A Causal-Comparative Study of Third Grade Reading Achievement and the Use of Commercial Reading Programs to Promote Literacy

ERIC Educational Resources Information Center

McDonald, Wendy E.

2013-01-01

This quantitative, causal-comparative study examined the reading achievement of third grade students to ascertain the reading health of elementary students as measured through South Carolina's standardized assessment, the Palmetto Assessment of State Standards (PASS). The purpose of this study was to determine if there was a significant difference…

Quantifying relative importance: Computing standardized effects in models with binary outcomes

USGS Publications Warehouse

Grace, James B.; Johnson, Darren; Lefcheck, Jonathan S.; Byrnes, Jarrett E.K.

2018-01-01

Results from simulation studies show that both the LT and OE methods of standardization support a similarly-broad range of coefficient comparisons. The LT method estimates effects that reflect underlying latent-linear propensities, while the OE method computes a linear approximation for the effects of predictors on binary responses. The contrast between assumptions for the two methods is reflected in persistently weaker standardized effects associated with OE standardization. Reliance on standard deviations for standardization (the traditional approach) is critically examined and shown to introduce substantial biases when predictors are non-Gaussian. The use of relevant ranges in place of standard deviations has the capacity to place LT and OE standardized coefficients on a more comparable scale. As ecologists address increasingly complex hypotheses, especially those that involve comparing the influences of different controlling factors (e.g., top-down versus bottom-up or biotic versus abiotic controls), comparable coefficients become a necessary component for evaluations.

Effects of Pilates-Based Core Stability Training in Ambulant People With Multiple Sclerosis: Multicenter, Assessor-Blinded, Randomized Controlled Trial.

PubMed

Fox, Esther E; Hough, Alan D; Creanor, Siobhan; Gear, Margaret; Freeman, Jennifer A

2016-08-01

Pilates exercise is often undertaken by people with multiple sclerosis (MS) who have balance and mobility difficulties. The primary aim of the study was to compare the effects of 12 weeks of Pilates exercises with relaxation on balance and mobility. Secondary aims were: (1) to compare standardized exercises with relaxation and (2) to compare Pilates exercises with standardized exercises. A multicenter, assessor-blinded, randomized controlled trial was conducted. Participants with Expanded Disability Status Scale scores of 4.0 to 6.5 were randomly allocated to groups receiving 12 weeks of Pilates exercises, standardized exercises, or relaxation. Assessments were undertaken at baseline and weeks 12 and 16 (primary outcome measure: 10-Meter Timed Walk Test [10MTW]). One hundred participants (mean age=54 years, 74% female) were randomized to study groups. Six participants relapsed (withdrew from the study), leaving 94 participants for intention-to-treat analysis. There was no significant difference in mean 10MTW measurements between the Pilates and relaxation groups. At 12 weeks, there was a mean reduction of 4.2 seconds for the standardized exercise group compared with the relaxation group (95% confidence interval [relaxation group minus standardized exercise group measurements]=0.0, 8.4) and a mean reduction of 3.7 seconds for the Pilates group compared with the standardized exercise group (95% confidence interval [Pilates group minus standardized exercise group measurements]=-0.4 to 7.8). At 16 weeks, mean 10MTW times for the standardized exercise group remained quicker than those for the Pilates and relaxation groups, although the differences were nonsignificant. There were no significant differences between the Pilates and relaxation groups for any secondary outcome measure. In this study, therapists were limited to a standardized basket of exercises that may have affected the study outcomes. Furthermore, choosing measures such as posturography to assess balance, accelerometry to assess walking, or a specific trunk assessment scale might have been more responsive in detecting changes in outcome. Participants did not improve significantly, either in the short term or at the 4-week follow-up, on the 10MTW after 12 weeks of Pilates exercises compared with 12 weeks of relaxation. © 2016 American Physical Therapy Association.

The Effects of Discourses in Regional Contexts on the Development of Curriculum-Based Literacy Standards for Adolescents in Schooling: A Comparative Study of South Australia and Ontario

ERIC Educational Resources Information Center

Fenwick, Lisl

2017-01-01

This study analyses how discourses in regional contexts affect the development of curriculum-based literacy standards for adolescents in schooling. A comparative case-study research design enabled the influences of discourses at the regional level to be analysed. The case studies include the development of curricula to define a minimum literacy…

Ultra-low-dose computed tomographic angiography with model-based iterative reconstruction compared with standard-dose imaging after endovascular aneurysm repair: a prospective pilot study.

PubMed

Naidu, Sailen G; Kriegshauser, J Scott; Paden, Robert G; He, Miao; Wu, Qing; Hara, Amy K

2014-12-01

An ultra-low-dose radiation protocol reconstructed with model-based iterative reconstruction was compared with our standard-dose protocol. This prospective study evaluated 20 men undergoing surveillance-enhanced computed tomography after endovascular aneurysm repair. All patients underwent standard-dose and ultra-low-dose venous phase imaging; images were compared after reconstruction with filtered back projection, adaptive statistical iterative reconstruction, and model-based iterative reconstruction. Objective measures of aortic contrast attenuation and image noise were averaged. Images were subjectively assessed (1 = worst, 5 = best) for diagnostic confidence, image noise, and vessel sharpness. Aneurysm sac diameter and endoleak detection were compared. Quantitative image noise was 26% less with ultra-low-dose model-based iterative reconstruction than with standard-dose adaptive statistical iterative reconstruction and 58% less than with ultra-low-dose adaptive statistical iterative reconstruction. Average subjective noise scores were not different between ultra-low-dose model-based iterative reconstruction and standard-dose adaptive statistical iterative reconstruction (3.8 vs. 4.0, P = .25). Subjective scores for diagnostic confidence were better with standard-dose adaptive statistical iterative reconstruction than with ultra-low-dose model-based iterative reconstruction (4.4 vs. 4.0, P = .002). Vessel sharpness was decreased with ultra-low-dose model-based iterative reconstruction compared with standard-dose adaptive statistical iterative reconstruction (3.3 vs. 4.1, P < .0001). Ultra-low-dose model-based iterative reconstruction and standard-dose adaptive statistical iterative reconstruction aneurysm sac diameters were not significantly different (4.9 vs. 4.9 cm); concordance for the presence of endoleak was 100% (P < .001). Compared with a standard-dose technique, an ultra-low-dose model-based iterative reconstruction protocol provides comparable image quality and diagnostic assessment at a 73% lower radiation dose.

Comparing Construct Definition in the Angoff and Objective Standard Setting Models: Playing in a House of Cards without a Full Deck

ERIC Educational Resources Information Center

Stone, Gregory Ethan; Koskey, Kristin L. K.; Sondergeld, Toni A.

2011-01-01

Typical validation studies on standard setting models, most notably the Angoff and modified Angoff models, have ignored construct development, a critical aspect associated with all conceptualizations of measurement processes. Stone compared the Angoff and objective standard setting (OSS) models and found that Angoff failed to define a legitimate…

Impact of a standardized test package on exit examination scores and NCLEX-RN outcomes.

PubMed

Homard, Catherine M

2013-03-01

The purpose of this ex post facto correlational study was to compare exit examination scores and NCLEX-RN(®) pass rates of baccalaureate nursing students who differed in level of participation in a standardized test package. Three cohort groups emerged as a standardized test package was introduced: (a) students who did not participate in a standardized test package; (b) students with two semesters of a standardized test package; and (c) students with four semesters of a standardized test package. Benner's novice-to-expert theory framed the study in the belief that students best acquire knowledge and skills through practice and reflection. Students participating in four semesters of a standardized test package demonstrated higher exit examination scores and NCLEX-RN pass rates compared with students who did not participate in this package. This study's results could inform nurse educators about strategies to facilitate nursing student success on exit examinations and the NCLEX-RN. Copyright 2013, SLACK Incorporated.

Improving the psychometric properties of dot-probe attention measures using response-based computation.

PubMed

Evans, Travis C; Britton, Jennifer C

2018-09-01

Abnormal threat-related attention in anxiety disorders is most commonly assessed and modified using the dot-probe paradigm; however, poor psychometric properties of reaction-time measures may contribute to inconsistencies across studies. Typically, standard attention measures are derived using average reaction-times obtained in experimentally-defined conditions. However, current approaches based on experimentally-defined conditions are limited. In this study, the psychometric properties of a novel response-based computation approach to analyze dot-probe data are compared to standard measures of attention. 148 adults (19.19 ± 1.42 years, 84 women) completed a standardized dot-probe task including threatening and neutral faces. We generated both standard and response-based measures of attention bias, attentional orientation, and attentional disengagement. We compared overall internal consistency, number of trials necessary to reach internal consistency, test-retest reliability (n = 72), and criterion validity obtained using each approach. Compared to standard attention measures, response-based measures demonstrated uniformly high levels of internal consistency with relatively few trials and varying improvements in test-retest reliability. Additionally, response-based measures demonstrated specific evidence of anxiety-related associations above and beyond both standard attention measures and other confounds. Future studies are necessary to validate this approach in clinical samples. Response-based attention measures demonstrate superior psychometric properties compared to standard attention measures, which may improve the detection of anxiety-related associations and treatment-related changes in clinical samples. Copyright © 2018 Elsevier Ltd. All rights reserved.

Anthropometric Measurement Standardization in the US-Affiliated Pacific: Report from the Children’s Healthy Living Program

PubMed Central

LI, FENFANG; WILKENS, LYNNE R.; NOVOTNY, RACHEL; FIALKOWSKI, MARIE K.; PAULINO, YVETTE C.; NELSON, RANDALL; BERSAMIN, ANDREA; MARTIN, URSULA; DEENIK, JONATHAN; BOUSHEY, CAROL J.

2016-01-01

Objectives Anthropometric standardization is essential to obtain reliable and comparable data from different geographical regions. The purpose of this study is to describe anthropometric standardization procedures and findings from the Children’s Healthy Living (CHL) Program, a study on childhood obesity in 11 jurisdictions in the US-Affiliated Pacific Region, including Alaska and Hawai‘i. Methods Zerfas criteria were used to compare the measurement components (height, waist, and weight) between each trainee and a single expert anthropometrist. In addition, intra- and inter-rater technical error of measurement (TEM), coefficient of reliability, and average bias relative to the expert were computed. Results From September 2012 to December 2014, 79 trainees participated in at least 1 of 29 standardization sessions. A total of 49 trainees passed either standard or alternate Zerfas criteria and were qualified to assess all three measurements in the field. Standard Zerfas criteria were difficult to achieve: only 2 of 79 trainees passed at their first training session. Intra-rater TEM estimates for the 49 trainees compared well with the expert anthropometrist. Average biases were within acceptable limits of deviation from the expert. Coefficient of reliability was above 99% for all three anthropometric components. Conclusions Standardization based on comparison with a single expert ensured the comparability of measurements from the 49 trainees who passed the criteria. The anthropometric standardization process and protocols followed by CHL resulted in 49 standardized field anthropometrists and have helped build capacity in the health workforce in the Pacific Region. PMID:26457888

Pilot randomized crossover study comparing the efficacy of transnasal disposable endosheath with standard endoscopy to detect Barrett's esophagus.

PubMed

Shariff, Mohammed K; Varghese, Sibu; O'Donovan, Maria; Abdullahi, Zarah; Liu, Xinxue; Fitzgerald, Rebecca C; di Pietro, Massimiliano

2016-02-01

The transnasal endosheath endoscope is a new disposable technology with potential applicability to the primary care setting. The aim of this study was to evaluate the efficacy of transnasal endosheath endoscopy (TEE) for the detection of Barrett's esophagus, by comparing the diagnostic accuracy of TEE with that of standard endoscopy. This was a prospective, randomized, crossover study performed in a single tertiary referral center. Consecutive patients undergoing surveillance for Barrett's esophagus or referred for diagnostic assessment were recruited. All patients were randomized to undergo TEE followed by standard endoscopy or the reverse. Endoscopy experiences and patient preferences were evaluated using a questionnaire. Endoscopic and histologic diagnosis of Barrett's esophagus, and optical image quality of both endoscopic procedures, were compared. A total of 21 of 25 patients completed the study. TEE had sensitivity and specificity of 100 % for an endoscopic diagnosis of Barrett's esophagus, and of 66.7 % and 100 %, respectively, for the histologic diagnosis of Barrett's esophagus. The mean optical quality of standard endoscopy was significantly better than that of TEE (7.11 ± 0.42 vs. 4.06 ± 0.27; P < 0.0001). However, following endoscopy, patients reported a significantly better experience with TEE compared with standard endoscopy (7.05 ± 0.49 vs. 4.35 ± 0.53; P = 0.0006), with 60 % preferring TEE and 25 % preferring sedated standard endoscopy. In this study, TEE had equal accuracy for an endoscopic diagnosis of Barrett's esophagus compared with standard endoscopy, at the expense of reduced image quality and a lower yield of intestinal metaplasia on biopsy. TEE was better tolerated and preferred by patients. Hence, TEE needs further evaluation in primary care as an initial diagnostic tool. © Georg Thieme Verlag KG Stuttgart · New York.

Decline eccentric squats increases patellar tendon loading compared to standard eccentric squats.

PubMed

Kongsgaard, M; Aagaard, P; Roikjaer, S; Olsen, D; Jensen, M; Langberg, H; Magnusson, S P

2006-08-01

Recent studies have shown excellent clinical results using eccentric squat training on a 25 degrees decline board to treat patellar tendinopathy. It remains unknown why therapeutic management of patellar tendinopathy using decline eccentric squats offer superior clinical efficacy compared to standard horizontal eccentric squats. This study aimed to compare electromyography activity, patellar tendon strain and joint angle kinematics during standard and decline eccentric squats. Thirteen subjects performed unilateral eccentric squats on flat-and a 25 degrees decline surface. During the squats, electromyography activity was obtained in eight representative muscles. Also, ankle, knee and hip joint goniometry was obtained. Additionally, patellar tendon strain was measured in vivo using ultrasonography as subjects maintained a unilateral isometric 90 degrees knee angle squat position on either flat or 25 degrees decline surface. Patellar tendon strain was significantly greater (P<0.05) during the squat position on the decline surface compared to the standard surface. The stop angles of the ankle and hip joints were significantly smaller during the decline compared to the standard squats (P<0.001, P<0.05). Normalized mean electromyography amplitudes of the knee extensor muscles were significantly greater during the decline compared to the standard squats (P<0.05). Hamstring and calf muscle mean electromyography did not differ, respectively, between standard and decline squats. The use of a 25 degrees decline board increases the load and the strain of the patellar tendon during unilateral eccentric squats. This finding likely explains previous reports of superior clinical efficacy of decline eccentric squats in the rehabilitative management of patellar tendinopathy.

ATMOSPHERIC RELEASES FROM STANDARDIZED NUCLEAR POWER PLANTS: A WIND TUNNEL STUDY

EPA Science Inventory

Laboratory experiments were conducted to simulate radiopollutant effluents released to the atmosphere from two standard design nuclear power plants. The main objective of the study was to compare the dispersion in the wake of the standardized nuclear power plants with that in a s...

The comparison between limited open carpal tunnel release using direct vision and tunneling technique and standard open carpal tunnel release: a randomized controlled trial study.

PubMed

Suppaphol, Sorasak; Worathanarat, Patarawan; Kawinwongkovit, Viroj; Pittayawutwinit, Preecha

2012-04-01

To compare the operative outcome of carpal tunnel release between limited open carpal tunnel release using direct vision and tunneling technique (group A) with standard open carpal tunnel release (group B). Twenty-eight patients were enrolled in the present study. A single blind randomized control trial study was conducted to compare the postoperative results between group A and B. The study parameters were Levine's symptom severity and functional score, grip and pinch strength, and average two-point discrimination. The postoperative results between two groups were comparable with no statistical significance. Only grip strength at three months follow up was significantly greater in group A than in group B. The limited open carpal tunnel release in the present study is effective comparable to the standard open carpal tunnel release. The others advantage of this technique are better cosmesis and improvement in grip strength at the three months postoperative period.

Comparing Internet Probing Methodologies Through an Analysis of Large Dynamic Graphs

DTIC Science & Technology

2014-06-01

comparable Internet topologies in less time. We compare these by modeling union of traceroute outputs as graphs, and using standard graph theoretical...topologies in less time. We compare these by modeling union of traceroute outputs as graphs, and using standard graph theoretical measurements as well...We compare these by modeling union of traceroute outputs as graphs, and study the graphs by using vertex and edge count, average vertex degree

Comparing Identification of Standardized and Regionally Valid Vowels

ERIC Educational Resources Information Center

Wright, Richard; Souza, Pamela

2012-01-01

Purpose: In perception studies, it is common to use vowel stimuli from standardized recordings or synthetic stimuli created using values from well-known published research. Although the use of standardized stimuli is convenient, unconsidered dialect and regional accent differences may introduce confounding effects. The goal of this study was to…

A Comparative Study on Bearing Capacity of Shallow Foundations in Sand from N and ϕ

NASA Astrophysics Data System (ADS)

Sakleshpur, V. A.; Satyanarayana Reddy, C. N. V.

2017-12-01

This work presents a comparative study on the bearing capacity of strip, square, circular footings and raft foundations in sand, estimated from the standard penetration resistance, N, and the angle of shearing resistance, ϕ. The net safe bearing capacity estimated directly from N using Teng's equation is compared with that obtained from ϕ as per IS:6403. Likewise, the net safe settlement pressure determined from IS:8009 (Part 1), based on N, is compared with that attained from the semi-empirical approach of Schmertmann et al. A parametric study quantifies the effects of the standard penetration resistance and the size and depth of foundation on the net safe bearing capacity and the net safe settlement pressure of strip, square, circular footings and raft foundations in sand. Interactive charts are prepared in terms of the standard penetration resistance to highlight the appropriate method for the benefit of civil engineers.

A robust ambient temperature collection and stabilization strategy: Enabling worldwide functional studies of the human microbiome

PubMed Central

Anderson, Ericka L.; Li, Weizhong; Klitgord, Niels; Highlander, Sarah K.; Dayrit, Mark; Seguritan, Victor; Yooseph, Shibu; Biggs, William; Venter, J. Craig; Nelson, Karen E.; Jones, Marcus B.

2016-01-01

As reports on possible associations between microbes and the host increase in number, more meaningful interpretations of this information require an ability to compare data sets across studies. This is dependent upon standardization of workflows to ensure comparability both within and between studies. Here we propose the standard use of an alternate collection and stabilization method that would facilitate such comparisons. The DNA Genotek OMNIgene∙Gut Stool Microbiome Kit was compared to the currently accepted community standard of freezing to store human stool samples prior to whole genome sequencing (WGS) for microbiome studies. This stabilization and collection device allows for ambient temperature storage, automation, and ease of shipping/transfer of samples. The device permitted the same data reproducibility as with frozen samples, and yielded higher recovery of nucleic acids. Collection and stabilization of stool microbiome samples with the DNA Genotek collection device, combined with our extraction and WGS, provides a robust, reproducible workflow that enables standardized global collection, storage, and analysis of stool for microbiome studies. PMID:27558918

Comparative Analysis and Considerations for PV Interconnection Standards in the United States and China

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

Gao, David Wenzhong; Muljadi, Eduard; Tian, Tian

The main objectives of this report are to evaluate China's photovoltaic (PV) interconnection standards and the U.S. counterparts and to propose recommendations for future revisions to these standards. This report references the 2013 report Comparative Study of Standards for Grid-Connected PV System in China, the U.S. and European Countries, which compares U.S., European, and China's PV grid interconnection standards; reviews various metrics for the characterization of distribution network with PV; and suggests modifications to China's PV interconnection standards and requirements. The recommendations are accompanied by assessments of four high-penetration PV grid interconnection cases in the United States to illustrate solutionsmore » implemented to resolve issues encountered at different sites. PV penetration in China and in the United States has significantly increased during the past several years, presenting comparable challenges depending on the conditions of the grid at the point of interconnection; solutions are generally unique to each interconnected PV installation or PV plant.« less

Growth References of Preschool Children Based on the Taiwan Birth Cohort Study and Compared to World Health Organization Growth Standards.

PubMed

Li, Yi-Fan; Lin, Shio-Jean; Lin, Kuan-Chia; Chiang, Tung-Liang

2016-02-01

To develop new growth references for height, weight, and body mass index (BMI) for children aged 0-5 years in the Taiwan Birth Cohort Study (TBCS) and to compare these references with both 1997 Taiwan references and World Health Organization (WHO) standards. Data were obtained from the TBCS of a nationally representative sample of 24,200 children. A total of 18,466 children completed the baseline survey at 6 months of age and three follow-up surveys at 18 months, 3 years, and 5.5 years of age. The modified LMS method was used to construct percentile curves by sex, including length/height for age, weight for age, and BMI for age. TBCS children of both sexes were shorter and lighter at birth compared with 1997 Taiwan references and WHO standards. The growth patterns of TBCS children were close to those of the 1997 Taiwan references after 6 months of age. Compared with WHO standards, however, TBCS children were heavier after 6 months of age. This study has developed TBCS references to monitor the growth of children in Taiwan, whose weight growth patterns differed from those "prescribed" by WHO standards. Copyright © 2016. Published by Elsevier B.V.

Preclinical evaluation of posterior spine stabilization devices: can the current standards represent basic everyday life activities?

PubMed

La Barbera, Luigi; Galbusera, Fabio; Wilke, Hans-Joachim; Villa, Tomaso

2016-09-01

To discuss whether the available standard methods for preclinical evaluation of posterior spine stabilization devices can represent basic everyday life activities and how to compare the results obtained with different procedures. A comparative finite element study compared ASTM F1717 and ISO 12189 standards to validated instrumented L2-L4 segments undergoing standing, upper body flexion and extension. The internal loads on the spinal rod and the maximum stress on the implant are analysed. ISO recommended anterior support stiffness and force allow for reproducing bending moments measured in vivo on an instrumented physiological segment during upper body flexion. Despite the significance of ASTM model from an engineering point of view, the overly conservative vertebrectomy model represents an unrealistic worst case scenario. A method is proposed to determine the load to apply on assemblies with different anterior support stiffnesses to guarantee a comparable bending moment and reproduce specific everyday life activities. The study increases our awareness on the use of the current standards to achieve meaningful results easy to compare and interpret.

Methodological issues when comparing hearing thresholds of a group with population standards: the case of the ferry engineers.

PubMed

Dobie, Robert A

2006-10-01

To discuss appropriate and inappropriate methods for comparing distributions of hearing thresholds of a study group with distributions in population standards and to determine whether the thresholds of Washington State Ferries engineers are different from those of men in the general population, using both frequency-by-frequency comparisons and analysis of audiometric shape. The most recent hearing conservation program audiograms of 321 noise-exposed engineers, ages 35 to 64, were compared with the predictions of Annexes A, B, and C from ANSI S3.44. There was no screening by history or otoscopy; all audiograms were included. 95% confidence intervals (95% CIs) were calculated for the engineers' median thresholds for each ear, for the better ear (defined two ways), and for the binaural average. For Annex B, where 95% CIs are also available, it was possible to calculate z scores for the differences between Annex B and the engineers' better ears. Bulge depth, an audiometric shape statistic, measured curvature between 1 and 6 kHz. Engineers' better-ear median thresholds were worse than those in Annex A but (except at 1 kHz) were as good as or better than those in Annexes B and C, which are more appropriate for comparison to an unscreened noise-exposed group like the engineers. Average bulge depth for the engineers was similar to that of the Annex B standard (no added occupational noise) and was much less than that of audiograms created by using the standard with added occupational noise between 90 and 100 dBA. Audiograms from groups that have been selected for a particular exposure, but, without regard to severity, can appropriately be compared with population standards, if certain pitfalls are avoided. For unscreened study groups with large age-sex subgroups, a simple method to assess statistical significance, taking into consideration uncertainties in both the study group and the comparison standard, is the calculation of z scores for the proportion of better-ear thresholds above the Annex B median. A less powerful method combines small age-sex subgroups after age correction. Small threshold differences, even if statistically significant, may not be due to genuine differences in hearing sensitivity between study group and standard. Audiometric shape analysis offers an independent dimension of comparison between the study group and audiograms predicted from the ANSI S3.44 standard, with and without occupational noise exposure. Important pitfalls in comparison to population standards include nonrandom selection of study groups, inappropriate choice of population standard, use of the right and left ear thresholds instead of the better-ear threshold for comparison to Annex B, and comparing means with medians. The thresholds of the engineers in this study were similar to published standards for an unscreened population.

Comparison of ambulatory blood pressure reference standards in children evaluated for hypertension.

PubMed

Jones, Deborah P; Richey, Phyllis A; Alpert, Bruce S

2009-06-01

The purpose of this study was to systematically compare methods for standardization of blood pressure levels obtained by ambulatory blood pressure monitoring (ABPM) in a group of 111 children studied at our institution. Blood pressure indices, blood pressure loads and standard deviation scores were calculated using the original ABPM and the modified reference standards. Bland-Altman plots and kappa statistics for the level of agreement were generated. Overall, the agreement between the two methods was excellent; however, approximately 5% of children were classified differently by one as compared with the other method. Depending on which version of the German Working Group's reference standards is used for interpretation of ABPM data, the classification of the individual as having hypertension or normal blood pressure may vary.

Comparison of ambulatory blood pressure reference standards in children evaluated for hypertension

PubMed Central

Jones, Deborah P.; Richey, Phyllis A.; Alpert, Bruce S.

2009-01-01

Objective The purpose of this study was to systematically compare methods for standardization of blood pressure levels obtained by ambulatory blood pressure monitoring (ABPM) in a group of 111 children studied at our institution. Methods Blood pressure indices, blood pressure loads and standard deviation scores were calculated using he original ABPM and the modified reference standards. Bland—Altman plots and kappa statistics for the level of agreement were generated. Results Overall, the agreement between the two methods was excellent; however, approximately 5% of children were classified differently by one as compared with the other method. Conclusion Depending on which version of the German Working Group’s reference standards is used for interpretation of ABPM data, the classification of the individual as having hypertension or normal blood pressure may vary. PMID:19433980

Anthropometric measurement standardization in the US-affiliated pacific: Report from the Children's Healthy Living Program.

PubMed

Li, Fenfang; Wilkens, Lynne R; Novotny, Rachel; Fialkowski, Marie K; Paulino, Yvette C; Nelson, Randall; Bersamin, Andrea; Martin, Ursula; Deenik, Jonathan; Boushey, Carol J

2016-05-01

Anthropometric standardization is essential to obtain reliable and comparable data from different geographical regions. The purpose of this study is to describe anthropometric standardization procedures and findings from the Children's Healthy Living (CHL) Program, a study on childhood obesity in 11 jurisdictions in the US-Affiliated Pacific Region, including Alaska and Hawai'i. Zerfas criteria were used to compare the measurement components (height, waist, and weight) between each trainee and a single expert anthropometrist. In addition, intra- and inter-rater technical error of measurement (TEM), coefficient of reliability, and average bias relative to the expert were computed. From September 2012 to December 2014, 79 trainees participated in at least 1 of 29 standardization sessions. A total of 49 trainees passed either standard or alternate Zerfas criteria and were qualified to assess all three measurements in the field. Standard Zerfas criteria were difficult to achieve: only 2 of 79 trainees passed at their first training session. Intra-rater TEM estimates for the 49 trainees compared well with the expert anthropometrist. Average biases were within acceptable limits of deviation from the expert. Coefficient of reliability was above 99% for all three anthropometric components. Standardization based on comparison with a single expert ensured the comparability of measurements from the 49 trainees who passed the criteria. The anthropometric standardization process and protocols followed by CHL resulted in 49 standardized field anthropometrists and have helped build capacity in the health workforce in the Pacific Region. Am. J. Hum. Biol. 28:364-371, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

The Impact of Scholastic Instrumental Music and Scholastic Chess Study on the Standardized Test Scores of Students in Grades Three, Four, and Five

ERIC Educational Resources Information Center

Martinez, Edwin E.

2012-01-01

This study examines the impact of instrumental music study and group chess lessons on the standardized test scores of suburban elementary public school students (grades three through five) in Levittown, New York. The study divides the students into the following groups and compares the standardized test scores of each: a) instrumental music…

Fetoscopic Open Neural Tube Defect Repair: Development and Refinement of a Two-Port, Carbon Dioxide Insufflation Technique.

PubMed

Belfort, Michael A; Whitehead, William E; Shamshirsaz, Alireza A; Bateni, Zhoobin H; Olutoye, Oluyinka O; Olutoye, Olutoyin A; Mann, David G; Espinoza, Jimmy; Williams, Erin; Lee, Timothy C; Keswani, Sundeep G; Ayres, Nancy; Cassady, Christopher I; Mehollin-Ray, Amy R; Sanz Cortes, Magdalena; Carreras, Elena; Peiro, Jose L; Ruano, Rodrigo; Cass, Darrell L

2017-04-01

To describe development of a two-port fetoscopic technique for spina bifida repair in the exteriorized, carbon dioxide-filled uterus and report early results of two cohorts of patients: the first 15 treated with an iterative technique and the latter 13 with a standardized technique. This was a retrospective cohort study (2014-2016). All patients met Management of Myelomeningocele Study selection criteria. The intraoperative approach was iterative in the first 15 patients and was then standardized. Obstetric, maternal, fetal, and early neonatal outcomes were compared. Standard parametric and nonparametric tests were used as appropriate. Data for 28 patients (22 endoscopic only, four hybrid, two abandoned) are reported, but only those with a complete fetoscopic repair were analyzed (iterative technique [n=10] compared with standardized technique [n=12]). Maternal demographics and gestational age (median [range]) at fetal surgery (25.4 [22.9-25.9] compared with 24.8 [24-25.6] weeks) were similar, but delivery occurred at 35.9 (26-39) weeks of gestation with the iterative technique compared with 39 (35.9-40) weeks of gestation with the standardized technique (P<.01). Duration of surgery (267 [107-434] compared with 246 [206-333] minutes), complication rates, preterm prelabor rupture of membranes rates (4/12 [33%] compared with 1/10 [10%]), and vaginal delivery rates (5/12 [42%] compared with 6/10 [60%]) were not statistically different in the iterative and standardized techniques, respectively. In 6 of 12 (50%) compared with 1 of 10 (10%), respectively (P=.07), there was leakage of cerebrospinal fluid from the repair site at birth. Management of Myelomeningocele Study criteria for hydrocephalus-death at discharge were met in 9 of 12 (75%) and 3 of 10 (30%), respectively, and 7 of 12 (58%) compared with 2 of 10 (20%) have been treated for hydrocephalus to date. These latter differences were not statistically significant. Fetoscopic open neural tube defect repair does not appear to increase maternal-fetal complications as compared with repair by hysterotomy, allows for vaginal delivery, and may reduce long-term maternal risks. ClinicalTrials.gov, https://clinicaltrials.gov, NCT02230072.

Assessment of Safety Standards for Automotive Electronic Control Systems

DOT National Transportation Integrated Search

2016-06-01

This report summarizes the results of a study that assessed and compared six industry and government safety standards relevant to the safety and reliability of automotive electronic control systems. These standards include ISO 26262 (Road Vehicles - ...

Standardized pivot shift test improves measurement accuracy.

PubMed

Hoshino, Yuichi; Araujo, Paulo; Ahlden, Mattias; Moore, Charity G; Kuroda, Ryosuke; Zaffagnini, Stefano; Karlsson, Jon; Fu, Freddie H; Musahl, Volker

2012-04-01

The variability of the pivot shift test techniques greatly interferes with achieving a quantitative and generally comparable measurement. The purpose of this study was to compare the variation of the quantitative pivot shift measurements with different surgeons' preferred techniques to a standardized technique. The hypothesis was that standardizing the pivot shift test would improve consistency in the quantitative evaluation when compared with surgeon-specific techniques. A whole lower body cadaveric specimen was prepared to have a low-grade pivot shift on one side and high-grade pivot shift on the other side. Twelve expert surgeons performed the pivot shift test using (1) their preferred technique and (2) a standardized technique. Electromagnetic tracking was utilized to measure anterior tibial translation and acceleration of the reduction during the pivot shift test. The variation of the measurement was compared between the surgeons' preferred technique and the standardized technique. The anterior tibial translation during pivot shift test was similar between using surgeons' preferred technique (left 24.0 ± 4.3 mm; right 15.5 ± 3.8 mm) and using standardized technique (left 25.1 ± 3.2 mm; right 15.6 ± 4.0 mm; n.s.). However, the variation in acceleration was significantly smaller with the standardized technique (left 3.0 ± 1.3 mm/s(2); right 2.5 ± 0.7 mm/s(2)) compared with the surgeons' preferred technique (left 4.3 ± 3.3 mm/s(2); right 3.4 ± 2.3 mm/s(2); both P < 0.01). Standardizing the pivot shift test maneuver provides a more consistent quantitative evaluation and may be helpful in designing future multicenter clinical outcome trials. Diagnostic study, Level I.

Human Elements and the Pragmatic Approach in the Australian, Scottish and Swedish Standards for Newly Qualified Teachers

ERIC Educational Resources Information Center

Fransson, Göran; Gallant, Andrea; Shanks, Rachel

2018-01-01

Teacher standards are used in many countries, but it has been argued that there is a disconnection between the standards and teachers' everyday practices. Mega-narratives about teachers' practices have been recognised as powerful for educational change and when implementing and legitimising standards. In this comparative study, the standards for…

What is the threshold for symptomatic response and remission for major depressive disorder, panic disorder, social anxiety disorder, and generalized anxiety disorder?

PubMed

Bandelow, Borwin; Baldwin, David S; Dolberg, Ornah T; Andersen, Henning Friis; Stein, Dan J

2006-09-01

Symptom-free remission is a goal for treatment in depression and anxiety disorders, but there is no consensus regarding the threshold for determining remission in individual disorders. We sought to determine these thresholds by comparing, in a post hoc analysis, scores on the Clinical Global Impressions scale (CGI) and disorder-specific symptom severity rating scales from all available studies of the treatment of major depressive disorder, panic disorder, generalized anxiety disorder, and social anxiety disorder with the same medication (escitalopram). We also sought to compare the standardized effect sizes of escitalopram for these 4 psychiatric disorders. Raw data from all randomized, double-blind, placebo-controlled, acute treatment studies sponsored by H. Lundbeck A/S (Copenhagen, Denmark) or Forest Laboratories, Inc. (New York, N.Y.), published through March 1, 2004, with patients treated with escitalopram for DSM-IV major depressive disorder (5 studies), panic disorder (1 study), generalized anxiety disorder (4 studies), or social anxiety disorder (2 studies) were compared with regard to the standardized effect sizes of change in CGI score and scores on rating scales that represent the "gold standard" for assessment of these disorders (the Montgomery-Asberg Depression Rating Scale, the Panic and Agoraphobia Scale, the Hamilton Rating Scale for Anxiety, and the Liebowitz Social Anxiety Scale, respectively). In all indications, treatment with escitalopram showed differences from placebo in treatment effect from 0.32 to 0.59 on the CGI-S and CGI-I and standardized effect sizes from 0.32 to 0.50 on the standard rating scales. There were no significant differences among the different disorders. Moderate to high correlations were found between scores on the CGI and the standard scales. The corresponding standard scale scores for CGI-defined "response" and "remission" were determined. Comparison of scores on the standard scales and scores on the CGI suggest that the traditional definition of response (i.e., a 50% reduction in a standard scale) may be too conservative.

Fast Foods, Organic Foods, Fad Diets

USDA-ARS?s Scientific Manuscript database

There is no standard definition of fast food. Generally, fast food is eaten without cutlery, and fast-food restaurants have no wait staff. Failure to have a standardized definition makes it difficult to compare studies. Foods available outside the home tend to be high in energy and fat compared w...

A Comparative Study of Standard-Setting Methods.

ERIC Educational Resources Information Center

Livingston, Samuel A.; Zieky, Michael J.

1989-01-01

The borderline group standard-setting method (BGSM), Nedelsky method (NM), and Angoff method (AM) were compared, using reading scores for 1,948 and mathematics scores for 2,191 sixth through ninth graders. The NM and AM were inconsistent with the BGSM. Passing scores were higher where students were more able. (SLD)

Impact of a product-specific reference standard for the measurement of a PEGylated rFVIII activity: the Swiss Multicentre Field Study.

PubMed

Bulla, O; Poncet, A; Alberio, L; Asmis, L M; Gähler, A; Graf, L; Nagler, M; Studt, J-D; Tsakiris, D A; Fontana, P

2017-07-01

Measuring factor VIII (FVIII) activity can be challenging when it has been modified, such as when FVIII is pegylated to increase its circulating half-life. Use of a product-specific reference standard may help avoid this issue. Evaluate the impact of using a product-specific reference standard for measuring the FVIII activity of BAX 855 - a pegylated FVIII - in eight of Switzerland's main laboratories. Factor VIII-deficient plasma, spiked with five different concentrations of BAX 855, plus a control FVIII sample, was sent to the participating laboratories. They measured FVIII activity by using either with a one-stage (OSA) or the chromogenic assay (CA) against their local or a product-specific reference standard. When using a local reference standard, there was an overestimation of BAX 855 activity compared to the target concentrations, both with the OSA and CA. The use of a product-specific reference standard reduced this effect: mean recovery ranged from 127.7% to 213.5% using the OSA with local reference standards, compared to 110% to 183.8% with a product-specific reference standard, and from 146.3% to 182.4% using the CA with local reference standards compared to 72.7% to 103.7% with a product-specific reference standard. In this in vitro study, the type of reference standard had a major impact on the measurement of BAX 855 activity. Evaluation was more accurate and precise when using a product-specific reference standard. © 2017 John Wiley & Sons Ltd.

Cost-effectiveness of peer role play and standardized patients in undergraduate communication training.

PubMed

Bosse, Hans Martin; Nickel, Martin; Huwendiek, Sören; Schultz, Jobst Hendrik; Nikendei, Christoph

2015-10-24

The few studies directly comparing the methodological approach of peer role play (RP) and standardized patients (SP) for the delivery of communication skills all suggest that both methods are effective. In this study we calculated the costs of both methods (given comparable outcomes) and are the first to generate a differential cost-effectiveness analysis of both methods. Medical students in their prefinal year were randomly assigned to one of two groups receiving communication training in Pediatrics either with RP (N = 34) or 19 individually trained SP (N = 35). In an OSCE with standardized patients using the Calgary-Cambridge Referenced Observation Guide both groups achieved comparable high scores (results published). In this study, corresponding costs were assessed as man-hours resulting from hours of work of SP and tutors. A cost-effectiveness analysis was performed. Cost-effectiveness analysis revealed a major advantage for RP as compared to SP (112 vs. 172 man hours; cost effectiveness ratio .74 vs. .45) at comparable performance levels after training with both methods. While both peer role play and training with standardized patients have their value in medical curricula, RP has a major advantage in terms of cost-effectiveness. This could be taken into account in future decisions.

Prevalence and determinants of non-standard motorcycle safety helmets amongst food delivery workers in Selangor and Kuala Lumpur.

PubMed

Kulanthayan, S; See, Lai Git; Kaviyarasu, Y; Nor Afiah, M Z

2012-05-01

Almost half of the global traffic crashes involve vulnerable groups such as pedestrian, cyclists and two-wheeler users. The main objective of this study was to determine the factors that influence standard of the safety helmets used amongst food delivery workers by presence of Standard and Industrial Research Institute of Malaysia (SIRIM) certification label. A cross sectional study was conducted amongst 150 food delivery workers from fast food outlets in the vicinity of Selangor and Kuala Lumpur. During observation, safety helmets were classified as standard safety helmet in the presence of SIRIM label and non-standard in the absence of the label. They were approached for questionnaire participation once consent was obtained and were requested to exchange their safety helmet voluntarily with a new one after the interview. Data analysis was carried out using SPSS. Chi square and logistic regression analysis was applied to determine the significance and odds ratio of the variables studied, respectively (penetration test, age, education level, knowledge, crash history, types of safety helmet, marital status and years of riding experience) against the presence of SIRIM label. The response rate for this study was 85.2%. The prevalence of non-standard helmets use amongst fast food delivery workers was 55.3%. Safety helmets that failed the penetration test had higher odds of being non-standard helmets compared with safety helmets passing the test. Types of safety helmet indicated half-shell safety helmets had higher odds to be non-standard safety helmets compared to full-shell safety helmets. Riders with more years of riding experience were in high odds of wearing non-standard safety helmets compared to riders with less riding experience. Non-standard (non-SIRIM approved) helmets were more likely to be half-shell helmets, were more likely to fail the standards penetration test, and were more likely to be worn by older, more experienced riders. The implications of these findings are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

The effect of customization and use of a fetal growth standard on the association between birthweight percentile and adverse perinatal outcome.

PubMed

Sovio, Ulla; Smith, Gordon C S

2018-02-01

It has been proposed that correction of offspring weight percentiles (customization) might improve the prediction of adverse pregnancy outcome; however, the approach is not accepted universally. A complication in the interpretation of the data is that the main method for calculation of customized percentiles uses a fetal growth standard, and multiple analyses have compared the results with birthweight-based standards. First, we aimed to determine whether women who deliver small-for-gestational-age infants using a customized standard differed from other women. Second, we aimed to compare the association between birthweight percentile and adverse outcome using 3 different methods for percentile calculation: (1) a noncustomized actual birthweight standard, (2) a noncustomized fetal growth standard, and (3) a fully customized fetal growth standard. We analyzed data from the Pregnancy Outcome Prediction study, a prospective cohort study of nulliparous women who delivered in Cambridge, UK, between 2008 and 2013. We used a composite adverse outcome, namely, perinatal morbidity or preeclampsia. Receiver operating characteristic curve analysis was used to compare the 3 methods of calculating birthweight percentiles in relation to the composite adverse outcome. We confirmed previous observations that delivering an infant who was small for gestational age (<10th percentile) with the use of a fully customized fetal growth standard but who was appropriate for gestational age with the use of a noncustomized actual birthweight standard was associated with higher rates of adverse outcomes. However, we also observed that the mothers of these infants were 3-4 times more likely to be obese and to deliver preterm. When we compared the risk of adverse outcome from logistic regression models that were fitted to the birthweight percentiles that were derived by each of the 3 predefined methods, the areas under the receiver operating characteristic curves were similar for all 3 methods: 0.56 (95% confidence interval, 0.54-0.59) fully customized, 0.56 (95% confidence interval, 0.53-0.59) noncustomized fetal weight standard, and 0.55 (95% confidence interval, 0.53-0.58) noncustomized actual birthweight standard. When we classified the top 5% of predicted risk as high risk, the methods that used a fetal growth standard showed attenuation after adjustment for gestational age, whereas the birthweight standard did not. Further adjustment for the maternal characteristics, which included weight, attenuated the association with the customized standard, but not the other 2 methods. The associations after full adjustment were similar when we compared the 3 approaches. The independent association between birthweight percentile and adverse outcome was similar when we compared actual birthweight standards and fetal growth standards and compared customized and noncustomized standards. Use of fetal weight standards and customized percentiles for maternal characteristics could lead to stronger associations with adverse outcome through confounding by preterm birth and maternal obesity. Copyright © 2017 Elsevier Inc. All rights reserved.

Cardiac arrest risk standardization using administrative data compared to registry data.

PubMed

Grossestreuer, Anne V; Gaieski, David F; Donnino, Michael W; Nelson, Joshua I M; Mutter, Eric L; Carr, Brendan G; Abella, Benjamin S; Wiebe, Douglas J

2017-01-01

Methods for comparing hospitals regarding cardiac arrest (CA) outcomes, vital for improving resuscitation performance, rely on data collected by cardiac arrest registries. However, most CA patients are treated at hospitals that do not participate in such registries. This study aimed to determine whether CA risk standardization modeling based on administrative data could perform as well as that based on registry data. Two risk standardization logistic regression models were developed using 2453 patients treated from 2000-2015 at three hospitals in an academic health system. Registry and administrative data were accessed for all patients. The outcome was death at hospital discharge. The registry model was considered the "gold standard" with which to compare the administrative model, using metrics including comparing areas under the curve, calibration curves, and Bland-Altman plots. The administrative risk standardization model had a c-statistic of 0.891 (95% CI: 0.876-0.905) compared to a registry c-statistic of 0.907 (95% CI: 0.895-0.919). When limited to only non-modifiable factors, the administrative model had a c-statistic of 0.818 (95% CI: 0.799-0.838) compared to a registry c-statistic of 0.810 (95% CI: 0.788-0.831). All models were well-calibrated. There was no significant difference between c-statistics of the models, providing evidence that valid risk standardization can be performed using administrative data. Risk standardization using administrative data performs comparably to standardization using registry data. This methodology represents a new tool that can enable opportunities to compare hospital performance in specific hospital systems or across the entire US in terms of survival after CA.

Systematic ultrasound-guided saturation and template biopsy of the prostate: indications and advantages of extended sampling.

PubMed

Isbarn, Hendrik; Briganti, Alberto; De Visschere, Pieter J L; Fütterer, Jurgen J; Ghadjar, Pirus; Giannarini, Gianluca; Ost, Piet; Ploussard, Guillaume; Sooriakumaran, Prasanna; Surcel, Christian I; van Oort, Inge M; Yossepowitch, Ofer; van den Bergh, Roderick C N

2015-04-01

Prostate biopsy (PB) is the gold standard for the diagnosis of prostate cancer (PCa). However, the optimal number of biopsy cores remains debatable. We sought to compare contemporary standard (10-12 cores) vs. saturation (=18 cores) schemes on initial as well as repeat PB. A non-systematic review of the literature was performed from 2000 through 2013. Studies of highest evidence (randomized controlled trials, prospective non-randomized studies, and retrospective reports of high quality) comparing standard vs saturation schemes on initial and repeat PB were evaluated. Outcome measures were overall PCa detection rate, detection rate of insignificant PCa, and procedure-associated morbidity. On initial PB, there is growing evidence that a saturation scheme is associated with a higher PCa detection rate compared to a standard one in men with lower PSA levels (<10 ng/ml), larger prostates (>40 cc), or lower PSA density values (<0.25 ng/ml/cc). However, these cut-offs are not uniform and differ among studies. Detection rates of insignificant PCa do not differ in a significant fashion between standard and saturation biopsies. On repeat PB, PCa detection rate is likewise higher with saturation protocols. Estimates of insignificant PCa vary widely due to differing definitions of insignificant disease. However, the rates of insignificant PCa appear to be comparable for the schemes in patients with only one prior negative biopsy, while saturation biopsy seems to detect more cases of insignificant PCa compared to standard biopsy in men with two or more prior negative biopsies. Very extensive sampling is associated with a high rate of acute urinary retention, whereas other severe adverse events, such as sepsis, appear not to occur more frequently with saturation schemes. Current evidence suggests that saturation schemes are associated with a higher PCa detection rate compared to standard ones on initial PB in men with lower PSA levels or larger prostates, and on repeat PB. Since most data are derived from retrospective studies, other endpoints such as detection rate of insignificant disease - especially on repeat PB - show broad variations throughout the literature and must, thus, be interpreted with caution. Future prospective controlled trials should be conducted to compare extended templates with newer techniques, such as image-guided sampling, in order to optimize PCa diagnostic strategy.

Early experience with stretch polytetrafluoroethylene grafts for haemodialysis access surgery: results of a prospective randomised study.

PubMed

Tordoir, J H; Hofstra, L; Leunissen, K M; Kitslaar, P J

1995-04-01

The purpose of this study was to evaluate the results and complications of standard ePTFE versus stretch ePTFE AV fistulas. Prospective randomised trial. University Hospital. During a 2-year period 37 patients received 17 stretch and 20 standard ePTFE graft AV fistulas. Patients were evaluated for the occurrence of complications and graft patency. Regular Duplex scans were performed to detect stenoses in the fistula circuit. Thrombotic events occurred in 40% of the standard ePTFE grafts, compared to 12% of the stretch ePTFE prostheses (p < 0.001). The incidence of puncture complications was similar in both groups. The cumulative primary patency rate in the stretch ePTFE group was significantly higher compared to the standard ePTFE group (1-year patency rates of 59% and 29%, respectively; p < 0.01). No differences in the duration of puncture site bleeding were observed. Duplex scanning showed a significantly greater number of stenoses in the standard ePTFE grafts. The new stretch ePTFE prosthesis has better primary patency rates and less stenoses due to intimal hyperplasia as compared to standard ePTFE grafts.

Comparing Standard Deviation Effects across Contexts

ERIC Educational Resources Information Center

Ost, Ben; Gangopadhyaya, Anuj; Schiman, Jeffrey C.

2017-01-01

Studies using tests scores as the dependent variable often report point estimates in student standard deviation units. We note that a standard deviation is not a standard unit of measurement since the distribution of test scores can vary across contexts. As such, researchers should be cautious when interpreting differences in the numerical size of…

Comparing Teachers' Literacy-Related Knowledge to Their State's Standards for Reading

ERIC Educational Resources Information Center

McCombes-Tolis, Jule; Feinn, Richard

2008-01-01

This study compared elementary and special education teachers' knowledge of when K-3 students develop key reading competencies, their knowledge of who is responsible for teaching K-3 students key reading competencies, and teachers' perceptions of their own instructionally relevant competencies to those standards articulated within their state's…

Mini vs standard percutaneous nephrolithotomy for renal stones: a comparative study.

PubMed

ElSheemy, Mohammed S; Elmarakbi, Akram A; Hytham, Mohammed; Ibrahim, Hamdy; Khadgi, Sanjay; Al-Kandari, Ahmed M

2018-03-16

To compare the outcome of mini-percutaneous nephrolithotomy (Mini-PNL) versus standard-PNL for renal stones. Retrospective study was performed between March 2010 and May 2013 for patients treated by Mini-PNL or standard-PNL through 18 and 30 Fr tracts, respectively, using pneumatic lithotripsy. Semirigid ureteroscope (8.5/11.5 Fr) was used for Mini-PNL and 24 Fr nephroscope for standard-PNL. Both groups were compared in stone free rate(SFR), complications and operative time using Student-t, Mann-Whitney, Chi square or Fisher's exact tests as appropriate in addition to logistic regression analysis. P < 0.05 was considered statistically significant. Mini-PNL (378) and standard-PNL (151) were nearly comparable in patients and stones criteria including stone burden (3.77 ± 2.21 vs 3.77 ± 2.43 cm 2 ; respectively). There was no significant difference in number of tracts or supracostal puncture. Mini-PNL had longer operative time (68.6 ± 29.09 vs 60.49 ± 11.38 min; p = 0.434), significantly shorter hospital stay (2.43 ± 1.46 vs 4.29 ± 1.28 days) and significantly higher rate of tubeless PNL (75.1 vs 4.6%). Complications were significantly higher in standard-PNL (7.9 vs 20.5%; p < 0.001). SFR was significantly lower in Mini-PNL (89.9 vs 96%; p = 0.022). This significant difference was found with multiple stones and large stone burden (> 2 cm 2 ), but the SFR was comparable between both groups with single stone or stone burden ≤ 2 cm. Logistic regression analysis confirmed significantly higher complications and SFR with standard-PNL but with significantly shorter operative time. Mini-PNL has significantly lower SFR when compared to standard-PNL (but clinically comparable) with markedly reduced complications and hospital stay. Most of cases can be performed tubeless. The significant difference in SFR was found with multiple stones or large stone burden (> 2 cm 2 ), but not with single stones or stone burden ≤ 2 cm 2 .

Comparison of total coliform, fecal coliform, and enterococcus bacterial indicator response for ocean recreational water quality testing.

PubMed

Noble, R T; Moore, D F; Leecaster, M K; McGee, C D; Weisberg, S B

2003-04-01

In July 1999, California's ocean recreational bacterial water quality standards were changed from a total coliform (TC) test to a standard requiring testing for all three bacterial indicators: TC, fecal coliforms (FC), and enterococci (EC). To compare the relationship between the bacterial indicators, and the effect that changing the standards would have on recreational water regulatory actions, three regional studies were conducted along the southern California shoreline from Santa Barbara to San Diego, California. Two studies were conducted during dry weather and one following a large storm event. In each study, samples were collected at over 200 sites which were selected using a stratified random design, with strata consisting of open beach areas and rocky shoreline, and areas near freshwater outlets that drain land-based runoff. During the dry weather studies, samples were collected once per week for 5 weeks. For the storm event study, sampling occurred on a single day about 24 h following the storm. The three indicator bacteria were measured at each site and the results were compared to the single sample standards (TC > 10,000; FC > 400 and EC > 104 MPN or cfu/100 ml). EC was the indicator that failed the single sample standards most often. During the wet weather study, 99% of all standard failures were detected using EC, compared with only 56% for FC, and 40% for TC. During the Summer Study, EC was again the indicator that failed the single sample standards most often, with 60% of the failures for EC alone. The increased failure of the EC standard occurred consistently regardless of whether the sample was collected at a beach or rocky shoreline site, or at a site near a freshwater outlet. Agreement among indicators was better during wet weather than during dry weather. During dry weather, agreement among indicators was better near freshwater outlets than along open shoreline. Cumulatively, our results suggest that replacement of a TC standard with an EC standard will lead to a five-fold increase in failures during dry weather and a doubling of failures during wet weather. Replacing a TC standard with one based on all three indicators will lead to an eight-fold increase in failures. Changes in the requirements for water quality testing have strong implications for increases in beach closures and restrictions. Copyright 2002 Elsevier Science Ltd.

Couple Relationship Standards and Migration: Comparing Hong Kong Chinese with Australian Chinese.

PubMed

Halford, W Kim; Leung, Patrick; Hung-Cheung, Chan; Chau-Wan, Lau; Hiew, Danika; van de Vijver, Fons J R

2017-12-14

Rates of international migration are increasing, which raises the question of how migration might influence couple relationship standards and impact on the standards of migrants forming intercultural relationships. We compared relationship standards in n = 286 Chinese living in Hong Kong, China, with standards in n = 401 Chinese migrants to a Western country (Australia) by administering the Chinese-Western Intercultural Couple Standards Scale (CWICSS). We also compared these two groups to n = 312 Westerners living in Australia. We first tested the structural invariance of the CWICSS across the three samples with a multigroup confirmatory factor analysis. There was marginal but acceptable fit of a model of two positively correlated latent factors: Couple Bond (with four indicators, such as demonstration of love and caring) and Family Responsibility (also with four indicators, such as extended family relations and preserving face). Within the limitations of the study, results suggest migration is associated predominantly with differences in women's, but not men's, relationship standards. Migrant Chinese women show alignment of Couple Bond standards with Western standards, and divergence of Family Responsibility standards from Western standards. Discussion focused on how migration and intercultural relationship experiences might differentially influence various domains of relationship standards, gender differences in migration effects on standards, and the implications for working with culturally diverse couples. © 2017 Family Process Institute.

Mortality and Outcome Comparison Between Brain Tissue Oxygen Combined with Intracranial Pressure/Cerebral Perfusion Pressure-Guided Therapy and Intracranial Pressure/Cerebral Perfusion Pressure-Guided Therapy in Traumatic Brain Injury: A Meta-Analysis.

PubMed

Xie, Qiang; Wu, Hai-Bing; Yan, Yu-Feng; Liu, Meng; Wang, Er-Song

2017-04-01

The combination of brain tissue oxygen and standard intracranial pressure (ICP)/cerebral perfusion pressure (CPP)-guided therapy is thought to improve traumatic brain injury (TBI) prognosis compared with standard ICP/CPP-guided therapy. However, related results of previous observational studies and recently published cohort studies and randomized controlled trials (RCTs) remain controversial. The objective of this study was to compare the effect of the combined therapy with that of standard ICP/CPP-guided therapy on mortality rate, favorable outcome, ICP/CPP, and length of stay (LOS). We systematically searched PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and Web of Science in July 2016 for studies comparing the combined therapy and standard ICP/CPP-guided therapy. Random-effect and fixed-effect models were used for pooled analyses. After screening 362 studies, 8 cohort studies and 1 RCT were included. Primary outcomes were mortality and favorable outcome. The overall mortality risk ratio showed no obvious advantages between the 2 groups (risk ratio [RR], 0.76; 95% confidence interval [CI], 0.54-1.06) and discharge mortality (RR, 1.01; 95% CI, 0.80-1.26) and 3-month mortality (RR, 0.77; 95% CI, 0.53-1.12). Compared with the ICP/CPP group, the combined group was more likely to achieve better outcome during the 6 months after TBI (RR, 1.26; 95% CI, 1.04-1.52) or exactly at 6 months (RR, 1.34; 95% CI, 1.07-1.68), whereas ICP (standardized mean difference [SMD], -0.19; 95% CI, -0.43 to 0.05), CPP (SMD, 0.13; 95% CI, -0.09 to 0.35), and LOS (SMD, 0.13; 95% CI, -0.11 to 0.37) showed no obvious differences. Compared with standard ICP/CPP-guided therapy, brain tissue oxygen combined with ICP/CPP-guided therapy improved long-term outcomes without any effects on mortality, ICP/CPP, or LOS. Copyright © 2016 Elsevier Inc. All rights reserved.

Surgical Space Suits Increase Particle and Microbiological Emission Rates in a Simulated Surgical Environment.

PubMed

Vijaysegaran, Praveen; Knibbs, Luke D; Morawska, Lidia; Crawford, Ross W

2018-05-01

The role of space suits in the prevention of orthopedic prosthetic joint infection remains unclear. Recent evidence suggests that space suits may in fact contribute to increased infection rates, with bioaerosol emissions from space suits identified as a potential cause. This study aimed to compare the particle and microbiological emission rates (PER and MER) of space suits and standard surgical clothing. A comparison of emission rates between space suits and standard surgical clothing was performed in a simulated surgical environment during 5 separate experiments. Particle counts were analyzed with 2 separate particle counters capable of detecting particles between 0.1 and 20 μm. An Andersen impactor was used to sample bacteria, with culture counts performed at 24 and 48 hours. Four experiments consistently showed statistically significant increases in both PER and MER when space suits are used compared with standard surgical clothing. One experiment showed inconsistent results, with a trend toward increases in both PER and MER when space suits are used compared with standard surgical clothing. Space suits cause increased PER and MER compared with standard surgical clothing. This finding provides mechanistic evidence to support the increased prosthetic joint infection rates observed in clinical studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of a telenovela designed to improve knowledge and behavioral intentions among Hispanic patients with end-stage renal disease in Southern California.

PubMed

Forster, Myriam; Allem, Jon-Patrick; Mendez, Nicole; Qazi, Yasir; Unger, Jennifer B

2016-01-01

Culturally relevant education is needed to improve rates of successful kidney transplantation among Hispanic patients with end-stage renal disease (ESRD). This study examined whether patients' knowledge about kidney disease, postoperative care, and proactive health practices improved after watching a telenovela series about ESRD. 334 ESRD patients and 94 family members/caregivers were assigned to watch a telenovela ('Fixing Paco,' a bilingual health education film) or receive standard of care at a transplant center or at a dialysis clinic. Outcomes for pre-transplant patients assigned to standard of care at dialysis centers or at a transplant center were compared to pre-transplant patients in the treatment condition (standard of care + telenovela). Knowledge and behavioral intention scores at baseline across conditions and locations were similar, suggesting that assignment resulted in comparable groups at baseline. Using linear regression, this study found statistically significant improvements in knowledge scores among the telenovela group as compared to the standard of care groups. The telenovela group also had greater improvements in behavioral intention scores compared to the standard of care groups. Family members assigned to the telenovela group had significant improvements in knowledge scores as compared to the standard of care groups. Being well informed about ESRD and adopting proactive health behaviors are important mechanisms in improving transplantation outcomes. These findings suggest that knowledge about kidney disease, postoperative care, and proactive health practices could be improved by viewing a telenovela. Implications, limitations, and directions for future research are discussed.

Cardiac arrest risk standardization using administrative data compared to registry data

PubMed Central

Gaieski, David F.; Donnino, Michael W.; Nelson, Joshua I. M.; Mutter, Eric L.; Carr, Brendan G.; Abella, Benjamin S.; Wiebe, Douglas J.

2017-01-01

Background Methods for comparing hospitals regarding cardiac arrest (CA) outcomes, vital for improving resuscitation performance, rely on data collected by cardiac arrest registries. However, most CA patients are treated at hospitals that do not participate in such registries. This study aimed to determine whether CA risk standardization modeling based on administrative data could perform as well as that based on registry data. Methods and results Two risk standardization logistic regression models were developed using 2453 patients treated from 2000–2015 at three hospitals in an academic health system. Registry and administrative data were accessed for all patients. The outcome was death at hospital discharge. The registry model was considered the “gold standard” with which to compare the administrative model, using metrics including comparing areas under the curve, calibration curves, and Bland-Altman plots. The administrative risk standardization model had a c-statistic of 0.891 (95% CI: 0.876–0.905) compared to a registry c-statistic of 0.907 (95% CI: 0.895–0.919). When limited to only non-modifiable factors, the administrative model had a c-statistic of 0.818 (95% CI: 0.799–0.838) compared to a registry c-statistic of 0.810 (95% CI: 0.788–0.831). All models were well-calibrated. There was no significant difference between c-statistics of the models, providing evidence that valid risk standardization can be performed using administrative data. Conclusions Risk standardization using administrative data performs comparably to standardization using registry data. This methodology represents a new tool that can enable opportunities to compare hospital performance in specific hospital systems or across the entire US in terms of survival after CA. PMID:28783754

Standard and reduced doses of dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation: a nationwide cohort study.

PubMed

Staerk, L; Gerds, T A; Lip, G Y H; Ozenne, B; Bonde, A N; Lamberts, M; Fosbøl, E L; Torp-Pedersen, C; Gislason, G H; Olesen, J B

2018-01-01

Comparative data of non-vitamin K antagonist oral anticoagulants (NOAC) are lacking in patients with atrial fibrillation (AF). We compared effectiveness and safety of standard and reduced dose NOAC in AF patients. Using Danish nationwide registries, we included all oral anticoagulant-naïve AF patients who initiated NOAC treatment (2012-2016). Outcome-specific and mortality-specific multiple Cox regressions were combined to compute average treatment effects as 1-year standardized differences in stroke and bleeding risks (g-formula). Amongst 31 522 AF patients, the distribution of NOAC/dose was as follows: dabigatran standard dose (22.4%), dabigatran-reduced dose (14.0%), rivaroxaban standard dose (21.8%), rivaroxaban reduced dose (6.7%), apixaban standard dose (22.9%), and apixaban reduced dose (12.2%). The 1-year standardized absolute risks of stroke/thromboembolism were 1.73-1.98% and 2.51-2.78% with standard and reduced NOAC dose, respectively, without statistically significant differences between NOACs for given dose level. Comparing standard doses, the 1-year standardized absolute risk (95% CI) for major bleeding was for rivaroxaban 2.78% (2.42-3.17%); corresponding absolute risk differences (95% CI) were for dabigatran -0.93% (-1.45% to -0.38%) and apixaban, -0.54% (-0.99% to -0.05%). The results for major bleeding were similar for reduced NOAC dose. The 1-year standardized absolute risk (95% CI) for intracranial bleeding was for standard dose dabigatran 0.19% (0.22-0.50%); corresponding absolute risk differences (95% CI) were for rivaroxaban 0.23% (0.06-0.41%) and apixaban, 0.18% (0.01-0.34%). Standard and reduced dose NOACs, respectively, showed no significant risk difference for associated stroke/thromboembolism. Rivaroxaban was associated with higher bleeding risk compared with dabigatran and apixaban and dabigatran was associated with lower intracranial bleeding risk compared with rivaroxaban and apixaban. © 2017 The Association for the Publication of the Journal of Internal Medicine.

Sensitivity and specificity of visual clinical assessment as compared to WHO 2006 standard and NCHS 1977 reference in measuring the growth status of Malaysian infants.

PubMed

Selamat, Rusidah; Zain, Fuziah; Raib, Junidah; Zakaria, Rosini; Marzuki, Mohd Shaffari; Ibrahim, Taziah Fatimah

2011-12-01

To study the validity of the visual clinical assessment of weight relative to length and length relative to age as compared to the World Health Organization (WHO) 2006 standard and National Center for Health Statistics (NCHS) 1977 reference in asssessing the physical growth of children younger than 1 year. A prospective cohort study was carried out among 684 infants attending goverment health clinics in 2 states in Malaysia. Body weight, length, and clinical assessment were measured on the same day for 9 visits, scheduled every month until 6 months of age and every 2 months until 12 months of age. All of the 3 z-scores for weight for age (WAZ), length for age (HAZ), and weight for length (WHZ) were calculated using WHO Anthro for Personal Computers software. The average sensitivity and specificity for the visual clinical assessment for the detection of thinness were higher using the WHO 2006 standard as compared with using NCHS 1977. However, the overall sensitivity of the visual clinical assessment for the detection of thin and lean children was lower from 1 month of age until a year as compared with the WHO 2006 standard and NCHS 1977 reference. The positive predictive value (PPV) for the visual clinical assessment versus the WHO 2006 standard was almost doubled as compared with the PPV of visual clinical assessment versus the NCHS 1977 reference. The overall average sensitivity, specificity, PPV, and negative predictive value for the detection of stunting was higher for visual clinical assessment versus the WHO 2006 standard as compared with visual clinical assessment versus the NCHS 1977 reference. The sensitivity and specificity of visual clinical assessment for the detection of wasting and stunting among infants are better for the WHO 2006 standard than the NCHS 1977 reference.

Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study.

PubMed

Brodén, Cyrus; Olivecrona, Henrik; Maguire, Gerald Q; Noz, Marilyn E; Zeleznik, Michael P; Sköldenberg, Olof

2016-01-01

Background and Purpose. The gold standard for detection of implant wear and migration is currently radiostereometry (RSA). The purpose of this study is to compare a three-dimensional computed tomography technique (3D CT) to standard RSA as an alternative technique for measuring migration of acetabular cups in total hip arthroplasty. Materials and Methods. With tantalum beads, we marked one cemented and one uncemented cup and mounted these on a similarly marked pelvic model. A comparison was made between 3D CT and standard RSA for measuring migration. Twelve repeated stereoradiographs and CT scans with double examinations in each position and gradual migration of the implants were made. Precision and accuracy of the 3D CT were calculated. Results. The accuracy of the 3D CT ranged between 0.07 and 0.32 mm for translations and 0.21 and 0.82° for rotation. The precision ranged between 0.01 and 0.09 mm for translations and 0.06 and 0.29° for rotations, respectively. For standard RSA, the precision ranged between 0.04 and 0.09 mm for translations and 0.08 and 0.32° for rotations, respectively. There was no significant difference in precision between 3D CT and standard RSA. The effective radiation dose of the 3D CT method, comparable to RSA, was estimated to be 0.33 mSv. Interpretation. Low dose 3D CT is a comparable method to standard RSA in an experimental setting.

A Comparison of the effectiveness of Mammographic Film-Screen and Standard Film-Screen in the Detection of Small Bone Fractures

PubMed Central

Sani, Karim Ghazikhanlou; Jafari, Mahmoodreza; Rostampoor, Nima

2011-01-01

The use of mammography film-screen is limited in general radiography. The purpose of this study was to compare the effectiveness of mammographic film-screen and standard film-screen systems in the detection of small bone fractures. Radiographs were taken from patients' extremities and neck areas using mammography film-screen and standard film-screen (n=57 each). Fourteen other radiographs were taken from other views (predominantly oblique views), making a total number of 128 radiographs. Paired radiographs, taken from the same areas, were compared by two radiologists in terms of image visual sharpness, presence of bony fractures, and soft tissue injuries. The surface dose received by patients in the two systems was also compared. The radiographs taken by mammography film-screen had a statistically better visual sharpness compared to those taken by the standard film-screen system. However, there was no statistically significant difference between the diagnostic accuracy of the two systems. Mammography film-screen was able to detect only one out of 57 lesions, whereas standard film-screen system did not detec any lesion. The surface dose received by patients in mammography film-screen was higher than that in standard film-screen system. The findings of the present study suggest that mammography film-screen may be recommended as a diagnostic tool for the detection of small fractures of tinny parts of body such as fingers, hand or foot. They also suggest that mammography film-screen has no advantage over standard film-screen for radiography of thick body parts such as neck and knee. PMID:23115417

Therapeutic efficacy of alternative primaquine regimens to standard treatment in preventing relapses by Plasmodium vivax: A systematic review and meta-analysis.

PubMed

Zuluaga-Idarraga, Lina Marcela; Tamayo Perez, María-Eulalia; Aguirre-Acevedo, Daniel Camilo

2015-12-30

To compare efficacy and safety of primaquine regimens currently used to prevent relapses by P. vivax. A systematic review was carried out to identify clinical trials evaluating efficacy and safety to prevent malaria recurrences by P. vivax of primaquine regimen 0.5 mg/kg/ day for 7 or 14 days compared to standard regimen of 0.25 mg/kg/day for 14 days. Efficacy of primaquine according to cumulative incidence of recurrences after 28 days was determined. The overall relative risk with fixed-effects meta-analysis was estimated. For the regimen 0.5 mg/kg/day/7 days were identified 7 studies, which showed an incidence of recurrence between 0% and 20% with follow-up 60-210 days; only 4 studies comparing with the standard regimen 0.25 mg/kg/day/14 days and no difference in recurrences between both regimens (RR= 0.977, 95% CI= 0.670 to 1.423) were found. 3 clinical trials using regimen 0.5 mg/kg/day/14 days with an incidence of recurrences between 1.8% and 18.0% during 330-365 days were identified; only one study comparing with the standard regimen (RR= 0.846, 95% CI= 0.484 to 1.477). High risk of bias and differences in handling of included studies were found. Available evidence is insufficient to determine whether currently PQ regimens used as alternative rather than standard treatment have better efficacy and safety in preventing relapse of P. vivax. Clinical trials are required to guide changes in treatment regimen of malaria vivax.

True communication skills assessment in interdepartmental OSCE stations: Standard setting using the MAAS-Global and EduG.

PubMed

Setyonugroho, Winny; Kropmans, Thomas; Murphy, Ruth; Hayes, Peter; van Dalen, Jan; Kennedy, Kieran M

2018-01-01

Comparing outcome of clinical skills assessment is challenging. This study proposes reliable and valid comparison of communication skills (1) assessment as practiced in Objective Structured Clinical Examinations (2). The aim of the present study is to compare CS assessment, as standardized according to the MAAS Global, between stations in a single undergraduate medical year. An OSCE delivered in an Irish undergraduate curriculum was studied. We chose the MAAS-Global as an internationally recognized and validated instrument to calibrate the OSCE station items. The MAAS-Global proportion is the percentage of station checklist items that can be considered as 'true' CS. The reliability of the OSCE was calculated with G-Theory analysis and nested ANOVA was used to compare mean scores of all years. MAAS-Global scores in psychiatry stations were significantly higher than those in other disciplines (p<0.03) and above the initial pass mark of 50%. The higher students' scores in psychiatry stations were related to higher MAAS-Global proportions when compared to the general practice stations. Comparison of outcome measurements, using the MAAS Global as a standardization instrument, between interdisciplinary station checklists was valid and reliable. The MAAS-Global was used as a single validated instrument and is suggested as gold standard. Copyright © 2017. Published by Elsevier B.V.

Review and standardization of cell phone exposure calculations using the SAM phantom and anatomically correct head models.

PubMed

Beard, Brian B; Kainz, Wolfgang

2004-10-13

We reviewed articles using computational RF dosimetry to compare the Specific Anthropomorphic Mannequin (SAM) to anatomically correct models of the human head. Published conclusions based on such comparisons have varied widely. We looked for reasons that might cause apparently similar comparisons to produce dissimilar results. We also looked at the information needed to adequately compare the results of computational RF dosimetry studies. We concluded studies were not comparable because of differences in definitions, models, and methodology. Therefore we propose a protocol, developed by an IEEE standards group, as an initial step in alleviating this problem. The protocol calls for a benchmark validation study comparing the SAM phantom to two anatomically correct models of the human head. It also establishes common definitions and reporting requirements that will increase the comparability of all computational RF dosimetry studies of the human head.

Review and standardization of cell phone exposure calculations using the SAM phantom and anatomically correct head models

PubMed Central

Beard, Brian B; Kainz, Wolfgang

2004-01-01

We reviewed articles using computational RF dosimetry to compare the Specific Anthropomorphic Mannequin (SAM) to anatomically correct models of the human head. Published conclusions based on such comparisons have varied widely. We looked for reasons that might cause apparently similar comparisons to produce dissimilar results. We also looked at the information needed to adequately compare the results of computational RF dosimetry studies. We concluded studies were not comparable because of differences in definitions, models, and methodology. Therefore we propose a protocol, developed by an IEEE standards group, as an initial step in alleviating this problem. The protocol calls for a benchmark validation study comparing the SAM phantom to two anatomically correct models of the human head. It also establishes common definitions and reporting requirements that will increase the comparability of all computational RF dosimetry studies of the human head. PMID:15482601

A Comparison of Higher-Order Thinking between the Common Core State Standards and the 2009 New Jersey Content Standards in High School

ERIC Educational Resources Information Center

Sforza, Dario; Tienken, Christopher H.; Kim, Eunyoung

2016-01-01

The creators and supporters of the Common Core State Standards claim that the Standards require greater emphasis on higher-order thinking than previous state standards in mathematics and English language arts. We used a qualitative case study design with content analysis methods to test the claim. We compared the levels of thinking required by the…

Private and social costs of surface mine reforestation performance criteria.

PubMed

Sullivan, Jay; Amacher, Gregory S

2010-02-01

We study the potentially unnecessary costs imposed by strict performance standards for forest restoration of surface coal mines in the Appalachian region under the Surface Mining Control and Reclamation Act of 1977 (SMCRA) that can vary widely across states. Both the unnecessary private costs to the mine operator and costs to society (social costs) are reported for two performance standards, a ground cover requirement, and a seedling survival target. These standards are examined using numerical analyses under a range of site productivity class and market conditions. We show that a strict (90%) ground cover standard may produce an unnecessary private cost of more than $700/ha and a social cost ranging from $428/ha to $710/ha, as compared with a 70% standard. A strict tree survival standard of 1235 trees/ha, as compared with the more typical 1087 trees/ha standard, may produce an unnecessary private cost of approximately $200/ha, and a social cost in the range of $120 to $208/ha. We conclude that strict performance standards may impose substantial unnecessary private costs and social costs, that strict performance standards may be discouraging the choice of forestry as a post-mining land use, and that opportunities exist for reform of reforestation performance standards. Our study provides a basis for evaluating tradeoffs between regulatory efficiency and optimal reforestation effort.

Bias from two analytical laboratories involved in a long-term air monitoring program measuring organic pollutants in the Arctic: a quality assurance/quality control assessment.

PubMed

Su, Yushan; Hung, Hayley; Stern, Gary; Sverko, Ed; Lao, Randy; Barresi, Enzo; Rosenberg, Bruno; Fellin, Phil; Li, Henrik; Xiao, Hang

2011-11-01

Initiated in 1992, air monitoring of organic pollutants in the Canadian Arctic provided spatial and temporal trends in support of Canada's participation in the Stockholm Convention of Persistent Organic Pollutants. The specific analytical laboratory charged with this task was changed in 2002 while field sampling protocols remained unchanged. Three rounds of intensive comparison studies were conducted in 2004, 2005, and 2008 to assess data comparability between the two laboratories. Analysis was compared for organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs) and polycyclic aromatic hydrocarbons (PAHs) in standards, blind samples of mixed standards and extracts of real air samples. Good measurement accuracy was achieved for both laboratories when standards were analyzed. Variation of measurement accuracy over time was found for some OCPs and PCBs in standards on a random and non-systematic manner. Relatively low accuracy in analyzing blind samples was likely related to the process of sample purification. Inter-laboratory measurement differences for standards (<30%) and samples (<70%) were generally less than or comparable to those reported in a previous inter-laboratory study with 21 participating laboratories. Regression analysis showed inconsistent data comparability between the two laboratories during the initial stages of the study. These inter-laboratory differences can complicate abilities to discern long-term trends of pollutants in a given sampling site. It is advisable to maintain long-term measurements with minimal changes in sample analysis.

Investigating the Language Demands in the Common Core State Standards for English Language Learners: A Comparison Study of Standards

ERIC Educational Resources Information Center

Wolf, Mikyung Kim; Wang, Yuan; Huang, Becky H.; Blood, Ian

2014-01-01

This study reports on a critical review of the language demands contained in the Common Core State Standards for English language arts (CCSS-ELA) with the aim of deriving important implications for the instruction of English language learners. The language demands of the CCSS-ELA were compared with those of existing English language arts (ELA) and…

Natural Language Processing–Enabled and Conventional Data Capture Methods for Input to Electronic Health Records: A Comparative Usability Study

PubMed Central

Sheehan, Barbara; Stetson, Peter; Bhatt, Ashish R; Field, Adele I; Patel, Chirag; Maisel, James Mark

2016-01-01

Background The process of documentation in electronic health records (EHRs) is known to be time consuming, inefficient, and cumbersome. The use of dictation coupled with manual transcription has become an increasingly common practice. In recent years, natural language processing (NLP)–enabled data capture has become a viable alternative for data entry. It enables the clinician to maintain control of the process and potentially reduce the documentation burden. The question remains how this NLP-enabled workflow will impact EHR usability and whether it can meet the structured data and other EHR requirements while enhancing the user’s experience. Objective The objective of this study is evaluate the comparative effectiveness of an NLP-enabled data capture method using dictation and data extraction from transcribed documents (NLP Entry) in terms of documentation time, documentation quality, and usability versus standard EHR keyboard-and-mouse data entry. Methods This formative study investigated the results of using 4 combinations of NLP Entry and Standard Entry methods (“protocols”) of EHR data capture. We compared a novel dictation-based protocol using MediSapien NLP (NLP-NLP) for structured data capture against a standard structured data capture protocol (Standard-Standard) as well as 2 novel hybrid protocols (NLP-Standard and Standard-NLP). The 31 participants included neurologists, cardiologists, and nephrologists. Participants generated 4 consultation or admission notes using 4 documentation protocols. We recorded the time on task, documentation quality (using the Physician Documentation Quality Instrument, PDQI-9), and usability of the documentation processes. Results A total of 118 notes were documented across the 3 subject areas. The NLP-NLP protocol required a median of 5.2 minutes per cardiology note, 7.3 minutes per nephrology note, and 8.5 minutes per neurology note compared with 16.9, 20.7, and 21.2 minutes, respectively, using the Standard-Standard protocol and 13.8, 21.3, and 18.7 minutes using the Standard-NLP protocol (1 of 2 hybrid methods). Using 8 out of 9 characteristics measured by the PDQI-9 instrument, the NLP-NLP protocol received a median quality score sum of 24.5; the Standard-Standard protocol received a median sum of 29; and the Standard-NLP protocol received a median sum of 29.5. The mean total score of the usability measure was 36.7 when the participants used the NLP-NLP protocol compared with 30.3 when they used the Standard-Standard protocol. Conclusions In this study, the feasibility of an approach to EHR data capture involving the application of NLP to transcribed dictation was demonstrated. This novel dictation-based approach has the potential to reduce the time required for documentation and improve usability while maintaining documentation quality. Future research will evaluate the NLP-based EHR data capture approach in a clinical setting. It is reasonable to assert that EHRs will increasingly use NLP-enabled data entry tools such as MediSapien NLP because they hold promise for enhancing the documentation process and end-user experience. PMID:27793791

Natural Language Processing-Enabled and Conventional Data Capture Methods for Input to Electronic Health Records: A Comparative Usability Study.

