, namely throughout the German telemedicine scene. Copyright © 2016. Published by Elsevier GmbH.

Diagnostic validity of early-onset obsessive-compulsive disorder in the Danish Psychiatric Central Register: findings from a cohort sample

PubMed Central

Powell, Shelagh; Koch, Susanne V; Crowley, James J; Matthiesen, Manuel; Grice, Dorothy E; Thomsen, Per H; Parner, E

2017-01-01

Objectives Employing national registers for research purposes depends on a high diagnostic validity. The aim of the present study was to examine the diagnostic validity of recorded diagnoses of early-onset obsessive-compulsive disorder (OCD) in the Danish Psychiatric Central Register (DPCR). Design Review of patient journals selected randomly through the DPCR. Method One hundred cases of OCD were randomly selected from DPCR. Using a predefined coding scheme based on the Children’s Yale Brown Obsessive Compulsive Scale (CYBOCS), experienced research nurse or child and adolescent psychiatrists assessed each journal to determine the presence/absence of OCD diagnostic criteria. The detailed assessments were reviewed by two senior child and adolescent psychiatrists to determine if diagnostic criteria were met. Primary outcome measurements Positive predictive value (PPV) was used as the primary outcome measurement. Results A total of 3462 children/adolescents received an OCD diagnosis as the main diagnosis between 1 January 1995 and 31 December 2015. The average age at diagnosis was 13.21±2.89 years. The most frequent registered OCD subcode was the combined diagnosis DF42.2. Of the 100 cases we examined, 35 had at least one registered comorbidity. For OCD, the PPV was good (PPV 0.85). Excluding journals with insufficient information, the PPV was 0.96. For the subcode F42.2 the PPV was 0.77. The inter-rater reliability was 0.94. The presence of the CYBOCS in the journal significantly increased the PPV for the OCD diagnosis altogether and for the subcode DF42.2. Conclusion The validity and reliability of International Classification of Disease 10th revision codes for OCD in the DPCR is generally high. The subcodes for predominant obsessions/predominant compulsions are less certain and should be used with caution. The results apply for both children and adolescents and for both older and more recent cases. Altogether, the study suggests that there is a high validity of the OCD diagnosis in the Danish National Registers. PMID:28928194

Level of evidence, sponsorship, conflict of interest policy and commercial impact of PubMed-listed clinical urolithiasis-related trials in 2014.

PubMed

Schoenthaler, Martin; Miernik, Arkadiusz; Wilhelm, Konrad; Schlager, Daniel; Schoeb, Dominik Stefan; Adams, Fabian; Dahm, Philipp; Hein, Simon

2016-05-01

To evaluate published trials on urolithiasis regarding level of evidence, type of sponsorship and declared conflicts of interest (COIs), and to elucidate a potential commercial impact. We performed a systematic PubMed(®) literature search using a predefined Boolean search term to identify PubMed-listed clinical research studies on urolithiasis in 2014 (fourth quarter). All authors screened the results for eligibility criteria and two independent reviewers evaluated and performed data extraction of predefined endpoints, including level of evidence, declaration of COI and sponsorship/funding (as indicated in the published print version), and commercial impact. A total of 110 clinical trials in urolithiasis listed in PubMed met the inclusion criteria. Levels of evidence 1, 2, 3 and 4 were found in 15%, 14%, 21% and 51% of trials, respectively. A COI was indicated in a total of 90% of publications, 93% of which declared no existing conflict of interest. Sponsorship was indicated in 36% of publications, 55% of which stated public funding, 33% institutional funding, 10% industrial funding and 2% both public and industrial funding. A total of 11% of the published trials were rated as having a high commercial impact. The present study provides evidence of increasing levels of evidence for published clinical trials on urolithiasis in 2014 (as compared with earlier data). Ninety percent of publications indicated conflicts of interest, whereas sponsoring of studies was declared only by one-third. A considerable number of trials involved issues of high commercial impact. Recently established legal programmes and voluntary acts on self-reporting of financial relationships will enhance transparency in the future; however, increased public funding will be needed to further promote the quality of trials on urolithiasis. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

Distractor interference during smooth pursuit eye movements.

PubMed

Spering, Miriam; Gegenfurtner, Karl R; Kerzel, Dirk

2006-10-01

When 2 targets for pursuit eye movements move in different directions, the eye velocity follows the vector average (S. G. Lisberger & V. P. Ferrera, 1997). The present study investigates the mechanisms of target selection when observers are instructed to follow a predefined horizontal target and to ignore a moving distractor stimulus. Results show that at 140 ms after distractor onset, horizontal eye velocity is decreased by about 25%. Vertical eye velocity increases or decreases by 1 degrees /s in the direction opposite from the distractor. This deviation varies in size with distractor direction, velocity, and contrast. The effect was present during the initiation and steady-state tracking phase of pursuit but only when the observer had prior information about target motion. Neither vector averaging nor winner-take-all models could predict the response to a moving to-be-ignored distractor during steady-state tracking of a predefined target. The contributions of perceptual mislocalization and spatial attention to the vertical deviation in pursuit are discussed. Copyright 2006 APA.

78 FR 54588 - Final Priorities, Requirements, Definitions, and Selection Criteria: Race to the Top-District...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-05

..., and the following three paragraphs: These final priorities, requirements, definitions, and selection... Priorities, Requirements, Definitions, and Selection Criteria: Race to the Top--District Program; Correction..., requirements, definitions, and selection criteria; correction. SUMMARY: The Secretary of Education is...

Selection of specific protein binders for pre-defined targets from an optimized library of artificial helicoidal repeat proteins (alphaRep).

PubMed

Guellouz, Asma; Valerio-Lepiniec, Marie; Urvoas, Agathe; Chevrel, Anne; Graille, Marc; Fourati-Kammoun, Zaineb; Desmadril, Michel; van Tilbeurgh, Herman; Minard, Philippe

2013-01-01

We previously designed a new family of artificial proteins named αRep based on a subgroup of thermostable helicoidal HEAT-like repeats. We have now assembled a large optimized αRep library. In this library, the side chains at each variable position are not fully randomized but instead encoded by a distribution of codons based on the natural frequency of side chains of the natural repeats family. The library construction is based on a polymerization of micro-genes and therefore results in a distribution of proteins with a variable number of repeats. We improved the library construction process using a "filtration" procedure to retain only fully coding modules that were recombined to recreate sequence diversity. The final library named Lib2.1 contains 1.7×10(9) independent clones. Here, we used phage display to select, from the previously described library or from the new library, new specific αRep proteins binding to four different non-related predefined protein targets. Specific binders were selected in each case. The results show that binders with various sizes are selected including relatively long sequences, with up to 7 repeats. ITC-measured affinities vary with Kd values ranging from micromolar to nanomolar ranges. The formation of complexes is associated with a significant thermal stabilization of the bound target protein. The crystal structures of two complexes between αRep and their cognate targets were solved and show that the new interfaces are established by the variable surfaces of the repeated modules, as well by the variable N-cap residues. These results suggest that αRep library is a new and versatile source of tight and specific binding proteins with favorable biophysical properties.

Selection of Specific Protein Binders for Pre-Defined Targets from an Optimized Library of Artificial Helicoidal Repeat Proteins (alphaRep)

PubMed Central

Chevrel, Anne; Graille, Marc; Fourati-Kammoun, Zaineb; Desmadril, Michel; van Tilbeurgh, Herman; Minard, Philippe

2013-01-01

We previously designed a new family of artificial proteins named αRep based on a subgroup of thermostable helicoidal HEAT-like repeats. We have now assembled a large optimized αRep library. In this library, the side chains at each variable position are not fully randomized but instead encoded by a distribution of codons based on the natural frequency of side chains of the natural repeats family. The library construction is based on a polymerization of micro-genes and therefore results in a distribution of proteins with a variable number of repeats. We improved the library construction process using a “filtration” procedure to retain only fully coding modules that were recombined to recreate sequence diversity. The final library named Lib2.1 contains 1.7×109 independent clones. Here, we used phage display to select, from the previously described library or from the new library, new specific αRep proteins binding to four different non-related predefined protein targets. Specific binders were selected in each case. The results show that binders with various sizes are selected including relatively long sequences, with up to 7 repeats. ITC-measured affinities vary with Kd values ranging from micromolar to nanomolar ranges. The formation of complexes is associated with a significant thermal stabilization of the bound target protein. The crystal structures of two complexes between αRep and their cognate targets were solved and show that the new interfaces are established by the variable surfaces of the repeated modules, as well by the variable N-cap residues. These results suggest that αRep library is a new and versatile source of tight and specific binding proteins with favorable biophysical properties. PMID:24014183

What criteria guide national entrepreneurs' policy decisions on user fee removal for maternal health care services? Use of a best-worst scaling choice experiment in West Africa.

PubMed

Torbica, Aleksandra; De Allegri, Manuela; Belemsaga, Danielle; Medina-Lara, Antonieta; Ridde, Valery

2014-10-01

Several countries in sub-Saharan Africa have implemented policies to remove or reduce user fees. Our aim was to identify criteria guiding such decisions among national policy entrepreneurs, those who link up problem definition, solution development and political processes. We administered a best-worst scaling (BWS) experiment to 89 policy entrepreneurs, asking them to identify the most and the least important criteria on a series of predefined sets. Sets were compiled using a Balance Incomplete Block Design which generated random combinations of all 11 criteria included in the experiment. In turn, those had emerged from a prior set of focus group discussions organized among policy entrepreneurs. Ordered logit models were used to investigate the value of single criteria as well as heterogeneity of preferences. Political commitment was identified as the most important criterion guiding policy decisions on user fee abolition or reduction to the overall sample, but particularly so for more experienced respondents aged over 50 years. International pressure and donor money were identified as least important while equity and institutional capacity were deemed of relatively little importance. Respondents more involved in advising on policy than on formulating policy rated economic issues such as financial sustainability and cost-effectiveness as less important. It is feasible to apply BWS experiments in low-income countries, although whether the technique can be adjusted to elicit preferences among non-literate respondents in these settings is unclear. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis.

PubMed

Lallas, A; Tschandl, P; Kyrgidis, A; Stolz, W; Rabinovitz, H; Cameron, A; Gourhant, J Y; Giacomel, J; Kittler, H; Muir, J; Argenziano, G; Hofmann-Wellenhof, R; Zalaudek, I

2016-05-01

Dermoscopy is limited in differentiating accurately between pigmented lentigo maligna (LM) and pigmented actinic keratosis (PAK). This might be related to the fact that most studies have focused on pigmented criteria only, without considering additional recognizable features. To investigate the diagnostic accuracy of established dermoscopic criteria for pigmented LM and PAK, but including in the evaluation features previously associated with nonpigmented facial actinic keratosis. Retrospectively enrolled cases of histopathologically diagnosed LM, PAK and solar lentigo/early seborrhoeic keratosis (SL/SK) were dermoscopically evaluated for the presence of predefined criteria. Univariate and multivariate regression analyses were performed and receiver operating characteristic curves were used. The study sample consisted of 70 LMs, 56 PAKs and 18 SL/SKs. In a multivariate analysis, the most potent predictors of LM were grey rhomboids (sixfold increased probability of LM), nonevident follicles (fourfold) and intense pigmentation (twofold). In contrast, white circles, scales and red colour were significantly correlated with PAK, posing a 14-fold, eightfold and fourfold probability for PAK, respectively. The absence of evident follicles also represented a frequent LM criterion, characterizing 71% of LMs. White and evident follicles, scales and red colour represent significant diagnostic clues for PAK. Conversely, intense pigmentation and grey rhomboidal lines appear highly suggestive of LM. © 2015 British Association of Dermatologists.

Systematic review to inform prevention and management of chronic disease for Indigenous Australians: overview and priorities.

PubMed

Gomersall, Judith Streak; Canuto, Karla; Aromataris, Edoardo; Braunack-Mayer, Annette; Brown, Alex

2016-02-01

To describe the main characteristics of systematic reviews addressing questions of chronic disease and related risk factors for Indigenous Australians. We searched databases for systematic reviews meeting inclusion criteria. Two reviewers assessed quality and extracted characteristics using pre-defined tools. We identified 14 systematic reviews. Seven synthesised evidence about health intervention effectiveness; four addressed chronic disease or risk factor prevalence; and six conducted critical appraisal as per current best practice. Only three reported steps to align the review with standards for ethical research with Indigenous Australians and/or capture Indigenous-specific knowledge. Most called for more high-quality research. Systematic review is an under-utilised method for gathering evidence to inform chronic disease prevention and management for Indigenous Australians. Relevance of future systematic reviews could be improved by: 1) aligning questions with community priorities as well as decision maker needs; 2) involvement of, and leadership by, Indigenous researchers with relevant cultural and contextual knowledge; iii) use of critical appraisal tools that include traditional risk of bias assessment criteria and criteria that reflect Indigenous standards of appropriate research. Systematic review method guidance, tools and reporting standards are required to ensure alignment with ethical obligations and promote rigor and relevance. © 2015 Public Health Association of Australia.

An Approach for Implementing a Microcomputer Based Report Origination System in the Ada Programming Language

DTIC Science & Technology

1983-03-01

Decision Tree -------------------- 62 4-E. PACKAGE unitrep Action/Area Selection flow Chart 82 4-7. PACKAGE unitrep Control Flow Chart...the originetor wculd manually draft simple, readable, formatted iressages using "-i predef.ined forms and decision logic trees . This alternative was...Study Analysis DATA CCNTENT ERRORS PERCENT OF ERRORS Character Type 2.1 Calcvlations/Associations 14.3 Message Identification 4.? Value Pisiratch 22.E

29 CFR 1926.1414 - Wire rope-selection and installation criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 8 2011-07-01 2011-07-01 false Wire rope-selection and installation criteria. 1926.1414... Derricks in Construction § 1926.1414 Wire rope—selection and installation criteria. (a) Original equipment wire rope and replacement wire rope must be selected and installed in accordance with the requirements...

34 CFR 75.211 - Selection criteria for unsolicited applications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 34 Education 1 2014-07-01 2014-07-01 false Selection criteria for unsolicited applications. 75.211 Section 75.211 Education Office of the Secretary, Department of Education DIRECT GRANT PROGRAMS How Grants Are Made Selection of New Projects § 75.211 Selection criteria for unsolicited applications. (a) If...

A spatial web/agent-based model to support stakeholders' negotiation regarding land development.

PubMed

Pooyandeh, Majeed; Marceau, Danielle J

2013-11-15

Decision making in land management can be greatly enhanced if the perspectives of concerned stakeholders are taken into consideration. This often implies negotiation in order to reach an agreement based on the examination of multiple alternatives. This paper describes a spatial web/agent-based modeling system that was developed to support the negotiation process of stakeholders regarding land development in southern Alberta, Canada. This system integrates a fuzzy analytic hierarchy procedure within an agent-based model in an interactive visualization environment provided through a web interface to facilitate the learning and negotiation of the stakeholders. In the pre-negotiation phase, the stakeholders compare their evaluation criteria using linguistic expressions. Due to the uncertainty and fuzzy nature of such comparisons, a fuzzy Analytic Hierarchy Process is then used to prioritize the criteria. The negotiation starts by a development plan being submitted by a user (stakeholder) through the web interface. An agent called the proposer, which represents the proposer of the plan, receives this plan and starts negotiating with all other agents. The negotiation is conducted in a step-wise manner where the agents change their attitudes by assigning a new set of weights to their criteria. If an agreement is not achieved, a new location for development is proposed by the proposer agent. This process is repeated until a location is found that satisfies all agents to a certain predefined degree. To evaluate the performance of the model, the negotiation was simulated with four agents, one of which being the proposer agent, using two hypothetical development plans. The first plan was selected randomly; the other one was chosen in an area that is of high importance to one of the agents. While the agents managed to achieve an agreement about the location of the land development after three rounds of negotiation in the first scenario, seven rounds were required in the second scenario. The proposed web/agent-based model facilitates the interaction and learning among stakeholders when facing multiple alternatives. Copyright © 2013 Elsevier Ltd. All rights reserved.

Dental insurance: A systematic review.

PubMed

Garla, Bharath Kumar; Satish, G; Divya, K T

2014-12-01

To review uses of finance in dentistry. A search of 25 electronic databases and World Wide Web was conducted. Relevant journals were hand searched and further information was requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Insurance has come of ages and has become the mainstay of payment in many developed countries. So much so that all the alternative forms of payment which originated as an alternative to fee for service now depend on insurance at one point or the other. Fee for service is still the major form of payment in many developing countries including India. It is preferred in many instances since the payment is made immediately.

Systems Maintenance Automated Repair Tasks (SMART)

NASA Technical Reports Server (NTRS)

2008-01-01

SMART is an interactive decision analysis and refinement software system that uses evaluation criteria for discrepant conditions to automatically provide and populate a document/procedure with predefined steps necessary to repair a discrepancy safely, effectively, and efficiently. SMART can store the tacit (corporate) knowledge merging the hardware specification requirements with the actual "how to" repair methods, sequences, and required equipment, all within a user-friendly interface. Besides helping organizations retain repair knowledge in streamlined procedures and sequences, SMART can also help them in saving processing time and expense, increasing productivity, improving quality, and adhering more closely to safety and other guidelines. Though SMART was developed for Space Shuttle applications, its interface is easily adaptable to any hardware that can be broken down by component, subcomponent, discrepancy, and repair.

Integral criteria for large-scale multiple fingerprint solutions

NASA Astrophysics Data System (ADS)

Ushmaev, Oleg S.; Novikov, Sergey O.

2004-08-01

We propose the definition and analysis of the optimal integral similarity score criterion for large scale multmodal civil ID systems. Firstly, the general properties of score distributions for genuine and impostor matches for different systems and input devices are investigated. The empirical statistics was taken from the real biometric tests. Then we carry out the analysis of simultaneous score distributions for a number of combined biometric tests and primary for ultiple fingerprint solutions. The explicit and approximate relations for optimal integral score, which provides the least value of the FRR while the FAR is predefined, have been obtained. The results of real multiple fingerprint test show good correspondence with the theoretical results in the wide range of the False Acceptance and the False Rejection Rates.

77 FR 71780 - U.S. Trade Mission to Asia in Conjunction With Trade Winds-Asia, The Philippines, Hong Kong...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

..., environmental technologies and services, financial services, franchising, healthcare & medical, hotel/restaurant... selection criteria as outlined below. A minimum of 65 companies and/or trade associations will be selected.... content. Selection Criteria for Participation Selection will be based on the following criteria...

34 CFR 225.11 - What selection criteria does the Secretary use in evaluating an application for a Credit...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false What selection criteria does the Secretary use in... Secretary Award a Grant? § 225.11 What selection criteria does the Secretary use in evaluating an... criteria to evaluate an application for a Credit Enhancement for Charter School Facilities grant: (a...

Selection Criteria, Skill Sets and Competencies: What Is Their Role in the Appointment of Vice-Chancellors in Australian Universities?

ERIC Educational Resources Information Center

O'Meara, Bernard; Petzall, Stanley

2009-01-01

Purpose: The research presented here attempts to identify and analyse the reported selection criteria used in the appointment of Australian vice-chancellors (VCs) and to contrast this with the selection criteria actually used. Design/methodology/approach: Contemporary research into the nature, role and purpose of section criteria in appointment…

Occupational exposure and risk of chronic obstructive pulmonary disease: a systematic review and meta-analysis.

PubMed

Alif, Sheikh M; Dharmage, Shyamali C; Bowatte, Gayan; Karahalios, Amalia; Benke, Geza; Dennekamp, Martine; Mehta, Amar J; Miedinger, David; Künzli, Nino; Probst-Hensch, Nicole; Matheson, Melanie C

2016-08-01

Due to contradictory literature we have performed a systematic review and meta-analyse of population-based studies that have used Job Exposure Matrices to assess occupational exposure and risk of Chronic Obstructive Pulmonary Disease (COPD). Two researchers independently searched databases for published articles using predefined inclusion criteria. Study quality was assessed, and results pooled for COPD and chronic bronchitis for exposure to biological dust, mineral dust, and gases/fumes using a fixed and random effect model. Five studies met predetermined inclusion criteria. The meta-analysis showed low exposure to mineral dust, and high exposure to gases/fumes were associated with an increased risk of COPD. We also found significantly increased the risk of chronic bronchitis for low and high exposure to biological dust and mineral dust. Expert commentary: The relationship between occupational exposure assessed by the JEM and the risk of COPD and chronic bronchitis shows significant association with occupational exposure. However, the heterogeneity of the meta-analyses suggests more wide population-based studies with older age groups and longitudinal phenotype assessment of COPD to clarify the role of occupational exposure to COPD risk.

Impact of urban atmospheric pollution on coronary disease.

PubMed

Maitre, Anne; Bonneterre, Vincent; Huillard, Laurent; Sabatier, Philippe; de Gaudemaris, Régis

2006-10-01

Recent epidemiological findings have suggested that urban atmospheric pollution may have adverse effects on the cardiovascular system as well as on the respiratory system. We carried out an exhaustive search of published studies investigating links between coronary heart disease and urban atmospheric pollution. The review was conducted on cited articles published between 1994 and 2005 and whose main objective was to measure the risk of ischaemic heart diseases related to urban pollution. Of the 236 references identified, 46 epidemiological studies were selected for analysis on the basis of pre-defined criteria. The studies were analysed according to short-term effects (time series and case-crossover designs) and long-term effects (case-control and cohort studies). A link between coronary heart disease and at least one of the pollutants studied (PM10, O3, NOx, CO, SO2) emerged in 40 publications. Particulate matter, nitrogen oxides, and carbon monoxide were the pollutants most often linked with coronary heart disease. The association was inconstant for O3. Although the mean mortality or morbidity risk related to urban atmospheric pollution is low compared with that associated with other better-known risk factors, its impact on health is nevertheless major because of the large number of people who are exposed. This exhaustive review supports the possibility that urban pollution is indeed an environmental cardiovascular risk factor and should be considered as such by the cardiologists.

Thermal Protection System Imagery Inspection Management System -TIIMS

NASA Technical Reports Server (NTRS)

Goza, Sharon; Melendrez, David L.; Henningan, Marsha; LaBasse, Daniel; Smith, Daniel J.

2011-01-01

TIIMS is used during the inspection phases of every mission to provide quick visual feedback, detailed inspection data, and determination to the mission management team. This system consists of a visual Web page interface, an SQL database, and a graphical image generator. These combine to allow a user to ascertain quickly the status of the inspection process, and current determination of any problem zones. The TIIMS system allows inspection engineers to enter their determinations into a database and to link pertinent images and video to those database entries. The database then assigns criteria to each zone and tile, and via query, sends the information to a graphical image generation program. Using the official TIPS database tile positions and sizes, the graphical image generation program creates images of the current status of the orbiter, coloring zones, and tiles based on a predefined key code. These images are then displayed on a Web page using customized JAVA scripts to display the appropriate zone of the orbiter based on the location of the user's cursor. The close-up graphic and database entry for that particular zone can then be seen by selecting the zone. This page contains links into the database to access the images used by the inspection engineer when they make the determination entered into the database. Status for the inspection zones changes as determinations are refined and shown by the appropriate color code.

Mining functionally relevant gene sets for analyzing physiologically novel clinical expression data.

PubMed

Turcan, Sevin; Vetter, Douglas E; Maron, Jill L; Wei, Xintao; Slonim, Donna K

2011-01-01

Gene set analyses have become a standard approach for increasing the sensitivity of transcriptomic studies. However, analytical methods incorporating gene sets require the availability of pre-defined gene sets relevant to the underlying physiology being studied. For novel physiological problems, relevant gene sets may be unavailable or existing gene set databases may bias the results towards only the best-studied of the relevant biological processes. We describe a successful attempt to mine novel functional gene sets for translational projects where the underlying physiology is not necessarily well characterized in existing annotation databases. We choose targeted training data from public expression data repositories and define new criteria for selecting biclusters to serve as candidate gene sets. Many of the discovered gene sets show little or no enrichment for informative Gene Ontology terms or other functional annotation. However, we observe that such gene sets show coherent differential expression in new clinical test data sets, even if derived from different species, tissues, and disease states. We demonstrate the efficacy of this method on a human metabolic data set, where we discover novel, uncharacterized gene sets that are diagnostic of diabetes, and on additional data sets related to neuronal processes and human development. Our results suggest that our approach may be an efficient way to generate a collection of gene sets relevant to the analysis of data for novel clinical applications where existing functional annotation is relatively incomplete.

[Soil transmitted helminthiasis in Argentina. A systematic review].

PubMed

Socías, M Eugenia; Fernández, Anabel; Gil, José F; Krolewiecki, Alejandro J

2014-01-01

A systematic review of surveys performed between 1980 and 2011 (published in MEDLINE/Pubmed and/or LILACS indexed journals, available in the baseline data from a Mass Deworming National Program (MDNP, 2005) was used to identify the prevalence, distribution and detection of risk areas for soil transmitted helminth infections (STH) in Argentina. We found 310 publications in the database using the pre-defined key-words (medical subject headings) for research purposes. Only 24 articles with 26 surveillance sites in 8 provinces and a total of 5495 surveyed individuals fulfilled the inclusion criteria. Frequency rates for STH had a wide range: Ascaris lumbricoides: 0-67%, hookworms: 0-90%, Trichuris trichiura: 0-24.6 and Strongyloides stercoralis: 0-83%. The estimated combined incidence varied from 0.8% to 88.6%. Baseline surveys from the MDNP reporting on 1943 children from 12 provinces confirmed the heterogeneity, with combined STH frequency rates ranging from 0 to 42.7%. Surveys included in this review showed that the distribution of STH in Argentina is not homogeneous, with areas of high incidence (> 20%) in the northeastern and northwestern provinces where mass deworming activities would be highly beneficial. In several surveys, the high overall incidence was mostly due to hookworms and S. stercoralis, a situation to be considered when selecting diagnostic and therapeutic control strategies. The scarcity or absence of data from various provinces and the availability of less than 8000 surveyed individuals should be considered.

Health Outcomes of Exposure to Biological and Chemical Components of Inhalable and Respirable Particulate Matter

PubMed Central

Morakinyo, Oyewale Mayowa; Mokgobu, Matlou Ingrid; Mukhola, Murembiwa Stanley; Hunter, Raymond Paul

2016-01-01

Particulate matter (PM) is a key indicator of air pollution and a significant risk factor for adverse health outcomes in humans. PM is not a self-contained pollutant but a mixture of different compounds including chemical and biological fractions. While several reviews have focused on the chemical components of PM and associated health effects, there is a dearth of review studies that holistically examine the role of biological and chemical components of inhalable and respirable PM in disease causation. A literature search using various search engines and (or) keywords was done. Articles selected for review were chosen following predefined criteria, to extract and analyze data. The results show that the biological and chemical components of inhalable and respirable PM play a significant role in the burden of health effects attributed to PM. These health outcomes include low birth weight, emergency room visit, hospital admission, respiratory and pulmonary diseases, cardiovascular disease, cancer, non-communicable diseases, and premature death, among others. This review justifies the importance of each or synergistic effects of the biological and chemical constituents of PM on health. It also provides information that informs policy on the establishment of exposure limits for PM composition metrics rather than the existing exposure limits of the total mass of PM. This will allow for more effective management strategies for improving outdoor air quality. PMID:27314370

Association between aspirin and upper gastrointestinal complications: Systematic review of epidemiologic studies

PubMed Central

Rodríguez, Luis A García; Hernández-Díaz, Sonia; de Abajo, Francisco J

2001-01-01

Aims Because of the widespread use of aspirin for prevention of cardiovascular diseases, side-effects associated with thromboprophylactic doses are of interest. This study summarizes the relative risk (RR) for serious upper gastrointestinal complications (UGIC) associated with aspirin exposure in general and with specific aspirin doses and formulations in particular. Methods After a systematic review, 17 original epidemiologic studies published between 1990 and 2001 were selected according to predefined criteria. Heterogeneity of effects was explored. Pooled estimates were calculated according to different study characteristics and patterns of aspirin use. Results The overall relative risk of UGIC associated with aspirin use was 2.2 (95% confidence interval (CI): 2.1, 2.4) for cohort studies and nested case-control studies and 3.1 (95% CI: 2.8, 3.3) for non-nested case-control studies. Original studies found a dose–response relationship between UGIC and aspirin, although the risk was still elevated for doses lower or up to 300 mg day−1. The summary RR was 2.6 (95% CI: 2.3, 2.9) for plain, 5.3 (95% CI: 3.0, 9.2) for buffered, and 2.4 (95% CI: 1.9, 2.9) for enteric-coated aspirin formulations. Conclusions Aspirin was associated with UGIC even when used at low doses or in buffered or enteric-coated formulations. The latter findings may be partially explained by channeling of susceptible patients to these formulations. PMID:11736865

Systematic review of the clinical efficacy of sibutramine and orlistat in weigth loss, quality of life and its adverse effects in obese adolescents.

PubMed

García Díaz, E; Martín Folgueras, T

2011-01-01

The prevalence of obesity, a serious public health problem, is increasing among teenagers and thus also increases cardiovascular morbidity and mortality in adulthood. To provide a systematic review of the best evidence about the effect of sibutramine and orlistat in weight loss, quality of life and its adverse effects in adolescents diagnosed with obesity. We searched electronic databases and bibliographies of selected articles were inspected for any further reference. We included only randomized controlled trials that met a set of predefined criteria. The studies were reviewed by a narrative synthesis. We included 6 randomized controlled trials of sibutramine and 3 of orlistat. The majority reached a moderate to high methodological quality. Sibutramine and orlistat showed a reduction in body mass index (BMI) that was significantly higher compared with the placebo group. We also found a variation of weight with these drugs significantly better than placebo. Only one trial evaluated the quality of life. The incidence of adverse effects was similar for sibutramine and placebo, except for tachycardia. The most common adverse reactions associated with orlistat were gastrointestinal, mild to moderate. Sibutramine and orlistat in combination with a hypocaloric diet and changes in lifestyle in obese adolescents achieve a short-term loss of weight greater than that achieved through the dietary-behavioral therapy alone.

The Treatment of Snake Bites in a First Aid Setting: A Systematic Review.

PubMed

Avau, Bert; Borra, Vere; Vandekerckhove, Philippe; De Buck, Emmy

2016-10-01

The worldwide burden of snakebite is high, especially in remote regions with lesser accessibility to professional healthcare. Therefore, adequate first aid for snakebite is of the utmost importance. A wide range of different first aid techniques have been described in literature, and are being used in practice. This systematic review aimed to summarize the best available evidence concerning effective and feasible first aid techniques for snakebite. A systematic literature screening, performed independently by two authors in the Cochrane Library, MEDLINE and Embase resulted in 14 studies, fulfilling our predefined selection criteria, concerning first aid techniques for snakebite management. Data was extracted and the body of evidence was appraised according to the GRADE approach. The pressure immobilization technique was identified as the only evidence-based first aid technique with effectiveness on venom spread. However, additional studies suggest that proper application of this technique is not feasible for laypeople. Evidence concerning other first aid measures, such as the application of a tourniquet, suggests avoiding the use of these techniques. The practical recommendation for the treatment of snakebite in a first aid setting is to immobilize the victim, while awaiting the emergency services. However, given the low to very low quality of the data collected, high quality randomized controlled trials concerning the efficacy and feasibility of different variations of the pressure immobilization technique are warranted.

Health Outcomes of Exposure to Biological and Chemical Components of Inhalable and Respirable Particulate Matter.

PubMed

Morakinyo, Oyewale Mayowa; Mokgobu, Matlou Ingrid; Mukhola, Murembiwa Stanley; Hunter, Raymond Paul

2016-06-14

Particulate matter (PM) is a key indicator of air pollution and a significant risk factor for adverse health outcomes in humans. PM is not a self-contained pollutant but a mixture of different compounds including chemical and biological fractions. While several reviews have focused on the chemical components of PM and associated health effects, there is a dearth of review studies that holistically examine the role of biological and chemical components of inhalable and respirable PM in disease causation. A literature search using various search engines and (or) keywords was done. Articles selected for review were chosen following predefined criteria, to extract and analyze data. The results show that the biological and chemical components of inhalable and respirable PM play a significant role in the burden of health effects attributed to PM. These health outcomes include low birth weight, emergency room visit, hospital admission, respiratory and pulmonary diseases, cardiovascular disease, cancer, non-communicable diseases, and premature death, among others. This review justifies the importance of each or synergistic effects of the biological and chemical constituents of PM on health. It also provides information that informs policy on the establishment of exposure limits for PM composition metrics rather than the existing exposure limits of the total mass of PM. This will allow for more effective management strategies for improving outdoor air quality.

SortNet: learning to rank by a neural preference function.

PubMed

Rigutini, Leonardo; Papini, Tiziano; Maggini, Marco; Scarselli, Franco

2011-09-01

Relevance ranking consists in sorting a set of objects with respect to a given criterion. However, in personalized retrieval systems, the relevance criteria may usually vary among different users and may not be predefined. In this case, ranking algorithms that adapt their behavior from users' feedbacks must be devised. Two main approaches are proposed in the literature for learning to rank: the use of a scoring function, learned by examples, that evaluates a feature-based representation of each object yielding an absolute relevance score, a pairwise approach, where a preference function is learned to determine the object that has to be ranked first in a given pair. In this paper, we present a preference learning method for learning to rank. A neural network, the comparative neural network (CmpNN), is trained from examples to approximate the comparison function for a pair of objects. The CmpNN adopts a particular architecture designed to implement the symmetries naturally present in a preference function. The learned preference function can be embedded as the comparator into a classical sorting algorithm to provide a global ranking of a set of objects. To improve the ranking performances, an active-learning procedure is devised, that aims at selecting the most informative patterns in the training set. The proposed algorithm is evaluated on the LETOR dataset showing promising performances in comparison with other state-of-the-art algorithms.

Health effects of employment: a systematic review of prospective studies.

PubMed

van der Noordt, Maaike; IJzelenberg, Helma; Droomers, Mariël; Proper, Karin I

2014-10-01

The purpose of this review was to systematically summarise the literature on the health effects of employment. A search for prospective studies investigating the effect of employment on health was executed in several electronic databases, and references of selected publications were checked. Subsequently, the methodological quality of each study was assessed by predefined criteria. To draw conclusions about the health effect of employment, a best evidence synthesis was used, and if possible, data were pooled. 33 prospective studies were included, of which 23 were of high quality. Strong evidence was found for a protective effect of employment on depression and general mental health. Pooled effect sizes showed favourable effects on depression (OR=0.52; 95% CI 0.33 to 0.83) and psychological distress (OR=0.79; 95% CI 0.72 to 0.86). Insufficient evidence was found for general health, physical health and mortality due to lack of studies or inconsistent findings. This systematic review indicates that employment is beneficial for health, particularly for depression and general mental health. There is a need for more research on the effects of employment on specific physical health effects and mortality to fill the knowledge gaps. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

External validation of preexisting first trimester preeclampsia prediction models.

PubMed

Allen, Rebecca E; Zamora, Javier; Arroyo-Manzano, David; Velauthar, Luxmilar; Allotey, John; Thangaratinam, Shakila; Aquilina, Joseph

2017-10-01

To validate the increasing number of prognostic models being developed for preeclampsia using our own prospective study. A systematic review of literature that assessed biomarkers, uterine artery Doppler and maternal characteristics in the first trimester for the prediction of preeclampsia was performed and models selected based on predefined criteria. Validation was performed by applying the regression coefficients that were published in the different derivation studies to our cohort. We assessed the models discrimination ability and calibration. Twenty models were identified for validation. The discrimination ability observed in derivation studies (Area Under the Curves) ranged from 0.70 to 0.96 when these models were validated against the validation cohort, these AUC varied importantly, ranging from 0.504 to 0.833. Comparing Area Under the Curves obtained in the derivation study to those in the validation cohort we found statistically significant differences in several studies. There currently isn't a definitive prediction model with adequate ability to discriminate for preeclampsia, which performs as well when applied to a different population and can differentiate well between the highest and lowest risk groups within the tested population. The pre-existing large number of models limits the value of further model development and future research should be focussed on further attempts to validate existing models and assessing whether implementation of these improves patient care. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

48 CFR 36.602-1 - Selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Selection criteria. 36.602-1 Section 36.602-1 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL... Selection criteria. (a) Agencies shall evaluate each potential contractor in terms of its— (1) Professional...

Selecting public relations personnel of hospitals by analytic network process.

PubMed

Liao, Sen-Kuei; Chang, Kuei-Lun

2009-01-01

This study describes the use of analytic network process (ANP) in the Taiwanese hospital public relations personnel selection process. Starting with interviewing 48 practitioners and executives in north Taiwan, we collected selection criteria. Then, we retained the 12 critical criteria that were mentioned above 40 times by theses respondents, including: interpersonal skill, experience, negotiation, language, ability to follow orders, cognitive ability, adaptation to environment, adaptation to company, emotion, loyalty, attitude, and Response. Finally, we discussed with the 20 executives to take these important criteria into three perspectives to structure the hierarchy for hospital public relations personnel selection. After discussing with practitioners and executives, we find that selecting criteria are interrelated. The ANP, which incorporates interdependence relationships, is a new approach for multi-criteria decision-making. Thus, we apply ANP to select the most optimal public relations personnel of hospitals. An empirical study of public relations personnel selection problems in Taiwan hospitals is conducted to illustrate how the selection procedure works.

Changes in water quality in agricultural catchments after deployment of wastewater treatment plant.

PubMed

Langhammer, Jakub; Rödlová, Sylva

2013-12-01

Insufficient wastewater remediation in small communities and nonpoint source pollution are the key factors in determining the water quality of small streams in an agricultural landscape. Despite the current extensive construction of municipal wastewater treatment facilities in small communities, the level of organic substances and nutrients in the recipient catchments has not decreased in many areas. This paper analyzes the changes in the water quality of the small streams after the deployment of wastewater treatment plants that were designed to address sources of pollution from small municipalities. The analysis is based on the results from a water quality monitoring network in the small watersheds in the Czech Republic. Five rural catchments with one dominant municipal pollution source, where a wastewater treatment plant was deployed during the monitoring period, were selected according to a predefined set of criteria, from a series of 317 profiles. Basic water quality indicators were selected for the assessment: O₂, BOD-5, COD, TOC, conductivity, NH₄-N, NO₂-N, NO₃-N, PT, and PO₄-P. Results of the analysis showed that the simple deployment of the water treatment facilities at these streams often did not lead to a reduction of contamination in the streams. The expected post-deployment changes, namely, a significant and permanent reduction of stream contamination, occurred only in one catchment, whereas in the remainder of the catchments, only marginal changes or even increased concentrations of the contaminants were detected. As the critical factors that determined the efficiency of wastewater treatment were studied, the need for the consideration of the local conditions during the design of the facility, particularly regarding the size of the catchments, initial level of contamination, proper system of operation, and process optimization of the treatment facility, emerged as the important factor.

The impact of cannabis and cannabinoids for medical conditions on health-related quality of life: A systematic review and meta-analysis.

PubMed

Goldenberg, Matthew; Reid, Mark William; IsHak, Waguih William; Danovitch, Itai

2017-05-01

The use of cannabis or cannabinoids to treat medical conditions and/or alleviate symptoms is increasingly common. However, the impact of this use on patient reported outcomes, such as health-related quality of life (HRQoL), remains unclear. We conducted a systematic review and meta-analysis, employing guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We categorized studies based on design, targeted disease condition, and type of cannabis or cannabinoid used. We scored studies based on quality and risk of bias. After eliminating some studies because of poor quality or insufficient data, we conducted meta-analyses of remaining studies based on design. Twenty studies met our pre-defined selection criteria. Eleven studies were randomized controlled trials (RCTs; 2322 participants); the remaining studies were of cohort and cross-sectional design. Studies of cannabinoids were mostly RCTs of higher design quality than studies of cannabis, which utilized smaller self-selected samples in observational studies. Although we did not uncover a significant association between cannabis and cannabinoids for medical conditions and HRQoL, some patients who used them to treat pain, multiple sclerosis, and inflammatory bower disorders have reported small improvements in HRQoL, whereas some HIV patients have reported reduced HRQoL. The relationship between HRQoL and the use of cannabis or cannabinoids for medical conditions is inconclusive. Some patient populations report improvements whereas others report reductions in HRQoL. In order to inform users, practitioners, and policymakers more clearly, future studies should adhere to stricter research quality guidelines and more clearly report patient outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

Long-Term Efficacy of Maintenance Therapy for Multiple Myeloma: A Quantitative Synthesis of 22 Randomized Controlled Trials.

