Faculty Training in Evidence-Based Medicine: Improving Evidence Acquisition and Critical Appraisal

ERIC Educational Resources Information Center

Nicholson, Laura J.; Warde, Carole M.; Boker, John R.

2007-01-01

Introduction: Evidence-based medicine (EBM) integrates published clinical evidence with patient values and clinical expertise, the output of which is informed medical decision making. Key skills for evidence-based practice include acquisition and appraisal of clinical information. Faculty clinicians often lack expertise in these skills and are…

Value-based Proposition for a Dedicated Interventional Pulmonology Suite: an Adaptable Business Model.

PubMed

Desai, Neeraj R; French, Kim D; Diamond, Edward; Kovitz, Kevin L

2018-05-31

Value-based care is evolving with a focus on improving efficiency, reducing cost, and enhancing the patient experience. Interventional pulmonology has the opportunity to lead an effective value-based care model. This model is supported by the relatively low cost of pulmonary procedures and has the potential to improve efficiencies in thoracic care. We discuss key strategies to evaluate and improve efficiency in Interventional Pulmonology practice and describe our experience in developing an interventional pulmonology suite. Such a model can be adapted to other specialty areas and may encourage a more coordinated approach to specialty care. Copyright © 2018. Published by Elsevier Inc.

Assessing the quality of life history information in publicly available databases.

PubMed

Thorson, James T; Cope, Jason M; Patrick, Wesley S

2014-01-01

Single-species life history parameters are central to ecological research and management, including the fields of macro-ecology, fisheries science, and ecosystem modeling. However, there has been little independent evaluation of the precision and accuracy of the life history values in global and publicly available databases. We therefore develop a novel method based on a Bayesian errors-in-variables model that compares database entries with estimates from local experts, and we illustrate this process by assessing the accuracy and precision of entries in FishBase, one of the largest and oldest life history databases. This model distinguishes biases among seven life history parameters, two types of information available in FishBase (i.e., published values and those estimated from other parameters), and two taxa (i.e., bony and cartilaginous fishes) relative to values from regional experts in the United States, while accounting for additional variance caused by sex- and region-specific life history traits. For published values in FishBase, the model identifies a small positive bias in natural mortality and negative bias in maximum age, perhaps caused by unacknowledged mortality caused by fishing. For life history values calculated by FishBase, the model identified large and inconsistent biases. The model also demonstrates greatest precision for body size parameters, decreased precision for values derived from geographically distant populations, and greatest between-sex differences in age at maturity. We recommend that our bias and precision estimates be used in future errors-in-variables models as a prior on measurement errors. This approach is broadly applicable to global databases of life history traits and, if used, will encourage further development and improvements in these databases.

Factors influencing the robustness of P-value measurements in CT texture prognosis studies

NASA Astrophysics Data System (ADS)

McQuaid, Sarah; Scuffham, James; Alobaidli, Sheaka; Prakash, Vineet; Ezhil, Veni; Nisbet, Andrew; South, Christopher; Evans, Philip

2017-07-01

Several studies have recently reported on the value of CT texture analysis in predicting survival, although the topic remains controversial, with further validation needed in order to consolidate the evidence base. The aim of this study was to investigate the effect of varying the input parameters in the Kaplan-Meier analysis, to determine whether the resulting P-value can be considered to be a robust indicator of the parameter’s prognostic potential. A retrospective analysis of the CT-based normalised entropy of 51 patients with lung cancer was performed and overall survival data for these patients were collected. A normalised entropy cut-off was chosen to split the patient cohort into two groups and log-rank testing was performed to assess the survival difference of the two groups. This was repeated for varying normalised entropy cut-offs and varying follow-up periods. Our findings were also compared with previously published results to assess robustness of this parameter in a multi-centre patient cohort. The P-value was found to be highly sensitive to the choice of cut-off value, with small changes in cut-off producing substantial changes in P. The P-value was also sensitive to follow-up period, with particularly noisy results at short follow-up periods. Using matched conditions to previously published results, a P-value of 0.162 was obtained. Survival analysis results can be highly sensitive to the choice in texture cut-off value in dichotomising patients, which should be taken into account when performing such studies to avoid reporting false positive results. Short follow-up periods also produce unstable results and should therefore be avoided to ensure the results produced are reproducible. Previously published findings that indicated the prognostic value of normalised entropy were not replicated here, but further studies with larger patient numbers would be required to determine the cause of the different outcomes.

Determination of the biotin content of select foods using accurate and sensitive HPLC/avidin binding

PubMed Central

Staggs, C.G.; Sealey, W.M.; McCabe, B.J.; Teague, A.M.; Mock, D.M.

2006-01-01

Assessing dietary biotin content, biotin bioavailability, and resulting biotin status are crucial in determining whether biotin deficiency is teratogenic in humans. Accuracy in estimating dietary biotin is limited both by data gaps in food composition tables and by inaccuracies in published data. The present study applied sensitive and specific analytical techniques to determine values for biotin content in a select group of foods. Total biotin content of 87 foods was determined using acid hydrolysis and the HPLC/avidin-binding assay. These values are consistent with published values in that meat, fish, poultry, egg, dairy, and some vegetables are relatively rich sources of biotin. However, these biotin values disagreed substantially with published values for many foods. Assay values varied between 247 times greater than published values for a given food to as much as 36% less than the published biotin value. Among 51 foods assayed for which published values were available, only seven agreed within analytical variability (720%). We conclude that published values for biotin content of foods are likely to be inaccurate. PMID:16648879

p-Curve and p-Hacking in Observational Research

PubMed Central

Bruns, Stephan B.; Ioannidis, John P. A.

2016-01-01

The p-curve, the distribution of statistically significant p-values of published studies, has been used to make inferences on the proportion of true effects and on the presence of p-hacking in the published literature. We analyze the p-curve for observational research in the presence of p-hacking. We show by means of simulations that even with minimal omitted-variable bias (e.g., unaccounted confounding) p-curves based on true effects and p-curves based on null-effects with p-hacking cannot be reliably distinguished. We also demonstrate this problem using as practical example the evaluation of the effect of malaria prevalence on economic growth between 1960 and 1996. These findings call recent studies into question that use the p-curve to infer that most published research findings are based on true effects in the medical literature and in a wide range of disciplines. p-values in observational research may need to be empirically calibrated to be interpretable with respect to the commonly used significance threshold of 0.05. Violations of randomization in experimental studies may also result in situations where the use of p-curves is similarly unreliable. PMID:26886098

Development of estimates of dietary nitrates, nitrites, and nitrosamines for use with the Short Willet Food Frequency Questionnaire.

PubMed

Griesenbeck, John S; Steck, Michelle D; Huber, John C; Sharkey, Joseph R; Rene, Antonio A; Brender, Jean D

2009-04-06

Studies have suggested that nitrates, nitrites, and nitrosamines have an etiologic role in adverse pregnancy outcomes and chronic diseases such as cancer. Although an extensive body of literature exists on estimates of these compounds in foods, the extant data varies in quality, quantified estimates, and relevance. We developed estimates of nitrates, nitrites, and nitrosamines for food items listed in the Short Willet Food Frequency Questionnaire (WFFQ) as adapted for use in the National Birth Defects Prevention Study. Multiple reference databases were searched for published literature reflecting nitrate, nitrite, and nitrosamine values in foods. Relevant published literature was reviewed; only publications reporting results for items listed on the WFFQ were selected for inclusion. The references selected were prioritized according to relevance to the U.S. population. Based on our estimates, vegetable products contain the highest levels of nitrate, contributing as much as 189 mg/serving. Meat and bean products contain the highest levels of nitrites with values up to 1.84 mg/serving. Alcohol, meat and dairy products contain the highest values of nitrosamines with a maximum value of 0.531 microg/serving. The estimates of dietary nitrates, nitrites, and nitrosamines generated in this study are based on the published values currently available. To our knowledge, these are the only estimates specifically designed for use with the adapted WFFQ and generated to represent food items available to the U.S. population. The estimates provided may be useful in other research studies, specifically in those exploring the relation between exposure to these compounds in foods and adverse health outcomes.

The Influence of Academic Values on Scholarly Publication and Communication Practices. Research and Occasional Paper Series: CSHE.13.06

ERIC Educational Resources Information Center

Harley, Diane; Earl-Novell, Sarah; Arter, Jennifer; Lawrence, Shannon; King, C. Judson

2006-01-01

This study reports on five disciplinary case studies that explore academic value systems as they influence publishing behavior and attitudes of University of California, Berkeley faculty. The case studies are based on direct interviews with relevant stakeholders--faculty, advancement reviewers, librarians, and editors--in five fields: chemical…

Modeling global mangrove soil carbon stocks: filling the gaps in coastal environments

NASA Astrophysics Data System (ADS)

Rovai, A.; Twilley, R.

2017-12-01

We provide an overview of contemporaneous global mangrove soil organic carbon (SOC) estimates, focusing on a framework to explain disproportionate differences among observed data as a way to improve global estimates. This framework is based on a former conceptual model, the coastal environmental setting, in contrast to the more popular latitude-based hypotheses largely believed to explain hemispheric variation in mangrove ecosystem properties. To demonstrate how local and regional estimates of SOC linked to coastal environmental settings can render more realistic global mangrove SOC extrapolations we combined published and unpublished data, yielding a total of 106 studies, reporting on 552 sites from 43 countries. These sites were classified into distinct coastal environmental setting types according to two concurrent worldwide typology of nearshore coastal systems classifications. Mangrove SOC density varied substantially across coastal environmental settings, ranging from 14.9 ± 0.8 in river dominated (deltaic) soils to 53.9 ± 1.6 mg cm-3 (mean ± SE) in karstic coastlines. Our findings reveal striking differences between published values and contemporary global mangrove SOC extrapolation based on country-level mean reference values, particularly for karstic-dominated coastlines where mangrove SOC stocks have been underestimated by up to 50%. Correspondingly, climate-based global estimates predicted lower mangrove SOC density values (32-41 mg C cm-3) for mangroves in karstic environments, differing from published (21-126 mg C cm-3) and unpublished (47-58 mg C cm-3) values. Moreover, climate-based projections yielded higher SOC density values (27-70 mg C cm-3) for river-dominated mangroves compared to lower ranges reported in the literature (11-24 mg C cm-3). We argue that this inconsistent reporting of SOC stock estimates between river-dominated and karstic coastal environmental settings is likely due to the omission of geomorphological and geophysical environmental drivers, which control C storage in coastal wetlands. We encourage the science community more close utilize coastal environmental settings and new inventories of geomorphological typologies to build more robust estimates of local and regional estimates of SOC that can be extrapolated to global C estimates.

Tall Buildings Initiative

Science.gov Websites

Design Task 7 - Guidelines on Modeling and Acceptance Values Task 8 - Input Ground Motions for Tall - Performance-Based Seismic Design Guidelines for Tall Buildings Task 12 - Quantification of seismic performance published Report No. 2017/06 titled: "Guidelines for Performance-Based Seismic Design of Tall Buildings

Competence in chronic mental illness: the relevance of practical wisdom.

PubMed

Widdershoven, Guy A M; Ruissen, Andrea; van Balkom, Anton J L M; Meynen, Gerben

2017-06-01

The concept of competence is central to healthcare because informed consent can only be obtained from a competent patient. The standard approach to competence focuses on cognitive abilities. Several authors have challenged this approach by emphasising the role of emotions and values. Combining cognition, emotion and values, we suggest an approach which is based on the notion of practical wisdom. This focuses on knowledge and on determining what is important in a specific situation and finding a balance between various values, which are enacted in an individual's personal life. Our approach is illustrated by two cases of patients with obsessive-compulsive disorder. 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/.

Place-based planning: innovations and applications from four western forests.

Treesearch

Jennifer O. Farnum; Linda E. Kruger

2008-01-01

Place-based planning is an emergent method of public lands planning that aims to redefine the scale at which planning occurs, using place meanings and place values to guide planning processes. Despite the approach's growing popularity, there exist few published accounts of place-based approaches. To provide practitioners and researchers with such examples, the...

Value-based integrated (renal) care: setting a development agenda for research and implementation strategies.

PubMed

Valentijn, Pim P; Biermann, Claus; Bruijnzeels, Marc A

2016-08-02

Integrated care services are considered a vital strategy for improving the Triple Aim values for people with chronic kidney disease. However, a solid scholarly explanation of how to develop, implement and evaluate such value-based integrated renal care services is limited. The aim of this study was to develop a framework to identify the strategies and outcomes for the implementation of value-based integrated renal care. First, the theoretical foundations of the Rainbow Model of Integrated Care and the Triple Aim were united into one overarching framework through an iterative process of key-informant consultations. Second, a rapid review approach was conducted to identify the published research on integrated renal care, and the Cochrane Library, Medline, Scopus, and Business Source Premier databases were searched for pertinent articles published between 2000 and 2015. Based on the framework, a coding schema was developed to synthesis the included articles. The overarching framework distinguishes the integrated care domains: 1) type of integration, 2) enablers of integration and the interrelated outcome domains, 3) experience of care, 4) population health and 5) costs. The literature synthesis indicated that integrated renal care implementation strategies have particularly focused on micro clinical processes and physical outcomes, while little emphasis has been placed on meso organisational as well as macro system integration processes. In addition, evidence regarding patients' perceived outcomes and economic outcomes has been weak. These results underscore that the future challenge for researchers is to explore which integrated care implementation strategies achieve better health and improved experience of care at a lower cost within a specific context. For this purpose, this study's framework and evidence synthesis have set a developmental agenda for both integrated renal care practice and research. Accordingly, we plan further work to develop an implementation model for value-based integrated renal services.

Value-based recruitment in midwifery: do the values align with what women say is important to them?

PubMed

Callwood, Alison; Cooke, Debbie; Allan, Helen

2016-10-01

The aim of this study was to discuss theoretical conceptualization and definition of values and value-based recruitment in the context of women's views about what they would like from their midwife. Value-based recruitment received headline status in the UK government's response to pervasive deficiencies in compassionate care identified in the health service. Core values which aim to inform service user's experience are defined in the National Health Service Constitution but clarity about whether these encompass all that women say is important to them is needed. Discussion paper. A literature search included published papers written in English relating to values, VBR and women's views of a 'good' midwife with no date limiters. Definitions of values and value-based recruitment are examined. Congruence is explored between what women say is important to them and key government and professional regulatory documentation. The importance of a 'sustainable emotional' dimension in the midwife-mother relationship is suggested. Inconsistencies are identified between women's views, government, professional documentation and what women say they want. An omission of any reference to emotions or emotionality in value-based recruitment policy, professional recruitment and selection guidance documentation is identified. A review of key professional documentation, in relation to selection for 'values', is proposed. We argue for clarity and revision so that values embedded in value-based recruitment are consistent with health service users' views. An enhancement of the 'values' in the value-based recruitment framework is recommended to include the emotionality that women state is a fundamental part of their relationship with their midwife. © 2016 John Wiley & Sons Ltd.

The Questionable Economic Case for Value-Based Drug Pricing in Market Health Systems.

PubMed

Pauly, Mark V

2017-02-01

This article investigates the economic theory and interpretation of the concept of "value-based pricing" for new breakthrough drugs with no close substitutes in a context (such as the United States) in which a drug firm with market power sells its product to various buyers. The interpretation is different from that in a country that evaluates medicines for a single public health insurance plan or a set of heavily regulated plans. It is shown that there will not ordinarily be a single value-based price but rather a schedule of prices with different volumes of buyers at each price. Hence, it is incorrect to term a particular price the value-based price, or to argue that the profit-maximizing monopoly price is too high relative to some hypothesized value-based price. When effectiveness of treatment or value of health is heterogeneous, the profit-maximizing price can be higher than that associated with assumed values of quality-adjusted life-years. If the firm sets a price higher than the value-based price for a set of potential buyers, the optimal strategy of the buyers is to decline to purchase that drug. The profit-maximizing price will come closer to a unique value-based price if demand is less heterogeneous. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Stakeholder value-linked sustainability assessment: Evaluating remedial alternatives for the Portland Harbor Superfund Site, Portland, Oregon, USA.

PubMed

Apitz, Sabine E; Fitzpatrick, Anne G; McNally, Amanda; Harrison, David; Coughlin, Conor; Edwards, Deborah A

2018-01-01

Regulatory decisions on remediation should consider affected communities' needs and values, and how these might be impacted by remedial options; this process requires that diverse stakeholders are able to engage in a transparent consideration of value trade-offs and of the distribution of risks and benefits associated with remedial actions and outcomes. The Stakeholder Values Assessment (SVA) tool was developed to evaluate remedial impacts on environmental quality, economic viability, and social equity in the context of stakeholder values and priorities. Stakeholder values were linked to the pillars of sustainability and also to a range of metrics to evaluate how sediment remediation affects these values. Sediment remedial alternatives proposed by the US Environmental Protection Agency (USEPA) for the Portland Harbor Superfund Site were scored for each metric, based upon data provided in published feasibility study (FS) documents. Metric scores were aggregated to generate scores for each value; these were then aggregated to generate scores for each pillar of sustainability. In parallel, the inferred priorities (in terms of regional remediation, restoration, planning, and development) of diverse stakeholder groups (SGs) were used to evaluate the sensitivity and robustness of the values-based sustainability assessment to diverse SG priorities. This approach, which addresses social indicators of impact and then integrates them with indicators of environmental and economic impacts, goes well beyond the Comprehensive Environmental Response, Compensation and Liability Act's (CERCLA) 9 criteria for evaluating remedial alternatives because it evaluates how remedial alternatives might be ranked in terms of the diverse values and priorities of stakeholders. This approach identified trade-offs and points of potential contention, providing a systematic, semiquantitative, transparent valuation tool that can be used in community engagement. Integr Environ Assess Manag 2018;14:43-62. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

What is the enduring value of research publications in clinical epilepsy? An assessment of papers published in 1981, 1991, and 2001.

PubMed

Gregoris, Nattanit; Shorvon, Simon

2013-09-01

There has been a rapid expansion in the number of research papers published on clinical epilepsy topics and the number of journals in the medical field. In this expanding publishing environment, the question arises as to how much of the published medical literature has 'enduring value' in terms of advancing knowledge in any significant way. We developed a methodology to assess the enduring value of papers published in the field of clinical epilepsy and established its internal validity. We studied 300 research papers published in 1981, 1991, and 2001 (100 in each year) and assessed their enduring value in four domains: citations in the last year, citations in the last 10years, citations in the standard epilepsy textbook, and a subjective assessment by an experienced epileptologist. Of the 300 papers, 214 (71%) were categorized as having 'no enduring value', and only 11 (4%) were identified as having 'high enduring value'. The 'high enduring value' papers could generally be identified immediately on publication, by high initial citation values, and were also more likely to be published in journals with a high impact factor. The commonest characteristics of a paper with no enduring value were that they reported research that was inherently unimportant (55.6%), not novel (38.8%), or had significant methodological flaws (22.0%). Although there are other reasons for publishing papers, the fact that the great majority of published papers lack enduring value in terms of advancing knowledge should be a concern to the medical and scientific community. Copyright © 2013 Elsevier Inc. All rights reserved.

Building an Open-source Simulation Platform of Acoustic Radiation Force-based Breast Elastography

PubMed Central

Wang, Yu; Peng, Bo; Jiang, Jingfeng

2017-01-01

Ultrasound-based elastography including strain elastography (SE), acoustic radiation force Impulse (ARFI) imaging, point shear wave elastography (pSWE) and supersonic shear imaging (SSI) have been used to differentiate breast tumors among other clinical applications. The objective of this study is to extend a previously published virtual simulation platform built for ultrasound quasi-static breast elastography toward acoustic radiation force-based breast elastography. Consequently, the extended virtual breast elastography simulation platform can be used to validate image pixels with known underlying soft tissue properties (i.e. “ground truth”) in complex, heterogeneous media, enhancing confidence in elastographic image interpretations. The proposed virtual breast elastography system inherited four key components from the previously published virtual simulation platform: an ultrasound simulator (Field II), a mesh generator (Tetgen), a finite element solver (FEBio) and a visualization and data processing package (VTK). Using a simple message passing mechanism, functionalities have now been extended to acoustic radiation force-based elastography simulations. Examples involving three different numerical breast models with increasing complexity – one uniform model, one simple inclusion model and one virtual complex breast model derived from magnetic resonance imaging data, were used to demonstrate capabilities of this extended virtual platform. Overall, simulation results were compared with the published results. In the uniform model, the estimated shear wave speed (SWS) values were within 4% compared to the predetermined SWS values. In the simple inclusion and the complex breast models, SWS values of all hard inclusions in soft backgrounds were slightly underestimated, similar to what has been reported. The elastic contrast values and visual observation show that ARFI images have higher spatial resolution, while SSI images can provide higher inclusion-to-background contrast. In summary, our initial results were consistent with our expectations and what have been reported in the literature. The proposed (open-source) simulation platform can serve as a single gateway to perform many elastographic simulations in a transparent manner, thereby promoting collaborative developments. PMID:28075330

Building an open-source simulation platform of acoustic radiation force-based breast elastography

NASA Astrophysics Data System (ADS)

Wang, Yu; Peng, Bo; Jiang, Jingfeng

2017-03-01

Ultrasound-based elastography including strain elastography, acoustic radiation force impulse (ARFI) imaging, point shear wave elastography and supersonic shear imaging (SSI) have been used to differentiate breast tumors among other clinical applications. The objective of this study is to extend a previously published virtual simulation platform built for ultrasound quasi-static breast elastography toward acoustic radiation force-based breast elastography. Consequently, the extended virtual breast elastography simulation platform can be used to validate image pixels with known underlying soft tissue properties (i.e. ‘ground truth’) in complex, heterogeneous media, enhancing confidence in elastographic image interpretations. The proposed virtual breast elastography system inherited four key components from the previously published virtual simulation platform: an ultrasound simulator (Field II), a mesh generator (Tetgen), a finite element solver (FEBio) and a visualization and data processing package (VTK). Using a simple message passing mechanism, functionalities have now been extended to acoustic radiation force-based elastography simulations. Examples involving three different numerical breast models with increasing complexity—one uniform model, one simple inclusion model and one virtual complex breast model derived from magnetic resonance imaging data, were used to demonstrate capabilities of this extended virtual platform. Overall, simulation results were compared with the published results. In the uniform model, the estimated shear wave speed (SWS) values were within 4% compared to the predetermined SWS values. In the simple inclusion and the complex breast models, SWS values of all hard inclusions in soft backgrounds were slightly underestimated, similar to what has been reported. The elastic contrast values and visual observation show that ARFI images have higher spatial resolution, while SSI images can provide higher inclusion-to-background contrast. In summary, our initial results were consistent with our expectations and what have been reported in the literature. The proposed (open-source) simulation platform can serve as a single gateway to perform many elastographic simulations in a transparent manner, thereby promoting collaborative developments.

The Enduring Value of the Physical Examination.

PubMed

Zaman, Junaid A B

2018-05-01

This article focuses exclusively on physical examination (PE) in the context of clinical medicine, that is, the interaction between a health care provider and patient. In essence, there is not only benefit (value) to PE but also that it will last (endure) for some time. Both "enduring" and "value" are explored in more depth with respect to the future integration of PE into the clinical assessment of a patient and how its value extends well beyond current diagnostic/cost-based metrics. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Estimation of skin entrance doses (SEDs) for common medical X-ray diagnostic examinations in India and proposed diagnostic reference levels (DRLs).

PubMed

Sonawane, A U; Shirva, V K; Pradhan, A S

2010-02-01

Skin entrance doses (SEDs) were estimated by carrying out measurements of air kerma from 101 X-ray machines installed in 45 major and selected hospitals in the country by using a silicon detector-based dose Test-O-Meter. 1209 number of air kerma measurements of diagnostic projections for adults have been analysed for seven types of common diagnostic examinations, viz. chest (AP, PA, LAT), lumbar spine (AP, LAT), thoracic spine (AP, LAT), abdomen (AP), pelvis (AP), hip joints (AP) and skull (PA, LAT) for different film-screen combinations. The values of estimated diagnostic reference levels (DRLs) (third quartile values of SEDs) were compared with guidance levels/DRLs of doses published by the IAEA-BSS-Safety Series No. 115, 1996; HPA (NRPB) (2000 and 2005), UK; CRCPD/CDRH (USA), European Commission and other national values. The values of DRLs obtained in this study are comparable with the values published by the IAEA-BSS-115 (1996); HPA (NRPB) (2000 and 2005) UK; EC and CRCPD/CDRH, USA including values obtained in previous studies in India.

Innovation in diagnostic imaging services: assessing the potential for value-based reimbursement.

PubMed

Garrison, Louis P; Bresnahan, Brian W; Higashi, Mitchell K; Hollingworth, William; Jarvik, Jeffrey G

2011-09-01

Innovation in the field of diagnostic imaging is based primarily on the availability of new and improved equipment that opens the door for new clinical applications. Payments for these imaging procedures are subject to complex Medicare price control schemes, affecting incentives for appropriate use and innovation. Achieving a "dynamically efficient" health care system-one that elicits a socially optimal amount of innovation-requires that innovators be rewarded in relation to the value they add and can demonstrate with evidence. The authors examine how and whether value-based reimbursement for diagnostic imaging services might better reward innovation explicitly for expected improvements in health and economic outcomes. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Development of estimates of dietary nitrates, nitrites, and nitrosamines for use with the short willet food frequency questionnaire

PubMed Central

Griesenbeck, John S; Steck, Michelle D; Huber, John C; Sharkey, Joseph R; Rene, Antonio A; Brender, Jean D

2009-01-01

Background Studies have suggested that nitrates, nitrites, and nitrosamines have an etiologic role in adverse pregnancy outcomes and chronic diseases such as cancer. Although an extensive body of literature exists on estimates of these compounds in foods, the extant data varies in quality, quantified estimates, and relevance. Methods We developed estimates of nitrates, nitrites, and nitrosamines for food items listed in the Short Willet Food Frequency Questionnaire (WFFQ) as adapted for use in the National Birth Defects Prevention Study. Multiple reference databases were searched for published literature reflecting nitrate, nitrite, and nitrosamine values in foods. Relevant published literature was reviewed; only publications reporting results for items listed on the WFFQ were selected for inclusion. The references selected were prioritized according to relevance to the U.S. population. Results Based on our estimates, vegetable products contain the highest levels of nitrate, contributing as much as 189 mg/serving. Meat and bean products contain the highest levels of nitrites with values up to 1.84 mg/serving. Alcohol, meat and dairy products contain the highest values of nitrosamines with a maximum value of 0.531 μg/serving. The estimates of dietary nitrates, nitrites, and nitrosamines generated in this study are based on the published values currently available. Conclusion To our knowledge, these are the only estimates specifically designed for use with the adapted WFFQ and generated to represent food items available to the U.S. population. The estimates provided may be useful in other research studies, specifically in those exploring the relation between exposure to these compounds in foods and adverse health outcomes. PMID:19348679

Continuously Variable Rating: a new, simple and logical procedure to evaluate original scientific publications

PubMed Central

Silva, Mauricio Rocha e

2011-01-01

OBJECTIVE: Impact Factors (IF) are widely used surrogates to evaluate single articles, in spite of known shortcomings imposed by cite distribution skewness. We quantify this asymmetry and propose a simple computer-based procedure for evaluating individual articles. METHOD: (a) Analysis of symmetry. Journals clustered around nine Impact Factor points were selected from the medical “Subject Categories” in Journal Citation Reports 2010. Citable items published in 2008 were retrieved and ranked by granted citations over the Jan/2008 - Jun/2011 period. Frequency distribution of cites, normalized cumulative cites and absolute cites/decile were determined for each journal cluster. (b) Positive Predictive Value. Three arbitrarily established evaluation classes were generated: LOW (1.3≤IF<2.6); MID: (2.6≤IF<3.9); HIGH: (IF≥3.9). Positive Predictive Value for journal clusters within each class range was estimated. (c) Continuously Variable Rating. An alternative evaluation procedure is proposed to allow the rating of individually published articles in comparison to all articles published in the same journal within the same year of publication. The general guiding lines for the construction of a totally dedicated software program are delineated. RESULTS AND CONCLUSIONS: Skewness followed the Pareto Distribution for (1

New journals for publishing medical case reports.

PubMed

Akers, Katherine G

2016-04-01

Because they do not rank highly in the hierarchy of evidence and are not frequently cited, case reports describing the clinical circumstances of single patients are seldom published by medical journals. However, many clinicians argue that case reports have significant educational value, advance medical knowledge, and complement evidence-based medicine. Over the last several years, a vast number (∼160) of new peer-reviewed journals have emerged that focus on publishing case reports. These journals are typically open access and have relatively high acceptance rates. However, approximately half of the publishers of case reports journals engage in questionable or "predatory" publishing practices. Authors of case reports may benefit from greater awareness of these new publication venues as well as an ability to discriminate between reputable and non-reputable journal publishers.

Comparison of base flows to selected streamflow statistics representative of 1930-2002 in West Virginia

USGS Publications Warehouse

Wiley, Jeffrey B.

2012-01-01

Base flows were compared with published streamflow statistics to assess climate variability and to determine the published statistics that can be substituted for annual and seasonal base flows of unregulated streams in West Virginia. The comparison study was done by the U.S. Geological Survey, in cooperation with the West Virginia Department of Environmental Protection, Division of Water and Waste Management. The seasons were defined as winter (January 1-March 31), spring (April 1-June 30), summer (July 1-September 30), and fall (October 1-December 31). Differences in mean annual base flows for five record sub-periods (1930-42, 1943-62, 1963-69, 1970-79, and 1980-2002) range from -14.9 to 14.6 percent when compared to the values for the period 1930-2002. Differences between mean seasonal base flows and values for the period 1930-2002 are less variable for winter and spring, -11.2 to 11.0 percent, than for summer and fall, -47.0 to 43.6 percent. Mean summer base flows (July-September) and mean monthly base flows for July, August, September, and October are approximately equal, within 7.4 percentage points of mean annual base flow. The mean of each of annual, spring, summer, fall, and winter base flows are approximately equal to the annual 50-percent (standard error of 10.3 percent), 45-percent (error of 14.6 percent), 75-percent (error of 11.8 percent), 55-percent (error of 11.2 percent), and 35-percent duration flows (error of 11.1 percent), respectively. The mean seasonal base flows for spring, summer, fall, and winter are approximately equal to the spring 50- to 55-percent (standard error of 6.8 percent), summer 45- to 50-percent (error of 6.7 percent), fall 45-percent (error of 15.2 percent), and winter 60-percent duration flows (error of 8.5 percent), respectively. Annual and seasonal base flows representative of the period 1930-2002 at unregulated streamflow-gaging stations and ungaged locations in West Virginia can be estimated using previously published values of statistics and procedures.

The Impact of Standards-Based Reform: Applying Brantlinger's Critique of "Hierarchical Ideologies"

ERIC Educational Resources Information Center

Bacon, Jessica; Ferri, Beth

2013-01-01

Brantlinger's [2004b. "Ideologies Discerned, Values Determined: Getting past the Hierarchies of Special Education." In "Ideology and the Politics of (in)Exclusion," edited by L. Ware, 11-31. New York: Peter Lang Publishing] critique of hierarchical ideologies lays bare the logics embedded in standards-based reform. Drawing on…

Editorial Commentary: "There, It Fits!"-Justifying Nonsignificant P Values.

PubMed

Lowe, Walter R

2016-11-01

The increasing emphasis placed on value-based medicine has become a powerful motivating factor that has driven the performance and publication of more comparative clinical outcome studies. Although these endeavors are well intentioned and significant progress has been made in our field over the past few decades, I believe that we need both to re-emphasize the importance of results derived from meaningful study designs and to avoid the notion that nonsignificant P values represent study failure. Published by Elsevier Inc.

Summary of Aquifer Test Data for Arkansas - 1940-2006

USGS Publications Warehouse

Pugh, Aaron L.

2008-01-01

As demands on Arkansas's ground water continue to increase, decision-makers need all available information to ensure the sustainability of this important natural resource. From 1940 through 2006, the U.S. Geological Survey has conducted over 300 aquifer tests in Arkansas. Much of these data never have been published. This report presents the results from 206 of these aquifer tests from 21 different hydrogeologic units spread across 51 Arkansas counties. Ten of the hydrogeologic units are within the Atlantic Plain of Arkansas and consist mostly of unconsolidated and semi-consolidated deposits. The remaining 11 units are within the Interior Highlands consisting mainly of consolidated rock. Descriptive statistics are reported for each hydrologic unit with two or more tests, including the mean, minimum, median, maximum and standard deviation values for specific capacity, transmissivity, hydraulic conductivity, and storage coefficient. Hydraulic conductivity values for the major water-bearing hydrogeologic units are estimated because few conductivity values are recorded in the original records. Nearly all estimated hydraulic conductivity values agree with published hydraulic conductivity values based on the hydrogeologic unit material types. Similarly, because few specific capacity values were available in the original aquifer test records, specific capacity values are estimated for individual wells.

Shared decision making as part of value based care: New U.S. policies challenge our readiness.

PubMed

Spatz, Erica S; Elwyn, Glyn; Moulton, Benjamin W; Volk, Robert J; Frosch, Dominick L

2017-06-01

Shared decision making in the United States is increasingly being recognized as part of value-based care. During the last decade, several state and federal initiatives have linked shared decision making with reimbursement and increased protection from litigation. Additionally, private and public foundations are increasingly funding studies to identify best practices for moving shared decision making from the research world into clinical practice. These shifts offer opportunities and challenges for ensuring effective implementation. Copyright © 2017. Published by Elsevier GmbH.

Cancer heterogeneity and imaging.

PubMed

O'Connor, James P B

2017-04-01

There is interest in identifying and quantifying tumor heterogeneity at the genomic, tissue pathology and clinical imaging scales, as this may help better understand tumor biology and may yield useful biomarkers for guiding therapy-based decision making. This review focuses on the role and value of using x-ray, CT, MRI and PET based imaging methods that identify, measure and map tumor heterogeneity. In particular we highlight the potential value of these techniques and the key challenges required to validate and qualify these biomarkers for clinical use. Copyright © 2016. Published by Elsevier Ltd.

Lateral Orbitofrontal Inactivation Dissociates Devaluation-Sensitive Behavior and Economic Choice.

PubMed

Gardner, Matthew P H; Conroy, Jessica S; Shaham, Michael H; Styer, Clay V; Schoenbaum, Geoffrey

2017-12-06

How do we choose between goods that have different subjective values, like apples and oranges? Neuroeconomics proposes that this is done by reducing complex goods to a single unitary value to allow comparison. This value is computed "on the fly" from the underlying model of the goods space, allowing decisions to meet current needs. This is termed "model-based" behavior to distinguish it from pre-determined, habitual, or "model-free" behavior. The lateral orbitofrontal cortex (OFC) supports model-based behavior in rats and primates, but whether the OFC is necessary for economic choice is less clear. Here we tested this question by optogenetically inactivating the lateral OFC in rats in a classic model-based task and during economic choice. Contrary to predictions, inactivation disrupted model-based behavior without affecting economic choice. Published by Elsevier Inc.

Getting published well requires fulfilling editors' and reviewers' needs and desires.

PubMed

Schoenwolf, Gary C

2013-12-01

Publication in international scientific journals provides an unparalleled opportunity for authors to showcase their work. Where authors publish affects how the community values the work. This value directly determines the impact of the work on the field-papers must be read and cited to advance the field, and because the scientific literature is vast, only a subset of the literature is widely read and cited. Moreover, the value placed on the work also affects the authors' scientific reputation and career advancement. Consequently, it is essential that manuscripts receive the recognition they deserve by being published in one of the "best" journals that the scientific findings allow. Several factors determine where a paper is published: how well the topic of the paper fits the scope of the journal, the quality of the study and the manuscript describing it, the advance the paper makes in its field, the importance of the advance, and the extent to which the paper impacts the broader community of science. As scientists, we assume that our papers will be assessed objectively using only well defined scientific standards, but editors and reviewers also view papers subjectively, having biases of what defines a high-quality publication based on Western standards. Therefore, scientists trained in other parts of the world can be significantly disadvantaged in getting their papers published in the best journals. Here, I present concrete suggestions for improving the perception of a paper in the reader's minds, increasing the likelihood that it will get published well. © 2013 The Authors Development, Growth & Differentiation © 2013 Japanese Society of Developmental Biologists.

Hui Malama O Ke Kai: A Positive Prevention-Based Youth Development Program Based on Native Hawaiian Values and Activities

ERIC Educational Resources Information Center

Hishinuma, Earl S.; Chang, Janice Y.; Sy, Angela; Greaney, Malia F.; Morris, Katherine A.; Scronce, Ami C.; Rehuher, Davis; Nishimura, Stephanie T.

2009-01-01

Evaluation of after-school programs that are culturally and place-based and promote positive youth development among minority and indigenous youths has not been widely published. The present evaluation is the first of its kind of an after-school, youth-risk prevention program called Hui Malama O Ke Kai (HMK), that emphasizes Native Hawaiian values…

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers.

PubMed

Dobie, Robert A; Wojcik, Nancy C

2015-07-13

The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. 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.

What is the value of Values Based Recruitment for nurse education programmes?

PubMed

Groothuizen, Johanna E; Callwood, Alison; Gallagher, Ann

2018-05-01

A discussion of issues associated with Values Based Recruitment (VBR) for nurse education programmes. Values Based Recruitment is a mandatory element in selection processes of students for Higher Education healthcare courses in England, including all programmes across nursing. Students are selected on the basis that their individual values align with those presented in the Constitution of the National Health Service. However, there are issues associated with the use of values as selection criteria that have been insufficiently addressed. These are discussed. Discussion paper. This article is based on documents published on the website of the executive body responsible for the implementation of a policy regarding VBR in Higher Education Institutions up until June 2017 and our evaluation of the conceptualisation of VBR, underpinned by contemporary theory and literature. Values Based Recruitment influences who is accepted onto a nurse education programme, but there has been limited critical evaluation regarding the effectiveness of employing values as selection criteria. Values are subject to interpretation and evidence regarding whether or how VBR will improve practice and care is lacking. The issues discussed in this article show that Higher Education Institutions offering nursing courses, whether in England or in other countries, should be critical and reflective regarding the implementation of VBR methods. We call for a debate regarding the meaning and implications of VBR and further research regarding its validity and effectiveness. © 2017 John Wiley & Sons Ltd.

Influence of time and length size feature selections for human activity sequences recognition.

PubMed

Fang, Hongqing; Chen, Long; Srinivasan, Raghavendiran

2014-01-01

In this paper, Viterbi algorithm based on a hidden Markov model is applied to recognize activity sequences from observed sensors events. Alternative features selections of time feature values of sensors events and activity length size feature values are tested, respectively, and then the results of activity sequences recognition performances of Viterbi algorithm are evaluated. The results show that the selection of larger time feature values of sensor events and/or smaller activity length size feature values will generate relatively better results on the activity sequences recognition performances. © 2013 ISA Published by ISA All rights reserved.

Lipid correction model of carbon stable isotopes for a cosmopolitan predator, spiny dogfish Squalus acanthias.

PubMed

Reum, J C P

2011-12-01

Three lipid correction models were evaluated for liver and white dorsal muscle from Squalus acanthias. For muscle, all three models performed well, based on the Akaike Information Criterion value corrected for small sample sizes (AIC(c) ), and predicted similar lipid corrections to δ(13) C that were up to 2.8 ‰ higher than those predicted using previously published models based on multispecies data. For liver, which possessed higher bulk C:N values compared to that of white muscle, all three models performed poorly and lipid-corrected δ(13) C values were best approximated by simply adding 5.74 ‰ to bulk δ(13) C values. © 2011 The Author. Journal of Fish Biology © 2011 The Fisheries Society of the British Isles.

Metrix Matrix: A Cloud-Based System for Tracking Non-Relative Value Unit Value-Added Work Metrics.

PubMed

Kovacs, Mark D; Sheafor, Douglas H; Thacker, Paul G; Hardie, Andrew D; Costello, Philip

2018-03-01

In the era of value-based medicine, it will become increasingly important for radiologists to provide metrics that demonstrate their value beyond clinical productivity. In this article the authors describe their institution's development of an easy-to-use system for tracking value-added but non-relative value unit (RVU)-based activities. Metrix Matrix is an efficient cloud-based system for tracking value-added work. A password-protected home page contains links to web-based forms created using Google Forms, with collected data populating Google Sheets spreadsheets. Value-added work metrics selected for tracking included interdisciplinary conferences, hospital committee meetings, consulting on nonbilled outside studies, and practice-based quality improvement. Over a period of 4 months, value-added work data were collected for all clinical attending faculty members in a university-based radiology department (n = 39). Time required for data entry was analyzed for 2 faculty members over the same time period. Thirty-nine faculty members (equivalent to 36.4 full-time equivalents) reported a total of 1,223.5 hours of value-added work time (VAWT). A formula was used to calculate "value-added RVUs" (vRVUs) from VAWT. VAWT amounted to 5,793.6 vRVUs or 6.0% of total work performed (vRVUs plus work RVUs [wRVUs]). Were vRVUs considered equivalent to wRVUs for staffing purposes, this would require an additional 2.3 full-time equivalents, on the basis of average wRVU calculations. Mean data entry time was 56.1 seconds per day per faculty member. As health care reimbursement evolves with an emphasis on value-based medicine, it is imperative that radiologists demonstrate the value they add to patient care beyond wRVUs. This free and easy-to-use cloud-based system allows the efficient quantification of value-added work activities. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

National animal health surveillance: Return on investment.

PubMed

Scott, Aaron E; Forsythe, Kenneth W; Johnson, Cynthia L

2012-08-01

A weighted benefit-cost analysis (BCA) supports prioritization of animal health surveillance activities to safeguard animal agriculture industries and reduce the impact of disease on the national economy. We propose to determine the value of investment in surveillance by assessing benefits from: avoiding disease incursion and expansion modified by the probability of occurrence of the disease event, the sensitivity of systems to detect it, and the degree to which we can mitigate disease impact when detected. The weighted benefit-cost ratio is the modified value of surveillance as laid out above divided by the cost of surveillance. We propose flexible, stream-based surveillance that capitalizes on combining multiple streams of information from both specific pathogen based and non-pathogen based surveillance. This stream-based type of system provides high value with lower costs and will provide a high return for the funds invested in animal health surveillance. Published by Elsevier B.V.

The Evolution of Approval Services.

ERIC Educational Resources Information Center

Warzala, Martin

1994-01-01

Describes major developments in book approval plans used by academic libraries for acquisition and for information dissemination and document distribution services based on approval-like concepts. Topics addressed include publishers; marketing; the impact of library automation; value-added services; the economic climate; the influence of…

Calculating meal glycemic index by using measured and published food values compared with directly measured meal glycemic index.

PubMed

Dodd, Hayley; Williams, Sheila; Brown, Rachel; Venn, Bernard

2011-10-01

Glycemic index (GI) testing is normally based on individual foods, whereas GIs for meals or diets are based on a formula using a weighted sum of the constituents. The accuracy with which the formula can predict a meal or diet GI is questionable. Our objective was to compare the GI of meals, obtained by using the formula and by using both measured food GI and published values, with directly measured meal GIs. The GIs of 7 foods were tested in 30 healthy people. The foods were combined into 3 meals, each of which provided 50 g available carbohydrate, including a staple (potato, rice, or spaghetti), vegetables, sauce, and pan-fried chicken. The mean (95% CI) meal GIs determined from individual food GI values and by direct measurement were as follows: potato meal [predicted, 63 (56, 70); measured, 53 (46, 62)], rice meal [predicted, 51 (45, 56); measured, 38 (33, 45)], and spaghetti meal [predicted, 54 (49, 60); measured, 38 (33, 44)]. The predicted meal GIs were all higher than the measured GIs (P < 0.001). The extent of the overestimation depended on the particular food, ie, 12, 15, and 19 GI units (or 22%, 40%, and 50%) for the potato, rice, and spaghetti meals, respectively. The formula overestimated the GI of the meals by between 22% and 50%. The use of published food values also overestimated the measured meal GIs. Investigators using the formula to calculate a meal or diet GI should be aware of limitations in the method. This trial is registered with the Australian and New Zealand Clinical Trials Registry as ACTRN12611000210976.

Writing the Book…Literally: The Convergence of Authentic Intellectual Work (AIW) and Project-Based Learning (PBL)

ERIC Educational Resources Information Center

Buckmiller, Tom M.; Kruse, Jerrid W.

2015-01-01

Using the Project-Based Learning (PBL) and Authentic Intellectual Work (AIW) models, we sought to create coursework that had value beyond the classroom. Refinements in the self-publishing book industry provide the opportunity to present student work to a larger audience and in a different, more engaging format. With the help of free software, our…

Calculation of global carbon dioxide emissions: Review of emission factors and a new approach taking fuel quality into consideration

NASA Astrophysics Data System (ADS)

Hiete, Michael; Berner, Ulrich; Richter, Otto

2001-03-01

Anthropogenic carbon dioxide emissions resulting from fossil fuel consumption play a major role in the current debate on climate change. Carbon dioxide emissions are calculated on the basis of a carbon dioxide emission factor (CEF) for each type of fuel. Published CEFs are reviewed in this paper. It was found that for nearly all CEFs, fuel quality is not adequately taken into account. This is especially true in the case of the CEFs for coal. Published CEFs are often based on generalized assumptions and inexact conversions. In particular, conversions from gross calorific value to net calorific value were examined. A new method for determining CEFs as a function of calorific value (for coal, peat, and natural gas) and specific gravity (for crude oil) is presented that permits CEFs to be calculated for specific fuel qualities. A review of proportions of fossil fuels that remain unoxidized owing to incomplete combustion or inclusion in petrochemical products, etc., (stored carbon) shows that these figures need to be updated and checked for their applicability on a global scale, since they are mostly based on U.S. data.

Movement asymmetry in working polo horses.

PubMed

Pfau, T; Parkes, R S; Burden, E R; Bell, N; Fairhurst, H; Witte, T H

2016-07-01

The high, repetitive demands imposed on polo horses in training and competition may predispose them to musculoskeletal injuries and lameness. To quantify movement symmetry and lameness in a population of polo horses, and to investigate the existence of a relationship with age. Convenience sampled cross-sectional study. Sixty polo horses were equipped with inertial measurement units (IMUs) attached to the poll, and between the tubera sacrale. Six movement symmetry measures were calculated for vertical head and pelvic displacement during in-hand trot and compared with values for perfect symmetry, compared between left and right limb lame horses, and compared with published thresholds for lameness. Regression lines were calculated as a function of age of horse. Based on 2 different sets of published asymmetry thresholds 52-53% of the horses were quantified with head movement asymmetry and 27-50% with pelvic movement asymmetry resulting in 60-67% of horses being classified with movement asymmetry outside published guideline values for either the forelimbs, hindlimbs or both. Neither forelimb nor hindlimb asymmetries were preferentially left or right sided, with directional asymmetry values across all horses not different from perfect symmetry and absolute values not different between left and right lame horses (P values >0.6 for all forelimb symmetry measures and >0.2 for all hindlimb symmetry measures). None of the symmetry parameters increased or decreased significantly with age. A large proportion of polo horses show gait asymmetries consistent with previously defined thresholds for lameness. These do not appear to be lateralised or associated with age. © 2015 EVJ Ltd.

Properties of animal-manure based hydrochars and predictions using published models

USDA-ARS?s Scientific Manuscript database

In order to fully utilize hydrothermal carbonization (HTC) to produce value-added hydrochars from animal manures, it is important to understand how process conditions (e.g., temperature, reaction time, solids concentration) influence product characteristics. The effect of process conditions on the e...

Progress in evidence-based medicine: a quarter century on.

PubMed

Djulbegovic, Benjamin; Guyatt, Gordon H

2017-07-22

In response to limitations in the understanding and use of published evidence, evidence-based medicine (EBM) began as a movement in the early 1990s. EBM's initial focus was on educating clinicians in the understanding and use of published literature to optimise clinical care, including the science of systematic reviews. EBM progressed to recognise limitations of evidence alone, and has increasingly stressed the need to combine critical appraisal of the evidence with patient's values and preferences through shared decision making. In another progress, EBM incorporated and further developed the science of producing trustworthy clinical practice guidelines pioneered by investigators in the 1980s. EBM's enduring contributions to clinical medicine include placing the practice of medicine on a solid scientific basis, the development of more sophisticated hierarchies of evidence, the recognition of the crucial role of patient values and preferences in clinical decision making, and the development of the methodology for generating trustworthy recommendations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Impact of Chromophoric dissolved organic matter on light absorption in lake water on the Tibetan Plateau, China

NASA Astrophysics Data System (ADS)

Nima, Ciren; Hamre, Børge; Frette, Øyvind; Erga, Svein Rune; Chen, Yi-Chun; Zhao, Lu; Sørensen, Kai; Norli, Marit; Stamnes, Jakob J.

2017-02-01

Ground-based measurements of optical properties are rare for water in lakes on the Tibetan Plateau (TP). We analyzed the spectral absorption of Chromophoric Dissolved Organic Matter (CDOM) for water samples from Lake Namtso (LN) on the TP. The mean value of the spectral slope S280-500 for CDOM absorption was found to be 0.036 nm-1, whereas the corresponding mean value for S350-500 was found to be 0.015 nm-1, implying that when comparing spectral slope values with published values, the wavelength range used for deriving them should be considered.

Is the learning value of workplace-based assessment being realised? A qualitative study of trainer and trainee perceptions and experiences.

PubMed

Barrett, Aileen; Galvin, Rose; Scherpbier, Albert J J A; Teunissen, Pim W; O'Shaughnessy, Ann; Horgan, Mary

2017-03-01

Workplace-based assessments (WBAs) were originally intended to inform learning and development by structuring effective observation-based feedback. The success of this innovation has not yet been established due in part to the widely varied tools, implementation strategies and research approaches. Using a conceptual framework of experience, trajectories and reifications in workplace learning, we aimed to explore trainer and trainee experiences and perceptions of the learning value of WBAs. Trainers and trainees who had used at least one WBA in the previous year were invited to participate in semistructured interviews for this phenomenological study. We used a template analysis method to explore and compare the experiences of the two groups, using the emergent themes to develop an understanding of the impact of these experiences on perceptions of learning value. Nine trainers and eight trainees participated in the study. Common themes emerged among the two groups around issues of responsibility and engagement along with (mis)understandings of the purpose of the individual tools. Trainer-specific themes emerged related to the concurrent implementation of a new e-portfolio and perceptions of increased workload. Trainees associated WBA with a training structure support value but could not translate experiences into learning values. WBAs provide trainees with a justified reason to approach trainers for feedback. WBAs, however, are not being reified as the formative assessments originally intended. A culture change may be required to change the focus of WBA research and reconceptualise this set of tools and methods as a workplace learning practice . 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/.

HPV self-sampling in CIN2+ detection: sensitivity and specificity of different RLU cut-off of HC2 in specimens from 786 women.

PubMed

Bottari, F; Igidbashian, S; Boveri, S; Tricca, A; Gulmini, C; Sesia, M; Spolti, N; Sideri, M; Landoni, F; Sandri, M T

2017-04-01

Mortality for cervical cancer varies between the different regions of the world, with high rates in low-income countries where screening programmes are not present and organised. However, increasing screening coverage is still a priority in all countries: one way to do that is to base screening on self-sampled screening. The success of a self-sampling screening strategy depends on capacity to recruit unscreened women, on the performance and acceptability of the device and on the clinical performance of the high-risk human papillomavirus (HPV) test. This study based on 786 enrolled women investigates the best cut-off value of Hybrid Capture 2 HPV test (HC2) for self-sampled specimens in terms of sensitivity and specificity. In this population, we found that the sensitivity and the specificity for cervical intraepithelial neoplasia grade 2 or more detection of HC2 performed on self-sampled specimens were 82.5% and 82.8%, respectively considering the relative light units (RLU) cut-off value of 1. Increasing the cut-off value the sensitivity decreases and the specificity raises and the best area under the curve for the RLU cut-off value is 1. Our results confirm that the cut-off value of 1 suggested by Qiagen for PreservCyt specimen is the best cut-off value also for self-sampled specimens. 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/.

Interpreting biomonitoring data for 2,4-dichlorophenoxyacetic acid: Update to Biomonitoring Equivalents and population biomonitoring data.

PubMed

Aylward, L L; Hays, S M

2015-12-01

Urinary biomonitoring data for 2,4-dichlorophenoxyacetic acid (2,4-D) reflect aggregate population exposures to trace 2,4-D residues in diet and the environment. These data can be interpreted in the context of current risk assessments by comparison to a Biomonitoring Equivalent (BE), which is an estimate of the average biomarker concentration consistent with an exposure guidance value such as the US EPA Reference Dose (RfD). BE values are updated here from previous published BE values to reflect a change in the US EPA RfD. The US EPA RfD has been updated to reflect a revised point of departure (POD) based on new information from additional toxicological studies and updated assessment of applicable uncertainty factors. In addition, new biomonitoring data from both the US National Health and Nutrition Examination Survey (NHANES) and the Canadian Health Measures Survey (CHMS) have been published. The updated US EPA chronic RfD of 0.21 mg/kg-d results in updated BE values of 10,500 and 7000 μg/L for adults and children, respectively. Comparison of the current population-representative data to these BE values shows that upper bound population biomarker concentrations are more than 5000-fold below BE values corresponding to the updated US EPA RfD. This biomonitoring-based risk assessment supports the conclusion that current use patterns in the US and Canada result in incidental exposures in the general population that can be considered negligible in the context of the current 2,4-D risk assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

Overstating values: medical facts, diverse values, bioethics and values-based medicine.

PubMed

Parker, Malcolm

2013-02-01

Fulford has argued that (1) the medical concepts illness, disease and dysfunction are inescapably evaluative terms, (2) illness is conceptually prior to disease, and (3) a model conforming to (2) has greater explanatory power and practical utility than the conventional value-free medical model. This 'reverse' model employs Hare's distinction between description and evaluation, and the sliding relationship between descriptive and evaluative meaning. Fulford's derivative 'Values Based Medicine' (VBM) readjusts the imbalance between the predominance of facts over values in medicine. VBM allegedly responds to the increased choices made available by, inter alia, the progress of medical science itself. VBM attributes appropriate status to evaluative meaning, where strong consensus about descriptive meaning is lacking. According to Fulford, quasi-legal bioethics, while it can be retained as a kind of deliberative framework, is outcome-based and pursues 'the right answer', while VBM approximates a democratic, process-oriented method for dealing with diverse values, in partnership with necessary contributions from evidence-based medicine (EBM). I support the non-cognitivist underpinnings of VBM, and its emphasis on the importance of values in medicine. But VBM overstates the complexity and diversity of values, misrepresents EBM and VBM as responses to scientific and evaluative complexity, and mistakenly depicts 'quasi-legal bioethics' as a space of settled descriptive meaning. Bioethical reasoning can expose strategies that attempt to reduce authentic values to scientific facts, illustrating that VBM provides no advantage over bioethics in delineating the connections between facts and values in medicine. © 2011 Blackwell Publishing Ltd.

In vivo study of the effectiveness of quantitative percussion diagnostics as an indicator of the level of structural pathology of teeth after restoration.

PubMed

Sheets, Cherilyn G; Wu, Jean C; Rashad, Samer; Phelan, Michael; Earthman, James C

2017-02-01

Conventional diagnostic aids based upon imagery and patient symptoms do not indicate whether restorative treatments have eliminated structural pathology. The purpose of this clinical study was to evaluate quantitative percussion diagnostics (QPD), a mechanics-based methodology that tests the structural integrity of teeth noninvasively. The study hypothesis was that QPD would provide knowledge of the structural instability of teeth after restorative work. Eight participants with 60 sites needing restoration were enrolled in an IRB-approved clinical study. Each participant was examined comprehensively, including QPD testing. Each site was disassembled and microscopically video documented, and the results were recorded on a defect assessment sheet. A predictive model was developed for the pathology rating based on normalized fit error (NFE) values using data from the before treatment phase of the study published previously. Each restored site was then tested using QPD. The mean change in NFE values after restoration was evaluated by the pathology rating before treatment. The model was then used to predictively classify the rating after restoration based on the NFE values after treatment. The diagnostic potential of the rating was explored as a marker for risk of pathology after restoration. After restoration, 51 of the 60 sites fell below an NFE of 0.04, representing a greatly stabilized tooth site sample group. Several sites remained in the high-risk category and some increased in pathologic micromovement. Two models were used to determine severity with indicative cutoff points to group sites with similar values. The data support the hypothesis that QPD can indicate a revised level of structural instability of teeth after restoration. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

A pilot study to assess feasibility of value based pricing in Cyprus through pharmacoeconomic modelling and assessment of its operational framework: sorafenib for second line renal cell cancer.

PubMed

Petrou, Panagiotis; Talias, Michael A

2014-01-01

The continuing increase of pharmaceutical expenditure calls for new approaches to pricing and reimbursement of pharmaceuticals. Value based pricing of pharmaceuticals is emerging as a useful tool and possess theoretical attributes to help health system cope with rising pharmaceutical expenditure. To assess the feasibility of introducing a value-based pricing scheme of pharmaceuticals in Cyprus and explore the integrative framework. A probabilistic Markov chain Monte Carlo model was created to simulate progression of advanced renal cell cancer for comparison of sorafenib to standard best supportive care. Literature review was performed and efficacy data were transferred from a published landmark trial, while official pricelists and clinical guidelines from Cyprus Ministry of Health were utilised for cost calculation. Based on proposed willingness to pay threshold the maximum price of sorafenib for the indication of second line renal cell cancer was assessed. Sorafenib value based price was found to be significantly lower compared to its current reference price. Feasibility of Value Based Pricing is documented and pharmacoeconomic modelling can lead to robust results. Integration of value and affordability in the price are its main advantages which have to be weighed against lack of documentation for several theoretical parameters that influence outcome. Smaller countries such as Cyprus may experience adversities in establishing and sustaining essential structures for this scheme.

Value Assessment Frameworks for HTA Agencies: The Organization of Evidence-Informed Deliberative Processes.

PubMed

Baltussen, Rob; Jansen, Maarten Paul Maria; Bijlmakers, Leon; Grutters, Janneke; Kluytmans, Anouck; Reuzel, Rob P; Tummers, Marcia; der Wilt, Gert Jan van

2017-02-01

Priority setting in health care has been long recognized as an intrinsically complex and value-laden process. Yet, health technology assessment agencies (HTAs) presently employ value assessment frameworks that are ill fitted to capture the range and diversity of stakeholder values and thereby risk compromising the legitimacy of their recommendations. We propose "evidence-informed deliberative processes" as an alternative framework with the aim to enhance this legitimacy. This framework integrates two increasingly popular and complementary frameworks for priority setting: multicriteria decision analysis and accountability for reasonableness. Evidence-informed deliberative processes are, on one hand, based on early, continued stakeholder deliberation to learn about the importance of relevant social values. On the other hand, they are based on rational decision-making through evidence-informed evaluation of the identified values. The framework has important implications for how HTA agencies should ideally organize their processes. First, HTA agencies should take the responsibility of organizing stakeholder involvement. Second, agencies are advised to integrate their assessment and appraisal phases, allowing for the timely collection of evidence on values that are considered relevant. Third, HTA agencies should subject their decision-making criteria to public scrutiny. Fourth, agencies are advised to use a checklist of potentially relevant criteria and to provide argumentation for how each criterion affected the recommendation. Fifth, HTA agencies must publish their argumentation and install options for appeal. The framework should not be considered a blueprint for HTA agencies but rather an aspirational goal-agencies can take incremental steps toward achieving this goal. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Validation of statistical predictive models meant to select melanoma patients for sentinel lymph node biopsy.

PubMed

Sabel, Michael S; Rice, John D; Griffith, Kent A; Lowe, Lori; Wong, Sandra L; Chang, Alfred E; Johnson, Timothy M; Taylor, Jeremy M G

2012-01-01

To identify melanoma patients at sufficiently low risk of nodal metastases who could avoid sentinel lymph node biopsy (SLNB), several statistical models have been proposed based upon patient/tumor characteristics, including logistic regression, classification trees, random forests, and support vector machines. We sought to validate recently published models meant to predict sentinel node status. We queried our comprehensive, prospectively collected melanoma database for consecutive melanoma patients undergoing SLNB. Prediction values were estimated based upon four published models, calculating the same reported metrics: negative predictive value (NPV), rate of negative predictions (RNP), and false-negative rate (FNR). Logistic regression performed comparably with our data when considering NPV (89.4 versus 93.6%); however, the model's specificity was not high enough to significantly reduce the rate of biopsies (SLN reduction rate of 2.9%). When applied to our data, the classification tree produced NPV and reduction in biopsy rates that were lower (87.7 versus 94.1 and 29.8 versus 14.3, respectively). Two published models could not be applied to our data due to model complexity and the use of proprietary software. Published models meant to reduce the SLNB rate among patients with melanoma either underperformed when applied to our larger dataset, or could not be validated. Differences in selection criteria and histopathologic interpretation likely resulted in underperformance. Statistical predictive models must be developed in a clinically applicable manner to allow for both validation and ultimately clinical utility.

Validation of Statistical Predictive Models Meant to Select Melanoma Patients for Sentinel Lymph Node Biopsy

PubMed Central

Sabel, Michael S.; Rice, John D.; Griffith, Kent A.; Lowe, Lori; Wong, Sandra L.; Chang, Alfred E.; Johnson, Timothy M.; Taylor, Jeremy M.G.

2013-01-01

Introduction To identify melanoma patients at sufficiently low risk of nodal metastases who could avoid SLN biopsy (SLNB). Several statistical models have been proposed based upon patient/tumor characteristics, including logistic regression, classification trees, random forests and support vector machines. We sought to validate recently published models meant to predict sentinel node status. Methods We queried our comprehensive, prospectively-collected melanoma database for consecutive melanoma patients undergoing SLNB. Prediction values were estimated based upon 4 published models, calculating the same reported metrics: negative predictive value (NPV), rate of negative predictions (RNP), and false negative rate (FNR). Results Logistic regression performed comparably with our data when considering NPV (89.4% vs. 93.6%); however the model’s specificity was not high enough to significantly reduce the rate of biopsies (SLN reduction rate of 2.9%). When applied to our data, the classification tree produced NPV and reduction in biopsies rates that were lower 87.7% vs. 94.1% and 29.8% vs. 14.3%, respectively. Two published models could not be applied to our data due to model complexity and the use of proprietary software. Conclusions Published models meant to reduce the SLNB rate among patients with melanoma either underperformed when applied to our larger dataset, or could not be validated. Differences in selection criteria and histopathologic interpretation likely resulted in underperformance. Development of statistical predictive models must be created in a clinically applicable manner to allow for both validation and ultimately clinical utility. PMID:21822550

Revised reference values for selenium intake.

PubMed

Kipp, A P; Strohm, D; Brigelius-Flohé, R; Schomburg, L; Bechthold, A; Leschik-Bonnet, E; Heseker, H

2015-10-01

The German, Austrian and Swiss nutrition societies are the joint editors of the 'reference values for nutrient intake'. They have revised the reference values for the intake of selenium and published them in February 2015. The saturation of selenoprotein P (SePP) in plasma is used as a criterion for the derivation of reference values for selenium intake in adults. For persons from selenium-deficient regions (China) SePP saturation was achieved with a daily intake of 49μg of selenium. When using the reference body weights the D-A-CH reference values are based upon, the resulting estimated value for selenium intake is 70μg/day for men and 60μg/day for women. The estimated value for selenium intake for children and adolescents is extrapolated using the estimated value for adults in relation to body weight. For infants aged 0 to under 4 months the estimated value of 10μg/day was derived from the basis of selenium intake via breast milk. For infants aged 4 to under 12 months this estimated value was used and taking into account the differences regarding body weight an estimated value of 15μg/day was derived. For lactating women compared to non-lactating women a higher reference value of 75μg/day is indicated due to the release of selenium with breast milk. The additional selenium requirement for pregnant women is negligible, so that no increased reference value is indicated. Copyright © 2015 The Authors. Published by Elsevier GmbH.. All rights reserved.

NHS constitution values for values-based recruitment: a virtue ethics perspective.

PubMed

Groothuizen, Johanna Elise; Callwood, Alison; Gallagher, Ann

2018-05-17

Values-based recruitment is used in England to select healthcare staff, trainees and students on the basis that their values align with those stated in the Constitution of the UK National Health Service (NHS). However, it is unclear whether the extensive body of existing literature within the field of moral philosophy was taken into account when developing these values. Although most values have a long historical tradition, a tendency to assume that they have just been invented, and to approach them uncritically, exists within the healthcare sector. Reflection is necessary. We are of the opinion that selected virtue ethics writings, which are underpinned by historical literature as well as practical analysis of the healthcare professions, provide a helpful framework for evaluation of the NHS Constitution values, to determine whether gaps exist and improvements can be made. Based on this evaluation, we argue that the definitions of certain NHS Constitution values are ambiguous. In addition to this, we argue that 'integrity' and 'practical wisdom', two important concepts in the virtue ethics literature, are not sufficiently represented within the NHS Constitution values. We believe that the NHS Constitution values could be strengthened by providing clearer definitions, and by integrating 'integrity' and 'practical wisdom'. This will benefit values-based recruitment strategies. Should healthcare policy-makers in other countries wish to develop a similar values-based recruitment framework, we advise that they proceed reflectively, and take previously published virtue ethics literature into consideration. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Serum levels of brominated flame retardants (BFRs: PBDE, HBCD) and influence of dietary factors in a population-based study on Swedish adults.

PubMed

Bjermo, Helena; Aune, Marie; Cantillana, Tatiana; Glynn, Anders; Lind, P Monica; Ridefelt, Peter; Darnerud, Per Ola

2017-01-01

The aim of this study was to investigate associations between serum concentrations of brominated flame retardants and personal characteristics, including diet, in adults participating in a population-based study in Sweden 2010-11. Moreover, observed concentrations were used in a health risk assessment, using published health-based reference values. Serum samples of 170 adult individuals of both sexes were analyzed for 10 PBDE congeners and HBCD by GC-MS. When including concentrations between LOD and LOQ, highest median serum concentration was observed for BDE-153 (1.2 ng/g serum lipid), followed by BDE-209 (0.95 ng/g lipid), BDE-47 (0.49 ng/g lipid) and BDE-100 (0.21 ng/g lipid). Median concentration of HBCD was 0.10 ng/g lipid. A few markedly elevated concentrations of BDE-209, HBCD (77-78 ng/g lipid) and BDE-47 (44 ng/g lipid) were observed. The only statistical significant findings were higher BDE-153 concentrations in men than in women, and positive associations between serum BDE-153 concentrations and consumption of fish (total), beef, mutton and poultry. PBDE concentrations were in accordance with concentrations reported in other European countries but generally lower than those found in North America. Median PBDE serum concentrations observed in adults from Sweden suggest sufficient health protection, when compared with published health-based reference values, although some outliers with high serum concentrations had lower safety margins. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

ERTS-1 MSS imagery: Its use in delineating soil associations and as a base map for publishing soils information. [South Dakota

NASA Technical Reports Server (NTRS)

Westin, F. C.

1974-01-01

ERTS 1 imagery is a useful tool in the identification and refinement of soil association areas and an excellent base map upon which soil association information can be published. Prints of bands 5 and 7 were found to be most useful to help delineate major soil and vegetation areas. After delineating major soil areas, over 4800 land sale prices covering a period of 1967-72 were located in the soil areas and averaged. The soil association then were described as soil association value areas and published on a 1:1,000,000 scale ERTS mosaic of South Dakota constructed using negative prints of band 7. The map is intended for use by state and county revenue officers, by individual buyers and sellers of land and lending institutions, and as a reference map by those planning road routes and cable lines and pipelines.

Reference guide to odor thresholds for hazardous air pollutants listed in the Clean Air Act amendments of 1990

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

Cain, W.S.; Shoaf, C.R.; Velasquez, S.F.

1992-03-01

In response to numerous requests for information related to odor thresholds, this document was prepared by the Air Risk Information Support Center in its role in providing technical assistance to State and Local government agencies on risk assessment of air pollutants. A discussion of basic concepts related to olfactory function and the measurement of odor thresholds is presented. A detailed discussion of criteria which are used to evaluate the quality of published odor threshold values is provided. The use of odor threshold information in risk assessment is discussed. The results of a literature search and review of odor threshold informationmore » for the chemicals listed as hazardous air pollutants in the Clean Air Act amendments of 1990 is presented. The published odor threshold values are critically evaluated based on the criteria discussed and the values of acceptable quality are used to determine a geometric mean or best estimate.« less

Ability Climates in Europe as Socially Represented Notability

ERIC Educational Resources Information Center

Persson, Roland S.

2011-01-01

The objective of this research was to study whether ability climate was a useful construct in exploring the possible pattern by which abilities were valued in the countries and cultures of Europe. Based on Moscovici's theory of social representations lists of famous and notable individuals published by the "Wikipedia Encyclopedia" were…

Leveraging Educational Technology to Overcome Social Obstacles to Help Seeking

ERIC Educational Resources Information Center

Howley, Iris

2015-01-01

This dissertation provides initial empirical evidence for Expectancy Value Theory for Help Sources and generates design recommendations for online courses based on the newfound understanding between theory and student behavior. (Abstract shortened by UMI.). [The dissertation citations contained here are published with the permission of ProQuest…

Perspectives on procedure-based assessments: a thematic analysis of semistructured interviews with 10 UK surgical trainees.

PubMed

Shalhoub, Joseph; Marshall, Dominic C; Ippolito, Kate

2017-03-24

The introduction of competency-based training has necessitated development and implementation of accompanying mechanisms for assessment. Procedure-based assessments (PBAs) are an example of workplace-based assessments that are used to examine focal competencies in the workplace. The primary objective was to understand surgical trainees' perspective on the value of PBA. Semistructured interviews with 10 surgical trainees individually interviewed to explore their views. Interviews were audio-recorded and transcribed; following this, they were open and axial coded. Thematic analysis was then performed. Semistructured interviews yielded several topical and recurring themes. In trainees' experience, the use of PBAs as a summative tool limits their educational value. Trainees reported a lack of support from seniors and variation in the usefulness of the tool based on stage of training. Concerns related to the validity of PBAs for evaluating trainees' performance with reports of 'gaming' the system and trainees completing their own assessments. Trainees did identify the significant value of PBAs when used correctly. Benefits included the identification of additional learning opportunities, standardisation of assessment and their role in providing a measure of progress. The UK surgical trainees interviewed identified both limitations and benefits to PBAs; however, we would argue based on their responses and our experience that their use as a summative tool limits their formative use as an educational opportunity. PBAs should either be used exclusively to support learning or solely as a summative tool; if so, further work is needed to audit, validate and standardise them for this purpose. 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/.

[Value-based health care (VbHC): Whence and wither].

PubMed

Raspe, Heiner

2018-02-01

Since about 2005 VbHC has become a prominent movement on the border between population medicine and health economics. The "value" it is aiming at is defined as health care "outcomes per dollar spent". The text focuses on the work of two prominent proponents: M.E. Porter and J.A.M. Gray. It considers background and central elements of VbHC and discusses similarities and differences between the two authors. Especially the differences raise questions that will hopefully play a role in the German discussion that is still in its infancy. Three complex topics seem to be particularly relevant: the relationship between VbHC and evidence-based health care, the question of who is to benefit from VbHC (total, diseased, patient population?), and the role of moral values especially the value of solidarity with the severely ill and socially deprived. Copyright © 2018. Published by Elsevier GmbH.

Enhancing Breast Cancer Recurrence Algorithms Through Selective Use of Medical Record Data.

PubMed

Kroenke, Candyce H; Chubak, Jessica; Johnson, Lisa; Castillo, Adrienne; Weltzien, Erin; Caan, Bette J

2016-03-01

The utility of data-based algorithms in research has been questioned because of errors in identification of cancer recurrences. We adapted previously published breast cancer recurrence algorithms, selectively using medical record (MR) data to improve classification. We evaluated second breast cancer event (SBCE) and recurrence-specific algorithms previously published by Chubak and colleagues in 1535 women from the Life After Cancer Epidemiology (LACE) and 225 women from the Women's Health Initiative cohorts and compared classification statistics to published values. We also sought to improve classification with minimal MR examination. We selected pairs of algorithms-one with high sensitivity/high positive predictive value (PPV) and another with high specificity/high PPV-using MR information to resolve discrepancies between algorithms, properly classifying events based on review; we called this "triangulation." Finally, in LACE, we compared associations between breast cancer survival risk factors and recurrence using MR data, single Chubak algorithms, and triangulation. The SBCE algorithms performed well in identifying SBCE and recurrences. Recurrence-specific algorithms performed more poorly than published except for the high-specificity/high-PPV algorithm, which performed well. The triangulation method (sensitivity = 81.3%, specificity = 99.7%, PPV = 98.1%, NPV = 96.5%) improved recurrence classification over two single algorithms (sensitivity = 57.1%, specificity = 95.5%, PPV = 71.3%, NPV = 91.9%; and sensitivity = 74.6%, specificity = 97.3%, PPV = 84.7%, NPV = 95.1%), with 10.6% MR review. Triangulation performed well in survival risk factor analyses vs analyses using MR-identified recurrences. Use of multiple recurrence algorithms in administrative data, in combination with selective examination of MR data, may improve recurrence data quality and reduce research costs. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Synthesis and evaluation of novel triazoles and mannich bases functionalized 1,4-dihydropyridine as angiotensin converting enzyme (ACE) inhibitors.