PubMed

Kaufman, David R; Sheehan, Barbara; Stetson, Peter; Bhatt, Ashish R; Field, Adele I; Patel, Chirag; Maisel, James Mark

2016-10-28

The process of documentation in electronic health records (EHRs) is known to be time consuming, inefficient, and cumbersome. The use of dictation coupled with manual transcription has become an increasingly common practice. In recent years, natural language processing (NLP)-enabled data capture has become a viable alternative for data entry. It enables the clinician to maintain control of the process and potentially reduce the documentation burden. The question remains how this NLP-enabled workflow will impact EHR usability and whether it can meet the structured data and other EHR requirements while enhancing the user's experience. The objective of this study is evaluate the comparative effectiveness of an NLP-enabled data capture method using dictation and data extraction from transcribed documents (NLP Entry) in terms of documentation time, documentation quality, and usability versus standard EHR keyboard-and-mouse data entry. This formative study investigated the results of using 4 combinations of NLP Entry and Standard Entry methods ("protocols") of EHR data capture. We compared a novel dictation-based protocol using MediSapien NLP (NLP-NLP) for structured data capture against a standard structured data capture protocol (Standard-Standard) as well as 2 novel hybrid protocols (NLP-Standard and Standard-NLP). The 31 participants included neurologists, cardiologists, and nephrologists. Participants generated 4 consultation or admission notes using 4 documentation protocols. We recorded the time on task, documentation quality (using the Physician Documentation Quality Instrument, PDQI-9), and usability of the documentation processes. A total of 118 notes were documented across the 3 subject areas. The NLP-NLP protocol required a median of 5.2 minutes per cardiology note, 7.3 minutes per nephrology note, and 8.5 minutes per neurology note compared with 16.9, 20.7, and 21.2 minutes, respectively, using the Standard-Standard protocol and 13.8, 21.3, and 18.7 minutes using the Standard-NLP protocol (1 of 2 hybrid methods). Using 8 out of 9 characteristics measured by the PDQI-9 instrument, the NLP-NLP protocol received a median quality score sum of 24.5; the Standard-Standard protocol received a median sum of 29; and the Standard-NLP protocol received a median sum of 29.5. The mean total score of the usability measure was 36.7 when the participants used the NLP-NLP protocol compared with 30.3 when they used the Standard-Standard protocol. In this study, the feasibility of an approach to EHR data capture involving the application of NLP to transcribed dictation was demonstrated. This novel dictation-based approach has the potential to reduce the time required for documentation and improve usability while maintaining documentation quality. Future research will evaluate the NLP-based EHR data capture approach in a clinical setting. It is reasonable to assert that EHRs will increasingly use NLP-enabled data entry tools such as MediSapien NLP because they hold promise for enhancing the documentation process and end-user experience. ©David R. Kaufman, Barbara Sheehan, Peter Stetson, Ashish R. Bhatt, Adele I. Field, Chirag Patel, James Mark Maisel. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 28.10.2016.

Different doses of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation

PubMed Central

Estcourt, Lise J; Stanworth, Simon; Doree, Carolyn; Trivella, Marialena; Hopewell, Sally; Blanco, Patricia; Murphy, Michael F

2015-01-01

Background Platelet transfusions are used in modern clinical practice to prevent and treat bleeding in people who are thrombocytopenic due to bone marrow failure. Although considerable advances have been made in platelet transfusion therapy in the last 40 years, some areas continue to provoke debate, especially concerning the use of prophylactic platelet transfusions for the prevention of thrombocytopenic bleeding. This is an update of a Cochrane review first published in 2004, and updated in 2012 that addressed four separate questions: prophylactic versus therapeutic-only platelet transfusion policy; prophylactic platelet transfusion threshold; prophylactic platelet transfusion dose; and platelet transfusions compared to alternative treatments. This review has now been split into four smaller reviews; this review compares different platelet transfusion doses. Objectives To determine whether different doses of prophylactic platelet transfusions (platelet transfusions given to prevent bleeding) affect their efficacy and safety in preventing bleeding in people with haematological disorders undergoing myelosuppressive chemotherapy with or without haematopoietic stem cell transplantation (HSCT). Search methods We searched for randomised controlled trials in the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library 2015, Issue 6), MEDLINE (from 1946), Embase (from 1974), CINAHL (from 1937), the Transfusion Evidence Library (from 1950), and ongoing trial databases to 23 July 2015. Selection criteria Randomised controlled trials involving transfusions of platelet concentrates, prepared either from individual units of whole blood or by apheresis, and given to prevent bleeding in people with malignant haematological disorders or undergoing HSCT that compared different platelet component doses (low dose 1.1 × 1011/m2 ± 25%, standard dose 2.2 × 1011/m2 ± 25%, high dose 4.4 × 1011/m2 ± 25%). Data collection and analysis We used the standard methodological procedures expected by The Cochrane Collaboration. Main results We included seven trials (1814 participants) in this review; six were conducted during one course of treatment (chemotherapy or HSCT). Overall the methodological quality of studies was low to moderate across different outcomes according to GRADE methodology. None of the included studies were at low risk of bias in every domain, and all the included studies had some threats to validity. Five studies reported the number of participants with at least one clinically significant bleeding episode within 30 days from the start of the study. There was no difference in the number of participants with a clinically significant bleeding episode between the low-dose and standard-dose groups (four studies; 1170 participants; risk ratio (RR) 1.04, 95% confidence interval (CI) 0.95 to 1.13; moderate-quality evidence); low-dose and high-dose groups (one study; 849 participants; RR 1.02, 95% CI 0.93 to 1.11; moderate-quality evidence); or high-dose and standard-dose groups (two studies; 951 participants; RR 1.02, 95% CI 0.93 to 1.11; moderate-quality evidence). Three studies reported the number of days with a clinically significant bleeding event per participant. There was no difference in the number of days of bleeding per participant between the low-dose and standard-dose groups (two studies; 230 participants; mean difference −0.17, 95% CI −0.51 to 0.17; low quality evidence). One study (855 participants) showed no difference in the number of days of bleeding per participant between high-dose and standard-dose groups, or between low-dose and high-dose groups (849 participants). Three studies reported the number of participants with severe or life-threatening bleeding. There was no difference in the number of participants with severe or life-threatening bleeding between a low-dose and a standard-dose platelet transfusion policy (three studies; 1059 participants; RR 1.33, 95% CI 0.91 to 1.92; low-quality evidence); low-dose and high-dose groups (one study; 849 participants; RR 1.20, 95% CI 0.82 to 1.77; low-quality evidence); or high-dose and standard-dose groups (one study; 855 participants; RR 1.11, 95% CI 0.73 to 1.68; low-quality evidence). Two studies reported the time to first bleeding episodes; we were unable to perform a meta-analysis. Both studies (959 participants) individually found that the time to first bleeding episode was either the same, or longer, in the low-dose group compared to the standard-dose group. One study (855 participants) found that the time to the first bleeding episode was the same in the high-dose group compared to the standard-dose group. Three studies reported all-cause mortality within 30 days from the start of the study. There was no difference in all-cause mortality between treatment arms (low-dose versus standard-dose: three studies; 1070 participants; RR 2.04, 95% CI 0.70 to 5.93; low-quality evidence; low-dose versus high-dose: one study; 849 participants; RR 1.33, 95% CI 0.50 to 3.54; low-quality evidence; and high-dose versus standard-dose: one study; 855 participants; RR 1.71, 95% CI 0.51 to 5.81; low-quality evidence). Six studies reported the number of platelet transfusions; we were unable to perform a meta-analysis. Two studies (959 participants) out of three (1070 participants) found that a low-dose transfusion strategy led to more transfusion episodes than a standard-dose. One study (849 participants) found that a low-dose transfusion strategy led to more transfusion episodes than a high-dose strategy. One study (855 participants) out of three (1007 participants) found no difference in the number of platelet transfusions between the high-dose and standard-dose groups. One study reported on transfusion reactions. This study’s authors suggested that a high-dose platelet transfusion strategy may lead to a higher rate of transfusion-related adverse events. None of the studies reported quality-of-life. Authors’ conclusions In haematology patients who are thrombocytopenic due to myelosuppressive chemotherapy or HSCT, we found no evidence to suggest that a low-dose platelet transfusion policy is associated with an increased bleeding risk compared to a standard-dose or high-dose policy, or that a high-dose platelet transfusion policy is associated with a decreased risk of bleeding when compared to a standard-dose policy. A low-dose platelet transfusion strategy leads to an increased number of transfusion episodes compared to a standard-dose strategy. A high-dose platelet transfusion strategy does not decrease the number of transfusion episodes per participant compared to a standard-dose regimen, and it may increase the number of transfusion-related adverse events. Findings from this review would suggest a change from current practice, with low-dose platelet transfusions used for people receiving in-patient treatment for their haematological disorder and high-dose platelet transfusion strategies not being used routinely. PMID:26505729

Reliability of the standard goniometry and diagrammatic recording of finger joint angles: a comparative study with healthy subjects and non-professional raters.

PubMed

Macionis, Valdas

2013-01-09

Diagrammatic recording of finger joint angles by using two criss-crossed paper strips can be a quick substitute to the standard goniometry. As a preliminary step toward clinical validation of the diagrammatic technique, the current study employed healthy subjects and non-professional raters to explore whether reliability estimates of the diagrammatic goniometry are comparable with those of the standard procedure. The study included two procedurally different parts, which were replicated by assigning 24 medical students to act interchangeably as 12 subjects and 12 raters. A larger component of the study was designed to compare goniometers side-by-side in measurement of finger joint angles varying from subject to subject. In the rest of the study, the instruments were compared by parallel evaluations of joint angles similar for all subjects in a situation of simulated change of joint range of motion over time. The subjects used special guides to position the joints of their left ring finger at varying angles of flexion and extension. The obtained diagrams of joint angles were converted to numerical values by computerized measurements. The statistical approaches included calculation of appropriate intraclass correlation coefficients, standard errors of measurements, proportions of measurement differences of 5 or less degrees, and significant differences between paired observations. Reliability estimates were similar for both goniometers. Intra-rater and inter-rater intraclass correlation coefficients ranged from 0.69 to 0.93. The corresponding standard errors of measurements ranged from 2.4 to 4.9 degrees. Repeated measurements of a considerable number of raters fell within clinically non-meaningful 5 degrees of each other in proportions comparable with a criterion value of 0.95. Data collected with both instruments could be similarly interpreted in a simulated situation of change of joint range of motion over time. The paper goniometer and the standard goniometer can be used interchangeably by non-professional raters for evaluation of normal finger joints. The obtained results warrant further research to assess clinical performance of the paper strip technique.

Reliability of the standard goniometry and diagrammatic recording of finger joint angles: a comparative study with healthy subjects and non-professional raters

PubMed Central

2013-01-01

Background Diagrammatic recording of finger joint angles by using two criss-crossed paper strips can be a quick substitute to the standard goniometry. As a preliminary step toward clinical validation of the diagrammatic technique, the current study employed healthy subjects and non-professional raters to explore whether reliability estimates of the diagrammatic goniometry are comparable with those of the standard procedure. Methods The study included two procedurally different parts, which were replicated by assigning 24 medical students to act interchangeably as 12 subjects and 12 raters. A larger component of the study was designed to compare goniometers side-by-side in measurement of finger joint angles varying from subject to subject. In the rest of the study, the instruments were compared by parallel evaluations of joint angles similar for all subjects in a situation of simulated change of joint range of motion over time. The subjects used special guides to position the joints of their left ring finger at varying angles of flexion and extension. The obtained diagrams of joint angles were converted to numerical values by computerized measurements. The statistical approaches included calculation of appropriate intraclass correlation coefficients, standard errors of measurements, proportions of measurement differences of 5 or less degrees, and significant differences between paired observations. Results Reliability estimates were similar for both goniometers. Intra-rater and inter-rater intraclass correlation coefficients ranged from 0.69 to 0.93. The corresponding standard errors of measurements ranged from 2.4 to 4.9 degrees. Repeated measurements of a considerable number of raters fell within clinically non-meaningful 5 degrees of each other in proportions comparable with a criterion value of 0.95. Data collected with both instruments could be similarly interpreted in a simulated situation of change of joint range of motion over time. Conclusions The paper goniometer and the standard goniometer can be used interchangeably by non-professional raters for evaluation of normal finger joints. The obtained results warrant further research to assess clinical performance of the paper strip technique. PMID:23302419

A BAYESIAN METHOD FOR CALCULATING REAL-TIME QUANTITATIVE PCR CALIBRATION CURVES USING ABSOLUTE PLASMID DNA STANDARDS

EPA Science Inventory

In real-time quantitative PCR studies using absolute plasmid DNA standards, a calibration curve is developed to estimate an unknown DNA concentration. However, potential differences in the amplification performance of plasmid DNA compared to genomic DNA standards are often ignore...

Crashworthiness of Small Poststandard School Buses: Safety Study.

ERIC Educational Resources Information Center

National Transportation Safety Board (DOT), Washington, DC.

In 1977, a series of Federal Motor Vehicle Safety Standards (FMVSS) for school buses became effective, mandating different performance standards for school buses compared to other buses. Because data on the crash performance of school buses built to these standards were lacking, the National Transportation Safety Board conducted a series of…

Comparing Assessments within Junior Geography Textbooks Used in Mainland China

ERIC Educational Resources Information Center

Yang, Daihu

2013-01-01

The 2001 Geography Standards for Junior Secondary Schools are the first national standards for geographic education since the founding of Communist China. The standards heralded several new ideas for geographic education, and textbook assessments are one important way for understanding their impact. This study examines the changes in assessments…

Reference Standard Test and the Diagnostic Ability of Spectral Domain Optical Coherence Tomography in Glaucoma.

PubMed

Rao, Harsha L; Yadav, Ravi K; Addepalli, Uday K; Begum, Viquar U; Senthil, Sirisha; Choudhari, Nikhil S; Garudadri, Chandra S

2015-08-01

To evaluate the relationship between the reference standard used to diagnose glaucoma and the diagnostic ability of spectral domain optical coherence tomograph (SDOCT). In a cross-sectional study, 280 eyes of 175 consecutive subjects, referred to a tertiary eye care center for glaucoma evaluation, underwent optic disc photography, visual field (VF) examination, and SDOCT examination. The cohort was divided into glaucoma and control groups based on 3 reference standards for glaucoma diagnosis: first based on the optic disc classification (179 glaucoma and 101 control eyes), second on VF classification (glaucoma hemifield test outside normal limits and pattern SD with P-value of <5%, 130 glaucoma and 150 control eyes), and third on the presence of both glaucomatous optic disc and glaucomatous VF (125 glaucoma and 155 control eyes). Relationship between the reference standards and the diagnostic parameters of SDOCT were evaluated using areas under the receiver operating characteristic curve, sensitivity, and specificity. Areas under the receiver operating characteristic curve and sensitivities of most of the SDOCT parameters obtained with the 3 reference standards (ranging from 0.74 to 0.88 and 72% to 88%, respectively) were comparable (P>0.05). However, specificities of SDOCT parameters were significantly greater (P<0.05) with optic disc classification as reference standard (74% to 88%) compared with VF classification as reference standard (57% to 74%). Diagnostic parameters of SDOCT that was significantly affected by reference standard was the specificity, which was greater with optic disc classification as the reference standard. This has to be considered when comparing the diagnostic ability of SDOCT across studies.

Comparison of the efficacy and safety of intensive-dose and standard-dose statin treatment for stroke prevention: A meta-analysis.

PubMed

Wang, Juan; Chen, Dan; Li, Da-Bing; Yu, Xin; Shi, Guo-Bing

2016-09-01

Previous study indicated that high-dose statin treatment might increase the risk of hemorrhagic stroke and adverse reactions. We aim to compare the efficacy and safety of intensive-dose and standard-dose statin treatment for preventing stroke in high-risk patients. A thorough search was performed of multiple databases for publications from 1990 to June 2015. We selected the randomized clinical trials comparing standard-dose statin with placebo and intensive-dose statin with standard-dose statin or placebo for the prevention of stroke events in patients. Duplicate independent data extraction and bias assessments were performed. Data were pooled using a fixed-effects model or a random-effects model if significant heterogeneity was present. For the all stroke incidences, intensive-dose statin treatment compared with placebo treatment and standard-dose statin treatment compared with placebo treatment showed a significant 21% reduction in relative risk (RR) (RR 0.79, 95% confidence interval (CI) [0.71, 0.87], P < 0.00001) and an 18% reduction in RR (RR 0.82, 95% CI [0.73, 0.93], P = 0.002) in the subgroup without renal transplant recipients and patients undergoing regular hemodialysis separately. For the fatal stroke incidences, intensive-dose statin treatment compared with standard dose or placebo was effective reducing fatal stroke (RR 0.61, 95% CI [0.39, 0.96], P = 0.03) and the RR was 1.01 (95% CI [0.85, 1.20], P = 0.90) in standard-dose statin treatment compared with placebo. The results of this meta-analysis suggest that intensive-dose statin treatment might be more favorable for reducing the incidences of all strokes than standard-dose statin treatment, especially for patients older than 65 years in reducing the incidences of all stroke incidences.

Is a mobile emergency severity index (ESI) triage better than the paper ESI?

PubMed

Savatmongkorngul, Sorravit; Yuksen, Chaiyaporn; Suwattanasilp, Chanakarn; Sawanyawisuth, Kittisak; Sittichanbuncha, Yuwares

2017-12-01

This study aims to evaluate the mobile emergency severity index (ESI) tool in terms of validity compared with the original ESI triage. The original ESI and mobile ESI were used with patients at the Department of Emergency Medicine, Ramathibodi Hospital, Thailand. Eligible patients were evaluated by sixth-year medical students/emergency physicians using either the original or mobile ESI. The ESI results for each patient were compared with the standard ESI. Concordance and kappa statistics were calculated for pairs of the evaluators. There were 486 patients enrolled in the study; 235 patients (48.4%) were assessed using the mobile ESI, and 251 patients (51.6%) were in the original ESI group. The baseline characteristics of patients in both groups were mostly comparable except for the ED visit time. The percentages of concordance and kappa statistics in the original ESI group were lower than in the mobile group in all three comparisons (medical students vs gold standard, emergency physicians vs gold standard, and medical students vs emergency physicians). The highest kappa in the original ESI group is 0.69, comparing emergency physicians vs gold standard, while the lowest kappa in the application group is 0.84 comparing the medical students vs gold standard. Both medical students and emergency physicians are more confident with the mobile ESI application triage. In conclusion, the mobile ESI has better inter-rater reliability, and is more user-friendly than the original paper form.

Construction of a standard test assembly for controlled laser studies in tissues: Preliminary study on human bone material

NASA Astrophysics Data System (ADS)

Beer, Franziska; Passow, Harald

2008-02-01

The aim of the study is the construction of a test assembly, which facilitates objective, comparative studies on the cutting performance of lasers in hard tissue. To ensure the applicability of our own construction for the reproducible performance of laser incisions in hard tissue, eleven freshly extracted blocks (2×1.5cm2) of human bone were prepared with a Er,Cr:YSGG laser by using a handheld handpiece, respectively, using the constructed device for a standardized cutting. A total of 44 cuts were executed. The specimen were then histologically evaluated. The standard test assembly met the requirements concerning the provision of objective results. The findings of the histological evaluation prove the reproducibility of the results. The standard test assembly presented in this paper facilitates comparative studies of different laser systems by reducing subjective influence on the preparation to a minimum. The results of this preliminary study show that the precision of the guiding instrument for laser cutting reduces the error of cut width by 50-fold, from 50to1μm.

Music therapy for depression.

PubMed

Maratos, A S; Gold, C; Wang, X; Crawford, M J

2008-01-23

Depression is a highly prevalent disorder associated with reduced social functioning, impaired quality of life, and increased mortality. Music therapy has been used in the treatment of a variety of mental disorders, but its impact on those with depression is unclear. To examine the efficacy of music therapy with standard care compared to standard care alone among people with depression and to compare the effects of music therapy for people with depression against other psychological or pharmacological therapies. CCDANCTR-Studies and CCDANCTR-References were searched on 7/11/2007, MEDLINE, PsycINFO, EMBASE, PsycLit, PSYindex, and other relevant sites were searched in November 2006. Reference lists of retrieved articles were hand searched, as well as specialist music and arts therapies journals. All randomised controlled trials comparing music therapy with standard care or other interventions for depression. Data on participants, interventions and outcomes were extracted and entered onto a database independently by two review authors. The methodological quality of each study was also assessed independently by two review authors. The primary outcome was reduction in symptoms of depression, based on a continuous scale. Five studies met the inclusion criteria of the review. Marked variations in the interventions offered and the populations studied meant that meta-analysis was not appropriate. Four of the five studies individually reported greater reduction in symptoms of depression among those randomised to music therapy than to those in standard care conditions. The fifth study, in which music therapy was used as an active control treatment, reported no significant change in mental state for music therapy compared with standard care. Dropout rates from music therapy conditions appeared to be low in all studies. Findings from individual randomised trials suggest that music therapy is accepted by people with depression and is associated with improvements in mood. However, the small number and low methodological quality of studies mean that it is not possible to be confident about its effectiveness. High quality trials evaluating the effects of music therapy on depression are required.

Comparative study between EDXRF and ASTM E572 methods using two-way ANOVA

NASA Astrophysics Data System (ADS)

Krummenauer, A.; Veit, H. M.; Zoppas-Ferreira, J.

2018-03-01

Comparison with reference method is one of the necessary requirements for the validation of non-standard methods. This comparison was made using the experiment planning technique with two-way ANOVA. In ANOVA, the results obtained using the EDXRF method, to be validated, were compared with the results obtained using the ASTM E572-13 standard test method. Fisher's tests (F-test) were used to comparative study between of the elements: molybdenum, niobium, copper, nickel, manganese, chromium and vanadium. All F-tests of the elements indicate that the null hypothesis (Ho) has not been rejected. As a result, there is no significant difference between the methods compared. Therefore, according to this study, it is concluded that the EDXRF method was approved in this method comparison requirement.

Student science achievement and the integration of Indigenous knowledge on standardized tests

NASA Astrophysics Data System (ADS)

Dupuis, Juliann; Abrams, Eleanor

2017-09-01

In this article, we examine how American Indian students in Montana performed on standardized state science assessments when a small number of test items based upon traditional science knowledge from a cultural curriculum, "Indian Education for All", were included. Montana is the first state in the US to mandate the use of a culturally relevant curriculum in all schools and to incorporate this curriculum into a portion of the standardized assessment items. This study compares White and American Indian student test scores on these particular test items to determine how White and American Indian students perform on culturally relevant test items compared to traditional standard science test items. The connections between student achievement on adapted culturally relevant science test items versus traditional items brings valuable insights to the fields of science education, research on student assessments, and Indigenous studies.

Rationale for the tinnitus retraining therapy trial.

PubMed

Formby, Craig; Scherer, Roberta

2013-01-01

The Tinnitus Retraining Therapy Trial (TRTT) is a National Institutes of Health-sponsored, multi-centered, placebo-controlled, randomized trial evaluating the efficacy of tinnitus retraining therapy (TRT) and its component parts, directive counseling and sound therapy, as treatments for subjective debilitating tinnitus in the military. The TRTT will enroll 228 individuals at an allocation ratio of 1:1:1 to: (1) directive counseling and sound therapy using conventional sound generators; (2) directive counseling and placebo sound generators; or (3) standard of care as administered in the military. Study centers include a Study Chair's Office, a Data Coordinating Center, and six Military Clinical Centers with treatment and data collection standardized across all clinics. The primary outcome is change in Tinnitus Questionnaire (TQ) score assessed longitudinally at 3, 6, 12, and 18-month follow-up visits. Secondary outcomes include: Change in TQ sub-scales, Tinnitus Handicap Inventory, Tinnitus Functional Index, and TRT interview visual analog scale; audiometric and psychoacoustic measures; and change in quality of life. The TRTT will evaluate TRT efficacy by comparing TRT (directive counseling and conventional sound generators) with standard of care; directive counseling by comparing directive counseling plus placebo sound generators versus standard of care; and sound therapy by comparing conventional versus placebo sound generators. We hypothesize that full TRT will be more efficacious than standard of care, directive counseling and placebo sound generators more efficacious than standard of care, and conventional more efficacious than placebo sound generators in habituating the tinnitus awareness, annoyance, and impact on the study participant's life.

Enhancement of Gas Barrier Properties of CFRP Laminates Fabricated Using Thin-Ply Prepregs

NASA Astrophysics Data System (ADS)

横関, 智弘; 高木, 智宏; 吉村, 彰記; Ogasawara, Toshio; 荻原, 慎二

Composite laminates manufactured using thin-ply prepregs are expected to have superior resistance properties against microcracking compared to those using standard prepregs. In this study, comparative investigations are presented on the microcrack accumulation and gas leakage characteristics of CFRP laminates fabricated using standard and thin-ply prepregs, consisting of high-performance carbon fiber and toughened epoxy, as a fundamental research on the cryogenic composite tanks for future space vehicles. It was shown that laminates using thin-ply prepregs exhibited much higher strain at microcrack initiation compared to those using standard prepregs at room and cryogenic temperatures. In addition, helium gas leak tests using CFRP laminated tubular specimens subjected to quasi-static tension loadings were performed. It was demonstrated that CFRP laminates using thin-ply prepregs have higher gas barrier properties than those using standard prepregs.

Alignment between the Physics Content Standard and the Standardized Test: A Comparison among the United States-New York State, Singapore, and China-Jiangsu

ERIC Educational Resources Information Center

Liu, Xiufeng; Zhang, Baohui; Liang, Ling L.; Fulmer, Gavin; Kim, Beaumie; Yuan, Haiquan

2009-01-01

Alignment between content standards and standardized tests is a significant issue to society, science pedagogy, and test validation. To better understand the issues related to alignment, this study compares the alignment in physics among three education systems: Jiangsu (China), New York State (United States), and Singapore. The same coding…

A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with standard care to treat vision loss associated with macular Edema secondary to branch retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 6.

PubMed

Scott, Ingrid U; Ip, Michael S; VanVeldhuisen, Paul C; Oden, Neal L; Blodi, Barbara A; Fisher, Marian; Chan, Clement K; Gonzalez, Victor H; Singerman, Lawrence J; Tolentino, Michael

2009-09-01

To compare the efficacy and safety of 1-mg and 4-mg doses of preservative-free intravitreal triamcinolone with standard care (grid photocoagulation in eyes without dense macular hemorrhage and deferral of photocoagulation until hemorrhage clears in eyes with dense macular hemorrhage) for eyes with vision loss associated with macular edema secondary to branch retinal vein occlusion (BRVO). Multicenter, randomized clinical trial of 411 participants. Main Outcome Measure Gain in visual acuity letter score of 15 or more from baseline to month 12. Twenty-nine percent, 26%, and 27% of participants achieved the primary outcome in the standard care, 1-mg, and 4-mg groups, respectively. None of the pairwise comparisons between the 3 groups was statistically significant at month 12. The rates of elevated intraocular pressure and cataract were similar for the standard care and 1-mg groups, but higher in the 4-mg group. There was no difference identified in visual acuity at 12 months for the standard care group compared with the triamcinolone groups; however, rates of adverse events (particularly elevated intraocular pressure and cataract) were highest in the 4-mg group. Application to Clinical Practice Grid photocoagulation as applied in the SCORE Study remains the standard care for patients with vision loss associated with macular edema secondary to BRVO who have characteristics similar to participants in the SCORE-BRVO trial. Grid photocoagulation should remain the benchmark against which other treatments are compared in clinical trials for eyes with vision loss associated with macular edema secondary to BRVO. Trial Registration clinicaltrials.gov Identifier: NCT00105027.

Taking the Lead in Science Education: Forging Next-Generation Science Standards. International Science Benchmarking Report. Appendix

ERIC Educational Resources Information Center

Achieve, Inc., 2010

2010-01-01

This appendix accompanies the report "Taking the Lead in Science Education: Forging Next-Generation Science Standards. International Science Benchmarking Report," a study conducted by Achieve to compare the science standards of 10 countries. This appendix includes the following: (1) PISA and TIMSS Assessment Rankings; (2) Courses and…

The Development of the Learning Object Standard Using a Pedagogic Approach: A Comparative Study.

ERIC Educational Resources Information Center

Yahya, Yazrina; Jenkins, John; Yusoff, Mohammed

Education is moving towards revenue generation from such channels as electronic learning, distance learning and virtual education. Hence learning technology standards are critical to the sector's success. Existing learning technology standards have focused on various topics such as metadata, question and test interoperability and others. However,…

The Relationship between Reading Level and Sixth Grade Students' Acquisition of Mathematics Standards

ERIC Educational Resources Information Center

Caruthers, Tarchell Peeples

2013-01-01

Current research shows that, despite standards-based mathematics reform, American students lag behind in mathematics achievement when compared to their counterparts in other countries. The purpose of this mixed methods study was to examine if reading level, as measured by the Scholastic Reading Inventory, is related to standards-based mathematics…

Comparing Panelists' Understanding of Standard Setting across Multiple Levels of an Alternate Science Assessment

ERIC Educational Resources Information Center

Hansen, Mary A.; Lyon, Steven R.; Heh, Peter; Zigmond, Naomi

2013-01-01

Large-scale assessment programs, including alternate assessments based on alternate achievement standards (AA-AAS), must provide evidence of technical quality and validity. This study provides information about the technical quality of one AA-AAS by evaluating the standard setting for the science component. The assessment was designed to have…

Chapter 23: International Standard reagents for harmonization of HPV serology and DNA assays--an update.

PubMed

Pagliusi, Sonia R; Dillner, Joakim; Pawlita, Michael; Quint, Wim G V; Wheeler, Cosette M; Ferguson, M

2006-08-31

International reference materials such as International Standard reagents facilitate quality assurance of essential biopharmaceutical products and related in vitro diagnostic tests. Standardization of antibody and DNA measurements and harmonization of laboratory procedures are key to the success of cancer prevention strategies through screening methods as well as for development and implementation of vaccination against the human papillomavirus (HPV). The WHO supported the preparation and initial analysis of a panel of candidate serological and DNA reference reagents aimed at facilitating inter-laboratory comparisons and detection of HPV worldwide. Two international collaborative studies assessed the performance of various HPV antibody and HPV-DNA detection assays and examined the feasibility of generating HPV antibody and DNA standard reagents. These studies showed that improvement in performance and comparability of assays is urgently needed and that the use of the same International Standard reference reagent could significantly improve performance and comparability. It is hoped that the establishment of International Units and International Standards for HPV antibody and DNA analysis will be pursued with high priority.

Continuous ECG Monitoring in Patients With Acute Coronary Syndrome or Heart Failure: EASI Versus Gold Standard.

PubMed

Lancia, Loreto; Toccaceli, Andrea; Petrucci, Cristina; Romano, Silvio; Penco, Maria

2018-05-01

The purpose of the study was to compare the EASI system with the standard 12-lead surface electrocardiogram (ECG) for the accuracy in detecting the main electrocardiographic parameters (J point, PR, QT, and QRS) commonly monitored in patients with acute coronary syndromes or heart failure. In this observational comparative study, 253 patients who were consecutively admitted to the coronary care unit with acute coronary syndrome or heart failure were evaluated. In all patients, two complete 12-lead ECGs were acquired simultaneously. A total of 6,072 electrocardiographic leads were compared (3,036 standard and 3,036 EASI). No significant differences were found between the investigate parameters of the two measurement methods, either in patients with acute coronary syndrome or in those with heart failure. This study confirmed the accuracy of the EASI system in monitoring the main ECG parameters in patients admitted to the coronary care unit with acute coronary syndrome or heart failure.

Educational standardization and gender differences in mathematics achievement: A comparative study.

PubMed

Ayalon, Hanna; Livneh, Idit

2013-03-01

We argue that between-country variations in the gender gap in mathematics are related to the level of educational system standardization. In countries with standardized educational systems both genders are exposed to similar knowledge and are motivated to invest in studying mathematics, which leads to similar achievements. We hypothesize that national examinations and between-teacher uniformity in covering major mathematics topics are associated with a smaller gender gap in a country. Based on Trends of International Mathematical and Science Study (TIMSS) 2003, we use multilevel regression models to compare the link of these two factors to the gender gap in 32 countries, controlling for various country characteristics. The use of national examinations and less between-teacher instructional variation prove major factors in reducing the advantage of boys over girls in mathematics scores and in the odds of excelling. Factors representing gender stratification, often analyzed in comparative gender-gap research in mathematics, are at most marginal in respect of the gap. Copyright © 2012 Elsevier Inc. All rights reserved.

Science Education in the Boy Scouts of America

ERIC Educational Resources Information Center

Hintz, Rachel Sterneman

2009-01-01

This study of science education in the Boy Scouts of America focused on males with Boy Scout experience. The mixed-methods study topics included: merit badge standards compared with National Science Education Standards, Scout responses to open-ended survey questions, the learning styles of Scouts, a quantitative assessment of science content…

Comparing a Behavioral Check-In/Check-Out (CICO) Intervention to Standard Practice in an Urban Middle School Setting Using an Experimental Group Design

ERIC Educational Resources Information Center

Simonsen, Brandi; Myers, Diane; Briere, Donald E., III

2011-01-01

Students who continue to demonstrate at-risk behaviors after a school implements schoolwide primary (Tier 1) interventions require targeted-group secondary (Tier 2) interventions. This study was conducted to compare the effectiveness of a targeted-group behavioral check-in/check-out (CICO) intervention with the school's standard practice (SP) with…

Comfort and exertion while using filtering facepiece respirators with exhalation valve and an active venting system among male military personnel.

PubMed

Seng, Melvin; Wee, Liang En; Zhao, Xiahong; Cook, Alex R; Chia, Sin Eng; Lee, Vernon J

2017-07-06

This study aimed to determine if disposable filtering facepiece respirators (FFRs), with exhalation valve (EV) and a novel active venting system (AVS), provided greater perceived comfort and exertion when compared to standard N95 FFRs without these features among male military personnel performing prolonged essential outdoor duties. We used a randomised open-label controlled crossover study design to compare three FFR options: (a) standard FFR; (b) FFR with EV; and (c) FFR with EV+AVS. Male military personnel aged between 18 and 20 years completed a questionnaire at the beginning (baseline), after two hours of standardised non-strenuous outdoor duty and after 12 hours of duty divided into two-hour work-rest cycles. Participants rated the degree of discomfort, exertion and symptoms using a five-point Likert scale. The association between outcomes and the types of FFR was assessed using a multivariate ordered probit mixed-effects model. For a majority of the symptoms, study participants rated FFR with EV and FFR with EV+AVS with significantly better scores than standard FFR. Both FFR with EV and FFR with EV+AVS had significantly less discomfort (FFR with EV+AVS: 91.1%; FFR with EV: 57.6%) and exertion (FFR with EV+AVS: 83.5%; FFR with EV: 34.4%) than standard FFR. FFR with EV+AVS also had significantly better scores for exertion (53.4%) and comfort (39.4%) when compared to FFR with EV. Usage of FFR with EV+AVS resulted in significantly reduced symptoms, discomfort and exertion when compared to FFR with EV and standard FFR.

Utilization of beta-carotene from Spirulina platensis by rats.

PubMed

Kapoor, R; Mehta, U

1993-01-01

The availability of beta-carotene from Spirulina as compared to standard all trans beta-carotene was studied by the liver and kidney vitamin A storage method. After 21 days of vitamin A depletion, the rats were repleted with beta-carotene from Spirulina and a standard source at two dietary levels (60 and 120 micrograms/day) for a 10 day period. At lower levels, the liver storage levels of vitamin A and the percent of beta-carotene absorption were comparable to those of the standard. At higher levels both these parameters of the Spirulina fed group were significantly (P < 0.01) inferior to the standard source fed group. However, the Spirulina fed group showed better (P < 0.05) growth than the standard fed group did at both low and high levels of feeding.

Comparing species interaction networks along environmental gradients.

PubMed

Pellissier, Loïc; Albouy, Camille; Bascompte, Jordi; Farwig, Nina; Graham, Catherine; Loreau, Michel; Maglianesi, Maria Alejandra; Melián, Carlos J; Pitteloud, Camille; Roslin, Tomas; Rohr, Rudolf; Saavedra, Serguei; Thuiller, Wilfried; Woodward, Guy; Zimmermann, Niklaus E; Gravel, Dominique

2018-05-01

Knowledge of species composition and their interactions, in the form of interaction networks, is required to understand processes shaping their distribution over time and space. As such, comparing ecological networks along environmental gradients represents a promising new research avenue to understand the organization of life. Variation in the position and intensity of links within networks along environmental gradients may be driven by turnover in species composition, by variation in species abundances and by abiotic influences on species interactions. While investigating changes in species composition has a long tradition, so far only a limited number of studies have examined changes in species interactions between networks, often with differing approaches. Here, we review studies investigating variation in network structures along environmental gradients, highlighting how methodological decisions about standardization can influence their conclusions. Due to their complexity, variation among ecological networks is frequently studied using properties that summarize the distribution or topology of interactions such as number of links, connectance, or modularity. These properties can either be compared directly or using a procedure of standardization. While measures of network structure can be directly related to changes along environmental gradients, standardization is frequently used to facilitate interpretation of variation in network properties by controlling for some co-variables, or via null models. Null models allow comparing the deviation of empirical networks from random expectations and are expected to provide a more mechanistic understanding of the factors shaping ecological networks when they are coupled with functional traits. As an illustration, we compare approaches to quantify the role of trait matching in driving the structure of plant-hummingbird mutualistic networks, i.e. a direct comparison, standardized by null models and hypothesis-based metaweb. Overall, our analysis warns against a comparison of studies that rely on distinct forms of standardization, as they are likely to highlight different signals. Fostering a better understanding of the analytical tools available and the signal they detect will help produce deeper insights into how and why ecological networks vary along environmental gradients. © 2017 Cambridge Philosophical Society.

Truth in Reporting: How Data Capture Methods Obfuscate Actual Surgical Site Infection Rates within a Health Care Network System.

PubMed

Bordeianou, Liliana; Cauley, Christy E; Antonelli, Donna; Bird, Sarah; Rattner, David; Hutter, Matthew; Mahmood, Sadiqa; Schnipper, Deborah; Rubin, Marc; Bleday, Ronald; Kenney, Pardon; Berger, David

2017-01-01

Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. This study aimed to compare database concordance. This is a multi-institution cohort study of systemwide Colorectal Surgery Collaborative. The National Surgical Quality Improvement Program requires rigorous, standardized data capture techniques; National Healthcare Safety Network allows 5 data capture techniques. Standardized surgical site infection rates were compared between databases. The Cohen κ-coefficient was calculated. This study was conducted at Boston-area hospitals. National Healthcare Safety Network or National Surgical Quality Improvement Program patients undergoing colorectal surgery were included. Standardized surgical site infection rates were the primary outcomes of interest. Thirty-day surgical site infection rates of 3547 (National Surgical Quality Improvement Program) vs 5179 (National Healthcare Safety Network) colorectal procedures (2012-2014). Discrepancies appeared: National Surgical Quality Improvement Program database of hospital 1 (N = 1480 patients) routinely found surgical site infection rates of approximately 10%, routinely deemed rate "exemplary" or "as expected" (100%). National Healthcare Safety Network data from the same hospital and time period (N = 1881) revealed a similar overall surgical site infection rate (10%), but standardized rates were deemed "worse than national average" 80% of the time. Overall, hospitals using less rigorous capture methods had improved surgical site infection rates for National Healthcare Safety Network compared with standardized National Surgical Quality Improvement Program reports. The correlation coefficient between standardized infection rates was 0.03 (p = 0.88). During 25 site-time period observations, National Surgical Quality Improvement Program and National Healthcare Safety Network data matched for 52% of observations (13/25). κ = 0.10 (95% CI, -0.1366 to 0.3402; p = 0.403), indicating poor agreement. This study investigated hospitals located in the Northeastern United States only. Variation in Centers for Medicare & Medicaid Services-mandated National Healthcare Safety Network infection surveillance methodology leads to unreliable results, which is apparent when these results are compared with standardized data. High-quality data would improve care quality and compare outcomes among institutions.

Eating in the absence of hunger in adolescents: intake after a large-array meal compared with that after a standardized meal.

PubMed

Shomaker, Lauren B; Tanofsky-Kraff, Marian; Zocca, Jaclyn M; Courville, Amber; Kozlosky, Merel; Columbo, Kelli M; Wolkoff, Laura E; Brady, Sheila M; Crocker, Melissa K; Ali, Asem H; Yanovski, Susan Z; Yanovski, Jack A

2010-10-01

Eating in the absence of hunger (EAH) is typically assessed by measuring youths' intake of palatable snack foods after a standard meal designed to reduce hunger. Because energy intake required to reach satiety varies among individuals, a standard meal may not ensure the absence of hunger among participants of all weight strata. The objective of this study was to compare adolescents' EAH observed after access to a very large food array with EAH observed after a standardized meal. Seventy-eight adolescents participated in a randomized crossover study during which EAH was measured as intake of palatable snacks after ad libitum access to a very large array of lunch-type foods (>10,000 kcal) and after a lunch meal standardized to provide 50% of the daily estimated energy requirements. The adolescents consumed more energy and reported less hunger after the large-array meal than after the standardized meal (P values < 0.001). They consumed ≈70 kcal less EAH after the large-array meal than after the standardized meal (295 ± 18 compared with 365 ± 20 kcal; P < 0.001), but EAH intakes after the large-array meal and after the standardized meal were positively correlated (P values < 0.001). The body mass index z score and overweight were positively associated with EAH in both paradigms after age, sex, race, pubertal stage, and meal intake were controlled for (P values ≤ 0.05). EAH is observable and positively related to body weight regardless of whether youth eat in the absence of hunger from a very large-array meal or from a standardized meal. This trial was registered at clinicaltrials.gov as NCT00631644.

Building a biomedical cyberinfrastructure for collaborative research.

PubMed

Schad, Peter A; Mobley, Lee Rivers; Hamilton, Carol M

2011-05-01

For the potential power of genome-wide association studies (GWAS) and translational medicine to be realized, the biomedical research community must adopt standard measures, vocabularies, and systems to establish an extensible biomedical cyberinfrastructure. Incorporating standard measures will greatly facilitate combining and comparing studies via meta-analysis. Incorporating consensus-based and well-established measures into various studies should reduce the variability across studies due to attributes of measurement, making findings across studies more comparable. This article describes two well-established consensus-based approaches to identifying standard measures and systems: PhenX (consensus measures for phenotypes and eXposures), and the Open Geospatial Consortium (OGC). NIH support for these efforts has produced the PhenX Toolkit, an assembled catalog of standard measures for use in GWAS and other large-scale genomic research efforts, and the RTI Spatial Impact Factor Database (SIFD), a comprehensive repository of geo-referenced variables and extensive meta-data that conforms to OGC standards. The need for coordinated development of cyberinfrastructure to support measures and systems that enhance collaboration and data interoperability is clear; this paper includes a discussion of standard protocols for ensuring data compatibility and interoperability. Adopting a cyberinfrastructure that includes standard measures and vocabularies, and open-source systems architecture, such as the two well-established systems discussed here, will enhance the potential of future biomedical and translational research. Establishing and maintaining the cyberinfrastructure will require a fundamental change in the way researchers think about study design, collaboration, and data storage and analysis. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Building a Biomedical Cyberinfrastructure for Collaborative Research

PubMed Central

Schad, Peter A.; Mobley, Lee Rivers; Hamilton, Carol M.

2018-01-01

For the potential power of genome-wide association studies (GWAS) and translational medicine to be realized, the biomedical research community must adopt standard measures, vocabularies, and systems to establish an extensible biomedical cyberinfrastructure. Incorporating standard measures will greatly facilitate combining and comparing studies via meta-analysis, which is a means for deriving larger populations, needed for increased statistical power to detect less apparent and more complex associations (gene-environment interactions and polygenic gene-gene interactions). Incorporating consensus-based and well-established measures into various studies should reduce the variability across studies due to attributes of measurement, making findings across studies more comparable. This article describes two consensus-based approaches to establishing standard measures and systems: PhenX (consensus measures for Phenotypes and eXposures), and the Open Geospatial Consortium (OGC). National Institutes of Health support for these efforts has produced the PhenX Toolkit, an assembled catalog of standard measures for use in GWAS and other large-scale genomic research efforts, and the RTI Spatial Impact Factor Database (SIFD), a comprehensive repository of georeferenced variables and extensive metadata that conforms to OGC standards. The need for coordinated development of cyberinfrastructure to support collaboration and data interoperability is clear, and we discuss standard protocols for ensuring data compatibility and interoperability. Adopting a cyberinfrastructure that includes standard measures, vocabularies, and open-source systems architecture will enhance the potential of future biomedical and translational research. Establishing and maintaining the cyberinfrastructure will require a fundamental change in the way researchers think about study design, collaboration, and data storage and analysis. PMID:21521587

[The comparative evaluation of level of security culture in medical organizations].

PubMed

Roitberg, G E; Kondratova, N V; Galanina, E V

2016-01-01

The study was carried out on the basis of clinic “Medicine” in 2014-2015 concerning security culture. The sampling included 465 filled HSPSC questionnaires. The comparative analysis of received was implemented. The “Zubovskaia district hospital” Having no accreditation according security standards and group of clinics from USA functioning for many years in the system of patient security support were selected as objects for comparison. The evaluation was implemented concerning dynamics of security culture in organization at implementation of strategies of security of patients during 5 years and comparison of obtained results with USA clinics was made. The study results demonstrated that in conditions of absence of implemented standards of security in medical organization total evaluation of security remains extremely low. The study of security culture using HSPSC questionnaire is an effective tool for evaluating implementation of various strategies of security ofpatient. The functioning in the system of international standards of quality, primarily JCI standards, permits during several years to achieve high indices of security culture.

Mental-orientation: A new approach to assessing patients across the Alzheimer's disease spectrum.

PubMed

Peters-Founshtein, Gregory; Peer, Michael; Rein, Yanai; Kahana Merhavi, Shlomzion; Meiner, Zeev; Arzy, Shahar

2018-05-21

This study aims to assess the role of mental-orientation in the diagnosis of mild cognitive impairment and Alzheimer's disease using a novel task. A behavioral study (Experiment 1) compared the mental-orientation task to standard neuropsychological tests in patients across the Alzheimer's disease spectrum. A functional MRI study (Experiment 2) in young adults compared activations evoked by the mental-orientation and standard-orientation tasks as well as their overlap with brain regions susceptible to Alzheimer's disease pathology. The mental-orientation task differentiated mild cognitively impaired and healthy controls at 95% accuracy, while the Addenbrooke's Cognitive Examination, Mini-Mental State Examination and standard-orientation achieved 74%, 70% and 50% accuracy, respectively. Functional MRI revealed the mental-orientation task to preferentially recruit brain regions exhibiting early Alzheimer's-related atrophy, unlike the standard-orientation test. Mental-orientation is suggested to play a key role in Alzheimer's disease, and consequently in early detection and follow-up of patients along the Alzheimer's disease spectrum. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Corticosteroid implants for chronic non-infectious uveitis

PubMed Central

Brady, Christopher J; Villanti, Andrea C; Law, Hua Andrew; Rahimy, Ehsan; Reddy, Rahul; Sieving, Pamela C; Garg, Sunir J; Tang, Johnny

2016-01-01

Background Uveitis is a term used to describe a heterogeneous group of intraocular inflammatory diseases of the anterior, intermediate, and posterior uveal tract (iris, ciliary body, choroid). Uveitis is the fifth most common cause of vision loss in high-income countries, accounting for 5% to 20% of legal blindness, with the highest incidence of disease in the working-age population. Corticosteroids are the mainstay of acute treatment for all anatomical subtypes of non-infectious uveitis and can be administered orally, topically with drops or ointments, by periocular (around the eye) or intravitreal (inside the eye) injection, or by surgical implantation. Objectives To determine the efficacy and safety of steroid implants in people with chronic non-infectious posterior uveitis, intermediate uveitis, and panuveitis. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (Issue 10, 2015), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2015), EMBASE (January 1980 to November 2015), PubMed (1948 to November 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to November 2015), the metaRegister of Controlled Trials (mRCT) (www.controlledtrials.com) (last searched 15 April 2013), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform(ICTRP) (www.who.int/ictrp/search/en).We did not use any date or language restrictions in the electronic search for studies. We last searched the electronic databases on 6 November 2015. We also searched reference lists of included study reports, citation databases, and abstracts and clinical study presentations from professional meetings. Selection criteria We included randomized controlled trials comparing either fluocinolone acetonide (FA) or dexamethasone intravitreal implants with standard-of-care therapy with at least six months of follow-up after treatment. We included studies that enrolled participants of all ages who had chronic non-infectious posterior uveitis, intermediate uveitis, or panuveitis with vision that was better than hand-motion. Data collection and analysis Two review authors independently reviewed studies for inclusion. Two review authors independently extracted data and assessed the risk of bias for each study. Main results We included data from two studies (619 eyes of 401 participants) that compared FA implants with standard-of-care therapy. Both studies used similar standard-of-care therapy that included administration of prednisolone and, if needed, immunosuppressive agents. The studies included participants from Australia, France, Germany, Israel, Italy, Portugal, Saudi Arabia, Spain, Switzerland, Turkey, the United Kingdom, and the United States. We assessed both studies at high risk of performance and detection bias. Only one study reported our primary outcome, recurrence of uveitis at any point during the study through 24 months. The evidence, judged as moderate-quality, showed that a FA implant probably prevents recurrence of uveitis compared with standard-of-care therapy (risk ratio (RR) 0.29, 95% confidence interval (CI) 0.14 to 0.59; 132 eyes). Both studies reported safety outcomes, and moderate-quality evidence showed increased risks of needing cataract surgery (RR 2.98, 95% CI 2.33 to 3.79; 371 eyes) and surgery to lower intraocular pressure (RR 7.48, 95% CI 3.94 to 14.19; 599 eyes) in the implant group compared with standard-of-care therapy through two years of follow-up. No studies compared dexamethasone implants with standard-of-care therapy. Authors’ conclusions After considering both benefits and harms reported from two studies in which corticosteroids implants were compared with standard-of-care therapy, we are unable to conclude that the implants are superior to traditional systemic therapy for the treatment of noninfectious uveitis. These studies exhibited heterogeneity in design and outcomes that measured efficacy. Pooled findings regarding safety outcomes suggest increased risks of post-implant surgery for cataract and high intraocular pressure compared with standard-of-care therapy. PMID:26866343

A comparative uncertainty study of the calibration of macrolide antibiotic reference standards using quantitative nuclear magnetic resonance and mass balance methods.

PubMed

Liu, Shu-Yu; Hu, Chang-Qin

2007-10-17

This study introduces the general method of quantitative nuclear magnetic resonance (qNMR) for the calibration of reference standards of macrolide antibiotics. Several qNMR experimental conditions were optimized including delay, which is an important parameter of quantification. Three kinds of macrolide antibiotics were used to validate the accuracy of the qNMR method by comparison with the results obtained by the high performance liquid chromatography (HPLC) method. The purities of five common reference standards of macrolide antibiotics were measured by the 1H qNMR method and the mass balance method, respectively. The analysis results of the two methods were compared. The qNMR is quick and simple to use. In a new medicine research and development process, qNMR provides a new and reliable method for purity analysis of the reference standard.

Accuracy of the clinical diagnosis of vaginitis compared with a DNA probe laboratory standard.

PubMed

Lowe, Nancy K; Neal, Jeremy L; Ryan-Wenger, Nancy A

2009-01-01

To estimate the accuracy of the clinical diagnosis of the three most common causes of acute vulvovaginal symptoms (bacterial vaginosis, candidiasis vaginitis, and trichomoniasis vaginalis) using a traditional, standardized clinical diagnostic protocol compared with a DNA probe laboratory standard. This prospective clinical comparative study had a sample of 535 active-duty United States military women presenting with vulvovaginal symptoms. Clinical diagnoses were made by research staff using a standardized protocol of history, physical examination including pelvic examination, determination of vaginal pH, vaginal fluid amines test, and wet-prep microscopy. Vaginal fluid samples were obtained for DNA analysis. The research clinicians were blinded to the DNA results. The participants described a presenting symptom of abnormal discharge (50%), itching/irritation (33%), malodor (10%), burning (4%), or others such as vulvar pain and vaginal discomfort. According to laboratory standard, there were 225 cases (42%) of bacterial vaginosis, 76 cases (14%) of candidiasis vaginitis, 8 cases (1.5%) of trichomoniasis vaginalis, 87 cases of mixed infections (16%), and 139 negative cases (26%). For each single infection, the clinical diagnosis had a sensitivity and specificity of 80.8% and 70.0% for bacterial vaginosis, 83.8% and 84.8% for candidiasis vaginitis, and 84.6% and 99.6% for trichomoniasis vaginalis when compared with the DNA probe standard. Compared with a DNA probe standard, clinical diagnosis is 81-85% sensitive and 70-99% specific for bacterial vaginosis, Candida vaginitis, and trichomoniasis. Even under research conditions that provided clinicians with sufficient time and materials to conduct a thorough and standardized clinical evaluation, the diagnosis and, therefore, subsequent treatment of these common vaginal problems remains difficult. II.

Standards and guidelines for observational studies: quality is in the eye of the beholder.

PubMed

Morton, Sally C; Costlow, Monica R; Graff, Jennifer S; Dubois, Robert W

2016-03-01

Patient care decisions demand high-quality research. To assist those decisions, numerous observational studies are being performed. Are the standards and guidelines to assess observational studies consistent and actionable? What policy considerations should be considered to ensure decision makers can determine if an observational study is of high-quality and valid to inform treatment decisions? Based on a literature review and input from six experts, we compared and contrasted nine standards/guidelines using 23 methodological elements involved in observational studies (e.g., study protocol, data analysis, and so forth). Fourteen elements (61%) were addressed by at least seven standards/guidelines; 12 of these elements disagreed in the approach. Nine elements (39%) were addressed by six or fewer standards/guidelines. Ten elements (43%) were not actionable in at least one standard/guideline that addressed the element. The lack of observational study standard/guideline agreement may contribute to variation in study conduct; disparities in what is considered credible research; and ultimately, what evidence is adopted. A common set of agreed on standards/guidelines for conducting observational studies will benefit funders, researchers, journal editors, and decision makers. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Relatively fast! Efficiency advantages of comparative thinking.

PubMed

Mussweiler, Thomas; Epstude, Kai

2009-02-01

Comparisons are a ubiquitous process in information processing. Seven studies examine whether, how, and when comparative thinking increases the efficiency of judgment and choice. Studies 1-4 demonstrate that procedurally priming participants to engage in more vs. less comparison influences how they process information about a target. Specifically, they retrieve less information about the target (Studies 1A, 1B), think more about an information-rich standard (Study 2) about which they activate judgment-relevant information (Study 3), and use this information to compensate for missing target information (Study 4). Studies 2-5 demonstrate the ensuing efficiency advantages. Participants who are primed on comparative thinking are faster in making a target judgment (Studies 2A, 2B, 4, 5) and have more residual processing capacities for a secondary task (Study 5). Studies 6 and 7 establish two boundary conditions by demonstrating that comparative thinking holds efficiency advantages only if target and standard are partly characterized by alignable features (Study 6) that are difficult to evaluate in isolation (Study 7). These findings indicate that comparative thinking may often constitute a useful mechanism to simplify information processing. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Are Disposable and Standard Gonioscopy Lenses Comparable?

PubMed

Lee, Bonny; Szirth, Bernard C; Fechtner, Robert D; Khouri, Albert S

2017-04-01

Gonioscopy is important in the evaluation and treatment of glaucoma. With increased scrutiny of acceptable sterilization processes for health care instruments, disposable gonioscopy lenses have recently been introduced. Single-time use lenses are theorized to decrease infection risk and eliminate the issue of wear and tear seen on standard, reusable lenses. However, patient care would be compromised if the quality of images produced by the disposable lens were inferior to those produced by the reusable lens. The purpose of this study was to compare the quality of images produced by disposable versus standard gonioscopy lenses. A disposable single mirror lens (Sensor Medical Technology) and a standard Volk G-1 gonioscopy lens were used to image 21 volunteers who were prospectively recruited for the study. Images of the inferior and temporal angles of each subject's left eye were acquired using a slit-lamp camera through the disposable and standard gonioscopy lens. In total, 74 images were graded using the Spaeth gonioscopic system and for clarity and quality. Clarity was scored as 1 or 2 and defined as either (1) all structures perceived or (2) all structures not perceived. Quality was scored as 1, 2, or 3, and defined as (1) all angle landmarks clear and well focused, (2) some angle landmarks clear, others blurred, or (3) angle landmarks could not be ascertained. The 74 images were divided into images taken with the disposable single mirror lens and images taken with the standard Volk G-1 gonioscopy lens. The clarity and quality scores for each of these 2 image groups were averaged and P-values were calculated. Average quality of images produced with the standard lens was 1.46±0.56 compared with 1.54±0.61 for those produced with the disposable lens (P=0.55). Average clarity of images produced with the standard lens was 1.47±0.51 compared with 1.49±0.51 (P=0.90) with the disposable lens. We conclude that there is no significant difference in quality of images produced with standard versus disposable gonioscopy lenses. Disposable gonioscopy lenses may be an acceptable alternative to standard reusable lenses, especially in conditions where sterilization is difficult.

The Impact of Inclusion and Resource Instruction on Standardized Test Scores of Special Education Students

ERIC Educational Resources Information Center

Derico, Vontrice L.

2017-01-01

The purpose of the proposed quasi-experimental quantitative study was to determine if students who were taught in the inclusive setting yielded higher standardized test scores compared to students who were taught in the resource setting. The researcher analyzed the standardized test scores, in the areas of Language Arts, Reading, and Mathematics…

An Analysis of Geography Content in Relation to Geography for Life Standards in Oman

ERIC Educational Resources Information Center

Al-Nofli, Mohammed Abdullah

2018-01-01

Since the publication of "Geography for Life: National Geography Standards" in the United States (Geography Education Standards Project, 1994), it has been widely used to develop quality curriculum materials for what students should know and able to do in geography. This study compared geography content taught in Omani public schools…

Rationale for the tinnitus retraining therapy trial

PubMed Central

Formby, Craig; Scherer, Roberta

2013-01-01

The Tinnitus Retraining Therapy Trial (TRTT) is a National Institutes of Health-sponsored, multi-centered, placebo-controlled, randomized trial evaluating the efficacy of tinnitus retraining therapy (TRT) and its component parts, directive counseling and sound therapy, as treatments for subjective debilitating tinnitus in the military. The TRTT will enroll 228 individuals at an allocation ratio of 1:1:1 to: (1) directive counseling and sound therapy using conventional sound generators; (2) directive counseling and placebo sound generators; or (3) standard of care as administered in the military. Study centers include a Study Chair’s Office, a Data Coordinating Center, and six Military Clinical Centers with treatment and data collection standardized across all clinics. The primary outcome is change in Tinnitus Questionnaire (TQ) score assessed longitudinally at 3, 6, 12, and 18-month follow-up visits. Secondary outcomes include: Change in TQ sub-scales, Tinnitus Handicap Inventory, Tinnitus Functional Index, and TRT interview visual analog scale; audiometric and psychoacoustic measures; and change in quality of life. The TRTT will evaluate TRT efficacy by comparing TRT (directive counseling and conventional sound generators) with standard of care; directive counseling by comparing directive counseling plus placebo sound generators versus standard of care; and sound therapy by comparing conventional versus placebo sound generators. We hypothesize that full TRT will be more efficacious than standard of care, directive counseling and placebo sound generators more efficacious than standard of care, and conventional more efficacious than placebo sound generators in habituating the tinnitus awareness, annoyance, and impact on the study participant’s life. PMID:23571304

A Comparison of Performance on Cloze Tests, Group Reading Inventories and Standardized Reading Achievement in Grades Seven, Eight and Nine.

ERIC Educational Resources Information Center

Rakes, Thomas A.; McWilliams, Lana J.

A random sample of 300 seventh, eighth, and ninth grade students participated in a comparative study of performance on social studies cloze tests, social studies group reading inventories (GRI), and a popular standardized test (Gates-MacGinitie Reading Tests, Survey E). It was found that cloze tests and GRIs constructed from social studies content…

Spinal cord testing: auditing for quality assurance.

PubMed

Marr, J A; Reid, B

1991-04-01

A quality assurance audit of spinal cord testing as documented by staff nurses was carried out. Twenty-five patient records were examined for accuracy of documented testing and compared to assessments performed by three investigators. A pilot study established interrater reliability of a tool that was designed especially for this study. Results indicated staff nurses failed to meet pre-established 100% standard in all categories of testing when compared with investigator's findings. Possible reasons for this disparity are discussed as well as indications for modifications in the spinal testing record, teaching program and preset standards.

Early mobilization of acute whiplash injuries.

PubMed Central

Mealy, K; Brennan, H; Fenelon, G C

1986-01-01

Acute whiplash injuries are a common cause of soft tissue trauma for which the standard treatment is rest and initial immobilisation with a soft cervical collar. Because the efficacy of this treatment is unknown a randomised study in 61 patients was carried out comparing the standard treatment with an alternative regimen of early active mobilisation. Results showed that eight weeks after the accident the degree of improvement seen in the actively treated group compared with the group given standard treatment was significantly greater for both cervical movement (p less than 0.05) and intensity of pain (p less than 0.0125). PMID:3081211

The use of customised versus population-based birthweight standards in predicting perinatal mortality.

PubMed

Zhang, X; Platt, R W; Cnattingius, S; Joseph, K S; Kramer, M S

2007-04-01

The objective of this study was to critically examine potential artifacts and biases underlying the use of 'customised' standards of birthweight for gestational age (GA). Population-based cohort study. Sweden. A total of 782,303 singletons > or =28 weeks of gestation born in 1992-2001 to Nordic mothers with complete data on birthweight; GA; and maternal age, parity, height, and pre-pregnancy weight. We compared perinatal mortality in four groups of infants based on the following classification of small for gestational age (SGA): non-SGA based on either population-based or customised standards (the reference group), SGA based on the population-based standard only, SGA based on the customised standard only, and SGA according to both standards. We used graphical methods to compare GA-specific birthweight cutoffs for SGA using the two standards and also used logistic regression to control for differences in GA and maternal pre-pregnancy body mass index (BMI) in the four groups. Perinatal mortality, including stillbirth and neonatal death. Customisation led to a large artifactual increase in the proportion of SGA infants born preterm. Adjustment for differences in GA and maternal BMI markedly reduced the excess risk among infants classified as SGA by customised standards only. The large increase in perinatal mortality risk among infants classified as SGA based on customised standards is largely an artifact due to inclusion of more preterm births.

Pressure ulcer risk assessment and prevention: a systematic comparative effectiveness review.

PubMed

Chou, Roger; Dana, Tracy; Bougatsos, Christina; Blazina, Ian; Starmer, Amy J; Reitel, Katie; Buckley, David I

2013-07-02

Pressure ulcers are associated with substantial health burdens but may be preventable. To review the clinical utility of pressure ulcer risk assessment instruments and the comparative effectiveness of preventive interventions in persons at higher risk. MEDLINE (1946 through November 2012), CINAHL, the Cochrane Library, grant databases, clinical trial registries, and reference lists. Randomized trials and observational studies on effects of using risk assessment on clinical outcomes and randomized trials of preventive interventions on clinical outcomes. Multiple investigators abstracted and checked study details and quality using predefined criteria. One good-quality trial found no evidence that use of a pressure ulcer risk assessment instrument, with or without a protocolized intervention strategy based on assessed risk, reduces risk for incident pressure ulcers compared with less standardized risk assessment based on nurses' clinical judgment. In higher-risk populations, 1 good-quality and 4 fair-quality randomized trials found that more advanced static support surfaces were associated with lower risk for pressure ulcers compared with standard mattresses (relative risk range, 0.20 to 0.60). Evidence on the effectiveness of low-air-loss and alternating-air mattresses was limited, with some trials showing no clear differences from advanced static support surfaces. Evidence on the effectiveness of nutritional supplementation, repositioning, and skin care interventions versus usual care was limited and had methodological shortcomings, precluding strong conclusions. Only English-language articles were included, publication bias could not be formally assessed, and most studies had methodological shortcomings. More advanced static support surfaces are more effective than standard mattresses for preventing ulcers in higher-risk populations. The effectiveness of formal risk assessment instruments and associated intervention protocols compared with less standardized assessment methods and the effectiveness of other preventive interventions compared with usual care have not been clearly established.

Scaled test statistics and robust standard errors for non-normal data in covariance structure analysis: a Monte Carlo study.

PubMed

Chou, C P; Bentler, P M; Satorra, A

1991-11-01

Research studying robustness of maximum likelihood (ML) statistics in covariance structure analysis has concluded that test statistics and standard errors are biased under severe non-normality. An estimation procedure known as asymptotic distribution free (ADF), making no distributional assumption, has been suggested to avoid these biases. Corrections to the normal theory statistics to yield more adequate performance have also been proposed. This study compares the performance of a scaled test statistic and robust standard errors for two models under several non-normal conditions and also compares these with the results from ML and ADF methods. Both ML and ADF test statistics performed rather well in one model and considerably worse in the other. In general, the scaled test statistic seemed to behave better than the ML test statistic and the ADF statistic performed the worst. The robust and ADF standard errors yielded more appropriate estimates of sampling variability than the ML standard errors, which were usually downward biased, in both models under most of the non-normal conditions. ML test statistics and standard errors were found to be quite robust to the violation of the normality assumption when data had either symmetric and platykurtic distributions, or non-symmetric and zero kurtotic distributions.

Collagen sealant patch to reduce lymphatic drainage after lymph node dissection.

PubMed

Di Monta, Gianluca; Caracò, Corrado; Crispo, Anna; Marone, Ugo; Mozzillo, Nicola

2012-12-19

Seroma formation is a frequent complication following radical lymph node dissection (RLND) in patients with metastatic melanoma. Several strategies have been used to prevent fluid accumulation and thereby reduce the duration of postoperative drainage, including fibrin sealants. This was a prospective, single-center study in which consecutive patients undergoing surgical treatment of stage III metastatic melanoma by axillary or ilio-inguinal RLND were randomized to receive standard treatment plus fibrinogen/thrombin-coated collagen sealant patch (CSP) or standard treatment alone. The primary endpoint of the study was postoperative duration of drainage. A total of 70 patients underwent axillary (n = 47) or ilio-inguinal (n = 23) RLND and received CSP plus standard treatment (n = 37) or standard treatment alone (n = 33). Mean duration of drainage was significantly reduced in the CSP group compared with standard treatment (ITT analysis: 20.1 ± 5.1 versus 23.3 ± 5.1 days; p = 0.010). The percentage of patients drainage-free on day 21 was significantly higher in the CSP group compared with the standard treatment group (86% versus 67%; p = 0.049). Use of the tissue sealant resulted in a significant reduction in duration of drainage. Further studies are warranted to confirm these results in different and selected types of lymphadenectomy.

Collagen sealant patch to reduce lymphatic drainage after lymph node dissection

PubMed Central

2012-01-01

Background Seroma formation is a frequent complication following radical lymph node dissection (RLND) in patients with metastatic melanoma. Several strategies have been used to prevent fluid accumulation and thereby reduce the duration of postoperative drainage, including fibrin sealants. Methods This was a prospective, single-center study in which consecutive patients undergoing surgical treatment of stage III metastatic melanoma by axillary or ilio-inguinal RLND were randomized to receive standard treatment plus fibrinogen/thrombin-coated collagen sealant patch (CSP) or standard treatment alone. The primary endpoint of the study was postoperative duration of drainage. Results A total of 70 patients underwent axillary (n = 47) or ilio-inguinal (n = 23) RLND and received CSP plus standard treatment (n = 37) or standard treatment alone (n = 33). Mean duration of drainage was significantly reduced in the CSP group compared with standard treatment (ITT analysis: 20.1 ± 5.1 versus 23.3 ± 5.1 days; p = 0.010). The percentage of patients drainage-free on day 21 was significantly higher in the CSP group compared with the standard treatment group (86% versus 67%; p = 0.049). Conclusions Use of the tissue sealant resulted in a significant reduction in duration of drainage. Further studies are warranted to confirm these results in different and selected types of lymphadenectomy. PMID:23253298

A Windows application for computing standardized mortality ratios and standardized incidence ratios in cohort studies based on calculation of exact person-years at risk.

PubMed

Geiss, Karla; Meyer, Martin

2013-09-01

Standardized mortality ratios and standardized incidence ratios are widely used in cohort studies to compare mortality or incidence in a study population to that in the general population on a age-time-specific basis, but their computation is not included in standard statistical software packages. Here we present a user-friendly Microsoft Windows program for computing standardized mortality ratios and standardized incidence ratios based on calculation of exact person-years at risk stratified by sex, age and calendar time. The program offers flexible import of different file formats for input data and easy handling of general population reference rate tables, such as mortality or incidence tables exported from cancer registry databases. The application of the program is illustrated with two examples using empirical data from the Bavarian Cancer Registry. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Caseload midwifery compared to standard or private obstetric care for first time mothers in a public teaching hospital in Australia: a cross sectional study of cost and birth outcomes.

PubMed

Tracy, Sally K; Welsh, Alec; Hall, Bev; Hartz, Donna; Lainchbury, Anne; Bisits, Andrew; White, Jan; Tracy, Mark B

2014-01-24

In many countries midwives act as the main providers of care for women throughout pregnancy, labour and birth. In our large public teaching hospital in Australia we restructured the way midwifery care is offered and introduced caseload midwifery for one third of women booked at the hospital. We then compared the costs and birth outcomes associated with caseload midwifery compared to the two existing models of care, standard hospital care and private obstetric care. We undertook a cross sectional study examining the risk profile, birth outcomes and cost of care for women booked into one of the three available models of care in a tertiary teaching hospital in Australia between July 1st 2009 December 31st 2010. To control for differences in population or case mix we described the outcomes for a cohort of low risk first time mothers known as the 'standard primipara'. Amongst the 1,379 women defined as 'standard primipara' there were significant differences in birth outcome. These first time 'low risk' mothers who received caseload care were more likely to have a spontaneous onset of labour and an unassisted vaginal birth 58.5% in MGP compared to 48.2% for Standard hospital care and 30.8% with Private obstetric care (p < 0.001). They were also significantly less likely to have an elective caesarean section 1.6% with MGP versus 5.3% with Standard care and 17.2% with private obstetric care (p < 0.001). From the public hospital perspective, over one financial year the average cost of care for the standard primipara in MGP was $3903.78 per woman. This was $1375.45 less per woman than those receiving Private obstetric care and $1590.91 less than Standard hospital care per woman (p < 0.001). Similar differences in cost were found in favour of MGP for all women in the study who received caseload care. Cost reduction appears to be achieved through reorganising the way care is delivered in the public hospital system with the introduction of Midwifery Group Practice or caseload care. The study also highlights the unexplained clinical variation that exists between the three models of care in Australia.

Caseload midwifery compared to standard or private obstetric care for first time mothers in a public teaching hospital in Australia: a cross sectional study of cost and birth outcomes

PubMed Central

2014-01-01

Background In many countries midwives act as the main providers of care for women throughout pregnancy, labour and birth. In our large public teaching hospital in Australia we restructured the way midwifery care is offered and introduced caseload midwifery for one third of women booked at the hospital. We then compared the costs and birth outcomes associated with caseload midwifery compared to the two existing models of care, standard hospital care and private obstetric care. Methods We undertook a cross sectional study examining the risk profile, birth outcomes and cost of care for women booked into one of the three available models of care in a tertiary teaching hospital in Australia between July 1st 2009 December 31st 2010. To control for differences in population or case mix we described the outcomes for a cohort of low risk first time mothers known as the 'standard primipara'. Results Amongst the 1,379 women defined as 'standard primipara' there were significant differences in birth outcome. These first time ‘low risk’ mothers who received caseload care were more likely to have a spontaneous onset of labour and an unassisted vaginal birth 58.5% in MGP compared to 48.2% for Standard hospital care and 30.8% with Private obstetric care (p < 0.001). They were also significantly less likely to have an elective caesarean section 1.6% with MGP versus 5.3% with Standard care and 17.2% with private obstetric care (p < 0.001). From the public hospital perspective, over one financial year the average cost of care for the standard primipara in MGP was $3903.78 per woman. This was $1375.45 less per woman than those receiving Private obstetric care and $1590.91 less than Standard hospital care per woman (p < 0.001). Similar differences in cost were found in favour of MGP for all women in the study who received caseload care. Conclusions Cost reduction appears to be achieved through reorganising the way care is delivered in the public hospital system with the introduction of Midwifery Group Practice or caseload care. The study also highlights the unexplained clinical variation that exists between the three models of care in Australia. PMID:24456576

Diagnostic accuracy of same-day microscopy versus standard microscopy for pulmonary tuberculosis: a systematic review and meta-analysis.

PubMed

Davis, J Lucian; Cattamanchi, Adithya; Cuevas, Luis E; Hopewell, Philip C; Steingart, Karen R

2013-02-01

Sputum smear microscopy is the most widely available diagnostic test for pulmonary tuberculosis in countries with a high burden of the disease. Improving its accuracy is crucial to achievement of case-detection targets established by the Millennium Development Goals. Unfortunately, many patients are unable to submit all of the specimens needed for examination or to return for treatment because standard sputum collection and reporting requires several clinic visits. To inform policy recommendations by a WHO-convened Expert Group, we aimed to assess the accuracy of sputum smear examination with strategies for obtaining sputum on 1 day compared with strategies for obtaining sputum over 2 days. We did a systematic review and meta-analysis of research articles comparing the accuracy of front-loaded or same-day microscopy and standard sputum smear microscopy for diagnosis of culture-confirmed pulmonary tuberculosis. We searched Medline, Embase, Biosis, and Web of Science for articles published between Jan 1, 2005, and Feb 14, 2012. Two investigators identified eligible articles and extracted data for individual study sites. We generated pooled summary estimates (95% CIs) for sensitivity and specificity by use of random-effects meta-analysis when four or more studies were available. We identified eight relevant studies from five articles enrolling 7771 patients with suspected tuberculosis in low-income countries. Compared with the standard approach of examination of two smears with Ziehl-Neelsen light microscopy over 2 days, examination of two smears taken on the same day had much the same sensitivity (64% [95% CI 60 to 69] for standard microscopy vs 63% [58 to 68] for same-day microscopy) and specificity (98% [97 to 99] vs 98% [97 to 99]). We noted similar results for studies employing light-emitting diode fluorescence microscopy and for studies examining three smears, whether they were compared with two-smear strategies or with one another. Same-day sputum smear microscopy is as accurate as standard smear microscopy. Data from tuberculosis programmes are needed to document the changes required in the health system to successfully implement the strategy and understand its effects. WHO and US National Institutes of Health. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparison of the efficacy and safety of intensive-dose and standard-dose statin treatment for stroke prevention

PubMed Central

Wang, Juan; Chen, Dan; Li, Da-Bing; Yu, Xin; Shi, Guo-Bing

2016-01-01

Abstract Background: Previous study indicated that high-dose statin treatment might increase the risk of hemorrhagic stroke and adverse reactions. We aim to compare the efficacy and safety of intensive-dose and standard-dose statin treatment for preventing stroke in high-risk patients. Methods: A thorough search was performed of multiple databases for publications from 1990 to June 2015. We selected the randomized clinical trials comparing standard-dose statin with placebo and intensive-dose statin with standard-dose statin or placebo for the prevention of stroke events in patients. Duplicate independent data extraction and bias assessments were performed. Data were pooled using a fixed-effects model or a random-effects model if significant heterogeneity was present. Results: For the all stroke incidences, intensive-dose statin treatment compared with placebo treatment and standard-dose statin treatment compared with placebo treatment showed a significant 21% reduction in relative risk (RR) (RR 0.79, 95% confidence interval (CI) [0.71, 0.87], P < 0.00001) and an 18% reduction in RR (RR 0.82, 95% CI [0.73, 0.93], P = 0.002) in the subgroup without renal transplant recipients and patients undergoing regular hemodialysis separately. For the fatal stroke incidences, intensive-dose statin treatment compared with standard dose or placebo was effective reducing fatal stroke (RR 0.61, 95% CI [0.39, 0.96], P = 0.03) and the RR was 1.01 (95% CI [0.85, 1.20], P = 0.90) in standard-dose statin treatment compared with placebo. Conclusion: The results of this meta-analysis suggest that intensive-dose statin treatment might be more favorable for reducing the incidences of all strokes than standard-dose statin treatment, especially for patients older than 65 years in reducing the incidences of all stroke incidences. PMID:27684837

Quantitative Imaging Biomarkers: A Review of Statistical Methods for Computer Algorithm Comparisons

PubMed Central

2014-01-01

Quantitative biomarkers from medical images are becoming important tools for clinical diagnosis, staging, monitoring, treatment planning, and development of new therapies. While there is a rich history of the development of quantitative imaging biomarker (QIB) techniques, little attention has been paid to the validation and comparison of the computer algorithms that implement the QIB measurements. In this paper we provide a framework for QIB algorithm comparisons. We first review and compare various study designs, including designs with the true value (e.g. phantoms, digital reference images, and zero-change studies), designs with a reference standard (e.g. studies testing equivalence with a reference standard), and designs without a reference standard (e.g. agreement studies and studies of algorithm precision). The statistical methods for comparing QIB algorithms are then presented for various study types using both aggregate and disaggregate approaches. We propose a series of steps for establishing the performance of a QIB algorithm, identify limitations in the current statistical literature, and suggest future directions for research. PMID:24919829

Pilot-Reported Beta-Blockers Identified by Forensic Toxicology Analysis of Postmortem Specimens

DOT National Transportation Integrated Search

2017-01-01

This study compared beta-blockers reported by pilots with the medications found by postmortem toxicology analysis of specimens received from fatal aviation accidents between 1999 and 2015. Several studies have compared drugs using the standard approa...

Different effectiveness of closed embryo culture system with time-lapse imaging (EmbryoScope(TM)) in comparison to standard manual embryology in good and poor prognosis patients: a prospectively randomized pilot study.

PubMed

Wu, Yan-Guang; Lazzaroni-Tealdi, Emanuela; Wang, Qi; Zhang, Lin; Barad, David H; Kushnir, Vitaly A; Darmon, Sarah K; Albertini, David F; Gleicher, Norbert

2016-08-24

Previously manual human embryology in many in vitro fertilization (IVF) centers is rapidly being replaced by closed embryo incubation systems with time-lapse imaging. Whether such systems perform comparably to manual embryology in different IVF patient populations has, however, never before been investigated. We, therefore, prospectively compared embryo quality following closed system culture with time-lapse photography (EmbryoScope™) and standard embryology. We performed a two-part prospectively randomized study in IVF (clinical trial # NCT92256309). Part A involved 31 infertile poor prognosis patients prospectively randomized to EmbryoScope™ and standard embryology. Part B involved embryos from 17 egg donor-recipient cycles resulting in large egg/embryo numbers, thus permitting prospectively alternative embryo assignments to EmbryoScope™ and standard embryology. We then compared pregnancy rates and embryo quality on day-3 after fertilization and embryologist time utilized per processed embryo. Part A revealed in poor prognosis patients no differences in day-3 embryo scores, implantation and clinical pregnancy rates between EmbryoScope™ and standard embryology. The EmbryoScope™, however, more than doubled embryology staff time (P < 0.0001). In Part B, embryos grown in the EmbyoScope™ demonstrated significantly poorer day-3 quality (depending on embryo parameter between P = 0.005 and P = 0.01). Suspicion that conical culture dishes of the EmbryoScope™ (EmbryoSlide™) may be the cause was disproven when standard culture dishes demonstrated no outcome difference in standard incubation. Though due to small patient numbers preliminary, this study raises concerns about the mostly uncontrolled introduction of closed incubation systems with time lapse imaging into routine clinical embryology. Appropriately designed and powered prospectively randomized studies appear urgently needed in well-defined patient populations before the uncontrolled utilization of these instruments further expands. NCT02246309 Registered September 18, 2014.

A new method to address verification bias in studies of clinical screening tests: cervical cancer screening assays as an example.

PubMed

Xue, Xiaonan; Kim, Mimi Y; Castle, Philip E; Strickler, Howard D

2014-03-01

Studies to evaluate clinical screening tests often face the problem that the "gold standard" diagnostic approach is costly and/or invasive. It is therefore common to verify only a subset of negative screening tests using the gold standard method. However, undersampling the screen negatives can lead to substantial overestimation of the sensitivity and underestimation of the specificity of the diagnostic test. Our objective was to develop a simple and accurate statistical method to address this "verification bias." We developed a weighted generalized estimating equation approach to estimate, in a single model, the accuracy (eg, sensitivity/specificity) of multiple assays and simultaneously compare results between assays while addressing verification bias. This approach can be implemented using standard statistical software. Simulations were conducted to assess the proposed method. An example is provided using a cervical cancer screening trial that compared the accuracy of human papillomavirus and Pap tests, with histologic data as the gold standard. The proposed approach performed well in estimating and comparing the accuracy of multiple assays in the presence of verification bias. The proposed approach is an easy to apply and accurate method for addressing verification bias in studies of multiple screening methods. Copyright © 2014 Elsevier Inc. All rights reserved.

Oral rivaroxaban versus standard therapy for the treatment of symptomatic venous thromboembolism: a pooled analysis of the EINSTEIN-DVT and PE randomized studies.