PubMed

Li, Jie-Li; Fan, Guang-Yu; Liu, Yu-Jie; Zeng, Zi-Hang; Huang, Jing-Juan; Yang, Zong-Ming; Meng, Xiang-Yu

2018-01-01

We aimed to quantitatively synthesize data from randomized controlled trials (RCTs) concerning maintenance for multiple myeloma (MM). We searched electronic literature databases and conference proceedings to identify relevant RCTs. We selected eligible RCTs using predefined selection criteria. We conducted meta-analysis comparing maintenance containing new agents and conventional maintenance, and subgroup analysis by transplantation status and mainstay agent as well. We performed trial sequential analysis (TSA) to determine adequacy of sample size for overall and subgroup meta-analyses. We performed network meta-analysis (NMA) to compare and rank included regimens. A total of 22 RCTs involving 9,968 MM patients and 15 regimens were included, the overall quality of which was adequate. Significant heterogeneity was detected for progression-free survival (PFS) but not overall survival (OS). Meta-analyses showed that maintenance containing new agents significantly improved PFS but not OS [PFS: Hazard Ratio (HR) = 0.59, 95% Confidence Interval (CI) = 0.54 to 0.64; OS: HR = 0.93, 95% CI = 0.87 to 1.00], compared with controls. Subgroup analyses revealed lenalidomide (Len)-based therapies better than thalidomide-based ones (HR = 0.50 and 0.66, respectively; P = 0.001). NMA revealed that most of the maintenance regimens containing new agents were significantly better than simple observation in terms of PFS but not OS. Len single agent was the most effective, considering PFS and OS both. We concluded that conventional maintenance has very limited effect. Maintenance containing new agents is highly effective in improving PFS, but has very limited effect on OS. Maintenance with Len may have the largest survival benefits. Emerging strategies may further change the landscape of maintenance of MM.

A genetic risk score based on direct associations with coronary heart disease improves coronary heart disease risk prediction in the Atherosclerosis Risk in Communities (ARIC), but not in the Rotterdam and Framingham Offspring, Studies

PubMed Central

Brautbar, Ariel; Pompeii, Lisa A.; Dehghan, Abbas; Ngwa, Julius S.; Nambi, Vijay; Virani, Salim S.; Rivadeneira, Fernando; Uitterlinden, André G.; Hofman, Albert; Witteman, Jacqueline C.M.; Pencina, Michael J.; Folsom, Aaron R.; Cupples, L. Adrienne; Ballantyne, Christie M.; Boerwinkle, Eric

2013-01-01

Objective Multiple studies have identified single-nucleotide polymorphisms (SNPs) that are associated with coronary heart disease (CHD). We examined whether SNPs selected based on predefined criteria will improve CHD risk prediction when added to traditional risk factors (TRFs). Methods SNPs were selected from the literature based on association with CHD, lack of association with a known CHD risk factor, and successful replication. A genetic risk score (GRS) was constructed based on these SNPs. Cox proportional hazards model was used to calculate CHD risk based on the Atherosclerosis Risk in Communities (ARIC) and Framingham CHD risk scores with and without the GRS. Results The GRS was associated with risk for CHD (hazard ratio [HR] = 1.10; 95% confidence interval [CI]: 1.07–1.13). Addition of the GRS to the ARIC risk score significantly improved discrimination, reclassification, and calibration beyond that afforded by TRFs alone in non-Hispanic whites in the ARIC study. The area under the receiver operating characteristic curve (AUC) increased from 0.742 to 0.749 (Δ= 0.007; 95% CI, 0.004–0.013), and the net reclassification index (NRI) was 6.3%. Although the risk estimates for CHD in the Framingham Offspring (HR = 1.12; 95% CI: 1.10–1.14) and Rotterdam (HR = 1.08; 95% CI: 1.02–1.14) Studies were significantly improved by adding the GRS to TRFs, improvements in AUC and NRI were modest. Conclusion Addition of a GRS based on direct associations with CHD to TRFs significantly improved discrimination and reclassification in white participants of the ARIC Study, with no significant improvement in the Rotterdam and Framingham Offspring Studies. PMID:22789513

Comparison of effects of seven treatment methods for distal radius fracture on minimizing complex regional pain syndrome

PubMed Central

Sun, Tao

2016-01-01

Introduction Using network meta-analysis, we evaluated the adverse effects of the seven most common treatment methods, i.e., bridging external fixation, non-bridging external fixation, K-wire fixation, plaster fixation, dorsal plating, volar plating, and dorsal and volar plating, by their associated risk of developing complex regional pain syndrome (CRPS) in distal radius fracture (DRF) patients. Material and methods Following an exhaustive search of scientific literature databases for high quality studies, randomized controlled trials (RCTs) related to our study topic were screened and selected based on stringent predefined inclusion and exclusion criteria. Data extracted from the selected studies were used for statistical analyses using Stata 12.0 software. Results A total of 17 RCTs, including 1658 DRF patients, were enrolled in this network meta-analysis. Among the 1658 DRF patients, 452 received bridging external fixation, 525 received non-bridging external fixation, 154 received K-wire fixation, 84 received plaster fixation, 132 received dorsal plating, 123 received volar plating, and 188 received dorsal and volar plating. When compared to bridging external fixation patients, there was no marked difference in the CRPS risk in DRF patients receiving different treatments (all p > 0.05). However, the surface under the cumulative ranking curves (SUCRA) for plaster fixation (77.0%) and non-bridging external fixation (71.3%) were significantly higher compared with the other five methods. Conclusions Our findings suggest that compared with bridging external fixation, K-wire fixation, dorsal plating, volar plating, dorsal and volar plating, plaster fixation and non-bridging external fixation might be the better treatment methods to reduce the risk of CRPS in DRF patients. PMID:28144268

The role of MRI in axillary lymph node imaging in breast cancer patients: a systematic review.

PubMed

Kuijs, V J L; Moossdorff, M; Schipper, R J; Beets-Tan, R G H; Heuts, E M; Keymeulen, K B M I; Smidt, M L; Lobbes, M B I

2015-04-01

To assess whether MRI can exclude axillary lymph node metastasis, potentially replacing sentinel lymph node biopsy (SLNB), and consequently eliminating the risk of SLNB-associated morbidity. PubMed, Cochrane, Medline and Embase databases were searched for relevant publications up to July 2014. Studies were selected based on predefined inclusion and exclusion criteria and independently assessed by two reviewers using a standardised extraction form. Sixteen eligible studies were selected from 1,372 publications identified by the search. A dedicated axillary protocol [sensitivity 84.7 %, negative predictive value (NPV) 95.0 %] was superior to a standard protocol covering both the breast and axilla simultaneously (sensitivity 82.0 %, NPV 82.6 %). Dynamic, contrast-enhanced MRI had a lower median sensitivity (60.0 %) and NPV (80.0 %) compared to non-enhanced T1w/T2w sequences (88.4, 94.7 %), diffusion-weighted imaging (84.2, 90.6 %) and ultrasmall superparamagnetic iron oxide (USPIO)- enhanced T2*w sequences (83.0, 95.9 %). The most promising results seem to be achievable when using non-enhanced T1w/T2w and USPIO-enhanced T2*w sequences in combination with a dedicated axillary protocol (sensitivity 84.7 % and NPV 95.0 %). The diagnostic performance of some MRI protocols for excluding axillary lymph node metastases approaches the NPV needed to replace SLNB. However, current observations are based on studies with heterogeneous study designs and limited populations. • Some axillary MRI protocols approach the NPV of an SLNB procedure. • Dedicated axillary MRI is more accurate than protocols also covering the breast. • T1w/T2w protocols combined with USPIO-enhanced sequences are the most promising sequences.

Impact of a structured intern education programme on clinical documentation in the emergency department.

PubMed

McLean, Andrew; Lawlor, Jenine; Mitchell, Rob; Kault, David; O'Kane, Carl; Lees, Michelle

2015-02-01

To evaluate the impact of More Learning for Interns in Emergency (MoLIE) on clinical documentation in the ED of a large regional hospital. MoLIE was implemented at The Townsville Hospital (TTH) in 2010, and has since provided ED interns with structured off-floor teaching and a dedicated clinical supervisor. A pre- and post-intervention study was conducted using retrospective medical record review methodology. Charts were selected by identifying all TTH ED patients seen by interns in the period 2008-2011. Two hundred pre-intervention records (2008-2009) and 200 post-intervention records (2010-2011) were reviewed. These were randomly selected following an initial screen by an ED staff specialist. The quality of clinical documentation for five common ED presentations (asthma, chest pain, lacerations, abdominal pain and upper limb fractures) was assessed. For each presentation, documentation quality was scored out of 10 using predefined criteria. An improvement of two or more was thought to be clinically significant. Mean scores for each group were compared using a Student's t-test for independent samples. Mean documentation scores (and 95% confidence intervals) were 5.55 (5.17-5.93) in 2008, 5.42 (4.98-5.86) in 2009, 6.37 (5.99-6.75) in 2010 and 6.08 (5.71-6.45) in 2011. There was a statistically but not clinically significant improvement in scores pre- and post-intervention (P ≤ 0.001). The introduction of MoLIE was associated with a small but statistically significant improvement in documentation, despite an 80% increase in intern placements. These results suggest that structured training programmes have potential to improve intern performance while simultaneously enhancing training capacity. The impact on quality of care requires further evaluation. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

77 FR 12234 - Changes in Hydric Soils Database Selection Criteria

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-29

... Conservation Service [Docket No. NRCS-2011-0026] Changes in Hydric Soils Database Selection Criteria AGENCY... Changes to the National Soil Information System (NASIS) Database Selection Criteria for Hydric Soils of the United States. SUMMARY: The National Technical Committee for Hydric Soils (NTCHS) has updated the...

48 CFR 2936.602-1 - Selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Selection criteria. 2936.602-1 Section 2936.602-1 Federal Acquisition Regulations System DEPARTMENT OF LABOR GENERAL... Selection criteria. HCAs are authorized to approve the use of design competition under the conditions in FAR...

48 CFR 436.602-1 - Selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Selection criteria. 436.602-1 Section 436.602-1 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE SPECIAL... Selection criteria. The HCA is authorized to approve the use of design competition under the conditions in...

48 CFR 636.602-1 - Selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Selection criteria. 636.602-1 Section 636.602-1 Federal Acquisition Regulations System DEPARTMENT OF STATE SPECIAL CATEGORIES... Selection criteria. (b) The head of the contracting activity is the agency head's designee for the purpose...

38 CFR 77.5 - Selection criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... ADAPTIVE SPORTS PROGRAMS FOR DISABLED VETERANS AND DISABLED MEMBERS OF THE ARMED FORCES § 77.5 Selection criteria. (a) VA will review all applications for adaptive sports grants using the following selection criteria: (1) The adaptive sports activities to be provided by the program are clearly stated; (2) The...

The NCAT process

NASA Technical Reports Server (NTRS)

Milburn, George

1992-01-01

The topics are presented in viewgraph form and include the following: National Center for Appropriate Technology (NCAT) history; technologies selection criteria; strategic plan status; implementation framework; forum composition; NCAT role as integrator; government/industry coordination; identification and selection process for demonstrations; criteria for demonstrations; criteria for non-selection; and future actions.

Criteria for selecting implementation science theories and frameworks: results from an international survey.

PubMed

Birken, Sarah A; Powell, Byron J; Shea, Christopher M; Haines, Emily R; Alexis Kirk, M; Leeman, Jennifer; Rohweder, Catherine; Damschroder, Laura; Presseau, Justin

2017-10-30

Theories provide a synthesizing architecture for implementation science. The underuse, superficial use, and misuse of theories pose a substantial scientific challenge for implementation science and may relate to challenges in selecting from the many theories in the field. Implementation scientists may benefit from guidance for selecting a theory for a specific study or project. Understanding how implementation scientists select theories will help inform efforts to develop such guidance. Our objective was to identify which theories implementation scientists use, how they use theories, and the criteria used to select theories. We identified initial lists of uses and criteria for selecting implementation theories based on seminal articles and an iterative consensus process. We incorporated these lists into a self-administered survey for completion by self-identified implementation scientists. We recruited potential respondents at the 8th Annual Conference on the Science of Dissemination and Implementation in Health and via several international email lists. We used frequencies and percentages to report results. Two hundred twenty-three implementation scientists from 12 countries responded to the survey. They reported using more than 100 different theories spanning several disciplines. Respondents reported using theories primarily to identify implementation determinants, inform data collection, enhance conceptual clarity, and guide implementation planning. Of the 19 criteria presented in the survey, the criteria used by the most respondents to select theory included analytic level (58%), logical consistency/plausibility (56%), empirical support (53%), and description of a change process (54%). The criteria used by the fewest respondents included fecundity (10%), uniqueness (12%), and falsifiability (15%). Implementation scientists use a large number of criteria to select theories, but there is little consensus on which are most important. Our results suggest that the selection of implementation theories is often haphazard or driven by convenience or prior exposure. Variation in approaches to selecting theory warn against prescriptive guidance for theory selection. Instead, implementation scientists may benefit from considering the criteria that we propose in this paper and using them to justify their theory selection. Future research should seek to refine the criteria for theory selection to promote more consistent and appropriate use of theory in implementation science.

First International Public Health Film Competition 2016-reflections on the development and use of competition judging criteria.

PubMed

Hoang, U; Luna, P; Russell, P; Bergonzi-King, L; Ashton, J; McCarthy, C; Donovan, H; Inman, P; Seminog, O; Botchway, S

2018-03-01

Film competitions can be a helpful method to understand issues of quality in health films. In this paper, we describe the development and use of explicit quality criteria to identify the 'best' films for the first ever international public health film competition. A film selection committee encompassing a range of stakeholders was compiled. The committee drew up 10 explicit quality criteria to judge films drawing upon other film festival's selection criteria. These criteria were then applied to a broad range of health-related films entered into a film competition to select the 'best' film to screen. Eighty-four films from 20 different countries were submitted to the public health film competition. The originality of the subject covered by the film, the public health importance of the issue and story-telling approach in the film were found to be the most discriminatory criteria to select films. Selection of health films for festivals can be undertaken using explicit quality criteria. There are a number of advantages to such an approach; however, explicit selection involves a large commitment of resources from film festival organizers and there is further research required to test the validity of the quality criteria applied to health-related films.

Multicentre clinical evaluation of the new highly sensitive Elecsys® thyroglobulin II assay in patients with differentiated thyroid carcinoma.

PubMed

Trimboli, P; Imperiali, M; Piccardo, A; CampennÌ, A; Giordani, I; Ruggeri, R M; Baldari, S; Orlandi, F; Giovanella, L

2018-02-01

A highly sensitive thyroglobulin assay (Elecsys® Tg II, Roche Diagnostics, Penzberg, Germany) has become available for monitoring patients with differentiated thyroid cancer (DTC). Here, we evaluated the clinical performance of Elecsys® Tg II assay in a multicentre patients series and compare it with the established Access® Tg assay (Beckman Coulter, Brea, CA, USA). Retrospective analysis on prospectively selected patients in four thyroid cancer referral centres with uniform DTC management. All DTC cases diagnosed, treated and followed up in four tertiary referral centres for thyroid cancer since January 2005 (n = 1456) were retrieved, and predefined selection criteria were applied to prevent relevant enrolment biases. A series of 204 patients was finally selected for this study. Samples had been stored at -80°C. Tg was measured by fully automated immunometric Elecsys® Tg II and Access® Tg assays in a centralized laboratory. Two hundred and four DTC were finally included. Of these, 10.8% had structural recurrence (sREC), and 81.4% showed no evidence of disease (NED) at the end of follow-up. There was a significant analytical bias between methods that cannot be used interchangeably. Using ROC curve analysis, the best basal and rhTSH-stimulated Tg cut-offs to detect sREC were 0.41 μg/L and 1.82 μg/L for Elecsys® and 0.36 μg/L and 1.62 μg/L for Access® assay, respectively. Using Cox proportional hazard regression, Tg was the only independent predictor of cancer relapse. Using appropriate assay-specific cut-offs, the clinical performance of the Elecsys® Tg II assay was comparable to that provided by the well-established Access® Tg assay. © 2017 John Wiley & Sons Ltd.

SU-F-T-405: Development of a Rapid Cardiac Contouring Tool Using Landmark-Driven Modeling

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

Pelletier, C; Jung, J; Mosher, E

2016-06-15

Purpose: This study aims to develop a tool to rapidly delineate cardiac substructures for use in dosimetry for large-scale clinical trial or epidemiological investigations. The goal is to produce a system that can semi-automatically delineate nine cardiac structures to a reasonable accuracy within a couple of minutes. Methods: The cardiac contouring tool employs a Most Similar Atlas method, where a selection criterion is used to pre-select the most similar model to the patient from a library of pre-defined atlases. Sixty contrast-enhanced cardiac computed tomography angiography (CTA) scans (30 male and 30 female) were manually contoured to serve as the atlasmore » library. For each CTA 12 structures were delineated. Kabsch algorithm was used to compute the optimum rotation and translation matrices between the patient and atlas. Minimum root mean squared distance between the patient and atlas after transformation was used to select the most-similar atlas. An initial study using 10 CTA sets was performed to assess system feasibility. Leave-one patient out method was performed, and fit criteria were calculated to evaluate the fit accuracy compared to manual contours. Results: For the pilot study, mean dice indices of .895 were achieved for the whole heart, .867 for the ventricles, and .802 for the atria. In addition, mean distance was measured via the chord length distribution (CLD) between ground truth and the atlas structures for the four coronary arteries. The mean CLD for all coronary arteries was below 14mm, with the left circumflex artery showing the best agreement (7.08mm). Conclusion: The cardiac contouring tool is able to delineate cardiac structures with reasonable accuracy in less than 90 seconds. Pilot data indicates that the system is able to delineate the whole heart and ventricles within a reasonable accuracy using even a limited library. We are extending the atlas sets to 60 adult males and females in total.« less

76 FR 17384 - Applications for New Awards; Carol M. White Physical Education Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... school food or child nutrition director), grocery stores, supermarkets, restaurants, corner stores... where you, the applicant, address the selection criteria that reviewers use to evaluate your application.... Application Review Information 1. Selection Criteria: The selection criteria for this program are from 34 CFR...

7 CFR 400.303 - Initial selection criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Initial selection criteria. 400.303 Section 400.303... Regulations for the 1991 and Succeeding Crop Years § 400.303 Initial selection criteria. (a) Nonstandard... .30 or greater; and (4) Either of the following apply: (i) The natural logarithm of the cumulative...

7 CFR 246.18 - Administrative review of State agency actions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... actions: (A) Denial of authorization based on the application of the vendor selection criteria for minimum...) Denial of authorization based on the vendor selection criteria for business integrity or for a current...)(iii)); (B) Denial of authorization based on the application of the vendor selection criteria for...

Establishing endangered species recovery criteria using predictive simulation modeling

USGS Publications Warehouse

McGowan, Conor P.; Catlin, Daniel H.; Shaffer, Terry L.; Gratto-Trevor, Cheri L.; Aron, Carol

2014-01-01

Listing a species under the Endangered Species Act (ESA) and developing a recovery plan requires U.S. Fish and Wildlife Service to establish specific and measurable criteria for delisting. Generally, species are listed because they face (or are perceived to face) elevated risk of extinction due to issues such as habitat loss, invasive species, or other factors. Recovery plans identify recovery criteria that reduce extinction risk to an acceptable level. It logically follows that the recovery criteria, the defined conditions for removing a species from ESA protections, need to be closely related to extinction risk. Extinction probability is a population parameter estimated with a model that uses current demographic information to project the population into the future over a number of replicates, calculating the proportion of replicated populations that go extinct. We simulated extinction probabilities of piping plovers in the Great Plains and estimated the relationship between extinction probability and various demographic parameters. We tested the fit of regression models linking initial abundance, productivity, or population growth rate to extinction risk, and then, using the regression parameter estimates, determined the conditions required to reduce extinction probability to some pre-defined acceptable threshold. Binomial regression models with mean population growth rate and the natural log of initial abundance were the best predictors of extinction probability 50 years into the future. For example, based on our regression models, an initial abundance of approximately 2400 females with an expected mean population growth rate of 1.0 will limit extinction risk for piping plovers in the Great Plains to less than 0.048. Our method provides a straightforward way of developing specific and measurable recovery criteria linked directly to the core issue of extinction risk. Published by Elsevier Ltd.

Context Aware Programmable Trackers for the Next Generation Internet

NASA Astrophysics Data System (ADS)

Sousa, Pedro

This work introduces and proposes the concept of context aware programmable trackers for the next generation Internet. The proposed solution gives ground for the development of advanced applications based on the P2P paradigm and will foster collaborative efforts among several network entities (e.g. P2P applications and ISPs). The proposed concept of context aware programmable trackers allows that several peer selection strategies might be supported by a P2P tracker entity able to improve the peer selection decisions according with pre-defined objectives and external inputs provided by specific services. The flexible, adaptive and enhanced peer selection semantics that might be achieved by the proposed solution will contribute for devising novel P2P based services and business models for the future Internet.

Evaluation and selection of 3PL provider using fuzzy AHP and grey TOPSIS in group decision making

NASA Astrophysics Data System (ADS)

Garside, Annisa Kesy; Saputro, Thomy Eko

2017-11-01

Selection of a 3PL provider is a problem of multi criteria decision making, where the decision maker has to select several 3PL provider alternatives based on several evaluation criteria. A decision maker will have difficulty to express judgments in exact numerical values due to the fact that information is often incomplete and the decision environment is uncertain. This paper presents an integrated fuzzy AHP and Grey TOPSIS for the evaluation and selection of 3PL provider method. Fuzzy AHP is used to determine the importance weight of evaluation criteria. For final selection, grey TOPSIS is used to evaluate the alternatives and obtain the overall performance which is measured as closeness coefficient. This method is applied to solve the selection of 3PL provider at PT. X. Five criterias and twelve sub-criterias were determined and then the best alternative among four 3PL providers was selected by proposed method.

Virtual hybrid test control of sinuous crack

NASA Astrophysics Data System (ADS)

Jailin, Clément; Carpiuc, Andreea; Kazymyrenko, Kyrylo; Poncelet, Martin; Leclerc, Hugo; Hild, François; Roux, Stéphane

2017-05-01

The present study aims at proposing a new generation of experimental protocol for analysing crack propagation in quasi brittle materials. The boundary conditions are controlled in real-time to conform to a predefined crack path. Servo-control is achieved through a full-field measurement technique to determine the pre-set fracture path and a simple predictor model based on linear elastic fracture mechanics to prescribe the boundary conditions on the fly so that the actual crack path follows at best the predefined trajectory. The final goal is to identify, for instance, non-local damage models involving internal lengths. The validation of this novel procedure is performed via a virtual test-case based on an enriched damage model with an internal length scale, a prior chosen sinusoidal crack path and a concrete sample. Notwithstanding the fact that the predictor model selected for monitoring the test is a highly simplified picture of the targeted constitutive law, the proposed protocol exhibits a much improved sensitivity to the sought parameters such as internal lengths as assessed from the comparison with other available experimental tests.

Grammar-based Automatic 3D Model Reconstruction from Terrestrial Laser Scanning Data

NASA Astrophysics Data System (ADS)

Yu, Q.; Helmholz, P.; Belton, D.; West, G.

2014-04-01

The automatic reconstruction of 3D buildings has been an important research topic during the last years. In this paper, a novel method is proposed to automatically reconstruct the 3D building models from segmented data based on pre-defined formal grammar and rules. Such segmented data can be extracted e.g. from terrestrial or mobile laser scanning devices. Two steps are considered in detail. The first step is to transform the segmented data into 3D shapes, for instance using the DXF (Drawing Exchange Format) format which is a CAD data file format used for data interchange between AutoCAD and other program. Second, we develop a formal grammar to describe the building model structure and integrate the pre-defined grammars into the reconstruction process. Depending on the different segmented data, the selected grammar and rules are applied to drive the reconstruction process in an automatic manner. Compared with other existing approaches, our proposed method allows the model reconstruction directly from 3D shapes and takes the whole building into account.

40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2011 CFR

2011-07-01

... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2013 CFR

2013-07-01

... level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final...

40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2014 CFR

2014-07-01

... level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final...

40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2014 CFR

2014-07-01

... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2013 CFR

2013-07-01

... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

48 CFR 1836.602-1 - Selection criteria. (NASA supplements paragraph (a))

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Selection criteria. (NASA... CONTRACTS Architect-Engineer Services 1836.602-1 Selection criteria. (NASA supplements paragraph (a)) (a)(2... the volume of work previously awarded to the firm by NASA, with the object of effecting an equitable...

48 CFR 1836.602-1 - Selection criteria. (NASA supplements paragraph (a))

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Selection criteria. (NASA... CONTRACTS Architect-Engineer Services 1836.602-1 Selection criteria. (NASA supplements paragraph (a)) (a)(2... the volume of work previously awarded to the firm by NASA, with the object of effecting an equitable...

48 CFR 1836.602-1 - Selection criteria. (NASA supplements paragraph (a))

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Selection criteria. (NASA... CONTRACTS Architect-Engineer Services 1836.602-1 Selection criteria. (NASA supplements paragraph (a)) (a)(2... the volume of work previously awarded to the firm by NASA, with the object of effecting an equitable...

48 CFR 1836.602-1 - Selection criteria. (NASA supplements paragraph (a))

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Selection criteria. (NASA... CONTRACTS Architect-Engineer Services 1836.602-1 Selection criteria. (NASA supplements paragraph (a)) (a)(2... the volume of work previously awarded to the firm by NASA, with the object of effecting an equitable...

48 CFR 1836.602-1 - Selection criteria. (NASA supplements paragraph (a))

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Selection criteria. (NASA... CONTRACTS Architect-Engineer Services 1836.602-1 Selection criteria. (NASA supplements paragraph (a)) (a)(2... the volume of work previously awarded to the firm by NASA, with the object of effecting an equitable...

40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective...

Grade and Gender Differences in Adolescents' Friendship Selection Criteria.

ERIC Educational Resources Information Center

Zook, Joan M.; Repinski, Daniel J.

Noting that when adolescents select friends, they are creating a relationship context that will be an important source of influence, this study examined the criteria adolescents use when choosing friends. Adolescents in grades 7 and 10 were interviewed about the criteria they used when selecting friends, particularly the importance they placed…

75 FR 8854 - Teacher Incentive Fund Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

...The Secretary of Education (Secretary) proposes priorities, requirements, definitions, and selection criteria under the Teacher Incentive Fund (TIF) program. These proposed priorities, requirements, definitions, and selection criteria are designed to be used in two separate and distinct TIF grant competitions: The Main TIF competition, which will provide TIF funding to eligible entities to support their implementation of performance-based compensation systems (PBCSs) in accordance with the priorities, the Main TIF requirements, the definitions, and the selection criteria proposed in this document, and the TIF Evaluation competition, which will provide, in accordance with the priorities, the Main TIF requirements, the definitions, and the selection criteria as well as the Evaluation requirements proposed in this document, TIF funding to help pay for the costs of implementing these eligible entities' PBCS in exchange for an agreement to participate in the national evaluation. The Secretary may use these proposed TIF priorities, requirements, definitions, and selection criteria in fiscal year (FY) 2010 and subsequent years. We intend the proposed priorities, requirements, definitions, and selection criteria to improve student achievement in high-need schools by creating incentives for effective teachers and principals in these schools.

Application of selection index calculations to determine selection strategies in genomic breeding programs.

PubMed

König, S; Swalve, H H

2009-10-01

The availability of genomic estimated breeding values (GEBV) allows for possible modifications to existing dairy cattle breeding programs. Selection index calculations including genomic and phenotypic observations as index sources were used to determine the optimal number of offspring per genotyped sire with a focus on functional traits and the design of cooperator herds, and to evaluate the importance of a central station test for genotyped bull dams. Evaluation criteria to compare different breeding strategies were correlations between index and aggregate genotype (r(TI)), and the relative selection response percentage (RSR) of an index without single nucleotide polymorphism information in relation to a single nucleotide polymorphism-based index. The number of required daughter records per sire to achieve a predefined r(TI) strongly depends on the accuracy of GEBV (r(mg)) and the heritability of the trait. For a desired r(TI) of 0.8, h(2) = 0.10, and r(mg) = 0.5, at least 57 additional daughters have to be included in the genetic evaluation. Daughter records of genotyped sires are not necessary for optimal scenarios where r(mg) is greater than or equal to r(TI). There still is a substantial need for phenotypic daughter records, especially for low-heritability functional traits and r(mg) < 0.7. Phenotypic records from genotyped potential bull dams have no relevance for increasing r(TI), even with a low value for r(mg) of 0.5. Hence, genomic breeding programs should focus on recording functional traits within progeny groups, preferably in cooperator herds. For low-heritability traits and with r(mg) > 0.7, the RSR of conventional breeding programs was only 10% of RSR from genomic breeding strategies. As shown in scenarios including 2 traits in the index as well as in the aggregate genotype, the availability of highly accurate GEBV for production traits and low-accuracy GEBV for functional traits increased the risk of widening the gap between selection responses in production and functionality. Counteractions are possible, such as via higher economic weights for low-heritability functional traits. Finally, an alternative selection strategy considering only 2 pathways of selection for genotyped male calves and for cow dams was evaluated. This strategy is competitive with a 4-pathway genomic breeding program if the fraction of selected male calves for the artificial insemination program is below 1% and if selection is focused on functionality, thus pointing to substantial insufficiencies caused by low reliabilities of breeding values for cows for such traits in conventional bull dam selection schemes.

Characterization of System Status Signals for Multivariate Time Series Discretization Based on Frequency and Amplitude Variation

PubMed Central

2018-01-01

Many fault detection methods have been proposed for monitoring the health of various industrial systems. Characterizing the monitored signals is a prerequisite for selecting an appropriate detection method. However, fault detection methods tend to be decided with user’s subjective knowledge or their familiarity with the method, rather than following a predefined selection rule. This study investigates the performance sensitivity of two detection methods, with respect to status signal characteristics of given systems: abrupt variance, characteristic indicator, discernable frequency, and discernable index. Relation between key characteristics indicators from four different real-world systems and the performance of two fault detection methods using pattern recognition are evaluated. PMID:29316731

Genetic improvement in mastitis resistance: comparison of selection criteria from cross-sectional and random regression sire models for somatic cell score.

PubMed

Odegård, J; Klemetsdal, G; Heringstad, B

2005-04-01

Several selection criteria for reducing incidence of mastitis were developed from a random regression sire model for test-day somatic cell score (SCS). For comparison, sire transmitting abilities were also predicted based on a cross-sectional model for lactation mean SCS. Only first-crop daughters were used in genetic evaluation of SCS, and the different selection criteria were compared based on their correlation with incidence of clinical mastitis in second-crop daughters (measured as mean daughter deviations). Selection criteria were predicted based on both complete and reduced first-crop daughter groups (261 or 65 daughters per sire, respectively). For complete daughter groups, predicted transmitting abilities at around 30 d in milk showed the best predictive ability for incidence of clinical mastitis, closely followed by average predicted transmitting abilities over the entire lactation. Both of these criteria were derived from the random regression model. These selection criteria improved accuracy of selection by approximately 2% relative to a cross-sectional model. However, for reduced daughter groups, the cross-sectional model yielded increased predictive ability compared with the selection criteria based on the random regression model. This result may be explained by the cross-sectional model being more robust, i.e., less sensitive to precision of (co)variance components estimates and effects of data structure.

Impacts of exposure to black carbon, elemental carbon, and ultrafine particles from indoor and outdoor sources on blood pressure in adults: A review of epidemiological evidence.

PubMed

Magalhaes, Sandra; Baumgartner, Jill; Weichenthal, Scott

2018-02-01

Ambient particulate air pollution is known to have detrimental effects on cardiovascular health but less is known about the specific effects of black carbon or elemental carbon (BC/EC) and ultrafine particles (UFP). We present a narrative review of the epidemiological evidence related to the impact of exposure to BC/EC and UFP on blood pressure in adults. We searched PubMed and EMBASE in September 2017, using a predefined search strategy. Abstracts were screened using predefined inclusion criteria. Data collection was completed using a standard data extraction form. We focused on main effect estimates for associations between short (≤7 days) and long-term exposures to BC/EC and UFP and systolic (SBP) and diastolic blood pressure (DBP). Effect estimates were rescaled to enable direct comparisons between studies. Thirty publications were included in the review: 19 studies examined outdoor exposure to BC/EC, 11 examined outdoor UFP, three studies examined indoor BC and one study examined indoor UFP. In general, existing evidence supports a positive association between BC/EC and blood pressure. Evidence for outdoor UFP exposures were less clear as effect estimates were small in magnitude and confidence intervals often included the null. Existing evidence supports a positive association between BC/EC and blood pressure in adults, whereas UFPs do not appear to have a meaningful impact on blood pressure. Copyright © 2017 Elsevier Inc. All rights reserved.

Image-Based Medical Expert Teleconsultation in Acute Care of Injuries. A Systematic Review of Effects on Information Accuracy, Diagnostic Validity, Clinical Outcome, and User Satisfaction

PubMed Central

Hasselberg, Marie; Beer, Netta; Blom, Lisa; Wallis, Lee A.; Laflamme, Lucie

2014-01-01

Objective To systematically review the literature on image-based telemedicine for medical expert consultation in acute care of injuries, considering system, user, and clinical aspects. Design Systematic review of peer-reviewed journal articles. Data sources Searches of five databases and in eligible articles, relevant reviews, and specialized peer-reviewed journals. Eligibility criteria Studies were included that covered teleconsultation systems based on image capture and transfer with the objective of seeking medical expertise for the diagnostic and treatment of acute injury care and that presented the evaluation of one or several aspects of the system based on empirical data. Studies of systems not under routine practice or including real-time interactive video conferencing were excluded. Method The procedures used in this review followed the PRISMA Statement. Predefined criteria were used for the assessment of the risk of bias. The DeLone and McLean Information System Success Model was used as a framework to synthesise the results according to system quality, user satisfaction, information quality and net benefits. All data extractions were done by at least two reviewers independently. Results Out of 331 articles, 24 were found eligible. Diagnostic validity and management outcomes were often studied; fewer studies focused on system quality and user satisfaction. Most systems were evaluated at a feasibility stage or during small-scale pilot testing. Although the results of the evaluations were generally positive, biases in the methodology of evaluation were concerning selection, performance and exclusion. Gold standards and statistical tests were not always used when assessing diagnostic validity and patient management. Conclusions Image-based telemedicine systems for injury emergency care tend to support valid diagnosis and influence patient management. The evidence relates to a few clinical fields, and has substantial methodological shortcomings. As in the case of telemedicine in general, user and system quality aspects are poorly documented, both of which affect scale up of such programs. PMID:24887257

Premorbid (early life) IQ and later mortality risk: systematic review.

PubMed

Batty, G David; Deary, Ian J; Gottfredson, Linda S

2007-04-01

Studies of middle-aged and particularly older-aged adults found that those with higher scores on tests of IQ (cognitive function) had lower rates of later mortality. Interpretation of such findings potentially is hampered by the problem of reverse causality: such somatic diseases as diabetes or hypertension, common in older adults, can decrease cognitive function. Studies that provide extended follow-up of the health experience of individuals who had their (premorbid) IQ assessed in childhood and/or early adulthood minimize this concern. The purpose of the present report is to systematically locate, evaluate, and interpret the findings of all such studies. We systematically identified individual-level studies linking premorbid IQ with later mortality by using four approaches: search of electronic databases (MEDLINE, EMBASE, and PSYCHINFO); scrutiny of the reference sections of identified reports; search of our own files; and contact with researchers in the field. Study quality was assessed by using predefined criteria. Nine cohort studies met the inclusion criteria. Overall, study quality was moderate. All reports showed an inverse IQ-mortality relation; i.e., higher IQ scores were associated with decreased mortality risk. The nature of this relation (i.e., dose-response or threshold) and whether it differs by sex was unclear. The IQ-mortality association did not appear to be explained by reverse causality or selection bias. Confounding by other early-life factors also did not seem to explain the association, although some studies were not well characterized in this regard. Adult socioeconomic position appeared to mediate the IQ-mortality association in some studies, but this was not a universal finding. In all studies, higher IQ in the first two decades of life was related to lower rates of total mortality in middle to late adulthood. Some plausible mechanistic pathways exist, but further examination is required. The precise nature of the IQ-mortality relation (particularly in ethnic minorities and women) and the link between IQ and disease-specific outcomes also warrants further research.

Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review

PubMed Central

Martins, Júlia Caetano; Aguiar, Larissa Tavares; Nadeau, Sylvie; Scianni, Aline Alvim; Teixeira-Salmela, Luci Fuscaldi; Faria, Christina Danielli Coelho de Morais

2017-01-01

Introduction Self-report physical activity assessment tools are commonly used for the evaluation of physical activity levels in individuals with stroke. A great variety of these tools have been developed and widely used in recent years, which justify the need to examine their measurement properties and clinical utility. Therefore, the main objectives of this systematic review are to examine the measurement properties and clinical utility of self-report measures of physical activity and discuss the strengths and limitations of the identified tools. Methods and analysis A systematic review of studies that investigated the measurement properties and/or clinical utility of self-report physical activity assessment tools in stroke will be conducted. Electronic searches will be performed in five databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed), Excerpta Medica Database (EMBASE), Physiotherapy Evidence Database (PEDro), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO), followed by hand searches of the reference lists of the included studies. Two independent reviewers will screen all retrieve titles, abstracts, and full texts, according to the inclusion criteria and will also extract the data. A third reviewer will be referred to solve any disagreement. A descriptive summary of the included studies will contain the design, participants, as well as the characteristics, measurement properties, and clinical utility of the self-report tools. The methodological quality of the studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and the clinical utility of the identified tools will be assessed considering predefined criteria. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Discussion This systematic review will provide an extensive review of the measurement properties and clinical utility of self-report physical activity assessment tools used in individuals with stroke, which would benefit clinicians and researchers. Trial registration number PROSPERO CRD42016037146. PMID:28193848

Functional Performance Testing and Patient Reported Outcomes following ACL Reconstruction: A Systematic Scoping Review

PubMed Central

Herrington, Lee

2014-01-01

Objective. A systematic scoping review of the literature to identify functional performance tests and patient reported outcomes for patients who undergo anterior cruciate ligament (ACL) reconstruction and rehabilitation that are used in clinical practice and research during the last decade. Methods. A literature search was conducted. Electronic databases used included Medline, PubMed, Cochrane Library, EMBASE, CINAHL, SPORTDiscus, PEDro, and AMED. The inclusion criteria were English language, publication between April 2004 and April 2014, and primary ACL reconstruction with objective and/or subjective outcomes used. Two authors screened the selected papers for title, abstract, and full-text in accordance with predefined inclusion and exclusion criteria. The methodological quality of all papers was assessed by a checklist of the Critical Appraisal Skills Programme (CASP). Results. A total of 16 papers were included with full-text. Different authors used different study designs for functional performance testing which led to different outcomes that could not be compared. All papers used a measurement for quantity of functional performance except one study which used both quantity and quality outcomes. Several functional performance tests and patient reported outcomes were identified in this review. Conclusion. No extensive research has been carried out over the past 10 years to measure the quality of functional performance testing and control stability of patients following ACL reconstruction. However this study found that the measurement of functional performance following ACL reconstruction consisting of a one-leg hop for a set distance or a combination of different hops using limb symmetry index (LSI) was a main outcome parameter of several studies. A more extensive series of tests is suggested to measure both the quantitative and qualitative aspects of functional performance after the ACL reconstruction. The KOOS and the IKDC questionnaires are both measures that are increasingly being used for ACL reconstruction throughout the last decade. PMID:27379330

Health impact of external funding for HIV, tuberculosis and malaria: systematic review

PubMed Central

de Jongh, Thyra E; Harnmeijer, Joanne H; Atun, Rifat; Korenromp, Eline L; Zhao, Jinkou; Puvimanasinghe, John; Baltussen, Rob

2014-01-01

Background Since 2002, development assistance for health has substantially increased, especially investments for HIV, tuberculosis (TB) and malaria control. We undertook a systematic review to assess and synthesize the existing evidence in the scientific literature on the health impacts of these investments. Methods and findings We systematically searched databases for peer-reviewed and grey literature, using tailored search strategies. We screened studies for study design and relevance, using predefined inclusion criteria, and selected those that enabled us to link health outcomes or impact to increased external funding. For all included studies, we recorded dataset and study characteristics, health outcomes and impacts. We analysed the data using a causal-chain framework to develop a narrative summary of the published evidence. Thirteen articles, representing 11 individual studies set in Africa and Asia reporting impacts on HIV, tuberculosis and malaria, met the inclusion criteria. Only two of these studies documented the entire causal-chain spanning from funding to programme scale-up, to outputs, outcomes and impacts. Nonetheless, overall we find a positive correlation between consecutive steps in the causal chain, suggesting that external funds for HIV, tuberculosis and malaria programmes contributed to improved health outcomes and impact. Conclusions Despite the large number of supported programmes worldwide and despite an abundance of published studies on HIV, TB and malaria control, we identified very few eligible studies that adequately demonstrated the full process by which external funding has been translated to health impact. Most of these studies did not move beyond demonstrating statistical association, as opposed to contribution or causation. We thus recommend that funding organizations and researchers increase the emphasis on ensuring data capture along the causal pathway to demonstrate effect and contribution of external financing. The findings of these comprehensive and rigorously conducted impact evaluations should also be made publicly accessible. PMID:23921987

Effects of a standardised extract of Trifolium pratense (Promensil) at a dosage of 80mg in the treatment of menopausal hot flushes: A systematic review and meta-analysis.