PubMed

Kumbhare, Ravindra M; Kosurkar, Umesh B; Bagul, Pankaj K; Kanwal, Abhinav; Appalanaidu, K; Dadmal, Tulshiram L; Banerjee, Sanjay Kumar

2014-11-01

A series of novel diethyl 2,6-dimethyl-1,4-dihydropyridine-3,5-dicarboxylate embedded triazole and mannich bases were synthesized, and evaluated for their angiotensin converting enzyme (ACE) inhibitory activity. Screening of above synthesized compounds for ACE inhibition showed that triazoles functionalized compounds have better ACE inhibitory activity compared to that of mannich bases analogues. Among all triazoles we found 6 h, 6 i and 6 j to have good ACE inhibition activity with IC50 values 0.713 μM, 0.409 μM and 0.653 μM, respectively. Among mannich bases series compounds, only 7c resulted as most active ACE inhibitor with IC50 value of 0.928 μM. Copyright © 2014. Published by Elsevier Ltd.

2017 ACR Annual Meeting Open-Microphone Session: Navigating the Landscape of Changing Practice Models: Private Practice, Corporate Radiology, and Enterprise Systems.

PubMed

Stern, Eric J; Everett, Catherine; Friedberg, Eric B; Kotsenas, Amy L; Glover, McKinley; Lightfoote, Johnson B; Lall, Neil; Swan, Timothy L

2017-11-01

Many practice groups are considering adopting new practice models, primarily to secure their practices by adapting to new payment models, government compliance and regulation, and increasing IT and infrastructure costs. As we move toward value-based care and capitation, the value equation (value = quality/cost) will lead us to also compete on cost to improve value. No matter what payment models ultimately dominate, we need to be prepared to lead in a value-based care environment. Measures of value will either be defined by radiologists or imposed by outside entities. It is critical to our continued success that practices and practice leaders continue to fully and strongly support the ACR to avoid the possibility of a decline in membership that may accompany a lack of practice engagement. Consolidation appears inevitable, but with the help of the ACR, radiologists should have a vibrant future if investments are made now in determining appropriate radiology-specific value measures that are meaningful in consolidated health care environments. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The Role of Patient-Reported Outcome Measures in Value-Based Payment Reform.

PubMed

Squitieri, Lee; Bozic, Kevin J; Pusic, Andrea L

2017-06-01

The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform. On November 17, 2016, the second annual Patient-Reported Outcomes in Healthcare Conference brought together international stakeholders across all health care disciplines to discuss the potential role of PROs in value-based health care reform. The purpose of this article was to summarize the findings from this conference in the context of recent literature and guidelines to inform implementation of PROs in value-based payment models. Recommendations for evaluating key perspectives and measurement goals are made to facilitate appropriate use of PROMs to best benefit and amplify the voice of our patients. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Current Practices of Measuring and Reference Range Reporting of Free and Total Testosterone in the United States.

PubMed

Le, Margaret; Flores, David; May, Danica; Gourley, Eric; Nangia, Ajay K

2016-05-01

The evaluation and management of male hypogonadism should be based on symptoms and on serum testosterone levels. Diagnostically this relies on accurate testing and reference values. Our objective was to define the distribution of reference values and assays for free and total testosterone by clinical laboratories in the United States. Upper and lower reference values, assay methodology and source of published reference ranges were obtained from laboratories across the country. A standardized survey was reviewed with laboratory staff via telephone. Descriptive statistics were used to tabulate results. We surveyed a total of 120 laboratories in 47 states. Total testosterone was measured in house at 73% of laboratories. At the remaining laboratories studies were sent to larger centralized reference facilities. The mean ± SD lower reference value of total testosterone was 231 ± 46 ng/dl (range 160 to 300) and the mean upper limit was 850 ± 141 ng/dl (range 726 to 1,130). Only 9% of laboratories where in-house total testosterone testing was performed created a reference range unique to their region. Others validated the instrument recommended reference values in a small number of internal test samples. For free testosterone 82% of laboratories sent testing to larger centralized reference laboratories where equilibrium dialysis and/or liquid chromatography with mass spectrometry was done. The remaining laboratories used published algorithms to calculate serum free testosterone. Reference ranges for testosterone assays vary significantly among laboratories. The ranges are predominantly defined by limited population studies of men with unknown medical and reproductive histories. These poorly defined and variable reference values, especially the lower limit, affect how clinicians determine treatment. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Inappropriate Use of Homeostasis Model Assessment Cutoff Values for Diagnosing Insulin Resistance in Pediatric Studies.

PubMed

Fox, Carrie; Bernardino, Lourdes; Cochran, Jill; Essig, Mary; Bridges, Kristie Grove

2017-11-01

Assessing pediatric patients for insulin resistance is one way to identify those who are at a high risk of developing type 2 diabetes mellitus. The homoeostasis model assessment (HOMA) is a measure of insulin resistance based on fasting blood glucose and insulin levels. Although this measure is widely used in research, cutoff values for pediatric populations have not been established. To assess the validity of HOMA cutoff values used in pediatric studies published in peer-reviewed journals. Studies published from January 2010 to December 2015 were identified through MEDLINE. Initial screening of abstracts was done to select studies that were conducted in pediatric populations and used HOMA to assess insulin resistance. Subsequent full-text review narrowed the list to only those studies that used a specific HOMA score to diagnose insulin resistance. Each study was classified as using a predetermined fixed HOMA cutoff value or a cutoff that was a percentile specific to that population. For studies that used a predetermined cutoff value, the references cited to provide evidence in support of that cutoff were evaluated. In the 298 articles analyzed, 51 different HOMA cutoff values were used to classify patients as having insulin resistance. Two hundred fifty-five studies (85.6%) used a predetermined fixed cutoff value, but only 72 (28.2%) of those studies provided a reference that supported its use. One hundred ten studies (43%) that used a fixed cutoff either cited a study that did not mention HOMA or provided no reference at all. Tracing of citation history indicated that the most commonly used cutoff values were ultimately based on studies that did not validate their use for defining insulin resistance. Little evidence exists to support HOMA cutoff values commonly used to define insulin resistance in pediatric studies. These findings highlight the importance of validating study design elements when training medical students and novice investigators. Using available data to generate population ranges for HOMA would improve its clinical utility.

Nuclear Data Sheets for A = 152

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

Martin, M.J.

2013-11-15

Detailed level schemes, decay schemes, and the experimental data on which they are based are presented for all nuclei with mass number A=152. The experimental data are evaluated; inconsistencies and discrepancies are noted; and adopted values for level and γ–ray energies, γ intensities, as well as for other nuclear properties are given. This evaluation replaces the A=152 evaluation published by Agda Artna–Cohen in Nuclear Data Sheets 79, 1 (1996) and the evaluation for 152Dy prepared by Balraj Singh and published in Nuclear Data Sheets 95, 995 (2002)

Assessing the State of Procurement Knowledge Production: Implications for the Federal Government

DTIC Science & Technology

2011-12-01

canonical knowledge base, quality control of published information, and assignment of priority and credit for their work to authors” (Rowland, 2002, p...The federal government recognizes the value of theory-based research and graduate education in 5 strategic purchasing—evidenced by its investment ...examination of the underlying trends present in the data. This finding also provided insights that may further other scholarly work in the field

Shared Reading: assessing the intrinsic value of a literature-based health intervention.

PubMed

Longden, Eleanor; Davis, Philip; Billington, Josie; Lampropoulou, Sofia; Farrington, Grace; Magee, Fiona; Walsh, Erin; Corcoran, Rhiannon

2015-12-01

Public health strategies have placed increasing emphasis on psychosocial and arts-based strategies for promoting well-being. This study presents preliminary findings for a specific literary-based intervention, Shared Reading, which provides community-based spaces in which individuals can relate with both literature and one another. A 12-week crossover design was conducted with 16 participants to compare benefits associated with six sessions of Shared Reading versus a comparison social activity, Built Environment workshops. Data collected included quantitative self-report measures of psychological well-being, as well as transcript analysis of session recordings and individual video-assisted interviews. Qualitative findings indicated five intrinsic benefits associated with Shared Reading: liveness, creative inarticulacy, the emotional, the personal and the group (or collective identity construction). Quantitative data additionally showed that the intervention is associated with enhancement of a sense of 'Purpose in Life'. Limitations of the study included the small sample size and ceiling effects created by generally high levels of psychological well-being at baseline. The therapeutic potential of reading groups is discussed, including the distinction between instrumental and intrinsic value within arts-and-health interventions. 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/

Abnormal glomerular filtration rate in children, adolescents and young adults starts below 75 mL/min/1.73 m(2).

PubMed

Pottel, Hans; Hoste, Liesbeth; Delanaye, Pierre

2015-05-01

The chronic kidney disease (CKD) classification system for children is similar to that for adults, with both mainly based on estimated glomerular filtration rate (eGFR) combined with fixed cut-off values. The main cut-off eGFR value used to define CKD is 60 mL/min/1.73 m(2), a value that is also applied for children older than 2 years of age, adolescents and young adults. Based on a literature search, we evaluated inclusion criteria for eGFR in clinical trials or research studies on CKD for children. We also collected information on direct measurements of GFR (mGFR) in children and adolescents, with the aim to estimate the normal reference range for GFR. Using serum creatinine (Scr) normal reference values and Scr-based eGFR-equations, we also evaluated the correspondence between Scr normal reference values and (e)GFR normal reference values. Based on our literature search, the inclusion of children in published CKD studies has been based on cut-off values for eGFR of >60 mL/min/1.73 m(2). The lower reference limits for mGFR far exceed this adult threshold. Using eGFR values calculated using Scr-based formulas, we found that abnormal Scr levels in children already correspond to eGFR values that are below a cut-off of 75 mL/min/1.73 m(2). Abnormal GFR in children, adolescents and young adults starts below 75 mL/min/1.73 m(2), and as abnormality is a sign of disease, we recommend referring children, adolescents and young adults with an (e)GFR of <75 mL/min/1.73 m(2) for further clinical assessment.

The cost of a small membrane bioreactor.

PubMed

Lo, C H; McAdam, E; Judd, S

2015-01-01

The individual cost contributions to the mechanical components of a small membrane bioreactor (MBR) (100-2,500 m3/d flow capacity) are itemised and collated to generate overall capital and operating costs (CAPEX and OPEX) as a function of size. The outcomes are compared to those from previously published detailed cost studies provided for both very small containerised plants (<40 m3/day capacity) and larger municipal plants (2,200-19,000 m3/d). Cost curves, as a function of flow capacity, determined for OPEX, CAPEX and net present value (NPV) based on the heuristic data used indicate a logarithmic function for OPEX and a power-based one for the CAPEX. OPEX correlations were in good quantitative agreement with those reported in the literature. Disparities in the calculated CAPEX trend compared with reported data were attributed to differences in assumptions concerning cost contributions. More reasonable agreement was obtained with the reported membrane separation component CAPEX data from published studies. The heuristic approach taken appears appropriate for small-scale MBRs with minimal costs associated with installation. An overall relationship of net present value=(a tb)Q(-c lnt+d) was determined for the net present value where a=1.265, b=0.44, c=0.00385 and d=0.868 according to the dataset employed for the analysis.

Computer modeling of obesity links theoretical energetic measures with experimental measures of fuel use for lean and obese men.

PubMed

Rossow, Heidi A; Calvert, C Chris

2014-10-01

The goal of this research was to use a computational model of human metabolism to predict energy metabolism for lean and obese men. The model is composed of 6 state variables representing amino acids, muscle protein, visceral protein, glucose, triglycerides, and fatty acids (FAs). Differential equations represent carbohydrate, amino acid, and FA uptake and output by tissues based on ATP creation and use for both lean and obese men. Model parameterization is based on data from previous studies. Results from sensitivity analyses indicate that model predictions of resting energy expenditure (REE) and respiratory quotient (RQ) are dependent on FA and glucose oxidation rates with the highest sensitivity coefficients (0.6, 0.8 and 0.43, 0.15, respectively, for lean and obese models). Metabolizable energy (ME) is influenced by ingested energy intake with a sensitivity coefficient of 0.98, and a phosphate-to-oxygen ratio by FA oxidation rate and amino acid oxidation rate (0.32, 0.24 and 0.55, 0.65 for lean and obese models, respectively). Simulations of previously published studies showed that the model is able to predict ME ranging from 6.6 to 9.3 with 0% differences between published and model values, and RQ ranging from 0.79 to 0.86 with 1% differences between published and model values. REEs >7 MJ/d are predicted with 6% differences between published and model values. Glucose oxidation increases by ∼0.59 mol/d, RQ increases by 0.03, REE increases by 2 MJ/d, and heat production increases by 1.8 MJ/d in the obese model compared with lean model simulations. Increased FA oxidation results in higher changes in RQ and lower relative changes in REE. These results suggest that because fat mass is directly related to REE and rate of FA oxidation, body fat content could be used as a predictor of RQ. © 2014 American Society for Nutrition.

A pilot study to assess feasibility of value based pricing in Cyprus through pharmacoeconomic modelling and assessment of its operational framework: sorafenib for second line renal cell cancer

PubMed Central

2014-01-01

Background The continuing increase of pharmaceutical expenditure calls for new approaches to pricing and reimbursement of pharmaceuticals. Value based pricing of pharmaceuticals is emerging as a useful tool and possess theoretical attributes to help health system cope with rising pharmaceutical expenditure. Aim To assess the feasibility of introducing a value-based pricing scheme of pharmaceuticals in Cyprus and explore the integrative framework. Methods A probabilistic Markov chain Monte Carlo model was created to simulate progression of advanced renal cell cancer for comparison of sorafenib to standard best supportive care. Literature review was performed and efficacy data were transferred from a published landmark trial, while official pricelists and clinical guidelines from Cyprus Ministry of Health were utilised for cost calculation. Based on proposed willingness to pay threshold the maximum price of sorafenib for the indication of second line renal cell cancer was assessed. Results Sorafenib value based price was found to be significantly lower compared to its current reference price. Conclusion Feasibility of Value Based Pricing is documented and pharmacoeconomic modelling can lead to robust results. Integration of value and affordability in the price are its main advantages which have to be weighed against lack of documentation for several theoretical parameters that influence outcome. Smaller countries such as Cyprus may experience adversities in establishing and sustaining essential structures for this scheme. PMID:24910539

Operational Risk Measurement of Chinese Commercial Banks Based on Extreme Value Theory

NASA Astrophysics Data System (ADS)

Song, Jiashan; Li, Yong; Ji, Feng; Peng, Cheng

The financial institutions and supervision institutions have all agreed on strengthening the measurement and management of operational risks. This paper attempts to build a model on the loss of operational risks basing on Peak Over Threshold model, emphasizing on weighted least square, which improved Hill’s estimation method, while discussing the situation of small sample, and fix the sample threshold more objectively basing on the media-published data of primary banks loss on operational risk from 1994 to 2007.

Model-based predictions for dopamine.

PubMed

Langdon, Angela J; Sharpe, Melissa J; Schoenbaum, Geoffrey; Niv, Yael

2018-04-01

Phasic dopamine responses are thought to encode a prediction-error signal consistent with model-free reinforcement learning theories. However, a number of recent findings highlight the influence of model-based computations on dopamine responses, and suggest that dopamine prediction errors reflect more dimensions of an expected outcome than scalar reward value. Here, we review a selection of these recent results and discuss the implications and complications of model-based predictions for computational theories of dopamine and learning. Copyright © 2017. Published by Elsevier Ltd.

Comparing quantitative values of two generations of laser-assisted indocyanine green dye angiography systems: can we predict necrosis?

PubMed

Phillips, Brett T; Fourman, Mitchell S; Rivara, Andrew; Dagum, Alexander B; Huston, Tara L; Ganz, Jason C; Bui, Duc T; Khan, Sami U

2014-01-01

Several devices exist today to assist the intraoperative determination of skin flap perfusion. Laser-Assisted Indocyanine Green Dye Angiography (LAICGA) has been shown to accurately predict mastectomy skin flap necrosis using quantitative perfusion values. The laser properties of the latest LAICGA device (SPY Elite) differ significantly from its predecessor system (SPY 2001), preventing direct translation of previous published data. The purpose of this study was to establish a mathematical relationship of perfusion values between these 2 devices. Breast reconstruction patients were prospectively enrolled into a clinical trial where skin flap evaluation and excision was based on quantitative SPY Q values previously established in the literature. Initial study patients underwent mastectomy skin flap evaluation using both SPY systems simultaneously. Absolute perfusion unit (APU) values at identical locations on the breast were then compared graphically. 210 data points were identified on the same patients (n = 4) using both SPY systems. A linear relationship (y = 2.9883x + 12.726) was identified with a high level or correlation (R(2) = 0.744). Previously published values using SPY 2001 (APU 3.7) provided a value of 23.8 APU on the SPY Elite. In addition, postoperative necrosis in these patients correlated to regions of skin identified with the SPY Elite with APU less than 23.8. Intraoperative comparison of LAICGA systems has provided direct correlation of perfusion values predictive of necrosis that were previously established in the literature. An APU value of 3.7 from the SPY 2001 correlates to a SPY Elite APU value of 23.8.

Comparing Quantitative Values of Two Generations of Laser-Assisted Indocyanine Green Dye Angiography Systems: Can We Predict Necrosis?

PubMed Central

Fourman, Mitchell S.; Rivara, Andrew; Dagum, Alexander B.; Huston, Tara L.; Ganz, Jason C.; Bui, Duc T.; Khan, Sami U.

2014-01-01

Objective: Several devices exist today to assist the intraoperative determination of skin flap perfusion. Laser-Assisted Indocyanine Green Dye Angiography (LAICGA) has been shown to accurately predict mastectomy skin flap necrosis using quantitative perfusion values. The laser properties of the latest LAICGA device (SPY Elite) differ significantly from its predecessor system (SPY 2001), preventing direct translation of previous published data. The purpose of this study was to establish a mathematical relationship of perfusion values between these 2 devices. Methods: Breast reconstruction patients were prospectively enrolled into a clinical trial where skin flap evaluation and excision was based on quantitative SPY Q values previously established in the literature. Initial study patients underwent mastectomy skin flap evaluation using both SPY systems simultaneously. Absolute perfusion unit (APU) values at identical locations on the breast were then compared graphically. Results: 210 data points were identified on the same patients (n = 4) using both SPY systems. A linear relationship (y = 2.9883x + 12.726) was identified with a high level or correlation (R2 = 0.744). Previously published values using SPY 2001 (APU 3.7) provided a value of 23.8 APU on the SPY Elite. In addition, postoperative necrosis in these patients correlated to regions of skin identified with the SPY Elite with APU less than 23.8. Conclusion: Intraoperative comparison of LAICGA systems has provided direct correlation of perfusion values predictive of necrosis that were previously established in the literature. An APU value of 3.7 from the SPY 2001 correlates to a SPY Elite APU value of 23.8. PMID:25525483

Research Supports Value of Updated School Facilities

ERIC Educational Resources Information Center

Fielding, Randall

2012-01-01

Two recent peer-reviewed studies support the need to update the traditional school design model that has remained fundamentally unchanged for over a century. In a 2011 study published by the American Educational Research Journal, entitled "Problem-Based Learning in K-12 Education," Clarice Wirkala and Deanna Kuhn document a 200-500…

Great Teaching

ERIC Educational Resources Information Center

Chetty, Raj; Friedman, John N.; Rockoff, Jonah E.

2012-01-01

In February 2012, the "New York Times" took the unusual step of publishing performance ratings for nearly 18,000 New York City teachers based on their students' test-score gains, commonly called value-added (VA) measures. This action, which followed a similar release of ratings in Los Angeles last year, drew new attention to the growing use of VA…

P-Hacking in Orthopaedic Literature: A Twist to the Tail.

PubMed

Bin Abd Razak, Hamid Rahmatullah; Ang, Jin-Guang Ernest; Attal, Hersh; Howe, Tet-Sen; Allen, John Carson

2016-10-19

"P-hacking" occurs when researchers preferentially select data or statistical analyses until nonsignificant results become significant. We wanted to evaluate if the phenomenon of p-hacking was evident in orthopaedic literature. We text-mined through all articles published in three top orthopaedic journals in 2015. For anonymity, we cipher-coded the three journals. We included all studies that reported a single p value to answer their main hypothesis. These p values were then charted and frequency graphs were generated to illustrate any evidence of p-hacking. Binomial tests were employed to look for evidence of evidential value and significance of p-hacking. Frequency plots for all three journals revealed evidence of p-hacking. Binomial tests for all three journals were significant for evidence of evidential value (p < 0.0001 for all). However, the binomial test for p-hacking was significant only for one journal (p = 0.0092). P-hacking is an evolving phenomenon that threatens to jeopardize the evidence-based practice of medicine. Although our results show that there is good evidential value for orthopaedic literature published in our top journals, there is some evidence of p-hacking of which authors and readers should be wary. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Research and development for a ground-based hydrogen-maser system

NASA Technical Reports Server (NTRS)

1972-01-01

The results of a joint experiment aimed primarily at the determination of the frequency of the H(1) hyperfine transition are reported. The transition frequency value for Cs-133 hyperfine transition is found. The result is the mean of two independent evaluations against the cesium reference, which differ by 0.002 Hz. The one-sigma uncertainty of the value nu sub H is also estimated to be 0.002 Hz. One evaluation is based on wall shift experiments at Harvard University; the other is a result of new wall shift measurement using many storage bulbs of different sizes at the National Bureau of Standards. The experimental procedures and the applied corrections are described. Results for the wall shift and for the frequency of hydrogen are compared with previously published values, and error limits of the experiments are discussed.

[Value-based medicine in ophthalmology].

PubMed

Hirneiss, C; Neubauer, A S; Tribus, C; Kampik, A

2006-06-01

Value-based medicine (VBM) unifies costs and patient-perceived value (improvement in quality of life, length of life, or both) of an intervention. Value-based ophthalmology is of increasing importance for decisions in eye care. The methods of VBM are explained and definitions for a specific terminology in this field are given. The cost-utility analysis as part of health care economic analyses is explained. VBM exceeds evidence-based medicine by incorporating parameters of cost and benefits from an ophthalmological intervention. The benefit of the intervention is defined as an increase or maintenance of visual quality of life and can be determined by utility analysis. The time trade-off method is valid and reliable for utility analysis. The resources expended for the value gained in VBM are measured with cost-utility analysis in terms of cost per quality-adjusted life years gained (euros/QALY). Numerous cost-utility analyses of different ophthalmological interventions have been published. The fundamental instrument of VBM is cost-utility analysis. The results in cost per QALY allow estimation of cost effectiveness of an ophthalmological intervention. Using the time trade-off method for utility analysis allows the comparison of ophthalmological cost-utility analyses with those of other medical interventions. VBM is important for individual medical decision making and for general health care.

Relations of principal components analysis site scores to algal-biomass, habitat, basin-characteristics, nutrient, and biological-community data in the Upper Wabash River Basin, Indiana, 2003

USGS Publications Warehouse

Leer, Donald R.; Caskey, Brian J.; Frey, Jeffrey W.; Lowe, B. Scott

2007-01-01

The values for nutrients (nitrate, total Kjeldahl nitrogen, total nitrogen, and total phosphorus) and chlorophyll a (periphyton and seston) were compared to published U.S. Environmental Protection Agency (USEPA) values for Aggregate Nutrient Ecoregions VI and VII and USEPA Level III Ecoregions 55 and 56. Several nutrient values were greater than the 25th percentile of the published USEPA values. Chlorophyll a (periphyton and seston) values either were greater than the 25th percentile of published USEPA values or extended data ranges in the Aggregate Nutrient and Level III Ecoregions. If the proposed values for the 25th percentile were adopted as nutrient water-quality criteria, many samples in the Upper Wabash River Basin would have exceeded the criteria.

Haematological, blood gas and acid-base values in the Galgo Español (Spanish greyhound).

PubMed

Mesa-Sanchez, I; Zaldivar-Lopez, S; Couto, C G; Gamito-Gomez, A; Granados-Machuca, M M; Lopez-Villalba, I; Galan-Rodriguez, A

2012-07-01

Haematologic profiles, electrolyte concentrations, blood gas values and acid-base balance have been studied and reported in healthy greyhounds; however, there is only one study published on blood gas values in Galgos Españoles. Because of their purported common origins with greyhounds (same group and class), it was hypothesised that Galgos Españoles also have differences in haematologic values, electrolyte concentrations, blood gas values and acid-base balance compared to other non-sporting breeds. Venous blood samples from 30 Galgos Españoles and 20 dogs from different breeds were collected, and complete blood counts, electrolyte concentrations, blood gas values and acid-base balance were measured. From the 24 parameters analysed, 5 had statistically significant differences (P<0·05). Galgos Españoles had higher haematocrit (P<0·001), haemoglobin concentration (P=0·003), erythrocyte count (P=0·016) and pH (P=0·03), and lower platelet count (P=0·005), than those in other-breed dogs. These results confirm that significant haematologic differences exist in Galgos Españoles when compared with other dogs, although these differences are not as striking as in greyhounds. Practitioners need to be aware of these breed-specific differences in order to make accurate diagnoses in Galgos Españoles. © 2012 British Small Animal Veterinary Association.

An original approach was used to better evaluate the capacity of a prognostic marker using published survival curves.

PubMed

Dantan, Etienne; Combescure, Christophe; Lorent, Marine; Ashton-Chess, Joanna; Daguin, Pascal; Classe, Jean-Marc; Giral, Magali; Foucher, Yohann

2014-04-01

Predicting chronic disease evolution from a prognostic marker is a key field of research in clinical epidemiology. However, the prognostic capacity of a marker is not systematically evaluated using the appropriate methodology. We proposed the use of simple equations to calculate time-dependent sensitivity and specificity based on published survival curves and other time-dependent indicators as predictive values, likelihood ratios, and posttest probability ratios to reappraise prognostic marker accuracy. The methodology is illustrated by back calculating time-dependent indicators from published articles presenting a marker as highly correlated with the time to event, concluding on the high prognostic capacity of the marker, and presenting the Kaplan-Meier survival curves. The tools necessary to run these direct and simple computations are available online at http://www.divat.fr/en/online-calculators/evalbiom. Our examples illustrate that published conclusions about prognostic marker accuracy may be overoptimistic, thus giving potential for major mistakes in therapeutic decisions. Our approach should help readers better evaluate clinical articles reporting on prognostic markers. Time-dependent sensitivity and specificity inform on the inherent prognostic capacity of a marker for a defined prognostic time. Time-dependent predictive values, likelihood ratios, and posttest probability ratios may additionally contribute to interpret the marker's prognostic capacity. Copyright © 2014 Elsevier Inc. All rights reserved.

Values-based practice in mental health and psychiatry.

PubMed

Woodbridge-Dodd, Kim

2012-11-01

Values-based practice (VBP) challenges traditions of clinical practice and moral decision-making and the literature published over the last 18 months demonstrates a growing momentum for its use. The VBP model has become part of the narrative of health and social care practice. It features in a range of publications and has been subject to philosophical analysis in relation to its theoretical rigour, and applied to clinical practice through education and training, implementation in the field and policy development. From a philosophical perspective the model faces several challenges; from a practice perspective it is welcomed as a necessary partner to Evidence-Based Practice. Both perspectives suggest VBP requires significant adjustment to professional ideas of good practice, expectations of the clinician service user relationship and notions of what constitutes good care. VBP is both a solution and a problem for clinicians. Whether VBP is seen as providing a much needed clinical skill for working with the complexity of mental health and psychiatry which is steeped in values or a solution to a dominant sociopolitical neoliberal ideology demand for choice and personalization of care, VBP will require clinicians to make personal changes to their values base that reach to the depths of their professional identity.

Time-Driven Activity-Based Costing in Emergency Medicine.

PubMed

Yun, Brian J; Prabhakar, Anand M; Warsh, Jonathan; Kaplan, Robert; Brennan, John; Dempsey, Kyle E; Raja, Ali S

2016-06-01

Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine which interventions might improve value for their patients. Although ongoing research may determine which outcomes are meaningful, an accurate costing system is also needed. This article reviews current costing mechanisms in the ED and their pitfalls. It then describes how time-driven activity-based costing may be superior to these current costing systems. Time-driven activity-based costing, in addition to being a more accurate costing system, can be used for process improvements in the ED. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Quality and Business Offer Driven Selection of Web Services for Compositions

NASA Astrophysics Data System (ADS)

D'Mello, Demian Antony; Ananthanarayana, V. S.

The service composition makes use of the existing services to produce a new value added service to execute the complex business process. The service discovery finds the suitable services (candidates) for the various tasks of the composition based on the functionality. The service selection in composition assigns the best candidate for each tasks of the pre-structured composition plan based on the non-functional properties. In this paper, we propose the broker based architecture for the QoS and business offer aware Web service compositions. The broker architecture facilitates the registration of a new composite service into three different registries. The broker publishes service information into the service registry and QoS into the QoS registry. The business offers of the composite Web service are published into a separate repository called business offer (BO) registry. The broker employs the mechanism for the optimal assignment of the Web services to the individual tasks of the composition. The assignment is based on the composite service providers’s (CSP) variety of requirements defined on the QoS and business offers. The broker also computes the QoS of resulting composition and provides the useful information for the CSP to publish thier business offers.

Comparative effectiveness and cost-effectiveness of the implantable miniature telescope.

PubMed

Brown, Gary C; Brown, Melissa M; Lieske, Heidi B; Lieske, Philip A; Brown, Kathryn S; Lane, Stephen S

2011-09-01

To assess the preference-based comparative effectiveness (human value gain) and the cost-utility (cost-effectiveness) of a telescope prosthesis (implantable miniature telescope) for the treatment of end-stage, age-related macular degeneration (AMD). A value-based medicine, second-eye model, cost-utility analysis was performed to quantify the comparative effectiveness and cost-effectiveness of therapy with the telescope prosthesis. Published, evidence-based data from the IMT002 Study Group clinical trial. Ophthalmic utilities were obtained from a validated cohort of >1000 patients with ocular diseases. Comparative effectiveness data were converted from visual acuity to utility (value-based) format. The incremental costs (Medicare) of therapy versus no therapy were integrated with the value gain conferred by the telescope prosthesis to assess its average cost-utility. The incremental value gains and incremental costs of therapy referent to (1) a fellow eye cohort and (2) a fellow eye cohort of those who underwent intra-study cataract surgery were integrated in incremental cost-utility analyses. All value outcomes and costs were discounted at a 3% annual rate, as per the Panel on Cost-Effectiveness in Health and Medicine. Comparative effectiveness was quantified using the (1) quality-adjusted life-year (QALY) gain and (2) percent human value gain (improvement in quality of life). The QALY gain was integrated with incremental costs into the cost-utility ratio ($/QALY, or US dollars expended per QALY gained). The mean, discounted QALY gain associated with use of the telescope prosthesis over 12 years was 0.7577. When the QALY loss of 0.0004 attributable to the adverse events was factored into the model, the final QALY gain was 0.7573. This resulted in a 12.5% quality of life gain for the average patient during the 12 years of the model. The average cost-utility versus no therapy for use of the telescope prosthesis was $14389/QALY. The incremental cost-utility referent to control fellow eyes was $14063/QALY, whereas the incremental cost-utility referent to fellow eyes that underwent intra-study cataract surgery was $11805/QALY. Therapy with the telescope prosthesis considerably improves quality of life and at the same time is cost-effective by conventional standards. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

A comparative review of estimates of the proportion unchanged genes and the false discovery rate

PubMed Central

Broberg, Per

2005-01-01

Background In the analysis of microarray data one generally produces a vector of p-values that for each gene give the likelihood of obtaining equally strong evidence of change by pure chance. The distribution of these p-values is a mixture of two components corresponding to the changed genes and the unchanged ones. The focus of this article is how to estimate the proportion unchanged and the false discovery rate (FDR) and how to make inferences based on these concepts. Six published methods for estimating the proportion unchanged genes are reviewed, two alternatives are presented, and all are tested on both simulated and real data. All estimates but one make do without any parametric assumptions concerning the distributions of the p-values. Furthermore, the estimation and use of the FDR and the closely related q-value is illustrated with examples. Five published estimates of the FDR and one new are presented and tested. Implementations in R code are available. Results A simulation model based on the distribution of real microarray data plus two real data sets were used to assess the methods. The proposed alternative methods for estimating the proportion unchanged fared very well, and gave evidence of low bias and very low variance. Different methods perform well depending upon whether there are few or many regulated genes. Furthermore, the methods for estimating FDR showed a varying performance, and were sometimes misleading. The new method had a very low error. Conclusion The concept of the q-value or false discovery rate is useful in practical research, despite some theoretical and practical shortcomings. However, it seems possible to challenge the performance of the published methods, and there is likely scope for further developing the estimates of the FDR. The new methods provide the scientist with more options to choose a suitable method for any particular experiment. The article advocates the use of the conjoint information regarding false positive and negative rates as well as the proportion unchanged when identifying changed genes. PMID:16086831

Esthetic or Functional, Saccharine or Shocking? An Editor Looks at Values in Children's Books.

ERIC Educational Resources Information Center

Giblin, James Cross

1977-01-01

Discusses artistic or esthetic, social and cultural, functional, and commercial values looked for by children's book editors in selecting and publishing manuscripts. Also reviews changes in social and cultural values as shown by children's books published in 1947, 1957, and 1967. (GT)

A pilot study of MD (psychiatry) theses-based research.

PubMed

Srivastava, Shrikant; Agarwal, Vivek; Subramanyam, Alka; Srivastava, Mona; Sathyanarayana Rao, T S; Rao, G Prasad; Khurana, Hitesh; Singh, Archana

2018-01-01

Undertaking a research project is mandatory for MD Psychiatry trainees. The present study was undertaken to assess the type of research activity being undertaken as part of MD Psychiatry dissertation, and its contribution to national and international literature. Three medical colleges supplied the data about the topic, names of the supervisor and the candidate, collaboration, funding accrued, and publication details of MD-based research carried out between years 2000 and 2010 inclusive; 95 records were collected for the final analysis. The details of the publications provided were cross-checked on the internet, which would have taken care of missed publications as well. Most studies were single-point assessment clinical studies. Only 2 studies had been funded, 11 had collaboration with other departments within the same institute, and 5 had inter-institute collaborations. Majority of the studies were not published. Only 30 were published as full paper and 9 as abstracts. Of these 30 full publications, only 3 were published in journals having JCI impact factor values (1.4, 1.3, and 1.4, respectively). The main finding of this pilot study was that MD-based research has low contribution to the national and international literature, and those articles which are published are in low impact journals. Suggestions for modifying this state of affairs are discussed.

Ambiguity in Social Network Data for Presence, Sensitive-Attribute, Degree and Relationship Privacy Protection.

PubMed

Rajaei, Mehri; Haghjoo, Mostafa S; Miyaneh, Eynollah Khanjari

2015-01-01

Maintaining privacy in network data publishing is a major challenge. This is because known characteristics of individuals can be used to extract new information about them. Recently, researchers have developed privacy methods based on k-anonymity and l-diversity to prevent re-identification or sensitive label disclosure through certain structural information. However, most of these studies have considered only structural information and have been developed for undirected networks. Furthermore, most existing approaches rely on generalization and node clustering so may entail significant information loss as all properties of all members of each group are generalized to the same value. In this paper, we introduce a framework for protecting sensitive attribute, degree (the number of connected entities), and relationships, as well as the presence of individuals in directed social network data whose nodes contain attributes. First, we define a privacy model that specifies privacy requirements for the above private information. Then, we introduce the technique of Ambiguity in Social Network data (ASN) based on anatomy, which specifies how to publish social network data. To employ ASN, individuals are partitioned into groups. Then, ASN publishes exact values of properties of individuals of each group with common group ID in several tables. The lossy join of those tables based on group ID injects uncertainty to reconstruct the original network. We also show how to measure different privacy requirements in ASN. Simulation results on real and synthetic datasets demonstrate that our framework, which protects from four types of private information disclosure, preserves data utility in tabular, topological and spectrum aspects of networks at a satisfactory level.

Ambiguity in Social Network Data for Presence, Sensitive-Attribute, Degree and Relationship Privacy Protection

PubMed Central

Rajaei, Mehri; Haghjoo, Mostafa S.; Miyaneh, Eynollah Khanjari

2015-01-01

Maintaining privacy in network data publishing is a major challenge. This is because known characteristics of individuals can be used to extract new information about them. Recently, researchers have developed privacy methods based on k-anonymity and l-diversity to prevent re-identification or sensitive label disclosure through certain structural information. However, most of these studies have considered only structural information and have been developed for undirected networks. Furthermore, most existing approaches rely on generalization and node clustering so may entail significant information loss as all properties of all members of each group are generalized to the same value. In this paper, we introduce a framework for protecting sensitive attribute, degree (the number of connected entities), and relationships, as well as the presence of individuals in directed social network data whose nodes contain attributes. First, we define a privacy model that specifies privacy requirements for the above private information. Then, we introduce the technique of Ambiguity in Social Network data (ASN) based on anatomy, which specifies how to publish social network data. To employ ASN, individuals are partitioned into groups. Then, ASN publishes exact values of properties of individuals of each group with common group ID in several tables. The lossy join of those tables based on group ID injects uncertainty to reconstruct the original network. We also show how to measure different privacy requirements in ASN. Simulation results on real and synthetic datasets demonstrate that our framework, which protects from four types of private information disclosure, preserves data utility in tabular, topological and spectrum aspects of networks at a satisfactory level. PMID:26110762

Value management program: performance, quantification, and presentation of imaging value-added actions.

PubMed

Patel, Samir

2015-03-01

Health care is in a state of transition, shifting from volume-based success to value-based success. Hospital executives and referring physicians often do not understand the total value a radiology group provides. A template for easy, cost-effective implementation in clinical practice for most radiology groups to demonstrate the value they provide to their clients (patients, physicians, health care executives) has not been well described. A value management program was developed to document all of the value-added activities performed by on-site radiologists, quantify them in terms of time spent on each activity (investment), and present the benefits to internal and external stakeholders (outcomes). The radiology value-added matrix is the platform from which value-added activities are categorized and synthesized into a template for defining investments and outcomes. The value management program was first implemented systemwide in 2013. Across all serviced locations, 9,931.75 hours were invested. An annual executive summary report template demonstrating outcomes is given to clients. The mean and median individual value-added hours per radiologist were 134.52 and 113.33, respectively. If this program were extrapolated to the entire field of radiology, approximately 30,000 radiologists, this would have resulted in 10,641,161 uncompensated value-added hours documented in 2013, with an estimated economic value of $2.21 billion. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Mode of action human relevance (species concordance) framework: Evolution of the Bradford Hill considerations and comparative analysis of weight of evidence

PubMed Central

Meek, M E (Bette); Palermo, Christine M; Bachman, Ammie N; North, Colin M; Jeffrey Lewis, R

2014-01-01

The mode of action human relevance (MOA/HR) framework increases transparency in systematically considering data on MOA for end (adverse) effects and their relevance to humans. This framework continues to evolve as experience increases in its application. Though the MOA/HR framework is not designed to address the question of “how much information is enough” to support a hypothesized MOA in animals or its relevance to humans, its organizing construct has potential value in considering relative weight of evidence (WOE) among different cases and hypothesized MOA(s). This context is explored based on MOA analyses in published assessments to illustrate the relative extent of supporting data and their implications for dose–response analysis and involved comparisons for chemical assessments on trichloropropane, and carbon tetrachloride with several hypothesized MOA(s) for cancer. The WOE for each hypothesized MOA was summarized in narrative tables based on comparison and contrast of the extent and nature of the supporting database versus potentially inconsistent or missing information. The comparison was based on evolved Bradford Hill considerations rank ordered to reflect their relative contribution to WOE determinations of MOA taking into account increasing experience in their application internationally. This clarification of considerations for WOE determinations as a basis for comparative analysis is anticipated to contribute to increasing consistency in the application of MOA/HR analysis and potentially, transparency in separating science judgment from public policy considerations in regulatory risk assessment. Copyright © 2014. The Authors. Journal of Applied Toxicology Published by John Wiley & Sons Ltd. The potential value of the mode of action (MOA)/human relevance (species concordance) framework in considering relative weight of evidence (WOE) amongst different cases and hypothesized MOA(s) is explored based on the content of several published assessments. The comparison is based on evolved Bradford Hill considerations rank ordered to reflect their relative contribution to WOE determinations for MOA based on experience internationally. PMID:24777878

Bruise chromophore concentrations over time

NASA Astrophysics Data System (ADS)

Duckworth, Mark G.; Caspall, Jayme J.; Mappus, Rudolph L., IV; Kong, Linghua; Yi, Dingrong; Sprigle, Stephen H.

2008-03-01

During investigations of potential child and elder abuse, clinicians and forensic practitioners are often asked to offer opinions about the age of a bruise. A commonality between existing methods of bruise aging is analysis of bruise color or estimation of chromophore concentration. Relative chromophore concentration is an underlying factor that determines bruise color. We investigate a method of chromophore concentration estimation that can be employed in a handheld imaging spectrometer with a small number of wavelengths. The method, based on absorbance properties defined by Beer-Lambert's law, allows estimation of differential chromophore concentration between bruised and normal skin. Absorption coefficient data for each chromophore are required to make the estimation. Two different sources of this data are used in the analysis- generated using Independent Component Analysis and taken from published values. Differential concentration values over time, generated using both sources, show correlation to published models of bruise color change over time and total chromophore concentration over time.

The Research Implications of Prostate Specific Antigen Registry Errors: Data from the Veterans Health Administration.

PubMed

Guo, David P; Thomas, I-Chun; Mittakanti, Harsha R; Shelton, Jeremy B; Makarov, Danil V; Skolarus, Ted A; Cooperberg, Mathew R; Sonn, Geoffrey A; Chung, Benjamin I; Brooks, James D; Leppert, John T

2018-04-06

We sought to characterize the effects of prostate specific antigen registry errors on clinical research by comparing cohorts based on cancer registry prostate specific antigen values with those based directly on results in the electronic health record. We defined sample cohorts of men with prostate cancer using data from the VHA (Veterans Health Administration), including those with a prostate specific antigen value less than 4.0, 4.0 to 10.0, 10.0 to 20.0 and 20.0 to 98.0 ng/ml, respectively. We compared the composition of each cohort and overall patient survival when using PSA values from the VACCR (Veteran Affairs Central Cancer Registry) vs the gold standard electronic health record laboratory file results. There was limited agreement among cohorts when defined by cancer registry PSA values vs the laboratory file of the electronic health record. The least agreement of 58% was seen in patients with PSA less than 4.0 ng/ml and greatest agreement of 89% was noted among patients with PSA between 4.0 and 10.0 ng/ml. In each cohort patients assigned to a cohort based only on the cancer registry PSA value had significantly different overall survival when compared with patients assigned based on registry and laboratory file PSA values. Cohorts based exclusively on cancer registry PSA values may have high rates of misclassification that can introduce concerning differences in key characteristics and result in measurable differences in clinical outcomes. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The Evidence Value Matrix for Diagnostic Imaging.

PubMed

Seidel, David; Frank, Richard A; Schmidt, Sebastian

2016-10-01

Evidence and value are independent factors that together affect the adoption of diagnostic imaging. For example, noncoverage decisions by reimbursement authorities can be justified by a lack of evidence and/or value. To create transparency and a common understanding among various stakeholders, we have proposed a two-dimensional matrix that allows classification of imaging devices into three distinct categories based on the available evidence and value: "question marks" (low value demonstrated in studies of any evidence level), "candidates" (high value demonstrated in retrospective case-control studies and smaller case series), and "stars" (high value demonstrated in large prospective cohort studies or, preferably, randomized controlled trials). We use several examples to illustrate the application of our matrix. A major benefit of the matrix includes the development of specific strategies for evidence and value generation. High-evidence/low-value studies are expensive and unlikely to convince decision makers, given the uncertainty of the impact on patient management and outcomes. Developing question marks into candidates first and then into stars will often be quicker and less expensive ("success sequence"). Only this more sophisticated and objective approach can justify the additional funding necessary to generate the evidence base to inform reimbursement by payers and adoption by providers. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

76 FR 13431 - Major Portion Prices and Due Date for Additional Royalty Payments on Indian Gas Production in...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

...: Notice of major portion prices for calendar year 2009. SUMMARY: Final regulations for valuing gas produced from Indian leases, published August 10, 1999, require the Office of Natural Resources Revenue... calendar year 2009. DATES: The due date to pay additional royalties based on the major portion prices is...

Leaders' Views on the Values of School-Based Research: Contemporary Themes and Issues

ERIC Educational Resources Information Center

Bryan, Hazel; Burstow, Bob

2017-01-01

In 2004, McLaughlin, Black-Hawkins and McIntyre published a literature review that explored the ways in which individual teachers, whole schools and groups of networked schools were engaging in practitioner research and enquiry. In the light of significant changes to the education landscape, the empirical research in this article provides an…

Yield of a Choctawhatchee Sand Pine Plantation at Age 28

Treesearch

Russell M. Burns; R.H. Brendemuehl

1969-01-01

A little-known tree, Choctawhatchee sand pine (Pinus clausa [Chapm.] Vasey), seems well adapted to the infertile, droughty soils common to the sandhills of Florida which now produce little value. Published yield data based on plantation-grown Choctawhatchee sand pine are not available. One 28-year-old plantation of this race of sand pine, growing...

Dose equivalent rate constants and barrier transmission data for nuclear medicine facility dose calculations and shielding design.

PubMed

Kusano, Maggie; Caldwell, Curtis B

2014-07-01

A primary goal of nuclear medicine facility design is to keep public and worker radiation doses As Low As Reasonably Achievable (ALARA). To estimate dose and shielding requirements, one needs to know both the dose equivalent rate constants for soft tissue and barrier transmission factors (TFs) for all radionuclides of interest. Dose equivalent rate constants are most commonly calculated using published air kerma or exposure rate constants, while transmission factors are most commonly calculated using published tenth-value layers (TVLs). Values can be calculated more accurately using the radionuclide's photon emission spectrum and the physical properties of lead, concrete, and/or tissue at these energies. These calculations may be non-trivial due to the polyenergetic nature of the radionuclides used in nuclear medicine. In this paper, the effects of dose equivalent rate constant and transmission factor on nuclear medicine dose and shielding calculations are investigated, and new values based on up-to-date nuclear data and thresholds specific to nuclear medicine are proposed. To facilitate practical use, transmission curves were fitted to the three-parameter Archer equation. Finally, the results of this work were applied to the design of a sample nuclear medicine facility and compared to doses calculated using common methods to investigate the effects of these values on dose estimates and shielding decisions. Dose equivalent rate constants generally agreed well with those derived from the literature with the exception of those from NCRP 124. Depending on the situation, Archer fit TFs could be significantly more accurate than TVL-based TFs. These results were reflected in the sample shielding problem, with unshielded dose estimates agreeing well, with the exception of those based on NCRP 124, and Archer fit TFs providing a more accurate alternative to TVL TFs and a simpler alternative to full spectral-based calculations. The data provided by this paper should assist in improving the accuracy and tractability of dose and shielding calculations for nuclear medicine facility design.

Taking action on overuse: Creating the culture for change.

PubMed

Parchman, Michael L; Henrikson, Nora B; Blasi, Paula R; Buist, Diana S; Penfold, Robert; Austin, Brian; Ganos, Emily H

2017-12-01

Unnecessary care contributes to high costs and places patients at risk of harm. While most providers support reducing low-value care, changing established practice patterns is difficult and requires active engagement in sustained behavioral, organizational, and cultural change. Here we describe an action-planning framework to engage providers in reducing overused services. The framework is informed by a comprehensive review of social science theory and literature, published reports of successful and unsuccessful efforts to reduce low-value care, and interviews with innovators of value-based care initiatives in twenty-three health care organizations across the United States. A multi-stakeholder advisory committee provided feedback on the framework and guidance on optimizing it for use in practice. The framework describes four conditions necessary for change: prioritize addressing low-value care; build a culture of trust, innovation and improvement; establish shared language and purpose; and commit resources to measurements. These conditions foster productive sense-making conversations between providers, between providers and patients, and among members of the health care team about the potential for harm from overuse and reflection on current frequency of use. Through these conversations providers, patients and team members think together as a group, learn how to coordinate individual behaviors, and jointly develop possibilities for coordinated action around specific areas of overuse. Organizational efforts to engage providers in value-based care focused on creating conditions for productive sense-making conversations that lead to change. Organizations can use this framework to enhance and strengthen provider engagement efforts to do less of what potentially harms and more of what truly helps patients. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

A chitosan-based coating with or without clove oil extends the shelf life of cooked pork sausages in refrigerated storage.

PubMed

Lekjing, Somwang

2016-01-01

Chitosan coatings, with and without clove oil, were investigated for effects on quality and shelf life of cooked pork sausages stored at a refrigerated temperature (4±2°C). The various treatments of cooked pork sausages were: untreated (control), coating with 2% chitosan (CS), and coating with a mixture having 2% chitosan and 1.5% clove oil (CS+CO). Various microbiological, physical, chemical and sensory properties were monitored over 25 days of storage. The total viable count, the psychrotrophic bacteria count, the L* value, peroxide value and the thiobarbituric acid reactive substances increased, while the a* value, the b* value, the pH and the sensory scores decreased with storage time, across all treatments. However, these changes were slowest with the CS+CO treatment. Based on sensory evaluation and microbiological quality, the shelf lives were 14 days for control, 20 days for CS, and 20 days for CS+CO treated samples, under refrigerated storage. Copyright © 2015. Published by Elsevier Ltd.

Assessing the State of Procurement Knowledge Production: Implications for the Federal Government

DTIC Science & Technology

2011-10-31

NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND...archiving of the canonical knowledge base, quality control of published information, and assignment of priority and credit for their work to authors...recognizes the value of theory-based research and graduate education in strategic purchasing—evidenced by its investment in an acclaimed strategic purchasing

Time-driven activity-based costing in health care: A systematic review of the literature.

PubMed

Keel, George; Savage, Carl; Rafiq, Muhammad; Mazzocato, Pamela

2017-07-01

Health care organizations around the world are investing heavily in value-based health care (VBHC), and time-driven activity-based costing (TDABC) has been suggested as the cost-component of VBHC capable of addressing costing challenges. The aim of this study is to explore why TDABC has been applied in health care, how its application reflects a seven-step method developed specifically for VBHC, and implications for the future use of TDABC. This is a systematic review following the PRISMA statement. Qualitative methods were employed to analyze data through content analyses. TDABC is applicable in health care and can help to efficiently cost processes, and thereby overcome a key challenge associated with current cost-accounting methods The method's ability to inform bundled payment reimbursement systems and to coordinate delivery across the care continuum remains to be demonstrated in the published literature, and the role of TDABC in this cost-accounting landscape is still developing. TDABC should be gradually incorporated into functional systems, while following and building upon the recommendations outlined in this review. In this way, TDABC will be better positioned to accurately capture the cost of care delivery for conditions and to control cost in the effort to create value in health care. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

OPATs: Omnibus P-value association tests.

PubMed

Chen, Chia-Wei; Yang, Hsin-Chou

2017-07-10

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

Health risk assessment of polycyclic aromatic hydrocarbons in the source water and drinking water of China: Quantitative analysis based on published monitoring data.

PubMed

Wu, Bing; Zhang, Yan; Zhang, Xu-Xiang; Cheng, Shu-Pei

2011-12-01

A carcinogenic risk assessment of polycyclic aromatic hydrocarbons (PAHs) in source water and drinking water of China was conducted using probabilistic techniques from a national perspective. The published monitoring data of PAHs were gathered and converted into BaP equivalent (BaP(eq)) concentrations. Based on the transformed data, comprehensive risk assessment was performed by considering different age groups and exposure pathways. Monte Carlo simulation and sensitivity analysis were applied to quantify uncertainties of risk estimation. The risk analysis indicated that, the risk values for children and teens were lower than the accepted value (1.00E-05), indicating no significant carcinogenic risk. The probability of risk values above 1.00E-05 was 5.8% and 6.7% for adults and lifetime groups, respectively. Overall, carcinogenic risks of PAHs in source water and drinking water of China were mostly accepted. However, specific regions, such as Yellow river of Lanzhou reach and Qiantang river should be paid more attention. Notwithstanding the uncertainties inherent in the risk assessment, this study is the first attempt to provide information on carcinogenic risk of PAHs in source water and drinking water of China, and might be useful for potential strategies of carcinogenic risk management and reduction. Copyright © 2011 Elsevier B.V. All rights reserved.

Using Publish-Subscribe Messaging for System Status and Automation

NASA Technical Reports Server (NTRS)

Smith, Danford S.

2015-01-01

The NASA Goddard Mission Services Evolution Center (GMSEC) system is a message-based plug-and-play open system architecture used in many of NASA mission operations centers. This presentation will focus on the use of GMSEC standard messages to report and analyze the status of a system and enable the automation of the system's components. In GMSEC systems, each component reports its status using a keep-alive message and also publishes status and activities as log messages. In addition, the components can accept functional directive messages from the GMSEC message bus. Over the past several years, development teams have found ways to utilize these messages to create innovative display pages and increasingly sophisticated approaches to automation. This presentation will show the flexibility and value of the message-based approach to system awareness and automation.

The ranking of scientists based on scientific publications assessment.

PubMed

Zerem, Enver

2017-11-01

It is generally accepted that the scientific impact factor (Web of Science) and the total number of citations of the articles published in a journal, are the most relevant parameters of the journal's significance. However, the significance of scientists is much more complicated to establish and the value of their scientific production cannot be directly reflected by the importance of the journals in which their articles are published. Evaluating the significance of scientists' accomplishments involves more complicated metrics than just their publication records. Based on a long term of academic experience, the author proposes objective criteria to estimate the scientific merit of an individual's publication record. This metric can serve as a pragmatic tool and the nidus for discussion within the readership of this journal. Copyright © 2017 Elsevier Inc. All rights reserved.

A Quantitative Description of Suicide Inhibition of Dichloroacetic Acid in Rats and Mice

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

Keys, Deborah A.; Schultz, Irv R.; Mahle, Deirdre A.

Dichloroacetic acid (DCA), a minor metabolite of trichloroethylene (TCE) and water disinfection byproduct, remains an important risk assessment issue because of its carcinogenic potency. DCA has been shown to inhibit its own metabolism by irreversibly inactivating glutathione transferase zeta (GSTzeta). To better predict internal dosimetry of DCA, a physiologically based pharmacokinetic (PBPK) model of DCA was developed. Suicide inhibition was described dynamically by varying the rate of maximal GSTzeta mediated metabolism of DCA (Vmax) over time. Resynthesis (zero-order) and degradation (first-order) of metabolic activity were described. Published iv pharmacokinetic studies in native rats were used to estimate an initial Vmaxmore » value, with Km set to an in vitro determined value. Degradation and resynthesis rates were set to estimated values from a published immunoreactive GSTzeta protein time course. The first-order inhibition rate, kd, was estimated to this same time course. A secondary, linear non-GSTzeta-mediated metabolic pathway is proposed to fit DCA time courses following treatment with DCA in drinking water. The PBPK model predictions were validated by comparing predicted DCA concentrations to measured concentrations in published studies of rats pretreated with DCA following iv exposure to 0.05 to 20 mg/kg DCA. The same model structure was parameterized to simulate DCA time courses following iv exposure in native and pretreated mice. Blood and liver concentrations during and postexposure to DCA in drinking water were predicted. Comparisons of PBPK model predicted to measured values were favorable, lending support for the further development of this model for application to DCA or TCE human health risk assessment.« less

Soil-vegetation correlations in the Connecticut River floodplain of Western Massachusetts

USGS Publications Warehouse

Veneman, Peter L.M.; Tiner, Ralph W.

1990-01-01

As part of a national study analyzing the relation between hydric soils and wetland vegetation, the vegetation associated with a series of known soils was sampled along the Connecticut River floodplain in Massachusetts. Weighted average and index average (presence/absence) values were calculated for vegetation using wetland ecological index values from the National List of Plant Species that Occur in Wetlands developed by the U.S. Fish and Wildlife Service and procedures developed by T. R. Wentworth and G. P. Johnson at North Carolina State University. Good correspondence between soils and vegetation was recorded with two exceptions. Two typically nonhydric soils were determined to be hydric based on vegetation analyses. Examination of the groundwater hydrology of these two soils confirmed their hydric nature. The authors suggested that one of these soils may need to be redefined and they also suggested that the assigned index values for a few species of vegetation should be reexamined. However, in general the index average values of vegetation based on published wetland index values corresponded with the hydric and nonhydric nature of soils.

What Is a Value Management Office? An Implementation Experience in Latin America.

PubMed

Makdisse, Marcia; Katz, Marcelo; Ramos, Pedro; Pereira, Adriano; Shiramizo, Sandra; Neto, Miguel Cendoroglo; Klajner, Sidney

2018-05-02

Value-based health care has been touted as the "strategy that will fix healthcare," yet putting this value agenda to work in the real world is not an easy task. Robert Kaplan and colleagues first introduced the concept of a value management office (VMO) that may help to accelerate the dissemination and adoption of this value agenda. In this article, we describe the first known experience of the implementation of a VMO in a Latin American hospital and the main steps we have already taken to accelerate this value agenda at Hospital Israelita Albert Einstein. We faced a number of challenges in implementing the VMO at Einstein, including integration with existing clinical and financial information areas, transition to a standardized outcomes model, adaptation to our "open medical staff" model by connecting the VMO with the Medical Practice Division, and involvement with our physician-led multidisciplinary groups. Copyright © 2018. Published by Elsevier Inc.

Handwriting: Feature Correlation Analysis for Biometric Hashes

NASA Astrophysics Data System (ADS)

Vielhauer, Claus; Steinmetz, Ralf

2004-12-01

In the application domain of electronic commerce, biometric authentication can provide one possible solution for the key management problem. Besides server-based approaches, methods of deriving digital keys directly from biometric measures appear to be advantageous. In this paper, we analyze one of our recently published specific algorithms of this category based on behavioral biometrics of handwriting, the biometric hash. Our interest is to investigate to which degree each of the underlying feature parameters contributes to the overall intrapersonal stability and interpersonal value space. We will briefly discuss related work in feature evaluation and introduce a new methodology based on three components: the intrapersonal scatter (deviation), the interpersonal entropy, and the correlation between both measures. Evaluation of the technique is presented based on two data sets of different size. The method presented will allow determination of effects of parameterization of the biometric system, estimation of value space boundaries, and comparison with other feature selection approaches.

Open access publishing: a study of current practices in orthopaedic research.

PubMed

Sabharwal, Sanjeeve; Patel, Nirav; Johal, Karanjeev

2014-06-01

Open access (OA) publications have changed the paradigm of dissemination of scientific research. Their benefits to low-income countries underline their value; however, critics question exorbitant publication fees as well as their effect on the peer review process and research quality. This study reports on the prevalence of OA publishing in orthopaedic research and compares benchmark citation indices as well as evidence quality derived from OA journals with conventional subscription based orthopaedic journals. All 63 orthopaedic journals listed in ISI's Web of Knowledge Journal Citation Report (JCR) were examined. Bibliometric data attributed to each journal for the year 2012 was acquired from the JCR. Studies that fulfilled the criteria of level I evidence were identified for each journal within PubMed. Individual journal websites were reviewed to identify their open access policy. A total of 38 (60.3 %) journals did not offer any form of OA publishing; however, 20 (31.7 %) hybrid journals were identified which offered authors the choice to publish their work as OA if a publication fee was paid. Only five (8 %) journals published all their articles as OA. There was variability amongst the different publication fees for OA articles. Journals that published OA articles did not differ from subscription based journals on the basis of 2012 impact factor, citation number, self citation proportion or the volume of level I evidence published (p > 0.05). OA journals are present in orthopaedic research, though in small numbers. Over a third of orthopaedic journals catalogued in the ISI Web of Knowledge JCR® are hybrid journals that provide authors with the opportunity to publish their articles as OA after a publication fee is paid. This study suggests equivalent importance and quality of articles between OA and subscription based orthopaedic journals based on bibliometric data and the volume of level I evidence produced. Orthopaedic researchers must recognize the potential benefits of OA publishing and its emerging presence within the field. Further examination and consensus is required in orthopaedic research to generate an OA system that is robustly regulated and maintains research quality.

Nonparametric spirometry reference values for Hispanic Americans.

PubMed

Glenn, Nancy L; Brown, Vanessa M

2011-02-01

Recent literature sites ethnic origin as a major factor in developing pulmonary function reference values. Extensive studies established reference values for European and African Americans, but not for Hispanic Americans. The Third National Health and Nutrition Examination Survey defines Hispanic as individuals of Spanish speaking cultures. While no group was excluded from the target population, sample size requirements only allowed inclusion of individuals who identified themselves as Mexican Americans. This research constructs nonparametric reference value confidence intervals for Hispanic American pulmonary function. The method is applicable to all ethnicities. We use empirical likelihood confidence intervals to establish normal ranges for reference values. Its major advantage: it is model free, but shares asymptotic properties of model based methods. Statistical comparisons indicate that empirical likelihood interval lengths are comparable to normal theory intervals. Power and efficiency studies agree with previously published theoretical results.

Half-Lives of 101Rh and 108m Ag

NASA Astrophysics Data System (ADS)

Norman, Eric; Browne, Edgardo; Shugart, Howard

2014-09-01

Half-lives of short-lived nuclei can easily be measured by direct counting techniques, whereas those of long-lived naturally-occurring nuclei are usually determined by specific activity measurements. However, half-lives in the range of 1 - 1,000,000 years are notoriously difficult to determine. For example, published values for the half-life of 101Rh range from 3.0 +/- 0.4 years to 10 +/- 1 years, and for 108m Ag published values range from 127 +/- 21 years to 438 +/- 9 years. In order to resolve the issues of what the half-lives of these isotopes actually are, we set up two separate long-term gamma-ray counting experiments. Gamma-ray data were collected in time bins using high-purity Ge detectors and ORTEC PC-based data acquisition systems. We counted in this manner for a period of approximately 5 years for 101Rh and 3 years for 108mAg. In this talk we will describe the details of these experiments and will present the final results for the half-lives of 101Rh and 108mAg determined from these measurements. Half-lives of short-lived nuclei can easily be measured by direct counting techniques, whereas those of long-lived naturally-occurring nuclei are usually determined by specific activity measurements. However, half-lives in the range of 1 - 1,000,000 years are notoriously difficult to determine. For example, published values for the half-life of 101Rh range from 3.0 +/- 0.4 years to 10 +/- 1 years, and for 108m Ag published values range from 127 +/- 21 years to 438 +/- 9 years. In order to resolve the issues of what the half-lives of these isotopes actually are, we set up two separate long-term gamma-ray counting experiments. Gamma-ray data were collected in time bins using high-purity Ge detectors and ORTEC PC-based data acquisition systems. We counted in this manner for a period of approximately 5 years for 101Rh and 3 years for 108mAg. In this talk we will describe the details of these experiments and will present the final results for the half-lives of 101Rh and 108mAg determined from these measurements. This work was supported in part by the U. S. Dept. of Energy under Contract Numbers DE-AC02-05CH11231 and DE-NA0000979.

Relationship Between Ebola Virus Real-Time Quantitative Polymerase Chain Reaction-Based Threshold Cycle Value and Virus Isolation From Human Plasma.

PubMed

Spengler, Jessica R; McElroy, Anita K; Harmon, Jessica R; Ströher, Ute; Nichol, Stuart T; Spiropoulou, Christina F

2015-10-01

We performed a longitudinal analysis of plasma samples obtained from 4 patients with Ebola virus (EBOV) disease (EVD) to determine the relationship between the real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR)-based threshold cycle (Ct) value and the presence of infectious EBOV. EBOV was not isolated from plasma samples with a Ct value of >35.5 or >12 days after onset of symptoms. EBOV was not isolated from plasma samples in which anti-EBOV nucleoprotein immunoglobulin G was detected. These data demonstrate the utility of interpreting qRT-PCR results in the context of the course of EBOV infection and associated serological responses for patient-management decisions. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Cuckoo search algorithm based satellite image contrast and brightness enhancement using DWT-SVD.

PubMed

Bhandari, A K; Soni, V; Kumar, A; Singh, G K

2014-07-01

This paper presents a new contrast enhancement approach which is based on Cuckoo Search (CS) algorithm and DWT-SVD for quality improvement of the low contrast satellite images. The input image is decomposed into the four frequency subbands through Discrete Wavelet Transform (DWT), and CS algorithm used to optimize each subband of DWT and then obtains the singular value matrix of the low-low thresholded subband image and finally, it reconstructs the enhanced image by applying IDWT. The singular value matrix employed intensity information of the particular image, and any modification in the singular values changes the intensity of the given image. The experimental results show superiority of the proposed method performance in terms of PSNR, MSE, Mean and Standard Deviation over conventional and state-of-the-art techniques. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Enhancing Breast Cancer Recurrence Algorithms Through Selective Use of Medical Record Data

PubMed Central

Chubak, Jessica; Johnson, Lisa; Castillo, Adrienne; Weltzien, Erin; Caan, Bette J.

2016-01-01

Abstract Background: The utility of data-based algorithms in research has been questioned because of errors in identification of cancer recurrences. We adapted previously published breast cancer recurrence algorithms, selectively using medical record (MR) data to improve classification. Methods: We evaluated second breast cancer event (SBCE) and recurrence-specific algorithms previously published by Chubak and colleagues in 1535 women from the Life After Cancer Epidemiology (LACE) and 225 women from the Women’s Health Initiative cohorts and compared classification statistics to published values. We also sought to improve classification with minimal MR examination. We selected pairs of algorithms—one with high sensitivity/high positive predictive value (PPV) and another with high specificity/high PPV—using MR information to resolve discrepancies between algorithms, properly classifying events based on review; we called this “triangulation.” Finally, in LACE, we compared associations between breast cancer survival risk factors and recurrence using MR data, single Chubak algorithms, and triangulation. Results: The SBCE algorithms performed well in identifying SBCE and recurrences. Recurrence-specific algorithms performed more poorly than published except for the high-specificity/high-PPV algorithm, which performed well. The triangulation method (sensitivity = 81.3%, specificity = 99.7%, PPV = 98.1%, NPV = 96.5%) improved recurrence classification over two single algorithms (sensitivity = 57.1%, specificity = 95.5%, PPV = 71.3%, NPV = 91.9%; and sensitivity = 74.6%, specificity = 97.3%, PPV = 84.7%, NPV = 95.1%), with 10.6% MR review. Triangulation performed well in survival risk factor analyses vs analyses using MR-identified recurrences. Conclusions: Use of multiple recurrence algorithms in administrative data, in combination with selective examination of MR data, may improve recurrence data quality and reduce research costs. PMID:26582243

Vacuum ultraviolet molecular nitrogen photoabsorption cross sections for planetary atmospheric transmission models

NASA Astrophysics Data System (ADS)

Stark, G.; Smith, P. L.; Yoshino, K.; Rufus, J.; Huber, K. P.

2001-11-01

The analyses of VUV occultation measurements of the N2-rich atmospheres of Titan and Triton are hampered by the lack of fundamental spectroscopic data for N2. In particular, there is a need for reliable photoabsorption f-values and line widths for the ~ 100 electronic bands of N2 in the 80 to 100 nm wavelength region. As part of our continuing program of laboratory measurements and analyses of the N2 VUV absorption spectrum, we present the results of new measurements of individual line strengths and widths in selected bands. These results indicate that within a number of individual bands there are significant departures from the predicted line strength distributions based on isolated band models. New line width measurements in the 95 to 100 nm region are also presented and compared to other values found in the literature. We have continued to compile on-line molecular spectroscopic atlas based on our N2 laboratory data: http://cfa-www.harvard.edu/amdata/ampdata/N2ARCHIVE/n2home.html. The archive includes published and unpublished 14N2, 14N15N, and 15N2 line lists and spectroscopic identifications, excited state energy levels, band and line f-values, a summary of published band f-value and line width measurements, and a cross-referenced summary of the relevant N2 literature. The listings are searchable by wavelength interval or band identification and are suitable for down-loading in a convenient format. We gratefully acknowledge funding support from NASA grant NAG5-9059 and the Smithsonian Institution Atherton-Seidel grant program.

Value Driven Outcomes (VDO): a pragmatic, modular, and extensible software framework for understanding and improving health care costs and outcomes.

PubMed

Kawamoto, Kensaku; Martin, Cary J; Williams, Kip; Tu, Ming-Chieh; Park, Charlton G; Hunter, Cheri; Staes, Catherine J; Bray, Bruce E; Deshmukh, Vikrant G; Holbrook, Reid A; Morris, Scott J; Fedderson, Matthew B; Sletta, Amy; Turnbull, James; Mulvihill, Sean J; Crabtree, Gordon L; Entwistle, David E; McKenna, Quinn L; Strong, Michael B; Pendleton, Robert C; Lee, Vivian S

2015-01-01

To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes). In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement. A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they spent in the unit; actual medication acquisition costs are allocated to patients based on utilization; and radiology costs are allocated based on the minutes required for study performance. Relevant process and outcome measures are also available. A visualization layer facilitates the identification of value improvement opportunities, such as high-volume, high-cost case types with high variability in costs across providers. Initial implementation was completed within 6 months, and all project objectives were fulfilled. The framework has been improved iteratively and is now a foundational tool for delivering high-value care. The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Reference Values for Human Posture Measurements Based on Computerized Photogrammetry: A Systematic Review.

PubMed

Macedo Ribeiro, Ana Freire; Bergmann, Anke; Lemos, Thiago; Pacheco, Antônio Guilherme; Mello Russo, Maitê; Santos de Oliveira, Laura Alice; de Carvalho Rodrigues, Erika

The main objective of this study was to review the literature to identify reference values for angles and distances of body segments related to upright posture in healthy adult women with the Postural Assessment Software (PAS/SAPO). Electronic databases (BVS, PubMed, SciELO and Scopus) were assessed using the following descriptors: evaluation, posture, photogrammetry, physical therapy, postural alignment, postural assessment, and physiotherapy. Studies that performed postural evaluation in healthy adult women with PAS/SAPO and were published in English, Portuguese and Spanish, between the years 2005 and 2014 were included. Four studies met the inclusion criteria. Data from the included studies were grouped to establish the statistical descriptors (mean, variance, and standard deviation) of the body angles and distances. A total of 29 variables were assessed (10 in the anterior views, 16 in the lateral right and left views, and 3 in the posterior views), and its respective mean and standard deviation were calculated. Reference values for the anterior and posterior views showed no symmetry between the right and left sides of the body in the frontal plane. There were also small differences in the calculated reference values for the lateral view. The proposed reference values for quantitative evaluation of the upright posture in healthy adult women estimated in the present study using PAS/SAPO could guide future studies and help clinical practice. Copyright © 2017. Published by Elsevier Inc.

Enabling Large-Scale IoT-Based Services through Elastic Publish/Subscribe.

PubMed

Vavassori, Sergio; Soriano, Javier; Fernández, Rafael

2017-09-19

In this paper, we report an algorithm that is designed to leverage the cloud as infrastructure to support Internet of Things (IoT) by elastically scaling in/out so that IoT-based service users never stop receiving sensors' data. This algorithm is able to provide an uninterrupted service to end users even during the scaling operation since its internal state repartitioning is transparent for publishers or subscribers; its scaling operation is time-bounded and depends only on the dimension of the state partitions to be transmitted to the different nodes. We describe its implementation in E-SilboPS, an elastic content-based publish/subscribe (CBPS) system specifically designed to support context-aware sensing and communication in IoT-based services. E-SilboPS is a key internal asset of the FIWARE IoT services enablement platform, which offers an architecture of components specifically designed to capture data from, or act upon, IoT devices as easily as reading/changing the value of attributes linked to context entities. In addition, we discuss the quantitative measurements used to evaluate the scale-out process, as well as the results of this evaluation. This new feature rounds out the context-aware content-based features of E-SilboPS by providing, for example, the necessary middleware for constructing dashboards and monitoring panels that are capable of dynamically changing queries and continuously handling data in IoT-based services.