PubMed

Prins, Martin H; Lensing, Anthonie Wa; Bauersachs, Rupert; van Bellen, Bonno; Bounameaux, Henri; Brighton, Timothy A; Cohen, Alexander T; Davidson, Bruce L; Decousus, Hervé; Raskob, Gary E; Berkowitz, Scott D; Wells, Philip S

2013-09-20

Standard treatment for venous thromboembolism (VTE) consists of a heparin combined with vitamin K antagonists. Direct oral anticoagulants have been investigated for acute and extended treatment of symptomatic VTE; their use could avoid parenteral treatment and/or laboratory monitoring of anticoagulant effects. A prespecified pooled analysis of the EINSTEIN-DVT and EINSTEIN-PE studies compared the efficacy and safety of rivaroxaban (15 mg twice-daily for 21 days, followed by 20 mg once-daily) with standard-therapy (enoxaparin 1.0 mg/kg twice-daily and warfarin or acenocoumarol). Patients were treated for 3, 6, or 12 months and followed for suspected recurrent VTE and bleeding. The prespecified noninferiority margin was 1.75. A total of 8282 patients were enrolled; 4151 received rivaroxaban and 4131 received standard-therapy. The primary efficacy outcome occurred in 86 (2.1%) rivaroxaban-treated patients compared with 95 (2.3%) standard-therapy-treated patients (hazard ratio, 0.89; 95% confidence interval [CI], 0.66-1.19; pnoninferiority < 0.001). Major bleeding was observed in 40 (1.0%) and 72 (1.7%) patients in the rivaroxaban and standard-therapy groups, respectively (hazard ratio, 0.54; 95% CI, 0.37-0.79; p = 0.002). In key subgroups, including fragile patients, cancer patients, patients presenting with large clots, and those with a history of recurrent VTE, the efficacy and safety of rivaroxaban were similar compared with standard-therapy. The single-drug approach with rivaroxaban resulted in similar efficacy to standard-therapy and was associated with a significantly lower rate of major bleeding. Efficacy and safety results were consistent among key patient subgroups. ClinicalTrials.gov, NCT00439777; EINSTEIN-DVT: ClinicalTrials.gov, NCT00440193.

Standard spacecraft economic analysis. Volume 1: Executive summary

NASA Technical Reports Server (NTRS)

Harris, E. D.; Large, J. P.

1976-01-01

A study of the comparative program costs associated with use of various standardized spacecraft for Air Force space test program missions to be flown on the space shuttle during the 1980-1990 time period is reviewed. The first phase of the study considered a variety of procurement mixes composed of existing or programmed NASA standard spacecraft designs and a Air Force standard spacecraft design. The results were briefed to a joint NASA/Air Force audience on July 11, 1976. The second phase considered additional procurement options using an upgraded version of an existing NASA design. The results of both phases are summarized.

Biodegradable implants versus standard metal fixation for displaced radial head fractures. A prospective, randomized, multicenter study.

PubMed

Helling, Hanns-Joachim; Prokop, Axel; Schmid, Hans Ulrich; Nagel, Michael; Lilienthal, Jürgen; Rehm, Klaus Emil

2006-01-01

This multicenter, prospective, randomized study compares the use of biodegradable polylactide pins with standard metal mini-fragment implants for the treatment of displaced radial head fractures. It compares complication rates and clinical outcomes of both treatment methods. At 2 years, 135 (82%) of 164 patients were available for evaluation. Equivalence of treatment method was defined as a difference of 10% or less in the number of complication-free patients. Functional status was assessed by using the Broberg and Morrey Elbow Score and compared by an unpaired t test. Good or excellent clinical results were achieved by 92% (56/61) of the control patients and 96% (71/74) of the polylactide patients. The incidence of complication-free patients was 3.7% less in the polylactide group than in the control group. The 1-sided 95% confidence interval for the treatment difference between the 2 groups was more than -6.1%. Biodegradable polylactide pins have at least comparable outcomes as standard metal implants for the internal fixation of reconstructable displaced radial head fractures.

A fast-track anaemia clinic in the Emergency Department: cost-analysis of intravenous iron administration for treating iron-deficiency anaemia.

PubMed

Quintana-Díaz, Manuel; Muñoz-Romo, Raúl; Gómez-Ramírez, Susana; Pavía, José; Borobia, Alberto M; García-Erce, José A; Muñoz, Manuel

2017-09-01

A fast-track anaemia clinic (FTAC) for the management of moderate-to-severe iron-deficiency anaemia (IDA) was established in our Emergency Department in 2010. In this FTAC, the replacement of packed red cell transfusion by ferric carboxymaltose administration was proven to be safe and effective. The aim of this study was a cost-analysis of IDA management in the FTAC, comparing this management with the previous standard care pathway consisting of packed red cell transfusion, if needed, and referral to outpatient specialised care. A cost study was performed for patients with IDA who were at risk of requiring transfusion (haemoglobin <9 g/dL) but did not require hospitalisation. Total IDA treatment costs in the FTAC were compared to those theoretically incurred if these patients had been managed using the standard care pathway. In addition, a sensitivity analysis considering variations of up to ±30% in ferric carboxymaltose and packed red cell acquisition costs was performed (49 possible scenarios). Between 2012 and 2015, 238 IDA patients were treated in the FTAC. The average treatment cost was € 594±337/patient in the FTAC group and € 672±301/patient in the standard care pathway group, with a saving of € 78±28/patient (95% CI, 22-133; p<0.001). The sensitivity analysis showed that IDA treatment costs in the FTAC (€ 480-722/patient), compared with those of the standard care pathway (€ 550-794/patient), resulted in significant cost-savings for all studied scenarios (€ 51-104/patient; p<0.005). The administration of ferric carboxymaltose for IDA management in a FTAC may be cost-saving compared with the standard care pathway.

A novel balloon colonoscope detects significantly more simulated polyps than a standard colonoscope in a colon model.

PubMed

Hasan, Nazia; Gross, Seth A; Gralnek, Ian M; Pochapin, Mark; Kiesslich, Ralf; Halpern, Zamir

2014-12-01

Although standard colonoscopy is considered the optimal test to detect adenomas, it can have a significant adenoma miss rate. A major contributing factor to high miss rates is the inability to visualize adenomas behind haustral folds and at anatomic flexures. To compare the diagnostic yield of balloon-assisted colonoscopy versus standard colonoscopy in the detection of simulated polyps in a colon model. Prospective, cohort study. International gastroenterology meeting. A colon model composed of elastic material, which mimics the flexible structure of haustral folds, allowing for dynamic responses to balloon inflation, with embedded simulated colon polyps (n = 12 silicone "polyps"). Fifty gastroenterologists were recruited to identify simulated colon polyps in a colon model, first using standard colonoscopy immediately followed by balloon-assisted colonoscopy. Detection of simulated polyps. The median polyp detection rate for all simulated polyps was significantly higher with balloon-assisted as compared with standard colonoscopy (91.7% vs 45.8%, respectively; P < .0001). The significantly higher simulated polyp detection rate with balloon-assisted versus standard colonoscopy was notable both for non-obscured polyps (100.0% vs 75.0%; P < .0001) and obscured polyps (88.0% vs 25.0%; P < .0001). Non-randomized design, use of a colon model, and simulated colon polyps. As compared with standard colonoscopy, balloon-assisted colonoscopy detected significantly more obscured and non-obscured simulated polyps in a colon model. Clinical studies in human participants are being pursued to further evaluate this new colonoscopic technology. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Production of isotopically labeled standards from a uniformly labeled precursor for quantitative volatile metabolomic studies.

PubMed

Gómez-Cortés, Pilar; Brenna, J Thomas; Sacks, Gavin L

2012-06-19

Optimal accuracy and precision in small-molecule profiling by mass spectrometry generally requires isotopically labeled standards chemically representative of all compounds of interest. However, preparation of mixed standards from commercially available pure compounds is often prohibitively expensive and time-consuming, and many labeled compounds are not available in pure form. We used a single-prototype uniformly labeled [U-(13)C]compound to generate [U-(13)C]-labeled volatile standards for use in subsequent experimental profiling studies. [U-(13)C]-α-Linolenic acid (18:3n-3, ALA) was thermally oxidized to produce labeled lipid degradation volatiles which were subsequently characterized qualitatively and quantitatively. Twenty-five [U-(13)C]-labeled volatiles were identified by headspace solid-phase microextraction-gas chromatography/time-of-flight mass spectrometry (HS-SPME-GC/TOF-MS) by comparison of spectra with unlabeled volatiles. Labeled volatiles were quantified by a reverse isotope dilution procedure. Using the [U-(13)C]-labeled standards, limits of detection comparable to or better than those of previous HS-SPME reports were achieved, 0.010-1.04 ng/g. The performance of the [U-(13)C]-labeled volatile standards was evaluated using a commodity soybean oil (CSO) oxidized at 60 °C from 0 to 15 d. Relative responses of n-decane, an unlabeled internal standard otherwise absent from the mixture, and [U-(13)C]-labeled oxidation products changed by up to 8-fold as the CSO matrix was oxidized, demonstrating that reliance on a single standard in volatile profiling studies yields inaccurate results due to changing matrix effects. The [U-(13)C]-labeled standard mixture was used to quantify 25 volatiles in oxidized CSO and low-ALA soybean oil with an average relative standard deviation of 8.5%. Extension of this approach to other labeled substrates, e.g., [U-(13)C]-labeled sugars and amino acids, for profiling studies should be feasible and can dramatically improve quantitative results compared to use of a single standard.

An international collaboration to standardize HIV-2 viral load assays: results from the 2009 ACHI(E)V(2E) quality control study.

PubMed

Damond, F; Benard, A; Balotta, Claudia; Böni, Jürg; Cotten, Matthew; Duque, Vitor; Ferns, Bridget; Garson, Jeremy; Gomes, Perpetua; Gonçalves, Fátima; Gottlieb, Geoffrey; Kupfer, Bernd; Ruelle, Jean; Rodes, Berta; Soriano, Vicente; Wainberg, Mark; Taieb, Audrey; Matheron, Sophie; Chene, Genevieve; Brun-Vezinet, Francoise

2011-10-01

Accurate HIV-2 plasma viral load quantification is crucial for adequate HIV-2 patient management and for the proper conduct of clinical trials and international cohort collaborations. This study compared the homogeneity of HIV-2 RNA quantification when using HIV-2 assays from ACHI(E)V(2E) study sites and either in-house PCR calibration standards or common viral load standards supplied to all collaborators. Each of the 12 participating laboratories quantified blinded HIV-2 samples, using its own HIV-2 viral load assay and standard as well as centrally validated and distributed common HIV-2 group A and B standards (http://www.hiv.lanl.gov/content/sequence/HelpDocs/subtypes-more.html). Aliquots of HIV-2 group A and B strains, each at 2 theoretical concentrations (2.7 and 3.7 log(10) copies/ml), were tested. Intralaboratory, interlaboratory, and overall variances of quantification results obtained with both standards were compared using F tests. For HIV-2 group A quantifications, overall and interlaboratory and/or intralaboratory variances were significantly lower when using the common standard than when using in-house standards at the concentration levels of 2.7 log(10) copies/ml and 3.7 log(10) copies/ml, respectively. For HIV-2 group B, a high heterogeneity was observed and the variances did not differ according to the type of standard used. In this international collaboration, the use of a common standard improved the homogeneity of HIV-2 group A RNA quantification only. The diversity of HIV-2 group B, particularly in PCR primer-binding regions, may explain the heterogeneity in quantification of this strain. Development of a validated HIV-2 viral load assay that accurately quantifies distinct circulating strains is needed.

Promotion of early pediatric hearing detection through patient navigation: A randomized controlled clinical trial.

PubMed

Bush, Matthew L; Taylor, Zachary R; Noblitt, Bryce; Shackleford, Taylor; Gal, Thomas J; Shinn, Jennifer B; Creel, Liza M; Lester, Cathy; Westgate, Philip M; Jacobs, Julie A; Studts, Christina R

2017-11-01

To assess the efficacy of a patient navigator intervention to decrease nonadherence to obtain audiological testing following failed screening, compared to those receiving the standard of care. Using a randomized controlled design, guardian-infant dyads, in which the infants had abnormal newborn hearing screening, were recruited within the first week after birth. All participants were referred for definitive audiological diagnostic testing. Dyads were randomized into a patient navigator study arm or standard of care arm. The primary outcome was the percentage of patients with follow-up nonadherence to obtain diagnostic testing. Secondary outcomes were parental knowledge of infant hearing testing recommendations and barriers in obtaining follow-up testing. Sixty-one dyads were enrolled in the study (patient navigator arm = 27, standard of care arm = 34). The percentage of participants nonadherent to diagnostic follow-up during the first 6 months after birth was significantly lower in the patient navigator arm compared with the standard of care arm (7.4% vs. 38.2%) (P = .005). The timing of initial follow-up was significantly lower in the navigator arm compared with the standard of care arm (67.9 days after birth vs. 105.9 days, P = .010). Patient navigation increased baseline knowledge regarding infant hearing loss diagnosis recommendations compared with the standard of care (P = .004). Patient navigation decreases nonadherence rates following abnormal infant hearing screening and improves knowledge of follow-up recommendations. This intervention has the potential to improve the timeliness of delivery of infant hearing healthcare; future research is needed to assess the cost and feasibility of larger scale implementation. 1b. Laryngoscope, 127:S1-S13, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

A novel protocol for dispatcher assisted CPR improves CPR quality and motivation among rescuers-A randomized controlled simulation study.

PubMed

Rasmussen, Stinne Eika; Nebsbjerg, Mette Amalie; Krogh, Lise Qvirin; Bjørnshave, Katrine; Krogh, Kristian; Povlsen, Jonas Agerlund; Riddervold, Ingunn Skogstad; Grøfte, Thorbjørn; Kirkegaard, Hans; Løfgren, Bo

2017-01-01

Emergency dispatchers use protocols to instruct bystanders in cardiopulmonary resuscitation (CPR). Studies changing one element in the dispatcher's protocol report improved CPR quality. Whether several changes interact is unknown and the effect of combining multiple changes previously reported to improve CPR quality into one protocol remains to be investigated. We hypothesize that a novel dispatch protocol, combining multiple beneficial elements improves CPR quality compared with a standard protocol. A novel dispatch protocol was designed including wording on chest compressions, using a metronome, regular encouragements and a 10-s rest each minute. In a simulated cardiac arrest scenario, laypersons were randomized to perform single-rescuer CPR guided with the novel or the standard protocol. a composite endpoint of time to first compression, hand position, compression depth and rate and hands-off time (maximum score: 22 points). Afterwards participants answered a questionnaire evaluating the dispatcher assistance. The novel protocol (n=61) improved CPR quality score compared with the standard protocol (n=64) (mean (SD): 18.6 (1.4)) points vs. 17.5 (1.7) points, p<0.001. The novel protocol resulted in deeper chest compressions (mean (SD): 58 (12)mm vs. 52 (13)mm, p=0.02) and improved rate of correct hand position (61% vs. 36%, p=0.01) compared with the standard protocol. In both protocols hands-off time was short. The novel protocol improved motivation among rescuers compared with the standard protocol (p=0.002). Participants guided with a standard dispatch protocol performed high quality CPR. A novel bundle of care protocol improved CPR quality score and motivation among rescuers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparative study of anatomical normalization errors in SPM and 3D-SSP using digital brain phantom.

PubMed

Onishi, Hideo; Matsutake, Yuki; Kawashima, Hiroki; Matsutomo, Norikazu; Amijima, Hizuru

2011-01-01

In single photon emission computed tomography (SPECT) cerebral blood flow studies, two major algorithms are widely used statistical parametric mapping (SPM) and three-dimensional stereotactic surface projections (3D-SSP). The aim of this study is to compare an SPM algorithm-based easy Z score imaging system (eZIS) and a 3D-SSP system in the errors of anatomical standardization using 3D-digital brain phantom images. We developed a 3D-brain digital phantom based on MR images to simulate the effects of head tilt, perfusion defective region size, and count value reduction rate on the SPECT images. This digital phantom was used to compare the errors of anatomical standardization by the eZIS and the 3D-SSP algorithms. While the eZIS allowed accurate standardization of the images of the phantom simulating a head in rotation, lateroflexion, anteflexion, or retroflexion without angle dependency, the standardization by 3D-SSP was not accurate enough at approximately 25° or more head tilt. When the simulated head contained perfusion defective regions, one of the 3D-SSP images showed an error of 6.9% from the true value. Meanwhile, one of the eZIS images showed an error as large as 63.4%, revealing a significant underestimation. When required to evaluate regions with decreased perfusion due to such causes as hemodynamic cerebral ischemia, the 3D-SSP is desirable. In a statistical image analysis, we must reconfirm the image after anatomical standardization by all means.

Reviving common standards in point-count surveys for broad inference across studies

Treesearch

Steven M. Matsuoka; C. Lisa Mahon; Colleen M. Handel; Péter Sólymos; Erin M. Bayne; Patricia C. Fontaine; C. John Ralph

2014-01-01

We revisit the common standards recommended by Ralph et al. (1993, 1995a) for conducting point-count surveys to assess the relative abundance of landbirds breeding in North America. The standards originated from discussions among ornithologists in 1991 and were developed so that point-count survey data could be broadly compared and jointly analyzed by national data...

Comparing Sport Coaches' and Administrators' Perceptions of the National Standards for Sport Coaches

ERIC Educational Resources Information Center

Hedlund, David P.; Fletcher, Carol A.; Dahlin, Sean

2018-01-01

The purpose of this study was to examine perceptions of sport coaches and administrators regarding the eight domains and 40 standards contained in the National Standards for Sport Coaches (NSSC). Data were primarily obtained from junior high school, high school, and college-level sport coaches (n = 308) and sport administrators (n = 99) in the…

Contrasting recovery patterns of 2, 4-dinitrophenylhydrazones (DNPH) derivative of carbonyls between liquid and gas phase standards using HPLC-based analysis

NASA Astrophysics Data System (ADS)

Saha, Subbroto Kumar; Jo, Sang-Hee; Song, Hee-Nam; Brown, Richard J. C.; Kim, Ki-Hyun

2012-12-01

This study evaluates the relative recovery (RR) of five different carbonyls (CCs) (i.e., acetaldehyde, propionaldehyde, butyraldehyde, isovaleraldehyde, and valeraldehyde) following their reaction as 2, 4-dinitrophenylhydrazine (DNPH) derivatives when using gas phase and liquid phase standards. To this end, relative efficiency of CC-DNPH derivatization is compared between two liquid-phase standards (commercially available vs. lab made mixture) and between liquid and gas-phase standard. If the results are compared in terms of response factors (RF) derived for five carbonyls from all different standard phases, the recovery of gaseous CC standard was distinguished from that of liquid counterparts. The RR of the heavier carbonyls (propionaldehyde, butyraldehyde, isovaleraldehyde, and valeraldehyde) was approximately 60% low relative to their liquid counterparts; however, it was not the case for the lighter carbonyls (acetaldehyde) with the RR of ˜92%. This study thus suggests that the quantification of heavy carbonyls in ambient air, unless made by standards of the same matrix (i.e., gas phase) or compensated by the proper correction factor, may be subject to a large bias due to difference in derivatization reaction efficiency between matrix types. Hence, consideration of the matrix effect at the calibration stage is of particular importance to measure CC quantitatively.

How Principals Learn to Lead: The Comparative Influence of On-the-Job Experiences, Administrator Credential Programs, and the ISLLC Standards in the Development of Leadership Expertise among Urban Public School Principals

ERIC Educational Resources Information Center

Davis, Stephen H.; Leon, Ronald J.; Fultz, Miriam

2013-01-01

The purpose of this study was to examine the comparative influence of college administrator credential programs, on-the-job experiences, and the ISLLC Standards in the development of leadership expertise among urban public school principals. An exploratory, ex-post-facto research design used both quantitative and qualitative approaches. A survey…

Smartphone assessment of knee flexion compared to radiographic standards.

PubMed

Dietz, Matthew J; Sprando, Daniel; Hanselman, Andrew E; Regier, Michael D; Frye, Benjamin M

2017-03-01

Measuring knee range of motion (ROM) is an important assessment for the outcomes of total knee arthroplasty. Recent technological advances have led to the development and use of accelerometer-based smartphone applications to measure knee ROM. The purpose of this study was to develop, standardize, and validate methods of utilizing smartphone accelerometer technology compared to radiographic standards, visual estimation, and goniometric evaluation. Participants used visual estimation, a long-arm goniometer, and a smartphone accelerometer to determine range of motion of a cadaveric lower extremity; these results were compared to radiographs taken at the same angles. The optimal smartphone position was determined to be on top of the leg at the distal femur and proximal tibia location. Between methods, it was found that the smartphone and goniometer were comparably reliable in measuring knee flexion (ICC=0.94; 95% CI: 0.91-0.96). Visual estimation was found to be the least reliable method of measurement. The results suggested that the smartphone accelerometer was non-inferior when compared to the other measurement techniques, demonstrated similar deviations from radiographic standards, and did not appear to be influenced by the person performing the measurements or the girth of the extremity. Copyright © 2016 Elsevier B.V. All rights reserved.

Smartphone Assessment of Knee Flexion Compared to Radiographic Standards

PubMed Central

Dietz, Matthew J.; Sprando, Daniel; Hanselman, Andrew E.; Regier, Michael D.; Frye, Benjamin M.

2017-01-01

Purpose Measuring knee range of motion (ROM) is an important assessment for the outcomes of total knee arthroplasty. Recent technological advances have led to the development and use of accelerometer-based smartphone applications to measure knee ROM. The purpose of this study was to develop, standardize, and validate methods of utilizing smartphone accelerometer technology compared to radiographic standards, visual estimation, and goniometric evaluation. Methods Participants used visual estimation, a long-arm goniometer, and a smartphone accelerometer to determine range of motion of a cadaveric lower extremity; these results were compared to radiographs taken at the same angles. Results The optimal smartphone position was determined to be on top of the leg at the distal femur and proximal tibia location. Between methods, it was found that the smartphone and goniometer were comparably reliable in measuring knee flexion (ICC = 0.94; 95% CI: 0.91–0.96). Visual estimation was found to be the least reliable method of measurement. Conclusions The results suggested that the smartphone accelerometer was non-inferior when compared to the other measurement techniques, demonstrated similar deviations from radiographic standards, and did not appear to be influenced by the person performing the measurements or the girth of the extremity. PMID:28179062

Student Competence in Understanding the Matter Concept and Its Implications for Science Curriculum Standards

ERIC Educational Resources Information Center

Liu, Xiufeng

2006-01-01

Using the US national sample from the 1995 Third International Mathematics and Science Study (TIMSS), this study examined students' competence levels in understanding the matter concept at grades 3, 4, 7, 8 and high school graduation, and compared them to the expectations in the US national science education standards. It was found that…

The Real-Life-Referent as a Standard for News Perspective Bias.

ERIC Educational Resources Information Center

Barbatsis, Gretchen S.

The concept of news perspective bias necessitates the creation of an empirical standard by which to judge that bias. A study defined and tested a real life referent applicable to planned, sustained news events that have identifiable and accessible participants. The study compared the television news coverage of court ordered busing to achieve…

Beliefs about the NCTM Standards of Special Educators of Students with Emotional Disturbance

ERIC Educational Resources Information Center

Floyd, Carlyn; Rice, Elisabeth Hess

2009-01-01

This study examined the beliefs of individuals providing the mathematics instruction to elementary students with ED in a self-contained setting as compared to general educators in the same school. The study also attempted to determine the factors that influence beliefs of the NCTM Standards. Through analyzing teachers' beliefs of the NCTM…

Use of telemedicine in the remote programming of cochlear implants.

PubMed

Ramos, Angel; Rodriguez, Carina; Martinez-Beneyto, Paz; Perez, Daniel; Gault, Alexandre; Falcon, Juan Carlos; Boyle, Patrick

2009-05-01

Remote cochlear implant (CI) programming is a viable, safe, user-friendly and cost-effective procedure, equivalent to standard programming in terms of efficacy and user's perception, which can complement the standard procedures. The potential benefits of this technique are outlined. We assessed the technical viability, risks and difficulties of remote CI programming; and evaluated the benefits for the user comparing the standard on-site CI programming versus the remote CI programming. The Remote Programming System (RPS) basically consists of completing the habitual programming protocol in a regular CI centre, assisted by local staff, although guided by a remote expert, who programs the CI device using a remote programming station that takes control of the local station through the Internet. A randomized prospective study has been designed with the appropriate controls comparing RPS to the standard on-site CI programming. Study subjects were implanted adults with a HiRes 90K(R) CI with post-lingual onset of profound deafness and 4-12 weeks of device use. Subjects underwent two daily CI programming sessions either remote or standard, on 4 programming days separated by 3 month intervals. A total of 12 remote and 12 standard sessions were completed. To compare both CI programming modes we analysed: program parameters, subjects' auditory progress, subjects' perceptions of the CI programming sessions, and technical aspects, risks and difficulties of remote CI programming. Control of the local station from the remote station was carried out successfully and remote programming sessions were achieved completely and without incidents. Remote and standard program parameters were compared and no significant differences were found between the groups. The performance evaluated in subjects who had been using either standard or remote programs for 3 months showed no significant difference. Subjects were satisfied with both the remote and standard sessions. Safety was proven by checking emergency stops in different conditions. A very small delay was noticed that did not affect the ease of the fitting. The oral and video communication between the local and the remote equipment was established without difficulties and was of high quality.

Injury Rates in Age-Only Versus Age-and-Weight Playing Standard Conditions in American Youth Football

PubMed Central

Kerr, Zachary Y.; Marshall, Stephen W.; Simon, Janet E.; Hayden, Ross; Snook, Erin M.; Dodge, Thomas; Gallo, Joseph A.; Valovich McLeod, Tamara C.; Mensch, James; Murphy, Joseph M.; Nittoli, Vincent C.; Dompier, Thomas P.; Ragan, Brian; Yeargin, Susan W.; Parsons, John T.

2015-01-01

Background: American youth football leagues are typically structured using either age-only (AO) or age-and-weight (AW) playing standard conditions. These playing standard conditions group players by age in the former condition and by a combination of age and weight in the latter condition. However, no study has systematically compared injury risk between these 2 playing standards. Purpose: To compare injury rates between youth tackle football players in the AO and AW playing standard conditions. Study Design: Cohort study; Level of evidence, 2. Methods: Athletic trainers evaluated and recorded injuries at each practice and game during the 2012 and 2013 football seasons. Players (age, 5-14 years) were drawn from 13 recreational leagues across 6 states. The sample included 4092 athlete-seasons (AW, 2065; AO, 2027) from 210 teams (AW, 106; O, 104). Injury rate ratios (RRs) with 95% CIs were used to compare the playing standard conditions. Multivariate Poisson regression was used to estimate RRs adjusted for residual effects of age and clustering by team and league. There were 4 endpoints of interest: (1) any injury, (2) non–time loss (NTL) injuries only, (3) time loss (TL) injuries only, and (4) concussions only. Results: Over 2 seasons, the cohort accumulated 1475 injuries and 142,536 athlete-exposures (AEs). The most common injuries were contusions (34.4%), ligament sprains (16.3%), concussions (9.6%), and muscle strains (7.8%). The overall injury rate for both playing standard conditions combined was 10.3 per 1000 AEs (95% CI, 9.8-10.9). The TL injury, NTL injury, and concussion rates in both playing standard conditions combined were 3.1, 7.2, and 1.0 per 1000 AEs, respectively. In multivariate Poisson regression models controlling for age, team, and league, no differences were found between playing standard conditions in the overall injury rate (RRoverall, 1.1; 95% CI, 0.4-2.6). Rates for the other 3 endpoints were also similar (RRNTL, 1.1 [95% CI, 0.4-3.0]; RRTL, 0.9 [95% CI, 0.4-1.9]; RRconcussion, 0.6 [95% CI, 0.3-1.4]). Conclusion: For the injury endpoints examined in this study, the injury rates were similar in the AO and AW playing standards. Future research should examine other policies, rules, and behavioral factors that may affect injury risk within youth football. PMID:26672778

Project RED Impacts Patient Experience.

PubMed

Cancino, Ramon S; Manasseh, Chris; Kwong, Lana; Mitchell, Suzanne E; Martin, Jessica; Jack, Brian W

2017-12-01

Hospitalized patients are frequently unprepared to care for themselves after discharge often leading to unplanned hospital readmission. One strategy to reduce readmission rates is improving the quality of patient education and preparation before hospital discharge. The ReEngineered Discharge (RED) is a standardized hospital-based program designed to provide patients and caregivers the information they need to continue care at home. We sought to study the impact of the RED intervention on posthospitalization adult patient experience scores in an urban academic safety-net hospital. We conducted a descriptive study of a pilot program that compared posthospitalization survey responses to the Press Ganey survey item "Instructions were given about how to care for yourself at home." We compared the survey results for 3 groups of adult patients: those receiving the RED program, those receiving a standard discharge on the same hospital unit, and those receiving a standard discharge on other hospital units. A greater percentage of adult patients who received the RED discharge program rated the quality of their discharge as "very good" as compared to those receiving a standard discharge on the same hospital unit and those receiving a standard discharge on other hospital units (61%, 35%, and 41%, respectively, P = .0001). Delivery of a standardized hospital discharge program resulted in a larger proportion of top-box "very good" responses on a Press Ganey posthospitalization survey. Future research should examine whether hospital-based transition programs can sustain improvement in patient experience measures and whether these improvements can be observed in other patient populations.

Estimation of Tooth Size Discrepancies among Different Malocclusion Groups.

PubMed

Hasija, Narender; Bala, Madhu; Goyal, Virender

2014-05-01

Regards and Tribute: Late Dr Narender Hasija was a mentor and visionary in the light of knowledge and experience. We pay our regards with deepest gratitude to the departed soul to rest in peace. Bolton's ratios help in estimating overbite, overjet relationships, the effects of contemplated extractions on posterior occlusion, incisor relationships and identification of occlusal misfit produced by tooth size discrepancies. To determine any difference in tooth size discrepancy in anterior as well as overall ratio in different malocclusions and comparison with Bolton's study. After measuring the teeth on all 100 patients, Bolton's analysis was performed. Results were compared with Bolton's means and standard deviations. The results were also subjected to statistical analysis. Results show that the mean and standard deviations of ideal occlusion cases are comparable with those Bolton but, when the mean and standard deviation of malocclusion groups are compared with those of Bolton, the values of standard deviation are higher, though the mean is comparable. How to cite this article: Hasija N, Bala M, Goyal V. Estimation of Tooth Size Discrepancies among Different Malocclusion Groups. Int J Clin Pediatr Dent 2014;7(2):82-85.

Economic evaluation of smoke alarm distribution methods in Baltimore, Maryland.

PubMed

Diamond-Smith, Nadia; Bishai, David; Perry, Elise; Shields, Wendy; Gielen, Andrea

2014-08-01

This paper analyses costs and potential lives saved from a door-to-door smoke alarm distribution programme using data from a programme run by the Baltimore City Fire Department in 2010-2011. We evaluate the impact of a standard home visit programme and an enhanced home visit programme that includes having community health workers provide advance notice, promote the programme, and accompany fire department personnel on the day of the home visit, compared with each other and with an option of not having a home visit programme (control). Study data show that the home visit programme increased by 10% the number of homes that went from having no working alarm to having any working alarm, and the enhanced programme added an additional 1% to the number of homes protected. We use published reports on the relative risk of death in homes with and without a working smoke alarm to show that the standard programme would save an additional 0.24 lives per 10,000 homes over 10 years, compared with control areas and the enhanced home visit programme saved an additional 0.07 lives compared with the standard programme. The incremental cost of each life saved for the standard programme compared with control was $28,252 per death averted and $284,501per additional death averted for the enhanced compared with the standard. Following the US guidelines for the value of a life, both programmes are cost effective, however, the standard programme may offer a better value in terms of dollars per death averted. The study also highlights the need for better data on the benefits of current smoke alarm recommendations and their impact on injury, death and property damage. 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.

A room with a viewpoint revisited: descriptive norms and hotel guests' towel reuse behavior.

PubMed

Bohner, Gerd; Schlüter, Lena E

2014-01-01

Field experiments on descriptive norms as a means to increase hotel guests' towel reuse [1] were replicated and extended. In two hotels in Germany (Study 1: N = 724; Study 2: N = 204), descriptive norm messages suggesting that 75% of guests had reused their towels, or a standard message appealing to environmental concerns, were placed in guests' bathrooms. Descriptive norm messages varied in terms of proximity of the reference group ("hotel guests" vs. "guests in this room") and temporal proximity (currently vs. two years previous). Reuse of towels was unobtrusively recorded. Results showed that reuse rates were high overall and that both standard and descriptive norm messages increased reuse rates compared to a no-message baseline. However, descriptive norm messages were not more effective than the standard message, and effects of proximity were inconsistent across studies. Discussion addresses cultural and conceptual issues in comparing the present findings with previous ones.

QUENCH STUDIES AND PREHEATING ANALYSIS OF SEAMLESS

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

Palczewski, Ari; Geng, Rongli; Eremeev, Grigory

One of the alternative manufacturing technologies for SRF cavities is hydroforming from seamless tubes. Although this technology has produced cavities with gradient and Q-values comparable to standard EBW/EP cavities, a few questions remain. One of these questions is whether the quench mechanism in hydroformed cavities is the same as in standard electron beam welded cavities. Towards this effort Jefferson Lab performed quench studies on 2 9 cell seamless hydroformed cavities. These cavities include DESY's - Z163 and Z164 nine-cell cavities hydroformed at DESY. Initial Rf test results Z163 were published in SRF2011. In this report we will present post JLABmore » surface re-treatment quench studies for each cavity. The data will include OST and T-mapping quench localization as well as quench location preheating analysis comparing them to the observations in standard electron beam welded cavities.« less

Validation of the international labour office digitized standard images for recognition and classification of radiographs of pneumoconiosis.

PubMed

Halldin, Cara N; Petsonk, Edward L; Laney, A Scott

2014-03-01

Chest radiographs are recommended for prevention and detection of pneumoconiosis. In 2011, the International Labour Office (ILO) released a revision of the International Classification of Radiographs of Pneumoconioses that included a digitized standard images set. The present study compared results of classifications of digital chest images performed using the new ILO 2011 digitized standard images to classification approaches used in the past. Underground coal miners (N = 172) were examined using both digital and film-screen radiography (FSR) on the same day. Seven National Institute for Occupational Safety and Health-certified B Readers independently classified all 172 digital radiographs, once using the ILO 2011 digitized standard images (DRILO2011-D) and once using digitized standard images used in the previous research (DRRES). The same seven B Readers classified all the miners' chest films using the ILO film-based standards. Agreement between classifications of FSR and digital radiography was identical, using a standard image set (either DRILO2011-D or DRRES). The overall weighted κ value was 0.58. Some specific differences in the results were seen and noted. However, intrareader variability in this study was similar to the published values and did not appear to be affected by the use of the new ILO 2011 digitized standard images. These findings validate the use of the ILO digitized standard images for classification of small pneumoconiotic opacities. When digital chest radiographs are obtained and displayed appropriately, results of pneumoconiosis classifications using the 2011 ILO digitized standards are comparable to film-based ILO classifications and to classifications using earlier research standards. Published by Elsevier Inc.

Hydrophobic Characteristics of Composite Insulators in Simulated Inland Arid Desert Environment

NASA Astrophysics Data System (ADS)

Khan, Yasin; Al-Arainy, Abdulrehman Ali; Malik, Nazar Hussain; Qureshi, Muhammad Iqbal

2010-06-01

Presently along with traditional insulators i.e. glass and porcelain, etc., the polymeric insulators are also used world widely. These polymeric insulators are very sensitive to various environmental parameters e.g. UV radiations, heat, etc. The UV radiation level in the central region of Saudi Arabia is high as compared to the recommended IEC-61109 standard for the accelerated aging of the composite insulators. In this study, thermoplastic elastomer (TPE) and Ethylene Propylene Diene Monomer (EPDM) insulators were subjected to accelerated aging stress as per IEC standard as well as modified IEC standard simulating the inland arid desert's atmospheric conditions. The hydrophobic characteristics were studied by measuring the contact angle along the insulator surface before and after the accelerated aging of the samples. It was found that TPE loses its hydrophobic properties more as compared to EPDM insulator. This loss was proportional to the intensity of UV irradiation. The rate of recovery is also low for both the tested materials as compared to Silicone Rubber insulators.

A prospective randomised study comparing the jubilee dressing method to a standard adhesive dressing for total hip and knee replacements.

PubMed

Burke, Neil G; Green, Connor; McHugh, Gavin; McGolderick, Niall; Kilcoyne, Carol; Kenny, Patrick

2012-08-01

It is important to reduce potential wound complications in total hip and total knee arthroplasty procedures. The purpose of this study was to compare the jubilee dressing method to a standard adhesive dressing. 124 patients (62 total hip replacements and 62 total knee replacements) were randomly selected to have either a standard adhesive dressing or jubilee method dressing. The number of dressing changes, incidence of blistering, leakage, appearance of inflammation, infection rate and the average stay in hospital was recorded for each patient. The jubilee dressing significantly reduced the rate of blistering, leakage and number of dressing changes when compare to a traditional adhesive dressing (p < 0.05). The rate of inflammation and average length of stay in hospital was not significantly different between the two groups. The authors recommend the use of this dressing for total hip and total knee arthroplasty procedures due to the associated lower complication rate. Copyright © 2012 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

HYDROPHOBIC CHARACTERISTICS OF COMPOSITE INSULATORS IN SIMULATED INLAND ARID DESERT ENVIRONMENT

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

Khan, Yasin; Al-Arainy, Abdulrehman Ali; Malik, Nazar Hussain

2010-06-15

Presently along with traditional insulators i.e. glass and porcelain, etc., the polymeric insulators are also used world widely. These polymeric insulators are very sensitive to various environmental parameters e.g. UV radiations, heat, etc. The UV radiation level in the central region of Saudi Arabia is high as compared to the recommended IEC-61109 standard for the accelerated aging of the composite insulators. In this study, thermoplastic elastomer (TPE) and Ethylene Propylene Diene Monomer (EPDM) insulators were subjected to accelerated aging stress as per IEC standard as well as modified IEC standard simulating the inland arid desert's atmospheric conditions. The hydrophobic characteristicsmore » were studied by measuring the contact angle along the insulator surface before and after the accelerated aging of the samples. It was found that TPE loses its hydrophobic properties more as compared to EPDM insulator. This loss was proportional to the intensity of UV irradiation. The rate of recovery is also low for both the tested materials as compared to Silicone Rubber insulators.« less

Environmental Assessment of the Muscatatuck Urban Training Center near Butlerville, Indiana, October and November 2005

USGS Publications Warehouse

Risch, Martin R.; Ulberg, Amanda L.; Robinson, Bret A.

2007-01-01

Concentrations of constituents detected in these samples were compared with regulatory standards (the Indiana Surface-Water-Quality Standards and Indiana Ground-Water-Quality Standards) and guidance criteria from the Indiana Department of Environmental Management's Risk Integrated System of Closures for contaminated soil and ground water. Standards or criteria were exceeded by 17 constituent concentrations in 11 environmental samples from 5 of the 7 geographic study areas. Standards or criteria were exceeded for 10 constituents: ammonia, arsenic, benzo(a)pyrene, beryllium, chloride, chloroform, copper, lead, sulfate, and zinc.

[Comparison and Discussion of National/Military Standards Related to Flow Measurement of Medical Injection Pump].

PubMed

Zhang, Nan; Zhou, Juan; Yu, Jinlai; Hua, Ziyu; Li, Yongxue; Wu, Jiangang

2018-05-30

Medical injection pump is a commonly used clinical equipment with high risk. Accurate detection of flow is an important aspect to ensure its reliable operation. In this paper, we carefully studied and analyzed the flow detection methods of three standards being used in medical injection pump detection in our country. The three standards were compared from the aspects of standard device, flow test point selection, length of test time and accuracy judgment. The advantages and disadvantages of these standards were analyzed and suggestions for improvement were put forward.

Elemental Diets May Reduce the Risk of Aspiration Pneumonia in Bedridden Gastrostomy-Fed Patients

PubMed Central

Horiuchi, Akira; Nakayama, Yoshiko; Sakai, Ryosei; Suzuki, Manabu; Kajiyama, Masashi; Tanaka, Naoki

2013-01-01

OBJECTIVES: Our clinical experience suggested that elemental diets were associated with a reduction in aspiration pneumonia among bedridden patients with percutaneous endoscopic gastrostomy (PEG). We compared the effects of elemental and standard liquid diets on the risk of clinical aspiration pneumonia and gastric emptying in bedridden patients receiving PEG feedings. METHODS: Study 1: consecutive bedridden PEG patients received elemental diets or standard liquid diets in the same fashion. The frequency of defecation, diet aspirated from the trachea, and aspiration pneumonia during hospitalization were prospectively recorded. Study 2: a randomized, crossover trial using elemental or standard liquid diets containing 13C sodium acetate as a tracer given to bedridden PEG patients who had experienced aspiration pneumonia. 13C breath tests were performed to estimate gastric emptying. RESULTS: Study 1: 127 patients were enrolled, 60 with elemental and 67 with standard liquid diets. The diet was aspirated from the trachea in none (0%) with the elemental diet vs. 8 (11.9%) with standard liquid diets (P=0.0057); aspiration pneumonia developed none with the elemental diet vs. 5 (7.5%) with standard liquid diets (P=0.031) (number needed to treat 14, 95% confidence interval 7–85). Study 2: 19 patients were enrolled. The elemental diet was associated with a significant increase in the 10, 30 or 50% emptying (excretion) time (P<0.001) and increased the area under the curve (% dose/h) compared with the standard liquid diet (P<0.05). CONCLUSIONS: Elemental diets were associated with more rapid gastric empting and fewer episodes of aspiration than standard liquid diets in bedridden PEG patients. They may be preferred for bedridden PEG patients especially who have experienced aspiration pneumonia. Properly performed randomized-controlled trials are needed to prove this potential benefit. PMID:23399554

Elemental diets may reduce the risk of aspiration pneumonia in bedridden gastrostomy-fed patients.

PubMed

Horiuchi, Akira; Nakayama, Yoshiko; Sakai, Ryosei; Suzuki, Manabu; Kajiyama, Masashi; Tanaka, Naoki

2013-05-01

Our clinical experience suggested that elemental diets were associated with a reduction in aspiration pneumonia among bedridden patients with percutaneous endoscopic gastrostomy (PEG). We compared the effects of elemental and standard liquid diets on the risk of clinical aspiration pneumonia and gastric emptying in bedridden patients receiving PEG feedings. Study 1: consecutive bedridden PEG patients received elemental diets or standard liquid diets in the same fashion. The frequency of defecation, diet aspirated from the trachea, and aspiration pneumonia during hospitalization were prospectively recorded. Study 2: a randomized, crossover trial using elemental or standard liquid diets containing (13)C sodium acetate as a tracer given to bedridden PEG patients who had experienced aspiration pneumonia. (13)C breath tests were performed to estimate gastric emptying. Study 1: 127 patients were enrolled, 60 with elemental and 67 with standard liquid diets. The diet was aspirated from the trachea in none (0%) with the elemental diet vs. 8 (11.9%) with standard liquid diets (P=0.0057); aspiration pneumonia developed none with the elemental diet vs. 5 (7.5%) with standard liquid diets (P=0.031) (number needed to treat 14, 95% confidence interval 7-85). Study 2: 19 patients were enrolled. The elemental diet was associated with a significant increase in the 10, 30 or 50% emptying (excretion) time (P<0.001) and increased the area under the curve (% dose/h) compared with the standard liquid diet (P<0.05). Elemental diets were associated with more rapid gastric empting and fewer episodes of aspiration than standard liquid diets in bedridden PEG patients. They may be preferred for bedridden PEG patients especially who have experienced aspiration pneumonia. Properly performed randomized-controlled trials are needed to prove this potential benefit.

Accelerated rehabilitation compared with a standard protocol after distal radial fractures treated with volar open reduction and internal fixation: a prospective, randomized, controlled study.

PubMed

Brehmer, Jess L; Husband, Jeffrey B

2014-10-01

There are relatively few studies in the literature that specifically evaluate accelerated rehabilitation protocols for distal radial fractures treated with open reduction and internal fixation (ORIF). The purpose of this study was to compare the early postoperative outcomes (at zero to twelve weeks postoperatively) of patients enrolled in an accelerated rehabilitation protocol with those of patients enrolled in a standard rehabilitation protocol following ORIF for a distal radial fracture. We hypothesized that patients with accelerated rehabilitation after volar ORIF for a distal radial fracture would have an earlier return to function compared with patients who followed a standard protocol. From November 2007 to November 2010, eighty-one patients with an unstable distal radial fracture were prospectively randomized to follow either an accelerated or a standard rehabilitation protocol after undergoing ORIF with a volar plate for a distal radial fracture. Both groups began with gentle active range of motion at three to five days postoperatively. At two weeks, the accelerated group initiated wrist/forearm passive range of motion and strengthening exercises, whereas the standard group initiated passive range of motion and strengthening at six weeks postoperatively. Patients were assessed at three to five days, two weeks, three weeks, four weeks, six weeks, eight weeks, twelve weeks, and six months postoperatively. Outcomes included Disabilities of the Arm, Shoulder and Hand (DASH) scores (primary outcome) and measurements of wrist flexion/extension, supination, pronation, grip strength, and palmar pinch. The patients in the accelerated group had better mobility, strength, and DASH scores at the early postoperative time points (zero to eight weeks postoperatively) compared with the patients in the standard rehabilitation group. The difference between the groups was both clinically relevant and statistically significant. Patients who follow an accelerated rehabilitation protocol that emphasizes motion immediately postoperatively and initiates strengthening at two weeks after volar ORIF of a distal radial fracture have an earlier return to function than patients who follow a more standard rehabilitation protocol. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Comparative Economics Systems in the Undergraduate Curriculum: An Update

ERIC Educational Resources Information Center

Kovzik, Alexander; Johnson, Marianne

2016-01-01

In this study, the authors report on the status of comparative economics systems in the U.S. undergraduate economics curriculum. The treatment of comparative economics systems topics in introductory courses is examined through a survey of standard textbooks. To evaluate comparative economics systems at the advanced undergraduate level, they rely…

Comparative Effectiveness of Standard versus Patient-Centered Collaborative Care Interventions for Depression among African Americans in Primary Care Settings: The BRIDGE Study

PubMed Central

Cooper, Lisa A; Ghods Dinoso, Bri K; Ford, Daniel E; Roter, Debra L; Primm, Annelle B; Larson, Susan M; Gill, James M; Noronha, Gary J; Shaya, Elias K; Wang, Nae-Yuh

2013-01-01

Objective To compare the effectiveness of standard and patient-centered, culturally tailored collaborative care (CC) interventions for African American patients with major depressive disorder (MDD) over 12 months of follow-up. Data Sources/Study Setting Twenty-seven primary care clinicians and 132 African American patients with MDD in urban community-based practices in Maryland and Delaware. Study Design Cluster randomized trial with patient-level, intent-to-treat analyses. Data Collection/Extraction Methods Patients completed screener and baseline, 6-, 12-, and 18-month interviews to assess depression severity, mental health functioning, health service utilization, and patient ratings of care. Principal Findings Patients in both interventions showed statistically significant improvements over 12 months. Compared with standard, patient-centered CC patients had similar reductions in depression symptom levels (−2.41 points; 95 percent confidence interval (CI), −7.7, 2.9), improvement in mental health functioning scores (+3.0 points; 95 percent CI, −2.2, 8.3), and odds of rating their clinician as participatory (OR, 1.48, 95 percent CI, 0.53, 4.17). Treatment rates increased among standard (OR = 1.8, 95 percent CI 1.0, 3.2), but not patient-centered (OR = 1.0, 95 percent CI 0.6, 1.8) CC patients. However, patient-centered CC patients rated their care manager as more helpful at identifying their concerns (OR, 3.00; 95 percent CI, 1.23, 7.30) and helping them adhere to treatment (OR, 2.60; 95 percent CI, 1.11, 6.08). Conclusions Patient-centered and standard CC approaches to depression care showed similar improvements in clinical outcomes for African Americans with depression; standard CC resulted in higher rates of treatment, and patient-centered CC resulted in better ratings of care. PMID:22716199

Comparison of Robotic Pyeloplasty and Standard Laparoscopic Pyeloplasty in Infants: A Bi-Institutional Study.

PubMed

Neheman, Amos; Kord, Eyal; Zisman, Amnon; Darawsha, Abd Elhalim; Noh, Paul H

2018-04-01

To compare outcomes between robotic pyeloplasty (RP) and standard laparoscopic pyeloplasty (LP) in the infant population for the treatment of ureteropelvic junction (UPJ) obstruction. We performed a retrospective cohort study of all children under 1 year of age who underwent RP or LP at two different medical centers between October 2009 and February 2016. Patient demographics, perioperative data, complications, and results were reviewed. Thirteen patients underwent standard LP, and 21 patients underwent RP during the study period. Median age and median weight at time of operation for the whole cohort were 6.1 months and 7.9 kg. Surgery success rates were similar with 95% and 92% in RP and LP, respectively. There was no statistically significant difference in operating time between the 2 groups, with a median time of 156 minutes in RP (range 125-249) and 192 minutes (range 98-229) in standard LP (P = .35). Median length of hospital stay was significantly shorter in the robotic group with a median stay of 1 day (range 1-3) and 7 days (range 7-12) in the standard LP group.(P < .0001) Drains or nephrostomy tubes were used more often in the laparoscopic group (100%, 13/13) as opposed to RP (9.5%, 2/21, P < .0001) There was a comparable complication rate between the 2 groups, 30.8% for LP and 23.8% for RP (P = .65). The minimally invasive dismembered pyeloplasty is safe and effective in the infant population and produces high success rates. The results, complication rates, and operative time were comparable between the two surgical methods while the standard LP demonstrated longer hospital stay. Both the robotic approach and the LP can be successfully utilized for the benefit of infants with UPJ obstruction.

Hypothesis Testing Using Factor Score Regression

PubMed Central

Devlieger, Ines; Mayer, Axel; Rosseel, Yves

2015-01-01

In this article, an overview is given of four methods to perform factor score regression (FSR), namely regression FSR, Bartlett FSR, the bias avoiding method of Skrondal and Laake, and the bias correcting method of Croon. The bias correcting method is extended to include a reliable standard error. The four methods are compared with each other and with structural equation modeling (SEM) by using analytic calculations and two Monte Carlo simulation studies to examine their finite sample characteristics. Several performance criteria are used, such as the bias using the unstandardized and standardized parameterization, efficiency, mean square error, standard error bias, type I error rate, and power. The results show that the bias correcting method, with the newly developed standard error, is the only suitable alternative for SEM. While it has a higher standard error bias than SEM, it has a comparable bias, efficiency, mean square error, power, and type I error rate. PMID:29795886

Comparison of Standards and Technical Requirements of Grid-Connected Wind Power Plants in China and the United States

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

Gao, David Wenzhong; Muljadi, Eduard; Tian, Tian

The rapid deployment of wind power has made grid integration and operational issues focal points in industry discussions and research. Compliance with grid connection standards for wind power plants (WPPs) is crucial to ensuring the reliable and stable operation of the electric power grid. This report compares the standards for grid-connected WPPs in China to those in the United States to facilitate further improvements in wind power standards and enhance the development of wind power equipment. Detailed analyses of power quality, low-voltage ride-through capability, active power control, reactive power control, voltage control, and wind power forecasting are provided to enhancemore » the understanding of grid codes in the two largest markets of wind power. This study compares WPP interconnection standards and technical requirements in China to those in the United States.« less

The Role of Standardized and Study-specific Human Brain Diffusion Tensor Templates in Inter-subject Spatial Normalization

PubMed Central

Zhang, Shengwei; Arfanakis, Konstantinos

2012-01-01

Purpose To investigate the effect of standardized and study-specific human brain diffusion tensor templates on the accuracy of spatial normalization, without ignoring the important roles of data quality and registration algorithm effectiveness. Materials and Methods Two groups of diffusion tensor imaging (DTI) datasets, with and without visible artifacts, were normalized to two standardized diffusion tensor templates (IIT2, ICBM81) as well as study-specific templates, using three registration approaches. The accuracy of inter-subject spatial normalization was compared across templates, using the most effective registration technique for each template and group of data. Results It was demonstrated that, for DTI data with visible artifacts, the study-specific template resulted in significantly higher spatial normalization accuracy than standardized templates. However, for data without visible artifacts, the study-specific template and the standardized template of higher quality (IIT2) resulted in similar normalization accuracy. Conclusion For DTI data with visible artifacts, a carefully constructed study-specific template may achieve higher normalization accuracy than that of standardized templates. However, as DTI data quality improves, a high-quality standardized template may be more advantageous than a study-specific template, since in addition to high normalization accuracy, it provides a standard reference across studies, as well as automated localization/segmentation when accompanied by anatomical labels. PMID:23034880

Innovative Multimodal Physical Therapy Reduces Incidence of Repeat Manipulation under Anesthesia in Post-Total Knee Arthroplasty Patients Who Had an Initial Manipulation under Anesthesia.

PubMed

Chughtai, Morad; McGinn, Tanner; Bhave, Anil; Khan, Sabahat; Vashist, Megha; Khlopas, Anton; Mont, Michael A

2016-11-01

Manipulation under anesthesia (MUA) is performed for knee stiffness following a total knee arthroplasty (TKA) when nonoperative treatments fail. It is important to develop an optimal outpatient physical therapy protocol following an MUA, to avoid a repeat procedure. The purpose of this study was to evaluate and compare: (1) range of motion and (2) the rate of repeat MUA in patients who either underwent innovative multimodal physical therapy (IMMPT) or standard-of-care physical therapy (standard) following an MUA after a TKA. We performed a retrospective database study of patients who underwent an MUA following a TKA between January 2013 to December 2014 ( N  = 57). There were 16 (28%) men and 41 (72%) women who had a mean age of 59 years (range, 32-81 years). The patients were stratified into those who underwent IMMPT ( n  = 22) and those who underwent standard physical therapy ( n  = 35). The 6-month range of motion and rate of repeat manipulation between the two cohorts was analyzed by using Student t-test and Chi-square tests. In addition, we performed a Kaplan-Meier analysis of time to repeat MUA. The IMMPT cohort had a statistically significant higher proportion of TKAs with an optimal range of motion as compared with the standard cohort. There was statistically significant lower proportion of patients who underwent a repeat MUA in the IMMPT as compared with the standard cohort. There was also a significantly lower incidence and longer time to MUA in the IMMPT cohort as compared with the standard cohort in the Kaplan-Meier analysis. The group who underwent IMMPT utilizing Astym therapy had a significantly higher proportion of patients with optimal range of motion, which implies the potential efficacy of this regimen to improve range of motion. Furthermore, the IMMPT cohort had a significantly lower proportion of repeat manipulations as compared with the standard cohort, which implies that an IMMPT approach could potentially reduce the need for a repeat MUA. These findings warrant further investigation into outcomes of different rehab approaches. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Driving performance and driver discomfort in an elevated and standard driving position during a driving simulation.

PubMed

Smith, Jordan; Mansfield, Neil; Gyi, Diane; Pagett, Mark; Bateman, Bob

2015-07-01

The primary purposes of a vehicle driver's seat, is to allow them to complete the driving task comfortably and safely. Within each class of vehicle (e.g. passenger, commercial, industrial, agricultural), there is an expected driving position to which a vehicle cabin is designed. This paper reports a study that compares two driving positions, in relation to Light Commercial Vehicles (LCVs), in terms of driver performance and driver discomfort. In the 'elevated' driving position, the seat is higher than usually used in road vehicles; this is compared to a standard driving position replicating the layout for a commercially available vehicle. It is shown that for a sample of 12 drivers, the elevated position did not, in general, show more discomfort than the standard position over a 60 min driving simulation, although discomfort increased with duration. There were no adverse effects shown for emergency stop reaction time or for driver headway for the elevated posture compared to the standard posture. The only body part that showed greater discomfort for the elevated posture compared to the standard posture was the right ankle. A second experiment confirmed that for 12 subjects, a higher pedal stiffness eliminated the ankle discomfort problem. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

High preservation of DNA standards diluted in 50% glycerol.

PubMed

Schaudien, Dirk; Baumgärtner, Wolfgang; Herden, Christiane

2007-09-01

Standard curves are important tools in real-time quantitative polymerase chain reaction (PCR) to precisely analyze gene expression patterns under physiologic and pathologic conditions. Handling of DNA standards often implies multiple cycles of freezing and thawing that might affect DNA stability and integrity. This in turn might influence the reliability and reproducibility of quantitative measurements in real-time PCR assays. In this study, 3 DNA standards such as murine tumor necrosis factor (TNF) alpha, interferon (IFN) gamma, and kainat-1 receptor were diluted in 50% glycerol or water after 1, 4, and 16 cycles of freezing and thawing and amplified copy numbers after real-time PCR were compared. The standards diluted in water showed a reduction to 83%, 55%, and 50% after 4 cycles, to 24%, 5%, and 4% after 16 cycles for kainat-1 receptor, TNFalpha, and IFNgamma standards, respectively, when compared with a single cycle of freezing and thawing. Interestingly, all cDNA samples diluted in 50% glycerol were amplified in comparable copy numbers even after 16 cycles of freezing and thawing. The effect of the standards undergoing different cycles of freezing and thawing on sample values was demonstrated by amplifying cDNA obtained from Borna disease virus infected and noninfected TNF-transgenic mice brain. This revealed significant differences of measured cDNA copy numbers using water-diluted DNA standards. In contrast, sample values did not vary using glycerol-diluted standards that were frozen and thawed for 16 times. In conclusion, glycerol storage of DNA standards represents a suitable tool for the accurate and reproducible quantification of cDNA samples in real-time PCR analysis.

Treating Depression during Pregnancy and the Postpartum: A Preliminary Meta-Analysis

ERIC Educational Resources Information Center

Bledsoe, Sarah E.; Grote, Nancy K.

2006-01-01

Objectives: This meta-analysis evaluates treatment effects for nonpsychotic major depression during pregnancy and postpartum comparing interventions by type and timing. Methods: Studies for decreasing depressive severity during pregnancy and postpartum applying treatment trials and standardized measures were included. Standardized mean differences…

Comparative Study of Standards for Grid-Connected Wind Power Plant in China and the U.S.

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

Gao, Wenzhong; Tian, Tian; Muljadi, Eduard

2015-10-06

The rapid deployment of wind power has made grid integration and operational issues focal points in industry discussions and research. Compliance with grid connection standards for wind power plants (WPP) is crucial to ensuring the safe and stable operation of the electric power grid. The standards for grid-connected WPPs in China and the United States are compared in this paper to facilitate further improvements to the standards and enhance the development of wind power equipment. Detailed analyses in power quality, low-voltage ride-through capability, active power control, reactive power control, voltage control, and wind power forecasting are provided to enhance themore » understanding of grid codes in the two largest markets of wind power.« less

Analytical evaluation of current starch methods used in the international sugar industry: Part I.

PubMed

Cole, Marsha; Eggleston, Gillian; Triplett, Alexa

2017-08-01

Several analytical starch methods exist in the international sugar industry to mitigate starch-related processing challenges and assess the quality of traded end-products. These methods use iodometric chemistry, mostly potato starch standards, and utilize similar solubilization strategies, but had not been comprehensively compared. In this study, industrial starch methods were compared to the USDA Starch Research method using simulated raw sugars. Type of starch standard, solubilization approach, iodometric reagents, and wavelength detection affected total starch determination in simulated raw sugars. Simulated sugars containing potato starch were more accurately detected by the industrial methods, whereas those containing corn starch, a better model for sugarcane starch, were only accurately measured by the USDA Starch Research method. Use of a potato starch standard curve over-estimated starch concentrations. Among the variables studied, starch standard, solubilization approach, and wavelength detection affected the sensitivity, accuracy/precision, and limited the detection/quantification of the current industry starch methods the most. Published by Elsevier Ltd.

Strategy aimed at reduction of sputum eosinophils decreases exacerbation rate in patients with asthma.

PubMed

Chlumský, J; Striz, I; Terl, M; Vondracek, J

2006-01-01

Under Global Initiative for Asthma guidelines, the clinical control of disease activity and the adjustment of treatment in patients with asthma are based on symptoms, use of rescue medication, lung function and peak expiratory flow measurement (standard strategy). We investigated whether a strategy to reduce the number of sputum eosinophils (EOS strategy) gives better clinical control and a lower exacerbation rate compared with the standard strategy. Fifty-five patients with moderate to severe asthma entered this open, randomized, parallel-group study and visited the out-patient department every 3 months for 18 months. The dose of corticosteroids was adjusted according to the standard strategy or the percentage of sputum eosinophils (EOS strategy). During the study period, the EOS strategy led to a significantly lower incidence of asthma exacerbations compared with the standard strategy group (0.22 and 0.78 exacerbations per year per patient, respectively). There were significant differences between the strategies in time to first exacerbation.

Refining an Automated Transcranial Doppler System for the Detection of Vasospasm after Traumatic Brain Injury

DTIC Science & Technology

2014-09-01

flow velocity in the MCA and ICA of patients with known vasospasm, as compared to standard TCD run by a trained neurosonographer. Proposed study: Use...the middle cerebral artery (MCA) and internal carotid artery (ICA) of patients with known vasospasm, as compared to standard TCD run by a trained ...Wechsler LR, Toole JF (eds). Transcranial Doppler Ultrasonography. Boston, MA: Butterworth- Heinemann; 1999:109–128. 2. Aaslid R, Nornes H. Musical

Affirm VPIII microbial identification test can be used to detect gardnerella vaginalis, Candida albicans and trichomonas vaginalis microbial infections in Korean women.

PubMed

Byun, Seung Won; Park, Yeon Joon; Hur, Soo Young

2016-04-01

The aim of this study was to compare Affirm VPIII Microbial Identification Test results for Korean women to those obtained for Gardnerella vaginalis through Nugent score, Candida albicans based on vaginal culture and Trichomonas vaginalis based on wet smear diagnostic standards. Study participants included 195 women with symptomatic or asymptomatic vulvovaginitis under hospital obstetric or gynecologic care. A definite diagnosis was made based on Nugent score for Gardnerella, vaginal culture for Candida and wet prep for Trichomonas vaginalis. Affirm VPIII Microbial Identification Test results were then compared to diagnostic standard results. Of the 195 participants, 152 were symptomatic, while 43 were asymptomatic. Final diagnosis revealed 68 (37.87%) cases of Gardnerella, 29 (14.87%) cases of Candida, one (0.51%) case of Trichomonas, and 10 (5.10%) cases of mixed infections. The detection rates achieved by each detection method (Affirm assay vs diagnostic standard) for Gardnerella and Candida were not significantly different (33.33% vs 34.8% for Gardnerella, 13.33% vs 14.87% for Candida, respectively). The sensitivity and specificity of the Affirm test for Gardnerella compared to the diagnostic standard were 75.0% and 88.98%, respectively. For Candida, the sensitivity and specificity of the Affirm test compared to the diagnostic standard were 82.76% and 98.80%, respectively. The number of Trichomonas cases was too small (1 case) to be statistically analyzed. The Affirm test is a quick tool that can help physicians diagnose and treat patients with infectious vaginitis at the point of care. © 2016 Japan Society of Obstetrics and Gynecology.

Active involvement and intervention in patients exposed to whiplash trauma in automobile crashes reduces costs: a randomized, controlled clinical trial and health economic evaluation.

PubMed

Rosenfeld, Mark; Seferiadis, Aris; Gunnarsson, Ronny

2006-07-15

To examine and compare the costs and consequences in a partial economic evaluation of two competing interventions in patients exposed to whiplash trauma in automobile crashes. The interventions were an active involvement and intervention using early mobilization and a standard intervention of rest, recommended short-term immobilization in a cervical collar and a cautious, gradual self-exercise program according to a leaflet. The study was randomized and controlled. The aim of the study was to compare the costs of an active involvement and intervention versus a standard intervention and to relate them to the clinical benefits in patients exposed to whiplash trauma in automobile crashes to facilitate decision-making regarding intervention and resource allocation. There is very little known about the health economic aspects of various interventions in the target treatment group of patients. Based on a prospective, randomized, clinical trial, data on clinical effectiveness and resources used for the active involvement and intervention and standard intervention were collected for a comparative analysis of the costs related to physical therapy treatment and sick leave. A cost-consequence analysis consisting of a modified cost-effectiveness analysis was used. The costs were significantly lower after 6 and 36 months with an active involvement and intervention as compared with the standard intervention. The active involvement and intervention were significantly superior in reducing experienced pain and reducing sick leave. For patients exposed to whiplash trauma in a motor vehicle collision, an active involvement and intervention were both less costly and more effective than a standard intervention.

Ibrutinib versus previous standard of care: an adjusted comparison in patients with relapsed/refractory chronic lymphocytic leukaemia.

PubMed

Hansson, Lotta; Asklid, Anna; Diels, Joris; Eketorp-Sylvan, Sandra; Repits, Johanna; Søltoft, Frans; Jäger, Ulrich; Österborg, Anders

2017-10-01

This study explored the relative efficacy of ibrutinib versus previous standard-of-care treatments in relapsed/refractory patients with chronic lymphocytic leukaemia (CLL), using multivariate regression modelling to adjust for baseline prognostic factors. Individual patient data were collected from an observational Stockholm cohort of consecutive patients (n = 144) diagnosed with CLL between 2002 and 2013 who had received at least second-line treatment. Data were compared with results of the RESONATE clinical trial. A multivariate Cox proportional hazards regression model was used which estimated the hazard ratio (HR) of ibrutinib versus previous standard of care. The adjusted HR of ibrutinib versus the previous standard-of-care cohort was 0.15 (p < 0.0001) for progression-free survival (PFS) and 0.36 (p < 0.0001) for overall survival (OS). A similar difference was observed also when patients treated late in the period (2012-) were compared separately. Multivariate analysis showed that later line of therapy, male gender, older age and poor performance status were significant independent risk factors for worse PFS and OS. Our results suggest that PFS and OS with ibrutinib in the RESONATE study were significantly longer than with previous standard-of-care regimens used in second or later lines in routine healthcare. The approach used, which must be interpreted with caution, compares patient-level data from a clinical trial with outcomes observed in a daily clinical practice and may complement results from randomised trials or provide preliminary wider comparative information until phase 3 data exist.

Added value of cost-utility analysis in simple diagnostic studies of accuracy: (18)F-fluoromethylcholine PET/CT in prostate cancer staging.

PubMed

Gerke, Oke; Poulsen, Mads H; Høilund-Carlsen, Poul Flemming

2015-01-01

Diagnostic studies of accuracy targeting sensitivity and specificity are commonly done in a paired design in which all modalities are applied in each patient, whereas cost-effectiveness and cost-utility analyses are usually assessed either directly alongside to or indirectly by means of stochastic modeling based on larger randomized controlled trials (RCTs). However the conduct of RCTs is hampered in an environment such as ours, in which technology is rapidly evolving. As such, there is a relatively limited number of RCTs. Therefore, we investigated as to which extent paired diagnostic studies of accuracy can be also used to shed light on economic implications when considering a new diagnostic test. We propose a simple decision tree model-based cost-utility analysis of a diagnostic test when compared to the current standard procedure and exemplify this approach with published data from lymph node staging of prostate cancer. Average procedure costs were taken from the Danish Diagnosis Related Groups Tariff in 2013 and life expectancy was estimated for an ideal 60 year old patient based on prostate cancer stage and prostatectomy or radiation and chemotherapy. Quality-adjusted life-years (QALYs) were deduced from the literature, and an incremental cost-effectiveness ratio (ICER) was used to compare lymph node dissection with respective histopathological examination (reference standard) and (18)F-fluoromethylcholine positron emission tomography/computed tomography (FCH-PET/CT). Lower bounds of sensitivity and specificity of FCH-PET/CT were established at which the replacement of the reference standard by FCH-PET/CT comes with a trade-off between worse effectiveness and lower costs. Compared to the reference standard in a diagnostic accuracy study, any imperfections in accuracy of a diagnostic test imply that replacing the reference standard generates a loss in effectiveness and utility. We conclude that diagnostic studies of accuracy can be put to a more extensive use, over and above a mere indication of sensitivity and specificity of an imaging test, and that health economic considerations should be undertaken when planning a prospective diagnostic accuracy study. These endeavors will prove especially fruitful when comparing several imaging techniques with one another, or the same imaging technique using different tracers, with an independent reference standard for the evaluation of results.

Does therapeutic hypothermia reduce acute kidney injury among term neonates with perinatal asphyxia?--a randomized controlled trial.

PubMed

Tanigasalam, Vasanthan; Bhat, Vishnu; Adhisivam, Bethou; Sridhar, M G

2016-01-01

The objective of this study is to evaluate whether therapeutic hypothermia reduces the incidence of acute kidney injury (AKI) among term neonates perinatal asphyxia. This randomized controlled trial conducted in a tertiary care teaching hospital, south India included 120 term neonates with perinatal asphyxia who were randomized to receive either therapeutic hypothermia or standard supportive care. Renal parameters of neonates in both the groups were monitored and AKI was ascertained as per Acute Kidney Injury Network criteria. The incidence of AKI was less in therapeutic hypothermia group compared to standard treatment group (32% versus 60%, p < 0.05). The incidence of Stages 1, 2, and 3 AKI was 22%, 5%, and 5% in therapeutic hypothermia group compared with 52%, 5%, and 3%, respectively, in the standard treatment group. The mortality was less in therapeutic hypothermia group compared with the standard treatment group (26% versus 50%, p < 0.05). Therapeutic hypothermia reduces the incidence and severity of AKI among term neonates with perinatal asphyxia.

A case-control pilot study of low-intensity IVF in good-prognosis patients.

PubMed

Gleicher, Norbert; Weghofer, Andrea; Barad, David H

2012-04-01

Low-intensity IVF (LI-IVF) is rapidly gaining in popularity. Yet studies comparing LI-IVF to standard IVF are lacking. This is a case-control pilot study, reporting on 14 first LI-IVF and 14 standard IVF cycles in women with normal age-specific ovarian reserve under age 38, matched for age, laboratory environment, staff and time of cycle. LI-IVF cycles underwent mild ovarian stimulation, utilizing clomiphene citrate, augmented by low-dose gonadotrophin stimulation. Control patients underwent routine ovarian stimulation. LI-IVF and regular IVF patients were similar in age, body mass index, FSH and anti-Müllerian hormone. Standard IVF utilized more gonadotrophins (P<0.001), yielded more oocytes (P<0.001) and cryopreserved more embryos (P<0.001). With similar embryo numbers transferred, after ethnicity adjustments, standard IVF demonstrated better odds for pregnancy (OR 7.07; P=0.046) and higher cumulative pregnancy rates (63.3% versus 21.4%; OR 6.6; P=0.02). Adjustments for age, ethnicity and diagnosis maintained significance but oocyte adjustment did not. Cost assessments failed to reveal differences between LI-IVF and standard IVF. In this small study, LI-IVF reduced pregnancy chances without demonstrating cost advantages, raising questions about its utility. In the absence of established clinical and/or economic foundations, LI-IVF should be considered an experimental procedure. Low-intensity IVF (LI-IVF) is increasingly propagated as an alternative to standard IVF. LI-IVF has, however, never been properly assessed in comparison to standard IVF. Such a comparison is presented in the format of a small pilot study, matching LI-IVF cycles with regular IVF cycles and comparing outcomes as well as costs. The study suggests that LI-IVF, at least in this setting, is clinically inferior and economically at best similar to standard IVF. LI-IVF should, therefore, as of this point not be offered as routine IVF treatment but only as an experimental procedure. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Improving adherence to Standard Precautions for the control of health care-associated infections.

PubMed

Moralejo, Donna; El Dib, Regina; Prata, Rafaela A; Barretti, Pasqual; Corrêa, Ione

2018-02-26

'Standard Precautions' refers to a system of actions, such as using personal protective equipment or adhering to safe handling of needles, that healthcare workers take to reduce the spread of germs in healthcare settings such as hospitals and nursing homes. To assess the effectiveness of interventions that target healthcare workers to improve adherence to Standard Precautions in patient care. We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS, two other databases, and two trials registers. We applied no language restrictions. The date of the most recent search was 14 February 2017. We included randomised trials of individuals, cluster-randomised trials, non-randomised trials, controlled before-after studies, and interrupted time-series studies that evaluated any intervention to improve adherence to Standard Precautions by any healthcare worker with responsibility for patient care in any hospital, long-term care or community setting, or artificial setting, such as a classroom or a learning laboratory. Two review authors independently screened search results, extracted data from eligible trials, and assessed risk of bias for each included study, using standard methodological procedures expected by Cochrane. Because of substantial heterogeneity among interventions and outcome measures, meta-analysis was not warranted. We used the GRADE approach to assess certainty of evidence and have presented results narratively in 'Summary of findings' tables. We included eight studies with a total of 673 participants; three studies were conducted in Asia, two in Europe, two in North America, and one in Australia. Five studies were randomised trials, two were cluster-randomised trials, and one was a non-randomised trial. Three studies compared different educational approaches versus no education, one study compared education with visualisation of respiratory particle dispersion versus education alone, two studies compared education with additional infection control support versus no intervention, one study compared peer evaluation versus no intervention, and one study evaluated use of a checklist and coloured cues. We considered all studies to be at high risk of bias with different risks. All eight studies used different measures to assess healthcare workers' adherence to Standard Precautions. Three studies also assessed healthcare workers' knowledge, and one measured rates of colonisation with methicillin-resistant Staphylococcus aureus (MRSA) among residents and staff of long-term care facilities. Because of heterogeneity in interventions and outcome measures, we did not conduct a meta-analysis.Education may slightly improve both healthcare workers' adherence to Standard Precautions (three studies; four centres) and their level of knowledge (two studies; three centres; low certainty of evidence for both outcomes).Education with visualisation of respiratory particle dispersion probably improves healthcare workers' use of facial protection but probably leads to little or no difference in knowledge (one study; 20 nurses; moderate certainty of evidence for both outcomes).Education with additional infection control support may slightly improve healthcare workers' adherence to Standard Precautions (two studies; 44 long-term care facilities; low certainty of evidence) but probably leads to little or no difference in rates of health care-associated colonisation with MRSA (one study; 32 long-term care facilities; moderate certainty of evidence).Peer evaluation probably improves healthcare workers' adherence to Standard Precautions (one study; one hospital; moderate certainty of evidence).Checklists and coloured cues probably improve healthcare workers' adherence to Standard Precautions (one study; one hospital; moderate certainty of evidence). Considerable variation in interventions and in outcome measures used, along with high risk of bias and variability in the certainty of evidence, makes it difficult to draw conclusions about effectiveness of the interventions. This review underlines the need to conduct more robust studies evaluating similar types of interventions and using similar outcome measures.

Traditional vs. Experiential: A Comparative Study of Instructional Methodologies on Student Achievement in New York City Public Schools

ERIC Educational Resources Information Center

Mohan, Subhas

2015-01-01

This study explores the differences in student achievement on state standardized tests between experiential learning and direct learning instructional methodologies. Specifically, the study compares student performances in Expeditionary Learning schools, which is a Comprehensive School Reform model that utilizes experiential learning, to their…

Counseling Persons with Comorbid Disorders: A Quantitative Comparison of Counselor Active Rehabilitation Service and Standard Rehabilitation Counseling Approaches

ERIC Educational Resources Information Center

Ferdinandi, Andrew D.; Li, Ming Hui

2007-01-01

The purpose of this quantitative study was to investigate the effect of counselor active rehabilitation service compared with the effect of standard rehabilitation counseling in assisting individuals with coexisting psychiatric and substance abuse disorders in attaining desired life roles. This study was conducted during a 6-month period in a…

Vibration safety limits for magnetic resonance elastography.

PubMed

Ehman, E C; Rossman, P J; Kruse, S A; Sahakian, A V; Glaser, K J

2008-02-21

Magnetic resonance elastography (MRE) has been demonstrated to have potential as a clinical tool for assessing the stiffness of tissue in vivo. An essential step in MRE is the generation of acoustic mechanical waves within a tissue via a coupled mechanical driver. Motivated by an increasing volume of human imaging trials using MRE, the objectives of this study were to audit the vibration amplitude of exposure for our IRB-approved human MRE studies, to compare these values to a conservative regulatory standard for vibrational exposure and to evaluate the applicability and implications of this standard for MRE. MRE displacement data were examined from 29 MRE exams, including the liver, brain, kidney, breast and skeletal muscle. Vibrational acceleration limits from a European Union directive limiting occupational exposure to whole-body and extremity vibrations (EU 2002/44/EC) were adjusted for time and frequency of exposure, converted to maximum displacement values and compared to the measured in vivo displacements. The results indicate that the vibrational amplitudes used in MRE studies are below the EU whole-body vibration limit, and the EU guidelines represent a useful standard that could be readily accepted by Institutional Review Boards to define standards for vibrational exposures for MRE studies in humans.

Vibration safety limits for magnetic resonance elastography

PubMed Central

Ehman, E C; Rossman, P J; Kruse, S A; Sahakian, A V; Glaser, K J

2010-01-01

Magnetic resonance elastography (MRE) has been demonstrated to have potential as a clinical tool for assessing the stiffness of tissue in vivo. An essential step in MRE is the generation of acoustic mechanical waves within tissue via a coupled mechanical driver. Motivated by an increasing volume of human imaging trials using MRE, the objectives of this study were to audit the vibration amplitude of exposure for our IRB-approved human MRE studies, to compare these values to a conservative regulatory standard for vibrational exposure, and to evaluate the applicability and implications of this standard for MRE. MRE displacement data were examined from 29 MRE exams, including the liver, brain, kidney, breast, and skeletal muscle. Vibrational acceleration limits from a European Union directive limiting occupational exposure to whole-body and extremity vibrations (EU 2002/44/EC) were adjusted for time and frequency of exposure, converted to maximum displacement values, and compared to the measured in vivo displacements. The results indicate that the vibrational amplitudes used in MRE studies are below the EU whole-body vibration limit and the EU guidelines represent a useful standard that could be readily accepted by Institutional Review Boards to define standards for vibrational exposures for MRE studies in humans. PMID:18263949

Effect of a change in housing conditions on body weight, behavior and brain neurotransmitters in male C57BL/6J mice.

PubMed

Pasquarelli, Noemi; Voehringer, Patrizia; Henke, Julia; Ferger, Boris

2017-08-30

The development of modern housing regimes such as individually ventilated cage (IVC) systems has become very popular and attractive in order to reduce spreading of pathogenic organisms and to lower the risk to develop a laboratory animal allergy for staff members. Additionally, optimal housing of laboratory animals contributes to improve animal health status and ensures high and comparable experimental and animal welfare standards. However, it has not been clearly elucidated whether 1) a change to IVC systems have an impact on various physiological phenotypic parameters of mice when compared to conventional, standard cages and 2) if this is further affected by changing from social to single housing. Therefore, we investigated the influence of a change in housing conditions (standard cages with social housing changed to standard or IVC cages combined with social or single housing) on body weight, behavior and a neurochemical fingerprint of male C57BL/6J mice. Body weight progression was significantly reduced when changing mice to single or social IVC cages as well as in single standard cages when compared to social standard housing. Automated motor activity measurement in the open field showed that mice maintained in social husbandry with standard cages displayed the lowest exploratory behavior but the highest activity difference upon amphetamine treatment. Elevated plus maze test revealed that a change to IVC single and social housing as well as single standard housing produced anxiety-related behavior when compared to maintenance in social standard housing. Additionally, postmortem neurochemical analysis of the striatum using high-performance liquid chromatography coupled to electrochemical detection showed significant differences in striatal dopamine and serotonin turnover levels. In summary, our data indicate a crucial influence of a change in housing conditions on several mouse phenotype parameters. We propose that the maintenance of well-defined housing conditions is mandatory to ensure reproducible and comparable results and contributes to the application of the 3R refinement principle in animal studies by contributing to welfare and hygienical standards. Copyright © 2017 Elsevier B.V. All rights reserved.

Standard spacecraft economic analysis. Volume 2: Findings and conclusions

NASA Technical Reports Server (NTRS)

Harris, E. D.; Large, J. P.

1976-01-01

The comparative program costs associated with use of various standardized spacecraft for Air Force space test program missions to be flown on the space shuttle were studied in two phases. In the first phase, a variety of procurement mixes composed of existing or programmed NASA standard spacecraft designs and an Air Force standard spacecraft design were considered. The second phase dealt with additional procurement options using an upgraded version of an existing NASA design. The results of both phases are discussed.