PubMed

Myers, S P; Vigar, V

2017-01-15

To critically assess the evidence for a specific standardised extract of Trifolium pratense isoflavones (Promensil) at a dosage of 80mg/day in the treatment of menopausal hot flushes. Systematic literature searches were performed in Medline, Scopus, CINAHL Plus, Cochrane, AMED and InforRMIT and citations obtained from 1996 to March 2016. Reference lists were checked; corresponding authors contacted and the grey literature searched for additional publications. Studies were selected according to predefined inclusion and exclusion criteria. All randomised clinical trials of a specific standardised extract of Trifolium pratense isoflavones (Promensil) used as a mono-component at 80mg/day and measuring vasomotor symptoms were included. The data extraction and quality assessment were performed independently by one reviewer and validated by a second with any disagreements being settled by discussion. Weighted mean differences and 95% confidence intervals were calculated for continuous data using the fixed-effects model. Twenty potentially relevant papers were identified, with only five studies meeting the inclusion criteria. The meta-analysis demonstrated a statistical and clinically relevant reduction in hot flush frequency in the active treatment group compared to placebo. Weighted mean difference 3.63 hot flushes per day: [95% CI 2.70-4.56]; p˂0.00001). Due to a lack of homogeneity a priori defined sub-group analyses were performed demonstrating a substantive difference between cross-over and parallel-arm clinical trial designs. There is evidence for a statistical and clinically significant benefit for using a specific standardised extract of red clover isoflavones (Promensil) at 80mg/day for treating hot flushes in menopausal women across the 3 studies included in the meta-analysis. The preparation was safe over the short-term duration of the studies (3 months). Copyright © 2016 The Authors. Published by Elsevier GmbH.. All rights reserved.

Health impact of external funding for HIV, tuberculosis and malaria: systematic review.

PubMed

de Jongh, Thyra E; Harnmeijer, Joanne H; Atun, Rifat; Korenromp, Eline L; Zhao, Jinkou; Puvimanasinghe, John; Baltussen, Rob

2014-08-01

Since 2002, development assistance for health has substantially increased, especially investments for HIV, tuberculosis (TB) and malaria control. We undertook a systematic review to assess and synthesize the existing evidence in the scientific literature on the health impacts of these investments. We systematically searched databases for peer-reviewed and grey literature, using tailored search strategies. We screened studies for study design and relevance, using predefined inclusion criteria, and selected those that enabled us to link health outcomes or impact to increased external funding. For all included studies, we recorded dataset and study characteristics, health outcomes and impacts. We analysed the data using a causal-chain framework to develop a narrative summary of the published evidence. Thirteen articles, representing 11 individual studies set in Africa and Asia reporting impacts on HIV, tuberculosis and malaria, met the inclusion criteria. Only two of these studies documented the entire causal-chain spanning from funding to programme scale-up, to outputs, outcomes and impacts. Nonetheless, overall we find a positive correlation between consecutive steps in the causal chain, suggesting that external funds for HIV, tuberculosis and malaria programmes contributed to improved health outcomes and impact. Despite the large number of supported programmes worldwide and despite an abundance of published studies on HIV, TB and malaria control, we identified very few eligible studies that adequately demonstrated the full process by which external funding has been translated to health impact. Most of these studies did not move beyond demonstrating statistical association, as opposed to contribution or causation. We thus recommend that funding organizations and researchers increase the emphasis on ensuring data capture along the causal pathway to demonstrate effect and contribution of external financing. The findings of these comprehensive and rigorously conducted impact evaluations should also be made publicly accessible. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Disability and recovery in schizophrenia: a systematic review of cognitive behavioral therapy interventions.

PubMed

Nowak, Izabela; Sabariego, Carla; Świtaj, Piotr; Anczewska, Marta

2016-07-11

Schizophrenia is a disabling disease that impacts all major life areas. There is a growing need for meeting the challenge of disability from a perspective that extends symptomatic reduction. Therefore, this study aimed to systematically review the extent to which traditional and "third wave" cognitive - behavioral (CBT) interventions address the whole scope of disabilities experienced by people with lived experience of schizophrenia using the WHO's International Classification of Functioning, Disability and Health (ICF) as a frame of reference. It also explores if current CBT interventions focus on recovery and what is their impact on disability domains. Medline and PsycINFO databases were searched for studies published in English between January 2009 and December 2015. Abstracts and full papers were screened against pre-defined selection criteria by two reviewers. Methodological quality of included studies was assessed by two independent raters using the Effective Public Health Practice Project Quality assessment tool for quantitative studies (EPHPP) guidelines. A total of 50 studies were included, 35 studies evaluating traditional CBT interventions and 15 evaluating "third wave" approaches. Overall, traditional CBT interventions addressed more disability domains than "third wave" approaches and mostly focused on mental functions reflecting schizophrenia psychopathology. Seven studies met the inclusion criteria of recovery-oriented interventions. The majority of studies evaluating these interventions had however a high risk of bias, therefore evidence on their effectiveness is inconclusive. Traditional CBT interventions address more disability domains than "third wave" therapies, however both approaches focus mostly on mental functions that reflect schizophrenia psychopathology. There are also few interventions that focus on recovery. These results indicate that CBT interventions going beyond symptom reduction are still needed. Recovery-focused CBT interventions seem to be a promising treatment approach as they target disability from a broader perspective including activity and participation domains. Although their effectiveness is inconclusive, they reflect users' views of recovery and trends towards improvement of mood, negative symptoms and functioning are shown.

Disentangling self-management goal setting and action planning: A scoping review

PubMed Central

Daniëls, Ramon; van Bokhoven, Marloes Amantia; van der Weijden, Trudy; Beurskens, Anna

2017-01-01

Introduction The ongoing rise in the numbers of chronically ill people necessitates efforts for effective self-management. Goal setting and action planning are frequently used, as they are thought to support patients in changing their behavior. However, it remains unclear how goal setting and action planning in the context of self-management are defined in the scientific literature. This study aimed to achieve a better understanding of the various definitions used. Methods A scoping review was conducted, searching PubMed, Cinahl, PsychINFO and Cochrane. Inclusion and exclusion criteria were formulated to ensure the focus on goal setting/action planning and self-management. The literature was updated to December 2015; data selection and charting was done by two reviewers. A qualitative content analysis approach was used. Results Out of 9115 retrieved articles, 58 met the inclusion criteria. We created an overview of goal setting phases that were applied (preparation, formulation of goals, formulation of action plan, coping planning and follow-up). Although the phases we found are in accordance with commonly known frameworks for goal setting, it was striking that the majority of studies (n = 39, 67%) did not include all phases. We also prepared an overview of components and strategies for each goal setting phase. Interestingly, few strategies were found for the communication between patients and professionals about goals/action plans. Most studies (n = 35, 60%) focused goal setting on one single disease and on a predefined lifestyle behavior; nearly half of the articles (n = 27, 47%) reported a theoretical framework. Discussion The results might provide practical support for developers of interventions. Moreover, our results might encourage professionals to become more aware of the phases of the goal setting process and of strategies emphasizing on patient reflection. However, more research might be useful to examine strategies to facilitate communication about goals/action plans. It might also be worthwhile to develop and evaluate goal setting/action planning strategies for people with different and multiple chronic conditions. PMID:29176800

A systematic review protocol on the effectiveness of therapeutic exercises utilised by physiotherapists to improve function in patients with burns.

PubMed

Mudawarima, Tapfuma; Chiwaridzo, Matthew; Jelsma, Jennifer; Grimmer, Karen; Muchemwa, Faith Chengetayi

2017-10-23

Therapeutic exercises play a crucial role in the management of burn injuries. The broad objective of this review is to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. Population = adults and children/adolescents with burns of any aspect of their bodies. Interventions = any aerobic and/or strength exercises delivered as part of a rehabilitation programme by anyone (e.g. physiotherapists, occupational therapists, nurses, doctors, community workers and patients themselves). Comparators = any comparator. Outcomes = any measure of outcome (e.g. quality of life, pain, muscle strength, range of movement, fear or quality of movement). Settings = any setting in any country. A systematic review will be conducted by two blinded independent reviewers who will search articles on PubMed, CiNAHL, Cochrane library, Medline, Pedro, OTseeker, EMBASE, PsychINFO and EBSCOhost using predefined criteria. Studies of human participants of any age suffering from burns will be eligible, and there will be no restrictions on total body surface area. Only randomised controlled trials will be considered for this review, and the methodological quality of studies meeting the selection criteria will be evaluated using the Cochrane Collaboration tool for assessing risk of bias. The PRISMA reporting standards will be used to write the review. A narrative analysis of the findings will be done, but if pooling is possible, meta-analysis will be considered. Burns may have a long-lasting impact on both psychological and physical functioning and thus it is important to identify and evaluate the effects of current and past aerobic and strength exercises on patients with burns. By identifying the characteristics of effective exercise programmes, guidelines can be suggested for developing intervention programmes aimed at improving the function of patients with burns. The safety and precautions of exercise regimes and the optimal frequency, duration, time and intensity will also be examined to inform further intervention. PROSPERO CDR42016048370 .

40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2014 CFR

2014-07-01

... level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective... failed engine is an engine whose final test results pursuant to § 90.509(b), for one or more of the...

40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

Code of Federal Regulations, 2012 CFR

2012-07-01

... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

Code of Federal Regulations, 2010 CFR

2010-07-01

... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

Code of Federal Regulations, 2011 CFR

2011-07-01

... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

Code of Federal Regulations, 2014 CFR

2014-07-01

... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results pursuant to...

40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

Code of Federal Regulations, 2013 CFR

2013-07-01

... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2013 CFR

2013-07-01

... level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective... failed engine is an engine whose final test results pursuant to § 90.509(b), for one or more of the...

25 CFR 1001.9 - Selection criteria for tribes/consortia seeking advance planning grant funding.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false Selection criteria for tribes/consortia seeking advance..., DEPARTMENT OF THE INTERIOR SELF-GOVERNANCE PROGRAM § 1001.9 Selection criteria for tribes/consortia seeking... before a tribe/consortium is admitted into the applicant pool? Any tribe/consortium that is not a self...

7 CFR Exhibit D to Subpart N of... - Project Selection Criteria-Outline Rating Form

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 13 2011-01-01 2009-01-01 true Project Selection Criteria-Outline Rating Form D Exhibit D to Subpart N of Part 1944 Agriculture Regulations of the Department of Agriculture (Continued... Preservation Grants Pt. 1944, Subpt. N, Exh. D Exhibit D to Subpart N of Part 1944—Project Selection Criteria...

75 FR 34094 - Re-Opening of Solicitation Period for the Opportunity To Serve on the Board of Directors of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... opportunity to express interest and submit information. The selection criteria contained in the April 19, 2010... consider this opportunity. The selection criteria contained in the April 19, 2010 notice continue to apply... United States. Selection Criteria The TPA directs the Secretary of Commerce (after consultation with the...

7 CFR Exhibit D to Subpart N of... - Project Selection Criteria-Outline Rating Form

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Project Selection Criteria-Outline Rating Form D Exhibit D to Subpart N of Part 1944 Agriculture Regulations of the Department of Agriculture (Continued... Preservation Grants Pt. 1944, Subpt. N, Exh. D Exhibit D to Subpart N of Part 1944—Project Selection Criteria...

Selection for Surgical Training: An Evidence-Based Review.

PubMed

Schaverien, Mark V

2016-01-01

The predictive relationship between candidate selection criteria for surgical training programs and future performance during and at the completion of training has been investigated for several surgical specialties, however there is no interspecialty agreement regarding which selection criteria should be used. Better understanding the predictive reliability between factors at selection and future performance may help to optimize the process and lead to greater standardization of the surgical selection process. PubMed and Ovid MEDLINE databases were searched. Over 560 potentially relevant publications were identified using the search strategy and screened using the Cochrane Collaboration Data Extraction and Assessment Template. 57 studies met the inclusion criteria. Several selection criteria used in the traditional selection demonstrated inconsistent correlation with subsequent performance during and at the end of surgical training. The following selection criteria, however, demonstrated good predictive relationships with subsequent resident performance: USMLE examination scores, Letters of Recommendation (LOR) including the Medical Student Performance Evaluation (MSPE), academic performance during clinical clerkships, the interview process, displaying excellence in extracurricular activities, and the use of unadjusted rank lists. This systematic review supports that the current selection process needs to be further evaluated and improved. Multicenter studies using standardized outcome measures of success are now required to improve the reliability of the selection process to select the best trainees. Published by Elsevier Inc.

7 CFR 1465.20 - Applications for participation and selecting applications for contracting.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Conservationist will develop ranking criteria and a ranking process to select applications, taking into account... State-developed ranking criteria and ranking process. (e) The State Conservationist, or designated... using the ranking criteria. ...

Secondary Use of Recorded or Self-expressed Personal Data: Consumer Health Informatics and Education in the Era of Social Media and Health Apps.

PubMed

Staccini, P; Fernandez-Luque, L

2017-08-01

Objective: To summarize the state of the art during the year 2016 in the areas related to consumer health informatics and education with a special emphasis in secondary use of patient data. Methods: We conducted a systematic review of articles published in 2016, using PubMed with a predefined set of queries. We identified over 320 potential articles for review. Papers were considered according to their relevance for the topic of the section. Using consensus, we selected the 15 most representative papers, which were submitted to external reviewers for full review and scoring. Based on the scoring and quality criteria, five papers were finally selected as best papers Results: The five best papers can be grouped in two major areas: 1) methods and tools to identify and collect formal requirements for secondary use of data, and 2) innovative topics highlighting the interest of carrying on "secondary" studies on patient data, more specifically on the data self-expressed by patients through social media tools. Regarding the formal requirements about informed consent, the selected papers report a comparison of legal aspects in European countries to find a common and unified grammar around the concept of "data donation". Regarding innovative approaches to value patient data, the selected papers report machine learning algorithms to extract knowledge from patient experience and satisfaction with health care delivery, drug and medication use, treatment compliance and barriers during cancer disease, or acceptation of public health actions such as vaccination. Conclusions: Secondary use of patient data (apart from personal health care record data) can be expressed according to many ways. Requirements to allow this secondary use have to be harmonized between countries, and social media platforms can be efficiently used to explore and create knowledge on patient experience with health problems or activities. Machine learning algorithms can explore those massive amounts of data to support health care professionals, and institutions provide more accurate knowledge about use and usage, behaviour, sentiment, or satisfaction about health care delivery. Georg Thieme Verlag KG Stuttgart.

40 CFR 86.098-30 - Certification.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas... with the selection criteria employed in selecting the failed vehicle, a new emission data vehicle which... selected in accordance with the selection criteria employed in selecting the failed vehicle, then two or...

40 CFR 86.098-30 - Certification.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and for 1985 and Later Model Year New Gasoline Fueled, Natural Gas-Fueled, Liquefied Petroleum Gas... with the selection criteria employed in selecting the failed vehicle, a new emission data vehicle which... selected in accordance with the selection criteria employed in selecting the failed vehicle, then two or...

Mixed features in patients with a major depressive episode: the BRIDGE-II-MIX study.

PubMed

Perugi, Giulio; Angst, Jules; Azorin, Jean-Michel; Bowden, Charles L; Mosolov, Sergey; Reis, Joao; Vieta, Eduard; Young, Allan H

2015-03-01

To estimate the frequency of mixed states in patients diagnosed with major depressive episode (MDE) according to conceptually different definitions and to compare their clinical validity. This multicenter, multinational cross-sectional Bipolar Disorders: Improving Diagnosis, Guidance and Education (BRIDGE)-II-MIX study enrolled 2,811 adult patients experiencing an MDE. Data were collected per protocol on sociodemographic variables, current and past psychiatric symptoms, and clinical variables that are risk factors for bipolar disorder. The frequency of mixed features was determined by applying both DSM-5 criteria and a priori described Research-Based Diagnostic Criteria (RBDC). Clinical variables associated with mixed features were assessed using logistic regression. Overall, 212 patients (7.5%) fulfilled DSM-5 criteria for MDE with mixed features (DSM-5-MXS), and 818 patients (29.1%) fulfilled diagnostic criteria for a predefined RBDC depressive mixed state (RBDC-MXS). The most frequent manic/hypomanic symptoms were irritable mood (32.6%), emotional/mood lability (29.8%), distractibility (24.4%), psychomotor agitation (16.1%), impulsivity (14.5%), aggression (14.2%), racing thoughts (11.8%), and pressure to keep talking (11.4%). Euphoria (4.6%), grandiosity (3.7%), and hypersexuality (2.6%) were less represented. In multivariate logistic regression analysis, RBDC-MXS was associated with the largest number of variables including diagnosis of bipolar disorder, family history of mania, lifetime suicide attempts, duration of the current episode > 1 month, atypical features, early onset, history of antidepressant-induced mania/hypomania, and lifetime comorbidity with anxiety, alcohol and substance use disorders, attention-deficit/hyperactivity disorder, and borderline personality disorder. Depressive mixed state, defined as the presence of 3 or more manic/hypomanic features, was present in around one-third of patients experiencing an MDE. The valid symptom, illness course and family history RBDC criteria we assessed identified 4 times more MDE patients as having mixed features and yielded statistically more robust associations with several illness characteristics of bipolar disorder than did DSM-5 criteria. © Copyright 2015 Physicians Postgraduate Press, Inc.

The effect of feature selection methods on computer-aided detection of masses in mammograms

NASA Astrophysics Data System (ADS)

Hupse, Rianne; Karssemeijer, Nico

2010-05-01

In computer-aided diagnosis (CAD) research, feature selection methods are often used to improve generalization performance of classifiers and shorten computation times. In an application that detects malignant masses in mammograms, we investigated the effect of using a selection criterion that is similar to the final performance measure we are optimizing, namely the mean sensitivity of the system in a predefined range of the free-response receiver operating characteristics (FROC). To obtain the generalization performance of the selected feature subsets, a cross validation procedure was performed on a dataset containing 351 abnormal and 7879 normal regions, each region providing a set of 71 mass features. The same number of noise features, not containing any information, were added to investigate the ability of the feature selection algorithms to distinguish between useful and non-useful features. It was found that significantly higher performances were obtained using feature sets selected by the general test statistic Wilks' lambda than using feature sets selected by the more specific FROC measure. Feature selection leads to better performance when compared to a system in which all features were used.

Selecting Anatomy and Physiology Textbooks for Nursing Students.

ERIC Educational Resources Information Center

Harder, Annie K.; Carline, Jan D.

1988-01-01

Describes the criteria used for textbook selection or rejection, how the criteria differ depending on the level of students, and how the criteria differ according to the instructor's training. Discusses results and implications for students, instructors, and publishers. (CW)

30 CFR 260.130 - What criteria does MMS use for selecting bidding systems and bidding system components?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What criteria does MMS use for selecting bidding systems and bidding system components? 260.130 Section 260.130 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OUTER CONTINENTAL SHELF OIL AND GAS LEASING Bidding Systems Bidding System Selection Criteria §...

The Effect of Hidden Curriculum on the Criteria Parents Use to Select Schools and Teachers

ERIC Educational Resources Information Center

Sahan, Hasan Hüseyin

2014-01-01

A framework of school and teacher qualities has been established by research. The need to identify families' school and teacher selection criteria, in particular, is the main motive behind the present study. It mainly aims to identify the criteria parents use when selecting schools and teachers, or the influence of hidden curriculum on school and…

Fully automated atlas-based method for prescribing 3D PRESS MR spectroscopic imaging: Toward robust and reproducible metabolite measurements in human brain.

PubMed

Bian, Wei; Li, Yan; Crane, Jason C; Nelson, Sarah J

2018-02-01

To implement a fully automated atlas-based method for prescribing 3D PRESS MR spectroscopic imaging (MRSI). The PRESS selected volume and outer-volume suppression bands were predefined on the MNI152 standard template image. The template image was aligned to the subject T 1 -weighted image during a scan, and the resulting transformation was then applied to the predefined prescription. To evaluate the method, H-1 MRSI data were obtained in repeat scan sessions from 20 healthy volunteers. In each session, datasets were acquired twice without repositioning. The overlap ratio of the prescribed volume in the two sessions was calculated and the reproducibility of inter- and intrasession metabolite peak height and area ratios was measured by the coefficient of variation (CoV). The CoVs from intra- and intersession were compared by a paired t-test. The average overlap ratio of the automatically prescribed selection volumes between two sessions was 97.8%. The average voxel-based intersession CoVs were less than 0.124 and 0.163 for peak height and area ratios, respectively. Paired t-test showed no significant difference between the intra- and intersession CoVs. The proposed method provides a time efficient method to prescribe 3D PRESS MRSI with reproducible imaging positioning and metabolite measurements. Magn Reson Med 79:636-642, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

An early warning system for marine storm hazard mitigation

NASA Astrophysics Data System (ADS)

Vousdoukas, M. I.; Almeida, L. P.; Pacheco, A.; Ferreira, O.

2012-04-01

The present contribution presents efforts towards the development of an operational Early Warning System for storm hazard prediction and mitigation. The system consists of a calibrated nested-model train which consists of specially calibrated Wave Watch III, SWAN and XBeach models. The numerical simulations provide daily forecasts of the hydrodynamic conditions, morphological change and overtopping risk at the area of interest. The model predictions are processed by a 'translation' module which is based on site-specific Storm Impact Indicators (SIIs) (Ciavola et al., 2011, Storm impacts along European coastlines. Part 2: lessons learned from the MICORE project, Environmental Science & Policy, Vol 14), and warnings are issued when pre-defined threshold values are exceeded. For the present site the selected SIIs were (i) the maximum wave run-up height during the simulations; and (ii) the dune-foot horizontal retreat at the end of the simulations. Both SIIs and pre-defined thresholds were carefully selected on the grounds of existing experience and field data. Four risk levels were considered, each associated with an intervention approach, recommended to the responsible coastal protection authority. Regular updating of the topography/bathymetry is critical for the performance of the storm impact forecasting, especially when there are significant morphological changes. The system can be extended to other critical problems, like implications of global warming and adaptive management strategies, while the approach presently followed, from model calibration to the early warning system for storm hazard mitigation, can be applied to other sites worldwide, with minor adaptations.

Prevalence of dental caries and fluoride concentration of drinking water: A systematic review

PubMed Central

Goodarzi, Fatemeh; Mahvi, Amir Hossein; Hosseini, Mostafa; Nodehi, Ramin Nabizadeh; Kharazifard, Mohammad Javad; Parvizishad, Mina

2017-01-01

Background: The objective of this study was to systematically review prevalence of dental caries at different water fluoride levels and emphasize fluoride concentration of drinking water and prevalence of dental caries. Materials and Methods: A comprehensive study was conducted using PubMed database. Inclusion criteria were predefined and some articles fulfilled these criteria. Study validity was assessed by some checklists. Surveys were conducted to determine prevalence of dental caries among individuals. Results: The heterogeneity in the group of children with deciduous teeth in terms of the amount of fluoride in drinking water and social class was significant, and the results of the studies in all the subgroups could not be pooled. However, the heterogeneity of group 2 for subjects with permanent teeth in terms of the fluoride level in drinking water and social class was not significant, and the results of the studies in each subgroup could be pooled together. Conclusion: The meta-regression showed that tooth type and social class had a significant association with the difference in the prevalence of dental caries. Therefore, these variables were the sources of heterogeneity, and the studies must be grouped and subgrouped based on these variables. PMID:28702056

Evaluation of the match between anthropometric measures and school furniture dimensions in Chile.

PubMed

Castellucci, H I; Catalán, M; Arezes, P M; Molenbroek, J F M

2015-01-01

Students are exposed to the first systematic tasks or activities that a human being carries out in his/her life while at school. In this workplace situation, school furniture is a key factor for the adoption of proper body posture. The aim of this paper was to observe and determine the potential mismatch between school furniture dimensions and anthropometric characteristics of the students from the Valparaíso region of Chile. The sample consisted of 3,078 volunteer participants from 18 schools (public, semi-public, private). Eight anthropometric measures were gathered, together with six furniture dimensions. Mismatch analyses were carried out by using pre-defined mismatch criteria. Many different types of school furniture were presented at the schools. Also, a high level of mismatch was registered for seat height, desk height and seat-to-desk clearance. Finally, the analysis of all considered dimensions together showed that there was a high level of cumulative mismatch. It can be concluded that there were high levels of mismatch between the school furniture and student anthropometric characteristics and that this mismatch varied within the difference types of schools. This situation may have occurred because furniture acquisition was made without considering any ergonomic criteria.

Pharmacotherapy of conduct disorder: Challenges, options and future directions.

PubMed

Hambly, Jessica L; Khan, Sohil; McDermott, Brett; Bor, William; Haywood, Alison

2016-10-01

There is a critical need for evaluation of the pharmacotherapies used in conduct disorder (CD), due to the high incidence of off-label prescribing. The aim of this review was to identify concerns associated with the safety, efficacy and impact on quality of life (QOL) that pharmacotherapy has in children and adolescents with CD. A systematic review was undertaken using pre-defined search criteria and four databases, including reference searches. We assessed these studies using the Strength of Recommendation Taxonomy, Grading of Recommendations Assessment, Development and Evaluation, and Review Manager Risk of Bias (RevMan®) tools. There were 12 randomised controlled trials that met our inclusion criteria. antipsychotics, atomoxetine, lithium, clonidine, divalproex sodium and psychostimulants. The antipsychotics demonstrated efficacy, but were associated with adverse effects. Other agents demonstrated mixed responses, highlighting the lack of clinical significance and increased incidence of adverse effects. The management of related adverse effects was addressed to assist with clinical gaps. Overall, there is limited evidence regarding the role of pharmacotherapy in CD. More research is needed that takes into account the heterogeneity of CD and analysis of pharmacotherapy in pure CD. © The Author(s) 2016.

An improved hybrid multi-criteria/multidimensional model for strategic industrial location selection: Casablanca industrial zones as a case study.

PubMed

Boutkhoum, Omar; Hanine, Mohamed; Agouti, Tarik; Tikniouine, Abdessadek

2015-01-01

In this paper, we examine the issue of strategic industrial location selection in uncertain decision making environments for implanting new industrial corporation. In fact, the industrial location issue is typically considered as a crucial factor in business research field which is related to many calculations about natural resources, distributors, suppliers, customers, and most other things. Based on the integration of environmental, economic and social decisive elements of sustainable development, this paper presents a hybrid decision making model combining fuzzy multi-criteria analysis with analytical capabilities that OLAP systems can provide for successful and optimal industrial location selection. The proposed model mainly consists in three stages. In the first stage, a decision-making committee has been established to identify the evaluation criteria impacting the location selection process. In the second stage, we develop fuzzy AHP software based on the extent analysis method to assign the importance weights to the selected criteria, which allows us to model the linguistic vagueness, ambiguity, and incomplete knowledge. In the last stage, OLAP analysis integrated with multi-criteria analysis employs these weighted criteria as inputs to evaluate, rank and select the strategic industrial location for implanting new business corporation in the region of Casablanca, Morocco. Finally, a sensitivity analysis is performed to evaluate the impact of criteria weights and the preferences given by decision makers on the final rankings of strategic industrial locations.

49 CFR Appendix C to Part 541 - Criteria for Selecting Light Duty Truck Lines Likely To Have High Theft Rates

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 6 2014-10-01 2014-10-01 false Criteria for Selecting Light Duty Truck Lines Likely To Have High Theft Rates C Appendix C to Part 541 Transportation Other Regulations Relating to... MOTOR VEHICLE THEFT PREVENTION STANDARD Pt. 541, App. C Appendix C to Part 541—Criteria for Selecting...

49 CFR Appendix C to Part 541 - Criteria for Selecting Light Duty Truck Lines Likely To Have High Theft Rates

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 6 2012-10-01 2012-10-01 false Criteria for Selecting Light Duty Truck Lines Likely To Have High Theft Rates C Appendix C to Part 541 Transportation Other Regulations Relating to... MOTOR VEHICLE THEFT PREVENTION STANDARD Pt. 541, App. C Appendix C to Part 541—Criteria for Selecting...

49 CFR Appendix C to Part 541 - Criteria for Selecting Light Duty Truck Lines Likely To Have High Theft Rates

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 6 2011-10-01 2011-10-01 false Criteria for Selecting Light Duty Truck Lines Likely To Have High Theft Rates C Appendix C to Part 541 Transportation Other Regulations Relating to... MOTOR VEHICLE THEFT PREVENTION STANDARD Pt. 541, App. C Appendix C to Part 541—Criteria for Selecting...

Vaccination in paediatric patients with auto-immune rheumatic diseases: a systemic literature review for the European League against Rheumatism evidence-based recommendations.

PubMed

Heijstek, M W; Ott de Bruin, L M; Borrow, R; van der Klis, F; Koné-Paut, I; Fasth, A; Minden, K; Ravelli, A; Abinun, M; Pileggi, G; Borte, M; Bijl, M; Wulffraat, N M

2011-12-01

To analyze available evidence on vaccinations in paediatric patients with rheumatic and autoinflammatory diseases. This evidence formed the basis of the recently constructed European League against Rheumatism (EULAR) recommendations for vaccination of these patients. A systematic literature review in the MEDLINE and EMBASE databases was conducted using various terms for vaccinations, paediatric rheumatic and autoinflammatory diseases and immunosuppressive drugs. Only papers on paediatric patients (<18 years of age) were selected. A panel of 13 experts in the field graded methodological quality and extracted data using predefined criteria. 27 papers were available. No studies were found on autoinflammatory diseases. 14 studies considered live-attenuated vaccines. Evidence so far supports the safety and immunogenicity of non-live composite vaccines, although studies were underpowered to accurately assess safety. Live-attenuated vaccines did not cause disease flares or severe adverse events, not even in patients on methotrexate and low dose glucocorticosteroids. Seven patients on anti-TNFalpha therapy were described receiving the live-attenuated measles, mumps, rubella (n=5) or varicella (n=2) booster without severe adverse events. Data on safety and efficacy of vaccinations in paediatric patients with rheumatic diseases is reassuring, but too limited to draw definite conclusions. More research is needed on the safety and efficacy of especially live-attenuated vaccines in patients with rheumatic and autoinflammatory diseases using high dose immunosuppressive drugs. Copyright © 2011 Elsevier B.V. All rights reserved.

Evaluation of a reduced centrifugation time and higher centrifugal force on various general chemistry and immunochemistry analytes in plasma and serum.

PubMed

Møller, Mette F; Søndergaard, Tove R; Kristensen, Helle T; Münster, Anna-Marie B

2017-09-01

Background Centrifugation of blood samples is an essential preanalytical step in the clinical biochemistry laboratory. Centrifugation settings are often altered to optimize sample flow and turnaround time. Few studies have addressed the effect of altering centrifugation settings on analytical quality, and almost all studies have been done using collection tubes with gel separator. Methods In this study, we compared a centrifugation time of 5 min at 3000 ×  g to a standard protocol of 10 min at 2200 ×  g. Nine selected general chemistry and immunochemistry analytes and interference indices were studied in lithium heparin plasma tubes and serum tubes without gel separator. Results were evaluated using mean bias, difference plots and coefficient of variation, compared with maximum allowable bias and coefficient of variation used in laboratory routine quality control. Results For all analytes except lactate dehydrogenase, the results were within the predefined acceptance criteria, indicating that the analytical quality was not compromised. Lactate dehydrogenase showed higher values after centrifugation for 5 min at 3000 ×  g, mean bias was 6.3 ± 2.2% and the coefficient of variation was 5%. Conclusions We found that a centrifugation protocol of 5 min at 3000 ×  g can be used for the general chemistry and immunochemistry analytes studied, with the possible exception of lactate dehydrogenase, which requires further assessment.

Individual influences on lifestyle change to reduce vascular risk: a qualitative literature review

PubMed Central

Murray, Jenni; Honey, Stephanie; Hill, Kate; Craigs, Cheryl; House, Allan

2012-01-01

Background Management of cardiovascular risk includes adoption of healthy lifestyles. Uptake and completion rates for lifestyle programmes are low and many barriers and facilitators to lifestyle behaviour change have been reported in the literature. Clarity on which barriers and facilitators to target during consultations in primary care may support a more systematic approach to lifestyle behaviour change in those at high risk of cardiovascular events. Aim To identify the main barriers and facilitators to lifestyle behaviour change in individuals at high risk of cardiovascular events. Design A content synthesis of the qualitative literature reporting patient-level influences on lifestyle change. Method Qualitative studies involving patients at high risk of cardiovascular events were identified through electronic searching and screening against predefined selection criteria. Factors (reported influences) were extracted and, using a clustering technique, organised into categories that were then linked to key themes through relationship mapping. Results A total of 348 factors were extracted from 33 studies. Factors were organised into 20 categories and from these categories five key themes were identified: emotions, beliefs, information and communication, friends and family support, and cost/transport. Conclusion It is possible to organise the large number of self-reported individual influences on lifestyle behaviours into a small number of themes. Further research is needed to clarify which of these patient-level barriers and facilitators are the best predictors of uptake and participation in programmes aimed at helping people to change lifestyle. PMID:22687232

Bowel Ultrasonography in the Management of Crohn's Disease. A Review with Recommendations of an International Panel of Experts.

PubMed

Calabrese, Emma; Maaser, Christian; Zorzi, Francesca; Kannengiesser, Klaus; Hanauer, Stephen B; Bruining, David H; Iacucci, Marietta; Maconi, Giovanni; Novak, Kerri L; Panaccione, Remo; Strobel, Deike; Wilson, Stephanie R; Watanabe, Mamoru; Pallone, Francesco; Ghosh, Subrata

2016-05-01

Bowel ultrasonography (US) is considered a useful technique for assessing mural inflammation and complications in Crohn's disease (CD). The aim of this review is to appraise the evidence on the accuracy of bowel US for CD. In addition, we aim to provide recommendations for its optimal use. Publications were identified by literature search from 1992 to 2014 and selected based on predefined criteria: 15 or more patients; bowel US for diagnosing CD, complications, postoperative recurrence, activity; adequate reference standards; prospective study design; data reported to allow calculation of sensitivity, specificity, agreement, or correlation values; articles published in English. The search yielded 655 articles, of which 63 were found to be eligible and retrieved as full-text articles for analysis. Bowel US showed 79.7% sensitivity and 96.7% specificity for the diagnosis of suspected CD, and 89% sensitivity and 94.3% specificity for initial assessment in established patients with CD. Bowel US identified ileal CD with 92.7% sensitivity, 88.2% specificity, and colon CD with 81.8% sensitivity, 95.3% specificity, with lower accuracy for detecting proximal lesions. The oral contrast agent improves the sensitivity and specificity in determining CD lesions and in assessing sites and extent. Bowel US is a tool for evaluation of CD lesions in terms of complications, postoperative recurrence, and monitoring response to medical therapy; it reliably detects postoperative recurrence and complications, as well as offers the possibility of monitoring disease progression.

A survey on annotation tools for the biomedical literature.

PubMed

Neves, Mariana; Leser, Ulf

2014-03-01

New approaches to biomedical text mining crucially depend on the existence of comprehensive annotated corpora. Such corpora, commonly called gold standards, are important for learning patterns or models during the training phase, for evaluating and comparing the performance of algorithms and also for better understanding the information sought for by means of examples. Gold standards depend on human understanding and manual annotation of natural language text. This process is very time-consuming and expensive because it requires high intellectual effort from domain experts. Accordingly, the lack of gold standards is considered as one of the main bottlenecks for developing novel text mining methods. This situation led the development of tools that support humans in annotating texts. Such tools should be intuitive to use, should support a range of different input formats, should include visualization of annotated texts and should generate an easy-to-parse output format. Today, a range of tools which implement some of these functionalities are available. In this survey, we present a comprehensive survey of tools for supporting annotation of biomedical texts. Altogether, we considered almost 30 tools, 13 of which were selected for an in-depth comparison. The comparison was performed using predefined criteria and was accompanied by hands-on experiences whenever possible. Our survey shows that current tools can support many of the tasks in biomedical text annotation in a satisfying manner, but also that no tool can be considered as a true comprehensive solution.

A systematic review of quantitative burn wound microbiology in the management of burns patients.

PubMed

Halstead, Fenella D; Lee, Kwang Chear; Kwei, Johnny; Dretzke, Janine; Oppenheim, Beryl A; Moiemen, Naiem S

2018-02-01

The early diagnosis of infection or sepsis in burns are important for patient care. Globally, a large number of burn centres advocate quantitative cultures of wound biopsies for patient management, since there is assumed to be a direct link between the bioburden of a burn wound and the risk of microbial invasion. Given the conflicting study findings in this area, a systematic review was warranted. Bibliographic databases were searched with no language restrictions to August 2015. Study selection, data extraction and risk of bias assessment were performed in duplicate using pre-defined criteria. Substantial heterogeneity precluded quantitative synthesis, and findings were described narratively, sub-grouped by clinical question. Twenty six laboratory and/or clinical studies were included. Substantial heterogeneity hampered comparisons across studies and interpretation of findings. Limited evidence suggests that (i) more than one quantitative microbiology sample is required to obtain reliable estimates of bacterial load; (ii) biopsies are more sensitive than swabs in diagnosing or predicting sepsis; (iii) high bacterial loads may predict worse clinical outcomes, and (iv) both quantitative and semi-quantitative culture reports need to be interpreted with caution and in the context of other clinical risk factors. The evidence base for the utility and reliability of quantitative microbiology for diagnosing or predicting clinical outcomes in burns patients is limited and often poorly reported. Consequently future research is warranted. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

The Future of the Space Age or how to Evaluate Innovative Ideas

NASA Astrophysics Data System (ADS)

Vollerthun, A.; Fricke, E.

2002-05-01

Based on an initiative of the German Aerospace Industry Association to foster a more transparent and structured funding of German commercial-oriented space projects a three-phased approach is suggested in this paper, to stepwise improve and evaluate proposed concepts for space-related innovations. The objective of this concept was to develop a transparent, structured, and reproducible process to select the right innovative project in terms of political, economical, and technical objectives for funding by e.g. a governmental agency. A stepwise process and related methods, that cover technical as well as economical aspects (and related sensitivities) are proposed. Based on the special needs and requirements of space industry the proposals are compared to a set of predefined top level objectives/requirements. Using an initial trades analysis with the criteria company, technology, product, and market, an initial business case is analyzed. The alternative innovative concepts are in the third process step subject to a very detailed analysis. The full economical and technical scale of the projects is evaluated and metrics for e.g. the 'Return on Investment' or 'Break Even Point' are determined, to compare the various innovations. Risks related to time, cost, and quality are considered, when performing sensitivity analysis by varying the most important factors of the project. Before discussing critical aspects of the proposed process, space-related examples will be presented to show how the process could be applied, and how different concepts should be evaluated.

Benchmarking: applications to transfusion medicine.

PubMed

Apelseth, Torunn Oveland; Molnar, Laura; Arnold, Emmy; Heddle, Nancy M

2012-10-01

Benchmarking is as a structured continuous collaborative process in which comparisons for selected indicators are used to identify factors that, when implemented, will improve transfusion practices. This study aimed to identify transfusion medicine studies reporting on benchmarking, summarize the benchmarking approaches used, and identify important considerations to move the concept of benchmarking forward in the field of transfusion medicine. A systematic review of published literature was performed to identify transfusion medicine-related studies that compared at least 2 separate institutions or regions with the intention of benchmarking focusing on 4 areas: blood utilization, safety, operational aspects, and blood donation. Forty-five studies were included: blood utilization (n = 35), safety (n = 5), operational aspects of transfusion medicine (n = 5), and blood donation (n = 0). Based on predefined criteria, 7 publications were classified as benchmarking, 2 as trending, and 36 as single-event studies. Three models of benchmarking are described: (1) a regional benchmarking program that collects and links relevant data from existing electronic sources, (2) a sentinel site model where data from a limited number of sites are collected, and (3) an institutional-initiated model where a site identifies indicators of interest and approaches other institutions. Benchmarking approaches are needed in the field of transfusion medicine. Major challenges include defining best practices and developing cost-effective methods of data collection. For those interested in initiating a benchmarking program, the sentinel site model may be most effective and sustainable as a starting point, although the regional model would be the ideal goal. Copyright © 2012 Elsevier Inc. All rights reserved.

Decision-making patterns for dietary supplement purchases among women aged 25 to 45 years.

PubMed

Miller, Carla K; Russell, Teri; Kissling, Grace

2003-11-01

Women frequently consume dietary supplements but the criteria used to select supplements have received little investigation. This research identified the decision-making criteria used for dietary supplements among women aged 25 to 45 years who consumed a supplement at least four times per week. Participants (N=51) completed an in-store shopping interview that was audiotaped, transcribed, and analyzed qualitatively for the criteria used to make supplement selections. Qualitative analysis revealed 10 key criteria and the number of times each person used each criterion was quantified. Cluster analysis identified five homogeneous subgroups of participants based on the criteria used. These included brand shopper, bargain shopper, quality shopper, convenience shopper, and information gatherer. Supplement users vary in the criteria used to make point-of-purchase supplement selections. Dietetics professionals can classify supplement users according to the criteria used to tailor their nutrition counseling and better meet the educational needs of consumers.

Limited Sampling Strategy for Accurate Prediction of Pharmacokinetics of Saroglitazar: A 3-point Linear Regression Model Development and Successful Prediction of Human Exposure.