Enabling Large-Scale IoT-Based Services through Elastic Publish/Subscribe

PubMed Central

2017-01-01

In this paper, we report an algorithm that is designed to leverage the cloud as infrastructure to support Internet of Things (IoT) by elastically scaling in/out so that IoT-based service users never stop receiving sensors’ data. This algorithm is able to provide an uninterrupted service to end users even during the scaling operation since its internal state repartitioning is transparent for publishers or subscribers; its scaling operation is time-bounded and depends only on the dimension of the state partitions to be transmitted to the different nodes. We describe its implementation in E-SilboPS, an elastic content-based publish/subscribe (CBPS) system specifically designed to support context-aware sensing and communication in IoT-based services. E-SilboPS is a key internal asset of the FIWARE IoT services enablement platform, which offers an architecture of components specifically designed to capture data from, or act upon, IoT devices as easily as reading/changing the value of attributes linked to context entities. In addition, we discuss the quantitative measurements used to evaluate the scale-out process, as well as the results of this evaluation. This new feature rounds out the context-aware content-based features of E-SilboPS by providing, for example, the necessary middleware for constructing dashboards and monitoring panels that are capable of dynamically changing queries and continuously handling data in IoT-based services. PMID:28925967

Report of the ACR's Economics Committee on Value-Based Payment Models.

PubMed

Boland, Giles W; Glenn, Lucille; Goldberg-Stein, Shlomit; Jha, Saurabh; Mangano, Mark; Patel, Samir; Schoppe, Kurt A; Seidenwurm, David; Lohnes, John; Silva, Ezequiel; Abramson, Richard; Durand, Daniel J; Pattie, Laura; Kassing, Pamela; Heller, Richard E

2017-01-01

A major outcome of the current health care reform process is the move away from unrestricted fee-for-service payment models toward those that are based on the delivery of better patient value and outcomes. The authors' purpose, therefore, is to critically evaluate and define those components of the overall imaging enterprise that deliver meaningful value to both patients and referrers and to determine how these components might be measured and quantified. These metrics might then be used to lobby providers and payers for sustainable payment solutions for radiologists and radiology services. The authors evaluated radiology operations and services using the framework of the imaging value chain, which divides radiology service into a number of discrete value-added activities, which ultimately deliver the primary product, most often the actionable report for diagnostic imaging or an effective outcome for interventional radiology. These value activities include scheduling and imaging appropriateness and stewardship, patient preparation, protocol design, modality operations, reporting, report communication, and clinical follow-up (eg, mammography reminder letters). Two further categories are hospital or health care organization citizenship and examination outcome. Each is discussed in turn, with specific activities highlighted. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Mind the gaps: what's missing from current economic evaluations of universal HPV vaccination?

PubMed

Marsh, Kevin; Chapman, Ruth; Baggaley, Rebecca F; Largeron, Nathalie; Bresse, Xavier

2014-06-24

Since the original licensing of human papilloma virus (HPV) vaccination for women, evidence is accumulating of its effectiveness in preventing HPV-related conditions in men, and universal vaccination (vaccinating men and women) is now recommended in some countries. Several models of the cost-effectiveness of universal HPV vaccination have been published, but results have been mixed. This article assesses the extent to which economic studies have captured the range of values associated with universal HPV vaccination, and how this influences estimates of its cost-effectiveness. Eight published economic evaluations of universal HPV vaccination were reviewed to identify which of the values associated with universal HPV vaccination were included in each analysis. Studies of the cost-effectiveness of universal HPV vaccination capture only a fraction of the values generated. Most studies focused on impacts on health and health system cost, and only captured these partially. A range of values is excluded from most studies, including impacts on productivity, patient time and costs, carers and family costs, and broader social values such as the right to access treatment. Further, those studies that attempted to capture these values only did so partially. Decisions to invest in universal HPV vaccination need to be based on a complete assessment of the value that it generates. This is not provided by existing economic evaluations. Further work is required to understand this value. First, research is required to understand how HPV-related health outcomes impact on society including, for instance, their impact on productivity. Second, consideration should be given to alternative approaches to capture this broader set of values in a manner useful to decisions-makers, such as multi-criteria decision analysis. Copyright © 2014 Elsevier Ltd. All rights reserved.

Do simple screening statistical tools help to detect reporting bias?

PubMed

Pirracchio, Romain; Resche-Rigon, Matthieu; Chevret, Sylvie; Journois, Didier

2013-09-02

As a result of reporting bias, or frauds, false or misunderstood findings may represent the majority of published research claims. This article provides simple methods that might help to appraise the quality of the reporting of randomized, controlled trials (RCT). This evaluation roadmap proposed herein relies on four steps: evaluation of the distribution of the reported variables; evaluation of the distribution of the reported p values; data simulation using parametric bootstrap and explicit computation of the p values. Such an approach was illustrated using published data from a retracted RCT comparing a hydroxyethyl starch versus albumin-based priming for cardiopulmonary bypass. Despite obvious nonnormal distributions, several variables are presented as if they were normally distributed. The set of 16 p values testing for differences in baseline characteristics across randomized groups did not follow a Uniform distribution on [0,1] (p = 0.045). The p values obtained by explicit computations were different from the results reported by the authors for the two following variables: urine output at 5 hours (calculated p value < 10-6, reported p ≥ 0.05); packed red blood cells (PRBC) during surgery (calculated p value = 0.08; reported p < 0.05). Finally, parametric bootstrap found p value > 0.05 in only 5 of the 10,000 simulated datasets concerning urine output 5 hours after surgery. Concerning PRBC transfused during surgery, parametric bootstrap showed that only the corresponding p value had less than a 50% chance to be inferior to 0.05 (3,920/10,000, p value < 0.05). Such simple evaluation methods might offer some warning signals. However, it should be emphasized that such methods do not allow concluding to the presence of error or fraud but should rather be used to justify asking for an access to the raw data.

Fragment-based approach to calculate hydrophobicity of anionic and nonionic surfactants derived from chromatographic retention on a C18 stationary phase.

PubMed

Hammer, Jort; Haftka, Joris J-H; Scherpenisse, Peter; Hermens, Joop L M; de Voogt, Pim W P

2017-02-01

To predict the fate and potential effects of organic contaminants, information about their hydrophobicity is required. However, common parameters to describe the hydrophobicity of organic compounds (e.g., octanol-water partition constant [K OW ]) proved to be inadequate for ionic and nonionic surfactants because of their surface-active properties. As an alternative approach to determine their hydrophobicity, the aim of the present study was therefore to measure the retention of a wide range of surfactants on a C 18 stationary phase. Capacity factors in pure water (k' 0 ) increased linearly with increasing number of carbon atoms in the surfactant structure. Fragment contribution values were determined for each structural unit with multilinear regression, and the results were consistent with the expected influence of these fragments on the hydrophobicity of surfactants. Capacity factors of reference compounds and log K OW values from the literature were used to estimate log K OW values for surfactants (log KOWHPLC). These log KOWHPLC values were also compared to log K OW values calculated with 4 computational programs: KOWWIN, Marvin calculator, SPARC, and COSMOThermX. In conclusion, capacity factors from a C 18 stationary phase are found to better reflect hydrophobicity of surfactants than their K OW values. Environ Toxicol Chem 2017;36:329-336. © 2016 The Authors. Environmental Toxicology and Chemistry Published by Wiley Periodicals, Inc. on behalf of SETAC. © 2016 The Authors. Environmental Toxicology and Chemistry Published by Wiley Periodicals, Inc. on behalf of SETAC.

Integrating genome-wide association study and expression quantitative trait loci data identifies multiple genes and gene set associated with neuroticism.

PubMed

Fan, Qianrui; Wang, Wenyu; Hao, Jingcan; He, Awen; Wen, Yan; Guo, Xiong; Wu, Cuiyan; Ning, Yujie; Wang, Xi; Wang, Sen; Zhang, Feng

2017-08-01

Neuroticism is a fundamental personality trait with significant genetic determinant. To identify novel susceptibility genes for neuroticism, we conducted an integrative analysis of genomic and transcriptomic data of genome wide association study (GWAS) and expression quantitative trait locus (eQTL) study. GWAS summary data was driven from published studies of neuroticism, totally involving 170,906 subjects. eQTL dataset containing 927,753 eQTLs were obtained from an eQTL meta-analysis of 5311 samples. Integrative analysis of GWAS and eQTL data was conducted by summary data-based Mendelian randomization (SMR) analysis software. To identify neuroticism associated gene sets, the SMR analysis results were further subjected to gene set enrichment analysis (GSEA). The gene set annotation dataset (containing 13,311 annotated gene sets) of GSEA Molecular Signatures Database was used. SMR single gene analysis identified 6 significant genes for neuroticism, including MSRA (p value=2.27×10 -10 ), MGC57346 (p value=6.92×10 -7 ), BLK (p value=1.01×10 -6 ), XKR6 (p value=1.11×10 -6 ), C17ORF69 (p value=1.12×10 -6 ) and KIAA1267 (p value=4.00×10 -6 ). Gene set enrichment analysis observed significant association for Chr8p23 gene set (false discovery rate=0.033). Our results provide novel clues for the genetic mechanism studies of neuroticism. Copyright © 2017. Published by Elsevier Inc.

Characterization of Radiation Fields in Biological Shields of Nuclear Power Plants for Assessing Concrete Degradation

NASA Astrophysics Data System (ADS)

Remec, Igor; Rosseel, Thomas M.; Field, Kevin G.; Le Pape, Yann

2016-02-01

Life extensions of nuclear power plants to 60 and potentially 80 years of operation have renewed interest in long-term material degradation. One material being considered is concrete, with a particular focus on radiation-induced effects. Based on the projected neutron fluence values (E > 0.1 MeV) in the concrete biological shields of the US pressurized water reactor fleet and the available data on radiation effects on concrete, some decrease in mechanical properties of concrete cannot be ruled out during extended operation beyond 60 years. An expansion of the irradiated concrete database and a reliable determination of relevant neutron fluence energy cutoff value are necessary to ensure reliable risk assessment for extended operation of nuclear power plants. Notice: This manuscript has been authored by UT-Battelle, LLC, under contract DE-AC0500OR22725 with the US Department of Energy. The United States Government retains and the publisher, by accepting the article for publication, acknowledges that the United States Government retains a nonexclusive, paid-up, irrevocable, worldwide license to publish or reproduce the published form of this manuscript, or allow others to do so, for United States Government purposes.

From the Lab Bench: Soy Hulls: A Special Feed for Cattle on Toxic Endophyte Fescue Pasture

USDA-ARS?s Scientific Manuscript database

Soy hulls have a nutritive value that is comparable to a moderate quality hay and is often fed as a hay substitute. However, based on results of published research we conducted, it may offer more than the typical hay if fed to cattle grazing toxic endophyte tall fescue. A grazing experiment was co...

A Note on Some Problems in the Testing of Personality Characteristics in Children with Visual Impairment

ERIC Educational Resources Information Center

Tobin, Michael; Hill, Eileen

2010-01-01

An examination is made of the value of using published personality tests with young blind and partially sighted children. Based on data gathered during a longitudinal investigation into the educational and psychological development of a group of 120 visually impaired learners, the authors conclude that their own selection of a test instrument…

The Robustness of Designs for Trials with Nested Data against Incorrect Initial Intracluster Correlation Coefficient Estimates

ERIC Educational Resources Information Center

Korendijk, Elly J. H.; Moerbeek, Mirjam; Maas, Cora J. M.

2010-01-01

In the case of trials with nested data, the optimal allocation of units depends on the budget, the costs, and the intracluster correlation coefficient. In general, the intracluster correlation coefficient is unknown in advance and an initial guess has to be made based on published values or subject matter knowledge. This initial estimate is likely…

Fasting energy metabolism of the Yucatan miniature pig.

PubMed

Parsons, A H; Mathieson, K W; Tagliaferro, A R

1990-03-01

The fasting metabolic rates (FMR) of Yucatan miniature swine were determined using an open-circuit indirect respiration calorimeter. Mature nulliparous females had a mean FMR of 93 kcal/kg BW.75 and did not change significantly during the estrous cycle. This value is comparable to that observed in mature domestic swine. The calculated metabolizable energy requirement for maintenance for the Yucatan sow is 116 kcal/kg BW.75. Growing Yucatan boars had FMR of 127, 119 and 101 kcal/kg BW.75 at 15, 21 and 38 weeks of age, respectively, and were similar to values for comparably aged domestic swine. The calculated estimate for the metabolizable energy requirement for maintenance for Yucatan boars ranged from 158 kcal at 15 weeks of age to 126 kcal/kg BW.75 for 38 week old animals. Based on the similarity between the FMR of the Yucatan miniature swine in the present study and values published for standard size commercial hogs, it is concluded that the metabolic rates of these breeds of pig are similar. It is suggested that the daily energy needs of the Yucatan miniature pig may be met using values published for production livestock having similar physiological condition when adjusted for the smaller body size of the Yucatan breed.

Radiologist manpower considerations and Imaging 3.0: effort planning for value-based imaging.

PubMed

Norbash, Alexander; Bluth, Edward; Lee, Christoph I; Francavilla, Michael; Donner, Michael; Dutton, Sharon C; Heilbrun, Marta; McGinty, Geraldine

2014-10-01

Our specialty is seeking to establish the value of imaging in the longitudinal patient-care continuum. We recognize the need to assess the value of our contributions rather than concentrating primarily on generating revenue. This recent focus is a result of both increased cost-containment efforts and regulatory demands. Imaging 3.0 is a value-based perspective that intends to describe and facilitate value-based imaging. Imaging 3.0 includes a broad set of initiatives addressing the visibility of radiologists, and emphasizing quality and safety oversight by radiologists, which are new directions of focus for us. Imaging 3.0 also addresses subspecialty imaging and off-hours imaging, which are existing areas of practice that are emblematic of inconsistent service delivery across all hours. Looking to the future, Imaging 3.0 describes how imaging services could be integrated into the framework of accountable care organizations. Although all these efforts may be essential, they necessitate manpower expenditures, and these efforts are not directly covered by revenue. If we recognize the urgency of need in developing these concepts, we can justify the manpower and staffing expenditures each organization is willing to shoulder in reaching Imaging 3.0. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A large-scale measurement, analysis and modelling of electromagnetic radiation levels in the vicinity of GSM/UMTS base stations in an urban area.

PubMed

Karadağ, Teoman; Yüceer, Mehmet; Abbasov, Teymuraz

2016-01-01

The present study analyses the electric field radiating from the GSM/UMTS base stations located in central Malatya, a densely populated urban area in Turkey. The authors have conducted both instant and continuous measurements of high-frequency electromagnetic fields throughout their research by using non-ionising radiation-monitoring networks. Over 15,000 instant and 13,000,000 continuous measurements were taken throughout the process. The authors have found that the normal electric field radiation can increase ∼25% during daytime, depending on mobile communication traffic. The authors' research work has also demonstrated the fact that the electric field intensity values can be modelled for each hour, day or week with the results obtained from continuous measurements. The authors have developed an estimation model based on these values, including mobile communication traffic (Erlang) values obtained from mobile phone base stations and the temperature and humidity values in the environment. The authors believe that their proposed artificial neural network model and multivariable least-squares regression analysis will help predict the electric field intensity in an environment in advance. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Don't Discount Societal Value in Cost-Effectiveness Comment on "Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness".

PubMed

Hall, William

2017-01-14

As healthcare resources become increasingly scarce due to growing demand and stagnating budgets, the need for effective priority setting and resource allocation will become ever more critical to providing sustainable care to patients. While societal values should certainly play a part in guiding these processes, the methodology used to capture these values need not necessarily be limited to multi-criterion decision analysis (MCDA)-based processes including 'evidence-informed deliberative processes.' However, if decision-makers intend to not only incorporates the values of the public they serve into decisions but have the decisions enacted as well, consideration should be given to more direct involvement of stakeholders. Based on the examples provided by Baltussen et al, MCDA-based processes like 'evidence-informed deliberative processes' could be one way of achieving this laudable goal. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Value Arguments in Science Research Articles: Making the Case for the Importance of Research

ERIC Educational Resources Information Center

Carter, Michael

2016-01-01

It is in the interest of scholarly journals to publish important research and of researchers to publish in important journals. One key to making the case for the importance of research in a scholarly article is to incorporate value arguments. Yet there has been no rhetorical analysis of value arguments in the literature. In the context of…

Intelligent content fitting for digital publishing

NASA Astrophysics Data System (ADS)

Lin, Xiaofan

2006-02-01

One recurring problem in Variable Data Printing (VDP) is that the existing contents cannot satisfy the VDP task as-is. So there is a strong need for content fitting technologies to support high-value digital publishing applications, in which text and image are the two major types of contents. This paper presents meta-Autocrop framework for image fitting and TextFlex technology for text fitting. The meta-Autocrop framework supports multiple modes: fixed aspect-ratio mode, advice mode, and verification mode. The TextFlex technology supports non-rectangular text wrapping and paragraph-based line breaking. We also demonstrate how these content fitting technologies are utilized in the overall automated composition and layout system.

Are cultural values and beliefs included in U.S. based HIV interventions?

PubMed

Wyatt, Gail E; Williams, John K; Gupta, Arpana; Malebranche, Dominique

2012-11-01

To determine the extent to which current United States based human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. A comprehensive literature review was conducted to determine which published human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions incorporated aspects of cultural beliefs. This review of 166 human immunodeficiency virus (HIV) prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. human immunodeficiency virus (HIV) interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual's risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. Copyright © 2011. Published by Elsevier Inc.

A value-based medicine cost-utility analysis of idiopathic epiretinal membrane surgery.

PubMed

Gupta, Omesh P; Brown, Gary C; Brown, Melissa M

2008-05-01

To perform a reference case, cost-utility analysis of epiretinal membrane (ERM) surgery using current literature on outcomes and complications. Computer-based, value-based medicine analysis. Decision analyses were performed under two scenarios: ERM surgery in better-seeing eye and ERM surgery in worse-seeing eye. The models applied long-term published data primarily from the Blue Mountains Eye Study and the Beaver Dam Eye Study. Visual acuity and major complications were derived from 25-gauge pars plana vitrectomy studies. Patient-based, time trade-off utility values, Markov modeling, sensitivity analysis, and net present value adjustments were used in the design and calculation of results. Main outcome measures included the number of discounted quality-adjusted-life-years (QALYs) gained and dollars spent per QALY gained. ERM surgery in the better-seeing eye compared with observation resulted in a mean gain of 0.755 discounted QALYs (3% annual rate) per patient treated. This model resulted in $4,680 per QALY for this procedure. When sensitivity analysis was performed, utility values varied from $6,245 to $3,746/QALY gained, medical costs varied from $3,510 to $5,850/QALY gained, and ERM recurrence rate increased to $5,524/QALY. ERM surgery in the worse-seeing eye compared with observation resulted in a mean gain of 0.27 discounted QALYs per patient treated. The $/QALY was $16,146 with a range of $20,183 to $12,110 based on sensitivity analyses. Utility values ranged from $21,520 to $12,916/QALY and ERM recurrence rate increased to $16,846/QALY based on sensitivity analysis. ERM surgery is a very cost-effective procedure when compared with other interventions across medical subspecialties.

History of the recommended atomic-weight values from 1882 to 1997: A comparision of differences from current values to the estimated uncertainties of earlier values.

USGS Publications Warehouse

Coplen, T.B.; Peiser, H.S.

1998-01-01

International commissions and national committees for atomic weights (mean relative atomic masses) have recommended regularly updated, best values for these atomic weights as applicable to terrestrial sources of the chemical elements. Presented here is a historically complete listing starting with the values in F. W. Clarke's 1882 recalculation, followed by the recommended values in the annual reports of the American Chemical Society's Atomic Weights Commission. From 1903, an International Commission published such reports and its values (scaled to an atomic weight of 16 for oxygen) are here used in preference to those of national committees of Britain, Germany, Spain, Switzerland, and the U.S.A. We have, however, made scaling adjustments from Ar(16O) to Ar(12C) where not negligible. From 1920, this International Commission constituted itself under the International Union of Pure and Applied Chemistry (IUPAC). Since then, IUPAC has published reports (mostly biennially) listing the recommended atomic weights, which are reproduced here. Since 1979, these values have been called the "standard atomic weights" and, since 1969, all values have been published, with their estimated uncertainties. Few of the earlier values were published with uncertainties. Nevertheless, we assessed such uncertainties on the basis of our understanding of the likely contemporary judgement of the values' reliability. While neglecting remaining uncertainties of 1997 values, we derive "differences" and a retrospective index of reliability of atomic-weight values in relation to assessments of uncertainties at the time of their publication. A striking improvement in reliability appears to have been achieved since the commissions have imposed upon themselves the rule of recording estimated uncertainties from all recognized sources of error.

Values exchange: using online technology to raise awareness of values and ethics in radiography education.

PubMed

Mc Inerney, John; Lees, Amanda

2018-03-01

Ethics and values are increasingly significant aspects of patient-centred healthcare. While it is widely agreed that ethics and values are essential for healthcare delivery, there is also an acknowledgement that these are areas that are challenging to teach. The purpose of this study is to report a small-scale evaluative research project of a web-based technology with the educational potential to facilitate learning in relation to ethics, values, self-reflection and peer-based learning. Five diagnostic radiography students took part in a semi-structured focus group with the aim of exploring their experiences of using Values Exchange, an online ethical decision-making framework, to examine practice-based ethical issues. Transcripts were interrogated for key themes. From the thematic analysis three major themes emerged, understanding and appreciating others, addressing the theory-practice gap and delivering a safe and effective learning environment. Perceived limitations of the platform included students' fear of misinterpreted responses and possibility of poor group dynamics. There are varied approaches to how ethics and values are taught and assessed within health-related environments. Values Exchange is one such teaching tool and has been investigated and described positively by radiography students in this study. Online teaching tools can have a positive effect in helping students identify their own values but require skilled implementation to reap positive rewards. © 2018 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Quality and Efficiency Improvement Tools for Every Radiologist.

PubMed

Kudla, Alexei U; Brook, Olga R

2018-06-01

In an era of value-based medicine, data-driven quality improvement is more important than ever to ensure safe and efficient imaging services. Familiarity with high-value tools enables all radiologists to successfully engage in quality and efficiency improvement. In this article, we review the model for improvement, strategies for measurement, and common practical tools with real-life examples that include Run chart, Control chart (Shewhart chart), Fishbone (Cause-and-Effect or Ishikawa) diagram, Pareto chart, 5 Whys, and Root Cause Analysis. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The role of between-parent values agreement in parent-to-child transmission of academic values.

PubMed

Gniewosz, Burkhard; Noack, Peter

2012-08-01

The present study investigates the intergenerational transmission of academic task values within family in early adolescence. Social learning processes are assumed to operate through the students' perceptions of their parents' values. The major goal of this study is to show that this values transmission is facilitated by between-parent value agreement. Based on a longitudinal data set including 1019 German students, their mothers (N = 847), and fathers (N = 733), structural equation models showed significant effects of the parents' task values regarding math and German language as academic subjects on the respective task values reported by the students, mediated through the student-perceived parental values. This transmission chain was only found if the between-parent agreement was high. The results are discussed in terms of parent-specific mechanisms fostering transmission if both parents agree on academic values, such as an improved perceptive accuracy as well as the increased salience and mutual reinforcement of parental messages. Copyright © 2011 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Formulae Based on Biomathematics to Estimate the Standard Value of Fetal Growth of Japanese.

PubMed

Miyagi, Yasunari; Tada, Katsuhiko; Takayoshi, Riko; Oguni, Nobutsugu; Sato, Yasushi; Shibata, Maki; Kiyokawa, Machiko; Hashimoto, Tadashi; Takada, Tomoyoshi; Oda, Takashi; Miyake, Takahito

2018-04-01

We devised biomathematics-based formulae to estimate the standard values of fetal growth of Japanese after 22 weeks' gestation. The growth rates of bi-parietal diameter (BPD), abdominal circumference (AC), femur length (FL), and estimated fetal body weight (EFBW) at the time of gestation were assumed to be proportional to the product of the value at the time and the rest value of an unknown maximum value, respectively. The EFBW was also assumed to follow a multiple logistic function of BPD, AC and FL to fit the standard values of Japanese fetuses published by the Japan Society of Ultrasonics in Medicine. The Mann-Whitney test was used for statistical analysis. The values as a function of gestational day, t, were as follows: BPD(t)=99.6/(1+exp (2.725-0.01837＊t)) (mm); AC(t)=39.7/(1+exp (2.454-0.01379＊t)) (cm); FL(t)=79.6/(1+exp (2.851-0.01710＊t)) (mm); EFBW(t)=8045.1/(1+exp (6.028-0.06582＊BPD(t)-0.1469＊AC(t)+ 0.07377＊FL(t))) (g). EFBW as a function of BPD, AC and FL was as follows: EFBW=8045.1/(1+exp (4.747+ 0.02584＊BPD+0.1010＊AC-0.1416＊FL)) (g). When the BPD, AC and FL were at -2 standard deviation (SD), -1SD, mean and + 2SD, the EFBW values calculated by the formula were statistically closer to the standard values than conventional formulas with p-values of 4.871×10-7, 4.228×10-7, 9.777×10-7 and 0.028, respectively. The formulae based on biomathematics might be useful to estimate the fetal growth standard values.

Evaluation of predictive capacities of biomarkers based on research synthesis.

PubMed

Hattori, Satoshi; Zhou, Xiao-Hua

2016-11-10

The objective of diagnostic studies or prognostic studies is to evaluate and compare predictive capacities of biomarkers. Suppose we are interested in evaluation and comparison of predictive capacities of continuous biomarkers for a binary outcome based on research synthesis. In analysis of each study, subjects are often classified into two groups of the high-expression and low-expression groups according to a cut-off value, and statistical analysis is based on a 2 × 2 table defined by the response and the high expression or low expression of the biomarker. Because the cut-off is study specific, it is difficult to interpret a combined summary measure such as an odds ratio based on the standard meta-analysis techniques. The summary receiver operating characteristic curve is a useful method for meta-analysis of diagnostic studies in the presence of heterogeneity of cut-off values to examine discriminative capacities of biomarkers. We develop a method to estimate positive or negative predictive curves, which are alternative to the receiver operating characteristic curve based on information reported in published papers of each study. These predictive curves provide a useful graphical presentation of pairs of positive and negative predictive values and allow us to compare predictive capacities of biomarkers of different scales in the presence of heterogeneity in cut-off values among studies. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Physician-Owned Surgical Hospitals Outperform Other Hospitals in Medicare Value-Based Purchasing Program.

PubMed

Ramirez, Adriana G; Tracci, Margaret C; Stukenborg, George J; Turrentine, Florence E; Kozower, Benjamin D; Jones, R Scott

2016-10-01

The Hospital Value-Based Purchasing Program measures value of care provided by participating Medicare hospitals and creates financial incentives for quality improvement and fosters increased transparency. Limited information is available comparing hospital performance across health care business models. The 2015 Hospital Value-Based Purchasing Program results were used to examine hospital performance by business model. General linear modeling assessed differences in mean total performance score, hospital case mix index, and differences after adjustment for differences in hospital case mix index. Of 3,089 hospitals with total performance scores, categories of representative health care business models included 104 physician-owned surgical hospitals, 111 University HealthSystem Consortium, 14 US News & World Report Honor Roll hospitals, 33 Kaiser Permanente, and 124 Pioneer accountable care organization affiliated hospitals. Estimated mean total performance scores for physician-owned surgical hospitals (64.4; 95% CI, 61.83-66.38) and Kaiser Permanente (60.79; 95% CI, 56.56-65.03) were significantly higher compared with all remaining hospitals, and University HealthSystem Consortium members (36.8; 95% CI, 34.51-39.17) performed below the mean (p < 0.0001). Significant differences in mean hospital case mix index included physician-owned surgical hospitals (mean 2.32; p < 0.0001), US News & World Report honorees (mean 2.24; p = 0.0140), and University HealthSystem Consortium members (mean 1.99; p < 0.0001), and Kaiser Permanente hospitals had lower case mix value (mean 1.54; p < 0.0001). Re-estimation of total performance scores did not change the original results after adjustment for differences in hospital case mix index. The Hospital Value-Based Purchasing Program revealed superior hospital performance associated with business model. Closer inspection of high-value hospitals can guide value improvement and policy-making decisions for all Medicare Value-Based Purchasing Program Hospitals. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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

Nisbet, A.F.; Woodman, R.F.M.

A database of soil-to-plant transfer factors for radiocesium and radiostrontium has been compiled for arable crops from published and unpublished sources. The database is more extensive than previous compilations of data published by the International Union of Radioecologists, containing new information for Scandinavia and Greece in particular. It also contains ancillary data on important soil characteristics. The database is sub-divided into 28 soil-crop combinations, covering four soil types and seven crop groups. Statistical analyses showed that transfer factors for radiocesium could not generally be predicted as a function of climatic region, type of experiment, age of contamination, or silt characteristics.more » However, significant relationships accounting for more than 30% of the variability in transfer factor were identified between transfer factors for radiostrontium and soil pH/organic matter status for a few soil-crop combinations. Best estimate transfer factors for radiocesium and radiostrontium were calculated for 28 soil-crop combinations, based on their geometric means: only the edible parts were considered. To predict the likely value of future individual transfer factors, 95% confidence intervals were also derived. A comparison of best estimate transfer factors derived in this study with recommended values published by the International Union of Radioecologists in 1989 and 1992 was made for comparable soil-crop groupings. While there were no significant differences between the best estimate values derived in this study and the 1992 data, radiological assessments that still use 1989 data may be unnecessarily cautious.« less

Health literacy: a study of internet-based information on advance directives.

PubMed

Stuart, Peter

2017-11-28

The aim of this study was to evaluate the quality and value of web-based information on advance directives. Internet-based information on advance directives was selected because, if it is inaccurate or difficult to understand, patients risk making decisions about their care that may not be followed in practice. Two validated health information evaluation tools, the Suitability Assessment of Materials and DISCERN, and a focus group were used to assess credibility, user orientation and effectiveness. Only one of the 34 internet-based information items on advance directives reviewed fulfilled the study criteria and 30% of the sites were classed as unreadable. In terms of learning and informing, 79% of the sites were considered unsuitable. Using health literacy tools to evaluate internet-based health information highlights that often it is not at a functional literacy level and neither informs nor empowers users to make independent and valid healthcare decisions. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Indoor radon activity concentration measurements in the great historical museums of University of Naples, Italy.

PubMed

Quarto, Maria; Pugliese, Mariagabriella; Loffredo, Filomena; La Verde, Giuseppe; Roca, Vincenzo

2016-01-01

Indoor radon activity concentrations were measured in seven Museums of University of Naples, very old buildings of great historical value. The measurements were performed using a time-integrated technique based on LR-115 solid-state nuclear track detectors. The annual average concentrations were found to range from 40 up to 1935 Bq m(-3) and in 26 % of measurement sites, the values were higher than 500 Bq m(-3) which is the limit value of Italian legislation for workplace. Moreover, we analysed the seasonal variations of radon concentrations observing the highest average in cold weather than in warm. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Medicare program; delay in implementing the adjustments to the practice expense relative value units under the physician fee schedule for calendar year 1998--HCFA. Notice of intent to regulate.

PubMed

1997-10-31

This notice identifies provisions in the Medicare physician fee schedule regulations that are affected by enactment of the Balanced Budget Act of 1997 (BBA 1997). Section 4505 of the BBA 1997 postpones implementation of a resource-based practice expense relative value unit system until January 1, 1999 and provides for a 4-year transition. In addition, it provides for an adjustment for practice expense relative value units for 1998. It also requires publication of a new proposed rule for practice expense by May 1, 1998, thus requiring significant revision of our proposal contained in the proposed rule published June 18, 1997 (62 FR 33158).

A single competency-based education and training and competency-based career framework for the Australian health workforce: discussing the potential value add.

PubMed

Brownie, Sharon Mary; Thomas, Janelle

2014-09-01

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable - in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project's genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers' commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia's current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented.

Disability Policy Implementation From a Cross-Cultural Perspective.

PubMed

Verdugo, Miguel A; Jenaro, Cristina; Calvo, Isabel; Navas, Patricia

2017-07-01

Implementation of disability policy is influenced by social, political, and cultural factors. Based on published work, this article discusses four guidelines considered critical for successful policy implementation from a cross-cultural perspective. These guidelines are to: (a) base policy implementation on a contextual analysis, (b) employ a value-based approach, (c) align the service delivery system both vertically and horizontally, and (d) engage in a partnership in policy implementation. Public policy should be understood from a systems perspective that includes cross-cultural issues, such as how different stakeholders are acting and the way they plan and implement policy.

Dielectric relaxation spectrum of undiluted poly(4-chlorostyrene), T≳Tg

NASA Astrophysics Data System (ADS)

Yoshihara, M.; Work, R. N.

1980-06-01

Dielectric relaxation characteristics of undiluted, atactic poly(4-chlorostyrene), P4CS, have been determined at temperatures 406 K⩽T⩽446 K from measurements made at frequencies 0.2 Hz⩽f⩽0.2 MHz. After effects of electrical conductivity are subtracted, it is found that the normalized complex dielectric constant K*=K'-i K″ can be represented quantitatively by the Havriliak-Negami (H-N) equation K*=[1+(iωτ0)1-α]-β, 0⩽α, β⩽1, except for a small, high frequency tail that appears in measurements made near the glass transition temperature, Tg. The parameter β is nearly constant, and α depends linearly on log τ0, where τ0 is a characteristic relaxation time. The parameters α and β extrapolate through values obtained from published data from P4CS solutions, and extrapolation to α=0 yields a value of τ0 which compares favorably with a published value for crankshaft motions of an equivalent isolated chain segment. These observations suggest that β may characterize effects of chain connectivity and α may describe effects of interactions of the surroundings with the chain. Experimental results are compared with alternative empirical and model-based representations of dielectric relaxation in polymers.

A cyclic universe approach to fine tuning

DOE PAGES

Alexander, Stephon; Cormack, Sam; Gleiser, Marcelo

2016-04-05

We present a closed bouncing universe model where the value of coupling constants is set by the dynamics of a ghost-like dilatonic scalar field. We show that adding a periodic potential for the scalar field leads to a cyclic Friedmann universe where the values of the couplings vary randomly from one cycle to the next. While the shuffling of values for the couplings happens during the bounce, within each cycle their time-dependence remains safely within present observational bounds for physically-motivated values of the model parameters. Our model presents an alternative to solutions of the fine tuning problem based on stringmore » landscape scenarios. (C) 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Funded by SCOAP(3).« less

A cyclic universe approach to fine tuning

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

Alexander, Stephon; Cormack, Sam; Gleiser, Marcelo

We present a closed bouncing universe model where the value of coupling constants is set by the dynamics of a ghost-like dilatonic scalar field. We show that adding a periodic potential for the scalar field leads to a cyclic Friedmann universe where the values of the couplings vary randomly from one cycle to the next. While the shuffling of values for the couplings happens during the bounce, within each cycle their time-dependence remains safely within present observational bounds for physically-motivated values of the model parameters. Our model presents an alternative to solutions of the fine tuning problem based on stringmore » landscape scenarios. (C) 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Funded by SCOAP(3).« less

Enhancing High Value Care in Gastroenterology Practice.

PubMed

Camilleri, Michael; Katzka, David A

2016-10-01

The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering costs. We provide examples of topics in gastroenterology where clinicians could enhance value by either using less invasive testing, choosing a single best test, or by using patient symptoms to guide additional testing. The topics selected for review are selected in esophageal, pancreatic, and colorectal cancer; functional gastrointestinal diseases (irritable bowel syndrome, bacterial overgrowth, constipation); immune-mediated gastrointestinal diseases; and pancreaticobiliary pathology. We propose guidance to alter practice based on current evidence. These studies support the need to review current practice and to continue performing research to further validate the proposed guidance to enhance value of care in gastroenterology and hepatology. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Assessment of Confounders in Comparative Effectiveness Studies From Secondary Databases.

PubMed

Franklin, Jessica M; Schneeweiss, Sebastian; Solomon, Daniel H

2017-03-15

Secondary clinical databases are an important and growing source of data for comparative effectiveness research (CER) studies. However, measurement of confounders, such as biomarker values or patient-reported health status, in secondary clinical databases may not align with the initiation of a new treatment. In many published CER analyses of registry data, investigators assessed confounders based on the first questionnaire in which the new exposure was recorded. However, it is known that adjustment for confounders measured after the start of exposure can lead to biased treatment effect estimates. In the present study, we conducted simulations to compare assessment strategies for a dynamic clinical confounder in a registry-based comparative effectiveness study of 2 therapies. As expected, we found that adjustment for the confounder value at the time of the first questionnaire after the start of exposure creates a biased estimate the total effect of exposure choice on outcome when the confounder mediates part of the effect. However, adjustment for the prior value can also be badly biased when measured long before exposure initiation. Thus, investigators should carefully consider the timing of confounder measurements relative to exposure initiation and the rate of change in the confounder in order to choose the most relevant measure for each patient. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A new NIST primary standardization of 18F.

PubMed

Fitzgerald, R; Zimmerman, B E; Bergeron, D E; Cessna, J C; Pibida, L; Moreira, D S

2014-02-01

A new primary standardization of (18)F by NIST is reported. The standard is based on live-timed beta-gamma anticoincidence counting with confirmatory measurements by three other methods: (i) liquid scintillation (LS) counting using CIEMAT/NIST (3)H efficiency tracing; (ii) triple-to-double coincidence ratio (TDCR) counting; and (iii) NaI integral counting and HPGe γ-ray spectrometry. The results are reported as calibration factors for NIST-maintained ionization chambers (including some "dose calibrators"). The LS-based methods reveal evidence for cocktail instability for one LS cocktail. Using an ionization chamber to link this work with previous NIST results, the new value differs from the previous reports by about 4%, but appears to be in good agreement with the key comparison reference value (KCRV) of 2005. © 2013 Published by Elsevier Ltd.

ANDROMEDA DWARFS IN LIGHT OF MODIFIED NEWTONIAN DYNAMICS

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

McGaugh, Stacy; Milgrom, Mordehai

We compare the recently published velocity dispersions for 17 Andromeda dwarf spheroidals with estimates of the modified Newtonian dynamics predictions, based on the luminosities of these dwarfs, with reasonable stellar mass-to-light values and no dark matter. We find that the two are consistent within the uncertainties. We further predict the velocity dispersions of another 10 dwarfs for which only photometric data are currently available.

Accurate Measurements of Refractive Indices for Dielectrics in an Undergraduate Optics Laboratory for Science and Engineering Students

ERIC Educational Resources Information Center

Hsu, Wei-Tai; Bahrim, Cristian

2009-01-01

Based on our novel method recently published in the "Am. J. Phys." 77 337-43 (2009) for finding precise values of the indices of refraction for dielectrics from measurements of the polarized light reflected by the surface, in this paper we propose an improved technique for finding Brewster angles with a better precision, of 0.001 degrees, using…

Exenatide versus insulin glargine in patients with type 2 diabetes in the UK: a model of long-term clinical and cost outcomes.

PubMed

Ray, Joshua A; Boye, Kristina S; Yurgin, Nicole; Valentine, William J; Roze, Stéphane; McKendrick, Jan; Tucker, Daniel M D; Foos, Volker; Palmer, Andrew J

2007-03-01

The aim of this study was to evaluate the long-term clinical and economic outcomes associated with exenatide or insulin glargine, added to oral therapy in individuals with type 2 diabetes inadequately controlled with combination oral agents in the UK setting. A published and validated computer simulation model of diabetes was used to project long-term complications, life expectancy, quality-adjusted life expectancy and direct medical costs. Probabilities of diabetes-related complications were derived from published sources. Treatment effects and patient characteristics were extracted from a recent randomised controlled trial comparing exenatide with insulin glargine. Simulations incorporated published quality of life utilities and UK-specific costs from 2004. Pharmacy costs for exenatide were based on 20, 40, 60, 80 and 100% of the US value (as no price for the UK was available at the time of analysis). Future costs and clinical benefits were discounted at 3.5% annually. Sensitivity analyses were performed. In the base-case analysis exenatide was associated with improvements in life expectancy of 0.057 years and in quality-adjusted life expectancy of 0.442 quality-adjusted life years (QALYs) versus insulin glargine. Long-term projections demonstrated that exenatide was associated with a lower cumulative incidence of most cardiovascular disease (CVD) complications and CVD-related death than insulin glargine. Using the range of cost values, evaluation results showed that exenatide is likely to fall in a range between dominant (cost and life saving) at 20% of the US price and cost-effective (with an ICER of 22,420 pounds per QALY gained) at 100% of the US price, versus insulin glargine. Based on the findings of a recent clinical trial, long-term projections indicated that exenatide is likely to be associated with improvement in life expectancy and quality-adjusted life expectancy compared to insulin glargine. The results from this modelling analysis suggest that that exenatide is likely to represent good value for money by generally accepted standards in the UK setting in individuals with type 2 diabetes inadequately controlled on oral therapy.

The Cost-Effectiveness of Ranibizumab for the Treatment of Diabetic Macular Edema.

PubMed

Brown, Gary C; Brown, Melissa M; Turpcu, Adam; Rajput, Yamina

2015-07-01

To assess the incremental, comparative effectiveness (patient value gain) and cost effectiveness (financial value gain) associated with 0.3-mg intravitreal ranibizumab injection therapy versus sham therapy for diabetic macular edema (DME). Value-Based Medicine (Center for Value-Based Medicine, Flourtown, PA) 14-year, cost-utility analysis using patient preferences and 2012 United States real dollars. Published data from the identical Ranibizumab Injection in Subjects with Clinically Significant Macular Edema with Center Involvement Secondary to Diabetes Mellitus (RISE and RIDE) clinical trials. An incremental cost-utility analysis was performed using societal and third-party insurer cost perspectives. Costs and outcomes were discounted with net present value analysis at 3% per annum. The incremental comparative effectiveness was measured in: (1) quality-adjusted life year (QALY) gain and (2) percent patient value (quality-of-life) gain. Cost effectiveness was quantified with the cost-utility ratio (CUR) measured as $/QALY. The 14-year, incremental patient value gain conferred by intravitreal ranibizumab therapy for diabetic maculopathy was 0.9981 QALY, equating to an 11.6% improvement in quality of life. The direct, ophthalmic medical cost for ranibizumab therapy in 1 eye was $30 116, whereas for 2 eyes it was $56 336. The direct, nonophthalmic, medical costs saved from decreased depression, injury, skilled nursing facility admissions, nursing home admissions, and other vision-associated costs totaled $51 758, resulting in an overall direct medical cost of $4578. The net mean societal cost for bilateral ranibizumab therapy was -$30 807. Of this total, decreased caregiver costs accrued a $31 406 savings against the direct medical costs, whereas decreased wage losses accrued a $3978 savings. The third-party insurer CUR for bilateral ranibizumab therapy was $4587/QALY. The societal cost perspective for bilateral therapy was -$30 807/QALY, indicating that ranibizumab therapy dominated sham therapy because it conferred both a positive QALY gain of 0.9981 and a financial value gain (positive financial return on investment) of $30 807 referent to the direct ophthalmic medical costs expended. Intravitreal ranibizumab therapy for the treatment of DME confers considerable patient (human) value gain. It also accrues financial value to patients, public and private insurers, and society. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

A template for a clinico-pathological audit of medical liver biopsies.

PubMed

Colling, Richard; Fryer, Eve; Cobbold, Jeremy; Collier, Jane; Collantes, Elena; Wang, Lai Mun; Hubscher, Stefan; Wyatt, Judith; Fleming, Kenneth

2015-11-01

With changing indications for performing medical liver biopsies, we aimed to develop a tool to allow pathologists to evaluate the current usefulness, value and impact of their medical liver biopsy service. We designed and piloted a questionnaire-based clinico-pathological audit for medical liver biopsies. The audit tool was simple to implement and provided useful information about our service. Hepatologists felt that 96% of reports were clinically useful. 56% of biopsies confirmed clinical diagnoses, 46% helped differentiate between diagnoses and 42% were able to exclude possible diagnoses. 74% resulted in a change of management and 27% of liver biopsies resulted in a diagnosis which was not clinically suspected. We demonstrate the usefulness of an audit tool in providing evidence of the value of the liver pathology service in a large UK regional centre. 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.

Complex systems approach to scientific publication and peer-review system: development of an agent-based model calibrated with empirical journal data.

PubMed

Kovanis, Michail; Porcher, Raphaël; Ravaud, Philippe; Trinquart, Ludovic

Scientific peer-review and publication systems incur a huge burden in terms of costs and time. Innovative alternatives have been proposed to improve the systems, but assessing their impact in experimental studies is not feasible at a systemic level. We developed an agent-based model by adopting a unified view of peer review and publication systems and calibrating it with empirical journal data in the biomedical and life sciences. We modeled researchers, research manuscripts and scientific journals as agents. Researchers were characterized by their scientific level and resources, manuscripts by their scientific value, and journals by their reputation and acceptance or rejection thresholds. These state variables were used in submodels for various processes such as production of articles, submissions to target journals, in-house and external peer review, and resubmissions. We collected data for a sample of biomedical and life sciences journals regarding acceptance rates, resubmission patterns and total number of published articles. We adjusted submodel parameters so that the agent-based model outputs fit these empirical data. We simulated 105 journals, 25,000 researchers and 410,000 manuscripts over 10 years. A mean of 33,600 articles were published per year; 19 % of submitted manuscripts remained unpublished. The mean acceptance rate was 21 % after external peer review and rejection rate 32 % after in-house review; 15 % publications resulted from the first submission, 47 % the second submission and 20 % the third submission. All decisions in the model were mainly driven by the scientific value, whereas journal targeting and persistence in resubmission defined whether a manuscript would be published or abandoned after one or many rejections. This agent-based model may help in better understanding the determinants of the scientific publication and peer-review systems. It may also help in assessing and identifying the most promising alternative systems of peer review.

Health-related utility values of patients with primary Sjögren's syndrome and its predictors.

PubMed

Lendrem, Dennis; Mitchell, Sheryl; McMeekin, Peter; Bowman, Simon; Price, Elizabeth; Pease, Colin T; Emery, Paul; Andrews, Jacqueline; Lanyon, Peter; Hunter, John; Gupta, Monica; Bombardieri, Michele; Sutcliffe, Nurhan; Pitzalis, Costantino; McLaren, John; Cooper, Annie; Regan, Marian; Giles, Ian; Isenberg, David; Vadivelu, Saravanan; Coady, David; Dasgupta, Bhaskar; McHugh, Neil; Young-Min, Steven; Moots, Robert; Gendi, Nagui; Akil, Mohammed; Griffiths, Bridget; Ng, Wan-Fai

2014-07-01

EuroQoL-5 dimension (EQ-5D) is a standardised preference-based tool for measurement of health-related quality of life and EQ-5D utility values can be converted to quality-adjusted life years (QALYs) to aid cost-utility analysis. This study aimed to evaluate the EQ-5D utility values of 639 patients with primary Sjögren's syndrome (PSS) in the UK. Prospective data collected using a standardised pro forma were compared with UK normative data. Relationships between utility values and the clinical and laboratory features of PSS were explored. The proportion of patients with PSS reporting any problem in mobility, self-care, usual activities, pain/discomfort and anxiety/depression were 42.2%, 16.7%, 56.6%, 80.6% and 49.4%, respectively, compared with 5.4%, 1.6%, 7.9%, 30.2% and 15.7% for the UK general population. The median EQ-5D utility value was 0.691 (IQR 0.587-0.796, range -0.239 to 1.000) with a bimodal distribution. Bivariate correlation analysis revealed significant correlations between EQ-5D utility values and many clinical features of PSS, but most strongly with pain, depression and fatigue (R values>0.5). After adjusting for age and sex differences, multiple regression analysis identified pain and depression as the two most important predictors of EQ-5D utility values, accounting for 48% of the variability. Anxiety, fatigue and body mass index were other statistically significant predictors, but they accounted for <5% in variability. This is the first report on the EQ-5D utility values of patients with PSS. These patients have significantly impaired utility values compared with the UK general population. EQ-5D utility values are significantly related to pain and depression scores in PSS. 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.

Comparing published scientific journal articles to their pre-print versions

DOE PAGES

Klein, Martin; Broadwell, Peter; Farb, Sharon E.; ...

2018-02-05

Academic publishers claim that they add value to scholarly communications by coordinating reviews and contributing and enhancing text during publication. These contributions come at a considerable cost: US academic libraries paid $1.7 billion for serial subscriptions in 2008 alone. Library budgets, in contrast, are flat and not able to keep pace with serial price inflation. Here, we have investigated the publishers’ value proposition by conducting a comparative study of pre-print papers from two distinct science, technology, and medicine corpora and their final published counterparts. This comparison had two working assumptions: (1) If the publishers’ argument is valid, the text ofmore » a pre-print paper should vary measurably from its corresponding final published version, and (2) by applying standard similarity measures, we should be able to detect and quantify such differences. Our analysis revealed that the text contents of the scientific papers generally changed very little from their pre-print to final published versions. These findings contribute empirical indicators to discussions of the added value of commercial publishers and therefore should influence libraries’ economic decisions regarding access to scholarly publications.« less

Comparing published scientific journal articles to their pre-print versions

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

Klein, Martin; Broadwell, Peter; Farb, Sharon E.

Academic publishers claim that they add value to scholarly communications by coordinating reviews and contributing and enhancing text during publication. These contributions come at a considerable cost: US academic libraries paid $1.7 billion for serial subscriptions in 2008 alone. Library budgets, in contrast, are flat and not able to keep pace with serial price inflation. Here, we have investigated the publishers’ value proposition by conducting a comparative study of pre-print papers from two distinct science, technology, and medicine corpora and their final published counterparts. This comparison had two working assumptions: (1) If the publishers’ argument is valid, the text ofmore » a pre-print paper should vary measurably from its corresponding final published version, and (2) by applying standard similarity measures, we should be able to detect and quantify such differences. Our analysis revealed that the text contents of the scientific papers generally changed very little from their pre-print to final published versions. These findings contribute empirical indicators to discussions of the added value of commercial publishers and therefore should influence libraries’ economic decisions regarding access to scholarly publications.« less

Comparing and transforming PROMIS utility values to the EQ-5D.

PubMed

Hartman, John D; Craig, Benjamin M

2018-03-01

Summarizing patient-reported outcomes (PROs) on a quality-adjusted life year (QALY) scale is an essential component to any economic evaluation comparing alternative medical treatments. While multiple studies have compared PRO items and instruments based on their psychometric properties, no study has compared the preference-based summary of the EQ-5D-3L and Patient Reported Outcomes Measurement Information System (PROMIS-29) instruments. As part of this comparison, a major aim of this manuscript is to transform PROMIS-29 utility values to an EQ-5D-3L scale. A nationally representative survey of 2623 US adults completed the 29-item PROMIS health profile instrument (PROMIS-29) and the 3-level version of the EQ-5D instrument (EQ-5D-3L). Their responses were summarized on a health utility scale using published estimates. Using regression analysis, PROMIS-29 and EQ-5D-3L utility weights were compared with each other as well as with self-reported general health. PROMIS-29 utility weights were much lower than the EQ-5D-3L weights. However, a correlation coefficient of 0.769 between the utility values of the two instruments suggests that the main discordance is simply a difference in scale between the measures. It is also possible to map PROMIS-29 utility weights onto an EQ-5D-3L scale. EQ-5D-3L losses equal .1784 × (PROMIS-29 Losses) .7286 . The published estimates of the PROMIS-29 produce lower utility values than many other health instruments. Mapping the PROMIS-29 estimates to an EQ-5D-3L scale alleviates this issue and allows for a more straightforward comparison between the PROMIS-29 and other common health instruments.

Challenges in Measuring Cost and Value in Oncology: Making It Personal.

PubMed

Yu, Peter P

2016-01-01

Oncology patients often find themselves facing an incurable disease with limited treatment options and increasing patient fragility. The importance of patient preferences and values increases in shared decision making especially when the cost of cancer care is continuing its steep rise. As our understanding of cancer systems biology increases, we are justifiably optimistic about therapeutic improvements but recognize that this has complicated the traditional Food and Drug Administration approval of drug indications based on organ-specific cancer for a particular drug. Dynamic and agile clinical guidelines that reflect a rapidly changing knowledge base for decision-making support are needed. The American Society of Clinical Oncology (ASCO) has been working on three initiatives to tackle these complex issues. The first initiative is ASCO's collaboration with other international organizations to create a framework to assess drugs for the World Health Organization's Essential Medicines List, including nongenerics. The second initiative aims to define clinically meaningful outcomes as precision medicine expands the definition of cancers, leading to increased demand for the use of targeted drugs as single agents or in combination. The third initiative is ASCO's value framework, published in 2015, focusing on patient-physician shared decision making. The framework incorporates three parameters: 1) the meaningfulness of the clinical benefit, 2) the toxicity of the treatment, and 3) the patient's financial out-of-pocket cost. ASCO is concerned about the rising cost of cancer care when the clinical complexity and the pace of change in oncology are accelerating, and it is committed to help improve patient outcomes and value in cancer care as well as to engage the broader health care community in a process of collaborative improvement. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Does Lean healthcare improve patient satisfaction? A mixed-method investigation into primary care.

PubMed

Poksinska, Bozena Bonnie; Fialkowska-Filipek, Malgorzata; Engström, Jon

2017-02-01

Lean healthcare is claimed to contribute to improved patient satisfaction, but there is limited evidence to support this notion. This study investigates how primary-care centres working with Lean define and improve value from the patient's perspective, and how the application of Lean healthcare influences patient satisfaction. This paper contains two qualitative case studies and a quantitative study based on results from the Swedish National Patient Survey. Through the case studies, we investigated how primary-care organisations realised the principle of defining and improving value from the patient's perspective. In the quantitative study, we compared results from the patient satisfaction survey for 23 primary-care centres working with Lean with a control group of 23 care centres not working with Lean. We also analysed changes in patient satisfaction over time. Our case studies reveal that Lean healthcare implementations primarily target efficiency and little attention is paid to the patient's perspective. The quantitative study shows no significantly better results in patient satisfaction for primary-care centres working with Lean healthcare compared with those not working with Lean. Further, care centres working with Lean show no significant improvements in patient satisfaction over time. Lean healthcare implementations seem to have a limited impact on improving patient satisfaction. Care providers need to pay more attention to integrating the patient's perspective in the application of Lean healthcare. Value needs to be defined and value streams need to be improved based on both the knowledge and clinical expertise of care providers, and the preferences and needs of patients. 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/.

Analysis of determinations of the distance between the sun and the galactic center

NASA Astrophysics Data System (ADS)

Malkin, Z. M.

2013-02-01

The paper investigates the question of whether or not determinations of the distance between the Sun and the Galactic center R 0 are affected by the so-called "bandwagon effect", leading to selection effects in published data that tend to be close to expected values, as was suggested by some authors. It is difficult to estimate numerically a systematic uncertainty in R 0 due to the bandwagon effect; however, it is highly probable that, even if widely accepted values differ appreciably from the true value, the published results should eventually approach the true value despite the bandwagon effect. This should be manifest as a trend in the published R 0 data: if this trend is statistically significant, the presence of the bandwagon effect can be suspected in the data. Fifty two determinations of R 0 published over the last 20 years were analyzed. These data reveal no statistically significant trend, suggesting they are unlikely to involve any systematic uncertainty due to the bandwagon effect. At the same time, the published data show a gradual and statistically significant decrease in the uncertainties in the R 0 determinations with time.

Ecological risk assessment of bisphenol A in surface waters of China based on both traditional and reproductive endpoints.

PubMed

Guo, Lei; Li, Zhengyan; Gao, Pei; Hu, Hong; Gibson, Mark

2015-11-01

Bisphenol A (BPA) occurs widely in natural waters with both traditional and reproductive toxicity to various aquatic species. The water quality criteria (WQC), however, have not been established in China, which hinders the ecological risk assessment for the pollutant. This study therefore aims to derive the water quality criteria for BPA based on both acute and chronic toxicity endpoints and to assess the ecological risk in surface waters of China. A total of 15 acute toxicity values tested with aquatic species resident in China were found in published literature, which were simulated with the species sensitivity distribution (SSD) model for the derivation of criterion maximum concentration (CMC). 18 chronic toxicity values with traditional endpoints were simulated for the derivation of traditional criterion continuous concentration (CCC) and 12 chronic toxicity values with reproductive endpoints were for reproductive CCC. Based on the derived WQC, the ecological risk of BPA in surface waters of China was assessed with risk quotient (RQ) method. The results showed that the CMC, traditional CCC and reproductive CCC were 1518μgL(-1), 2.19μgL(-1) and 0.86μgL(-1), respectively. The acute risk of BPA was negligible with RQ values much lower than 0.1. The chronic risk was however much higher with RQ values of between 0.01-3.76 and 0.03-9.57 based on traditional and reproductive CCC, respectively. The chronic RQ values on reproductive endpoints were about threefold as high as those on traditional endpoints, indicating that ecological risk assessment based on traditional effects may not guarantee the safety of aquatic biota. Copyright © 2015 Elsevier Ltd. All rights reserved.

Developing a Measure of Value in Health Care.

PubMed

Ken Lee, K H; Matthew Austin, J; Pronovost, Peter J

2016-06-01

There is broad support to pay for value, rather than volume, for health care in the United States. Despite the support, practical approaches for measuring value remain elusive. Value is commonly defined as quality divided by costs, where quality reflects patient outcomes and costs are the total costs for providing care, whether these be costs related to an episode, a diagnosis, or per capita. Academicians have proposed a conceptual approach to measure value, in which we measure outcomes important to patients and costs using time-driven activity-based costing. This approach is conceptually sound, but has significant practical challenges. In our commentary, we describe how health care can use existing quality measures and cost accounting data to measure value. Although not perfect, we believe this approach is practical, valid, and scalable and can establish the foundation for future work in this area. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

MetCCS predictor: a web server for predicting collision cross-section values of metabolites in ion mobility-mass spectrometry based metabolomics.

PubMed

Zhou, Zhiwei; Xiong, Xin; Zhu, Zheng-Jiang

2017-07-15

In metabolomics, rigorous structural identification of metabolites presents a challenge for bioinformatics. The use of collision cross-section (CCS) values of metabolites derived from ion mobility-mass spectrometry effectively increases the confidence of metabolite identification, but this technique suffers from the limit number of available CCS values. Currently, there is no software available for rapidly generating the metabolites' CCS values. Here, we developed the first web server, namely, MetCCS Predictor, for predicting CCS values. It can predict the CCS values of metabolites using molecular descriptors within a few seconds. Common users with limited background on bioinformatics can benefit from this software and effectively improve the metabolite identification in metabolomics. The web server is freely available at: http://www.metabolomics-shanghai.org/MetCCS/ . jiangzhu@sioc.ac.cn. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

The role of different PI-RADS versions in prostate multiparametric magnetic resonance tomography assessment.

PubMed

Aliukonis, Paulius; Letauta, Tadas; Briedienė, Rūta; Naruševičiūtė, Ieva; Letautienė, Simona

2017-01-01

Background . Standardised Prostate Imaging Reporting and Data System (PI-RADS) guidelines for the assessment of prostate alterations were designed for the assessment of prostate pathology. Published by the ESUR in 2012, PI-RADS v1 was based on the total score of different MRI sequences with subsequent calculation. PI-RADS v2 was published by the American College of Radiology in 2015 and featured different assessment criteria for prostate peripheral and transitory zones. Aim . To assess the correlations of PI-RADS v1 and PI-RADS v2 with Gleason score values and to define their predictive values of the diagnosis of prostate cancer. Materials and methods . A retrospective analysis of 66 patients. Prostate specific antigen (PSA) value and the Gleason score (GS) were assessed. One the most malignant focal lesion was selected in the peripheral zone of each lobe of the prostate (91 in total). Statistical analysis was carried out applying SPSS software, v.23, p < 0.05. Results . Focal lesions assessed by PI-RADS v1 score: 10% - 1, 12% - 2, 41% - 3, 23% - 4, 14% - 5. Assessment applying PI-RADS v.2: 20% - 1, 7.5% - 2, 26%, 29.5%, and 17% were assessed by 3, 4, and 5 scores. Statistically relevant correlation was found only between GS and PI-RADS ( p = 0.033). The positive predictive value of both versions of PI-RADS - 75%, negative predictive value of PI-RADS v1 - 46%, PI-RADS v2 - 43%. Conclusions . PI-RADS v1 was more statistically relevant in assessing the grade of tumour. Prediction values were similar in both versions.

Misrepresenting random sampling? A systematic review of research papers in the Journal of Advanced Nursing.

PubMed

Williamson, Graham R

2003-11-01

This paper discusses the theoretical limitations of the use of random sampling and probability theory in the production of a significance level (or P-value) in nursing research. Potential alternatives, in the form of randomization tests, are proposed. Research papers in nursing, medicine and psychology frequently misrepresent their statistical findings, as the P-values reported assume random sampling. In this systematic review of studies published between January 1995 and June 2002 in the Journal of Advanced Nursing, 89 (68%) studies broke this assumption because they used convenience samples or entire populations. As a result, some of the findings may be questionable. The key ideas of random sampling and probability theory for statistical testing (for generating a P-value) are outlined. The result of a systematic review of research papers published in the Journal of Advanced Nursing is then presented, showing how frequently random sampling appears to have been misrepresented. Useful alternative techniques that might overcome these limitations are then discussed. REVIEW LIMITATIONS: This review is limited in scope because it is applied to one journal, and so the findings cannot be generalized to other nursing journals or to nursing research in general. However, it is possible that other nursing journals are also publishing research articles based on the misrepresentation of random sampling. The review is also limited because in several of the articles the sampling method was not completely clearly stated, and in this circumstance a judgment has been made as to the sampling method employed, based on the indications given by author(s). Quantitative researchers in nursing should be very careful that the statistical techniques they use are appropriate for the design and sampling methods of their studies. If the techniques they employ are not appropriate, they run the risk of misinterpreting findings by using inappropriate, unrepresentative and biased samples.

Prediction of frozen food properties during freezing using product composition.

PubMed

Boonsupthip, W; Heldman, D R

2007-06-01

Frozen water fraction (FWF), as a function of temperature, is an important parameter for use in the design of food freezing processes. An FWF-prediction model, based on concentrations and molecular weights of specific product components, has been developed. Published food composition data were used to determine the identity and composition of key components. The model proposed in this investigation had been verified using published experimental FWF data and initial freezing temperature data, and by comparison to outputs from previously published models. It was found that specific food components with significant influence on freezing temperature depression of food products included low molecular weight water-soluble compounds with molality of 50 micromol per 100 g food or higher. Based on an analysis of 200 high-moisture food products, nearly 45% of the experimental initial freezing temperature data were within an absolute difference (AD) of +/- 0.15 degrees C and standard error (SE) of +/- 0.65 degrees C when compared to values predicted by the proposed model. The predicted relationship between temperature and FWF for all analyzed food products provided close agreements with experimental data (+/- 0.06 SE). The proposed model provided similar prediction capability for high- and intermediate-moisture food products. In addition, the proposed model provided statistically better prediction of initial freezing temperature and FWF than previous published models.

The Coalition for Publishing Data in the Earth and Space Sciences

NASA Astrophysics Data System (ADS)

Lehnert, Kerstin; Hanson, Brooks; Cutcher-Gershenfeld, Joel

2015-04-01

Scholarly publishing remains a key high-value point in making data available and will for the foreseeable future be tied to the availability of science data. Data need to be included in or released as part of publications to make the science presented in an article reproducible, and most publishers have statements related to the inclusion of data, recognizing that such release enhances the value and is part of the integrity of the research. Unfortunately, practices for reporting and documenting data in the scientific literature are inconsistent and inadequate, and the vast majority of data submitted along with publications is still in formats and forms of storage that make discovery and reuse difficult or impossible. Leading earth and space science repositories on the other hand are eager and set up to provide persistent homes for these data, and also ensure quality, enhancing their value, access, and reusability. Unfortunately only a small fraction of the data associated with scientific publications makes it to these data facilities. Connecting scholarly publication more firmly with data facilities is essential in meeting the expectations of open, accessible and useful data as aspired by all stakeholders and expressed in position statements, policies, and guidelines. To strengthen these connections, a new initiative was launched in Fall 2014 at a conference that brought together major publishers, data facilities, and consortia in the Earth and space sciences, as well as governmental, association, and foundation funders. The aim of this initiative is to foster consensus and consistency among publishers, editors, funders, and data repositories on how data that are part of scholarly publications should be curated and published, and guide the development of practical resources based on those guidelines that will help authors and publishers support open data policies, facilitate proper data archiving, and support the linking of data to publications. The most relevant outcome of the conference is the formation of a working group: Coalition for Publishing Data in the Earth and Space Sciences by publishers and data facilities and consortia that will establish a permanent international coordinating conference on Earth science data publication. Marking the launch of the partnership is a joint statement of commitment (to be be released in January 2015), signed by the major Earth and space science publishers and many data facilities, to ensure that Earth science data will, to the greatest extent possible, be stored in community approved repositories that can provide additional data services. The development of a functional directory of Earth and space science repositories is underway that can be used by journals as part of their information to authors, and by authors to identify rapidly which repositories are the best homes for specific data types and how to structure such deposition.

Process value of care safety: women's willingness to pay for perinatal services.

PubMed

Anezaki, Hisataka; Hashimoto, Hideki

2017-08-01

To evaluate the process value of care safety from the patient's view in perinatal services. Cross-sectional survey. Fifty two sites of mandated public neonatal health checkup in 6 urban cities in West Japan. Mothers who attended neonatal health checkups for their babies in 2011 (n = 1316, response rate = 27.4%). Willingness to pay (WTP) for physician-attended care compared with midwife care as the process-related value of care safety. WTP was estimated using conjoint analysis based on the participants' choice over possible alternatives that were randomly assigned from among eight scenarios considering attributes such as professional attendance, amenities, painless delivery, caesarean section rate, travel time and price. The WTP for physician-attended care over midwife care was estimated 1283 USD. Women who had experienced complications in prior deliveries had a 1.5 times larger WTP. We empirically evaluated the process value for safety practice in perinatal care that was larger than a previously reported accounting-based value. Our results indicate that measurement of process value from the patient's view is informative for the evaluation of safety care, and that it is sensitive to individual risk perception for the care process. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Measures of precision for dissimilarity-based multivariate analysis of ecological communities.

PubMed

Anderson, Marti J; Santana-Garcon, Julia

2015-01-01

Ecological studies require key decisions regarding the appropriate size and number of sampling units. No methods currently exist to measure precision for multivariate assemblage data when dissimilarity-based analyses are intended to follow. Here, we propose a pseudo multivariate dissimilarity-based standard error (MultSE) as a useful quantity for assessing sample-size adequacy in studies of ecological communities. Based on sums of squared dissimilarities, MultSE measures variability in the position of the centroid in the space of a chosen dissimilarity measure under repeated sampling for a given sample size. We describe a novel double resampling method to quantify uncertainty in MultSE values with increasing sample size. For more complex designs, values of MultSE can be calculated from the pseudo residual mean square of a permanova model, with the double resampling done within appropriate cells in the design. R code functions for implementing these techniques, along with ecological examples, are provided. © 2014 The Authors. Ecology Letters published by John Wiley & Sons Ltd and CNRS.

Design, synthesis and anti-tumor activity study of novel histone deacetylase inhibitors containing isatin-based caps and o-phenylenediamine-based zinc binding groups.

PubMed

Gao, Shuai; Zang, Jie; Gao, Qianwen; Liang, Xuewu; Ding, Qinge; Li, Xiaoyang; Xu, Wenfang; Chou, C James; Zhang, Yingjie

2017-06-15

As a hot topic of epigenetic studies, histone deacetylases (HDACs) are related to lots of diseases, especially cancer. Further researches indicated that different HDAC isoforms played various roles in a wide range of tumor types. Herein a novel series of HDAC inhibitors with isatin-based caps and o-phenylenediamine-based zinc binding groups have been designed and synthesized through scaffold hopping strategy. Among these compounds, the most potent compound 9n exhibited similar if not better HDAC inhibition and antiproliferative activities against multiple tumor cell lines compared with the positive control entinostat (MS-275). Additionally, compared with MS-275 (IC 50 values for HDAC1, 2 and 3 were 0.163, 0.396 and 0.605µM, respectively), compound 9n with IC 50 values of 0.032, 0.256 and 0.311µM for HDAC1, 2 and 3 respectively, showed a moderate HDAC1 selectivity. Copyright © 2017. Published by Elsevier Ltd.

The Changing Business of Scholarly Publishing.

ERIC Educational Resources Information Center

Hunter, Karen

1993-01-01

Discussion of changes and trends in scholarly publishing highlights monographs; journals; user-centered publishing; electronic products and services, including adding value, marketing strategies, and new pricing systems; changing attitudes regarding copyright; trends in publishing industry reorganization; and impacts on research libraries. (LRW)

In multiple situational light settings, visual observation for skin colour assessment is comparable with colorimeter measurement.

PubMed

Wright, C Y; Wilkes, M; du Plessis, J L; Reeder, A I; Albers, P N

2016-08-01

Finding inexpensive and reliable techniques for assessing skin colour is important, given that it is related to several adverse human health outcomes. Visual observation is considered a subjective approach assessment and, even when made by trained assessor, concern has been raised about the need for controlled lighting in the study venue. The aim of this study is to determine whether visual skin colour assessments correlate with objective skin colour measurements in study venues with different lighting types and configurations. Two trained investigators, with confirmed visual acuity, visually classified the inner, upper arm skin colour of 556 adults using Munsell(®) colour classifications converted to Individual Typology Angle (°ITA) values based on published data. Skin colour at the same anatomic site was also measured using a colorimeter. Each participant was assessed in one of 10 different buildings, each with a different study day. Munsell(®) -derived °ITA values were compared to colorimeter °ITA values for the full sample and by building/day. We found a strong positive, monotonic correlation between Munsell(®) derived °ITA values and colorimeter °ITA values for all participants (Spearman ρ = 0.8585, P < 0.001). Similar relationships were found when Munsell(®) and colorimeter °ITA values were compared for participants assessed in the same building for all 10 buildings (Spearman ρ values ranged from 0.797 to 0.934, all correlations were statistically significant at P < 0.001). It is possible to visually assess individual skin colour in multiple situational lighting settings and retrieve results that are comparable with objective measurements of skin colour. This was true for individuals of varying population groups and skin pigmentation. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The prognostic value of standardized reference values for speckle-tracking global longitudinal strain in hypertrophic cardiomyopathy.

PubMed

Hartlage, Gregory R; Kim, Jonathan H; Strickland, Patrick T; Cheng, Alan C; Ghasemzadeh, Nima; Pernetz, Maria A; Clements, Stephen D; Williams, B Robinson

2015-03-01

Speckle-tracking left ventricular global longitudinal strain (GLS) assessment may provide substantial prognostic information for hypertrophic cardiomyopathy (HCM) patients. Reference values for GLS have been recently published. We aimed to evaluate the prognostic value of standardized reference values for GLS in HCM patients. An analysis of HCM clinic patients who underwent GLS was performed. GLS was defined as normal (more negative or equal to -16%) and abnormal (less negative than -16%) based on recently published reference values. Patients were followed for a composite of events including heart failure hospitalization, sustained ventricular arrhythmia, and all-cause death. The power of GLS to predict outcomes was assessed relative to traditional clinical and echocardiographic variables present in HCM. 79 HCM patients were followed for a median of 22 months (interquartile range 9-30 months) after imaging. During follow-up, 15 patients (19%) met the primary outcome. Abnormal GLS was the only echocardiographic variable independently predictive of the primary outcome [multivariate Hazard ratio 5.05 (95% confidence interval 1.09-23.4, p = 0.038)]. When combined with traditional clinical variables, abnormal GLS remained independently predictive of the primary outcome [multivariate Hazard ratio 5.31 (95 % confidence interval 1.18-24, p = 0.030)]. In a model including the strongest clinical and echocardiographic predictors of the primary outcome, abnormal GLS demonstrated significant incremental benefit for risk stratification [net reclassification improvement 0.75 (95 % confidence interval 0.21-1.23, p < 0.0001)]. Abnormal GLS is an independent predictor of adverse outcomes in HCM patients. Standardized use of GLS may provide significant incremental value over traditional variables for risk stratification.