Comparing satisfaction and burnout between caseload and standard care midwives: findings from two cross-sectional surveys conducted in Victoria, Australia.

PubMed

Newton, Michelle S; McLachlan, Helen L; Willis, Karen F; Forster, Della A

2014-12-24

Caseload midwifery reduces childbirth interventions and increases women's satisfaction with care. It is therefore important to understand the impact of caseload midwifery on midwives working in and alongside the model. While some studies have reported higher satisfaction for caseload compared with standard care midwives, others have suggested a need to explore midwives' work-life balance as well as potential for stress and burnout. This study explored midwives' attitudes to their professional role, and also measured burnout in caseload midwives compared to standard care midwives at two sites in Victoria, Australia with newly introduced caseload midwifery models. All midwives providing maternity care at the study sites were sent questionnaires at the commencement of the caseload midwifery model and two years later. Data items included the Midwifery Process Questionnaire (MPQ) to examine midwives' attitude to their professional role, the Copenhagen Burnout Inventory (CBI) to measure burnout, and questions about midwives' views of caseload work. Data were pooled for the two sites and comparisons made between caseload and standard care midwives. The MPQ and CBI data were summarised as individual and group means. Twenty caseload midwives (88%) and 130 standard care midwives (41%) responded at baseline and 22 caseload midwives (95%) and 133 standard care midwives (45%) at two years. Caseload and standard care midwives were initially similar across all measures except client-related burnout, which was lower for caseload midwives (12.3 vs 22.4, p = 0.02). After two years, compared to midwives in standard care, caseload midwives had higher mean scores in professional satisfaction (1.08 vs 0.76, p = 0.01), professional support (1.06 vs 0.11, p <0.01) and client interaction (1.4 vs 0.09, p <0.01) and lower scores for personal burnout (35.7 vs 47.7, p < 0.01), work-related burnout (27.3 vs 42.7, p <0.01), and client-related burnout (11.3 vs 21.4, p < 0.01). Caseload midwifery was associated with lower burnout scores and higher professional satisfaction. Further research should focus on understanding the key features of the caseload model that are related to these outcomes to help build a picture of what is required to ensure the long-term sustainability of the model.

A randomized clinical trial comparing metabolic parameters after 48 weeks of standard- and low-dose stavudine therapy and tenofovir disoproxil fumarate therapy in HIV-infected South African patients.

PubMed

Menezes, C N; Crowther, N J; Duarte, R; Van Amsterdam, D; Evans, D; Dickens, C; Dix-Peek, T; Rassool, M; Prinsloo, A; Raal, F; Sanne, I

2014-01-01

Low-dose stavudine therapy may have a lower toxicity profile compared with standard dose. A randomized controlled trial comparing these two doses of stavudine with tenofovir disoproxil fumarate (tenofovir DF) was performed to assess the effects on anthropometry, markers of inflammation, and lipid and glucose metabolism in Black South African patients. Sixty patients were randomized 1:1:1 to either standard-dose (30-40 mg) or low-dose (20-30 mg) stavudine or tenofovir DF (300 mg), each combined with lamivudine and efavirenz, for 48 weeks. Anthropometry, markers of inflammation, and lipid and glucose metabolism were assessed using standard techniques. In all three treatment arms, there was a significant increase in lipid levels over the study period. At 48 weeks, fasting glucose level (P < 0.005) and homeostasis model assessment (HOMA) score (P < 0.05) increased significantly in the standard-dose stavudine arm, as did insulin and C-peptide levels in both the standard- and low-dose stavudine arms. At week 48, a significant decrease (P < 0.05) in adiponectin was noted in the standard-dose stavudine arm, but there was an increase (P < 0.005) in the tenofovir DF arm. In both the stavudine arms, significant increases in anthropometric measures occurred at 24 weeks but these decreased by week 48. Mitochondrial toxicities occurred in both the stavudine arms. Immunological and virological outcomes were similar for all three arms. This study highlights the occurrence of metabolic abnormalities with both stavudine and tenofovir DF treatment. Awareness of the potential increased cardiovascular risk should be of concern with the use of both these therapies. © 2013 British HIV Association.

Comparative effectiveness: its role in the healthcare system.

PubMed

Brown, Melissa M; Luo, Betsy; Brown, Heidi C; Brown, Gary C

2009-05-01

To describe comparative effectiveness and assess its role in crafting new healthcare policy. Senate Bill S.3408 would establish a nongovernment-affiliated Healthcare Comparative Effectiveness Research Institute that would work with healthcare experts and stakeholders in healthcare to prioritize interventions and services to be studied. A value-based medicine system of standardized comparative effectiveness and cost-effectiveness data using utilities would allow physicians to assess the total value (improvement in quality of life and/or length of life) conferred by interventions. Standardized comparativeness and cost-effectiveness data will give physicians an information system to identify the interventions that confer the greatest value to patients, and thus deliver higher quality care than possible with evidence-based data alone while allowing the most cost-effective care.

Effectiveness of a Closed-System Transfer Device in Reducing Surface Contamination in a New Antineoplastic Drug-Compounding Unit: A Prospective, Controlled, Parallel Study

PubMed Central

Pinturaud, Marine; Soichot, Marion; Richeval, Camille; Humbert, Luc; Lebecque, Michèle; Sidikou, Ousseini; Barthelemy, Christine; Bonnabry, Pascal; Allorge, Delphine; Décaudin, Bertrand; Odou, Pascal

2016-01-01

Background The objective of this randomized, prospective and controlled study was to investigate the ability of a closed-system transfer device (CSTD; BD-Phaseal) to reduce the occupational exposure of two isolators to 10 cytotoxic drugs and compare to standard compounding devices. Methods and Findings The 6-month study started with the opening of a new compounding unit. Two isolators were set up with 2 workstations each, one to compound with standard devices (needles and spikes) and the other using the Phaseal system. Drugs were alternatively compounded in each isolator. Sampling involved wiping three surfaces (gloves, window, worktop), before and after a cleaning process. Exposure to ten antineoplastic drugs (cyclophosphamide, ifosfamide, dacarbazine, 5-FU, methotrexate, gemcitabine, cytarabine, irinotecan, doxorubicine and ganciclovir) was assessed on wipes by LC-MS/MS analysis. Contamination rates were compared using a Chi2 test and drug amounts by a Mann-Whitney test. Significance was defined for p<0.05. Overall contamination was lower in the “Phaseal” isolator than in the “Standard” isolator (12.24% vs. 26.39%; p < 0.0001) although it differed according to drug. Indeed, the contamination rates of gemcitabine were 49.3 and 43.4% (NS) for the Standard and Phaseal isolators, respectively, whereas for ganciclovir, they were 54.2 and 2.8% (p<0.0001). Gemcitabine amounts were 220.6 and 283.6 ng for the Standard and Phaseal isolators (NS), and ganciclovir amounts were 179.9 and 2.4 ng (p<0.0001). Conclusion This study confirms that using a CSTD may significantly decrease the chemical contamination of barrier isolators compared to standard devices for some drugs, although it does not eliminate contamination totally. PMID:27391697

Implications of a Comparative Study for Mathematics Education in the English Education System

ERIC Educational Resources Information Center

Delice, Ali; Roper, Tom

2006-01-01

This paper reports upon particular aspects of a study carried out by Delice in 2003, the main aim of which was to compare the performance of students in the 16-19 age group from Turkey and England on trigonometry of "A-level standard" and then to compare the curriculum and assessment provision in each country to seek possible…

[Comparison of the effect of different diagnostic criteria of subclinical hypothyroidism and positive TPO-Ab on pregnancy outcomes].

PubMed

He, Yiping; He, Tongqiang; Wang, Yanxia; Xu, Zhao; Xu, Yehong; Wu, Yiqing; Ji, Jing; Mi, Yang

2014-11-01

To explore the effect of different diagnositic criteria of subclinical hypothyroidism using thyroid stimulating hormone (TSH) and positive thyroid peroxidase antibodies (TPO-Ab) on the pregnancy outcomes. 3 244 pregnant women who had their antenatal care and delivered in Child and Maternity Health Hospital of Shannxi Province August from 2011 to February 2013 were recruited prospectively. According to the standard of American Thyroid Association (ATA), pregnant women with normal serum free thyroxine (FT4) whose serum TSH level> 2.50 mU/L were diagnosed as subclinical hypothyroidism in pregnancy (foreign standard group). According to the Guideline of Diagnosis and Therapy of Prenatal and Postpartum Thyroid Disease made by Chinese Society of Endocrinology and Chinese Society of Perinatal Medicine in 2012, pregnant women with serum TSH level> 5.76 mU/L, and normal FT4 were diagnosed as subclinical hypothyroidism in pregnancy(national standard group). Pregnant women with subclinical hypothyroidism whose serum TSH levels were between 2.50-5.76 mU/L were referred as the study observed group; and pregnant women with serum TSH level< 2.50 mU/L and negative TPO- Ab were referred as the control group. Positive TPO-Ab results and the pregnancy outcomes were analyzed. (1) There were 635 cases in the foreign standard group, with the incidence of 19.57% (635/3 244). And there were 70 cases in the national standard group, with the incidence of 2.16% (70/3 244). There were statistically significant difference between the two groups (P < 0.01). There were 565 cases in the study observed group, with the incidence of 17.42% (565/3 244). There was statistically significant difference (P < 0.01) when compared with the national standard group; while there was no statistically significant difference (P > 0.05) when compared with the foreign standard group. (2) Among the 3 244 cases, 402 cases had positive TPO-Ab. 318 positive cases were in the foreign standard group, and the incidence of subclinical hypothyroidism was 79.10% (318/402). There were 317 negative cases in the foreign standard group, with the incidence of 11.15% (317/2 842). The difference was statistically significant (P < 0.01) between them. In the national standard group, 46 cases had positive TPO-Ab, with the incidence of 11.44% (46/402), and 24 cases had negative result, with the incidence of 0.84% (24/2 842). There were statistically significant difference (P < 0.01) between them. In the study observed group, 272 cases were TPO-Ab positive, with the incidence of 67.66% (272/402), and 293 cases were negative, with the incidence of 10.31% (293/2 842), the difference was statistically significant (P < 0.01). (3) The incidence of miscarriage, premature delivery, gestational hypertension disease, gestational diabetes mellitus(GDM)in the foreign standard group had statistically significant differences (P < 0.05) when compared with the control group, respectively. While there was no statistically significant difference (P > 0.05) in the incidence of placental abruption or fetal distress. And the incidence of miscarriage, premature delivery, gestational hypertension disease, GDM in the national standard group had statistical significant difference (P < 0.05) compared with the control group, respectively. While there was no statistically significant difference (P > 0.05) in the incidence of placental abruption or fetal distress. This study observed group of pregnant women's abortion, gestational hypertension disease, GDM incidence respectively compared with control group, the difference had statistical significance (P < 0.05); but in preterm labor, placental abruption, and fetal distress incidence, there were no statistically significant difference (P > 0.05). (4) The incidence of miscarriage, premature delivery, gestational hypertension disease, GDM, placental abruption, fetal distress in the TPO-Ab positive cases of the national standard group showed an increase trend when compared with TPO-Ab negative cases, with no statistically significant difference (P > 0.05). The incidence of gestational hypertension disease and GDM in the TPO-Ab positive cases of the study observed group had statistical significance difference (P < 0.05) when compared with TPO-Ab negative cases; while the incidence of miscarriage, premature birth, placental abruption, fetal distress had no statistically significant difference (P > 0.05). The incidence of gestational hypertension disease and GDM in the TPO-Ab positive cases had statistically significance difference when compared with TPO-Ab negtive cases of foreign standard group (P < 0.05). (1) The incidence of subclinical hypothyroidism is rather high during early pregnancy and can lead to adverse pregnancy outcome. (2) Positive TPO-Ab result has important predictive value of the thyroid dysfunction and GDM. (3) Relatively, the ATA standard of diagnosis (serum TSH level> 2.50 mU/L) is safer for the antenatal care; the national standard (serum TSH level> 5.76 mU/L) is not conducive to pregnancy management.

Gastric acid control with esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole: a five-way crossover study.

PubMed

Miner, Philip; Katz, Philip O; Chen, Yusong; Sostek, Mark

2003-12-01

Proton pump inhibitors owe their clinical efficacy to their ability to suppress gastric acid production. The objective of this study was to evaluate and compare intragastric pH following standard doses of esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole. This randomized, open-label, comparative five-way crossover study evaluated the 24-h intragastric pH profile of oral esomeprazole 40 mg, lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg, and rabeprazole 20 mg once daily in 34 Helicobacter pylori-negative patients aged 18-60 yr with symptoms of gastroesophageal reflux disease. Patients were randomly assigned to one of five treatment sequences and study drug was taken on 5 consecutive mornings 30 minutes prior to a standardized breakfast. A washout period of at least 10 days separated each treatment phase. Thirty-four patients provided evaluable data for all five comparators. The mean number of hours of evaluable pH data was > or =23.75 hours. On day 5, intragastric pH was maintained above 4.0 for a mean of 14.0 h with esomeprazole, 12.1 h with rabeprazole, 11.8 h with omeprazole, 11.5 h with lansoprazole, and 10.1 h with pantoprazole (p < or = 0.001 for differences between esomeprazole and all other comparators). Esomeprazole also provided a significantly higher percentage of patients with an intragastric pH greater than 4.0 for more than 12 h relative to the other proton pump inhibitors (p < 0.05). The frequency of adverse events was similar between treatment groups. Esomeprazole at the standard dose of 40 mg once daily provided more effective control of gastric acid at steady state than standard doses of lansoprazole, omeprazole, pantoprazole, and rabeprazole in patients with symptoms of gastroesophageal reflux disease.

Microbial consortium role in processing liquid waste of vegetables in Keputran Market Surabaya as organic liquid fertilizer ferti-plus

NASA Astrophysics Data System (ADS)

Rizqi, Fauziah; Supriyanto, Agus; Lestari, Intan; Lita Indri D., L.; Elmi Irmayanti, A.; Rahmaniyah, Fadilatur

2016-03-01

Many activities in this market is directly proportional to increase production of vegetables waste, especially surabaya. Therefore, in this study aims to utilize liquid waste of vegetables into liquid organic fertilizer by mixing microbial consorsium. The microbial consorsium consist of Azotobacter chrococcum, Azospirillum brasilense, Rhizobium leguminosarum, Bacillus subtilis, Bacillus megaterium, Pseudomonas putida, and Pseudomonas fluorescens. Ttreatment of microbial concentrations (5%, 10%, 15%) and the length of the incubation period (7 days, 14 days, 21 days) used in this research. The parameters used are: C/N ratio, levels of CNP, and BOD value. This study uses a standard organic fertilizer value according SNI19-7030-2004, The results show the value of C/N ratio comply with the ISO standards. C levels showed an increase during the incubation period but not compare with standards. N levels that compare with standards are microbial treatment in all group concentration except control group with an incubation period of 21 days is > 7. P levels compare with the existing standards in the group of microbe concentration of 10% and 15% during the incubation period. The value of the initial BOD liquid waste of vegetable is 790.25 mg / L, this value indicates that the waste should not go into the water body. Accordingly, the results of this study can not be used as a liquid organic fertilizer, but potentially if it is used as a natural career or build natural soil. The Building natural soil is defined as the natural ingredients that can be used to improve soil properties.

How to compare cross-lagged associations in a multilevel autoregressive model.

PubMed

Schuurman, Noémi K; Ferrer, Emilio; de Boer-Sonnenschein, Mieke; Hamaker, Ellen L

2016-06-01

By modeling variables over time it is possible to investigate the Granger-causal cross-lagged associations between variables. By comparing the standardized cross-lagged coefficients, the relative strength of these associations can be evaluated in order to determine important driving forces in the dynamic system. The aim of this study was twofold: first, to illustrate the added value of a multilevel multivariate autoregressive modeling approach for investigating these associations over more traditional techniques; and second, to discuss how the coefficients of the multilevel autoregressive model should be standardized for comparing the strength of the cross-lagged associations. The hierarchical structure of multilevel multivariate autoregressive models complicates standardization, because subject-based statistics or group-based statistics can be used to standardize the coefficients, and each method may result in different conclusions. We argue that in order to make a meaningful comparison of the strength of the cross-lagged associations, the coefficients should be standardized within persons. We further illustrate the bivariate multilevel autoregressive model and the standardization of the coefficients, and we show that disregarding individual differences in dynamics can prove misleading, by means of an empirical example on experienced competence and exhaustion in persons diagnosed with burnout. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Are the defined substrate-based methods adequate to determine the microbiological quality of natural recreational waters?

PubMed

Valente, Marta Sofia; Pedro, Paulo; Alonso, M Carmen; Borrego, Juan J; Dionísio, Lídia

2010-03-01

Monitoring the microbiological quality of water used for recreational activities is very important to human public health. Although the sanitary quality of recreational marine waters could be evaluated by standard methods, they are time-consuming and need confirmation. For these reasons, faster and more sensitive methods, such as the defined substrate-based technology, have been developed. In the present work, we have compared the standard method of membrane filtration using Tergitol-TTC agar for total coliforms and Escherichia coli, and Slanetz and Bartley agar for enterococci, and the IDEXX defined substrate technology for these faecal pollution indicators to determine the microbiological quality of natural recreational waters. ISO 17994:2004 standard was used to compare these methods. The IDEXX for total coliforms and E. coli, Colilert, showed higher values than those obtained by the standard method. Enterolert test, for the enumeration of enterococci, showed lower values when compared with the standard method. It may be concluded that more studies to evaluate the precision and accuracy of the rapid tests are required in order to apply them for routine monitoring of marine and freshwater recreational bathing areas. The main advantages of these methods are that they are more specific, feasible and simpler than the standard methodology.

Different lasers and techniques for proliferative diabetic retinopathy.

PubMed

Moutray, Tanya; Evans, Jennifer R; Lois, Noemi; Armstrong, David J; Peto, Tunde; Azuara-Blanco, Augusto

2018-03-15

Diabetic retinopathy (DR) is a chronic progressive disease of the retinal microvasculature associated with prolonged hyperglycaemia. Proliferative DR (PDR) is a sight-threatening complication of DR and is characterised by the development of abnormal new vessels in the retina, optic nerve head or anterior segment of the eye. Argon laser photocoagulation has been the gold standard for the treatment of PDR for many years, using regimens evaluated by the Early Treatment of Diabetic Retinopathy Study (ETDRS). Over the years, there have been modifications of the technique and introduction of new laser technologies. To assess the effects of different types of laser, other than argon laser, and different laser protocols, other than those established by the ETDRS, for the treatment of PDR. We compared different wavelengths; power and pulse duration; pattern, number and location of burns versus standard argon laser undertaken as specified by the ETDRS. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 5); Ovid MEDLINE; Ovid Embase; LILACS; the ISRCTN registry; ClinicalTrials.gov and the ICTRP. The date of the search was 8 June 2017. We included randomised controlled trials (RCTs) of pan-retinal photocoagulation (PRP) using standard argon laser for treatment of PDR compared with any other laser modality. We excluded studies of lasers that are not in common use, such as the xenon arc, ruby or Krypton laser. We followed Cochrane guidelines and graded the certainty of evidence using the GRADE approach. We identified 11 studies from Europe (6), the USA (2), the Middle East (1) and Asia (2). Five studies compared different types of laser to argon: Nd:YAG (2 studies) or diode (3 studies). Other studies compared modifications to the standard argon laser PRP technique. The studies were poorly reported and we judged all to be at high risk of bias in at least one domain. The sample size varied from 20 to 270 eyes but the majority included 50 participants or fewer.Nd:YAG versus argon laser (2 studies): very low-certainty evidence on vision loss, vision gain, progression and regression of PDR, pain during laser treatment and adverse effects.Diode versus argon laser (3 studies): very-low certainty evidence on vision loss, vision gain, progression and regression of PDR and adverse effects; moderate-certainty evidence that diode laser was more painful (risk ratio (RR) troublesome pain during laser treatment (RR 3.12, 95% CI 2.16 to 4.51; eyes = 202; studies = 3; I 2 = 0%).0.5 second versus 0.1 second exposure (1 study): low-certainty evidence of lower chance of vision loss with 0.5 second compared with 0.1 second exposure but estimates were imprecise and compatible with no difference or an increased chance of vision loss (RR 0.42, 95% CI 0.08 to 2.04, 44 eyes, 1 RCT); low-certainty evidence that people treated with 0.5 second exposure were more likely to gain vision (RR 2.22, 95% CI 0.68 to 7.28, 44 eyes, 1 RCT) but again the estimates were imprecise . People given 0.5 second exposure were more likely to have regression of PDR compared with 0.1 second laser PRP again with imprecise estimate (RR 1.17, 95% CI 0.92 to 1.48, 32 eyes, 1 RCT). There was very low-certainty evidence on progression of PDR and adverse effects.'Light intensity' PRP versus classic PRP (1 study): vision loss or gain was not reported but the mean difference in logMAR acuity at 1 year was -0.09 logMAR (95% CI -0.22 to 0.04, 65 eyes, 1 RCT); and low-certainty evidence that fewer patients had pain during light PRP compared with classic PRP with an imprecise estimate compatible with increased or decreased pain (RR 0.23, 95% CI 0.03 to 1.93, 65 eyes, 1 RCT).'Mild scatter' (laser pattern limited to 400 to 600 laser burns in one sitting) PRP versus standard 'full' scatter PRP (1 study): very low-certainty evidence on vision and visual field loss. No information on adverse effects.'Central' (a more central PRP in addition to mid-peripheral PRP) versus 'peripheral' standard PRP (1 study): low-certainty evidence that people treated with central PRP were more likely to lose 15 or more letters of BCVA compared with peripheral laser PRP (RR 3.00, 95% CI 0.67 to 13.46, 50 eyes, 1 RCT); and less likely to gain 15 or more letters (RR 0.25, 95% CI 0.03 to 2.08) with imprecise estimates compatible with increased or decreased risk.'Centre sparing' PRP (argon laser distribution limited to 3 disc diameters from the upper temporal and lower margin of the fovea) versus standard 'full scatter' PRP (1 study): low-certainty evidence that people treated with 'centre sparing' PRP were less likely to lose 15 or more ETDRS letters of BCVA compared with 'full scatter' PRP (RR 0.67, 95% CI 0.30 to 1.50, 53 eyes). Low-certainty evidence of similar risk of regression of PDR between groups (RR 0.96, 95% CI 0.73 to 1.27, 53 eyes). Adverse events were not reported.'Extended targeted' PRP (to include the equator and any capillary non-perfusion areas between the vascular arcades) versus standard PRP (1 study): low-certainty evidence that people in the extended group had similar or slightly reduced chance of loss of 15 or more letters of BCVA compared with the standard PRP group (RR 0.94, 95% CI 0.70 to 1.28, 270 eyes). Low-certainty evidence that people in the extended group had a similar or slightly increased chance of regression of PDR compared with the standard PRP group (RR 1.11, 95% CI 0.95 to 1.31, 270 eyes). Very low-certainty information on adverse effects. Modern laser techniques and modalities have been developed to treat PDR. However there is limited evidence available with respect to the efficacy and safety of alternative laser systems or strategies compared with the standard argon laser as described in ETDRS.

Quantitative imaging biomarkers: a review of statistical methods for computer algorithm comparisons.

PubMed

Obuchowski, Nancy A; Reeves, Anthony P; Huang, Erich P; Wang, Xiao-Feng; Buckler, Andrew J; Kim, Hyun J Grace; Barnhart, Huiman X; Jackson, Edward F; Giger, Maryellen L; Pennello, Gene; Toledano, Alicia Y; Kalpathy-Cramer, Jayashree; Apanasovich, Tatiyana V; Kinahan, Paul E; Myers, Kyle J; Goldgof, Dmitry B; Barboriak, Daniel P; Gillies, Robert J; Schwartz, Lawrence H; Sullivan, Daniel C

2015-02-01

Quantitative biomarkers from medical images are becoming important tools for clinical diagnosis, staging, monitoring, treatment planning, and development of new therapies. While there is a rich history of the development of quantitative imaging biomarker (QIB) techniques, little attention has been paid to the validation and comparison of the computer algorithms that implement the QIB measurements. In this paper we provide a framework for QIB algorithm comparisons. We first review and compare various study designs, including designs with the true value (e.g. phantoms, digital reference images, and zero-change studies), designs with a reference standard (e.g. studies testing equivalence with a reference standard), and designs without a reference standard (e.g. agreement studies and studies of algorithm precision). The statistical methods for comparing QIB algorithms are then presented for various study types using both aggregate and disaggregate approaches. We propose a series of steps for establishing the performance of a QIB algorithm, identify limitations in the current statistical literature, and suggest future directions for research. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Sports eyewear protective standards.

PubMed

Dain, Stephen J

2016-01-01

Eye injuries sustained during sport comprise up to 20 per cent of all injuries to the eye serious enough for medical attention to be sought. The prevalence of eye injuries in sport is not easily assessed due to lack of authoritative participation rates, so most studies report total numbers in a time period. The evidence on the proportion of all ocular injuries that are from sport is reviewed. The relative frequencies in different sports are compared in a qualitative manner and the sports with greater numbers of ocular injuries are detailed. In common with occupational injuries to the eye, most sports eye injuries are considered preventable. The hierarchy of action for occupational risk is detailed and adapted to use in a sports scenario. All the available international, regional and national standards on sports eye protection are detailed and their provisions compared. The major function of the standards is to provide adequate protection against the hazard of the sport concerned. These are detailed and compared as a function of energy transfer. Eye protection must not introduce additional or secondary hazards (for instance, fracturing into sharp fragments on impact) and not introduce features that would deter the wearing of eye protection (for instance, restricting field of view to impede playing the sport). The provisions of the standards intended to limit secondary hazards are detailed and compared. The need for future work in standards writing and the activities of the International Standardization Organization in sports eye protection are detailed. © 2016 Optometry Australia.

Preliminary evaluation of a gel tube agglutination major cross-match method in dogs.

PubMed

Villarnovo, Dania; Burton, Shelley A; Horney, Barbara S; MacKenzie, Allan L; Vanderstichel, Raphaël

2016-09-01

A major cross-match gel tube test is available for use in dogs yet has not been clinically evaluated. This study compared cross-match results obtained using the gel tube and the standard tube methods for canine samples. Study 1 included 107 canine sample donor-recipient pairings cross-match tested with the RapidVet-H method gel tube test and compared results with the standard tube method. Additionally, 120 pairings using pooled sera containing anti-canine erythrocyte antibody at various concentrations were tested with leftover blood from a hospital population to assess sensitivity and specificity of the gel tube method in comparison with the standard method. The gel tube method had a good relative specificity of 96.1% in detecting lack of agglutination (compatibility) compared to the standard tube method. Agreement between the 2 methods was moderate. Nine of 107 pairings showed agglutination/incompatibility on either test, too few to allow reliable calculation of relative sensitivity. Fifty percent of the gel tube method results were difficult to interpret due to sample spreading in the reaction and/or negative control tubes. The RapidVet-H method agreed with the standard cross-match method on compatible samples, but detected incompatibility in some sample pairs that were compatible with the standard method. Evaluation using larger numbers of incompatible pairings is needed to assess diagnostic utility. The gel tube method results were difficult to categorize due to sample spreading. Weak agglutination reactions or other factors such as centrifuge model may be responsible. © 2016 American Society for Veterinary Clinical Pathology.

Comparison Between Manual Auditing and a Natural Language Process With Machine Learning Algorithm to Evaluate Faculty Use of Standardized Reports in Radiology.

PubMed

Guimaraes, Carolina V; Grzeszczuk, Robert; Bisset, George S; Donnelly, Lane F

2018-03-01

When implementing or monitoring department-sanctioned standardized radiology reports, feedback about individual faculty performance has been shown to be a useful driver of faculty compliance. Most commonly, these data are derived from manual audit, which can be both time-consuming and subject to sampling error. The purpose of this study was to evaluate whether a software program using natural language processing and machine learning could accurately audit radiologist compliance with the use of standardized reports compared with performed manual audits. Radiology reports from a 1-month period were loaded into such a software program, and faculty compliance with use of standardized reports was calculated. For that same period, manual audits were performed (25 reports audited for each of 42 faculty members). The mean compliance rates calculated by automated auditing were then compared with the confidence interval of the mean rate by manual audit. The mean compliance rate for use of standardized reports as determined by manual audit was 91.2% with a confidence interval between 89.3% and 92.8%. The mean compliance rate calculated by automated auditing was 92.0%, within that confidence interval. This study shows that by use of natural language processing and machine learning algorithms, an automated analysis can accurately define whether reports are compliant with use of standardized report templates and language, compared with manual audits. This may avoid significant labor costs related to conducting the manual auditing process. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Identifying appropriate reference data models for comparative effectiveness research (CER) studies based on data from clinical information systems.

PubMed

Ogunyemi, Omolola I; Meeker, Daniella; Kim, Hyeon-Eui; Ashish, Naveen; Farzaneh, Seena; Boxwala, Aziz

2013-08-01

The need for a common format for electronic exchange of clinical data prompted federal endorsement of applicable standards. However, despite obvious similarities, a consensus standard has not yet been selected in the comparative effectiveness research (CER) community. Using qualitative metrics for data retrieval and information loss across a variety of CER topic areas, we compare several existing models from a representative sample of organizations associated with clinical research: the Observational Medical Outcomes Partnership (OMOP), Biomedical Research Integrated Domain Group, the Clinical Data Interchange Standards Consortium, and the US Food and Drug Administration. While the models examined captured a majority of the data elements that are useful for CER studies, data elements related to insurance benefit design and plans were most detailed in OMOP's CDM version 4.0. Standardized vocabularies that facilitate semantic interoperability were included in the OMOP and US Food and Drug Administration Mini-Sentinel data models, but are left to the discretion of the end-user in Biomedical Research Integrated Domain Group and Analysis Data Model, limiting reuse opportunities. Among the challenges we encountered was the need to model data specific to a local setting. This was handled by extending the standard data models. We found that the Common Data Model from the OMOP met the broadest complement of CER objectives. Minimal information loss occurred in mapping data from institution-specific data warehouses onto the data models from the standards we assessed. However, to support certain scenarios, we found a need to enhance existing data dictionaries with local, institution-specific information.

The evaluation of hospital laboratory information management systems based on the standards of the American National Standard Institute

PubMed Central

Isfahani, Sakineh Saghaeiannejad; Khajouei, Reza; Jahanbakhsh, Maryan; Mirmohamadi, Mahboubeh

2014-01-01

Introduction: Nowadays, modern laboratories are faced with a huge volume of information. One of the goals of the Laboratory Information Management System (LIMS) is to assist in the management of the information generated in the laboratory. This study intends to evaluate the LIMS based on the standards of the American National Standard Institute (ANSI). Materials and Methods: This research is a descriptive–analytical study, which had been conducted in 2011, on the LIMSs in use, in the teaching and private hospitals in Isfahan. The data collecting instrument was a checklist, which was made by evaluating three groups of information components namely: ‘System capabilities’, ‘work list functions,’ and ‘reporting’ based on LIS8-A. Data were analyzed using the SPSS 20. Data were analyzed using (relative) frequency, percentage. To compare the data the following statistical tests were used: Leven test, t-test, and Analysis of Variance (ANOVA). Results: The results of the study indicated that the LIMS had a low conformity (30%) with LIS8-A (P = 0.001), with no difference between teaching and private hospitals (P = 0.806). The ANOVA revealed that in terms of conformity with the LIS8-A standard, there was a significant difference between the systems produced by different vendors (P = 0.023). According to the results, a Kowsar system with more than %57 conformity in the three groups of information components had a better conformity to the standard, compared to the other systems. Conclusions: This study indicated that none of the LIMSs had a good conformity to the standard. It seems that system providers did not pay sufficient attention to many of the information components required by the standards when designing and developing their systems. It was suggested that standards from certified organizations and institutions be followed in the design and development process of health information systems. PMID:25077154

The evaluation of hospital laboratory information management systems based on the standards of the American National Standard Institute.

PubMed

Isfahani, Sakineh Saghaeiannejad; Khajouei, Reza; Jahanbakhsh, Maryan; Mirmohamadi, Mahboubeh

2014-01-01

Nowadays, modern laboratories are faced with a huge volume of information. One of the goals of the Laboratory Information Management System (LIMS) is to assist in the management of the information generated in the laboratory. This study intends to evaluate the LIMS based on the standards of the American National Standard Institute (ANSI). This research is a descriptive-analytical study, which had been conducted in 2011, on the LIMSs in use, in the teaching and private hospitals in Isfahan. The data collecting instrument was a checklist, which was made by evaluating three groups of information components namely: 'System capabilities', 'work list functions,' and 'reporting' based on LIS8-A. Data were analyzed using the SPSS 20. Data were analyzed using (relative) frequency, percentage. To compare the data the following statistical tests were used: Leven test, t-test, and Analysis of Variance (ANOVA). The results of the study indicated that the LIMS had a low conformity (30%) with LIS8-A (P = 0.001), with no difference between teaching and private hospitals (P = 0.806). The ANOVA revealed that in terms of conformity with the LIS8-A standard, there was a significant difference between the systems produced by different vendors (P = 0.023). According to the results, a Kowsar system with more than %57 conformity in the three groups of information components had a better conformity to the standard, compared to the other systems. This study indicated that none of the LIMSs had a good conformity to the standard. It seems that system providers did not pay sufficient attention to many of the information components required by the standards when designing and developing their systems. It was suggested that standards from certified organizations and institutions be followed in the design and development process of health information systems.

Kinetic Analysis of Benign and Malignant Breast Lesions With Ultrafast Dynamic Contrast-Enhanced MRI: Comparison With Standard Kinetic Assessment.

PubMed

Abe, Hiroyuki; Mori, Naoko; Tsuchiya, Keiko; Schacht, David V; Pineda, Federico D; Jiang, Yulei; Karczmar, Gregory S

2016-11-01

The purposes of this study were to evaluate diagnostic parameters measured with ultrafast MRI acquisition and with standard acquisition and to compare diagnostic utility for differentiating benign from malignant lesions. Ultrafast acquisition is a high-temporal-resolution (7 seconds) imaging technique for obtaining 3D whole-breast images. The dynamic contrast-enhanced 3-T MRI protocol consists of an unenhanced standard and an ultrafast acquisition that includes eight contrast-enhanced ultrafast images and four standard images. Retrospective assessment was performed for 60 patients with 33 malignant and 29 benign lesions. A computer-aided detection system was used to obtain initial enhancement rate and signal enhancement ratio (SER) by means of identification of a voxel showing the highest signal intensity in the first phase of standard imaging. From the same voxel, the enhancement rate at each time point of the ultrafast acquisition and the AUC of the kinetic curve from zero to each time point of ultrafast imaging were obtained. There was a statistically significant difference between benign and malignant lesions in enhancement rate and kinetic AUC for ultrafast imaging and also in initial enhancement rate and SER for standard imaging. ROC analysis showed no significant differences between enhancement rate in ultrafast imaging and SER or initial enhancement rate in standard imaging. Ultrafast imaging is useful for discriminating benign from malignant lesions. The differential utility of ultrafast imaging is comparable to that of standard kinetic assessment in a shorter study time.

The Effect of Massage on Acute Postoperative Pain in Critically and Acutely Ill Adults Post-thoracic Surgery: Systematic Review and Meta-analysis of Randomized Controlled Trials.

PubMed

Boitor, Madalina; Gélinas, Céline; Richard-Lalonde, Melissa; Thombs, Brett D

Critical care practice guidelines identify a lack of clear evidence on the effectiveness of massage for pain control. To assess the effect of massage on acute pain in critically and acutely ill adults post-thoracic surgery. Medline, Embase, CINAHL, PsychInfo, Web of Science, Scopus and Cochrane Library databases were searched. Eligible studies were randomized controlled trials (RCTs) evaluating the effect of massage compared to attention control/sham massage or standard care alone on acute pain intensity post-thoracic surgery. Twelve RCTs were included. Of these, nine evaluated massage in addition to standard analgesia, including 2 that compared massage to attention control/sham massage in the intensive care unit (ICU), 6 that compared massage to standard analgesia alone early post-ICU discharge, and 1 that compared massage to both attention control and standard care in the ICU. Patients receiving massage with analgesia reported less pain (0-10 scale) compared to attention control/sham massage (3 RCTs; N = 462; mean difference -0.80, 95% confidence interval [CI] -1.25 to -0.35; p < 0.001; I 2  = 13%) and standard care (7 RCTs; N = 1087; mean difference -0.85, 95% CI -1.28 to -0.42; p < 0.001; I 2  = 70%). Massage, in addition to pharmacological analgesia, reduces acute post-cardiac surgery pain intensity. Copyright © 2017 Elsevier Inc. All rights reserved.

Assessing the Added Value of Dynamical Downscaling Using the Standardized Precipitation Index

EPA Science Inventory

In this study, the Standardized Precipitation Index (SPI) is used to ascertain the added value of dynamical downscaling over the contiguous United States. WRF is used as a regional climate model (RCM) to dynamically downscale reanalysis fields to compare values of SPI over drough...

[Characterization and comparison of interferon reference standards using UPLC-MS].

PubMed

Tao, Lei; Pei, De-ning; Han, Chun-mei; Chen, Wei; Rao, Chun-ming; Wang, Jun-zhi

2015-01-01

The study aims to characterize and compare interferon reference standards from 5 manufacturers. By testing molecular mass and trypsin-digested peptide mass mapping, the amino acid sequence was verified and post-translational modifications such as disulfide bond were identified. Results show that the molecular mass and amino acid sequence were consistent with theory; the disulfide bonds of 4 lots of interferon were Cys1-Cys98/Cys29-Cys138, 1 lot was Cys29-Cys139/Cys86-Cys99; N-terminal "+Met", acetyl N-terminal and Met oxidation were identified in part of the sample. UPLC-MS can be used to characterize and compare interferon reference standards from different manufacturers.

The role of ultrasound guidance in pediatric caudal block

PubMed Central

Erbüyün, Koray; Açıkgöz, Barış; Ok, Gülay; Yılmaz, Ömer; Temeltaş, Gökhan; Tekin, İdil; Tok, Demet

2016-01-01

Objectives: To compare the time interval of the procedure, possible complications, post-operative pain levels, additional analgesics, and nurse satisfaction in ultrasonography-guided and standard caudal block applications. Methods: This retrospective study was conducted in Celal Bayar University Hospital, Manisa, Turkey, between January and December 2014, included 78 pediatric patients. Caudal block was applied to 2 different groups; one with ultrasound guide, and the other using the standard method. Results: The time interval of the procedure was significantly shorter in the standard application group compared with ultrasound-guided group (p=0.020). Wong-Baker FACES Pain Rating Scale values obtained at the 90th minute was statistically lower in the standard application group compared with ultrasound-guided group (p=0.035). No statistically significant difference was found on the other parameters between the 2 groups. The shorter time interval of the procedure at standard application group should not be considered as a distinctive mark by the pediatric anesthesiologists, because this time difference was as short as seconds. Conclusion: Ultrasound guidance for caudal block applications would neither increase nor decrease the success of the treatment. However, ultrasound guidance should be needed in cases where the detection of sacral anatomy is difficult, especially by palpations. PMID:26837396

Sources of Biased Inference in Alcohol and Drug Services Research: An Instrumental Variable Approach

PubMed Central

Schmidt, Laura A.; Tam, Tammy W.; Larson, Mary Jo

2012-01-01

Objective: This study examined the potential for biased inference due to endogeneity when using standard approaches for modeling the utilization of alcohol and drug treatment. Method: Results from standard regression analysis were compared with those that controlled for endogeneity using instrumental variables estimation. Comparable models predicted the likelihood of receiving alcohol treatment based on the widely used Aday and Andersen medical care–seeking model. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions and included a representative sample of adults in households and group quarters throughout the contiguous United States. Results: Findings suggested that standard approaches for modeling treatment utilization are prone to bias because of uncontrolled reverse causation and omitted variables. Compared with instrumental variables estimation, standard regression analyses produced downwardly biased estimates of the impact of alcohol problem severity on the likelihood of receiving care. Conclusions: Standard approaches for modeling service utilization are prone to underestimating the true effects of problem severity on service use. Biased inference could lead to inaccurate policy recommendations, for example, by suggesting that people with milder forms of substance use disorder are more likely to receive care than is actually the case. PMID:22152672

A comparative appraisal of two equivalence tests for multiple standardized effects.

PubMed

Shieh, Gwowen

2016-04-01

Equivalence testing is recommended as a better alternative to the traditional difference-based methods for demonstrating the comparability of two or more treatment effects. Although equivalent tests of two groups are widely discussed, the natural extensions for assessing equivalence between several groups have not been well examined. This article provides a detailed and schematic comparison of the ANOVA F and the studentized range tests for evaluating the comparability of several standardized effects. Power and sample size appraisals of the two grossly distinct approaches are conducted in terms of a constraint on the range of the standardized means when the standard deviation of the standardized means is fixed. Although neither method is uniformly more powerful, the studentized range test has a clear advantage in sample size requirements necessary to achieve a given power when the underlying effect configurations are close to the priori minimum difference for determining equivalence. For actual application of equivalence tests and advance planning of equivalence studies, both SAS and R computer codes are available as supplementary files to implement the calculations of critical values, p-values, power levels, and sample sizes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Estimation of Tooth Size Discrepancies among Different Malocclusion Groups

PubMed Central

Bala, Madhu; Goyal, Virender

2014-01-01

ABSTRACT Regards and Tribute: Late Dr Narender Hasija was a mentor and visionary in the light of knowledge and experience. We pay our regards with deepest gratitude to the departed soul to rest in peace. Bolton’s ratios help in estimating overbite, overjet relationships, the effects of contemplated extractions on posterior occlusion, incisor relationships and identification of occlusal misfit produced by tooth size discrepancies. Aim: To determine any difference in tooth size discrepancy in anterior as well as overall ratio in different malocclusions and comparison with Bolton’s study. Materials and methods: After measuring the teeth on all 100 patients, Bolton’s analysis was performed. Results were compared with Bolton’s means and standard deviations. The results were also subjected to statistical analysis. Results show that the mean and standard deviations of ideal occlusion cases are comparable with those Bolton but, when the mean and standard deviation of malocclusion groups are compared with those of Bolton, the values of standard deviation are higher, though the mean is comparable. How to cite this article: Hasija N, Bala M, Goyal V. Estimation of Tooth Size Discrepancies among Different Malocclusion Groups. Int J Clin Pediatr Dent 2014;7(2):82-85. PMID:25356005

Optimization of a chondrogenic medium through the use of factorial design of experiments.

PubMed

Enochson, Lars; Brittberg, Mats; Lindahl, Anders

2012-12-01

The standard culture system for in vitro cartilage research is based on cells in a three-dimensional micromass culture and a defined medium containing the chondrogenic key growth factor, transforming growth factor (TGF)-β1. The aim of this study was to optimize the medium for chondrocyte micromass culture. Human chondrocytes were cultured in different media formulations, designed with a factorial design of experiments (DoE) approach and based on the standard medium for redifferentiation. The significant factors for the redifferentiation of the chondrocytes were determined and optimized in a two-step process through the use of response surface methodology. TGF-β1, dexamethasone, and glucose were significant factors for differentiating the chondrocytes. Compared to the standard medium, TGF-β1 was increased 30%, dexamethasone reduced 50%, and glucose increased 22%. The potency of the optimized medium was validated in a comparative study against the standard medium. The optimized medium resulted in micromass cultures with increased expression of genes important for the articular chondrocyte phenotype and in cultures with increased glycosaminoglycan/DNA content. Optimizing the standard medium with the efficient DoE method, a new medium that gave better redifferentiation for articular chondrocytes was determined.

Comparison of joint angles and electromyographic activity of the lower extremities during standing with wearing standard and revised high-heeled shoes: A pilot study.

PubMed

Bae, Young-Hyeon; Ko, Mansoo; Lee, Suk Min

2016-04-29

Revised high-heeled shoes (HHSs) were designed to improve the shortcomings of standard HHSs. This study was conducted to compare revised and standard HHSs with regard to joint angles and electromyographic (EMG) activity of the lower extremities during standing. The participants were five healthy young women. Data regarding joint angles and EMG activity of the lower extremities were obtained under three conditions: barefoot, when wearing revised HHSs, and when wearing standard HHSs. Lower extremity joint angles in the three dimensional plane were confirmed using a VICON motion capture system. EMG activity of the lower extremities was measured using active bipolar surface EMG. Kruskal-Wallis one-way analysis of variance by rank applied to analyze differences during three standing conditions. Compared with the barefoot condition, the standard HHSs condition was more different than the revised HHSs condition with regard to lower extremity joint angles during standing. EMG activity of the lower extremities was different for the revised HHSs condition, but the differences among the three conditions were not significant. Wearing revised HHSs may positively impact joint angles and EMG activity of the lower extremities by improving body alignment while standing.

Improving the readability and processability of a pediatric informed consent document: effects on parents' understanding.

PubMed

Tait, Alan R; Voepel-Lewis, Terri; Malviya, Shobha; Philipson, Sandra J

2005-04-01

To examine whether a consent document modified to conform with the federal guidelines for readability and processability would result in greater parental understanding compared with a standard form. Randomized clinical study. The preoperative waiting area of a larger tertiary care children's hospital. A total of 305 parents of children scheduled for minor elective surgical procedures. Parents were randomized to receive information about a clinical study in 1 of 4 ways: (1) standard consent form alone, (2) standard consent form with verbal disclosure, (3) modified form alone (standard form modified to meet the federal guidelines for readability and processability), and (4) modified form with verbal disclosure. Parents were interviewed to determine their understanding of 11 elements of consent, including study purpose, protocol, risks, benefits to child (direct), benefit to others (indirect), freedom to withdraw, alternatives, duration of study, voluntariness, confidentiality, and whom to contact. Their responses were scored by 2 independent assessors. Understanding of the protocol, study duration, risks, and direct benefits, together with overall understanding, was greater among parents who received the modified form (P<.001). Additionally, parents reported that the modified form had greater clarity (P = .009) and improved layout compared with the standard form (P<.001). When parents were shown both forms, 81.2% preferred the modified version. Results suggest that a consent form written according to federal guidelines for readability and processability can improve parent understanding and thus will be important in enhancing the informed consent process.

A Comparative Study of Microscopic Images Captured by a Box Type Digital Camera Versus a Standard Microscopic Photography Camera Unit

PubMed Central

Desai, Nandini J.; Gupta, B. D.; Patel, Pratik Narendrabhai

2014-01-01

Introduction: Obtaining images of slides viewed by a microscope can be invaluable for both diagnosis and teaching.They can be transferred among technologically-advanced hospitals for further consultation and evaluation. But a standard microscopic photography camera unit (MPCU)(MIPS-Microscopic Image projection System) is costly and not available in resource poor settings. The aim of our endeavour was to find a comparable and cheaper alternative method for photomicrography. Materials and Methods: We used a NIKON Coolpix S6150 camera (box type digital camera) with Olympus CH20i microscope and a fluorescent microscope for the purpose of this study. Results: We got comparable results for capturing images of light microscopy, but the results were not as satisfactory for fluorescent microscopy. Conclusion: A box type digital camera is a comparable, less expensive and convenient alternative to microscopic photography camera unit. PMID:25478350

The average Indian female nose.

PubMed

Patil, Surendra B; Kale, Satish M; Jaiswal, Sumeet; Khare, Nishant; Math, Mahantesh

2011-12-01

This study aimed to delineate the anthropometric measurements of the noses of young women of an Indian population and to compare them with the published ideals and average measurements for white women. This anthropometric survey included a volunteer sample of 100 young Indian women ages 18 to 35 years with Indian parents and no history of previous surgery or trauma to the nose. Standardized frontal, lateral, oblique, and basal photographs of the subjects' noses were taken, and 12 standard anthropometric measurements of the nose were determined. The results were compared with published standards for North American white women. In addition, nine nasal indices were calculated and compared with the standards for North American white women. The nose of Indian women differs significantly from the white nose. All the nasal measurements for the Indian women were found to be significantly different from those for North American white women. Seven of the nine nasal indices also differed significantly. Anthropometric analysis suggests differences between the Indian female nose and the North American white nose. Thus, a single aesthetic ideal is inadequate. Noses of Indian women are smaller and wider, with a less projected and rounded tip than the noses of white women. This study established the nasal anthropometric norms for nasal parameters, which will serve as a guide for cosmetic and reconstructive surgery in Indian women.

Comparative Study between Standard and Totally Tubeless Percutaneous Nephrolithotomy.

PubMed

Yun, Sung Il; Lee, Yoon Hyung; Kim, Jae Soo; Cho, Sung Ryong; Kim, Bum Soo; Kwon, Joon Beom

2012-11-01

Several recent studies have reported the benefits of tubeless percutaneous nephrolithotomy (PNL). Postoperatively, tubeless PNL patients have an indwelling ureteral stent placed, which is often associated with stent-related morbidity. We have performed totally tubeless (tubeless and stentless) PNL in which no nephrostomy tube or ureteral stent is placed postoperatively. We evaluated the safety, effectiveness, and feasibility of totally tubeless PNL. From March 2008 to February 2012, 57 selected patients underwent standard or totally tubeless PNL. Neither a nephrostomy tube nor a ureteral stent was placed in the totally tubeless PNL group. We compared patient and stone characteristics, operation time, length of hospitalization, analgesia requirements, stone-free rate, blood loss, change in creatinine, and perioperative complications between the standard and totally tubeless PNL groups. There were no significant differences in preoperative patient characteristics, postoperative complications, or the stone-free rate between the two groups, but the totally tubeless PNL group showed a shorter hospitalization and a lesser analgesic requirement compared with the standard PNL group. Blood loss and change in creatinine were not significantly different between the two groups. Totally tubeless PNL appears to be a safe and effective alternative for the management of renal stone patients and is associated with a decrease in length of hospital stay.

Comparative Study between Standard and Totally Tubeless Percutaneous Nephrolithotomy

PubMed Central

Yun, Sung Il; Lee, Yoon Hyung; Kim, Jae Soo; Cho, Sung Ryong; Kim, Bum Soo

2012-01-01

Purpose Several recent studies have reported the benefits of tubeless percutaneous nephrolithotomy (PNL). Postoperatively, tubeless PNL patients have an indwelling ureteral stent placed, which is often associated with stent-related morbidity. We have performed totally tubeless (tubeless and stentless) PNL in which no nephrostomy tube or ureteral stent is placed postoperatively. We evaluated the safety, effectiveness, and feasibility of totally tubeless PNL. Materials and Methods From March 2008 to February 2012, 57 selected patients underwent standard or totally tubeless PNL. Neither a nephrostomy tube nor a ureteral stent was placed in the totally tubeless PNL group. We compared patient and stone characteristics, operation time, length of hospitalization, analgesia requirements, stone-free rate, blood loss, change in creatinine, and perioperative complications between the standard and totally tubeless PNL groups. Results There were no significant differences in preoperative patient characteristics, postoperative complications, or the stone-free rate between the two groups, but the totally tubeless PNL group showed a shorter hospitalization and a lesser analgesic requirement compared with the standard PNL group. Blood loss and change in creatinine were not significantly different between the two groups. Conclusions Totally tubeless PNL appears to be a safe and effective alternative for the management of renal stone patients and is associated with a decrease in length of hospital stay. PMID:23185671

The use of computerized image guidance in lumbar disk arthroplasty.

PubMed

Smith, Harvey E; Vaccaro, Alexander R; Yuan, Philip S; Papadopoulos, Stephen; Sasso, Rick

2006-02-01

Surgical navigation systems have been increasingly studied and applied in the application of spinal instrumentation. Successful disk arthroplasty requires accurate midline and rotational positioning for optimal function and longevity. A surgical simulation study in human cadaver specimens was done to evaluate and compare the accuracy of standard fluoroscopy, computer-assisted fluoroscopic image guidance, and Iso-C3D image guidance in the placement of lumbar intervertebral disk replacements. Lumbar intervertebral disk prostheses were placed using three different image guidance techniques in three human cadaver spine specimens at multiple levels. Postinstrumentation accuracy was assessed with thin-cut computed tomography scans. Intervertebral disk replacements placed using the StealthStation with Iso-C3D were more accurately centered than those placed using the StealthStation with FluoroNav and standard fluoroscopy. Intervertebral disk replacements placed with Iso-C3D and FluoroNav had improved rotational divergence compared with standard fluoroscopy. Iso-C3D and FluoroNav had a smaller interprocedure variance than standard fluoroscopy. These results did not approach statistical significance. Relative to both virtual and standard fluoroscopy, use of the StealthStation with Iso-C3D resulted in improved accuracy in centering the lumbar disk prosthesis in the coronal midline. The StealthStation with FluoroNav appears to be at least equivalent to standard fluoroscopy and may offer improved accuracy with rotational alignment while minimizing radiation exposure to the surgeon. Surgical guidance systems may offer improved accuracy and less interprocedure variation in the placement of intervertebral disk replacements than standard fluoroscopy. Further study regarding surgical navigation systems for intervertebral disk replacement is warranted.

Comparing Geologic Data Sets Collected by Planetary Analog Traverses and by Standard Geologic Field Mapping: Desert Rats Data Analysis

NASA Technical Reports Server (NTRS)

Feng, Wanda; Evans, Cynthia; Gruener, John; Eppler, Dean

2014-01-01

Geologic mapping involves interpreting relationships between identifiable units and landforms to understand the formative history of a region. Traditional field techniques are used to accomplish this on Earth. Mapping proves more challenging for other planets, which are studied primarily by orbital remote sensing and, less frequently, by robotic and human surface exploration. Systematic comparative assessments of geologic maps created by traditional mapping versus photogeology together with data from planned traverses are limited. The objective of this project is to produce a geologic map from data collected on the Desert Research and Technology Studies (RATS) 2010 analog mission using Apollo-style traverses in conjunction with remote sensing data. This map is compared with a geologic map produced using standard field techniques.

Femtosecond laser-assisted compared with standard cataract surgery for removal of advanced cataracts.

PubMed

Hatch, Kathryn M; Schultz, Tim; Talamo, Jonathan H; Dick, H Burkhard

2015-09-01

To compare effective phacoemulsification time (EPT) for the removal of brunescent cataracts treated with femtosecond laser-assisted cataract surgery with standard cataract phacoemulsification techniques. Ruhr University Eye Hospital, Bochum, Germany. Comparative prospective case study. The Lens Opacities Classification System III (LOCS III) grading system was used to measure eyes divided into 4 groups having cataract surgery. Groups 1 and 2 contained eyes with LOCS III grade nuclear opalescence (NO) 3 cataracts treated with standard cataract surgery and femtosecond laser-assisted cataract surgery, respectively. Groups 3 and 4 contained brunescent cataracts, LOCS III grades NO5, treated with standard cataract surgery and femtosecond laser-assisted cataract surgery, respectively. There were 240 eyes, with 60 eyes in each group. The EPT in Group 1 ranged from 0.46 to 3.10 (mean 1.38); the EPT in all eyes in Group 2 was 0 (P < .001). The EPT in Groups 3 and 4 was 2.12 to 19.29 (mean 6.85) and 0 to 6.75 (mean 1.35), respectively (P < .001). A comparison between EPT in Groups 1 and 4 showed that EPT in Group 4 was also lower than in Group 1 (P = .013). Groups 4 and 1 were the most statistically similar of all groups compared, suggesting that EPT for a femtosecond laser-treated grade 5 cataract was most similar to that of a standard-treated grade 3 cataract. Femtosecond laser pretreatment for brunescent cataracts allowed for a significant reduction in EPT compared with manual standard phacoemulsification techniques. Drs. Hatch, Talamo, and Dick are consultants to Abbott Medical Optics, Inc. Dr. Schultz has no financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

A prospective double-blinded randomized controlled trial comparing systemic stress response in Laparoascopic cholecystectomy between low-pressure and standard-pressure pneumoperitoneum.

PubMed

Shoar, Saeed; Naderan, Mohammad; Ebrahimpour, Hossein; Soroush, Ahmadreza; Nasiri, Shirzad; Movafegh, Ali; Khorgami, Zhamak

2016-04-01

Laparoscopic cholecystectomy (LC) has become the gold-standard treatment for gallstone diseases. However, despite huge reduction in operative injury, systemic stress response remains high. This randomized controlled trial (RCT) aimed to compare systemic stress response between 2 different techniques of CO2 pneumoperitoneum. Trough a prospective, double-blinded RCT, serum levels of cortisol, adrenaline, glucose, and C-reactive protein (CRP) were compared between the two groups consisted of 50 patients undergoing LC under low-pressure and standard-pressure CO2 pneimoperitoneum. A total of fifty patients undergoing LC were equally assigned to 2 groups of twenty five patients. Average age was 48 ± 13.8 years (range, 19-74 years). Operative time was similar between standard-pressure group (47.8 ± 16.8 min) and low-pressure group (53.6 ± 25.1). Moreover, intra-operative IV volume administration and urine output did not differ significantly between the 2 groups (p > 0.05). Although the average heart rate and mean arterial pressure were slightly higher in a standard-pressure group compared with a low-pressure group, serial measurements of these parameters were statistically similar between the 2 groups. Serial changes of serum levels of cortisol, glucose, adrenaline, and CRP were compared between surgery day, postoperative 6-h and 1st postoperative day, which did not differ significantly between the standard-pressure and the low-pressure groups (p > 0.05). Our study did not reveal any alteration in systemic stress response with reduction in intra-abdominal pressure of pneumoperitoneum in LC. RCT REGISTRATION: irct.ir ID: IRCT201110072982N5. Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Comparative Analysis of Selected Motor Fitness Profile of Football Referees in Cross River and AKWA IBOM States, Nigeria

ERIC Educational Resources Information Center

Ogabor, J. O.; Sanusi, M.; Saulawa, A. I.

2015-01-01

The purpose of this study was to compare selected motor fitness profile of football referees in Cross River and Akwa Ibom States. Motor fitness profiles compared were running speed and agility of the referees. Standardized equipment and procedures were employed in the tests. To achieve the objectives of the study, two research hypotheses were…

High-definition vs. standard-definition colonoscopy in the characterization of small colonic polyps: results from a randomized trial.

PubMed

Longcroft-Wheaton, G; Brown, J; Cowlishaw, D; Higgins, B; Bhandari, P

2012-10-01

The resolution of endoscopes has increased in recent years. Modern Fujinon colonoscopes have a charge-coupled device (CCD) pixel density of 650,000 pixels compared with the 410,000 pixel CCD in standard-definition scopes. Acquiring high-definition scopes represents a significant capital investment and their clinical value remains uncertain. The aim of the current study was to investigate the impact of high-definition endoscopes on the in vivo histology prediction of colonic polyps. Colonoscopy procedures were performed using Fujinon colonoscopes and EPX-4400 processor. Procedures were randomized to be performed using either a standard-definition EC-530 colonoscope or high-definition EC-530 and EC-590 colonoscopes. Polyps of <10 mm were assessed using both white light imaging (WLI) and flexible spectral imaging color enhancement (FICE), and the predicted diagnosis was recorded. Polyps were removed and sent for histological analysis by a pathologist who was blinded to the endoscopic diagnosis. The predicted diagnosis was compared with the histology to calculate the accuracy, sensitivity, and specificity of in vivo assessment using either standard or high-definition scopes. A total of 293 polyps of <10 mm were examined–150 polyps using the standard-definition colonoscope and 143 polyps using high-definition colonoscopes. There was no difference in sensitivity, specificity or accuracy between the two scopes when WLI was used (standard vs. high: accuracy 70% [95% CI 62–77] vs. 73% [95% CI 65–80]; P=0.61). When FICE was used, high-definition colonoscopes showed a sensitivity of 93% compared with 83% for standard-definition colonoscopes (P=0.048); specificity was 81% and 82%, respectively. There was no difference between high- and standard-definition colonoscopes when white light was used, but FICE significantly improved the in vivo diagnosis of small polyps when high-definition scopes were used compared with standard definition.

The "Glocalization" of Medical School Accreditation: Case Studies From Taiwan, South Korea, and Japan.

PubMed

Ho, Ming-Jung; Abbas, Joan; Ahn, Ducksun; Lai, Chi-Wan; Nara, Nobuo; Shaw, Kevin

2017-12-01

In an age of globalized medical education, medical school accreditation has been hailed as an approach to external quality assurance. However, accreditation standards can vary widely across national contexts. To achieve recognition by the World Federation for Medical Education (WFME), national accrediting bodies must develop standards suitable for both local contexts and international recognition. This study framed this issue in terms of "glocalization" and aimed to shine light on this complicated multistakeholder process by exploring accreditation in Taiwan, South Korea, and Japan. This study employed a comparative case-study design, examining the national standards that three accreditation bodies in East Asia developed using international reference standards. In 2015-2016, the authors conducted document analysis of the English versions of the standards to identify the differences between the national and international reference standards as well as how and why external standards were adapted. Each country's accreditation body sought to balance local needs with global demands. Each used external standards as a template (e.g., Liaison Committee on Medical Education, General Medical Council, or WFME standards) and either revised (Taiwan, South Korea) or annotated (Japan) the standards to fit the local context. Four categories of differences emerged to account for how and why national standards departed from external references: structural, regulatory, developmental, and aspirational. These countries' glocalization of medical accreditation standards serve as examples for others seeking to bring their accreditation practices in line with global standards while ensuring that local values and societal needs are given adequate consideration.

Differences in Anticipatory Behaviour between Rats (Rattus norvegicus) Housed in Standard versus Semi-Naturalistic Laboratory Environments.

PubMed

Makowska, I Joanna; Weary, Daniel M

2016-01-01

Laboratory rats are usually kept in relatively small cages, but research has shown that they prefer larger and more complex environments. The physiological, neurological and health effects of standard laboratory housing are well established, but fewer studies have addressed the sustained emotional impact of a standard cage environment. One method of assessing affective states in animals is to look at the animals' anticipatory behaviour between the presentation of a cue signalling the arrival of a reward and the arrival of that reward. The primary aim of this study was to use anticipatory behaviour to assess the affective state experienced by female rats a) reared and housed long-term in a standard laboratory cage versus a semi-naturalistic environment, and b) before and after treatment with an antidepressant or an anxiolytic. A secondary aim was to add to the literature on anticipatory behaviour by describing and comparing the frequency and duration of individual elements of anticipatory behaviour displayed by rats reared in these two systems. In all experiments, total behavioural frequency was higher in standard-housed rats compared to rats from the semi-naturalistic condition, suggesting that standard-housed rats were more sensitive to rewards and experiencing poorer welfare than rats reared in the semi-naturalistic environment. What rats did in anticipation of the reward also differed between housing treatments, with standard-housed rats mostly rearing and rats from the semi-naturalistic condition mostly sitting facing the direction of the upcoming treat. Drug interventions had no effect on the quantity or form of anticipatory behaviour, suggesting that the poorer welfare experienced by standard-housed rats was not analogous to depression or anxiety, or alternatively that the drug interventions were ineffective. This study adds to mounting evidence that standard laboratory housing for rats compromises rat welfare, and provides further scientific support for recommendations that current minimum standards be raised.

The accuracy of ultrashort echo time MRI sequences for medical additive manufacturing.

PubMed

van Eijnatten, Maureen; Rijkhorst, Erik-Jan; Hofman, Mark; Forouzanfar, Tymour; Wolff, Jan

2016-01-01

Additively manufactured bone models, implants and drill guides are becoming increasingly popular amongst maxillofacial surgeons and dentists. To date, such constructs are commonly manufactured using CT technology that induces ionizing radiation. Recently, ultrashort echo time (UTE) MRI sequences have been developed that allow radiation-free imaging of facial bones. The aim of the present study was to assess the feasibility of UTE MRI sequences for medical additive manufacturing (AM). Three morphologically different dry human mandibles were scanned using a CT and MRI scanner. Additionally, optical scans of all three mandibles were made to acquire a "gold standard". All CT and MRI scans were converted into Standard Tessellation Language (STL) models and geometrically compared with the gold standard. To quantify the accuracy of the AM process, the CT, MRI and gold-standard STL models of one of the mandibles were additively manufactured, optically scanned and compared with the original gold-standard STL model. Geometric differences between all three CT-derived STL models and the gold standard were <1.0 mm. All three MRI-derived STL models generally presented deviations <1.5 mm in the symphyseal and mandibular area. The AM process introduced minor deviations of <0.5 mm. This study demonstrates that MRI using UTE sequences is a feasible alternative to CT in generating STL models of the mandible and would therefore be suitable for surgical planning and AM. Further in vivo studies are necessary to assess the usability of UTE MRI sequences in clinical settings.

An International Collaboration To Standardize HIV-2 Viral Load Assays: Results from the 2009 ACHIEV2E Quality Control Study▿

PubMed Central

Damond, F.; Benard, A.; Balotta, Claudia; Böni, Jürg; Cotten, Matthew; Duque, Vitor; Ferns, Bridget; Garson, Jeremy; Gomes, Perpetua; Gonçalves, Fátima; Gottlieb, Geoffrey; Kupfer, Bernd; Ruelle, Jean; Rodes, Berta; Soriano, Vicente; Wainberg, Mark; Taieb, Audrey; Matheron, Sophie; Chene, Genevieve; Brun-Vezinet, Francoise

2011-01-01

Accurate HIV-2 plasma viral load quantification is crucial for adequate HIV-2 patient management and for the proper conduct of clinical trials and international cohort collaborations. This study compared the homogeneity of HIV-2 RNA quantification when using HIV-2 assays from ACHIEV2E study sites and either in-house PCR calibration standards or common viral load standards supplied to all collaborators. Each of the 12 participating laboratories quantified blinded HIV-2 samples, using its own HIV-2 viral load assay and standard as well as centrally validated and distributed common HIV-2 group A and B standards (http://www.hiv.lanl.gov/content/sequence/HelpDocs/subtypes-more.html). Aliquots of HIV-2 group A and B strains, each at 2 theoretical concentrations (2.7 and 3.7 log10 copies/ml), were tested. Intralaboratory, interlaboratory, and overall variances of quantification results obtained with both standards were compared using F tests. For HIV-2 group A quantifications, overall and interlaboratory and/or intralaboratory variances were significantly lower when using the common standard than when using in-house standards at the concentration levels of 2.7 log10 copies/ml and 3.7 log10 copies/ml, respectively. For HIV-2 group B, a high heterogeneity was observed and the variances did not differ according to the type of standard used. In this international collaboration, the use of a common standard improved the homogeneity of HIV-2 group A RNA quantification only. The diversity of HIV-2 group B, particularly in PCR primer-binding regions, may explain the heterogeneity in quantification of this strain. Development of a validated HIV-2 viral load assay that accurately quantifies distinct circulating strains is needed. PMID:21813718

A simulation-based training program improves emergency department staff communication.

PubMed

Sweeney, Lynn A; Warren, Otis; Gardner, Liz; Rojek, Adam; Lindquist, David G

2014-01-01

The objectives of this study were to evaluate the effectiveness of Project CLEAR!, a novel simulation-based training program designed to instill Crew Resource Management (CRM) as the communication standard and to create a service-focused environment in the emergency department (ED) by standardizing the patient encounter. A survey-based study compared physicians' and nurses' perceptions of the quality of communication before and after the training program. Surveys were developed to measure ED staff perceptions of the quality of communication between staff members and with patients. Pretraining and posttraining survey results were compared. After the training program, survey scores improved significantly on questions that asked participants to rate the overall communication between staff members and between staff and patients. A simulation-based training program focusing on CRM and standardizing the patient encounter improves communication in the ED, both between staff members and between staff members and patients.

Varicose Veins in Women Cotton Workers. An Epidemiological Study in England and Egypt*

PubMed Central

Mekky, Siza; Schilling, R. S. F.; Walford, Joan

1969-01-01

The prevalence of varicose veins was studied in 504 women cotton workers in England and 467 in Egypt, by a standardized questionary and a specially developed method of examination. The English mill population showed a much higher prevalence of varicose veins than the Egyptian, probably owing to environmental rather than ethnic reasons. Among the European women the prevalence of varicose veins was significantly related to age, parity, body weight, type of corsetry, and occupation—that is, whether or not they stood at their work. After standardizing for the other variables there was a statistically significant excess of varicose veins in women wearing corsets and roll-ons compared with those wearing less-constrictive garments. After a similar standardization a significant excess was found in women who stood at their work compared with those whose jobs entailed walking or sitting. Imagesp593-a PMID:5798468

A Room with a Viewpoint Revisited: Descriptive Norms and Hotel Guests' Towel Reuse Behavior

PubMed Central

Bohner, Gerd; Schlüter, Lena E.

2014-01-01

Field experiments on descriptive norms as a means to increase hotel guests' towel reuse [1] were replicated and extended. In two hotels in Germany (Study 1: N = 724; Study 2: N = 204), descriptive norm messages suggesting that 75% of guests had reused their towels, or a standard message appealing to environmental concerns, were placed in guests' bathrooms. Descriptive norm messages varied in terms of proximity of the reference group (“hotel guests” vs. “guests in this room”) and temporal proximity (currently vs. two years previous). Reuse of towels was unobtrusively recorded. Results showed that reuse rates were high overall and that both standard and descriptive norm messages increased reuse rates compared to a no-message baseline. However, descriptive norm messages were not more effective than the standard message, and effects of proximity were inconsistent across studies. Discussion addresses cultural and conceptual issues in comparing the present findings with previous ones. PMID:25084348

LC-MS/MS-based approach for obtaining exposure estimates of metabolites in early clinical trials using radioactive metabolites as reference standards.

PubMed

Zhang, Donglu; Raghavan, Nirmala; Chando, Theodore; Gambardella, Janice; Fu, Yunlin; Zhang, Duxi; Unger, Steve E; Humphreys, W Griffith

2007-12-01

An LC-MS/MS-based approach that employs authentic radioactive metabolites as reference standards was developed to estimate metabolite exposures in early drug development studies. This method is useful to estimate metabolite levels in studies done with non-radiolabeled compounds where metabolite standards are not available to allow standard LC-MS/MS assay development. A metabolite mixture obtained from an in vivo source treated with a radiolabeled compound was partially purified, quantified, and spiked into human plasma to provide metabolite standard curves. Metabolites were analyzed by LC-MS/MS using the specific mass transitions and an internal standard. The metabolite concentrations determined by this approach were found to be comparable to those determined by valid LC-MS/MS assays. This approach does not requires synthesis of authentic metabolites or the knowledge of exact structures of metabolites, and therefore should provide a useful method to obtain early estimates of circulating metabolites in early clinical or toxicological studies.

Comparing interval estimates for small sample ordinal CFA models

PubMed Central

Natesan, Prathiba

2015-01-01

Robust maximum likelihood (RML) and asymptotically generalized least squares (AGLS) methods have been recommended for fitting ordinal structural equation models. Studies show that some of these methods underestimate standard errors. However, these studies have not investigated the coverage and bias of interval estimates. An estimate with a reasonable standard error could still be severely biased. This can only be known by systematically investigating the interval estimates. The present study compares Bayesian, RML, and AGLS interval estimates of factor correlations in ordinal confirmatory factor analysis models (CFA) for small sample data. Six sample sizes, 3 factor correlations, and 2 factor score distributions (multivariate normal and multivariate mildly skewed) were studied. Two Bayesian prior specifications, informative and relatively less informative were studied. Undercoverage of confidence intervals and underestimation of standard errors was common in non-Bayesian methods. Underestimated standard errors may lead to inflated Type-I error rates. Non-Bayesian intervals were more positive biased than negatively biased, that is, most intervals that did not contain the true value were greater than the true value. Some non-Bayesian methods had non-converging and inadmissible solutions for small samples and non-normal data. Bayesian empirical standard error estimates for informative and relatively less informative priors were closer to the average standard errors of the estimates. The coverage of Bayesian credibility intervals was closer to what was expected with overcoverage in a few cases. Although some Bayesian credibility intervals were wider, they reflected the nature of statistical uncertainty that comes with the data (e.g., small sample). Bayesian point estimates were also more accurate than non-Bayesian estimates. The results illustrate the importance of analyzing coverage and bias of interval estimates, and how ignoring interval estimates can be misleading. Therefore, editors and policymakers should continue to emphasize the inclusion of interval estimates in research. PMID:26579002

Comparing interval estimates for small sample ordinal CFA models.

PubMed

Natesan, Prathiba

2015-01-01

Robust maximum likelihood (RML) and asymptotically generalized least squares (AGLS) methods have been recommended for fitting ordinal structural equation models. Studies show that some of these methods underestimate standard errors. However, these studies have not investigated the coverage and bias of interval estimates. An estimate with a reasonable standard error could still be severely biased. This can only be known by systematically investigating the interval estimates. The present study compares Bayesian, RML, and AGLS interval estimates of factor correlations in ordinal confirmatory factor analysis models (CFA) for small sample data. Six sample sizes, 3 factor correlations, and 2 factor score distributions (multivariate normal and multivariate mildly skewed) were studied. Two Bayesian prior specifications, informative and relatively less informative were studied. Undercoverage of confidence intervals and underestimation of standard errors was common in non-Bayesian methods. Underestimated standard errors may lead to inflated Type-I error rates. Non-Bayesian intervals were more positive biased than negatively biased, that is, most intervals that did not contain the true value were greater than the true value. Some non-Bayesian methods had non-converging and inadmissible solutions for small samples and non-normal data. Bayesian empirical standard error estimates for informative and relatively less informative priors were closer to the average standard errors of the estimates. The coverage of Bayesian credibility intervals was closer to what was expected with overcoverage in a few cases. Although some Bayesian credibility intervals were wider, they reflected the nature of statistical uncertainty that comes with the data (e.g., small sample). Bayesian point estimates were also more accurate than non-Bayesian estimates. The results illustrate the importance of analyzing coverage and bias of interval estimates, and how ignoring interval estimates can be misleading. Therefore, editors and policymakers should continue to emphasize the inclusion of interval estimates in research.

Improved overall delivery documentation following implementation of a standardized shoulder dystocia delivery form

PubMed Central

Moragianni, Vasiliki A.; Hacker, Michele R.; Craparo, Frank J.

2013-01-01

Objective Our objective was to evaluate whether using a standardized shoulder dystocia delivery form improved documentation. A standardized delivery form was added to our institution’s obstetrical record in August 2003. Methods A retrospective cohort study was conducted comparing 100 vaginal deliveries complicated by shoulder dystocia before, and 81 after implementation of the standardized delivery form. The two groups were compared in terms of obstetric characteristics, neonatal outcomes and documentation components. Results Charts that included the standardized delivery form were more likely to contain documentation of estimated fetal weight (82.7% vs. 39.0% without the form, P<0.001) and head-to-shoulder delivery interval (76.5% vs. 15.0% without the form, P<0.001). Both groups were statistically similar in terms of documenting estimated blood loss and fetal weight, umbilical cord pH, type and order of maneuvers utilized to relieve the shoulder dystocia, and second stage duration. Conclusions Inclusion of a standardized form in the delivery record improves the rate of documentation of both shoulder dystocia-specific and general delivery components. PMID:22017330

Scripted or Non-Scripted: A Comparative Analysis of Two Reading Programs

ERIC Educational Resources Information Center

Bosen, Pamela K.

2014-01-01

The focus of this quantitative comparative study was to analyze school achievement on third-grade reading assessments in 60 similar schools over a three-year period on Washington state standardized criterion-referenced assessments. This study provides statistical data showing the non-scripted programs were consistent for all three years while…

Intravenous iron isomaltoside 1000 administered by high single-dose infusions or standard medical care for the treatment of fatigue in women after postpartum haemorrhage: study protocol for a randomised controlled trial.

PubMed

Holm, Charlotte; Thomsen, Lars Lykke; Norgaard, Astrid; Langhoff-Roos, Jens

2015-01-14

Postpartum haemorrhage can lead to iron deficiency with and without anaemia, the clinical consequences of which include physical fatigue. Although oral iron is the standard treatment, it is often associated with gastrointestinal side effects and poor compliance. To date, no published randomised controlled studies have compared the clinical efficacy and safety of standard medical care with intravenous administration of iron supplementation after postpartum haemorrhage.The primary objective of this study is to compare the efficacy of an intravenous high single-dose of iron isomaltoside 1000 with standard medical care on physical fatigue in women with postpartum haemorrhage. In a single centre, open-labelled, randomised trial, women with postpartum haemorrhage exceeding 700 mL will be allocated to either a single dose of 1,200 mg of iron isomaltoside 1000 or standard medical care. Healthy parturients with a singleton pregnancy will be included within 48 hours after delivery.Participants will complete structured questionnaires that focus on several dimensions of fatigue and mental health (Multidimensional Fatigue Inventory, Edinburgh Postnatal Depression Scale and the Postpartum Questionnaire), at inclusion and at follow-up visits after three days, one week, three weeks, eight weeks, and 12 weeks postpartum. The primary endpoint is the aggregated change in physical fatigue score within 12 weeks postpartum, as measured by a subscale of the Multidimensional Fatigue Inventory. The primary objective will be considered to have been met if an intravenous high single dose of iron isomaltoside 1000 is shown to be superior to standard medical care in women after postpartum haemorrhage regarding physical fatigue.For claiming superiority, we set the minimal clinically relevant difference between the mean scores at 1.8, and the assumed standard deviation at 4.2. Hence, 87 participants per treatment group are needed in order to demonstrate superiority; to provide an extra margin for missing data and dropouts, 200 women will be included. The study will provide evidence on relevant clinical outcomes beyond biochemical parameters for intravenous iron isomaltoside 1000 compared to standard medical care in women after postpartum haemorrhage. This trial is registered with Clinicaltrials.gov (identifier: NCT01895218) on 26 June 2013.

Additional considerations are required when preparing a protocol for a systematic review with multiple interventions.

PubMed

Chaimani, Anna; Caldwell, Deborah M; Li, Tianjing; Higgins, Julian P T; Salanti, Georgia

2017-03-01

The number of systematic reviews that aim to compare multiple interventions using network meta-analysis is increasing. In this study, we highlight aspects of a standard systematic review protocol that may need modification when multiple interventions are to be compared. We take the protocol format suggested by Cochrane for a standard systematic review as our reference and compare the considerations for a pairwise review with those required for a valid comparison of multiple interventions. We suggest new sections for protocols of systematic reviews including network meta-analyses with a focus on how to evaluate their assumptions. We provide example text from published protocols to exemplify the considerations. Standard systematic review protocols for pairwise meta-analyses need extensions to accommodate the increased complexity of network meta-analysis. Our suggested modifications are widely applicable to both Cochrane and non-Cochrane systematic reviews involving network meta-analyses. Copyright © 2017 Elsevier Inc. All rights reserved.

Thermodynamic Properties of a First-Generation Carbosilane Dendrimer with Terminal Phenylethyl Groups

NASA Astrophysics Data System (ADS)

Sologubov, S. S.; Markin, A. V.; Smirnova, N. N.; Novozhilova, N. A.; Tatarinova, E. A.; Muzafarov, A. M.

2018-02-01

The heat capacity of a first-generation carbosilane dendrimer with terminal phenylethyl groups as a function of temperature in the range from 6 to 520 K is studied for the first time via precision adiabatic vacuum calorimetry and differential scanning calorimetry. Physical transformations, such as low-temperature structural anomaly and glass transition are detected in the above-mentioned range of temperatures, and their standard thermodynamic characteristics are determined and analyzed. The standard thermodynamic functions of the studied dendrimer in the range of T → 0 to 520 K are calculated from the experimental data, as is the standard entropy in the devitrified state at T = 298.15 K. The standard thermodynamic characteristics of the carbosilane dendrimers studied in this work and earlier are compared.

Standardized Methods for Enhanced Quality and Comparability of Tuberculous Meningitis Studies.

PubMed

Marais, Ben J; Heemskerk, Anna D; Marais, Suzaan S; van Crevel, Reinout; Rohlwink, Ursula; Caws, Maxine; Meintjes, Graeme; Misra, Usha K; Mai, Nguyen T H; Ruslami, Rovina; Seddon, James A; Solomons, Regan; van Toorn, Ronald; Figaji, Anthony; McIlleron, Helen; Aarnoutse, Robert; Schoeman, Johan F; Wilkinson, Robert J; Thwaites, Guy E

2017-02-15

Tuberculous meningitis (TBM) remains a major cause of death and disability in tuberculosis-endemic areas, especially in young children and immunocompromised adults. Research aimed at improving outcomes is hampered by poor standardization, which limits study comparison and the generalizability of results. We propose standardized methods for the conduct of TBM clinical research that were drafted at an international tuberculous meningitis research meeting organized by the Oxford University Clinical Research Unit in Vietnam. We propose a core dataset including demographic and clinical information to be collected at study enrollment, important aspects related to patient management and monitoring, and standardized reporting of patient outcomes. The criteria proposed for the conduct of observational and intervention TBM studies should improve the quality of future research outputs, can facilitate multicenter studies and meta-analyses of pooled data, and could provide the foundation for a global TBM data repository.