PubMed

Joshi, Shuchi N; Srinivas, Nuggehally R; Parmar, Deven V

2018-03-01

Our aim was to develop and validate the extrapolative performance of a regression model using a limited sampling strategy for accurate estimation of the area under the plasma concentration versus time curve for saroglitazar. Healthy subject pharmacokinetic data from a well-powered food-effect study (fasted vs fed treatments; n = 50) was used in this work. The first 25 subjects' serial plasma concentration data up to 72 hours and corresponding AUC 0-t (ie, 72 hours) from the fasting group comprised a training dataset to develop the limited sampling model. The internal datasets for prediction included the remaining 25 subjects from the fasting group and all 50 subjects from the fed condition of the same study. The external datasets included pharmacokinetic data for saroglitazar from previous single-dose clinical studies. Limited sampling models were composed of 1-, 2-, and 3-concentration-time points' correlation with AUC 0-t of saroglitazar. Only models with regression coefficients (R 2 ) >0.90 were screened for further evaluation. The best R 2 model was validated for its utility based on mean prediction error, mean absolute prediction error, and root mean square error. Both correlations between predicted and observed AUC 0-t of saroglitazar and verification of precision and bias using Bland-Altman plot were carried out. None of the evaluated 1- and 2-concentration-time points models achieved R 2 > 0.90. Among the various 3-concentration-time points models, only 4 equations passed the predefined criterion of R 2 > 0.90. Limited sampling models with time points 0.5, 2, and 8 hours (R 2 = 0.9323) and 0.75, 2, and 8 hours (R 2 = 0.9375) were validated. Mean prediction error, mean absolute prediction error, and root mean square error were <30% (predefined criterion) and correlation (r) was at least 0.7950 for the consolidated internal and external datasets of 102 healthy subjects for the AUC 0-t prediction of saroglitazar. The same models, when applied to the AUC 0-t prediction of saroglitazar sulfoxide, showed mean prediction error, mean absolute prediction error, and root mean square error <30% and correlation (r) was at least 0.9339 in the same pool of healthy subjects. A 3-concentration-time points limited sampling model predicts the exposure of saroglitazar (ie, AUC 0-t ) within predefined acceptable bias and imprecision limit. Same model was also used to predict AUC 0-∞ . The same limited sampling model was found to predict the exposure of saroglitazar sulfoxide within predefined criteria. This model can find utility during late-phase clinical development of saroglitazar in the patient population. Copyright © 2018 Elsevier HS Journals, Inc. All rights reserved.

Selection of remedial alternatives for mine sites: a multicriteria decision analysis approach.

PubMed

Betrie, Getnet D; Sadiq, Rehan; Morin, Kevin A; Tesfamariam, Solomon

2013-04-15

The selection of remedial alternatives for mine sites is a complex task because it involves multiple criteria and often with conflicting objectives. However, an existing framework used to select remedial alternatives lacks multicriteria decision analysis (MCDA) aids and does not consider uncertainty in the selection of alternatives. The objective of this paper is to improve the existing framework by introducing deterministic and probabilistic MCDA methods. The Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) methods have been implemented in this study. The MCDA analysis involves processing inputs to the PROMETHEE methods that are identifying the alternatives, defining the criteria, defining the criteria weights using analytical hierarchical process (AHP), defining the probability distribution of criteria weights, and conducting Monte Carlo Simulation (MCS); running the PROMETHEE methods using these inputs; and conducting a sensitivity analysis. A case study was presented to demonstrate the improved framework at a mine site. The results showed that the improved framework provides a reliable way of selecting remedial alternatives as well as quantifying the impact of different criteria on selecting alternatives. Copyright © 2013 Elsevier Ltd. All rights reserved.

Safety approach to the selection of design criteria for the CRBRP reactor refueling system

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

Meisl, C J; Berg, G E; Sharkey, N F

1979-01-01

The selection of safety design criteria for Liquid Metal Fast Breeder Reactor (LMFBR) refueling systems required the extrapolation of regulations and guidelines intended for Light Water Reactor refueling systems and was encumbered by the lack of benefit from a commercially licensed predecessor other than Fermi. The overall approach and underlying logic are described for developing safety design criteria for the reactor refueling system (RRS) of the Clinch River Breeder Reactor Plant (CRBRP). The complete selection process used to establish the criteria is presented, from the definition of safety functions to the finalization of safety design criteria in the appropriate documents.more » The process steps are illustrated by examples.« less

Selected reaction monitoring mass spectrometry: a methodology overview.

PubMed

Ebhardt, H Alexander

2014-01-01

Moving past the discovery phase of proteomics, the term targeted proteomics combines multiple approaches investigating a certain set of proteins in more detail. One such targeted proteomics approach is the combination of liquid chromatography and selected or multiple reaction monitoring mass spectrometry (SRM, MRM). SRM-MS requires prior knowledge of the fragmentation pattern of peptides, as the presence of the analyte in a sample is determined by measuring the m/z values of predefined precursor and fragment ions. Using scheduled SRM-MS, many analytes can robustly be monitored allowing for high-throughput sample analysis of the same set of proteins over many conditions. In this chapter, fundaments of SRM-MS are explained as well as an optimized SRM pipeline from assay generation to data analyzed.

Comparative SWOT analysis of strategic environmental assessment systems in the Middle East and North Africa region.

PubMed

Rachid, G; El Fadel, M

2013-08-15

This paper presents a SWOT analysis of SEA systems in the Middle East North Africa region through a comparative examination of the status, application and structure of existing systems based on country-specific legal, institutional and procedural frameworks. The analysis is coupled with the multi-attribute decision making method (MADM) within an analytical framework that involves both performance analysis based on predefined evaluation criteria and countries' self-assessment of their SEA system through open-ended surveys. The results show heterogenous status with a general delayed progress characterized by varied levels of weaknesses embedded in the legal and administrative frameworks and poor integration with the decision making process. Capitalizing on available opportunities, the paper highlights measures to enhance the development and enactment of SEA in the region. Copyright © 2013 Elsevier Ltd. All rights reserved.

Disappointing performance of literature-derived selective screening criteria for asymptomatic Chlamydia trachomatis infection in an inner-city population.

PubMed

van Valkengoed, I G; Boeke, A J; Morré, S A; van den Brule, A J; Meijer, C J; Devillé, W; Bouter, L M

2000-10-01

In an inner-city population with a low prevalence of Chlamydia trachomatis infection, selective screening may be indicated to increase the efficiency of screening. To evaluate the performance of sets of selective screening criteria for asymptomatic Chlamydia trachomatis infection in an inner-city population. The criteria were derived from reports of studies carried out in various settings. A total of 5714 women age 15 to 40 years living in Amsterdam were invited for a screening based on home-obtained urine specimens. Criteria identified from the literature were applied to the screening population. A calculated area under the receiver-operator characteristic curve (AUC) of greater than 0.75 was considered a good measure of diagnostic accuracy. Of the four sets of criteria, selection based on the following determinants showed the highest diagnostic accuracy: younger than 25 years, being unmarried, number of partners during the previous 6 months, Surinam or Antillean origin (black), and vaginal douching (AUC, 0.67; 95% CI, 0.65-0.69). Selection based on age alone showed an AUC of 0.57 (95% CI, 0.55-0.69). The performance of selective screening criteria for asymptomatic C trachomatis infection in an inner-city population in Amsterdam was insufficient to recommend its implementation in practice.

A multi-criteria decision-making approach to rank supplier selection criteria for hospital waste management: A case from Pakistan.

PubMed

Ishtiaq, Palvisha; Khan, Sharfuddin Ahmed; Haq, Moiz-Ul

2018-04-01

To address environmental issues and cost effectiveness, waste management is necessary for healthcare facilities. Most importantly, segregation of hazardous and non-hazardous waste must be done as in many developing countries; disposal of both types of healthcare waste is done together, which is an unsafe practice. Waste generated in hospitals needs proper management to minimise hazards for patient and healthcare workers. At the same time, it is quite difficult for hospitals to find a systematic way to select appropriate suppliers for hospital waste management. Therefore, the purpose of this article is to identify, validate, and rank criteria that are essential for hospital waste management suppliers' selection. The analytical hierarchal process approach has been used and a survey from Pakistan's largest city (Karachi) has been considered to rank the most appropriate criteria that is necessary to select the supplier, especially in a developing country like Pakistan. Results show that waste management cost (45.5%) and suppliers' details (31.5%) are the top two main criteria for supplier selection; and storage cost (15.7%), waste handling cost (14.7%), and qualification of the suppliers (10.9%) are the top three most important overall sub-criteria for supplier selection for hospital waste management.

An overview of international issues in astronaut psychological selection.

PubMed

Santy, P A; Jones, D R

1994-10-01

The NASA Johnson Space Center Medical Sciences Division convened an In-House Working Group on Psychiatric and Psychological Selection of Astronauts in 1988. Working with the European Space Agency (ESA) and the National Space Development Agency (NASDA) of Japan, psychiatrists and psychologists experienced in selecting individuals for training as astronauts or analogous duties studied the development of appropriate criteria. Psychiatric criteria generally concern the detection of pathological conditions, and thus "select-out" applicants by disqualification. Psychological criteria may be used to identify specific affirmative criteria that make an individual particularly well-qualified for such duties, and thus concern "select-in" processes for operational crews. As space missions grow longer, and as crews become larger and more demographically diversified, the long-ignored questions, "What sort of healthy individuals should be selected for such missions," and "How do we know this?" will become more critical to the success of space exploration. The papers included in this Panel concern the results of these investigations, and represent long-needed quantification of these two selection processes, select-out and select-in, in several cultures.

7 CFR 1944.529 - Project selection.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 13 2010-01-01 2009-01-01 true Project selection. 1944.529 Section 1944.529... selection. (a) Projects must meet the following criteria: (1) Provide a program of supervisory assistance as... section, the following criteria will be considered in the selection of grant recipients: (1) The extent to...

Composition of zeotropic mixtures having predefined temperature glide

DOEpatents

Mahmoud, Ahmad M.; Lee, Jaeseon; Luo, Dong

2015-05-26

A composition of a zeotropic mixture has a first chemical constituent and at least one second, different chemical constituent. The zeoptropic mixture has a temperature glide of 5.degree. C.-25.degree. C. with regard to its saturated vapor temperature and its saturated liquid temperature. The first chemical constituent is selected from 1,1,1,3,3-pentafluoropropane, 1,1,2,2,3-pentafluoropropane, 1,1,1,3,3-pentafluorobutane, methyl perfluoropropyl ether, 1,1,1,2,3,3-hexafluoropropane and 1,1,1,2,2,4,5,5,5-nonafluoro-4-(trifluoromethyl)-3-pentanone.

Identifying Luminous AGN in Deep Surveys: Revised IRAC Selection Criteria

NASA Astrophysics Data System (ADS)

Donley, Jennifer; Koekemoer, A. M.; Brusa, M.; Capak, P.; Cardamone, C. N.; Civano, F.; Ilbert, O.; Impey, C. D.; Kartaltepe, J.; Miyaji, T.; Salvato, M.; Sanders, D. B.; Trump, J. R.; Zamorani, G.

2012-01-01

Spitzer IRAC selection is a powerful tool for identifying luminous AGN. The AGN selection wedges currently in use, however, are heavily contaminated by star-forming galaxies, especially at high redshift. Using the large samples of luminous AGN and high-redshift star-forming galaxies in COSMOS, we redefine the AGN selection criteria for use in deep IRAC surveys. The new IRAC criteria are designed to be both highly complete and reliable, and incorporate the best aspects of the current AGN selection wedges and of infrared power-law selection while excluding high redshift star-forming galaxies selected via the BzK, DRG, LBG, and SMG criteria. At QSO-luminosities of log L(2-10 keV)>44, the new IRAC criteria recover 75% of the hard X-ray and IRAC-detected XMM-COSMOS sample, yet only 37% of the IRAC AGN candidates have X-ray counterparts, a fraction that rises to 51% in regions with Chandra exposures of 50-160 ks. X-ray stacking of the individually X-ray non-detected AGN candidates leads to a hard X-ray signal indicative of heavily obscured to mildly Compton-thick obscuration (log NH >= 23.7). While IRAC selection recovers a substantial fraction of luminous unobscured and obscured AGN, it is incomplete to low-luminosity and host-dominated AGN.

Balancing costs and benefits at different stages of medical innovation: a systematic review of Multi-criteria decision analysis (MCDA).

PubMed

Wahlster, Philip; Goetghebeur, Mireille; Kriza, Christine; Niederländer, Charlotte; Kolominsky-Rabas, Peter

2015-07-09

The diffusion of health technologies from translational research to reimbursement depends on several factors included the results of health economic analysis. Recent research identified several flaws in health economic concepts. Additionally, the heterogeneous viewpoints of participating stakeholders are rarely systematically addressed in current decision-making. Multi-criteria Decision Analysis (MCDA) provides an opportunity to tackle these issues. The objective of this study was to review applications of MCDA methods in decisions addressing the trade-off between costs and benefits. Using basic steps of the PRISMA guidelines, a systematic review of the healthcare literature was performed to identify original research articles from January 1990 to April 2014. Medline, PubMed, Springer Link and specific journals were searched. Using predefined categories, bibliographic records were systematically extracted regarding the type of policy applications, MCDA methodology, criteria used and their definitions. 22 studies were included in the analysis. 15 studies (68 %) used direct MCDA approaches and seven studies (32 %) used preference elicitation approaches. Four studies (19 %) focused on technologies in the early innovation process. The majority (18 studies - 81 %) examined reimbursement decisions. Decision criteria used in studies were obtained from the literature research and context-specific studies, expert opinions, and group discussions. The number of criteria ranged between three up to 15. The most frequently used criteria were health outcomes (73 %), disease impact (59 %), and implementation of the intervention (40 %). Economic criteria included cost-effectiveness criteria (14 studies, 64 %), and total costs/budget impact of an intervention (eight studies, 36 %). The process of including economic aspects is very different among studies. Some studies directly compare costs with other criteria while some include economic consideration in a second step. In early innovation processes, MCDA can provide information about stakeholder preferences as well as evidence needs in further development. However, only a minority of these studies include economic features due to the limited evidence. The most important economic criterion cost-effectiveness should not be included from a technical perspective as it is already a composite of costs and benefit. There is a significant lack of consensus in methodology employed by the various studies which highlights the need for guidance on application of MCDA at specific phases of an innovation.

Green supply chain management strategy selection using analytic network process: case study at PT XYZ

NASA Astrophysics Data System (ADS)

Adelina, W.; Kusumastuti, R. D.

2017-01-01

This study is about business strategy selection for green supply chain management (GSCM) for PT XYZ by using Analytic Network Process (ANP). GSCM is initiated as a response to reduce environmental impacts from industrial activities. The purposes of this study are identifying criteria and sub criteria in selecting GSCM Strategy, and analysing a suitable GSCM strategy for PT XYZ. This study proposes ANP network with 6 criteria and 29 sub criteria, which are obtained from the literature and experts’ judgements. One of the six criteria contains GSCM strategy options, namely risk-based strategy, efficiency-based strategy, innovation-based strategy, and closed loop strategy. ANP solves complex GSCM strategy-selection by using a more structured process and considering green perspectives from experts. The result indicates that innovation-based strategy is the most suitable green supply chain management strategy for PT XYZ.

[The research protocol III. Study population].

PubMed

Arias-Gómez, Jesús; Villasís-Keever, Miguel Ángel; Miranda-Novales, María Guadalupe

2016-01-01

The study population is defined as a set of cases, determined, limited, and accessible, that will constitute the subjects for the selection of the sample, and must fulfill several characteristics and distinct criteria. The objectives of this manuscript are focused on specifying each one of the elements required to make the selection of the participants of a research project, during the elaboration of the protocol, including the concepts of study population, sample, selection criteria and sampling methods. After delineating the study population, the researcher must specify the criteria that each participant has to comply. The criteria that include the specific characteristics are denominated selection or eligibility criteria. These criteria are inclusion, exclusion and elimination, and will delineate the eligible population. The sampling methods are divided in two large groups: 1) probabilistic or random sampling and 2) non-probabilistic sampling. The difference lies in the employment of statistical methods to select the subjects. In every research, it is necessary to establish at the beginning the specific number of participants to be included to achieve the objectives of the study. This number is the sample size, and can be calculated or estimated with mathematical formulas and statistic software.

Comparison of fuzzy AHP and fuzzy TODIM methods for landfill location selection.

PubMed

Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik

2016-01-01

Landfill location selection is a multi-criteria decision problem and has a strategic importance for many regions. The conventional methods for landfill location selection are insufficient in dealing with the vague or imprecise nature of linguistic assessment. To resolve this problem, fuzzy multi-criteria decision-making methods are proposed. The aim of this paper is to use fuzzy TODIM (the acronym for Interactive and Multi-criteria Decision Making in Portuguese) and the fuzzy analytic hierarchy process (AHP) methods for the selection of landfill location. The proposed methods have been applied to a landfill location selection problem in the region of Casablanca, Morocco. After determining the criteria affecting the landfill location decisions, fuzzy TODIM and fuzzy AHP methods are applied to the problem and results are presented. The comparisons of these two methods are also discussed.

34 CFR 366.15 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Training and Technical Assistance § 366.15 What selection criteria does the Secretary use? The Secretary uses the following criteria to evaluate applications for new awards for training and technical... project; and (2) How the objectives further training and technical assistance with respect to planning...

GES DISC Datalist Enables Easy Data Selection For Natural Phenomena Studies

NASA Technical Reports Server (NTRS)

Li, Angela; Shie, Chung-Lin; Hegde, Mahabaleshwa; Petrenko, Maksym; Teng, William; Bryant, Keith; Liu, Zhong; Hearty, Thomas; Shen, Suhung; Seiler, Edward;

Stroke-model-based character extraction from gray-level document images.

PubMed

Ye, X; Cheriet, M; Suen, C Y

2001-01-01

Global gray-level thresholding techniques such as Otsu's method, and local gray-level thresholding techniques such as edge-based segmentation or the adaptive thresholding method are powerful in extracting character objects from simple or slowly varying backgrounds. However, they are found to be insufficient when the backgrounds include sharply varying contours or fonts in different sizes. A stroke-model is proposed to depict the local features of character objects as double-edges in a predefined size. This model enables us to detect thin connected components selectively, while ignoring relatively large backgrounds that appear complex. Meanwhile, since the stroke width restriction is fully factored in, the proposed technique can be used to extract characters in predefined font sizes. To process large volumes of documents efficiently, a hybrid method is proposed for character extraction from various backgrounds. Using the measurement of class separability to differentiate images with simple backgrounds from those with complex backgrounds, the hybrid method can process documents with different backgrounds by applying the appropriate methods. Experiments on extracting handwriting from a check image, as well as machine-printed characters from scene images demonstrate the effectiveness of the proposed model.

Economic Evaluation of Text-Messaging and Smartphone-Based Interventions to Improve Medication Adherence in Adolescents with Chronic Health Conditions: A Systematic Review.

PubMed

Badawy, Sherif M; Kuhns, Lisa M

2016-10-25

The rate of chronic health conditions (CHCs) in children and adolescents has doubled in the past 20 years, with increased health care costs. Technology-based interventions have demonstrated efficacy to improving medication adherence. However, data to support the cost effectiveness of these interventions are lacking. The objective of this study is to conduct an economic evaluation of text-messaging and smartphone-based interventions that focus on improving medication adherence in adolescents with CHCs. Searches included PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, and Inspec. Eligibility criteria included age (12-24 years old), original articles, outcomes for medication adherence, and economic outcomes. Our search identified 1118 unique articles that were independently screened. A total of 156 articles met inclusion criteria and were then examined independently with full-text review. A total of 15 articles met most criteria but lacked economic outcomes such as cost effectiveness or cost-utility data. No articles met all predefined criteria to be included for final review. Only 4 articles (text messaging [n=3], electronic directly observed therapy [n=1]) described interventions with possible future cost-saving but no formal economic evaluation. The evidence to support the cost effectiveness of text-messaging and smartphone-based interventions in improving medication adherence in adolescents with CHCs is insufficient. This lack of research highlights the need for comprehensive economic evaluation of such interventions to better understand their role in cost-savings while improving medication adherence and health outcomes. Economic evaluation of technology-based interventions can contribute to more evidence-based assessment of the scalability, sustainability, and benefits of broader investment of such technology tools in adolescents with CHCs.

MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy.

PubMed

Lalla, Rajesh V; Bowen, Joanne; Barasch, Andrei; Elting, Linda; Epstein, Joel; Keefe, Dorothy M; McGuire, Deborah B; Migliorati, Cesar; Nicolatou-Galitis, Ourania; Peterson, Douglas E; Raber-Durlacher, Judith E; Sonis, Stephen T; Elad, Sharon

2014-05-15

Mucositis is a highly significant, and sometimes dose-limiting, toxicity of cancer therapy. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for mucositis. A literature search was conducted to identify eligible published articles, based on predefined inclusion/exclusion criteria. Each article was independently reviewed by 2 reviewers. Studies were rated according to the presence of major and minor flaws as per previously published criteria. The body of evidence for each intervention, in each treatment setting, was assigned a level of evidence, based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. The literature search identified 8279 papers, 1032 of which were retrieved for detailed evaluation based on titles and abstracts. Of these, 570 qualified for final inclusion in the systematic reviews. Sixteen new guidelines were developed for or against the use of various interventions in specific treatment settings. In total, the MASCC/ISOO Mucositis Guidelines now include 32 guidelines: 22 for oral mucositis and 10 for gastrointestinal mucositis. This article describes these updated guidelines. The updated MASCC/ISOO Clinical Practice Guidelines for mucositis will help clinicians provide evidence-based management of mucositis secondary to cancer therapy. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Bi-criteria travelling salesman subtour problem with time threshold

NASA Astrophysics Data System (ADS)

Kumar Thenepalle, Jayanth; Singamsetty, Purusotham

2018-03-01

This paper deals with the bi-criteria travelling salesman subtour problem with time threshold (BTSSP-T), which comes from the family of the travelling salesman problem (TSP) and is NP-hard in the strong sense. The problem arises in several application domains, mainly in routing and scheduling contexts. Here, the model focuses on two criteria: total travel distance and gains attained. The BTSSP-T aims to determine a subtour that starts and ends at the same city and visits a subset of cities at a minimum travel distance with maximum gains, such that the time spent on the tour does not exceed the predefined time threshold. A zero-one integer-programming problem is adopted to formulate this model with all practical constraints, and it includes a finite set of feasible solutions (one for each tour). Two algorithms, namely, the Lexi-Search Algorithm (LSA) and the Tabu Search (TS) algorithm have been developed to solve the BTSSP-T problem. The proposed LSA implicitly enumerates the feasible patterns and provides an efficient solution with backtracking, whereas the TS, which is metaheuristic, will give the better approximate solution. A numerical example is demonstrated in order to understand the search mechanism of the LSA. Numerical experiments are carried out in the MATLAB environment, on the different benchmark instances available in the TSPLIB domain as well as on randomly generated test instances. The experimental results show that the proposed LSA works better than the TS algorithm in terms of solution quality and, computationally, both LSA and TS are competitive.

Can living donor liver transplantation offer similar outcomes to deceased donor liver transplantation using expanded selection criteria for hepatocellular carcinoma?

PubMed Central

Chen, Li-Ping; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin

2015-01-01

Objective: To compare the outcomes of living donor liver transplantation (LDLT) versus deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC) in different selection criteria. Methods: Data of patients with HCC who underwent liver transplantation between 2005 and 2013 at our center were reviewed. Clinical data of LDLT recipients and DDLT recipients were compared. The postoperative recurrence-free survival (RFS) rate and overall survival (OS) rate after LDLT versus DDLT were compared in the Milan recipients, the University of California, San Francisco (UCSF) recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients. Results: Data of 255 patients were retrospectively reviewed in this study. Seventeen DDLT recipient and 9 LDLT recipients died during the perioperative period. Among the remaining 229 recipients (NLDLT=66, NDDLT=163), 96 patients met the Milan criteria, 123 recipients met the UCSF criteria, 135 patients met the up-to-seven criteria, 216 patients met the Hangzhou criteria, and 229 recipients met the Chengdu criteria. The overall RFS and OS rates of the Milan recipients, the UCSF recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients after LDLT and DDLT were all similar. Conclusion: Using well-studied selection criteria, LDLT offers similar outcomes to DDLT for patient with HCC, even using expanded selection criteria. PMID:26430399

Can living donor liver transplantation offer similar outcomes to deceased donor liver transplantation using expanded selection criteria for hepatocellular carcinoma?

PubMed

Chen, Li-Ping; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin

2015-01-01

To compare the outcomes of living donor liver transplantation (LDLT) versus deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC) in different selection criteria. Data of patients with HCC who underwent liver transplantation between 2005 and 2013 at our center were reviewed. Clinical data of LDLT recipients and DDLT recipients were compared. The postoperative recurrence-free survival (RFS) rate and overall survival (OS) rate after LDLT versus DDLT were compared in the Milan recipients, the University of California, San Francisco (UCSF) recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients. Data of 255 patients were retrospectively reviewed in this study. Seventeen DDLT recipient and 9 LDLT recipients died during the perioperative period. Among the remaining 229 recipients (NLDLT=66, NDDLT=163), 96 patients met the Milan criteria, 123 recipients met the UCSF criteria, 135 patients met the up-to-seven criteria, 216 patients met the Hangzhou criteria, and 229 recipients met the Chengdu criteria. The overall RFS and OS rates of the Milan recipients, the UCSF recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients after LDLT and DDLT were all similar. Using well-studied selection criteria, LDLT offers similar outcomes to DDLT for patient with HCC, even using expanded selection criteria.

The Impact of Varied Discrimination Parameters on Mixed-Format Item Response Theory Model Selection

ERIC Educational Resources Information Center

Whittaker, Tiffany A.; Chang, Wanchen; Dodd, Barbara G.

2013-01-01

Whittaker, Chang, and Dodd compared the performance of model selection criteria when selecting among mixed-format IRT models and found that the criteria did not perform adequately when selecting the more parameterized models. It was suggested by M. S. Johnson that the problems when selecting the more parameterized models may be because of the low…

40 CFR 228.6 - Specific criteria for site selection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Specific criteria for site selection... selection. (a) In the selection of disposal sites, in addition to other necessary or appropriate factors...) Existence at or in close proximity to the site of any significant natural or cultural features of historical...

Head and neck squamous cell carcinoma of unknown primary: Outcomes of a pre-defined institutional treatment policy in a region with a high prevalence of skin cancer.

PubMed

Huo, Michael; Panizza, Benedict; Bernard, Anne; Porceddu, Sandro V

2018-02-01

To determine the rate of subsequent primary site failure in patients with head and neck squamous cell carcinoma of unknown primary (UKP HNSCC) in a region with a high prevalence of cutaneous squamous cell carcinoma, according to a pre-determined institutional policy. Secondary aims included regional and distant control, and overall survival. Patients presenting between April 2005 and June 2016 to the Princess Alexandra Hospital Head and Neck Multidisciplinary Meeting with UKP HNSCC from either presumed mucosal or cutaneous sites treated with curative intent were eligible. Patients with presumed mucosal origin were treated with radiation therapy (RT) with or without chemotherapy, while patients with presumed cutaneous SCC were treated with surgery and post-operative RT with or without chemotherapy. A total of 63 patients met the inclusion criteria. Median follow up duration was 3.9 years (IQR 2.07-5.14). There were no subsequent primary site failures. The rate of nodal failure among presumed mucosal patients was 11.5%, and 8.1% among presumed cutaneous patients. The rate of distant metastatic failure was 11.1% among all patients. The estimated 5 year overall survival was 71.2% (95% CI 59.2-85.7%). Treatment according to our pre-defined institutional policy for UKP HNSCC in a region with a high prevalence of cutaneous SCC appears to be safe and effective with low rates of mucosal primary emergence and nodal failure. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

A 12-week interdisciplinary rehabilitation trial in patients with gliomas - a feasibility study.

PubMed

Hansen, Anders; Søgaard, Karen; Minet, Lisbeth Rosenbek; Jarden, Jens Ole

2018-06-01

This report aims to assess the safety and feasibility of using an interdisciplinary rehabilitation intervention for a future randomized controlled trial in patients with gliomas in the initial treatment phase. We conducted an outpatient two-part rehabilitation intervention that involved six weeks of therapeutic supervised training (part one) and six weeks of unsupervised training in a local gym following a training protocol (part two). Predefined feasibility objectives of safety (100%), consent rate (>80%), drop-out (<20%), adherence (>80%) and patient satisfaction (>80%) was achieved at part one. However, the failure to meet predefined feasibility objectives of drop-out, adherence and patient satisfaction of the unsupervised intervention at part two have led to a protocol revision for a future randomized controlled trial. This study demonstrates that an intensive rehabilitation intervention of physical therapy and occupational therapy in the initial treatment phase of patients with gliomas whose Karnofsky performance status is ≥70 is safe and feasible, if relevant inclusion criteria and precautionary screening are made. With the revised protocol, we are confident that the foundation for conducting a successful randomized controlled trial among these vulnerable patients has been established. Implications for rehabilitation Brain tumors constitute some of the most challenging cancer diagnoses presenting for rehabilitation intervention. Patients with gliomas experiences limitations in physical functioning, cognition, and emotional wellbeing. In a relatively small sample this study shows that supervised physical- and occupational therapy in patients with gliomas is safe and feasible in the initial treatment phase. Patients with gliomas can potentially improve functioning through interdisciplinary rehabilitation.

Path planning during combustion mode switch

DOEpatents

Jiang, Li; Ravi, Nikhil

2015-12-29

Systems and methods are provided for transitioning between a first combustion mode and a second combustion mode in an internal combustion engine. A current operating point of the engine is identified and a target operating point for the internal combustion engine in the second combustion mode is also determined. A predefined optimized transition operating point is selected from memory. While operating in the first combustion mode, one or more engine actuator settings are adjusted to cause the operating point of the internal combustion engine to approach the selected optimized transition operating point. When the engine is operating at the selected optimized transition operating point, the combustion mode is switched from the first combustion mode to the second combustion mode. While operating in the second combustion mode, one or more engine actuator settings are adjusted to cause the operating point of the internal combustion to approach the target operating point.

Robust LS-SVM-based adaptive constrained control for a class of uncertain nonlinear systems with time-varying predefined performance

NASA Astrophysics Data System (ADS)

Luo, Jianjun; Wei, Caisheng; Dai, Honghua; Yuan, Jianping

2018-03-01

This paper focuses on robust adaptive control for a class of uncertain nonlinear systems subject to input saturation and external disturbance with guaranteed predefined tracking performance. To reduce the limitations of classical predefined performance control method in the presence of unknown initial tracking errors, a novel predefined performance function with time-varying design parameters is first proposed. Then, aiming at reducing the complexity of nonlinear approximations, only two least-square-support-vector-machine-based (LS-SVM-based) approximators with two design parameters are required through norm form transformation of the original system. Further, a novel LS-SVM-based adaptive constrained control scheme is developed under the time-vary predefined performance using backstepping technique. Wherein, to avoid the tedious analysis and repeated differentiations of virtual control laws in the backstepping technique, a simple and robust finite-time-convergent differentiator is devised to only extract its first-order derivative at each step in the presence of external disturbance. In this sense, the inherent demerit of backstepping technique-;explosion of terms; brought by the recursive virtual controller design is conquered. Moreover, an auxiliary system is designed to compensate the control saturation. Finally, three groups of numerical simulations are employed to validate the effectiveness of the newly developed differentiator and the proposed adaptive constrained control scheme.

Lean Information Management: Criteria For Selecting Key Performance Indicators At Shop Floor

NASA Astrophysics Data System (ADS)

Iuga, Maria Virginia; Kifor, Claudiu Vasile; Rosca, Liviu-Ion

2015-07-01

Most successful organizations worldwide use key performance indicators as an important part of their corporate strategy in order to forecast, measure and plan their businesses. Performance metrics vary in their purpose, definition and content. Therefore, the way organizations select what they think are the optimal indicators for their businesses varies from company to company, sometimes even from department to department. This study aims to answer the question of what is the most suitable way to define and select key performance indicators. More than that, it identifies the right criteria to select key performance indicators at shop floor level. This paper contributes to prior research by analysing and comparing previously researched selection criteria and proposes an original six-criteria-model, which caters towards choosing the most adequate KPIs. Furthermore, the authors take the research a step further by further steps to closed research gaps within this field of study.

Which family physician should I choose? The analytic hierarchy process approach for ranking of criteria in the selection of a family physician.

PubMed

Kuruoglu, Emel; Guldal, Dilek; Mevsim, Vildan; Gunvar, Tolga

2015-08-05

Choosing the most appropriate family physician (FP) for the individual, plays a fundamental role in primary care. The aim of this study is to determine the selection criteria for the patients in choosing their family doctors and priority ranking of these criteria by using the multi-criteria decision-making method of the Analytic Hierarchy Process (AHP) model. The study was planned and conducted in two phases. In the first phase, factors affecting the patients' decisions were revealed with a qualitative research. In the next phase, the priorities of FP selection criteria were determined by using AHP model. Criteria were compared in pairs. 96 patient were asked to fill the information forms which contains comparison scores in the Family Health Centres. According to the analysis of focus group discussions FP selection criteria were congregated in to five groups: Individual Characteristics, Patient-Doctor relationship, Professional characteristics, the Setting, and Ethical Characteristics. For each of the 96 participants, comparison matrixes were formed based on the scores of their information forms. Of these, models of only 5 (5.2 %) of the participants were consistent, in other words, they have been able to score consistent ranking. The consistency ratios (CR) were found to be smaller than 0.10. Therefore the comparison matrix of this new model, which was formed based on the medians of scores only given by these 5 participants, was consistent (CR = 0.06 < 0.10). According to comparison results; with a 0.467 value-weight, the most important criterion for choosing a family physician is his/her 'Professional characteristics'. Selection criteria for choosing a FP were put in a priority order by using AHP model. These criteria can be used as measures for selecting alternative FPs in further researches.

77 FR 74407 - Proposed Priorities, Requirements, Definitions, and Selection Criteria-Investing in Innovation Fund

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-14

...The Assistant Deputy Secretary for Innovation and Improvement proposes priorities, requirements, definitions, and selection criteria under the Investing in Innovation Fund (i3). The Assistant Deputy Secretary may use these priorities, requirements, definitions, and selection criteria for competitions in fiscal year (FY) 2013 and later years. The U.S. Department of Education (Department) has conducted three competitions under the i3 program and awarded 92 i3 grants since the program was established under the American Recovery and Reinvestment Act of 2009 (ARRA). These proposed priorities, requirements, definitions, and selection criteria maintain the overall purpose and structure of the i3 program, which is discussed later in this document, and incorporate changes based on specific lessons learned from the first three competitions.

An Examination of Program Selection Criteria for Part-Time MBA Students

ERIC Educational Resources Information Center

Colburn, Michael; Fox, Daniel E.; Westerfelt, Debra Kay

2011-01-01

Prospective graduate students select a graduate program as a result of a multifaceted decision-making process. This study examines the selection criteria that part-time MBA students used in selecting a program at a private university. Further, it analyzes the methods by which the students first learned of the MBA program. The authors posed the…

American College of Rheumatology provisional criteria for defining clinical inactive disease in select categories of juvenile idiopathic arthritis.

PubMed

Wallace, Carol A; Giannini, Edward H; Huang, Bin; Itert, Lukasz; Ruperto, Nicolino

2011-07-01

To prospectively validate the preliminary criteria for clinical inactive disease (CID) in patients with select categories of juvenile idiopathic arthritis (JIA). We used the process for development of classification and response criteria recommended by the American College of Rheumatology Quality of Care Committee. Patient-visit profiles were extracted from the phase III randomized controlled trial of infliximab in polyarticular-course JIA (i.e., patients considered to resemble those with select categories of JIA) and sent to an international group of expert physician raters. Using the physician ratings as the gold standard, the sensitivity and specificity were calculated using the preliminary criteria. Modifications to the criteria were made, and these were sent to a larger group of pediatric rheumatologists to determine quantitative, face, and content validity. Variables weighted heaviest by physicians when making their judgment were the number of joints with active arthritis, erythrocyte sedimentation rate (ESR), physician's global assessment, and duration of morning stiffness. Three modifications were made: the definition of uveitis, the definition of abnormal ESR, and the addition of morning stiffness. These changes did not alter the accuracy of the preliminary set. The modified criteria, termed the "criteria for CID in select categories of JIA," have excellent feasibility and face, content, criterion, and discriminant validity to detect CID in select categories of JIA. The small changes made to the preliminary criteria set did not alter the area under the receiver operating characteristic curve (0.954) or accuracy (91%), but have increased face and content validity. Copyright © 2011 by the American College of Rheumatology.

78 FR 13041 - Applications for New Awards; Carol M. White Physical Education Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-26

... child nutrition director), grocery stores, supermarkets, restaurants, corner stores, farmers' markets... this program. Page Limit: The application narrative is where you, the applicant, address the selection.... Application Review Information 1. Selection Criteria: The selection criteria for this program are from 34 CFR...

Fuzzy approaches to supplier selection problem

NASA Astrophysics Data System (ADS)

Ozkok, Beyza Ahlatcioglu; Kocken, Hale Gonce

2013-09-01

Supplier selection problem is a multi-criteria decision making problem which includes both qualitative and quantitative factors. In the selection process many criteria may conflict with each other, therefore decision-making process becomes complicated. In this study, we handled the supplier selection problem under uncertainty. In this context; we used minimum criterion, arithmetic mean criterion, regret criterion, optimistic criterion, geometric mean and harmonic mean. The membership functions created with the help of the characteristics of used criteria, and we tried to provide consistent supplier selection decisions by using these memberships for evaluating alternative suppliers. During the analysis, no need to use expert opinion is a strong aspect of the methodology used in the decision-making.

Criteria for Selection and Rejection of Social Relationships among Children in Urban and Rural Kindergartens in Greece

ERIC Educational Resources Information Center

Rekalidou, Galini; Petrogiannis, Konstantinos

2012-01-01

This paper reports on preschool children's social relationships developed in urban and rural kindergarten classes in Greece. We investigated the selection and rejection criteria children use and examined potential criteria differences as a function of a number of socio-demographic variables (children's age group, gender, parental job status,…

Optimization Of Mean-Semivariance-Skewness Portfolio Selection Model In Fuzzy Random Environment

NASA Astrophysics Data System (ADS)

Chatterjee, Amitava; Bhattacharyya, Rupak; Mukherjee, Supratim; Kar, Samarjit

2010-10-01

The purpose of the paper is to construct a mean-semivariance-skewness portfolio selection model in fuzzy random environment. The objective is to maximize the skewness with predefined maximum risk tolerance and minimum expected return. Here the security returns in the objectives and constraints are assumed to be fuzzy random variables in nature and then the vagueness of the fuzzy random variables in the objectives and constraints are transformed into fuzzy variables which are similar to trapezoidal numbers. The newly formed fuzzy model is then converted into a deterministic optimization model. The feasibility and effectiveness of the proposed method is verified by numerical example extracted from Bombay Stock Exchange (BSE). The exact parameters of fuzzy membership function and probability density function are obtained through fuzzy random simulating the past dates.

Image compression/decompression based on mathematical transform, reduction/expansion, and image sharpening

DOEpatents

Fu, Chi-Yung; Petrich, Loren I.

1997-01-01

An image represented in a first image array of pixels is first decimated in two dimensions before being compressed by a predefined compression algorithm such as JPEG. Another possible predefined compression algorithm can involve a wavelet technique. The compressed, reduced image is then transmitted over the limited bandwidth transmission medium, and the transmitted image is decompressed using an algorithm which is an inverse of the predefined compression algorithm (such as reverse JPEG). The decompressed, reduced image is then interpolated back to its original array size. Edges (contours) in the image are then sharpened to enhance the perceptual quality of the reconstructed image. Specific sharpening techniques are described.

34 CFR 1100.20 - How is a fellow selected?

Code of Federal Regulations, 2010 CFR

2010-07-01

... LITERACY NATIONAL INSTITUTE FOR LITERACY: LITERACY LEADER FELLOWSHIP PROGRAM How Does the Director Award a... literacy field to rank applications according to the selection criteria in § 1100.21, and then provide the... order, recommendations by the board, and any other information relevant to any of the selection criteria...

49 CFR 268.17 - Project selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... criteria will govern FRA's selection of projects to receive funding under the Maglev Deployment Program. (a... are to be expected in the United States. (4) The degree to which the project will augment a Maglev... development status of the Maglev technology selected by the applicant for the project. (c) Benefits for the...

49 CFR 268.17 - Project selection criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... criteria will govern FRA's selection of projects to receive funding under the Maglev Deployment Program. (a... are to be expected in the United States. (4) The degree to which the project will augment a Maglev... development status of the Maglev technology selected by the applicant for the project. (c) Benefits for the...

34 CFR 1100.20 - How is a fellow selected?

Code of Federal Regulations, 2011 CFR

2011-07-01

... LITERACY NATIONAL INSTITUTE FOR LITERACY: LITERACY LEADER FELLOWSHIP PROGRAM How Does the Director Award a... literacy field to rank applications according to the selection criteria in § 1100.21, and then provide the... order, recommendations by the board, and any other information relevant to any of the selection criteria...

Dynamic Educational e-Content Selection Using Multiple Criteria in Web-Based Personalized Learning Environments.