Validation of light water reactor calculation methods and JEF-1-based data libraries by TRX and BAPL critical experiments

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

Paratte, J.M.; Pelloni, S.; Grimm, P.

1991-04-01

This paper analyzes the capability of various code systems and JEF-1-based nuclear data libraries to compute light water reactor lattices by comparing calculations with results from thermal reactor benchmark experiments TRX and BAPL and with previously published values. With the JEF-1 evaluation, eigenvalues are generally well predicted within 8 mk (1 mk = 0.001) or less by all code systems, and all methods give reasonable results for the measured reaction rate ratios within, or not too far from, the experimental uncertainty.

[Valuation of health-related quality of life and utilities in health economics].

PubMed

Greiner, Wolfgang; Klose, Kristina

2014-01-01

Measuring health-related quality of life is an important aspect in economic evaluation of health programmes. The development of utility-based (preference-based) measures is advanced by the discipline of health economics. Different preference measures are applied for valuing health states to produce a weighted health state index. Those preference weights should be derived from a general population sample in case of resource allocation on a collective level (as in current valuation studies of the EuroQol group). Copyright © 2014. Published by Elsevier GmbH.

A Value-Added Framework for Analyzing Electronic and Print Publishing.

ERIC Educational Resources Information Center

Perritt, Henry H., Jr.

1991-01-01

Discusses changes in the publishing industry resulting from digital electronic networks and optical storage technologies, and explains attributes of information products as types of value for both print and electronic contexts. Electronic products necessary for a shift from paper to electronic formats are identified, and legal issues are…

Using instrumental (CIE and reflectance) measures to predict consumers' acceptance of beef colour.

PubMed

Holman, Benjamin W B; van de Ven, Remy J; Mao, Yanwei; Coombs, Cassius E O; Hopkins, David L

2017-05-01

We aimed to establish colorimetric thresholds based upon the capacity for instrumental measures to predict consumer satisfaction with beef colour. A web-based survey was used to distribute standardised photographs of beef M. longissimus lumborum with known colorimetrics (L*, a*, b*, hue, chroma, ratio of reflectance at 630nm and 580nm, and estimated deoxymyoglobin, oxymyoglobin and metmyoglobin concentrations) for scrutiny. Consumer demographics and perceived importance of colour to beef value were also evaluated. It was found that a* provided the most simple and robust prediction of beef colour acceptability. Beef colour was considered acceptable (with 95% acceptance) when a* values were equal to or above 14.5. Demographic effects on this threshold were negligible, but consumer nationality and gender did contribute to variation in the relative importance of colour to beef value. These results provide future beef colour studies with context to interpret objective colour measures in terms of consumer acceptance and market appeal. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Defining the value of magnetic resonance imaging in prostate brachytherapy using time-driven activity-based costing.

PubMed

Thaker, Nikhil G; Orio, Peter F; Potters, Louis

Magnetic resonance imaging (MRI) simulation and planning for prostate brachytherapy (PBT) may deliver potential clinical benefits but at an unknown cost to the provider and healthcare system. Time-driven activity-based costing (TDABC) is an innovative bottom-up costing tool in healthcare that can be used to measure the actual consumption of resources required over the full cycle of care. TDABC analysis was conducted to compare patient-level costs for an MRI-based versus traditional PBT workflow. TDABC cost was only 1% higher for the MRI-based workflow, and utilization of MRI allowed for cost shifting from other imaging modalities, such as CT and ultrasound, to MRI during the PBT process. Future initiatives will be required to follow the costs of care over longer periods of time to determine if improvements in outcomes and toxicities with an MRI-based approach lead to lower resource utilization and spending over the long-term. Understanding provider costs will become important as healthcare reform transitions to value-based purchasing and other alternative payment models. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Visualizing value for money in public health interventions.

PubMed

Leigh-Hunt, Nicholas; Cooper, Duncan; Furber, Andrew; Bevan, Gwyn; Gray, Muir

2018-01-23

The Socio-Technical Allocation of Resources (STAR) has been developed for value for money analysis of health services through stakeholder workshops. This article reports on its application for prioritization of interventions within public health programmes. The STAR tool was used by identifying costs and service activity for interventions within commissioned public health programmes, with benefits estimated from the literature on economic evaluations in terms of costs per Quality-Adjusted Life Years (QALYs); consensus on how these QALY values applied to local services was obtained with local commissioners. Local cost-effectiveness estimates could be made for some interventions. Methodological issues arose from gaps in the evidence base for other interventions, inability to closely match some performance monitoring data with interventions, and disparate time horizons of published QALY data. Practical adjustment for these issues included using population prevalences and utility states where intervention specific evidence was lacking, and subdivision of large contracts into specific intervention costs using staffing ratios. The STAR approach proved useful in informing commissioning decisions and understanding the relative value of local public health interventions. Further work is needed to improve robustness of the process and develop a visualization tool for use by public health departments. © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Implications of Web of Science journal impact factor for scientific output evaluation in 16 institutions and investigators' opinion.

PubMed

Wáng, Yì-Xiáng J; Arora, Richa; Choi, Yongdoo; Chung, Hsiao-Wen; Egorov, Vyacheslav I; Frahm, Jens; Kudo, Hiroyuki; Kuyumcu, Suleyman; Laurent, Sophie; Loffroy, Romaric; Maurea, Simone; Morcos, Sameh K; Ni, Yicheng; Oei, Edwin H G; Sabarudin, Akmal; Yu, Xin

2014-12-01

Journal based metrics is known not to be ideal for the measurement of the quality of individual researcher's scientific output. In the current report 16 contributors from Hong Kong SAR, India, Korea, Taiwan, Russia, Germany, Japan, Turkey, Belgium, France, Italy, UK, The Netherlands, Malaysia, and USA are invited. The following six questions were asked: (I) is Web of Sciences journal impact factor (IF) and Institute for Scientific Information (ISI) citation the main academic output performance evaluation tool in your institution? and your country? (II) How does Google citation count in your institution? and your country? (III) If paper is published in a non-SCI journal but it is included in PubMed and searchable by Google scholar, how it is valued when compared with a paper published in a journal with an IF? (IV) Do you value to publish a piece of your work in a non-SCI journal as much as a paper published in a journal with an IF? (V) What is your personal view on the metric measurement of scientific output? (VI) Overall, do you think Web of Sciences journal IF is beneficial, or actually it is doing more harm? The results show that IF and ISI citation is heavily affecting the academic life in most of the institutions. Google citation and evaluation, while is being used and convenient and speedy, has not gain wide 'official' recognition as a tool for scientific output evaluation.

Underlying mechanism of drug-drug interaction between pioglitazone and gemfibrozil: Gemfibrozil acyl-glucuronide is a mechanism-based inhibitor of CYP2C8.

PubMed

Takagi, Motoi; Sakamoto, Masaya; Itoh, Tomoo; Fujiwara, Ryoichi

2015-08-01

While co-administered gemfibrozil can increase the area under the concentration/time curve (AUC) of pioglitazone more than 3-fold, the underlying mechanism of the drug-drug interaction between gemfibrozil and pioglitazone has not been fully understood. In the present study, gemfibrozil preincubation time-dependently inhibited the metabolism of pioglitazone in the cytochrome P450 (CYP)- and UDP-glucuronosyltransferase (UGT)-activated human liver microsomes. We estimated the kinact and K'app values, which are the maximum inactivation rate constant and the apparent dissociation constant, of gemfibrozil to be 0.071 min(-1) and 57.3 μM, respectively. In this study, the kobs, in vivo value was defined as a parameter that indicates the potency of the mechanism-based inhibitory effect at the blood drug concentration in vivo. The kobs, in vivo values of potent mechanism-based inhibitors, clarithromycin and erythromycin, were estimated to be 0.0096 min(-1) and 0.0051 min(-1), respectively. The kobs, in vivo value of gemfibrozil was 0.0060 min(-1), which was comparable to those of clarithromycin and erythromycin, suggesting that gemfibrozil could be a mechanism-based inhibitor as potent as clarithromycin and erythromycin in vivo. Copyright © 2015 The Japanese Society for the Study of Xenobiotics. Published by Elsevier Ltd. All rights reserved.

Use of spaced education to deliver a curriculum in quality, safety and value for postgraduate medical trainees: trainee satisfaction and knowledge.

PubMed

Bruckel, Jeffrey; Carballo, Victoria; Kalibatas, Orinta; Soule, Michael; Wynne, Kathryn E; Ryan, Megan P; Shaw, Tim; Co, John Patrick T

2016-03-01

Quality, patient safety and value are important topics for graduate medical education (GME). Spaced education delivers case-based content in a structured longitudinal experience. Use of spaced education to deliver quality and safety education in GME at an institutional level has not been previously evaluated. To implement a spaced education course in quality, safety and value; to assess learner satisfaction; and to describe trainee knowledge in these areas. We developed a case-based spaced education course addressing learning objectives related to quality, safety and value. This course was offered to residents and fellows about two-thirds into the academic year (March 2014) and new trainees during orientation (June 2014). We assessed learner satisfaction by reviewing the course completion rate and a postcourse survey, and trainee knowledge by the per cent of correct responses. The course was offered to 1950 trainees. A total of 305 (15.6%) enrolled in the course; 265/305 (86.9%) answered at least one question, and 106/305 (34.8%) completed the course. Fewer participants completed the March programme compared with the orientation programme (42/177 (23.7%) vs 64/128 (50.0%), p<0.001). Completion rates differed by specialty, 80/199 (40.2%) in non-surgical specialties compared with 16/106 (24.5%) in surgical specialties (p=0.008). The proportion of questions answered correctly on the first attempt was 53.2% (95% CI 49.4% to 56.9%). Satisfaction among those completing the programme was high. Spaced education can help deliver and assess learners' understanding of quality, safety and value principles. Offering a voluntary course may result in low completion. Learners were satisfied with their experience and were introduced to new concepts. 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/

Saturated linkage map construction in Rubus idaeus using genotyping by sequencing and genome-independent imputation

PubMed Central

2013-01-01

Background Rapid development of highly saturated genetic maps aids molecular breeding, which can accelerate gain per breeding cycle in woody perennial plants such as Rubus idaeus (red raspberry). Recently, robust genotyping methods based on high-throughput sequencing were developed, which provide high marker density, but result in some genotype errors and a large number of missing genotype values. Imputation can reduce the number of missing values and can correct genotyping errors, but current methods of imputation require a reference genome and thus are not an option for most species. Results Genotyping by Sequencing (GBS) was used to produce highly saturated maps for a R. idaeus pseudo-testcross progeny. While low coverage and high variance in sequencing resulted in a large number of missing values for some individuals, a novel method of imputation based on maximum likelihood marker ordering from initial marker segregation overcame the challenge of missing values, and made map construction computationally tractable. The two resulting parental maps contained 4521 and 2391 molecular markers spanning 462.7 and 376.6 cM respectively over seven linkage groups. Detection of precise genomic regions with segregation distortion was possible because of map saturation. Microsatellites (SSRs) linked these results to published maps for cross-validation and map comparison. Conclusions GBS together with genome-independent imputation provides a rapid method for genetic map construction in any pseudo-testcross progeny. Our method of imputation estimates the correct genotype call of missing values and corrects genotyping errors that lead to inflated map size and reduced precision in marker placement. Comparison of SSRs to published R. idaeus maps showed that the linkage maps constructed with GBS and our method of imputation were robust, and marker positioning reliable. The high marker density allowed identification of genomic regions with segregation distortion in R. idaeus, which may help to identify deleterious alleles that are the basis of inbreeding depression in the species. PMID:23324311

Community pharmacy-based research in Spain (1995-2005): A bibliometric study

PubMed Central

Andrés Iglesias, José Carlos; Andrés Rodríguez, N. Floro; Fornos Pérez, José Antonio

Only one study evaluated the scientific activity in community pharmacies in Spain, and it was restricted to articles published in just two journals. Objective To assess the scientific activity in community pharmacies in Spain through a bibliometric analysis of the original papers published during the years 1995-2005. Methods IPA, MEDLINE, CSIC database and the journals Seguimiento Farmacoterapéutico y Pharmaceutical Care España were used as data sources. Production indicators, consumption indicators and the impact factor (IF) as a repercussion index were analyzed. Results 122 articles were included in the review. The articles were published in 12 journals, 78.7% of them in Pharmaceutical Care España and Seguimiento Farmacoterapéutico. The mean number of authors per article was 4.2 (SD=2.1). The transitivity index was 71.3%. The total number of references cited in the articles was 2110. The mean number of references per article was 17.3 SD=9.3. The value of the insularity index was 57.6%. Self citation was 6.8% and the Price index was 66.5%. No impact factor was available for 6 journals. Conclusions Publication of articles on community pharmacy-based research in Spain has undergone an important increase in the last 5 years. The existence of authors who publish very few studies, the high insularity index and the lack of randomized, controlled trials may be considered as negative indicators in community pharmacy-based research in Spain. PMID:25214914

Developing a tooth restorability index.

PubMed

McDonald, Ailbhe; Setchell, Derrick

2005-01-01

It is generally agreed that the inherent strength of a tooth is dependent on the remaining dentine. It therefore seems logical that preservation of coronal dentine is important to the survival of intra- and extra-coronal restorations. The clinical assessment of the amount of dentine needed for functional requirements and the strategic value of remaining tooth structure is currently based on clinical opinion. This paper discusses what recommendations have been published and proposes an index that may be useful in assessing the restorability of a tooth. An index used to assess the amount and contribution of remaining coronal dentine to resistance and retention form could be of value in treatment planning.

The Expanding Spectrum of Espionage by Americans, 1947-2015

DTIC Science & Technology

2017-08-01

time expressed concern about a decline in American values when , during the Cold War, so many young people were willing to betray their country’s...Herbig & Wiskoff, 2002). The third PERSEREC espionage report was published in 2008, when there were 173 Americans to consider. This report shifted the...civilian or volunteer versus recruited spy, people were divided into three cohorts based on when they began espionage and analyzed accordingly. For

Connecting United States Air Force Core Values to Mission Accomplishment

DTIC Science & Technology

2014-06-04

making ( Kohlberg , 2008), to published works with a specific focus on ethics in the Air Force. The case studies referenced throughout the paper are used...useful backdrop for solving this problem. Lawrence Kohlberg , an American psychologist, experimentally derived a model for moral development based...on the cognitive reasoning one employs in making moral decisions and solving ethical quandaries ( Kohlberg , 2008). How one thinks through moral and

Patient-Centered Specialty Practice: Defining the Role of Specialists in Value-Based Health Care.

PubMed

Ward, Lawrence; Powell, Rhea E; Scharf, Michael L; Chapman, Andrew; Kavuru, Mani

2017-04-01

Health care is at a crossroads and under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. However, primary care accounts for only a small portion of total health-care spending, and there is a need for policies and frameworks to support high-quality, cost-efficient care in specialty practices of the medical neighborhood. The Patient-Centered Specialty Practice (PCSP) model offers ambulatory-based specialty practices one such framework, supported by a formal recognition program through the National Committee for Quality Assurance. The key elements of the PCSP model include processes to support timely access to referral requests, improved communication and coordination with patients and referring clinicians, reduced unnecessary and duplicative testing, and an emphasis on continuous measurement of quality, safety, and performance improvement for a population of patients. Evidence to support the model remains limited, and estimates of net costs and value to practices are not fully understood. The PCSP model holds promise for promoting value-based health care in specialty practices. The continued development of appropriate incentives is required to ensure widespread adoption. Copyright © 2017. Published by Elsevier Inc.

[The German Statutory Accident Insurance: A successful example of a value-based healthcare structure].

PubMed

Wich, Michael; Auhuber, Thomas; Scholtysik, Dirk; Ekkernkamp, Axel

2018-02-01

In the mid-1920s Porter and others developed a reform approach for existing health care systems, aiming at a patient-focused, value-based orientation. Improving patient outcomes by attaining, preserving and restoring good health is inherently less costly than dealing with poor health. The authors of the present article will outline that the German statutory accident insurance system, which was already introduced in1884 and is of an evolving nature, reflects key elements of Porter's efficient value-based health care system. The German accident insurance system with its statutory mandate limited to the prevention and rehabilitation of work-related damage to one's health can also serve as a model for other larger health care insurance systems. Prevention and rehabilitation is pursued using all appropriate means to achieve the set goals of protecting and restoring individual health. In line with these objectives, the statutory health insurance controls the process in terms of the required care quality. The components of a complex health care system, usually managed by a variety of different institutions, are consolidated. Thus it can be ensured that in both prevention and rehabilitation all services that are necessary to keep focussing the value "individual health" rather than indemnities are applied. Copyright © 2018. Published by Elsevier GmbH.

The value of non-invasive ventilation.

PubMed

Hull, Jeremy

2014-11-01

Non-invasive ventilation (NIV) use has increased markedly over the last 10 years. Children being treated with NIV are now a common sight in most paediatric intensive care units and high dependency units and nearly all tertiary respiratory units will look after a cohort of children who use NIV at home. Although the published evidence base for use of NIV in acute and chronic respiratory failure is relatively weak, it is now very unlikely that there will be any more randomised controlled trials of this intervention. Effectiveness of NIV will need to be evaluated on each child as it used. It is important to define the purpose of using NIV in each child, and then determine whether it is effective. 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.

Quantifying the costs and benefits of privacy-preserving health data publishing.

PubMed

Khokhar, Rashid Hussain; Chen, Rui; Fung, Benjamin C M; Lui, Siu Man

2014-08-01

Cost-benefit analysis is a prerequisite for making good business decisions. In the business environment, companies intend to make profit from maximizing information utility of published data while having an obligation to protect individual privacy. In this paper, we quantify the trade-off between privacy and data utility in health data publishing in terms of monetary value. We propose an analytical cost model that can help health information custodians (HICs) make better decisions about sharing person-specific health data with other parties. We examine relevant cost factors associated with the value of anonymized data and the possible damage cost due to potential privacy breaches. Our model guides an HIC to find the optimal value of publishing health data and could be utilized for both perturbative and non-perturbative anonymization techniques. We show that our approach can identify the optimal value for different privacy models, including K-anonymity, LKC-privacy, and ∊-differential privacy, under various anonymization algorithms and privacy parameters through extensive experiments on real-life data. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessment of ionization chamber correction factors in photon beams using a time saving strategy with PENELOPE code.

PubMed

Reis, C Q M; Nicolucci, P

2016-02-01

The purpose of this study was to investigate Monte Carlo-based perturbation and beam quality correction factors for ionization chambers in photon beams using a saving time strategy with PENELOPE code. Simulations for calculating absorbed doses to water using full spectra of photon beams impinging the whole water phantom and those using a phase-space file previously stored around the point of interest were performed and compared. The widely used NE2571 ionization chamber was modeled with PENELOPE using data from the literature in order to calculate absorbed doses to the air cavity of the chamber. Absorbed doses to water at reference depth were also calculated for providing the perturbation and beam quality correction factors for that chamber in high energy photon beams. Results obtained in this study show that simulations with phase-space files appropriately stored can be up to ten times shorter than using a full spectrum of photon beams in the input-file. Values of kQ and its components for the NE2571 ionization chamber showed good agreement with published values in the literature and are provided with typical statistical uncertainties of 0.2%. Comparisons to kQ values published in current dosimetry protocols such as the AAPM TG-51 and IAEA TRS-398 showed maximum percentage differences of 0.1% and 0.6% respectively. The proposed strategy presented a significant efficiency gain and can be applied for a variety of ionization chambers and clinical photon beams. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

An empirical method for deriving RBE values associated with electrons, photons and radionuclides.

PubMed

Bellamy, M; Puskin, J; Hertel, N; Eckerman, K

2015-12-01

There is substantial evidence to justify using relative biological effectiveness (RBE) values of >1 for low-energy electrons and photons. But, in the field of radiation protection, radiation associated with low linear energy transfer has been assigned a radiation weighting factor wR of 1. This value may be suitable for radiation protection but, for risk considerations, it is important to evaluate the potential elevated biological effectiveness of radiation to improve the quality of risk estimates. RBE values between 2 and 3 for tritium are implied by several experimental measurements. Additionally, elevated RBE values have been found for other similar low-energy radiation sources. In this work, RBE values are derived for electrons based upon the fractional deposition of absorbed dose of energies less than a few kiloelectron volts. Using this empirical method, RBE values were also derived for monoenergetic photons and 1070 radionuclides from ICRP Publication 107 for which photons and electrons are the primary emissions. Published by Oxford University Press 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Trends in P Value, Confidence Interval, and Power Analysis Reporting in Health Professions Education Research Reports: A Systematic Appraisal.

PubMed

Abbott, Eduardo F; Serrano, Valentina P; Rethlefsen, Melissa L; Pandian, T K; Naik, Nimesh D; West, Colin P; Pankratz, V Shane; Cook, David A

2018-02-01

To characterize reporting of P values, confidence intervals (CIs), and statistical power in health professions education research (HPER) through manual and computerized analysis of published research reports. The authors searched PubMed, Embase, and CINAHL in May 2016, for comparative research studies. For manual analysis of abstracts and main texts, they randomly sampled 250 HPER reports published in 1985, 1995, 2005, and 2015, and 100 biomedical research reports published in 1985 and 2015. Automated computerized analysis of abstracts included all HPER reports published 1970-2015. In the 2015 HPER sample, P values were reported in 69/100 abstracts and 94 main texts. CIs were reported in 6 abstracts and 22 main texts. Most P values (≥77%) were ≤.05. Across all years, 60/164 two-group HPER studies had ≥80% power to detect a between-group difference of 0.5 standard deviations. From 1985 to 2015, the proportion of HPER abstracts reporting a CI did not change significantly (odds ratio [OR] 2.87; 95% CI 1.04, 7.88) whereas that of main texts reporting a CI increased (OR 1.96; 95% CI 1.39, 2.78). Comparison with biomedical studies revealed similar reporting of P values, but more frequent use of CIs in biomedicine. Automated analysis of 56,440 HPER abstracts found 14,867 (26.3%) reporting a P value, 3,024 (5.4%) reporting a CI, and increased reporting of P values and CIs from 1970 to 2015. P values are ubiquitous in HPER, CIs are rarely reported, and most studies are underpowered. Most reported P values would be considered statistically significant.

Consumer willingness to pay for pharmacy services: An updated review of the literature.

PubMed

Painter, Jacob T; Gressler, Laura; Kathe, Niranjan; Slabaugh, S Lane; Blumenschein, Karen

2018-02-02

Quantifying the value of pharmacy services is imperative for the profession as it works to establish an expanded role within evolving health care systems. The literature documents the work that many have contributed toward meeting this goal. To date, however, the preponderance of evidence evaluates the value of pharmacist services to third-party payers; few published studies address the value that consumers place on these services. In 1999, a review of studies that used the contingent valuation method to value pharmacy services was published. The objective of this manuscript is to provide an update of that review. Relevant studies published in the English language were identified searching MEDLINE, ECONLIT and International Pharmaceutical Abstracts databases from January 1999 to November 2017. Only studies that specifically elicited willingness to pay for a community pharmacist provided service from actual or potential consumers were included. Thirty-one studies using the contingent valuation method to value pharmacy services were identified using the search strategy outlined. These studies included surveys in different demographic and geographic populations and valuing various pharmacy services. Improving the quality of studies using contingent valuation to value pharmacy services will aid the profession in marketing pharmacy services to consumers, and may assist practitioners who wish to implement various pharmacy services in their practice settings. A limited number of studies have been conducted, but the quality of contingent valuation studies valuing pharmacist services is improving. Understanding the pharmacy services that consumers value, and understanding the level of their monetary willingness to pay for those services will be crucial as the profession continues to work toward establishing a sustainable and economically viable role within the evolving health care systems. Copyright © 2018. Published by Elsevier Inc.

Publishing integrity and good practices in editing in biomedicine.

PubMed

Polenakovic, Momir; Gucev, Zoran

2014-01-01

The Macedonian Academy of Sciences and Arts (MASA), held a scientific workshop for journal editors in biomedicine: "Publishing integrity and good practices in editing in biomedicine" on April 25, 2014 in MASA, Skopje. The meeting looked into old problems and new situations in editing and publishing, with emphasis on the situation in developing countries. This global knowledge-based society is founded on the results obtained from scientific research. The data from basic research in developed countries contribute in a quite substantial manner to the newly added economic value. One of the main reasons for underdevelopment in South Eastern Europe (SEE) is certainly a low or non-existent contribution of scientific research in the newly added economic value. This has largely to do with the perception of the political elites which simply lack the insight on the crucial importance of science in development. In the long term this leads to societies in which there are distortions in the understanding of the most basic values. Academic publishing has experienced tremendous growth: so far there are at least 50 million scientific articles. Interestingly, publishing in developing countries has experienced a rate of growth higher than in developed countries. However, this is not the case with the Balkan countries. The meeting looked at some old and some newly emerging problems in editing and publishing. First, the high cost for universities and researchers to purchase journals adversely affects both publishing and editing. In developing countries the high cost of purchasing scientific literature is an almost insurmountable problem in spite of the fact that some publishing companies offer discounted fees. Open access journals in South Eastern European (SEE) countries are hardly achievable as this also incurs costs that have to be covered in some way or other. The peer review process has the fundamental difficulty that reviewers are in the situation of a Procrustean bed, tending to accept reports which support the reviewer's concepts of thinking and, like Procrustes, cutting everything else out. Authorship is often a contentious issue, as undeserved authors appear on the list of authors. Some principles are now a norm in academic publishing. This applies to the declaration of a conflict of interest, the consent of the patient and the approval of the Ethical Board of the institution. This global informational technological revolution has, unfortunately, led to largely widespread and increasingly sophisticated deviations: plagiarism, data fabrication and data falsification as forms of scientific misconduct. Those events are now more widespread than in the past. Luckily new tools to track them are much better than previously. The race for perfect publishing integrity and for the best good practices in editing in biomedicine is on. New and old challenges will be met. The benevolent and caring society, educated professionals and an enlightened public remain essential preconditions. The wealth of nations depends on R&D and consequently on academic publishing.

Discriminating Between Legitimate and Predatory Open Access Journals: Report from the International Federation for Emergency Medicine Research Committee

PubMed Central

Hansoti, Bhakti; Langdorf, Mark I.; Murphy, Linda S.

2016-01-01

Introduction Open access (OA) medical publishing is growing rapidly. While subscription-based publishing does not charge the author, OA does. This opens the door for “predatory” publishers who take authors’ money but provide no substantial peer review or indexing to truly disseminate research findings. Discriminating between predatory and legitimate OA publishers is difficult. Methods We searched a number of library indexing databases that were available to us through the University of California, Irvine Libraries for journals in the field of emergency medicine (EM). Using criteria from Jeffrey Beall, University of Colorado librarian and an expert on predatory publishing, and the Research Committee of the International Federation for EM, we categorized EM journals as legitimate or likely predatory. Results We identified 150 journal titles related to EM from all sources, 55 of which met our criteria for OA (37%, the rest subscription based). Of these 55, 25 (45%) were likely to be predatory. We present lists of clearly legitimate OA journals, and, conversely, likely predatory ones. We present criteria a researcher can use to discriminate between the two. We present the indexing profiles of legitimate EM OA journals, to inform the researcher about degree of dissemination of research findings by journal. Conclusion OA journals are proliferating rapidly. About half in EM are legitimate. The rest take substantial money from unsuspecting, usually junior, researchers and provide no value for true dissemination of findings. Researchers should be educated and aware of scam journals. PMID:27625710

Discriminating Between Legitimate and Predatory Open Access Journals: Report from the International Federation for Emergency Medicine Research Committee.

PubMed

Hansoti, Bhakti; Langdorf, Mark I; Murphy, Linda S

2016-09-01

Open access (OA) medical publishing is growing rapidly. While subscription-based publishing does not charge the author, OA does. This opens the door for "predatory" publishers who take authors' money but provide no substantial peer review or indexing to truly disseminate research findings. Discriminating between predatory and legitimate OA publishers is difficult. We searched a number of library indexing databases that were available to us through the University of California, Irvine Libraries for journals in the field of emergency medicine (EM). Using criteria from Jeffrey Beall, University of Colorado librarian and an expert on predatory publishing, and the Research Committee of the International Federation for EM, we categorized EM journals as legitimate or likely predatory. We identified 150 journal titles related to EM from all sources, 55 of which met our criteria for OA (37%, the rest subscription based). Of these 55, 25 (45%) were likely to be predatory. We present lists of clearly legitimate OA journals, and, conversely, likely predatory ones. We present criteria a researcher can use to discriminate between the two. We present the indexing profiles of legitimate EM OA journals, to inform the researcher about degree of dissemination of research findings by journal. OA journals are proliferating rapidly. About half in EM are legitimate. The rest take substantial money from unsuspecting, usually junior, researchers and provide no value for true dissemination of findings. Researchers should be educated and aware of scam journals.

A complexity measure based method for studying the dependance of 222Rn concentration time series on indoor air temperature and humidity.

PubMed

Mihailovic, D T; Udovičić, V; Krmar, M; Arsenić, I

2014-02-01

We have suggested a complexity measure based method for studying the dependence of measured (222)Rn concentration time series on indoor air temperature and humidity. This method is based on the Kolmogorov complexity (KL). We have introduced (i) the sequence of the KL, (ii) the Kolmogorov complexity highest value in the sequence (KLM) and (iii) the KL of the product of time series. The noticed loss of the KLM complexity of (222)Rn concentration time series can be attributed to the indoor air humidity that keeps the radon daughters in air. © 2013 Published by Elsevier Ltd.

A single competency-based education and training and competency-based career framework for the Australian health workforce: discussing the potential value add

PubMed Central

Brownie, Sharon Mary; Thomas, Janelle

2014-01-01

This brief discusses the policy implications of a research study commissioned by Health Workforce Australia (HWA) within its health workforce innovation and reform work program. The project explored conceptually complex and operationally problematic concepts related to developing a whole-of-workforce competency-based education and training and competency-based career framework for the Australian health workforce and culminated with the production of three reports published by HWA. The project raised important queries as to whether such a concept is desirable, feasible or implementable – in short what is the potential value add and is it achievable? In setting the scene for discussion, the foundation of the project’s genesis and focus of the study are highlighted. A summary of key definitions related to competency-based education and training frameworks and competency-based career frameworks are provided to further readers’ commonality of understanding. The nature of the problem to be solved is explored and the potential value-add for the Australian health workforce and its key constituents proposed. The paper concludes by discussing relevance and feasibility issues within Australia’s current and changing healthcare context along with the essential steps and implementation realities that would need to be considered and actioned if whole-of-workforce frameworks were to be developed and implemented. PMID:25279384

The Impact of Electronic Commerce on the Publishing Industry: Towards a Business Value Complementarity Framework of Electronic Publishing.

ERIC Educational Resources Information Center

Scupola, Ada

1999-01-01

Discussion of the publishing industry and its use of information and communication technologies focuses on the way in which electronic-commerce technologies are changing and could change the publishing processes, and develops a business complementarity model of electronic publishing to maximize profitability and improve the competitive position.…

Predictive ecotoxicity of MoA 1 of organic chemicals using in silico approaches.

PubMed

de Morais E Silva, Luana; Alves, Mateus Feitosa; Scotti, Luciana; Lopes, Wilton Silva; Scotti, Marcus Tullius

2018-05-30

Persistent organic products are compounds used for various purposes, such as personal care products, surfactants, colorants, industrial additives, food, pesticides and pharmaceuticals. These substances are constantly introduced into the environment and many of these pollutants are difficult to degrade. Toxic compounds classified as MoA 1 (Mode of Action 1) are low toxicity compounds that comprise nonreactive chemicals. In silico methods such as Quantitative Structure-Activity Relationships (QSARs) have been used to develop important models for prediction in several areas of science, as well as aquatic toxicity studies. The aim of the present study was to build a QSAR model-based set of theoretical Volsurf molecular descriptors using the fish acute toxicity values of compounds defined as MoA 1 to identify the molecular properties related to this mechanism. The selected Partial Least Squares (PLS) results based on the values of cross-validation coefficients of determination (Q cv 2 ) show the following values: Q cv 2 = 0.793, coefficient of determination (R 2 ) = 0.823, explained variance in external prediction (Q ext 2 ) = 0.87. From the selected descriptors, not only the hydrophobicity is related to the toxicity as already mentioned in previously published studies but other physicochemical properties combined contribute to the activity of these compounds. The symmetric distribution of the hydrophobic moieties in the structure of the compounds as well as the shape, as branched chains, are important features that are related to the toxicity. This information from the model can be useful in predicting so as to minimize the toxicity of organic compounds. Copyright © 2018. Published by Elsevier Inc.

Assessment of an extended dataset of in vitro human dermal absorption studies on pesticides to determine default values, opportunities for read-across and influence of dilution on absorption.

PubMed

Aggarwal, M; Fisher, P; Hüser, A; Kluxen, F M; Parr-Dobrzanski, R; Soufi, M; Strupp, C; Wiemann, C; Billington, R

2015-06-01

Dermal absorption is a key parameter in non-dietary human safety assessments for agrochemicals. Conservative default values and other criteria in the EFSA guidance have substantially increased generation of product-specific in vitro data and in some cases, in vivo data. Therefore, data from 190 GLP- and OECD guideline-compliant human in vitro dermal absorption studies were published, suggesting EFSA defaults and criteria should be revised (Aggarwal et al., 2014). This follow-up article presents data from an additional 171 studies and also the combined dataset. Collectively, the data provide consistent and compelling evidence for revision of EFSA's guidance. This assessment covers 152 agrochemicals, 19 formulation types and representative ranges of spray concentrations. The analysis used EFSA's worst-case dermal absorption definition (i.e., an entire skin residue, except for surface layers of stratum corneum, is absorbed). It confirmed previously proposed default values of 6% for liquid and 2% for solid concentrates, irrespective of active substance loading, and 30% for all spray dilutions, irrespective of formulation type. For concentrates, absorption from solvent-based formulations provided reliable read-across for other formulation types, as did water-based products for solid concentrates. The combined dataset confirmed that absorption does not increase linearly beyond a 5-fold increase in dilution. Finally, despite using EFSA's worst-case definition for absorption, a rationale for routinely excluding the entire stratum corneum residue, and ideally the entire epidermal residue in in vitro studies, is presented. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Valuing innovative endoscopic techniques: per-oral endoscopic myotomy for the management of achalasia.

PubMed

Shah, Eric D; Chang, Andrew C; Law, Ryan

2018-04-20

Unclear reimbursement for new and innovative endoscopic procedures can limit adoption in clinical practice despite effectiveness in clinical trials. The aim of this study was to determine maximum cost-effective reimbursement for per-oral endoscopic myotomy (POEM) in treating achalasia. We constructed a decision analytic model assessing POEM versus laparoscopic Heller myotomy with Dor fundoplication (LHM) in managing achalasia from a payer perspective over a 1-year time horizon. Reimbursement data were derived from 2017 Medicare data. Responder rates were based on clinically meaningful improvement in validated Eckardt scores. Validated health utility values were assigned to terminal health states based on data previously derived with a standard gamble technique. Contemporary willingness-to-pay (WTP) levels per quality-adjusted life year (QALY) were used to estimate maximum reimbursement for POEM using threshold analysis. Effectiveness of POEM and LHM was similar at one year of follow-up (0.91 QALY). Maximum cost-effective reimbursement for POEM was $1,200.07 to $1,389.85 (33.4-38.7 total 2017 RVUs). This compares to contemporary total reimbursement of 10-15 total RVU for advanced endoscopic procedures. The model was most sensitive to the probability of GERD after procedure. The rate of conversion to open laparotomy due to perforation or bleeding was infrequent in published clinical practice experience, thus did not significantly affect reimbursement. POEM is an example of an innovative and potentially disruptive endoscopic technique offering greater cost-effective value and similar outcomes to the established surgical standard at contemporary reimbursement levels. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

An evaluation of freshwater mussel toxicity data in the derivation of water quality guidance and standards for copper

USGS Publications Warehouse

March, F.A.; Dwyer, F.J.; Augspurger, T.; Ingersoll, C.G.; Wang, N.; Mebane, C.A.

2007-01-01

The state of Oklahoma has designated several areas as freshwater mussel sanctuaries in an attempt to provide freshwater mussel species a degree of protection and to facilitate their reproduction. We evaluated the protection afforded freshwater mussels by the U.S. Environmental Protection Agency (U.S. EPA) hardness-based 1996 ambient copper water quality criteria, the 2007 U.S. EPA water quality criteria based on the biotic ligand model and the 2005 state of Oklahoma copper water quality standards. Both the criterion maximum concentration and criterion continuous concentration were evaluated. Published acute and chronic copper toxicity data that met American Society for Testing and Materials guidance for test acceptability were obtained for exposures conducted with glochidia or juvenile freshwater mussels. We tabulated toxicity data for glochidia and juveniles to calculate 20 species mean acute values for freshwater mussels. Generally, freshwater mussel species mean acute values were similar to those of the more sensitive species included in the U.S. EPA water quality derivation database. When added to the database of genus mean acute values used in deriving 1996 copper water quality criteria, 14 freshwater mussel genus mean acute values included 10 of the lowest 15 genus mean acute values, with three mussel species having the lowest values. Chronic exposure and sublethal effects freshwater mussel data available for four species and acute to chronic ratios were used to evaluate the criterion continuous concentration. On the basis of the freshwater mussel toxicity data used in this assessment, the hardness-based 1996 U.S. EPA water quality criteria, the 2005 Oklahoma water quality standards, and the 2007 U.S. EPA water quality criteria based on the biotic ligand model might need to be revised to afford protection to freshwater mussels. ?? 2007 SETAC.

Multi-modal management of acromegaly: a value perspective.

PubMed

Kimmell, Kristopher T; Weil, Robert J; Marko, Nicholas F

2015-10-01

The Acromegaly Consensus Group recently released updated guidelines for medical management of acromegaly patients. We subjected these guidelines to a cost analysis. We conducted a cost analysis of the recommendations based on published efficacy rates as well as publicly available cost data. The results were compared to findings from a previously reported comparative effectiveness analysis of acromegaly treatments. Using decision tree software, two models were created based on the Acromegaly Consensus Group's recommendations and the comparative effectiveness analysis. The decision tree for the Consensus Group's recommendations was subjected to multi-way tornado analysis to identify variables that most impacted the value analysis of the decision tree. The value analysis confirmed the Consensus Group's recommendations of somatostatin analogs as first line therapy for medical management. Our model also demonstrated significant value in using dopamine agonist agents as upfront therapy as well. Sensitivity analysis identified the cost of somatostatin analogs and growth hormone receptor antagonists as having the most significant impact on the cost effectiveness of medical therapies. Our analysis confirmed the value of surgery as first-line therapy for patients with surgically accessible lesions. Surgery provides the greatest value for management of patients with acromegaly. However, in accordance with the Acromegaly Consensus Group's recent recommendations, somatostatin analogs provide the greatest value and should be used as first-line therapy for patients who cannot be managed surgically. At present, the substantial cost is the most significant negative factor in the value of medical therapies for acromegaly.

With you or against you: social orientation dependent learning signals guide actions made for others.

PubMed

Christopoulos, George I; King-Casas, Brooks

2015-01-01

In social environments, it is crucial that decision-makers take account of the impact of their actions not only for oneself, but also on other social agents. Previous work has identified neural signals in the striatum encoding value-based prediction errors for outcomes to oneself; also, recent work suggests that neural activity in prefrontal cortex may similarly encode value-based prediction errors related to outcomes to others. However, prior work also indicates that social valuations are not isomorphic, with social value orientations of decision-makers ranging on a cooperative to competitive continuum; this variation has not been examined within social learning environments. Here, we combine a computational model of learning with functional neuroimaging to examine how individual differences in orientation impact neural mechanisms underlying 'other-value' learning. Across four experimental conditions, reinforcement learning signals for other-value were identified in medial prefrontal cortex, and were distinct from self-value learning signals identified in striatum. Critically, the magnitude and direction of the other-value learning signal depended strongly on an individual's cooperative or competitive orientation toward others. These data indicate that social decisions are guided by a social orientation-dependent learning system that is computationally similar but anatomically distinct from self-value learning. The sensitivity of the medial prefrontal learning signal to social preferences suggests a mechanism linking such preferences to biases in social actions and highlights the importance of incorporating heterogeneous social predispositions in neurocomputational models of social behavior. Published by Elsevier Inc.

No evidential value in samples of transcranial direct current stimulation (tDCS) studies of cognition and working memory in healthy populations.

PubMed

Medina, Jared; Cason, Samuel

2017-09-01

A substantial number of studies have been published over the last decade, claiming that transcranial direct current stimulation (tDCS) can influence performance on cognitive tasks. However, there is some skepticism regarding the efficacy of tDCS, and evidence from meta-analyses are mixed. One major weakness of these meta-analyses is that they only examine outcomes in published studies. Given biases towards publishing positive results in the scientific literature, there may be a substantial "file-drawer" of unpublished negative results in the tDCS literature. Furthermore, multiple researcher degrees of freedom can also inflate published p-values. Recently, Simonsohn, Nelson and Simmons (2014) created a novel meta-analytic tool that examines the distribution of significant p-values in a literature, and compares it to expected distributions with different effect sizes. Using this tool, one can assess whether the selected studies have evidential value. Therefore, we examined a random selection of studies that used tDCS to alter performance on cognitive tasks, and tDCS studies on working memory in a recently published meta-analysis (Mancuso et al., 2016). Using a p-curve analysis, we found no evidence that the tDCS studies had evidential value (33% power or greater), with the estimate of statistical power of these studies being approximately 14% for the cognitive studies, and 5% (what would be expected from randomly generated data) for the working memory studies. It is likely that previous tDCS studies are substantially underpowered, and we provide suggestions for future research to increase the evidential value of future tDCS studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cost-Effectiveness and Value of Information Analysis of Brief Interventions to Promote Physical Activity in Primary Care.

PubMed

Gc, Vijay Singh; Suhrcke, Marc; Hardeman, Wendy; Sutton, Stephen; Wilson, Edward C F

2018-01-01

Brief interventions (BIs) delivered in primary care have shown potential to increase physical activity levels and may be cost-effective, at least in the short-term, when compared with usual care. Nevertheless, there is limited evidence on their longer term costs and health benefits. To estimate the cost-effectiveness of BIs to promote physical activity in primary care and to guide future research priorities using value of information analysis. A decision model was used to compare the cost-effectiveness of three classes of BIs that have been used, or could be used, to promote physical activity in primary care: 1) pedometer interventions, 2) advice/counseling on physical activity, and (3) action planning interventions. Published risk equations and data from the available literature or routine data sources were used to inform model parameters. Uncertainty was investigated with probabilistic sensitivity analysis, and value of information analysis was conducted to estimate the value of undertaking further research. In the base-case, pedometer interventions yielded the highest expected net benefit at a willingness to pay of £20,000 per quality-adjusted life-year. There was, however, a great deal of decision uncertainty: the expected value of perfect information surrounding the decision problem for the National Health Service Health Check population was estimated at £1.85 billion. Our analysis suggests that the use of pedometer BIs is the most cost-effective strategy to promote physical activity in primary care, and that there is potential value in further research into the cost-effectiveness of brief (i.e., <30 minutes) and very brief (i.e., <5 minutes) pedometer interventions in this setting. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Method and Excel VBA Algorithm for Modeling Master Recession Curve Using Trigonometry Approach.

PubMed

Posavec, Kristijan; Giacopetti, Marco; Materazzi, Marco; Birk, Steffen

2017-11-01

A new method was developed and implemented into an Excel Visual Basic for Applications (VBAs) algorithm utilizing trigonometry laws in an innovative way to overlap recession segments of time series and create master recession curves (MRCs). Based on a trigonometry approach, the algorithm horizontally translates succeeding recession segments of time series, placing their vertex, that is, the highest recorded value of each recession segment, directly onto the appropriate connection line defined by measurement points of a preceding recession segment. The new method and algorithm continues the development of methods and algorithms for the generation of MRC, where the first published method was based on a multiple linear/nonlinear regression model approach (Posavec et al. 2006). The newly developed trigonometry-based method was tested on real case study examples and compared with the previously published multiple linear/nonlinear regression model-based method. The results show that in some cases, that is, for some time series, the trigonometry-based method creates narrower overlaps of the recession segments, resulting in higher coefficients of determination R 2 , while in other cases the multiple linear/nonlinear regression model-based method remains superior. The Excel VBA algorithm for modeling MRC using the trigonometry approach is implemented into a spreadsheet tool (MRCTools v3.0 written by and available from Kristijan Posavec, Zagreb, Croatia) containing the previously published VBA algorithms for MRC generation and separation. All algorithms within the MRCTools v3.0 are open access and available free of charge, supporting the idea of running science on available, open, and free of charge software. © 2017, National Ground Water Association.

Erratum: Substructure in clusters of galaxies and the value of {OMEGA}

NASA Astrophysics Data System (ADS)

Dutta, Suvendra N.

1996-05-01

The paper `Substructure in clusters of galaxies and the value of {OMEGA}' was published in Mon. Not. R. Astron. Soc. 276, 1109- 1115(1995). Unfortunately, the wrong set of figures was inadvertently supplied to the publishers after the paper had been accepted. The correct figures are reproduced below, with the corresponding captions. [See Journal].

Pretreatment evaluation of fluorescence resonance energy transfer-based drug sensitivity test for patients with chronic myelogenous leukemia treated with dasatinib.

PubMed

Kondo, Takeshi; Fujioka, Mari; Tsuda, Masumi; Murai, Kazunori; Yamaguchi, Kohei; Miyagishima, Takuto; Shindo, Motohiro; Nagashima, Takahiro; Wakasa, Kentaro; Fujimoto, Nozomu; Yamamoto, Satoshi; Yonezumi, Masakatsu; Saito, Souichi; Sato, Shinji; Ogawa, Kazuei; Chou, Takaaki; Watanabe, Reiko; Kato, Yuichi; Takahashi, Shuichiro; Okano, Yoshiaki; Yamamoto, Joji; Ohta, Masatsugu; Iijima, Hiroaki; Oba, Koji; Kishino, Satoshi; Sakamoto, Junichi; Ishida, Yoji; Ohba, Yusuke; Teshima, Takanori

2018-05-02

Tyrosine kinase inhibitors (TKI) are used for primary therapy in patients with newly diagnosed CML. However, a reliable method for optimal selection of a TKI from the viewpoint of drug sensitivity of CML cells has not been established. We have developed a FRET-based drug sensitivity test in which a CrkL-derived fluorescent biosensor efficiently quantifies the kinase activity of BCR-ABL of living cells and sensitively evaluates the inhibitory activity of a TKI against BCR-ABL. Here, we validated the utility of the FRET-based drug sensitivity test carried out at diagnosis for predicting the molecular efficacy. Sixty-two patients with newly diagnosed chronic phase CML were enrolled in this study and treated with dasatinib. Bone marrow cells at diagnosis were subjected to FRET analysis. The ΔFRET value was calculated by subtraction of FRET efficiency in the presence of dasatinib from that in the absence of dasatinib. Treatment response was evaluated every 3 months by the BCR-ABL1 International Scale. Based on the ΔFRET value and molecular response, a threshold of the ΔFRET value in the top 10% of FRET efficiency was set to 0.31. Patients with ΔFRET value ≥0.31 had significantly superior molecular responses (MMR at 6 and 9 months and both MR4 and MR4.5 at 6, 9, and 12 months) compared with the responses in patients with ΔFRET value <0.31. These results suggest that the FRET-based drug sensitivity test at diagnosis can predict early and deep molecular responses. This study is registered with UMIN Clinical Trials Registry (UMIN000006358). © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

The DEP-6D, a new preference-based measure to assess health states of dependency.

PubMed

Rodríguez-Míguez, E; Abellán-Perpiñán, J M; Alvarez, X C; González, X M; Sampayo, A R

2016-03-01

In medical literature there are numerous multidimensional scales to measure health states for dependence in activities of daily living. However, these scales are not preference-based and are not able to yield QALYs. On the contrary, the generic preference-based measures are not sensitive enough to measure changes in dependence states. The objective of this paper is to propose a new dependency health state classification system, called DEP-6D, and to estimate its value set in such a way that it can be used in QALY calculations. DEP-6D states are described as a combination of 6 attributes (eat, incontinence, personal care, mobility, housework and cognition problems), with 3-4 levels each. A sample of 312 Spanish citizens was surveyed in 2011 to estimate the DEP-6D preference-scoring algorithm. Each respondent valued six out of the 24 states using time trade-off questions. After excluding those respondents who made two or more inconsistencies (6% out of the sample), each state was valued between 66 and 77 times. The responses present a high internal and external consistency. A random effect model accounting for main effects was the preferred model to estimate the scoring algorithm. The DEP-6D describes, in general, more severe problems than those usually described by means of generic preference-based measures. The minimum score predicted by the DEP-6D algorithm is -0.84, which is considerably lower than the minimum value predicted by the EQ-5D and SF-6D algorithms. The DEP-6D value set is based on community preferences. Therefore it is consistent with the so-called 'societal perspective'. Moreover, DEP-6D preference weights can be used in QALY calculations and cost-utility analysis. Copyright © 2016. Published by Elsevier Ltd.

Utility-Based Instruments for People with Dementia: A Systematic Review and Meta-Regression Analysis.

PubMed

Li, Li; Nguyen, Kim-Huong; Comans, Tracy; Scuffham, Paul

2018-04-01

Several utility-based instruments have been applied in cost-utility analysis to assess health state values for people with dementia. Nevertheless, concerns and uncertainty regarding their performance for people with dementia have been raised. To assess the performance of available utility-based instruments for people with dementia by comparing their psychometric properties and to explore factors that cause variations in the reported health state values generated from those instruments by conducting meta-regression analyses. A literature search was conducted and psychometric properties were synthesized to demonstrate the overall performance of each instrument. When available, health state values and variables such as the type of instrument and cognitive impairment levels were extracted from each article. A meta-regression analysis was undertaken and available covariates were included in the models. A total of 64 studies providing preference-based values were identified and included. The EuroQol five-dimension questionnaire demonstrated the best combination of feasibility, reliability, and validity. Meta-regression analyses suggested that significant differences exist between instruments, type of respondents, and mode of administration and the variations in estimated utility values had influences on incremental quality-adjusted life-year calculation. This review finds that the EuroQol five-dimension questionnaire is the most valid utility-based instrument for people with dementia, but should be replaced by others under certain circumstances. Although no utility estimates were reported in the article, the meta-regression analyses that examined variations in utility estimates produced by different instruments impact on cost-utility analysis, potentially altering the decision-making process in some circumstances. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

An international age- and gender-controlled model for the Spinal Cord Injury Ability Realization Measurement Index (SCI-ARMI).

PubMed

Scivoletto, Giorgio; Glass, Clive; Anderson, Kim D; Galili, Tal; Benjamin, Yoav; Front, Lilach; Aidinoff, Elena; Bluvshtein, Vadim; Itzkovich, Malka; Aito, Sergio; Baroncini, Ilaria; Benito-Penalva, Jesùs; Castellano, Simona; Osman, Aheed; Silva, Pedro; Catz, Amiram

2015-01-01

Background. A quadratic formula of the Spinal Cord Injury Ability Realization Measurement Index (SCI-ARMI) has previously been published. This formula was based on a model of Spinal Cord Independence Measure (SCIM95), the 95th percentile of the SCIM III values, which correspond with the American Spinal Injury Association Motor Scores (AMS) of SCI patients. Objective. To further develop the original formula. Setting. Spinal cord injury centers from 6 countries and the Statistical Laboratory, Tel-Aviv University, Israel. Methods. SCIM95 of 661 SCI patients was modeled, using a quantile regression with or without adjustment for age and gender, to calculate SCI-ARMI values. SCI-ARMI gain during rehabilitation and its correlations were examined. Results. A new quadratic SCIM95 model was created. This resembled the previously published model, which yielded similar SCIM95 values in all the countries, after adjustment for age and gender. Without this adjustment, however, only 86% of the non-Israeli SCIM III observations were lower than those SCIM95 values (P < .0001). Adding the variables age and gender to the new model affected the SCIM95 value significantly (P < .04). Adding country information did not add a significant effect (P > .1). SCI-ARMI gain was positive (38.8 ± 22 points, P < .0001) and correlated weakly with admission age and AMS. Conclusions. The original quadratic SCI-ARMI formula is valid for an international population after adjustment for age and gender. The new formula considers more factors that affect functional ability following SCI. © The Author(s) 2014.

Does convenience matter in health care delivery? A systematic review of convenience-based aspects of process utility.

PubMed

Higgins, A; Barnett, J; Meads, C; Singh, J; Longworth, L

2014-12-01

To systematically review the existing literature on the value associated with convenience in health care delivery, independent of health outcomes, and to try to estimate the likely magnitude of any value found. A systematic search was conducted for previously published studies that reported preferences for convenience-related aspects of health care delivery in a manner that was consistent with either cost-utility analysis or cost-benefit analysis. Data were analyzed in terms of the methodologies used, the aspects of convenience considered, and the values reported. Literature searches generated 4715 records. Following a review of abstracts or full-text articles, 27 were selected for inclusion. Twenty-six studies reported some evidence of convenience-related process utility, in the form of either a positive utility or a positive willingness to pay. The aspects of convenience valued most often were mode of administration (n = 11) and location of treatment (n = 6). The most common valuation methodology was a discrete-choice experiment containing a cost component (n = 15). A preference for convenience-related process utility exists, independent of health outcomes. Given the diverse methodologies used to calculate it, and the range of aspects being valued, however, it is difficult to assess how large such a preference might be, or how it may be effectively incorporated into an economic evaluation. Increased consistency in reporting these preferences is required to assess these issues more accurately. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Environmental assessment for the satellite power system-concept development and evaluation program-microwave health and ecological effects

NASA Technical Reports Server (NTRS)

1980-01-01

Potential health and ecological effects of the microwave beam from the microwave power transmission system (MPTS) of the satellite power system (SPS) are discussed. A detailed critical review of selected scientific articles from the published literature on the biological effects of nonionizing electromagnetic radiation is provided followed by an assessment of the possible effects of the SPS, based on exposure values for the reference system.

Estimating Cleanup Times Associated With Combining Source-Area Remediation With Monitored Natural Attenuation

DTIC Science & Technology

2008-02-01

1994, Chiou and Kile (USGS, 2000) 3.2.2 Source Characteristics The source area was based on estimates of the locations where contaminants were...values for Koc and solubility for some of the SVOC’s appear in published literature (Chiou and Kile , 2000), which suggests a larger range of...Monitored Natural Attenuation. United States Geological Survey Water Resources Investigations Report 03-4057. Chiou, C.T. and Kile , D.E., 2000

Mushroom cultivation, processing and value added products: a patent based review.

PubMed

Singhal, Somya; Rasane, Prasad; Kaur, Sawinder; Garba, Umar; Singh, Jyoti; Raj, Nishant; Gupta, Neeru

2018-06-03

Edible mushrooms are an abundant source of carbohydrates, proteins, and multiple antioxidants and phytonutrients. This paper presents a general overview on the edible fungus describing the inventions made in the field of its cultivation, equipment and value added products. To understand and review the innovations and nutraceutical benefits of mushrooms as well as to develop interest regarding the edible mushrooms. Information provided in this review is based on the available research investigations and patents. Mushrooms are an edible source of a wide variety of antioxidants and phytonutrients with a number of nutraceutical properties including anti-tumor and anti-carcinogenic. Thus, several investigations are made for cultivation and improvement of the yield of mushrooms through improvisation of growth substrates and equipment used for mushroom processing. The mushroom has been processed into various products to increase its consumption, providing the health and nutritional benefit to mankind. This paper summarizes the cultivation practices of mushroom, its processing equipments, methods of preservation, value added based products, and its nutraceutical properties. The review also highlights the various scientific feats achieved in terms of patents and research publications promoting mushroom as a wholesome food. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Correlation of the Cretaceous formations of Greenland and Alaska

USGS Publications Warehouse

Imlay, Ralph Willard; Reeside, John B.

1953-01-01

This is Number 10d of a series of correlation charts prepared for the Committee on Stratigraphy of the National Research Council. It has been sponsored by the U.S. Geological Survey and has required about seven months' time of both authors gathering and compiling data and evaluating fossil evidence. As the two regions dealt with in the chart are widely separated, the lists of references are also given separately. The annotations dealing with Greenland are based entirely on published information. The annotations dealing with Alaska are based on a re-examination of nearly all the Cretaceous fossils from Alaska are based on a re-examination of nearly all the Cretaceous fossils from Alaska in the collections of the Geological Survey. This has resulted in many concepts not hitherto published and in some concepts that are completely at variance with those that have been published. Naturally for large areas undergoing active exploration, such as Alaska, a correlation chart is out of date in many particulars as soon as published. Nevertheless it is valuable to the field man whose activities are confined to small areas but who must interpret much of his data in terms of surrounding areas that he has not seen. It is valuable to the student and to the general geologist because it organizes scattered information in a manner that can be applied in their field problems, makes quite unnecessary the memorization of stratigraphic correlations are based on observation and reasoning and not on a vast memory. It is probably of greatest value to the specialist who makes the chart because he discovers what areas and problems are most in need of research and can thereby direct his efforts and those of his associates in a manner that will yield the greatest results.

Fish tissue lipid-C:N relationships for correcting δ(13) C values and estimating lipid content in aquatic food-web studies.

PubMed

Hoffman, Joel C; Sierszen, Michael E; Cotter, Anne M

2015-11-15

Normalizing δ(13) C values of animal tissue for lipid content is necessary to accurately interpret food-web relationships from stable isotope analysis. To reduce the effort and expense associated with chemical extraction of lipids, various studies have tested arithmetic mass balance to mathematically normalize δ(13) C values for lipid content; however, the approach assumes that lipid content is related to the tissue C:N ratio. We evaluated two commonly used models for estimating tissue lipid content based on C:N ratio (a mass balance model and a stoichiometric model) by comparing model predictions to measure the lipid content of white muscle tissue. We then determined the effect of lipid model choice on δ(13) C values normalized using arithmetic mass balance. To do so, we used a collection of fish from Lake Superior spanning a wide range in lipid content (5% to 73% lipid). We found that the lipid content was positively related to the bulk muscle tissue C:N ratio. The two different lipid models produced similar estimates of lipid content based on tissue C:N, within 6% for tissue C:N values <7. Normalizing δ(13) C values using an arithmetic mass-balance equation based on either model yielded similar results, with a small bias (<1‰) compared with results based on chemical extraction. Among-species consistency in the relationship between fish muscle tissue C:N ratio and lipid content supports the application of arithmetic mass balance to normalize δ(13) C values for lipid content. The uncertainty associated with both lipid extraction quality and choice of model parameters constrains the achievable precision of normalized δ(13) C values to about ±1.0‰. Published in 2015. This article is a U.S. Government work and is in the public domain in the U.S.A.

Cost-effectiveness and pricing of antibacterial drugs.

PubMed

Verhoef, Talitha I; Morris, Stephen

2015-01-01

Growing resistance to antibacterial agents has increased the need for the development of new drugs to treat bacterial infections. Given increasing pressure on limited health budgets, it is important to study the cost-effectiveness of these drugs, as well as their safety and efficacy, to find out whether or not they provide value for money and should be reimbursed. In this article, we systematically reviewed 38 cost-effectiveness analyses of new antibacterial agents. Most studies showed the new antibacterial drugs were cost-effective compared to older generation drugs. Drug pricing is a complicated process, involving different stakeholders, and has a large influence on cost-effectiveness. Value-based pricing is a method to determine the price of a drug at which it can be cost-effective. It is currently unclear what the influence of value-based pricing will be on the prices of new antibacterial agents, but an important factor will be the definition of 'value', which as well as the impact of the drug on patient health might also include other factors such as wider social impact and the health impact of disease. © 2015 The Authors. Chemical Biology & Drug Design Published by John Wiley & Sons Ltd.

The health care value transparency movement and its implications for radiology.

PubMed

Durand, Daniel J; Narayan, Anand K; Rybicki, Frank J; Burleson, Judy; Nagy, Paul; McGinty, Geraldine; Duszak, Richard

2015-01-01

The US health care system is in the midst of disruptive changes intended to expand access, improve outcomes, and lower costs. As part of this movement, a growing number of stakeholders have advocated dramatically increasing consumer transparency into the quality and price of health care services. The authors review the general movement toward American health care value transparency within the public, private, and nonprofit sectors, with an emphasis on those initiatives most relevant to radiology. They conclude that radiology, along with other "ancillary services," has been a major focus of early efforts to enhance consumer price transparency. By contrast, radiology as a field remains in the "middle of the pack" with regard to quality transparency. There is thus the danger that radiology value transparency in its current form will stimulate primarily price-based competition, erode provider profit margins, and disincentivize quality. The authors conclude with suggested actions radiologists can take to ensure that a more optimal balance is struck between quality transparency and price transparency, one that will enable true value-based competition among radiologists rather than commoditization. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Combination of CDF and D0 results on the mass of the top quark using up $$9.7\\:{\\rm fb}^{-1}$$ at the Tevatron

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

Tevatron Electroweak Working Group, Tevatron Group; Aaltonen, T.

2016-08-05

We summarize the current top quark mass (m t) measurements from the CDF and D0 experiments at Fermilab. We combine published results from Run I (1992–1996) with the most precise published and preliminary Run II (2001–2011) measurements based onmore » $$p\\bar{p}$$ data corresponding to up to 9.7 fb $-$1 of $$p\\bar{p}$$ collisions. Taking correlations of uncertainties into account, and combining the statistical and systematic contributions in quadrature, the preliminary Tevatron average mass value for the top quark is m t = 174.30 ± 0.65 GeV/c 2, corresponding to a relative precision of 0.37%.« less

A 25-year analysis of the American College of Gastroenterology Research Grant Program:

PubMed Central

Crockett, Seth D.; Dellon, Evan S.; Bright, Stephanie D.; Shaheen, Nicholas J.

2011-01-01

Introduction The American College of Gastroenterology (ACG) has awarded research grants for 25 years. We assessed the characteristics of grant recipients, their current academic status, and the likelihood of publication resulting from the grant. Methods Demographic data, year and amount of award, title of project, and recipient’s institution were extracted from ACG databases. Using ACG reports and medical literature search engines, we assessed publication based on grant-funded research, as well as career publication record. We also determined the current position of awardees. Similar analysis was performed for recipients of junior investigator awards. Results A total of 396 clinical research awards totaling $5,374,497 ($6,867,937 in 2008 dollars) were awarded to 341 recipients in the 25 years between 1983 and 2008. The most commonly funded areas of research were endoscopy (22% of awards) and motility/functional disorders (21%). At least one peer-reviewed publication based on grant-funded research occurred in 255 of the awards (69%). Higher award value was associated with subsequent publication. Of 341 past awardees, 195 (62%) are currently in academic positions. Factors associated with staying in academics included higher award value (p<0.01), a Master’s degree (p=0.02) and publishing grant-funded research (p<0.01). The junior faculty career development award was granted to 27 individuals for a total of $3,000,000 (3,398,004 in 2008 dollars). Publication resulted from 90% of the funded projects, and 95% of awardees have remained in academics. Overall, the mean cost in grant dollars per published paper based on the research was $14,875. Conclusion The majority of ACG grant recipients published the results of their research and remained in academics. Higher amount of award, holding an advanced degree, and publication were associated with careers in academics. The ACG research grant award program is an important engine of investigation, publications, and academic career development in the field of gastroenterology. PMID:19319125

Funds Flow in the Era of Value-Based Health Care.

PubMed

Itri, Jason N; Mithqal, Ayman; Krishnaraj, Arun

2017-06-01

Health care reform is creating significant challenges for hospital systems and academic medical centers (AMCs), requiring a new operating model to adapt to declining reimbursement, diminishing research funding, market consolidation, payers' focus on higher quality and lower cost, and greater cost sharing by patients. Maintaining and promoting the triple mission of clinical care, research, and education will require AMCs to be system-based with strong alignment around governance, operations, clinical care, and finances. Funds flow is the primary mechanism whereby an AMC maintains the triple mission through alignment of the hospital, physician practices, school of medicine, undergraduate university, and other professional schools. The purpose of this article is to discuss challenges with current funds flow models, impact of funds flow on academic and private practice radiology groups, and strategies that can increase funds flow to support radiology practices achieving clinical, research, and teaching missions in the era of value-based health care. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Four-hour quantitative real-time polymerase chain reaction-based comprehensive chromosome screening and accumulating evidence of accuracy, safety, predictive value, and clinical efficacy.

PubMed

Treff, Nathan R; Scott, Richard T

2013-03-15

Embryonic comprehensive chromosomal euploidy may represent a powerful biomarker to improve the success of IVF. However, there are a number of aneuploidy screening strategies to consider, including different technologic platforms with which to interrogate the embryonic DNA, and different embryonic developmental stages from which DNA can be analyzed. Although there are advantages and disadvantages associated with each strategy, a series of experiments producing evidence of accuracy, safety, clinical predictive value, and clinical efficacy indicate that trophectoderm biopsy and quantitative real-time polymerase chain reaction (qPCR)-based comprehensive chromosome screening (CCS) may represent a useful strategy to improve the success of IVF. This Biomarkers in Reproductive Medicine special issue review summarizes the accumulated experience with the development and clinical application of a 4-hour blastocyst qPCR-based CCS technology. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

A generic biokinetic model for noble gases with application to radon.

PubMed

Leggett, Rich; Marsh, James; Gregoratto, Demetrio; Blanchardon, Eric

2013-06-01

To facilitate the estimation of radiation doses from intake of radionuclides, the International Commission on Radiological Protection (ICRP) publishes dose coefficients (dose per unit intake) based on reference biokinetic and dosimetric models. The ICRP generally has not provided biokinetic models or dose coefficients for intake of noble gases, but plans to provide such information for (222)Rn and other important radioisotopes of noble gases in a forthcoming series of reports on occupational intake of radionuclides (OIR). This paper proposes a generic biokinetic model framework for noble gases and develops parameter values for radon. The framework is tailored to applications in radiation protection and is consistent with a physiologically based biokinetic modelling scheme adopted for the OIR series. Parameter values for a noble gas are based largely on a blood flow model and physical laws governing transfer of a non-reactive and soluble gas between materials. Model predictions for radon are shown to be consistent with results of controlled studies of its biokinetics in human subjects.

a Genetic Algorithm Based on Sexual Selection for the Multidimensional 0/1 Knapsack Problems

NASA Astrophysics Data System (ADS)

Varnamkhasti, Mohammad Jalali; Lee, Lai Soon

In this study, a new technique is presented for choosing mate chromosomes during sexual selection in a genetic algorithm. The population is divided into groups of males and females. During the sexual selection, the female chromosome is selected by the tournament selection while the male chromosome is selected based on the hamming distance from the selected female chromosome, fitness value or active genes. Computational experiments are conducted on the proposed technique and the results are compared with some selection mechanisms commonly used for solving multidimensional 0/1 knapsack problems published in the literature.

What's in a Name? The Incorrect Use of Case Series as a Study Design Label in Studies Involving Dogs and Cats.

PubMed

Sargeant, J M; O'Connor, A M; Cullen, J N; Makielski, K M; Jones-Bitton, A

2017-07-01

Study design labels are used to identify relevant literature to address specific clinical and research questions and to aid in evaluating the evidentiary value of research. Evidence from the human healthcare literature indicates that the label "case series" may be used inconsistently and inappropriately. Our primary objective was to determine the proportion of studies in the canine and feline veterinary literature labeled as case series that actually corresponded to descriptive cohort studies, population-based cohort studies, or other study designs. Our secondary objective was to identify the proportion of case series in which potentially inappropriate inferential statements were made. Descriptive evaluation of published literature. One-hundred published studies (from 19 journals) labeled as case series. Studies were identified by a structured literature search, with random selection of 100 studies from the relevant citations. Two reviewers independently characterized each study, with disagreements resolved by consensus. Of the 100 studies, 16 were case series. The remaining studies were descriptive cohort studies (35), population-based cohort studies (36), or other observational or experimental study designs (13). Almost half (48.8%) of the case series or descriptive cohort studies, with no control group and no formal statistical analysis, included inferential statements about the efficacy of treatment or statistical significance of potential risk factors. Authors, peer-reviewers, and editors should carefully consider the design elements of a study to accurately identify and label the study design. Doing so will facilitate an understanding of the evidentiary value of the results. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Futile and Potentially Inappropriate Interventions: Semantics Matter.

PubMed

Kon, Alexander A

2018-01-01

In 1997, the Society for Critical Care Medicine (SCCM) published a statement regarding futile and inadvisable treatments. Recently, five critical care organizations published a consensus statement supporting and expanding upon the 1997 SCCM statement, and the SCCM issued a companion statement defining futile and potentially inappropriate interventions. In all of these statements, there is agreement that the term futile should be used only when an intervention cannot accomplish the intended physiologic goal. The organizations provide recommendations for optimizing communication, however even when clinicians use excellent communication techniques, there are times when competing ethical considerations mean that a surrogate persists in requesting an intervention that the clinician does not believe is justified. In such cases, clinicians should not label the requested intervention as futile, because doing so is disrespectful to patients and families, overly empowers clinicians, and stifles communication. When clinicians believe that they are justified in declining such a request due to differences in values or beliefs, they should refer to the requested treatment as "potentially inappropriate," indicating that the disagreement is based on values, and that any decision to withhold the requested intervention is preliminary until reviewed through a fair process.

Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework.

PubMed

Angelis, Aris; Kanavos, Panos

2017-09-01

Escalating drug prices have catalysed the generation of numerous "value frameworks" with the aim of informing payers, clinicians and patients on the assessment and appraisal process of new medicines for the purpose of coverage and treatment selection decisions. Although this is an important step towards a more inclusive Value Based Assessment (VBA) approach, aspects of these frameworks are based on weak methodologies and could potentially result in misleading recommendations or decisions. In this paper, a Multiple Criteria Decision Analysis (MCDA) methodological process, based on Multi Attribute Value Theory (MAVT), is adopted for building a multi-criteria evaluation model. A five-stage model-building process is followed, using a top-down "value-focused thinking" approach, involving literature reviews and expert consultations. A generic value tree is structured capturing decision-makers' concerns for assessing the value of new medicines in the context of Health Technology Assessment (HTA) and in alignment with decision theory. The resulting value tree (Advance Value Tree) consists of three levels of criteria (top level criteria clusters, mid-level criteria, bottom level sub-criteria or attributes) relating to five key domains that can be explicitly measured and assessed: (a) burden of disease, (b) therapeutic impact, (c) safety profile (d) innovation level and (e) socioeconomic impact. A number of MAVT modelling techniques are introduced for operationalising (i.e. estimating) the model, for scoring the alternative treatment options, assigning relative weights of importance to the criteria, and combining scores and weights. Overall, the combination of these MCDA modelling techniques for the elicitation and construction of value preferences across the generic value tree provides a new value framework (Advance Value Framework) enabling the comprehensive measurement of value in a structured and transparent way. Given its flexibility to meet diverse requirements and become readily adaptable across different settings, the Advance Value Framework could be offered as a decision-support tool for evaluators and payers to aid coverage and reimbursement of new medicines. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The distribution of P-values in medical research articles suggested selective reporting associated with statistical significance.

PubMed

Perneger, Thomas V; Combescure, Christophe

2017-07-01

Published P-values provide a window into the global enterprise of medical research. The aim of this study was to use the distribution of published P-values to estimate the relative frequencies of null and alternative hypotheses and to seek irregularities suggestive of publication bias. This cross-sectional study included P-values published in 120 medical research articles in 2016 (30 each from the BMJ, JAMA, Lancet, and New England Journal of Medicine). The observed distribution of P-values was compared with expected distributions under the null hypothesis (i.e., uniform between 0 and 1) and the alternative hypothesis (strictly decreasing from 0 to 1). P-values were categorized according to conventional levels of statistical significance and in one-percent intervals. Among 4,158 recorded P-values, 26.1% were highly significant (P < 0.001), 9.1% were moderately significant (P ≥ 0.001 to < 0.01), 11.7% were weakly significant (P ≥ 0.01 to < 0.05), and 53.2% were nonsignificant (P ≥ 0.05). We noted three irregularities: (1) high proportion of P-values <0.001, especially in observational studies, (2) excess of P-values equal to 1, and (3) about twice as many P-values less than 0.05 compared with those more than 0.05. The latter finding was seen in both randomized trials and observational studies, and in most types of analyses, excepting heterogeneity tests and interaction tests. Under plausible assumptions, we estimate that about half of the tested hypotheses were null and the other half were alternative. This analysis suggests that statistical tests published in medical journals are not a random sample of null and alternative hypotheses but that selective reporting is prevalent. In particular, significant results are about twice as likely to be reported as nonsignificant results. Copyright © 2017 Elsevier Inc. All rights reserved.