High quality, patient centred and coordinated care for Alstrom syndrome: a model of care for an ultra-rare disease.

PubMed

Van Groenendael, Stephanie; Giacovazzi, Luca; Davison, Fabian; Holtkemper, Oliver; Huang, Zexin; Wang, Qiaoying; Parkinson, Kay; Barrett, Timothy; Geberhiwot, Tarekegn

2015-11-24

Patients with rare and ultra-rare diseases make heavy demands on the resources of both health and social services, but these resources are often used inefficiently due to delays in diagnosis, poor and fragmented care. We analysed the national service for an ultra-rare disease, Alstrom syndrome, and compared the outcome and cost of the service to the standard care. Between the 9th and 26th of March 2014 we undertook a cross-sectional study of the UK Alstrom syndrome patients and their carers. We developed a semi-structured questionnaire to assess our rare patient need, quality of care and costs incurred to patients and their careers. In the UK all Alstrom syndrome patients are seen in two centres, based in Birmingham, and we systematically evaluated the national service and compared the quality and cost of care with patients' previous standard of care. One quarter of genetically confirmed Alstrom syndrome UK patients were enrolled in this study. Patients that have access to a highly specialised clinical service reported that their care is well organised, personalised, holistic, and that they have a say in their care. All patients reported high level of satisfaction in their care. Patient treatment compliance and clinic attendance was better in multidisciplinary clinic than the usual standard of NHS care. Following a variable costing approach based on personnel and consumables' cost, our valuation of the clinics was just under £700/patient/annum compared to the standard care of £960/patient/annum. Real savings, however, came in terms of patients' quality of life. Furthermore there was found to have been a significant reduction in frequency of clinic visits and ordering of investigations since the establishment of the national service. Our study has shown that organised, multidisciplinary "one stop" clinics are patient centred and individually tailored to the patient need with a better outcome and comparable cost compared with the current standard of care for rare disease. Our proposed care model can be adapted to several other rare and ultra-rare diseases.

A prospective, randomised, controlled, multi-centre comparative effectiveness study of healing using dehydrated human amnion/chorion membrane allograft, bioengineered skin substitute or standard of care for treatment of chronic lower extremity diabetic ulcers.

PubMed

Zelen, Charles M; Gould, Lisa; Serena, Thomas E; Carter, Marissa J; Keller, Jennifer; Li, William W

2015-12-01

A prospective, randomised, controlled, parallel group, multi-centre clinical trial was conducted at three sites to compare the healing effectiveness of treatment of chronic lower extremity diabetic ulcers with either weekly applications of Apligraf(®) (Organogenesis, Inc., Canton, MA), EpiFix(®) (MiMedx Group, Inc., Marietta, GA), or standard wound care with collagen-alginate dressing. The primary study outcome was the percent change in complete wound healing after 4 and 6 weeks of treatment. Secondary outcomes included percent change in wound area per week, velocity of wound closure and a calculation of the amount and cost of Apligraf or EpiFix used. A total of 65 subjects entered the 2-week run-in period and 60 were randomised (20 per group). The proportion of patients in the EpiFix group achieving complete wound closure within 4 and 6 weeks was 85% and 95%, significantly higher (all adjusted P-values ≤ 0·003) than for patients receiving Apligraf (35% and 45%), or standard care (30% and 35%). After 1 week, wounds treated with EpiFix had reduced in area by 83·5% compared with 53·1% for wounds treated with Apligraf. Median time to healing was significantly faster (all adjusted P-values ≤0·001) with EpiFix (13 days) compared to Apligraf (49 days) or standard care (49 days). The mean number of grafts used and the graft cost per patient were lower in the EpiFix group campared to the Apligraf group, at 2·15 grafts at a cost of $1669 versus 6·2 grafts at a cost of $9216, respectively. The results of this study demonstrate the clinical and resource utilisation superiority of EpiFix compared to Apligraf or standard of care, for the treatment of diabetic ulcers of the lower extremities. © 2014 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

An Analysis of Fourth and Sixth Grade Reader Performance Using Cloze Tests, Group Reading Inventories, an Informal Reading Inventory, and a Standardized Reading Test.

ERIC Educational Resources Information Center

Davidson, Emma Sue

A study was conducted to explore the issue of testing to determine reading levels of students. A group of 624 fourth and sixth grade students from 13 schools participated in the study, which compared results from an informal reading inventory (IRI), a standardized achievement test, a group reading inventory (GRI), and a cloze test. Pupil…

Selecting for Ethnically Diverse Children Who May Be Gifted Using Raven's Standard Progressive Matrices and Naglieri Nonverbal Abilities Test

ERIC Educational Resources Information Center

Lewis, Joan D.; DeCamp-Fritson, Stephanie S.; Ramage, Jean C.; McFarland, Max A.; Archwamety, Teara

2007-01-01

The purpose of this study was to compare the effectiveness of the Raven's Standard Progressive Matrices, the Naglieri Nonverbal Abilities Test (NNAT), and the Iowa Test of Basic Skills (ITBS) in selecting for ethnically diverse students who may be gifted. The participants of the study were 175 students enrolled in Grades 3-5 and Grade 8 in a…

Historical Development of NATO Stanag 6001 Language Standards and Common European Framework (CEF) and the Comparison of Their Current Status

ERIC Educational Resources Information Center

Solak, Ekrem

2011-01-01

The aim of the article is to shed light on the historical development of language studies in military and social context and to compare the current status of NATO Stanag (Standard Agreement) 6001 language scale with Common European Framework (CEF). Language studies in military context date back to World War II and the emergence of Army Specialized…

Comparison of automated BAX polymerase chain reaction and standard culture methods for detection of Listeria monocyogenes in blue crab meat (Callinectus sapidus) and blue crab processing plants

USDA-ARS?s Scientific Manuscript database

This study compared the BAX Polymerase Chain Reaction method (BAX PCR) with the Standard Culture Method (SCM) for detection of L. monocytogenes in blue crab meat and crab processing plants. The aim of this study was to address this data gap. Raw crabs, finished products and environmental sponge samp...

The impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students.

PubMed

Sarikoc, Gamze; Ozcan, Celale Tangul; Elcin, Melih

2017-04-01

The use of standardized patients is not very common in psychiatric nursing education and there has been no study conducted in Turkey. This study evaluated the impact of using standardized patients in psychiatric cases on the levels of motivation and perceived learning of the nursing students. This manuscript addressed the quantitative aspect of a doctoral thesis study in which both quantitative and qualitative methods were used. A pre-test and post-test were employed in the quantitative analysis in a randomized and controlled study design. The motivation scores, and interim and post-test scores for perceived learning were higher in the experimental group compared to pre-test scores and the scores of the control group. The students in the experimental group reported that they felt more competent about practical training in clinical psychiatry, as well as in performing interviews with patients having mental problems, and reported less anxiety about performing an interview when compared to students in the control group. It is considered that the inclusion of standardized patient methodology in the nursing education curriculum in order to improve the knowledge level and skills of students would be beneficial in the training of mental health nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Kwok, A.G.

This paper examines the comfort criteria of ANSI/ASHRAE Standard 55-1992 for their applicability in tropical classrooms. A field study conducted in Hawaii used a variety of methods to collect the data: survey questionnaires, physical measurements, interviews, and behavioral observations. A total of 3,544 students and teachers completed questionnaires in 29 naturally ventilated and air-conditioned classrooms in six schools during two seasons. The majority of classrooms failed to meet the physical specifications of the Standard 55 comfort zone. Thermal neutrality, preference, and acceptability results are compared with other field studies and the Standard 55 criteria. Acceptability votes by occupants of bothmore » naturally ventilated and air-conditioned classrooms exceeded the standard`s 80% acceptability criteria, regardless of whether physical conditions were in or out of the comfort zone. Responses from these two school populations suggest not only a basis for separate comfort standards but energy conservation opportunities through raising thermostat set points.« less

Creation of a bovine herpes virus 1 (BoHV-1) quantitative particle standard by transmission electron microscopy and comparison with established standards for use in real-time PCR.

PubMed

Hoferer, Marc; Braun, Anne; Sting, Reinhard

2017-07-01

Standards are pivotal for pathogen quantification by real-time PCR (qPCR); however, the creation of a complete and universally applicable virus particle standard is challenging. In the present study a procedure based on purification of bovine herpes virus type 1 (BoHV-1) and subsequent quantification by transmission electron microscopy (TEM) is described. Accompanying quantitative quality controls of the TEM preparation procedure using qPCR yielded recovery rates of more than 95% of the BoHV-1 virus particles on the grid used for virus counting, which was attributed to pre-treatment of the grid with 5% bovine albumin. To compare the value of the new virus particle standard for use in qPCR, virus counter based quantification and established pure DNA standards represented by a plasmid and an oligonucleotide were included. It could be shown that the numbers of virus particles, plasmid and oligonucleotide equivalents were within one log10 range determined on the basis of standard curves indicating that different approaches provide comparable quantitative values. However, only virus particles represent a complete, universally applicable quantitative virus standard that meets the high requirements of an RNA and DNA virus gold standard. In contrast, standards based on pure DNA have to be considered as sub-standard due to limited applications. Copyright © 2017 International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

A Comparison of Assertive Community Treatment Fidelity Measures and Patient-Centered Medical Home Standards

PubMed Central

Vanderlip, Erik R.; Cerimele, Joseph M.; Monroe-DeVita, Maria

2014-01-01

Objective This study compared program measures of assertive community treatment (ACT) with standards of accreditation for the patient-centered medical home (PCMH) to determine whether there were similarities in the infrastructure of the two methods of service delivery and whether high-fidelity ACT teams would qualify for medical home accreditation. Methods The authors compared National Committee for Quality Assurance PCMH standards with two ACT fidelity measures (the Dartmouth Assertive Community Treatment Scale and the Tool for Measurement of Assertive Community Treatment [TMACT]) and with national ACT program standards. Results PCMH standards pertaining to enhanced access and continuity, management of care, and self-care support demonstrated strong overlap across ACT measures. Standards for identification and management of populations, care coordination and follow-up, and quality improvement demonstrated less overlap. The TMACT and the program standards had sufficient overlap to score in the range of a level 1 PCMH, but no ACT measure sufficiently detailed methods of population-based screening and tracking of referrals to satisfy “must-pass” elements of the standards. Conclusions ACT measures and medical home standards had significant overlap in innate infrastructure. ACT teams following the program standards or undergoing TMACT fidelity review could have the necessary infrastructure to serve as medical homes if they were properly equipped to supervise general medical care and administer activities to improve management of chronic diseases. PMID:23820753

Comparison of anthropometry with photogrammetry based on a standardized clinical photographic technique using a cephalostat and chair.

PubMed

Han, Kihwan; Kwon, Hyuk Joon; Choi, Tae Hyun; Kim, Jun Hyung; Son, Daegu

2010-03-01

The aim of this study was to standardize clinical photogrammetric techniques, and to compare anthropometry with photogrammetry. To standardize clinical photography, we have developed a photographic cephalostat and chair. We investigated the repeatability of the standardized clinical photogrammetric technique. Then, with 40 landmarks, a total of 96 anthropometric measurement items was obtained from 100 Koreans. Ninety six photogrammetric measurements from the same subjects were also obtained from standardized clinical photographs using Adobe Photoshop version 7.0 (Adobe Systems Corporation, San Jose, CA, USA). The photogrammetric and anthropometric measurement data (mm, degree) were then compared. A coefficient was obtained by dividing the anthropometric measurements by the photogrammetric measurements. The repeatability of the standardized photography was statistically significantly high (p=0.463). Among the 96 measurement items, 44 items were reliable; for these items the photogrammetric measurements were not different to the anthropometric measurements. The remaining 52 items must be classified as unreliable. By developing a photographic cephalostat and chair, we have standardized clinical photogrammetric techniques. The reliable set of measurement items can be used as anthropometric measurements. For unreliable measurement items, applying a suitable coefficient to the photogrammetric measurement allows the anthropometric measurement to be obtained indirectly.

Studies of non-standard effects in atmospheric neutrino oscillations of Super-Kamiokande

NASA Astrophysics Data System (ADS)

Wang, Wei

Neutrino oscillation due to mass eigenstate mixing has become the standard theory accounting for both solar and atmospheric neutrino data. This explanation indicates that neutrinos have small but non-vanishing masses, which is a sign of new physics beyond the Standard Model. In this dissertation, we will compare the standard explanation with three types of alternative theories using Super-Kamiokande (SK) atmospheric neutrino data. The first type of non-standard theory involves sterile neutrinos. By using the neutral current enhanced data samples of SK and by considering matter effect, we conclude it is unlikely that sterile neutrinos are responsible for SK atmospheric neutrino zenith angle distributions. Furthermore, we study the allowance of sterile neutrino admixture in atmospheric neutrino mixing and find an admixture of 23% sterile neutrino is allowed at 90% confidence level based on a 2+2 mass hierarchy model. The second type of non-standard theory involves neutrino oscillation induced by violations of Lorentz invariance (LIV) and CPT symmetry (CPTV). The neutrino oscillations induced by the temporal components of the LIV and CPTV terms in the minimal Standard Model Extension (SME) have different energy and pathlength dependences compared to the standard oscillation. Our analysis indicates that it is unlikely to explain SK atmospheric neutrino data with the oscillation effects induced by the temporal components of the minimal SME separately. By treating LIV- and CPTV-induced oscillations as sub-dominant effects, limits on symmetry-breaking parameters are established. The third category of non-standard theory involves vanishing neutrinos caused by neutrino decoherence and neutrino decay. Our study shows that it is unlikely to explain SK atmospheric neutrino zenith angle distributions using these two non-oscillatory models. By treating them as sub-dominant effects, limits on these two types of new physics are set based on several specific models. Our study shows that the oscillation between muon neutrinos and tau neutrinos is the best model explaining SK atmospheric neutrino data among the models we test. In most cases, limits on new physics established in this study using SK atmospheric neutrino data are the best currently available.

A Comparison of Three Professional Development Mechanisms for Improving the Quality of Standards-Based IEP Objectives

ERIC Educational Resources Information Center

Lowman, J. Joneen

2016-01-01

Professional development is a necessary component of maintaining competency in professional practice. Technology has opened the door to new formats for delivering professional development, in addition to more traditional modes of training. This study compared three professional development formats for improving the quality of standards-based…

Stress Corrosion Cracking of Pipeline Steels in Fuel Grade Ethanol and Blends - Study to Evaluate Alternate Standard Tests and Phenomenological Understanding of SCC

DOT National Transportation Integrated Search

2011-10-30

Main aim of this project was to evaluate alternate standard test methods for stress corrosion cracking (SCC) and compare them with the results from slow strain rate test (SSRT) results under equivalent environmental conditions. Other important aim of...

Parent-Child Interaction Therapy in a Community Setting: Examining Outcomes, Attrition, and Treatment Setting

ERIC Educational Resources Information Center

Lanier, Paul; Kohl, Patrica L.; Benz, Joan; Swinger, Dawn; Moussette, Pam; Drake, Brett

2011-01-01

Objectives: The purpose of this study was to evaluate Parent-Child Interaction Therapy (PCIT) deployed in a community setting comparing in-home with the standard office-based intervention. Child behavior, parent stress, parent functioning, and attrition were examined. Methods: Using a quasi-experimental design, standardized measures at three time…

Effects of Enhanced Anchored Instruction on Skills Aligned to Common Core Math Standards

ERIC Educational Resources Information Center

Bottge, Brian A.; Cho, Sun-Joo

2013-01-01

This study compared how students with learning difficulties in math (MLD) who were randomly assigned to two instructional conditions answered items on problem solving tests aligned to the Common Core State Standards Initiative for Mathematics. Posttest scores showed improvement in the math performance of students receiving Enhanced Anchored…

DIFFUSION IN THE VICINITY OF STANDARD-DESIGN NUCLEAR POWER PLANTS--II: WIND-TUNNEL EVALUATION OF BUILDING-WAKE CHARACTERISTICS

EPA Science Inventory

Laboratory experiments were conducted to simulate radiopollutant effluents released to the atmosphere from two standard-design nuclear power plants. The main objective of the study was to compare the dispersion in the wakes of the plants with that in a simulated atmospheric bound...

The Development of MST Test Information for the Prediction of Test Performances

ERIC Educational Resources Information Center

Park, Ryoungsun; Kim, Jiseon; Chung, Hyewon; Dodd, Barbara G.

2017-01-01

The current study proposes novel methods to predict multistage testing (MST) performance without conducting simulations. This method, called MST test information, is based on analytic derivation of standard errors of ability estimates across theta levels. We compared standard errors derived analytically to the simulation results to demonstrate the…

A Methodology for the Geometric Standardization of Vehicle Hoods to Compare Real-World Pedestrian Crashes

PubMed Central

Koetje, Bethany D.; Grabowski, Jurek G.

2008-01-01

This paper describes a standardization method that allows injury researchers to directly compare pedestrian hood contact points across a variety of hood sizes and geometries. To standardize hood contact locations a new coordinate system was created at the geometric center of the hood. Standardizing hood contact locations was done by turning each coordinate location into a ratio of the entire length or width of the hood. The standardized pedestrian contact locations could then be compared for various hood sizes. The standardized hood was divided into a three-by-three grid to aggregate contact points into hood regions. Data was obtained from the National Highway Traffic Safety Administration’s Pedestrian Crash Data Study from 1994 to 1998. To understand injury severity with respect to pedestrian hood contact location, the injuries were narrowed to the single most severe Abreviated Injury Scale injury to the pedestrian and hood location at which that injury was sustained. Of the 97 pedestrian/vehicle cases, pedestrians received 270 injuries from 141 unique hood contact locations. After standardization, 36%, 28%, 36% of all contact points were located on the left, center and right side of the hood respectively. Vertically, 26%, 45%, 28% of contacts occurred at the front, middle, and rear regions of the hood respectively. The middle passenger side of the hood contained the most number of AIS 3+ injuries. By using real-world crash data, engineers can make evidence based decisions to decease the severity of pedestrian injuries. PMID:19026236

Permissible Inferences from the Outcome of Training Studies in Cognitive Development Research. Technical Report No. 127.

ERIC Educational Resources Information Center

Brown, Ann L.; Campione, Joseph C.

In modal training studies, the comparative groups differ in the use of a particular cognitive process; training to overcome the deficiency is provided for the deficient group only, and their performance is then compared to the standard set by the untrained group. Improvements are necessary in the design of training studies, as are a…

Favorable mortality profile of naltrexone implants for opiate addiction.

PubMed

Reece, Albert Stuart

2010-01-01

Several reports express concern at the mortality associated with the use of oral naltrexone for opiate dependency. Registry controlled follow-up of patients treated with naltrexone implant and buprenorphine was performed. In the study, 255 naltrexone implant patients were followed for a mean (+/- standard deviation) of 5.22 +/- 1.87 years and 2,518 buprenorphine patients were followed for a mean (+/- standard deviation) of 3.19 +/- 1.61 years, accruing 1,332.22 and 8,030.02 patient-years of follow-up, respectively. The crude mortality rates were 3.00 and 5.35 per 1,000 patient-years, respectively, and the age standardized mortality rate ratio for naltrexone compared to buprenorphine was 0.676 (95% confidence interval = 0.014 to 1.338). Most sex, treatment group, and age comparisons significantly favored the naltrexone implant group. Mortality rates were shown to be comparable to, and intermediate between, published mortality rates of an age-standardized methadone treated cohort and the Australian population. These data suggest that the mortality rate from naltrexone implant is comparable to that of buprenorphine, methadone, and the Australian population.

Sequential (as Opposed to Simultaneous) Antibiotic Therapy Improves Helicobacter pylori Eradication in the Pediatric Population: A Meta-Analysis.

PubMed

Lau, Christine S M; Ward, Amanda; Chamberlain, Ronald S

2016-06-01

Helicobacter pylori is a common infection associated with many gastrointestinal diseases. Triple or quadruple therapy is the current recommendation for H pylori eradication in children but is associated with success rates as low as 50%. Recent studies have demonstrated that a 10-day sequential therapy regimen, rather than simultaneous antibiotic administration, achieved eradication rates of nearly 95%. This meta-analysis found that sequential therapy increased eradication rates by 14.2% (relative risk [RR] = 1.142; 95% confidence interval [CI] = 1.082-1.207; P < .001). Ten-day sequential therapy significantly improved H pylori eradication rates compared to the 7-day standard therapy (RR = 1.182; 95% CI = 1.102-1.269; p < .001) and 10-day standard therapy (RR = 1.179; 95% CI = 1.074-1.295; P = .001), but had lower eradication rates compared to 14-day standard therapy (RR = 0.926; 95% CI = 0.811-1.059; P = .261). The use of sequential therapy is associated with increased H pylori eradication rates in children compared to standard therapy of equal or shorter duration. © The Author(s) 2015.

Micro-mass standards to calibrate the sensitivity of mass comparators

NASA Astrophysics Data System (ADS)

Madec, Tanguy; Mann, Gaëlle; Meury, Paul-André; Rabault, Thierry

2007-10-01

In mass metrology, the standards currently used are calibrated by a chain of comparisons, performed using mass comparators, that extends ultimately from the international prototype (which is the definition of the unit of mass) to the standards in routine use. The differences measured in the course of these comparisons become smaller and smaller as the standards approach the definitions of their units, precisely because of how accurately they have been adjusted. One source of uncertainty in the determination of the difference of mass between the mass compared and the reference mass is the sensitivity error of the comparator used. Unfortunately, in the market there are no mass standards small enough (of the order of a few hundreds of micrograms) for a valid evaluation of this source of uncertainty. The users of these comparators therefore have no choice but to rely on the characteristics claimed by the makers of the comparators, or else to determine this sensitivity error at higher values (at least 1 mg) and interpolate from this result to smaller differences of mass. For this reason, the LNE decided to produce and calibrate micro-mass standards having nominal values between 100 µg and 900 µg. These standards were developed, then tested in multiple comparisons on an A5 type automatic comparator. They have since been qualified and calibrated in a weighing design, repeatedly and over an extended period of time, to establish their stability with respect to oxidation and the harmlessness of the handling and storage procedure associated with their use. Finally, the micro-standards so qualified were used to characterize the sensitivity errors of two of the LNE's mass comparators, including the one used to tie France's Platinum reference standard (Pt 35) to stainless steel and superalloy standards.

Prospective Evaluation of a Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry System in a Hospital Clinical Microbiology Laboratory for Identification of Bacteria and Yeasts: a Bench-by-Bench Study for Assessing the Impact on Time to Identification and Cost-Effectiveness

PubMed Central

Tan, K. E.; Ellis, B. C.; Lee, R.; Stamper, P. D.; Zhang, S. X.

2012-01-01

Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) has been found to be an accurate, rapid, and inexpensive method for the identification of bacteria and yeasts. Previous evaluations have compared the accuracy, time to identification, and costs of the MALDI-TOF MS method against standard identification systems or commercial panels. In this prospective study, we compared a protocol incorporating MALDI-TOF MS (MALDI protocol) with the current standard identification protocols (standard protocol) to determine the performance in actual practice using a specimen-based, bench-by-bench approach. The potential impact on time to identification (TTI) and costs had MALDI-TOF MS been the first-line identification method was quantitated. The MALDI protocol includes supplementary tests, notably for Streptococcus pneumoniae and Shigella, and indications for repeat MALDI-TOF MS attempts, often not measured in previous studies. A total of 952 isolates (824 bacterial isolates and 128 yeast isolates) recovered from 2,214 specimens were assessed using the MALDI protocol. Compared with standard protocols, the MALDI protocol provided identifications 1.45 days earlier on average (P < 0.001). In our laboratory, we anticipate that the incorporation of the MALDI protocol can reduce reagent and labor costs of identification by $102,424 or 56.9% within 12 months. The model included the fixed annual costs of the MALDI-TOF MS, such as the cost of protein standards and instrument maintenance, and the annual prevalence of organisms encountered in our laboratory. This comprehensive cost analysis model can be generalized to other moderate- to high-volume laboratories. PMID:22855510

The Impact of Cochlear Implant in the Oral Language of Children with Congenital Deafness.

PubMed

Ramos, Daniela; Jorge, João Xavier; Teixeira, António; Ribeiro, Carlos; Paiva, António

2015-01-01

Children with severe to profound sensorineural deafness can acquire vocabulary and syntactic structures to communicate by oral language, after cochlear implant. Identify the linguistic skills of children with cochlear implant. Eighteen children of both gender, between 9 and 10 years, with congenital bilateral deafness, using cochlear implant, were studied. The evaluation instrument used was Observation Chart of Language-School Level. The results were compared with standard of normal-hearing children with the same hearing age. The scores registered in the linguistics structures studied, comparing implanted children and standard, was: phonology, 29.44 ± 8.4 vs. 29.68 ± 5.90, p = 0.91; semantics, 18.55 ± 8.89 vs. 19.20 ± 4.85, p = 0.76; morpho-syntax 21.89 ± 12.85 vs. 26.35 ± 10.36, p = 0.159. Regarding the tests of semantics, there was no significant difference. Concerning the tests of morpho-syntactic structure, the difference was significant in the derivation of words, 2.83 ± 2.81 vs. 4.65 ± 1.64, p = 0.014. In the phonology, a significant difference was found comparing implanted children and standard, in the discrimination of pseudo words, 6.6 ± 2.8 vs. 8.37 ± 2.32, p = 0.023. However, in syllabic segmentation, implanted children had a mean score 8.56 ± 1.6 significantly higher than standard, 5.9 ± 1.58, p < 0.001. The similarity of the scores obtained by children with cochlear implants with the standard, in the language components studied confirms that cochlear implant promotes the development of oral verbal language in children with congenital deafness. Implanted children had acquired language skills similar to normal-hearing children with the same hearing age.

Prospective evaluation of a matrix-assisted laser desorption ionization-time of flight mass spectrometry system in a hospital clinical microbiology laboratory for identification of bacteria and yeasts: a bench-by-bench study for assessing the impact on time to identification and cost-effectiveness.

PubMed

Tan, K E; Ellis, B C; Lee, R; Stamper, P D; Zhang, S X; Carroll, K C

2012-10-01

Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been found to be an accurate, rapid, and inexpensive method for the identification of bacteria and yeasts. Previous evaluations have compared the accuracy, time to identification, and costs of the MALDI-TOF MS method against standard identification systems or commercial panels. In this prospective study, we compared a protocol incorporating MALDI-TOF MS (MALDI protocol) with the current standard identification protocols (standard protocol) to determine the performance in actual practice using a specimen-based, bench-by-bench approach. The potential impact on time to identification (TTI) and costs had MALDI-TOF MS been the first-line identification method was quantitated. The MALDI protocol includes supplementary tests, notably for Streptococcus pneumoniae and Shigella, and indications for repeat MALDI-TOF MS attempts, often not measured in previous studies. A total of 952 isolates (824 bacterial isolates and 128 yeast isolates) recovered from 2,214 specimens were assessed using the MALDI protocol. Compared with standard protocols, the MALDI protocol provided identifications 1.45 days earlier on average (P < 0.001). In our laboratory, we anticipate that the incorporation of the MALDI protocol can reduce reagent and labor costs of identification by $102,424 or 56.9% within 12 months. The model included the fixed annual costs of the MALDI-TOF MS, such as the cost of protein standards and instrument maintenance, and the annual prevalence of organisms encountered in our laboratory. This comprehensive cost analysis model can be generalized to other moderate- to high-volume laboratories.

Rocker shoe, minimalist shoe, and standard running shoe: a comparison of running economy.

PubMed

Sobhani, Sobhan; Bredeweg, Steef; Dekker, Rienk; Kluitenberg, Bas; van den Heuvel, Edwin; Hijmans, Juha; Postema, Klaas

2014-05-01

Running with rocker shoes is believed to prevent lower limb injuries. However, it is not clear how running in these shoes affects the energy expenditure. The purpose of this study was, therefore, to assess the effects of rocker shoes on running economy in comparison with standard and minimalist running shoes. Cross-over design. Eighteen endurance female runners (age=23.6 ± 3 years), who were inexperienced in running with rocker shoes and with minimalist/barefoot running, participated in this study. Oxygen consumption, carbon dioxide production, heart rate and rate of perceived exertion were measured while participants completed a 6-min sub-maximal treadmill running test for each footwear condition. The data of the last 2 min of each shoe condition were averaged for analysis. A linear mixed model was used to compare differences among three footwear conditions. Oxygen consumption during running with rocker shoes was on average 4.5% higher than with the standard shoes (p<0.001) and 5.6% higher than with the minimalist shoe (p<0.001). No significant differences were found in heart rate and rate of perceived exertion across three shoe conditions. Female runners, who are not experienced in running with the rocker shoes and minimalist shoes, show more energy expenditure during running with the rocker shoes compared with the standard and minimalist shoes. As the studied shoes were of different masses, part of the effect of increased energy expenditure with the rocker shoe is likely to be due to its larger mass as compared with standard running shoes and minimalist shoes. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

A systematic review of dosing frequency with bone-targeted agents for patients with bone metastases from breast cancer

PubMed Central

Hutton, Brian; Addison, Christina L.; Campbell, Kaitryn; Fergusson, Dean; Mazarello, Sasha; Clemons, Mark

2013-01-01

Background Bone-targeted agents are usually administered to breast cancer patients with bone metastases every 3–4 weeks. Less frequent (‘de-escalated’) treatment may provide similar benefits with improved safety and reduced cost. Methods To systematically review randomised trials comparing de-escalated treatment with bone-targeted agents (i.e. every 12–16 weeks) to standard treatment (i.e. every 3–4 weeks), a formal systematic review of the literature was performed. Two individuals independently screened citations and full text articles. Random effects meta-analyses of clinically important outcomes were planned provided homogeneous studies were identified. Results Five relevant studies (n=1287 patients) were identified. Sample size ranged from 38 to 425. Information on outcomes including occurrence of SREs, bone pain, urinary N-telopeptide concentrations, serum C-telopeptide concentrations, pain medication use and safety outcomes was not consistently available. Two trials were non-inferiority studies, two dose-response evaluations and one was a pilot study. Bone-targeted agents use varied between studies, as did duration of prior therapy. Patient populations were considered heterogeneous in several ways, and thus no meta-analyses were performed. Observations from the included studies suggest there is potential that 3 month de-escalated treatment may provide similar benefits compared to 3–4 weekly treatment and that lower doses of zoledronic acid and denosumab might be equally effective. Conclusions Studies comparing standard and de-escalated treatment with bone-targeted agents in breast cancer are rare. The benefits of standard treatment compared to de-escalated therapy on important clinical outcomes remain unclear. Future pragmatic studies must be conducted to determine the merits of this approach. PMID:26909282

Apparent annual survival estimates of tropical songbirds better reflect life history variation when based on intensive field methods

USGS Publications Warehouse

Martin, Thomas E.; Riordan, Margaret M.; Repin, Rimi; Mouton, James C.; Blake, William M.

2017-01-01

AimAdult survival is central to theories explaining latitudinal gradients in life history strategies. Life history theory predicts higher adult survival in tropical than north temperate regions given lower fecundity and parental effort. Early studies were consistent with this prediction, but standard-effort netting studies in recent decades suggested that apparent survival rates in temperate and tropical regions strongly overlap. Such results do not fit with life history theory. Targeted marking and resighting of breeding adults yielded higher survival estimates in the tropics, but this approach is thought to overestimate survival because it does not sample social and age classes with lower survival. We compared the effect of field methods on tropical survival estimates and their relationships with life history traits.LocationSabah, Malaysian Borneo.Time period2008–2016.Major taxonPasseriformes.MethodsWe used standard-effort netting and resighted individuals of all social and age classes of 18 tropical songbird species over 8 years. We compared apparent survival estimates between these two field methods with differing analytical approaches.ResultsEstimated detection and apparent survival probabilities from standard-effort netting were similar to those from other tropical studies that used standard-effort netting. Resighting data verified that a high proportion of individuals that were never recaptured in standard-effort netting remained in the study area, and many were observed breeding. Across all analytical approaches, addition of resighting yielded substantially higher survival estimates than did standard-effort netting alone. These apparent survival estimates were higher than for temperate zone species, consistent with latitudinal differences in life histories. Moreover, apparent survival estimates from addition of resighting, but not from standard-effort netting alone, were correlated with parental effort as measured by egg temperature across species.Main conclusionsInclusion of resighting showed that standard-effort netting alone can negatively bias apparent survival estimates and obscure life history relationships across latitudes and among tropical species.

Wheeled and standard walkers in Parkinson's disease patients with gait freezing.

PubMed

Cubo, Esther; Moore, Charity G; Leurgans, Sue; Goetz, Christopher G

2003-10-01

Compare the efficacy of two walking assistance devices (wheeled walker and standard walker) to unassisted walking for patients with PD and gait freezing. Although numerous walking devices are used clinically, their relative effects on freezing and walking speed have never been systematically tested. Nineteen PD patients (14 non-demented) walked under three conditions in randomized order: unassisted walking, standard walker, and wheeled walker. Patients walked up to three times in each condition through a standard course that included rising from a chair, walking through a doorway, straightway walking, pivoting, and return. Total walking time, freezing time and number of freezes were compared for the three conditions using mixed models (walking time) and Friedman's test (freezing). The wheeled walker was further studied by comparing the effect of an attached laser that projected a bar of light on the floor as a visual walking cue. Use of either type of device significantly slowed walking compared to unassisted walking. Neither walker reduced any index of freezing, nor the laser attachment offered any advantage to the wheeled walker. The standard walker increased freezing, and the wheeled walker had no effect on freezing. Among the non-demented subjects (n=14), the same patterns occurred, although the walking speed was less impaired by the wheeled walker than the standard walker in this group. Though walkers may stabilize patients and increase confidence, PD patients walk more slowly when using them, without reducing freezing. Because the wheeled walker was intermediate for walking time and does not aggravate freezing, if walkers are used for these subjects, this type of walker should be favored.

Footwear Matters: Influence of Footwear and Foot Strike on Load Rates during Running.

PubMed

Rice, Hannah M; Jamison, Steve T; Davis, Irene S

2016-12-01

Running with a forefoot strike (FFS) pattern has been suggested to reduce the risk of overuse running injuries, due to a reduced vertical load rate compared with rearfoot strike (RFS) running. However, resultant load rate has been reported to be similar between foot strikes when running in traditional shoes, leading to questions regarding the value of running with a FFS. The influence of minimal footwear on the resultant load rate has not been considered. This study aimed to compare component and resultant instantaneous loading rate (ILR) between runners with different foot strike patterns in their habitual footwear conditions. Twenty-nine injury-free participants (22 men, seven women) ran at 3.13 m·s along a 30-m runway, with their habitual foot strike and footwear condition. Ground reaction force data were collected. Peak ILR values were compared between three conditions; those who habitually run with an RFS in standard shoes, with an FFS in standard shoes, and with an FFS in minimal shoes. Peak resultant, vertical, lateral, and medial ILR were lower (P < 0.001) when running in minimal shoes with an FFS than in standard shoes with either foot strike. When running with an FFS, peak posterior ILR were lower (P < 0.001) in minimal than standard shoes. When running in a standard shoe, peak resultant and component ILR were similar between footstrike patterns. However, load rates were lower when running in minimal shoes with a FFS, compared with running in standard shoes with either foot strike. Therefore, it appears that footwear alters the load rates during running, even with similar foot strike patterns.

How big is a food portion? A pilot study in Australian families.

PubMed

Collins, Clare E; Bucher, Tamara; Taylor, Aimee; Pezdirc, Kristine; Lucas, Hannah; Watson, Jane; Rollo, Megan; Duncanson, Kerith; Hutchesson, Melinda J; Burrows, Tracy

2015-08-01

It is not known whether individuals can accurately estimate the portion size of foods usually consumed relative to standard serving sizes in national food selection guides. The aim of the present cross-sectional pilot study was to quantify what adults and children deem a typical portion for a variety of foods and compare these with the serving sizes specified in the Australian Guide to Healthy Eating (AGHE). Adults and children were independently asked to serve out their typical portion of 10 common foods (rice, pasta, breakfast cereal, chocolate, confectionary, ice cream, meat, vegetables, soft drink and milk). They were also asked to serve what they perceived a small, medium and large portion of each food to be. Each portion was weighed and recorded by an assessor and compared with the standard AGHE serving sizes. Twenty-one individuals (nine mothers, one father, 11 children) participated in the study. There was a large degree of variability in portion sizes measured out by both parents and children, with means exceeding the standard AGHE serving size for all items, except for soft drink and milk, where mean portion sizes were less than the AGHE serving size. The greatest mean overestimations were for pasta (155%; mean 116 g; range 94-139 g) and chocolate (151%; mean 38 g; range 25-50 g), each of which represented approximately 1.5 standard AGHE servings. The findings of the present study indicate that there is variability between parents' and children's estimation of typical portion sizes compared with national recommendations. SO WHAT? Dietary interventions to improve individuals' dietary patterns should target education regarding portion size.

Effect of a Standardized Protocol of Antibiotic Therapy on Surgical Site Infection after Laparoscopic Surgery for Complicated Appendicitis.

PubMed

Park, Hyoung-Chul; Kim, Min Jeong; Lee, Bong Hwa

Although it is accepted that complicated appendicitis requires antibiotic therapy to prevent post-operative surgical infections, consensus protocols on the duration and regimens of treatment are not well established. This study aimed to compare the outcome of post-operative infectious complications in patients receiving old non-standardized and new standard antibiotic protocols, involving either 5 or 10 days of treatment, respectively. We enrolled 1,343 patients who underwent laparoscopic surgery for complicated appendicitis between January 2009 and December 2014. At the beginning of the new protocol, the patients were divided into two groups; 10 days of various antibiotic regimens (between January 2009 and June 2012, called the non-standardized protocol; n = 730) and five days of cefuroxime and metronidazole regimen (between July 2012 and December 2014; standardized protocol; n = 613). We compared the clinical outcomes, including surgical site infection (SSI) (superficial and deep organ/space infections) in the two groups. The standardized protocol group had a slightly shorter operative time (67 vs. 69 min), a shorter hospital stay (5 vs. 5.4 d), and lower medical cost (US$1,564 vs. US$1,654). Otherwise, there was no difference between the groups. No differences were found in the non-standardized and standard protocol groups with regard to the rate of superficial infection (10.3% vs. 12.7%; p = 0.488) or deep organ/space infection (2.3% vs. 2.1%; p = 0.797). In patients undergoing laparoscopic surgery for complicated appendicitis, five days of cefuroxime and metronidazole did not lead to more SSIs, and it decreased the medical costs compared with non-standardized antibiotic regimens.

Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment.

PubMed

Schnakers, Caroline; Vanhaudenhuyse, Audrey; Giacino, Joseph; Ventura, Manfredi; Boly, Melanie; Majerus, Steve; Moonen, Gustave; Laureys, Steven

2009-07-21

Previously published studies have reported that up to 43% of patients with disorders of consciousness are erroneously assigned a diagnosis of vegetative state (VS). However, no recent studies have investigated the accuracy of this grave clinical diagnosis. In this study, we compared consensus-based diagnoses of VS and MCS to those based on a well-established standardized neurobehavioral rating scale, the JFK Coma Recovery Scale-Revised (CRS-R). We prospectively followed 103 patients (55 +/- 19 years) with mixed etiologies and compared the clinical consensus diagnosis provided by the physician on the basis of the medical staff's daily observations to diagnoses derived from CRS-R assessments performed by research staff. All patients were assigned a diagnosis of 'VS', 'MCS' or 'uncertain diagnosis.' Of the 44 patients diagnosed with VS based on the clinical consensus of the medical team, 18 (41%) were found to be in MCS following standardized assessment with the CRS-R. In the 41 patients with a consensus diagnosis of MCS, 4 (10%) had emerged from MCS, according to the CRS-R. We also found that the majority of patients assigned an uncertain diagnosis by clinical consensus (89%) were in MCS based on CRS-R findings. Despite the importance of diagnostic accuracy, the rate of misdiagnosis of VS has not substantially changed in the past 15 years. Standardized neurobehavioral assessment is a more sensitive means of establishing differential diagnosis in patients with disorders of consciousness when compared to diagnoses determined by clinical consensus.

The diagnostic performance of reduced-dose CT for suspected appendicitis in paediatric and adult patients: A systematic review and diagnostic meta-analysis.

PubMed

Yoon, Hee Mang; Suh, Chong Hyun; Cho, Young Ah; Kim, Jeong Rye; Lee, Jin Seong; Jung, Ah Young; Kim, Jung Heon; Lee, Jeong-Yong; Kim, So Yeon

2018-06-01

To evaluate the diagnostic performance of reduced-dose CT for suspected appendicitis. A systematic search of the MEDLINE and EMBASE databases was carried out through to 10 January 2017. Studies evaluating the diagnostic performance of reduced-dose CT for suspected appendicitis in paediatric and adult patients were selected. Pooled summary estimates of sensitivity and specificity were calculated using hierarchical logistic regression modelling. Meta-regression was performed. Fourteen original articles with a total of 3,262 patients were included. For all studies using reduced-dose CT, the summary sensitivity was 96 % (95 % CI 93-98) with a summary specificity of 94 % (95 % CI 92-95). For the 11 studies providing a head-to-head comparison between reduced-dose CT and standard-dose CT, reduced-dose CT demonstrated a comparable summary sensitivity of 96 % (95 % CI 91-98) and specificity of 94 % (95 % CI 93-96) without any significant differences (p=.41). In meta-regression, there were no significant factors affecting the heterogeneity. The median effective radiation dose of the reduced-dose CT was 1.8 mSv (1.46-4.16 mSv), which was a 78 % reduction in effective radiation dose compared to the standard-dose CT. Reduced-dose CT shows excellent diagnostic performance for suspected appendicitis. • Reduced-dose CT shows excellent diagnostic performance for evaluating suspected appendicitis. • Reduced-dose CT has a comparable diagnostic performance to standard-dose CT. • Median effective radiation dose of reduced-dose CT was 1.8 mSv (1.46-4.16). • Reduced-dose CT achieved a 78 % dose reduction compared to standard-dose CT.

A Multicenter comparative trial of a novel EUS-guided core biopsy needle (SharkCore™) with the 22-gauge needle in patients with solid pancreatic mass lesions

PubMed Central

Naveed, Mariam; Siddiqui, Ali A.; Kowalski, Thomas E.; Loren, David E.; Khalid, Ammara; Soomro, Ayesha; Mazhar, Syed M.; Yoo, Joseph; Hasan, Raza; Yalamanchili, Silpa; Tarangelo, Nicholas; Taylor, Linda J.; Adler, Douglas G.

2018-01-01

Background and Objectives: The ability to obtain adequate tissue of solid pancreatic lesions by EUS-guided remains a challenge. The aim of this study was to compare the performance characteristics and safety of EUS-FNA for evaluating solid pancreatic lesions using the standard 22-gauge needle versus a novel EUS biopsy needle. Methods: This was a multicenter retrospective study of EUS-guided sampling of solid pancreatic lesions between 2009 and 2015. Patients underwent EUS-guided sampling with a 22-gauge SharkCore (SC) needle or a standard 22-gauge FNA needle. Technical success, performance characteristics of EUS-FNA, the number of needle passes required to obtain a diagnosis, diagnostic accuracy, and complications were compared. Results: A total of 1088 patients (mean age = 66 years; 49% female) with pancreatic masses underwent EUS-guided sampling with a 22-gauge SC needle (n = 115) or a standard 22-gauge FNA needle (n = 973). Technical success was 100%. The frequency of obtaining an adequate cytology by EUS-FNA was similar when using the SC and the standard needle (94.1% vs. 92.7%, respectively). The sensitivity, specificity, and diagnostic accuracy of EUS-FNA for tissue diagnosis were not significantly different between two needles. Adequate sample collection leading to a definite diagnosis was achieved by the 1st, 2nd, and 3rd pass in 73%, 92%, and 98% of procedures using the SC needle and 20%, 37%, and 94% procedures using the standard needle (P < 0.001), respectively. The median number of passes to obtain a tissue diagnosis using the SC needle was significantly less as compared to the standard needle (1 and 3, respectively; P < 0.001). Conclusions: The EUS SC biopsy needle is safe and technically feasible for EUS-FNA of solid pancreatic mass lesions. Preliminary results suggest that the SC needle has a diagnostic yield similar to the standard EUS needle and significantly reduces the number of needle passes required to obtain a tissue diagnosis. PMID:29451167

Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months' Follow-Up

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

Niewald, Marcus, E-mail: marcus.niewald@uks.eu; Seegenschmiedt, M. Heinrich; Micke, Oliver

2012-11-15

Purpose: To conduct a randomized trial of radiation therapy for painful heel spur, comparing a standard dose with a very low dose. Methods and Materials: Sixty-six patients were randomized to receive radiation therapy either with a total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy twice weekly (standard dose) or with a total dose of 0.6 Gy applied in 6 fractions of 0.1 Gy twice weekly (low dose). In all patients lateral opposing 4- to 6-MV photon beams were used. The results were measured using a visual analogue scale, the Calcaneodynia score, and the SF12 health survey.more » The fundamental phase of the study ended after 3 months, and the follow-up was continued up to 1 year. Patients with insufficient pain relief after 3 months were offered reirradiation with the standard dosage at any time afterward. Results: Of 66 patients, 4 were excluded because of withdrawal of consent or screening failures. After 3 months the results in the standard arm were highly significantly superior compared with those in the low-dose arm (visual analogue scale, P=.001; Calcaneodynia score, P=.027; SF12, P=.045). The accrual of patients was stopped at this point. Further evaluation after 12 months' follow-up showed the following results: (1) highly significant fewer patients were reirradiated in the standard arm compared with the low-dose arm (P<.001); (2) the results of patients in the low-dose arm who were reirradiated were identical to those in the standard arm not reirradiated (reirradiation as a salvage therapy if the lower dose was ineffective); (3) patients experiencing a favorable result after 3 months showed this even after 12 months, and some results even improved further between 3 and 12 months. Conclusions: This study confirms the superior analgesic effect of radiation therapy with 6-Gy doses on painful heel spur even for a longer time period of at least 1 year.« less

A standardized test battery for the study of synesthesia

PubMed Central

Eagleman, David M.; Kagan, Arielle D.; Nelson, Stephanie S.; Sagaram, Deepak; Sarma, Anand K.

2014-01-01

Synesthesia is an unusual condition in which stimulation of one modality evokes sensation or experience in another modality. Although discussed in the literature well over a century ago, synesthesia slipped out of the scientific spotlight for decades because of the difficulty in verifying and quantifying private perceptual experiences. In recent years, the study of synesthesia has enjoyed a renaissance due to the introduction of tests that demonstrate the reality of the condition, its automatic and involuntary nature, and its measurable perceptual consequences. However, while several research groups now study synesthesia, there is no single protocol for comparing, contrasting and pooling synesthetic subjects across these groups. There is no standard battery of tests, no quantifiable scoring system, and no standard phrasing of questions. Additionally, the tests that exist offer no means for data comparison. To remedy this deficit we have devised the Synesthesia Battery. This unified collection of tests is freely accessible online (http://www.synesthete.org). It consists of a questionnaire and several online software programs, and test results are immediately available for use by synesthetes and invited researchers. Performance on the tests is quantified with a standard scoring system. We introduce several novel tests here, and offer the software for running the tests. By presenting standardized procedures for testing and comparing subjects, this endeavor hopes to speed scientific progress in synesthesia research. PMID:16919755

Two Different Percutaneous Bone-Anchored Hearing Aid Abutment Systems: Comparative Clinical Study.

PubMed

Polat, Beldan; İşeri, Mete; Orhan, Kadir Serkan; Yılmazer, Ayça Başkadem; Enver, Necati; Ceylan, Didem; Kara, Ahmet; Güldiken, Yahya; Çomoğlu, Şenol

2016-04-01

To compare two different percutaneous bone-anchored hearing aid (BAHA) abutment systems regarding operation time, scar healing, quality of life, implant stability, audiologic results, and complications. The study involves a prospective multi-center clinical evaluation. Thirty-two consecutive patients who had undergone BAHA surgery from January 2011 to January 2013 in two tertiary centers were included in the study. The Glasgow Inventory Benefit Score was used to assess the patients at least 6 months after surgery. The operation time and complications were recorded. Implant stability quotient (ISQ) values were recorded using resonance frequency analysis. Holger's classification was used to evaluate skin reactions. The mean length of the operation was 39.2±4 min for standard abutment and 18.3±5.7 min for hydroxyapatite-coated abutment. ISQ scores were significantly better for standard abutment in all tests. The mean total Glasgow Inventory Benefit Score was 39.3±19 for the standard abutment and 46.3±24.5 for the hydroxyapatite-coated abutment groups, but there was no statistical significance between the two groups. There was no difference in audiological improvement between the two groups after surgery. Hydroxyapatite-coated abutment provided a shorter operation time that was significantly different from standard abutment. There were no significant differences between standard abutment and hydroxyapatite-coated abutment regarding audiologic improvement, quality of life, loading time, and complications.

Comparison of different platelet count thresholds to guide administration of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation

PubMed Central

Estcourt, Lise J; Stanworth, Simon J; Doree, Carolyn; Hopewell, Sally; Trivella, Marialena; Murphy, Michael F

2015-01-01

Background Platelet transfusions are used in modern clinical practice to prevent and treat bleeding in people who are thrombocytopenic due to bone marrow failure. Although considerable advances have been made in platelet transfusion therapy in the last 40 years, some areas continue to provoke debate, especially concerning the use of prophylactic platelet transfusions for the prevention of thrombocytopenic bleeding. This is an update of a Cochrane review first published in 2004, and previously updated in 2012 that addressed four separate questions: prophylactic versus therapeutic-only platelet transfusion policy; prophylactic platelet transfusion threshold; prophylactic platelet transfusion dose; and platelet transfusions compared to alternative treatments. This review has now been split into four smaller reviews looking at these questions individually; this review compares prophylactic platelet transfusion thresholds. Objectives To determine whether different platelet transfusion thresholds for administration of prophylactic platelet transfusions (platelet transfusions given to prevent bleeding) affect the efficacy and safety of prophylactic platelet transfusions in preventing bleeding in people with haematological disorders undergoing myelosuppressive chemotherapy or haematopoietic stem cell transplantation (HSCT). Search methods We searched for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library 2015, Issue 6, 23 July 2015), MEDLINE (from 1946), Embase (from 1974), CINAHL (from 1937), the Transfusion Evidence Library (from 1950), and ongoing trial databases to 23 July 2015. Selection criteria We included RCTs involving transfusions of platelet concentrates, prepared either from individual units of whole blood or by apheresis, and given to prevent bleeding in people with haematological disorders (receiving myelosuppressive chemotherapy or undergoing HSCT) that compared different thresholds for administration of prophylactic platelet transfusions (low trigger (5 × 109/L); standard trigger (10 × 109/L); higher trigger (20 × 109/L, 30 × 109/L, 50 × 109/L); or alternative platelet trigger (for example platelet mass)). Data collection and analysis We used the standard methodological procedures expected by Cochrane. Main results Three trials met our predefined inclusion criteria and were included for analysis in the review (499 participants). All three trials compared a standard trigger (10 × 109/L) versus a higher trigger (20 × 109/L or 30 × 109/L). None of the trials compared a low trigger versus a standard trigger or an alternative platelet trigger. The trials were conducted between 1991 and 2001 and enrolled participants from fairly comparable patient populations. The original review contained four trials (658 participants); in the previous update of this review we excluded one trial (159 participants) because fewer than 80% of participants had a haematological disorder. We identified no new trials in this update of the review. Overall, the methodological quality of the studies was low across different outcomes according to GRADE methodology. None of the included studies were at low risk of bias in every domain, and all the included studies had some threats to validity. Three studies reported the number of participants with at least one clinically significant bleeding episode within 30 days from the start of the study. There was no evidence of a difference in the number of participants with a clinically significant bleeding episode between the standard and higher trigger groups (three studies; 499 participants; risk ratio (RR) 1.35, 95% confidence interval (CI) 0.95 to 1.90; low-quality evidence). One study reported the number of days with a clinically significant bleeding event (adjusted for repeated measures). There was no evidence of a difference in the number of days of bleeding per participant between the standard and higher trigger groups (one study; 255 participants; relative proportion of days with World Health Organization Grade 2 or worse bleeding (RR 1.71, 95% CI 0.84 to 3.48, P = 0.162; authors’ own results; low-quality evidence). Two studies reported the number of participants with severe or life-threatening bleeding. There was no evidence of any difference in the number of participants with severe or life-threatening bleeding between a standard trigger level and a higher trigger level (two studies; 421 participants; RR 0.99, 95% CI 0.52 to 1.88; low-quality evidence). Only one study reported the time to first bleeding episode. There was no evidence of any difference in the time to the first bleeding episode between a standard trigger level and a higher trigger level (one study; 255 participants; hazard ratio 1.11, 95% CI 0.64 to 1.91; low-quality evidence). Only one study reported on all-cause mortality within 30 days from the start of the study. There was no evidence of any difference in all-cause mortality between standard and higher trigger groups (one study; 255 participants; RR 1.78, 95% CI 0.83 to 3.81; low-quality evidence). Three studies reported on the number of platelet transfusions per participant. Two studies reported on the mean number of platelet transfusions per participant. There was a significant reduction in the number of platelet transfusions per participant in the standard trigger group (two studies, mean difference −2.09, 95% CI −3.20 to −0.99; low-quality evidence). One study reported on the number of transfusion reactions. There was no evidence to demonstrate any difference in transfusion reactions between the standard and higher trigger groups (one study; 79 participants; RR 0.07, 95% CI 0.00 to 1.09). None of the studies reported on quality of life. Authors’ conclusions In people with haematological disorders who are thrombocytopenic due to myelosuppressive chemotherapy or HSCT, we found low-quality evidence that a standard trigger level (10 × 109/L) is associated with no increase in the risk of bleeding when compared to a higher trigger level (20 × 109/L or 30 × 109/L). There was low-quality evidence that a standard trigger level is associated with a decreased number of transfusion episodes when compared to a higher trigger level (20 × 109/L or 30 × 109/L). Findings from this review were based on three studies and 499 participants. Without further evidence, it is reasonable to continue with the current practice of administering prophylactic platelet transfusions using the standard trigger level (10 × 109/L) in the absence of other risk factors for bleeding. PMID:26576687

Comparison of different platelet count thresholds to guide administration of prophylactic platelet transfusion for preventing bleeding in people with haematological disorders after myelosuppressive chemotherapy or stem cell transplantation.

PubMed

Estcourt, Lise J; Stanworth, Simon J; Doree, Carolyn; Hopewell, Sally; Trivella, Marialena; Murphy, Michael F

2015-11-18

Platelet transfusions are used in modern clinical practice to prevent and treat bleeding in people who are thrombocytopenic due to bone marrow failure. Although considerable advances have been made in platelet transfusion therapy in the last 40 years, some areas continue to provoke debate, especially concerning the use of prophylactic platelet transfusions for the prevention of thrombocytopenic bleeding.This is an update of a Cochrane review first published in 2004, and previously updated in 2012 that addressed four separate questions: prophylactic versus therapeutic-only platelet transfusion policy; prophylactic platelet transfusion threshold; prophylactic platelet transfusion dose; and platelet transfusions compared to alternative treatments. This review has now been split into four smaller reviews looking at these questions individually; this review compares prophylactic platelet transfusion thresholds. To determine whether different platelet transfusion thresholds for administration of prophylactic platelet transfusions (platelet transfusions given to prevent bleeding) affect the efficacy and safety of prophylactic platelet transfusions in preventing bleeding in people with haematological disorders undergoing myelosuppressive chemotherapy or haematopoietic stem cell transplantation (HSCT). We searched for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library 2015, Issue 6, 23 July 2015), MEDLINE (from 1946), Embase (from 1974), CINAHL (from 1937), the Transfusion Evidence Library (from 1950), and ongoing trial databases to 23 July 2015. We included RCTs involving transfusions of platelet concentrates, prepared either from individual units of whole blood or by apheresis, and given to prevent bleeding in people with haematological disorders (receiving myelosuppressive chemotherapy or undergoing HSCT) that compared different thresholds for administration of prophylactic platelet transfusions (low trigger (5 x 10(9)/L); standard trigger (10 x 10(9)/L); higher trigger (20 x 10(9)/L, 30 x 10(9)/L, 50 x 10(9)/L); or alternative platelet trigger (for example platelet mass)). We used the standard methodological procedures expected by Cochrane. Three trials met our predefined inclusion criteria and were included for analysis in the review (499 participants). All three trials compared a standard trigger (10 x 10(9)/L) versus a higher trigger (20 x 10(9)/L or 30 x 10(9)/L). None of the trials compared a low trigger versus a standard trigger or an alternative platelet trigger. The trials were conducted between 1991 and 2001 and enrolled participants from fairly comparable patient populations.The original review contained four trials (658 participants); in the previous update of this review we excluded one trial (159 participants) because fewer than 80% of participants had a haematological disorder. We identified no new trials in this update of the review.Overall, the methodological quality of the studies was low across different outcomes according to GRADE methodology. None of the included studies were at low risk of bias in every domain, and all the included studies had some threats to validity.Three studies reported the number of participants with at least one clinically significant bleeding episode within 30 days from the start of the study. There was no evidence of a difference in the number of participants with a clinically significant bleeding episode between the standard and higher trigger groups (three studies; 499 participants; risk ratio (RR) 1.35, 95% confidence interval (CI) 0.95 to 1.90; low-quality evidence).One study reported the number of days with a clinically significant bleeding event (adjusted for repeated measures). There was no evidence of a difference in the number of days of bleeding per participant between the standard and higher trigger groups (one study; 255 participants; relative proportion of days with World Health Organization Grade 2 or worse bleeding (RR 1.71, 95% CI 0.84 to 3.48, P = 0.162; authors' own results; low-quality evidence).Two studies reported the number of participants with severe or life-threatening bleeding. There was no evidence of any difference in the number of participants with severe or life-threatening bleeding between a standard trigger level and a higher trigger level (two studies; 421 participants; RR 0.99, 95% CI 0.52 to 1.88; low-quality evidence).Only one study reported the time to first bleeding episode. There was no evidence of any difference in the time to the first bleeding episode between a standard trigger level and a higher trigger level (one study; 255 participants; hazard ratio 1.11, 95% CI 0.64 to 1.91; low-quality evidence).Only one study reported on all-cause mortality within 30 days from the start of the study. There was no evidence of any difference in all-cause mortality between standard and higher trigger groups (one study; 255 participants; RR 1.78, 95% CI 0.83 to 3.81; low-quality evidence).Three studies reported on the number of platelet transfusions per participant. Two studies reported on the mean number of platelet transfusions per participant. There was a significant reduction in the number of platelet transfusions per participant in the standard trigger group (two studies, mean difference -2.09, 95% CI -3.20 to -0.99; low-quality evidence).One study reported on the number of transfusion reactions. There was no evidence to demonstrate any difference in transfusion reactions between the standard and higher trigger groups (one study; 79 participants; RR 0.07, 95% CI 0.00 to 1.09).None of the studies reported on quality of life. In people with haematological disorders who are thrombocytopenic due to myelosuppressive chemotherapy or HSCT, we found low-quality evidence that a standard trigger level (10 x 10(9)/L) is associated with no increase in the risk of bleeding when compared to a higher trigger level (20 x 10(9)/L or 30 x 10(9)/L). There was low-quality evidence that a standard trigger level is associated with a decreased number of transfusion episodes when compared to a higher trigger level (20 x 10(9)/L or 30 x 10(9)/L).Findings from this review were based on three studies and 499 participants. Without further evidence, it is reasonable to continue with the current practice of administering prophylactic platelet transfusions using the standard trigger level (10 x 10(9)/L) in the absence of other risk factors for bleeding.

Quality control evaluation of Keshamasi, Keshanjana and Keshamasi eye ointment.

PubMed

Dhiman, Kartar Singh; Shukla, Vinay J; Bhalodia, Nayan R; Sharma, Vinay R

2014-01-01

Keshanjana (collyrium) is a well known Ayurvedic preparation prepared out of Keshamasi (ash prepared by scalp hairs) mixed with Goghrita (cow's ghee). This medicine is indicated for the treatment of Shushkakshipaka (dry eye syndrome) in the classical literature of Ayurveda; hence, it was under taken for standardization and clinical evaluation in an extra-mural research project from Central Council for Research in Ayurvedic Sciences, Department of AYUSH, New Delhi. To develop standard quality parameters for the Keshamasi, Keshanjana and Keshamasi ointment. Scalp hairs of male and females collected from saloons were converted to classical Masi Kalpana and mixed with cow ghee and petrolatum in the ratio of 1:5 to prepare the Keshanjana and Keshamasi ointment respectively. Standard Operation Procedure (SOP) were adopted and recorded accordingly. The raw material, furnished products and plain Goghrita were subjected for quality control parameters i.e., physico-chemical evaluation, anti-microbial study, particle size analysis, heavy metal analysis through inductive couple plasma spectroscopy with high performance thin layer liquid chromatography fingerprints. Rancidity was negative in all the samples, indicating that the physico-chemical parameters are in acceptable range. Lead and zinc were present in most of the samples; while all samples are were free from microbial contamination. As no standards are available to compare the results of the current study, the observations cannot be compared. Thus the profile generated in the current study can be considered as standard to refer in future studies.

Quality control evaluation of Keshamasi, Keshanjana and Keshamasi eye ointment

PubMed Central

Dhiman, Kartar Singh; Shukla, Vinay J.; Bhalodia, Nayan R.; Sharma, Vinay R.

2014-01-01

Background: Keshanjana (collyrium) is a well known Ayurvedic preparation prepared out of Keshamasi (ash prepared by scalp hairs) mixed with Goghrita (cow's ghee). This medicine is indicated for the treatment of Shushkakshipaka (dry eye syndrome) in the classical literature of Ayurveda; hence, it was under taken for standardization and clinical evaluation in an extra-mural research project from Central Council for Research in Ayurvedic Sciences, Department of AYUSH, New Delhi. Aim: To develop standard quality parameters for the Keshamasi, Keshanjana and Keshamasi ointment. Materials and Methods: Scalp hairs of male and females collected from saloons were converted to classical Masi Kalpana and mixed with cow ghee and petrolatum in the ratio of 1:5 to prepare the Keshanjana and Keshamasi ointment respectively. Standard Operation Procedure (SOP) were adopted and recorded accordingly. The raw material, furnished products and plain Goghrita were subjected for quality control parameters i.e., physico-chemical evaluation, anti-microbial study, particle size analysis, heavy metal analysis through inductive couple plasma spectroscopy with high performance thin layer liquid chromatography fingerprints. Results: Rancidity was negative in all the samples, indicating that the physico-chemical parameters are in acceptable range. Lead and zinc were present in most of the samples; while all samples are were free from microbial contamination. Conclusion: As no standards are available to compare the results of the current study, the observations cannot be compared. Thus the profile generated in the current study can be considered as standard to refer in future studies. PMID:25364202

Direct magnitude estimates of speech intelligibility in dysarthria: effects of a chosen standard.

PubMed

Weismer, Gary; Laures, Jacqueline S

2002-06-01

Direct magnitude estimation (DME) has been used frequently as a perceptual scaling technique in studies of the speech intelligibility of persons with speech disorders. The technique is typically used with a standard, or reference stimulus, chosen as a good exemplar of "midrange" intelligibility. In several published studies, the standard has been chosen subjectively, usually on the basis of the expertise of the investigators. The current experiment demonstrates that a fixed set of sentence-level utterances, obtained from 4 individuals with dysarthria (2 with Parkinson disease, 2 with traumatic brain injury) as well as 3 neurologically normal speakers, is scaled differently depending on the identity of the standard. Four different standards were used in the main experiment, three of which were judged qualitatively in two independent evaluations to be good exemplars of midrange intelligibility. Acoustic analyses did not reveal obvious differences between these four standards but suggested that the standard with the worst-scaled intelligibility had much poorer voice source characteristics compared to the other three standards. Results are discussed in terms of possible standardization of midrange intelligibility exemplars for DME experiments.

Frequency of data extraction errors and methods to increase data extraction quality: a methodological review.

PubMed

Mathes, Tim; Klaßen, Pauline; Pieper, Dawid

2017-11-28

Our objective was to assess the frequency of data extraction errors and its potential impact on results in systematic reviews. Furthermore, we evaluated the effect of different extraction methods, reviewer characteristics and reviewer training on error rates and results. We performed a systematic review of methodological literature in PubMed, Cochrane methodological registry, and by manual searches (12/2016). Studies were selected by two reviewers independently. Data were extracted in standardized tables by one reviewer and verified by a second. The analysis included six studies; four studies on extraction error frequency, one study comparing different reviewer extraction methods and two studies comparing different reviewer characteristics. We did not find a study on reviewer training. There was a high rate of extraction errors (up to 50%). Errors often had an influence on effect estimates. Different data extraction methods and reviewer characteristics had moderate effect on extraction error rates and effect estimates. The evidence base for established standards of data extraction seems weak despite the high prevalence of extraction errors. More comparative studies are needed to get deeper insights into the influence of different extraction methods.

Autologous platelet-rich gel for treatment of diabetic chronic refractory cutaneous ulcers: A prospective, randomized clinical trial.

PubMed

Li, Lan; Chen, Dawei; Wang, Chun; Yuan, Nanbing; Wang, Yan; He, Liping; Yang, Yanzhi; Chen, Lihong; Liu, Guanjian; Li, Xiujun; Ran, Xingwu

2015-01-01

The purpose of the study is to examine the safety and effectiveness of topical autologous platelet-rich gel (APG) application on facilitating the healing of diabetic chronic refractory cutaneous ulcers. The study was designed as a prospective, randomized controlled trial between January 1, 2007 and December 31, 2011. Eligible inpatients at the Diabetic Foot Care Center of West China Hospital, Sichuan University (China) were randomly prescribed with a 12-week standard treatment of ulcers (the control group) or standard treatment plus topical application APG (the APG group). The wound healing grades (primary endpoint), time to complete healing, and healing velocity within 12 weeks were monitored as short-term effectiveness measurements, while side effects were documented safety endpoints. The rates of survival and recurrence within the follow up were recorded as long-term effectiveness endpoints. Analysis on total diabetic ulcers (DUs) (n = 117) and subgroup analysis on diabetic foot ulcers (DFUs) (n = 103) were both conducted. Standard treatment plus APG treatment was statistically more effective than standard treatment (p < 0.05 in both total DUs and subgroup of DFUs). The subjects defined as healing grade 1 were 50/59 (84.8%) in total DUs and 41/48 (85.4%) in DFUs in the APG group compared with 40/58 (69.0%) and 37/55 (67.3%) in the control group from intent to treat population. The Kaplan-Meier time-to-healing were significantly different between the two groups (p < 0.05 in both total DUs and subgroup of DFUs). No side effects were identified after topical APG application. The long-term survival and recurrence rates were comparative between groups (p > 0.05). This study shows that topical APG application plus standard treatment is safe and quite effective on diabetic chronic refractory cutaneous ulcers, compared with standard treatment. © 2015 by the Wound Healing Society.

Adjuvant therapy with carboplatin and pamidronate for canine appendicular osteosarcoma.

PubMed

Kozicki, A R; Robat, C; Chun, R; Kurzman, I D

2015-09-01

Amputation and chemotherapy are the mainstay of treatment for canine appendicular osteosarcoma (OSA). In vitro studies have demonstrated anti-tumour activity of pamidronate against canine OSA. The purpose of this study was to assess the safety of adding pamidronate to standard post-operative carboplatin chemotherapy in 17 dogs with appendicular OSA treated with limb amputation. Median disease-free interval (DFI) and median survival time (MST) were evaluated as secondary endpoints. Incidence of side effects and treatment outcomes were compared to 14 contemporary control patients treated with carboplatin alone. There were no identified side effects to the pamidronate treatment. The median DFI for the study group was 185 days compared to 172 days for the control group (P = 0.90). The MST of the study group was 311 days compared to 294 days for the control group (P = 0.89). Addition of pamidronate to carboplatin chemotherapy for the treatment of canine appendicular OSA is safe and does not impair efficacy of standard carboplatin treatment. © 2013 Blackwell Publishing Ltd.

Biofortified red mottled beans (phaseolus vulgaris L.) in a maize and bean diet provide more bioavailable iron than standard red mottled beans: studies in poultry (Gallus gallus) and an in vitro digestion/Caco-2 model

USDA-ARS?s Scientific Manuscript database

The objective was to compare the capacities of biofortified and standard colored beans to deliver iron (Fe) for hemoglobin synthesis. Two isolines of large-seeded, red mottled Andean beans (Phaseolus valgaris L.), one standard (“Low FE”) and the other biofortified (“High Fe”) in Fe (49 and 71 ug Fe...

Developing a Fleet Standardization Index for Airline Planning

NASA Technical Reports Server (NTRS)

deBorgesPan, Alexis George; EspiritoSanto, Respicio A., Jr.

2003-01-01

Quantifying subjective aspects is a difficult task that requires a great dedication of time from researchers and analysts. Nevertheless, one of the main objectives of it is to pave the way for a better understanding of the focused aspects. Fleet standardization is one of these subjective aspects that is extremely difficult to mm into numbers. Although, it is of great importance to know the benefits that may come with a higher level of standardization for airlines, which may be economical advantages, maintenance facilitation and others. A more standardized fleet may represent lower costs of operations and maintenance facilitation and others. A more standardized fleet may represent lower costs of operations and maintenance plus a much better planning of routes and flights. This study presents the first step on developing an index, hereto called "Fleet Standardization Index" or FSI (or IPF in Portuguese, for "Indice de Padronizacao de Frotas"), that will allow senior airline planners to compare different fleets and also simulate some results from maintaining or renewing their fleets. Although being a preliminary study, the results obtained may already be tested to compare different fleets (different airlines) and also analyze some possible impacts of a fleet renewal before it takes place. Therefore, the main objective of this paper is to introduce the proposed IPF index and to demonstrate that it is inversely proportional to the number of different airplane models, engines and other equipment, such as avionics.

High efficiency endocrine operation protocol: From design to implementation.

PubMed

Mascarella, Marco A; Lahrichi, Nadia; Cloutier, Fabienne; Kleiman, Simcha; Payne, Richard J; Rosenberg, Lawrence

2016-10-01

We developed a high efficiency endocrine operative protocol based on a mathematical programming approach, process reengineering, and value-stream mapping to increase the number of operations completed per day without increasing operating room time at a tertiary-care, academic center. Using this protocol, a case-control study of 72 patients undergoing endocrine operation during high efficiency days were age, sex, and procedure-matched to 72 patients undergoing operation during standard days. The demographic profile, operative times, and perioperative complications were noted. The average number of cases per 8-hour workday in the high efficiency and standard operating rooms were 7 and 5, respectively. Mean procedure times in both groups were similar. The turnaround time (mean ± standard deviation) in the high efficiency group was 8.5 (±2.7) minutes as compared with 15.4 (±4.9) minutes in the standard group (P < .001). Transient postoperative hypocalcemia was 6.9% (5/72) and 8.3% (6/72) for the high efficiency and standard groups, respectively (P = .99). In this study, patients undergoing high efficiency endocrine operation had similar procedure times and perioperative complications compared with the standard group. The proposed high efficiency protocol seems to better utilize operative time and decrease the backlog of patients waiting for endocrine operation in a country with a universal national health care program. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of pulse-oximetry oxygen saturation taken through skin protective covering

PubMed Central

James, Jyotsna; Tiwari, Lokesh; Upadhyay, Pramod; Sreenivas, Vishnubhatla; Bhambhani, Vikas; Puliyel, Jacob M

2006-01-01

Background The hard edges of adult finger clip probes of the pulse oximetry oxygen saturation (POOS) monitor can cause skin damage if used for prolonged periods in a neonate. Covering the skin under the probe with Micropore surgical tape or a gauze piece might prevent such injury. The study was done to see if the protective covering would affect the accuracy of the readings. Methods POOS was studied in 50 full-term neonates in the first week of life. After obtaining consent from their parents the neonates had POOS readings taken directly (standard technique) and through the protective covering. Bland-Altman plots were used to compare the new method with the standard technique. A test of repeatability for each method was also performed. Results The Bland-Altman plots suggest that there is no significant loss of accuracy when readings are taken through the protective covering. The mean difference was 0.06 (SD of 1.39) and 0.04 (SD 1.3) with Micropore and gauze respectively compared to the standard method. The mean difference was 0.22 (SD 0.23) on testing repeatability with the standard method. Conclusion Interposing Micropore or gauze does not significantly affect the accuracy of the POOS reading. The difference between the standard method and the new method was less than the difference seen on testing repeatability of the standard method. PMID:16677394

Evaluation of pulse-oximetry oxygen saturation taken through skin protective covering.

PubMed

James, Jyotsna; Tiwari, Lokesh; Upadhyay, Pramod; Sreenivas, Vishnubhatla; Bhambhani, Vikas; Puliyel, Jacob M

2006-05-06

The hard edges of adult finger clip probes of the pulse oximetry oxygen saturation (POOS) monitor can cause skin damage if used for prolonged periods in a neonate. Covering the skin under the probe with Micropore surgical tape or a gauze piece might prevent such injury. The study was done to see if the protective covering would affect the accuracy of the readings. POOS was studied in 50 full-term neonates in the first week of life. After obtaining consent from their parents the neonates had POOS readings taken directly (standard technique) and through the protective covering. Bland-Altman plots were used to compare the new method with the standard technique. A test of repeatability for each method was also performed. The Bland-Altman plots suggest that there is no significant loss of accuracy when readings are taken through the protective covering. The mean difference was 0.06 (SD of 1.39) and 0.04 (SD 1.3) with Micropore and gauze respectively compared to the standard method. The mean difference was 0.22 (SD 0.23) on testing repeatability with the standard method. Interposing Micropore or gauze does not significantly affect the accuracy of the POOS reading. The difference between the standard method and the new method was less than the difference seen on testing repeatability of the standard method.

Sleep disordered breathing analysis in a general population using standard pulse oximeter signals.

PubMed

Barak-Shinar, Deganit; Amos, Yariv; Bogan, Richard K

2013-09-01

Obstructive sleep apnea reported as the apnea-hypopnea index (AHI) is usually measured in sleep laboratories using a high number of electrodes connected to the patient's body. In this study, we examined the use of a standard pulse oximeter system with an automated analysis based on the photoplethysmograph (PPG) signal for the diagnosis of sleep disordered breathing. Using a standard and simple device with high accuracy might provide a convenient diagnostic or screening solution for patient evaluation at home or in other out of center testing environments. The study included 140 consecutive patients that were referred routinely to a sleep laboratory [SleepMed Inc.] for the diagnosis of sleep disordered breathing. Each patient underwent an overnight polysomnography (PSG) study according to AASM guidelines in an AASM-accredited sleep laboratory. The automatic analysis is based on photoplethysmographic and saturation signals only. Those two signals were recorded for the entire night as part of the full overnight PSG sleep study. The AHI calculated from the PPG analysis is compared to the AHI calculated from the manual scoring gold standard full PSG. The AHI and total respiratory events measured by the pulse oximeter analysis correlated very well with the corresponding results obtained by the gold standard full PSG. The sensitivity and specificity of AHI = or > 5 and 15 levels measured by the analysis are both above 90 %. The sensitivity and positive predictive value for the detection of respiratory event are both above 84 %. The tested system in this study yielded an acceptable result of sleep disordered breathing compared to the gold standard PSG in patients with moderate to severe sleep apnea. Accordingly and given the convenience and simplicity of the standard pulse oximeter device, the new system can be considered suitable for home and ambulatory diagnosis or screening of sleep disordered breathing patients.

Tablet-based cardiac arrest documentation: a pilot study.

PubMed

Peace, Jack M; Yuen, Trevor C; Borak, Meredith H; Edelson, Dana P

2014-02-01

Conventional paper-based resuscitation transcripts are notoriously inaccurate, often lacking the precision that is necessary for recording a fast-paced resuscitation. The aim of this study was to evaluate whether a tablet computer-based application could improve upon conventional practices for resuscitation documentation. Nurses used either the conventional paper code sheet or a tablet application during simulated resuscitation events. Recorded events were compared to a gold standard record generated from video recordings of the simulations and a CPR-sensing defibrillator/monitor. Events compared included defibrillations, medication deliveries, and other interventions. During the study period, 199 unique interventions were observed in the gold standard record. Of these, 102 occurred during simulations recorded by the tablet application, 78 by the paper code sheet, and 19 during scenarios captured simultaneously by both documentation methods These occurred over 18 simulated resuscitation scenarios, in which 9 nurses participated. The tablet application had a mean sensitivity of 88.0% for all interventions, compared to 67.9% for the paper code sheet (P=0.001). The median time discrepancy was 3s for the tablet, and 77s for the paper code sheet when compared to the gold standard (P<0.001). Similar to prior studies, we found that conventional paper-based documentation practices are inaccurate, often misreporting intervention delivery times or missing their delivery entirely. However, our study also demonstrated that a tablet-based documentation method may represent a means to substantially improve resuscitation documentation quality, which could have implications for resuscitation quality improvement and research. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Effect of multizone refractive multifocal contact lenses on standard automated perimetry.

PubMed

Madrid-Costa, David; Ruiz-Alcocer, Javier; García-Lázaro, Santiago; Albarrán-Diego, César; Ferrer-Blasco, Teresa

2012-09-01

The aim of this study was to evaluate whether the creation of 2 foci (distance and near) provided by multizone refractive multifocal contact lenses (CLs) for presbyopia correction affects the measurements on Humphreys 24-2 Swedish interactive threshold algorithm (SITA) standard automated perimetry (SAP). In this crossover study, 30 subjects were fitted in random order with either a multifocal CL or a monofocal CL. After 1 month, a Humphrey 24-2 SITA standard strategy was performed. The visual field global indices (the mean deviation [MD] and pattern standard deviation [PSD]), reliability indices, test duration, and number of depressed points deviating at P<5%, P<2%, P<1%, and P<0.5% on pattern deviation probability plots were determined and compared between multifocal and monofocal CLs. Thirty eyes of 30 subjects were included in this study. There were no statistically significant differences in reliability indices or test duration. There was a statistically significant reduction in the MD with the multifocal CL compared with monfocal CL (P=0.001). Differences were not found in PSD nor in the number of depressed points deviating at P<5%, P<2%, P<1%, and P<0.5% in the pattern deviation probability maps studied. The results of this study suggest that the multizone refractive lens produces a generalized depression in threshold sensitivity as measured by the Humphreys 24-2 SITA SAP.

A meta-analysis of hypnosis for chronic pain problems: a comparison between hypnosis, standard care, and other psychological interventions.

PubMed

Adachi, Tomonori; Fujino, Haruo; Nakae, Aya; Mashimo, Takashi; Sasaki, Jun

2014-01-01

Hypnosis is regarded as an effective treatment for psychological and physical ailments. However, its efficacy as a strategy for managing chronic pain has not been assessed through meta-analytical methods. The objective of the current study was to conduct a meta-analysis to assess the efficacy of hypnosis for managing chronic pain. When compared with standard care, hypnosis provided moderate treatment benefit. Hypnosis also showed a moderate superior effect as compared to other psychological interventions for a nonheadache group. The results suggest that hypnosis is efficacious for managing chronic pain. Given that large heterogeneity among the included studies was identified, the nature of hypnosis treatment is further discussed.

Motor neuron disease mortality rates in New Zealand 1992-2013.