ERIC Educational Resources Information Center

Manouselis, Nikos; Sampson, Demetrios

This paper focuses on the way a multi-criteria decision making methodology is applied in the case of agent-based selection of offered learning objects. The problem of selection is modeled as a decision making one, with the decision variables being the learner model and the learning objects' educational description. In this way, selection of…

Tomorrow's Teachers--Selecting the Best: An Exploration of the Quality Rationale behind Academic and Experiential Selection Criteria for Initial Teacher Education Programmes

ERIC Educational Resources Information Center

Heinz, Manuela

2013-01-01

Using Ireland as an example, this paper explores the rationale behind various selection criteria currently used to select suitable candidates for initial teacher education courses. It investigates and discusses patterns of association between second-level student teachers' background characteristics on entry to their teacher education programme…

pyAmpli: an amplicon-based variant filter pipeline for targeted resequencing data.

PubMed

Beyens, Matthias; Boeckx, Nele; Van Camp, Guy; Op de Beeck, Ken; Vandeweyer, Geert

2017-12-14

Haloplex targeted resequencing is a popular method to analyze both germline and somatic variants in gene panels. However, involved wet-lab procedures may introduce false positives that need to be considered in subsequent data-analysis. No variant filtering rationale addressing amplicon enrichment related systematic errors, in the form of an all-in-one package, exists to our knowledge. We present pyAmpli, a platform independent parallelized Python package that implements an amplicon-based germline and somatic variant filtering strategy for Haloplex data. pyAmpli can filter variants for systematic errors by user pre-defined criteria. We show that pyAmpli significantly increases specificity, without reducing sensitivity, essential for reporting true positive clinical relevant mutations in gene panel data. pyAmpli is an easy-to-use software tool which increases the true positive variant call rate in targeted resequencing data. It specifically reduces errors related to PCR-based enrichment of targeted regions.

The effectiveness of social marketing interventions for health improvement: what's the evidence?

PubMed

Gordon, Ross; McDermott, Laura; Stead, Martine; Angus, Kathryn

2006-12-01

To review the effectiveness of social marketing interventions designed to improve diet, increase physical activity, and tackle substance misuse. This article describes three reviews of systematic reviews and primary studies that evaluate social marketing effectiveness. All three reviews used pre-defined search and inclusion criteria and defined social marketing interventions as those which adopted six key social marketing principles. The reviews provide evidence that social marketing interventions can be effective in improving diet, increasing exercise, and tackling the misuse of substances like alcohol, tobacco, and illicit drugs. There is evidence that social marketing interventions can work with a range of target groups, in different settings, and can work upstream as well as with individuals. Social marketing provides a very promising framework for improving health both at the individual level and at wider environmental and policy-levels. Problems with research design, lack of conceptual understanding or implementation are valid research concerns.

A unified design space of synthetic stripe-forming networks

PubMed Central

Schaerli, Yolanda; Munteanu, Andreea; Gili, Magüi; Cotterell, James; Sharpe, James; Isalan, Mark

2014-01-01

Synthetic biology is a promising tool to study the function and properties of gene regulatory networks. Gene circuits with predefined behaviours have been successfully built and modelled, but largely on a case-by-case basis. Here we go beyond individual networks and explore both computationally and synthetically the design space of possible dynamical mechanisms for 3-node stripe-forming networks. First, we computationally test every possible 3-node network for stripe formation in a morphogen gradient. We discover four different dynamical mechanisms to form a stripe and identify the minimal network of each group. Next, with the help of newly established engineering criteria we build these four networks synthetically and show that they indeed operate with four fundamentally distinct mechanisms. Finally, this close match between theory and experiment allows us to infer and subsequently build a 2-node network that represents the archetype of the explored design space. PMID:25247316

Smart trigger logic for focal plane arrays

DOEpatents

Levy, James E; Campbell, David V; Holmes, Michael L; Lovejoy, Robert; Wojciechowski, Kenneth; Kay, Randolph R; Cavanaugh, William S; Gurrieri, Thomas M

2014-03-25

An electronic device includes a memory configured to receive data representing light intensity values from pixels in a focal plane array and a processor that analyzes the received data to determine which light values correspond to triggered pixels, where the triggered pixels are those pixels that meet a predefined set of criteria, and determines, for each triggered pixel, a set of neighbor pixels for which light intensity values are to be stored. The electronic device also includes a buffer that temporarily stores light intensity values for at least one previously processed row of pixels, so that when a triggered pixel is identified in a current row, light intensity values for the neighbor pixels in the previously processed row and for the triggered pixel are persistently stored, as well as a data transmitter that transmits the persistently stored light intensity values for the triggered and neighbor pixels to a data receiver.

Inventory and recently increasing GLOF susceptibility of glacial lakes in Sikkim, Eastern Himalaya

NASA Astrophysics Data System (ADS)

Aggarwal, Suruchi; Rai, S. C.; Thakur, P. K.; Emmer, Adam

2017-10-01

Climatic changes alter the climate system, leading to a decrease of glacier mass volumes and swelling glacial lakes. This study provides a new inventory of glacial and high-altitude lakes for Sikkim, Eastern Himalaya, and evaluates the susceptibility of lakes to Glacial Lake Outburst Flood (GLOF). By using satellite data of high spatial resolution (5 m), we obtain 1104 glacial and high-altitude lakes with total area 30.498 km2, of which 472 have an area > 0.01 km2. Applying pre-defined GLOF susceptibility criteria on these 472 lakes yields 21 lakes susceptible to GLOF, which all increased in area from 1972-2015. Using Analytic Hierarchy Processes (AHP), the pairwise comparison matrix further reveals that 5 of these glacial lakes have low, 14 have medium and 2 have high GLOF susceptibility. Especially these 16 glacial lakes with high and medium GLOF susceptibility may threaten downstream communities and infrastructure and need further attention.

Hazardous waste and health impact: a systematic review of the scientific literature.

PubMed

Fazzo, L; Minichilli, F; Santoro, M; Ceccarini, A; Della Seta, M; Bianchi, F; Comba, P; Martuzzi, M

2017-10-11

Waste is part of the agenda of the European Environment and Health Process and included among the topics of the Sixth Ministerial Conference on Environment and Health. Disposal and management of hazardous waste are worldwide challenges. We performed a systematic review to evaluate the evidence of the health impact of hazardous waste exposure, applying transparent and a priori defined methods. The following five steps, based on pre-defined systematic criteria, were applied. 1. Specify the research question, in terms of "Population-Exposure-Comparators-Outcomes" (PECO). people living near hazardous waste sites; Exposure: exposure to hazardous waste; Comparators: all comparators; Outcomes: all diseases/health disorders. 2. Carry out the literature search, in Medline and EMBASE. 3. Select studies for inclusion: original epidemiological studies, published between 1999 and 2015, on populations residentially exposed to hazardous waste. 4. Assess the quality of selected studies, taking into account study design, exposure and outcome assessment, confounding control. 5. Rate the confidence in the body of evidence for each outcome taking into account the reliability of each study, the strength of the association and concordance of results.Fifty-seven papers of epidemiological investigations on the health status of populations living near hazardous waste sites were selected for the evidence evaluation. The association between 95 health outcomes (diseases and disorders) and residential exposure to hazardous waste sites was evaluated. Health effects of residential hazardous waste exposure, previously partially unrecognized, were highlighted. Sufficient evidence was found of association between exposure to oil industry waste that releases high concentrations of hydrogen sulphide and acute symptoms. The evidence of causal relationship with hazardous waste was defined as limited for: liver, bladder, breast and testis cancers, non-Hodgkin lymphoma, asthma, congenital anomalies overall and anomalies of the neural tube, urogenital, connective and musculoskeletal systems, low birth weight and pre-term birth; evidence was defined as inadequate for the other health outcomes. The results, although not conclusive, provide indications that more effective public health policies on hazardous waste management are urgently needed. International, national and local authorities should oppose and eliminate poor, outdated and illegal practices of waste disposal, including illegal transboundary trade, and increase support regulation and its enforcement.

Standardized quantitative measurements of wrist cartilage in healthy humans using 3T magnetic resonance imaging

PubMed Central

Zink, Jean-Vincent; Souteyrand, Philippe; Guis, Sandrine; Chagnaud, Christophe; Fur, Yann Le; Militianu, Daniela; Mattei, Jean-Pierre; Rozenbaum, Michael; Rosner, Itzhak; Guye, Maxime; Bernard, Monique; Bendahan, David

2015-01-01

AIM: To quantify the wrist cartilage cross-sectional area in humans from a 3D magnetic resonance imaging (MRI) dataset and to assess the corresponding reproducibility. METHODS: The study was conducted in 14 healthy volunteers (6 females and 8 males) between 30 and 58 years old and devoid of articular pain. Subjects were asked to lie down in the supine position with the right hand positioned above the pelvic region on top of a home-built rigid platform attached to the scanner bed. The wrist was wrapped with a flexible surface coil. MRI investigations were performed at 3T (Verio-Siemens) using volume interpolated breath hold examination (VIBE) and dual echo steady state (DESS) MRI sequences. Cartilage cross sectional area (CSA) was measured on a slice of interest selected from a 3D dataset of the entire carpus and metacarpal-phalangeal areas on the basis of anatomical criteria using conventional image processing radiology software. Cartilage cross-sectional areas between opposite bones in the carpal region were manually selected and quantified using a thresholding method. RESULTS: Cartilage CSA measurements performed on a selected predefined slice were 292.4 ± 39 mm2 using the VIBE sequence and slightly lower, 270.4 ± 50.6 mm2, with the DESS sequence. The inter (14.1%) and intra (2.4%) subject variability was similar for both MRI methods. The coefficients of variation computed for the repeated measurements were also comparable for the VIBE (2.4%) and the DESS (4.8%) sequences. The carpus length averaged over the group was 37.5 ± 2.8 mm with a 7.45% between-subjects coefficient of variation. Of note, wrist cartilage CSA measured with either the VIBE or the DESS sequences was linearly related to the carpal bone length. The variability between subjects was significantly reduced to 8.4% when the CSA was normalized with respect to the carpal bone length. CONCLUSION: The ratio between wrist cartilage CSA and carpal bone length is a highly reproducible standardized measurement which normalizes the natural diversity between individuals. PMID:26396941

Review on dog rabies vaccination coverage in Africa: a question of dog accessibility or cost recovery?

PubMed

Jibat, Tariku; Hogeveen, Henk; Mourits, Monique C M

2015-02-01

Rabies still poses a significant human health problem throughout most of Africa, where the majority of the human cases results from dog bites. Mass dog vaccination is considered to be the most effective method to prevent rabies in humans. Our objective was to systematically review research articles on dog rabies parenteral vaccination coverage in Africa in relation to dog accessibility and vaccination cost recovery arrangement (i.e.free of charge or owner charged). A systematic literature search was made in the databases of CAB abstracts (EBSCOhost and OvidSP), Scopus, Web of Science, PubMed, Medline (EBSCOhost and OvidSP) and AJOL (African Journal Online) for peer reviewed articles on 1) rabies control, 2) dog rabies vaccination coverage and 3) dog demography in Africa. Identified articles were subsequently screened and selected using predefined selection criteria like year of publication (viz. ≥ 1990), type of study (cross sectional), objective(s) of the study (i.e. vaccination coverage rates, dog demographics and financial arrangements of vaccination costs), language of publication (English) and geographical focus (Africa). The selection process resulted in sixteen peer reviewed articles which were used to review dog demography and dog ownership status, and dog rabies vaccination coverage throughout Africa. The main review findings indicate that 1) the majority (up to 98.1%) of dogs in African countries are owned (and as such accessible), 2) puppies younger than 3 months of age constitute a considerable proportion (up to 30%) of the dog population and 3) male dogs are dominating in numbers (up to 3.6 times the female dog population). Dog rabies parenteral vaccination coverage was compared between "free of charge" and "owner charged" vaccination schemes by the technique of Meta-analysis. Results indicate that the rabies vaccination coverage following a free of charge vaccination scheme (68%) is closer to the World Health Organization recommended coverage rate (70%) than the achieved coverage rate in owner-charged dog rabies vaccination schemes (18%). Most dogs in Africa are owned and accessible for parenteral vaccination against rabies if the campaign is performed "free of charge".

Review on Dog Rabies Vaccination Coverage in Africa: A Question of Dog Accessibility or Cost Recovery?

PubMed Central

Jibat, Tariku; Hogeveen, Henk; Mourits, Monique C. M.

2015-01-01

Background Rabies still poses a significant human health problem throughout most of Africa, where the majority of the human cases results from dog bites. Mass dog vaccination is considered to be the most effective method to prevent rabies in humans. Our objective was to systematically review research articles on dog rabies parenteral vaccination coverage in Africa in relation to dog accessibility and vaccination cost recovery arrangement (i.e.free of charge or owner charged). Methodology/Principal Findings A systematic literature search was made in the databases of CAB abstracts (EBSCOhost and OvidSP), Scopus, Web of Science, PubMed, Medline (EBSCOhost and OvidSP) and AJOL (African Journal Online) for peer reviewed articles on 1) rabies control, 2) dog rabies vaccination coverage and 3) dog demography in Africa. Identified articles were subsequently screened and selected using predefined selection criteria like year of publication (viz. ≥ 1990), type of study (cross sectional), objective(s) of the study (i.e. vaccination coverage rates, dog demographics and financial arrangements of vaccination costs), language of publication (English) and geographical focus (Africa). The selection process resulted in sixteen peer reviewed articles which were used to review dog demography and dog ownership status, and dog rabies vaccination coverage throughout Africa. The main review findings indicate that 1) the majority (up to 98.1%) of dogs in African countries are owned (and as such accessible), 2) puppies younger than 3 months of age constitute a considerable proportion (up to 30%) of the dog population and 3) male dogs are dominating in numbers (up to 3.6 times the female dog population). Dog rabies parenteral vaccination coverage was compared between “free of charge” and “owner charged” vaccination schemes by the technique of Meta-analysis. Results indicate that the rabies vaccination coverage following a free of charge vaccination scheme (68%) is closer to the World Health Organization recommended coverage rate (70%) than the achieved coverage rate in owner-charged dog rabies vaccination schemes (18%). Conclusions/Significance Most dogs in Africa are owned and accessible for parenteral vaccination against rabies if the campaign is performed “free of charge”. PMID:25646774

Gene selection with multiple ordering criteria.

PubMed

Chen, James J; Tsai, Chen-An; Tzeng, Shengli; Chen, Chun-Houh

2007-03-05

A microarray study may select different differentially expressed gene sets because of different selection criteria. For example, the fold-change and p-value are two commonly known criteria to select differentially expressed genes under two experimental conditions. These two selection criteria often result in incompatible selected gene sets. Also, in a two-factor, say, treatment by time experiment, the investigator may be interested in one gene list that responds to both treatment and time effects. We propose three layer ranking algorithms, point-admissible, line-admissible (convex), and Pareto, to provide a preference gene list from multiple gene lists generated by different ranking criteria. Using the public colon data as an example, the layer ranking algorithms are applied to the three univariate ranking criteria, fold-change, p-value, and frequency of selections by the SVM-RFE classifier. A simulation experiment shows that for experiments with small or moderate sample sizes (less than 20 per group) and detecting a 4-fold change or less, the two-dimensional (p-value and fold-change) convex layer ranking selects differentially expressed genes with generally lower FDR and higher power than the standard p-value ranking. Three applications are presented. The first application illustrates a use of the layer rankings to potentially improve predictive accuracy. The second application illustrates an application to a two-factor experiment involving two dose levels and two time points. The layer rankings are applied to selecting differentially expressed genes relating to the dose and time effects. In the third application, the layer rankings are applied to a benchmark data set consisting of three dilution concentrations to provide a ranking system from a long list of differentially expressed genes generated from the three dilution concentrations. The layer ranking algorithms are useful to help investigators in selecting the most promising genes from multiple gene lists generated by different filter, normalization, or analysis methods for various objectives.

Designated Airworthiness Representatives Qualification Criteria, Selection, and Appointment Procedures -- FAA Order 8000.62

DOT National Transportation Integrated Search

1985-10-01

This order contains qualification criteria and procedures for the selection and appointment of Designated Airworthiness Representatives (DAR's) to perform certain certification functions as representatives of the Administrator.

Get SET: aligning anatomy demonstrator programmes with Surgical Education and Training selection criteria.

PubMed

Rhodes, Danielle; Fogg, Quentin A; Lazarus, Michelle D

2018-05-01

Prevocational doctors aspiring to surgical careers are commonly recruited as anatomy demonstrators for undergraduate and graduate medical programmes. Entry into Surgical Education and Training (SET) is highly competitive and a unique opportunity exists to align anatomy demonstrator programmes with the selection criteria and core competencies of SET programmes. This study used a qualitative approach to (i) determine what criteria applicants for SET are assessed on and (ii) identify criteria that could be aligned with and enhanced by an anatomy demonstrator programme. The selection guidelines of all nine surgical specialties for the 2017 intake of SET trainees were analysed using qualitative content analysis methodology. The Royal Australasian College of Surgeons adopted a holistic approach to trainee selection that assessed both discipline-specific and discipline-independent skills. Qualitative content analysis identified eight categories of key selection criteria: medical expertise, scholarly activity, professional identity, interpersonal skills, integrity, self-management, insight and self-awareness and community involvement. The structured curriculum vitae was heavily weighted towards discipline-specific skills, such as medical expertise and scholarly activity. Insufficient information was available to determine the weighting of selection criteria assessed by the structured referee reports or interviews. Anatomy demonstrator programmes provide prevocational doctors with unique opportunities to develop surgical skills and competencies in a non-clinical setting. Constructively aligned anatomy demonstrator programmes may be particularly beneficial for prevocational doctors seeking to improve their anatomical knowledge, teaching skills or scholarly activity. © 2017 Royal Australasian College of Surgeons.

A randomized clinical trial of the effectiveness of mechanical traction for sub-groups of patients with low back pain: study methods and rationale

PubMed Central

2010-01-01

Background Patients with signs of nerve root irritation represent a sub-group of those with low back pain who are at increased risk of persistent symptoms and progression to costly and invasive management strategies including surgery. A period of non-surgical management is recommended for most patients, but there is little evidence to guide non-surgical decision-making. We conducted a preliminary study examining the effectiveness of a treatment protocol of mechanical traction with extension-oriented activities for patients with low back pain and signs of nerve root irritation. The results suggested this approach may be effective, particularly in a more specific sub-group of patients. The aim of this study will be to examine the effectiveness of treatment that includes traction for patients with low back pain and signs of nerve root irritation, and within the pre-defined sub-group. Methods/Design The study will recruit 120 patients with low back pain and signs of nerve root irritation. Patients will be randomized to receive an extension-oriented treatment approach, with or without the addition of mechanical traction. Randomization will be stratified based on the presence of the pre-defined sub-grouping criteria. All patients will receive 12 physical therapy treatment sessions over 6 weeks. Follow-up assessments will occur after 6 weeks, 6 months, and 1 year. The primary outcome will be disability measured with a modified Oswestry questionnaire. Secondary outcomes will include self-reports of low back and leg pain intensity, quality of life, global rating of improvement, additional healthcare utilization, and work absence. Statistical analysis will be based on intention to treat principles and will use linear mixed model analysis to compare treatment groups, and examine the interaction between treatment and sub-grouping status. Discussion This trial will provide a methodologically rigorous evaluation of the effectiveness of using traction for patients with low back pain and signs of nerve root irritation, and will examine the validity of a pre-defined sub-grouping hypothesis. The results will provide evidence to inform non-surgical decision-making for these patients. Trial Registration This trial has been registered with http://ClinicalTrials.gov: NCT00942227 PMID:20433733

Preclinical evaluation and intraoperative human retinal imaging with a high-resolution microscope-integrated spectral domain optical coherence tomography device.

PubMed

Hahn, Paul; Migacz, Justin; O'Donnell, Rachelle; Day, Shelley; Lee, Annie; Lin, Phoebe; Vann, Robin; Kuo, Anthony; Fekrat, Sharon; Mruthyunjaya, Prithvi; Postel, Eric A; Izatt, Joseph A; Toth, Cynthia A

2013-01-01

The authors have recently developed a high-resolution microscope-integrated spectral domain optical coherence tomography (MIOCT) device designed to enable OCT acquisition simultaneous with surgical maneuvers. The purpose of this report is to describe translation of this device from preclinical testing into human intraoperative imaging. Before human imaging, surgical conditions were fully simulated for extensive preclinical MIOCT evaluation in a custom model eye system. Microscope-integrated spectral domain OCT images were then acquired in normal human volunteers and during vitreoretinal surgery in patients who consented to participate in a prospective institutional review board-approved study. Microscope-integrated spectral domain OCT images were obtained before and at pauses in surgical maneuvers and were compared based on predetermined diagnostic criteria to images obtained with a high-resolution spectral domain research handheld OCT system (HHOCT; Bioptigen, Inc) at the same time point. Cohorts of five consecutive patients were imaged. Successful end points were predefined, including ≥80% correlation in identification of pathology between MIOCT and HHOCT in ≥80% of the patients. Microscope-integrated spectral domain OCT was favorably evaluated by study surgeons and scrub nurses, all of whom responded that they would consider participating in human intraoperative imaging trials. The preclinical evaluation identified significant improvements that were made before MIOCT use during human surgery. The MIOCT transition into clinical human research was smooth. Microscope-integrated spectral domain OCT imaging in normal human volunteers demonstrated high resolution comparable to tabletop scanners. In the operating room, after an initial learning curve, surgeons successfully acquired human macular MIOCT images before and after surgical maneuvers. Microscope-integrated spectral domain OCT imaging confirmed preoperative diagnoses, such as full-thickness macular hole and vitreomacular traction, and demonstrated postsurgical changes in retinal morphology. Two cohorts of five patients were imaged. In the second cohort, the predefined end points were exceeded with ≥80% correlation between microscope-mounted OCT and HHOCT imaging in 100% of the patients. This report describes high-resolution MIOCT imaging using the prototype device in human eyes during vitreoretinal surgery, with successful achievement of predefined end points for imaging. Further refinements and investigations will be directed toward fully integrating MIOCT with vitreoretinal and other ocular surgery to image surgical maneuvers in real time.

Comparison of rheumatoid arthritis clinical trial outcome measures: a simulation study.

PubMed

Anderson, Jennifer J; Bolognese, James A; Felson, David T

2003-11-01

Isolated studies have suggested that continuous measures of response may be better than predefined, dichotomous definitions (e.g., the American College of Rheumatology 20% improvement criteria [ACR20]) for discriminating between rheumatoid arthritis (RA) treatments. Our goal was to determine the statistical power of predefined dichotomous outcome measures (termed "a priori"), compared with that of continuous measures derived from trial data in which there was no predefined response threshold (termed "data driven"), and to evaluate the sensitivity to change of these measures in the context of different treatments and early versus later-stage disease. In order to generalize beyond results from a single trial, we performed simulation studies. We obtained summary data from trials comparing disease-modifying antirheumatic drugs (DMARDs) and from comparative coxib-placebo trials to test the power of 2 a priori outcomes, the ACR20 and improvement of the Disease Activity Score (DDAS), as well as 2 data-driven outcomes. We studied patients with early RA and those with later-stage RA (duration of <4 years and 4-9 years, respectively). We performed simulation studies, using the interrelationship of ACR core set measures in the trials to generate multiple trial data sets consistent with the original data. The data-driven outcomes had greater power than did the a priori measures. The DMARD comparison was more powerful in early disease than in later-stage disease (the sample sizes needed to achieve 80% power for the most powerful test were 64 for early disease versus 100 for later disease), but the coxib-versus-placebo comparison was less powerful in early disease than in later disease (the sample sizes needed to achieve 80% power were 200 and 100, respectively). When the effects of treatment on core set items were small and/or inconsistent, power was reduced, particularly for a less broadly based outcome (e.g., DDAS) compared with the ACR20. The simulation studies demonstrate that data-driven outcome definitions can provide better sensitivity to change than does the ACR20 or DDAS. Using such methods would improve power, but at the expense of trial standardization. The studies also show how patient population and treatment characteristics affect the power of specific outcome measures in RA clinical trials, and provide quantification of those effects.

Measurement properties of adult quality-of-life measurement instruments for eczema: protocol for a systematic review.

PubMed

Apfelbacher, Christian J; Heinl, Daniel; Prinsen, Cecilia A C; Deckert, Stefanie; Chalmers, Joanne; Ofenloch, Robert; Humphreys, Rosemary; Sach, Tracey; Chamlin, Sarah; Schmitt, Jochen

2015-04-16

Eczema is a common chronic or chronically relapsing skin disease that has a substantial impact on quality of life (QoL). By means of a consensus-based process, the Harmonising Outcome Measures in Eczema (HOME) initiative has identified QoL as one of the four core outcome domains to be assessed in all eczema trials (Allergy 67(9):1111-7, 2012). Various measurement instruments exist to measure QoL in adults with eczema, but there is a great variability in both content and quality (for example, reliability and validity) of the instruments used, and it is not always clear if the best instrument is being used. Therefore, the aim of the proposed research is a comprehensive systematic assessment of the measurement properties of the existing measurement instruments that were developed and/or validated for the measurement of patient-reported QoL in adults with eczema. This study is a systematic review of the measurement properties of patient-reported measures of QoL developed and/or validated for adults with eczema. Medline via PubMed and EMBASE will be searched using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing, or comparing measurement properties of QoL instruments for adult patients with eczema. Eligibility assessment and data abstraction will be performed independently by two reviewers. Evidence tables will be generated for study characteristics, instrument characteristics, measurement properties, and interpretability. The quality of the measurement properties will be assessed using predefined criteria. Methodological quality of studies will be assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. A best evidence synthesis will be undertaken if more than one study has investigated a particular measurement property. The proposed systematic review will produce a comprehensive assessment of measurement properties of existing QoL instruments in adult patients with eczema. We aim to identify one best currently available instrument to measure QoL in eczema patients. PROSPERO CRD42015017138.

A genetic risk score based on direct associations with coronary heart disease improves coronary heart disease risk prediction in the Atherosclerosis Risk in Communities (ARIC), but not in the Rotterdam and Framingham Offspring, Studies.

PubMed

Brautbar, Ariel; Pompeii, Lisa A; Dehghan, Abbas; Ngwa, Julius S; Nambi, Vijay; Virani, Salim S; Rivadeneira, Fernando; Uitterlinden, André G; Hofman, Albert; Witteman, Jacqueline C M; Pencina, Michael J; Folsom, Aaron R; Cupples, L Adrienne; Ballantyne, Christie M; Boerwinkle, Eric

2012-08-01

Multiple studies have identified single-nucleotide polymorphisms (SNPs) that are associated with coronary heart disease (CHD). We examined whether SNPs selected based on predefined criteria will improve CHD risk prediction when added to traditional risk factors (TRFs). SNPs were selected from the literature based on association with CHD, lack of association with a known CHD risk factor, and successful replication. A genetic risk score (GRS) was constructed based on these SNPs. Cox proportional hazards model was used to calculate CHD risk based on the Atherosclerosis Risk in Communities (ARIC) and Framingham CHD risk scores with and without the GRS. The GRS was associated with risk for CHD (hazard ratio [HR] = 1.10; 95% confidence interval [CI]: 1.07-1.13). Addition of the GRS to the ARIC risk score significantly improved discrimination, reclassification, and calibration beyond that afforded by TRFs alone in non-Hispanic whites in the ARIC study. The area under the receiver operating characteristic curve (AUC) increased from 0.742 to 0.749 (Δ = 0.007; 95% CI, 0.004-0.013), and the net reclassification index (NRI) was 6.3%. Although the risk estimates for CHD in the Framingham Offspring (HR = 1.12; 95% CI: 1.10-1.14) and Rotterdam (HR = 1.08; 95% CI: 1.02-1.14) Studies were significantly improved by adding the GRS to TRFs, improvements in AUC and NRI were modest. Addition of a GRS based on direct associations with CHD to TRFs significantly improved discrimination and reclassification in white participants of the ARIC Study, with no significant improvement in the Rotterdam and Framingham Offspring Studies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Review: a conceptual model of perceived burden of informal caregivers for older persons with a severe functional psychiatric syndrome and concomitant problematic behaviour.

PubMed

Zegwaard, Marian I; Aartsen, Marja J; Cuijpers, Pim; Grypdonck, Mieke Hf

2011-08-01

This literature review aims to delineate the determinants of perceived burden by informal caregivers and provide insight into the interrelatedness between these determinants. Despite the attention given to the various determinants of perceived burden, their interrelatedness has not been unravelled. Insight into this interrelatedness is mandatory for the development of successful, complex, multivariate interventions to reduce perceived burden of informal caregivers. DESIGN; Systematic review. Four electronic databases, CINAHL, Embase psychiatry, Medline, Psychinfo and reference lists of selected articles, were searched. Publications between January 1985-2008 were included if they concerned mental illness, burden and care giving. Articles were selected according to predefined inclusion and exclusion criteria. The results of mostly descriptive, cross-sectional and univariate research and the more process-oriented results coming from qualitative burden research are organised in a process orientated conceptual scheme or model adapted from the stress-theoretical framework by Lazarus and Folkman. The model indicates that perceived burden must be understood through the individual appraisal of stressors and the availability and use of internal and external resources. Perceived burden is the outcome of multiple, clinically overlapping psychiatric problems, problematic behaviour and functional disabilities. So far, intervention programs to reduce perceived burden of informal caregivers have not devoted much attention to the interrelatedness of the origins of burden. The conceptual model provides an overview of the various determinants of perceived burden and a clear picture of the possible interrelatedness appears. This overview of the most important sources of burden helps to develop a complex, multivariate intervention that is comprehensive, long-term, individually tailored and has the flexibility to meet the dynamics of burden over time. Use of the conceptual model is crucial to professional nursing and the quality of support of informal caregivers. © 2011 Blackwell Publishing Ltd.

Building Winning Teams in the 21st Century Operating Environment

DTIC Science & Technology

2011-02-28

react to critical incidents and organizational crisis, (3) deliberate role modeling and coaching, (4) criteria for the allocation of rewards and...status, and (5) operational criteria for recruitment, selection and promotion.39 Leaders use reinforcing mechanisms as secondary means to assist...pay attention to, deliberate role modeling, and most importantly, operational criteria for selection and promotion, the Army will not achieve

Selecting an E-(Text)Book: Evaluation Criteria

ERIC Educational Resources Information Center

Marczak, Mariusz

2013-01-01

This paper aims to propose a repository of pre-use evaluation criteria for language teachers who wish to introduce e-books or e-textbooks to their own teaching practices. By selectively using a set of such criteria, they will be able to evaluate to what extent a given e-book/e-textbook lends itself to utilisation within their own teaching context.…

When paradigms collide at the road rail interface: evaluation of a sociotechnical systems theory design toolkit for cognitive work analysis.

PubMed

Read, Gemma J M; Salmon, Paul M; Lenné, Michael G

2016-09-01

The Cognitive Work Analysis Design Toolkit (CWA-DT) is a recently developed approach that provides guidance and tools to assist in applying the outputs of CWA to design processes to incorporate the values and principles of sociotechnical systems theory. In this paper, the CWA-DT is evaluated based on an application to improve safety at rail level crossings. The evaluation considered the extent to which the CWA-DT met pre-defined methodological criteria and aligned with sociotechnical values and principles. Both process and outcome measures were taken based on the ratings of workshop participants and human factors experts. Overall, workshop participants were positive about the process and indicated that it met the methodological criteria and sociotechnical values. However, expert ratings suggested that the CWA-DT achieved only limited success in producing RLX designs that fully aligned with the sociotechnical approach. Discussion about the appropriateness of the sociotechnical approach in a public safety context is provided. Practitioner Summary: Human factors and ergonomics practitioners need evidence of the effectiveness of methods. A design toolkit for cognitive work analysis, incorporating values and principles from sociotechnical systems theory, was applied to create innovative designs for rail level crossings. Evaluation results based on the application are provided and discussed.

Socioeconomic Differences in Informed Decisions About Down Syndrome Screening: A Systematic Review and Research Agenda.

PubMed

Smith, Sian K; Sousa, Mariana S; Essink-Bot, Marie-Louise; Halliday, Jane; Peate, Michelle; Fransen, Mirjam

2016-08-01

Supporting pregnant women to make informed choices about Down syndrome screening is widely endorsed. We reviewed the literature on: (a) the association between socioeconomic position and informed choices and decision-making about Down syndrome screening, and (b) the possible mediating variables (e.g., health literacy, numeracy skills, behavioral and communication variables) that might explain the relationship. EMBASE, MEDLINE, PubMed, CINAHL, and PsycINFO were searched from January 1999 to September 2014. The methodological quality of studies was determined by predefined criteria regarding the research aims, study design, study population and setting, measurement tools, and statistical analysis. A total of 33 studies met the inclusion criteria. Women from lower socioeconomic groups experience greater difficulties making informed choices about Down syndrome screening compared to women from higher socioeconomic groups. Most studies focus on individual dimensions of informed decision-making rather than assessing elements in conjunction with one another. Few studies have explored why there are socioeconomic differences in women's ability to make informed screening decisions. Future work is needed to identify mediating variables in this pathway. Systematic evidence-based intervention development to improve communication, understanding, and decision-making about Down syndrome screening is needed to ensure that women have an equal opportunity to make an informed choice about screening regardless of their socioeconomic position.

What Is the Evidence for “Food Addiction?” A Systematic Review

PubMed Central

Ariel-Donges, Aviva H.; Bauman, Viviana; Merlo, Lisa J.

2018-01-01

The diagnostic construct of “food addiction” is a highly controversial subject. The current systematic review is the first to evaluate empirical studies examining the construct of “food addiction” in humans and animals. Studies were included if they were quantitative, peer-reviewed, and in the English language. The 52 identified studies (35 articles) were qualitatively assessed to determine the extent to which their findings indicated the following addiction characteristics in relation to food: brain reward dysfunction, preoccupation, risky use, impaired control, tolerance/withdrawal, social impairment, chronicity, and relapse. Each pre-defined criterion was supported by at least one study. Brain reward dysfunction and impaired control were supported by the largest number of studies (n = 21 and n = 12, respectively); whereas risky use was supported by the fewest (n = 1). Overall, findings support food addiction as a unique construct consistent with criteria for other substance use disorder diagnoses. The evidence further suggests that certain foods, particularly processed foods with added sweeteners and fats, demonstrate the greatest addictive potential. Though both behavioral and substance-related factors are implicated in the addictive process, symptoms appear to better fit criteria for substance use disorder than behavioral addiction. Future research should explore social/role impairment, preoccupation, and risky use associated with food addiction and evaluate potential interventions for prevention and treatment. PMID:29649120

Patient-days: a better measure of incidence of occupational bloodborne exposures.

PubMed

Chen, Luke F; Sexton, Daniel J; Kaye, Keith S; Anderson, Deverick J

2009-09-01

There is currently no accepted standard denominator to calculate and to report the incidence of occupational exposures to bloodborne pathogens (OEBBPs) in health care. We performed a multicenter study of OEBBP injuries reported from 31 community hospitals in the southeastern United States from January 2003 to December 2006. A qualitative design was used to assess 4 commonly used denominators to calculate the incidence of OEBBP: patient-days; staffed beds; occupied beds and full-time employee equivalents (FTEs). Six criteria were used to assess the quality and suitability of each denominator as a standard method to calculate incidence of OEBBP. We also analyzed the correlation of hospital rankings produced by these 4 denominators. During 4 years of study, a total of 3375 occupational exposures were reported. Patient-days outperformed others as a denominator to calculate rates of OEBBP when judged by 6 predefined criteria. Data for staffed beds, occupied beds, and FTE were manually collected, infrequently reported, and often subject to missing data. Furthermore, FTE and staffed beds data also captured unoccupied beds and non-clinical employee data that were not associated with risk of OEBBP. Patient-days may be the most suitable and readily available denominator for standard reporting and benchmarking of incidence of OEBBP. Patient-days may be used as a standard method for comparing rates of OEBBP.

[Validation of cold chain during distribution of parenteral nutrition].

PubMed

Tuan, Federico; Perone, Virginia; Verdini, Rocio; Pell, Maria Betina; Traverso, Maria Luz

2015-09-01

this study aims to demonstrate the suitability of the process used to condition the extemporaneous mixtures of parenteral nutrition for distribution, considering the objective of preserving the cold chain during transport until it reaches the patient, necessary to ensure stability, effectiveness and safety of these mixtures. concurrent validation, design and implementation of a protocol for evaluating the process of packaging and distribution of MNPE developed by a pharmaceutical laboratory. Running tests, according to predefined acceptance criteria. It is performed twice, in summer and on routes that require longer transfer time. Evaluation of conservation of temperature by monitoring the internal temperature values of each type of packaging, recorded by data loggers calibrated equipment. the different tests meet the established criteria. The collected data ensure the maintenance of the cold chain for longer than the transfer time to the most distant points. this study establishes the suitability of the processes to maintaining the cold chain for transfer from the laboratory to the patient pharmacist. Whereas the breaking of cold chain can cause changes of compatibility and stability of parenteral nutrition and failures nutritional support, this study contributes to patient safety, one of the relevant dimensions of quality of care the health. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

The ability of adults with an intellectual disability to recognise facial expressions of emotion in comparison with typically developing individuals: A systematic review.

PubMed

Scotland, Jennifer L; Cossar, Jill; McKenzie, Karen

2015-01-01

This review systematically examined the literature on the ability of adults with an intellectual disability (ID) to recognise facial expressions of emotion. Studies were included that: recruited only adult participants with ID; that did not specifically recruit participants with co-morbid diagnoses of syndrome(s) related to ID; and that directly compared the performance of adults with ID with a group of people without ID. Nine papers met the eligibility criteria for review and were assessed against pre-defined quality rating criteria and the findings synthesised. The majority of included studies were assessed as being of acceptable overall methodological quality. All of the studies reported a relative impairment in emotion recognition for participants with ID on at least some of the tasks administered, with a large effect size being found for most of the significant results. The review suggests that adults with ID are relatively impaired in recognising facial expressions of emotion, when compared with either adults or children without ID. Methodological variation between studies limits the extent to which any interpretations can be made as to the cause of impaired emotion recognition in adults with ID. Copyright © 2015 Elsevier Ltd. All rights reserved.

High throughput reconfigurable data analysis system

NASA Technical Reports Server (NTRS)

Bearman, Greg (Inventor); Pelletier, Michael J. (Inventor); Seshadri, Suresh (Inventor); Pain, Bedabrata (Inventor)

2008-01-01

The present invention relates to a system and method for performing rapid and programmable analysis of data. The present invention relates to a reconfigurable detector comprising at least one array of a plurality of pixels, where each of the plurality of pixels can be selected to receive and read-out an input. The pixel array is divided into at least one pixel group for conducting a common predefined analysis. Each of the pixels has a programmable circuitry programmed with a dynamically configurable user-defined function to modify the input. The present detector also comprises a summing circuit designed to sum the modified input.

A Framework for Orbital Performance Evaluation in Distributed Space Missions for Earth Observation

NASA Technical Reports Server (NTRS)

Nag, Sreeja; LeMoigne-Stewart, Jacqueline; Miller, David W.; de Weck, Olivier

2015-01-01

Distributed Space Missions (DSMs) are gaining momentum in their application to earth science missions owing to their unique ability to increase observation sampling in spatial, spectral and temporal dimensions simultaneously. DSM architectures have a large number of design variables and since they are expected to increase mission flexibility, scalability, evolvability and robustness, their design is a complex problem with many variables and objectives affecting performance. There are very few open-access tools available to explore the tradespace of variables which allow performance assessment and are easy to plug into science goals, and therefore select the most optimal design. This paper presents a software tool developed on the MATLAB engine interfacing with STK, for DSM orbit design and selection. It is capable of generating thousands of homogeneous constellation or formation flight architectures based on pre-defined design variable ranges and sizing those architectures in terms of predefined performance metrics. The metrics can be input into observing system simulation experiments, as available from the science teams, allowing dynamic coupling of science and engineering designs. Design variables include but are not restricted to constellation type, formation flight type, FOV of instrument, altitude and inclination of chief orbits, differential orbital elements, leader satellites, latitudes or regions of interest, planes and satellite numbers. Intermediate performance metrics include angular coverage, number of accesses, revisit coverage, access deterioration over time at every point of the Earth's grid. The orbit design process can be streamlined and variables more bounded along the way, owing to the availability of low fidelity and low complexity models such as corrected HCW equations up to high precision STK models with J2 and drag. The tool can thus help any scientist or program manager select pre-Phase A, Pareto optimal DSM designs for a variety of science goals without having to delve into the details of the engineering design process.

Dorzagliatin (HMS5552), a Novel Dual Acting Glucokinase Activator, Improves Glycemic Control and Pancreatic β-cell Function in Patients with Type 2 Diabetes: A 28-day Treatment Study Using Biomarker-Guided Patient Selection.