Supply chain optimization for pediatric perioperative departments.

PubMed

Davis, Janice L; Doyle, Robert

2011-09-01

Economic challenges compel pediatric perioperative departments to reduce nonlabor supply costs while maintaining the quality of patient care. Optimization of the supply chain introduces a framework for decision making that drives fiscally responsible decisions. The cost-effective supply chain is driven by implementing a value analysis process for product selection, being mindful of product sourcing decisions to reduce supply expense, creating logistical efficiency that will eliminate redundant processes, and managing inventory to ensure product availability. The value analysis approach is an analytical methodology for product selection that involves product evaluation and recommendation based on consideration of clinical benefit, overall financial impact, and revenue implications. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

RADIOLOGICAL IMPACTS ASSESSMENT FOR WORKERS IN CERAMIC INDUSTRY IN SERBIA.

PubMed

Todorovic, Nataša; Mrda, Dušan; Hansman, Jan; Todorovic, Slavko; Nikolov, Jovana; Krmar, Miodrag

2017-11-01

Studies have been carried out to determine the natural radioactivity in some materials used in ceramic industry (zircon, zirkosil, Zircobit MO/S, zircon silicate, zirklonil frit, hematite, bentonite, wollastonite, raw kaolin, kaolinized granite, sileks ball, feldspar, pigment, white base serigraphic, engobe) and their associated radiation hazard. The external hazard index, Hex, values, radium equivalent activity, Raeq, total absorbed dose rates, D and annual effective dose, De were derived for all measured materials and compared with the recommended values to assess the external radiation hazards to workers who worked in ceramic industries in Serbia. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Carbon dioxide stripping in aquaculture. part 1: terminology and reporting

USGS Publications Warehouse

Colt, John; Watten, Barnaby; Pfeiffer, Tim

2012-01-01

The removal of carbon dioxide gas in aquacultural systems is much more complex than for oxygen or nitrogen gas because of liquid reactions of carbon dioxide and their kinetics. Almost all published carbon dioxide removal information for aquaculture is based on the apparent removal value after the CO2(aq) + HOH ⇔ H2CO3 reaction has reached equilibrium. The true carbon dioxide removal is larger than the apparent value, especially for high alkalinities and seawater. For low alkalinity freshwaters (<2000 μeq/kg), the difference between the true and apparent removal is small and can be ignored for many applications. Analytical and reporting standards are recommended to improve our understanding of carbon dioxide removal.

Interventional radiology delivers high-value health care and is an Imaging 3.0 vanguard.

PubMed

Charalel, Resmi A; McGinty, Geraldine; Brant-Zawadzki, Michael; Goodwin, Scott C; Khilnani, Neil M; Matsumoto, Alan H; Min, Robert J; Soares, Gregory M; Cook, Philip S

2015-05-01

Given the changing climate of health care and the imperative to add value, radiologists must join forces with the rest of medicine to deliver better patient care in a more cost-effective, evidence-based manner. For several decades, interventional radiology has added value to the health care system through innovation and the provision of alternative and effective minimally invasive treatments, which have decreased morbidity, mortality, and overall cost. The clinical practice of interventional radiology embodies many of the features of Imaging 3.0, the program recently launched by the ACR. We provide a review of some of the major contributions made by interventional radiology and offer general principles from that experience, which are applicable to all radiologists. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Linking Quality and Spending to Measure Value for People with Serious Illness.

PubMed

Ryan, Andrew M; Rodgers, Phillip E

2018-03-01

Healthcare payment is rapidly evolving to reward value by measuring and paying for quality and spending performance. Rewarding value for the care of seriously ill patients presents unique challenges. To evaluate the state of current efforts to measure and reward value for the care of seriously ill patients. We performed a PubMed search of articles related to (1) measures of spending for people with serious illness and (2) linking spending and quality measures and rewarding performance for the care of people with serious illness. We limited our search to U.S.-based studies published in English between January 1, 1960, and March 31, 2017. We supplemented this search by identifying public programs and other known initiatives that linked quality and spending for the seriously ill and extracted key program elements. Our search related to linking spending and quality measures and rewarding performance for the care of people with serious illness yielded 277 articles. We identified three current public programs that currently link measures of quality and spending-or are likely to within the next few years-the Oncology Care Model; the Comprehensive End-Stage Renal Disease Model; and Home Health Value-Based Purchasing. Models that link quality and spending consist of four core components: (1) measuring quality, (2) measuring spending, (3) the payment adjustment model, and (4) the linking/incentive model. We found that current efforts to reward value for seriously ill patients are targeted for specific patient populations, do not broadly encourage the use of palliative care, and have not closely aligned quality and spending measures related to palliative care. We develop recommendations for policymakers and stakeholders about how measures of spending and quality can be balanced in value-based payment programs.

Linking Quality and Spending to Measure Value for People with Serious Illness

PubMed Central

Rodgers, Phillip E.

2018-01-01

Abstract Background: Healthcare payment is rapidly evolving to reward value by measuring and paying for quality and spending performance. Rewarding value for the care of seriously ill patients presents unique challenges. Objective: To evaluate the state of current efforts to measure and reward value for the care of seriously ill patients. Design: We performed a PubMed search of articles related to (1) measures of spending for people with serious illness and (2) linking spending and quality measures and rewarding performance for the care of people with serious illness. We limited our search to U.S.-based studies published in English between January 1, 1960, and March 31, 2017. We supplemented this search by identifying public programs and other known initiatives that linked quality and spending for the seriously ill and extracted key program elements. Results: Our search related to linking spending and quality measures and rewarding performance for the care of people with serious illness yielded 277 articles. We identified three current public programs that currently link measures of quality and spending—or are likely to within the next few years—the Oncology Care Model; the Comprehensive End-Stage Renal Disease Model; and Home Health Value-Based Purchasing. Models that link quality and spending consist of four core components: (1) measuring quality, (2) measuring spending, (3) the payment adjustment model, and (4) the linking/incentive model. We found that current efforts to reward value for seriously ill patients are targeted for specific patient populations, do not broadly encourage the use of palliative care, and have not closely aligned quality and spending measures related to palliative care. Conclusions: We develop recommendations for policymakers and stakeholders about how measures of spending and quality can be balanced in value-based payment programs. PMID:29091529

Value-Based Caching in Information-Centric Wireless Body Area Networks

PubMed Central

Al-Turjman, Fadi M.; Imran, Muhammad; Vasilakos, Athanasios V.

2017-01-01

We propose a resilient cache replacement approach based on a Value of sensed Information (VoI) policy. To resolve and fetch content when the origin is not available due to isolated in-network nodes (fragmentation) and harsh operational conditions, we exploit a content caching approach. Our approach depends on four functional parameters in sensory Wireless Body Area Networks (WBANs). These four parameters are: age of data based on periodic request, popularity of on-demand requests, communication interference cost, and the duration for which the sensor node is required to operate in active mode to capture the sensed readings. These parameters are considered together to assign a value to the cached data to retain the most valuable information in the cache for prolonged time periods. The higher the value, the longer the duration for which the data will be retained in the cache. This caching strategy provides significant availability for most valuable and difficult to retrieve data in the WBANs. Extensive simulations are performed to compare the proposed scheme against other significant caching schemes in the literature while varying critical aspects in WBANs (e.g., data popularity, cache size, publisher load, connectivity-degree, and severe probabilities of node failures). These simulation results indicate that the proposed VoI-based approach is a valid tool for the retrieval of cached content in disruptive and challenging scenarios, such as the one experienced in WBANs, since it allows the retrieval of content for a long period even while experiencing severe in-network node failures. PMID:28106817

Data submission and quality in microarray-based microRNA profiling

PubMed Central

Witwer, Kenneth W.

2014-01-01

Background Public sharing of scientific data has assumed greater importance in the ‘omics’ era. Transparency is necessary for confirmation and validation, and multiple examiners aid in extracting maximal value from large datasets. Accordingly, database submission and provision of the Minimum Information About a Microarray Experiment (MIAME) are required by most journals as a prerequisite for review or acceptance. Methods In this study, the level of data submission and MIAME compliance was reviewed for 127 articles that included microarray-based microRNA profiling and that were published from July, 2011 through April, 2012 in the journals that published the largest number of such articles—PLOS ONE, the Journal of Biological Chemistry, Blood, and Oncogene—along with articles from nine other journals, including Clinical Chemistry, that published smaller numbers of array-based articles. Results Overall, data submission was reported at publication for less than 40% of all articles, and almost 75% of articles were MIAME-noncompliant. On average, articles that included full data submission scored significantly higher on a quality metric than articles with limited or no data submission, and studies with adequate description of methods disproportionately included larger numbers of experimental repeats. Finally, for several articles that were not MIAME-compliant, data re-analysis revealed less than complete support for the published conclusions, in one case leading to retraction. Conclusions These findings buttress the hypothesis that reluctance to share data is associated with low study quality and suggest that most miRNA array investigations are underpowered and/or potentially compromised by a lack of appropriate reporting and data submission. PMID:23358751

Data submission and quality in microarray-based microRNA profiling.

PubMed

Witwer, Kenneth W

2013-02-01

Public sharing of scientific data has assumed greater importance in the omics era. Transparency is necessary for confirmation and validation, and multiple examiners aid in extracting maximal value from large data sets. Accordingly, database submission and provision of the Minimum Information About a Microarray Experiment (MIAME)(3) are required by most journals as a prerequisite for review or acceptance. In this study, the level of data submission and MIAME compliance was reviewed for 127 articles that included microarray-based microRNA (miRNA) profiling and were published from July 2011 through April 2012 in the journals that published the largest number of such articles--PLOS ONE, the Journal of Biological Chemistry, Blood, and Oncogene--along with articles from 9 other journals, including Clinical Chemistry, that published smaller numbers of array-based articles. Overall, data submission was reported at publication for <40% of all articles, and almost 75% of articles were MIAME noncompliant. On average, articles that included full data submission scored significantly higher on a quality metric than articles with limited or no data submission, and studies with adequate description of methods disproportionately included larger numbers of experimental repeats. Finally, for several articles that were not MIAME compliant, data reanalysis revealed less than complete support for the published conclusions, in 1 case leading to retraction. These findings buttress the hypothesis that reluctance to share data is associated with low study quality and suggest that most miRNA array investigations are underpowered and/or potentially compromised by a lack of appropriate reporting and data submission. © 2012 American Association for Clinical Chemistry

Inappropriate fiddling with statistical analyses to obtain a desirable p-value: tests to detect its presence in published literature.

PubMed

Gadbury, Gary L; Allison, David B

2012-01-01

Much has been written regarding p-values below certain thresholds (most notably 0.05) denoting statistical significance and the tendency of such p-values to be more readily publishable in peer-reviewed journals. Intuition suggests that there may be a tendency to manipulate statistical analyses to push a "near significant p-value" to a level that is considered significant. This article presents a method for detecting the presence of such manipulation (herein called "fiddling") in a distribution of p-values from independent studies. Simulations are used to illustrate the properties of the method. The results suggest that the method has low type I error and that power approaches acceptable levels as the number of p-values being studied approaches 1000.

Calculating the return on investment of mobile healthcare.

PubMed

Oriol, Nancy E; Cote, Paul J; Vavasis, Anthony P; Bennet, Jennifer; Delorenzo, Darien; Blanc, Philip; Kohane, Isaac

2009-06-02

Mobile health clinics provide an alternative portal into the healthcare system for the medically disenfranchised, that is, people who are underinsured, uninsured or who are otherwise outside of mainstream healthcare due to issues of trust, language, immigration status or simply location. Mobile health clinics as providers of last resort are an essential component of the healthcare safety net providing prevention, screening, and appropriate triage into mainstream services. Despite the face value of providing services to underserved populations, a focused analysis of the relative value of the mobile health clinic model has not been elucidated. The question that the return on investment algorithm has been designed to answer is: can the value of the services provided by mobile health programs be quantified in terms of quality adjusted life years saved and estimated emergency department expenditures avoided? Using a sample mobile health clinic and published research that quantifies health outcomes, we developed and tested an algorithm to calculate the return on investment of a typical broad-service mobile health clinic: the relative value of mobile health clinic services = annual projected emergency department costs avoided + value of potential life years saved from the services provided. Return on investment ratio = the relative value of the mobile health clinic services/annual cost to run the mobile health clinic. Based on service data provided by The Family Van for 2008 we calculated the annual cost savings from preventing emergency room visits, $3,125,668 plus the relative value of providing 7 of the top 25 priority prevention services during the same period, US$17,780,000 for a total annual value of $20,339,968. Given that the annual cost to run the program was $567,700, the calculated return on investment of The Family Van was 36:1. By using published data that quantify the value of prevention practices and the value of preventing unnecessary use of emergency departments, an empirical method was developed to determine the value of a typical mobile health clinic. The Family Van, a mobile health clinic that has been serving the medically disenfranchised of Boston for 16 years, was evaluated accordingly and found to have return on investment of $36 for every $1 invested in the program.

Measuring Success in Health Care Value-Based Purchasing Programs

PubMed Central

Damberg, Cheryl L.; Sorbero, Melony E.; Lovejoy, Susan L.; Martsolf, Grant R.; Raaen, Laura; Mandel, Daniel

2014-01-01

Abstract Value-based purchasing (VBP) refers to a broad set of performance-based payment strategies that link financial incentives to health care providers' performance on a set of defined measures in an effort to achieve better value. The U.S. Department of Health and Human Services is advancing the implementation of VBP across an array of health care settings in the Medicare program in response to requirements in the 2010 Patient Protection and Affordable Care Act, and policymakers are grappling with many decisions about how best to design and implement VBP programs so that they are successful in achieving stated goals. This article summarizes the current state of knowledge about VBP based on a review of the published literature, a review of publicly available documentation from VBP programs, and discussions with an expert panel composed of VBP program sponsors, health care providers and health systems, and academic researchers with VBP evaluation expertise. Three types of VBP models were the focus of the review: (1) pay-for-performance programs, (2) accountable care organizations, and (3) bundled payment programs. The authors report on VBP program goals and what constitutes success; the evidence on the impact of these programs; factors that characterize high– and low–performing providers in VBP programs; the measures, incentive structures, and benchmarks used by VBP programs; evidence on spillover effects and unintended consequences; and gaps in the knowledge base. PMID:28083347

[The added value of information summaries supporting clinical decisions at the point-of-care.

PubMed

Banzi, Rita; González-Lorenzo, Marien; Kwag, Koren Hyogene; Bonovas, Stefanos; Moja, Lorenzo

2016-11-01

Evidence-based healthcare requires the integration of the best research evidence with clinical expertise and patients' values. International publishers are developing evidence-based information services and resources designed to overcome the difficulties in retrieving, assessing and updating medical information as well as to facilitate a rapid access to valid clinical knowledge. Point-of-care information summaries are defined as web-based medical compendia that are specifically designed to deliver pre-digested, rapidly accessible, comprehensive, and periodically updated information to health care providers. Their validity must be assessed against marketing claims that they are evidence-based. We periodically evaluate the content development processes of several international point-of-care information summaries. The number of these products has increased along with their quality. The last analysis done in 2014 identified 26 products and found that three of them (Best Practice, Dynamed e Uptodate) scored the highest across all evaluated dimensions (volume, quality of the editorial process and evidence-based methodology). Point-of-care information summaries as stand-alone products or integrated with other systems, are gaining ground to support clinical decisions. The choice of one product over another depends both on the properties of the service and the preference of users. However, even the most innovative information system must rely on transparent and valid contents. Individuals and institutions should regularly assess the value of point-of-care summaries as their quality changes rapidly over time.

Messy but Fair: The ACA's Hospital Value-Based Purchasing Program and the Notice-and-Comment Process.

PubMed

Pan, Janus

2017-01-01

The Centers for Medicare and Medicaid Services (CMS) promulgated a new Medicare program called the Value-Based Purchasing Program (VBPP) as part of the 2010 Affordable Care Act (ACA). Like many other regulatory agencies, CMS used the Notice-and-Comment process to issue proposed rules, solicit public comments, and then publish final rules. Conventional literature suggests that CMS should disproportionately favor business interests during the Notice-and-Comment process, mainly due to the business interests' greater resources and capacity to draft well-reasoned comments. However, this article argues against this presumption and contends instead that CMS listens equally well to both business interest comments and private citizen comments during the formation of the VBPP. With regard to the VBPP and the ACA, CMS appears to be resisting disproportionate sway by business interests and is instead privileging the ACA's goal of improving healthcare quality.

Reduced-order model based active disturbance rejection control of hydraulic servo system with singular value perturbation theory.

PubMed

Wang, Chengwen; Quan, Long; Zhang, Shijie; Meng, Hongjun; Lan, Yuan

2017-03-01

Hydraulic servomechanism is the typical mechanical/hydraulic double-dynamics coupling system with the high stiffness control and mismatched uncertainties input problems, which hinder direct applications of many advanced control approaches in the hydraulic servo fields. In this paper, by introducing the singular value perturbation theory, the original double-dynamics coupling model of the hydraulic servomechanism was reduced to a integral chain system. So that, the popular ADRC (active disturbance rejection control) technology could be directly applied to the reduced system. In addition, the high stiffness control and mismatched uncertainties input problems are avoided. The validity of the simplified model is analyzed and proven theoretically. The standard linear ADRC algorithm is then developed based on the obtained reduced-order model. Extensive comparative co-simulations and experiments are carried out to illustrate the effectiveness of the proposed method. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Diagnostic Value of Isolated Mentalis Versus Mentalis Plus Upper Limb Electromyography in Idiopathic REM Sleep Behavior Disorder Patients Eventually Developing a Neurodegenerative Syndrome.

PubMed

Fernández-Arcos, Ana; Iranzo, Alex; Serradell, Mónica; Gaig, Carles; Guaita, Marc; Salamero, Manel; Santamaria, Joan

2017-04-01

To compare two electromyographic (EMG) montages, isolated mentalis muscle versus mentalis in combination with upper limb muscles in the baseline diagnostic video-polysomnography (V-PSG) of patients with idiopathic REM sleep behaviors disorder (IRBD) who eventually were diagnosed with a clinically defined neurodegenerative syndrome. Forty-nine patients were included. At baseline, diagnosis of RBD was based on a typical history of dream enactment behaviors plus V-PSG showing REM sleep with qualitative increased EMG activity and/or abnormal behaviors. Quantification of EMG activity (tonic, phasic and "any") in the mentalis and upper limb muscles (biceps brachii-BB, n = 36 or flexor digitorum superficialis-FDS, n = 13) was performed manually and compared with published cut-offs. Nine (18.4%) patients had either tonic or phasic EMG below the cut-offs for the isolated mentalis and four of them (11.1 %) also had values below the cut-off for the mentalis combined with BB. All 13 patients recorded with the FDS were above the mentalis combined with FDS cut-off. For the diagnosis of IRBD, sensitivity of isolated mentalis was 81.6% and of the combination of mentalis plus upper limb muscles was 91.8% (p = .03). Audiovisual analysis showed abnormal REM sleep behaviors in all nine patients with values below the cut-offs. Quantification of EMG activity in the upper limbs combined with the mentalis increases the ability to diagnose IRBD when compared with the isolated measurement of the mentalis. Detection of typical abnormal behaviors during REM sleep with audiovisual analysis is essential for the diagnosis of IRBD in patients with EMG values below the published cut-offs. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Perspective of Value-Based Management of Spinal Disorders in Brazil.

PubMed

Teles, Alisson R; Righesso, Orlando; Gullo, Maria Carolina R; Ghogawala, Zoher; Falavigna, Asdrubal

2016-03-01

The state of value-based management of spinal disorders and ongoing Brazilian strategies toward its implementation are highlighted in this article. The health care system, economic impact of spine surgery, use of patient-reported outcomes, ongoing studies about health economics, and current strategies toward implementation of quality assessment of spine care in Brazil are reviewed. During the past 20 years, there has been an increase of 226% in the number and 540% in the total cost of spine surgeries in the public health system. Examples of economic regulatory mechanisms involve the process of health technology assessment and the auditing processes imposed by health insurance companies. Some barriers to implementing clinical registries were identified from a large Latin American survey. Strategies based on education and technical support have been conducted to improve the quality of comparative-effectiveness research in spine care. Only 1 cost-utility study on spine care has been published until now. The paradigm of value-based management of spinal disorders is still incipient in Brazil. Some issues from our analysis must be emphasized: (1) Brazil presents many regional disparities and scarce resources for health care; it is crucial for the health system to allocate resources based on the value of interventions; (2) because of the high economic and social burden of developing new technologies for diagnosis and treatment, research in health economics of spine care in Brazil should be prioritized; (3) these efforts would help to provide a more accessible and effective health system for patients with spinal problems. Copyright © 2016 Elsevier Inc. All rights reserved.

The validity of a structured interactive 24-hour recall in estimating energy and nutrient intakes in 15-month-old rural Malawian children.

PubMed

Thakwalakwa, Chrissie M; Kuusipalo, Heli M; Maleta, Kenneth M; Phuka, John C; Ashorn, Per; Cheung, Yin Bun

2012-07-01

This study aimed to compare the nutritional intake values among 15-month-old rural Malawian children obtained by weighed food record (WFR) with those obtained by modified 24-hour recall (mod 24-HR), and to develop algorithm for adjusting mod 24-HR values so as to predict mean intake based on WFRs. The study participants were 169 15-month-old children who participated in a clinical trial. Food consumption on one day was observed and weighed (established criterion) by a research assistant to provide the estimates of energy and nutrient intakes. On the following day, another research assistant, blinded to the direct observation, conducted the structured interactive 24-hour recall (24-HR) interview (test method). Paired t-tests and scatter-plots were used to compare intake values of the two methods. The structured interactive 24-HR method tended to overestimate energy and nutrient intakes (each P < 0.001). The regression-through-the-origin method was used to develop adjustment algorithms. Results showed that multiplying the mean energy, protein, fat, iron, zinc and vitamin A intake estimates based on the test method by 0.86, 0.80, 0.68, 0.69, 0.72 and 0.76, respectively, provides an approximation of the mean values based on WFRs. © 2011 Blackwell Publishing Ltd.

Entropy-Based Adaptive Nuclear Texture Features are Independent Prognostic Markers in a Total Population of Uterine Sarcomas

PubMed Central

Nielsen, Birgitte; Hveem, Tarjei Sveinsgjerd; Kildal, Wanja; Abeler, Vera M; Kristensen, Gunnar B; Albregtsen, Fritz; Danielsen, Håvard E; Rohde, Gustavo K

2015-01-01

Nuclear texture analysis measures the spatial arrangement of the pixel gray levels in a digitized microscopic nuclear image and is a promising quantitative tool for prognosis of cancer. The aim of this study was to evaluate the prognostic value of entropy-based adaptive nuclear texture features in a total population of 354 uterine sarcomas. Isolated nuclei (monolayers) were prepared from 50 µm tissue sections and stained with Feulgen-Schiff. Local gray level entropy was measured within small windows of each nuclear image and stored in gray level entropy matrices, and two superior adaptive texture features were calculated from each matrix. The 5-year crude survival was significantly higher (P < 0.001) for patients with high texture feature values (72%) than for patients with low feature values (36%). When combining DNA ploidy classification (diploid/nondiploid) and texture (high/low feature value), the patients could be stratified into three risk groups with 5-year crude survival of 77, 57, and 34% (Hazard Ratios (HR) of 1, 2.3, and 4.1, P < 0.001). Entropy-based adaptive nuclear texture was an independent prognostic marker for crude survival in multivariate analysis including relevant clinicopathological features (HR = 2.1, P = 0.001), and should therefore be considered as a potential prognostic marker in uterine sarcomas. © The Authors. Published 2014 International Society for Advancement of Cytometry PMID:25483227

Feed-forward and feed-backward amplification model from cochlear cytoarchitecture: an interspecies comparison.

PubMed

Yoon, Yong-Jin; Steele, Charles R; Puria, Sunil

2011-01-05

The high sensitivity and wide bandwidth of mammalian hearing are thought to derive from an active process involving the somatic and hair-bundle motility of the thousands of outer hair cells uniquely found in mammalian cochleae. To better understand this, a biophysical three-dimensional cochlear fluid model was developed for gerbil, chinchilla, cat, and human, featuring an active "push-pull" cochlear amplifier mechanism based on the cytoarchitecture of the organ of Corti and using the time-averaged Lagrangian method. Cochlear responses are simulated and compared with in vivo physiological measurements for the basilar membrane (BM) velocity, V(BM), frequency tuning of the BM vibration, and Q₁₀ values representing the sharpness of the cochlear tuning curves. The V(BM) simulation results for gerbil and chinchilla are consistent with in vivo cochlea measurements. Simulated mechanical tuning curves based on maintaining a constant V(BM) value agree with neural-tuning threshold measurements better than those based on a constant displacement value, which implies that the inner hair cells are more sensitive to V(BM) than to BM displacement. The Q₁₀ values of the V(BM) tuning curve agree well with those of cochlear neurons across species, and appear to be related in part to the width of the basilar membrane. Copyright © 2011 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Intra-individual reaction time variability based on ex-Gaussian distribution as a potential endophenotype for attention-deficit/hyperactivity disorder.

PubMed

Lin, H-Y; Hwang-Gu, S-L; Gau, S S-F

2015-07-01

Intra-individual variability in reaction time (IIV-RT), defined by standard deviation of RT (RTSD), is considered as an endophenotype for attention-deficit/hyperactivity disorder (ADHD). Ex-Gaussian distributions of RT, rather than RTSD, could better characterize moment-to-moment fluctuations in neuropsychological performance. However, data of response variability based on ex-Gaussian parameters as an endophenotypic candidate for ADHD are lacking. We assessed 411 adolescents with clinically diagnosed ADHD based on the DSM-IV-TR criteria as probands, 138 unaffected siblings, and 138 healthy controls. The output parameters, mu, sigma, and tau, of an ex-Gaussian RT distribution were derived from the Conners' continuous performance test. Multi-level models controlling for sex, age, comorbidity, and use of methylphenidate were applied. Compared with unaffected siblings and controls, ADHD probands had elevated sigma value, omissions, commissions, and mean RT. Unaffected siblings formed an intermediate group in-between probands and controls in terms of tau value and RTSD. There was no between-group difference in mu value. Conforming to a context-dependent nature, unaffected siblings still had an intermediate tau value in-between probands and controls across different interstimulus intervals. Our findings suggest IIV-RT represented by tau may be a potential endophenotype for inquiry into genetic underpinnings of ADHD in the context of heterogeneity. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Estimating the Diffusion Coefficients of Sugars Using Diffusion Experiments in Agar-Gel and Computer Simulations.

PubMed

Miyamoto, Shuichi; Atsuyama, Kenji; Ekino, Keisuke; Shin, Takashi

2018-01-01

The isolation of useful microbes is one of the traditional approaches for the lead generation in drug discovery. As an effective technique for microbe isolation, we recently developed a multidimensional diffusion-based gradient culture system of microbes. In order to enhance the utility of the system, it is favorable to have diffusion coefficients of nutrients such as sugars in the culture medium beforehand. We have, therefore, built a simple and convenient experimental system that uses agar-gel to observe diffusion. Next, we performed computer simulations-based on random-walk concepts-of the experimental diffusion system and derived correlation formulas that relate observable diffusion data to diffusion coefficients. Finally, we applied these correlation formulas to our experimentally-determined diffusion data to estimate the diffusion coefficients of sugars. Our values for these coefficients agree reasonably well with values published in the literature. The effectiveness of our simple technique, which has elucidated the diffusion coefficients of some molecules which are rarely reported (e.g., galactose, trehalose, and glycerol) is demonstrated by the strong correspondence between the literature values and those obtained in our experiments.

Trust as commodity: social value orientation affects the neural substrates of learning to cooperate.

PubMed

Lambert, Bruno; Declerck, Carolyn H; Emonds, Griet; Boone, Christophe

2017-04-01

Individuals differ in their motives and strategies to cooperate in social dilemmas. These differences are reflected by an individual's social value orientation: proselfs are strategic and motivated to maximize self-interest, while prosocials are more trusting and value fairness. We hypothesize that when deciding whether or not to cooperate with a random member of a defined group, proselfs, more than prosocials, adapt their decisions based on past experiences: they 'learn' instrumentally to form a base-line expectation of reciprocity. We conducted an fMRI experiment where participants (19 proselfs and 19 prosocials) played 120 sequential prisoner's dilemmas against randomly selected, anonymous and returning partners who cooperated 60% of the time. Results indicate that cooperation levels increased over time, but that the rate of learning was steeper for proselfs than for prosocials. At the neural level, caudate and precuneus activation were more pronounced for proselfs relative to prosocials, indicating a stronger reliance on instrumental learning and self-referencing to update their trust in the cooperative strategy. © The Author (2017). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Return period adjustment for runoff coefficients based on analysis in undeveloped Texas watersheds

USGS Publications Warehouse

Dhakal, Nirajan; Fang, Xing; Asquith, William H.; Cleveland, Theodore G.; Thompson, David B.

2013-01-01

The rational method for peak discharge (Qp) estimation was introduced in the 1880s. The runoff coefficient (C) is a key parameter for the rational method that has an implicit meaning of rate proportionality, and the C has been declared a function of the annual return period by various researchers. Rate-based runoff coefficients as a function of the return period, C(T), were determined for 36 undeveloped watersheds in Texas using peak discharge frequency from previously published regional regression equations and rainfall intensity frequency for return periods T of 2, 5, 10, 25, 50, and 100 years. The C(T) values and return period adjustments C(T)/C(T=10  year) determined in this study are most applicable to undeveloped watersheds. The return period adjustments determined for the Texas watersheds in this study and those extracted from prior studies of non-Texas data exceed values from well-known literature such as design manuals and textbooks. Most importantly, the return period adjustments exceed values currently recognized in Texas Department of Transportation design guidance when T>10  years.

Design of batch audio/video conversion platform based on JavaEE

NASA Astrophysics Data System (ADS)

Cui, Yansong; Jiang, Lianpin

2018-03-01

With the rapid development of digital publishing industry, the direction of audio / video publishing shows the diversity of coding standards for audio and video files, massive data and other significant features. Faced with massive and diverse data, how to quickly and efficiently convert to a unified code format has brought great difficulties to the digital publishing organization. In view of this demand and present situation in this paper, basing on the development architecture of Sptring+SpringMVC+Mybatis, and combined with the open source FFMPEG format conversion tool, a distributed online audio and video format conversion platform with a B/S structure is proposed. Based on the Java language, the key technologies and strategies designed in the design of platform architecture are analyzed emphatically in this paper, designing and developing a efficient audio and video format conversion system, which is composed of “Front display system”, "core scheduling server " and " conversion server ". The test results show that, compared with the ordinary audio and video conversion scheme, the use of batch audio and video format conversion platform can effectively improve the conversion efficiency of audio and video files, and reduce the complexity of the work. Practice has proved that the key technology discussed in this paper can be applied in the field of large batch file processing, and has certain practical application value.

Agricultural implications of providing soil-based constraints on urban expansion: Land use forecasts to 2050.

PubMed

Smidt, Samuel J; Tayyebi, Amin; Kendall, Anthony D; Pijanowski, Bryan C; Hyndman, David W

2018-07-01

Urbanization onto adjacent farmlands directly reduces the agricultural area available to meet the resource needs of a growing society. Soil conservation is a common objective in urban planning, but little focus has been placed on targeting soil value as a metric for conservation. This study assigns commodity and water storage values to the agricultural soils across all of the watersheds in Michigan's Lower Peninsula to evaluate how cities might respond to a soil conservation-based urbanization strategy. Land Transformation Model (LTM) simulations representing both traditional and soil conservation-based urbanization, are used to forecast urban area growth from 2010 to 2050 at five year intervals. The expansion of urban areas onto adjacent farmland is then evaluated to quantify the conservation effects of soil-based development. Results indicate that a soil-based protection strategy significantly conserves total farmland, especially more fertile soils within each soil type. In terms of revenue, ∼$88 million (in current dollars) would be conserved in 2050 using soil-based constraints, with the projected savings from 2011 to 2050 totaling more than $1.5 billion. Soil-based urbanization also increased urban density for each major metropolitan area. For example, there were 94,640 more acres directly adjacent to urban land by 2050 under traditional development compared to the soil-based urbanization strategy, indicating that urban sprawl was more tightly contained when including soil value as a metric to guide development. This study indicates that implementing a soil-based urbanization strategy would better satisfy future agricultural resource needs than traditional urban planning. Copyright © 2018. Published by Elsevier Ltd.

The Geochemical Databases GEOROC and GeoReM - What's New?

NASA Astrophysics Data System (ADS)

Sarbas, B.; Jochum, K. P.; Nohl, U.; Weis, U.

2017-12-01

The geochemical databases GEOROC (http: georoc.mpch-mainz.gwdg.de) and GeoReM (http: georem.mpch-mainz.gwdg.de) are maintained by the Max Planck Institute for Chemistry in Mainz, Germany. Both online databases became crucial tools for geoscientists from different research areas. They are regularly upgraded by new tools and new data from recent publications obtained from a wide range of international journals. GEOROC is a collection of published analyses of volcanic rocks and mantle xenoliths. Since recently, data for plutonic rocks are added. The analyses include major and trace element concentrations, radiogenic and non-radiogenic isotope ratios as well as analytical ages for whole rocks, glasses, minerals and inclusions. Samples come from eleven geological settings and span the whole geological age scale from Archean to Recent. Metadata include, among others, geographic location, rock class and rock type, geological age, degree of alteration, analytical method, laboratory, and reference. The GEOROC web page allows selection of samples by geological setting, geography, chemical criteria, rock or sample name, and bibliographic criteria. In addition, it provides a large number of precompiled files for individual locations, minerals and rock classes. GeoReM is a database collecting information about reference materials of geological and environmental interest, such as rock powders, synthetic and natural glasses as well as mineral, isotopic, biological, river water and seawater reference materials. It contains published data and compilation values (major and trace element concentrations and mass fractions, radiogenic and stable isotope ratios). Metadata comprise, among others, uncertainty, analytical method and laboratory. Reference materials are important for calibration, method validation, quality control and to establish metrological traceability. GeoReM offers six different search strategies: samples or materials (published values), samples (GeoReM preferred values), chemical criteria, chemical criteria based on bibliography, bibliography, as well as methods and institutions.

Analysis of the harmonic and intermodulation distortion in a multimode fiber optic link.

PubMed

Gasulla, I; Capmany, J

2007-07-23

We present an analytical evaluation of the harmonic and the intermodulation distortion effects produced in the transmission of an analog signal composed of various RF tones through a multimode fiber link. It is based on the electric field propagation model previously published by the authors. Results show the possibility of implementing subcarrier multiplexing techniques (SCM) with Composite Second Order (CSO) values below -50 dBc over short and middle reach multimode fiber links.

Are Cultural Values and Beliefs Included in U.S. Based HIV Interventions?

PubMed Central

Wyatt, Gail E.; Williams, John K.; Gupta, Arpana; Malebranche, Dominique

2013-01-01

Objective To determine the extent to which current U.S. based HIV/AIDS prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. Method A comprehensive literature review was conducted to determine which published HIV/AIDS prevention and risk reduction interventions incorporated aspects of cultural beliefs. Results This review of 166 HIV prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. Conclusion HIV interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual’s risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. PMID:21884721

A Large-Scale Analysis of Impact Factor Biased Journal Self-Citations.

PubMed

Chorus, Caspar; Waltman, Ludo

2016-01-01

Based on three decades of citation data from across scientific fields of science, we study trends in impact factor biased self-citations of scholarly journals, using a purpose-built and easy to use citation based measure. Our measure is given by the ratio between i) the relative share of journal self-citations to papers published in the last two years, and ii) the relative share of journal self-citations to papers published in preceding years. A ratio higher than one suggests that a journal's impact factor is disproportionally affected (inflated) by self-citations. Using recently reported survey data, we show that there is a relation between high values of our proposed measure and coercive journal self-citation malpractices. We use our measure to perform a large-scale analysis of impact factor biased journal self-citations. Our main empirical result is, that the share of journals for which our measure has a (very) high value has remained stable between the 1980s and the early 2000s, but has since risen strongly in all fields of science. This time span corresponds well with the growing obsession with the impact factor as a journal evaluation measure over the last decade. Taken together, this suggests a trend of increasingly pervasive journal self-citation malpractices, with all due unwanted consequences such as inflated perceived importance of journals and biased journal rankings.

Psychometric Principles in Measurement for Geoscience Education Research: A Climate Change Example

NASA Astrophysics Data System (ADS)

Libarkin, J. C.; Gold, A. U.; Harris, S. E.; McNeal, K.; Bowles, R.

2015-12-01

Understanding learning in geoscience classrooms requires that we use valid and reliable instruments aligned with intended learning outcomes. Nearly one hundred instruments assessing conceptual understanding in undergraduate science and engineering classrooms (often called concept inventories) have been published and are actively being used to investigate learning. The techniques used to develop these instruments vary widely, often with little attention to psychometric principles of measurement. This paper will discuss the importance of using psychometric principles to design, evaluate, and revise research instruments, with particular attention to the validity and reliability steps that must be undertaken to ensure that research instruments are providing meaningful measurement. An example from a climate change inventory developed by the authors will be used to exemplify the importance of validity and reliability, including the value of item response theory for instrument development. A 24-item instrument was developed based on published items, conceptions research, and instructor experience. Rasch analysis of over 1000 responses provided evidence for the removal of 5 items for misfit and one item for potential bias as measured via differential item functioning. The resulting 18-item instrument can be considered a valid and reliable measure based on pre- and post-implementation metrics. Consideration of the relationship between respondent demographics and concept inventory scores provides unique insight into the relationship between gender, religiosity, values and climate change understanding.

Pediatric idiopathic intracranial hypertension - Is the fixed threshold value of elevated LP opening pressure set too high?

PubMed

Gerstl, Lucia; Schoppe, Nikola; Albers, Lucia; Ertl-Wagner, Birgit; Alperin, Noam; Ehrt, Oliver; Pomschar, Andreas; Landgraf, Mirjam N; Heinen, Florian

2017-11-01

Idiopathic intracranial hypertension (IIH) in children is a rare condition of unknown etiology and various clinical presentations. The primary aim of this study was to evaluate if our pediatric IIH study group fulfilled the revised diagnostic criteria for IIH published in 2013, particularly with regard to clinical presentation and threshold value of an elevated lumbar puncture opening pressure. Additionally we investigated the potential utilization of MR-based and fundoscopic methods of estimating intracranial pressure for improved diagnosis. Clinical data were collected retrospectively from twelve pediatric patients diagnosed with IIH between 2008 and 2012 and revised diagnostic criteria were applied. Comparison with non-invasive methods for measuring intracranial pressure, MRI-based measurement (MR-ICP) and venous ophthalmodynamometry was performed. Only four of the twelve children (33%) fulfilled the revised diagnostic criteria for a definite diagnosis of IIH. Regarding noninvasive methods, MR-ICP (n = 6) showed a significantly higher mean of intracranial pressure compared to a healthy age- and sex-matched control group (p = 0.0043). Venous ophthalmodynamometry (n = 4) showed comparable results to invasive lumbar puncture. The revised diagnostic criteria for IIH may be too strict especially in children without papilledema. MR-ICP and venous ophthalmodynamometry are promising complementary procedures for monitoring disease progression and response to treatment. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Systematic reviews and meta-analyses on treatment of asthma: critical evaluation

PubMed Central

Jadad, Alejandro R; Moher, Michael; Browman, George P; Booker, Lynda; Sigouin, Christopher; Fuentes, Mario; Stevens, Robert

2000-01-01

Objective To evaluate the clinical, methodological, and reporting aspects of systematic reviews and meta-analyses on the treatment of asthma and to compare those published by the Cochrane Collaboration with those published in paper based journals. Design Analysis of studies identified from Medline, CINAHL, HealthSTAR, EMBASE, Cochrane Library, personal collections, and reference lists. Studies Articles describing a systematic review or a meta-analysis of the treatment of asthma that were published as a full report, in any language or format, in a peer reviewed journal or the Cochrane Library. Main outcome measures General characteristics of studies reviewed and methodological characteristics (sources of articles; language restrictions; format, design, and publication status of studies included; type of data synthesis; and methodological quality). Results 50 systematic reviews and meta-analyses were included. More than half were published in the past two years. Twelve reviews were published in the Cochrane Library and 38 were published in 22 peer reviewed journals. Forced expiratory volume in one second was the most frequently used outcome, but few reviews evaluated the effect of treatment on costs or patient preferences. Forty reviews were judged to have serious or extensive flaws. All six reviews associated with industry were in this group. Seven of the 10 most rigorous reviews were published in the Cochrane Library. Conclusions Most reviews published in peer reviewed journals or funded by industry have serious methodological flaws that limit their value to guide decisions. Cochrane reviews are more rigorous and better reported than those published in peer reviewed journals. PMID:10688558

Principle-based concept analysis: Caring in nursing education

PubMed Central

Salehian, Maryam; Heydari, Abbas; Aghebati, Nahid; Moonaghi, Hossein Karimi; Mazloom, Seyed Reza

2016-01-01

Introduction The aim of this principle-based concept analysis was to analyze caring in nursing education and to explain the current state of the science based on epistemologic, pragmatic, linguistic, and logical philosophical principles. Methods A principle-based concept analysis method was used to analyze the nursing literature. The dataset included 46 English language studies, published from 2005 to 2014, and they were retrieved through PROQUEST, MEDLINE, CINAHL, ERIC, SCOPUS, and SID scientific databases. The key dimensions of the data were collected using a validated data-extraction sheet. The four principles of assessing pragmatic utility were used to analyze the data. The data were managed by using MAXQDA 10 software. Results The scientific literature that deals with caring in nursing education relies on implied meaning. Caring in nursing education refers to student-teacher interactions that are formed on the basis of human values and focused on the unique needs of the students (epistemological principle). The result of student-teacher interactions is the development of both the students and the teachers. Numerous applications of the concept of caring in nursing education are available in the literature (pragmatic principle). There is consistency in the meaning of the concept, as a central value of the faculty-student interaction (linguistic principle). Compared with other related concepts, such as “caring pedagogy,” “value-based education,” and “teaching excellence,” caring in nursing education does not have exact and clear conceptual boundaries (logic principle). Conclusion Caring in nursing education was identified as an approach to teaching and learning, and it is formed based on teacher-student interactions and sustainable human values. A greater understanding of the conceptual basis of caring in nursing education will improve the caring behaviors of teachers, create teaching-learning environments, and help experts in curriculum development. PMID:27123225

Principle-based concept analysis: Caring in nursing education.

PubMed

Salehian, Maryam; Heydari, Abbas; Aghebati, Nahid; Karimi Moonaghi, Hossein; Mazloom, Seyed Reza

2016-03-01

The aim of this principle-based concept analysis was to analyze caring in nursing education and to explain the current state of the science based on epistemologic, pragmatic, linguistic, and logical philosophical principles. A principle-based concept analysis method was used to analyze the nursing literature. The dataset included 46 English language studies, published from 2005 to 2014, and they were retrieved through PROQUEST, MEDLINE, CINAHL, ERIC, SCOPUS, and SID scientific databases. The key dimensions of the data were collected using a validated data-extraction sheet. The four principles of assessing pragmatic utility were used to analyze the data. The data were managed by using MAXQDA 10 software. The scientific literature that deals with caring in nursing education relies on implied meaning. Caring in nursing education refers to student-teacher interactions that are formed on the basis of human values and focused on the unique needs of the students (epistemological principle). The result of student-teacher interactions is the development of both the students and the teachers. Numerous applications of the concept of caring in nursing education are available in the literature (pragmatic principle). There is consistency in the meaning of the concept, as a central value of the faculty-student interaction (linguistic principle). Compared with other related concepts, such as "caring pedagogy," "value-based education," and "teaching excellence," caring in nursing education does not have exact and clear conceptual boundaries (logic principle). Caring in nursing education was identified as an approach to teaching and learning, and it is formed based on teacher-student interactions and sustainable human values. A greater understanding of the conceptual basis of caring in nursing education will improve the caring behaviors of teachers, create teaching-learning environments, and help experts in curriculum development.

Cost-effectiveness simulation and analysis of colorectal cancer screening in Hong Kong Chinese population: comparison amongst colonoscopy, guaiac and immunologic fecal occult blood testing.

PubMed

Wong, Carlos K H; Lam, Cindy L K; Wan, Y F; Fong, Daniel Y T

2015-10-15

The aim of this study was to evaluate the cost-effectiveness of CRC screening strategies from the healthcare service provider perspective based on Chinese population. A Markov model was constructed to compare the cost-effectiveness of recommended screening strategies including annual/biennial guaiac fecal occult blood testing (G-FOBT), annual/biennial immunologic FOBT (I-FOBT), and colonoscopy every 10 years in Chinese aged 50 year over a 25-year period. External validity of model was tested against data retrieved from published randomized controlled trials of G-FOBT. Recourse use data collected from Chinese subjects among staging of colorectal neoplasm were combined with published unit cost data ($USD in 2009 price values) to estimate a stage-specific cost per patient. Quality-adjusted life-years (QALYs) were quantified based on the stage duration and SF-6D preference-based value of each stage. The cost-effectiveness outcome was the incremental cost-effectiveness ratio (ICER) represented by costs per life-years (LY) and costs per QALYs gained. In base-case scenario, the non-dominated strategies were annual and biennial I-FOBT. Compared with no screening, the ICER presented $20,542/LYs and $3155/QALYs gained for annual I-FOBT, and $19,838/LYs gained and $2976/QALYs gained for biennial I-FOBT. The optimal screening strategy was annual I-FOBT that attained the highest ICER at the threshold of $50,000 per LYs or QALYs gained. The Markov model informed the health policymakers that I-FOBT every year may be the most effective and cost-effective CRC screening strategy among recommended screening strategies, depending on the willingness-to-pay of mass screening for Chinese population. ClinicalTrials.gov Identifier NCT02038283.

A novel gel based vehicle for the delivery of acetylcholine in quantitative sudomotor axon reflex testing.

PubMed

Sletten, David M; Kimpinski, Kurt; Weigand, Stephen D; Low, Phillip A

2009-10-05

This study describes a novel gel based vehicle for the delivery of acetylcholine (ACh) during quantitative sudomotor axon reflex testing (QSART). A dose and current response study were undertaken on 20 healthy control participants to characterize the efficiency of a gel based vehicle for the delivery of ACh. Values obtained for total sweat volume and latency to sweat onset with gel iontophoresis of ACh during QSART were comparable to previously published normative data using solution based vehicles. Patient discomfort, utilizing the gel based vehicle during the QSART procedure, was minimal. Improvement in iontophoresis using the gel formulation as a vehicle for ACh delivery has the potential to lower the voltage required to overcome skin resistance during QSART and may result in improved patient comfort during the procedure.

Tissue dielectric constant (TDC) as an index of localized arm skin water: differences between measuring probes and genders.

PubMed

Mayrovitz, H N; Weingrad, D N; Brlit, F; Lopez, L B; Desfor, R

2015-03-01

An easily measured, non-invasive, quantitative estimate of local skin tissue water is useful to assess local lymphedema and its change. One method uses skin tissue dielectric constant (TDC) values that at 300 MHz TDC depend on free and bound water within the measurement volume. In practice such measurements have been done with a research-type multi-probe, but recently a hand-held compact-probe has become available that may be more clinically convenient. Because most available published data is based on multiprobe measurements it is important to characterize possible differences between devices that unless known might lead to ambiguous quantitative comparisons between TDC values. Thus, our purpose was to evaluate potential differences in measured TDC values between multi-probe and compact-probe devices with respect to probe effective sampling depth, anatomical site, and gender and also to compare compact-probe TDC values measured on women with and without breast cancer (BC). TDC was measured bilaterally on forearms and biceps of 32 male and 32 female volunteers and on 12 female patients awaiting surgery for breast cancer. Results show that 1) TDC values at 2.5 mm depth were significantly less than at 1.5 mm; 2) Female TDC values were significantly less than male values; 3) TDC values were not different between females with and without BC; and 4) dominant/non-dominant arm TDC ratios were not significantly different for any probe among genders or arm anatomical site. These findings indicate that probe type differences in absolute TDC values are present and should be taken into account when TDC values are compared. However, comparisons based on inter-arm TDC ratios are not statistically different among probes with respect to gender or anatomical location.

Evidence-based medicine for every day, everyone, and every therapeutic study.

PubMed

Govindarajan, Raghav; Narayanaswami, Pushpa

2018-04-17

The rapid growth in published medical literature makes it difficult for clinicians to keep up with advances in their fields. This may result in a cursory scan of the abstract and conclusion of a study without critically evaluating study quality. The application of evidence-based medicine (EBM) is the process of converting the abstract task of reading the literature into a practical method of using the literature to inform care in a specific clinical context while simultaneously expanding one's knowledge. EBM involves 4 steps: (1) stating the clinical problem in a defined question; (2) searching the literature for the evidence; (3) critically appraising the evidence for its validity; and (4) applying the evidence in the context of the patient's situation, preferences, and values. In this review, we use the recently published trial of thymectomy in myasthenia gravis as an example and systematically go through the steps of assessing internal validity, precision, and external validity. Muscle Nerve, 2018. © 2018 Wiley Periodicals, Inc.

Application of electronic medical record data for health outcomes research: a review of recent literature.

PubMed

Lin, Junji; Jiao, Tianze; Biskupiak, Joseph E; McAdam-Marx, Carrie

2013-04-01

Electronic medical records (EMRs) have become a common source of data for outcomes research. This review discusses trends in EMR data use for outcomes research as well as strengths and limitations, and likely future developments to help optimize value and use of EMR data for outcomes research. EMR-based studies reporting treatment outcomes published between 2007 and 2012 were predominantly from the USA and Europe. There has been a substantial increase in the number of EMR-based outcomes studies published from 2007-2008 (n = 28) to 2010-2011 (n = 55). Many studies evaluated biometric and laboratory test outcomes in common chronic conditions. However, researchers are expanding the scope of evaluated diseases and outcomes using advanced techniques, such as natural language processing and linking EMRs to other patient-level data to overcome issues with missing data or data that cannot be accessed using standard queries. These advances will help to expand the scope and sophistication of outcomes research in the coming years.

Environmental and nutrition impact of achieving new School Food Plan recommendations in the primary school meals sector in England.

PubMed

Wickramasinghe, Kremlin; Rayner, Mike; Goldacre, Michael; Townsend, Nick; Scarborough, Peter

2017-04-05

The aim of this modelling study was to estimate the expected changes in the nutritional quality and greenhouse gas emissions (GHGEs) of primary school meals due to the adoption of new mandatory food-based standards for school meals. Nationally representative random sample of 136 primary schools in England was selected for the Primary School Food Survey (PSFS) with 50% response rate. A sample of 6690 primary students from PSFS who consumed school meals. Primary School Food Plan (SFP) nutritional impact was assessed using both macronutrient and micronutrient quality. The environmental impact was measured by GHGEs. The scenario tested was one in which every meal served in schools met more than half of the food-based standards mentioned in the SFP (SFP scenario). We used findings from a systematic review to assign GHGE values for each food item in the data set. The GHGE value and nutritional quality of SFP scenario meals was compared with the average primary school meal in the total PSFS data set (pre-SFP scenario). Prior to introduction of the SFP (pre-SFP scenario), the primary school meals had mandatory nutrient-based guidelines. The percentage of meals that met the protein standard increased in the SFP scenario and the proportion of meals that met the standards for important micronutrients (eg, iron, calcium, vitamin A and C) also increased. However, the SFP scenario did not improve the salt, saturated fat and free sugar levels. The mean GHGE value of meals which met the SFP standards was 0.79 (95% CI 0.77 to 0.81) kgCO 2 e compared with a mean value of 0.72 (0.71 to 0.74) kgCO 2 e for all meals. Adopting the SFP would increase the total emissions associated with primary school meals by 22 000 000 kgCO 2 e per year. The universal adoption of the new food-based standards, without reformulation would result in an increase in the GHGEs of school meals and improve some aspects of the nutritional quality, but it would not improve the average salt, sugar and saturated fat content levels. 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/.

Pushed by Symptoms, Pulled by Values: Promotion Goals Increase Motivation in Therapeutic Tasks.

PubMed

Katz, Benjamin A; Catane, Sara; Yovel, Iftah

2016-03-01

While many therapies focus on the reduction of disturbing symptoms, others pursue behavior consistent with personally held values. Based on regulatory focus theory (Higgins, 1997), reducing symptoms is a type of prevention goal while pursuing values is a promotion goal. In the current study, 123 undergraduate students elicited a negative, self-focused emotion-laden cognition. They were then randomly assigned to construe their negative thought as either (a) an impediment to valued behaviors, (b) a cause of unpleasant symptoms, or to one of two control conditions: (c) distraction or (d) no intervention. Then, participants in all groups completed a series of repetitive therapeutic tasks that targeted their elicited negative cognitions. Results showed that participants who construed treatment in terms of valued behavior promotion spent more time on a therapeutic task than all other groups. The group in the unpleasant symptom promotion condition did not differ from either control group. The motivational advantage of value promotion was not accounted for by differences in mood. The present findings suggest that clients may be better motivated through value promotion goals, as opposed to symptom prevention goals. Copyright © 2015. Published by Elsevier Ltd.

Development of algal interspecies correlation estimation models for chemical hazard assessment.

PubMed

Brill, Jessica L; Belanger, Scott E; Chaney, Joel G; Dyer, Scott D; Raimondo, Sandy; Barron, Mace G; Pittinger, Charles A

2016-09-01

Web-based Interspecies Correlation Estimation (ICE) is an application developed to predict the acute toxicity of a chemical from 1 species to another taxon. Web-ICE models use the acute toxicity value for a surrogate species to predict effect values for other species, thus potentially filling in data gaps for a variety of environmental assessment purposes. Web-ICE has historically been dominated by aquatic and terrestrial animal prediction models. Web-ICE models for algal species were essentially absent and are addressed in the present study. A compilation of public and private sector-held algal toxicity data were compiled and reviewed for quality based on relevant aspects of individual studies. Interspecies correlations were constructed from the most commonly tested algal genera for a broad spectrum of chemicals. The ICE regressions were developed based on acute 72-h and 96-h endpoint values involving 1647 unique studies on 476 unique chemicals encompassing 40 genera and 70 species of green, blue-green, and diatom algae. Acceptance criteria for algal ICE models were established prior to evaluation of individual models and included a minimum sample size of 3, a statistically significant regression slope, and a slope estimation parameter ≥0.65. A total of 186 ICE models were possible at the genus level, with 21 meeting quality criteria; and 264 ICE models were developed at the species level, with 32 meeting quality criteria. Algal ICE models will have broad utility in screening environmental hazard assessments, data gap filling in certain regulatory scenarios, and as supplemental information to derive species sensitivity distributions. Environ Toxicol Chem 2016;35:2368-2378. Published 2016 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America. Published 2016 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America.

A CONSORT analysis of randomised controlled trials for the treatment of invasive aspergillosis.

PubMed

Jones, Brian L; Richardson, Malcolm D; Ingram, Patricia M; Agrawal, Samir G

2017-08-01

There is no assessment of the reporting quality of antifungal randomized, controlled trials (RCT), upon which guidelines for the treatment of invasive aspergillosis (IA) in patients with hematological malignancy are based. Trial reports were identified through Trip, Cochrane, Medline, and Embase database searches. Report quality was assessed using the 25-item CONSORT checklist and a rating scale of 1 (strongly disagree) to 4 (strongly agree). The primary endpoint was quality as assessed by mean group-scores among papers published at the time of the most recent IA treatment guidelines. Seven RCTs were identified for analysis. Overall mean group-score for all seven papers was 2.44 (out of a total of four). There were significant differences between publications regarding overall reporting quality (P < .001) and specifically for the Methods and Results (P = .004 and P = .010, respectively), which best reflect data quality. The Cornely trial report achieved the highest mean group-score overall (3.15 ± 0.93; 95% CI, 2.82, 3.47), as well as for Methods (3.36) and Results (3.40). Mean group scores also showed that it was of significantly higher overall quality than the other six publications (P-value range; .012 to <.001), and of higher quality for Methods than five publications (P-value range; .013 to <.001). Incorporating this CONSORT analysis into the evidence-based grading systems in North American (IDSA), European (ECIL and ESCMID) IA guidelines could alter the value placed on these RCTs, thereby impacting on clinical recommendations. © The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Implant use for primary hip and knee arthroplasty: are we getting it right first time?

PubMed

Ng Man Sun, Stephen; Gillott, Elizabeth; Bhamra, Jagmeet; Briggs, Tim

2013-06-01

Implants used for hip and knee arthroplasties have recently come under increased scrutiny. In England, a large variety of prostheses are currently being used. With the need for savings within the NHS of up to £20 billion over the next five years, we should be 'getting it right first time' by using the most reliable implants with proven survivorship. The 8th Annual Report from the NJR (2011) reporting on prostheses used in 2010 was analysed to determine whether implants had published survivorship data. This study demonstrates that the majority of implants did have long-term results but a small percentage had no published data. The cost of these implants was calculated to see if the implants provided best value for money based on survivorship. Implant choice was also correlated to revision rates published in the NJR report (2011) to help determine whether their continued use was justified. Copyright © 2013 Elsevier Inc. All rights reserved.

Status of linear boundary-layer stability and the e to the nth method, with emphasis on swept-wing applications

NASA Technical Reports Server (NTRS)

Hefner, J. N.; Bushnell, D. M.

1980-01-01

The-state-of-the-art for the application of linear stability theory and the e to the nth power method for transition prediction and laminar flow control design are summarized, with analyses of previously published low disturbance, swept wing data presented. For any set of transition data with similar stream distrubance levels and spectra, the e to the nth power method for estimating the beginning of transition works reasonably well; however, the value of n can vary significantly, depending upon variations in disturbance field or receptivity. Where disturbance levels are high, the values of n are appreciably below the usual average value of 9 to 10 obtained for relatively low disturbance levels. It is recommended that the design of laminar flow control systems be based on conservative estimates of n and that, in considering the values of n obtained from different analytical approaches or investigations, the designer explore the various assumptions which entered into the analyses.

Prognostic value of lymph node ratio in head and neck squamous cell carcinoma.

PubMed

Talmi, Yoav P; Takes, Robert P; Alon, Eran E; Nixon, Iain J; López, Fernando; de Bree, Remco; Rodrigo, Juan P; Shaha, Ashok R; Halmos, Gyorgy B; Rinaldo, Alessandra; Ferlito, Alfio

2018-05-01

Lymph node ratio (LNR) is increasingly reported as a potential prognostic tool. The purpose of this review was to analyze the available literature on the prognostic significance of LNR in head and neck squamous cell carcinoma (HNSCC). A PubMed internet search was performed and articles meeting selection criteria were reviewed. Twenty-eight studies were identified in the literature dealing with the prognostic value of LNR. The published results are variable with a range of cutoff values of LNR associated with prognosis (overall survival [OS] and/or disease-specific survival [DSS]) between 0.02 and 0.20, with an average of 0.09. The LNR is reported to be of value in assessing prognosis in the patients with HNSCC. Although it is easy to calculate and could be considered in the staging of these patients, the currently available evidence in the literature does not yet provide a solid base for implementation. © 2018 Wiley Periodicals, Inc.

Scanning the horizon for high value-add manufacturing science: Accelerating manufacturing readiness for the next generation of disruptive, high-value curative cell therapeutics.

PubMed

Hourd, Paul; Williams, David J

2018-05-01

Since the regenerative medicine sector entered the second phase of its development (RegenMed 2.0) more than a decade ago, there is increasing recognition that current technology innovation trajectories will drive the next translational phase toward the production of disruptive, high-value curative cell and gene-based regenerative medicines. To identify the manufacturing science problems that must be addressed to permit translation of these next generation therapeutics. In this short report, a long lens look within the pluripotent stem cell therapeutic space, both embryonic and induced, is used to gain early insights on where critical technology and manufacturing challenges may emerge. This report offers a future perspective on the development and innovation that will be needed within manufacturing science to add value in the production and commercialization of the next generation of advanced cell therapies and precision medicines. Copyright © 2018 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

A review of lung-to-blood absorption rates for radon progeny.

PubMed

Marsh, J W; Bailey, M R

2013-12-01

The International Commission on Radiological Protection (ICRP) Publication 66 Human Respiratory Tract Model (HRTM) treats clearance of materials from the respiratory tract as a competitive process between absorption into blood and particle transport to the alimentary tract and lymphatics. The ICRP recommended default absorption rates for lead and polonium (Type M) in ICRP Publication 71 but stated that the values were not appropriate for short-lived radon progeny. This paper reviews and evaluates published data from volunteer and laboratory animal experiments to estimate the HRTM absorption parameter values for short-lived radon progeny. Animal studies showed that lead ions have two phases of absorption: ∼10 % absorbed with a half-time of ∼15 min, the rest with a half-time of ∼10 h. The studies also indicated that some of the lead ions were bound to respiratory tract components. Bound fractions, f(b), for lead were estimated from volunteer and animal studies and ranged from 0.2 to 0.8. Based on the evaluations of published data, the following HRTM absorption parameter values were derived for lead as a decay product of radon: f(r) = 0.1, s(r) = 100 d(-1), s(s) = 1.7 d(-1), f(b) = 0.5 and s(b) = 1.7 d(-1). Effective doses calculated assuming these absorption parameter values instead of a single absorption half-time of 10 h with no binding (as has generally been assumed) are only a few per cent higher. However, as there is some conflicting evidence on the absorption kinetics for radon progeny, dose calculations have been carried out for different sets of absorption parameter values derived from different studies. The results of these calculations are discussed.

Sensory irritation structure-activity study of inhaled aldehydes in B6C3F1 and Swiss-Webster mice

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

Steinhagen, W.H.; Barrow, C.S.

1984-03-15

The sensory irritation potential of a series of saturated and unsaturated aliphatic and cyclic aldehydes was investigated in B6C3F1 and Swiss-Webster mice. With the reflex decrease in respiratory rate as the endpoint response, alpha, beta-unsaturated aliphatic aldehydes yielded RD/sub 50/ values (concentration which elicits a 50% decrease in respiratory rate) ranging from 1 to 5 ppm while saturated aliphatic aldehydes with two or more carbons produced RD/sub 50/ values from 750 to 4200 ppm. Cyclic aldehydes produced intermediate RD/sub 50/ values which ranged from 60 to 400 ppm. No statistically significant differences were found between concentration-response curves of B6C3F1 andmore » Swiss-Webster mice. Saturated aliphatic aldehydes with two or more carbons were nearly 1000 times less potent than formaldehyde. Although the mechanisms responsible for stimulation of trigeminal nerve endings by airborne chemicals are poorly understood, several hypotheses may help to explain the differences seen in this study. For example, the sensory irritation potency of the saturated aliphatic aldehydes diminished with their reported dehydration constants which may determine the degree to which these aldehydes crosslink with receptor proteins. The sensory irritation potency of acrolein and crotonaldehyde was probably due to 1,2 or 1,4 addition reactions. Additionally, molecular conformation and a recently published physical mechanism may contribute to sensory irritation responses, particularly for the less reactive aldehydes. Tentative threshold limit values (TLVs), based upon prevention of sensory irritation, were extrapolated from the RD/sub 50/ values of Swiss-Webster mice. With the exception of crotonaldehyde, good agreement was found with currently published TLVs.« less

Compilation of PZC and IEP of sparingly soluble metal oxides and hydroxides from literature.

PubMed

Kosmulski, Marek

2009-11-30

The values of PZC and IEP of metal oxides reported in the literature are affected by the choice of the specimens to be studied. The specimens, which have PZC and IEP similar to the "recommended" value, are preferred by the scientists. The biased choice leads to accumulation of results for a few specimens, and the other specimens are seldom studied or they are subjected to washing procedures aimed at shift of the original IEP toward the "recommended" value. Taking the average or median of all published PZC and IEP for certain oxide as the "recommended" value leads to substantiation of previously published results due to overrepresentation of certain specimens in the sample.

The Four Ps of Publishing: Demystifying Publishing in Peer-Reviewed Journals for Social Work Doctoral Students

ERIC Educational Resources Information Center

Bender, Kimberly; Windsor, Liliane Cambraia

2010-01-01

Since the 1990s, the field of social work has placed substantial value on social work research. As a result, publishing has become an important aspect of contributing to the social work field. While encouragement for faculty to publish may vary across settings, publication has not traditionally been expected of doctoral students. The purpose of…

Occurrence and distribution of algal biomass and Its relation to nutrients and selected basin characteristics in Indiana streams, 2001-2005

USGS Publications Warehouse

Lowe, B. Scott; Leer, Donald R.; Frey, Jeffrey W.; Caskey, Brian J.

2008-01-01

The seasonal values for nutrients (nitrate, TKN, TN, and TP) and algal biomass (periphyton CHLa, AFDM, seston CHLa, and POC) were compared to published U. S. Environmental Protection Agency (USEPA) values for their respective ecoregions. Algal biomass values either were greater than the 25th percentile published USEPA values or extended the range of data in Aggregate Nutrient Ecoregions VI, VII, IX and USEPA Level III Ecoregions 54, 55, 56, 71, and 72. If the values for the 25th percentile proposed by the USEPA were adopted as nutrient water-quality criteria, then about 71 percent of the nutrient samples and 57 percent of the CHLa samples within the eight study basins would be considered nutrient enriched.

Inappropriate Fiddling with Statistical Analyses to Obtain a Desirable P-value: Tests to Detect its Presence in Published Literature

PubMed Central

Gadbury, Gary L.; Allison, David B.

2012-01-01

Much has been written regarding p-values below certain thresholds (most notably 0.05) denoting statistical significance and the tendency of such p-values to be more readily publishable in peer-reviewed journals. Intuition suggests that there may be a tendency to manipulate statistical analyses to push a “near significant p-value” to a level that is considered significant. This article presents a method for detecting the presence of such manipulation (herein called “fiddling”) in a distribution of p-values from independent studies. Simulations are used to illustrate the properties of the method. The results suggest that the method has low type I error and that power approaches acceptable levels as the number of p-values being studied approaches 1000. PMID:23056287

Anthropometric indicators of obesity as screening tools for high blood pressure in the elderly.

PubMed

Leal Neto, João de Souza; Coqueiro, Raildo da Silva; Freitas, Roberta Souza; Fernandes, Marcos Henrique; Oliveira, Daniela Sousa; Barbosa, Aline Rodrigues

2013-08-01

The study objectives were to investigate the indicators of obesity most associated with high blood pressure in community-dwelling elderly and identify among these which one best discriminates high blood pressure. This is an epidemiological, population, cross-sectional and home-based study of elderly people (≥ 60 years, n = 316) residing in northeastern Brazil. The results showed that the body mass index and the body adiposity index were the indicators more closely associated with high blood pressure in both sexes. Both in female and male genders, body mass index showed high values of specificity and low sensitivity values for discriminating high blood pressure, whereas the body adiposity index showed high sensitivity and moderate specificity values. In clinical practice and health surveillance, it is suggested that both indicators be used as screening tools for hypertension in the elderly. © 2013 Wiley Publishing Asia Pty Ltd.

Emotion and decision-making: affect-driven belief systems in anxiety and depression.

PubMed

Paulus, Martin P; Yu, Angela J

2012-09-01

Emotion processing and decision-making are integral aspects of daily life. However, our understanding of the interaction between these constructs is limited. In this review, we summarize theoretical approaches that link emotion and decision-making, and focus on research with anxious or depressed individuals to show how emotions can interfere with decision-making. We integrate the emotional framework based on valence and arousal with a Bayesian approach to decision-making in terms of probability and value processing. We discuss how studies of individuals with emotional dysfunctions provide evidence that alterations of decision-making can be viewed in terms of altered probability and value computation. We argue that the probabilistic representation of belief states in the context of partially observable Markov decision processes provides a useful approach to examine alterations in probability and value representation in individuals with anxiety and depression, and outline the broader implications of this approach. Copyright © 2012. Published by Elsevier Ltd.

Hydrostatic compression of Fe(1-x)O wuestite

NASA Technical Reports Server (NTRS)

Jeanloz, R.; Sato-Sorensen, Y.

1986-01-01

Hydrostatic compression measurements on Fe(0.95)O wuestite up to 12 GPa yield a room temperature value for the isothermal bulk modulus of K(ot) = 157 (+ or - 10) GPa at zero pressure. This result is in accord with previous hydrostatic and nonhydrostatic measurements of K(ot) for wuestites of composition: 0.89 = Fe/O 0.95. Dynamic measurements of the bulk modulus by ultrasonic, shock-wave and neutron-scattering experiments tend to yield a larger value: K(ot) approximately 180 GPa. The discrepancy between static and dynamic values cannot be explained by the variation of K(ot) with composition, as has been proposed. This conclusion is based on high-precision compression data and on theoretical models of the effects of defects on elastic constants. Barring serious errors in the published measurements, the available data suggest that wuestite exhibits a volume relaxation under pressure.

Bioconcentration of 5,5',6-trichlorobiphenyl and pentachlorophenol in the midge, Chironomus riparius, as measured by a pharmacokinetic model

USGS Publications Warehouse

Lydy, M.J.; Hayton, W.L.; Staubus, A.E.; Fisher, S.W.

1994-01-01

A two compartment pharmacokinetic model was developed which describes the uptake and elimination of 5,5',6-trichlorobiphenyl (TCB) and pentachlorophenol (PCP) in the midge, Chironomus riparius. C. riparius were exposed to nominal TCB (2 ??g L-1) and PCP (9 ??g L-1) concentrations during a 16 h static uptake phase. Depuration was determined over approximately 45 h using a flowthrough system without feeding. The uptake clearance (P) was 330 ?? 61 ml g-1 midge h-1 for TCB and 55 ?? 4 ml g-1 midge h-1 for PCP, while measured bioconcentration factors (BCF) were 35,900 and 458 for TCB and PCP, respectively. Overall, the clearance-volume- based pharmacokinetic model predicted BCF values that were consistent with published values as well as with BCF values obtained from the octanol-water partition coefficient (K(ow)).

A call for a value based approach to laboratory medicine funding.

PubMed

St John, A; Edwards, G; Fisher, S; Badrick, T; Callahan, J; Crothers, J

2015-09-01

All areas of healthcare, including pathology, are being challenged by the reality that the days of ever increasing budgets are over and the key debate is about how to provide value for money. As originally described by Porter and Tiesberg, value-based healthcare is defined as maximising outcomes over cost by moving away from fee for service models to ones that reward providers on the basis of outcomes (1). While production efficiencies will continue to evolve, the opportunities for future stepwise improvements in production costs are likely to have diminished. The focus now is on delivering improved testing outcomes in a relatively cost neutral or at least cost effective way. This brings pathology into line with other health services that focus on value for money for payers, and maximising health outcomes for consumers. This would signal a break from the existing pathology funding model, which does not directly recognise or reward the contribution of pathology towards improved health outcomes, or seek to decommission tests that offer little clinical value. Pathology has a direct impact on clinical and economic outcomes that extend from testing and it is important to garner support for a new approach to funding that incentivises improvements of the overall quality and contribution of the pathology service. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Measuring the value of process improvement initiatives in a preoperative assessment center using time-driven activity-based costing.

PubMed

French, Katy E; Albright, Heidi W; Frenzel, John C; Incalcaterra, James R; Rubio, Augustin C; Jones, Jessica F; Feeley, Thomas W

2013-12-01

The value and impact of process improvement initiatives are difficult to quantify. We describe the use of time-driven activity-based costing (TDABC) in a clinical setting to quantify the value of process improvements in terms of cost, time and personnel resources. Difficulty in identifying and measuring the cost savings of process improvement initiatives in a Preoperative Assessment Center (PAC). Use TDABC to measure the value of process improvement initiatives that reduce the costs of performing a preoperative assessment while maintaining the quality of the assessment. Apply the principles of TDABC in a PAC to measure the value, from baseline, of two phases of performance improvement initiatives and determine the impact of each implementation in terms of cost, time and efficiency. Through two rounds of performance improvements, we quantified an overall reduction in time spent by patient and personnel of 33% that resulted in a 46% reduction in the costs of providing care in the center. The performance improvements resulted in a 17% decrease in the total number of full time equivalents (FTE's) needed to staff the center and a 19% increase in the numbers of patients assessed in the center. Quality of care, as assessed by the rate of cancellations on the day of surgery, was not adversely impacted by the process improvements. © 2013 Published by Elsevier Inc.