PubMed

Cao, Maize C; Chancellor, Andrew; Charleston, Alison; Dragunow, Mike; Scotter, Emma L

2018-05-01

We determined the mortality rates of motor neuron disease (MND) in New Zealand over 22 years from 1992 to 2013. Previous studies have found an unusually high and/or increasing incidence of MND in certain regions of New Zealand; however, no studies have examined MND rates nationwide to corroborate this. Death certificate data coded G12.2 by International Classification of Diseases (ICD)-10 coding, or 335.2 by ICD-9 coding were obtained. These codes specify amyotrophic lateral sclerosis, progressive bulbar palsy, or other motor neuron diseases as the underlying cause of death. Mortality rates for MND deaths in New Zealand were age-standardized to the European Standard Population and compared with rates from international studies that also examined death certificate data and were age-standardized to the same standard population. The age-standardized mortality from MND in New Zealand was 2.3 per 100,000 per year from 1992-2007 and 2.8 per 100,000 per year from 2008-2013. These rates were 3.3 and 4.0 per 100,000 per year, respectively, for the population 20 years and older. The increase in rate between these two time periods was likely due to changes in MND death coding from 2008. Contrary to a previous regional study of MND incidence, nationwide mortality rates did not increase steadily over this time period once aging was accounted for. However, New Zealand MND mortality rate was higher than comparable studies we examined internationally (mean 1.67 per 100,000 per year), suggesting that further analysis of MND burden in New Zealand is warranted.

Co-Teaching in Middle School Classrooms: Quantitative Comparative Study of Special Education Student Assessment Performance

ERIC Educational Resources Information Center

Reese, De'borah Reese

2017-01-01

The purpose of this quantitative comparative study was to determine the existence or nonexistence of performance pass rate differences of special education middle school students on standardized assessments between pre and post co-teaching eras disaggregated by subject area and school. Co-teaching has altered classroom environments in many ways.…

Computerization of the standard corsi block-tapping task affects its underlying cognitive concepts: a pilot study.

PubMed

Claessen, Michiel H G; van der Ham, Ineke J M; van Zandvoort, Martine J E

2015-01-01

The tablet computer initiates an important step toward computerized administration of neuropsychological tests. Because of its lack of standardization, the Corsi Block-Tapping Task could benefit from advantages inherent to computerization. This task, which requires reproduction of a sequence of movements by tapping blocks as demonstrated by an examiner, is widely used as a representative of visuospatial attention and working memory. The aim was to validate a computerized version of the Corsi Task (e-Corsi) by comparing recall accuracy to that on the standard task. Forty university students (Mage = 22.9 years, SD = 2.7 years; 20 female) performed the standard Corsi Task and the e-Corsi on an iPad 3. Results showed higher accuracy in forward reproduction on the standard Corsi compared with the e-Corsi, whereas backward performance was comparable. These divergent performance patterns on the 2 versions (small-to-medium effect sizes) are explained as a result of motor priming and interference effects. This finding implies that computerization has serious consequences for the cognitive concepts that the Corsi Task is assumed to assess. Hence, whereas the e-Corsi was shown to be useful with respect to administration and registration, these findings also stress the need for reconsideration of the underlying theoretical concepts of this task.

Discrepancy between the composition of some commercial cat foods and their package labelling and suitability for meeting nutritional requirements.

PubMed

Gosper, E C; Raubenheimer, D; Machovsky-Capuska, G E; Chaves, A V

2016-01-01

To investigate if the label information and nutrient composition of commercial cat foods are accurate and compliant with the Australian Standard (AS 5812-2011) and if they meet the nutritional requirements of an adult cat. A chemical analysis of 10 wet and 10 dry commercial cat foods labelled as 'nutritionally complete' for the adult cat was performed. The results were compared with the package composition values, the Australian Standard and the unique dietary requirements of the cat. In addition, the results of the chemical analysis were compared with the nutrient requirements published by the Association of the American Feed Control Officials and the National Research Council. When compared with the Australian Standard, 9 of the 20 cat foods did not adhere to their 'guaranteed analysis' and 8 did not adhere to the standards for nutrient composition. Also, various deficiencies and excesses of crude protein, crude fat, fatty acid and amino acid were observed in the majority of the cat foods. The results of this study highlight a need for an improved method of ensuring that label information and nutrient composition are accurate and comply with the Australian Standard (AS 5812-2011) to ensure the adult cat's unique dietary requirements are being met by commercial adult cat food. © 2016 Australian Veterinary Association.

[The costs of new drugs compared to current standard treatment].

PubMed

Ujeyl, Mariam; Schlegel, Claudia; Gundert-Remy, Ursula

2013-01-01

Until AMNOG came into effect Germany had free pricing of new drugs. Our exemplary work investigates the costs of new drugs that were licensed in the two years prior to AMNOG, and compares them to the costs of standard treatment that has been used in pivotal trials. Also, the important components of pharmaceutical prices will be illustrated. We retrospectively analysed the European Public Assessment Reports of proprietary medicinal products that the European Medicinal Agency initially approved in 2009 and 2010 and that were tested against an active control in at least one pivotal trial. If the standard treatment was a generic, the average pharmacy retail price of new drugs was 7.4 times (median 7.1) higher than that of standard treatment. If the standard treatment was an originator drug the average price was 1.4 times (median 1.2) higher than that of the new drug. There was no clear correlation of an increase in costs for new drugs and their "grade of innovation" as rated according to the criteria of Fricke. Our study shows that prices of new drugs must be linked to the evidence of comparative benefit; since German drug pricing is complex, cost saving effects obtained thereby will depend on a range of other rules and decisions. Copyright © 2013. Published by Elsevier GmbH.

Pass rates on the American Board of Family Medicine Certification Exam by residency location and size.

PubMed

Falcone, John L; Middleton, Donald B

2013-01-01

The Accreditation Council for Graduate Medical Education (ACGME) sets residency performance standards for the American Board of Family Medicine Certification Examination. This study aims are to describe the compliance of residency programs with ACGME standards and to determine whether residency pass rates depend on program size and location. In this retrospective cohort study, residency performance from 2007 to 2011 was compared with the ACGME performance standards. Simple linear regression was performed to see whether program pass rates were dependent on program size. Regional differences in performance were compared with χ(2) tests, using an α level of 0.05. Of 429 total residency programs, there were 205 (47.8%) that violate ACGME performance standards. Linear regression showed that program pass rates were positively correlated and dependent on program size (P < .001). The median pass rate per state was 86.4% (interquartile range, 82.0-90.8. χ(2) Tests showed that states in the West performed higher than the other 3 US Census Bureau Regions (all P < .001). Approximately half of the family medicine training programs do not meet the ACGME examination performance standards. Pass rates are associated with residency program size, and regional variation occurs. These findings have the potential to affect ACGME policy and residency program application patterns.

Accuracy of Blood Loss Measurement during Cesarean Delivery.

PubMed

Doctorvaladan, Sahar V; Jelks, Andrea T; Hsieh, Eric W; Thurer, Robert L; Zakowski, Mark I; Lagrew, David C

2017-04-01

Objective  This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard. Study Design  In 50 patients having cesarean deliveries blood loss determined by assays of hemoglobin content on surgical sponges and in suction canisters was compared with obstetricians' visual estimates, a quantitative gravimetric method, and the blood loss determined by a novel colorimetric system. Agreement between the reference assay and other measures was evaluated by the Bland-Altman method. Results  Compared with the blood loss measured by the reference assay (470 ± 296 mL), the colorimetric system (572 ± 334 mL) was more accurate than either visual estimation (928 ± 261 mL) or gravimetric measurement (822 ± 489 mL). The correlation between the assay method and the colorimetric system was more predictive (standardized coefficient = 0.951, adjusted R 2  = 0.902) than either visual estimation (standardized coefficient = 0.700, adjusted R 2  = 00.479) or the gravimetric determination (standardized coefficient = 0.564, adjusted R 2  = 0.304). Conclusion  During cesarean delivery, measuring blood loss using colorimetric image analysis is superior to visual estimation and a gravimetric method. Implementation of colorimetric analysis may enhance the ability of management protocols to improve clinical outcomes.

Accuracy of Blood Loss Measurement during Cesarean Delivery

PubMed Central

Doctorvaladan, Sahar V.; Jelks, Andrea T.; Hsieh, Eric W.; Thurer, Robert L.; Zakowski, Mark I.; Lagrew, David C.

2017-01-01

Objective This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard. Study Design In 50 patients having cesarean deliveries blood loss determined by assays of hemoglobin content on surgical sponges and in suction canisters was compared with obstetricians' visual estimates, a quantitative gravimetric method, and the blood loss determined by a novel colorimetric system. Agreement between the reference assay and other measures was evaluated by the Bland–Altman method. Results Compared with the blood loss measured by the reference assay (470 ± 296 mL), the colorimetric system (572 ± 334 mL) was more accurate than either visual estimation (928 ± 261 mL) or gravimetric measurement (822 ± 489 mL). The correlation between the assay method and the colorimetric system was more predictive (standardized coefficient = 0.951, adjusted R2 = 0.902) than either visual estimation (standardized coefficient = 0.700, adjusted R2 = 00.479) or the gravimetric determination (standardized coefficient = 0.564, adjusted R2 = 0.304). Conclusion During cesarean delivery, measuring blood loss using colorimetric image analysis is superior to visual estimation and a gravimetric method. Implementation of colorimetric analysis may enhance the ability of management protocols to improve clinical outcomes. PMID:28497007

Arterial puncture using insulin needle is less painful than with standard needle: a randomized crossover study.

PubMed

Ibrahim, Irwani; Yau, Ying Wei; Ong, Lizhen; Chan, Yiong Huak; Kuan, Win Sen

2015-03-01

Arterial punctures are important procedures performed by emergency physicians in the assessment of ill patients. However, arterial punctures are painful and can create anxiety and needle phobia in patients. The pain score of radial arterial punctures were compared between the insulin needle and the standard 23-gauge hypodermic needle. In a randomized controlled crossover design, healthy volunteers were recruited to undergo bilateral radial arterial punctures. They were assigned to receive either the insulin or the standard needle as the first puncture, using blocked randomization. The primary outcome was the pain score measured on a 100-mm visual analogue scale (VAS) for pain, and secondary outcomes were rate of hemolysis, mean potassium values, and procedural complications immediately and 24 hours postprocedure. Fifty healthy volunteers were included in the study. The mean (±standard deviation) VAS score in punctures with the insulin needle was lower than the standard needle (23 ± 22 mm vs. 39 ± 24 mm; mean difference = -15 mm; 95% confidence interval = -22 mm to -7 mm; p < 0.001). The rates of hemolysis and mean potassium value were greater in samples obtained using the insulin needle compared to the standard needle (31.3% vs. 11.6%, p = 0.035; and 4.6 ±0.7 mmol/L vs. 4.2 ±0.5 mmol/L, p = 0.002). Procedural complications were lower in punctures with the insulin needle both immediately postprocedure (0% vs. 24%; p < 0.001) and at 24 hours postprocedure (5.4% vs. 34.2%; p = 0.007). Arterial punctures using insulin needles cause less pain and fewer procedural complications compared to standard needles. However, due to the higher rate of hemolysis, its use should be limited to conditions that do not require a concurrent potassium value in the same blood sample. © 2015 by the Society for Academic Emergency Medicine.

The Cultural Influence in Accounting Standard Setting: A Comparative Analysis of the United States, Canada, and England.

ERIC Educational Resources Information Center

Bloom, Robert; And Others

A study of the processes for establishing the principles and policies of measurement and disclosure in preparing financial reports examines differences in these processes in the United States, Canada, and England. Information was drawn from international accounting literature on standard setting. The differences and similarities in the…

What Is "Good" Technical Communication? A Comparison of the Standards of Writing and Engineering Instructors.

ERIC Educational Resources Information Center

Smith, Summer

2003-01-01

Presents the results of an empirical study comparing writing and engineering instructors' responses to students' technical writing. Indicates that the gap between engineering and writing teachers' standards for evaluating technical writing is not as wide as is generally assumed. Concludes that the differences that do emerge suggest ways that the…

Elementary Teacher Knowledge of and Practices for Teaching Reading to African American Students

ERIC Educational Resources Information Center

Little, Camille

2017-01-01

State standardized tests results indicated that between 2012 and 2016, fewer African American students at a rural, Title I elementary school met state standards in reading compared with other racial/ethnic groups of students. A gap in practice existed because the school and district had not conducted studies to understand teacher knowledge and…

Technical Note: Comparison of accelerated methods for evaluating leaching from preservative-treated wood

Treesearch

Stan T. Lebow; Patricia K. Lebow; Kolby C. Hirth

2017-01-01

Current standardized methods are not well-suited for estimating in-service preservative leaching from treated wood products. This study compared several alternative leaching methods to a commonly used standard method, and to leaching under natural exposure conditions. Small blocks or lumber specimens were pressure treated with a wood preservative containing borax and...

Media Representations of National and International Standardized Testing in the Israeli Education System

ERIC Educational Resources Information Center

Yemini, Miri; Gordon, Noa

2017-01-01

This study applies discourse analysis to Israeli media coverage of national and international standardized examinations within Israel's public education system. Through systematic analysis of the topic in the two main Israeli financial publications between the years 2000 and 2013, we explore the nature and narrative of the media and compare the…

A Comparison of Performance on a Silent Informal Reading Inventory and Achievement on a Standardized Reading Test.

ERIC Educational Resources Information Center

Birger, Barbara

A study compared performance on a silent informal reading inventory and achievement on a standardized reading test, focusing on students' individual skill needs and how effective tests were in identifying specific strengths and weaknesses in these skill areas. Subjects, 25 students entering fourth grade in a primarily middle class suburban…

Joint Inquiry: Teachers' Collective Learning about the Common Core in High-Poverty Urban Schools

ERIC Educational Resources Information Center

Stosich, Elizabeth Leisy

2016-01-01

Recent research on the relationship between standards and teachers' practice suggests that teachers are unlikely to make changes to practice without extensive opportunities for learning about standards with colleagues. This article extends this line of research, using a comparative case study of three high-poverty urban schools to examine the…

Comparing Simulated and Theoretical Sampling Distributions of the U3 Person-Fit Statistic.

ERIC Educational Resources Information Center

Emons, Wilco H. M.; Meijer, Rob R.; Sijtsma, Klaas

2002-01-01

Studied whether the theoretical sampling distribution of the U3 person-fit statistic is in agreement with the simulated sampling distribution under different item response theory models and varying item and test characteristics. Simulation results suggest that the use of standard normal deviates for the standardized version of the U3 statistic may…

Impact of CT perfusion imaging on the assessment of peripheral chronic pulmonary thromboembolism: clinical experience in 62 patients.

PubMed

Le Faivre, Julien; Duhamel, Alain; Khung, Suonita; Faivre, Jean-Baptiste; Lamblin, Nicolas; Remy, Jacques; Remy-Jardin, Martine

2016-11-01

To evaluate the impact of CT perfusion imaging on the detection of peripheral chronic pulmonary embolisms (CPE). 62 patients underwent a dual-energy chest CT angiographic examination with (a) reconstruction of diagnostic and perfusion images; (b) enabling depiction of vascular features of peripheral CPE on diagnostic images and perfusion defects (20 segments/patient; total: 1240 segments examined). The interpretation of diagnostic images was of two types: (a) standard (i.e., based on cross-sectional images alone) or (b) detailed (i.e., based on cross-sectional images and MIPs). The segment-based analysis showed (a) 1179 segments analyzable on both imaging modalities and 61 segments rated as nonanalyzable on perfusion images; (b) the percentage of diseased segments was increased by 7.2 % when perfusion imaging was compared to the detailed reading of diagnostic images, and by 26.6 % when compared to the standard reading of images. At a patient level, the extent of peripheral CPE was higher on perfusion imaging, with a greater impact when compared to the standard reading of diagnostic images (number of patients with a greater number of diseased segments: n = 45; 72.6 % of the study population). Perfusion imaging allows recognition of a greater extent of peripheral CPE compared to diagnostic imaging. • Dual-energy computed tomography generates standard diagnostic imaging and lung perfusion analysis. • Depiction of CPE on central arteries relies on standard diagnostic imaging. • Detection of peripheral CPE is improved by perfusion imaging.

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

PubMed

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

2017-09-01

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

Cost and health consequences of treatment of primary biliary cirrhosis with ursodeoxycholic acid.

PubMed

Boberg, K M; Wisløff, T; Kjøllesdal, K S; Støvring, H; Kristiansen, I S

2013-10-01

Long-term use of ursodeoxycholic acid (UDCA) is the recommended therapy in primary biliary cirrhosis (PBC). The lifetime effectiveness and cost-effectiveness of UDCA in PBC have, however, not been assessed. To estimate the health outcomes and lifetime costs of a Norwegian cohort of PBC patients on UDCA. Norwegian PBC patients (n = 182) (90% females; mean age 56.3 ± 8.9 years; Mayo risk score 4.38) who were included in a 5-year open-label study of UDCA therapy were subsequently followed up for up to 11.5 years. The lifetime survival was estimated using a Weibull survival model. The survival benefit from UDCA was based on a randomised clinical trial from Canada, comparing the effect of non-UDCA and UDCA. Survival and costs of standard care vs. standard care plus UDCA were simulated in a Markov model with death and liver transplantation as major events, invoking transition of a patient's state in the model. The gain in life expectancy for a PBC patient on UDCA compared with standard care was 2.24 years (1.19 years discounted). The lifetime treatment costs were EUR 151,403 and EUR 157,741 (EUR 102,912 and EUR 115,031 discounted) for patients with and without UDCA respectively. A probabilistic sensitivity analysis indicated an 82% probability that UDCA entails both greater life expectancy and lower costs than standard care. The results of this study indicate that UDCA therapy is a dominant strategy as it confers reduced morbidity and mortality, as well as cost savings, compared with standard therapy. © 2013 John Wiley & Sons Ltd.

Relevance similarity: an alternative means to monitor information retrieval systems

PubMed Central

Dong, Peng; Loh, Marie; Mondry, Adrian

2005-01-01

Background Relevance assessment is a major problem in the evaluation of information retrieval systems. The work presented here introduces a new parameter, "Relevance Similarity", for the measurement of the variation of relevance assessment. In a situation where individual assessment can be compared with a gold standard, this parameter is used to study the effect of such variation on the performance of a medical information retrieval system. In such a setting, Relevance Similarity is the ratio of assessors who rank a given document same as the gold standard over the total number of assessors in the group. Methods The study was carried out on a collection of Critically Appraised Topics (CATs). Twelve volunteers were divided into two groups of people according to their domain knowledge. They assessed the relevance of retrieved topics obtained by querying a meta-search engine with ten keywords related to medical science. Their assessments were compared to the gold standard assessment, and Relevance Similarities were calculated as the ratio of positive concordance with the gold standard for each topic. Results The similarity comparison among groups showed that a higher degree of agreements exists among evaluators with more subject knowledge. The performance of the retrieval system was not significantly different as a result of the variations in relevance assessment in this particular query set. Conclusion In assessment situations where evaluators can be compared to a gold standard, Relevance Similarity provides an alternative evaluation technique to the commonly used kappa scores, which may give paradoxically low scores in highly biased situations such as document repositories containing large quantities of relevant data. PMID:16029513

Correcting the Standard Errors of 2-Stage Residual Inclusion Estimators for Mendelian Randomization Studies

PubMed Central

Palmer, Tom M; Holmes, Michael V; Keating, Brendan J; Sheehan, Nuala A

2017-01-01

Abstract Mendelian randomization studies use genotypes as instrumental variables to test for and estimate the causal effects of modifiable risk factors on outcomes. Two-stage residual inclusion (TSRI) estimators have been used when researchers are willing to make parametric assumptions. However, researchers are currently reporting uncorrected or heteroscedasticity-robust standard errors for these estimates. We compared several different forms of the standard error for linear and logistic TSRI estimates in simulations and in real-data examples. Among others, we consider standard errors modified from the approach of Newey (1987), Terza (2016), and bootstrapping. In our simulations Newey, Terza, bootstrap, and corrected 2-stage least squares (in the linear case) standard errors gave the best results in terms of coverage and type I error. In the real-data examples, the Newey standard errors were 0.5% and 2% larger than the unadjusted standard errors for the linear and logistic TSRI estimators, respectively. We show that TSRI estimators with modified standard errors have correct type I error under the null. Researchers should report TSRI estimates with modified standard errors instead of reporting unadjusted or heteroscedasticity-robust standard errors. PMID:29106476

Laparoendoscopic Single-site Surgery (LESS) for Prophylactic Salpingo-oophorectomy Improves Cosmetic Satisfaction Compared to Standard Laparoscopy.

PubMed

Miailhe, Gregoire; Dauchy, Sarah; Bentivegna, Enrica; Gouy, Sebastien; Charles, Cecile; Delaloge, Suzette; Morice, Philippe; Uzan, Catherine

2015-11-01

Less invasive prophylactic bilateral salpingo-oophorectomy (PBSO) may diminish the general consequences of surgery for BRCA mutation carriers. The objective of the present study was to compare the psychological impact and satisfaction following minimal-invasive laparoendoscopic single-site surgery (LESS) versus that observed with the standard procedure. This prospective longitudinal study was proposed to all consecutive patients who underwent ambulatory PBSO between January 2012 and January 2014 at our Center. The psychological impact and esthetic satisfaction were prospectively studied. Patients rated their satisfaction using the 4-grade Likert scale. Their emotional state and postoperative pain were explored respectively with validated questionnaires (IES-R, PANAS) and the Verbal Numerical Rating Scale (VNRS). Operative outcomes were also analyzed. Twenty patients underwent LESS PBSO and 10 patients had the standard laparoscopic (SL) PBSO. The mean satisfaction scores were significantly higher in the LESS group one month and six months after surgery. Both groups reported a reduction of intrusive thoughts and negative affects after surgery. Postoperative pain and operative outcomes were similar. A significant improvement of cosmetic satisfaction after LESS compared to SL could help patients accept PBSO. The emotional impact of PBSO is not modified by ambulatory LESS. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Under-treatment of elderly patients with ovarian cancer: a population based study.

PubMed

Fourcadier, Elisabeth; Trétarre, Brigitte; Gras-Aygon, Claudine; Ecarnot, Fiona; Daurès, Jean-Pierre; Bessaoud, Faïza

2015-11-26

Ovarian cancer is the fourth most common cancer among women in France, and mainly affects the elderly. The primary objective of this study was to compare treatment of ovarian cancer according to age. All patients with invasive cancer (n=1151) diagnosed between 1997 and 2011 in the Herault Department of southern France were included. Demographic data (age, area of residence), cancer characteristics (stage, histology, grade) and treatment modality (type, period and location of treatment) were analysed. Univariate and multivariate logistic regression was used to compare treatment by age. Ovarian cancer was less treated in elderly compared to younger patients, regardless of the type of treatment. This difference was more pronounced for chemotherapy, and was maximal for surgery followed by chemotherapy (odds ratio (OR) for surgery for patients aged >70 vs those aged <70 years=0.47 [0.24-0.91], OR for chemotherapy, age>70 vs <70=0.30 [0.16-0.55] and OR for surgery plus chemotherapy, age>70 vs <70=0.14 [0.08-0.28]). This effect of age was independent of other variables, including stage and grade. The probability of receiving standard treatment, in accordance with recommendations, was reduced by 50% in elderly patients compared to their younger counterparts. Overall and net survival of elderly patients with standard treatment was similar to those of younger patients treated outside standard treatment. Elderly women with ovarian cancer were therapeutically disadvantaged compared to younger women. Further studies including co morbidities are necessary to refine these results and to improve therapeutic management of elderly patients with ovarian cancer.

Diversity of assessing circulating tumor cells (CTCs) emphasizes need for standardization: a CTC Guide to design and report trials.

PubMed

Bünger, S; Zimmermann, M; Habermann, J K

2015-09-01

Hematogenous spreading of tumor cells from primary tumors is a crucial step in the cascade to metastasis, the latter being the most limiting factor for patients' survival prognosis. Therefore, circulating tumor cells (CTCs) have become a field of intensive research. However, the process of isolation and identification of CTCs lacks standardization. This article presents an overview of 71 CTC studies reported in PUBMED since 2000 and focusing on colorectal cancer. These studies are evaluated regarding standardization of CTC isolation and identification, marker proteins used, study population and blood sample quality management, clinical performance, and quality measures. Overall, standardization of CTC assessment seems insufficient. Thus, comparability of CTC studies is hampered and results should be interpreted carefully. We here propose a standardized CTC guideline (CTC Guide) to prospectively design and report studies/trials in a harmonized form. Despite the current interstudy heterogeneity, the data indicate that CTC detection is of clinical relevance and CTCs should be considered as a surrogate prognostic marker. Many studies indicate the high potential for CTCs as prognostic markers, e.g., in colorectal cancer treatment. However, standardized, large-scale multicenter validation studies are still needed to pave the way for clinical implementation of CTC detection that could ameliorate individualized medicine regimes.

Effect of the Macintosh curved blade size on direct laryngoscopic view in edentulous patients.

PubMed

Kim, Hyerim; Chang, Jee-Eun; Han, Sung-Hee; Lee, Jung-Man; Yoon, Soohyuk; Hwang, Jin-Young

2018-01-01

In the present study, we compared the laryngoscopic view depending on the size of the Macintosh curved blade in edentulous patients. Thirty-five edentulous adult patients scheduled for elective surgery were included in the study. After induction of anesthesia, two direct laryngoscopies were performed alternately using a standard-sized Macintosh curved blade (No. 4 for men and No. 3 for women) and smaller-sized Macintosh curved blade (No. 3 for men and No. 2 for women). During direct laryngoscopy with each blade, two digital photographs of the lateral view were taken when the blade tip was placed in the valleculae; the laryngoscope was lifted to achieve the best laryngeal view. Then, the best laryngeal views were assessed using the percentage of glottic opening (POGO) score. On the photographs of the lateral view of direct laryngoscopy, the angles between the line extending along the laryngoscopic handle and the horizontal line were measured. The POGO score was improved with the smaller-sized blade compared with the standard-sized blade (87.3% [11.8%] vs. 71.3% [20.0%], P<0.001, respectively). The angles between the laryngoscopic handle and the horizontal line were greater with the smaller-sized blade compared to the standard-sized blade when the blade tip was placed on the valleculae and when the laryngoscope was lifted to achieve the best laryngeal view (both P<0.001). Compared to a standard-sized Macintosh blade, a smaller-sized Macintosh curved blade improved the laryngeal exposure in edentulous patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Accuracy of a smartphone to test laryngoscope's light and an audit to our laryngoscopes using an ISO standard.

PubMed

Machado, Diogo Alcino de Abreu Ribeiro Carvalho; Esteves, Dina da Assunção Azevedo; Branca, Pedro Manuel Araújo de Sousa

Laryngoscope is a key tool in anesthetic practice. Direct laryngoscopy is a crucial moment and inadequate laryngoscope's light can lead to catastrophic consequences. From our experience laryngoscope's light is assessed in a subjective manner and we believe a more precise evaluation should be used. Our objective is to compare the accuracy of a smartphone compared to a lux meter. Secondly we audited our Operating Room laryngoscopes. We designed a pragmatic study, using as primary outcome the accuracy of a smartphone compared to the lux meter. Further we audited with both the lux meter and the smartphone all laryngoscopes and blades ready to use in our Operating Rooms, using the International Standard form the International Organization for Standardization. For primary outcome we found no significant difference between devices. Our audit showed that only 2 in 48 laryngoscopes complied with the ISO norm. When comparing the measurements between the lux meter and the smartphone we found no significant difference. Ideally every laryngoscope should perform as required. We believe all laryngoscopes should have a practical but reliable and objective test prior to its utilization. Our results suggest the smartphone was accurate enough to be used as a lux meter to test laryngoscope's light. Audit results showing only 4% comply with the ISO standard are consistent with other studies. The tested smartphone has enough accuracy to perform light measurement in laryngoscopes. We believe this is a step further to perform an objective routine check to laryngoscope's light. Copyright © 2016. Published by Elsevier Editora Ltda.

Comparison of Quadrapolar™ radiofrequency lesions produced by standard versus modified technique: an experimental model.

PubMed

Safakish, Ramin

2017-01-01

Lower back pain (LBP) is a global public health issue and is associated with substantial financial costs and loss of quality of life. Over the years, different literature has provided different statistics regarding the causes of the back pain. The following statistic is the closest estimation regarding our patient population. The sacroiliac (SI) joint pain is responsible for LBP in 18%-30% of individuals with LBP. Quadrapolar™ radiofrequency ablation, which involves ablation of the nerves of the SI joint using heat, is a commonly used treatment for SI joint pain. However, the standard Quadrapolar radiofrequency procedure is not always effective at ablating all the sensory nerves that cause the pain in the SI joint. One of the major limitations of the standard Quadrapolar radiofrequency procedure is that it produces small lesions of ~4 mm in diameter. Smaller lesions increase the likelihood of failure to ablate all nociceptive input. In this study, we compare the standard Quadrapolar radiofrequency ablation technique to a modified Quadrapolar ablation technique that has produced improved patient outcomes in our clinic. The methodology of the two techniques are compared. In addition, we compare results from an experimental model comparing the lesion sizes produced by the two techniques. Taken together, the findings from this study suggest that the modified Quadrapolar technique provides longer lasting relief for the back pain that is caused by SI joint dysfunction. A randomized controlled clinical trial is the next step required to quantify the difference in symptom relief and quality of life produced by the two techniques.

Cluster-randomized Studies in Educational Research: Principles and Methodological Aspects

PubMed Central

Dreyhaupt, Jens; Mayer, Benjamin; Keis, Oliver; Öchsner, Wolfgang; Muche, Rainer

2017-01-01

An increasing number of studies are being performed in educational research to evaluate new teaching methods and approaches. These studies could be performed more efficiently and deliver more convincing results if they more strictly applied and complied with recognized standards of scientific studies. Such an approach could substantially increase the quality in particular of prospective, two-arm (intervention) studies that aim to compare two different teaching methods. A key standard in such studies is randomization, which can minimize systematic bias in study findings; such bias may result if the two study arms are not structurally equivalent. If possible, educational research studies should also achieve this standard, although this is not yet generally the case. Some difficulties and concerns exist, particularly regarding organizational and methodological aspects. An important point to consider in educational research studies is that usually individuals cannot be randomized, because of the teaching situation, and instead whole groups have to be randomized (so-called “cluster randomization”). Compared with studies with individual randomization, studies with cluster randomization normally require (significantly) larger sample sizes and more complex methods for calculating sample size. Furthermore, cluster-randomized studies require more complex methods for statistical analysis. The consequence of the above is that a competent expert with respective special knowledge needs to be involved in all phases of cluster-randomized studies. Studies to evaluate new teaching methods need to make greater use of randomization in order to achieve scientifically convincing results. Therefore, in this article we describe the general principles of cluster randomization and how to implement these principles, and we also outline practical aspects of using cluster randomization in prospective, two-arm comparative educational research studies. PMID:28584874

Cluster-randomized Studies in Educational Research: Principles and Methodological Aspects.

PubMed

Dreyhaupt, Jens; Mayer, Benjamin; Keis, Oliver; Öchsner, Wolfgang; Muche, Rainer

2017-01-01

An increasing number of studies are being performed in educational research to evaluate new teaching methods and approaches. These studies could be performed more efficiently and deliver more convincing results if they more strictly applied and complied with recognized standards of scientific studies. Such an approach could substantially increase the quality in particular of prospective, two-arm (intervention) studies that aim to compare two different teaching methods. A key standard in such studies is randomization, which can minimize systematic bias in study findings; such bias may result if the two study arms are not structurally equivalent. If possible, educational research studies should also achieve this standard, although this is not yet generally the case. Some difficulties and concerns exist, particularly regarding organizational and methodological aspects. An important point to consider in educational research studies is that usually individuals cannot be randomized, because of the teaching situation, and instead whole groups have to be randomized (so-called "cluster randomization"). Compared with studies with individual randomization, studies with cluster randomization normally require (significantly) larger sample sizes and more complex methods for calculating sample size. Furthermore, cluster-randomized studies require more complex methods for statistical analysis. The consequence of the above is that a competent expert with respective special knowledge needs to be involved in all phases of cluster-randomized studies. Studies to evaluate new teaching methods need to make greater use of randomization in order to achieve scientifically convincing results. Therefore, in this article we describe the general principles of cluster randomization and how to implement these principles, and we also outline practical aspects of using cluster randomization in prospective, two-arm comparative educational research studies.

On prediction of genetic values in marker-assisted selection.

PubMed Central

Lange, C; Whittaker, J C

2001-01-01

We suggest a new approximation for the prediction of genetic values in marker-assisted selection. The new approximation is compared to the standard approach. It is shown that the new approach will often provide substantially better prediction of genetic values; furthermore the new approximation avoids some of the known statistical problems of the standard approach. The advantages of the new approach are illustrated by a simulation study in which the new approximation outperforms both the standard approach and phenotypic selection. PMID:11729177

Protocol for Usability Testing and Validation of the ISO Draft International Standard 19223 for Lung Ventilators

PubMed Central

2017-01-01

Background Clinicians, such as respiratory therapists and physicians, are often required to set up pieces of medical equipment that use inconsistent terminology. Current lung ventilator terminology that is used by different manufacturers contributes to the risk of usage errors, and in turn the risk of ventilator-associated lung injuries and other conditions. Human factors and communication issues are often associated with ventilator-related sentinel events, and inconsistent ventilator terminology compounds these issues. This paper describes our proposed protocol, which will be implemented at the University of Waterloo, Canada when this project is externally funded. Objective We propose to determine whether a standardized vocabulary improves the ease of use, safety, and utility as it relates to the usability of medical devices, compared to legacy medical devices from multiple manufacturers, which use different terms. Methods We hypothesize that usage errors by clinicians will be lower when standardization is consistently applied by all manufacturers. The proposed study will experimentally examine the impact of standardized nomenclature on performance declines in the use of an unfamiliar ventilator product in clinically relevant scenarios. Participants will be respiratory therapy practitioners and trainees, and we propose studying approximately 60 participants. Results The work reported here is in the proposal phase. Once the protocol is implemented, we will report the results in a follow-up paper. Conclusions The proposed study will help us better understand the effects of standardization on medical device usability. The study will also help identify any terms in the International Organization for Standardization (ISO) Draft International Standard (DIS) 19223 that may be associated with recurrent errors. Amendments to the standard will be proposed if recurrent errors are identified. This report contributes a protocol that can be used to assess the effect of standardization in any given domain that involves equipment, multiple manufacturers, inconsistent vocabulary, symbology, audio tones, or patterns in interface navigation. Second, the protocol can be used to experimentally evaluate the ISO DIS 19223 for its effectiveness, as researchers around the world may wish to conduct such tests and compare results. PMID:28887292

A simulation study of nonparametric total deviation index as a measure of agreement based on quantile regression.

PubMed

Lin, Lawrence; Pan, Yi; Hedayat, A S; Barnhart, Huiman X; Haber, Michael

2016-01-01

Total deviation index (TDI) captures a prespecified quantile of the absolute deviation of paired observations from raters, observers, methods, assays, instruments, etc. We compare the performance of TDI using nonparametric quantile regression to the TDI assuming normality (Lin, 2000). This simulation study considers three distributions: normal, Poisson, and uniform at quantile levels of 0.8 and 0.9 for cases with and without contamination. Study endpoints include the bias of TDI estimates (compared with their respective theoretical values), standard error of TDI estimates (compared with their true simulated standard errors), and test size (compared with 0.05), and power. Nonparametric TDI using quantile regression, although it slightly underestimates and delivers slightly less power for data without contamination, works satisfactorily under all simulated cases even for moderate (say, ≥40) sample sizes. The performance of the TDI based on a quantile of 0.8 is in general superior to that of 0.9. The performances of nonparametric and parametric TDI methods are compared with a real data example. Nonparametric TDI can be very useful when the underlying distribution on the difference is not normal, especially when it has a heavy tail.

Improving post-stroke dysphagia outcomes through a standardized and multidisciplinary protocol: an exploratory cohort study.

PubMed

Gandolfi, Marialuisa; Smania, Nicola; Bisoffi, Giulia; Squaquara, Teresa; Zuccher, Paola; Mazzucco, Sara

2014-12-01

Stroke is a major cause of dysphagia. Few studies to date have reported on standardized multidisciplinary protocolized approaches to the management of post-stroke dysphagia. The aim of this retrospective cohort study was to evaluate the impact of a standardized multidisciplinary protocol on clinical outcomes in patients with post-stroke dysphagia. We performed retrospective chart reviews of patients with post-stroke dysphagia admitted to the neurological ward of Verona University Hospital from 2004 to 2008. Outcomes after usual treatment for dysphagia (T- group) were compared versus outcomes after treatment under a standardized diagnostic and rehabilitative multidisciplinary protocol (T+ group). Outcome measures were death, pneumonia on X-ray, need for respiratory support, and proportion of patients on tube feeding at discharge. Of the 378 patients admitted with stroke, 84 had dysphagia and were enrolled in the study. A significantly lower risk of in-hospital death (odds ratio [OR] 0.20 [0.53-0.78]), pneumonia (OR 0.33 [0.10-1.03]), need for respiratory support (OR 0.48 [0.14-1.66]), and tube feeding at discharge (OR 0.30 [0.09-0.91]) was recorded for the T+ group (N = 39) as compared to the T- group (N = 45). The adjusted OR showed no difference between the two groups for in-hospital death and tube feeding at discharge. Use of a standardized multidisciplinary protocolized approach to the management of post-stroke dysphagia may significantly reduce rates of aspiration pneumonia, in-hospital mortality, and tube feeding in dysphagic stroke survivors. Consistent with the study's exploratory purposes, our findings suggest that the multidisciplinary protocol applied in this study offers an effective model of management of post-stroke dysphagia.

Mineralocorticoid receptor blockade in addition to angiotensin converting enzyme inhibitor or angiotensin II receptor blocker treatment: an emerging paradigm in diabetic nephropathy: a systematic review.

PubMed

Mavrakanas, Thomas A; Gariani, Karim; Martin, Pierre-Yves

2014-02-01

Blockade of the renin-angiotensin-aldosterone system (RAAS) is a standard therapeutic intervention in diabetic patients with chronic kidney disease (CKD). Concomitant mineralocorticoid receptor blockade has been studied as a novel approach to further slow down CKD progression. We used PubMed and EMBASE databases to search for relevant literature. We included in our review eight studies in patients of at least 18 years of age, with a diagnosis of type 1 or type 2 diabetes mellitus and diabetic nephropathy, under an angiotensin converting enzyme inhibitor (ACEI) and/or an angiotensin II receptor blocker (ARB) as standard treatment. A subset of patients in each study also received a mineralocorticoid receptor blocker (MRB) (either spironolactone or eplerenone) in addition to standard treatment. Combined treatment with a mineralocorticoid receptor blocker further reduced albuminuria by 23 to 61% compared with standard treatment. Estimated glomerular filtration rate values upon study completion slightly decreased under combined treatment. Blood pressure levels upon study completion were significantly lower with combined treatment in three studies. Hyperkalemia prevalence increased in patients under combined treatment raising dropout rate up to 17%. Therefore, combined treatment by an ACEI/ARB and a MRB may further decrease albuminuria in diabetic nephropathy. This effect may be due to the specific properties of the MRB treatment. Clinicians should regularly check potassium levels because of the increased risk of hyperkalemia. Available evidence should be confirmed by an adequately powered comparative trial of the standard treatment (ACEI or ARB) versus combined treatment by an ACEI/ARB and a MRB. Copyright © 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

A Comparative Analysis of Charter Schools and Traditional Public Schools

ERIC Educational Resources Information Center

Smith, Jodi Renee Abbott

2014-01-01

The focus of this descriptive research study was to compare charter and traditional public schools on the academic knowledge of fifth grade students as measured by Arizona's Instrument to Measure Standards (AIMS) in a suburb of a large southwestern city. This analysis also compared charter and traditional public schools on AYP status. It was…

Diagnostic accuracy of 22/25-gauge core needle in endoscopic ultrasound-guided sampling: systematic review and meta-analysis.

PubMed

Oh, Hyoung-Chul; Kang, Hyun; Lee, Jae Young; Choi, Geun Joo; Choi, Jung Sik

2016-11-01

To compare the diagnostic accuracy of endoscopic ultrasound-guided core needle aspiration with that of standard fine-needle aspiration by systematic review and meta-analysis. Studies using 22/25-gauge core needles, irrespective of comparison with standard fine needles, were comprehensively reviewed. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic curves for the diagnosis of malignancy were used to estimate the overall diagnostic efficiency. The pooled sensitivity, specificity, and DOR of the core needle for the diagnosis of malignancy were 0.88 (95% confidence interval [CI], 0.84 to 0.90), 0.99 (95% CI, 0.96 to 1), and 167.37 (95% CI, 65.77 to 425.91), respectively. The pooled sensitivity, specificity, and DOR of the standard needle were 0.84 (95% CI, 0.79 to 0.88), 1 (95% CI, 0.97 to 1), and 130.14 (95% CI, 34.00 to 495.35), respectively. The area under the curve of core and standard needle in the diagnosis of malignancy was 0.974 and 0.955, respectively. The core and standard needle were comparable in terms of pancreatic malignancy diagnosis. There was no significant difference in procurement of optimal histologic cores between core and standard needles (risk ratio [RR], 0.545; 95% CI, 0.187 to 1.589). The number of needle passes for diagnosis was significantly lower with the core needle (standardized mean difference, -0.72; 95% CI, -1.02 to -0.41). There were no significant differences in overall complications (RR, 1.26; 95% CI, 0.34 to 4.62) and technical failure (RR, 5.07; 95% CI, 0.68 to 37.64). Core and standard needles were comparable in terms of diagnostic accuracy, technical performance, and safety profile.

A multifaceted feedback strategy alone does not improve the adherence to organizational guideline-based standards: a cluster randomized trial in intensive care.

PubMed

de Vos, Maartje L G; van der Veer, Sabine N; Wouterse, Bram; Graafmans, Wilco C; Peek, Niels; de Keizer, Nicolette F; Jager, Kitty J; Westert, Gert P; van der Voort, Peter H J

2015-07-08

Organizational data such as bed occupancy rate and nurse-to-patient ratio are related to clinical outcomes and to the efficient use of intensive care unit (ICU) resources. Standards for these performance indicators are provided in guidelines. We studied the effects of a multifaceted feedback strategy to improve the adherence to these standards. In a cluster randomized controlled study design the intervention ICUs received extensive monthly feedback reports, they received outreach visits and initiated a quality improvement team. The control ICUs received limited quarterly feedback reports only. We collected primary data prospectively within the setting of a Dutch national ICU registry over a 14-month study period. The target indicators were bed occupancy rate (aiming at 80 % or below) and nurse-to-patient ratio (aiming at 0.5 or higher). Data were collected per 8-h nursing shift. Logistic regression analysis was performed. For both study end points, the odds ratios (OR) for improvements at follow-up versus at baseline were calculated separately for control and intervention ICUs. We analyzed data on 67,237 nursing shifts. The bed occupancy rate did not improve in the intervention group compared to baseline (adjusted OR 0.88; 95 % confidence interval (CI), 0.62-1.27) or compared to control group (OR 0.67; 95 % CI 0.39-1.15). The nurse-to-patient ratio did not improve (OR 0.72; 95 % CI 0.41-1.26 compared to baseline and OR 0.65; 95 % CI 0.35-1.19 compared to control group). A multifaceted feedback intervention did not improve the adherence to guideline-based standards on the organizational issues bed occupancy rate and nurse-to-patient ratio in the ICU. The reasons may be a limited confidence in data quality, the lack of practical tools for improvement, and the relatively short follow-up. ISRCTN50542146.

A reference case for economic evaluations in osteoarthritis: an expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

PubMed

Hiligsmann, Mickaël; Cooper, Cyrus; Guillemin, Francis; Hochberg, Marc C; Tugwell, Peter; Arden, Nigel; Berenbaum, Francis; Boers, Maarten; Boonen, Annelies; Branco, Jaime C; Maria-Luisa, Brandi; Bruyère, Olivier; Gasparik, Andrea; Kanis, John A; Kvien, Tore K; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Pinedo-Villanueva, Rafael; Pinto, Daniel; Reiter-Niesert, Susanne; Rizzoli, René; Rovati, Lucio C; Severens, Johan L; Silverman, Stuart; Reginster, Jean-Yves

2014-12-01

General recommendations for a reference case for economic studies in rheumatic diseases were published in 2002 in an initiative to improve the comparability of cost-effectiveness studies in the field. Since then, economic evaluations in osteoarthritis (OA) continue to show considerable heterogeneity in methodological approach. To develop a reference case specific for economic studies in OA, including the standard optimal care, with which to judge new pharmacologic and non-pharmacologic interventions. Four subgroups of an ESCEO expert working group on economic assessments (13 experts representing diverse aspects of clinical research and/or economic evaluations) were charged with producing lists of recommendations that would potentially improve the comparability of economic analyses in OA: outcome measures, comparators, costs and methodology. These proposals were discussed and refined during a face-to-face meeting in 2013. They are presented here in the format of the recommendations of the recently published Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, so that an initiative on economic analysis methodology might be consolidated with an initiative on reporting standards. Overall, three distinct reference cases are proposed, one for each hand, knee and hip OA; with diagnostic variations in the first two, giving rise to different treatment options: interphalangeal or thumb-based disease for hand OA and the presence or absence of joint malalignment for knee OA. A set of management strategies is proposed, which should be further evaluated to help establish a consensus on the "standard optimal care" in each proposed reference case. The recommendations on outcome measures, cost itemisation and methodological approaches are also provided. The ESCEO group proposes a set of disease-specific recommendations on the conduct and reporting of economic evaluations in OA that could help the standardisation and comparability of studies that evaluate therapeutic strategies of OA in terms of costs and effectiveness. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Randomized trials published in Chinese or Western journals: comparative empirical analysis.

PubMed

Purgato, Marianna; Cipriani, Andrea; Barbui, Corrado

2012-06-01

A major concern to the inclusion in systematic reviews of studies originating in China and published in Chinese journals refers to the quality of study reporting. In this systematic survey of randomized trials, we compared the characteristics of studies published in Chinese journals with those of studies published in Western journals. We included 69 studies comparing citalopram with other antidepressant drugs in the treatment of major depression. Of these, 37 (54%) were published in Chinese journals. The standard of reporting was generally poor in both Western and Chinese studies. In some Chinese studies, the generation of the randomization sequence raised concern about their experimental nature, and in almost all included studies, the concealment of allocation was not properly described. Blinding was seldom adopted in Chinese studies, and the risk of sponsorship bias was uncertain because Chinese studies did not report any financial support. In most Western studies, outcome data were selectively and incompletely reported. Pooling together all trials revealed that citalopram was similarly effective in comparison with all other antidepressant drugs both in Western studies (standardized mean difference, -0.04; 95% confidence interval, -0.15 to 0.06) and in Chinese studies (standardized mean difference, -0.08, 95% confidence interval, -0.18 to 0.02). Randomized controlled trials published in Chinese journals represent most of the studies included in this review. This suggests that omitting to search biomedical databases originating from China would systematically exclude a relevant proportion of randomized trials published in Chinese journals, with a risk of random error or bias. The increasing inclusion of Chinese studies in systematic reviews reinforces the need to check the quality of randomized trials that are meta-analyzed.

A comparative study of the aerobic fitness of 421 healthy adult males in Singapore.

PubMed

Ong, T C

1993-02-01

The maximum oxygen consumption (VO2 max) of 421 healthy adult males from three ethnic groups (Chinese, Malay and Indian), aged 25-54 years, was assessed from direct analyses of their expired respiratory gases during all-out runs on a treadmill as a measure of aerobic fitness. The subjects were divided into three age groups: group 1, 25-34 years; group 2, 35-44 years; group 3, 45-54 years. Each group was further subdivided into non-exercisers (NE), non-regular exercisers (NRE) and regular exercisers (RE). Consistently within each age group, regular exercisers produced significantly higher VO2 max values compared to non-regular exercisers and non-exercisers. They also met the VO2 max requirements for heavy physical work and compared favourably with the standards of the National Physical Fitness Award of Singapore and Cooper's aerobic fitness classification standards based on North American males. Non-regular exercisers and non-exercisers only met the VO2 max requirements for moderate physical work and compared poorly in both of the aerobic fitness standards.

A Pilot Study Evaluating Mindfulness-Based Stress Reduction and Massage for the Management of Chronic Pain

PubMed Central

Plews-Ogan, Margaret; Owens, Justine E; Goodman, Matthew; Wolfe, Pamela; Schorling, John

2005-01-01

Background Mindfulness-based stress reduction (MBSR) and massage may be useful adjunctive therapies for chronic musculoskeletal pain. Objective To evaluate the feasibility of studying MBSR and massage for the management of chronic pain and estimate their effects on pain and mood. Design Randomized trial comparing MBSR or massage with standard care. Participants Thirty patients with chronic musculoskeletal pain. Measurements Pain was assessed with 0 to 10 numeric rating scales. Physical and mental health status was measured with the SF-12. Results The study completion rate was 76.7%. At week 8, the massage group had average difference scores for pain unpleasantness of 2.9 and mental health status of 13.6 compared with 0.13 (P<.05) and 3.9 (P<.04), respectively, for the standard care group. These differences were no longer significant at week 12. There were no significant differences in the pain outcomes for the MBSR group. At week 12, the mean change in mental health status for the MBSR group was 10.2 compared with −1.7 in the standard care group (P<.04). Conclusions It is feasible to study MBSR and massage in patients with chronic musculoskeletal pain. Mindfulness-based stress reduction may be more effective and longer-lasting for mood improvement while massage may be more effective for reducing pain. PMID:16423104

The Efficacy of a Viscoelastic Foam Overlay on Prevention of Pressure Injury in Acutely Ill Patients: A Prospective Randomized Controlled Trial.

PubMed

Park, Kyung Hee; Park, Joohee

The purpose of this study was to compare a viscoelastic foam overlay (VEFO) to a standard hospital mattress for pressure injury (PI) prevention. We also compared interface pressures (IPs) of the VEFO to our facility's standard hospital mattress. Prospective, randomized controlled trial. Data analysis was based on 110 participants (55 in each group) who were 19 years or older, had a Braden Scale for Pressure Sore Risk score of 16 or less, and were cared for on a neurology, oncology, or pulmonology inpatient care unit. The research setting was the Samsung Medical Center in Seoul, South Korea. Participants were divided into 2 groups: the experimental group were based on a VEFO on top of the standard hospital mattress used in our facility. Participants in the control group were placed on a standard hospital mattress with/without air overlay. All patients were given standard nursing care for prevention of PI. Skin assessments were completed daily over a period of 2 weeks. In addition, we compared IPs of the standard hospital mattress and the VEFO in participants randomly allocated to the intervention group. Interface pressure was measured over the sacral/coccygeal area with subjects in the supine position. Pressures were measured immediately before and immediately following placement of the VEFO and just before data collection began. Data were collected between October 2013 and November 2014. Pressure injury incidence was compared between groups using the χ test, and IPs were compared using the paired t test. Pressure injury development was determined using the staging system described in guidelines from the National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance in 2014. Interface pressure was measured using a device manufactured for this purpose. The incidence of PI development was significantly lower in subjects assigned to the experimental group as compared to those in the control group (3.6%-27.3% over the 2-week data collection period; P = .001). The maximum IP was significantly lower on the VEFO with standard hospital mattress than on the standard hospital mattress (paired t = 8.87, P < .001). Patients managed with a VEFO had a significantly lower incidence of PI than those managed with a standard hospital mattress. Additional research is needed to further characterize the efficacy of the VEFO, its effect on PI healing, and its effect of PI prevention in high-risk populations such as critically ill patients.

Evaluating maturation and genetic modification of human dendritic cells in a new polyolefin cell culture bag system.

PubMed

Macke, Lars; Garritsen, Henk S P; Meyring, Wilhelm; Hannig, Horst; Pägelow, Ute; Wörmann, Bernhard; Piechaczek, Christoph; Geffers, Robert; Rohde, Manfred; Lindenmaier, Werner; Dittmar, Kurt E J

2010-04-01

Dendritic cells (DCs) are applied worldwide in several clinical studies of immune therapy of malignancies, autoimmune diseases, and transplantations. Most legislative bodies are demanding high standards for cultivation and transduction of cells. Closed-cell cultivating systems like cell culture bags would simplify and greatly improve the ability to reach these cultivation standards. We investigated if a new polyolefin cell culture bag enables maturation and adenoviral modification of human DCs in a closed system and compare the results with standard polystyrene flasks. Mononuclear cells were isolated from HLA-A*0201-positive blood donors by leukapheresis. A commercially available separation system (CliniMACS, Miltenyi Biotec) was used to isolate monocytes by positive selection using CD14-specific immunomagnetic beads. The essentially homogenous starting cell population was cultivated in the presence of granulocyte-macrophage-colony-stimulating factor and interleukin-4 in a closed-bag system in parallel to the standard flask cultivation system. Genetic modification was performed on Day 4. After induction of maturation on Day 5, mature DCs could be harvested and cryopreserved on Day 7. During the cultivation period comparative quality control was performed using flow cytometry, gene expression profiling, and functional assays. Both flasks and bags generated mature genetically modified DCs in similar yields. Surface membrane markers, expression profiles, and functional testing results were comparable. The use of a closed-bag system facilitated clinical applicability of genetically modified DCs. The polyolefin bag-based culture system yields DCs qualitatively and quantitatively comparable to the standard flask preparation. All steps including cryopreservation can be performed in a closed system facilitating standardized, safe, and reproducible preparation of therapeutic cells.

Accuracy investigation of phthalate metabolite standards.

PubMed

Langlois, Éric; Leblanc, Alain; Simard, Yves; Thellen, Claude

2012-05-01

Phthalates are ubiquitous compounds whose metabolites are usually determined in urine for biomonitoring studies. Following suspect and unexplained results from our laboratory in an external quality-assessment scheme, we investigated the accuracy of all phthalate metabolite standards in our possession by comparing them with those of several suppliers. Our findings suggest that commercial phthalate metabolite certified solutions are not always accurate and that lot-to-lot discrepancies significantly affect the accuracy of the results obtained with several of these standards. These observations indicate that the reliability of the results obtained from different lots of standards is not equal, which reduces the possibility of intra-laboratory and inter-laboratory comparisons of results. However, agreements of accuracy have been observed for a majority of neat standards obtained from different suppliers, which indicates that a solution to this issue is available. Data accuracy of phthalate metabolites should be of concern for laboratories performing phthalate metabolite analysis because of the standards used. The results of our investigation are presented from the perspective that laboratories performing phthalate metabolite analysis can obtain accurate and comparable results in the future. Our findings will contribute to improving the quality of future phthalate metabolite analyses and will affect the interpretation of past results.

Transmission-blocking activity is determined by transmission-reducing activity and number of control oocysts in Plasmodium falciparum standard membrane-feeding assay.

PubMed

Miura, Kazutoyo; Swihart, Bruce J; Deng, Bingbing; Zhou, Luwen; Pham, Thao P; Diouf, Ababacar; Burton, Timothy; Fay, Michael P; Long, Carole A

2016-07-29

Malaria transmission-blocking vaccines (TBVs) are potentially helpful tools for malaria eradication. The standard membrane-feeding assay (SMFA) is considered one of the "gold standard" assays for TBV development. However, lack of consensus in reporting results from SMFA has made it very challenging to compare results from different studies. Two main readouts, % inhibition in mean oocyst count per mosquito (TRA) and % inhibition in prevalence of infected mosquitoes (TBA), have been used widely. In this study, we statistically modeled the oocyst data in SMFA using data from 105 independent feeding experiments including 9804 mosquitoes. The model was validated using an independent data set that included 10,790 mosquitoes from 110 feeding studies. The model delineates a relationship between TRA, the mean oocyst count in the control mosquitoes (mo-contl), and TBA. While TRA was independent from mo-contl, TBA values changed depending on mo-contl. Regardless of monoclonal or polyclonal antibodies tested, there were strong concordances between observed TBA and predicted TBA based on the model using mo-contl and observed TRA. Simulations showed that SMFA with lower true control means had increased uncertainty in TRA estimates. The strong linkage between TBA, TRA and mo-contl inspired creation of a standardized TBA, a model-based TBA standardized to a target control mean, which allows comparison across multiple feeds regardless of mo-contl. This is the first study showing that the observed TBA can be reasonably predicted by mo-contl and the TRA of the test antibody using independent experimental data. This study indicates that TRA should be used to compare results from multiple feeds with different levels of mo-contl. If a measure of TBA is desired, it is better to report standardized TBA rather than observed TBA. These recommendations support rational comparisons of results from different studies, thus benefiting future TBV development. Published by Elsevier Ltd.

Relationship between vertebral artery blood flow in different head positions and vertigo.

PubMed

Araz Server, Ela; Edizer, Deniz Tuna; Yiğit, Özgür; Yasak, Ahmet Görkem; Erdim, Çağrı

2018-01-01

To identify the vertebral artery blood flow in different head positions in patients with positional vertigo with no specific diagnosis. Patients with history of vestibular symptoms associated with changes in head position were enrolled into the study. Healthy volunteers were evaluated as control group. Doppler ultrasonography examination of the cervical segment of the vertebral arteries was performed under three different head positions: (i) supine position, (ii) head hyperextended and rotated to the right side and (iii) head hyperextended and rotated to the left side. In the study group, right and left vertebral artery blood flow was significantly lower in the ipsilateral hyperextended position compared to standard supine position (respectively p = .014; p = .001), but did not differ significantly when compared between the standard supine and contralateral hyperextended positions (respectively = .959; p = .669). In the control group, left and right vertebral artery blood flow did not differ significantly when the head was hyperextended to the right or left sides compared to standard supine position (p > .05). Our data demonstrated that the etiology of vestibular complaints in patients with undiagnosed positional vertigo might be related to impairment in vertebral artery blood flow according to head positions.

Evaluating the risks of clinical research: direct comparative analysis.

PubMed

Rid, Annette; Abdoler, Emily; Roberson-Nay, Roxann; Pine, Daniel S; Wendler, David

2014-09-01

Many guidelines and regulations allow children and adolescents to be enrolled in research without the prospect of clinical benefit when it poses minimal risk. However, few systematic methods exist to determine when research risks are minimal. This situation has led to significant variation in minimal risk judgments, raising concern that some children are not being adequately protected. To address this concern, we describe a new method for implementing the widely endorsed "risks of daily life" standard for minimal risk. This standard defines research risks as minimal when they do not exceed the risks posed by daily life activities or routine examinations. This study employed a conceptual and normative analysis, and use of an illustrative example. Different risks are composed of the same basic elements: Type, likelihood, and magnitude of harm. Hence, one can compare the risks of research and the risks of daily life by comparing the respective basic elements with each other. We use this insight to develop a systematic method, direct comparative analysis, for implementing the "risks of daily life" standard for minimal risk. The method offers a way of evaluating research procedures that pose the same types of risk as daily life activities, such as the risk of experiencing anxiety, stress, or other psychological harm. We thus illustrate how direct comparative analysis can be applied in practice by using it to evaluate whether the anxiety induced by a respiratory CO2 challenge poses minimal or greater than minimal risks in children and adolescents. Direct comparative analysis is a systematic method for applying the "risks of daily life" standard for minimal risk to research procedures that pose the same types of risk as daily life activities. It thereby offers a method to protect children and adolescents in research, while ensuring that important studies are not blocked because of unwarranted concerns about research risks.

Evaluating the Risks of Clinical Research: Direct Comparative Analysis

PubMed Central

Abdoler, Emily; Roberson-Nay, Roxann; Pine, Daniel S.; Wendler, David

2014-01-01

Abstract Objectives: Many guidelines and regulations allow children and adolescents to be enrolled in research without the prospect of clinical benefit when it poses minimal risk. However, few systematic methods exist to determine when research risks are minimal. This situation has led to significant variation in minimal risk judgments, raising concern that some children are not being adequately protected. To address this concern, we describe a new method for implementing the widely endorsed “risks of daily life” standard for minimal risk. This standard defines research risks as minimal when they do not exceed the risks posed by daily life activities or routine examinations. Methods: This study employed a conceptual and normative analysis, and use of an illustrative example. Results: Different risks are composed of the same basic elements: Type, likelihood, and magnitude of harm. Hence, one can compare the risks of research and the risks of daily life by comparing the respective basic elements with each other. We use this insight to develop a systematic method, direct comparative analysis, for implementing the “risks of daily life” standard for minimal risk. The method offers a way of evaluating research procedures that pose the same types of risk as daily life activities, such as the risk of experiencing anxiety, stress, or other psychological harm. We thus illustrate how direct comparative analysis can be applied in practice by using it to evaluate whether the anxiety induced by a respiratory CO2 challenge poses minimal or greater than minimal risks in children and adolescents. Conclusions: Direct comparative analysis is a systematic method for applying the “risks of daily life” standard for minimal risk to research procedures that pose the same types of risk as daily life activities. It thereby offers a method to protect children and adolescents in research, while ensuring that important studies are not blocked because of unwarranted concerns about research risks. PMID:25210944

Do "premium" joint implants add value?: analysis of high cost joint implants in a community registry.

PubMed

Gioe, Terence J; Sharma, Amit; Tatman, Penny; Mehle, Susan

2011-01-01

Numerous joint implant options of varying cost are available to the surgeon, but it is unclear whether more costly implants add value in terms of function or longevity. We evaluated registry survival of higher-cost "premium" knee and hip components compared to lower-priced standard components. Premium TKA components were defined as mobile-bearing designs, high-flexion designs, oxidized-zirconium designs, those including moderately crosslinked polyethylene inserts, or some combination. Premium THAs included ceramic-on-ceramic, metal-on-metal, and ceramic-on-highly crosslinked polyethylene designs. We compared 3462 standard TKAs to 2806 premium TKAs and 868 standard THAs to 1311 premium THAs using standard statistical methods. The cost of the premium implants was on average approximately $1000 higher than the standard implants. There was no difference in the cumulative revision rate at 7-8 years between premium and standard TKAs or THAs. In this time frame, premium implants did not demonstrate better survival than standard implants. Revision indications for TKA did not differ, and infection and instability remained contributors. Longer followup is necessary to demonstrate whether premium implants add value in younger patient groups. Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

A pilot study of reference vibrotactile perception thresholds on the fingertip obtained with Malaysian healthy people using ISO 13091-1 equipment.

PubMed

Daud, Roshada; Maeda, Setsuo; Kameel, Nur Nazmin Mustafa; Ripin, Muhamad Yunus; Bakrun, Norazman; Md Zein, Raemy; Kido, Masaharu; Higuchi, Kiyotaka

2004-04-01

The purpose of this paper is to clarify the reference vibrotactile perception thresholds (VPT) for healthy people in Malaysia. The measurement equipment standard, ISO 13091-1, of the vibrotactile perception thresholds for the assessment of nerve dysfunction and the analysis and interpretation of measurements at the fingertips standard, ISO 13091-2, were published in ISO/TC108/SC4/WG8 on 2001 and 2003 individually. In the ISO 13091-2 standard, the reference VPT data were obtained from few research papers. Malaysian people's VPT data don't include to this standard. In Malaysia, when the VPT is using to diagnose of the hand-arm vibration syndrome, the reference VPT data need to compare with the worker's ones. But, Malaysia does not have the reference VPT data yet. So, in this paper, the VPT was measured by using ISO 13091-1 standard equipment to obtain the reference data for Malaysian people. And these data were compared with the ISO reference data on the ISO 13091-2 standard. From the comparison of these data, it was clear that the Malaysian healthy people's VPT data were consistent with the reference data of the ISO 13091-2 standard.

Standardization of Sonographic Lung-to-Head Ratio Measurements in Isolated Congenital Diaphragmatic Hernia: Impact on the Reproducibility and Efficacy to Predict Outcomes.

PubMed

Britto, Ingrid Schwach Werneck; Sananes, Nicolas; Olutoye, Oluyinka O; Cass, Darrell L; Sangi-Haghpeykar, Haleh; Lee, Timothy C; Cassady, Christopher I; Mehollin-Ray, Amy; Welty, Stephen; Fernandes, Caraciolo; Belfort, Michael A; Lee, Wesley; Ruano, Rodrigo

2015-10-01

The purpose of this study was to evaluate the impact of standardization of the lung-to-head ratio measurements in isolated congenital diaphragmatic hernia on prediction of neonatal outcomes and reproducibility. We conducted a retrospective cohort study of 77 cases of isolated congenital diaphragmatic hernia managed in a single center between 2004 and 2012. We compared lung-to-head ratio measurements that were performed prospectively in our institution without standardization to standardized measurements performed according to a defined protocol. The standardized lung-to-head ratio measurements were statistically more accurate than the nonstandardized measurements for predicting neonatal mortality (area under the receiver operating characteristic curve, 0.85 versus 0.732; P = .003). After standardization, there were no statistical differences in accuracy between measurements regardless of whether we considered observed-to-expected values (P > .05). Standardization of the lung-to-head ratio did not improve prediction of the need for extracorporeal membrane oxygenation (P> .05). Both intraoperator and interoperator reproducibility were good for the standardized lung-to-head ratio (intraclass correlation coefficient, 0.98 [95% confidence interval, 0.97-0.99]; bias, 0.02 [limits of agreement, -0.11 to +0.15], respectively). Standardization of lung-to-head ratio measurements improves prediction of neonatal outcomes. Further studies are needed to confirm these results and to assess the utility of standardization of other prognostic parameters.

Patient-specific targeting guides compared with traditional instrumentation for glenoid component placement in shoulder arthroplasty: a multi-surgeon study in 70 arthritic cadaver specimens.

PubMed

Throckmorton, Thomas W; Gulotta, Lawrence V; Bonnarens, Frank O; Wright, Stephen A; Hartzell, Jeffrey L; Rozzi, William B; Hurst, Jason M; Frostick, Simon P; Sperling, John W

2015-06-01

The purpose of this study was to compare the accuracy of patient-specific guides for total shoulder arthroplasty (TSA) with traditional instrumentation in arthritic cadaver shoulders. We hypothesized that the patient-specific guides would place components more accurately than standard instrumentation. Seventy cadaver shoulders with radiographically confirmed arthritis were randomized in equal groups to 5 surgeons of varying experience levels who were not involved in development of the patient-specific guidance system. Specimens were then randomized to patient-specific guides based off of computed tomography scanning, standard instrumentation, and anatomic TSA or reverse TSA. Variances in version or inclination of more than 10° and more than 4 mm in starting point were considered indications of significant component malposition. TSA glenoid components placed with patient-specific guides averaged 5° of deviation from the intended position in version and 3° in inclination; those with standard instrumentation averaged 8° of deviation in version and 7° in inclination. These differences were significant for version (P = .04) and inclination (P = .01). Multivariate analysis of variance to compare the overall accuracy for the entire cohort (TSA and reverse TSA) revealed patient-specific guides to be significantly more accurate (P = .01) for the combined vectors of version and inclination. Patient-specific guides also had fewer instances of significant component malposition than standard instrumentation did. Patient-specific targeting guides were more accurate than traditional instrumentation and had fewer instances of component malposition for glenoid component placement in this multi-surgeon cadaver study of arthritic shoulders. Long-term clinical studies are needed to determine if these improvements produce improved functional outcomes. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

A randomised study of tailored toxicity-based dosage of fluorouracil-epirubicin-cyclophosphamide chemotherapy for early breast cancer (SBG 2000-1).

PubMed

Lindman, H; Andersson, M; Ahlgren, J; Balslev, E; Sverrisdottir, A; Holmberg, S B; Bengtsson, N O; Jacobsen, E H; Jensen, A B; Hansen, J; Tuxen, M K; Malmberg, L; Villman, K; Anderson, H; Ejlertsen, B; Bergh, J; Blomqvist, C

2018-05-01

Retrospective studies have demonstrated a worse outcome in breast cancer patients not developing leukopenia during adjuvant chemotherapy. The SBG 2000-1 is the first randomised trial designed to compare individually dosed chemotherapy without G-CSF support based on grade of toxicity to standard-dosed chemotherapy based on body surface area (BSA). Patients with early breast cancer were included and received the first cycle of standard FEC (fluorouracil 600 mg/m 2 , epirubicin 60 mg/m 2 , cyclophosphamide 600 mg/m 2 ). Patients with nadir leukopenia grade 0-2 after first cycle were randomised between either 6 additional courses of tailored FEC with increased doses (E 75-90 mg/m 2 , C 900-1200 mg/m 2 ) or fixed treatment with 6 standard FEC. Patients with grade 3-4 leukopenia were registered and treated with 6 standard FEC. Primary end-point was distant disease-free survival (DDFS). The study enrolled 1535 patients, of which 1052 patients were randomised to tailored FEC (N = 524) or standard FEC (N = 528), whereas 401 patients with leukopenia grade 3-4 continued standard FEC and formed the registered cohort. Dose escalation did not statistically significantly improve 10-year DDFS (79% and 77%, HR 0.87, CI 0.67-1.14, P = 0.32) or OS (82% and 78%, respectively, HR 0.89, CI 0.57-1.16, P = 0.38). Corresponding estimates for the registered group of patients were DDFS 79% and OS 82%, respectively. The SBG 2000-1 study failed to show a statistically significant improvement of escalated and tailored-dosed chemotherapy compared with standard BSA-based chemotherapy in patients with low haematological toxicity, although all efficacy parameters showed a numerical advantage for tailored treatment. Copyright © 2018 Elsevier Ltd. All rights reserved.

Standardized likelihood ratio test for comparing several log-normal means and confidence interval for the common mean.

PubMed

Krishnamoorthy, K; Oral, Evrim

2017-12-01

Standardized likelihood ratio test (SLRT) for testing the equality of means of several log-normal distributions is proposed. The properties of the SLRT and an available modified likelihood ratio test (MLRT) and a generalized variable (GV) test are evaluated by Monte Carlo simulation and compared. Evaluation studies indicate that the SLRT is accurate even for small samples, whereas the MLRT could be quite liberal for some parameter values, and the GV test is in general conservative and less powerful than the SLRT. Furthermore, a closed-form approximate confidence interval for the common mean of several log-normal distributions is developed using the method of variance estimate recovery, and compared with the generalized confidence interval with respect to coverage probabilities and precision. Simulation studies indicate that the proposed confidence interval is accurate and better than the generalized confidence interval in terms of coverage probabilities. The methods are illustrated using two examples.

Teaching Performance Assessment: A Comparative Study of Implementation and Impact amongst California State University Campuses

ERIC Educational Resources Information Center

Guaglianone, Curtis L.; Payne, Maggie; Kinsey, Gary W.; Chiero, Robin

2009-01-01

This article is based on the perceptions of California State University administrators and provides a comparative study of the challenges and benefits resulting from the implementation of the teaching performance assessment requirement of SB 2042 standards 19-21 on the California State University (CSU) campuses. With 23 campuses and almost 450,000…

The Effects of Two Scheduling Formats on Student Achievement in a Suburban High School Setting

ERIC Educational Resources Information Center

Jackson, Kenyada Morton

2013-01-01

Limited studies have been conducted on the relationship between scheduling formats and academic performance of high school students. At the target high school, students underperform on standardized tests in English language arts (ELA) and math. The purpose of this causal comparative quantitative study was to compare the means of ELA and math test…

Modified Drop Tower Impact Tests for American Football Helmets.

PubMed

Rush, G Alston; Prabhu, R; Rush, Gus A; Williams, Lakiesha N; Horstemeyer, M F

2017-02-19

A modified National Operating Committee on Standards for Athletic Equipment (NOCSAE) test method for American football helmet drop impact test standards is presented that would provide better assessment of a helmet's on-field impact performance by including a faceguard on the helmet. In this study, a merger of faceguard and helmet test standards is proposed. The need for a more robust systematic approach to football helmet testing procedures is emphasized by comparing representative results of the Head Injury Criterion (HIC), Severity Index (SI), and peak acceleration values for different helmets at different helmet locations under modified NOCSAE standard drop tower tests. Essentially, these comparative drop test results revealed that the faceguard adds a stiffening kinematic constraint to the shell that lessens total energy absorption. The current NOCSAE standard test methods can be improved to represent on-field helmet hits by attaching the faceguards to helmets and by including two new helmet impact locations (Front Top and Front Top Boss). The reported football helmet test method gives a more accurate representation of a helmet's performance and its ability to mitigate on-field impacts while promoting safer football helmets.

Inter-laboratory comparison study on measuring semi-volatile organic chemicals in standards and air samples.

PubMed

Su, Yushan; Hung, Hayley

2010-11-01

Measurements of semi-volatile organic chemicals (SVOCs) were compared among 21 laboratories from 7 countries through the analysis of standards, a blind sample, an air extract, and an atmospheric dust sample. Measurement accuracy strongly depended on analytes, laboratories, and types of standards and samples. Intra-laboratory precision was generally good with relative standard deviations (RSDs) of triplicate injections <10% and with median differences of duplicate samples between 2.1 and 22%. Inter-laboratory variability, measured by RSDs of all measurements, was in the range of 2.8-58% in analyzing standards, and 6.9-190% in analyzing blind sample and air extract. Inter-laboratory precision was poorer when samples were subject to cleanup processes, or when SVOCs were quantified at low concentrations. In general, inter-laboratory differences up to a factor of 2 can be expected to analyze atmospheric SVOCs. When comparing air measurements from different laboratories, caution should be exercised if the data variability is less than the inter-laboratory differences. 2010. Published by Elsevier Ltd. All rights reserved.

Seasonal skin darkening in Chinese women: the Shanghaiese experience of daily sun protection.

PubMed

Qiu, Huixia; Flament, Frederic; Long, Xiaohui; Wu, Jun; Xu, Mengzhi; Leger, Didier Saint; Meaudre, Helene; Senee, Jerome; Piot, Bertrand; Bazin, Roland

2013-01-01

The facial skin tone of two groups of Chinese women from Shanghai was compared using standard colorimetric space techniques during a 6-month interval between January and July 2011. During the study period, one group of women (n = 40) applied a potent sun-protective cosmetic product daily, while the other group (n = 40) did not use any sun protection. The results, based on images taken using a standardized digital camera coupled to a spectroradiometer, showed that sun protection largely mitigated changes in the components of skin tone, ie, lightness, melanization, and individual typology angle parameters. The skin darkening process appeared to be reduced or prevented in the sun-protected group when compared with the control group. The sun-protected women had participated in an earlier study in 2008, which confirmed that seasonal skin darkening occurs from winter through summer in Shanghaiese women. Comparing the data obtained in the winters of 2008 and 2011, we were able to identify better the impact of 3 years of aging on the components of skin tone. Comparing data between seasons on the same women with (2011 study) and without (2008 study) sun protection highlights the role of the test product in preventing skin darkening.

Difference in muscle activation patterns during high-speed versus standard-speed yoga: A randomized sequence crossover study.

PubMed

Potiaumpai, Melanie; Martins, Maria Carolina Massoni; Wong, Claudia; Desai, Trusha; Rodriguez, Roberto; Mooney, Kiersten; Signorile, Joseph F

2017-02-01

To compare the difference in muscle activation between high-speed yoga and standard-speed yoga and to compare muscle activation of the transitions between poses and the held phases of a yoga pose. Randomized sequence crossover trial SETTING: A laboratory of neuromuscular research and active aging Interventions: Eight minutes of continuous Sun Salutation B was performed, at a high speed versus a standard-speed, separately. Electromyography was used to quantify normalized muscle activation patterns of eight upper and lower body muscles (pectoralis major, medial deltoids, lateral head of the triceps, middle fibers of the trapezius, vastus medialis, medial gastrocnemius, thoracic extensor spinae, and external obliques) during the high-speed and standard-speed yoga protocols. Difference in normalized muscle activation between high-speed yoga and standard-speed yoga. Normalized muscle activity signals were significantly higher in all eight muscles during the transition phases of poses compared to the held phases (p<0.01). There was no significant interaction between speed×phase; however, greater normalized muscle activity was seen for highspeed yoga across the entire session. Our results show that transitions from one held phase of a pose to another produces higher normalized muscle activity than the held phases of the poses and that overall activity is greater during highspeed yoga than standard-speed yoga. Therefore, the transition speed and associated number of poses should be considered when targeting specific improvements in performance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Higher convection volume exchange with online hemodiafiltration is associated with survival advantage for dialysis patients: the effect of adjustment for body size.

PubMed

Davenport, Andrew; Peters, Sanne A E; Bots, Michiel L; Canaud, Bernard; Grooteman, Muriel P C; Asci, Gulay; Locatelli, Francesco; Maduell, Francisco; Morena, Marion; Nubé, Menso J; Ok, Ercan; Torres, Ferran; Woodward, Mark; Blankestijn, Peter J

2016-01-01

Mortality remains high for hemodialysis patients. Online hemodiafiltration (OL-HDF) removes more middle-sized uremic toxins but outcomes of individual trials comparing OL-HDF with hemodialysis have been discrepant. Secondary analyses reported higher convective volumes, easier to achieve in larger patients, and improved survival. Here we tested different methods to standardize OL-HDF convection volume on all-cause and cardiovascular mortality compared with hemodialysis. Pooled individual patient analysis of four prospective trials compared thirds of delivered convection volume with hemodialysis. Convection volumes were either not standardized or standardized to weight, body mass index, body surface area, and total body water. Data were analyzed by multivariable Cox proportional hazards modeling from 2793 patients. All-cause mortality was reduced when the convective dose was unstandardized or standardized to body surface area and total body water; hazard ratio (95% confidence intervals) of 0.65 (0.51-0.82), 0.74 (0.58-0.93), and 0.71 (0.56-0.93) for those receiving higher convective doses. Standardization by body weight or body mass index gave no significant survival advantage. Higher convection volumes were generally associated with greater survival benefit with OL-HDF, but results varied across different ways of standardization for body size. Thus, further studies should take body size into account when evaluating the impact of delivered convection volume on mortality end points. Copyright © 2015 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Effectiveness of Adaptive Statistical Iterative Reconstruction for 64-Slice Dual-Energy Computed Tomography Pulmonary Angiography in Patients With a Reduced Iodine Load: Comparison With Standard Computed Tomography Pulmonary Angiography.

PubMed

Lee, Ji Won; Lee, Geewon; Lee, Nam Kyung; Moon, Jin Il; Ju, Yun Hye; Suh, Young Ju; Jeong, Yeon Joo

2016-01-01

The aim of the study was to assess the effectiveness of the adaptive statistical iterative reconstruction (ASIR) for dual-energy computed tomography pulmonary angiography (DE-CTPA) with a reduced iodine load. One hundred forty patients referred for chest CT were randomly divided into a DE-CTPA group with a reduced iodine load or a standard CTPA group. Quantitative and qualitative image qualities of virtual monochromatic spectral (VMS) images with filtered back projection (VMS-FBP) and those with 50% ASIR (VMS-ASIR) in the DE-CTPA group were compared. Image qualities of VMS-ASIR images in the DE-CTPA group and ASIR images in the standard CTPA group were also compared. All quantitative and qualitative indices, except attenuation value of pulmonary artery in the VMS-ASIR subgroup, were superior to those in the VMS-FBP subgroup (all P < 0.001). Noise and signal-to-noise ratio of VMS-ASIR images were superior to those of ASIR images in the standard CTPA group (P < 0.001 and P = 0.007, respectively). Regarding qualitative indices, noise was significantly lower in VMS-ASIR images of the DE-CTPA group than in ASIR images of the standard CTPA group (P = 0.001). The ASIR technique tends to improve the image quality of VMS imaging. Dual-energy computed tomography pulmonary angiography with ASIR can reduce contrast medium volume and produce images of comparable quality with those of standard CTPA.

Evaluation of motivationally tailored vs. standard self-help physical activity interventions at the workplace.

PubMed

Marcus, B H; Emmons, K M; Simkin-Silverman, L R; Linnan, L A; Taylor, E R; Bock, B C; Roberts, M B; Rossi, J S; Abrams, D B

1998-01-01

This study compares the efficacy of a self-help intervention tailored to the individual's stage of motivational readiness for exercise adoption with a standard self-help exercise promotion intervention. Interventions were delivered at baseline and 1 month; assessments were collected at baseline and 3 months. Eleven worksites participating in the Working Healthy Research Trial. Participants (n = 1559) were a subsample of employees at participating worksites, individually randomized to one of two treatment conditions. Printed self-help exercise promotion materials either (1) matched to the individual's stage of motivational readiness for exercise adoption (motivationally tailored), or (2) standard materials (standard). Measures of stage of motivational readiness for exercise and items from the 7-Day Physical Activity Recall. Among intervention completers (n = 903), chi-square analyses showed that, compared to the standard intervention, those receiving the motivationally tailored intervention were significantly more likely to show increases (37% vs. 27%) and less likely to show either no change (52% vs. 58%) or regression (11% vs. 15%) in stage of motivational readiness. Multivariate analyses of variance showed that changes in stage of motivational readiness were significantly associated with changes in self-reported time spent in exercise. This is the first prospective, randomized, controlled trial demonstrating the efficacy of a brief motivationally tailored intervention compared to a standard self-help intervention for exercise adoption. These findings appear to support treatment approaches that tailor interventions to the individual's stage of motivational readiness for exercise adoption.