PubMed

Zhu, Xiao-Xue; Zhu, Da-Long; Li, Xiao-Ying; Li, Ya-Lin; Jin, Xiao-Wei; Hu, Tian-Xin; Zhao, Yu; Li, Yong-Guo; Zhao, Gui-Yu; Ren, Shuang; Zhang, Yi; Ding, Yan-Hua; Chen, Li

2018-04-29

To investigate pharmacokinetics and pharmacodynamics of a dual acting glucokinase activator dorzagliatin and its safety, tolerability and effect on pancreatic β-cell function in Chinese type 2 diabetes patients. Twenty-four T2D subjects were selected utilizing a set of predefined clinical biomarkers. They were randomized to receive dorzagliatin 75mg twice or once a day (BID, QD) for 28 days. Changes in HbA1c and glycemic parameters from baseline to Day 28 were assessed. In addition, changes of β-cell function from baseline to Day 32 were evaluated. Significant HbA1c reduction were observed in both regimens on Day 28 (-0.79%, 75mg BID; -1.22%, 75 mg QD). Similar trends were found in the following parameters, including reductions from baseline of fasting plasma glucose by 1.20 mmol/L and 1.51 mmol/L, 2-hour postprandial glucose by 2.48 mmol/L and 5.03 mmol/L, and glucose AUC 0-24 by 18.59% and 20.98%, for BID and QD groups, respectively. Both regimens resulted in improvement of β-cell function as measured by steady state HOMA 2 parameter, %B, which increased by 36.31% and 40.59%, and by dynamic state parameter, ΔC 30 /ΔG 30 , which increased by 24.66% and 167.67%, for BID and QD groups, respectively. Dorzagliatin was well tolerated in both regimens with good pharmacokinetics profiles. Dorzagliatin treatment for 28 days in Chinese T2D patients selected based on pre-defined biomarkers resulted in significant improvement of β-cell function and glycemic control. The safety and pharmacokinetics profile of dorzagliatin supports a subsequent Phase II trial design and continued clinical development. This article is protected by copyright. All rights reserved.

Remaining lifetime modeling using State-of-Health estimation

NASA Astrophysics Data System (ADS)

Beganovic, Nejra; Söffker, Dirk

2017-08-01

Technical systems and system's components undergo gradual degradation over time. Continuous degradation occurred in system is reflected in decreased system's reliability and unavoidably lead to a system failure. Therefore, continuous evaluation of State-of-Health (SoH) is inevitable to provide at least predefined lifetime of the system defined by manufacturer, or even better, to extend the lifetime given by manufacturer. However, precondition for lifetime extension is accurate estimation of SoH as well as the estimation and prediction of Remaining Useful Lifetime (RUL). For this purpose, lifetime models describing the relation between system/component degradation and consumed lifetime have to be established. In this contribution modeling and selection of suitable lifetime models from database based on current SoH conditions are discussed. Main contribution of this paper is the development of new modeling strategies capable to describe complex relations between measurable system variables, related system degradation, and RUL. Two approaches with accompanying advantages and disadvantages are introduced and compared. Both approaches are capable to model stochastic aging processes of a system by simultaneous adaption of RUL models to current SoH. The first approach requires a priori knowledge about aging processes in the system and accurate estimation of SoH. An estimation of SoH here is conditioned by tracking actual accumulated damage into the system, so that particular model parameters are defined according to a priori known assumptions about system's aging. Prediction accuracy in this case is highly dependent on accurate estimation of SoH but includes high number of degrees of freedom. The second approach in this contribution does not require a priori knowledge about system's aging as particular model parameters are defined in accordance to multi-objective optimization procedure. Prediction accuracy of this model does not highly depend on estimated SoH. This model has lower degrees of freedom. Both approaches rely on previously developed lifetime models each of them corresponding to predefined SoH. Concerning first approach, model selection is aided by state-machine-based algorithm. In the second approach, model selection conditioned by tracking an exceedance of predefined thresholds is concerned. The approach is applied to data generated from tribological systems. By calculating Root Squared Error (RSE), Mean Squared Error (MSE), and Absolute Error (ABE) the accuracy of proposed models/approaches is discussed along with related advantages and disadvantages. Verification of the approach is done using cross-fold validation, exchanging training and test data. It can be stated that the newly introduced approach based on data (denoted as data-based or data-driven) parametric models can be easily established providing detailed information about remaining useful/consumed lifetime valid for systems with constant load but stochastically occurred damage.

The System of Objectified Judgement Analysis (SOJA). A tool in rational drug selection for formulary inclusion.

PubMed

Janknegt, R; Steenhoek, A

1997-04-01

Rational drug selection for formulary purposes is important. Besides rational selection criteria, other factors play a role in drug decision making, such as emotional, personal financial and even unconscious criteria. It is agreed that these factors should be excluded as much as possible in the decision making process. A model for drug decision making for formulary purposes is described, the System of Objectified Judgement Analysis (SOJA). In the SOJA method, selection criteria for a given group of drugs are prospectively defined and the extent to which each drug fulfils the requirements for each criterion is determined. Each criterion is given a relative weight, i.e. the more important a given selection criterion is considered, the higher the relative weight. Both the relative scores for each drug per selection criterion and the relative weight of each criterion are determined by a panel of experts in this field. The following selection criteria are applied in all SOJA scores: clinical efficacy, incidence and severity of adverse effects, dosage frequency, drug interactions, acquisition cost, documentation, pharmacokinetics and pharmaceutical aspects. Besides these criteria, group specific criteria are also used, such as development of resistance when a SOJA score was made for antimicrobial agents. The relative weight that is assigned to each criterion will always be a subject of discussion. Therefore, interactive software programs for use on a personal computer have been developed, in which the user of the system may enter their own personal relative weight to each selection criterion and make their own personal SOJA score. The main advantage of the SOJA method is that all nonrational selection criteria are excluded and that drug decision making is based solely on rational criteria. The use of the interactive SOJA discs makes the decision process fully transparent as it becomes clear on which criteria and weighting decisions are based. We have seen that the use of this method for drug decision making greatly aids the discussion in the formulary committee, as discussion becomes much more concrete. The SOJA method is time dependent. Documentation on most products is still increasing and the score for this criterion will therefore change continuously. New products are introduced and prices are also subject to change. To overcome the time-dependence of the SOJA method, regular updates of interactive software programs are being made, in which changes in acquisition cost, documentation or a different weighting of criteria are included, as well as newly introduced products. The possibility of changing the official acquisition cost into the actual purchasing costs for the hospital in question provides a tailor-made interactive program.

A Review on influencing criteria for selecting supplier of information technology services in the hospital

PubMed Central

Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh

2014-01-01

Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals. PMID:25540781

A Review on influencing criteria for selecting supplier of information technology services in the hospital.

PubMed

Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh

2014-01-01

Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals.

Application Of Decision Tree Approach To Student Selection Model- A Case Study

NASA Astrophysics Data System (ADS)

Harwati; Sudiya, Amby

2016-01-01

The main purpose of the institution is to provide quality education to the students and to improve the quality of managerial decisions. One of the ways to improve the quality of students is to arrange the selection of new students with a more selective. This research takes the case in the selection of new students at Islamic University of Indonesia, Yogyakarta, Indonesia. One of the university's selection is through filtering administrative selection based on the records of prospective students at the high school without paper testing. Currently, that kind of selection does not yet has a standard model and criteria. Selection is only done by comparing candidate application file, so the subjectivity of assessment is very possible to happen because of the lack standard criteria that can differentiate the quality of students from one another. By applying data mining techniques classification, can be built a model selection for new students which includes criteria to certain standards such as the area of origin, the status of the school, the average value and so on. These criteria are determined by using rules that appear based on the classification of the academic achievement (GPA) of the students in previous years who entered the university through the same way. The decision tree method with C4.5 algorithm is used here. The results show that students are given priority for admission is that meet the following criteria: came from the island of Java, public school, majoring in science, an average value above 75, and have at least one achievement during their study in high school.

Multi-criteria decision aid approach for the selection of the best compromise management scheme for ELVs: the case of Cyprus.

PubMed

Mergias, I; Moustakas, K; Papadopoulos, A; Loizidou, M

2007-08-25

Each alternative scheme for treating a vehicle at its end of life has its own consequences from a social, environmental, economic and technical point of view. Furthermore, the criteria used to determine these consequences are often contradictory and not equally important. In the presence of multiple conflicting criteria, an optimal alternative scheme never exists. A multiple-criteria decision aid (MCDA) method to aid the Decision Maker (DM) in selecting the best compromise scheme for the management of End-of-Life Vehicles (ELVs) is presented in this paper. The constitution of a set of alternatives schemes, the selection of a list of relevant criteria to evaluate these alternative schemes and the choice of an appropriate management system are also analyzed in this framework. The proposed procedure relies on the PROMETHEE method which belongs to the well-known family of multiple criteria outranking methods. For this purpose, level, linear and Gaussian functions are used as preference functions.

Optimal Contractor Selection in Construction Industry: The Fuzzy Way

NASA Astrophysics Data System (ADS)

Krishna Rao, M. V.; Kumar, V. S. S.; Rathish Kumar, P.

2018-02-01

A purely price-based approach to contractor selection has been identified as the root cause for many serious project delivery problems. Therefore, the capability of the contractor to execute the project should be evaluated using a multiple set of selection criteria including reputation, past performance, performance potential, financial soundness and other project specific criteria. An industry-wide questionnaire survey was conducted with the objective of identifying the important criteria for adoption in the selection process. In this work, a fuzzy set based model was developed for contractor prequalification/evaluation, by using effective criteria obtained from the percept of construction professionals, taking subjective judgments of decision makers also into consideration. A case study consisting of four alternatives (contractors in the present case) solicited from a public works department of Pondicherry in India, is used to illustrate the effectiveness of the proposed approach. The final selection of contractor is made based on the integrated score or Overall Evaluation Score of the decision alternative in prequalification as well as bid evaluation stages.

Landfill site selection using combination of GIS and fuzzy AHP, a case study: Iranshahr, Iran.

PubMed

Torabi-Kaveh, M; Babazadeh, R; Mohammadi, S D; Zaresefat, M

2016-03-09

One of the most important recent challenges in solid waste management throughout the world is site selection of sanitary landfill. Commonly, because of simultaneous effects of social, environmental, and technical parameters on suitability of a landfill site, landfill site selection is a complex process and depends on several criteria and regulations. This study develops a multi-criteria decision analysis (MCDA) process, which combines geographic information system (GIS) analysis with a fuzzy analytical hierarchy process (FAHP), to determine suitable sites for landfill construction in Iranshahr County, Iran. The GIS was used to calculate and classify selected criteria and FAHP was used to assess the criteria weights based on their effectiveness on selection of potential landfill sites. Finally, a suitability map was prepared by overlay analyses and suitable areas were identified. Four suitability classes within the study area were separated, including high, medium, low, and very low suitability areas, which represented 18%, 15%, 55%, and 12% of the study area, respectively. © The Author(s) 2016.

Statin Selection in Qatar Based on Multi-indication Pharmacotherapeutic Multi-criteria Scoring Model, and Clinician Preference.

PubMed

Al-Badriyeh, Daoud; Fahey, Michael; Alabbadi, Ibrahim; Al-Khal, Abdullatif; Zaidan, Manal

2015-12-01

Statin selection for the largest hospital formulary in Qatar is not systematic, not comparative, and does not consider the multi-indication nature of statins. There are no reports in the literature of multi-indication-based comparative scoring models of statins or of statin selection criteria weights that are based primarily on local clinicians' preferences and experiences. This study sought to comparatively evaluate statins for first-line therapy in Qatar, and to quantify the economic impact of this. An evidence-based, multi-indication, multi-criteria pharmacotherapeutic model was developed for the scoring of statins from the perspective of the main health care provider in Qatar. The literature and an expert panel informed the selection criteria of statins. Relative weighting of selection criteria was based on the input of the relevant local clinician population. Statins were comparatively scored based on literature evidence, with those exceeding a defined scoring threshold being recommended for use. With 95% CI and 5% margin of error, the scoring model was successfully developed. Selection criteria comprised 28 subcriteria under the following main criteria: clinical efficacy, best publish evidence and experience, adverse effects, drug interaction, dosing time, and fixed dose combination availability. Outcome measures for multiple indications were related to effects on LDL cholesterol, HDL cholesterol, triglyceride, total cholesterol, and C-reactive protein. Atorvastatin, pravastatin, and rosuvastatin exceeded defined pharmacotherapeutic thresholds. Atorvastatin and pravastatin were recommended as first-line use and rosuvastatin as a nonformulary alternative. It was estimated that this would produce a 17.6% cost savings in statins expenditure. Sensitivity analyses confirmed the robustness of the evaluation's outcomes against input uncertainties. Incorporating a comparative evaluation of statins in Qatari practices based on a locally developed, transparent, multi-indication, multi-criteria scoring model has the potential to considerably reduce expenditures on statins. Atorvastatin and pravastatin should be the first-line statin therapies in the main Qatari health care provider, with rosuvastatin as an alternative. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

Bayesian Item Selection in Constrained Adaptive Testing Using Shadow Tests

ERIC Educational Resources Information Center

Veldkamp, Bernard P.

2010-01-01

Application of Bayesian item selection criteria in computerized adaptive testing might result in improvement of bias and MSE of the ability estimates. The question remains how to apply Bayesian item selection criteria in the context of constrained adaptive testing, where large numbers of specifications have to be taken into account in the item…

76 FR 21985 - Notice of Final Priorities, Requirements, Definitions, and Selection Criteria

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-19

... only after a research base has been established to support the use of the assessments for such purposes..., research-based assessment practices. Discussion: We agree that the selection criteria should address the... selection criterion, which addresses methods of scoring, to allow for self-scoring of student performance on...

40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES Selective Enforcement Auditing § 89.510...

34 CFR 611.12 - What additional selection criteria are used for an application proposing teacher recruitment...

Code of Federal Regulations, 2010 CFR

2010-07-01

... EDUCATION TEACHER QUALITY ENHANCEMENT GRANTS PROGRAM State Grants Program § 611.12 What additional selection... 34 Education 3 2010-07-01 2010-07-01 false What additional selection criteria are used for an application proposing teacher recruitment activities? 611.12 Section 611.12 Education Regulations of the...

Dependency of image quality on acquisition protocol and image processing in chest tomosynthesis-a visual grading study based on clinical data.

PubMed

Jadidi, Masoud; Båth, Magnus; Nyrén, Sven

2018-04-09

To compare the quality of images obtained with two different protocols with different acquisition time and the influence from image post processing in a chest digital tomosynthesis (DTS) system. 20 patients with suspected lung cancer were imaged with a chest X-ray equipment with tomosynthesis option. Two examination protocols with different acquisition times (6.3 and 12 s) were performed on each patient. Both protocols were presented with two different image post-processing (standard DTS processing and more advanced processing optimised for chest radiography). Thus, 4 series from each patient, altogether 80 series, were presented anonymously and in a random order. Five observers rated the quality of the reconstructed section images according to predefined quality criteria in three different classes. Visual grading characteristics (VGC) was used to analyse the data and the area under the VGC curve (AUC VGC ) was used as figure-of-merit. The 12 s protocol and the standard DTS processing were used as references in the analyses. The protocol with 6.3 s acquisition time had a statistically significant advantage over the vendor-recommended protocol with 12 s acquisition time for the classes of criteria, Demarcation (AUC VGC = 0.56, p = 0.009) and Disturbance (AUC VGC = 0.58, p < 0.001). A similar value of AUC VGC was found also for the class Structure (definition of bone structures in the spine) (0.56) but it could not be statistically separated from 0.5 (p = 0.21). For the image processing, the VGC analysis showed a small but statistically significant advantage for the standard DTS processing over the more advanced processing for the classes of criteria Demarcation (AUC VGC = 0.45, p = 0.017) and Disturbance (AUC VGC = 0.43, p = 0.005). A similar value of AUC VGC was found also for the class Structure (0.46), but it could not be statistically separated from 0.5 (p = 0.31). The study indicates that the protocol with 6.3 s acquisition time yields slightly better image quality than the vender-recommended protocol with acquisition time 12 s for several anatomical structures. Furthermore, the standard gradation processing  (the vendor-recommended post-processing for DTS), yields to some extent advantage over the gradation processing/multiobjective frequency processing/flexible noise control processing in terms of image quality for all classes of criteria. Advances in knowledge: The study proves that the image quality may be strongly affected by the selection of DTS protocol and that the vendor-recommended protocol may not always be the optimal choice.

Genetic improvement of total milk yield and total lactation persistency of the first three lactations in dairy cattle.

PubMed

Togashi, K; Lin, C Y

2008-07-01

The objective of this study was to compare 6 selection criteria in terms of 3-parity total milk yield and 9 selection criteria in terms of total net merit (H) comprising 3-parity total milk yield and total lactation persistency. The 6 selection criteria compared were as follows: first-parity milk estimated breeding value (EBV; M1), first 2-parity milk EBV (M2), first 3-parity milk EBV (M3), first-parity eigen index (EI(1)), first 2-parity eigen index (EI(2)), and first 3-parity eigen index (EI(3)). The 9 selection criteria compared in terms of H were M1, M2, M3, EI(1), EI(2), EI(3), and first-parity, first 2-parity, and first 3-parity selection indices (I(1), I(2), and I(3), respectively). In terms of total milk yield, selection on M3 or EI(3) achieved the greatest genetic response, whereas selection on EI(1) produced the largest genetic progress per day. In terms of total net merit, selection on I(3) brought the largest response, whereas selection EI(1) yielded the greatest genetic progress per day. A multiple-lactation random regression test-day model simultaneously yields the EBV of the 3 lactations for all animals included in the analysis even though the younger animals do not have the opportunity to complete the first 3 lactations. It is important to use the first 3 lactation EBV for selection decision rather than only the first lactation EBV in spite of the fact that the first-parity selection criteria achieved a faster genetic progress per day than the 3-parity selection criteria. Under a multiple-lactation random regression animal model analysis, the use of the first 3 lactation EBV for selection decision does not prolong the generation interval as compared with the use of only the first lactation EBV. Thus, it is justified to compare genetic response on a lifetime basis rather than on a per-day basis. The results suggest the use of M3 or EI(3) for genetic improvement of total milk yield and the use of I(3) for genetic improvement of total net merit H. Although this study deals with selection for 3-parity milk production, the same principle applies to selection for lifetime milk production.

Using marketing research concepts to investigate specialty selection by medical students.

PubMed

Weissman, Charles; Schroeder, Josh; Elchalal, Uriel; Weiss, Yoram; Tandeter, Howard; Zisk-Rony, Rachel Y

2012-10-01

This study was intended to examine whether a marketing research approach improves understanding of medical specialty selection by medical students. This approach likens students to consumers who are deciding whether or not to purchase a product (specialty). This approach proposes that when consumers' criteria match their perceptions of a product's features, the likelihood that they will purchase it (select the specialty) increases. This study examines whether exploring students' selection criteria and perceptions of various specialties provides additional insights into the selection process. Using a consumer behaviour model as a framework, a questionnaire was designed and administered to Year 6 (final-year) students in 2008 and 2009 to elicit information on their knowledge about and interests in various specialties, the criteria they used in specialty selection, and their perceptions of six specialties. A total of 132 (67%) questionnaires were returned. In many instances, consistency between selection criteria and perceptions of a specialty was accompanied by interest in pursuing the specialty. Exceptions were noted and pointed to areas requiring additional research. For example, although > 70% of female students replied that the affordance of a controllable lifestyle was an important selection criterion, many were interested in obstetrics and gynaecology despite the fact that it was not perceived as providing a controllable lifestyle. Minimal overlap among students reporting interest in primary specialties that possess similar characteristics (e.g. paediatrics and family medicine) demonstrated the need to target marketing (recruitment) efforts for each specialty individually. Using marketing research concepts to examine medical specialty selection may precipitate a conceptual shift among health care leaders which acknowledges that, to attract students, specialties must meet students' selection criteria. Moreover, if consumers (students) deem a product (specialty) unattractive, it may need to be examined further to improve its appeal. © Blackwell Publishing Ltd 2012.

Accreditation the Education Development Centers of Medical-Sciences Universities: Another Step toward Quality Improvement in Education

PubMed Central

Haghdoost, AA; Momtazmanesh, N; Shoghi, F; Mohagheghi, M; Mehrolhassani, MH

2013-01-01

Background: In order to improve the quality of education in universities of medical sciences (UMS), and because of the key role of education development centers (EDCs), an accreditation scheme was developed to evaluate their performance. Method: A group of experts in the medical education field was selected based on pre-defined criteria by EDC of Ministry of Health and Medical education. The team, worked intensively for 6 months to develop a list of essential standards to assess the performance of EDCs. Having checked for the content validity of standards, clear and measurable indicators were created via consensus. Then, required information were collected from UMS EDCs; the first round of accreditation was carried out just to check the acceptability of this scheme, and make force universities to prepare themselves for the next factual round of accreditation. Results: Five standards domains were developed as the conceptual framework for defining main categories of indicators. This included: governing and leadership, educational planning, faculty development, assessment and examination and research in education. Nearly all of UMS filled all required data forms precisely with minimum confusion which shows the practicality of this accreditation scheme. Conclusion: It seems that the UMS have enough interest to provide required information for this accreditation scheme. However, in order to receive promising results, most of universities have to work intensively in order to prepare minimum levels in all required standards. However, it seems that in long term, implementation of a valid accreditation scheme plays an important role in improvement of the quality of medical education around the country. PMID:23865031

Lay and peer counsellors to reduce leprosy-related stigma--lessons learnt in Cirebon, Indonesia.

PubMed

Lusli, Mimi; Peters, Ruth M H; Zweekhorst, Marjolein B M; Van Brakel, Wim H; Seda, Francisia S S E; Bunders, Joske F G; Irwanto

2015-03-01

Counselling has been identified as a promising strategy to reduce stigma. Lay and peer counsellors have provided counselling in various fields, but this has not yet been studied in the field of leprosy. The Stigma Assessment and Reduction of Impact (SARI) project in Cirebon District, Indonesia took up this endeavour. This paper describes the initial experiences based on the perspectives of the lay and peer counsellors and aims to provide lessons learnt for future initiatives. The selection of lay and peer counsellors was based upon pre-defined criteria such as completed junior high school and level of confidence. This study draws on the notes of seven monitoring and evaluation meetings and 21 group discussions the main researcher facilitated with the lay and peer counsellors and the notes written by the lay and peer counsellors on the sessions with their clients. In total, 198 people affected by leprosy were offered counselling by the 11 lay and 12 peer counsellors; 145 accepted this offer. The other 53 either did not need counselling or did not want to participate for example due to worries about disclosure. Effective communication skills such as listening and asking effective questions were important, but also difficult to acquire for the lay and peer counsellors. Sharing personal experiences was highly appreciated by clients and stimulated a deepened reflection. Challenges related to concealment and effective skills exist, but some people affected by leprosy and others can become effective counsellors making it at the outset a challenging but nevertheless promising intervention.

CUSUM method for construction of trainee spinal ultrasound learning curves following standardised teaching.

PubMed

Deacon, A J; Melhuishi, N S; Terblanche, N C S

2014-07-01

Spinal ultrasonography is a promising aid for epidural insertion. We aimed to determine the learning curve of spinal ultrasonography tasks and the number of training scans required to reach competency after undergoing standardised step-wise teaching. Trainees were required to complete a minimum of 60 assessed scans on selected non-pregnant models following attendance at two training sessions, with feedback from an expert after each scan. Learning curves were plotted using the non-risk cumulative summation technique and an acceptable failure rate of 20%. Five trainees completed between 65 and 75 scans each. All trainees were competent at identifying a randomly assigned intervertebral space after a median of five scans (range one to nine) and at measuring the depth from skin to the posterior complex after a median of 10 scans (range 1 to 42). Two trainees were competent at marking an ideal needle insertion point after 55 scans, while three trainees did not attain competency. All trainees were competent after 60 scans if the tolerance was changed from five to eight millimetre for marking the needle insertion point. The average time taken to complete a scan was 163 seconds. Our study showed that after a standardised educational intervention, anaesthetic trainees are able to identify a lumbar interlaminar space easily and can measure the depth to the posterior complex after a reasonable number of additional practice scans, but experienced difficulty accurately marking the needle insertion point whilst using spinal ultrasonography. We confirmed that it was hard to achieve competency in all aspects of spinal ultrasonography, based on assessment using our predefined competency criteria.

Accreditation the Education Development Centers of Medical-Sciences Universities: Another Step toward Quality Improvement in Education.

PubMed

Haghdoost, Aa; Momtazmanesh, N; Shoghi, F; Mohagheghi, M; Mehrolhassani, Mh

2013-01-01

In order to improve the quality of education in universities of medical sciences (UMS), and because of the key role of education development centers (EDCs), an accreditation scheme was developed to evaluate their performance. A group of experts in the medical education field was selected based on pre-defined criteria by EDC of Ministry of Health and Medical education. The team, worked intensively for 6 months to develop a list of essential standards to assess the performance of EDCs. Having checked for the content validity of standards, clear and measurable indicators were created via consensus. Then, required information were collected from UMS EDCs; the first round of accreditation was carried out just to check the acceptability of this scheme, and make force universities to prepare themselves for the next factual round of accreditation. Five standards domains were developed as the conceptual framework for defining main categories of indicators. This included: governing and leadership, educational planning, faculty development, assessment and examination and research in education. Nearly all of UMS filled all required data forms precisely with minimum confusion which shows the practicality of this accreditation scheme. It seems that the UMS have enough interest to provide required information for this accreditation scheme. However, in order to receive promising results, most of universities have to work intensively in order to prepare minimum levels in all required standards. However, it seems that in long term, implementation of a valid accreditation scheme plays an important role in improvement of the quality of medical education around the country.

An approach to optimize sample preparation for MALDI imaging MS of FFPE sections using fractional factorial design of experiments.

PubMed

Oetjen, Janina; Lachmund, Delf; Palmer, Andrew; Alexandrov, Theodore; Becker, Michael; Boskamp, Tobias; Maass, Peter

2016-09-01

A standardized workflow for matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI imaging MS) is a prerequisite for the routine use of this promising technology in clinical applications. We present an approach to develop standard operating procedures for MALDI imaging MS sample preparation of formalin-fixed and paraffin-embedded (FFPE) tissue sections based on a novel quantitative measure of dataset quality. To cover many parts of the complex workflow and simultaneously test several parameters, experiments were planned according to a fractional factorial design of experiments (DoE). The effect of ten different experiment parameters was investigated in two distinct DoE sets, each consisting of eight experiments. FFPE rat brain sections were used as standard material because of low biological variance. The mean peak intensity and a recently proposed spatial complexity measure were calculated for a list of 26 predefined peptides obtained by in silico digestion of five different proteins and served as quality criteria. A five-way analysis of variance (ANOVA) was applied on the final scores to retrieve a ranking of experiment parameters with increasing impact on data variance. Graphical abstract MALDI imaging experiments were planned according to fractional factorial design of experiments for the parameters under study. Selected peptide images were evaluated by the chosen quality metric (structure and intensity for a given peak list), and the calculated values were used as an input for the ANOVA. The parameters with the highest impact on the quality were deduced and SOPs recommended.

Citrus fruits intake and oral cancer risk: a systematic review and meta-analysis.

PubMed

Cirmi, Santa; Navarra, Michele; Woodside, Jayne V; Cantwell, Marie M

2018-05-10

To quantify the relationship between Citrus intake and risk of cancer of the oral cavity and pharynx. Systematic review and meta-analysis. Ovid MEDLINE, EMBASE, and Web of Science were searched until September 2017. Search terms included Citrus, Citrus aurantifolia, Citrus sinensis, Citrus paradisi, Citrus fruits, Citrus fruits extract, Citrus oil, fruits, oral cancer, mouth cancer, mouth neoplasm. The selection of studies and the systematic review were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A pre-defined inclusion checklist resulted in the inclusion of articles which were (i) published in peer-reviewed scientific journals; (ii) English language; (iii) and included a measure of Citrus fruit intake and risk of oral and pharyngeal cancer. Studies were excluded if (i) preparations derived from other fruits were used, (ii) Citrus intake was combined with intake of other fruits; (iii) in vitro or animal models were used. We also excluded reviews, systematic reviews, meta-analyses, letters, personal opinions, conference abstracts and book chapters. Three reviewers independently performed the extraction of data from studies included. Seventeen studies met our inclusion criteria and were included in the final review. Pooled analyses showed that those with the highest Citrus fruit intake compared to the lowest intake had a 50% reduction in risk of oral cavity and pharyngeal cancer (OR 0.50; 95% CI 0.43-0.59). The studies included in this review and meta-analysis showed an inverse association between Citrus fruit intake and oral cancer. Copyright © 2018. Published by Elsevier Ltd.

[Immigrants' access to health care in Spain: a review].

PubMed

Llop-Gironés, Alba; Vargas Lorenzo, Ingrid; Garcia-Subirats, Irene; Aller, Marta-Beatriz; Vázquez Navarrete, María Luisa

2014-01-01

An important proportion of the population in Spain is immigrant and the international literature indicates their inadequate access to health services. The objective is to contribute to improving the knowledge on access to health care of the immigrant population in Spain. Review of original papers published (1998-2012) on access to health services of the immigrant population in Spain published in Medline and MEDES. Out of 319 studies, 20 were selected, applying predefined criteria. The results were analyzed using the Aday and Andersen framework. Among the publications, 13 quantitative studies analysed differences in health care use between the immigrant and the native population, and 7 studied determinants of access of immigrants. Studies showed less use of specialized care by immigrants, higher use of emergency care and no differences in the use of primary care between groups. Five quantitative articles on determinants of access focused on factors related to the immigrant population (sex, age, educational level and holding private health insurance), but without observing clear patterns. The two qualitative studies analyzed factors related to health services, describing access to healthcare barriers such as the limited provision of information or the requirements for personal health card. Access to health care in immigrants has been scarcely studied, using different approaches and the barely analysed factors related to the services. No clear patterns were observed, as differences depend on the classification of migrants according to country of origin and the level of care. However, studies showed less use of specialized care by immigrants, higher use of emergency care and the existence of determinants of access different to their needs.

Cell assisted lipotransfer in breast augmentation and reconstruction: A systematic review of safety, efficacy, use of patient reported outcomes and study quality.

PubMed

Arshad, Zeeshaan; Karmen, Lindsey; Choudhary, Rajan; Smith, James A; Branford, Olivier A; Brindley, David A; Pettitt, David; Davies, Benjamin M

2016-12-01

Cell assisted lipotransfer serves as a novel technique for both breast reconstruction and breast augmentation. This systematic review assesses the efficacy, safety and use of patient reported outcome measures in studies involving cell assisted lipotransfer. We also carry out an objective assessment of study quality focussing on recruitment, follow-up and provide an up-to-date clinical trial landscaping analysis. Key electronic databases were searched according to PRISMA guidelines and pre-defined inclusion and exclusion criteria. Two independent reviewers examined the retrieved publications and performed data extraction. 3980 publications were identified. Following screening, 11 studies were included for full review, representing a total of 336 patients with a follow-up time ranging from six to 42 months. A degree of variation was noted in graft retention and reported satisfaction levels, although there were only three comparative studies with conflicting results. Complications occurred at a rate of 37%. Additionally, there was a paucity of objective outcomes assessments (e.g. 3D assessment modalities or validated patient reported outcome measures) in the selected studies. Cell assisted lipotransfer is a surgical technique that is currently employed sparingly within the plastic & reconstructive surgery community. Presently, further technical and outcome standardization is required, in addition to rigorous randomized controlled trials and supporting long-term follow-up data to better determine procedural safety and efficacy. Routine use of more objective outcome measures, particularly 3D assessments and validated patient reported outcome measures, will also help facilitate wider clinical adoption and establish procedural utility.

Core Items for a Standardized Resource Use Measure: Expert Delphi Consensus Survey.

PubMed

Thorn, Joanna C; Brookes, Sara T; Ridyard, Colin; Riley, Ruth; Hughes, Dyfrig A; Wordsworth, Sarah; Noble, Sian M; Thornton, Gail; Hollingworth, William

2018-06-01

Resource use measurement by patient recall is characterized by inconsistent methods and a lack of validation. A validated standardized resource use measure could increase data quality, improve comparability between studies, and reduce research burden. To identify a minimum set of core resource use items that should be included in a standardized adult instrument for UK health economic evaluation from a provider perspective. Health economists with experience of UK-based economic evaluations were recruited to participate in an electronic Delphi survey. Respondents were asked to rate 60 resource use items (e.g., medication names) on a scale of 1 to 9 according to the importance of the item in a generic context. Items considered less important according to predefined consensus criteria were dropped and a second survey was developed. In the second round, respondents received the median score and their own score from round 1 for each item alongside summarized comments and were asked to rerate items. A final project team meeting was held to determine the recommended core set. Forty-five participants completed round 1. Twenty-six items were considered less important and were dropped, 34 items were retained for the second round, and no new items were added. Forty-two respondents (93.3%) completed round 2, and greater consensus was observed. After the final meeting, 10 core items were selected, with further items identified as suitable for "bolt-on" questionnaire modules. The consensus on 10 items considered important in a generic context suggests that a standardized instrument for core resource use items is feasible. Copyright © 2018. Published by Elsevier Inc.

The effect of care pathways for hip fractures: a systematic review.

PubMed

Leigheb, Fabrizio; Vanhaecht, Kris; Sermeus, Walter; Lodewijckx, Cathy; Deneckere, Svin; Boonen, Steven; Boto, Paulo Alexandre Faria; Mendes, Rita Veloso; Panella, Massimiliano

2012-07-01

We performed a systematic review for primary studies on care pathways (CPs) for hip fracture (HF). The online databases MEDLINE-PubMed, Ovid-EMBASE, CINAHL-EBSCO host, and The Cochrane Library (Cochrane Central Register of Clinical Trials, Health Technology Assessment Database, NHS Economic Evaluation Database) were searched. Two researchers reviewed the literature independently. Primary studies that met predefined inclusion criteria were assessed for their methodological quality. A total of 15 publications were included: 15 primary studies corresponding with 12 main investigations. Primary studies were evaluated for clinical outcomes, process outcomes, and economic outcomes. The studies assessed a wide range of outcome measures. While a number of divergent clinical outcomes were reported, most studies showed positive results of process management and health-services utilization. In terms of mortality, the results provided evidence for a positive impact of CPs on in-hospital mortality. Most studies also showed a significantly reduced risk of complications, including medical complications, wound infections, and pressure sores. Moreover, time-span process measures showed that an improvement in the organization of care was achieved through the use of CPs. Conflicting results were observed with regard to functional recovery and mobility between patients treated with CPs compared to usual care. Although our review suggests that CPs can have positive effects in patients with HF, the available evidence is insufficient for formal recommendations. There is a need for more research on CPs with selected process and outcome indicators, for in-hospital and postdischarge management of HF, with an emphasis on well-designed randomized trials.

Orthorexic and restrained eating behaviour in vegans, vegetarians, and individuals on a diet.

PubMed

Barthels, Friederike; Meyer, Frank; Pietrowsky, Reinhard

2018-04-01

Orthorexic eating behaviour, restrained eating, and veganism/vegetarianism are food selection strategies sharing several characteristics. Since there are no studies investigating their interrelationships, aim of the present study was to analyse orthorexic and restrained eating behaviour in (1) a sample of vegans and vegetarians and (2) a sample of individuals on a diet to lose weight. Division of samples according to pre-defined criteria in (1) vegans (n = 114), vegetarians (n = 63), individuals with rare meat consumption (n = 83) and individuals with frequent meat consumption (n = 91) and in (2) participants on a diet with dietary change (n = 104), without dietary change (n = 37) and a control group of individuals not on a diet (n = 258). Orthorexic eating behaviour was assessed with the Düsseldorfer Orthorexie Skala and restrained eating was assessed with the Restraint Eating Scale. Vegans and vegetarians do not differ in orthorexic eating behaviour, but both groups score higher in orthorexic eating behaviour than individuals consuming red meat. There are no differences regarding restrained eating. Individuals on a diet with dietary change score higher in both orthorexic and restrained eating, than individuals without dietary change and individuals not on a diet. Individuals who restrict their eating behaviour, either predominantly due to ethical reasons or with the intention to lose weight, display more orthorexic eating behaviour than individuals not limiting their food consumption. Further research is needed to investigate whether veganism, vegetarianism, or frequent dieting behaviour serve as risk factors for orthorexia. Level V, cross-sectional descriptive study.

Reduced Sodium Current in the Lateral Ventricular Wall Induces Inferolateral J-Waves.

PubMed

Meijborg, Veronique M F; Potse, Mark; Conrath, Chantal E; Belterman, Charly N W; De Bakker, Jacques M T; Coronel, Ruben

2016-01-01

J-waves in inferolateral leads are associated with a higher risk for idiopathic ventricular fibrillation. We aimed to test potential mechanisms (depolarization or repolarization dependent) responsible for inferolateral J-waves. We hypothesized that inferolateral J-waves can be caused by regional delayed activation of myocardium that is activated late during normal conditions. Computer simulations were performed to evaluate how J-point elevation is influenced by reducing sodium current conductivity (GNa), increasing transient outward current conductivity (Gto), or cellular uncoupling in three predefined ventricular regions (lateral, anterior, or septal). Two pig hearts were Langendorff-perfused with selective perfusion with a sodium channel blocker of lateral or anterior/septal regions. Volume-conducted pseudo-electrocardiograms (ECG) were recorded to detect the presence of J-waves. Epicardial unipolar electrograms were simultaneously recorded to obtain activation times (AT). Simulation data showed that conduction slowing, caused by reduced sodium current, in lateral, but not in other regions induced inferolateral J-waves. An increase in transient outward potassium current or cellular uncoupling in the lateral zone elicited slight J-point elevations which did not meet J-wave criteria. Additional conduction slowing in the entire heart attenuated J-waves and J-point elevations on the ECG, because of masking by the QRS. Experimental data confirmed that conduction slowing attributed to sodium channel blockade in the left lateral but not in the anterior/septal ventricular region induced inferolateral J-waves. J-waves coincided with the delayed activation. Reduced sodium current in the left lateral ventricular myocardium can cause inferolateral J-waves on the ECG.

A rapid echocardiographic screening protocol for rheumatic heart disease in Samoa: a high prevalence of advanced disease.

PubMed

Allen, Marvin; Allen, John; Naseri, Take; Gardner, Rebecca; Tolley, Dennis; Allen, Lori

2017-10-01

Echocardiography has been proposed as a method to screen children for rheumatic heart disease. The World Heart Federation has established guidelines for echocardiographic screening. In this study, we describe a rapid echocardiogram screening protocol according to the World Heart Federation guidelines in Samoa, endemic for rheumatic heart disease. We performed echocardiogram screening in schoolchildren in Samoa between 2013 and 2015. A brief screening echocardiogram was performed on all students. Children with predefined criteria suspicious for rheumatic hear diseases were referred for a more comprehensive echocardiogram. Complete echocardiograms were classified according to the World Heart Federation guidelines and severity of valve disease. Echocardiographic screening was performed on 11,434 children, with a mean age of 10.2 years; 51% of them were females. A total of 558 (4.8%) children underwent comprehensive echocardiography, including 49 students who were randomly selected as controls. Definite rheumatic heart disease was observed in 115 students (10.0 per 1000): 92 students were classified as borderline (8.0 per 1000) and 23 with CHD. Advanced disease was identified in 50 students (4.4 per 1000): 15 with severe mitral regurgitation, five with severe aortic regurgitation, 11 with mitral stenoses, and 19 with mitral and aortic valve disease. We successfully applied a rapid echocardiographic screening protocol to a large number of students over a short time period - 28 days of screening over a 3-year time period - to identify a high prevalence of rheumatic heart disease. We also reported a significantly higher rate of advanced disease compared with previously published echocardiographic screening programmes.

External quality assessment unravels interlaboratory differences in quality of RAS testing for anti-EGFR therapy in colorectal cancer.

PubMed

Tack, Véronique; Ligtenberg, Marjolijn J L; Tembuyser, Lien; Normanno, Nicola; Vander Borght, Sara; Han van Krieken, J; Dequeker, Elisabeth M C

2015-03-01

Regulations for the selection of patients with metastatic colorectal cancer for anti-EGFR treatment changed at the end of 2013. The set of mutations to be tested extended from KRAS codons 12 and 13 to KRAS and NRAS exons 2, 3, and 4. A European external quality assessment scheme monitored the performance of laboratories and evaluated the implementation of the new regulations. The 131 participating laboratories received 10 samples of formalin-fixed paraffin-embedded material, including RAS (exon 2, 3, 4) and BRAF mutations. Mock clinical data were provided for three cases. Using their routine methods, laboratories determined the genotypes and submitted three written reports. Assessors scored the results according to predefined evaluation criteria. Half of the participants (49.3%) had completely implemented the new test requirements (codons 12, 13, 59, 61, 117, and 146 of KRAS and NRAS), and 96 laboratories (73.3%) made no genotype mistakes. Correct nomenclature, according to the Human Genome Variation Society, was used by 82 laboratories (62.6%). Although regulations were effective for several months, many laboratories were not ready for full RAS testing in the context of anti-EGFR therapy. Nevertheless, in each participating country, there are laboratories that provide complete and correct testing. External quality assessments can be used to monitor implementation of new test regulations and to stimulate the laboratories to improve their testing procedures. Because the results of this program are available on the website of the European Society of Pathology, patients and clinicians can refer test samples to a reliable laboratory. ©AlphaMed Press.

Image compression/decompression based on mathematical transform, reduction/expansion, and image sharpening

DOEpatents

Fu, C.Y.; Petrich, L.I.