Variation in hair δ13C and δ15N values in long-tailed macaques (Macaca fascicularis) from Singapore

USGS Publications Warehouse

Schillaci, Michael A.; Castellini, J. Margaret; Stricker, Craig A.; Jones-Engel, Lisa; Lee, Benjamin P.Y.-H.

2014-01-01

Much of the primatology literature on stable isotope ratios of carbon (δ13C) and nitrogen (δ15N) has focused on African and New World species, with comparatively little research published on Asian primates. Here we present hair δ13C and δ15N isotope values for a sample of 33 long-tailed macaques from Singapore. We evaluate the suggestion by a previous researcher that forest degradation and biodiversity loss in Singapore have led to a decline in macaque trophic level. The results of our analysis indicated significant spatial variability in δ13C but not δ15N. The range of variation in δ13C was consistent with a diet based on C3 resources, with one group exhibiting low values consistent with a closed canopy environment. Relative to other macaque species from Europe and Asia, the macaques from Singapore exhibited a low mean δ13C value but mid-range mean δ15N value. Previous research suggesting a decline in macaque trophic level is not supported by the results of our study.

2012 Nitrogen Dioxide Monitoring Site Design Values

EPA Pesticide Factsheets

A design value is a statistic that describes the air quality status of a given location relative to the level of the National Ambient Air Quality Standards (NAAQS). Design values are defined to be consistent with the individual NAAQS as described in CFR Part 50. They are typically used to designate and classify nonattainment areas, as well as to assess progress towards meeting the NAAQS. To view a list of areas designated nonattainment, see EPA's Green Book site. Design values are computed and published annually by EPA's Office of Air Quality Planning and Standards and reviewed in conjunction with the EPA Regional Offices. Some of these design values can change after the date of publication for a variety of reasons, including but not limited to: 1) EPA agreement that certain data were influenced by exceptional events and therefore not subject for comparison with the NAAQS, 2) States retroactively entering or changing erroneous data based on later findings, and/or 3) notification of a monitoring issue (e.g. network design, site combination, change in the regulatory status of a monitor) that would prompt a revision.

Brain Tissue Compartment Density Estimated Using Diffusion-Weighted MRI Yields Tissue Parameters Consistent With Histology

PubMed Central

Sepehrband, Farshid; Clark, Kristi A.; Ullmann, Jeremy F.P.; Kurniawan, Nyoman D.; Leanage, Gayeshika; Reutens, David C.; Yang, Zhengyi

2015-01-01

We examined whether quantitative density measures of cerebral tissue consistent with histology can be obtained from diffusion magnetic resonance imaging (MRI). By incorporating prior knowledge of myelin and cell membrane densities, absolute tissue density values were estimated from relative intra-cellular and intra-neurite density values obtained from diffusion MRI. The NODDI (neurite orientation distribution and density imaging) technique, which can be applied clinically, was used. Myelin density estimates were compared with the results of electron and light microscopy in ex vivo mouse brain and with published density estimates in a healthy human brain. In ex vivo mouse brain, estimated myelin densities in different sub-regions of the mouse corpus callosum were almost identical to values obtained from electron microscopy (Diffusion MRI: 42±6%, 36±4% and 43±5%; electron microscopy: 41±10%, 36±8% and 44±12% in genu, body and splenium, respectively). In the human brain, good agreement was observed between estimated fiber density measurements and previously reported values based on electron microscopy. Estimated density values were unaffected by crossing fibers. PMID:26096639

Brief communication: the relation between standard error of the estimate and sample size of histomorphometric aging methods.

PubMed

Hennig, Cheryl; Cooper, David

2011-08-01

Histomorphometric aging methods report varying degrees of precision, measured through Standard Error of the Estimate (SEE). These techniques have been developed from variable samples sizes (n) and the impact of n on reported aging precision has not been rigorously examined in the anthropological literature. This brief communication explores the relation between n and SEE through a review of the literature (abstracts, articles, book chapters, theses, and dissertations), predictions based upon sampling theory and a simulation. Published SEE values for age prediction, derived from 40 studies, range from 1.51 to 16.48 years (mean 8.63; sd: 3.81 years). In general, these values are widely distributed for smaller samples and the distribution narrows as n increases--a pattern expected from sampling theory. For the two studies that have samples in excess of 200 individuals, the SEE values are very similar (10.08 and 11.10 years) with a mean of 10.59 years. Assuming this mean value is a 'true' characterization of the error at the population level, the 95% confidence intervals for SEE values from samples of 10, 50, and 150 individuals are on the order of ± 4.2, 1.7, and 1.0 years, respectively. While numerous sources of variation potentially affect the precision of different methods, the impact of sample size cannot be overlooked. The uncertainty associated with SEE values derived from smaller samples complicates the comparison of approaches based upon different methodology and/or skeletal elements. Meaningful comparisons require larger samples than have frequently been used and should ideally be based upon standardized samples. Copyright © 2011 Wiley-Liss, Inc.

"Taste Strips" - a rapid, lateralized, gustatory bedside identification test based on impregnated filter papers.

PubMed

Landis, Basile Nicolas; Welge-Luessen, Antje; Brämerson, Annika; Bende, Mats; Mueller, Christian Albert; Nordin, Steven; Hummel, Thomas

2009-02-01

To elaborate normative values for a clinical psychophysical taste test ("Taste Strips"). The "Taste Strips" are a psychophysical chemical taste test. So far, no definitive normative data had been published and only a fairly small sample size has been investigated. In light of this shortcoming for this easy, reliable and quick taste testing device, we attempted to provide normative values suitable for the clinical use. Normative value acquisition study, multicenter study. The investigation involved 537 participants reporting a normal sense of smell and taste (318 female, 219 male, mean age 44 years, age range 18-87 years). The taste test was based on spoon-shaped filter paper strips ("Taste Strips") impregnated with the four (sweet, sour, salty, and bitter) taste qualities in four different concentrations. The strips were placed on the left or right side of the anterior third of the extended tongue, resulting in a total of 32 trials. With their tongue still extended, patients had to identify the taste from a list of four descriptors, i. e., sweet, sour, salty, and bitter (multiple forced-choice). To obtain an impression of overall gustatory function, the number of correctly identified tastes was summed up for a "taste score". Taste function decreased significantly with age. Women exhibited significantly higher taste scores than men which was true for all age groups. The taste score at the 10(th) percentile was selected as a cut-off value to distinguish normogeusia from hypogeusia. Results from a small series of patients with ageusia confirmed the clinical usefulness of the proposed normative values. The present data provide normative values for the "Taste Strips" based on over 500 subjects tested.

Using physiologically based pharmacokinetic modeling and benchmark dose methods to derive an occupational exposure limit for N-methylpyrrolidone.

PubMed

Poet, T S; Schlosser, P M; Rodriguez, C E; Parod, R J; Rodwell, D E; Kirman, C R

2016-04-01

The developmental effects of NMP are well studied in Sprague-Dawley rats following oral, inhalation, and dermal routes of exposure. Short-term and chronic occupational exposure limit (OEL) values were derived using an updated physiologically based pharmacokinetic (PBPK) model for NMP, along with benchmark dose modeling. Two suitable developmental endpoints were evaluated for human health risk assessment: (1) for acute exposures, the increased incidence of skeletal malformations, an effect noted only at oral doses that were toxic to the dam and fetus; and (2) for repeated exposures to NMP, changes in fetal/pup body weight. Where possible, data from multiple studies were pooled to increase the predictive power of the dose-response data sets. For the purposes of internal dose estimation, the window of susceptibility was estimated for each endpoint, and was used in the dose-response modeling. A point of departure value of 390 mg/L (in terms of peak NMP in blood) was calculated for skeletal malformations based on pooled data from oral and inhalation studies. Acceptable dose-response model fits were not obtained using the pooled data for fetal/pup body weight changes. These data sets were also assessed individually, from which the geometric mean value obtained from the inhalation studies (470 mg*hr/L), was used to derive the chronic OEL. A PBPK model for NMP in humans was used to calculate human equivalent concentrations corresponding to the internal dose point of departure values. Application of a net uncertainty factor of 20-21, which incorporates data-derived extrapolation factors, to the point of departure values yields short-term and chronic occupational exposure limit values of 86 and 24 ppm, respectively. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

77 FR 66464 - Federal Acquisition Regulation; Submission for OMB Review; Value Engineering Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-05

...; Submission for OMB Review; Value Engineering Requirements AGENCIES: Department of Defense (DOD), General... collection requirement concerning Value Engineering Requirements. A notice was published in the Federal... comments identified by Information Collection 9000- 0027, Value Engineering Requirements, by any of the...

Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data.

PubMed

Browne, Joyce L; Kayode, Gbenga A; Arhinful, Daniel; Fidder, Samuel A J; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin

2016-03-18

This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care. A population-based cross-sectional study. We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status. Utilisation of antenatal, skilled delivery and postnatal care. Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care. After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p value<0.001) and of skilled delivery by 129% (OR 2.29; 95% CI 1.92 to 2.74; p value<0.001), while postnatal care among insured women increased by 61% (OR 1.61; 95% CI 1.17 to 2.21; p value<0.01). This study demonstrated that maternal health insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service. 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/

Role of milk protein-based products in some quality attributes of goat milk yogurt.

PubMed

Gursel, A; Gursoy, A; Anli, E A K; Budak, S O; Aydemir, S; Durlu-Ozkaya, F

2016-04-01

Goat milk yogurts were manufactured with the fortification of 2% (wt/vol) skim goat milk powder (SGMP), sodium caseinate (NaCn), whey protein concentrate (WPC), whey protein isolate (WPI), or yogurt texture improver (YTI). Yogurts were characterized based on compositional, microbiological, and textural properties; volatile flavor components (with gas chromatography); and sensory analyses during storage (21d at 5 °C). Compared with goat milk yogurt made by using SGMP, the other goat milk yogurt variants had higher protein content and lower acidity values. Goat milk yogurts with NaCn and WPC, in particular, had better physical characteristics. Using WPI caused the hardest structure in yogurt, leading to higher syneresis values. Acetaldehyde and ethanol formation increased with the incorporation of WPI, WPC, or YTI to yogurt milk. The tyrosine value especially was higher in the samples with NaCn and YTI than in the samples with WPC and WPI. Counts of Streptococcus thermophilus were higher than the counts of Lactobacillus delbrueckii ssp. bulgaricus, possibly due to a stimulatory effect of milk protein-based ingredients other than SGMP on the growth of S. thermophilus. Yogurt with NaCn was the best accepted among the yogurts. For the parameters used, milk protein-based products such as NaCn or WPC have promising features as suitable ingredients for goat milk yogurt manufacture. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Using a Root Cause Analysis Curriculum for Practice-Based Learning and Improvement in General Surgery Residency.

PubMed

Ramanathan, Rajesh; Duane, Therese M; Kaplan, Brian J; Farquhar, Doris; Kasirajan, Vigneshwar; Ferrada, Paula

2015-01-01

To describe and evaluate a root cause analysis (RCA)-based educational curriculum for quality improvement (QI) practice-based learning and implementation in general surgery residency. A QI curriculum was designed using RCA and spaced-learning approaches to education. The program included a didactic session about the RCA methodology. Resident teams comprising multiple postgraduate years then selected a personal complication, completed an RCA, and presented the findings to the Department of Surgery. Mixed methods consisting of quantitative assessment of performance and qualitative feedback about the program were used to assess the value, strengths, and limitations of the program. Urban tertiary academic medical center. General surgery residents, faculty, and medical students. An RCA was completed by 4 resident teams for the following 4 adverse outcomes: postoperative neck hematoma, suboptimal massive transfusion for trauma, venous thromboembolism, and decubitus ulcer complications. Quantitative peer assessment of their performance revealed proficiency in selecting an appropriate case, defining the central problem, identifying root causes, and proposing solutions. During the qualitative feedback assessment, residents noted value of the course, with the greatest limitation being time constraints and equal participation. An RCA-based curriculum can provide general surgery residents with QI exposure and training that they value. Barriers to successful implementation include time restrictions and equal participation from all involved members. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Hospital-Based Comparative Effectiveness Centers: Translating Research into Practice to Improve the Quality, Safety and Value of Patient Care

PubMed Central

Williams, Kendal; Brennan, Patrick J.

2010-01-01

Hospital-based comparative effectiveness (CE) centers provide a model that clinical leaders can use to improve evidence-based practice locally. The model is used by integrated health systems outside the US, but is less recognized in the US. Such centers can identify and adapt national evidence-based policies for the local setting, create local evidence-based policies in the absence of national policies, and implement evidence into practice through health information technology (HIT) and quality initiatives. Given the increasing availability of CE evidence and incentives to meaningfully use HIT, the relevance of this model to US practitioners is increasing. This is especially true in the context of healthcare reform, which will likely reduce reimbursements for care deemed unnecessary by published evidence or guidelines. There are challenges to operating hospital-based CE centers, but many of these challenges can be overcome using solutions developed by those currently leading such centers. In conclusion, these centers have the potential to improve the quality, safety and value of care locally, ultimately translating into higher quality and more cost-effective care nationally. To better understand this potential, the current activity and impact of hospital-based CE centers in the US should be rigorously examined. PMID:20697961

Precise Determination of the Intensity of 226Ra Alpha Decay to the 186 keV Excited State

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

S.P. LaMont; R.J. Gehrke; S.E. Glover

There is a significant discrepancy in the reported values for the emission probability of the 186 keV gamma-ray resulting from the alpha decay of 226 Ra to 186 keV excited state of 222 Rn. Published values fall in the range of 3.28 to 3.59 gamma-rays per 100 alpha-decays. An interesting observation is that the lower value, 3.28, is based on measuring the 186 keV gamma-ray intensity relative to the 226 Ra alpha-branch to the 186 keV level. The higher values, which are close to 3.59, are based on measuring the gamma-ray intensity from mass standards of 226 Ra that aremore » traceable to the mass standards prepared by HÓNIGSCHMID in the early 1930''s. This discrepancy was resolved in this work by carefully measuring the 226 Ra alpha-branch intensities, then applying the theoretical E2 multipolarity internal conversion coefficient of 0.692±0.007 to calculate the 186 keV gamma-ray emission probability. The measured value for the alpha branch to the 186 keV excited state was (6.16±0.03)%, which gives a 186 keV gamma-ray emission probability of (3.64±0.04)%. This value is in excellent agreement with the most recently reported 186 keV gamma-ray emission probabilities determined using 226 Ra mass standards.« less

Diagnostic accuracy of APRI and FIB-4 for predicting hepatitis B virus-related liver fibrosis accompanied with hepatocellular carcinoma.

PubMed

Xiao, Guangqin; Zhu, Feng; Wang, Min; Zhang, Hang; Ye, Dawei; Yang, Jiayin; Jiang, Li; Liu, Chang; Yan, Lunan; Qin, Renyi

2016-10-01

Aspartate aminotransferase to platelet ratio index (APRI) and the fibrosis index based on four factors (FIB-4) are the two most focused non-invasive models to assess liver fibrosis. We aimed to examine the validity of these two models for predicting hepatitis B virus (HBV)-related liver fibrosis accompanied with hepatocellular carcinoma (HCC). We enrolled HBV-infected patients with liver cancer who had received hepatectomy. The accuracy of APRI and FIB-4 for diagnosing liver fibrosis was assessed based on their sensitivity, specificity, diagnostic efficiency, positive predictive value (PPV), negative predictive value (NPV), kappa (κ) value and area under the receiver-operating characteristic curve (AUC). Finally 2176 patients were included, with 1682 retrospective subjects and 494 prospective subjects. APRI (rs=0.310) and FIB-4 (rs=0.278) were positively correlated with liver fibrosis. And χ(2) analysis demonstrated that APRI and FIB-4 values correlated with different levels of liver fibrosis with all P values less than 0.01. The AUC values for APRI and FIB-4 were 0.685 and 0.626 (P=0.73) for predicting significant fibrosis, 0.681 and 0.648 (P=0.81) for differentiation of advanced fibrosis and 0.676 and 0.652 (P=0.77) for diagnosing cirrhosis. APRI and FIB-4 correlate with liver fibrosis. However these two models have low accuracy for predicting HBV-related liver fibrosis in HCC patients. Copyright © 2016. Published by Elsevier Ltd.

Designing the Information Literacy Competency Standards for nursing.

PubMed

Phelps, Sue F

2013-01-01

This column documents the rationale for creating information literacy competency standards for nursing based on the Association of College and Research Libraries (ACRL) "Information Literacy Competency Standards for Higher Education" and the three documents from the American Association of Colleges of Nursing (AACN) on essential skills for nurses in baccalaureate, masters, and doctoral level education and practice. It chronicles the process of the task force which is designing the discipline specific skills and predicts the value of their use, once they are published.

Micromachined modulator arrays for use in free-space optical communication systems

NASA Astrophysics Data System (ADS)

Lewis, Keith L.; Ridley, Kevin D.; McNie, Mark E.; Smith, Gilbert W.; Scott, Andrew M.

2004-12-01

A summary is presented of some of the design criteria relevant to the realisation of silicon micromachined modulator arrays for use in free-space optical communication systems. Theoretical performance levels achievable are compared with values measured on experimental devices produced using a modified Multi-User MEMS Process (MUMPS). Devices capable of realising modulation rates in excess of 300 kHz are described and their optical characteristics compared with published data on devices based on multiple quantum well technology.

Seminar on Basic Documentation Practices (Les Pratiques de Base en Matiere de Documentation)

DTIC Science & Technology

1992-08-01

information might be of high S ...........I................... interest to a competitor because of its commercial value, since its knowledge might save years...Consultant and Exchange Programme ofAGARD presented on" 3rd--4th.September 1992 in Ankara, Turkey, 7th--gth September 1992 in Athen~ s , Greece and lIt...l lth September 1992 in Lisbon, Portugal. S ~NORTH ATLANTIC TREATY ORGANIZATION Published August 1992 I Ditrbtinand Availability on Back Cover AGARD-R

Editorial Commentary: Rising Interest in "Big Data" in Arthroscopy: Is the Juice Worth the Squeeze?

PubMed

Pugely, Andrew J; Bozic, Kevin J

2017-01-01

The use of "big data" in orthopaedic sports medicine research is on the rise. Greater access to data sources that allow for analysis of outpatient procedures has contributed to this surge. Important advantages and disadvantages to each database exist and should be understood to properly interpret these studies. In the era of value-based medicine, this macro data will drive policy and payment. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

CHEST: Home of the Clinician-Educator.

PubMed

Kelly, William F; Niven, Alexander S

2018-03-01

Many hands can build a house; it takes trust to make that house a home. Trust has two main components: credibility (worthiness based on preparation and past performance) and empathy (the ability to understand and share another person's values). CHEST has maintained its credibility and empathy as the global leader in clinical pulmonary, critical care, and sleep medical education. It follows that the leader in chest clinical education would also be the home of the clinician-educator. You are that educator. Published by Elsevier Inc.

Receding horizon online optimization for torque control of gasoline engines.

PubMed

Kang, Mingxin; Shen, Tielong

2016-11-01

This paper proposes a model-based nonlinear receding horizon optimal control scheme for the engine torque tracking problem. The controller design directly employs the nonlinear model exploited based on mean-value modeling principle of engine systems without any linearizing reformation, and the online optimization is achieved by applying the Continuation/GMRES (generalized minimum residual) approach. Several receding horizon control schemes are designed to investigate the effects of the integral action and integral gain selection. Simulation analyses and experimental validations are implemented to demonstrate the real-time optimization performance and control effects of the proposed torque tracking controllers. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

Inventory count strategies.

PubMed

Springer, W H

1996-02-01

An important principle of accounting is that asset inventory needs to be correctly valued to ensure that the financial statements of the institution are accurate. Errors is recording the value of ending inventory in one fiscal year result in errors to published financial statements for that year as well as the subsequent fiscal year. Therefore, it is important that accurate physical counts be periodically taken. It is equally important that any system being used to generate inventory valuation, reordering or management reports be based on consistently accurate on-hand balances. At the foundation of conducting an accurate physical count of an inventory is a comprehensive understanding of the process coupled with a written plan. This article presents a guideline of the physical count processes involved in a traditional double-count approach.

A Weibull statistics-based lignocellulose saccharification model and a built-in parameter accurately predict lignocellulose hydrolysis performance.

PubMed

Wang, Mingyu; Han, Lijuan; Liu, Shasha; Zhao, Xuebing; Yang, Jinghua; Loh, Soh Kheang; Sun, Xiaomin; Zhang, Chenxi; Fang, Xu

2015-09-01

Renewable energy from lignocellulosic biomass has been deemed an alternative to depleting fossil fuels. In order to improve this technology, we aim to develop robust mathematical models for the enzymatic lignocellulose degradation process. By analyzing 96 groups of previously published and newly obtained lignocellulose saccharification results and fitting them to Weibull distribution, we discovered Weibull statistics can accurately predict lignocellulose saccharification data, regardless of the type of substrates, enzymes and saccharification conditions. A mathematical model for enzymatic lignocellulose degradation was subsequently constructed based on Weibull statistics. Further analysis of the mathematical structure of the model and experimental saccharification data showed the significance of the two parameters in this model. In particular, the λ value, defined the characteristic time, represents the overall performance of the saccharification system. This suggestion was further supported by statistical analysis of experimental saccharification data and analysis of the glucose production levels when λ and n values change. In conclusion, the constructed Weibull statistics-based model can accurately predict lignocellulose hydrolysis behavior and we can use the λ parameter to assess the overall performance of enzymatic lignocellulose degradation. Advantages and potential applications of the model and the λ value in saccharification performance assessment were discussed. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Can value-based insurance impose societal costs?

PubMed

Koenig, Lane; Dall, Timothy M; Ruiz, David; Saavoss, Josh; Tongue, John

2014-09-01

Among policy alternatives considered to reduce health care costs and improve outcomes, value-based insurance design (VBID) has emerged as a promising option. Most applications of VBID, however, have not used higher cost sharing to discourage specific services. In April 2011, the state of Oregon introduced a policy for public employees that required additional cost sharing for high-cost procedures such as total knee arthroplasty (TKA). Our objectives were to estimate the societal impact of higher co-pays for TKA using Oregon as a case study and building on recent work demonstrating the effects of knee osteoarthritis and surgical treatment on employment and disability outcomes. We used a Markov model to estimate the societal impact in terms of quality of life, direct costs, and indirect costs of higher co-pays for TKA using Oregon as a case study. We found that TKA for a working population can generate societal benefits that offset the direct medical costs of the procedure. Delay in receiving surgical care, because of higher co-payment or other reasons, reduced the societal savings from TKA. We conclude that payers moving toward value-based cost sharing should consider consequences beyond direct medical expenses. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The application and value of information sources in clinical practice: an examination of the perspective of naturopaths.

PubMed

Steel, Amie; Adams, Jon

2011-06-01

The approach of evidence-based medicine (EBM), providing a paradigm to validate information sources and a process for critiquing their value, is an important platform for guiding practice. Researchers have explored the application and value of information sources in clinical practice with regard to a range of health professions; however, naturopathic practice has been overlooked. An exploratory study of naturopaths' perspectives of the application and value of information sources has been undertaken. Semi-structured interviews with 12 naturopaths in current clinical practice, concerning the information sources used in clinical practice and their perceptions of these sources. Thematic analysis identified differences in the application of the variety of information sources used, depending upon the perceived validity. Internet databases were viewed as highly valid. Textbooks, formal education and interpersonal interactions were judged based upon a variety of factors, whilst validation of general internet sites and manufacturers information was required prior to use. The findings of this study will provide preliminary aid to those responsible for supporting naturopaths' information use and access. In particular, it may assist publishers, medical librarians and professional associations in developing strategies to expand the clinically useful information sources available to naturopaths. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

Valuing Trial Designs from a Pharmaceutical Perspective Using Value-Based Pricing.

PubMed

Breeze, Penny; Brennan, Alan

2015-11-01

Our aim was to adapt the traditional framework for expected net benefit of sampling (ENBS) to be more compatible with drug development trials from the pharmaceutical perspective. We modify the traditional framework for conducting ENBS and assume that the price of the drug is conditional on the trial outcomes. We use a value-based pricing (VBP) criterion to determine price conditional on trial data using Bayesian updating of cost-effectiveness (CE) model parameters. We assume that there is a threshold price below which the company would not market the new intervention. We present a case study in which a phase III trial sample size and trial duration are varied. For each trial design, we sampled 10,000 trial outcomes and estimated VBP using a CE model. The expected commercial net benefit is calculated as the expected profits minus the trial costs. A clinical trial with shorter follow-up, and larger sample size, generated the greatest expected commercial net benefit. Increasing the duration of follow-up had a modest impact on profit forecasts. Expected net benefit of sampling can be adapted to value clinical trials in the pharmaceutical industry to optimise the expected commercial net benefit. However, the analyses can be very time consuming for complex CE models. © 2014 The Authors. Health Economics published by John Wiley & Sons Ltd.

Prediction models for the risk of spontaneous preterm birth based on maternal characteristics: a systematic review and independent external validation.

PubMed

Meertens, Linda J E; van Montfort, Pim; Scheepers, Hubertina C J; van Kuijk, Sander M J; Aardenburg, Robert; Langenveld, Josje; van Dooren, Ivo M A; Zwaan, Iris M; Spaanderman, Marc E A; Smits, Luc J M

2018-04-17

Prediction models may contribute to personalized risk-based management of women at high risk of spontaneous preterm delivery. Although prediction models are published frequently, often with promising results, external validation generally is lacking. We performed a systematic review of prediction models for the risk of spontaneous preterm birth based on routine clinical parameters. Additionally, we externally validated and evaluated the clinical potential of the models. Prediction models based on routinely collected maternal parameters obtainable during first 16 weeks of gestation were eligible for selection. Risk of bias was assessed according to the CHARMS guidelines. We validated the selected models in a Dutch multicenter prospective cohort study comprising 2614 unselected pregnant women. Information on predictors was obtained by a web-based questionnaire. Predictive performance of the models was quantified by the area under the receiver operating characteristic curve (AUC) and calibration plots for the outcomes spontaneous preterm birth <37 weeks and <34 weeks of gestation. Clinical value was evaluated by means of decision curve analysis and calculating classification accuracy for different risk thresholds. Four studies describing five prediction models fulfilled the eligibility criteria. Risk of bias assessment revealed a moderate to high risk of bias in three studies. The AUC of the models ranged from 0.54 to 0.67 and from 0.56 to 0.70 for the outcomes spontaneous preterm birth <37 weeks and <34 weeks of gestation, respectively. A subanalysis showed that the models discriminated poorly (AUC 0.51-0.56) for nulliparous women. Although we recalibrated the models, two models retained evidence of overfitting. The decision curve analysis showed low clinical benefit for the best performing models. This review revealed several reporting and methodological shortcomings of published prediction models for spontaneous preterm birth. Our external validation study indicated that none of the models had the ability to predict spontaneous preterm birth adequately in our population. Further improvement of prediction models, using recent knowledge about both model development and potential risk factors, is necessary to provide an added value in personalized risk assessment of spontaneous preterm birth. © 2018 The Authors Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

Excel-Based Tool for Pharmacokinetically Guided Dose Adjustment of Paclitaxel.

PubMed

Kraff, Stefanie; Lindauer, Andreas; Joerger, Markus; Salamone, Salvatore J; Jaehde, Ulrich

2015-12-01

Neutropenia is a frequent and severe adverse event in patients receiving paclitaxel chemotherapy. The time above a paclitaxel threshold concentration of 0.05 μmol/L (Tc > 0.05 μmol/L) is a strong predictor for paclitaxel-associated neutropenia and has been proposed as a target pharmacokinetic (PK) parameter for paclitaxel therapeutic drug monitoring and dose adaptation. Up to now, individual Tc > 0.05 μmol/L values are estimated based on a published PK model of paclitaxel by using the software NONMEM. Because many clinicians are not familiar with the use of NONMEM, an Excel-based dosing tool was developed to allow calculation of paclitaxel Tc > 0.05 μmol/L and give clinicians an easy-to-use tool. Population PK parameters of paclitaxel were taken from a published PK model. An Alglib VBA code was implemented in Excel 2007 to compute differential equations for the paclitaxel PK model. Maximum a posteriori Bayesian estimates of the PK parameters were determined with the Excel Solver using individual drug concentrations. Concentrations from 250 patients were simulated receiving 1 cycle of paclitaxel chemotherapy. Predictions of paclitaxel Tc > 0.05 μmol/L as calculated by the Excel tool were compared with NONMEM, whereby maximum a posteriori Bayesian estimates were obtained using the POSTHOC function. There was a good concordance and comparable predictive performance between Excel and NONMEM regarding predicted paclitaxel plasma concentrations and Tc > 0.05 μmol/L values. Tc > 0.05 μmol/L had a maximum bias of 3% and an error on precision of <12%. The median relative deviation of the estimated Tc > 0.05 μmol/L values between both programs was 1%. The Excel-based tool can estimate the time above a paclitaxel threshold concentration of 0.05 μmol/L with acceptable accuracy and precision. The presented Excel tool allows reliable calculation of paclitaxel Tc > 0.05 μmol/L and thus allows target concentration intervention to improve the benefit-risk ratio of the drug. The easy use facilitates therapeutic drug monitoring in clinical routine.

Quantifying the utility of taking pills for preventing adverse health outcomes: a cross-sectional survey.

PubMed

Hutchins, Robert; Pignone, Michael P; Sheridan, Stacey L; Viera, Anthony J

2015-05-11

The utility value attributed to taking pills for prevention can have a major effect on the cost-effectiveness of interventions, but few published studies have systematically quantified this value. We sought to quantify the utility value of taking pills used for prevention of cardiovascular disease (CVD). Cross-sectional survey. Central North Carolina. 708 healthcare employees aged 18 years and older. Utility values for taking 1 pill/day, assessed using time trade-off, modified standard gamble and willingness-to-pay methods. Mean age of respondents was 43 years (19-74). The majority of the respondents were female (83%) and Caucasian (80%). Most (80%) took at least 2 pills/day. Mean utility values for taking 1 pill/day using the time trade-off method were: 0.9972 (95% CI 0.9962 to 0.9980). Values derived from the standard gamble and willingness-to-pay methods were 0.9967 (0.9954 to 0.9979) and 0.9989 (95% CI 0.9986 to 0.9991), respectively. Utility values varied little across characteristics such as age, sex, race, education level or number of pills taken per day. The utility value of taking pills daily in order to prevent an adverse CVD health outcome is approximately 0.997. 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.

Reconsidering the use of rankings in the valuation of health states: a model for estimating cardinal values from ordinal data

PubMed Central

Salomon, Joshua A

2003-01-01

Background In survey studies on health-state valuations, ordinal ranking exercises often are used as precursors to other elicitation methods such as the time trade-off (TTO) or standard gamble, but the ranking data have not been used in deriving cardinal valuations. This study reconsiders the role of ordinal ranks in valuing health and introduces a new approach to estimate interval-scaled valuations based on aggregate ranking data. Methods Analyses were undertaken on data from a previously published general population survey study in the United Kingdom that included rankings and TTO values for hypothetical states described using the EQ-5D classification system. The EQ-5D includes five domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) with three possible levels on each. Rank data were analysed using a random utility model, operationalized through conditional logit regression. In the statistical model, probabilities of observed rankings were related to the latent utilities of different health states, modeled as a linear function of EQ-5D domain scores, as in previously reported EQ-5D valuation functions. Predicted valuations based on the conditional logit model were compared to observed TTO values for the 42 states in the study and to predictions based on a model estimated directly from the TTO values. Models were evaluated using the intraclass correlation coefficient (ICC) between predictions and mean observations, and the root mean squared error of predictions at the individual level. Results Agreement between predicted valuations from the rank model and observed TTO values was very high, with an ICC of 0.97, only marginally lower than for predictions based on the model estimated directly from TTO values (ICC = 0.99). Individual-level errors were also comparable in the two models, with root mean squared errors of 0.503 and 0.496 for the rank-based and TTO-based predictions, respectively. Conclusions Modeling health-state valuations based on ordinal ranks can provide results that are similar to those obtained from more widely analyzed valuation techniques such as the TTO. The information content in aggregate ranking data is not currently exploited to full advantage. The possibility of estimating cardinal valuations from ordinal ranks could also simplify future data collection dramatically and facilitate wider empirical study of health-state valuations in diverse settings and population groups. PMID:14687419

Accurate Diabetes Risk Stratification Using Machine Learning: Role of Missing Value and Outliers.

PubMed

Maniruzzaman, Md; Rahman, Md Jahanur; Al-MehediHasan, Md; Suri, Harman S; Abedin, Md Menhazul; El-Baz, Ayman; Suri, Jasjit S

2018-04-10

Diabetes mellitus is a group of metabolic diseases in which blood sugar levels are too high. About 8.8% of the world was diabetic in 2017. It is projected that this will reach nearly 10% by 2045. The major challenge is that when machine learning-based classifiers are applied to such data sets for risk stratification, leads to lower performance. Thus, our objective is to develop an optimized and robust machine learning (ML) system under the assumption that missing values or outliers if replaced by a median configuration will yield higher risk stratification accuracy. This ML-based risk stratification is designed, optimized and evaluated, where: (i) the features are extracted and optimized from the six feature selection techniques (random forest, logistic regression, mutual information, principal component analysis, analysis of variance, and Fisher discriminant ratio) and combined with ten different types of classifiers (linear discriminant analysis, quadratic discriminant analysis, naïve Bayes, Gaussian process classification, support vector machine, artificial neural network, Adaboost, logistic regression, decision tree, and random forest) under the hypothesis that both missing values and outliers when replaced by computed medians will improve the risk stratification accuracy. Pima Indian diabetic dataset (768 patients: 268 diabetic and 500 controls) was used. Our results demonstrate that on replacing the missing values and outliers by group median and median values, respectively and further using the combination of random forest feature selection and random forest classification technique yields an accuracy, sensitivity, specificity, positive predictive value, negative predictive value and area under the curve as: 92.26%, 95.96%, 79.72%, 91.14%, 91.20%, and 0.93, respectively. This is an improvement of 10% over previously developed techniques published in literature. The system was validated for its stability and reliability. RF-based model showed the best performance when outliers are replaced by median values.

Quantitative Analysis of Complex Drug-Drug Interactions Between Repaglinide and Cyclosporin A/Gemfibrozil Using Physiologically Based Pharmacokinetic Models With In Vitro Transporter/Enzyme Inhibition Data.

PubMed

Kim, Soo-Jin; Toshimoto, Kota; Yao, Yoshiaki; Yoshikado, Takashi; Sugiyama, Yuichi

2017-09-01

Quantitative analysis of transporter- and enzyme-mediated complex drug-drug interactions (DDIs) is challenging. Repaglinide (RPG) is transported into the liver by OATP1B1 and then is metabolized by CYP2C8 and CYP3A4. The purpose of this study was to describe the complex DDIs of RPG quantitatively based on unified physiologically based pharmacokinetic (PBPK) models using in vitro K i values for OATP1B1, CYP3A4, and CYP2C8. Cyclosporin A (CsA) or gemfibrozil (GEM) increased the blood concentrations of RPG. The time profiles of RPG and the inhibitors were analyzed by PBPK models, considering the inhibition of OATP1B1 and CYP3A4 by CsA or OATP1B1 inhibition by GEM and its glucuronide and the mechanism-based inhibition of CYP2C8 by GEM glucuronide. RPG-CsA interaction was closely predicted using a reported in vitro K i,OATP1B1 value in the presence of CsA preincubation. RPG-GEM interaction was underestimated compared with observed data, but the simulation was improved with the increase of f m,CYP2C8 . These results based on in vitro K i values for transport and metabolism suggest the possibility of a bottom-up approach with in vitro inhibition data for the prediction of complex DDIs using unified PBPK models and in vitro f m value of a substrate for multiple enzymes should be considered carefully for the prediction. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Cutoff value of Japanese Orthopaedic Association shoulder score in patients with rotator cuff repair: Based on the University of California at Los Angeles shoulder score.

PubMed

Imai, Takaki; Gotoh, Masafumi; Tokunaga, Tsuyoshi; Kawakami, Jyunichi; Mitsui, Yasuhiro; Fukuda, Keiji; Ogino, Misa; Okawa, Takahiro; Shiba, Naoto

2017-05-01

The Japanese Orthopaedic Association shoulder score cutoff values were calculated in patients with rotator cuff repair using the University of California at Los Angeles shoulder score. Overall, 175 patients with rotator cuff repair were subjects in this study. The University of California at Los Angeles and Japanese Orthopaedic Association shoulder scores were evaluated before surgery and at 3, 6, 9, and 12 months after surgery. The cutoff value of the Japanese Orthopaedic Association shoulder score was determined using the 4-stage criteria of the University of California at Los Angeles shoulder score and a University of California at Los Angeles shoulder score of 28 points, which is the boundary between an excellent/good group and a fair/poor group. Both the JOA shoulder and UCLA shoulder scores showed significant improvement at 6, 9, and 12 months from the preoperative scores (p < 0.0001). There was a strong correlation between the total values of the two scores (r = 0.85, p < 0.0001). The cutoff value of the Japanese Orthopaedic Association shoulder score based on the highest accuracy from receiver operating characteristic curve analysis was 83 points. A Japanese Orthopaedic Association shoulder score cutoff value of 83 was equivalent to a University of California at Los Angeles shoulder score cutoff value of 28 for distinguishing between excellent/good and fair/poor outcomes after rotator cuff repair. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Validating internet research: a test of the psychometric equivalence of internet and in-person samples.

PubMed

Meyerson, Paul; Tryon, Warren W

2003-11-01

This study evaluated the psychometric equivalency of Web-based research. The Sexual Boredom Scale was presented via the World-Wide Web along with five additional scales used to validate it. A subset of 533 participants that matched a previously published sample (Watt & Ewing, 1996) on age, gender, and race was identified. An 8 x 8 correlation matrix from the matched Internet sample was compared via structural equation modeling with a similar 8 x 8 correlation matrix from the previously published study. The Internet and previously published samples were psychometrically equivalent. Coefficient alpha values calculated on the matched Internet sample yielded reliability coefficients almost identical to those for the previously published sample. Factors such as computer administration and uncontrollable administration settings did not appear to affect the results. Demographic data indicated an overrepresentation of males by about 6% and Caucasians by about 13% relative to the U.S. Census (2000). A total of 2,230 participants were obtained in about 8 months without remuneration. These results suggest that data collection on the Web is (1) reliable, (2) valid, (3) reasonably representative, (4) cost effective, and (5) efficient.

Publishing FAIR Data: An Exemplar Methodology Utilizing PHI-Base.

PubMed

Rodríguez-Iglesias, Alejandro; Rodríguez-González, Alejandro; Irvine, Alistair G; Sesma, Ane; Urban, Martin; Hammond-Kosack, Kim E; Wilkinson, Mark D

2016-01-01

Pathogen-Host interaction data is core to our understanding of disease processes and their molecular/genetic bases. Facile access to such core data is particularly important for the plant sciences, where individual genetic and phenotypic observations have the added complexity of being dispersed over a wide diversity of plant species vs. the relatively fewer host species of interest to biomedical researchers. Recently, an international initiative interested in scholarly data publishing proposed that all scientific data should be "FAIR"-Findable, Accessible, Interoperable, and Reusable. In this work, we describe the process of migrating a database of notable relevance to the plant sciences-the Pathogen-Host Interaction Database (PHI-base)-to a form that conforms to each of the FAIR Principles. We discuss the technical and architectural decisions, and the migration pathway, including observations of the difficulty and/or fidelity of each step. We examine how multiple FAIR principles can be addressed simultaneously through careful design decisions, including making data FAIR for both humans and machines with minimal duplication of effort. We note how FAIR data publishing involves more than data reformatting, requiring features beyond those exhibited by most life science Semantic Web or Linked Data resources. We explore the value-added by completing this FAIR data transformation, and then test the result through integrative questions that could not easily be asked over traditional Web-based data resources. Finally, we demonstrate the utility of providing explicit and reliable access to provenance information, which we argue enhances citation rates by encouraging and facilitating transparent scholarly reuse of these valuable data holdings.

Publishing FAIR Data: An Exemplar Methodology Utilizing PHI-Base

PubMed Central

Rodríguez-Iglesias, Alejandro; Rodríguez-González, Alejandro; Irvine, Alistair G.; Sesma, Ane; Urban, Martin; Hammond-Kosack, Kim E.; Wilkinson, Mark D.

2016-01-01

Pathogen-Host interaction data is core to our understanding of disease processes and their molecular/genetic bases. Facile access to such core data is particularly important for the plant sciences, where individual genetic and phenotypic observations have the added complexity of being dispersed over a wide diversity of plant species vs. the relatively fewer host species of interest to biomedical researchers. Recently, an international initiative interested in scholarly data publishing proposed that all scientific data should be “FAIR”—Findable, Accessible, Interoperable, and Reusable. In this work, we describe the process of migrating a database of notable relevance to the plant sciences—the Pathogen-Host Interaction Database (PHI-base)—to a form that conforms to each of the FAIR Principles. We discuss the technical and architectural decisions, and the migration pathway, including observations of the difficulty and/or fidelity of each step. We examine how multiple FAIR principles can be addressed simultaneously through careful design decisions, including making data FAIR for both humans and machines with minimal duplication of effort. We note how FAIR data publishing involves more than data reformatting, requiring features beyond those exhibited by most life science Semantic Web or Linked Data resources. We explore the value-added by completing this FAIR data transformation, and then test the result through integrative questions that could not easily be asked over traditional Web-based data resources. Finally, we demonstrate the utility of providing explicit and reliable access to provenance information, which we argue enhances citation rates by encouraging and facilitating transparent scholarly reuse of these valuable data holdings. PMID:27433158

Modeling of aluminum/gallium interdiffusion in aluminum gallium arsenide/gallium arsenide heterostructure materials

NASA Astrophysics Data System (ADS)

Tai, Cheng-Yu

There is considerable interest in interdiffusion in III-IV based structures, such as AlGaAs/GaAs heterojunctions and superlattices (SL). This topic is of practical and fundamental interest since it relates to the stability of devices based on superlattices and heterojunctions, as well as to fundamental diffusion theory. The main goals of this study are to obtain the Al/Ga interdiffusivity, to understand Al/Ga interdiffusion behavior, and to understand how Si doping enhances the diffusion in AlGaAs/GaAs structures. Our first approach entails experimental studies of Al/Ga interdiffusion using Molecular Beam Epitaxy (MBE) samples of AlGaAs/GaAs structures, with or without Si doping. SUPREM-IV.GS was used to model the Fermi-level dependencies and extract the diffusivities. The experimental results show that Al/Ga interdiffusion in undoped AlGaAs/GaAs structures is small, but can be greatly enhanced in doped materials. The extracted Al/Ga interdiffusivity values match well with the Al/Ga interdiffusivity values reported by other groups, and they appear to be composition-independent. The interdiffusivity values are smaller than published Ga self-diffusivity values which are often mistakenly assumed to be equivalent to the interdiffusivity. Another set of Al/Ga interdiffusion experiments using AlAs/GaAs SL were performed to study Al/Ga interdiffusion. The experimental results are consistent with the previously discussed heterostructure results. Using Darken's analysis and treating the AlAs/GaAs SL material as a non-ideal solution, ALAMODE was used to model our SL disordering results explicitly. Assuming that the Al/Ga interdiffusivity is different from the Ga and Al self-diffusivities, we extracted the Al self-diffusivity and the Al activity coefficient as a function of composition using published Ga self-diffusivity values. The simulation results fit well with the experimental results. The extracted Al self-diffusivity value is close to the extracted Al/Ga interdiffusivity but different from the Ga self-diffusivity. The last part of this thesis focuses on modeling localized Al/Ga disordering in AlGaAs/GaAs devices. We present a localized disordering process as a solution to controlling the lateral oxidation process in AlGaAs/GaAs materials. SUPREM can predict these localized disordering results and can help to design an annealing process corresponding to the required aperture size in devices.

Computational tools for fitting the Hill equation to dose-response curves.

PubMed

Gadagkar, Sudhindra R; Call, Gerald B

2015-01-01

Many biological response curves commonly assume a sigmoidal shape that can be approximated well by means of the 4-parameter nonlinear logistic equation, also called the Hill equation. However, estimation of the Hill equation parameters requires access to commercial software or the ability to write computer code. Here we present two user-friendly and freely available computer programs to fit the Hill equation - a Solver-based Microsoft Excel template and a stand-alone GUI-based "point and click" program, called HEPB. Both computer programs use the iterative method to estimate two of the Hill equation parameters (EC50 and the Hill slope), while constraining the values of the other two parameters (the minimum and maximum asymptotes of the response variable) to fit the Hill equation to the data. In addition, HEPB draws the prediction band at a user-defined confidence level, and determines the EC50 value for each of the limits of this band to give boundary values that help objectively delineate sensitive, normal and resistant responses to the drug being tested. Both programs were tested by analyzing twelve datasets that varied widely in data values, sample size and slope, and were found to yield estimates of the Hill equation parameters that were essentially identical to those provided by commercial software such as GraphPad Prism and nls, the statistical package in the programming language R. The Excel template provides a means to estimate the parameters of the Hill equation and plot the regression line in a familiar Microsoft Office environment. HEPB, in addition to providing the above results, also computes the prediction band for the data at a user-defined level of confidence, and determines objective cut-off values to distinguish among response types (sensitive, normal and resistant). Both programs are found to yield estimated values that are essentially the same as those from standard software such as GraphPad Prism and the R-based nls. Furthermore, HEPB also has the option to simulate 500 response values based on the range of values of the dose variable in the original data and the fit of the Hill equation to that data. Copyright © 2014. Published by Elsevier Inc.

Measuring Effective Leaf Area Index, Foliage Profile, and Stand Height in New England Forest Stands Using a Full-Waveform Ground-Based Lidar

NASA Technical Reports Server (NTRS)

Zhao, Feng; Yang, Xiaoyuan; Schull, Mithcell A.; Roman-Colon, Miguel O.; Yao, Tian; Wang, Zhuosen; Zhang, Qingling; Jupp, David L. B.; Lovell, Jenny L.; Culvenor, Darius;

3-D Quantitative Dynamic Contrast Ultrasound for Prostate Cancer Localization.

PubMed

Schalk, Stefan G; Huang, Jing; Li, Jia; Demi, Libertario; Wijkstra, Hessel; Huang, Pintong; Mischi, Massimo

2018-04-01

To investigate quantitative 3-D dynamic contrast-enhanced ultrasound (DCE-US) and, in particular 3-D contrast-ultrasound dispersion imaging (CUDI), for prostate cancer detection and localization, 43 patients referred for 10-12-core systematic biopsy underwent 3-D DCE-US. For each 3-D DCE-US recording, parametric maps of CUDI-based and perfusion-based parameters were computed. The parametric maps were divided in regions, each corresponding to a biopsy core. The obtained parameters were validated per biopsy location and after combining two or more adjacent regions. For CUDI by correlation (r) and for the wash-in time (WIT), a significant difference in parameter values between benign and malignant biopsy cores was found (p < 0.001). In a per-prostate analysis, sensitivity and specificity were 94% and 50% for r, and 53% and 81% for WIT. Based on these results, it can be concluded that quantitative 3-D DCE-US could aid in localizing prostate cancer. Therefore, we recommend follow-up studies to investigate its value for targeting biopsies. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

Ethical, Scientific, and Educational Concerns With Unproven Medications

PubMed Central

Pray, W. Steven

2006-01-01

Quackery (promotion of products that do not work or have not been proven to work) was once a commonly used term within the pharmacy and medical communities. However, an increasingly anti-scientific national climate culminated in passage of the 1994 Dietary Supplement Health and Education Act, which granted unprecedented legitimacy to “dietary supplements” that had not been scientifically proven to be effective and/or safe. In part, this was facilitated when professional pharmacy magazines and journals published advertisements and articles promoting these unproven medications. Gradually, pharmacy codes of ethics eliminated references to quackery, and some pharmacy organizations seemed to accept the unproven medications they once exhorted the pharmacist not to sell. The profession's shift in attitude toward unproven medications occurred as the medical community at large began to realize the value of evidence-based medicine. Academicians must resist pressure to present unproven therapies as realistic alternatives for medications with scientific proof of safety and efficacy. They must stress the value of evidence-based medicine and urge students and pharmacists to recommend only those medications with evidence-based proof of safety and efficacy. PMID:17332867

Statistical flaws in design and analysis of fertility treatment studies on cryopreservation raise doubts on the conclusions

PubMed Central

van Gelder, P.H.A.J.M.; Nijs, M.

2011-01-01

Decisions about pharmacotherapy are being taken by medical doctors and authorities based on comparative studies on the use of medications. In studies on fertility treatments in particular, the methodological quality is of utmost importance in the application of evidence-based medicine and systematic reviews. Nevertheless, flaws and omissions appear quite regularly in these types of studies. Current study aims to present an overview of some of the typical statistical flaws, illustrated by a number of example studies which have been published in peer reviewed journals. Based on an investigation of eleven studies at random selected on fertility treatments with cryopreservation, it appeared that the methodological quality of these studies often did not fulfil the required statistical criteria. The following statistical flaws were identified: flaws in study design, patient selection, and units of analysis or in the definition of the primary endpoints. Other errors could be found in p-value and power calculations or in critical p-value definitions. Proper interpretation of the results and/or use of these study results in a meta analysis should therefore be conducted with care. PMID:24753877

Statistical flaws in design and analysis of fertility treatment -studies on cryopreservation raise doubts on the conclusions.

PubMed

van Gelder, P H A J M; Nijs, M

2011-01-01

Decisions about pharmacotherapy are being taken by medical doctors and authorities based on comparative studies on the use of medications. In studies on fertility treatments in particular, the methodological quality is of utmost -importance in the application of evidence-based medicine and systematic reviews. Nevertheless, flaws and omissions appear quite regularly in these types of studies. Current study aims to present an overview of some of the typical statistical flaws, illustrated by a number of example studies which have been published in peer reviewed journals. Based on an investigation of eleven studies at random selected on fertility treatments with cryopreservation, it appeared that the methodological quality of these studies often did not fulfil the -required statistical criteria. The following statistical flaws were identified: flaws in study design, patient selection, and units of analysis or in the definition of the primary endpoints. Other errors could be found in p-value and power calculations or in critical p-value definitions. Proper -interpretation of the results and/or use of these study results in a meta analysis should therefore be conducted with care.

Methods and approaches in the topology-based analysis of biological pathways

PubMed Central

Mitrea, Cristina; Taghavi, Zeinab; Bokanizad, Behzad; Hanoudi, Samer; Tagett, Rebecca; Donato, Michele; Voichiţa, Călin; Drăghici, Sorin

2013-01-01

The goal of pathway analysis is to identify the pathways significantly impacted in a given phenotype. Many current methods are based on algorithms that consider pathways as simple gene lists, dramatically under-utilizing the knowledge that such pathways are meant to capture. During the past few years, a plethora of methods claiming to incorporate various aspects of the pathway topology have been proposed. These topology-based methods, sometimes referred to as “third generation,” have the potential to better model the phenomena described by pathways. Although there is now a large variety of approaches used for this purpose, no review is currently available to offer guidance for potential users and developers. This review covers 22 such topology-based pathway analysis methods published in the last decade. We compare these methods based on: type of pathways analyzed (e.g., signaling or metabolic), input (subset of genes, all genes, fold changes, gene p-values, etc.), mathematical models, pathway scoring approaches, output (one or more pathway scores, p-values, etc.) and implementation (web-based, standalone, etc.). We identify and discuss challenges, arising both in methodology and in pathway representation, including inconsistent terminology, different data formats, lack of meaningful benchmarks, and the lack of tissue and condition specificity. PMID:24133454

Peer-review: An IOP Publishing Perspective

NASA Astrophysics Data System (ADS)

Smith, Timothy

2015-03-01

Online publishing is challenging, and potentially changing, the role of publishers in both managing the peer-review process and disseminating the work that they publish in meeting contrasting needs from diverse groups of research communities. Recognizing the value of peer-review as a fundamental service to authors and the research community, the underlying principles of managing the process for journals published by IOP Publishing remain unchanged and yet the potential and demand for alternative models exists. This talk will discuss the traditional approach to peer-review placed in the context of this changing demand.

Option B+ for the prevention of mother-to-child transmission of HIV infection in developing countries: a review of published cost-effectiveness analyses.

PubMed

Karnon, Jonathan; Orji, Nneka

2016-10-01

To review the published literature on the cost effectiveness of Option B+ (lifelong antiretroviral therapy) for preventing mother-to-child transmission (PMTCT) of HIV during pregnancy and breastfeeding to inform decision making in low- and middle-income countries. PubMed, Scopus, Google scholar and Medline were searched to identify studies of the cost effectiveness of the World Health Organization (WHO) treatment guidelines for PMTCT. Study quality was appraised using the consolidated health economic evaluation reporting standards checklist. Eligible studies were reviewed in detail to assess the relevance and impact of alternative evaluation frameworks, assumptions and input parameter values. Five published cost effectiveness analyses of Option B+ for the PMTCT of HIV were identified. The reported cost-effectiveness of Option B+ varies substantially, with the results of different studies implying that Option B+ is dominant (lower costs, greater benefits), cost-effective (additional benefits at acceptable additional costs) or not cost-effective (additional benefits at unacceptable additional costs). This variation is due to significant differences in model structures and input parameter values. Structural differences were observed around the estimation of programme effects on infants, HIV-infected mothers and their HIV negative partners, over multiple pregnancies, as well assumptions regarding routine access to antiretroviral therapies. Significant differences in key input parameters were observed in transmission rates, intervention costs and effects and downstream cost savings. Across five model-based cost-effectiveness analyses of strategies for the PMTCT of HIV, the most comprehensive analysis reported that option B+ is highly likely to be cost-effective. This evaluation may have been overly favourable towards option B+ with respect to some input parameter values, but potentially important additional benefits were omitted. Decision makers might be best advised to review this analysis, with a view to requesting additional analyses of the model to inform local funding decisions around alternative strategies for the PMTCT of HIV. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

SU-F-T-23: Correspondence Factor Correction Coefficient for Commissioning of Leipzig and Valencia Applicators with the Standard Imaging IVB 1000

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

Donaghue, J; Gajdos, S

Purpose: To determine the correction factor of the correspondence factor for the Standard Imaging IVB 1000 well chamber for commissioning of Elekta’s Leipzig and Valencia skin applicators. Methods: The Leipzig and Valencia applicators are designed to treat small skin lesions by collimating irradiation to the treatment area. Published output factors are used to calculate dose rates for clinical treatments. To validate onsite applicators, a correspondence factor (CFrev) is measured and compared to published values. The published CFrev is based on well chamber model SI HDR 1000 Plus. The CFrev is determined by correlating raw values of the source calibration setupmore » (Rcal,raw) and values taken when each applicator is mounted on the same well chamber with an adapter (Rapp,raw). The CFrev is calculated by using the equation CFrev =Rapp,raw/Rcal,raw. The CFrev was measured for each applicator in both the SI HDR 1000 Plus and the SI IVB 1000. A correction factor, CFIVB for the SI IVB 1000 was determined by finding the ratio of CFrev (SI IVB 1000) and CFrev (SI HDR 1000 Plus). Results: The average correction factors at dwell position 1121 were found to be 1.073, 1.039, 1.209, 1.091, and 1.058 for the Valencia V2, Valencia V3, Leipzig H1, Leipzig H2, and Leipzig H3 respectively. There were no significant variations in the correction factor for dwell positions 1119 through 1121. Conclusion: By using the appropriate correction factor, the correspondence factors for the Leipzig and Valencia surface applicators can be validated with the Standard Imaging IVB 1000. This allows users to correlate their measurements with the Standard Imaging IVB 1000 to the published data. The correction factor is included in the equation for the CFrev as follows: CFrev= Rapp,raw/(CFIVB*Rcal,raw). Each individual applicator has its own correction factor, so care must be taken that the appropriate factor is used.« less

Overtaking method based on sand-sifter mechanism: Why do optimistic value functions find optimal solutions in multi-armed bandit problems?

PubMed

Ochi, Kento; Kamiura, Moto

2015-09-01

A multi-armed bandit problem is a search problem on which a learning agent must select the optimal arm among multiple slot machines generating random rewards. UCB algorithm is one of the most popular methods to solve multi-armed bandit problems. It achieves logarithmic regret performance by coordinating balance between exploration and exploitation. Since UCB algorithms, researchers have empirically known that optimistic value functions exhibit good performance in multi-armed bandit problems. The terms optimistic or optimism might suggest that the value function is sufficiently larger than the sample mean of rewards. The first definition of UCB algorithm is focused on the optimization of regret, and it is not directly based on the optimism of a value function. We need to think the reason why the optimism derives good performance in multi-armed bandit problems. In the present article, we propose a new method, which is called Overtaking method, to solve multi-armed bandit problems. The value function of the proposed method is defined as an upper bound of a confidence interval with respect to an estimator of expected value of reward: the value function asymptotically approaches to the expected value of reward from the upper bound. If the value function is larger than the expected value under the asymptote, then the learning agent is almost sure to be able to obtain the optimal arm. This structure is called sand-sifter mechanism, which has no regrowth of value function of suboptimal arms. It means that the learning agent can play only the current best arm in each time step. Consequently the proposed method achieves high accuracy rate and low regret and some value functions of it can outperform UCB algorithms. This study suggests the advantage of optimism of agents in uncertain environment by one of the simplest frameworks. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Publish, Don't Perish: Ten Tips

ERIC Educational Resources Information Center

Carter, Katherine; Aulette, Judy

2016-01-01

Going public with research is an important part of the research process. Besides the intrinsic value of sharing experience and insights with a community of peers, in higher education, publishing is vital for job security and promotion. Despite these forces encouraging publishing, few academics actually do. The purpose of this article is to provide…

Comparison of protocols measuring diffusion and partition coefficients in the stratum corneum.

PubMed

Rothe, H; Obringer, C; Manwaring, J; Avci, C; Wargniez, W; Eilstein, J; Hewitt, N; Cubberley, R; Duplan, H; Lange, D; Jacques-Jamin, C; Klaric, M; Schepky, A; Grégoire, S

2017-07-01

Partition (K) and diffusion (D) coefficients are important to measure for the modelling of skin penetration of chemicals through the stratum corneum (SC). We compared the feasibility of three protocols for the testing of 50 chemicals in our main studies, using three cosmetics-relevant model chemicals with a wide range of logP values. Protocol 1: SC concentration-depth profile using tape-stripping (measures K SC/v and D SC /H SC 2 , where H SC is the SC thickness); Protocol 2A: incubation of isolated SC with chemical (direct measurement of K SC/v only) and Protocol 2B: diffusion through isolated SC mounted on a Franz cell (measures K SC/v and D SC /H SC 2 , and is based on Fick's laws). K SC/v values for caffeine and resorcinol using Protocol 1 and 2B were within 30% of each other, values using Protocol 2A were ~two-fold higher, and all values were within 10-fold of each other. Only indirect determination of K SC/v by Protocol 2B was different from the direct measurement of K SC/v by Protocol 2A and Protocol 1 for 7-EC. The variability of K SC/v for all three chemicals using Protocol 2B was higher compared to Protocol 1 and 2A. D SC /H SC 2 values for the three chemicals were of the same order of magnitude using all three protocols. Additionally, using Protocol 1, there was very little difference between parameters measured in pig and human SC. In conclusion, K SC/v, and D SC values were comparable using different methods. Pig skin might be a good surrogate for human skin for the three chemicals tested. Copyright © 2017 The Authors Journal of Applied Toxicology published by John Wiley & Sons Ltd. Copyright © 2017 The Authors Journal of Applied Toxicology published by John Wiley & Sons Ltd.

Ambulatory cleft lip surgery: A value analysis.

PubMed

Arneja, Jugpal S; Mitton, Craig

2013-01-01

Socialized health systems face fiscal constraints due to a limited supply of resources and few reliable ways to control patient demand. Some form of prioritization must occur as to what services to offer and which programs to fund. A data-driven approach to decision making that incorporates outcomes, including safety and quality, in the setting of fiscal prudence is required. A value model championed by Michael Porter encompasses these parameters, in which value is defined as outcomes divided by cost. To assess ambulatory cleft lip surgery from a quality and safety perspective, and to assess the costs associated with ambulatory cleft lip surgery in North America. Conclusions will be drawn as to how the overall value of cleft lip surgery may be enhanced. A value analysis of published articles related to ambulatory cleft lip repair over the past 30 years was performed to determine what percentage of patients would be candidates for ambulatory cleft lip repair from a quality and safety perspective. An economic model was constructed based on costs associated with the inpatient stay related to cleft lip repair. On analysis of the published reports in the literature, a minority (28%) of patients are currently discharged in an ambulatory fashion following cleft lip repair. Further analysis suggests that 88.9% of patients would be safe candidates for same-day discharge. From an economic perspective, the mean cost per patient for the overnight admission component of ambulatory cleft surgery to the health care system in the United States was USD$2,390 and $1,800 in Canada. The present analysis reviewed germane publications over a 30-year period, ultimately suggesting that ambulatory cleft lip surgery results in preservation of quality and safety metrics for most patients. The financial model illustrates a potential cost saving through the adoption of such a practice change. For appropriately selected patients, ambulatory cleft surgery enhances overall health care value.

Quality Measurements in Radiology: A Systematic Review of the Literature and Survey of Radiology Benefit Management Groups.

PubMed

Narayan, Anand; Cinelli, Christina; Carrino, John A; Nagy, Paul; Coresh, Josef; Riese, Victoria G; Durand, Daniel J

2015-11-01

As the US health care system transitions toward value-based reimbursement, there is an increasing need for metrics to quantify health care quality. Within radiology, many quality metrics are in use, and still more have been proposed, but there have been limited attempts to systematically inventory these measures and classify them using a standard framework. The purpose of this study was to develop an exhaustive inventory of public and private sector imaging quality metrics classified according to the classic Donabedian framework (structure, process, and outcome). A systematic review was performed in which eligibility criteria included published articles (from 2000 onward) from multiple databases. Studies were double-read, with discrepancies resolved by consensus. For the radiology benefit management group (RBM) survey, the six known companies nationally were surveyed. Outcome measures were organized on the basis of standard categories (structure, process, and outcome) and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy yielded 1,816 citations; review yielded 110 reports (29 included for final analysis). Three of six RBMs (50%) responded to the survey; the websites of the other RBMs were searched for additional metrics. Seventy-five unique metrics were reported: 35 structure (46%), 20 outcome (27%), and 20 process (27%) metrics. For RBMs, 35 metrics were reported: 27 structure (77%), 4 process (11%), and 4 outcome (11%) metrics. The most commonly cited structure, process, and outcome metrics included ACR accreditation (37%), ACR Appropriateness Criteria (85%), and peer review (95%), respectively. Imaging quality metrics are more likely to be structural (46%) than process (27%) or outcome (27%) based (P < .05). As national value-based reimbursement programs increasingly emphasize outcome-based metrics, radiologists must keep pace by developing the data infrastructure required to collect outcome-based quality metrics. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Model-based prediction of myelosuppression and recovery based on frequent neutrophil monitoring.

PubMed

Netterberg, Ida; Nielsen, Elisabet I; Friberg, Lena E; Karlsson, Mats O

2017-08-01

To investigate whether a more frequent monitoring of the absolute neutrophil counts (ANC) during myelosuppressive chemotherapy, together with model-based predictions, can improve therapy management, compared to the limited clinical monitoring typically applied today. Daily ANC in chemotherapy-treated cancer patients were simulated from a previously published population model describing docetaxel-induced myelosuppression. The simulated values were used to generate predictions of the individual ANC time-courses, given the myelosuppression model. The accuracy of the predicted ANC was evaluated under a range of conditions with reduced amount of ANC measurements. The predictions were most accurate when more data were available for generating the predictions and when making short forecasts. The inaccuracy of ANC predictions was highest around nadir, although a high sensitivity (≥90%) was demonstrated to forecast Grade 4 neutropenia before it occurred. The time for a patient to recover to baseline could be well forecasted 6 days (±1 day) before the typical value occurred on day 17. Daily monitoring of the ANC, together with model-based predictions, could improve anticancer drug treatment by identifying patients at risk for severe neutropenia and predicting when the next cycle could be initiated.

cit: hypothesis testing software for mediation analysis in genomic applications.

PubMed

Millstein, Joshua; Chen, Gary K; Breton, Carrie V

2016-08-01

The challenges of successfully applying causal inference methods include: (i) satisfying underlying assumptions, (ii) limitations in data/models accommodated by the software and (iii) low power of common multiple testing approaches. The causal inference test (CIT) is based on hypothesis testing rather than estimation, allowing the testable assumptions to be evaluated in the determination of statistical significance. A user-friendly software package provides P-values and optionally permutation-based FDR estimates (q-values) for potential mediators. It can handle single and multiple binary and continuous instrumental variables, binary or continuous outcome variables and adjustment covariates. Also, the permutation-based FDR option provides a non-parametric implementation. Simulation studies demonstrate the validity of the cit package and show a substantial advantage of permutation-based FDR over other common multiple testing strategies. The cit open-source R package is freely available from the CRAN website (https://cran.r-project.org/web/packages/cit/index.html) with embedded C ++ code that utilizes the GNU Scientific Library, also freely available (http://www.gnu.org/software/gsl/). joshua.millstein@usc.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Measurement-based model of a wide-bore CT scanner for Monte Carlo dosimetric calculations with GMCTdospp software.

PubMed

Skrzyński, Witold

2014-11-01

The aim of this work was to create a model of a wide-bore Siemens Somatom Sensation Open CT scanner for use with GMCTdospp, which is an EGSnrc-based software tool dedicated for Monte Carlo calculations of dose in CT examinations. The method was based on matching spectrum and filtration to half value layer and dose profile, and thus was similar to the method of Turner et al. (Med. Phys. 36, pp. 2154-2164). Input data on unfiltered beam spectra were taken from two sources: the TASMIP model and IPEM Report 78. Two sources of HVL data were also used, namely measurements and documentation. Dose profile along the fan-beam was measured with Gafchromic RTQA-1010 (QA+) film. Two-component model of filtration was assumed: bow-tie filter made of aluminum with 0.5 mm thickness on central axis, and flat filter made of one of four materials: aluminum, graphite, lead, or titanium. Good agreement between calculations and measurements was obtained for models based on the measured values of HVL. Doses calculated with GMCTdospp differed from the doses measured with pencil ion chamber placed in PMMA phantom by less than 5%, and root mean square difference for four tube potentials and three positions in the phantom did not exceed 2.5%. The differences for models based on HVL values from documentation exceeded 10%. Models based on TASMIP spectra and IPEM78 spectra performed equally well. Copyright © 2014 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Cost description of chemotherapy regimens for the treatment of metastatic pancreas cancer.

PubMed

Goldstein, Daniel A; Krishna, Kavya; Flowers, Christopher R; El-Rayes, Bassel F; Bekaii-Saab, Tanios; Noonan, Anne M

2016-05-01

Multiple chemotherapy regimens are available for the treatment of metastatic pancreas cancer (mPCA). Choice of regimen is based on the patient's performance status and toxicity profile of the regimen. The objective of this study was to analyze the costs of first-line regimens to further aid in decision-making and develop a platform upon which to assess value. We calculated the monthly cost for individual standard regimens (gemcitabine, gemcitabine/nab-paclitaxel, gemcitabine/erlotinib and FOLFIRINOX) and the overall treatment cost for a course of therapy based on the median progression-free survival achieved in published studies. In addition to cost of drugs, we included administration costs and costs of toxicities (including growth factor support, blood product transfusion and hospitalization for toxicities). Costs for administration and management of adverse events were based on Medicare reimbursement rates for hospital and physician services. Drug costs were based on Medicare average sale prices (all 2014 US$). The monthly costs for gemcitabine, FOLFIRINOX, gemcitabine/erlotinib and gemcitabine/nab-paclitaxel were $1363, $7234, $8007 and $12,221, respectively. The overall treatment costs for a course of the same regimens based on median PFS were $5043, $46,298, $51,004 and $67,216, respectively. The choice of chemotherapy regimen for mPCA should be based on tolerability and efficacy of the regimen individualized to patient's performance status. Healthcare systems have finite resources; thus, there is increasing emphasis on metrics to define value in health care when outcomes of therapy are similar or produce marked differences in value. These data provide useful financial information to incorporate into the decision-making process.

Keeping patients safe in healthcare organizations: a structuration theory of safety culture.

PubMed

Groves, Patricia S; Meisenbach, Rebecca J; Scott-Cawiezell, Jill

2011-08-01

This paper presents a discussion of the use of structuration theory to facilitate understanding and improvement of safety culture in healthcare organizations. Patient safety in healthcare organizations is an important problem worldwide. Safety culture has been proposed as a means to keep patients safe. However, lack of appropriate theory limits understanding and improvement of safety culture. The proposed structuration theory of safety culture was based on a critique of available English-language literature, resulting in literature published from 1983 to mid-2009. CINAHL, Communication and Mass Media Complete, ABI/Inform and Google Scholar databases were searched using the following terms: nursing, safety, organizational culture and safety culture. When viewed through the lens of structuration theory, safety culture is a system involving both individual actions and organizational structures. Healthcare organization members, particularly nurses, share these values through communication and enact them in practice, (re)producing an organizational safety culture system that reciprocally constrains and enables the actions of the members in terms of patient safety. This structurational viewpoint illuminates multiple opportunities for safety culture improvement. Nurse leaders should be cognizant of competing value-based culture systems in the organization and attend to nursing agency and all forms of communication when attempting to create or strengthen a safety culture. Applying structuration theory to the concept of safety culture reveals a dynamic system of individual action and organizational structure constraining and enabling safety practice. Nurses are central to the (re)production of this safety culture system. © 2011 Blackwell Publishing Ltd.

A Generic Individual-Based Spatially Explicit Model as a Novel Tool for Investigating Insect-Plant Interactions: A Case Study of the Behavioural Ecology of Frugivorous Tephritidae

PubMed Central

Wang, Ming; Cribb, Bronwen; Clarke, Anthony R.; Hanan, Jim

2016-01-01

Computational modelling of mechanisms underlying processes in the real world can be of great value in understanding complex biological behaviours. Uptake in general biology and ecology has been rapid. However, it often requires specific data sets that are overly costly in time and resources to collect. The aim of the current study was to test whether a generic behavioural ecology model constructed using published data could give realistic outputs for individual species. An individual-based model was developed using the Pattern-Oriented Modelling (POM) strategy and protocol, based on behavioural rules associated with insect movement choices. Frugivorous Tephritidae (fruit flies) were chosen because of economic significance in global agriculture and the multiple published data sets available for a range of species. The Queensland fruit fly (Qfly), Bactrocera tryoni, was identified as a suitable individual species for testing. Plant canopies with modified architecture were used to run predictive simulations. A field study was then conducted to validate our model predictions on how plant architecture affects fruit flies’ behaviours. Characteristics of plant architecture such as different shapes, e.g., closed-canopy and vase-shaped, affected fly movement patterns and time spent on host fruit. The number of visits to host fruit also differed between the edge and centre in closed-canopy plants. Compared to plant architecture, host fruit has less contribution to effects on flies’ movement patterns. The results from this model, combined with our field study and published empirical data suggest that placing fly traps in the upper canopy at the edge should work best. Such a modelling approach allows rapid testing of ideas about organismal interactions with environmental substrates in silico rather than in vivo, to generate new perspectives. Using published data provides a saving in time and resources. Adjustments for specific questions can be achieved by refinement of parameters based on targeted experiments. PMID:26999285

An ecological risk assessment of the acute and chronic effects of the herbicide clopyralid to rainbow trout (Oncorhynchus mykiss)

USGS Publications Warehouse

Fairchild, J.F.; Allert, A.L.; Feltz, K.P.; Nelson, K.J.; Valle, J.A.