EOS 2D/3D X-ray imaging system: a systematic review and economic evaluation.

PubMed

McKenna, C; Wade, R; Faria, R; Yang, H; Stirk, L; Gummerson, N; Sculpher, M; Woolacott, N

2012-01-01

EOS is a biplane X-ray imaging system manufactured by EOS Imaging (formerly Biospace Med, Paris, France). It uses slot-scanning technology to produce a high-quality image with less irradiation than standard imaging techniques. To determine the clinical effectiveness and cost-effectiveness of EOS two-dimensional (2D)/three-dimensional (3D) X-ray imaging system for the evaluation and monitoring of scoliosis and other relevant orthopaedic conditions. For the systematic review of EOS, electronic databases (MEDLINE, Allied and Complementary Medicine Database, BIOSIS Previews, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, Health Management Information Consortium, Inspec, ISI Science Citation Index and PASCAL), clinical trials registries and the manufacturer's website were searched from 1993 to November 2010. A systematic review of studies comparing EOS with standard X-ray [film, computed radiography (CR) or digital radiography] in any orthopaedic condition was performed. A narrative synthesis was undertaken. A decision-analytic model was developed to assess the cost-effectiveness of EOS in the relevant indications compared with standard X-ray and incorporated the clinical effectiveness of EOS and the adverse effects of radiation. The model incorporated a lifetime horizon to estimate outcomes in terms of quality-adjusted life-years (QALYs) and costs from the perspective of the NHS. Three studies met the inclusion criteria for the review. Two studies compared EOS with film X-ray and one study compared EOS with CR. The three included studies were small and of limited quality. One study used an earlier version of the technology, the Charpak system. Both studies comparing EOS with film X-ray found image quality to be comparable or better with EOS overall. Radiation dose was considerably lower with EOS: ratio of means for posteroanterior spine was 5.2 (13.1 for the study using the Charpak system); ratio of means for the lateral spine was 6.2 (15.1 for the study using the Charpak system). The study comparing EOS with CR found image quality to be comparable or better with EOS. Radiation dose was considerably lower with EOS than CR; ratio of means for the centre of the back was 5.9 and for the proximal lateral point 8.8. The lowest ratio of means was at the nape of the neck, which was 2.9. No other outcomes were assessed in the included studies, such as implications for patient management from the nature and quality of the image. Patient throughput is the major determinant of the cost-effectiveness of EOS. The average cost per procedure of EOS decreases with utilisation. Using estimates of patient throughput at national level from Hospital Episode Statistics data suggests that EOS is not cost-effective for the indications considered. Throughput in the region of 15,100 to 26,500 (corresponding to a workload of 60 to 106 patient appointments per working day) for EOS compared with a throughput of only 7530 for CR (30 patient appointments per working day) is needed to achieve an incremental cost-effectiveness ratio of £30,000 per QALY. EOS can be shown to be cost-effective only when compared with CR if the utilisation for EOS is about double the utilisation of CR. The main limitation of the systematic review of the clinical effectiveness of EOS was the limited number and quality of the data available. In particular, there were no studies assessing the potential health benefits arising from the quality and nature of the image, over and above those associated with reduced radiation exposure. Uncertainty in the model inputs was not fully explored owing to a lack of reporting of standard deviations or confidence intervals in the published literature for most of the parameters. As a result, uncertainty in the cost-effectiveness results was not presented. Radiation dose is considerably lower with EOS than standard X-ray, whereas image quality remains comparable or better with EOS. However, the long-term health benefits from reduced radiation exposure with EOS are very small and there was a lack of data on other potential patient health benefits. The implications of any changes in the quality and nature of the EOS image compared with standard X-ray, for patient health outcomes, needs to be assessed. Given the higher cost of an EOS machine, utilisation is the major determinant of cost-effectiveness. Estimates of patient throughput at national level suggest that EOS is not cost-effective. The National Institute for Health Research Health Technology Assessment programme.

Recommendations for incorporating patient-reported outcomes into clinical comparative effectiveness research in adult oncology.

PubMed

Basch, Ethan; Abernethy, Amy P; Mullins, C Daniel; Reeve, Bryce B; Smith, Mary Lou; Coons, Stephen Joel; Sloan, Jeff; Wenzel, Keith; Chauhan, Cynthia; Eppard, Wayland; Frank, Elizabeth S; Lipscomb, Joseph; Raymond, Stephen A; Spencer, Merianne; Tunis, Sean

2012-12-01

Examining the patient's subjective experience in prospective clinical comparative effectiveness research (CER) of oncology treatments or process interventions is essential for informing decision making. Patient-reported outcome (PRO) measures are the standard tools for directly eliciting the patient experience. There are currently no widely accepted standards for developing or implementing PRO measures in CER. Recommendations for the design and implementation of PRO measures in CER were developed via a standardized process including multistakeholder interviews, a technical working group, and public comments. Key recommendations are to include assessment of patient-reported symptoms as well as health-related quality of life in all prospective clinical CER studies in adult oncology; to identify symptoms relevant to a particular study population and context based on literature review and/or qualitative and quantitative methods; to assure that PRO measures used are valid, reliable, and sensitive in a comparable population (measures particularly recommended include EORTC QLQ-C30, FACT, MDASI, PRO-CTCAE, and PROMIS); to collect PRO data electronically whenever possible; to employ methods that minimize missing patient reports and include a plan for analyzing and reporting missing PRO data; to report the proportion of responders and cumulative distribution of responses in addition to mean changes in scores; and to publish results of PRO analyses simultaneously with other clinical outcomes. Twelve core symptoms are recommended for consideration in studies in advanced or metastatic cancers. Adherence to methodologic standards for the selection, implementation, and analysis/reporting of PRO measures will lead to an understanding of the patient experience that informs better decisions by patients, providers, regulators, and payers.

Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessment

PubMed Central

Schnakers, Caroline; Vanhaudenhuyse, Audrey; Giacino, Joseph; Ventura, Manfredi; Boly, Melanie; Majerus, Steve; Moonen, Gustave; Laureys, Steven

2009-01-01

Background Previously published studies have reported that up to 43% of patients with disorders of consciousness are erroneously assigned a diagnosis of vegetative state (VS). However, no recent studies have investigated the accuracy of this grave clinical diagnosis. In this study, we compared consensus-based diagnoses of VS and MCS to those based on a well-established standardized neurobehavioral rating scale, the JFK Coma Recovery Scale-Revised (CRS-R). Methods We prospectively followed 103 patients (55 ± 19 years) with mixed etiologies and compared the clinical consensus diagnosis provided by the physician on the basis of the medical staff's daily observations to diagnoses derived from CRS-R assessments performed by research staff. All patients were assigned a diagnosis of 'VS', 'MCS' or 'uncertain diagnosis.' Results Of the 44 patients diagnosed with VS based on the clinical consensus of the medical team, 18 (41%) were found to be in MCS following standardized assessment with the CRS-R. In the 41 patients with a consensus diagnosis of MCS, 4 (10%) had emerged from MCS, according to the CRS-R. We also found that the majority of patients assigned an uncertain diagnosis by clinical consensus (89%) were in MCS based on CRS-R findings. Conclusion Despite the importance of diagnostic accuracy, the rate of misdiagnosis of VS has not substantially changed in the past 15 years. Standardized neurobehavioral assessment is a more sensitive means of establishing differential diagnosis in patients with disorders of consciousness when compared to diagnoses determined by clinical consensus. PMID:19622138

A comparative study of electrical potential sensors and Ag/AgCl electrodes for characterising spontaneous and event related electroencephalagram signals.

PubMed

Fatoorechi, M; Parkinson, J; Prance, R J; Prance, H; Seth, A K; Schwartzman, D J

2015-08-15

Electroencephalography (EEG) is still a widely used imaging tool that combines high temporal resolution with a relatively low cost. Ag/AgCl metal electrodes have been the gold standard for non-invasively monitoring electrical brain activity. Although reliable, these electrodes have multiple drawbacks: they suffer from noise, such as offset potential drift, and usability issues, for example, difficult skin preparation and cross-coupling of adjacent electrodes. In order to tackle these issues a prototype Electric Potential Sensor (EPS) device based on an auto-zero operational amplifier was developed and evaluated. The EPS is a novel active ultrahigh impedance capacitively coupled sensor. The absence of 1/f noise makes the EPS ideal for use with signal frequencies of ∼10Hz or less. A comprehensive study was undertaken to compare neural signals recorded by the EPS with a standard commercial EEG system. Quantitatively, highly similar signals were observed between the EPS and EEG sensors for both free running and evoked brain activity with cross correlations of higher than 0.9 between the EPS and a standard benchmark EEG system. These studies comprised measurements of both free running EEG and Event Related Potentials (ERPs) from a commercial EEG system and EPS. The EPS provides a promising alternative with many added benefits compared to standard EEG sensors, including reduced setup time and elimination of sensor cross-coupling. In the future the scalability of the EPS will allow the implementation of a whole head ultra-dense EPS array. Copyright © 2015 Elsevier B.V. All rights reserved.

Efficacy of a rituximab regimen based on B cell depletion in thrombotic thrombocytopenic purpura with suboptimal response to standard treatment: Results of a phase II, multicenter noncomparative study.

PubMed

Benhamou, Ygal; Paintaud, Gilles; Azoulay, Elie; Poullin, Pascale; Galicier, Lionel; Desvignes, Céline; Baudel, Jean-Luc; Peltier, Julie; Mira, Jean-Paul; Pène, Frédéric; Presne, Claire; Saheb, Samir; Deligny, Christophe; Rousseau, Alexandra; Féger, Frédéric; Veyradier, Agnès; Coppo, Paul

2016-12-01

The standard four-rituximab infusions treatment in acquired thrombotic thrombocytopenic purpura (TTP) remains empirical. Peripheral B cell depletion is correlated with the decrease in serum concentrations of anti-ADAMTS13 and associated with clinical response. To assess the efficacy of a rituximab regimen based on B cell depletion, 24 TTP patients were enrolled in this prospective multicentre single arm phase II study and then compared to patients from a previous study. Patients with a suboptimal response to a plasma exchange-based regimen received two infusions of rituximab 375 mg m -2 within 4 days, and a third dose at day +15 of the first infusion if peripheral B cells were still detectable. Primary endpoint was the assessment of the time required to platelet count recovery from the first plasma exchange. Three patients died after the first rituximab administration. In the remaining patients, the B cell-driven treatment hastened remission and ADAMTS13 activity recovery as a result of rapid anti-ADAMTS13 depletion in a similar manner to the standard four-rituximab infusions schedule. The 1-year relapse-free survival was also comparable between both groups. A rituximab regimen based on B cell depletion is feasible and provides comparable results than with the four-rituximab infusions schedule. This regimen could represent a new standard in TTP. This trial was registered at www.clinicaltrials.gov (NCT00907751). Am. J. Hematol. 91:1246-1251, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Experimental study of hybrid-knife endoscopic submucosal dissection (ESD) versus standard ESD in a Western country.

PubMed

De-la-Peña, Joaquín; Calderón, Ángel; Esteban, José Miguel; López-Rosés, Leopoldo; Martínez-Ares, David; Nogales, Óscar; Orive-Calzada, Aitor; Rodríguez, Sarbelio; Sánchez-Hernández, Eloy; Vila, Juan; Fernández-Esparrach, Gloria

2014-02-01

Endoscopic submucosal dissection (ESD) is an effective but time-consuming treatment for early neoplasia that requires a high level of expertise. The objective of this study was to assess the efficacy and learning curve of gastric ESD with a hybrid knife with high pressure water jet and to compare with standard ESD. We performed a prospective non survival animal study comparing hybrid-knife and standard gastric ESD. Variables recorded were: Number of en-bloc ESD, number of ESD with all marks included (R0), size of specimens, time and speed of dissection and adverse events. Ten endoscopists performed a total of 50 gastric ESD (30 hybrid-knife and 20 standard). Forty-six (92 %) ESD were en-bloc and 25 (50 %) R0 (hybrid-knife: n = 13, 44 %; standard: n = 16, 80 %; p = 0.04). Hybrid-knife ESD was faster than standard (time: 44.6 +/- 21.4 minutes vs. 68.7 +/- 33.5 minutes; p = 0.009 and velocity: 20.8 +/- 9.2 mm(2)/min vs. 14.3 +/- 9.3 mm(2)/min (p = 0.079). Adverse events were not different. There was no change in speed with any of two techniques (hybrid-knife: From 20.33 +/- 15.68 to 28.18 +/- 20.07 mm(2)/min; p = 0.615 and standard: From 6.4 +/- 0.3 to 19.48 +/- 19.21 mm(2)/min; p = 0.607). The learning curve showed a significant improvement in R0 rate in the hybrid-knife group (from 30 % to 100 %). despite the initial performance of hybrid-knife ESD is worse than standard ESD, the learning curve with hybrid knife ESD is short and is associated with a rapid improvement. The introduction of new tools to facilitate ESD should be implemented with caution in order to avoid a negative impact on the results.

Breast density quantification with cone-beam CT: A post-mortem study

PubMed Central

Johnson, Travis; Ding, Huanjun; Le, Huy Q.; Ducote, Justin L.; Molloi, Sabee

2014-01-01

Forty post-mortem breasts were imaged with a flat-panel based cone-beam x-ray CT system at 50 kVp. The feasibility of breast density quantification has been investigated using standard histogram thresholding and an automatic segmentation method based on the fuzzy c-means algorithm (FCM). The breasts were chemically decomposed into water, lipid, and protein immediately after image acquisition was completed. The percent fibroglandular volume (%FGV) from chemical analysis was used as the gold standard for breast density comparison. Both image-based segmentation techniques showed good precision in breast density quantification with high linear coefficients between the right and left breast of each pair. When comparing with the gold standard using %FGV from chemical analysis, Pearson’s r-values were estimated to be 0.983 and 0.968 for the FCM clustering and the histogram thresholding techniques, respectively. The standard error of the estimate (SEE) was also reduced from 3.92% to 2.45% by applying the automatic clustering technique. The results of the postmortem study suggested that breast tissue can be characterized in terms of water, lipid and protein contents with high accuracy by using chemical analysis, which offers a gold standard for breast density studies comparing different techniques. In the investigated image segmentation techniques, the FCM algorithm had high precision and accuracy in breast density quantification. In comparison to conventional histogram thresholding, it was more efficient and reduced inter-observer variation. PMID:24254317

Long-term outcomes and recurrence patterns of standard versus extended pancreatectomy for pancreatic head cancer: a multicenter prospective randomized controlled study.

PubMed

Jang, Jin-Young; Kang, Jae Seung; Han, Youngmin; Heo, Jin Seok; Choi, Seong Ho; Choi, Dong Wook; Park, Sang Jae; Han, Sung-Sik; Yoon, Dong Sup; Park, Joon Seong; Yu, Hee Chul; Kang, Koo Jeong; Kim, Sang Geol; Lee, Hongeun; Kwon, Wooil; Yoon, Yoo-Seok; Han, Ho-Seong; Kim, Sun-Whe

2017-07-01

Our previous randomized controlled trial revealed no difference in 2-year overall survival (OS) between extended and standard resection for pancreatic adenocarcinoma. The present study evaluated the 5-year OS and recurrence patterns according to the extent of pancreatectomy. Between 2006 and 2009, 169 consecutive patients were prospectively enrolled and randomized to standard (n = 83) or extended resection (n = 86) groups to compare 5-year OS rate, long-term recurrence patterns and factors associated with long-term survival. The surgical R0 rate was similar between the standard and extended groups (85.5 vs. 90.7%, P = 0.300). Five-year OS (18.4 vs. 14.4%, P = 0.388), 5-year disease-free survival (14.8 vs. 14.0%, P = 0.531), and overall recurrence rates (74.7 vs. 69.9%, P = 0.497) were not significantly different between the two groups, although the incidence of peritoneal seeding was higher in the extended group (25 vs. 8.1%, P = 0.014). Extended pancreatectomy does not have better short-term and long-term survival outcomes, and shows similar R0 rates and overall recurrence rates compared with standard pancreatectomy. Extended pancreatectomy does not have to be performed routinely for all cases of resectable pancreatic adenocarcinoma, especially considering its associated increased morbidity shown in our previous study. © 2017 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

A Comparative Study of English Language Arts Content Standards Test Scores in California for Online and Traditional Public High School Students

ERIC Educational Resources Information Center

Maddox, Pamela Rena

2013-01-01

Every educator's quest is to help students learn in the environment that will allow them to obtain and retain the information presented to them. In the new age of technology, more students are able to choose the environment in which they learn. This study is a quantitative comparative study of the academic performance between online and…

A collaborative comparison of objective structured clinical examination (OSCE) standard setting methods at Australian medical schools.

PubMed

Malau-Aduli, Bunmi Sherifat; Teague, Peta-Ann; D'Souza, Karen; Heal, Clare; Turner, Richard; Garne, David L; van der Vleuten, Cees

2017-12-01

A key issue underpinning the usefulness of the OSCE assessment to medical education is standard setting, but the majority of standard-setting methods remain challenging for performance assessment because they produce varying passing marks. Several studies have compared standard-setting methods; however, most of these studies are limited by their experimental scope, or use data on examinee performance at a single OSCE station or from a single medical school. This collaborative study between 10 Australian medical schools investigated the effect of standard-setting methods on OSCE cut scores and failure rates. This research used 5256 examinee scores from seven shared OSCE stations to calculate cut scores and failure rates using two different compromise standard-setting methods, namely the Borderline Regression and Cohen's methods. The results of this study indicate that Cohen's method yields similar outcomes to the Borderline Regression method, particularly for large examinee cohort sizes. However, with lower examinee numbers on a station, the Borderline Regression method resulted in higher cut scores and larger difference margins in the failure rates. Cohen's method yields similar outcomes as the Borderline Regression method and its application for benchmarking purposes and in resource-limited settings is justifiable, particularly with large examinee numbers.

Social skills programmes for schizophrenia.

PubMed

Almerie, Muhammad Qutayba; Okba Al Marhi, Muhammad; Jawoosh, Muhammad; Alsabbagh, Mohamad; Matar, Hosam E; Maayan, Nicola; Bergman, Hanna

2015-06-09

Social skills programmes (SSP) are treatment strategies aimed at enhancing the social performance and reducing the distress and difficulty experienced by people with a diagnosis of schizophrenia and can be incorporated as part of the rehabilitation package for people with schizophrenia. The primary objective is to investigate the effects of social skills training programmes, compared to standard care, for people with schizophrenia. We searched the Cochrane Schizophrenia Group's Trials Register (November 2006 and December 2011) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO, and registries of clinical trials. We inspected references of all identified studies for further trials.A further search for studies has been conducted by the Cochrane Schizophrenia Group in 2015, 37 citations have been found and are currently being assessed by review authors. We included all relevant randomised controlled trials for social skills programmes versus standard care involving people with serious mental illnesses. We extracted data independently. For dichotomous data we calculated risk ratios (RRs) and their 95% confidence intervals (CI) on an intention-to-treat basis. For continuous data, we calculated mean differences (MD) and 95% CIs. We included 13 randomised trials (975 participants). These evaluated social skills programmes versus standard care, or discussion group. We found evidence in favour of social skills programmes compared to standard care on all measures of social functioning. We also found that rates of relapse and rehospitalisation were lower for social skills compared to standard care (relapse: 2 RCTs, n = 263, RR 0.52 CI 0.34 to 0.79, very low quality evidence), (rehospitalisation: 1 RCT, n = 143, RR 0.53 CI 0.30 to 0.93, very low quality evidence) and participants' mental state results (1 RCT, n = 91, MD -4.01 CI -7.52 to -0.50, very low quality evidence) were better in the group receiving social skill programmes. Global state was measured in one trial by numbers not experiencing a clinical improvement, results favoured social skills (1 RCT, n = 67, RR 0.29 CI 0.12 to 0.68, very low quality evidence). Quality of life was also improved in the social skills programme compared to standard care (1 RCT, n = 112, MD -7.60 CI -12.18 to -3.02, very low quality evidence). However, when social skills programmes were compared to a discussion group control, we found no significant differences in the participants social functioning, relapse rates, mental state or quality of life, again the quality of evidence for these outcomes was very low. Compared to standard care, social skills training may improve the social skills of people with schizophrenia and reduce relapse rates, but at present, the evidence is very limited with data rated as very low quality. When social skills training was compared to discussion there was no difference on patients outcomes. Cultural differences might limit the applicability of the current results, as most reported studies were conducted in China. Whether social skills training can improve social functioning of people with schizophrenia in different settings remains unclear and should be investigated in a large multi-centre randomised controlled trial.

Metallic artifacts from internal scaphoid fracture fixation screws: comparison between C-arm flat-panel, cone-beam, and multidetector computed tomography.

PubMed

Finkenstaedt, Tim; Morsbach, Fabian; Calcagni, Maurizio; Vich, Magdalena; Pfirrmann, Christian W A; Alkadhi, Hatem; Runge, Val M; Andreisek, Gustav; Guggenberger, Roman

2014-08-01

The aim of this study was to compare image quality and extent of artifacts from scaphoid fracture fixation screws using different computed tomography (CT) modalities and radiation dose protocols. Imaging of 6 cadaveric wrists with artificial scaphoid fractures and different fixation screws was performed in 2 screw positions (45° and 90° orientation in relation to the x/y-axis) using multidetector CT (MDCT) and 2 flat-panel CT modalities, C-arm flat-panel CT (FPCT) and cone-beam CT (CBCT), the latter 2 with low and standard radiation dose protocols. Mean cartilage attenuation and metal artifact-induced absolute Hounsfield unit changes (= artifact extent) were measured. Two independent radiologists evaluated different image quality criteria using a 5-point Likert-scale. Interreader agreements (Cohen κ) were calculated. Mean absolute Hounsfield unit changes and quality ratings were compared using Friedman and Wilcoxon signed-rank tests. Artifact extent was significantly smaller for MDCT and standard-dose FPCT compared with CBCT low- and standard-dose acquisitions (all P < 0.05). No significant differences in artifact extent among different screw types and scanning positions were noted (P > 0.05). Both MDCT and FPCT standard-dose protocols showed equal ratings for screw bone interface, fracture line, and trabecular bone evaluation (P = 0.06, 0.2, and 0.2, respectively) and performed significantly better than FPCT low- and CBCT low- and standard-dose acquisitions (all P < 0.05). Good interreader agreement was found for image quality comparisons (Cohen κ = 0.76-0.78). Both MDCT and FPCT standard-dose acquisition showed comparatively less metal-induced artifacts and better overall image quality compared with FPCT low-dose and both CBCT acquisitions. Flat-panel CT may provide sufficient image quality to serve as a versatile CT alternative for postoperative imaging of internally fixated wrist fractures.

A new responder criterion (relative effect per patient (REPP) > 0.2) externally validated in a large total hip replacement multicenter cohort (EUROHIP).

PubMed

Huber, J; Hüsler, J; Dieppe, P; Günther, K P; Dreinhöfer, K; Judge, A

2016-03-01

To validate a new method to identify responders (relative effect per patient (REPP) >0.2) using the OMERACT-OARSI criteria as gold standard in a large multicentre sample. The REPP ([score before - after treatment]/score before treatment) was calculated for 845 patients of a large multicenter European cohort study for THR. The patients with a REPP >0.2 were defined as responders. The responder rate was compared to the gold standard (OMERACT-OARSI criteria) using receiver operator characteristic (ROC) curve analysis for sensitivity, specificity and percentage of appropriately classified patients. With the criterion REPP>0.2 85.4% of the patients were classified as responders, applying the OARSI-OMERACT criteria 85.7%. The new method had 98.8% sensitivity, 94.2% specificity and 98.1% of the patients were correctly classified compared to the gold standard. The external validation showed a high sensitivity and also specificity of a new criterion to identify a responder compared to the gold standard method. It is simple and has no uncertainties due to a single classification criterion. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Family Resources in Two Generations and School Readiness among Children of Teen Parents

PubMed Central

Fomby, Paula; James-Hawkins, Laurie; Mollborn, Stefanie

2015-01-01

Overall, children born to teen parents experience disadvantaged cognitive achievement at school entry compared to children born to older parents. However, within this population there is variation, with a significant fraction of teen parents’ children acquiring adequate preparation for school entry during early childhood. We ask whether the family background of teen parents explains this variation. We use data on children born to teen mothers from three waves of the Early Childhood Longitudinal Study-Birth Cohort (N~700) to study the association of family background with children's standardized reading and mathematics achievement scores at kindergarten entry. When neither maternal grandparent has completed high school, children's scores on standardized assessments of math and reading achievement are one-quarter to one-third of a standard deviation lower compared to families where at least one grandparent finished high school. This association is net of teen mothers’ own socioeconomic status in the year prior to children's school entry. PMID:26806989

Professional Development Urban Schools: What Do Teachers Say?

ERIC Educational Resources Information Center

Green, Tanya R.; Allen, Mishaleen

2015-01-01

This quantitative causal-comparative study compared perceptions of professional development opportunities between high-achieving and low-achieving elementary-middle school teachers in an urban school district using the Standards Assessment Inventory (SAI). A total of 271 teachers participated including 134 (n = 134) teachers from high-achieving…

Assessing disease severity: accuracy and reliability of rater estimates in relation to number of diagrams in a standard area diagram set

USDA-ARS?s Scientific Manuscript database

Error in rater estimates of plant disease severity occur, and standard area diagrams (SADs) help improve accuracy and reliability. The effects of diagram number in a SAD set on accuracy and reliability is unknown. The objective of this study was to compare estimates of pecan scab severity made witho...

Comparison of amino acid digestibility of feedstuffs determined with the precision-fed cecectomized rooster assay and the standardized ileal amino acid digestibility assay

USDA-ARS?s Scientific Manuscript database

The objective of this study was to evaluate and compare amino acid digestibility of several feedstuffs using 2 commonly accepted methods: the precision-fed cecectomized rooster assay (PFR) and the standardized ileal amino acid assay (SIAAD). Six corn, 6 corn distillers dried grains with or without s...

Examining the Native Speakers' Understanding of Communicative Purposes of a Written Genre in Modern Standard Chinese.

ERIC Educational Resources Information Center

Yunxia, Zhu

1997-01-01

Examines the different attitudes of native speakers in understanding a written genre of Modern Standard Chinese--sales letters. The study focuses on the use of formulaic components appearing in real Chinese sales letters and compares these components with the advice given in textbooks. Findings reveal a gap between business teaching and business…

Intimate Partner Violence during Pregnancy: A Pilot Intervention Program in Lima, Peru

ERIC Educational Resources Information Center

Cripe, Swee May; Sanchez, Sixto E.; Sanchez, Elena; Quintanilla, Beatriz Ayala; Alarcon, Christian Hernandez; Gelaye, Bizu; Williams, Michelle A.

2010-01-01

This pilot study examined the effectiveness of standard care and an empowerment intervention for abused pregnant women. Severe psychological abuse was most prevalent (42.2%) among this sample of women. Compared with women in the standard care group at the postintervention survey, women in the empowerment group were more likely to hide money (44.6%…

Dietary Intakes and Eating Habits of College Athletes: Are Female College Athletes Following the Current Sports Nutrition Standards?

ERIC Educational Resources Information Center

Shriver, Lenka H.; Betts, Nancy M.; Wollenberg, Gena

2013-01-01

Objective: The objective of this study was to assess dietary intakes and eating habits of female college athletes and compared them with the minimum sports nutrition standards. Participants: Data were obtained from 52 female college athletes from a National Collegiate Athletic Association (NCAA) Division I university between January 2009 and May…

Field Performance of High-Quality and Standard Northern Red Oak Seedlings in Tennessee

Treesearch

David S. Buckley

2002-01-01

First-year performance of high-quality (HQ), high-quality cull (HQC) and standard (ST) northern red oak (Quercus rubra) nursery seedlings was compared in a study established in a recent clearcut in mid-March, 2000. Objectives were to test effects of 1) seedling type, 2) planting treatment, and 3) control of competitors on the growth, browsing, and...

Comparing Standardized Test Scores among Arts-Integrated and Non-Arts Integrated Schools in Central Mississippi

ERIC Educational Resources Information Center

Dean, Darlene

2014-01-01

The topic of arts integration creates continuing dialog among educators and arts advocates. This study examined the degree to which student achievement was affected when arts education is limited or eliminated from schools to meet the mandates of NCLB (2001) legislation. Standardized test scores from 12 schools in Central Mississippi were used to…

Non-Native Japanese Listeners' Perception of Vowel Length Contrasts in Japanese and Modern Standard Arabic (MSA)

ERIC Educational Resources Information Center

Tsukada, Kimiko

2012-01-01

This study aimed to compare the perception of short vs. long vowel contrasts in Japanese and Modern Standard Arabic (MSA) by four groups of listeners differing in their linguistic backgrounds: native Arabic (NA), native Japanese (NJ), non-native Japanese (NNJ) and Australian English (OZ) speakers. The NNJ and OZ groups shared the first language…

The Relationship between the Rigor of a State's Proficiency Standard and Student Achievement in the State

ERIC Educational Resources Information Center

Stoneberg, Bert D.

2015-01-01

The National Center of Education Statistics conducted a mapping study that equated the percentage proficient or above on each state's NCLB reading and mathematics tests in grades 4 and 8 to the NAEP scale. Each "NAEP equivalent score" was labeled according to NAEP's achievement levels and used to compare state proficiency standards and…

Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group.

PubMed

Rodeghiero, Francesco; Stasi, Roberto; Gernsheimer, Terry; Michel, Marc; Provan, Drew; Arnold, Donald M; Bussel, James B; Cines, Douglas B; Chong, Beng H; Cooper, Nichola; Godeau, Bertrand; Lechner, Klaus; Mazzucconi, Maria Gabriella; McMillan, Robert; Sanz, Miguel A; Imbach, Paul; Blanchette, Victor; Kühne, Thomas; Ruggeri, Marco; George, James N

2009-03-12

Diagnosis and management of immune thrombocytopenic purpura (ITP) remain largely dependent on clinical expertise and observations more than on evidence derived from clinical trials of high scientific quality. One major obstacle to the implementation of such studies and in producing reliable meta-analyses of existing data is a lack of consensus on standardized critical definitions, outcome criteria, and terminology. Moreover, the demand for comparative clinical trials has dramatically increased since the introduction of new classes of therapeutic agents, such as thrombopoietin receptor agonists, and innovative treatment modalities, such as anti-CD 20 antibodies. To overcome the present heterogeneity, an International Working Group of recognized expert clinicians convened a 2-day structured meeting (the Vicenza Consensus Conference) to define standard terminology and definitions for primary ITP and its different phases and criteria for the grading of severity, and clinically meaningful outcomes and response. These consensus criteria and definitions could be used by investigational clinical trials or cohort studies. Adoption of these recommendations would serve to improve communication among investigators, to enhance comparability among clinical trials, to facilitate meta-analyses and development of therapeutic guidelines, and to provide a standardized framework for regulatory agencies.

Double row equivalent for rotator cuff repair: A biomechanical analysis of a new technique.

PubMed

Robinson, Sean; Krigbaum, Henry; Kramer, Jon; Purviance, Connor; Parrish, Robin; Donahue, Joseph

2018-06-01

There are numerous configurations of double row fixation for rotator cuff tears however, there remains to be a consensus on the best method. In this study, we evaluated three different double-row configurations, including a new method. Our primary question is whether the new anchor and technique compares in biomechanical strength to standard double row techniques. Eighteen prepared fresh frozen bovine infraspinatus tendons were randomized to one of three groups including the New Double Row Equivalent, Arthrex Speedbridge and a transosseous equivalent using standard Stabilynx anchors. Biomechanical testing was performed on humeri sawbones and ultimate load, strain, yield strength, contact area, contact pressure, and a survival plots were evaluated. The new double row equivalent method demonstrated increased survival as well as ultimate strength at 415N compared to the remainder testing groups as well as equivalent contact area and pressure to standard double row techniques. This new anchor system and technique demonstrated higher survival rates and loads to failure than standard double row techniques. This data provides us with a new method of rotator cuff fixation which should be further evaluated in the clinical setting. Basic science biomechanical study.

Modification of claims-based measures improves identification of comorbidities in non-elderly women undergoing mastectomy for breast cancer: a retrospective cohort study.

PubMed

Nickel, Katelin B; Wallace, Anna E; Warren, David K; Ball, Kelly E; Mines, Daniel; Fraser, Victoria J; Olsen, Margaret A

2016-08-16

Accurate identification of underlying health conditions is important to fully adjust for confounders in studies using insurer claims data. Our objective was to evaluate the ability of four modifications to a standard claims-based measure to estimate the prevalence of select comorbid conditions compared with national prevalence estimates. In a cohort of 11,973 privately insured women aged 18-64 years with mastectomy from 1/04-12/11 in the HealthCore Integrated Research Database, we identified diabetes, hypertension, deficiency anemia, smoking, and obesity from inpatient and outpatient claims for the year prior to surgery using four different algorithms. The standard comorbidity measure was compared to revised algorithms which included outpatient medications for diabetes, hypertension and smoking; an expanded timeframe encompassing the mastectomy admission; and an adjusted time interval and number of required outpatient claims. A χ2 test of proportions was used to compare prevalence estimates for 5 conditions in the mastectomy population to national health survey datasets (Behavioral Risk Factor Surveillance System and the National Health and Nutrition Examination Survey). Medical record review was conducted for a sample of women to validate the identification of smoking and obesity. Compared to the standard claims algorithm, use of the modified algorithms increased prevalence from 4.79 to 6.79 % for diabetes, 14.75 to 24.87 % for hypertension, 4.23 to 6.65 % for deficiency anemia, 1.78 to 12.87 % for smoking, and 1.14 to 6.31 % for obesity. The revised estimates were more similar, but not statistically equivalent, to nationally reported prevalence estimates. Medical record review revealed low sensitivity (17.86 %) to capture obesity in the claims, moderate negative predictive value (NPV, 71.78 %) and high specificity (99.15 %) and positive predictive value (PPV, 90.91 %); the claims algorithm for current smoking had relatively low sensitivity (62.50 %) and PPV (50.00 %), but high specificity (92.19 %) and NPV (95.16 %). Modifications to a standard comorbidity measure resulted in prevalence estimates that were closer to expected estimates for non-elderly women than the standard measure. Adjustment of the standard claims algorithm to identify underlying comorbid conditions should be considered depending on the specific conditions and the patient population studied.

Report - Antibacterial activity of sea buckthorn (Hippophae rhamnoides L.) against methicillin resistant Staphylococcus aureus (MRSA).

PubMed

Qadir, Muhammad Imran; Abbas, Khizar; Younus, Adnan; Shaikh, Rehan Sadiq

2016-09-01

Objective of the present study was to investigate the antibacterial activity of Sea buckthorn (Hippophae rhamnoides L.) berries and leaves against methicillin resistant Staphylococcus aureus (MRSA) by using the standard disc diffusion method. Chloroform, n-hexane and aqueous extract of the plant parts were used. Doses of 2mg/ml, 4 mg/ml and 6mg/ml were tested against the microorganism, and the zone of inhibition was compared against the standard drug vancomycin. Results indicated that n-hexane and chloroform extracts of berries and n-hexane extract leaves showed significant (p<0.05) antibacterial activity comparable with vancomycin. It was concluded from the study that extracts berries and leaves of Hippophae rhamnoides have antibacterial activity against MRSA.

Effect of Accreditation on Accuracy of Diagnostic Tests in Medical Laboratories.

PubMed

Jang, Mi Ae; Yoon, Young Ahn; Song, Junghan; Kim, Jeong Ho; Min, Won Ki; Lee, Ji Sung; Lee, Yong Wha; Lee, You Kyoung

2017-05-01

Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective. We analyzed the results of the KEQAS to identify significant differences between laboratories with or without KLAP and to determine the impact of laboratory standardization on the accuracy of diagnostic tests. We analyzed KEQAS participant data on clinical chemistry tests such as albumin, ALT, AST, and glucose from 2010 to 2013. As a statistical parameter to assess performance bias between laboratories, we compared 4-yr variance index score (VIS) between the two groups with or without KLAP. Compared with the group without KLAP, the group with KLAP exhibited significantly lower geometric means of 4-yr VIS for all clinical chemistry tests (P<0.0001); this difference justified a high level of confidence in standardized services provided by accredited laboratories. Confidence intervals for the mean of each test in the two groups (accredited and non-accredited) did not overlap, suggesting that the means of the groups are significantly different. These results confirmed that practice standardization is strongly associated with the accuracy of test results. Our study emphasizes the necessity of establishing a system for standardization of diagnostic testing. © The Korean Society for Laboratory Medicine

Comparison of standardized versus individualized caloric prescriptions in the nutritional rehabilitation of inpatients with anorexia nervosa

PubMed Central

Haynos, Ann F.; Snipes, Cassandra; Guarda, Angela; Mayer, Laurel E.; Attia, Evelyn

2015-01-01

Objective Sparse research informs how caloric prescriptions should be advanced during nutritional rehabilitation of inpatients with anorexia nervosa (AN). This study compared the impact of a standardized caloric increase approach, in which increases occurred on a predetermined schedule, to an individualized approach, in which increases occurred only following insufficient weight gain, on rate, pattern, and cumulative amount of weight gain and other weight restoration outcomes. Method This study followed a natural experiment design comparing AN inpatients consecutively admitted before (n = 35) and after (n = 35) an institutional change from individualized to standardized caloric prescriptions. Authors examined the impact of prescription plan on weekly weight gain in the first treatment month using multilevel modeling. Within a subsample remaining inpatient through weight restoration (n = 40), multiple regressions examined the impact of caloric prescription plan on time to weight restoration, length of hospitalization, maximum caloric prescription, discharge BMI, and incidence of activity restriction and edema. Results There were significant interactions between prescription plan and quadratic time on average weekly weight gain (p = .03) and linear time on cumulative weekly weight gain (p < .001). Under the standardized plan, patients gained in an accelerated curvilinear pattern (p = .04) and, therefore, gained cumulatively greater amounts of weight over time (p < .001). Additionally, 30% fewer patients required activity restriction under the standardized plan. Discussion Standardized caloric prescriptions may confer advantage by facilitating accelerated early weight gain and lower incidence of bed rest without increasing the incidence of refeeding syndrome. PMID:26769581

Effect of Accreditation on Accuracy of Diagnostic Tests in Medical Laboratories

PubMed Central

Jang, Mi-Ae; Yoon, Young Ahn; Song, Junghan; Kim, Jeong-Ho; Min, Won-Ki; Lee, Ji Sung

2017-01-01

Background Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective. We analyzed the results of the KEQAS to identify significant differences between laboratories with or without KLAP and to determine the impact of laboratory standardization on the accuracy of diagnostic tests. Methods We analyzed KEQAS participant data on clinical chemistry tests such as albumin, ALT, AST, and glucose from 2010 to 2013. As a statistical parameter to assess performance bias between laboratories, we compared 4-yr variance index score (VIS) between the two groups with or without KLAP. Results Compared with the group without KLAP, the group with KLAP exhibited significantly lower geometric means of 4-yr VIS for all clinical chemistry tests (P<0.0001); this difference justified a high level of confidence in standardized services provided by accredited laboratories. Confidence intervals for the mean of each test in the two groups (accredited and non-accredited) did not overlap, suggesting that the means of the groups are significantly different. Conclusions These results confirmed that practice standardization is strongly associated with the accuracy of test results. Our study emphasizes the necessity of establishing a system for standardization of diagnostic testing. PMID:28224767

Systematic review: proton pump inhibitors (PPIs) for the healing of reflux oesophagitis - a comparison of esomeprazole with other PPIs.

PubMed

Edwards, S J; Lind, T; Lundell, L

2006-09-01

No randomized controlled trial has compared all the licensed standard dose proton pump inhibitors in the healing of reflux oesophagitis. To compare the effectiveness of esomeprazole with licensed standard dose proton pump inhibitors for healing of reflux oesophagitis (i.e. lansoprazole 30 mg, omeprazole 20 mg, pantoprazole 40 mg and rabeprazole 20 mg). Systematic review of CENTRAL, BIOSIS, EMBASE and MEDLINE for randomized controlled trials in patients with reflux oesophagitis. Searching was completed in February 2005. Data on endoscopic healing rates at 4 and 8 weeks were extracted and re-analysed if not analysed by intention-to-treat. Meta-analysis was conducted using a fixed effects model. Of 133 papers identified in the literature search, six were of sufficient quality to be included in the analysis. No studies were identified comparing rabeprazole with esomeprazole. A meta-analysis of healing rates of esomeprazole 40 mg compared with standard dose proton pump inhibitors gave the following results: at 4 weeks [relative risk (RR) 0.92; 95% CI: 0.90, 0.94; P < 0.00001], and 8 weeks (RR 0.95; 95% CI: 0.94, 0.97; P < 0.00001). Publication bias did not have a significant impact on the results. The results were robust to changes in the inclusion/exclusion criteria and using a random effects model. Esomeprazole consistently demonstrates higher healing rates when compared with standard dose proton pump inhibitors.

Comparison of INTERGROWTH-21 and Fenton growth standards to assess size at birth and extrauterine growth in very preterm infants.

PubMed

Tuzun, Funda; Yucesoy, Ebru; Baysal, Bora; Kumral, Abdullah; Duman, Nuray; Ozkan, Hasan

2018-09-01

This study aimed to compare the recently published prescriptive INTERGROWTH-21st standards with commonly used intrauterine based Fenton growth standards in terms of birth size classification and extrauterine growth restriction (EUGR) incidence in a sample of very preterm infants. The anthropometric measures of preterm infants born before 32 weeks of gestation at the Dokuz Eylul University Hospital during the period from January 2012 to February 2016 were obtained at birth, at the 36th gestational weeks or at the time of discharge. Birth and growth data were presented as percentiles according to the two reference standards. A total of 248 infants with mean gestational age of 29.1 ± 2.1 weeks were included. The small for gestational age (SGA) rate was significantly higher (12 versus 15%, p = .004) and the EUGR rate was significantly lower (40.2 versus 31.5%, p < .001) with the INTERGROWTH-21st charts compared with the Fentons'. Twenty-four per cent of the infants who were accepted as SGA according to the INTERGROWTH-21st standards were appropriate for gestational age (AGA) according to the Fenton preterm growth charts. However, these newly identified SGA infants according to the Intergrowth-21st standards did not have increased risks of early morbidities. Furthermore, 77% of the cases who had EUGR due to the Fenton standards were categorized as EUGR when evaluated using the INTERGROWTH-21st standards. Results indicated that almost one out of every five cases assessed as EUGR according to Fenton standards was within the normal interval according to Intergrowth standards. On the contrary, one out of every four cases assessed as SGA according to the INTERGROWTH-21st standards was within the normal interval according to Fentons'. These differences observed with INTERGROWTH-21st standards may affect in-hospital and postdischarge nutrition plan of these vulnerable infants. However, new standards are needed to be evaluated against currently used ones before they are implemented and further studies should be conducted to evaluate the functional impact of these differences on long-term outcomes including neurologic and cardio-metabolic morbidities.

Thermodynamic properties of a liquid crystal carbosilane dendrimer

NASA Astrophysics Data System (ADS)

Samosudova, Ya. S.; Markin, A. V.; Smirnova, N. N.; Ogurtsov, T. G.; Boiko, N. I.; Shibaev, V. P.

2016-11-01

The temperature dependence of the heat capacity of a first-generation liquid crystal carbosilane dendrimer with methoxyphenyl benzoate end groups is studied for the first time in the region of 6-370 K by means of precision adiabatic vacuum calorimetry. Physical transformations are observed in this interval of temperatures, and their standard thermodynamic characteristics are determined and discussed. Standard thermodynamic functions C p ° ( T), H°( T) - H°(0), S°( T) - S°(0), and G°( T) - H°(0) are calculated from the obtained experimental data for the region of T → 0 to 370 K. The standard entropy of formation of the dendrimer in the partially crystalline state at T = 298.15 K is calculated, and the standard entropy of the hypothetic reaction of its synthesis at this temperature is estimated. The thermodynamic properties of the studied dendrimer are compared to those of second- and fourth-generation liquid crystal carbosilane dendrimers with the same end groups studied earlier.

Rabies vaccine standards: comparison of the 5th and 6th WHO international reference standards to the USDA veterinary reference standard.

PubMed

Hermann, J; Fry, A; Reising, M; Patterson, P; Siev, D; Gatewood, D

2012-11-06

Ensuring rabies vaccines are potent and effective is paramount in preventing transmission of this deadly disease and safeguarding public health. Efficacy of human and veterinary vaccines is ensured by evaluating relative potency estimates of the vaccine compared to a rabies reference standard using the National Institutes of Health (NIH) test. Reference vaccines are based on the International Standard for Rabies Vaccine provided by the World Health Organization (WHO). A comparison study was conducted to determine the relative potency of the 5th WHO, 6th WHO, and United States Department of Agriculture's (USDA) 08-14 reference standards using the NIH test. Results from the study demonstrate that the 6th WHO reference standard is approximately twice as potent as the 5th WHO reference when reconstituted to contain 1 IU per ml. Based on these results, the Center for Veterinary Biologics (CVB) doubled the reconstitution volume of USDA veterinary reference 08-14 from 13 ml to 26 ml, for an initial use dilution of 0.7 IU per ml for use by veterinary biologics manufacturers in the NIH test. This study emphasizes the importance of reference standard calibration for use in the National Institutes of Health test. Published by Elsevier Ltd.

The effect of stimulation therapy and donepezil on cognitive function in Alzheimer's disease. A community based RCT with a two-by-two factorial design.

PubMed

Andersen, Fred; Viitanen, Matti; Halvorsen, Dag S; Straume, Bjørn; Wilsgaard, Tom; Engstad, Torgeir A

2012-07-19

Progressive neurodegeneration in Alzheimer's disease (AD) induces cognitive deterioration, and there is controversy regarding the optimal treatment strategy in early AD. Stimulation therapy, including physical exercise and cholinesterase inhibitors are both reported to postpone cognitive deterioration in separate studies. We aimed to study the effect of stimulation therapy and the additional effect of donepezil on cognitive function in early AD. A two-by-two factorial trial comprising stimulation therapy for one year compared to standard care to which a randomized double-blinded placebo controlled trial with donepezil was added. Nine rural municipalities in Northern Norway. 187 participants 65 years and older with a recent diagnosis of mild or moderate AD were included in the study of which 146 completed a one-year follow-up. In five municipalities the participants received stimulation therapy whereas participants in four received standard care. All participants were randomised double-blindly to donepezil or placebo and tested with three different cognitive tests four times during the one-year study period. Changes in MMSE sum score.Secondary outcome: Changes in ADAS-Cog and Clock Drawing Test. MMSE scores remained unchanged amongst AD participants receiving stimulation therapy and those receiving standard care. The results were consistent for ADAS-Cog and Clock Drawing Test. No time trend differences were found during one-year follow-up between groups receiving stimulation therapy versus standard care or between donepezil versus placebo. In rural AD patients non-pharmacological and pharmacological therapy did not improve outcome compared with standard care but all groups retained cognitive function during one year follow-up. Other studies are needed to confirm these results. ClinicalTrials.gov (Identifier: NCT00443014). EudraCT database (no 2004-002613-37).

Sharing good NEWS across the world: developing comparable scores across 12 countries for the Neighborhood Environment Walkability Scale (NEWS).

PubMed

Cerin, Ester; Conway, Terry L; Cain, Kelli L; Kerr, Jacqueline; De Bourdeaudhuij, Ilse; Owen, Neville; Reis, Rodrigo S; Sarmiento, Olga L; Hinckson, Erica A; Salvo, Deborah; Christiansen, Lars B; Macfarlane, Duncan J; Davey, Rachel; Mitáš, Josef; Aguinaga-Ontoso, Ines; Sallis, James F

2013-04-08

The IPEN (International Physical Activity and Environment Network) Adult project seeks to conduct pooled analyses of associations of perceived neighborhood environment, as measured by the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated version (NEWS-A), with physical activity using data from 12 countries. As IPEN countries used adapted versions of the NEWS/NEWS-A, this paper aimed to develop scoring protocols that maximize cross-country comparability in responses. This information is also highly relevant to non-IPEN studies employing the NEWS/NEWS-A, which is one of the most popular measures of perceived environment globally. The following countries participated in the IPEN Adult study: Australia, Belgium, Brazil, Colombia, Czech Republic, Denmark, Hong Kong, Mexico, New Zealand, Spain, the United Kingdom, and the United States. Participants (N = 14,305) were recruited from neighborhoods varying in walkability and socio-economic status. Countries collected data on the perceived environment using a self- or interviewer-administered version of the NEWS/NEWS-A. Confirmatory Factor Analysis (CFA) was used to derive comparable country-specific measurement models of the NEWS/NEWS-A. The level of correspondence between standard and alternative versions of the NEWS/NEWS-A factor-analyzable subscales was determined by estimating the correlations and mean standardized difference (Cohen's d) between them using data from countries that had included items from both standard and alternative versions of the subscales. Final country-specific measurement models of the NEWS/NEWS-A provided acceptable levels of fit to the data and shared the same factorial structure with six latent factors and two single items. The correspondence between the standard and alternative versions of subscales of Land use mix - access, Infrastructure and safety for walking/cycling, and Aesthetics was high. The Brazilian version of the Traffic safety subscale was highly, while the Australian and Belgian versions were marginally, comparable to the standard version. Single-item versions of the Street connectivity subscale used in Australia and Belgium showed marginally acceptable correspondence to the standard version. We have proposed country-specific modifications to the original scoring protocol of the NEWS/NEWS-A that enhance inter-country comparability. These modifications have yielded sufficiently equivalent measurement models of the NEWS/NEWS-A. Some inter-country discrepancies remain. These need to be considered when interpreting findings from different countries.

Sharing good NEWS across the world: developing comparable scores across 12 countries for the neighborhood environment walkability scale (NEWS)

PubMed Central

2013-01-01

Background The IPEN (International Physical Activity and Environment Network) Adult project seeks to conduct pooled analyses of associations of perceived neighborhood environment, as measured by the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated version (NEWS-A), with physical activity using data from 12 countries. As IPEN countries used adapted versions of the NEWS/NEWS-A, this paper aimed to develop scoring protocols that maximize cross-country comparability in responses. This information is also highly relevant to non-IPEN studies employing the NEWS/NEWS-A, which is one of the most popular measures of perceived environment globally. Methods The following countries participated in the IPEN Adult study: Australia, Belgium, Brazil, Colombia, Czech Republic, Denmark, Hong Kong, Mexico, New Zealand, Spain, the United Kingdom, and the United States. Participants (N = 14,305) were recruited from neighborhoods varying in walkability and socio-economic status. Countries collected data on the perceived environment using a self- or interviewer-administered version of the NEWS/NEWS-A. Confirmatory Factor Analysis (CFA) was used to derive comparable country-specific measurement models of the NEWS/NEWS-A. The level of correspondence between standard and alternative versions of the NEWS/NEWS-A factor-analyzable subscales was determined by estimating the correlations and mean standardized difference (Cohen’s d) between them using data from countries that had included items from both standard and alternative versions of the subscales. Results Final country-specific measurement models of the NEWS/NEWS-A provided acceptable levels of fit to the data and shared the same factorial structure with six latent factors and two single items. The correspondence between the standard and alternative versions of subscales of Land use mix – access, Infrastructure and safety for walking/cycling, and Aesthetics was high. The Brazilian version of the Traffic safety subscale was highly, while the Australian and Belgian versions were marginally, comparable to the standard version. Single-item versions of the Street connectivity subscale used in Australia and Belgium showed marginally acceptable correspondence to the standard version. Conclusions We have proposed country-specific modifications to the original scoring protocol of the NEWS/NEWS-A that enhance inter-country comparability. These modifications have yielded sufficiently equivalent measurement models of the NEWS/NEWS-A. Some inter-country discrepancies remain. These need to be considered when interpreting findings from different countries. PMID:23566032

Randomized Trials Comparing Inactivated Vaccine After Medium- or High-titer Measles Vaccine With Standard Titer Measles Vaccine After Inactivated Vaccine: A Meta-analysis.

PubMed

Aaby, Peter; Ravn, Henrik; Benn, Christine S; Rodrigues, Amabelia; Samb, Badara; Ibrahim, Salah A; Libman, Michael D; Whittle, Hilton C

2016-11-01

Observational studies have suggested that girls have higher mortality if their most recent immunization is an inactivated vaccine rather than a live vaccine. We therefore reanalyzed 5 randomized trials of early measles vaccine (MV) in which it was possible to compare an inactivated vaccines [after medium-titer MV (MTMV) or high-titer MV (HTMV)] and a live standard titer MV (after an initial inactivated vaccine). The trials were conducted in Sudan, Senegal, The Gambia and Guinea-Bissau. The intervention group received live MTMV or HTMV from 4 to 5 months and then an inactivated vaccine from 9 to 10 months of age; the control children received inactivated vaccine/placebo from 4 to 5 months and standard titer MV from 9 to 10 months of age. We compared mortality from 9 months until end of study at 3 to 5 years of age for children who received inactivated vaccine (after MTMV or HTMV) and standard titer MV (after inactivated vaccine), respectively. The original datasets were analyzed using a Cox proportional hazards model stratified by trial. The mortality rate ratio (MRR) was 1.38 (95% confidence interval: 1.05-1.83) after an inactivated vaccine (after MTMV or HTMV) compared with a standard titer MV (after inactivated vaccine). Girls had a MRR of 1.89 (1.27-2.80), whereas there was no effect for boys, the sex-differential effect being significant (P = 0.02). Excluding measles cases did not alter these conclusions, the MRR after inactivated vaccines (after MTMV or HTMV) being 1.40 (1.06-1.86) higher overall and 1.92 (1.29-2.86) for girls. Control for variations in national immunization schedules for other vaccines did not modify these results. After 9 months of age, all children had been immunized against measles, and mortality in girls was higher when they had received inactivated vaccines (after MTMV or HTMV) rather than live standard titer MV (after an inactivated vaccine).

The effects of therapeutic climbing in patients with chronic low back pain: a randomized controlled study.

PubMed

Engbert, Kai; Weber, Michaela

2011-05-15

A randomized controlled study investigated the effects of therapeutic climbing in patients with chronic low back pain. Before and after 4 weeks of training, physical and mental well-being were measured by two questionnaires (36-Item Short Form Health Survey [SF-36]; Hannover Functional Ability Questionnaire for measuring back pain-related disability [FFbH-R]). Therapeutic climbing has been suggested to increase muscular strength and perceived physical and mental well-being. This study focused on the psychological effects of therapeutic climbing and compared it with standard exercise therapy. Therapeutic climbing has become increasingly popular in rehabilitation and its effects on muscular strengthening have been shown. Therapeutic climbing has also been suggested to yield psychological effects such as changes in attentional focus from pain to physical capabilities. To date, no controlled clinical trial has investigated these psychological effects and it is unclear whether therapeutic climbing is comparable or superior to other forms of exercise. Twenty-eight patients with chronic low back pain conducted either a therapeutic climbing or a standard exercise regime. Each program took 4 weeks, including four guided training sessions per week. Before and after the program, patients answered two questionnaires assessing their physical and mental well-being. For the Hannover Functional Ability Questionnaire for measuring back pain-related disability, there was no difference before versus after or between the treatments. For the SF-36, both treatments showed significant improvements in 3/8 subscales of the SF-36. In 2/8 subscales, only the participants of the therapeutic climbing improved and in 1/8 subscales the converse was true. Comparing both groups, significantly larger improvements were found after therapeutic climbing in two subscales of the SF-36: physical functioning and general health perception. The benefits of therapeutic climbing were comparable with those of a standard exercise regime. In two subscales of the SF-36, the benefits of therapeutic climbing exceeded those of standard exercise therapy, primarily in perceived health and physical functioning of the patients. This finding demonstrates that therapeutic climbing is equivalent and partly superior to standard exercise therapy for patients with chronic low back pain.

The Stock Performance of C. Everett Koop Award Winners Compared With the Standard & Poor's 500 Index.

PubMed

Goetzel, Ron Z; Fabius, Raymond; Fabius, Dan; Roemer, Enid C; Thornton, Nicole; Kelly, Rebecca K; Pelletier, Kenneth R

2016-01-01

To explore the link between companies investing in the health and well-being programs of their employees and stock market performance. Stock performance of C. Everett Koop National Health Award winners (n = 26) was measured over time and compared with the average performance of companies comprising the Standard and Poor's (S&P) 500 Index. The Koop Award portfolio outperformed the S&P 500 Index. In the 14-year period tracked (2000-2014), Koop Award winners' stock values appreciated by 325% compared with the market average appreciation of 105%. This study supports prior and ongoing research demonstrating a higher market valuation--an affirmation of business success by Wall Street investors--of socially responsible companies that invest in the health and well-being of their workers when compared with other publicly traded firms.

Assessment of the usefulness of the standardized uptake values and the radioactivity levels for the preoperative diagnosis of thyroid cancer measured by using 18F-FDG PET/CT dual-time-point imaging

NASA Astrophysics Data System (ADS)

Lee, Hyeon-Guck; Hong, Seong-Jong; Cho, Jae-Hwan; Han, Man-Seok; Kim, Tae-Hyung; Lee, Ik-Han

2013-02-01

The purpose of this study was to assess and compare the changes in the SUV (standardized uptake value), the 18F-FDG (18F-fluorodeoxyglucose) uptake pattern, and the radioactivity level for the diagnosis of thyroid cancer via dual-time-point 18F-FDG PET/CT (positron emission tomographycomputed tomography) imaging. Moreover, the study aimed to verify the usefulness and significance of SUV values and radioactivity levels to discriminate tumor malignancy. A retrospective analysis was performed on 40 patients who received 18F-FDG PET/CT for thyroid cancer as a primary tumor. To set the background, we compared changes in values by calculating the dispersion of scattered rays in the neck area and the lung apex, and by comparing the mean and SD (standard deviation) values of the maxSUV and the radioactivity levels. According to the statistical analysis of the changes in 18F-FDG uptake for the diagnosis of thyroid cancer, a high similarity was observed with the coefficient of determination being R2 = 0.939, in the SUVs and the radioactivity levels. Moreover, similar results were observed in the assessment of tumor malignancy using dual-time-point. The quantitative analysis method for assessing tumor malignancy using radioactivity levels was neither specific nor discriminative compared to the semi-quantitative analysis method.

Timeliness of notification systems for infectious diseases: A systematic literature review.

PubMed

Swaan, Corien; van den Broek, Anouk; Kretzschmar, Mirjam; Richardus, Jan Hendrik

2018-01-01

Timely notification of infectious diseases is crucial for prompt response by public health services. Adequate notification systems facilitate timely notification. A systematic literature review was performed to assess outcomes of studies on notification timeliness and to determine which aspects of notification systems are associated with timely notification. Articles reviewing timeliness of notifications published between 2000 and 2017 were searched in Pubmed and Scopus. Using a standardized notification chain, timeliness of reporting system for each article was defined as either sufficient (≥ 80% notifications in time), partly sufficient (≥ 50-80%), or insufficient (< 50%) according to the article's predefined timeframe, a standardized timeframe for all articles, and a disease specific timeframe. Electronic notification systems were compared with conventional methods (postal mail, fax, telephone, email) and mobile phone reporting. 48 articles were identified. In almost one third of the studies with a predefined timeframe (39), timeliness of notification systems was either sufficient or insufficient (11/39, 28% and 12/39, 31% resp.). Applying the standardized timeframe (45 studies) revealed similar outcomes (13/45, 29%, sufficient notification timeframe, vs 15/45, 33%, insufficient). The disease specific timeframe was not met by any study. Systems involving reporting by laboratories most often complied sufficiently with predefined or standardized timeframes. Outcomes were not related to electronic, conventional notification systems or mobile phone reporting. Electronic systems were faster in comparative studies (10/13); this hardly resulted in sufficient timeliness, neither according to predefined nor to standardized timeframes. A minority of notification systems meets either predefined, standardized or disease specific timeframes. Systems including laboratory reporting are associated with timely notification. Electronic systems reduce reporting delay, but implementation needs considerable effort to comply with notification timeframes. During outbreak threats, patient, doctors and laboratory testing delays need to be reduced to achieve timely detection and notification. Public health authorities should incorporate procedures for this in their preparedness plans.

Reasoning and Proving Opportunities in Textbooks: A Comparative Analysis

ERIC Educational Resources Information Center

Hong, Dae S.; Choi, Kyong Mi

2018-01-01

In this study, we analyzed and compared reasoning and proving opportunities in geometry lessons from American standard-based textbooks and Korean textbooks to understand how these textbooks provide student opportunities to engage in reasoning and proving activities. Overall, around 40% of exercise problems in Core Plus Mathematics Project (CPMP)…

Oral budesonide for induction of remission in ulcerative colitis.

PubMed

Sherlock, Mary E; MacDonald, John K; Griffiths, Anne Marie; Steinhart, A Hillary; Seow, Cynthia H

2015-10-26

Corticosteroids are first-line therapy for induction of remission in ulcerative colitis. Although corticosteroids may improve symptoms, they have significant adverse effects. Steroids which act topically, with less systemic side-effects may be more desirable. Budesonide is a topically acting corticosteroid with extensive first pass hepatic metabolism. There are currently three formulations of budesonide: two standard formulations including a controlled-ileal release capsule and a pH-dependent capsule both designed to release the drug in the distal small intestine and right colon; and the newer Budesonide-MMX® capsule designed to release the drug throughout the entire colon. The primary objective was to evaluate the efficacy and safety of oral budesonide for the induction of remission in ulcerative colitis. We searched MEDLINE, EMBASE, CENTRAL, and the Cochrane IBD Group Specialised Register from inception to April 2015. We also searched reference lists of articles, conference proceedings and ClinicalTrials.gov. Randomised controlled trials comparing oral budesonide to placebo or another active therapy for induction of remission in ulcerative colitis were considered eligible. There were no exclusions based on patient age or the type, dose, duration or formulation of budesonide therapy. Two independent investigators reviewed studies for eligibility, extracted data and assessed study quality. Methodological quality was assessed using the Cochrane risk of bias tool. The overall quality of the evidence supporting the outcomes was evaluated using the GRADE criteria. The primary outcome was induction of remission (as defined by the primary studies) at week eight. Secondary outcomes included clinical, endoscopic and histologic improvement, adverse events and early withdrawal. We calculated the risk ratio (RR) and corresponding 95% confidence interval (CI) for each dichotomous outcome and the mean difference (MD) and corresponding 95% CI for each continuous outcome. Data were analysed on an intention-to-treat basis. Six studies (1808 participants) were included. Four studies compared budesonide-MMX® with placebo, one small pilot study looked at clinical remission at week four, and was subsequently followed by three large, studies that assessed combined clinical and endoscopic remission at week eight. Although two placebo-controlled studies had mesalamine and Entocort (standard budesonide) treatment arms, these studies were not sufficiently powered to compare Budesonide-MMX® with these active comparators. One small study compared standard budesonide with prednisolone and one study compared standard budesonide to mesalamine. Four studies were rated as low risk of bias and two studies had an unclear risk of bias. A pooled analysis of three studies (900 participants) showed that budesonide-MMX® 9 mg was significantly superior to placebo for inducing remission (combined clinical and endoscopic remission) at 8 weeks. Fifteen per cent (71/462) of budesonide-MMX® 9 mg patients achieved remission compared to 7% (30/438) of placebo patients (RR 2.25, 95% CI 1.50 to 3.39). A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was moderate due to sparse data (101 events). A subgroup analysis by concurrent mesalamine use suggests higher efficacy in the 442 patients who were not considered to be mesalamine-refractory (RR 2.89, 95% CI 1.59 to 5.25). A subgroup analysis by disease location suggests budesonide is most effective in patients with left-sided disease (RR 2.98, 95% CI 1.56 to 5.67; 289 patients). A small pilot study reported no statistically significant difference in endoscopic remission between budesonide and prednisolone (RR 0.75, 95% CI 0.23 to 2.42; 72 patients). GRADE indicated that the overall quality of the evidence supporting this outcome was very low due to unclear risk of bias and very sparse data (10 events). Standard oral budesonide was significantly less likely to induce clinical remission than oral mesalamine after 8 weeks of therapy (RR 0.72, 95% CI 0.57 to 0.91; 1 study, 343 patients). A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was moderate due to sparse data (161 events). Another study found no difference in remission rates between budesonide-MMX® 9 mg and mesalamine (RR 1.48, 95% CI 0.81 to 2.71; 247 patients). GRADE indicated that the overall quality of the evidence supporting this outcome was low due to very sparse data (37 events). One study found no difference in remission rates between budesonide-MMX® 9 mg and standard budesonide 9 mg (RR 1.38, 95% CI 0.72 to 2.65; 212 patients). A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was low due to very sparse data (32 events). Suppression of plasma cortisol was more common in prednisolone-treated patients (RR 0.02, 95% CI 0.0 to 0.33). While budesonide does appear to suppress morning cortisol to some extent, mean morning cortisol values remained within the normal range in 2 large studies (n = 899) and there was no difference in glucocorticoid-related side-effects across different treatment groups. Further, study withdrawal due to adverse events was not more common in budesonide compared with placebo treated patients (RR 0.85, 95% CI 0.53 to 1.38). Common adverse events included worsening ulcerative colitis, headache, pyrexia, insomnia, back pain, nausea, abdominal pain, diarrhoea, flatulence and nasopharyngitis. Moderate quality evidence to supports the use of oral budesonide-MMX® at a 9 mg daily dose for induction of remission in active ulcerative colitis, particularly in patients with left-sided colitis. Budesonide-MMX® 9 mg daily is effective for induction of remission in the presence or absence of concurrent 5-ASA therapy. Further, budesonide-MMX® appears to be safe, and does not lead to significant impairment of adrenocorticoid function compared to placebo. Moderate quality evidence from a single study suggests that mesalamine may be superior to standard budesonide for the treatment of active ulcerative colitis. Low quality evidence from one study found no difference in remission rates between budesonide MMX® and mesalamine. Very low quality evidence from one small study showed no difference in endoscopic remission rates between standard budesonide and prednisolone. Low quality evidence from one study showed no difference in remission rates between budesonide-MMX® and standard budesonide. Adequately powered studies are needed to allow conclusions regarding the comparative efficacy and safety of budesonide versus prednisolone, budesonide-MMX® versus standard budesonide and budesonide versus mesalamine.

Wind Tunnel Force Balance Calibration Study - Interim Results

NASA Technical Reports Server (NTRS)

Rhew, Ray D.

2012-01-01

Wind tunnel force balance calibration is preformed utilizing a variety of different methods and does not have a direct traceable standard such as standards used for most calibration practices (weights, and voltmeters). These different calibration methods and practices include, but are not limited to, the loading schedule, the load application hardware, manual and automatic systems, re-leveling and non-re-leveling. A study of the balance calibration techniques used by NASA was undertaken to develop metrics for reviewing and comparing results using sample calibrations. The study also includes balances of different designs, single and multi-piece. The calibration systems include, the manual, and the automatic that are provided by NASA and its vendors. The results to date will be presented along with the techniques for comparing the results. In addition, future planned calibrations and investigations based on the results will be provided.

The role of socio-communicative rearing environments in the development of social and physical cognition in apes.

PubMed

Russell, Jamie L; Lyn, Heidi; Schaeffer, Jennifer A; Hopkins, William D

2011-11-01

The cultural intelligence hypothesis (CIH) claims that humans' advanced cognition is a direct result of human culture and that children are uniquely specialized to absorb and utilize this cultural experience (Tomasello, 2000). Comparative data demonstrating that 2.5-year-old human children outperform apes on measures of social cognition but not on measures of physical cognition support this claim (Herrmann et al., 2007). However, the previous study failed to control for rearing when comparing these two species. Specifically, the human children were raised in a human culture whereas the apes were raised in standard sanctuary settings. To further explore the CIH, here we compared the performance on multiple measures of social and physical cognition in a group of standard reared apes raised in conditions typical of zoo and biomedical laboratory settings to that of apes reared in an enculturated socio-communicatively rich environment. Overall, the enculturated apes significantly outperformed their standard reared counterparts on the cognitive tasks and this was particularly true for measures of communication. Furthermore, the performance of the enculturated apes was very similar to previously reported data from 2.5-year-old children. We conclude that apes who are reared in a human-like socio-communicatively rich environment develop superior communicative abilities compared to apes reared in standard laboratory settings, which supports some assumptions of the cultural intelligence hypothesis. 2011 Blackwell Publishing Ltd.

Assessment of the effectiveness of head only and back-of-the-head electrical stunning of chickens

PubMed Central

Gibson, T. J.; Taylor, A. H.; Gregory, N. G.

2016-01-01

Abstract The study assesses the effectiveness of reversible head-only and back-of-the-head electrical stunning of chickens using 130–950 mA per bird at 50 Hz AC.Three trials were conducted to compare both stunning systems: (a) behavioural assessment of return of consciousness, (b) insensibility to thermal pain, and (c) assessment of return of brain activity with visually evoked potentials (VEPs).Assessment of behaviour suggested that the period of unconsciousness following head-only electrical stunning was shorter in hens compared to broilers.Stunning across the back-of-the-head delayed the time to return of brainstem function compared to stunning with standard head-only electrodes. Additionally, back-of-the-head stunning produced a more prolonged period of electroanalgesia compared to head-only.Based on examination of return of brain function with VEPs in hens, back-of-the-head stunning produced a shorter-lasting stun than standard head-only. However, even for standard head-only, the stun was notably shorter than previously reported. In some birds, brain function had returned within 9 s after the end of stunning.The results suggest that some birds may recover consciousness prior to or during the neck cut. Based on these findings, back-of-the-head stunning and standard head-only stunning of hens should not be recommended without further development. PMID:27023411

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

Panek, R.L.; Dixon, W.R.; Rutledge, C.O.

The effect of dietary lipid treatment on sympathetic neuronal function was examined in isolated perfused tail arteries of adult rats. The hypothesis that dietary manipulations alter the lipid environment of receptor proteins which may result in the perturbation of specific membrane-associated processes that regulate peripheral adrenergic neurotransmission in the vasculature was the basis for this investigation. In the present study, rats were fed semisynthetic diets enriched in either 16% coconut oil (saturated fat) or 16% sunflower oil (unsaturated fat). The field stimulation-evoked release of endogenous norepinephrine and total /sup 3/H was decreased significantly in rats receiving the coconut oil dietmore » when compared to either sunflower oil- or standard lab chow-fed rats. Norepinephrine content in artery segments from coconut oil-treated rats was significantly higher compared to either sunflower oil- or standard lab chow-fed rats. Tail arteries from rats receiving the coconut oil diet displayed significantly lower perfusion pressure responses to nerve stimulation at all frequencies tested when compared to the sunflower oil- or standard lab chow-fed rats. Vasoconstrictor responses of perfused tail arteries exposed to exogenous norepinephrine resulted in an EC50 for norepinephrine that was not changed by the dietary treatment, but adult rats receiving the sunflower oil diet displayed a significantly greater maximum response to exogenous norepinephrine (10(-5) M) compared to arteries from either coconut oil- or standard lab chow-fed rats.« less

Extended pancreatectomy as defined by the ISGPS: useful in selected cases of pancreatic cancer but invaluable in other complex pancreatic tumors.

PubMed

Mitra, Abhishek; Pai, Esha; Dusane, Rohit; Ranganathan, Priya; DeSouza, Ashwin; Goel, Mahesh; Shrikhande, Shailesh V

2018-03-01

Extended pancreatectomy aimed at R0 resection of pancreatic tumors with adjacent vessel and organ involvement may be the only option for cure. This study was done with an objective to analyze the short- and long-term outcomes of extended pancreatic resections. All pancreatectomies performed between 2006 and 2015 were included. The pancreatectomies were classified as standard or extended, as per the International Study Group for Pancreatic Surgery. All surgical complications and terminologies were according to Clavien-Dindo classification and International Study Group for Pancreatic Surgery guidelines. Morbidity and mortality were primary outcomes and disease-free survival was a secondary outcome. Sixty-three extended and 620 standard pancreatectomies were performed. Major morbidity (Clavien grades III, IV and V) (37 vs. 29%, p = 0.21) and mortality (6 vs. 4%, p = 0.3) for extended pancreatectomies were comparable to those for standard pancreatectomies. Blood loss > 855 ml, need for blood transfusion, and tumor size were independent risk factors for morbidity, and the latter two for mortality. Standard pancreatectomies were associated with better 3-year disease-free survival than extended pancreatectomies (67 vs. 41%, p < 0.001). Extended pancreatectomies resulted in a significantly better median disease-free survival for non-pancreatic adenocarcinoma vs. pancreatic adenocarcinoma (33.3 vs. 9.5 months, p = 0.01). Extended pancreatectomies resulted in similar peri-operative morbidity and mortality compared to standard pancreatectomies. Although the survival of patients undergoing these complex procedures is inferior to standard pancreatectomies, they should be undertaken not only in selected cases of pancreatic cancer but even more so in other complex pancreatic tumors.

Battlefield acupuncture to treat low back pain in the emergency department.

PubMed

Fox, Lindsay M; Murakami, Mikiko; Danesh, Houman; Manini, Alex F

2018-06-01

Battlefield acupuncture (BFA) is an ear acupuncture protocol used by the military for immediate pain relief. This is a pilot feasibility study of BFA as a treatment for acute low back pain (LBP) in the emergency department (ED). Thirty acute LBP patients that presented to ED were randomized to standard care plus BFA or standard care alone. In the BFA group, outcomes were assessed at the time of randomization, 5 min after intervention, and again within 1 h after intervention. In the standard care group outcomes were assessed at the time of randomization and again an hour later. Primary outcomes included post-intervention LBP on a 10-point numeric pain rating scale (NRS) and the timed get-up-and-go test (GUGT). t-Test and chi squared tests were used to compare differences between groups demographics to evaluate randomization, and Analysis of Covariance (ANCOVA) was used to assess differences in primary/secondary outcomes. We randomized 15 patients to BFA plus standard care, and 15 patients to standard care alone. Demographics were similar between groups. Post-intervention LBP NRS was significantly lower in the BFA group compared with the standard care group (5.2 vs. 6.9, ANCOVA p = 0.04). GUGT was similar between groups (21.3 s vs. 19.0 s, ANCOVA p = 0.327). No adverse events from acupuncture were reported. This pilot study demonstrates that BFA is feasible as a therapy for LBP in the ED. Furthermore, our data suggest that BFA may be efficacious to improve LBP symptoms, and thus further efficacy studies are warranted. (Clinicaltrials.gov registration number NCT02399969). Copyright © 2018 Elsevier Inc. All rights reserved.

Rationale and design of the HepZero study: a prospective, multicenter, international, open, randomized, controlled clinical study with parallel groups comparing heparin-free dialysis with heparin-coated dialysis membrane (Evodial) versus standard care: study protocol for a randomized controlled trial.

PubMed

Rossignol, Patrick; Dorval, Marc; Fay, Renaud; Ros, Joan Fort; Loughraieb, Nathalie; Moureau, Frédérique; Laville, Maurice

2013-06-01

Anticoagulation for chronic dialysis patients with contraindications to heparin administration is challenging. Current guidelines state that in patients with increased bleeding risks, strategies that can induce systemic anticoagulation should be avoided. Heparin-free dialysis using intermittent saline flushes is widely adopted as the method of choice for patients at risk of bleeding, although on-line blood predilution may also be used. A new dialyzer, Evodial (Gambro, Lund, Sweden), is grafted with unfractionated heparin during the manufacturing process and may allow safe and efficient heparin-free hemodialysis sessions. In the present trial, Evodial was compared to standard care with either saline flushes or blood predilution. The HepZero study is the first international (seven countries), multicenter (10 centers), randomized, controlled, open-label, non-inferiority (and if applicable subsequently, superiority) trial with two parallel groups, comprising 252 end-stage renal disease patients treated by maintenance hemodialysis for at least 3 months and requiring heparin-free dialysis treatments. Patients will be treated during a maximum of three heparin-free dialysis treatments with either saline flushes or blood predilution (control group), or Evodial. The first heparin-free dialysis treatment will be considered successful when there is: no complete occlusion of air traps or dialyzer rendering dialysis impossible; no additional saline flushes to prevent clotting; no change of dialyzer or blood lines because of clotting; and no premature termination (early rinse-back) because of clotting.The primary objectives of the study are to determine the effectiveness of the Evodial dialyzer, compared with standard care in terms of successful treatments during the first heparin-free dialysis. If the non-inferiority of Evodial is demonstrated then the superiority of Evodial over standard care will be tested. The HepZero study results may have major clinical implications for patient care. ClinicalTrials.gov NCT01318486.

Low-dose or standard-dose proton pump inhibitors for maintenance therapy of gastro-oesophageal reflux disease: a cost-effectiveness analysis.

PubMed

You, J H S; Lee, A C M; Wong, S C Y; Chan, F K L

2003-03-15

Studies on the use of low-dose proton pump inhibitor for the maintenance therapy of gastro-oesophageal reflux disease have shown that it might be comparable with standard-dose proton pump inhibitor treatment and superior to standard-dose histamine-2 receptor antagonist therapy. To compare the impact of standard-dose histamine-2 receptor antagonist, low-dose proton pump inhibitor and standard-dose proton pump inhibitor treatment for the maintenance therapy of gastro-oesophageal reflux disease on symptom control and health care resource utilization from the perspective of a public health organization in Hong Kong. A Markov model was designed to simulate, over 12 months, the economic and clinical outcomes of gastro-oesophageal reflux disease patients treated with standard-dose histamine-2 receptor antagonist, low-dose proton pump inhibitor and standard-dose proton pump inhibitor. The transition probabilities were derived from the literature. Resource utilization was retrieved from a group of gastro-oesophageal reflux disease patients in Hong Kong. Sensitivity analysis was conducted to examine the robustness of the model. The standard-dose proton pump inhibitor strategy was associated with the highest numbers of symptom-free patient-years (0.954 years) and quality-adjusted life-years gained (0.999 years), followed by low-dose proton pump inhibitor and standard-dose histamine-2 receptor antagonist. The direct medical cost per patient in the standard-dose proton pump inhibitor group (904 US dollars) was lower than those of the low-dose proton pump inhibitor and standard-dose histamine-2 receptor antagonist groups. The standard-dose proton pump inhibitor strategy appears to be the most effective and least costly for the maintenance management of patients with gastro-oesophageal reflux disease in Hong Kong.

Reproducibility of preclinical animal research improves with heterogeneity of study samples

PubMed Central

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

2018-01-01

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

School performance for children with cleft lip and palate: a population-based study.

PubMed

Bell, J C; Raynes-Greenow, C; Turner, R; Bower, C; Dodson, A; Nicholls, W; Nassar, N

2017-03-01

Educational attainment is important in shaping young people's life prospects. To investigate whether being born with orofacial cleft (OFC) affects school performance, we compared school test results between children born with and without OFC. Using record-linked datasets, we conducted a population-based cohort study of children liveborn in Western Australia 1980-2010 with a diagnosis of OFC on the Register of Developmental Anomalies, and a random sample of 6603 children born without OFC. We compared odds ratios for meeting national minimum standards in five domains (reading, numeracy, writing, spelling, grammar and punctuation), and adjusted OR (aOR) for children with cleft lip only (CLO), cleft lip and palate (CL + P) and cleft palate only (CPO) for each domain. Results from two testing programs (WALNA and NAPLAN) were available for 3238 (89%) children expected to participate. Most met the national minimum standards. Compared with children without OFC, children with CPO were less likely to meet minimum standards for NAPLAN reading (aOR 0.57 [95%CI 0.34, 0.96]) grammar and punctuation (aOR 0.49 [95%CI 0.32, 0.76]), WALNA writing (aOR 0.66 [95%CI 0.47, 0.92]), and WALNA and NAPLAN numeracy (aOR 0.64 [95%CI 0.43, 0.95] and aOR 0.47 [95%CI 0.28, 0.82]), respectively. Children with CL + P had significantly lower odds for reaching the spelling standard in NAPLAN tests (aOR 0.52 [95%CI 0.29, 0.94]). Children with CLO had similar odds for reaching all minimum standards. Children born with OFC, particularly children with CPO, should be monitored to identify learning difficulties early, to enable intervention to maximize school attainment. © 2016 John Wiley & Sons Ltd.