1997-12-30

An image represented in a first image array of pixels is first decimated in two dimensions before being compressed by a predefined compression algorithm such as JPEG. Another possible predefined compression algorithm can involve a wavelet technique. The compressed, reduced image is then transmitted over the limited bandwidth transmission medium, and the transmitted image is decompressed using an algorithm which is an inverse of the predefined compression algorithm (such as reverse JPEG). The decompressed, reduced image is then interpolated back to its original array size. Edges (contours) in the image are then sharpened to enhance the perceptual quality of the reconstructed image. Specific sharpening techniques are described. 22 figs.

B-spline parameterization of the dielectric function and information criteria: the craft of non-overfitting

NASA Astrophysics Data System (ADS)

Likhachev, Dmitriy V.

2017-06-01

Johs and Hale developed the Kramers-Kronig consistent B-spline formulation for the dielectric function modeling in spectroscopic ellipsometry data analysis. In this article we use popular Akaike, corrected Akaike and Bayesian Information Criteria (AIC, AICc and BIC, respectively) to determine an optimal number of knots for B-spline model. These criteria allow finding a compromise between under- and overfitting of experimental data since they penalize for increasing number of knots and select representation which achieves the best fit with minimal number of knots. Proposed approach provides objective and practical guidance, as opposite to empirically driven or "gut feeling" decisions, for selecting the right number of knots for B-spline models in spectroscopic ellipsometry. AIC, AICc and BIC selection criteria work remarkably well as we demonstrated in several real-data applications. This approach formalizes selection of the optimal knot number and may be useful in practical perspective of spectroscopic ellipsometry data analysis.

Fuzzy decision-making framework for treatment selection based on the combined QUALIFLEX-TODIM method

NASA Astrophysics Data System (ADS)

Ji, Pu; Zhang, Hong-yu; Wang, Jian-qiang

2017-10-01

Treatment selection is a multi-criteria decision-making problem of significant concern in the medical field. In this study, a fuzzy decision-making framework is established for treatment selection. The framework mitigates information loss by introducing single-valued trapezoidal neutrosophic numbers to denote evaluation information. Treatment selection has multiple criteria that remarkably exceed the alternatives. In consideration of this characteristic, the framework utilises the idea of the qualitative flexible multiple criteria method. Furthermore, it considers the risk-averse behaviour of a decision maker by employing a concordance index based on TODIM (an acronym in Portuguese of interactive and multi-criteria decision-making) method. A sensitivity analysis is performed to illustrate the robustness of the framework. Finally, a comparative analysis is conducted to compare the framework with several extant methods. Results indicate the advantages of the framework and its better performance compared with the extant methods.

A new spatial multi-criteria decision support tool for site selection for implementation of managed aquifer recharge.

PubMed

Rahman, M Azizur; Rusteberg, Bernd; Gogu, R C; Lobo Ferreira, J P; Sauter, Martin

2012-05-30

This study reports the development of a new spatial multi-criteria decision analysis (SMCDA) software tool for selecting suitable sites for Managed Aquifer Recharge (MAR) systems. The new SMCDA software tool functions based on the combination of existing multi-criteria evaluation methods with modern decision analysis techniques. More specifically, non-compensatory screening, criteria standardization and weighting, and Analytical Hierarchy Process (AHP) have been combined with Weighted Linear Combination (WLC) and Ordered Weighted Averaging (OWA). This SMCDA tool may be implemented with a wide range of decision maker's preferences. The tool's user-friendly interface helps guide the decision maker through the sequential steps for site selection, those steps namely being constraint mapping, criteria hierarchy, criteria standardization and weighting, and criteria overlay. The tool offers some predetermined default criteria and standard methods to increase the trade-off between ease-of-use and efficiency. Integrated into ArcGIS, the tool has the advantage of using GIS tools for spatial analysis, and herein data may be processed and displayed. The tool is non-site specific, adaptive, and comprehensive, and may be applied to any type of site-selection problem. For demonstrating the robustness of the new tool, a case study was planned and executed at Algarve Region, Portugal. The efficiency of the SMCDA tool in the decision making process for selecting suitable sites for MAR was also demonstrated. Specific aspects of the tool such as built-in default criteria, explicit decision steps, and flexibility in choosing different options were key features, which benefited the study. The new SMCDA tool can be augmented by groundwater flow and transport modeling so as to achieve a more comprehensive approach to the selection process for the best locations of the MAR infiltration basins, as well as the locations of recovery wells and areas of groundwater protection. The new spatial multicriteria analysis tool has already been implemented within the GIS based Gabardine decision support system as an innovative MAR planning tool. Copyright © 2012 Elsevier Ltd. All rights reserved.

Criteria for the evaluation of a cloud-based hospital information system outsourcing provider.

PubMed

Low, Chinyao; Hsueh Chen, Ya

2012-12-01

As cloud computing technology has proliferated rapidly worldwide, there has been a trend toward adopting cloud-based hospital information systems (CHISs). This study examines the critical criteria for selecting the CHISs outsourcing provider. The fuzzy Delphi method (FDM) is used to evaluate the primary indicator collected from 188 useable responses at a working hospital in Taiwan. Moreover, the fuzzy analytic hierarchy process (FAHP) is employed to calculate the weights of these criteria and establish a fuzzy multi-criteria model of CHISs outsourcing provider selection from 42 experts. The results indicate that the five most critical criteria related to CHISs outsourcing provider selection are (1) system function, (2) service quality, (3) integration, (4) professionalism, and (5) economics. This study may contribute to understanding how cloud-based hospital systems can reinforce content design and offer a way to compete in the field by developing more appropriate systems.

Protocol for a systematic review of instruments for the assessment of quality of life and well-being in children and adolescents with cerebral palsy.

PubMed

Mpundu-Kaambwa, Christine; Chen, Gang; Huynh, Elisabeth; Russo, Remo; Ratcliffe, Julie

2017-09-11

Cerebral palsy is the most common cause of physical disability in children and adolescents and is associated with impairments that may reduce the quality of life (QOL) of this population. Patient-reported outcome measures (PROMs) can facilitate the assessment of the effect of disease and treatment on QOL, from a patient viewpoint. The purpose of this systematic review is to identify PROMs that are used to measure QOL and subjective well-being (SWB) outcomes in young people with cerebral palsy and to evaluate the suitability of these PROMs for application in economic evaluations within this population. MEDLINE, Scopus, the Cochrane Library, Web of Science Core Collection, EconLit, PsycINFO, CINAHL, EMBASE and Informit will be systematically searched from inception to date of search. Published peer-reviewed, English-language articles reporting PROMs measuring QOL or SWB outcomes in children and adolescents with cerebral palsy will be included. One reviewer will conduct the initial search and screen titles and abstracts for potentially eligible studies. The search will be performed in November 2017. To reduce the likelihood of reviewer selection bias, two other reviewers will independently screen a randomly selected subsample (10%) of the citations. Two reviewers will then retrieve full texts of potentially eligible studies and assess them against predefined inclusion criteria. The suitability of selected PROMs for use in economic evaluations of young people with cerebral palsy will be assessed using the International Society of Quality of Life Research recommended Minimum Standards and the Patient-Centered Outcomes and Comparative Effectiveness Research checklist. A narrative synthesis of extracted data will be presented including study descriptive data, PROMs measurement properties, settings in which they were applied and the valuation methods. Recommendations for practice on the selection of PROMs for use in economic evaluations of children and adolescents with cerebral palsy will be presented. Ethical approval is not required as the proposed systematic review will not use primary data. The results of this study will be widely disseminated through publication in a peer-reviewed journal and conference presentation(s). International Prospective Register of Systematic Reviews number: CRD42016049746. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Internet presence of psychiatrists in private practice. Status, chances and legal framework].

PubMed

Kuhnigk, O; Ramuschkat, M; Schreiner, J; Schäfer, I; Reimer, J

2013-05-01

Physicians increasingly use home pages to call attention to their practice. Based on predefined criteria, this study examines the web presence of psychiatrists and medical psychotherapists in private practice. All registered psychiatrists and psychotherapists of six northern German states were examined in May 2010 with regards to existence and quality of their web presence. Homepages were evaluated by means of a standardized criteria catalogue with 42 items. Statistical analysis comprised descriptive and analytic approaches (ANOVA, linear models). The analysis included 956 physicians, 168 of whom (17.6%) had a web presence. More physicians in city states had a web presence as compared to those in states with larger territories. However, there was no difference between eastern and western states. Male as compared to female physicians more often possessed an Internet presence. The average score was 19 (± 5.2) out of 42 items, with practices with more than one physician scoring higher than single physician practices. Websites often contained general information about the practice, medical services and diseases, and rarely online services, professional information about the physician, access for disabled, emergency services and holiday substitution. Legal requirements were not sufficiently considered by more than half of the physicians. Only a smaller number of psychiatrists and psychotherapists in private practice make use of their own web presence. The quality of information varies. The criteria catalogue used in this study may offer a guideline for development of a good quality Internet presence. A consensus Internet guideline with participation of physician chambers and medical societies would be of use to establish quality standards.

Protruding anterior medial meniscus-An indirect sign of posterior cruciate ligament deficiency.

PubMed

Parkar, Anagha P; Bleskestad, Kristiane; Løken, Susanne; Adriaensen, Miraude E A P M; Solheim, Eirik

2018-02-01

to examine if PROTruding of the Anterior Medial Meniscus (PROTAMM) could be an indirect sign of PCL deficiency by comparing PROTAMM to passive posterior tibial sagging (PSS) for chronic PCL rupture on routine MRI. Patients with PCL reconstruction between 2011 and 2016 were included in a case control study. Primarily cases with combined ACL/PCL injury were excluded. Secondary exclusion criteria were bony fractures, medial meniscus pathology and poor quality MRIs. Three (blinded) observers reviewed the pre-operative MRIs according to a pre-defined protocol. After applying the inclusion and primary exclusion criteria 16 patients were identified in the PCL rupture group. The control group consisted of 15 patients. After reviewing the MRIs, 6 were excluded due to secondary exclusion criteria. Mean PPS measured 4.8 mm (± 4.4 mm) in the PCL rupture group and 1.8 mm (±2.9 mm) in the control group, p = 0.05. Mean PROTAMM was 3.6 mm (±0.6 mm) in the PCL rupture group and 0.7 mm (±0.9 mm) in the control group, p = 0.004. We found a mean PROTAMM of 3.6 mm in patients with PCL rupture. We suggest that this sign, after knee injury in an otherwise normal medial meniscus, is a promising indirect sign of PCL deficiency compared to PPS. Implementation of this sign in clinical practice may improve the sensitivity of routine non-weight bearing MRI in identifying PCL deficient knees. Copyright © 2018 Elsevier B.V. All rights reserved.

Accuracy of Handheld Blood Glucose Meters at High Altitude

PubMed Central

de Vries, Suzanna T.; Fokkert, Marion J.; Dikkeschei, Bert D.; Rienks, Rienk; Bilo, Karin M.; Bilo, Henk J. G.

2010-01-01

Background Due to increasing numbers of people with diabetes taking part in extreme sports (e.g., high-altitude trekking), reliable handheld blood glucose meters (BGMs) are necessary. Accurate blood glucose measurement under extreme conditions is paramount for safe recreation at altitude. Prior studies reported bias in blood glucose measurements using different BGMs at high altitude. We hypothesized that glucose-oxidase based BGMs are more influenced by the lower atmospheric oxygen pressure at altitude than glucose dehydrogenase based BGMs. Methodology/Principal Findings Glucose measurements at simulated altitude of nine BGMs (six glucose dehydrogenase and three glucose oxidase BGMs) were compared to glucose measurement on a similar BGM at sea level and to a laboratory glucose reference method. Venous blood samples of four different glucose levels were used. Moreover, two glucose oxidase and two glucose dehydrogenase based BGMs were evaluated at different altitudes on Mount Kilimanjaro. Accuracy criteria were set at a bias <15% from reference glucose (when >6.5 mmol/L) and <1 mmol/L from reference glucose (when <6.5 mmol/L). No significant difference was observed between measurements at simulated altitude and sea level for either glucose oxidase based BGMs or glucose dehydrogenase based BGMs as a group phenomenon. Two GDH based BGMs did not meet set performance criteria. Most BGMs are generally overestimating true glucose concentration at high altitude. Conclusion At simulated high altitude all tested BGMs, including glucose oxidase based BGMs, did not show influence of low atmospheric oxygen pressure. All BGMs, except for two GDH based BGMs, performed within predefined criteria. At true high altitude one GDH based BGM had best precision and accuracy. PMID:21103399

Subjective and clinical assessment criteria suggestive for five clinical patterns discernible in nonspecific neck pain patients. A Delphi-survey of clinical experts.

PubMed

Dewitte, Vincent; Peersman, Wim; Danneels, Lieven; Bouche, Katie; Roets, Arne; Cagnie, Barbara

2016-12-01

Nonspecific neck pain patients form a heterogeneous group with different musculoskeletal impairments. Classifying nonspecific neck pain patients into subgroups based on clinical characteristics might lead to more comprehensive diagnoses and can guide effective management. To establish consensus among a group of experts regarding the clinical criteria suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central' and 'sensorimotor control' dysfunction patterns distinguishable in patients with nonspecific neck pain. Delphi study. A focus group with 10 academic experts was organized to elaborate on the different dysfunction patterns discernible in neck pain patients. Consecutively, a 3-round online Delphi-survey was designed to obtain consensual symptoms and physical examination findings for the 5 distinct dysfunction patterns resulting from the focus group. A total of 21 musculoskeletal physical therapists from Belgium and the Netherlands experienced in assessing and treating neck pain patients completed the 3-round Delphi-survey. Respectively, 33 (response rate, 100.0%), 27 (81.8%) and 21 (63.6%) respondents replied to rounds 1, 2 and 3. Eighteen 'articular', 16 'myofascial', 20 'neural', 18 'central' and 10 'sensorimotor control' clinical indicators reached a predefined ≥80% consensus level. These indicators suggestive of a clinical dominance of 'articular', 'myofascial', 'neural', 'central', and 'sensorimotor control' dysfunction patterns may help clinicians to assess and diagnose patients with nonspecific neck pain. Future validity testing is needed to determine how these criteria may help to improve the outcome of physical therapy interventions in nonspecific neck pain patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using multi-criteria risk ranking methodology to select case studies for a generic risk assessment framework for exotic disease incursion and spread through Europe.

PubMed

Horigan, V; De Nardi, M; Simons, R R L; Bertolini, S; Crescio, M I; Estrada-Peña, A; Léger, A; Maurella, C; Ru, G; Schuppers, M; Stärk, K D C; Adkin, A

2018-05-01

We present a novel approach of using the multi-criteria pathogen prioritisation methodology as a basis for selecting the most appropriate case studies for a generic risk assessment framework. The approach uses selective criteria to rank exotic animal health pathogens according to the likelihood of introduction and the impact of an outbreak if it occurred in the European Union (EU). Pathogens were evaluated based on their impact on production at the EU level and international trade. A subsequent analysis included criteria of relevance to quantitative risk assessment case study selection, such as the availability of data for parameterisation, the need for further research and the desire for the case studies to cover different routes of transmission. The framework demonstrated is flexible with the ability to adjust both the criteria and their weightings to the user's requirements. A web based tool has been developed using the RStudio shiny apps software, to facilitate this. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

An Exploratory Analysis for the Selection and Implementation of Advanced Manufacturing Technology by Fuzzy Multi-criteria Decision Making Methods: A Comparative Study

NASA Astrophysics Data System (ADS)

Nath, Surajit; Sarkar, Bijan

2017-08-01

Advanced Manufacturing Technologies (AMTs) offer opportunities for the manufacturing organizations to excel their competitiveness and in turn their effectiveness in manufacturing. Proper selection and evaluation of AMTs is the most significant task in today's modern world. But this involves a lot of uncertainty and vagueness as it requires many conflicting criteria to deal with. So the task of selection and evaluation of AMTs becomes very tedious for the evaluators as they are not able to provide crisp data for the criteria. Different Fuzzy Multi-criteria Decision Making (MCDM) methods help greatly in dealing with this problem. This paper focuses on the application of two very much potential Fuzzy MCDM methods namely COPRAS-G, EVAMIX and a comparative study between them on some rarely mentioned criteria. Each of the two methods is very powerful evaluation tool and has beauty in its own. Although, performance wise these two methods are almost at same level, but, the approach of each one of them are quite unique. This uniqueness is revealed by introducing a numerical example of selection of AMT.

Elective percutaneous coronary intervention without on-site surgical backup: a community hospital experience.

PubMed

Djelmami-Hani, M; Mouanoutoua, Mouatou; Hashim, Abdelazim; Solis, Joaquin; Bergen, Lawrence; Oldridge, Neil; Egbujiobi, Leo C; Allaqaband, Suhail; Akhtar, Masood; Bajwa, Tanvir

2007-12-01

The American College of Cardiology guidelines consider elective percutaneous coronary intervention (PCI) without on-site surgical backup (OSB) a Class-III indication. Our objective was to determine the safety of elective PCI without OSB. The study is a prospective analysis of a cohort of patients who underwent elective PCI without OSB at our institution. All patients were at our community satellite institution in Beloit, Wis. Three hundred twenty-one elective interventions were performed (mean age 64 +/-12, 68% male). The prevalence of diabetes and hypertension was 28% and 82.5% respectively. A predefined protocol was designed to transfer patients to a cardiac surgical facility if necessary. An experienced interventional cardiologist reviewed the diagnostic angiograms. Patients with complex lesions were excluded from the study. Any procedure-related death or emergency coronary artery bypass graft surgery. Three hundred eighty-two vessels were stented. Multi-vessel intervention was performed in 61 patients (19%). Only 5% of lesions were type C. Four hundred thirty-seven stents were deployed. IIb-IIIa inhibitors were used in 77 (24%) cases. Procedural success was 99.7%. There were no deaths, myocardial infarctions nor need for urgent target vessel revascularization at 6 months. With careful patient/lesion selection, an experienced interventional cardiologist and a predefined transfer protocol, elective PCI without OSB can be performed safely.

New GES DISC Services Shortening the Path in Science Data Discovery

NASA Technical Reports Server (NTRS)

Li, Angela; Shie, Chung-Lin; Petrenko, Maksym; Hegde, Mahabaleshwa; Teng, William; Liu, Zhong; Bryant, Keith; Shen, Suhung; Hearty, Thomas; Wei, Jennifer;

You're Hired! A Study Investigating Selection Practices for High School Teachers and the High School Principals' Role in Decision-Making

ERIC Educational Resources Information Center

Mulieri, Vincent K.

2010-01-01

The purpose of this study was to investigate teacher selection practices in public high schools on Long Island, New York. More specifically, this study sought to identify criteria used to guide teacher selection, how the criteria are developed and used within the process, and the role of the principal in teacher selection. This research was…

Interface between hospital and fire authorities--a concept for management of incidents in hospitals.

PubMed

Gretenkort, Peter; Harke, Henning; Blazejak, Jan; Pache, Bernd; Leledakis, Georgios

2002-01-01

Although every hospital needs a security plan for the support of immobile patients who do not possess autonomous escape capabilities, little information exists to assist in the development of practical patient evacuation methods. 1) In hospitals during disasters, incident leadership of the fire authorities can be supported effectively by hospital executives experienced in the management of mass casualties; and 2) As an alternative for canvas carry sheets, rescue drag sheets can be employed for emergency, elevator-independent, patient evacuation. A hospital evacuation exercise was planned and performed to obtain experiences in incident command and to permit calculation of elevator-independent patient transport times. Performance of incident leadership was observed by means of pre-defined checklists. The effectiveness and efficiency of carrying teams with five persons each were compared to those with a rescue drag sheet employed by a single person. Incident command for hospitals during a disaster is enhanced considerably by pre-defined and trained executives who are placed at the immediate disposal of the fire authorities. For elevator-independent patient transport, the rescue drag sheet was superior to conventional carrying measures because of a reduced number of transport personnel required to move each patient. With this method, patient transport times averaged 54 m/min. flat and 18 seconds for one floor descent. Experiences from a hospital during an evacuation exercise provided decision criteria for changes in the disaster preparedness plan. Hospital incident leadership was assigned to executives-in-charge in close co-operation with the fire authorities. All beds were equipped with a rescue drag sheet. Both concepts may help to cope with an emergency evacuation of a hospital.

Evidence of a locus for schizophrenia and related disorders on the short arm of chromosome 5 in a large pedigree

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

Silverman, J.M.; Altstiel, L.D.; Siever, L.J.

We attempted to identify a locus for schizophrenia and related disorders in 24 nuclear families of schizophrenic probands using a predefined classification system for affected cases that included those disorders most clearly identified as sharing a genetic relationship with schizophrenia-schizoaffective disorder and schizotypal personality disorder. Initially, we evaluated 8 markers on chromosome 5 on the first 12 families with available genotyping and diagnostic assessments and, assuming autosomal dominant transmission, found a lod score of 2.67 for the D5S111 locus (5p14.1-13.1) in one large nuclear family (no. 17; sibship: n = 12; schizophrenia: n = 3; schizotypal personality disorder: n =more » 2); the other 11 families were much smaller, less complete, and provided little additional information. Other branches of no. 17 were then assessed and the 2-point lod score for family 17 rose to 3.72; using multipoint analysis the lod score in 17 was 4.37. When only schizophrenia was used to define affectedness, the positive evidence for linkage to D5S111 was greatly reduced. Sensitivity analysis indicated that the lod score is heavily dependent upon the predefined diagnostic criteria. Our studies of other families of schizophrenic probands eventually totalled 23, but linkage to D5S111 in these yielded a -2.41 lod score. The results provide evidence for genetic linkage of the D5S111 locus to schizophrenia and related disorders in one family. It may be of interest that over several generations, almost all the ancestors of family 17 could be traced back to a small, relatively isolated, hill region of Puerto Rico. 74 refs., 2 figs., 2 tabs.« less

Temsirolimus in women with platinum-refractory/resistant ovarian cancer or advanced/recurrent endometrial carcinoma. A phase II study of the AGO-study group (AGO-GYN8).

PubMed

Emons, Günter; Kurzeder, Christian; Schmalfeldt, Barbara; Neuser, Petra; de Gregorio, Nikolaus; Pfisterer, Jacobus; Park-Simon, Tjoung-Won; Mahner, Sven; Schröder, Willibald; Lück, Hans-Joachim; Heubner, Martin Leonhard; Hanker, Lars; Thiel, Falk; Hilpert, Felix

2016-03-01

To evaluate activity and toxicity of mTOR inhibitor temsirolimus in patients with platinum-refractory/resistant ovarian cancer (OC) or advanced/recurrent endometrial carcinoma (EC). Women with epithelial ovarian, fallopian tube or primary peritoneal cancer were eligible, when they had progression during treatment with a platinum based regimen or within 6 months after receiving a platinum based regimen and a previous taxane treatment. Women with advanced/recurrent EC, no longer amenable to curative surgery and/or radiotherapy were eligible when they had no previous or only adjuvant chemotherapy. Preceding endocrine therapy for metastatic/recurrent disease was allowed. Patients received weekly IV infusions of 25mg temsirolimus. Primary endpoint was progression free survival rate after 4 months (OC) or 6 months (EC). A two stage design was applied. Forty-four patients (OC: n=22; EC: n=22) were enrolled and received temsirolimus treatment. Median age was 56 years (OC) or 63 years (EC). After eight weeks of treatment, 10 of 21 evaluable patients in the OC cohort and 8 of 20 evaluable patients in the EC cohort had progressive disease. Thus efficacy did not meet the predefined levels during the first stage of recruitment and the trial was stopped. Some patients in both cohorts had long lasting PFS (>7 months). Toxicity of temsirolimus was mild. Temsirolimus treatment was well tolerated in our patients, but did not meet the predefined efficacy criteria. In our study as in other trials on rapalogs in OC or EC, a few patients had long lasting disease stabilisations. Copyright © 2015. Published by Elsevier Inc.

Objective Evidence of Reflux Control After Magnetic Sphincter Augmentation: One Year Results From a Post Approval Study.

PubMed

Louie, Brian E; Smith, C Daniel; Smith, Christopher C; Bell, Reginald C W; Gillian, George Kevin; Mandel, Jeffrey S; Perry, Kyle A; Birkenhagen, Walter Kurt; Taiganides, Paul A; Dunst, Christy M; McCollister, Howard M; Lipham, John C; Khaitan, Leena K; Tsuda, Shawn T; Jobe, Blair A; Kothari, Shanu N; Gould, Jon C

2018-04-24

To report 1-year results from a 5-year mandated study. In 2012, the United States Food and Drug Administration approved magnetic sphincter augmentation (MSA) with the LINX Reflux Management System (Torax Medical, Shoreview, MN), a novel device for the surgical treatment of gastroesophageal reflux disease (GERD). Continued assessment of safety and effectiveness has been monitored in a Post Approval Study. Multicenter, prospective study of patients with pathologic acid reflux confirmed by esophageal pH testing undergoing MSA. Predefined clinical outcomes were assessed at the annual visit including a validated, disease-specific questionnaire, esophagogastricduodenoscopy and esophageal pH monitoring, and use of proton pump inhibitors. A total of 200 patients (102 males, 98 females) with a mean age of 48.5 years (range 19.7-71.6) were treated with MSA between March 2013 and August 2015. At 1 year, the mean total acid exposure time decreased from 10.0% at baseline to 3.6%, and 74.4% of patients had normal esophageal acid exposure time (% time pH<4 ≤5.3%). GERD Health-Related Quality of Life scores improved from a median score of 26.0 at baseline to 4.0 at 1 year, with 84% of patients meeting the predefined success criteria of at least a 50% reduction in total GERD Health-Related Quality of Life score compared with baseline. The device removal rate at 1 year was 2.5%. One erosion and no serious adverse events were reported. Safety and effectiveness of magnetic sphincter augmentation has been demonstrated outside of an investigational setting to further confirm MSA as treatment for GERD.

Interventions to reduce neonatal mortality from neonatal tetanus in low and middle income countries--a systematic review.

PubMed

Khan, Adeel Ahmed; Zahidie, Aysha; Rabbani, Fauziah

2013-04-09

In 1988, WHO estimated around 787,000 newborns deaths due to neonatal tetanus. Despite few success stories majority of the Low and Middle Income Countries (LMICs) are still struggling to reduce neonatal mortality due to neonatal tetanus. We conducted a systematic review to understand the interventions that have had a substantial effect on reducing neonatal mortality rate due to neonatal tetanus in LMICs and come up with feasible recommendations for decreasing neonatal tetanus in the Pakistani setting. We systemically reviewed the published literature (Pubmed and Pubget databases) to identify appropriate interventions for reducing tetanus related neonatal mortality. A total of 26 out of 30 studies were shortlisted for preliminary screening after removing overlapping information. Key words used were "neonatal tetanus, neonatal mortality, tetanus toxoid women". Of these twenty-six studies, 20 were excluded. The pre-defined exclusion criteria was (i) strategies and interventions to reduce mortality among neonates not described (ii) no abstract/author (4 studies) (iii) not freely accessible online (1 study) (iv) conducted in high income countries (2 studies) and (v) not directly related to neonatal tetanus mortality and tetanus toxoid immunization (5). Finally six studies which met the eligibility criteria were entered in the pre-designed data extraction form and five were selected for commentary as they were directly linked with neonatal tetanus reduction. Interventions that were identified to reduce neonatal mortality in LMICs were: a) vaccination of women of child bearing age (married and unmarried both) with tetanus toxoid b) community based interventions i.e. tetanus toxoid immunization for all mothers; clean and skilled care at delivery; newborn resuscitation; exclusive breastfeeding; umbilical cord care and management of infections in newborns c) supplementary immunization (in addition to regular EPI program) d) safer delivery practices. The key intervention to reduce neonatal mortality from neonatal tetanus was found to be vaccination of pregnant women with tetanus toxoid. In the resource poor countries like Pakistan, this single intervention coupled with regular effective antenatal checkups, clean delivery practices and compliance with the "high- risk" approach can be effective in reducing neonatal tetanus.

Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review.

PubMed

Martins, Júlia Caetano; Aguiar, Larissa Tavares; Nadeau, Sylvie; Scianni, Aline Alvim; Teixeira-Salmela, Luci Fuscaldi; Faria, Christina Danielli Coelho de Morais

2017-02-13

Self-report physical activity assessment tools are commonly used for the evaluation of physical activity levels in individuals with stroke. A great variety of these tools have been developed and widely used in recent years, which justify the need to examine their measurement properties and clinical utility. Therefore, the main objectives of this systematic review are to examine the measurement properties and clinical utility of self-report measures of physical activity and discuss the strengths and limitations of the identified tools. A systematic review of studies that investigated the measurement properties and/or clinical utility of self-report physical activity assessment tools in stroke will be conducted. Electronic searches will be performed in five databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed), Excerpta Medica Database (EMBASE), Physiotherapy Evidence Database (PEDro), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO), followed by hand searches of the reference lists of the included studies. Two independent reviewers will screen all retrieve titles, abstracts, and full texts, according to the inclusion criteria and will also extract the data. A third reviewer will be referred to solve any disagreement. A descriptive summary of the included studies will contain the design, participants, as well as the characteristics, measurement properties, and clinical utility of the self-report tools. The methodological quality of the studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and the clinical utility of the identified tools will be assessed considering predefined criteria. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. This systematic review will provide an extensive review of the measurement properties and clinical utility of self-report physical activity assessment tools used in individuals with stroke, which would benefit clinicians and researchers. PROSPERO CRD42016037146. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Interventions to reduce neonatal mortality from neonatal tetanus in low and middle income countries - a systematic review

PubMed Central

2013-01-01

Background In 1988, WHO estimated around 787,000 newborns deaths due to neonatal tetanus. Despite few success stories majority of the Low and Middle Income Countries (LMICs) are still struggling to reduce neonatal mortality due to neonatal tetanus. We conducted a systematic review to understand the interventions that have had a substantial effect on reducing neonatal mortality rate due to neonatal tetanus in LMICs and come up with feasible recommendations for decreasing neonatal tetanus in the Pakistani setting. Methods We systemically reviewed the published literature (Pubmed and Pubget databases) to identify appropriate interventions for reducing tetanus related neonatal mortality. A total of 26 out of 30 studies were shortlisted for preliminary screening after removing overlapping information. Key words used were “neonatal tetanus, neonatal mortality, tetanus toxoid women”. Of these twenty-six studies, 20 were excluded. The pre-defined exclusion criteria was (i) strategies and interventions to reduce mortality among neonates not described (ii) no abstract/author (4 studies) (iii) not freely accessible online (1 study) (iv) conducted in high income countries (2 studies) and (v) not directly related to neonatal tetanus mortality and tetanus toxoid immunization (5). Finally six studies which met the eligibility criteria were entered in the pre-designed data extraction form and five were selected for commentary as they were directly linked with neonatal tetanus reduction. Results Interventions that were identified to reduce neonatal mortality in LMICs were: a) vaccination of women of child bearing age (married and unmarried both) with tetanus toxoid b) community based interventions i.e. tetanus toxoid immunization for all mothers; clean and skilled care at delivery; newborn resuscitation; exclusive breastfeeding; umbilical cord care and management of infections in newborns c) supplementary immunization (in addition to regular EPI program) d) safer delivery practices. Conclusion The key intervention to reduce neonatal mortality from neonatal tetanus was found to be vaccination of pregnant women with tetanus toxoid. In the resource poor countries like Pakistan, this single intervention coupled with regular effective antenatal checkups, clean delivery practices and compliance with the “high- risk” approach can be effective in reducing neonatal tetanus. PMID:23570611

Optimizing otoacoustic emission protocols for a UNHS program.

PubMed

Hatzopoulos, S; Petruccelli, J; Ciorba, A; Martini, A

2009-01-01

To identify the optimal test protocol to screen for hearing problems in newborns, an evaluation of three distortion product otoacoustic emission (DPOAE) protocols was conducted in neonates, from a well-baby nursery (WBN) and from a neonatal intensive care unit (NICU) and compared to the performance in newborns of a more standard protocol based on transient-evoked OAEs (TEOAEs). The DPOAE protocols used asymmetrical stimulus intensities (L(1) > L(2)) with a frequency ratio of 1.22, in the following format: (P1), L(1) = 60, L(2) = 50 dB SPL; (P2), L(1) = 65, L(2) = 55 dB SPL, and (P3), L(1) = 75, L(2) = 65 dB SPL. Linear TEOAE responses, evoked by click stimuli of 75 dB peSPL, were used as controls of normal cochlear function. Five frequencies at 1.5, 2.0, 3.0, 4.0 and 5.0 kHz were tested with a common commercially available macro-based software subroutine (Otodynamics Corp, ILO-92). The project evaluated the responses from 1200 WBN infants (average age 48 h) and 350 low-birth-weight NICU infants, all randomly selected. Statistical analyses comparing the signal-to-noise ratios (S/N), at the predefined f(2) frequencies, indicated that the P1 and P2 DPOAE protocols generated similar responses. Significant S/N differences were observed in the P3 to P2 dataset comparisons. DPOAE scoring criteria were estimated from the P3 dataset using a one-sided, distribution-free confidence intervals. The scoring criteria for a 'pass' were estimated as a minimum S/N of 6.0, 7.0 and 6.0 dB at 2.0, 3.0 and 4.0 kHz, respectively. In terms of feasibility, the P3 protocol generated responses in 98% of the WBN and 94.8% of the NICU infants. All three DPOAE protocols demonstrated shorter time-recording requirements than the standard TEOAE test. The false-positive and false-negative rates for the NICU infants were estimated as 0.0028 and 0.003%, respectively.

Distraction osteogenesis as a treatment of obstructive sleep apnea syndrome

PubMed Central

Tsui, Wai Kin; Yang, Yanqi; Cheung, Lim Kwong; Leung, Yiu Yan

2016-01-01

Abstract Background: To conduct a systematic review to answer the clinical question “What are the effectiveness of mandibular distraction osteogenesis (MDO) and its complications to treat patients with obstructive sleep apnea syndrome (OSAS)?”. Methods: A systematic search including a computer search with specific keywords, reference list search, and manual search were done. Relevant articles on MDO were assessed and selected in 3 rounds for final review based on 5 predefined inclusion criteria and followed by a round of critical appraisal. Different types of distraction and their treatment outcomes of OSAS were recorded with standardized form and analyzed. Results: Twelve articles were included in the final review. A total of 256 patients aged 7 days to 60 years were treated with either external or internal MDO, with a mean follow-up period of 6 to 37 months. The average distraction distance of 12 to 29 mm was achieved with various distraction protocols. The success rate for adult patients was 100%, and cure rates were ranged from 82% to 100%. The definition of success or cure for OSAS in children or infants was not defined. Therefore, there were no clearly reported success or cure rates for children/infants in the included studies. However, all studies reported that these patients showed significant improvement in OSAS, with many of them who avoided tracheostomy or had the tracheostomy decannulated. The complication rates were ranged from 0% to 21.4%, with most being from local wound infections or neurosensory disturbances. Conclusion: This systematic review showed that MDO was effective in resolving OSAS in adults with retrognathic mandible. MDO also showed promising results in infants or children with OSAS. From the results of this systematic review, we recommend to define the criteria of success or cure for OSAS surgery in children and infants. We also recommend setting up randomized controlled trials to compare MDO with traditional maxillomandibular advancement surgery for OSAS patients and to provide a better evidence on the success and complication rates of the techniques. PMID:27603361

Calcium supplementation for the prevention of colorectal adenomas: A systematic review and meta-analysis of randomized controlled trials.

PubMed

Bonovas, Stefanos; Fiorino, Gionata; Lytras, Theodore; Malesci, Alberto; Danese, Silvio

2016-05-14

To determine the efficacy of calcium supplementation in reducing the recurrence of colorectal adenomas. We conducted a systematic review and meta-analysis of published studies. We searched PubMed, Scopus, the Cochrane Library, the WHO International Clinical Trials Registry Platform, and the ClinicalTrials.gov website, through December 2015. Randomized, placebo-controlled trials assessing supplemental calcium intake for the prevention of recurrence of adenomas were eligible for inclusion. Two reviewers independently selected studies based on predefined criteria, extracted data and outcomes (recurrence of colorectal adenomas, and advanced or "high-risk" adenomas), and rated each trial's risk-of-bias. Between-study heterogeneity was assessed, and pooled risk ratio (RR) estimates with their 95% confidence intervals (95%CI) were calculated using fixed- and random-effects models. To express the treatment effect in clinical terms, we calculated the number needed to treat (NNT) to prevent one adenoma recurrence. We also assessed the quality of evidence using GRADE. Four randomized, placebo-controlled trials met the eligibility criteria and were included. Daily doses of elemental calcium ranged from 1200 to 2000 mg, while the duration of treatment and follow-up of participants ranged from 36 to 60 mo. Synthesis of intention-to-treat data, for participants who had undergone follow-up colonoscopies, indicated a modest protective effect of calcium in prevention of adenomas (fixed-effects, RR = 0.89, 95%CI: 0.82-0.96; random-effects, RR = 0.87, 95%CI: 0.77-0.98; high quality of evidence). The NNT was 20 (95%CI: 12-61) to prevent one colorectal adenoma recurrence within a period of 3 to 5 years. On the other hand, the association between calcium treatment and advanced adenomas did not reach statistical significance (fixed-effects, RR = 0.92, 95%CI: 0.75-1.13; random-effects, RR = 0.92, 95%CI: 0.71-1.18; moderate quality of evidence). Our results suggest a modest chemopreventive effect of calcium supplements against recurrent colorectal adenomas over a period of 36 to 60 mo. Further research is warranted.

Calcium supplementation for the prevention of colorectal adenomas: A systematic review and meta-analysis of randomized controlled trials

PubMed Central

Bonovas, Stefanos; Fiorino, Gionata; Lytras, Theodore; Malesci, Alberto; Danese, Silvio

2016-01-01

AIM: To determine the efficacy of calcium supplementation in reducing the recurrence of colorectal adenomas. METHODS: We conducted a systematic review and meta-analysis of published studies. We searched PubMed, Scopus, the Cochrane Library, the WHO International Clinical Trials Registry Platform, and the ClinicalTrials.gov website, through December 2015. Randomized, placebo-controlled trials assessing supplemental calcium intake for the prevention of recurrence of adenomas were eligible for inclusion. Two reviewers independently selected studies based on predefined criteria, extracted data and outcomes (recurrence of colorectal adenomas, and advanced or “high-risk” adenomas), and rated each trial’s risk-of-bias. Between-study heterogeneity was assessed, and pooled risk ratio (RR) estimates with their 95% confidence intervals (95%CI) were calculated using fixed- and random-effects models. To express the treatment effect in clinical terms, we calculated the number needed to treat (NNT) to prevent one adenoma recurrence. We also assessed the quality of evidence using GRADE. RESULTS: Four randomized, placebo-controlled trials met the eligibility criteria and were included. Daily doses of elemental calcium ranged from 1200 to 2000 mg, while the duration of treatment and follow-up of participants ranged from 36 to 60 mo. Synthesis of intention-to-treat data, for participants who had undergone follow-up colonoscopies, indicated a modest protective effect of calcium in prevention of adenomas (fixed-effects, RR = 0.89, 95%CI: 0.82-0.96; random-effects, RR = 0.87, 95%CI: 0.77-0.98; high quality of evidence). The NNT was 20 (95%CI: 12-61) to prevent one colorectal adenoma recurrence within a period of 3 to 5 years. On the other hand, the association between calcium treatment and advanced adenomas did not reach statistical significance (fixed-effects, RR = 0.92, 95%CI: 0.75-1.13; random-effects, RR = 0.92, 95%CI: 0.71-1.18; moderate quality of evidence). CONCLUSION: Our results suggest a modest chemopreventive effect of calcium supplements against recurrent colorectal adenomas over a period of 36 to 60 mo. Further research is warranted. PMID:27182169

Bipolar Disorder and Early Affective Trauma.

PubMed

de Codt, Aloise; Monhonval, Pauline; Bongaerts, Xavier; Belkacemi, Ikram; Tecco, Juan Martin

2016-09-01

Bipolar disorder is a chronic psychiatric disease with a high prevalence and is a major psychosocial and medical burden. The exact etiological pathways of bipolar disorder are not fully understood. Genetic factors are known to play an important role in the etiology of bipolar disorder. However, high rates of discordance among identical twins and a growing body of evidence that environmental factors such as early stress can influence the onset and course of psychiatric diseases underline the importance of additional etiological mechanisms of bipolar disorders. There has been little investigation about early trauma in bipolar disorder. The aim of this study was to review the literature on the association between early traumatic interactions like child neglect, mistreatment, abuse or early parental separation and the occurrence of bipolar disorder in adulthood or impact on the course of the disease. Studies investigating associations between child neglect, mistreatment, abuse or early parental separation and occurrence of bipolar disorder in adulthood or impact on the course of the disease were searched in the Pubmed database. More than 700 articles were sorted independently by two of the authors using predefined criteria. Only research articles, reviews and meta-analyses were selected for this review. 53 articles met the inclusion criteria. To date, four systematic reviews partially addressed our research question. Early trauma is more frequently found in the past of bipolar patients than in the general population. Studies support a harmful effect of childhood trauma on the course of bipolar disease, with more anxious, depressive or psychotic symptoms, an early age of onset and a worse prognosis. Early trauma is more often found in the past of bipolar adult patients than the general population and studies support a harmful effect of childhood trauma on the course of bipolar disease, with more anxious, depressive or psychotic symptoms, an early age of onset and a worse prognosis. In further studies attention should be paid to the age of trauma occurrence and the definition of trauma. The findings also support the importance of additional psychoanalytic oriented psychotherapy for the treatment of bipolar disorder.