2009-01-01

Clopyralid (3,6-dichloro-2-pyridinecarboxylic acid) is a pyridine herbicide frequently used to control invasive, noxious weeds in the northwestern United States. Clopyralid exhibits low acute toxicity to fish, including the rainbow trout (Oncorhynchus mykiss) and the threatened bull trout (Salvelinus confluentus). However, there are no published chronic toxicity data for clopyralid and fish that can be used in ecological risk assessments. We conducted 30-day chronic toxicity studies with juvenile rainbow trout exposed to the acid form of clopyralid. The 30-day maximum acceptable toxicant concentration (MATC) for growth, calculated as the geometric mean of the no observable effect concentration (68 mg/L) and the lowest observable effect concentration (136 mg/L), was 96 mg/L. No mortality was measured at the highest chronic concentration tested (273 mg/L). The acute:chronic ratio, calculated by dividing the previously published 96-h acutely lethal concentration (96-h ALC50; 700 mg/L) by the MATC was 7.3. Toxicity values were compared to a four-tiered exposure assessment profile assuming an application rate of 1.12 kg/ha. The Tier 1 exposure estimation, based on direct overspray of a 2-m deep pond, was 0.055 mg/L. The Tier 2 maximum exposure estimate, based on the Generic Exposure Estimate Concentration model (GEENEC), was 0.057 mg/L. The Tier 3 maximum exposure estimate, based on previously published results of the Groundwater Loading Effects of Agricultural Management Systems model (GLEAMS), was 0.073 mg/L. The Tier 4 exposure estimate, based on published edge-of-field monitoring data, was estimated at 0.008 mg/L. Comparison of toxicity data to estimated environmental concentrations of clopyralid indicates that the safety factor for rainbow trout exposed to clopyralid at labeled use rates exceeds 1000. Therefore, the herbicide presents little to no risk to rainbow trout or other salmonids such as the threatened bull trout. ?? 2009 US Government.

Stable carbon isotope ratios of archaeal GDGTs in the marine water column and surface sediments

NASA Astrophysics Data System (ADS)

Pearson, A.; Hurley, S.; Close, H. G.; Jasper, C. E.

2016-12-01

Archaeal glycerol dibiphytanyl glycerol tetraether (GDGT) lipids are ubiquitous throughout the marine environment and are preserved in sediments and sedimentary rocks on million-year timescales. Variations in the number of ring-containing GDGT isomers in sediments correlate with differences in overlying sea surface temperatures, a relationship formalized in the TEX86 paleotemperature proxy. Ammonia-oxidizing Thaumarchaeota are believed to be the major sources of these GDGTs, implying that the greatest production and export of GDGTs from the water column should be associated with the maximum expression of ammonia monooxygenase (amoA) genes and maximum number of thaumarchaeal cells, both of which occur in the subsurface NO2- maximum near a depth of ca. 80-250 m. To examine the relationship between production and export of GDGTs from the water column, we measured the concentrations and δ13C values of GDGTs in suspended particulate matter (SPM) of the western South Atlantic Ocean and compared them to values from pure thaumarchaeal cultures and from available sediment core-tops from other locations. Thaumarchaeota are believed to fix the majority of their carbon directly from dissolved inorganic carbon (DIC). However, both the SPM and core-top δ13C values in some cases are moderately more 13C-depleted than would be predicted based on the 13C content of local DIC and the previously-published biosynthetic isotope fractionation (ɛ). This indicates that the average metabolism of the planktonic archaeal community either is mixotrophic (≥ 25% organic carbon assimilation) or that the published ɛ value for the model organism Nitrosopumilus maritimus may not be representative of the total autotrophic community. In addition to this offset, δ13C values of GDGTs in SPM inversely mirror DIC profiles, with lowest values in the nitrite maximum and higher values in the deeper water column, similar to the overall trends for bulk SPM. Finally, while individual GDGTs in SPM samples have similar δ13C values, in many sediments measured to date, the isotopic composition of individual GDGTs differs. This implies that multiple sources of GDGTs are required to explain core-top 13C distributions, especially on continental margins.

Finding Value in Surgical Didactics: Longitudinal Resident Feedback From Case-Based and Traditional Lectures in an Orthopaedic Residency.

PubMed

Barnwell, Jonathan C; Halvorson, Jason J; Teasdall, Robert D; Carroll, Eben A

To evaluate orthopedic resident perceptions of a didactic curriculum presented in traditional and case-based formats. Prospective cohort study using anonymous web-based survey after each conference evaluating resident perceptions of faculty participation, didactic delivery, content, and overall conference value. Conferences were structured as primarily case-based or traditional lecture. Logistic analysis was performed to determine factors predictive of rating a conference as valuable time spent. Orthopedic residency training program at single institution over an academic year. Orthopedic residents in postgraduate training year 1 to 5 attending mandatory didactic conference. Cased-based conferences received higher Likert ratings on residents' perception of faculty participation, instructor delivery, and improvement in topic understanding when compared to traditional lecture-based conferences (p < 0.0001 for each factor). Residents also were more likely to rate case-based conferences as valuable time spent (p < 0.0001). In our logistic model, factors associated with a negative likelihood of rating a conference as valuable were lecture format (odds ratio [OR] = 0.155, 95% CI: 0.115-0.208), PGY-2 level presenter (OR = 0.288, 95% CI: 0.169-0.490), and PGY-3 level presenter (OR = 0.433, 95% CI: 0.269-0.696). Timing in the year, surgical subspeciality, and conference identity were not significant predictors of conference value rating. Longitudinal resident feedback demonstrates highly favorable resident perceptions toward case-based formats in didactic sessions. Junior levels residents are not perceived as effective as senior residents and faculty in presenting material in either format. These methods allow for a dynamic approach to identifying strengths and weaknesses in a resident curriculum as a well as a means for more focused and real-time improvements. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Derivation of Continuum Models from An Agent-based Cancer Model: Optimization and Sensitivity Analysis.

PubMed

Voulgarelis, Dimitrios; Velayudhan, Ajoy; Smith, Frank

2017-01-01

Agent-based models provide a formidable tool for exploring complex and emergent behaviour of biological systems as well as accurate results but with the drawback of needing a lot of computational power and time for subsequent analysis. On the other hand, equation-based models can more easily be used for complex analysis in a much shorter timescale. This paper formulates an ordinary differential equations and stochastic differential equations model to capture the behaviour of an existing agent-based model of tumour cell reprogramming and applies it to optimization of possible treatment as well as dosage sensitivity analysis. For certain values of the parameter space a close match between the equation-based and agent-based models is achieved. The need for division of labour between the two approaches is explored. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Ground motion values for use in the seismic design of the Trans-Alaska Pipeline system

USGS Publications Warehouse

Page, Robert A.; Boore, D.M.; Joyner, W.B.; Coulter, H.W.

1972-01-01

The proposed trans-Alaska oil pipeline, which would traverse the state north to south from Prudhoe Bay on the Arctic coast to Valdez on Prince William Sound, will be subject to serious earthquake hazards over much of its length. To be acceptable from an environmental standpoint, the pipeline system is to be designed to minimize the potential of oil leakage resulting from seismic shaking, faulting, and seismically induced ground deformation. The design of the pipeline system must accommodate the effects of earthquakes with magnitudes ranging from 5.5 to 8.5 as specified in the 'Stipulations for Proposed Trans-Alaskan Pipeline System.' This report characterizes ground motions for the specified earthquakes in terms of peak levels of ground acceleration, velocity, and displacement and of duration of shaking. Published strong motion data from the Western United States are critically reviewed to determine the intensity and duration of shaking within several kilometers of the slipped fault. For magnitudes 5 and 6, for which sufficient near-fault records are available, the adopted ground motion values are based on data. For larger earthquakes the values are based on extrapolations from the data for smaller shocks, guided by simplified theoretical models of the faulting process.

Vertical profiles of CO and CH4 in the lower and middle troposphere over the Eastern United States January 1978

NASA Technical Reports Server (NTRS)

Reichle, H. G., Jr.; Condon, E. P.

1979-01-01

Samples of tropospheric air were obtained over the Eastern United States during January of 1978. These samples were analyzed by gas chromatography using flame ionization detection to produce vertical profiles of carbon monoxide and methane from the surface to 8 km. The carbon monoxide mixing ratios at 35 deg N and 45 deg N agree with previously published values; however, the mixing ratio at 25 deg N was significantly lower than most published values. The methane mixing ratio was weakly dependent on latitude and has an average value of 1.64 ppm.

Using evidence-based medicine to protect healthcare workers from pandemic influenza: Is it possible?

PubMed

Gralton, Jan; McLaws, Mary-Louise

2011-01-01

To use evidence-based principles to develop infection control algorithms to ensure the protection of healthcare workers and the continuity of health service provision during a pandemic. : Evidence-based algorithms were developed from published research as well as "needs and values" assessments. Research evidence was obtained from 97 studies reporting the protectiveness of antiviral prophylaxis, seasonal vaccination, and mask use. Needs and values assessments were undertaken by international experts in pandemic infection control and local healthcare workers. Opportunity and resources costs were not determined. The Australian government commissioned the development of an evidence-based algorithm for inclusion in the 2008 revision of the Australian Health and Management Plan for Pandemic Influenza. Two international infection control teams responsible for healthcare worker safety during the Severe Acute Respiratory Syndrome outbreak reviewed the evidence-based algorithms. The algorithms were then reviewed for needs and values by eight local clinicians who were considered key frontline clinicians during the contain and sustain phases. The international teams reviewed for practicability of implementation, whereas local clinicians reviewed for clinician compliance. Despite strong evidence for vaccination and antiviral prophylaxis providing significant protection, clinicians believed they required the additional combinations of both masks and face shields. Despite the equivocal evidence for the efficacy of surgical and N95 masks and the provision of algorithms appropriate for the level of risk according to clinical care during a pandemic, clinicians still demanded N95 masks plus face shields in combination with prophylaxis and novel vaccination. Conventional evidence-based principles could not be applied to formulate recommendations due to the lack of pandemic-specific efficacy data of protection tools and the inherent unpredictability of pandemics. As an alternative, evidence-based principles have been used to formulate recommendations while giving priority to the needs and values of healthcare workers over the research evidence.

Time-based understanding of DLCO and DLNO.

PubMed

Kang, Min-Yeong; Sapoval, Bernard

2016-05-01

Capture of CO and NO by blood requires molecules to travel by diffusion from alveolar gas to haemoglobin molecules inside RBCs and then to react. One can attach to these processes two times, a time for diffusion and a time for reaction. This reaction time is known from chemical kinetics and, therefore, constitutes a unique physical clock. This paper presents a time-based bottom-up theory that yields a simple expression for DLCO and DLNO that produces quantitative predictions which compare successfully with experiments. Specifically, when this new approach is applied to DLCO experiments, it can be used to determine the value of the characteristic diffusion time, and the value of capillary volume (Vc). The new theory also provides a simple explanation for still unexplained correlations such as the observed proportionality between the so-called membrane conductance DM and Vc of Roughton and Forster's interpretation. This new theory indicates that DLCO should be proportional to the haematocrit as found in several experiments. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Estimating clinical chemistry reference values based on an existing data set of unselected animals.

PubMed

Dimauro, Corrado; Bonelli, Piero; Nicolussi, Paola; Rassu, Salvatore P G; Cappio-Borlino, Aldo; Pulina, Giuseppe

2008-11-01

In an attempt to standardise the determination of biological reference values, the International Federation of Clinical Chemistry (IFCC) has published a series of recommendations on developing reference intervals. The IFCC recommends the use of an a priori sampling of at least 120 healthy individuals. However, such a high number of samples and laboratory analysis is expensive, time-consuming and not always feasible, especially in veterinary medicine. In this paper, an alternative (a posteriori) method is described and is used to determine reference intervals for biochemical parameters of farm animals using an existing laboratory data set. The method used was based on the detection and removal of outliers to obtain a large sample of animals likely to be healthy from the existing data set. This allowed the estimation of reliable reference intervals for biochemical parameters in Sarda dairy sheep. This method may also be useful for the determination of reference intervals for different species, ages and gender.

Critical appraisal of the Vienna consensus: performance indicators for assisted reproductive technology laboratories.

PubMed

Lopez-Regalado, María Luisa; Martínez-Granados, Luis; González-Utor, Antonio; Ortiz, Nereyda; Iglesias, Miriam; Ardoy, Manuel; Castilla, Jose A

2018-05-24

The Vienna consensus, based on the recommendations of an expert panel, has identified 19 performance indicators for assisted reproductive technology (ART) laboratories. Two levels of reference values are established for these performance indicators: competence and benchmark. For over 10 years, the Spanish embryology association (ASEBIR) has participated in the definition and design of ART performance indicators, seeking to establish specific guidelines for ART laboratories to enhance quality, safety and patient welfare. Four years ago, ASEBIR took part in an initiative by AENOR, the Spanish Association for Standardization and Certification, to develop a national standard in this field (UNE 17900:2013 System of quality management for assisted reproduction laboratories), extending the former requirements, based on ISO 9001, to include performance indicators. Considering the experience acquired, we discuss various aspects of the Vienna consensus and consider certain discrepancies in performance indicators between the consensus and UNE 179007:2013, and analyse the definitions, methodology and reference values used. Copyright © 2018. Published by Elsevier Ltd.

Cultural competence in the era of evidence-based practice.

PubMed

Engebretson, Joan; Mahoney, Jane; Carlson, Elizabeth D

2008-01-01

Cultural competence has become an important concern for contemporary health care delivery, with ethical and legal implications. Numerous educational approaches have been developed to orient clinicians, and standards and position statements promoting cultural competence have been published by both the American Medical Association and the American Nurses Association. Although a number of health care regulatory agencies have developed standards or recommendations, clinical application to patient care has been challenging. These challenges include the abstract nature of the concept, essentializing culture to race or ethnicity, and the attempts to associate culture with health disparities. To make cultural competence relevant to clinical practice, we linked a cultural competency continuum that identifies the levels of cultural competency (cultural destructiveness, cultural incapacity, cultural blindness, cultural precompetence, and cultural proficiency) to well-established values in health care. This situates cultural competence and proficiency in alignment with patient-centered care. A model integrating the cultural competency continuum with the components of evidence-based care (i.e., best research practice, clinical expertise, and patient's values and circumstances) is presented.

Biomass-based pyrolytic polygeneration system on cotton stalk pyrolysis: influence of temperature.

PubMed

Chen, Yingquan; Yang, Haiping; Wang, Xianhua; Zhang, Shihong; Chen, Hanping

2012-03-01

To study the process of biomass-based pyrolytic polygeneration and its mechanism in depth, the pyrolysis of cotton stalk was investigated in a packed bed, with focus on the evolution of the chemical and physical structures of the solid, liquid and gaseous products. The evolution of product characteristics could be good explaining the process mechanism of biomass pyrolysis. A relationship between the pore distribution of solid products and the fused aromatic rings system revealed by Raman analysis might be exist and need to quantify in further study. Regarding the optimum conditions for obtaining high-quality pyrolytic products from the polygeneration system, the optimum temperature is 550-750°C, with a higher calorific value of the obtained charcoal (≈ 28 MJ/kg) and a higher surface area (>200 m(2)/g). Meanwhile, the calorific value of the gas reaches 8-9 MJ/m(3) and the liquid oil would be used as a platform product in biorefinery. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Mapping NEHRP VS30 site classes

USGS Publications Warehouse

Holzer, T.L.; Padovani, A.C.; Bennett, M.J.; Noce, T.E.; Tinsley, J. C.

2005-01-01

Site-amplification potential in a 140-km2 area on the eastern shore of San Francisco Bay, California, was mapped with data from 210 seismic cone penetration test (SCPT) soundings. NEHRP VS30 values were computed on a 50-m grid by both taking into account the thickness and using mean values of locally measured shear-wave velocities of shallow geologic units. The resulting map of NEHRP VS30 site classes differs from other published maps that (1) do not include unit thickness and (2) are based on regional compilations of velocity. Although much of the area in the new map is now classified as NEHRP Site Class D, the velocities of the geologic deposits within this area are either near the upper or lower VS30 boundary of Class D. If maps of NEHRP site classes are to be based on geologic maps, velocity distributions of geologic units may need to be considered in the definition of VS30 boundaries of NEHRP site classes. ?? 2005, Earthquake Engineering Research Institute.

Lessons Learned From A Study Of Genomics-Based Carrier Screening For Reproductive Decision Making.

PubMed

Wilfond, Benjamin S; Kauffman, Tia L; Jarvik, Gail P; Reiss, Jacob A; Richards, C Sue; McMullen, Carmit; Gilmore, Marian; Himes, Patricia; Kraft, Stephanie A; Porter, Kathryn M; Schneider, Jennifer L; Punj, Sumit; Leo, Michael C; Dickerson, John F; Lynch, Frances L; Clarke, Elizabeth; Rope, Alan F; Lutz, Kevin; Goddard, Katrina A B

2018-05-01

Genomics-based carrier screening is one of many opportunities to use genomic information to inform medical decision making, but clinicians, health care delivery systems, and payers need to determine whether to offer screening and how to do so in an efficient, ethical way. To shed light on this issue, we conducted a study in the period 2014-17 to inform the design of clinical screening programs and guide further health services research. Many of our results have been published elsewhere; this article summarizes the lessons we learned from that study and offers policy insights. Our experience can inform understanding of the potential impact of expanded carrier screening services on health system workflows and workforces-impacts that depend on the details of the screening approach. We found limited patient or health system harms from expanded screening. We also found that some patients valued the information they learned from the process. Future policy discussions should consider the value of offering such expanded carrier screening in health delivery systems with limited resources.

A novel bioassay for evaluating the efficacy of biocides to inhibit settling and early establishment of marine biofilms.

PubMed

Arrhenius, Åsa; Backhaus, Thomas; Hilvarsson, Annelie; Wendt, Ida; Zgrundo, Aleksandra; Blanck, Hans

2014-10-15

This paper presents a novel assay that allows a quick and robust assessment of the effects of biocides on the initial settling and establishment of marine photoautotrophic biofilms including the multitude of indigenous fouling organisms. Briefly, biofilms are established in the field, sampled, comminuted and re-settled on clean surfaces, after 72h chlorophyll a is measured as an integrating endpoint to reflect both settling and growth. Eight antifoulants were used to evaluate the assay. Efficacy ranking, based on EC98 values from most to least efficacious compound is: copper pyrithione>TPBP>DCOIT>tolylfluanid>zinc pyrithione>medetomidine>copper (Cu(2+)), while ecotoxicological ranking (based on EC10 values) is irgarol, copper pyrithione>zinc pyrithione>TPBP>tolylfluanid>DCOIT>copper (Cu(2+))>medetomidine. The algaecide irgarol did not cause full inhibition. Instead the inhibition leveled out at 95% effect at 30 nmoll(-)(1), a concentration that was clearly lower than for any other of the tested biocides. Copyright © 2014. Published by Elsevier Ltd.

Educational Professionals' Values: Voices from Secondary Schools in England

ERIC Educational Resources Information Center

Sunley, Roz; Locke, Rachel

2012-01-01

Background: Values continue to play an integral part in education across the globe, but the importance of teachers' personal values is often overlooked (Klein, M.B., "New teaching and teacher issues," Nova Science Publishers Inc., 2006; Aspin, D.N., and J.D. Chapman, eds, "Values education and lifelong learning: Principles,…

A 25-year analysis of the American College of Gastroenterology research grant program: factors associated with publication and advancement in academics.

PubMed

Crockett, Seth D; Dellon, Evan S; Bright, Stephanie D; Shaheen, Nicholas J

2009-05-01

The American College of Gastroenterology (ACG) has awarded research grants for 25 years. We assessed the characteristics of grant recipients, their current academic status, and the likelihood of publication resulting from the grant. Demographic data, the year and amount of award, title of project, and recipient's institution were extracted from ACG databases. Using ACG reports and medical literature search engines, we assessed publication based on grant-funded research, as well as career publication record. We also determined the current position of awardees. A similar analysis was performed for recipients of junior investigator awards. A total of 396 clinical research awards totaling $5,374,497 ($6,867,937 in 2008 dollars) were awarded to 341 recipients in the 25 years between 1983 and 2008. The most commonly funded areas of research were endoscopy (22% of awards) and motility/functional disorders (21%). At least one peer-reviewed publication based on grant-funded research occurred with 255 of the 368 awards (69%) for 1983-2006 [corrected]. Higher award value was associated with subsequent publication. Of the 313 awardees over the same period, 195 (62%) are currently in academic positions [corrected]. Factors associated with staying in academics included higher award value (P < 0.01), a Master's degree (P = 0.02), and publishing grant-funded research (P < 0.01). The junior faculty career development award was granted to 27 individuals for a total of $3,000,000 (3,398,004 in 2008 dollars). Publication resulted from 90% of the funded projects, and 95% of awardees have remained in academics. Overall, the mean cost in grant dollars per published paper based on the research was $14,875. The majority of ACG grant recipients published the results of their research and remained in academics. Higher amount of award, holding an advanced degree, and publication were associated with careers in academics. The ACG research grant award program is an important engine of investigation, publication, and academic career development in the field of gastroenterology.

Virtual slides in peer reviewed, open access medical publication.

PubMed

Kayser, Klaus; Borkenfeld, Stephan; Goldmann, Torsten; Kayser, Gian

2011-12-19

Application of virtual slides (VS), the digitalization of complete glass slides, is in its infancy to be implemented in routine diagnostic surgical pathology and to issues that are related to tissue-based diagnosis, such as education and scientific publication. Electronic publication in Pathology offers new features of scientific communication in pathology that cannot be obtained by conventional paper based journals. Most of these features are based upon completely open or partly directed interaction between the reader and the system that distributes the article. One of these interactions can be applied to microscopic images allowing the reader to navigate and magnify the presented images. VS and interactive Virtual Microscopy (VM) are a tool to increase the scientific value of microscopic images. The open access journal Diagnostic Pathology http://www.diagnosticpathology.org has existed for about five years. It is a peer reviewed journal that publishes all types of scientific contributions, including original scientific work, case reports and review articles. In addition to digitized still images the authors of appropriate articles are requested to submit the underlying glass slides to an institution (DiagnomX.eu, and Leica.com) for digitalization and documentation. The images are stored in a separate image data bank which is adequately linked to the article. The normal review process is not involved. Both processes (peer review and VS acquisition) are performed contemporaneously in order to minimize a potential publication delay. VS are not provided with a DOI index (digital object identifier). The first articles that include VS were published in March 2011. Several logistic constraints had to be overcome until the first articles including VS could be published. Step by step an automated acquisition and distribution system had to be implemented to the corresponding article. The acceptance of VS by the reader is high as well as by the authors. Of specific value are the increased confidence to and reputation of authors as well as the presented information to the reader. Additional associated functions such as access to author-owned related image collections, reader-controlled automated image measurements and image transformations are in preparation. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1232133347629819.

Comparison of retention between maxillary milled and conventional denture bases: A clinical study.

PubMed

AlHelal, Abdulaziz; AlRumaih, Hamad S; Kattadiyil, Mathew T; Baba, Nadim Z; Goodacre, Charles J

2017-02-01

Clinical studies comparing the retention values of milled denture bases with those of conventionally processed denture bases are lacking. The purpose of this clinical study was to compare the retention values of conventional heat-polymerized denture bases with those of digitally milled maxillary denture bases. Twenty individuals with completely edentulous maxillary arches participated in this study. Definitive polyvinyl siloxane impressions were scanned (iSeries; Dental Wings), and the standard tessellation language files were sent to Global Dental Science for the fabrication of a computer-aided design and computer-aided manufacturing (CAD-CAM) milled denture base (group MB) (AvaDent). The impression was then poured to obtain a definitive cast that was used to fabricate a heat-polymerized acrylic resin denture base resin (group HB). A custom-designed testing device was used to measure denture retention (N). Each denture base was subjected to a vertical pulling force by using an advanced digital force gauge 3 times at 10-minute intervals. The average retention of the 2 fabrication methods was compared using repeated ANOVA (α=.05). Significantly increased retention was observed for the milled denture bases compared with that of the conventional heat-polymerized denture bases (P<.001). The retention offered by milled complete denture bases from prepolymerized poly(methyl methacrylate) resin was significantly higher than that offered by conventional heat- polymerized denture bases. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Willingness to pay for diagnostic technologies: a review of the contingent valuation literature.

PubMed

Lin, Pei-Jung; Cangelosi, Michael J; Lee, David W; Neumann, Peter J

2013-01-01

To understand how people value information from diagnostic technologies, we reviewed and analyzed published willingness-to-pay (WTP) studies on the topic. We searched PubMed for English-language articles related to WTP for diagnostic laboratory tests published from 1985 through 2011. We characterized methodological differences across studies, examined individual- and technology-level factors associated with WTP, and summarized median WTP values across different diagnostic tests. We identified 66 relevant WTP studies. Half focused on oncology, while others analyzed infectious diseases (n = 11, 16.1%) and obstetric or gynecological conditions (n = 8, 11.7%), among others. Most laboratory tests included in studies were biological samples/genetic testing (n = 44, 61.1%) or imaging tests (n = 23, 31.9%). Approximately one third of the analyses (n = 20, 30.3%) used discrete-choice questions to elicit WTP values. Higher income, education, disease severity, perceived disease risk, family history, and more accurate tests were in general associated with higher WTP values for diagnostic information. Of the 44 studies with median WTP values available, most reported a median WTP value below $100. The median WTP value for colon or colorectal cancer screening ranged from below $100 to over $1000. The contingent valuation literature in diagnostics has grown rapidly, and suggests that many respondents place considerable value on diagnostic information. There exists, however, great variation in studies with respect to the type of technologies and diseases assessed, respondent characteristics, and study methodology. The perceived value of diagnostic technologies is also influenced by the study design and elicitation methods. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Research Publication Output by Academicians in Public and Private Universities in Malaysia

ERIC Educational Resources Information Center

Suryani, Ina; Yaacob, Aizan; Hashima, Noor; Rashid, Salleh Abd; Desa, Hazry

2013-01-01

The number of publication has been one of the measurement values in the performance evaluation for higher education academicians. Over the years, the obligation to publish has amplified to not just on getting published but also on getting published in high quality journal whereby the quality ranking is determined by publication categories. This…

Amides and neolignans from the aerial parts of Piper bonii.

PubMed

Ding, Duo-Duo; Wang, Yue-Hu; Chen, Ya-Hui; Mei, Ren-Qiang; Yang, Jun; Luo, Ji-Feng; Li, Yan; Long, Chun-Lin; Kong, Yi

2016-09-01

Six amides, piperbonamides A-F, three neolignans piperbonins A-C, and 11 known compounds were isolated from the aerial parts of Piper bonii (Piperaceae). The structures of piperbonamides A-F and piperbonins A-C were elucidated based on the analysis of 1D and 2D NMR and MS data. Piperbonin A, (+)-trans-acuminatin, (+)-cis-acuminatin, (+)-kadsurenone, and pipernonaline showed weak activity against platelet aggregation with IC50 values of 118.2, 108.5, 90.02, 107.3, and 116.3 μM, respectively, as compared with the positive control, tirofiban, with an IC50 value of 5.24 μM. Piperbonamides A-F were inactive against five tumor cell lines at concentrations up to 40 μM. Copyright © 2016. Published by Elsevier Ltd.

The Economic and Social Value of an Image Exchange Network: A Case for the Cloud.

PubMed

Mayo, Ray Cody; Pearson, Kathryn L; Avrin, David E; Leung, Jessica W T

2017-01-01

As the health care environment continually changes, radiologists look to the ACR's Imaging 3.0 ® initiative to guide the search for value. By leveraging new technology, a cloud-based image exchange network could provide secure universal access to prior images, which were previously siloed, to facilitate accurate interpretation, improved outcomes, and reduced costs. The breast imaging department represents a viable starting point given the robust data supporting the benefit of access to prior imaging studies, existing infrastructure for image sharing, and the current workflow reliance on prior images. This concept is scalable not only to the remainder of the radiology department but also to the broader medical record. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Estimation of ground motion parameters

USGS Publications Warehouse

Boore, David M.; Joyner, W.B.; Oliver, A.A.; Page, R.A.

1978-01-01

Strong motion data from western North America for earthquakes of magnitude greater than 5 are examined to provide the basis for estimating peak acceleration, velocity, displacement, and duration as a function of distance for three magnitude classes. A subset of the data (from the San Fernando earthquake) is used to assess the effects of structural size and of geologic site conditions on peak motions recorded at the base of structures. Small but statistically significant differences are observed in peak values of horizontal acceleration, velocity and displacement recorded on soil at the base of small structures compared with values recorded at the base of large structures. The peak acceleration tends to b3e less and the peak velocity and displacement tend to be greater on the average at the base of large structures than at the base of small structures. In the distance range used in the regression analysis (15-100 km) the values of peak horizontal acceleration recorded at soil sites in the San Fernando earthquake are not significantly different from the values recorded at rock sites, but values of peak horizontal velocity and displacement are significantly greater at soil sites than at rock sites. Some consideration is given to the prediction of ground motions at close distances where there are insufficient recorded data points. As might be expected from the lack of data, published relations for predicting peak horizontal acceleration give widely divergent estimates at close distances (three well known relations predict accelerations between 0.33 g to slightly over 1 g at a distance of 5 km from a magnitude 6.5 earthquake). After considering the physics of the faulting process, the few available data close to faults, and the modifying effects of surface topography, at the present time it would be difficult to accept estimates less than about 0.8 g, 110 cm/s, and 40 cm, respectively, for the mean values of peak acceleration, velocity, and displacement at rock sites within 5 km of fault rupture in a magnitude 6.5 earthquake. These estimates can be expected to change as more data become available.

Economic Evaluation in Global Perspective: A Bibliometric Analysis of the Recent Literature.

PubMed

Pitt, Catherine; Goodman, Catherine; Hanson, Kara

2016-02-01

We present a bibliometric analysis of recently published full economic evaluations of health interventions and reflect critically on the implications of our findings for this growing field. We created a database drawing on 14 health, economic, and/or general literature databases for articles published between 1 January 2012 and 3 May 2014 and identified 2844 economic evaluations meeting our criteria. We present findings regarding the sensitivity, specificity, and added value of searches in the different databases. We examine the distribution of publications between countries, regions, and health areas studied and compare the relative volume of research with disease burden. We analyse authors' country and institutional affiliations, journals and journal type, language, and type of economic evaluation conducted. More than 1200 economic evaluations were published annually, of which 4% addressed low-income countries, 4% lower-middle-income countries, 14% upper-middle-income countries, and 83% high-income countries. Across country income levels, 53, 54, 86, and 100% of articles, respectively, included an author based in a country within the income level studied. Biomedical journals published 74% of economic evaluations. The volume of research across health areas correlates more closely with disease burden in high-income than in low-income and middle-income countries. Our findings provide an empirical basis for further study on methods, research prioritization, and capacity development in health economic evaluation. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Initial Investigation of Factors Influencing Radiation Dose to Patients Undergoing Barium-Based Fluoroscopy Procedures in Tanzania.

PubMed

Ngaile, J E; Msaki, P K; Kazema, R R; Schreiner, L J

2017-04-25

The aim of this study was to investigate the nature and causes of radiation dose imparted to patients undergoing barium-based X-ray fluoroscopy procedures in Tanzania and to compare these doses to those reported in the literature from other regions worldwide. The air kerma area product (KAP) to patient undergoing barium investigations of gastrointestinal tract system was obtained from four consultant hospitals. The KAP was determined using a flat transparent transmission ionization chamber. Mean values of KAP for barium swallow (BS), barium meal (BM) and barium enema (BE) were 2.79, 2.62 and 15.04 Gy cm2, respectively. The mean values of KAP per hospital for the BS, BM and BE procedures varied by factors of up to 7.3, 1.6 and 2.0, respectively. The overall difference between individual patient doses across the four consultant hospitals investigated differed by factors of up to 53, 29.5 and 12 for the BS, BM and BE procedures, respectively. The majority of the mean values of KAP was lower than the reported values for Ghana, Greece, Spain and the UK, while slightly higher than those reported for India. The observed wide variation of KAP values for the same fluoroscopy procedure within and among the hospitals was largely attributed to the dynamic nature of the procedures, the patient characteristics, the skills and experience of personnel, and the different examination protocols employed among hospitals. The observed great variations of procedural protocols and patient doses within and across the hospitals call for the need to standardize examination protocols and optimize barium-based fluoroscopy procedures. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Autonomic dysfunction assessed by EZSCAN and subclinical atherosclerosis.

PubMed

Sun, Jichao; Zhang, Yinfei; Xu, Baihui; Lv, Xiaofei; Ding, Lin; Chen, Ying; Sun, Wanwan; Lu, Jieli; Xu, Min; Bi, Yufang; Ning, Guang

2014-09-01

The present study aimed to explore the association between autonomic dysfunction and measurements of atherosclerosis in a middle-aged and elderly Chinese population. A population-based cross-sectional study was performed in Shanghai, China, from March to August 2010, with 5076 participants included in the analysis. Autonomic function was assessed by a novel EZSCAN test based on sudomotor function analysis. Carotid intima-media thickness (CIMT) was measured using B-mode ultrasonography and brachial-ankle pulse wave velocity (ba-PWV) was measured using an autonomic device. Participants were divided into three groups based on EZSCAN values: Group 1: EZSCAN 0-24; Group 2, EZSCAN 25-49; and Group 3, EZSCAN 50-100. These groups denoted autonomic dysfunction risk groups as follows: no risk, moderate risk and high risk, respectively. The prevalence of elevated CIMT and ba-PWV increased markedly with increasing EZSCAN values (elevated CIMT 7.4%, 17.5%, and 29.7%, elevated ba-PWV 3.2%, 19.7%, and 36.5%, in Groups 1, 2, and 3, respectively; both Ptrend < 0.0001). Logistic regressions revealed that EZSCAN values ≥50 were associated with a non-significantly higher risk of elevated CIMT (odds ratio [OR] = 1.43; 95% confidence interval [CI] 0.98-2.07) and a significantly higher risk of elevated ba-PWV (OR = 2.16; 95% CI 1.25-3.71) compared with EZSCAN values <25, after controlling for conventional risk factors. A higher EZSCAN value (≥50), an index of high autonomic dysfunction risk, was associated with an increased risk of elevated ba-PWV and CIMT. Such associations were partially explained by traditional atherosclerotic risk factors. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Costs of providing infusion therapy for patients with inflammatory bowel disease in a hospital-based infusion center setting.

PubMed

Afzali, Anita; Ogden, Kristine; Friedman, Michael L; Chao, Jingdong; Wang, Anthony

2017-04-01

Inflammatory bowel disease (IBD) (e.g. ulcerative colitis [UC] and Crohn's disease [CD]) severely impacts patient quality-of-life. Moderate-to-severe disease is often treated with biologics requiring infusion therapy, adding incremental costs beyond drug costs. This study evaluates US hospital-based infusion services costs for treatment of UC or CD patients receiving infliximab or vedolizumab therapy. A model was developed, estimating annual costs of providing monitored infusions using an activity-based costing framework approach. Multiple sources (published literature, treatment product inserts) informed base-case model input estimates. The total modeled per patient infusion therapy costs in Year 1 with infliximab and vedolizumab was $38,782 and $41,320, respectively, and Year 2+, $49,897 and $36,197, respectively. Drug acquisition cost was the largest total costs driver (90-93%), followed by costs associated with hospital-based infusion provision: labor (53-56%, non-drug costs), allocated overhead (23%, non-drug costs), non-labor (23%, non-drug costs), and laboratory (7-10%, non-drug costs). Limitations included reliance on published estimates, base-case cost estimates infusion drug, and supplies, not accounting for volume pricing, assumption of a small hospital infusion center, and that, given the model adopts the hospital perspective, costs to the patient were not included in infusion administration cost base-case estimates. This model is an early step towards a framework to fully analyze infusion therapies' associated costs. Given the lack of published data, it would be beneficial for hospital administrators to assess total costs and trade-offs with alternative means of providing biologic therapies. This analysis highlights the value to hospital administrators of assessing cost associated with infusion patient mix to make more informed resource allocation decisions. As the landscape for reimbursement changes, tools for evaluating the costs of infusion therapy may help hospital administrators make informed choices and weigh trade-offs associated with providing infusion services for IBD patients.

Reconciling Estimates of the Value to Firms of Reduced Regulatory Delay in the Marketing of Their New Drugs.

PubMed

Wilmoth, Daniel R

2015-12-01

The prescription drug user fee program provides additional resources to the U.S. Food and Drug Administration at the expense of regulated firms. Those resources accelerate the review of new drugs. Faster approvals allow firms to realize profits sooner, and the program is supported politically by industry. However, published estimates of the value to firms of reduced regulatory delay vary dramatically. It is shown here that this variation is driven largely by differences in methods that correspond to differences in implicit assumptions about the effects of reduced delay. Theoretical modeling is used to derive an equation describing the relationship between estimates generated using different methods. The method likely to yield the most accurate results is identified. A reconciliation of published estimates yields a value to a firm for a one-year reduction in regulatory delay at the time of approval of about $60 million for a typical drug. Published 2015. This article is a U.S. Government work and is in the public domain in the U.S.A. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Uncertainty and risk in wildland fire management: a review.

PubMed

Thompson, Matthew P; Calkin, Dave E

2011-08-01

Wildland fire management is subject to manifold sources of uncertainty. Beyond the unpredictability of wildfire behavior, uncertainty stems from inaccurate/missing data, limited resource value measures to guide prioritization across fires and resources at risk, and an incomplete scientific understanding of ecological response to fire, of fire behavior response to treatments, and of spatiotemporal dynamics involving disturbance regimes and climate change. This work attempts to systematically align sources of uncertainty with the most appropriate decision support methodologies, in order to facilitate cost-effective, risk-based wildfire planning efforts. We review the state of wildfire risk assessment and management, with a specific focus on uncertainties challenging implementation of integrated risk assessments that consider a suite of human and ecological values. Recent advances in wildfire simulation and geospatial mapping of highly valued resources have enabled robust risk-based analyses to inform planning across a variety of scales, although improvements are needed in fire behavior and ignition occurrence models. A key remaining challenge is a better characterization of non-market resources at risk, both in terms of their response to fire and how society values those resources. Our findings echo earlier literature identifying wildfire effects analysis and value uncertainty as the primary challenges to integrated wildfire risk assessment and wildfire management. We stress the importance of identifying and characterizing uncertainties in order to better quantify and manage them. Leveraging the most appropriate decision support tools can facilitate wildfire risk assessment and ideally improve decision-making. Published by Elsevier Ltd.

What can qualitative research do for randomised controlled trials? A systematic mapping review

PubMed Central

O'Cathain, A; Thomas, K J; Drabble, S J; Rudolph, A; Hewison, J

2013-01-01

Objective To develop an empirically based framework of the aspects of randomised controlled trials addressed by qualitative research. Design Systematic mapping review of qualitative research undertaken with randomised controlled trials and published in peer-reviewed journals. Data sources MEDLINE, PreMEDLINE, EMBASE, the Cochrane Library, Health Technology Assessment, PsycINFO, CINAHL, British Nursing Index, Social Sciences Citation Index and ASSIA. Eligibility criteria Articles reporting qualitative research undertaken with trials published between 2008 and September 2010; health research, reported in English. Results 296 articles met the inclusion criteria. Articles focused on 22 aspects of the trial within five broad categories. Some articles focused on more than one aspect of the trial, totalling 356 examples. The qualitative research focused on the intervention being trialled (71%, 254/356); the design, process and conduct of the trial (15%, 54/356); the outcomes of the trial (1%, 5/356); the measures used in the trial (3%, 10/356); and the target condition for the trial (9%, 33/356). A minority of the qualitative research was undertaken at the pretrial stage (28%, 82/296). The value of the qualitative research to the trial itself was not always made explicit within the articles. The potential value included optimising the intervention and trial conduct, facilitating interpretation of the trial findings, helping trialists to be sensitive to the human beings involved in trials, and saving money by steering researchers towards interventions more likely to be effective in future trials. Conclusions A large amount of qualitative research undertaken with specific trials has been published, addressing a wide range of aspects of trials, with the potential to improve the endeavour of generating evidence of effectiveness of health interventions. Researchers can increase the impact of this work on trials by undertaking more of it at the pretrial stage and being explicit within their articles about the learning for trials and evidence-based practice. PMID:23794542

Oral health-related cultural beliefs for four racial/ethnic groups: Assessment of the literature

PubMed Central

Butani, Yogita; Weintraub, Jane A; Barker, Judith C

2008-01-01

Background The purpose of this study was to assess information available in the dental literature on oral health-related cultural beliefs. In the US, as elsewhere, many racial/ethnic minority groups shoulder a disproportionate burden of oral disease. Cultural beliefs, values and practices are often implicated as causes of oral health disparities, yet little is known about the breadth or adequacy of literature about cultural issues that could support these assertions. Hence, this rigorous assessment was conducted of work published in English on cultural beliefs and values in relation to oral health status and dental practice. Four racial/ethnic groups in the US (African-American, Chinese, Filipino and Hispanic/Latino) were chosen as exemplar populations. Methods The dental literature published in English for the period 1980–2006 noted in the electronic database PUBMED was searched, using keywords and MeSH headings in different combinations for each racial/ethnic group to identify eligible articles. To be eligible the title and abstract when available had to describe the oral health-related cultural knowledge or orientation of the populations studied. Results Overall, the majority of the literature on racial/ethnic groups was epidemiologic in nature, mainly demonstrating disparities in oral health rather than the oral beliefs or practices of these groups. A total of 60 relevant articles were found: 16 for African-American, 30 for Chinese, 2 for Filipino and 12 for Hispanic/Latino populations. Data on beliefs and practices from these studies has been abstracted, compiled and assessed. Few research-based studies were located. Articles lacked adequate identification of groups studied, used limited methods and had poor conceptual base. Conclusion The scant information available from the published dental and medical literature provides at best a rudimentary framework of oral health related ideas and beliefs for specific populations. PMID:18793438

Modelling duodenum radiotherapy toxicity using cohort dose-volume-histogram data.

PubMed

Holyoake, Daniel L P; Aznar, Marianne; Mukherjee, Somnath; Partridge, Mike; Hawkins, Maria A

2017-06-01

Gastro-intestinal toxicity is dose-limiting in abdominal radiotherapy and correlated with duodenum dose-volume parameters. We aimed to derive updated NTCP model parameters using published data and prospective radiotherapy quality-assured cohort data. A systematic search identified publications providing duodenum dose-volume histogram (DVH) statistics for clinical studies of conventionally-fractionated radiotherapy. Values for the Lyman-Kutcher-Burman (LKB) NTCP model were derived through sum-squared-error minimisation and using leave-one-out cross-validation. Data were corrected for fraction size and weighted according to patient numbers, and the model refined using individual patient DVH data for two further cohorts from prospective clinical trials. Six studies with published DVH data were utilised, and with individual patient data included outcomes for 531 patients in total (median follow-up 16months). Observed gastro-intestinal toxicity rates ranged from 0% to 14% (median 8%). LKB parameter values for unconstrained fit to published data were: n=0.070, m=0.46, TD 50(1) [Gy]=183.8, while the values for the model incorporating the individual patient data were n=0.193, m=0.51, TD 50(1) [Gy]=299.1. LKB parameters derived using published data are shown to be consistent to those previously obtained using individual patient data, supporting a small volume-effect and dependence on exposure to high threshold dose. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Fragment-Based Drug Design Facilitated by Protein-Templated Click Chemistry: Fragment Linking and Optimization of Inhibitors of the Aspartic Protease Endothiapepsin.

PubMed

Mondal, Milon; Unver, M Yagiz; Pal, Asish; Bakker, Matthijs; Berrier, Stephan P; Hirsch, Anna K H

2016-10-10

There is an urgent need for the development of efficient methodologies that accelerate drug discovery. We demonstrate that the strategic combination of fragment linking/optimization and protein-templated click chemistry is an efficient and powerful method that accelerates the hit-identification process for the aspartic protease endothiapepsin. The best binder, which inhibits endothiapepsin with an IC 50 value of 43 μm, represents the first example of triazole-based inhibitors of endothiapepsin. Our strategy could find application on a whole range of drug targets. © 2016 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA.

Let the Core Microbiota Be Functional.

PubMed

Lemanceau, Philippe; Blouin, Manuel; Muller, Daniel; Moënne-Loccoz, Yvan

2017-07-01

The microbial community that is systematically associated with a given host plant is called the core microbiota. The definition of the core microbiota was so far based on its taxonomic composition, but we argue that it should also be based on its functions. This so-called functional core microbiota encompasses microbial vehicles carrying replicators (genes) with essential functions for holobiont (i.e., plant plus microbiota) fitness. It builds up from enhanced horizontal transfers of replicators as well as from ecological enrichment of their vehicles. The transmission pathways of this functional core microbiota vary over plant generations according to environmental constraints and its added value for holobiont fitness. Copyright © 2017. Published by Elsevier Ltd.

Validation of cystatin C-based equations for evaluating residual renal function in patients on continuous ambulatory peritoneal dialysis.

PubMed

Zhong, Hui; Zhang, Wei; Qin, Min; Gou, ZhongPing; Feng, Ping

2017-06-01

Residual renal function needs to be assessed frequently in patients on continuous ambulatory peritoneal dialysis (CAPD). A commonly used method is to measure creatinine (Cr) and urea clearance in urine collected over 24 h, but collection can be cumbersome and difficult to manage. A faster, simpler alternative is to measure levels of cystatin C (CysC) in serum, but the accuracy and reliability of this method is controversial. Our study aims to validate published CysC-based equations for estimating residual renal function in patients on CAPD. Residual renal function was measured by calculating average clearance of urea and Cr in 24-h urine as well as by applying CysC- or Cr-based equations published by Hoek and Yang. We then compared the performance of the equations against the 24-h urine results. In our sample of 255 patients ages 47.9 ± 15.6 years, the serum CysC level was 6.43 ± 1.13 mg/L. Serum CysC level was not significantly associated with age, gender, height, weight, body mass index, hemoglobin, intact parathyroid hormone, normalized protein catabolic rate or the presence of diabetes. In contrast, serum CysC levels did correlate with peritoneal clearance of CysC and with levels of prealbumin and high-sensitivity C-reactive protein. Residual renal function was 2.56 ± 2.07 mL/min/1.73 m 2 based on 24-h urine sampling, compared with estimates (mL/min/1.73 m 2 ) of 2.98 ± 0.66 for Hoek's equation, 2.03 ± 0.97 for Yang's CysC-based equation and 2.70 ± 1.30 for Yang's Cr-based equation. Accuracies within 30%/50% of measured residual renal function for the three equations were 29.02/48.24, 34.90/56.86 and 31.37/54.90. The three equations for estimating residual renal function showed similar limits of agreement and differed significantly from the measured value. Published CysC-based equations do not appear to be particularly reliable for patients on CAPD. Further development and validation of CysC-based equations should take into account peritoneal clearance of CysC and other relevant factors. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Statistical analysis of electromagnetic radiation measurements in the vicinity of GSM/UMTS base station installed on buildings in Serbia.

PubMed

Koprivica, Mladen; Slavkovic, Vladimir; Neskovic, Natasa; Neskovic, Aleksandar

2016-03-01

As a result of dense deployment of public mobile base stations, additional electromagnetic (EM) radiation occurs in the modern human environment. At the same time, public concern about the exposure to EM radiation emitted by such sources has increased. In order to determine the level of radio frequency radiation generated by base stations, extensive EM field strength measurements were carried out for 664 base station locations, from which 276 locations refer to the case of base stations with antenna system installed on buildings. Having in mind the large percentage (42 %) of locations with installations on buildings, as well as the inevitable presence of people in their vicinity, a detailed analysis of this location category was performed. Measurement results showed that the maximum recorded value of total electric field strength has exceeded International Commission on Non-Ionizing Radiation Protection general public exposure reference levels at 2.5 % of locations and Serbian national reference levels at 15.6 % of locations. It should be emphasised that the values exceeding the reference levels were observed only outdoor, while in indoor total electric field strength in no case exceeded the defined reference levels. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Accuracy, risk and the intrinsic value of diagnostic imaging: a review of the cost-utility literature.

PubMed

Otero, Hansel J; Fang, Chi H; Sekar, Meera; Ward, Robert J; Neumann, Peter J

2012-05-01

The aim of this study was to systematically review the reporting of the value of imaging unrelated to treatment consequences and test characteristics in all imaging-related published cost-utility analyses (CUAs) in the medical literature. All CUAs published between 1976 and 2008 evaluating diagnostic imaging technologies contained in the CEA Registry, a publicly available comprehensive database of health related CUAs, were screened. Publication characteristics, imaging modality, and the inclusion of test characteristics including accuracy, costs, risks, and the potential value unrelated to treatment consequences (eg, reassurance or anxiety) were assessed. Ninety-six published CUAs evaluating 155 different imaging technologies were included in the final sample; 27 studies were published in imaging-specialized journals. Fifty-two studies (54%) evaluated the performance of a single imaging modality, while 44 studies (46%) compared two or more different imaging modalities. The most common areas of interest were cardiovascular (45%) and neuroradiology (17%). Forty-two technologies (27%) concerned ultrasound, while 34 (22%) concerned magnetic resonance. Seventy-nine (51%) technologies used ionizing radiation. Test accuracy was reported or calculated for 90% (n = 133 and n = 5, respectively) and assumed perfect (reference test or gold-standard test without alternative testing strategy to capture false-negatives and false-positives) for 8% (n = 12) of technologies. Only 22 studies (23%) assessing 40 imaging technologies (26%) considered inconclusive or indeterminate results. The risk of testing was reported for 32 imaging technologies (21%). Fifteen studies (16%) considered the value of diagnostic imaging unrelated to treatment. Four studies incorporated it as quality-of-life adjustments, while 10 studies mentioned it only in their discussions or as a limitation. The intrinsic value of imaging (the value of imaging unrelated to treatment) has not been appropriately defined or incorporated in the existing cost-utility literature, which could be due to a lack of evidence on the issue. Thus, more research is needed on metrics for a more comprehensive evaluation of diagnostic imaging. Similarly, the incorporation of variations in imaging tests accuracy, inconclusive results and associated risks has lacked uniformity in the cost-utility literature. Acknowledgment of these characteristics in future cost-utility publications will enhance their value and provide results that more closely resemble routine clinical practice. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Innovations in diagnostic imaging of localized prostate cancer.

PubMed

Pummer, Karl; Rieken, Malte; Augustin, Herbert; Gutschi, Thomas; Shariat, Shahrokh F

2014-08-01

In recent years, various imaging modalities have been developed to improve diagnosis, staging, and localization of early-stage prostate cancer (PCa). A MEDLINE literature search of the time frame between 01/2007 and 06/2013 was performed on imaging of localized PCa. Conventional transrectal ultrasound (TRUS) is mainly used to guide prostate biopsy. Contrast-enhanced ultrasound is based on the assumption that PCa tissue is hypervascularized and might be better identified after intravenous injection of a microbubble contrast agent. However, results on its additional value for cancer detection are controversial. Computer-based analysis of the transrectal ultrasound signal (C-TRUS) appears to detect cancer in a high rate of patients with previous biopsies. Real-time elastography seems to have higher sensitivity, specificity, and positive predictive value than conventional TRUS. However, the method still awaits prospective validation. The same is true for prostate histoscanning, an ultrasound-based method for tissue characterization. Currently, multiparametric MRI provides improved tissue visualization of the prostate, which may be helpful in the diagnosis and targeting of prostate lesions. However, most published series are small and suffer from variations in indication, methodology, quality, interpretation, and reporting. Among ultrasound-based techniques, real-time elastography and C-TRUS seem the most promising techniques. Multiparametric MRI appears to have advantages over conventional T2-weighted MRI in the detection of PCa. Despite these promising results, currently, no recommendation for the routine use of these novel imaging techniques can be made. Prospective studies defining the value of various imaging modalities are urgently needed.

League tables and school effectiveness: a mathematical model.

PubMed Central

Hoyle, Rebecca B; Robinson, James C

2003-01-01

'School performance tables', an alphabetical list of secondary schools along with aggregates of their pupils' performances in national tests, have been published in the UK since 1992. Inevitably, the media have responded by publishing ranked 'league tables'. Despite concern over the potentially divisive effect of such tables, the current government has continued to publish this information in the same form. The effect of this information on standards and on the social make-up of the community has been keenly debated. Since there is no control group available that would allow us to investigate this issue directly, we present here a simple mathematical model. Our results indicate that, while random fluctuations from year to year can cause large distortions in the league-table positions, some schools still establish themselves as 'desirable'. To our surprise, we found that 'value-added' tables were no more accurate than tables based on raw exam scores, while a different method of drawing up the tables, in which exam results are averaged over a period of time, appears to give a much more reliable measure of school performance. PMID:12590748

Optimising the clinical strategy for autoimmune liver diseases: Principles of value-based medicine.

PubMed

Carbone, Marco; Cristoferi, Laura; Cortesi, Paolo Angelo; Rota, Matteo; Ciaccio, Antonio; Okolicsanyi, Stefano; Gemma, Marta; Scalone, Luciana; Cesana, Giancarlo; Fabris, Luca; Colledan, Michele; Fagiuoli, Stefano; Ideo, Gaetano; Belli, Luca Saverio; Munari, Luca Maria; Mantovani, Lorenzo; Strazzabosco, Mario

2018-04-01

Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis represent the three major autoimmune liver diseases (AILDs). Their management is highly specialized, requires a multidisciplinary approach and often relies on expensive, orphan drugs. Unfortunately, their treatment is often unsatisfactory, and the care pathway heterogeneous across different centers. Disease-specific clinical outcome indicators (COIs) able to evaluate the whole cycle of care are needed to assist both clinicians and administrators in improving quality and value of care. Aim of our study was to generate a set of COIs for the three AILDs. We then prospectively validated these indicators based on a series of consecutive patients recruited at three tertiary clinical centers in Lombardy, Italy. In phase I using a Delphi method and a RAND 9-point appropriateness scale a set of COIs was generated. In phase II the indicators were applied in a real-life dataset. Two-hundred fourteen patients were enrolled and followed-up for a median time of 54months and the above COIs were recorded using a web-based electronic medical record program. The COIs were easy to collect in the clinical practice environment and their values compared well with the available natural history studies. We have generated a comprehensive set of COIs which sequentially capture different clinical outcome of the three AILDs explored. These indicators represent a critical tool to implement a value-based approach to patients with these conditions, to monitor, compare and improve quality through benchmarking of clinical performance and to assess the significance of novel drugs and technologies. This article is part of a Special Issue entitled: Cholangiocytes in Health and Diseaseedited by Jesus Banales, Marco Marzioni, Nicholas LaRusso and Peter Jansen. Copyright © 2017. Published by Elsevier B.V.

An Evidence Framework for Off-Patent Pharmaceutical Review (EFOR) for Health Technology Assessment in Emerging Markets.

PubMed

Brixner, Diana; Kaló, Zoltán; Maniadakis, Nikos; Kim, Kyoo; Wijaya, Kalman

2018-03-29

This article introduces an Evidence Framework for Off-Patent Pharmaceutical Review (EFOR), which establishes value-based criteria in a template that manufacturers use to provide evidence showing how their products meet those criteria. Health authorities in emerging markets can then use the evidence presented in the EFOR to evaluate off-patent pharmaceuticals (OPPs) in a consistent, transparent, and evidence-based manner to support policy decisions, including pricing, reimbursement, formulary listing, and drug procurement. A literature search found no multi-criteria evidence framework for evaluating OPPs in emerging markets. An International Outcomes Research Board (IORB) of academia and industry experts conducted extensive research, meetings, and workshops to define high-priority criteria to incorporate into an evidence-based health technology assessment (HTA) tool using the multi-criteria decision analysis (MCDA) technique. The resulting framework was further tailored for country-specific needs in workshops in three emerging countries (Kazakhstan, Vietnam, and Indonesia). The IORB defined nine criteria four categories (Product, Manufacturing, Service, and Value Assessment), which OPP manufacturers can use to provide evidence for reimbursement and health policy decision making. Then the IORB developed the EFOR as a base case document, which can be adapted and used as a template by health authorities in emerging countries. Emerging countries have a significant need for an HTA tool that balances affordability with accurate evidence showing the value differentiation of OPPs. The value attributes in this setting often are different from those in developed markets, which emphasize new products and have high regulation and manufacturing standards. The EFOR is an easy-to-use, adaptable framework that emerging countries can use to increase the consistency, transparency, and effectiveness of drug decision making. The open source EFOR is available as Supplemental Materials. Copyright © 2018. Published by Elsevier Inc.

Monte Carlo simulation of photon buildup factors for shielding materials in diagnostic x-ray facilities.

PubMed

Kharrati, Hedi; Agrebi, Amel; Karoui, Mohamed Karim

2012-10-01

A simulation of buildup factors for ordinary concrete, steel, lead, plate glass, lead glass, and gypsum wallboard in broad beam geometry for photons energies from 10 keV to 150 keV at 5 keV intervals is presented. Monte Carlo N-particle radiation transport computer code has been used to determine the buildup factors for the studied shielding materials. An example concretizing the use of the obtained buildup factors data in computing the broad beam transmission for tube potentials at 70, 100, 120, and 140 kVp is given. The half value layer, the tenth value layer, and the equilibrium tenth value layer are calculated from the broad beam transmission for these tube potentials. The obtained values compared with those calculated from the published data show the ability of these data to predict shielding transmission curves. Therefore, the buildup factors data can be combined with primary, scatter, and leakage x-ray spectra to provide a computationally based solution to broad beam transmission for barriers in shielding x-ray facilities.

Effects of systemic cholinergic antagonism on reinforcer devaluation in macaques.

PubMed

Waguespack, Hannah F; Málková, Ludise; Forcelli, Patrick A; Turchi, Janita

2018-06-21

The capacity to adjust actions based on new information is a vital cognitive function. An animal's ability to adapt behavioral responses according to changes in reward value can be measured using a reinforcer devaluation task, wherein the desirability of a given object is reduced by decreasing the value of the associated food reinforcement. Elements of the neural circuits serving this ability have been studied in both rodents and nonhuman primates. Specifically, the basolateral amygdala, orbitofrontal cortex, nucleus accumbens, and mediodorsal thalamus have each been shown to play a critical role in the process of value updating, required for adaptive goal selection. As these regions receive dense cholinergic input, we investigated whether systemic injections of non-selective nicotinic or muscarinic acetylcholine receptor antagonists, mecamylamine and scopolamine, respectively, would impair performance on a reinforcer devaluation task. Here we demonstrate that in the presence of either a nicotinic or muscarinic antagonist, animals are able to shift their behavioral responses in an appropriate manner, suggesting that disruption of cholinergic neuromodulation is not sufficient to disrupt value updating, and subsequent goal selection, in rhesus macaques. Published by Elsevier B.V.

Prognostic Value of RUNX1 Mutations in AML: A Meta-Analysis

PubMed

Jalili, Mahdi; Yaghmaie, Marjan; Ahmadvand, Mohammad; Alimoghaddam, Kamran; Mousavi, Seyed Asadollah; Vaezi, Mohammad; Ghavamzadeh, Ardeshir

2018-02-26

The RUNX1 (AML1) gene is a relatively infrequent mutational target in cases of acute myeloid leukemia (AML). Previous work indicated that RUNX1 mutations can have pathological and prognostic implications. To evaluate prognostic value, we conducted a meta-analysis of 4 previous published works with data for survival according to RUNX1 mutation status. Pooled hazard ratios for overall survival and disease-free survival were 1.55 (95% confidence interval (CI) = 1.11–2.15; p-value = 0.01) and 1.76 (95% CI = 1.24–2.52; p-value = 0.002), respectively, for cases positive for RUNX1 mutations. This evidence supports clinical implications of RUNX1 mutations in the development and progression of AML cases and points to the possibility of a distinct category within the newer WHO classification. Though it must be kept in mind that the present work was based on data extracted from observational studies, the findings suggest that the RUNX1 status can contribute to risk-stratification and decision-making in management of AML. Creative Commons Attribution License

Monte Carlo simulation of photon buildup factors for shielding materials in diagnostic x-ray facilities

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

Kharrati, Hedi; Agrebi, Amel; Karoui, Mohamed Karim

2012-10-15

Purpose: A simulation of buildup factors for ordinary concrete, steel, lead, plate glass, lead glass, and gypsum wallboard in broad beam geometry for photons energies from 10 keV to 150 keV at 5 keV intervals is presented. Methods: Monte Carlo N-particle radiation transport computer code has been used to determine the buildup factors for the studied shielding materials. Results: An example concretizing the use of the obtained buildup factors data in computing the broad beam transmission for tube potentials at 70, 100, 120, and 140 kVp is given. The half value layer, the tenth value layer, and the equilibrium tenthmore » value layer are calculated from the broad beam transmission for these tube potentials. Conclusions: The obtained values compared with those calculated from the published data show the ability of these data to predict shielding transmission curves. Therefore, the buildup factors data can be combined with primary, scatter, and leakage x-ray spectra to provide a computationally based solution to broad beam transmission for barriers in shielding x-ray facilities.« less

Model-based learning and the contribution of the orbitofrontal cortex to the model-free world.

PubMed

McDannald, Michael A; Takahashi, Yuji K; Lopatina, Nina; Pietras, Brad W; Jones, Josh L; Schoenbaum, Geoffrey

2012-04-01

Learning is proposed to occur when there is a discrepancy between reward prediction and reward receipt. At least two separate systems are thought to exist: one in which predictions are proposed to be based on model-free or cached values; and another in which predictions are model-based. A basic neural circuit for model-free reinforcement learning has already been described. In the model-free circuit the ventral striatum (VS) is thought to supply a common-currency reward prediction to midbrain dopamine neurons that compute prediction errors and drive learning. In a model-based system, predictions can include more information about an expected reward, such as its sensory attributes or current, unique value. This detailed prediction allows for both behavioral flexibility and learning driven by changes in sensory features of rewards alone. Recent evidence from animal learning and human imaging suggests that, in addition to model-free information, the VS also signals model-based information. Further, there is evidence that the orbitofrontal cortex (OFC) signals model-based information. Here we review these data and suggest that the OFC provides model-based information to this traditional model-free circuitry and offer possibilities as to how this interaction might occur. © 2012 The Authors. European Journal of Neuroscience © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

Adult men's beliefs, values, attitudes and experiences regarding contraceptives: a systematic review of qualitative studies.

PubMed

Hoga, Luiza A K; Rodolpho, Juliana R C; Sato, Priscila M; Nunes, Michelly C M; Borges, Ana L V

2014-04-01

To explore the men's beliefs, values, attitudes and experiences towards contraceptives. The promotion of male participation in contraceptive practices requires the knowledge and consideration of the beliefs, values, attitudes and experiences involved. The systematic review of the literature focusing on these themes can be useful for the evidence-based health care. A systematic review of qualitative studies. Studies published between 1994 until 2011 (inclusive) were included. The participants included men from all cultures, ethnic backgrounds and religions who have expressed their beliefs, values, attitudes and experiences regarding male contraceptives. The databases CINAHL, PubMed, PsycINFO, SciELO, LILACS and MedCarib were explored. The appraisal of primary studies, carried out through the JBI-QARI (Qualitative Assessment and Review Instrument) resulted in the inclusion of 16 studies in this systematic review. The set of statements of beliefs, values, attitudes and experiences regarding contraceptives resulted in five synthesis: (1) contraceptive behaviour is influenced by religious, family and social backgrounds; (2) gendered, male-centred values predominate in contraceptive behaviours; (3) the sense of invulnerability influences contraceptive behaviours; (4) strong obstacles should be overcome to use contraceptives; (5) behaviours, decision-making and experiences regarding male contraceptives. The male beliefs and values regarding contraceptives are strongly influenced by religious, family and social backgrounds, and their attitudes in this scope are male centred. A deeper male consciousness regarding contraceptive responsibility should be promoted. It requires the knowledge of the men's personal backgrounds regarding contraceptives because they can be diverse according to family, social and cultural contexts. The consideration of the men's personal perspective is essential in the planning and implementation of reproductive health care. These aspects are essential for the concretisation of the evidence-based health care, a current challenge worldwide. © 2013 John Wiley & Sons Ltd.

The OPALS Plan for Operations: Use of ISS Trajectory and Attitude Models in the OPALS Pointing Strategy

NASA Technical Reports Server (NTRS)

Abrahamson, Matthew J.; Oaida, Bogdan; Erkmen, Baris

2013-01-01

This paper will discuss the OPALS pointing strategy, focusing on incorporation of ISS trajectory and attitude models to build pointing predictions. Methods to extrapolate an ISS prediction based on past data will be discussed and will be compared to periodically published ISS predictions and Two-Line Element (TLE) predictions. The prediction performance will also be measured against GPS states available in telemetry. The performance of the pointing products will be compared to the allocated values in the OPALS pointing budget to assess compliance with requirements.

Extraction of shear viscosity in stationary states of relativistic particle systems

NASA Astrophysics Data System (ADS)

Reining, F.; Bouras, I.; El, A.; Wesp, C.; Xu, Z.; Greiner, C.

2012-02-01

Starting from a classical picture of shear viscosity we construct a stationary velocity gradient in a microscopic parton cascade. Employing the Navier-Stokes ansatz we extract the shear viscosity coefficient η. For elastic isotropic scatterings we find an excellent agreement with the analytic values. This confirms the applicability of this method. Furthermore, for both elastic and inelastic scatterings with pQCD based cross sections we extract the shear viscosity coefficient η for a pure gluonic system and find a good agreement with already published calculations.

Design and development of radioactive xenon gas purification and analysis system based on molecular sieves.

PubMed

Sabzian, M; Nasrabadi, M N; Haji-Hosseini, M

2018-10-01

The dynamic adsorption of xenon on molecular sieve packed columns was investigated. The modified Wheeler-Jonas equation was used to describe adsorption parameters such as adsorption capacity and adsorption rate coefficient. Different experimental conditions were accomplished to study their effects and to touch appropriate adsorbing circumstances. Respectable consistency was reached between experimental and modeled values. A purification and analysis setup was developed for radioactive xenon gas determination. Standard sample analysis results approved acceptable quantification accuracy. Copyright © 2018. Published by Elsevier Ltd.

Extraction of Events and Temporal Expressions from Clinical Narratives (Open Access, Publisher’s Version)

DTIC Science & Technology

2013-09-08

Modality and Polarity. There are 6 possible values for the Type attribute: (1) laboratory tests, etc. (TEST), (2) treatments, medications, surgeries , etc...confident that first and third events (‘‘hemoptysis’’ and ‘‘ abdominal pain’’) are both problems. Based on the constraint that all the elements in a...days after the operation date. We also cap- ture other variations of ‘‘POD#n’’ like ‘‘ postoperative day n’’, etc. 2. A similar procedure as described

Cutaneous scarring: Pathophysiology, molecular mechanisms, and scar reduction therapeutics Part II. Strategies to reduce scar formation after dermatologic procedures.

PubMed

Tziotzios, Christos; Profyris, Christos; Sterling, Jane

2012-01-01

The evidence base underpinning most traditional scar reduction approaches is limited, but some of the novel strategies are promising and accumulating. We review a number of commonly adopted strategies for scar reduction. The outlined novel agents are paradigmatic of the value of translational medical research and are likely to change the scenery in the much neglected but recently revived field of scar reduction therapeutics. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Integrating Behavioral Economics into Nutrition Education Research and Practice.

PubMed

Guthrie, Joanne F

2017-09-01

Nutrition education has a long history of being informed by economic thinking, with the earliest nutrition education guides incorporating household food budgeting into nutrition advice. Behavioral economics research goes beyond that traditional role to provide new insights into how consumers make choices. These insights have numerous potential applications for nutrition interventions to promote healthy food choices consistent with the US Dietary Guidelines for Americans. Research to test the value of such applications can contribute to the development of evidence-based nutrition education practice called for in federal nutrition education programs. Published by Elsevier Inc.

Methodology of Numerical Optimization for Orbital Parameters of Binary Systems

NASA Astrophysics Data System (ADS)

Araya, I.; Curé, M.

2010-02-01

The use of a numerical method of maximization (or minimization) in optimization processes allows us to obtain a great amount of solutions. Therefore, we can find a global maximum or minimum of the problem, but this is only possible if we used a suitable methodology. To obtain the global optimum values, we use the genetic algorithm called PIKAIA (P. Charbonneau) and other four algorithms implemented in Mathematica. We demonstrate that derived orbital parameters of binary systems published in some papers, based on radial velocity measurements, are local minimum instead of global ones.

Social Learning Theory: its application in the context of nurse education.

PubMed

Bahn, D

2001-02-01

Cognitive theories are fundamental to enable problem solving and the ability to understand and apply principles in a variety of situations. This article looks at Social Learning Theory, critically analysing its principles, which are based on observational learning and modelling, and considering its value and application in the context of nurse education. It also considers the component processes that will determine the outcome of observed behaviour, other than reinforcement, as identified by Bandura, namely: attention, retention, motor reproduction, and motivation. Copyright 2001 Harcourt Publishers Ltd.

A Study of Carrier Based Aircraft Readiness Sustainability in the Event of External Air Logistic Support Deprivation

DTIC Science & Technology

1987-06-01

equation for 7R investment has been used in combination with the linear equation for COD/VOD delivery to produce six " iso -readiness" lines. Each iso ...readiness line represents the value of inventory investment and days since last COD/VOD delivery required to maintain a specific level of FMC. The iso ...Truett, D.B., Manaaerial Economics, second edition, South-Western Publish..ng Co., 1984, p. 65. 158 Iso -Readiness Plot o80mna4C Mad" of ?R Ve COO/VOo WO

Setting Research Priorities for Kidney Cancer.

PubMed

Jones, Jennifer M; Bhatt, Jaimin; Avery, Jonathan; Laupacis, Andreas; Cowan, Katherine; Basappa, Naveen S; Basiuk, Joan; Canil, Christina; Al-Asaaed, Sohaib; Heng, Daniel Y C; Wood, Lori; Stacey, Dawn; Kollmannsberger, Christian; Jewett, Michael A S

2017-12-01

Defining disease-specific research priorities in cancer can facilitate better allocation of limited resources. Involving patients and caregivers as well as expert clinicians in this process is of value. We undertook this approach for kidney cancer as an example. The Kidney Cancer Research Network of Canada sponsored a collaborative consensus-based priority-setting partnership that identified ten research priorities in the management of kidney cancer. These are discussed in the context of current initiatives and gaps in knowledge. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Passenger car equivalents of becak bermotor at road segment in Medan

NASA Astrophysics Data System (ADS)

Surbakti, M. S.; Sembiring, I.

2018-02-01

The road traffic systems, travel patterns and other traffic characteristics are different for each country due to differences in the geometric patterns, available transport facilities for commuters, proportional and type of the vehicle itself and so on. In Indonesia, the standard of pce (Passenger Car Equivalent) value found on IHCM (Indonesian Highway Capacity Manual) published in 1997. IHCM stated that the value of pce for heavy vehicles and motorcycles are 1.3 and 0.5 respectively. On these day, regarding Medan as a third biggest city in Indonesia, there have been lot of changes with regarding to the composition of the vehicle, as well as variations of the type of the vehicle itself. Becak bermotor (motorized tricycles) is a vehicle which is widely available in the city of Medan. Data from Medan City Transportation Department stated that there are more than 20,000 motorized motorized tricycles vehicles operating in the city at these day. Pce value of these rickshaws will be calculated based on observations at road and intersections in Medan. The calculation result shows that the pce value of motorized rickshaw is more than 1. This value will make the calculations regarding the performance of the traffic can be performed more accurately.

Dynamics of co-authorship and productivity across different fields of scientific research.

PubMed

Parish, Austin J; Boyack, Kevin W; Ioannidis, John P A

2018-01-01

We aimed to assess which factors correlate with collaborative behavior and whether such behavior associates with scientific impact (citations and becoming a principal investigator). We used the R index which is defined for each author as log(Np)/log(I1), where I1 is the number of co-authors who appear in at least I1 papers written by that author and Np are his/her total papers. Higher R means lower collaborative behavior, i.e. not working much with others, or not collaborating repeatedly with the same co-authors. Across 249,054 researchers who had published ≥30 papers in 2000-2015 but had not published anything before 2000, R varied across scientific fields. Lower values of R (more collaboration) were seen in physics, medicine, infectious disease and brain sciences and higher values of R were seen for social science, computer science and engineering. Among the 9,314 most productive researchers already reaching Np ≥ 30 and I1 ≥ 4 by the end of 2006, R mostly remained stable for most fields from 2006 to 2015 with small increases seen in physics, chemistry, and medicine. Both US-based authorship and male gender were associated with higher values of R (lower collaboration), although the effect was small. Lower values of R (more collaboration) were associated with higher citation impact (h-index), and the effect was stronger in certain fields (physics, medicine, engineering, health sciences) than in others (brain sciences, computer science, infectious disease, chemistry). Finally, for a subset of 400 U.S. researchers in medicine, infectious disease and brain sciences, higher R (lower collaboration) was associated with a higher chance of being a principal investigator by 2016. Our analysis maps the patterns and evolution of collaborative behavior across scientific disciplines.

Nuclear DNA amounts in angiosperms: progress, problems and prospects.

PubMed

Bennett, M D; Leitch, I J

2005-01-01

The nuclear DNA amount in an unreplicated haploid chromosome complement (1C-value) is a key diversity character with many uses. Angiosperm C-values have been listed for reference purposes since 1976, and pooled in an electronic database since 1997 (http://www.kew.org/cval/homepage). Such lists are cited frequently and provide data for many comparative studies. The last compilation was published in 2000, so a further supplementary list is timely to monitor progress against targets set at the first plant genome size workshop in 1997 and to facilitate new goal setting. The present work lists DNA C-values for 804 species including first values for 628 species from 88 original sources, not included in any previous compilation, plus additional values for 176 species included in a previous compilation. 1998-2002 saw striking progress in our knowledge of angiosperm C-values. At least 1700 first values for species were measured (the most in any five-year period) and familial representation rose from 30 % to 50 %. The loss of many densitometers used to measure DNA C-values proved less serious than feared, owing to the development of relatively inexpensive flow cytometers and computer-based image analysis systems. New uses of the term genome (e.g. in 'complete' genome sequencing) can cause confusion. The Arabidopsis Genome Initiative C-value for Arabidopsis thaliana (125 Mb) was a gross underestimate, and an exact C-value based on genome sequencing alone is unlikely to be obtained soon for any angiosperm. Lack of this expected benchmark poses a quandary as to what to use as the basal calibration standard for angiosperms. The next decade offers exciting prospects for angiosperm genome size research. The database (http://www.kew.org/cval/homepage) should become sufficiently representative of the global flora to answer most questions without needing new estimations. DNA amount variation will remain a key interest as an integrated strand of holistic genomics.

Serum anti-PLA2R antibody as a diagnostic biomarker of idiopathic membranous nephropathy: The optimal cut-off value for Chinese patients.

PubMed

Liu, Yipeng; Li, Xuan; Ma, Chaoqun; Wang, Ping; Liu, Ju; Su, Hong; Zhuo, Hao; Kong, Xianglei; Xu, Dayu; Xu, Dongmei

2018-01-01

The M-type phospholipase A2 receptor (PLA2R) is a specific target autoantigen identified in idiopathic membranous nephropathy (IMN). The autoantibody against PLA2R (anti-PLA2R) may be used to diagnose IMN. However, the appropriate diagnosis cut-off value for Chinese patients with IMN has not been established. In total, 119 patients who underwent renal biopsy (57 patients with IMN and 62 patients with non-IMN glomerulonephritis) and 22 healthy individuals were recruited for our observation study from Qianfoshan Hospital between September 2011 and March 2016. The serum concentration of anti-PLA2R was measured using a quantitative enzyme-linked immunosorbent assay (ELISA). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and receiver operating characteristic (ROC) curve of anti-PLA2R in diagnosing IMN were analysed based on the ELISA detection. The sensitivity, specificity, PPV, and NPV of anti-PLA2R in the diagnosis of IMN in the Chinese patients were 82.5, 75, 69.1, and 86.3% for the 2RU/ml cut-off value; 78.9, 91.7, 86.5, and 86.5% for the 2.6RU/ml cut-off value; 59.6, 95.2, 89.5, and 77.7% for the 14RU/ml cut-off value; 50.9, 96.4, 90.6, and 74.3% for the 20RU/ml cut-off value; and 47.4, 97.6, 93.1, and 73.2% for the 40RU/ml cut-off value, respectively. The area under the ROC curve was 0.879. The cut-off value of 2.6RU/ml is recommended for the use of anti-PLA2R for the diagnosis of IMN in Chinese patients based on the ELISA. Copyright © 2017. Published by Elsevier B.V.

Recreation economics to inform migratory species conservation: Case study of the northern pintail

USGS Publications Warehouse

Mattsson, Brady J.; Dubovsky, James A.; Thogmartin, Wayne E.; Bagstad, Kenneth J.; Goldstein, Joshua H.; Loomis, John B.; Diffendorfer, James E.; Semmens, Darius J.; Wiederholt, Ruscena; Lopez-Hoffman, Laura

2018-01-01

Quantification of the economic value provided by migratory species can aid in targeting management efforts and funding to locations yielding the greatest benefits to society and species conservation. Here we illustrate a key step in this process by estimating hunting and birding values of the northern pintail (Anas acuta) within primary breeding and wintering habitats used during the species’ annual migratory cycle in North America. We used published information on user expenditures and net economic values (consumer surplus) for recreational viewing and hunting to determine the economic value of pintail-based recreation in three primary breeding areas and two primary wintering areas. Summed expenditures and consumer surplus for northern pintail viewing were annually valued at $70M, and annual sport hunting totaled $31M (2014 USD). Expenditures for viewing ($42M) were more than twice as high than those for hunting ($18M). Estimates of consumer surplus, defined as the amount consumers are willing to pay above their current expenditures, were $15M greater for viewing ($28M) than for hunting ($13M). We discovered substantial annual consumer surplus ($41M) available for pintail conservation from birders and hunters. We also found spatial differences in economic value among the primary regions used by pintails, with viewing generally valued more in breeding regions than in wintering regions and the reverse being true for hunting. The economic value of pintail-based recreation in the Western wintering region ($26M) exceeded that in any other region by at least a factor of three. Our approach of developing regionally explicit economic values can be extended to other taxonomic groups, and is particularly suitable for migratory game birds because of the availability of large amounts of data. When combined with habitat-linked population models, regionally explicit values could inform development of more effective conservation finance and policy mechanisms to enhance environmental management and societal benefits across the geographically dispersed areas used by migratory species.

Recreation economics to inform migratory species conservation: Case study of the northern pintail.

PubMed

Mattsson, Brady J; Dubovsky, James A; Thogmartin, Wayne E; Bagstad, Kenneth J; Goldstein, Joshua H; Loomis, John B; Diffendorfer, James E; Semmens, Darius J; Wiederholt, Ruscena; López-Hoffman, Laura

2018-01-15

Quantification of the economic value provided by migratory species can aid in targeting management efforts and funding to locations yielding the greatest benefits to society and species conservation. Here we illustrate a key step in this process by estimating hunting and birding values of the northern pintail (Anas acuta) within primary breeding and wintering habitats used during the species' annual migratory cycle in North America. We used published information on user expenditures and net economic values (consumer surplus) for recreational viewing and hunting to determine the economic value of pintail-based recreation in three primary breeding areas and two primary wintering areas. Summed expenditures and consumer surplus for northern pintail viewing were annually valued at $70M, and annual sport hunting totaled $31M (2014 USD). Expenditures for viewing ($42M) were more than twice as high than those for hunting ($18M). Estimates of consumer surplus, defined as the amount consumers are willing to pay above their current expenditures, were $15M greater for viewing ($28M) than for hunting ($13M). We discovered substantial annual consumer surplus ($41M) available for pintail conservation from birders and hunters. We also found spatial differences in economic value among the primary regions used by pintails, with viewing generally valued more in breeding regions than in wintering regions and the reverse being true for hunting. The economic value of pintail-based recreation in the Western wintering region ($26M) exceeded that in any other region by at least a factor of three. Our approach of developing regionally explicit economic values can be extended to other taxonomic groups, and is particularly suitable for migratory game birds because of the availability of large amounts of data. When combined with habitat-linked population models, regionally explicit values could inform development of more effective conservation finance and policy mechanisms to enhance environmental management and societal benefits across the geographically dispersed areas used by migratory species. Copyright © 2017 Elsevier Ltd. All rights reserved.

Renal function, nephrogenic systemic fibrosis and other adverse reactions associated with gadolinium-based contrast media.

PubMed

Canga, Ana; Kislikova, Maria; Martínez-Gálvez, María; Arias, Mercedes; Fraga-Rivas, Patricia; Poyatos, Cecilio; de Francisco, Angel L M

2014-01-01

Nephrogenic systemic fibrosis is a fibrosing disorder that affects patients with impaired renal function and is associated with the administration of gadolinium-based contrast media used in MRI. Despite being in a group of drugs that were considered safe, report about this potentially serious adverse reaction was a turning point in the administration guidelines of these contrast media. There has been an attempt to establish safety parameters to identify patients with risk factors of renal failure. The close pharmacovigilance and strict observation of current regulations, with special attention being paid to the value of glomerular filtration, have reduced the published cases involving the use of gadolinium-based contrast media. In a meeting between radiologists and nephrologists we reviewed the most relevant aspects currently and recommendations for its prevention.

Confidence assignment for mass spectrometry based peptide identifications via the extreme value distribution.

PubMed

Alves, Gelio; Yu, Yi-Kuo

2016-09-01

There is a growing trend for biomedical researchers to extract evidence and draw conclusions from mass spectrometry based proteomics experiments, the cornerstone of which is peptide identification. Inaccurate assignments of peptide identification confidence thus may have far-reaching and adverse consequences. Although some peptide identification methods report accurate statistics, they have been limited to certain types of scoring function. The extreme value statistics based method, while more general in the scoring functions it allows, demands accurate parameter estimates and requires, at least in its original design, excessive computational resources. Improving the parameter estimate accuracy and reducing the computational cost for this method has two advantages: it provides another feasible route to accurate significance assessment, and it could provide reliable statistics for scoring functions yet to be developed. We have formulated and implemented an efficient algorithm for calculating the extreme value statistics for peptide identification applicable to various scoring functions, bypassing the need for searching large random databases. The source code, implemented in C ++ on a linux system, is available for download at ftp://ftp.ncbi.nlm.nih.gov/pub/qmbp/qmbp_ms/RAId/RAId_Linux_64Bit yyu@ncbi.nlm.nih.gov Supplementary data are available at Bioinformatics online. Published by Oxford University Press 2016. This work is written by US Government employees and is in the public domain in the US.

Properties of hydrophobic free energy found by gas–liquid transfer

PubMed Central

Baldwin, Robert L.

2013-01-01

The hydrophobic free energy in current use is based on transfer of alkane solutes from liquid alkanes to water, and it has been argued recently that these values are incorrect and should be based instead on gas–liquid transfer data. Hydrophobic free energy is measured here by gas–liquid transfer of hydrocarbon gases from vapor to water. The new definition reduces more than twofold the values of the apparent hydrophobic free energy. Nevertheless, the newly defined hydrophobic free energy is still the dominant factor that drives protein folding as judged by ΔCp, the change in heat capacity, found from the free energy change for heat-induced protein unfolding. The ΔCp for protein unfolding agrees with ΔCp values for solvating hydrocarbon gases and disagrees with ΔCp for breaking peptide hydrogen bonds, which has the opposite sign. The ΔCp values for the enthalpy of liquid–liquid and gas–liquid transfer are similar. The plot of free energy against the apparent solvent-exposed surface area is given for linear alkanes, but only for a single conformation, the extended conformation, of these flexible-chain molecules. The ability of the gas–liquid hydrophobic factor to predict protein stability is tested and reasonable agreement is found, using published data for the dependences on temperature of the unfolding enthalpy of ribonuclease T1 and the solvation enthalpies of the nonpolar and polar groups. PMID:23319615

Properties of hydrophobic free energy found by gas-liquid transfer.

PubMed

Baldwin, Robert L

2013-01-29

The hydrophobic free energy in current use is based on transfer of alkane solutes from liquid alkanes to water, and it has been argued recently that these values are incorrect and should be based instead on gas-liquid transfer data. Hydrophobic free energy is measured here by gas-liquid transfer of hydrocarbon gases from vapor to water. The new definition reduces more than twofold the values of the apparent hydrophobic free energy. Nevertheless, the newly defined hydrophobic free energy is still the dominant factor that drives protein folding as judged by ΔCp, the change in heat capacity, found from the free energy change for heat-induced protein unfolding. The ΔCp for protein unfolding agrees with ΔCp values for solvating hydrocarbon gases and disagrees with ΔCp for breaking peptide hydrogen bonds, which has the opposite sign. The ΔCp values for the enthalpy of liquid-liquid and gas-liquid transfer are similar. The plot of free energy against the apparent solvent-exposed surface area is given for linear alkanes, but only for a single conformation, the extended conformation, of these flexible-chain molecules. The ability of the gas-liquid hydrophobic factor to predict protein stability is tested and reasonable agreement is found, using published data for the dependences on temperature of the unfolding enthalpy of ribonuclease T1 and the solvation enthalpies of the nonpolar and polar groups.

Public magnetic field exposure based on internal current density for electric low voltage systems.

PubMed

Keikko, Tommi; Seesvuori, Reino; Hyvönen, Martti; Valkealahti, Seppo

2009-04-01

A measurement concept utilizing a new magnetic field exposure metering system has been developed for indoor substations where voltage is transformed from a medium voltage of 10 or 20 kV to a low voltage of 400 V. The new metering system follows the guidelines published by the International Commission on Non-Ionizing Radiation Protection. It can be used to measure magnetic field values, total harmonic distortion of the magnetic field, magnetic field exposure ratios for public and workers, load current values, and total harmonic distortion of the load current. This paper demonstrates how exposure to non-sinusoidal magnetic fields and magnetic flux density exposure values can be compared directly with limit values for internal current densities in a human body. Further, we present how the magnetic field and magnetic field exposure behaves in the vicinity of magnetic field sources within the indoor substation and in the neighborhood. Measured magnetic fields around the substation components have been used to develop a measurement concept by which long-term measurements in the substations were performed. Long-term measurements revealed interesting and partly unexpected dependencies between the measured quantities, which have been further analyzed. The principle of this paper is to substitute a demanding exposure measurement with measurements of the basic quantities like the 50 Hz fundamental magnetic field component, which can be estimated based on the load currents for certain classes of substation lay-out.

Paving the way for the use of the SDQ in economic evaluations of school-based population health interventions: an empirical analysis of the external validity of SDQ mapping algorithms to the CHU9D in an educational setting.

PubMed

Boyer, Nicole R S; Miller, Sarah; Connolly, Paul; McIntosh, Emma

2016-04-01

The Strengths and Difficulties Questionnaire (SDQ) is a behavioural screening tool for children. The SDQ is increasingly used as the primary outcome measure in population health interventions involving children, but it is not preference based; therefore, its role in allocative economic evaluation is limited. The Child Health Utility 9D (CHU9D) is a generic preference-based health-related quality of-life measure. This study investigates the applicability of the SDQ outcome measure for use in economic evaluations and examines its relationship with the CHU9D by testing previously published mapping algorithms. The aim of the paper is to explore the feasibility of using the SDQ within economic evaluations of school-based population health interventions. Data were available from children participating in a cluster randomised controlled trial of the school-based roots of empathy programme in Northern Ireland. Utility was calculated using the original and alternative CHU9D tariffs along with two SDQ mapping algorithms. t tests were performed for pairwise differences in utility values from the preference-based tariffs and mapping algorithms. Mean (standard deviation) SDQ total difficulties and prosocial scores were 12 (3.2) and 8.3 (2.1). Utility values obtained from the original tariff, alternative tariff, and mapping algorithms using five and three SDQ subscales were 0.84 (0.11), 0.80 (0.13), 0.84 (0.05), and 0.83 (0.04), respectively. Each method for calculating utility produced statistically significantly different values except the original tariff and five SDQ subscale algorithm. Initial evidence suggests the SDQ and CHU9D are related in some of their measurement properties. The mapping algorithm using five SDQ subscales was found to be optimal in predicting mean child health utility. Future research valuing changes in the SDQ scores would contribute to this research.

Chimeric recombinant antibody fragments in cardiac troponin I immunoassay.

PubMed

Hyytiä, Heidi; Heikkilä, Taina; Brockmann, Eeva-Christine; Kekki, Henna; Hedberg, Pirjo; Puolakanaho, Tarja; Lövgren, Timo; Pettersson, Kim

2015-03-01

To introduce a novel nanoparticle-based immunoassay for cardiac troponin I (cTnI) utilizing chimeric antibody fragments and to demonstrate that removal of antibody Fc-part and antibody chimerization decrease matrix related interferences. A sandwich-type immunoassay for cTnI based on recombinant chimeric (mouse variable/human constant) antigen binding (cFab) antibodies and intrinsically fluorescent nanoparticles was developed. To test whether using chimeric antibody fragments helps to avoid matrix related interferences, samples (n=39) with known amounts of triglycerides, bilirubin, rheumatoid factor (RF) or human anti-mouse antibodies (HAMAs) were measured with the novel assay, along with a previously published nanoparticle-based research assay with the same antibody epitopes. The limit of detection (LoD) was 3.30ng/L. Within-laboratory precision for 29ng/L and 2819ng/L cTnI were 13.7% and 15.9%, respectively. Regression analysis with Siemens ADVIA Centaur® yielded a slope (95% confidence intervals) of 0.18 (0.17-1.19) and a y-intercept of 1.94 (-1.28-3.91) ng/L. When compared to a previously published nanoparticle-based assay, the novel assay showed substantially reduced interference in the tested interference prone samples, 15.4 vs. 51.3%. A rheumatoid factor containing sample was decreased from 241ng/L to

A systematic literature review of health state utility values in head and neck cancer.

PubMed

Meregaglia, Michela; Cairns, John

2017-09-02

Health state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and provides guidance for selecting them from a growing body of health-related quality of life studies. We systematically reviewed the published literature by searching PubMed, EMBASE and The Cochrane Library using a pre-defined combination of keywords. The Tufts Cost-Effectiveness Analysis Registry and the School of Health and Related Research Health Utilities Database (ScHARRHUD) specifically containing health utilities were also queried, in addition to the Health Economics Research Centre database of mapping studies. Studies were considered for inclusion if reporting original HSUVs assessed using established techniques. The characteristics of each study including country, design, sample size, cancer subsite addressed and demographics of responders were summarized narratively using a data extraction form. Quality scoring and critical appraisal of the included studies were performed based on published recommendations. Of a total 1048 records identified by the search, 28 studies qualified for data extraction and 346 unique HSUVs were retrieved from them. HSUVs were estimated using direct methods (e.g. standard gamble; n = 10 studies), multi-attribute utility instruments (MAUIs; n = 13) and mapping techniques (n = 3); two studies adopted both direct and indirect approaches. Within the MAUIs, the EuroQol 5-dimension questionnaire (EQ-5D) was the most frequently used (n = 11), followed by the Health Utility Index Mark 3 (HUI3; n = 2), the 15D (n = 2) and the Short Form-Six Dimension (SF-6D; n = 1). Different methods and types of responders (i.e. patients, healthy subjects, clinical experts) influenced the magnitude of HSUVs for comparable health states. Only one mapping study developed an original algorithm using head and neck cancer data. The identified studies were considered of intermediate quality. This review provides a dataset of HSUVs systematically retrieved from published studies in head and neck cancer. There is currently a lack of research for some disease phases including recurrent and metastatic cancer, and treatment-related complications. In selecting HSUVs for cost-effectiveness modeling purposes, preference should be given to EQ-5D utility values; however, mapping to EQ-5D is a potentially valuable technique that should be further developed in this cancer population.

Quality of reporting in oncology phase II trials: A 5-year assessment through systematic review.

PubMed

Langrand-Escure, Julien; Rivoirard, Romain; Oriol, Mathieu; Tinquaut, Fabien; Rancoule, Chloé; Chauvin, Frank; Magné, Nicolas; Bourmaud, Aurélie

2017-01-01

Phase II clinical trials are a cornerstone of the development in experimental treatments They work as a "filter" for phase III trials confirmation. Surprisingly the attrition ratio in Phase III trials in oncology is significantly higher than in any other medical specialty. This suggests phase II trials in oncology fail to achieve their goal. Objective The present study aims at estimating the quality of reporting in published oncology phase II clinical trials. A literature review was conducted among all phase II and phase II/III clinical trials published during a 5-year period (2010-2015). All articles electronically published by three randomly-selected oncology journals with Impact-Factors>4 were included: Journal of Clinical Oncology, Annals of Oncology and British Journal of Cancer. Quality of reporting was assessed using the Key Methodological Score. 557 articles were included. 315 trials were single-arm studies (56.6%), 193 (34.6%) were randomized and 49 (8.8%) were non-randomized multiple-arm studies. The Methodological Score was equal to 0 (lowest level), 1, 2, 3 (highest level) respectively for 22 (3.9%), 119 (21.4%), 270 (48.5%) and 146 (26.2%) articles. The primary end point is almost systematically reported (90.5%), while sample size calculation is missing in 66% of the articles. 3 variables were independently associated with reporting of a high standard: presence of statistical design (p-value <0.001), multicenter trial (p-value = 0.012), per-protocol analysis (p-value <0.001). Screening was mainly performed by a sole author. The Key Methodological Score was based on only 3 items, making grey zones difficult to translate. This literature review highlights the existence of gaps concerning the quality of reporting. It therefore raised the question of the suitability of the methodology as well as the quality of these trials, reporting being incomplete in the corresponding articles.

Quality of reporting in oncology phase II trials: A 5-year assessment through systematic review

PubMed Central

Langrand-Escure, Julien; Rivoirard, Romain; Oriol, Mathieu; Tinquaut, Fabien; Rancoule, Chloé; Chauvin, Frank; Magné, Nicolas; Bourmaud, Aurélie

2017-01-01

Background Phase II clinical trials are a cornerstone of the development in experimental treatments They work as a "filter" for phase III trials confirmation. Surprisingly the attrition ratio in Phase III trials in oncology is significantly higher than in any other medical specialty. This suggests phase II trials in oncology fail to achieve their goal. Objective The present study aims at estimating the quality of reporting in published oncology phase II clinical trials. Data sources A literature review was conducted among all phase II and phase II/III clinical trials published during a 5-year period (2010–2015). Study eligibility criteria All articles electronically published by three randomly-selected oncology journals with Impact-Factors>4 were included: Journal of Clinical Oncology, Annals of Oncology and British Journal of Cancer. Intervention Quality of reporting was assessed using the Key Methodological Score. Results 557 articles were included. 315 trials were single-arm studies (56.6%), 193 (34.6%) were randomized and 49 (8.8%) were non-randomized multiple-arm studies. The Methodological Score was equal to 0 (lowest level), 1, 2, 3 (highest level) respectively for 22 (3.9%), 119 (21.4%), 270 (48.5%) and 146 (26.2%) articles. The primary end point is almost systematically reported (90.5%), while sample size calculation is missing in 66% of the articles. 3 variables were independently associated with reporting of a high standard: presence of statistical design (p-value <0.001), multicenter trial (p-value = 0.012), per-protocol analysis (p-value <0.001). Limitations Screening was mainly performed by a sole author. The Key Methodological Score was based on only 3 items, making grey zones difficult to translate. Conclusions & implications of key findings This literature review highlights the existence of gaps concerning the quality of reporting. It therefore raised the question of the suitability of the methodology as well as the quality of these trials, reporting being incomplete in the corresponding articles. PMID:29216190

Evaluating the formulae for integrated lethality in ethylene oxide sterilization using six different endospore forming strains of bacteria, and comparisons of integrated lethality for ethylene oxide and steam systems.

PubMed

Mosley, Gregg A; Gillis, John R; Krushefski, Garrett

2005-01-01

Bacterial endospores from six different species of bacteria were exposed to a spectrum of ethylene oxide (EtO) sterilizing conditions. Temperature was varied from 40 to 60 degrees C and the ethylene oxide concentration was varied from 300 to 750 mg/L. Relative humidity was maintained at 60+/-10% RH. The fraction negative procedure was used to determine the D value for each of the test conditions. Bacterial species tested included Bacillus atrophaeus ATCC # 9372, Bacillus smithii ATCC # 51232, Bacillus subtilis "5230" ATCC # 35021, Bacillus subtilis, DSM # 4181, Bacillus pumilus ATCC # 27142, and Geobacillus stearothermophilus ATCC # 7953. All spore preparations were inoculated on filter paper strips packaged in blue, sterilizable glassine pouches. G. stearothermophilus was the least resistant organism tested. The most resistant organisms tested were B. atrophaeus and B. subtilis "5230". The B. subtilis "5230" strain was slightly more resistant than B. atrophaeus at conditions of 54C and EtO concentrations of 400, 600, and 750 mg/L, as well as at 60C/750mg/L EtO. The other species were between these extremes. This empirical data allowed the application of the recently published formula for converting D values from one set of conditions to another and evaluations of accuracy. The measured D values also allowed the determination of Z values based on temperature variations. These formulae, when applied to process temperatures independent of gas concentration, result in a Z value of approximately 32 degrees C that appears to be similar for all species tested. These data support the application of the previously published formulae 1-6 and allow the same approach to integrated lethality for ethylene oxide processes as is commonly applied to steam sterilization. A review of steam sterilization and related principles was conducted for comparison of integrated lethality for these two methods of sterilization. Errors associated with D values, Z values, extrapolation, and integrated lethality for both methods of sterilization are discussed.

Dairy farmers' use and non-use values in animal welfare: Determining the empirical content and structure with anchored best-worst scaling.

PubMed

Hansson, H; Lagerkvist, C J

2016-01-01

In this study, we sought to identify empirically the types of use and non-use values that motivate dairy farmers in their work relating to animal welfare of dairy cows. We also sought to identify how they prioritize between these use and non-use values. Use values are derived from productivity considerations; non-use values are derived from the wellbeing of the animals, independent of the present or future use the farmer may make of the animal. In particular, we examined the empirical content and structure of the economic value dairy farmers associate with animal welfare of dairy cows. Based on a best-worst scaling approach and data from 123 Swedish dairy farmers, we suggest that the economic value those farmers associate with animal welfare of dairy cows covers aspects of both use and non-use type, with non-use values appearing more important. Using principal component factor analysis, we were able to check unidimensionality of the economic value construct. These findings are useful for understanding why dairy farmers may be interested in considering dairy cow welfare. Such understanding is essential for improving agricultural policy and advice aimed at encouraging dairy farmers to improve animal welfare; communicating to consumers the values under which dairy products are produced; and providing a basis for more realistic assumptions when developing economic models about dairy farmers' behavior. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Developing an E-Textbook for the Consumer and Family Sciences Classroom: Challenges and Rewards

ERIC Educational Resources Information Center

Coussement, Martha A.; Johnson, Shannon; Goodson, Ludwika Aniela

2016-01-01

This article describes the self-publishing journey, challenges and methods of development, impact, the value of a self-published e-textbook in tenure decisions, and recommendations. This journey led to the self-publishing of an e-textbook for iPad® delivery at a Midwest university for a course on electronic distribution and hotel management in the…

Precise measurement of renal filtration and vascular parameters using a two-compartment model for dynamic contrast-enhanced MRI of the kidney gives realistic normal values.

PubMed

Tofts, Paul S; Cutajar, Marica; Mendichovszky, Iosif A; Peters, A Michael; Gordon, Isky

2012-06-01

To model the uptake phase of T(1)-weighted DCE-MRI data in normal kidneys and to demonstrate that the fitted physiological parameters correlate with published normal values. The model incorporates delay and broadening of the arterial vascular peak as it appears in the capillary bed, two distinct compartments for renal intravascular and extravascular Gd tracer, and uses a small-vessel haematocrit value of 24%. Four physiological parameters can be estimated: regional filtration K ( trans ) (ml min(-1) [ml tissue](-1)), perfusion F (ml min(-1) [100 ml tissue](-1)), blood volume v ( b ) (%) and mean residence time MRT (s). From these are found the filtration fraction (FF; %) and total GFR (ml min(-1)). Fifteen healthy volunteers were imaged twice using oblique coronal slices every 2.5 s to determine the reproducibility. Using parenchymal ROIs, group mean values for renal biomarkers all agreed with published values: K ( trans ): 0.25; F: 219; v ( b ): 34; MRT: 5.5; FF: 15; GFR: 115. Nominally cortical ROIs consistently underestimated total filtration (by ~50%). Reproducibility was 7-18%. Sensitivity analysis showed that these fitted parameters are most vulnerable to errors in the fixed parameters kidney T(1), flip angle, haematocrit and relaxivity. These renal biomarkers can potentially measure renal physiology in diagnosis and treatment. • Dynamic contrast-enhanced magnetic resonance imaging can measure renal function. • Filtration and perfusion values in healthy volunteers agree with published normal values. • Precision measured in healthy volunteers is between 7 and 15%.

Glycaemic index and glycaemic load values of cereal products and weight-management meals available in the UK.

PubMed

Henry, C Jeya K; Lightowler, Helen J; Dodwell, Lis M; Wynne, Jacqueline M

2007-07-01

There is currently an increased global interest in the published glycaemic index (GI) values of foods. The aim of the present work was to supplement a previous study on the glycaemic response of 140 foods available in the UK by studying a further forty-four foods. One hundred and twenty-two healthy subjects, with a mean age of 32.4 (sd 11.4) years and a mean BMI of 23.6 (sd 3.6) kg/m2, were recruited to the study. Subjects were served equivalent available carbohydrate amounts (50 or 30 g) of test foods (cereal products and weight-management meals) and a standard food (glucose) on separate occasions. Capillary blood glucose was measured from finger-prick samples in fasted subjects (0 min) and at 15, 30, 45, 60, 90 and 120 min after starting to eat each test food. For each test food, the GI value was determined, and the glycaemic load was calculated as the product of the GI and the amount of available carbohydrate in a reference serving size. The GI values of the foods tested ranged from 23 to 83. Of the forty-four foods tested, thirty-three were classified as low-GI, eight as medium-GI and three as high-GI foods. Most GI values of the foods tested compared well with previously published values for similar foods. In summary, this study provides reliable GI and glycaemic load values for a range of foods, further advancing our understanding of the glycaemic response of different foods. The data reported here make an important addition to published GI values.

Sex-specific predictive power of 6-minute walk test in chronic heart failure is not enhanced using percent achieved of published reference equations.

PubMed

Frankenstein, Lutz; Zugck, Christian; Nelles, Manfred; Schellberg, Dieter; Katus, Hugo; Remppis, Andrew

2008-04-01

The 6-minute walk test (6MWT) is an established prognostic tool in chronic heart failure. The strong influence of height, weight, age, and sex on 6MWT distance may be accounted for by using percentage achieved of predicted value rather than uncorrected 6MWT values. The study included 1069 patients (862 men) with a mean age 55.2 +/- 11.7 years and mean left ventricular ejection fraction of 29% +/- 10%, attending the heart failure clinic of the University of Heidelberg between 1995 and 2005. The predictive power and accuracy of 6MWT and achieved percentage values according to all available published equations for mortality and mortality or transplant combined were tested separately for each sex. The percentage values varied largely between equations. For all equations, women in New York Heart Association (NYHA) functional class I had higher values than men. Although the 6MWT significantly discriminated all NYHA classes for both sexes, only 1 equation discriminated all NYHA classes. No significant differences in the area under the receiver operating-characteristic curve were noted between achieved percentage values and 6MWT. Despite strong univariate significance, achieved percentage values did not retain multivariate significance. The 6MWT was independent from N-terminal brain natriuretic propeptide, NYHA, left ventricular ejection fraction, and peak oxygen uptake. We confirmed 6MWT to be a strong and independent risk predictor for both sexes. Because the prognostic power of 6MWT is not enhanced using percentage achieved of published reference equations, we suggest recalibration of these reference values rather than discarding this approach.

Opportunities to improve the value of outpatient surgical care.

PubMed

Erhun, Feryal; Malcolm, Elizabeth; Kalani, Maziyar; Brayton, Kimberly; Nguyen, Christine; Asch, Steven M; Platchek, Terry; Milstein, Arnold

2016-09-01

Nearly 57 million outpatient surgeries-invasive procedures performed on an outpatient basis in hospital outpatient departments (HOPDs) or ambulatory surgery centers (ASCs)-produced annually in the United States account for roughly 7% of healthcare expenditures. Although moving inpatient surgeries to outpatient settings has lowered the cost of care, substantial opportunities to improve the value of outpatient surgery remain. To exploit these remaining opportunities, we composed an evidence-based care delivery composite for national discussion and pilot testing. Evidence-based care delivery composite. We synthesized peer-reviewed publications describing efforts to improve the value of outpatient surgical care, interviewed patients and clinicians to understand their most deeply felt discontents, reviewed potentially relevant emerging science and technology, and observed surgeries at healthcare organizations nominated by researchers as exemplars of efficiency and effectiveness. Primed by this information, we iterated potential new designs utilizing criticism from practicing clinicians, health services researchers, and healthcare managers. We found that 3 opportunities are most likely to improve value: 1) maximizing the appropriate use of surgeries via decision aids, clinical decision support, and a remote surgical coach for physicians considering a surgical referral; 2) safely shifting surgeries from HOPDs to high-volume, multi-specialty ASCs where costs are much lower; and 3) standardizing processes in ASCs from referral to recovery. Extrapolation based on published studies of the effects of each component suggests that the proposed 3-part composite may lower annual national outpatient surgical spending by as much as one-fifth, while maintaining or improving outcomes and the care experience for patients and clinicians. Pilot testing and evaluation will allow refinement of this composite.

Privacy preserving data anonymization of spontaneous ADE reporting system dataset.

PubMed

Lin, Wen-Yang; Yang, Duen-Chuan; Wang, Jie-Teng

2016-07-18

To facilitate long-term safety surveillance of marketing drugs, many spontaneously reporting systems (SRSs) of ADR events have been established world-wide. Since the data collected by SRSs contain sensitive personal health information that should be protected to prevent the identification of individuals, it procures the issue of privacy preserving data publishing (PPDP), that is, how to sanitize (anonymize) raw data before publishing. Although much work has been done on PPDP, very few studies have focused on protecting privacy of SRS data and none of the anonymization methods is favorable for SRS datasets, due to which contain some characteristics such as rare events, multiple individual records, and multi-valued sensitive attributes. We propose a new privacy model called MS(k, θ (*) )-bounding for protecting published spontaneous ADE reporting data from privacy attacks. Our model has the flexibility of varying privacy thresholds, i.e., θ (*) , for different sensitive values and takes the characteristics of SRS data into consideration. We also propose an anonymization algorithm for sanitizing the raw data to meet the requirements specified through the proposed model. Our algorithm adopts a greedy-based clustering strategy to group the records into clusters, conforming to an innovative anonymization metric aiming to minimize the privacy risk as well as maintain the data utility for ADR detection. Empirical study was conducted using FAERS dataset from 2004Q1 to 2011Q4. We compared our model with four prevailing methods, including k-anonymity, (X, Y)-anonymity, Multi-sensitive l-diversity, and (α, k)-anonymity, evaluated via two measures, Danger Ratio (DR) and Information Loss (IL), and considered three different scenarios of threshold setting for θ (*) , including uniform setting, level-wise setting and frequency-based setting. We also conducted experiments to inspect the impact of anonymized data on the strengths of discovered ADR signals. With all three different threshold settings for sensitive value, our method can successively prevent the disclosure of sensitive values (nearly all observed DRs are zeros) without sacrificing too much of data utility. With non-uniform threshold setting, level-wise or frequency-based, our MS(k, θ (*))-bounding exhibits the best data utility and the least privacy risk among all the models. The experiments conducted on selected ADR signals from MedWatch show that only very small difference on signal strength (PRR or ROR) were observed. The results show that our method can effectively prevent the disclosure of patient sensitive information without sacrificing data utility for ADR signal detection. We propose a new privacy model for protecting SRS data that possess some characteristics overlooked by contemporary models and an anonymization algorithm to sanitize SRS data in accordance with the proposed model. Empirical evaluation on the real SRS dataset, i.e., FAERS, shows that our method can effectively solve the privacy problem in SRS data without influencing the ADR signal strength.

Magnetic Resonance Imaging More Accurately Classifies Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease Than Transient Elastography.

PubMed

Imajo, Kento; Kessoku, Takaomi; Honda, Yasushi; Tomeno, Wataru; Ogawa, Yuji; Mawatari, Hironori; Fujita, Koji; Yoneda, Masato; Taguri, Masataka; Hyogo, Hideyuki; Sumida, Yoshio; Ono, Masafumi; Eguchi, Yuichiro; Inoue, Tomio; Yamanaka, Takeharu; Wada, Koichiro; Saito, Satoru; Nakajima, Atsushi

2016-03-01

Noninvasive methods have been evaluated for the assessment of liver fibrosis and steatosis in patients with nonalcoholic fatty liver disease (NAFLD). We compared the ability of transient elastography (TE) with the M-probe, and magnetic resonance elastography (MRE) to assess liver fibrosis. Findings from magnetic resonance imaging (MRI)-based proton density fat fraction (PDFF) measurements were compared with those from TE-based controlled attenuation parameter (CAP) measurements to assess steatosis. We performed a cross-sectional study of 142 patients with NAFLD (identified by liver biopsy; mean body mass index, 28.1 kg/m(2)) in Japan from July 2013 through April 2015. Our study also included 10 comparable subjects without NAFLD (controls). All study subjects were evaluated by TE (including CAP measurements), MRI using the MRE and PDFF techniques. TE identified patients with fibrosis stage ≥2 with an area under the receiver operating characteristic (AUROC) curve value of 0.82 (95% confidence interval [CI]: 0.74-0.89), whereas MRE identified these patients with an AUROC curve value of 0.91 (95% CI: 0.86-0.96; P = .001). TE-based CAP measurements identified patients with hepatic steatosis grade ≥2 with an AUROC curve value of 0.73 (95% CI: 0.64-0.81) and PDFF methods identified them with an AUROC curve value of 0.90 (95% CI: 0.82-0.97; P < .001). Measurement of serum keratin 18 fragments or alanine aminotransferase did not add value to TE or MRI for identifying nonalcoholic steatohepatitis. MRE and PDFF methods have higher diagnostic performance in noninvasive detection of liver fibrosis and steatosis in patients with NAFLD than TE and CAP methods. MRI-based noninvasive assessment of liver fibrosis and steatosis is a potential alternative to liver biopsy in clinical practice. UMIN Clinical Trials Registry No. UMIN000012757. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

High-Throughput RNA Interference Screening: Tricks of the Trade

PubMed Central

Nebane, N. Miranda; Coric, Tatjana; Whig, Kanupriya; McKellip, Sara; Woods, LaKeisha; Sosa, Melinda; Sheppard, Russell; Rasmussen, Lynn; Bjornsti, Mary-Ann; White, E. Lucile

2016-01-01

The process of validating an assay for high-throughput screening (HTS) involves identifying sources of variability and developing procedures that minimize the variability at each step in the protocol. The goal is to produce a robust and reproducible assay with good metrics. In all good cell-based assays, this means coefficient of variation (CV) values of less than 10% and a signal window of fivefold or greater. HTS assays are usually evaluated using Z′ factor, which incorporates both standard deviation and signal window. A Z′ factor value of 0.5 or higher is acceptable for HTS. We used a standard HTS validation procedure in developing small interfering RNA (siRNA) screening technology at the HTS center at Southern Research. Initially, our assay performance was similar to published screens, with CV values greater than 10% and Z′ factor values of 0.51 ± 0.16 (average ± standard deviation). After optimizing the siRNA assay, we got CV values averaging 7.2% and a robust Z′ factor value of 0.78 ± 0.06 (average ± standard deviation). We present an overview of the problems encountered in developing this whole-genome siRNA screening program at Southern Research and how equipment optimization led to improved data quality. PMID:23616418

Costs and benefits of individuals conceived after IVF: a net tax evaluation in The Netherlands.

PubMed

Moolenaar, L M; Connolly, M; Huisman, B; Postma, M J; Hompes, P G A; van der Veen, F; Mol, B W J

2014-02-01

This study evaluated the lifetime future net tax revenues from individuals conceived after IVF relative to those naturally conceived. A model based on the method of generational accounting was developed to evaluate investments in IVF. Calculations were based on average investments paid and received from the government by an individual. All costs were discounted to their net present values and adjusted for survival. The lifetime net present value of IVF-conceived individuals was -€81,374 (the minus sign reflecting negative net present value). The lifetime net present value of IVF-conceived men and women were -€47,091 and -€123,177, respectively. The lifetime net present value of naturally conceived individuals was -€70,392; respective amounts for men and women were -€36,109 and -€112,195. The model was most sensitive to changes in the growth of healthcare costs, economic growth and the discount rate. Therefore, it is concluded that, similarly to naturally conceived individuals in the Netherlands, IVF-conceived individuals have negative discounted net tax revenue at the end of life. The analytic framework described here undervalues the incremental value of an additional birth because it only considers the fiscal consequences of life and does not take into consideration broader macroeconomic benefits. This study evaluated the lifetime future net tax revenues from individuals conceived after IVF relative those naturally conceived. A model based on the method of generational accounting to evaluate investments in IVF was used. Calculations were based on average investments paid and received from the government by an individual. The lifetime net present value of IVF-conceived individuals was -€81,374 (the minus sign reflecting negative net present value). The lifetime net present value of IVF-conceived men and women were -€47,091 and -€123,177, respectively. The lifetime net present value of naturally conceived individuals was -€70,392; respective amounts for men and women were -€36,109 and -€112,195. The model was most sensitive for changes in the growth in healthcare costs, economic growth and the discount rate. Just as naturally conceived individuals in the Netherlands, IVF-conceived individuals have negative discounted net tax revenue at the end of life. The analytic framework described here undervalues the incremental value of an additional birth because it only considers the fiscal consequences of life and does not take into consideration broader macroeconomic benefits. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

The shelf life extension of refrigerated grass carp (Ctenopharyngodon idellus) fillets by chitosan coating combined with glycerol monolaurate.

PubMed

Yu, Dawei; Jiang, Qixing; Xu, Yanshun; Xia, Wenshui

2017-08-01

A novel chitosan-based coating solution was prepared by combining glycerol monolaurate (GML) for shelf life extension of refrigerated grass carp fillets. The control and coated fillets were analyzed periodically for physicochemical (pH, thiobarbituric acid (TBA) value, total volatile basic nitrogen (TVB-N) value, K value, and shear force), microbiological (total viable counts (TVC), psychrophilic bacteria counts (PTC), Pseudomonads and H 2 S-producing bacteria) and sensorial characteristics. The results showed that chitosan-GML coated samples presented better quality preservation effects than chitosan coating alone. In addition, 2% chitosan enriched with 0.3% GML showed the significant (P<0.05) effectiveness in inhibiting microbial growth, nucleotide breakdown, the formation of alkaline components and texture deterioration, and maintaining sensory acceptability among the groups. These findings confirmed that chitosan coating enriched with GML was a promising method to extend the shelf life of refrigerated fillets. Copyright © 2017. Published by Elsevier B.V.

The new on-line Czech Food Composition Database.

PubMed

Machackova, Marie; Holasova, Marie; Maskova, Eva

2013-10-01

The new on-line Czech Food Composition Database (FCDB) was launched on http://www.czfcdb.cz in December 2010 as a main freely available channel for dissemination of Czech food composition data. The application is based on a complied FCDB documented according to the EuroFIR standardised procedure for full value documentation and indexing of foods by the LanguaL™ Thesaurus. A content management system was implemented for administration of the website and performing data export (comma-separated values or EuroFIR XML transport package formats) by a compiler. Reference/s are provided for each published value with linking to available freely accessible on-line sources of data (e.g. full texts, EuroFIR Document Repository, on-line national FCDBs). LanguaL™ codes are displayed within each food record as searchable keywords of the database. A photo (or a photo gallery) is used as a visual descriptor of a food item. The application is searchable on foods, components, food groups, alphabet and a multi-field advanced search. Copyright © 2013 Elsevier Ltd. All rights reserved.

Monitoring of a Southern Giant Petrel Macronectes giganteus population on the Frazier Islands, Wilkes Land, Antarctica

USGS Publications Warehouse

Creuwels, J.C.S.; Stark, J.S.; Woehler, Eric J.; Van Franeker, J. A.; Ribic, C.A.

2005-01-01

Since 1956, Southern Giant Petrels on the Frazier Islands, East Antarctica, have been counted with different census techniques, sometimes varying within seasons and among islands, which hindered analysis of the data. Protective measures for the islands from 1986 onwards have increased the need for reliable long-term census data, but reduced the ways to collect these data. Published and unpublished data were re-examined, and population trends were reconstructed based on two relatively standardised techniques: the number of active chicks (AC) and the number of apparently occupied nests (AON) around hatching. AC-values from Nelly Island from 1959 to 1998 indicate substantial periodic fluctuations, but no consistent long-term change. Since the late 1970s, AC-values on the other two islands and AON-values suggest that the breeding population may have grown by 35%. This recent growth, however, is within the extent of periodic fluctuations observed in Southern Giant Petrel population that is stable over the long term. ?? Springer-Verlag 2004.

EuroFIR Guideline on calculation of nutrient content of foods for food business operators.

PubMed

Machackova, Marie; Giertlova, Anna; Porubska, Janka; Roe, Mark; Ramos, Carlos; Finglas, Paul

2018-01-01

This paper presents a Guideline for calculating nutrient content of foods by calculation methods for food business operators and presents data on compliance between calculated values and analytically determined values. In the EU, calculation methods are legally valid to determine the nutrient values of foods for nutrition labelling (Regulation (EU) No 1169/2011). However, neither a specific calculation method nor rules for use of retention factors are defined. EuroFIR AISBL (European Food Information Resource) has introduced a Recipe Calculation Guideline based on the EuroFIR harmonized procedure for recipe calculation. The aim is to provide food businesses with a step-by-step tool for calculating nutrient content of foods for the purpose of nutrition declaration. The development of this Guideline and use in the Czech Republic is described and future application to other Member States is discussed. Limitations of calculation methods and the importance of high quality food composition data are discussed. Copyright © 2017. Published by Elsevier Ltd.

Building Brand Love and Gaining the Advocacy You Crave by Communicating Your Library's Value

ERIC Educational Resources Information Center

Albert, Amanda B.

2017-01-01

Five years ago the Association of College and Research Libraries published "The Value of Academic Libraries" report, spurring academic libraries to action concerning assessment. Communicating library value is especially important when reaching distance learning populations outside the walls of the library. By employing marketing and…

Hematologic values of the yucatan miniature pig.

PubMed

Parsons, A H; Wells, R E

1998-01-01

Mean values and ranges for 16 hematological parameters for healthy, young, sexually-mature Yucatan miniature swine are presented. No significant differences were observed between sexes with regard to hemograms. Comparison of observed values with those published in the literature for standard domestic and other breeds of miniature swine reveals no major differences.

76 FR 3192 - Value Pricing Pilot Program Participation, Fiscal Years 2010 and 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-19

... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Value Pricing Pilot Program... Value Pricing Pilot (VPP) program, which was published on October 19, 2010, at 75 FR 64397. The original... interest at the following Web site: http://ops.fhwa.dot.gov/tolling_pricing/participation.htm . FOR FURTHER...

Errata and update to ;Experimental cross sections for L-shell X-ray production and ionization by protons;

NASA Astrophysics Data System (ADS)

Miranda, J.; Lapicki, G.

2018-01-01

A compilation of experimental L-shell X-ray production and ionization cross sections induced by proton impact was published recently (Miranda and Lapicki, 2014), collecting 15 439 experimental cross sections. The database covers an energy range from 10 keV to 1 GeV, and targets from 10Ne to 95Am. A correction to several tabulated values that were in error, as well as an update including new data published after 2012 and older references not found previously are given in the present work. The updated data base increased the total number of experimental cross sections by 3.1% to 15 921. A new analysis of the total number of experimental points per year shows that the possible saturation in the cumulative total number of data is increased to 15 950 ± 110 points.

The influence of ethnicity and culture on dementia caregiving: a review of empirical studies on Chinese Americans.

PubMed

Sun, Fei; Ong, Rebecca; Burnette, Denise

2012-02-01

The purpose of this article is to pinpoint the cultural and ethnic influences on dementia caregiving in Chinese American families through a systemic review and analysis of published research findings. Eighteen publications on Chinese American dementia family caregivers published in peer-reviewed journals between 1990 and early 2011 were identified. Based on a systematic database search and review process, we found that caregivers' beliefs concerning dementia and the concept of family harmony as evidenced through the practice of filial piety are permeating cultural values, which together affect attitudes toward research and help-seeking behaviors (ie, seeking information on diagnosis and using formal services). There is also evidence to suggest that these cultural beliefs impinge on key elements of the caregiving process, including caregivers' appraisal of stress, coping strategies, and informal and formal support. The study concludes with recommendations for future research and practice with the Chinese American population.

Publisher Correction: Unravelling the immune signature of Plasmodium falciparum transmission-reducing immunity.

PubMed

Stone, Will J R; Campo, Joseph J; Ouédraogo, André Lin; Meerstein-Kessel, Lisette; Morlais, Isabelle; Da, Dari; Cohuet, Anna; Nsango, Sandrine; Sutherland, Colin J; van de Vegte-Bolmer, Marga; Siebelink-Stoter, Rianne; van Gemert, Geert-Jan; Graumans, Wouter; Lanke, Kjerstin; Shandling, Adam D; Pablo, Jozelyn V; Teng, Andy A; Jones, Sophie; de Jong, Roos M; Fabra-García, Amanda; Bradley, John; Roeffen, Will; Lasonder, Edwin; Gremo, Giuliana; Schwarzer, Evelin; Janse, Chris J; Singh, Susheel K; Theisen, Michael; Felgner, Phil; Marti, Matthias; Drakeley, Chris; Sauerwein, Robert; Bousema, Teun; Jore, Matthijs M

2018-04-11

The original version of this Article contained errors in Fig. 3. In panel a, bars from a chart depicting the percentage of antibody-positive individuals in non-infectious and infectious groups were inadvertently included in place of bars depicting the percentage of infectious individuals, as described in the Article and figure legend. However, the p values reported in the Figure and the resulting conclusions were based on the correct dataset. The corrected Fig. 3a now shows the percentage of infectious individuals in antibody-negative and -positive groups, in both the PDF and HTML versions of the Article. The incorrect and correct versions of Figure 3a are also presented for comparison in the accompanying Publisher Correction as Figure 1.The HTML version of the Article also omitted a link to Supplementary Data 6. The error has now been fixed and Supplementary Data 6 is available to download.

The application of dual-electrode through vial impedance spectroscopy for the determination of ice interface temperatures, primary drying rate and vial heat transfer coefficient in lyophilization process development.

PubMed

Smith, Geoff; Jeeraruangrattana, Yowwares; Ermolina, Irina

2018-06-22

Through vial impedance spectroscopy (TVIS) is a product non-invasive process analytical technology which exploits the frequency dependence of the complex impedance spectrum of a composite object (i.e. the freeze-drying vial and its contents) in order to track the progression of the freeze-drying cycle. This work demonstrates the use of a dual electrode system, attached to the external surface of a type I glass tubing vial (nominal capacity 10 mL) in the prediction of (i) the ice interface temperatures at the sublimation front and at the base of the vial, and (ii) the primary drying rate. A value for the heat transfer coefficient (for a chamber pressure of 270 µbar) was then calculated from these parameters and shown to be comparable to that published by Tchessalov[1]. Copyright © 2018. Published by Elsevier B.V.

[Professor Kazimierz Jaegermann--forensic pathologist--scientist--thinker].

PubMed

Nasiłowski, Władysław

2009-01-01

Professor Kazimierz Jaegermann, a founder of the theory of medico-legal opinionating, passed away 20 years ago. Numerous specialists in forensic medicine and an ever increasing number of lawyers substantiate the importance and value of the creative thought and the entire research work of Professor Jaegermann that have been an inspiration of progress in forensic medicine and in the science of applied law. His unique ability to perform a scientific synthesis leading to recognizing forensic medicine as an applied bridging knowledge points to the eminently creative role played by Professor Jaegermann in development of forensic medicine. There is an urgent need to recall his research activities and to publish a complete collection of his articles and publications. With this idea in mind, I present below an article based on the text published in No. 1 of the Zeszyty Naukowe Katedry Medycyny Sadowej Slaskiej Akademii Medycznej in 1995.

78 FR 39632 - Cotton Board Rules and Regulations: Adjusting Supplemental Assessment on Imports (2013 Amendment)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-02

...This proposed rule is a companion to the Agricultural Marketing Service's (AMS) direct final rule (published today in the ``Rules and Regulations'' section of the Federal Register), amending the Cotton Board Rules and Regulations by decreasing the value assigned to imported cotton for calculating supplemental assessments collected for use by the Cotton Research and Promotion Program. An amendment is required to adjust the value assigned to imported cotton and the cotton content of imported products so that it is the same as those paid on domestically produced cotton. In addition, AMS is updating two Harmonized Tariff Schedule (HTS) statistical reporting numbers that were amended since the last assessment adjustment. This proposed rule is a companion document to the direct final rule published elsewhere in this issue of the Federal Register. AMS is publishing this amendment as a direct final rule without prior proposal because the agency is contemplated by statute and required by regulation in 7 CFR 1205.510 and anticipates no significant adverse comment. AMS has explained its reasons in the preamble of the direct final rule. If AMS receives no significant adverse comment during the comment period, no further action on this proposed rule will be taken. If, however, AMS receives significant adverse comment, AMS will withdraw the direct final rule and it will not take effect. In that case, AMS will address all public comments in a subsequent final rule based on this proposed rule. AMS will not institute a second comment period on this rule. Any parties interested in commenting must do so during this comment period.

Trace element partitioning between plagioclase and melt: An investigation of the impact of experimental and analytical procedures

NASA Astrophysics Data System (ADS)

Nielsen, Roger L.; Ustunisik, Gokce; Weinsteiger, Allison B.; Tepley, Frank J.; Johnston, A. Dana; Kent, Adam J. R.

2017-09-01

Quantitative models of petrologic processes require accurate partition coefficients. Our ability to obtain accurate partition coefficients is constrained by their dependence on pressure temperature and composition, and on the experimental and analytical techniques we apply. The source and magnitude of error in experimental studies of trace element partitioning may go unrecognized if one examines only the processed published data. The most important sources of error are relict crystals, and analyses of more than one phase in the analytical volume. Because we have typically published averaged data, identification of compromised data is difficult if not impossible. We addressed this problem by examining unprocessed data from plagioclase/melt partitioning experiments, by comparing models based on that data with existing partitioning models, and evaluated the degree to which the partitioning models are dependent on the calibration data. We found that partitioning models are dependent on the calibration data in ways that result in erroneous model values, and that the error will be systematic and dependent on the value of the partition coefficient. In effect, use of different calibration datasets will result in partitioning models whose results are systematically biased, and that one can arrive at different and conflicting conclusions depending on how a model is calibrated, defeating the purpose of applying the models. Ultimately this is an experimental data problem, which can be solved if we publish individual analyses (not averages) or use a projection method wherein we use an independent compositional constraint to identify and estimate the uncontaminated composition of each phase.

Weighing the impact (factor) of publishing in veterinary journals.

PubMed

Christopher, Mary M

2015-06-01

The journal in which you publish your research can have a major influence on the perceived value of your work and on your ability to reach certain audiences. The impact factor, a widely used metric of journal quality and prestige, has evolved into a benchmark of quality for institutions and graduate programs and, inappropriately, as a proxy for the quality of individual authors and articles, affecting tenure, promotion, and funding decisions. As a result, despite its many limitations, publishing decisions by authors often are based solely on a journal's impact factor. This can disadvantage journals in small disciplines, such as veterinary medicine, and limit the ability of authors to reach key audiences. In this article, factors that can influence the impact factor of a journal and its applicability, including precision, citation practices, article type, editorial policies, and size of the research community will be reviewed. The value and importance of veterinary journals such as the Journal of Veterinary Cardiology for reaching relevant audiences and for helping shape disciplinary specialties and influence clinical practice will also be discussed. Lastly, the efforts underway to develop alternative measures to assess the scientific quality of individual authors and articles, such as article-level metrics, as well as institutional measures of the economic and social impact of biomedical research will be considered. Judicious use of the impact factor and the implementation of new metrics for assessing the quality and societal relevance of veterinary research articles will benefit both authors and journals. Copyright © 2015 Elsevier B.V. All rights reserved.

Towards optimal intraoperative conditions in esophageal surgery: A review of literature for the prevention of esophageal anastomotic leakage.

PubMed

Bootsma, Boukje Titia; Huisman, Daitlin Esmee; Plat, Victor Dirk; Schoonmade, Linda Jeanne; Stens, Jurre; Hubens, Guy; van der Peet, Donald Leonard; Daams, Freek

2018-04-30

Esophageal anastomotic leakage (EAL) is a severe complication following gastric and esophageal surgery for cancer. Several non-modifiable, patient or surgery related risk factors for EAL have been identified, however, the contribution of modifiable intraoperative parameters remains undetermined. This review provides an overview of current literature on potentially modifiable intraoperative risk factors for EAL. The PubMed, EMBASE and Cochrane databases were searched by two researchers independently. Clinical studies published in English between 1970 and January 2017 that evaluated the effect of intraoperative parameters on the development of EAL were included. Levels of evidence as defined by the Centre of Evidence Based Medicine (CEBM) were assigned to the studies. A total of 25 articles were included in the final analysis. These articles show evidence that anemia, increased amount of blood loss, low pH and high pCO2 values, prolonged duration of procedure and lack of surgical experience independently increase the risk of EAL. Supplemental oxygen therapy, epidural analgesia and selective digestive decontamination seem to have a beneficial effect. Potential risk factors include blood pressure, requirement of blood products, vasopressor use and glucocorticoid administration, however the results are ambiguous. Apart from fixed surgical and patient related factors, several intraoperative factors that can be modified in clinical practice can influence the risk of developing EAL. More prospective, observational studies are necessary focusing on modifiable intraoperative parameters to assess more evidence and to elucidate optimal values of these factors. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

The theory of reference values: an unfinished symphony.

PubMed

Siest, Gerard; Henny, Joseph; Gräsbeck, Ralph; Wilding, Peter; Petitclerc, Claude; Queraltó, Josep M; Hyltoft Petersen, Peter

2013-01-01

The history of the theory of reference values can be written as an unfinished symphony. The first movement, allegro con fuoco, played from 1960 to 1980: a mix of themes devoted to the study of biological variability (intra-, inter-individual, short- and long-term), preanalytical conditions, standardization of analytical methods, quality control, statistical tools for deriving reference limits, all of them complex variations developed on a central melody: the new concept of reference values that would replace the notion of normality whose definition was unclear. Additional contributions (multivariate reference values, use of reference limits from broad sets of patient data, drug interferences) conclude the movement on the variability of laboratory tests. The second movement, adagio, from 1980 to 2000, slowly develops and implements initial works. International and national recommendations were published by the IFCC-LM (International Federation of Clinical Chemistry and Laboratory Medicine) and scientific societies [French (SFBC), Spanish (SEQC), Scandinavian societies…]. Reference values are now topics of many textbooks and of several congresses, workshops, and round tables that are organized all over the world. Nowadays, reference values are part of current practice in all clinical laboratories, but not without difficulties, particularly for some laboratories to produce their own reference values and the unsuitability of the concept with respect to new technologies such as HPLC, GCMS, and PCR assays. Clinicians through consensus groups and practice guidelines have introduced their own tools, the decision limits, likelihood ratios and Reference Change Value (RCV), creating confusion among laboratorians and clinicians in substituting reference values and decision limits in laboratory reports. The rapid development of personalized medicine will eventually call for the use of individual reference values. The beginning of the second millennium is played allegro ma non-troppo from 2000 to 2012: the theory of reference values is back into fashion. The need to revise the concept is emerging. The manufacturers make a friendly pressure to facilitate the integration of Reference Intervals (RIs) in their technical documentation. Laboratorians are anxiously awaiting the solutions for what to do. The IFCC-LM creates Reference Intervals and Decision Limits Committee (C-RIDL) in 2005. Simultaneously, a joint working group IFCC-CLSI is created on the same topic. In 2008 the initial recommendations of IFCC-LM are revised and new guidelines are published by the Clinical and Laboratory Standards Institute (CLSI C28-A3). Fundamentals of the theory of reference values are not changed, but new avenues are explored: RIs transference, multicenter reference intervals, and a robust method for deriving RIs from small number of subjects. Concomitantly, other statistical methods are published such as bootstraps calculation and partitioning procedures. An alternative to recruiting healthy subjects proposes the use of biobanks conditional to the availability of controlled preanalytical conditions and of bioclinical data. The scope is also widening to include veterinary biology! During the early 2000s, several groups proposed the concept of 'Universal RIs' or 'Global RIs'. Still controversial, their applications await further investigations. The fourth movement, finale: beyond the methodological issues (statistical and analytical essentially), important questions remain unanswered. Do RIs intervene appropriately in medical decision-making? Are RIs really useful to the clinicians? Are evidence-based decision limits more appropriate? It should be appreciated that many laboratory tests represent a continuum that weakens the relevance of RIs. In addition, the boundaries between healthy and pathological states are shady areas influenced by many biological factors. In such a case the use of a single threshold is questionable. Wherever it will apply, individual reference values and reference change values have their place. A variation on an old theme! It is strange that in the period of personalized medicine (that is more stratified medicine), the concept of reference values which is based on stratification of homogeneous subgroups of healthy people could not be discussed and developed in conjunction with the stratification of sick patients. That is our message for the celebration of the 50th anniversary of Clinical Chemistry and Laboratory Medicine. Prospects are broad, enthusiasm is not lacking: much remains to be done, good luck for the new generations!

Can a Resident's Publication Record Predict Fellowship Publications?

PubMed Central

Prasad, Vinay; Rho, Jason; Selvaraj, Senthil; Cheung, Mike; Vandross, Andrae; Ho, Nancy

2014-01-01

Background Internal medicine fellowship programs have an incentive to select fellows who will ultimately publish. Whether an applicant's publication record predicts long term publishing remains unknown. Methods Using records of fellowship bound internal medicine residents, we analyzed whether publications at time of fellowship application predict publications more than 3 years (2 years into fellowship) and up to 7 years after fellowship match. We calculate the sensitivity, specificity, positive and negative predictive values and likelihood ratios for every cutoff number of application publications, and plot a receiver operator characteristic curve of this test. Results Of 307 fellowship bound residents, 126 (41%) published at least one article 3 to 7 years after matching, and 181 (59%) of residents do not publish in this time period. The area under the receiver operator characteristic curve is 0.59. No cutoff value for application publications possessed adequate test characteristics. Conclusion The number of publications an applicant has at time of fellowship application is a poor predictor of who publishes in the long term. These findings do not validate the practice of using application publications as a tool for selecting fellows. PMID:24658088

Can a resident's publication record predict fellowship publications?

PubMed

Prasad, Vinay; Rho, Jason; Selvaraj, Senthil; Cheung, Mike; Vandross, Andrae; Ho, Nancy

2014-01-01

Internal medicine fellowship programs have an incentive to select fellows who will ultimately publish. Whether an applicant's publication record predicts long term publishing remains unknown. Using records of fellowship bound internal medicine residents, we analyzed whether publications at time of fellowship application predict publications more than 3 years (2 years into fellowship) and up to 7 years after fellowship match. We calculate the sensitivity, specificity, positive and negative predictive values and likelihood ratios for every cutoff number of application publications, and plot a receiver operator characteristic curve of this test. Of 307 fellowship bound residents, 126 (41%) published at least one article 3 to 7 years after matching, and 181 (59%) of residents do not publish in this time period. The area under the receiver operator characteristic curve is 0.59. No cutoff value for application publications possessed adequate test characteristics. The number of publications an applicant has at time of fellowship application is a poor predictor of who publishes in the long term. These findings do not validate the practice of using application publications as a tool for selecting fellows.

Relative value unit-based compensation incentivization in an academic vascular practice improves productivity with no early adverse impact on quality.

PubMed

Awad, Nadia; Caputo, Francis J; Carpenter, Jeffrey P; Alexander, James B; Trani, José L; Lombardi, Joseph V

2017-02-01

Given the increased pressure from governmental programs to restructure reimbursements to reflect quality metrics achieved by physicians, review of current reimbursement schemes is necessary to ensure sustainability of the physician's performance while maintaining and ultimately improving patient outcomes. This study reviewed the impact of reimbursement incentives on evidence-based care outcomes within a vascular surgical program at an academic tertiary care center. Data for patients with a confirmed 30-day follow-up for the vascular surgery subset of our institution's National Surgical Quality Improvement Program submission for the years 2013 and 2014 were reviewed. The outcomes reviewed included 30-day mortality, readmission, unplanned returns to the operating room, and all major morbidities. A comparison of both total charges and work relative value units (RVUs) generated was performed before and after changes were made from a salary-based to a productivity-based compensation model. P value analysis was used to determine if there were any statistically significant differences in patient outcomes between the two study years. No statistically significant difference in outcomes of the core measures studied was identified between the two periods. There was a trend toward a lower incidence of respiratory complications, largely driven by a lower incidence in pneumonia between 2013 and 2014. The vascular division had a net increase of 8.2% in total charges and 5.7% in work RVUs after the RVU-based incentivization program was instituted. Revenue-improving measures can improve sustainability of a vascular program without negatively affecting patient care as evidenced by the lack of difference in evidence-based core outcome measures in our study period. Further studies are needed to elucidate the long-term effects of incentivization programs on both patient care and program viability. Copyright © 2016. Published by Elsevier Inc.

The Effect of Occupation-based Cognitive Rehabilitation for Traumatic Brain Injury: A Meta-analysis of Randomized Controlled Trials.

PubMed

Park, Hae Yean; Maitra, Kinsuk; Martinez, Kristina Marie

2015-06-01

Traumatic brain injury (TBI) is the leading cause of death and disability among people younger than 35 years in the United States. Cognitive difficulty is a common consequence of TBI. To address cognitive deficits of patients with TBI, various cognitive rehabilitation approaches have been used for the clinical setting. The purpose of this study was to investigate the overall effect of occupation-based cognitive rehabilitation on patients' improvement in cognitive performance components, activity of daily living (ADL) performance, and values, beliefs and spirituality functions of patients with TBI. The papers used in this study were retrieved from the Cochrane Database, EBSCO (CINAHL), PsycINFO, PubMed and Web of Science published between 1997 and 2014. The keywords for searching were cognitive, rehabilitation, occupation, memory, attention, problem-solving, executive function, ADL, values, beliefs, spirituality, randomized controlled trials and TBI. For the meta-analysis, we examined 60 effect sizes from nine studies that are related to the occupation-based cognitive rehabilitation on persons with TBI. In persons with TBI, overall mental functions, ADL, and values, beliefs and spirituality were significantly improved in the groups that received occupation-based cognitive rehabilitation compared with comparison groups (mean d = 0.19, p < .05). Evidence from the present meta-analytic study suggests that occupation-based cognitive rehabilitation would be beneficial for individuals with TBI for improving daily functioning and positively be able to affect their psychosocial functions. Collecting many outcome measures in studies with relatively few participants and the final data are less reliable than the whole instrument itself. Future research should evaluate the effectiveness of specific occupation-based cognitive rehabilitations programmes in order to improve consistency among rehabilitation providers. Copyright © 2015 John Wiley & Sons, Ltd.

75 FR 14126 - Amended Final Determination of Sales at Less Than Fair Value: Diamond Sawblades and Parts Thereof...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... of Sales at Less Than Fair Value: Diamond Sawblades and Parts Thereof From the Republic of Korea... Department'') published its notice of final determination of sales at less than fair value (``LTFV'') in the... Notice of Final Determination of Sales at Less Than Fair Value and Final Determination of Critical...

Reporting the national antimicrobial consumption in Danish pigs: influence of assigned daily dosage values and population measurement.

PubMed

Dupont, Nana; Fertner, Mette; Kristensen, Charlotte Sonne; Toft, Nils; Stege, Helle

2016-05-03

Transparent calculation methods are crucial when investigating trends in antimicrobial consumption over time and between populations. Until 2011, one single standardized method was applied when quantifying the Danish pig antimicrobial consumption with the unit "Animal Daily Dose" (ADD). However, two new methods for assigning values for ADDs have recently emerged, one implemented by DANMAP, responsible for publishing annual reports on antimicrobial consumption, and one by the Danish Veterinary and Food Administration (DVFA), responsible for the Yellow Card initiative. In addition to new ADD assignment methods, Denmark has also experienced a shift in the production pattern, towards a larger export of live pigs. The aims of this paper were to (1) describe previous and current ADD assignment methods used by the major Danish institutions and (2) to illustrate how ADD assignment method and choice of population and population measurement affect the calculated national antimicrobial consumption in pigs (2007-2013). The old VetStat ADD-values were based on SPCs in contrast to the new ADD-values, which were based on active compound, concentration and administration route. The new ADD-values stated by both DANMAP and DVFA were only identical for 48 % of antimicrobial products approved for use in pigs. From 2007 to 2013, the total number of ADDs per year increased by 9 % when using the new DVFA ADD-values, but decreased by 2 and 7 % when using the new DANMAP ADD-values or the old VetStat ADD-values, respectively. Through 2007 to 2013, the production of pigs increased from 26.1 million pigs per year with 18 % exported live to 28.7 million with 34 % exported live. In the same time span, the annual pig antimicrobial consumption increased by 22.2 %, when calculated using the new DVFA ADD-values and pigs slaughtered per year as population measurement (13.0 ADDs/pig/year to 15.9 ADDs/pig/year). However, when based on the old VetStat ADD values and pigs produced per year (including live export), a 10.9 % decrease was seen (10.6 ADDs/pig/year to 9.4 ADDs/pig/year). The findings of this paper clearly highlight that calculated national antimicrobial consumption is highly affected by chosen population measurement and the applied ADD-values.

Life-cycle studies with 2 marine species and bisphenol A: The mysid shrimp (Americamysis bahia) and sheepshead minnow (Cyprinodon variegatus).

PubMed

Mihaich, Ellen; Staples, Charles; Ortego, Lisa; Klečka, Gary; Woelz, Jan; Dimond, Steve; Hentges, Steven

2018-02-01

Bisphenol A (BPA) is a high production volume compound primarily used to produce epoxy resins and polycarbonate plastic. Exposure to low concentrations of BPA occurs in freshwater and marine systems, primarily from wastewater treatment plant discharges. The dataset for chronic toxicity of BPA to freshwater organisms includes studies on fish, amphibians, invertebrates, algae, and aquatic plants. To broaden the dataset, a 1.5-generation test with sheepshead minnow (Cyprinodon variegatus) and a full life-cycle test with mysid shrimp (Americamysis bahia) were conducted. Testing focused on apical endpoints of survival, growth and development, and reproduction. The respective no-observed-effect concentration (NOEC) and lowest-observed-effect concentration (LOEC) values of 170 and 370 µg/L for mysid and 66 and 130 μg/L for sheepshead were based on reduced fecundity. The hazardous concentrations for 5% of the species (HC5) values of 18 μg/L were calculated from species sensitivity distributions (SSDs) with freshwater-only data and combined freshwater and marine data. Inclusion of marine data resulted in no apparent difference in SSD shape, R 2 values for the distributions, or HC5 values. Upper-bound 95th percentile concentrations of BPA measured in marine waters of North America and Europe (0.024 and 0.15 μg/L, respectively) are below the HC5 value of 18 μg/L. These results suggest that marine and freshwater species are of generally similar sensitivity and that chronic studies using a diverse set of species can be combined to assess the aquatic toxicity of BPA. Environ Toxicol Chem 2018;37:398-410. © 2017 The Authors. Environmental Toxicology and Chemistry Published by Wiley Periodicals, Inc. on behalf of SETAC. © 2017 The Authors. Environmental Toxicology and Chemistry Published by Wiley Periodicals, Inc. on behalf of SETAC.

Economic impact of reduced mortality due to increased cycling.

PubMed

Rutter, Harry; Cavill, Nick; Racioppi, Francesca; Dinsdale, Hywell; Oja, Pekka; Kahlmeier, Sonja

2013-01-01

Increasing regular physical activity is a key public health goal. One strategy is to change the physical environment to encourage walking and cycling, requiring partnerships with the transport and urban planning sectors. Economic evaluation is an important factor in the decision to fund any new transport scheme, but techniques for assessing the economic value of the health benefits of cycling and walking have tended to be less sophisticated than the approaches used for assessing other benefits. This study aimed to produce a practical tool for estimating the economic impact of reduced mortality due to increased cycling. The tool was intended to be transparent, easy to use, reliable, and based on conservative assumptions and default values, which can be used in the absence of local data. It addressed the question: For a given volume of cycling within a defined population, what is the economic value of the health benefits? The authors used published estimates of relative risk of all-cause mortality among regular cyclists and applied these to levels of cycling defined by the user to produce an estimate of the number of deaths potentially averted because of regular cycling. The tool then calculates the economic value of the deaths averted using the "value of a statistical life." The outputs of the tool support decision making on cycle infrastructure or policies, or can be used as part of an integrated economic appraisal. The tool's unique contribution is that it takes a public health approach to a transport problem, addresses it in epidemiologic terms, and places the results back into the transport context. Examples of its use include its adoption by the English and Swedish departments of transport as the recommended methodologic approach for estimating the health impact of walking and cycling. Copyright © 2013 World Health Organization. Published by Elsevier Inc. All rights reserved.