The effectiveness of theory- and model-based lifestyle interventions on HbA1c among patients with type 2 diabetes: a systematic review and meta-analysis.

PubMed

Doshmangir, P; Jahangiry, L; Farhangi, M A; Doshmangir, L; Faraji, L

2018-02-01

The prevalence of type 2 diabetes is rising rapidly around the world. A number of systematic reviews have provided evidence for the effectiveness of lifestyle interventions on diabetic patients. The effectiveness of theory- and model-based education-lifestyle interventions for diabetic patients are unclear. The systematic review and meta-analysis aimed to evaluate and quantify the impact of theory-based lifestyle interventions on type 2 diabetes. A literature search of authentic electronic resources including PubMed, Scopus, and Cochrane collaboration was performed to identify published papers between January 2002 and July 2016. The PICOs (participants, intervention, comparison, and outcomes) elements were used for the selection of studies to meet the inclusion and exclusion criteria. Mean differences and standard deviations of hemoglobin A1c (HbA1c [mmol/mol]) level in baseline and follow-up measures of studies in intervention and control groups were considered for data synthesis. A random-effects model was used for estimating pooled effect sizes. To investigate the source of heterogeneity, predefined subgroup analyses were performed using trial duration, baseline HbA1c (mmol/mol) level, and the age of participants. Meta-regression was performed to examine the contribution of trial duration, baseline HbA1c (mmol/mol) level, the age of participants, and mean differences of HbA1c (mmol/mol) level. The significant level was considered P < 0.05. Eighteen studies with 2384 participants met the inclusion criteria. The pooled main outcomes by random-effects model showed significant improvements in HbA1c (mmol/mol) -5.35% (95% confidence interval = -6.3, -4.40; P < 0.001) with the evidence of heterogeneity across studies. The findings of this meta-analysis suggest that theory- and model-based lifestyle interventions have positive effects on HbA1c (mmol/mol) indices in patients with type 2 diabetes. Health education theories have been applied as a useful tool for lifestyle change among people with type 2 diabetes. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The Impact of Timing of Antibiotics on Outcomes in Severe Sepsis and Septic Shock: A Systematic Review and Meta-analysis

PubMed Central

Sterling, Sarah A.; Miller, W. Ryan; Pryor, Jason; Puskarich, Michael A.; Jones, Alan E.

2015-01-01

Objectives We sought to systematically review and meta-analyze the available data on the association between timing of antibiotic administration and mortality in severe sepsis and septic shock. Data Sources and Study Selection A comprehensive search was performed using a pre-defined protocol. Inclusion criteria: adult patients with severe sepsis or septic shock, reported time to antibiotic administration in relation to ED triage and/or shock recognition, and mortality. Exclusion criteria: immunosuppressed populations, review article, editorial, or non-human studies. Data Extraction Two reviewers screened abstracts with a third reviewer arbitrating. The effect of time to antibiotic administration on mortality was based on current guideline recommendations: 1) administration within 3 hours of ED triage; 2) administration within 1 hour of severe sepsis/septic shock recognition. Odds Ratios (OR) were calculated using a random effect model. The primary outcome was mortality. Data Synthesis 1123 publications were identified and 11 were included in the analysis. Among the 11 included studies, 16,178 patients were evaluable for antibiotic administration from ED triage. Patients who received antibiotics more than 3 hours after ED triage (< 3 hours reference), had a pooled OR for mortality of 1.16 (0.92 to 1.46, p = 0.21). A total of 11,017 patients were evaluable for antibiotic administration from severe sepsis/septic shock recognition. Patients who received antibiotics more than 1 hour after severe sepsis/shock recognition (< 1 hour reference) had a pooled OR for mortality of 1.46 (0.89 to 2.40, p = 0.13). There was no increased mortality in the pooled ORs for each hourly delay from <1 to >5 hours in antibiotic administration from severe sepsis/shock recognition. Conclusion Using the available pooled data we found no significant mortality benefit of administering antibiotics within 3 hours of ED triage or within 1 hour of shock recognition in severe sepsis and septic shock. These results suggest that currently recommended timing metrics as measures of quality of care are not supported by the available evidence. PMID:26121073

Co-occurrence of Pain Symptoms and Somatosensory Sensitivity in Burning Mouth Syndrome: A Systematic Review

PubMed Central

Moisset, Xavier; Calbacho, Valentina; Torres, Pilar; Gremeau-Richard, Christelle; Dallel, Radhouane

2016-01-01

Background Burning mouth syndrome (BMS) is a chronic and spontaneous oral pain with burning quality in the tongue or other oral mucosa without any identifiable oral lesion or laboratory finding. Pathogenesis and etiology of BMS are still unknown. However, BMS has been associated with other chronic pain syndromes including other idiopathic orofacial pain, the dynias group and the family of central sensitivity syndromes. This would imply that BMS shares common mechanisms with other cephalic and/or extracephalic chronic pains. The primary aim of this systematic review was to determine whether BMS is actually associated with other pain syndromes, and to analyze cephalic and extracephalic somatosensory sensitivity in these patients. Methods This report followed the PRISMA Statement. An electronic search was performed until January 2015 in PubMed, Cochrane library, Wiley and ScienceDirect. Searched terms included “burning mouth syndrome OR stomatodynia OR glossodynia OR burning tongue OR oral burning”. Studies were selected according to predefined inclusion criteria (report of an association between BMS and other pain(s) symptoms or of cutaneous cephalic and/or extracephalic quantitative sensory testing in BMS patients), and a descriptive analysis conducted. Results The search retrieved 1512 reports. Out of these, twelve articles met criteria for co-occurring pain symptoms and nine studies for quantitative sensory testing (QST) in BMS patients. The analysis reveals that in BMS patients co-occurring pain symptoms are rare, assessed by only 0.8% (12 of 1512) of the retrieved studies. BMS was associated with headaches, TMD, atypical facial pain, trigeminal neuralgia, post-herpetic facial pain, back pain, fibromyalgia, joint pain, abdominal pain, rectal pain or vulvodynia. However, the prevalence of pain symptoms in BMS patients is not different from that in the age-matched general population. QST studies reveal no or inconsistent evidence of abnormal cutaneous cephalic and extracephalic somatosensory sensitivity. Conclusions There is no evidence for a high rate of other pain symptoms or somatosensory impairments co-occurring with BMS. These results thus suggest that BMS rather depends on specific mechanisms, likely at the trigeminal level. Nevertheless, more thoroughly conducted research is required to draw definitive conclusion. PMID:27657531

Characterizing the Role of U.S. Surgeons in the Provision of Palliative Care: A Systematic Review and Mixed-Methods Meta-Synthesis.

PubMed

Suwanabol, Pasithorn A; Kanters, Arielle E; Reichstein, Ari C; Wancata, Lauren M; Dossett, Lesly A; Rivet, Emily B; Silveira, Maria J; Morris, Arden M

2018-04-01

The provision of palliative care varies appropriately by clinical factors such as patient age and severity of disease and also varies by provider practice and specialty. Surgical patients are persistently less likely to receive palliative care than their medical counterparts for reasons that are not clear. We sought to characterize surgeon-specific determinants of palliative care in seriously ill and dying patients. We performed a systematic review of the literature focused on surgery and palliative care within PubMed, CINAHL, EMBASE, Scopus, and Ovid Medline databases from January 1, 2000 through December 31, 2016 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Quantitative and qualitative studies with primary data evaluating surgeons' attitudes, knowledge, and behaviors or experiences in care for seriously ill and dying patients were selected for full review by at least two study team members based on predefined inclusion criteria. Data were extracted based on a predetermined instrument and compared across studies using thematic analysis in a meta-synthesis of qualitative and quantitative findings. A total of 2589 abstracts were identified and screened, and 35 articles (26 quantitative and nine qualitative) fulfilled criteria for full review. Among these, 17 articles explored practice and attitudes of surgeons regarding palliative and end-of-life care, 11 articles assessed training in palliative care, five characterized surgical decision making, one described behaviors of surgeons caring for seriously ill and dying patients, and one explicitly identified barriers to use of palliative care. Four major themes across studies affected receipt of palliative care for surgical patients: 1) surgeons' experience and knowledge, 2) surgeons' attitudes, 3) surgeons' preferences and decision making for treatment, and 4) perceived barriers. Among the articles reviewed, surgeons overall demonstrated insight into the benefits of palliative care but reported limited knowledge and comfort as well as a multitude of challenges to introducing palliative care to their patients. These findings indicate a need for wider implementation of strategies that allow optimal integration of palliative care with surgical decision making. Published by Elsevier Inc.

Criteria Utilized by College-Educated Women to Select Newspaper Science News.

ERIC Educational Resources Information Center

Dunwoody, Sharon

In an attempt to identify criteria used by readers to select science news, a homogeneous group of women in the Philadelphia area was asked to indicate which of 48 science-news statements they would be interested in reading in their newspapers. The statements were condensed from stories selected from Philadelphia newspapers over a…

Image Analyzed by Mars Rover for Selection of Target

NASA Image and Video Library

2010-03-23

NASA Opportunity used newly developed and uploaded software called AEGIS, to analyze images to identify features that best matched criteria for selecting an observation target; the criteria in this image -- rocks that are larger and darker than others.

75 FR 9574 - Caribbean Trade Mission

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-03

...; Hotel & Restaurant Equipment; Medical Equipment & Supplies; Automotive Parts & Accessories; and... apply to the program, and once accepted (see `Criteria for Participant Selection') will work with the... conditions and best satisfy the selection criteria as outlined below. Target recruitment for the Trade...

Diffusion of Educational Knowledge Through Journals: Gatekeepers' Selection Criteria

ERIC Educational Resources Information Center

Silverman, Robert J.

1978-01-01

Report is made of a survey of 248 editors representing scholarly, professional, association, and research journals in regard to their editorial role, criteria for accepting or rejecting manuscripts, and selection of editorial boards and reviewers. (Author/MJB)

45 CFR 1232.11 - Employment and volunteer selection criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Employment and volunteer selection criteria. 1232.11 Section 1232.11 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR... that impair sensory, manual, or speaking skills. ...

45 CFR 1232.11 - Employment and volunteer selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Employment and volunteer selection criteria. 1232.11 Section 1232.11 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR... that impair sensory, manual, or speaking skills. ...

Dermatology Residency Selection Criteria with an Emphasis on Program Characteristics: A National Program Director Survey

PubMed Central

Gorouhi, Farzam; Alikhan, Ali; Rezaei, Arash; Fazel, Nasim

2014-01-01

Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors' (PDs') perception based on specific program demographics. Methods. This cross-sectional nationwide observational survey utilized a 41-item questionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, and K-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs' perception regarding the importance of the selection criteria based on program demographics. Results. Ninety-five out of 114 PDs (83.3%) responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: “advanced degrees,” “interest in academics,” “reputation of undergraduate and medical school,” “prior unsuccessful attempts to match,” and “number of publications.” Conclusions. Our survey provides up-to-date factual data on dermatology PDs' perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process. PMID:24772165

Orthogonal Array Testing for Transmit Precoding based Codebooks in Space Shift Keying Systems

NASA Astrophysics Data System (ADS)

Al-Ansi, Mohammed; Alwee Aljunid, Syed; Sourour, Essam; Mat Safar, Anuar; Rashidi, C. B. M.

2018-03-01

In Space Shift Keying (SSK) systems, transmit precoding based codebook approaches have been proposed to improve the performance in limited feedback channels. The receiver performs an exhaustive search in a predefined Full-Combination (FC) codebook to select the optimal codeword that maximizes the Minimum Euclidean Distance (MED) between the received constellations. This research aims to reduce the codebook size with the purpose of minimizing the selection time and the number of feedback bits. Therefore, we propose to construct the codebooks based on Orthogonal Array Testing (OAT) methods due to their powerful inherent properties. These methods allow to acquire a short codebook where the codewords are sufficient to cover almost all the possible effects included in the FC codebook. Numerical results show the effectiveness of the proposed OAT codebooks in terms of the system performance and complexity.

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

Honorio, J.; Goldstein, R.; Honorio, J.

We propose a simple, well grounded classification technique which is suited for group classification on brain fMRI data sets that have high dimensionality, small number of subjects, high noise level, high subject variability, imperfect registration and capture subtle cognitive effects. We propose threshold-split region as a new feature selection method and majority voteas the classification technique. Our method does not require a predefined set of regions of interest. We use average acros ssessions, only one feature perexperimental condition, feature independence assumption, and simple classifiers. The seeming counter-intuitive approach of using a simple design is supported by signal processing and statisticalmore » theory. Experimental results in two block design data sets that capture brain function under distinct monetary rewards for cocaine addicted and control subjects, show that our method exhibits increased generalization accuracy compared to commonly used feature selection and classification techniques.« less

A Comparative Study of the Employee Skills/Training Acceptable to Employers Under Varying Degrees of Labor Market Stringencies. Final Report.

ERIC Educational Resources Information Center

Fisher, W. Halder; And Others

The purposes of this stud y were to test the dependability of stated employee selection criteria, to ascertain the degree of congruence between stated and actual selection criteria, and to determine the degree of change in criteria due to "looseness" or "tightness" of the local labor market. Seven test labor market areas representing a variety of…

Species-specific variation in nesting and postfledging resource selection for two forest breeding migrant songbirds.

PubMed

Jenkins, Julianna M A; Thompson, Frank R; Faaborg, John

2017-01-01

Habitat selection is a fundamental component of community ecology, population ecology, and evolutionary biology and can be especially important to species with complex annual habitat requirements, such as migratory birds. Resource preferences on the breeding grounds may change during the postfledging period for migrant songbirds, however, the degree to which selection changes, timing of change, and whether all or only a few species alter their resource use is unclear. We compared resource selection for nest sites and resource selection by postfledging juvenile ovenbirds (Seiurus aurocapilla) and Acadian flycatchers (Empidonax virescens) followed with radio telemetry in Missouri mature forest fragments from 2012-2015. We used Bayesian discrete choice modeling to evaluate support for local vegetation characteristics on the probability of selection for nest sites and locations utilized by different ages of postfledging juveniles. Patterns of resource selection variation were species-specific. Resource selection models indicated that Acadian flycatcher habitat selection criteria were similar for nesting and dependent postfledging juveniles and selection criteria diverged when juveniles became independent from adults. After independence, flycatcher resource selection was more associated with understory foliage density. Ovenbirds differed in selection criteria between the nesting and postfledging periods. Fledgling ovenbirds selected areas with higher densities of understory structure compared to nest sites, and the effect of foliage density on selection increased as juveniles aged and gained independence. The differences observed between two sympatric forest nesting species, in both the timing and degree of change in resource selection criteria over the course of the breeding season, illustrates the importance of considering species-specific traits and postfledging requirements when developing conservation efforts, especially when foraging guilds or prey bases differ. We recommend that postfledging habitat selection be considered in future conservation efforts dealing with Neotropical migrants and other forest breeding songbirds.

Clinical Criteria Versus a Possible Research Case Definition in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.

PubMed

Jason, Leonard A; McManimen, Stephanie; Sunnquist, Madison; Newton, Julia L; Strand, Elin Bolle

2017-01-01

The Institute of Medicine (IOM) recently developed clinical criteria for what had been known as chronic fatigue syndrome (CFS). Given the broad nature of the clinical IOM criteria, there is a need for a research definition that would select a more homogenous and impaired group of patients than the IOM clinical criteria. At the present time, it is unclear what will serve as the research definition. The current study focused on a research definition which selected homebound individuals who met the four IOM criteria, excluding medical and psychiatric co-morbidities. Our research criteria were compared to those participants meeting the IOM criteria. Those not meeting either of these criteria sets were placed in a separate group defined by 6 or more months of fatigue. Data analyzed were from the DePaul Symptom Questionnaire and the SF-36. Due to unequal sample sizes and variances, Welch's F tests and Games-Howell post hoc tests were conducted. Using a large database of over 1,000 patients from several countries, we found that those meeting a more restrictive research definition were even more impaired and more symptomatic than those meeting criteria for the other two groups. Deciding on a particular research case definition would allow researchers to select more comparable patient samples across settings, and this would represent one of the most significant methodologic advances for this field of study.

Report of the Paris consensus meeting on expanded criteria donors in liver transplantation.

PubMed

Durand, François; Renz, John F; Alkofer, Barbara; Burra, Patrizia; Clavien, Pierre-Alain; Porte, Robert J; Freeman, Richard B; Belghiti, Jacques

2008-12-01

Because of organ shortage and a constant imbalance between available organs and candidates for liver transplantation, expanded criteria donors are needed. Experience shows that there are wide variations in the definitions, selection criteria, and use of expanded criteria donors according to different geographic areas and different centers. Overall, selection criteria for donors have tended to be relaxed in recent years. Consensus recommendations are needed. This article reports the conclusions of a consensus meeting held in Paris in March 2007 with the contribution of experts from Europe, the United States, and Asia. Definitions of expanded criteria donors with respect to donor variables (including age, liver function tests, steatosis, infections, malignancies, and heart-beating versus non-heart-beating, among others) are proposed. It is emphasized that donor quality represents a continuum of risk rather than "good or bad." A distinction is made between donor factors that generate increased risk of graft failure and factors independent of graft function, such as transmissible infectious disease or donor-derived malignancy, that may preclude a good outcome. Updated data concerning the risks associated with different donor variables in different recipient populations are given. Recommendations on how to safely expand donor selection criteria are proposed.

Clustering and group selection of multiple criteria alternatives with application to space-based networks.

PubMed

Malakooti, Behnam; Yang, Ziyong

2004-02-01

In many real-world problems, the range of consequences of different alternatives are considerably different. In addition, sometimes, selection of a group of alternatives (instead of only one best alternative) is necessary. Traditional decision making approaches treat the set of alternatives with the same method of analysis and selection. In this paper, we propose clustering alternatives into different groups so that different methods of analysis, selection, and implementation for each group can be applied. As an example, consider the selection of a group of functions (or tasks) to be processed by a group of processors. The set of tasks can be grouped according to their similar criteria, and hence, each cluster of tasks to be processed by a processor. The selection of the best alternative for each clustered group can be performed using existing methods; however, the process of selecting groups is different than the process of selecting alternatives within a group. We develop theories and procedures for clustering discrete multiple criteria alternatives. We also demonstrate how the set of alternatives is clustered into mutually exclusive groups based on 1) similar features among alternatives; 2) ideal (or most representative) alternatives given by the decision maker; and 3) other preferential information of the decision maker. The clustering of multiple criteria alternatives also has the following advantages. 1) It decreases the set of alternatives to be considered by the decision maker (for example, different decision makers are assigned to different groups of alternatives). 2) It decreases the number of criteria. 3) It may provide a different approach for analyzing multiple decision makers problems. Each decision maker may cluster alternatives differently, and hence, clustering of alternatives may provide a basis for negotiation. The developed approach is applicable for solving a class of telecommunication networks problems where a set of objects (such as routers, processors, or intelligent autonomous vehicles) are to be clustered into similar groups. Objects are clustered based on several criteria and the decision maker's preferences.

In silico evolution of biochemical networks

NASA Astrophysics Data System (ADS)

Francois, Paul

2010-03-01

We use computational evolution to select models of genetic networks that can be built from a predefined set of parts to achieve a certain behavior. Selection is made with the help of a fitness defining biological functions in a quantitative way. This fitness has to be specific to a process, but general enough to find processes common to many species. Computational evolution favors models that can be built by incremental improvements in fitness rather than via multiple neutral steps or transitions through less fit intermediates. With the help of these simulations, we propose a kinetic view of evolution, where networks are rapidly selected along a fitness gradient. This mathematics recapitulates Darwin's original insight that small changes in fitness can rapidly lead to the evolution of complex structures such as the eye, and explain the phenomenon of convergent/parallel evolution of similar structures in independent lineages. We will illustrate these ideas with networks implicated in embryonic development and patterning of vertebrates and primitive insects.

Controlling the selective formation of calcium sulfate polymorphs at room temperature.

PubMed

Tritschler, Ulrich; Van Driessche, Alexander E S; Kempter, Andreas; Kellermeier, Matthias; Cölfen, Helmut

2015-03-23

Calcium sulfate is a naturally abundant and technologically important mineral with a broad scope of applications. However, controlling CaSO4 polymorphism and, with it, its final material properties still represents a major challenge, and to date there is no universal method for the selective production of the different hydrated and anhydrous forms under mild conditions. Herein we report the first successful synthesis of pure anhydrite from solution at room temperature. We precipitated calcium sulfate in alcoholic media at low water contents. Moreover, by adjusting the amount of water in the syntheses, we can switch between the distinct polymorphs and fine-tune the outcome of the reaction, yielding either any desired CaSO4 phase in pure state or binary mixtures with predefined compositions. This concept provides full control over phase selection in CaSO4 mineralization and may allow for the targeted fabrication of corresponding materials for use in various areas. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The application of fuzzy Delphi and fuzzy inference system in supplier ranking and selection

NASA Astrophysics Data System (ADS)

Tahriri, Farzad; Mousavi, Maryam; Hozhabri Haghighi, Siamak; Zawiah Md Dawal, Siti

2014-06-01

In today's highly rival market, an effective supplier selection process is vital to the success of any manufacturing system. Selecting the appropriate supplier is always a difficult task because suppliers posses varied strengths and weaknesses that necessitate careful evaluations prior to suppliers' ranking. This is a complex process with many subjective and objective factors to consider before the benefits of supplier selection are achieved. This paper identifies six extremely critical criteria and thirteen sub-criteria based on the literature. A new methodology employing those criteria and sub-criteria is proposed for the assessment and ranking of a given set of suppliers. To handle the subjectivity of the decision maker's assessment, an integration of fuzzy Delphi with fuzzy inference system has been applied and a new ranking method is proposed for supplier selection problem. This supplier selection model enables decision makers to rank the suppliers based on three classifications including "extremely preferred", "moderately preferred", and "weakly preferred". In addition, in each classification, suppliers are put in order from highest final score to the lowest. Finally, the methodology is verified and validated through an example of a numerical test bed.

New decision criteria for selecting delta check methods based on the ratio of the delta difference to the width of the reference range can be generally applicable for each clinical chemistry test item.

PubMed

Park, Sang Hyuk; Kim, So-Young; Lee, Woochang; Chun, Sail; Min, Won-Ki

2012-09-01

Many laboratories use 4 delta check methods: delta difference, delta percent change, rate difference, and rate percent change. However, guidelines regarding decision criteria for selecting delta check methods have not yet been provided. We present new decision criteria for selecting delta check methods for each clinical chemistry test item. We collected 811,920 and 669,750 paired (present and previous) test results for 27 clinical chemistry test items from inpatients and outpatients, respectively. We devised new decision criteria for the selection of delta check methods based on the ratio of the delta difference to the width of the reference range (DD/RR). Delta check methods based on these criteria were compared with those based on the CV% of the absolute delta difference (ADD) as well as those reported in 2 previous studies. The delta check methods suggested by new decision criteria based on the DD/RR ratio corresponded well with those based on the CV% of the ADD except for only 2 items each in inpatients and outpatients. Delta check methods based on the DD/RR ratio also corresponded with those suggested in the 2 previous studies, except for 1 and 7 items in inpatients and outpatients, respectively. The DD/RR method appears to yield more feasible and intuitive selection criteria and can easily explain changes in the results by reflecting both the biological variation of the test item and the clinical characteristics of patients in each laboratory. We suggest this as a measure to determine delta check methods.

77 FR 4553 - Proposed Revision to Selection Criteria-Enhanced Assessment Instruments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-30

... Selection Criteria--Enhanced Assessment Instruments AGENCY: Office of Elementary and Secondary Education, Department of Education. ACTION: Notice. SUMMARY: The Assistant Secretary for Elementary and Secondary..., Office of Elementary and Secondary Education (Attention: EAG Comments), U.S. Department of Education, 400...

Development of Selection Criteria and Their Application in Evaluation of CELSS Candidate Species

NASA Technical Reports Server (NTRS)

Hoff, J. E.; Howe, J. M.; Mitchell, C. A.

1982-01-01

A total of 21 criteria were considered; nine of them fall into the realm of human nutrition and convenience (the "use' criteria), and the remaining 12 are predominantly cultural considerations. Five criteria were considered to be of great importance in the selection of plant species and were given double eight relative to the remaining criteria. "Use' criteria include the following: energy concentration, nutritional composition, palatability, serving size and frequency, processing requirements, use flexibility, toxicity, and human experience. "Cultural' criteria include the following: proportion of edible biomass, yield of edible plant biomass, continuous vs. determinate harvestability, growth habit and morphology, environmental tolerance, photoperiodic and temperature requirements, symbiotic requirements and restrictions, carbon dioxide-light intensity response, suitability for soilless culture, disease resistance, familarity with species, and pollination and propagation. A total of 115 species were evaluated and scored according to suitability for a CELSS.

Best Practices and Processes for Choosing Research Priorities

NASA Astrophysics Data System (ADS)

Briscoe, M. G.

2015-12-01

Individuals, teams, departments, organizations, funding agencies, committees, and others all need to select desirable research priorities from many possible alternatives. One cannot do everything, one cannot afford everything, so what to select? Essays and reports since Weinberg (1963) have suggested criteria for choosing science topics. Popper et al (2000) reviewed and summarized all that had gone before in the subject of setting priorities; their main conclusions were that the underlying principles were the promotion of excellence and relevance. Sea Change (2015) from the NRC/OSB focused on four criteria. From most important to least important, they were transformative science, societal impacts, readiness, and partnership potential; these four criteria embodied the essence of the suggestions from Weinberg on, framed with the pragmatism of ORPISS (2007). Getting to the final set of priorities from many candidates involves a sequence of formal or informal processes, only the last of which is the application of the selected, weighted criteria. As developed by professional prioritization experts, the best-practice steps and processes are: Collection of input candidates from the community. Clustering and parsing/rephrasing of the input to eliminate redundancy and repetition and develop statements at a useful level of specificity. (NOTE:there is no counting of input to see how many times a particular topic was mentioned. The goal is diversity in the input, not a popularity contest.) Development of the selection criteria, and weighting the chosen criteria. Application of the selection criteria to the clustered/adjusted candidates. Finally, two more best practices: Do continuing sanity checks, to avoid losing sight of the goals of the effort. Resist the temptation to just sit around a table and talk about it to arrive at the priorities, which depends too much on who the specific members of the prioritization team are, and provides no transparency or explanation of why those specific priorities were selected.

Identifying and mitigating errors in satellite telemetry of polar bears

USGS Publications Warehouse

Arthur, Stephen M.; Garner, Gerald W.; Olson, Tamara L.

1998-01-01

Satellite radiotelemetry is a useful method of tracking movements of animals that travel long distances or inhabit remote areas. However, the logistical constraints that encourage the use of satellite telemetry also inhibit efforts to assess accuracy of the resulting data. To investigate effectiveness of methods that might be used to improve the reliability of these data, we compared 3 sets of criteria designed to select the most plausible locations of polar bears (Ursus maritimus) that were tracked using satellite radiotelemetry in the Bering, Chukchi, East Siberian, Laptev, and Kara seas during 1988-93. We also evaluated several indices of location accuracy. Our results suggested that, although indices could provide information useful in evaluating location accuracy, no index or set of criteria was sufficient to identify all the implausible locations. Thus, it was necessary to examine the data and make subjective decisions about which locations to accept or reject. However, by using a formal set of selection criteria, we simplified the task of evaluating locations and ensured that decisions were made consistently. This approach also enabled us to evaluate biases that may be introduced by the criteria used to identify location errors. For our study, the best set of selection criteria comprised: (1) rejecting locations for which the distance to the nearest other point from the same day was >50 km; (2) determining the highest accuracy code (NLOC) for a particular day and rejecting locations from that day with lesser values; and (3) from the remaining locations for each day, selecting the location closest to the location chosen for the previous transmission period. Although our selection criteria seemed unlikely to bias studies of habitat use or geographic distribution, basing selection decisions on distances between points might bias studies of movement rates or distances. It is unlikely that any set of criteria will be best for all situations; to make efficient use of data and minimize bias, these rules must be tailored to specific study objectives.

Multi-indication Pharmacotherapeutic Multicriteria Decision Analytic Model for the Comparative Formulary Inclusion of Proton Pump Inhibitors in Qatar.

PubMed

Al-Badriyeh, Daoud; Alabbadi, Ibrahim; Fahey, Michael; Al-Khal, Abdullatif; Zaidan, Manal

2016-05-01

The formulary inclusion of proton pump inhibitors (PPIs) in the government hospital health services in Qatar is not comparative or restricted. Requests to include a PPI in the formulary are typically accepted if evidence of efficacy and tolerability is presented. There are no literature reports of a PPI scoring model that is based on comparatively weighted multiple indications and no reports of PPI selection in Qatar or the Middle East. This study aims to compare first-line use of the PPIs that exist in Qatar. The economic effect of the study recommendations was also quantified. A comparative, evidence-based multicriteria decision analysis (MCDA) model was constructed to follow the multiple indications and pharmacotherapeutic criteria of PPIs. Literature and an expert panel informed the selection criteria of PPIs. Input from the relevant local clinician population steered the relative weighting of selection criteria. Comparatively scored PPIs, exceeding a defined score threshold, were recommended for selection. Weighted model scores were successfully developed, with 95% CI and 5% margin of error. The model comprised 7 main criteria and 38 subcriteria. Main criteria are indication, dosage frequency, treatment duration, best published evidence, available formulations, drug interactions, and pharmacokinetic and pharmacodynamic properties. Most weight was achieved for the indications selection criteria. Esomeprazole and rabeprazole were suggested as formulary options, followed by lansoprazole for nonformulary use. The estimated effect of the study recommendations was up to a 15.3% reduction in the annual PPI expenditure. Robustness of study conclusions against variabilities in study inputs was confirmed via sensitivity analyses. The implementation of a locally developed PPI-specific comparative MCDA scoring model, which is multiweighted indication and criteria based, into the Qatari formulary selection practices is a successful evidence-based cost-cutting exercise. Esomeprazole and rabeprazole should be the first-line choice from among the PPIs available at the Qatari government hospital health services. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

40 CFR 610.32 - Test fleet selection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Test fleet selection. 610.32 Section 610.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria Test Requirement Criteria § 610.32 Test...

40 CFR 610.32 - Test fleet selection.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Test fleet selection. 610.32 Section 610.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria Test Requirement Criteria § 610.32 Test...

40 CFR 610.32 - Test fleet selection.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Test fleet selection. 610.32 Section 610.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria Test Requirement Criteria § 610.32 Test...

40 CFR 610.32 - Test fleet selection.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Test fleet selection. 610.32 Section 610.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria Test Requirement Criteria § 610.32 Test...

40 CFR 610.32 - Test fleet selection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Test fleet selection. 610.32 Section 610.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY RETROFIT DEVICES Test Procedures and Evaluation Criteria Test Requirement Criteria § 610.32 Test...

28 CFR 34.3 - Selection criteria.

Code of Federal Regulations, 2013 CFR

2013-07-01

... achievement of project objectives; (4) The project management structure is adequate to the successful conduct....3 Selection criteria. (a) All individual project applications will, at a minimum, be subject to... to be addressed by the project is clearly stated; (2) The objectives of the proposed project are...

28 CFR 34.3 - Selection criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... achievement of project objectives; (4) The project management structure is adequate to the successful conduct....3 Selection criteria. (a) All individual project applications will, at a minimum, be subject to... to be addressed by the project is clearly stated; (2) The objectives of the proposed project are...

28 CFR 34.3 - Selection criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... achievement of project objectives; (4) The project management structure is adequate to the successful conduct....3 Selection criteria. (a) All individual project applications will, at a minimum, be subject to... to be addressed by the project is clearly stated; (2) The objectives of the proposed project are...

28 CFR 34.3 - Selection criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

... achievement of project objectives; (4) The project management structure is adequate to the successful conduct....3 Selection criteria. (a) All individual project applications will, at a minimum, be subject to... to be addressed by the project is clearly stated; (2) The objectives of the proposed project are...

32 CFR 903.3 - Selection criteria.

Code of Federal Regulations, 2013 CFR

2013-07-01

... must furnish a certified transcript from each high school or civilian preparatory school attended... Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE MILITARY TRAINING AND SCHOOLS AIR FORCE ACADEMY PREPARATORY SCHOOL § 903.3 Selection criteria. (a) Cadet candidates for the HQ USAFA/PL...

32 CFR 903.3 - Selection criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... must furnish a certified transcript from each high school or civilian preparatory school attended... Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE MILITARY TRAINING AND SCHOOLS AIR FORCE ACADEMY PREPARATORY SCHOOL § 903.3 Selection criteria. (a) Cadet candidates for the HQ USAFA/PL...

32 CFR 903.3 - Selection criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... must furnish a certified transcript from each high school or civilian preparatory school attended... Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE MILITARY TRAINING AND SCHOOLS AIR FORCE ACADEMY PREPARATORY SCHOOL § 903.3 Selection criteria. (a) Cadet candidates for the HQ USAFA/PL...

15 CFR 295.6 - Criteria for selection.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Criteria for selection. 295.6 Section 295.6 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS ADVANCED TECHNOLOGY...

15 CFR 295.6 - Criteria for selection.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false Criteria for selection. 295.6 Section 295.6 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS ADVANCED TECHNOLOGY...

15 CFR 295.6 - Criteria for selection.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false Criteria for selection. 295.6 Section 295.6 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NIST EXTRAMURAL PROGRAMS ADVANCED TECHNOLOGY...

44 CFR 150.4 - Nomination and selection criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Nomination and selection criteria. 150.4 Section 150.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY FIRE PREVENTION AND CONTROL PUBLIC SAFETY AWARDS TO PUBLIC SAFETY OFFICERS...

Selection criteria for internships in clinical neuropsychology.

PubMed

Ritchie, David; Odland, Anthony P; Ritchie, Abigail S; Mittenberg, Wiley

2012-01-01

Criteria used in the evaluation and selection of applicants for clinical neuropsychology internships were identified by a survey of programs that met guidelines for specialty training. The number of internships that offer training with specialization in clinical neuropsychology has more than doubled during the past 10 years. Supervising neuropsychologists from 75 programs replied to the survey, yielding a 72.8% response rate. Clinical experience in neuropsychological assessment, specialization in clinical neuropsychology during graduate education, personal interview, and letters of recommendation were reported to be the most salient selection criteria. Practica that provide experience with flexible or functional systems assessment approaches at university-affiliated or VA (U.S. Department of Veterans Affairs) medical centers and doctoral curricula that follow International Neuropsychological Society/Division 40 course guidelines, with teaching and supervision provided by neuropsychologists, were preferred prerequisites to internship. These results are consistent with selection criteria reported over a decade ago and indicate continued endorsement of the vertically integrated model of education and training outlined by the Houston Conference on Specialty Education and Training in Clinical Neuropsychology.

Selection Criteria for Patients With Chronic Ankle Instability in Controlled Research: A Position Statement of the International Ankle Consortium

PubMed Central

Gribble, Phillip A.; Delahunt, Eamonn; Bleakley, Christopher M.; Caulfield, Brian; Docherty, Carrie L.; Fong, Daniel Tik-Pui; Fourchet, François; Hertel, Jay; Hiller, Claire E.; Kaminski, Thomas W.; McKeon, Patrick O.; Refshauge, Kathryn M.; van der Wees, Philip; Vicenzino, William; Wikstrom, Erik A.

2014-01-01

ABSTRACT While research on chronic ankle instability (CAI) and awareness of its impact on society and health care systems has grown substantially in the last 2 decades, the inconsistency in participant or patient selection criteria across studies presents a potential obstacle to addressing the problem properly. This major gap within the literature limits the ability to generalize this evidence to the target patient population. Therefore, there is a need to provide standards for patient or participant selection criteria in research focused on CAI with justifications using the best available evidence. The International Ankle Consortium provides this position paper to present and discuss an endorsed set of selection criteria for patients with CAI based on the best available evidence to be used in future research and study designs. These recommendations will enhance the validity of research conducted in this clinical population with the end goal of bringing the research evidence to the clinician and patient. PMID:24377963

Proposed acceptance, qualification, and characterization tests for thin-film PV modules

NASA Technical Reports Server (NTRS)

Waddington, D.; Mrig, L.; Deblasio, R.; Ross, R.

1988-01-01

Details of a proposed test program for PV thin-film modules which the Department of Energy has directed the Solar Energy Research Institute (SERI) to prepare are presented. Results of one of the characterization tests that SERI has performed are also presented. The objective is to establish a common approach to testing modules that will be acceptable to both users and manufacturers. The tests include acceptance, qualification, and characterization tests. Acceptance tests verify that randomly selected modules have similar characteristics. Qualification tests are based on accelerated test methods designed to simulate adverse conditions. Characterization tests provide data on performance in a predefined environment.

Non-Cognitive Selected Students Do Not Outperform Lottery-Admitted Students in the Pre-Clinical Stage of Medical School

ERIC Educational Resources Information Center

Lucieer, Susanna M.; Stegers-Jager, Karen M.; Rikers, Remy M. J. P.; Themmen, Axel P. N.

2016-01-01

Medical schools all over the world select applicants using non-cognitive and cognitive criteria. The predictive value of these different types of selection criteria has however never been investigated within the same curriculum while using a control group. We therefore set up a study that enabled us to compare the academic performance of three…

A Primer for Model Selection: The Decisive Role of Model Complexity

NASA Astrophysics Data System (ADS)

Höge, Marvin; Wöhling, Thomas; Nowak, Wolfgang

2018-03-01

Selecting a "best" model among several competing candidate models poses an often encountered problem in water resources modeling (and other disciplines which employ models). For a modeler, the best model fulfills a certain purpose best (e.g., flood prediction), which is typically assessed by comparing model simulations to data (e.g., stream flow). Model selection methods find the "best" trade-off between good fit with data and model complexity. In this context, the interpretations of model complexity implied by different model selection methods are crucial, because they represent different underlying goals of modeling. Over the last decades, numerous model selection criteria have been proposed, but modelers who primarily want to apply a model selection criterion often face a lack of guidance for choosing the right criterion that matches their goal. We propose a classification scheme for model selection criteria that helps to find the right criterion for a specific goal, i.e., which employs the correct complexity interpretation. We identify four model selection classes which seek to achieve high predictive density, low predictive error, high model probability, or shortest compression of data. These goals can be achieved by following either nonconsistent or consistent model selection and by either incorporating a Bayesian parameter prior or not. We allocate commonly used criteria to these four classes, analyze how they represent model complexity and what this means for the model selection task. Finally, we provide guidance on choosing the right type of criteria for specific model selection tasks. (A quick guide through all key points is given at the end of the introduction.)

Accelerating rejection-based simulation of biochemical reactions with bounded acceptance probability

NASA Astrophysics Data System (ADS)

Thanh, Vo Hong; Priami, Corrado; Zunino, Roberto

2016-06-01

Stochastic simulation of large biochemical reaction networks is often computationally expensive due to the disparate reaction rates and high variability of population of chemical species. An approach to accelerate the simulation is to allow multiple reaction firings before performing update by assuming that reaction propensities are changing of a negligible amount during a time interval. Species with small population in the firings of fast reactions significantly affect both performance and accuracy of this simulation approach. It is even worse when these small population species are involved in a large number of reactions. We present in this paper a new approximate algorithm to cope with this problem. It is based on bounding the acceptance probability of a reaction selected by the exact rejection-based simulation algorithm, which employs propensity bounds of reactions and the rejection-based mechanism to select next reaction firings. The reaction is ensured to be selected to fire with an acceptance rate greater than a predefined probability in which the selection becomes exact if the probability is set to one. Our new algorithm improves the computational cost for selecting the next reaction firing and reduces the updating the propensities of reactions.

Accelerating rejection-based simulation of biochemical reactions with bounded acceptance probability

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

Thanh, Vo Hong, E-mail: vo@cosbi.eu; Priami, Corrado, E-mail: priami@cosbi.eu; Department of Mathematics, University of Trento, Trento

Stochastic simulation of large biochemical reaction networks is often computationally expensive due to the disparate reaction rates and high variability of population of chemical species. An approach to accelerate the simulation is to allow multiple reaction firings before performing update by assuming that reaction propensities are changing of a negligible amount during a time interval. Species with small population in the firings of fast reactions significantly affect both performance and accuracy of this simulation approach. It is even worse when these small population species are involved in a large number of reactions. We present in this paper a new approximatemore » algorithm to cope with this problem. It is based on bounding the acceptance probability of a reaction selected by the exact rejection-based simulation algorithm, which employs propensity bounds of reactions and the rejection-based mechanism to select next reaction firings. The reaction is ensured to be selected to fire with an acceptance rate greater than a predefined probability in which the selection becomes exact if the probability is set to one. Our new algorithm improves the computational cost for selecting the next reaction firing and reduces the updating the propensities of reactions.« less