The Economic Impact of Closed-Incision Negative-Pressure Therapy in High-Risk Abdominal Incisions: A Cost-Utility Analysis.

PubMed

Chopra, Karan; Gowda, Arvind U; Morrow, Chris; Holton, Luther; Singh, Devinder P

2016-04-01

Complex abdominal wall reconstruction is beset by postoperative complications. A recent meta-analysis comparing the use of closed-incision negative-pressure therapy to standard dressings found a statistically significant reduction in surgical-site infection. The use of closed-incision negative-pressure therapy is gaining acceptance in this population; however, the economic impact of this innovative dressing remains unknown. In this study, a cost-utility analysis was performed assessing closed-incision negative-pressure therapy and standard dressings following closure of abdominal incisions in high-risk patients. Cost-utility methodology involved reviewing literature related to closed-incision negative-pressure therapy in abdominal wall surgery, obtaining utility estimates to calculate quality-adjusted life-year scores for successful surgery and surgery complicated by surgical-site infection, summing costs using Medicare Current Procedural Terminology codes, and creating a decision tree illuminating the most cost-effective dressing strategy. One-way sensitivity analysis was performed to assess the robustness of the results. The aforementioned meta-analysis comparing closed-incision negative-pressure therapy to standard dressings included a subset of five studies assessing abdominal wall surgery in 829 patients (260 closed-incision negative-pressure therapy and 569 standard dressings). Decision tree analysis revealed an estimated savings of $1546.52 and a gain of 0.0024 quality-adjusted life-year with closed-incision negative-pressure therapy compared with standard dressings; therefore, closed-incision negative-pressure therapy is a dominant treatment strategy. One-way sensitivity analysis revealed that closed-incision negative-pressure therapy is a cost-effective option when the surgical-site infection rate is greater than 16.39 percent. The use of closed-incision negative-pressure therapy is cost-saving following closure of abdominal incisions in high-risk patients.

Development of consensus treatment plans for juvenile localized scleroderma: a roadmap toward comparative effectiveness studies in juvenile localized scleroderma.

PubMed

Li, Suzanne C; Torok, Kathryn S; Pope, Elena; Dedeoglu, Fatma; Hong, Sandy; Jacobe, Heidi T; Rabinovich, C Egla; Laxer, Ronald M; Higgins, Gloria C; Ferguson, Polly J; Lasky, Andrew; Baszis, Kevin; Becker, Mara; Campillo, Sarah; Cartwright, Victoria; Cidon, Michael; Inman, Christi J; Jerath, Rita; O'Neil, Kathleen M; Vora, Sheetal; Zeft, Andrew; Wallace, Carol A; Ilowite, Norman T; Fuhlbrigge, Robert C

2012-08-01

Juvenile localized scleroderma (LS) is a chronic inflammatory skin disorder associated with substantial morbidity and disability. Although a wide range of therapeutic strategies has been reported in the literature, a lack of agreement on treatment specifics and accepted methods for clinical assessment has made it difficult to compare approaches and identify optimal therapy. Our objective was to develop standardized treatment plans, clinical assessments, and response criteria for active, moderate to high severity juvenile LS. A core group of pediatric rheumatologists, dermatologists, and a lay advisor was engaged by the Childhood Arthritis and Rheumatology Research Alliance (CARRA) to develop standardized treatment plans and assessment parameters for juvenile LS using consensus methods/nominal group techniques. Recommendations were validated in 2 face-to-face conferences with a larger group of practitioners with expertise in juvenile LS and with the full membership of CARRA, which encompasses the majority of pediatric rheumatologists in the US and Canada. Consensus was achieved on standardized treatment plans that reflect the prevailing treatment practices of CARRA members. Standardized clinical assessment methods and provisional treatment response criteria were also developed. Greater than 90% of pediatric rheumatologists responding to a survey (66% of CARRA membership) affirmed the final recommendations and agreed to utilize these consensus plans to treat patients with juvenile LS. Using consensus methodology, we have developed standardized treatment plans and assessment methods for juvenile LS. The high level of support among pediatric rheumatologists will support future comparative effectiveness studies and enable the development of evidence-based guidelines for the treatment of juvenile LS. Copyright © 2012 by the American College of Rheumatology.

The relation between knee flexion angle and anterior cruciate ligament femoral tunnel characteristics: a cadaveric study comparing a standard and a far anteromedial portal.

PubMed

Alavekios, Damon; Peterson, Alexander; Patton, John; McGarry, Michelle H; Lee, Thay Q

2014-11-01

The purpose of this study was to compare the anterior cruciate ligament (ACL) femoral tunnel characteristics between 2 common arthroscopic portals used for ACL reconstruction, a standard anteromedial portal and a far anteromedial portal. Seven cadaveric knees were used. A 1.25-mm Kirschner wire was drilled through the center of the ACL femoral footprint and through the distal femur from the standard anteromedial and far anteromedial portals at knee flexion angles of 100°, 120°, and 140°. No formal tunnels were drilled. Each tunnel exit point was marked with a colored pin. After all tunnels were created, the specimens were digitized with a MicroScribe device (Revware, Raleigh, NC) to measure the tunnel length; distance to the posterior femoral cortical wall (posterior cortical margin); and tunnel orientation in the sagittal, coronal, and axial planes. The standard anteromedial portal resulted in a longer tunnel length, a less horizontal tunnel in the coronal plane, and a greater posterior cortical margin compared with the far anteromedial portal at all knee flexion angles. For both portal locations, the tunnel length and posterior cortical margin increased, and the tunnel position became more horizontal in the coronal plane, more anterior in the sagittal plane, and less horizontal in the transverse plane as knee flexion increased. Portal position affects femoral tunnel characteristics, with results favoring the more laterally positioned standard anteromedial portal at all flexion angles. Increasing the knee flexion angle leads to a longer femoral tunnel length and posterior femoral cortical margin with either portal position. Understanding how portal positioning and knee flexion angle affect femoral tunnel orientation and characteristics may lead to improved surgical outcomes after ACL reconstruction. Published by Elsevier Inc.

The long-term cost-effectiveness of varenicline (12-week standard course and 12 + 12-week extended course) vs. other smoking cessation strategies in Canada.

PubMed

von Wartburg, M; Raymond, V; Paradis, P E

2014-05-01

Smoking is the leading risk factor for preventable morbidity and mortality as a result of heart and lung diseases and various forms of cancer. Reimbursement coverage for smoking cessation therapies remains limited in Canada and the United States despite the health and economic benefits of smoking cessation. This study aimed to evaluate the long-term cost-effectiveness of varenicline compared with other smoking cessation interventions in Canada using the Benefits of Smoking Cessation on Outcomes (BENESCO) model. Efficacy rates of the standard course (12 weeks) varenicline, extended course (12 + 12 weeks) varenicline, bupropion, nicotine replacement therapy and unaided intervention were derived based on a published mixed treatment comparison methodology and analysed within a Markov cohort model to estimate their cost-effectiveness over the lifetime cycle. Study cohort, smoking rates and prevalence, incidence and mortality of smoking-related diseases were calibrated to represent the Canadian population. Over the subjects' lifetime, both the standard and the extended course of varenicline are shown to dominate (e.g. less costly and more effective) all other alternative smoking cessation interventions considered. Compared with the standard varenicline treatment course, the extended course is highly cost-effective with an incremental cost-effectiveness ratio (ICER) less than $4000 per quality-adjusted life year. Including indirect cost and benefits of smoking cessation interventions further strengthens the result with the extended course of varenicline dominating all other alternatives considered. Evidence from complex smoking cessation models requiring numerous inputs and assumptions should be assessed in conjunction with evidence from other methodologies. The standard and extended courses of varenicline are decidedly cost-effective treatment regimes compared with alternative smoking cessation interventions and can provide significant cost savings to the healthcare system. © 2014 John Wiley & Sons Ltd.

A new customized fetal growth standard for African American women: the PRB/NICHD Detroit Study

PubMed Central

Tarca, Adi L.; Romero, Roberto; Gudicha, Dereje W.; Erez, Offer; Hernandez-Andrade, Edgar; Yeo, Lami; Bhatti, Gaurav; Pacora, Percy; Maymon, Eli; Hassan, Sonia S.

2018-01-01

Background The assessment of fetal growth disorders requires a standard. Current nomograms for the assessment of fetal growth in African American women have been derived either from neonatal (rather than fetal) biometry data or have not been customized for maternal ethnicity, weight, height, parity, and fetal sex. Objective We sought to 1) develop a new customized fetal growth standard for African American mothers; and 2) compare such a standard to three existing standards for the classification of fetuses as small (SGA) or large (LGA) for gestational age. Study Design A retrospective cohort study included 4,183 women (4,001 African American and 182 Caucasian) from the Detroit metropolitan area who underwent ultrasound examinations between 14 and 40 weeks of gestation (the median number of scans per pregnancy was 5, interquartile range 3-7) and for whom relevant covariate data were available. Longitudinal quantile regression was used to build models defining the “normal” estimated fetal weight (EFW) centiles for gestational age in African American women, adjusted for maternal height, weight, parity, and fetal sex, and excluding pathologic factors with a significant effect on fetal weight. The resulting Perinatology Research Branch/Eunice Kennedy Shriver National Institute of Child Health and Human Development (hereinafter, PRB/NICHD) growth standard was compared to 3 other existing standards—the customized gestation-related optimal weight (GROW) standard; the Eunice Kennedy Shriver National Institute of Child Health and Human Development (hereinafter, NICHD) African American standard; and the multinational World Health Organization (WHO) standard—utilized to screen fetuses for SGA (<10th centile) or LGA (>90th centile) based on the last available ultrasound examination for each pregnancy. Results 1) First, the mean birthweight at 40 weeks was 133g higher for neonates born to Caucasian than to African American mothers and 150g higher for male than female neonates; maternal weight, height, and parity had a positive effect on birthweight.Second, analysis of longitudinal EFW revealed the following features of fetal growth: (1) all weight centiles were about 2% higher for male than for female fetuses; (2) maternal height had a positive effect on EFW, with larger fetuses being affected more (2% increase in the 95th centile of weight for each 10-cm increase in height); and (3) maternal weight and parity had a positive effect on EFW that increased with gestation and varied among the weight centiles. Third, the screen-positive rate for SGA was 7.2% for the NICHD African American standard, 12.3% for the GROW standard, 13% for the WHO standard customized by fetal sex, and 14.4% for the PRB/NICHD customized standard. For all standards, the screen-positive rate for SGA was at least two-fold higher among fetuses delivered preterm than at term.Fourth, the screen-positive rate for LGA was 8.7% for the GROW standard, 9.2% for the PRB/NICHD customized standard, 10.8% for the WHO standard customized by fetal sex, and 12.3% for the NICHD African American standard. Finally, the highest overall agreement among standards was between the GROW and PRB/NICHD customized standards (Cohen’s inter-rater agreement, kappa=0.85). Conclusions We developed a novel customized PRB/NICHD fetal growth standard from fetal data in an African American population without assuming proportionality of the effects of covariates and also without assuming that these effects are equal on all centiles of weight; we also provide an easy-to-use centile calculator. This standard classified more fetuses as being at risk for SGA compared to existing standards, especially among fetuses delivered preterm, but classified about the same number of LGA fetuses. The comparison among the four growth standards also revealed that the most important factor determining agreement among standards is whether they account for the same factors known to affect fetal growth. PMID:29422207

A comparative study of three cytotoxicity test methods for nanomaterials using sodium lauryl sulfate.

PubMed

Kwon, Jae-Sung; Kim, Kwang-Mahn; Kim, Kyoung-Nam

2014-10-01

The biocompatibility evaluation of nanomaterials is essential for their medical diagnostic and therapeutic usage, where a cytotoxicity test is the simplest form of biocompatibility evaluation. Three methods have been commonly used in previous studies for the cytotoxicity testing of nanomaterials: trypan blue exclusion, colorimetric assay using water soluble tetrazolium (WST), and imaging under a microscope following calcein AM/ethidium homodimer-1 staining. However, there has yet to be a study to compare each method. Therefore, in this study three methods were compared using the standard reference material of sodium lauryl sulfate (SLS). Each method of the cytotoxicity test was carried out using mouse fibroblasts of L-929 exposed to different concentrations of SLS. Compared to the gold standard trypan blue exclusion test, both colorimetric assay using water soluble tetrazolium (WST) and imaging under microscope with calcein AM/ethidium homodimer-1 staining showed results that were not statistically different. Also, each method exhibited various advantages and disadvantages, which included the need of equipment, time taken for the experiment, and provision of additional information such as cell morphology. Therefore, this study concludes that all three methods of cytotoxicity testing may be valid, though careful consideration will be needed when selecting tests with regard to time, finances, and the amount of information required by the researcher(s).

A Standard Mammography Unit - Standard 3D Ultrasound Probe Fusion Prototype: First Results.

PubMed

Schulz-Wendtland, Rüdiger; Jud, Sebastian M; Fasching, Peter A; Hartmann, Arndt; Radicke, Marcus; Rauh, Claudia; Uder, Michael; Wunderle, Marius; Gass, Paul; Langemann, Hanna; Beckmann, Matthias W; Emons, Julius

2017-06-01

The combination of different imaging modalities through the use of fusion devices promises significant diagnostic improvement for breast pathology. The aim of this study was to evaluate image quality and clinical feasibility of a prototype fusion device (fusion prototype) constructed from a standard tomosynthesis mammography unit and a standard 3D ultrasound probe using a new method of breast compression. Imaging was performed on 5 mastectomy specimens from patients with confirmed DCIS or invasive carcinoma (BI-RADS ™ 6). For the preclinical fusion prototype an ABVS system ultrasound probe from an Acuson S2000 was integrated into a MAMMOMAT Inspiration (both Siemens Healthcare Ltd) and, with the aid of a newly developed compression plate, digital mammogram and automated 3D ultrasound images were obtained. The quality of digital mammogram images produced by the fusion prototype was comparable to those produced using conventional compression. The newly developed compression plate did not influence the applied x-ray dose. The method was not more labour intensive or time-consuming than conventional mammography. From the technical perspective, fusion of the two modalities was achievable. In this study, using only a few mastectomy specimens, the fusion of an automated 3D ultrasound machine with a standard mammography unit delivered images of comparable quality to conventional mammography. The device allows simultaneous ultrasound - the second important imaging modality in complementary breast diagnostics - without increasing examination time or requiring additional staff.

Breast Tissue Characterization with Photon-counting Spectral CT Imaging: A Postmortem Breast Study

PubMed Central

Ding, Huanjun; Klopfer, Michael J.; Ducote, Justin L.; Masaki, Fumitaro

2014-01-01

Purpose To investigate the feasibility of breast tissue characterization in terms of water, lipid, and protein contents with a spectral computed tomographic (CT) system based on a cadmium zinc telluride (CZT) photon-counting detector by using postmortem breasts. Materials and Methods Nineteen pairs of postmortem breasts were imaged with a CZT-based photon-counting spectral CT system with beam energy of 100 kVp. The mean glandular dose was estimated to be in the range of 1.8–2.2 mGy. The images were corrected for pulse pile-up and other artifacts by using spectral distortion corrections. Dual-energy decomposition was then applied to characterize each breast into water, lipid, and protein contents. The precision of the three-compartment characterization was evaluated by comparing the composition of right and left breasts, where the standard error of the estimations was determined. The results of dual-energy decomposition were compared by using averaged root mean square to chemical analysis, which was used as the reference standard. Results The standard errors of the estimations of the right-left correlations obtained from spectral CT were 7.4%, 6.7%, and 3.2% for water, lipid, and protein contents, respectively. Compared with the reference standard, the average root mean square error in breast tissue composition was 2.8%. Conclusion Spectral CT can be used to accurately quantify the water, lipid, and protein contents in breast tissue in a laboratory study by using postmortem specimens. © RSNA, 2014 PMID:24814180

Realization of improved metallization-Ti/Al/Ti/W/Au ohmic contacts to n-GaN for high temperature application

NASA Astrophysics Data System (ADS)

Motayed, A.; Davydov, A. V.; Boettinger, W. J.; Josell, D.; Shapiro, A. J.; Levin, I.; Zheleva, T.; Harris, G. L.

2005-05-01

Tungsten metal layer was used for the first time as an effective diffusion barrier for the standard Ti/Al/Ti/Au ohmic metallization scheme to obtain thermally stable ohmic contact suitable for high temperature applications. Comparative studies were performed on three distinct metallization schemes: 1) standard GaN/Ti/Al/Ti/Au, 2) GaN/Ti/Al/W/Au, and 3) GaN/Ti/Al/Ti/W/Au. For the GaN with doping level of 5 × 1017 cm-3, the lowest specific contact resistance for the Ti/Al/Ti/W/Au metallization scheme annealed in argon at 750 °C for 30 sec was 5 × 10-6 .cm2, which is comparable to the standard Ti/Al/Ti/Au scheme. X-ray diffractions (XRD), auger electron spectroscopy (AES) depth profiling, field-emission scanning electron microscopy (FE-SEM), atomic force microscopy (AFM), and cross-sectional transmission electron microscopy (TEM) revealed that the Ti/Al/Ti/W/Au metallization has superior morphology and microstructural properties compared to standard Ti/Al/Ti/Au metallizations. Remarkably, this metallization was able to withstand thermal aging at 500 °C for 50 hrs with only marginal morphological and electrical deterioration. These studies revealed that the utilization of a compound diffusion barrier stack, as in the Ti/Al/Ti/W/Au metallization, yields electrically, structurally, and morphologically superior metallizations with exceptional thermal stability.

Dual mobility cups provide biomechanical advantages in situations at risk for dislocation: a finite element analysis.

PubMed

Terrier, Alexandre; Latypova, Adeliya; Guillemin, Maika; Parvex, Valérie; Guyen, Olivier

2017-03-01

Constrained devices, standard implants with large heads, and dual mobility systems have become popular options to manage instability after total hip arthroplasty (THA). Clinical results with these options have shown variable success rates and significant higher rates of aseptic loosening and mechanical failures with constrained implants. Literature suggests potential advantages of dual mobility, however little is known about its biomechanics. We present a comparative biomechanical study of a standard implant, a constrained implant, and a dual mobility system. A finite element analysis was developed to assess and compare these acetabular options with regard to the range of motion (ROM) to impingement, the angle of dislocation, the resistive torque, the volume of polyethylene (PE) with a stress above 80% of the elastic limit, and the interfacial cup/bone stress. Dual mobility implants provided the greatest ROM to impingement and allowed delaying subluxation and dislocation when compared to standard and constrained implants. Dual mobility also demonstrated the lowest resistive torque at subluxation while the constrained implant provided the greatest one. The lowest critical PE volume was observed with the dual mobility implant, and the highest stress at the interfaces was observed with the constrained implant. This study highlights the biomechanical advantages of dual mobility systems over constrained and standard implants, and is supported by the clinical results reported. Therefore, the use of dual mobility systems in situations at risk for instability should be advocated and constrained implants should be restricted to salvage situations.

Correcting the Standard Errors of 2-Stage Residual Inclusion Estimators for Mendelian Randomization Studies.

PubMed

Palmer, Tom M; Holmes, Michael V; Keating, Brendan J; Sheehan, Nuala A

2017-11-01

Mendelian randomization studies use genotypes as instrumental variables to test for and estimate the causal effects of modifiable risk factors on outcomes. Two-stage residual inclusion (TSRI) estimators have been used when researchers are willing to make parametric assumptions. However, researchers are currently reporting uncorrected or heteroscedasticity-robust standard errors for these estimates. We compared several different forms of the standard error for linear and logistic TSRI estimates in simulations and in real-data examples. Among others, we consider standard errors modified from the approach of Newey (1987), Terza (2016), and bootstrapping. In our simulations Newey, Terza, bootstrap, and corrected 2-stage least squares (in the linear case) standard errors gave the best results in terms of coverage and type I error. In the real-data examples, the Newey standard errors were 0.5% and 2% larger than the unadjusted standard errors for the linear and logistic TSRI estimators, respectively. We show that TSRI estimators with modified standard errors have correct type I error under the null. Researchers should report TSRI estimates with modified standard errors instead of reporting unadjusted or heteroscedasticity-robust standard errors. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Reporting of interventions and "standard of care" control arms in pediatric clinical trials: a quantitative analysis.

PubMed

Yu, Ashley M; Balasubramanaiam, Bannuya; Offringa, Martin; Kelly, Lauren E

2018-06-13

In pediatric medicine, the usual treatment received by children ("standard of care") varies across centers. Evaluations of new treatments often compare to the existing "standard of care" to determine if a treatment is more effective, has a better safety profile, or costs less. The objective of our study was to evaluate intervention and "standard of care" control arms reported in published pediatric clinical trials. Pediatric clinical trials, published in 2014, reporting the use of a "standard of care" control arm were included. Duplicate assessment of reporting completeness was done using the 12-item TIDieR (Template for Intervention Description and Replication) checklist for both the "standard of care" control arms and intervention arms within the same published study. Following screening, 214 pediatric trials in diverse therapeutic areas were included. Several different terms were used to describe "standard of care." There was a significant difference between the mean reported TIDieR checklist items of "standard of care" control arms (5.81 (SD 2.13) and intervention arms (8.45 (SD 1.39, p < 0.0001). Reporting of intervention and "standard of care" control arms in pediatric clinical trials should be improved as current "standard of care" reporting deficiencies limit reproducibility of research and may ultimately contribute to research waste.

Software thresholds alter the bias of actigraphy for monitoring sleep in team-sport athletes.

PubMed

Fuller, Kate L; Juliff, Laura; Gore, Christopher J; Peiffer, Jeremiah J; Halson, Shona L

2017-08-01

Actical ® actigraphy is commonly used to monitor athlete sleep. The proprietary software, called Actiware ® , processes data with three different sleep-wake thresholds (Low, Medium or High), but there is no standardisation regarding their use. The purpose of this study was to examine validity and bias of the sleep-wake thresholds for processing Actical ® sleep data in team sport athletes. Validation study comparing actigraph against accepted gold standard polysomnography (PSG). Sixty seven nights of sleep were recorded simultaneously with polysomnography and Actical ® devices. Individual night data was compared across five sleep measures for each sleep-wake threshold using Actiware ® software. Accuracy of each sleep-wake threshold compared with PSG was evaluated from mean bias with 95% confidence limits, Pearson moment-product correlation and associated standard error of estimate. The Medium threshold generated the smallest mean bias compared with polysomnography for total sleep time (8.5min), sleep efficiency (1.8%) and wake after sleep onset (-4.1min); whereas the Low threshold had the smallest bias (7.5min) for wake bouts. Bias in sleep onset latency was the same across thresholds (-9.5min). The standard error of the estimate was similar across all thresholds; total sleep time ∼25min, sleep efficiency ∼4.5%, wake after sleep onset ∼21min, and wake bouts ∼8 counts. Sleep parameters measured by the Actical ® device are greatly influenced by the sleep-wake threshold applied. In the present study the Medium threshold produced the smallest bias for most parameters compared with PSG. Given the magnitude of measurement variability, confidence limits should be employed when interpreting changes in sleep parameters. Copyright © 2017 Sports Medicine Australia. All rights reserved.

Dabigatran Levels in Elderly Patients with Atrial Fibrillation: First Post-Marketing Experiences.

PubMed

Bolek, Tomáš; Samoš, Matej; Škorňová, Ingrid; Stančiaková, Lucia; Staško, Ján; Galajda, Peter; Kubisz, Peter; Mokáň, Marián

2018-05-08

The number of elderly individuals with non-valvular atrial fibrillation (NV-AF) requiring long-term anticoagulation is rising. The pharmacokinetics of oral anticoagulants in elderly individuals may differ from that for younger patients. The aim of this study was to assess the dabigatran levels in elderly patients with NV-AF. A pilot prospective post-marketing study in patients with NV-AF on dabigatran therapy was performed; we enrolled 21 consecutive elderly patients (aged ≥ 75 years) on a reduced dabigatran regimen (110 mg twice daily) and compared them with 13 younger (≤ 70 years) individuals on reduced dabigatran therapy due to renal impairment and with 16 younger patients on standard dabigatran therapy (150 mg twice daily). Blood samples were taken for the assessment of dabigatran trough and peak levels. Dabigatran levels were measured with the Hemoclot ® Thrombin Inhibitor Assay. There were significant differences in dabigatran trough levels when comparing elderly patients on reduced dabigatran with non-elderly patients on reduced dabigatran (99.3 ± 73.6 vs 51.6 ± 25.6 ng/mL; p < 0.01). Similarly, the detected dabigatran peak levels were significantly higher in elderly patients on reduced dabigatran compared with non-elderly patients on reduced dabigatran (173.4 ± 116.2 vs 116.1 ± 19.1 ng/mL; p < 0.01). No significant differences in dabigatran trough and peak levels were found when comparing elderly patients on reduced dabigatran with non-elderly patients on standard dabigatran therapy. This pilot study demonstrated that elderly patients on reduced dabigatran exhibit significantly higher dabigatran levels than younger individuals on a reduced regimen, and similar levels compared with younger individuals on standard dabigatran.

Housekeeping genes as internal standards: use and limits.

PubMed

Thellin, O; Zorzi, W; Lakaye, B; De Borman, B; Coumans, B; Hennen, G; Grisar, T; Igout, A; Heinen, E

1999-10-08

Quantitative studies are commonly realised in the biomedical research to compare RNA expression in different experimental or clinical conditions. These quantifications are performed through their comparison to the expression of the housekeeping gene transcripts like glyceraldehyde-3-phosphate dehydrogenase (G3PDH), albumin, actins, tubulins, cyclophilin, hypoxantine phsophoribosyltransferase (HRPT), L32. 28S, and 18S rRNAs are also used as internal standards. In this paper, it is recalled that the commonly used internal standards can quantitatively vary in response to various factors. Possible variations are illustrated using three experimental examples. Preferred types of internal standards are then proposed for each of these samples and thereafter the general procedure concerning the choice of an internal standard and the way to manage its uses are discussed.

Realism of Indian Summer Monsoon Simulation in a Quarter Degree Global Climate Model

NASA Astrophysics Data System (ADS)

Salunke, P.; Mishra, S. K.; Sahany, S.; Gupta, K.

2017-12-01

This study assesses the fidelity of Indian Summer Monsoon (ISM) simulations using a global model at an ultra-high horizontal resolution (UHR) of 0.25°. The model used was the atmospheric component of the Community Earth System Model version 1.2.0 (CESM 1.2.0) developed at the National Center for Atmospheric Research (NCAR). Precipitation and temperature over the Indian region were analyzed for a wide range of space and time scales to evaluate the fidelity of the model under UHR, with special emphasis on the ISM simulations during the period of June-through-September (JJAS). Comparing the UHR simulations with observed data from the India Meteorological Department (IMD) over the Indian land, it was found that 0.25° resolution significantly improved spatial rainfall patterns over many regions, including the Western Ghats and the South-Eastern peninsula as compared to the standard model resolution. Convective and large-scale rainfall components were analyzed using the European Centre for Medium Range Weather Forecast (ECMWF) Re-Analysis (ERA)-Interim (ERA-I) data and it was found that at 0.25° resolution, there was an overall increase in the large-scale component and an associated decrease in the convective component of rainfall as compared to the standard model resolution. Analysis of the diurnal cycle of rainfall suggests a significant improvement in the phase characteristics simulated by the UHR model as compared to the standard model resolution. Analysis of the annual cycle of rainfall, however, failed to show any significant improvement in the UHR model as compared to the standard version. Surface temperature analysis showed small improvements in the UHR model simulations as compared to the standard version. Thus, one may conclude that there are some significant improvements in the ISM simulations using a 0.25° global model, although there is still plenty of scope for further improvement in certain aspects of the annual cycle of rainfall.

A Standard System to Study Vertebrate Embryos

PubMed Central

Werneburg, Ingmar

2009-01-01

Staged embryonic series are important as reference for different kinds of biological studies. I summarise problems that occur when using ‘staging tables’ of ‘model organisms’. Investigations of developmental processes in a broad scope of taxa are becoming commonplace. Beginning in the 1990s, methods were developed to quantify and analyse developmental events in a phylogenetic framework. The algorithms associated with these methods are still under development, mainly due to difficulties of using non-independent characters. Nevertheless, the principle of comparing clearly defined newly occurring morphological features in development (events) in quantifying analyses was a key innovation for comparative embryonic research. Up to date no standard was set for how to define such events in a comparative approach. As a case study I compared the external development of 23 land vertebrate species with a focus on turtles, mainly based on reference staging tables. I excluded all the characters that are only identical for a particular species or general features that were only analysed in a few species. Based on these comparisons I defined 104 developmental characters that are common either for all vertebrates (61 characters), gnathostomes (26), tetrapods (3), amniotes (7), or only for sauropsids (7). Characters concern the neural tube, somite, ear, eye, limb, maxillary and mandibular process, pharyngeal arch, eyelid or carapace development. I present an illustrated guide listing all the defined events. This guide can be used for describing developmental series of any vertebrate species or for documenting specimen variability of a particular species. The guide incorporates drawings and photographs as well as consideration of species identifying developmental features such as colouration. The simple character-code of the guide is extendable to further characters pertaining to external and internal morphological, physiological, genetic or molecular development, and also for other vertebrate groups not examined here, such as Chondrichthyes or Actinopterygii. An online database to type in developmental events for different stages and species could be a basis for further studies in comparative embryology. By documenting developmental events with the standard code, sequence heterochrony studies (i.e. Parsimov) and studies on variability can use this broad comparative data set. PMID:19521537

Effectiveness of prehospital continuous positive airway pressure in the management of acute pulmonary edema.

PubMed

Hubble, Michael W; Richards, Michael E; Jarvis, Roger; Millikan, Tori; Young, Dwayne

2006-01-01

To compare the effectiveness of continuous positive airway pressure (CPAP) with standard pharmacologic treatment in the management of prehospital acute pulmonary edema. Using a nonrandomized control group design, all consecutive patients presenting to two participating emergency medical services (EMS) systems with a field impression of acute pulmonary edema between July 1, 2004, and June 30, 2005, were included in the study. The control EMS system patients received standard treatment with oxygen, nitrates, furosemide, morphine, and, if indicated, endotracheal intubation. The intervention EMS system patients received CPAP via face mask at 10 cm H2O in addition to standard therapy. Ninety-five patients received standard therapy, and 120 patients received CPAP and standard therapy. Intubation was required in 8.9% of CPAP-treated patients compared with 25.3% in the control group (p = 0.003), and mortality was lower in the CPAP group than in the control group (5.4% vs. 23.2%; p = 0.000). When compared with the control group, the CPAP group had more improvement in respiratory rate (-4.55 vs. -1.81; p = 0.001), pulse rate (-4.77 vs. 0.82; p = 0.013), and dyspnea score (-2.11 vs. -1.36; p = 0.008). Using logistic regression to control for potential confounders, patients receiving standard treatment were more likely to be intubated (odds ratio, 4.04; 95% confidence interval, 1.64 to 9.95) and more likely to die (odds ratio, 7.48; 95% confidence interval, 1.96 to 28.54) than those receiving standard therapy and CPAP. The prehospital use of CPAP is feasible, may avert the need for endotracheal intubation, and may reduce short-term mortality.

An examination of racial bias in the Beck Depression Inventory-II.

PubMed

Sashidharan, Tracy; Pawlow, Laura A; Pettibone, Jonathan C

2012-04-01

Historically, many psychological measures were developed and standardized based on a primarily Caucasian population. These tests are subsequently applied to minorities and may be inappropriate and possibly even pathologizing. The widely used Beck Depression Inventory-II (BDI-II) was initially standardized on a sample of Caucasian university students and its use with minorities has only recently been investigated. This study examined the possibility of racial bias in the BDI-II by comparing Caucasian and African American Midwestern university students. A hierarchical multiple regression compared the scores of the BDI-II with a similar measure of depression that is standardized for use with African Americans. There was no evidence of racial bias discovered in the BDI-II in this sample. Implications and future directions of research are discussed. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Aircraft pollution in the vicinity of airports

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

Segal, H.M.

1981-01-01

A study carried out by the FAA and the Environmental Protection Agency that reassessed the impact of aircraft emissions on air quality around airports is discussed. Improvements in measuring techniques, for example, the use of vertical towers at different elevations, made it possible to compare emissions with the National Ambient Air Quality Standards (NAAQS). For CO, it was found that one-hour average concentrations never exceeded seven ppm, which is to be compared with the 35 ppm limiting level of the NAAQS. Emissions of NO/sub 2/ were only 10% of the long-term NAAQS standard. With regard to the short-term standard, however,more » the measurements were inconclusive because it is not yet known how much of the NO emitted by the engine is converted into NO/sub 2/ before reaching populated areas.« less

Diagnostic Performance of a Novel Coronary CT Angiography Algorithm: Prospective Multicenter Validation of an Intracycle CT Motion Correction Algorithm for Diagnostic Accuracy.

PubMed

Andreini, Daniele; Lin, Fay Y; Rizvi, Asim; Cho, Iksung; Heo, Ran; Pontone, Gianluca; Bartorelli, Antonio L; Mushtaq, Saima; Villines, Todd C; Carrascosa, Patricia; Choi, Byoung Wook; Bloom, Stephen; Wei, Han; Xing, Yan; Gebow, Dan; Gransar, Heidi; Chang, Hyuk-Jae; Leipsic, Jonathon; Min, James K

2018-06-01

Motion artifact can reduce the diagnostic accuracy of coronary CT angiography (CCTA) for coronary artery disease (CAD). The purpose of this study was to compare the diagnostic performance of an algorithm dedicated to correcting coronary motion artifact with the performance of standard reconstruction methods in a prospective international multicenter study. Patients referred for clinically indicated invasive coronary angiography (ICA) for suspected CAD prospectively underwent an investigational CCTA examination free from heart rate-lowering medications before they underwent ICA. Blinded core laboratory interpretations of motion-corrected and standard reconstructions for obstructive CAD (≥ 50% stenosis) were compared with ICA findings. Segments unevaluable owing to artifact were considered obstructive. The primary endpoint was per-subject diagnostic accuracy of the intracycle motion correction algorithm for obstructive CAD found at ICA. Among 230 patients who underwent CCTA with the motion correction algorithm and standard reconstruction, 92 (40.0%) had obstructive CAD on the basis of ICA findings. At a mean heart rate of 68.0 ± 11.7 beats/min, the motion correction algorithm reduced the number of nondiagnostic scans compared with standard reconstruction (20.4% vs 34.8%; p < 0.001). Diagnostic accuracy for obstructive CAD with the motion correction algorithm (62%; 95% CI, 56-68%) was not significantly different from that of standard reconstruction on a per-subject basis (59%; 95% CI, 53-66%; p = 0.28) but was superior on a per-vessel basis: 77% (95% CI, 74-80%) versus 72% (95% CI, 69-75%) (p = 0.02). The motion correction algorithm was superior in subgroups of patients with severely obstructive (≥ 70%) stenosis, heart rate ≥ 70 beats/min, and vessels in the atrioventricular groove. The motion correction algorithm studied reduces artifacts and improves diagnostic performance for obstructive CAD on a per-vessel basis and in selected subgroups on a per-subject basis.

Comparison of visual field test results obtained through Humphrey matrix frequency doubling technology perimetry versus standard automated perimetry in healthy children.

PubMed

Kocabeyoglu, Sibel; Uzun, Salih; Mocan, Mehmet Cem; Bozkurt, Banu; Irkec, Murat; Orhan, Mehmet

2013-10-01

The aim of this study was to compare the visual field test results in healthy children obtained via the Humphrey matrix 24-2 threshold program and standard automated perimetry (SAP) using the Swedish interactive threshold algorithm (SITA)-Standard 24-2 test. This prospective study included 55 healthy children without ocular or systemic disorders who underwent both SAP and frequency doubling technology (FDT) perimetry visual field testing. Visual field test reliability indices, test duration, global indices (mean deviation [MD], and pattern standard deviation [PSD]) were compared between the 2 tests using the Wilcoxon signed-rank test and paired t-test. The performance of the Humphrey field analyzer (HFA) 24-2 SITA-standard and frequency-doubling technology Matrix 24-2 tests between genders were compared with Mann-Whitney U-test. Fifty-five healthy children with a mean age of 12.2 ± 1.9 years (range from 8 years to 16 years) were included in this prospective study. The test durations of SAP and FDT were similar (5.2 ± 0.5 and 5.1 ± 0.2 min, respectively, P = 0.651). MD and the PSD values obtained via FDT Matrix were significantly higher than those obtained via SAP (P < 0.001), and fixation losses and false negative errors were significantly less with SAP (P < 0.05). A weak positive correlation between the two tests in terms of MD (r = 0.352, P = 0.008) and PSD (r = 0.329, P = 0.014) was observed. Children were able to complete both the visual test algorithms successfully within 6 min. However, SAP testing appears to be associated with less depression of the visual field indices of healthy children. FDT Matrix and SAP should not be used interchangeably in the follow-up of children.

Estimating site index of ponderosa pine in Northern California...standard curves, soil series, stem analysis

Treesearch

Robert F. Powers

1972-01-01

Four sets of standard site index curves based on statewide or regionwide averages were compared with data on natural growth from nine young stands of ponderosa pine in northern California. The curves tested were by Meyer; Dunning; Dunning and Reineke; and Arvanitis, Lindquist, and Palley. The effects of soils on height growth were also studied. Among the curves tested...

Comparison of Body Mass Index (BMI) Categories Based on Asian and Universal Standards and Language Spoken at Home among Asian American University Students

ERIC Educational Resources Information Center

Ng, Tiffany; McMahan, Shari; Mouttapa, Michele; Tanjasiri, Sora Park; Beam, William

2009-01-01

Background: The World Health Organization released lower Body Mass Index (BMI) cutoff points for Asian individuals to account for increased body fat percentage (BF%) and risk of obesity-related conditions at a lower body mass index. Purpose: This preliminary study: (1) explores the impact of utilizing Asian BMI standards (compared to universal…

The Impact of Year-Round Education on Fifth Grade African American Reading Achievement Scores in an Urban Illinois School

ERIC Educational Resources Information Center

Merrill, Carolyn Ann

2012-01-01

The purpose of this quantitative, causal-comparative study was to determine the impact of the year-round education school calendar on the standardized test performance of fifth grade African American students, as measured by the Illinois Standards Achievement Test (ISAT) in reading. The ISAT reading scores from two year-round education (YRE)…

A study of response time of pitot pressure probes designed for rapid response and protection of transducer

NASA Technical Reports Server (NTRS)

Moore, J. A.

1979-01-01

An eight orifice probe, designed to protect the transducer without the use of a baffle, was compared to a standard orifice-baffle probe in the small shock tube and in the expansion tube under normal run conditions. In both facilities, the response time of eight orifice probe was considerable better than the standard probe design.

A Comparison of Kernel Equating and Traditional Equipercentile Equating Methods and the Parametric Bootstrap Methods for Estimating Standard Errors in Equipercentile Equating

ERIC Educational Resources Information Center

Choi, Sae Il

2009-01-01

This study used simulation (a) to compare the kernel equating method to traditional equipercentile equating methods under the equivalent-groups (EG) design and the nonequivalent-groups with anchor test (NEAT) design and (b) to apply the parametric bootstrap method for estimating standard errors of equating. A two-parameter logistic item response…

Comparison of Nutrient Content and Cost of Home-Packed Lunches to Reimbursable School Lunch Nutrient Standards and Prices

ERIC Educational Resources Information Center

Johnson, Cara M.; Bednar, Carolyn; Kwon, Junehee; Gustof, Alissa

2009-01-01

Purpose: The purpose of this study was to compare nutrient content and cost of home-packed lunches to nutrient standards and prices for reimbursable school lunches. Methods: Researchers observed food and beverage contents of 333 home packed lunches at four north Texas elementary schools. Nutritionist Pro was used to analyze lunches for calories,…

An echocardiographic study of healthy Border Collies with normal reference ranges for the breed.

PubMed

Jacobson, Jake H; Boon, June A; Bright, Janice M

2013-06-01

The objectives of this study were to obtain standard echocardiographic measurements from healthy Border Collies and to compare these measurements to those previously reported for a general population of dogs. Standard echocardiographic data were obtained from twenty apparently healthy Border Collie dogs. These data (n = 20) were compared to data obtained from a general population of healthy dogs (n = 69). Border Collies were deemed healthy based on normal history, physical examination, complete blood count, serum biochemical profile, electrocardiogram, and blood pressure, with no evidence of congenital or acquired heart disease on echocardiographic examination. Standard two dimensional, M-mode, and Doppler echocardiographic measurements were obtained and normal ranges determined. The data were compared to data previously obtained at our hospital from a general population of normal dogs. Two dimensional, M-mode, and Doppler reference ranges for healthy Border Collies are presented in tabular form. Comparison of the weight adjusted M-mode echocardiographic means from Border Collies to those from the general population of dogs showed Border Collies to have larger left ventricular systolic and diastolic dimensions, smaller interventricular septal thickness, and lower fractional shortening. There are differences in some echocardiographic parameters between healthy Border Collies and the general dog population, and the echocardiographic reference ranges provided in this study should be used as breed specific reference values for Border Collies. Copyright © 2013 Elsevier B.V. All rights reserved.

Is a videotape to change beliefs and behaviors superior to a standard videotape in acute low back pain? A randomized controlled trial.

PubMed

Newcomer, Karen L; Vickers Douglas, Kristin S; Shelerud, Randy A; Long, Kirsten Hall; Crawford, Brianna

2008-01-01

Cognitive behavioral therapy has been used successfully in acute low back pain (LBP) treatment, but the use of a cognitive behavioral videotape as an adjunct to treatment has not been studied. To determine outcomes for patients with acute LBP receiving a videotape designed to change beliefs and behaviors compared with a standard instructional videotape. Randomized controlled trial; multidisciplinary clinic in an academic setting. Consecutive subjects with less than 3 months of LBP. Of 224 eligible subjects, 138 participated and completed the initial questionnaires. Oswestry Disability Index, Pain and Impairment Relationship Scale, Fear-Avoidance Beliefs Questionnaire; medical costs related to LBP and total medical costs incurred by participants during 1 year of follow-up. Subjects were randomly assigned to receive a behavioral videotape or a control videotape. Other than the videotape, usual care was provided to each patient. No significant differences in any outcome measures or medical costs between the two groups at 12 months. However, baseline Vermont Disability Prediction Questionnaire was significantly lower in those who completed the entire study compared with those who did not complete the study. Compared with a standard instructional videotape, a behavioral videotape did not change beliefs, outcomes, or costs over 1 year. Cost-effective behavioral interventions with high patient retention rates are needed, especially for those at greatest risk of high utilization of resources.

Add-on deep Transcranial Magnetic Stimulation (dTMS) for the treatment of chronic migraine: A preliminary study.

PubMed

Rapinesi, Chiara; Del Casale, Antonio; Scatena, Paola; Kotzalidis, Georgios D; Di Pietro, Simone; Ferri, Vittoria Rachele; Bersani, Francesco Saverio; Brugnoli, Roberto; Raccah, Ruggero Nessim; Zangen, Abraham; Ferracuti, Stefano; Orzi, Francesco; Girardi, Paolo; Sette, Giuliano

2016-06-03

Deep Transcranial Magnetic Stimulation (dTMS) can be an alternative treatment to relieve pain in chronic migraine (CM). The aim of this study was to evaluate the effect of high-frequency dTMS in add-on to standard treatment for CM in patients not responding to effective abortive or preventive drug treatment. We randomized 14 patients with International Classification of Headache Disorders, 3rd Edition (ICHD-3) treatment-resistant CM to add-on dTMS (n=7) or standard abortive or preventive antimigraine treatment (n=7). Three sessions of alternate day 10Hz dTMS consisting of 600 pulses in 10 trains were delivered to the dorsolateral prefrontal cortex (DLPFC), bilaterally, but with left hemisphere prevalence, for 12 sessions spread over one month. The add-on dTMS treatment was well tolerated. Patients treated with dTMS showed significant reduction of pain intensity, frequency of attacks, analgesic overuse, and depressive symptoms during treatment and one month later, compared to the month preceding treatment and at the same time-points compared to the control group. As compared to standard pharmacological treatment alone, add-on high-frequency dTMS of the bilateral DLPFC reduced the frequency and intensity of migraine attack, drug overuse, and depressive symptoms. This study supports the add-on dTMS treatment in treatment-resistant CM. Copyright © 2016. Published by Elsevier Ireland Ltd.

Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises

PubMed Central

2012-01-01

Background Disaster medicine is a fairly young scientific discipline and there is a need for the development of new methods for evaluation and research. This includes full-scale disaster exercisers. A standardized concept on how to evaluate these exercises, could lead to easier identification of pitfalls caused by system-errors in the organization. The aim of this study was to demonstrate the feasibility of using a combination of performance and outcome indicators so that results can be compared in standardized full-scale exercises. Methods Two multidisciplinary, full-scale exercises were studied in 2008 and 2010. The panorama had the same setup. Sets of performance indicators combined with indicators for unfavorable patient outcome were recorded in predesigned templates. Evaluators, all trained in a standardized way at a national disaster medicine centre, scored the results on predetermined locations; at the scene, at hospital and at the regional command and control. Results All data regarding the performance indicators of the participants during the exercises were obtained as well as all data regarding indicators for patient outcome. Both exercises could therefore be compared regarding performance (processes) as well as outcome indicators. The data from the performance indicators during the exercises showed higher scores for the prehospital command in the second exercise 15 points and 3 points respectively. Results from the outcome indicators, patient survival and patient complications, demonstrated a higher number of preventable deaths and a lower number of preventable complications in the exercise 2010. In the exercise 2008 the number of preventable deaths was lower and the number of preventable complications was higher. Conclusions Standardized multidisciplinary, full-scale exercises in different settings can be conducted and evaluated with performance indicators combined with outcome indicators enabling results from exercises to be compared. If exercises are performed in a standardized way, results may serve as a basis for lessons learned. Future use of the same concept using the combination of performance indicators and patient outcome indicators may demonstrate new and important evidence that could lead to new and better knowledge that also may be applied during real incidents. PMID:22929479

Combining performance and outcome indicators can be used in a standardized way: a pilot study of two multidisciplinary, full-scale major aircraft exercises.

PubMed

Rådestad, Monica; Nilsson, Heléne; Castrén, Maaret; Svensson, Leif; Rüter, Anders; Gryth, Dan

2012-08-28

Disaster medicine is a fairly young scientific discipline and there is a need for the development of new methods for evaluation and research. This includes full-scale disaster exercisers. A standardized concept on how to evaluate these exercises, could lead to easier identification of pitfalls caused by system-errors in the organization. The aim of this study was to demonstrate the feasibility of using a combination of performance and outcome indicators so that results can be compared in standardized full-scale exercises. Two multidisciplinary, full-scale exercises were studied in 2008 and 2010. The panorama had the same setup. Sets of performance indicators combined with indicators for unfavorable patient outcome were recorded in predesigned templates. Evaluators, all trained in a standardized way at a national disaster medicine centre, scored the results on predetermined locations; at the scene, at hospital and at the regional command and control. All data regarding the performance indicators of the participants during the exercises were obtained as well as all data regarding indicators for patient outcome. Both exercises could therefore be compared regarding performance (processes) as well as outcome indicators. The data from the performance indicators during the exercises showed higher scores for the prehospital command in the second exercise 15 points and 3 points respectively. Results from the outcome indicators, patient survival and patient complications, demonstrated a higher number of preventable deaths and a lower number of preventable complications in the exercise 2010. In the exercise 2008 the number of preventable deaths was lower and the number of preventable complications was higher. Standardized multidisciplinary, full-scale exercises in different settings can be conducted and evaluated with performance indicators combined with outcome indicators enabling results from exercises to be compared. If exercises are performed in a standardized way, results may serve as a basis for lessons learned. Future use of the same concept using the combination of performance indicators and patient outcome indicators may demonstrate new and important evidence that could lead to new and better knowledge that also may be applied during real incidents.

Gold standards and expert panels: a pulmonary nodule case study with challenges and solutions

NASA Astrophysics Data System (ADS)

Miller, Dave P.; O'Shaughnessy, Kathryn F.; Wood, Susan A.; Castellino, Ronald A.

2004-05-01

Comparative evaluations of reader performance using different modalities, e.g. CT with computer-aided detection (CAD) vs. CT without CAD, generally require a "truth" definition based on a gold standard. There are many situations in which a true invariant gold standard is impractical or impossible to obtain. For instance, small pulmonary nodules are generally not assessed by biopsy or resection. In such cases, it is common to use a unanimous consensus or majority agreement from an expert panel as a reference standard for actionability in lieu of the unknown gold standard for disease. Nonetheless, there are three major concerns about expert panel reference standards: (1) actionability is not synonymous with disease (2) it may be possible to obtain different conclusions about which modality is better using different rules (e.g. majority vs. unanimous consensus), and (3) the variability associated with the panelists is not formally captured in the p-values or confidence intervals that are generally produced for estimating the extent to which one modality is superior to the other. A multi-reader-multi-case (MRMC) receiver operating characteristic (ROC) study was performed using 90 cases, 15 readers, and a reference truth based on 3 experienced panelists. The primary analyses were conducted using a reference truth of unanimous consensus regarding actionability (3 out of 3 panelists). To assess the three concerns noted above: (1) additional data from the original radiology reports were compared to the panel (2) the complete analysis was repeated using different definitions of truth, and (3) bootstrap analyses were conducted in which new truth panels were constructed by picking 1, 2, or 3 panelists at random. The definition of the reference truth affected the results for each modality (CT with CAD and CT without CAD) considered by itself, but the effects were similar, so the primary analysis comparing the modalities was robust to the choice of the reference truth.

New categories for traditional medicine in the Economic Botany Data Collection Standard.

PubMed

Gruca, Marta; Cámara-Leret, Rodrigo; Macía, Manuel J; Balslev, Henrik

2014-09-11

The Economic Botany Data Collection Standard (EBDCS) has been successfully followed by ethnobotanists investigating plant uses in many parts of the world. However, we have encountered some cases in our study of traditional medicine where the standard seems incomplete and inaccurate when it is applied to plant uses of rural or indigenous societies in developing countries. We propose two categories to be added to the EBDCS: Cultural Diseases and Disorders, and Ritual/Magical Uses. Adding these categories, we believe will give a more accurate insight into traditional medicine and will contribute to developing an integrative ethnomedicinal data collection protocol, which will make ethnomedicinal studies more comparable. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Comparison of standard automated perimetry with matrix frequency-doubling technology in patients with resolved optic neuritis.

PubMed

Sakai, Tsutomu; Matsushima, Masato; Shikishima, Keigo; Kitahara, Kenji

2007-05-01

To examine performance characteristics of frequency-doubling perimetry (FDP) in comparison with standard automated perimetry (SAP) in patients with resolved optic neuritis in a short-term follow-up study. Comparative consecutive case series. Twenty patients with resolved optic neuritis and 20 healthy volunteers participated in this study. The subjects were patients who recovered normal vision (1.0 or better) after optic neuritis. The Swedish interactive thresholding algorithm 30-2 program was used for SAP and a full-threshold 30-2 program was used for FDP. Using both forms of perimetry, the mean deviation (MD), pattern standard deviation (PSD), and the percentage of abnormal points significantly depressed <0.5% in the total deviation probability plot were compared. The visual fields were divided into 5 zones, and the mean sensitivity in each zone in affected eyes was compared with that in healthy eyes of the volunteers within 2 weeks of vision recovery and in follow-up after 2 weeks and 2 and 5 months. Standard automated perimetry and FDP showed general depression in the fovea and extrafoveal areas. Correlations between SAP and FDP were statistically significant for MD (Pearson r>0.75; P<0.001) and PSD (r>0.6; P<0.005). Defects detected with FDP were larger than with SAP in 14 eyes (70 %). In follow-up after 2 weeks and again after 2 and 5 months, FDP indicated slower improvement in visual field defects in the fovea and extrafoveal areas, whereas SAP indicated rapid improvement in these defects. Frequency-doubling perimetry is at least comparable with and potentially more sensitive than SAP in detecting visual field defects in resolved optic neuritis. This short-term follow-up study in patients with resolved optic neuritis suggests that FDP detects characteristics of slower recovery more effectively than SAP in the fovea and extrafoveal areas. These properties may allow more accurate detection of visual field defects and may prove advantageous for monitoring of patients with resolved optic neuritis.

Effects of Low Phytanic Acid-Concentrated DHA on Activated Microglial Cells: Comparison with a Standard Phytanic Acid-Concentrated DHA.

PubMed

Ruiz-Roso, María Belén; Olivares-Álvaro, Elena; Quintela, José Carlos; Ballesteros, Sandra; Espinosa-Parrilla, Juan F; Ruiz-Roso, Baltasar; Lahera, Vicente; de Las Heras, Natalia; Martín-Fernández, Beatriz

2018-05-30

Docosahexaenoic acid (DHA, 22:6 n-3) is an essential omega-3 (ω-3) long chain polyunsaturated fatty acid of neuronal membranes involved in normal growth, development, and function. DHA has been proposed to reduce deleterious effects in neurodegenerative processes. Even though, some inconsistencies in findings from clinical and pre-clinical studies with DHA could be attributed to the presence of phytanic acid (PhA) in standard DHA treatments. Thus, the aim of our study was to analyze and compare the effects of a low PhA-concentrated DHA with a standard PhA-concentrated DHA under different neurotoxic conditions in BV-2 activated microglial cells. To this end, mouse microglial BV-2 cells were stimulated with either lipopolysaccharide (LPS) or hydrogen peroxide (H 2 O 2 ) and co-incubated with DHA 50 ppm of PhA (DHA (PhA:50)) or DHA 500 ppm of PhA (DHA (PhA:500)). Cell viability, superoxide anion (O 2 - ) production, Interleukin 6 (L-6), cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), glutathione peroxidase (GtPx), glutathione reductase (GtRd), Caspase-3, and the brain-derived neurotrophic factor (BDNF) protein expression were explored. Low PhA-concentrated DHA protected against LPS or H 2 O 2 -induced cell viability reduction in BV-2 activated cells and O 2 - production reduction compared to DHA (PhA:500). Low PhA-concentrated DHA also decreased COX-2, IL-6, iNOS, GtPx, GtRd, and SOD-1 protein expression when compared to DHA (PhA:500). Furthermore, low PhA-concentrated DHA increased BDNF protein expression in comparison to DHA (PhA:500). The study provides data supporting the beneficial effect of low PhA-concentrated DHA in neurotoxic injury when compared to a standard PhA-concentrated DHA in activated microglia.

Upgrade to iterative image reconstruction (IR) in MDCT imaging: a clinical study for detailed parameter optimization beyond vendor recommendations using the adaptive statistical iterative reconstruction environment (ASIR) Part2: The chest.

PubMed

Mueck, F G; Michael, L; Deak, Z; Scherr, M K; Maxien, D; Geyer, L L; Reiser, M; Wirth, S

2013-07-01

To compare the image quality in dose-reduced 64-row CT of the chest at different levels of adaptive statistical iterative reconstruction (ASIR) to full-dose baseline examinations reconstructed solely with filtered back projection (FBP) in a realistic upgrade scenario. A waiver of consent was granted by the institutional review board (IRB). The noise index (NI) relates to the standard deviation of Hounsfield units in a water phantom. Baseline exams of the chest (NI = 29; LightSpeed VCT XT, GE Healthcare) were intra-individually compared to follow-up studies on a CT with ASIR after system upgrade (NI = 45; Discovery HD750, GE Healthcare), n = 46. Images were calculated in slice and volume mode with ASIR levels of 0 - 100 % in the standard and lung kernel. Three radiologists independently compared the image quality to the corresponding full-dose baseline examinations (-2: diagnostically inferior, -1: inferior, 0: equal, + 1: superior, + 2: diagnostically superior). Statistical analysis used Wilcoxon's test, Mann-Whitney U test and the intraclass correlation coefficient (ICC). The mean CTDIvol decreased by 53 % from the FBP baseline to 8.0 ± 2.3 mGy for ASIR follow-ups; p < 0.001. The ICC was 0.70. Regarding the standard kernel, the image quality in dose-reduced studies was comparable to the baseline at ASIR 70 % in volume mode (-0.07 ± 0.29, p = 0.29). Concerning the lung kernel, every ASIR level outperformed the baseline image quality (p < 0.001), with ASIR 30 % rated best (slice: 0.70 ± 0.6, volume: 0.74 ± 0.61). Vendors' recommendation of 50 % ASIR is fair. In detail, the ASIR 70 % in volume mode for the standard kernel and ASIR 30 % for the lung kernel performed best, allowing for a dose reduction of approximately 50 %. © Georg Thieme Verlag KG Stuttgart · New York.

Development of new method and protocol for cryopreservation related to embryo and oocytes freezing in terms of fertilization rate: A comparative study including review of literature.

PubMed

Barik, Mayadhar; Bajpai, Minu; Patnaik, Santosh; Mishra, Pravash; Behera, Priyamadhaba; Dwivedi, Sada Nanda

2016-01-01

Cryopreservation is basically related to meritorious thin samples or small clumps of cells that are cooled quickly without loss. Our main objective is to establish and formulate an innovative method and protocol development for cryopreservation as a gold standard for clinical uses in laboratory practice and treatment. The knowledge regarding usefulness of cryopreservation in clinical practice is essential to carry forward the clinical practice and research. We are trying to compare different methods of cryopreservation (in two dozen of cells) at the same time we compare the embryo and oocyte freezing interms of fertilization rate according to the International standard protocol. The combination of cryoprotectants and regimes of rapid cooling and rinsing during warming often allows successful cryopreservation of biological materials, particularly cell suspensions or thin tissue samples. Examples include semen, blood, tissue samples like tumors, histological cross-sections, human eggs and human embryos. Although presently many studies have reported that the children born from frozen embryos or "frosties," show consistently positive results with no increase in birth defects or development abnormalities is quite good enough and similar to our study (50-85%). We ensure that cryopreservation technology provided useful cell survivability, tissue and organ preservation in a proper way. Although it varies according to different laboratory conditions, it is certainly beneficial for patient's treatment and research. Further studies are needed for standardization and development of new protocol.

Effect of an interactive cardiopulmonary resuscitation assist device with an automated external defibrillator synchronised with a ventilator on the CPR performance of emergency medical service staff: a randomised simulation study.

PubMed

Nitzschke, Rainer; Doehn, Christoph; Kersten, Jan F; Blanz, Julian; Kalwa, Tobias J; Scotti, Norman A; Kubitz, Jens C

2017-04-04

The present study evaluates whether the quality of advanced cardiac life support (ALS) is improved with an interactive prototype assist device. This device consists of an automated external defibrillator linked to a ventilator and provides synchronised visual and acoustic instructions for guidance through the ALS algorithm and assistance for face-mask ventilations. We compared the cardiopulmonary resuscitation (CPR) quality of emergency medical system (EMS) staff members using the study device or standard equipment in a mannequin simulation study with a prospective, controlled, randomised cross-over study design. Main outcome was the effect of the study device compared to the standard equipment and the effect of the number of prior ALS trainings of the EMS staff on the CPR quality. Data were analysed using analyses of covariance (ANCOVA) and binary logistic regression, accounting for the study design. In 106 simulations of 56 two-person rescuer teams, the mean hands-off time was 24.5% with study equipment and 23.5% with standard equipment (Difference 1.0% (95% CI: -0.4 to 2.5%); p = 0.156). With both types of equipment, the hands-off time decreased with an increasing cumulative number of previous CPR trainings (p = 0.042). The study equipment reduced the mean time until administration of adrenaline (epinephrine) by 23 s (p = 0.003) and that of amiodarone by 17 s (p = 0.016). It also increased the mean number of changes in the person doing chest compressions (0.6 per simulation; p < 0.001) and decreased the mean number of chest compressions (2.8 per minute; p = 0.022) and the mean number of ventilations (1.8 per minute; p < 0.001). The chance of administering amiodarone at the appropriate time was higher, with an odds ratio of 4.15, with the use of the study equipment CPR.com compared to the standard equipment (p = 0.004). With an increasing number of prior CPR trainings, the time intervals in the ALS algorithm until the defibrillations decreased with standard equipment but increased with the study device. EMS staff with limited training in CPR profit from guidance through the ALS algorithm by the study device. However, the study device somehow reduced the ALS quality of well-trained rescuers and thus can only be recommended for ALS provider with limited experience.

Randomized comparison of the magnetic navigation system vs. standard wires in the treatment of bifurcations.

PubMed

Ramcharitar, Steve; van der Giessen, Willem J; van der Ent, Martin; Serruys, Patrick W; van Geuns, Robert Jan

2011-06-01

Aims Randomly compare the magnetic navigation system (MNS) to standard guidewire techniques in managing bifurcating lesions. Methods and results Thirty-one consecutive patients with bifurcating lesions were randomized to cross the bifurcating vessels prior to treatment and thereafter the struts of deployed stents with either magnetic or standard guidewires. Crossing success, crossing/fluoroscopy times, and contrast media usage were directly compared. Similar times were noted in both the magnetic wire crossings (median, IQR; 68 s, 45-138 s vs. 59 s, 32-133 s) and fluoroscopic times (median, IQR; 62 s, 44-135 s vs. 55 s, 27-133 s) when compared with standard conventional wires passage through the deployed struts. The MNS successful crossings were 30/31 (96.8%) compared with 28/31 (90.0%) observed with the standard wires. Two previously failed standard wire cases were successfully crossed with magnetic guidewires. Conclusion In contemporary stented bifurcations, the MNS achieved equivalent crossing/fluoroscopy times through deployed stents struts and may be useful in salvaging failed standard wire cases.

Evaluating the Comparability of Paper-and-Pencil and Computerized Versions of a Large-Scale Certification Test. Research Report. ETS RR-05-21

ERIC Educational Resources Information Center

Puhan, Gautam; Boughton, Keith A.; Kim, Sooyeon

2005-01-01

The study evaluated the comparability of two versions of a teacher certification test: a paper-and-pencil test (PPT) and computer-based test (CBT). Standardized mean difference (SMD) and differential item functioning (DIF) analyses were used as measures of comparability at the test and item levels, respectively. Results indicated that effect sizes…

Cost-effectiveness of a motivational intervention for alcohol-involved youth in a hospital emergency department.

PubMed

Neighbors, Charles J; Barnett, Nancy P; Rohsenow, Damaris J; Colby, Suzanne M; Monti, Peter M

2010-05-01

Brief interventions in the emergency department targeting risk-taking youth show promise to reduce alcohol-related injury. This study models the cost-effectiveness of a motivational interviewing-based intervention relative to brief advice to stop alcohol-related risk behaviors (standard care). Average cost-effectiveness ratios were compared between conditions. In addition, a cost-utility analysis examined the incremental cost of motivational interviewing per quality-adjusted life year gained. Microcosting methods were used to estimate marginal costs of motivational interviewing and standard care as well as two methods of patient screening: standard emergency-department staff questioning and proactive outreach by counseling staff. Average cost-effectiveness ratios were computed for drinking and driving, injuries, vehicular citations, and negative social consequences. Using estimates of the marginal effect of motivational interviewing in reducing drinking and driving, estimates of traffic fatality risk from drinking-and-driving youth, and national life tables, the societal costs per quality-adjusted life year saved by motivational interviewing relative to standard care were also estimated. Alcohol-attributable traffic fatality risks were estimated using national databases. Intervention costs per participant were $81 for standard care, $170 for motivational interviewing with standard screening, and $173 for motivational interviewing with proactive screening. The cost-effectiveness ratios for motivational interviewing were more favorable than standard care across all study outcomes and better for men than women. The societal cost per quality-adjusted life year of motivational interviewing was $8,795. Sensitivity analyses indicated that results were robust in terms of variability in parameter estimates. This brief intervention represents a good societal investment compared with other commonly adopted medical interventions.

Outcome after polytrauma in a certified trauma network: comparing standard vs. maximum care facilities concept of the study and study protocol (POLYQUALY).

PubMed

Koller, Michael; Ernstberger, Antonio; Zeman, Florian; Loss, Julika; Nerlich, Michael

2016-07-11

The aim of this study is to evaluate the performance of the first certified regional trauma network in Germany, the Trauma Network Eastern Bavaria (TNO) addressing the following specific research questions: Do standard and maximum care facilities produce comparable (risk-adjusted) levels of patient outcome? Does TNO outperform reference data provided by the German Trauma Register 2008? Does TNO comply with selected benchmarks derived from the S3 practice guideline? Which barriers and facilitators can be identified in the health care delivery processes for polytrauma patients? The design is based on a prospective multicenter cohort study comparing two cohorts of polytrauma patients: those treated in maximum care facilities and those treated in standard care facilities. Patient recruitment will take place in the 25 TNO clinics. It is estimated that n = 1.100 patients will be assessed for eligibility within a two-year period and n = 800 will be included into the study and analysed. Main outcome measures include the TraumaRegisterQM form, which has been implemented in the clinical routine since 2009 and is filled in via a web-based data management system in participating hospitals on a mandatory basis. Furthermore, patient-reported outcome is assessed using the EQ-5D at 6, 12 and 24 months after trauma. Comparisons will be drawn between the two cohorts. Further standards of comparisons are secondary data derived from German Trauma Registry as well as benchmarks from German S3 guideline on polytrauma. The qualitative part of the study will be based on semi-standardized interviews and focus group discussions with health care providers within TNO. The goal of the qualitative analysis is to elucidate which facilitating and inhibiting forces influence cooperation and performance within the network. This is the first study to evaluate a certified trauma network within the German health care system using a unique combination of a quantitative (prospective cohort study) and a qualitative (in-depth facilitator/barrier analysis) approach. The information generated by this project will be used in two ways. Firstly, within the region the results of the study will help to optimize the pre-hospital and clinical management of polytrauma patients. Secondly, on a nationwide scale, influential decision-making bodies, such as the Ministries of Health, the Hospital Associations, sickness funds, insurance companies and professional societies, will be addressed. The results will not only be applicable to the region of Eastern Bavaria, but also in most other parts of Germany with a comparable infrastructure. VfD_Polyqualy_12_001978 , 10.Jan.2013; German Clinical Trials Register DRKS00010039 , 18.02.2016.

Endoscope-assisted approach to excision of branchial cleft cysts.

PubMed

Teng, Stephanie E; Paul, Benjamin C; Brumm, John D; Fritz, Mark; Fang, Yixin; Myssiorek, David

2016-06-01

The purpose of this study is to describe an endoscope-assisted surgical technique for the excision of branchial cleft cysts and compare it to the standard approach. Retrospective case series review. Twenty-seven cases described as branchial cleft excisions performed by a single surgeon at one academic medical center were identified between 2007 and 2014. Twenty-five cases (8 endoscopic, 17 standard approach) were included in the study. Cases were excluded if final pathology was malignant. Patient charts were reviewed, and two techniques were compared through analysis of incision size, operative time, and surgical outcomes. This study showed that the length of incision required for the endoscopic approach (mean = 2.13 ± 0.23) was significantly less than that of the standard approach (mean = 4.10 ± 1.46, P = 0.008) despite the fact that there was no significant difference in cyst size between the two groups (P = 0.09). The other variables examined, including operative time and surgical outcomes, were not significantly different between the two groups. This transcervical endoscope-assisted approach to branchial cleft cyst excision is a viable option for uncomplicated cases. It provides better cosmetic results than the standard approach and does not negatively affect outcomes, increase operative time, or result in recurrence. 4. Laryngoscope, 126:1339-1342, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Bootstrap-after-bootstrap model averaging for reducing model uncertainty in model selection for air pollution mortality studies.

PubMed

Roberts, Steven; Martin, Michael A

2010-01-01

Concerns have been raised about findings of associations between particulate matter (PM) air pollution and mortality that have been based on a single "best" model arising from a model selection procedure, because such a strategy may ignore model uncertainty inherently involved in searching through a set of candidate models to find the best model. Model averaging has been proposed as a method of allowing for model uncertainty in this context. To propose an extension (double BOOT) to a previously described bootstrap model-averaging procedure (BOOT) for use in time series studies of the association between PM and mortality. We compared double BOOT and BOOT with Bayesian model averaging (BMA) and a standard method of model selection [standard Akaike's information criterion (AIC)]. Actual time series data from the United States are used to conduct a simulation study to compare and contrast the performance of double BOOT, BOOT, BMA, and standard AIC. Double BOOT produced estimates of the effect of PM on mortality that have had smaller root mean squared error than did those produced by BOOT, BMA, and standard AIC. This performance boost resulted from estimates produced by double BOOT having smaller variance than those produced by BOOT and BMA. Double BOOT is a viable alternative to BOOT and BMA for producing estimates of the mortality effect of PM.

Neural response in obsessive-compulsive washers depends on individual fit of triggers

PubMed Central

Baioui, Ali; Pilgramm, Juliane; Merz, Christian J.; Walter, Bertram; Vaitl, Dieter; Stark, Rudolf

2013-01-01

Background: Patients with obsessive-compulsive disorder (OCD) have highly idiosyncratic triggers. To fully understand which role this idiosyncrasy plays in the neurobiological mechanisms behind OCD, it is necessary to elucidate the impact of individualization regarding the applied investigation methods. This functional magnetic resonance imaging (fMRI) study explores the neural correlates of contamination/washing-related OCD with a highly individualized symptom provocation paradigm. Additionally, it is the first study to directly compare individualized and standardized symptom provocation. Methods: Nineteen patients with washing compulsions created individual OCD hierarchies, which later served as instructions to photograph their own individualized stimulus sets. The patients and 19 case-by-case matched healthy controls participated in a symptom provocation fMRI experiment with individualized and standardized stimulus sets created for each patient. Results: OCD patients compared to healthy controls displayed stronger activation in the basal ganglia (nucleus accumbens, nucleus caudatus, pallidum) for individualized symptom provocation. Using standardized symptom provocation, this group comparison led to stronger activation in the nucleus caudatus. The direct comparison of between-group effects for both symptom provocation approaches revealed stronger activation of the orbitofronto-striatal network for individualized symptom provocation. Conclusions: The present study provides insight into the differential impact of individualized and standardized symptom provocation on the orbitofronto-striatal network of OCD washers. Behavioral and neural responses imply a higher symptom-specificity of individualized symptom provocation. PMID:23630478

Telemedicine compared with standard care in type 2 diabetes mellitus: A randomized trial in an outpatient clinic.

PubMed

Rasmussen, Ole W; Lauszus, F F; Loekke, M

2016-09-01

Good metabolic control is important in type 2 diabetes mellitus to improve quality of life, work ability and life expectancy, and the use of telemedicine has proved efficient as an add-on to the usual treatment. However, few studies in type 2 diabetes patients have directly compared telemedicine with conventional outpatient treatment, and we wanted to evaluate whether telemedicine, compared with standard care, provides equivalent clinical outcomes. Forty patients with type 2 diabetes mellitus allocated from October 2011-July 2012 were randomized to either treatment at home by video conferences only or standard outpatient treatment. Primary outcomes were HbA1c and blood glucose levels and secondary outcomes were 24-hour blood pressure, cholesterol levels and albuminuria. The video-telephone was a broadband solution installed and serviced by the Danish Telephone Company (TDC). The improvements in the two treatments, given as changes in percentage of telemedicine vs standard, showed significant differences in HbA1c (-15 vs -11%), mean blood glucose (-18 vs -13%) and in cholesterol (-7 vs -6%). No differences in LDL (-4 vs -6%), weight (-1 vs 2%), diastolic diurnal blood pressure (-1 vs -7%), and systolic diurnal blood pressure (0 vs -1%) were found. Nine consultations were missed in the standard outpatient group and none in the telemedicine group. In the direct comparison of home video consultations vs standard outpatient treatment in type 2 diabetes mellitus, telemedicine was a safe and available option with favourable outcomes after six months treatment. © The Author(s) 2015.

Standardizing Type Ia supernovae optical brightness using near-infrared rebrightening time

NASA Astrophysics Data System (ADS)

Shariff, H.; Dhawan, S.; Jiao, X.; Leibundgut, B.; Trotta, R.; van Dyk, D. A.

2016-12-01

Accurate standardization of Type Ia supernovae (SNIa) is instrumental to the usage of SNIa as distance indicators. We analyse a homogeneous sample of 22 low-z SNIa, observed by the Carnegie Supernova Project in the optical and near-infrared (NIR). We study the time of the second peak in the J band, t2, as an alternative standardization parameter of SNIa peak optical brightness, as measured by the standard SALT2 parameter mB. We use BAHAMAS, a Bayesian hierarchical model for SNIa cosmology, to estimate the residual scatter in the Hubble diagram. We find that in the absence of a colour correction, t2 is a better standardization parameter compared to stretch: t2 has a 1σ posterior interval for the Hubble residual scatter of σΔμ = {0.250, 0.257} mag, compared to σΔμ = {0.280, 0.287} mag when stretch (x1) alone is used. We demonstrate that when employed together with a colour correction, t2 and stretch lead to similar residual scatter. Using colour, stretch and t2 jointly as standardization parameters does not result in any further reduction in scatter, suggesting that t2 carries redundant information with respect to stretch and colour. With a much larger SNIa NIR sample at higher redshift in the future, t2 could be a useful quantity to perform robustness checks of the standardization procedure.

Asthma Outcomes: Healthcare Utilization and Costs

PubMed Central

Akinbami, Lara J.; Sullivan, Sean D.; Campbell, Jonathan D.; Grundmeier, Robert W.; Hartert, Tina V.; Lee, Todd A.; Smith, Robert A.

2014-01-01

Background Measures of healthcare utilization and indirect impact of asthma morbidity are used to assess clinical interventions and estimate cost. Objective National Institutes of Health (NIH) institutes and other federal agencies convened an expert group to propose standardized measurement, collection, analysis, and reporting of healthcare utilization and cost outcomes in future asthma studies. Methods We used comprehensive literature reviews and expert opinion to compile a list of asthma healthcare utilization outcomes that we classified as core (required in future studies), supplemental (used according to study aims and standardized) and emerging (requiring validation and standardization). We also have identified methodology to assign cost to these outcomes. This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results We identified 3 ways to promote comparability across clinical trials for measures of healthcare utilization, resource use, and cost: (1) specify the study perspective (patient, clinician, payer, society), (2) standardize the measurement period (ideally, 12 months), and (3) use standard units to measure healthcare utilization and other asthma-related events. Conclusions Large clinical trials and observational studies should collect and report detailed information on healthcare utilization, intervention resources, and indirect impact of asthma, so that costs can be calculated and cost-effectiveness analyses can be conducted across several studies. Additional research is needed to develop standard, validated survey instruments for collection of provider-reported and participant-reported data regarding asthma-related health care. PMID:22386509

Waist Circumferences of Chilean Students: Comparison of the CDC-2012 Standard and Proposed Percentile Curves

PubMed Central

Gómez-Campos, Rossana; Lee Andruske, Cinthya; Hespanhol, Jefferson; Sulla Torres, Jose; Arruda, Miguel; Luarte-Rocha, Cristian; Cossio-Bolaños, Marco Antonio

2015-01-01

The measurement of waist circumference (WC) is considered to be an important means to control overweight and obesity in children and adolescents. The objectives of the study were to (a) compare the WC measurements of Chilean students with the international CDC-2012 standard and other international standards, and (b) propose a specific measurement value for the WC of Chilean students based on age and sex. A total of 3892 students (6 to 18 years old) were assessed. Weight, height, body mass index (BMI), and WC were measured. WC was compared with the CDC-2012 international standard. Percentiles were constructed based on the LMS method. Chilean males had a greater WC during infancy. Subsequently, in late adolescence, males showed values lower than those of the international standards. Chilean females demonstrated values similar to the standards until the age of 12. Subsequently, females showed lower values. The 85th and 95th percentiles were adopted as cutoff points for evaluating overweight and obesity based on age and sex. The WC of Chilean students differs from the CDC-2012 curves. The regional norms proposed are a means to identify children and adolescents with a high risk of suffering from overweight and obesity disorders. PMID:26184250

A simple web-based tool to compare freshwater fish data collected using AFS standard methods

USGS Publications Warehouse

Bonar, Scott A.; Mercado-Silva, Norman; Rahr, Matt; Torrey, Yuta T.; Cate, Averill

2016-01-01

The American Fisheries Society (AFS) recently published Standard Methods for Sampling North American Freshwater Fishes. Enlisting the expertise of 284 scientists from 107 organizations throughout Canada, Mexico, and the United States, this text was developed to facilitate comparisons of fish data across regions or time. Here we describe a user-friendly web tool that automates among-sample comparisons in individual fish condition, population length-frequency distributions, and catch per unit effort (CPUE) data collected using AFS standard methods. Currently, the web tool (1) provides instantaneous summaries of almost 4,000 data sets of condition, length frequency, and CPUE of common freshwater fishes collected using standard gears in 43 states and provinces; (2) is easily appended with new standardized field data to update subsequent queries and summaries; (3) compares fish data from a particular water body with continent, ecoregion, and state data summaries; and (4) provides additional information about AFS standard fish sampling including benefits, ongoing validation studies, and opportunities to comment on specific methods. The web tool—programmed in a PHP-based Drupal framework—was supported by several AFS Sections, agencies, and universities and is freely available from the AFS website and fisheriesstandardsampling.org. With widespread use, the online tool could become an important resource for fisheries biologists.

Comparative Evaluations of Randomly Selected Four Point-of-Care Glucometer Devices in Addis Ababa, Ethiopia.

PubMed

Wolde, Mistire; Tarekegn, Getahun; Kebede, Tedla

2018-05-01

Point-of-care glucometer (PoCG) devices play a significant role in self-monitoring of the blood sugar level, particularly in the follow-up of high blood sugar therapeutic response. The aim of this study was to evaluate blood glucose test results performed with four randomly selected glucometers on diabetes and control subjects versus standard wet chemistry (hexokinase) methods in Addis Ababa, Ethiopia. A prospective cross-sectional study was conducted on randomly selected 200 study participants (100 participants with diabetes and 100 healthy controls). Four randomly selected PoCG devices (CareSens N, DIAVUE Prudential, On Call Extra, i-QARE DS-W) were evaluated against hexokinase method and ISO 15197:2003 and ISO 15197:2013 standards. The minimum and maximum blood sugar values were recorded by CareSens N (21 mg/dl) and hexokinase method (498.8 mg/dl), respectively. The mean sugar values of all PoCG devices except On Call Extra showed significant differences compared with the reference hexokinase method. Meanwhile, all four PoCG devices had strong positive relationship (>80%) with the reference method (hexokinase). On the other hand, none of the four PoCG devices fulfilled the minimum accuracy measurement set by ISO 15197:2003 and ISO 15197:2013 standards. In addition, the linear regression analysis revealed that all four selected PoCG overestimated the glucose concentrations. The overall evaluation of the selected four PoCG measurements were poorly correlated with standard reference method. Therefore, before introducing PoCG devices to the market, there should be a standardized evaluation platform for validation. Further similar large-scale studies on other PoCG devices also need to be undertaken.

Reduction of right ventricular pacing with advanced atrioventricular search hysteresis: results of the PREVENT study.

PubMed

Kolb, Christof; Schmidt, Roland; Dietl, Josef U; Weyerbrock, Sonja; Morgenstern, Martin; Fleckenstein, Martin; Beier, Thomas; Von Bary, Christian; Mackes, Karl G; Widmaier, Jochen; Kreuzer, Jörg; Semmler, Verena; Zrenner, Bernhard

2011-08-01

Right ventricular pacing predisposes to the development of heart failure and atrial fibrillation. Automatic atrioventricular search hysteresis (AVSH) is a commonly used strategy to decrease the percentage of right ventricular pacing (%VP) in patients without permanent AV block, but the results have not been optimal. The randomized, crossover PREVENT study evaluated whether an enhanced AVSH with two new features can reduce %VP compared with standard AVSH. The new features are the repetitive hysteresis [switch from extended to basic AV delay after a consistent loss of intrinsic AV conduction (IAVC) lasting for six consecutive atrial cycles] and the scan hysteresis (periodic IAVC search extension over six consecutive atrial cycles). Both standard AVSH and enhanced AVSH performed a periodic IAVC search every 180 cardiac cycles and operated with a basic AV-delay of 225 ms and a rate-independent maximum AV-delay of 300 ms for paced and sensed atrial events. Among 178 patients, 53.4% had no evidence of AV block at enrollment and 46.6% had history of intermittent AV block. The median %VP was decreased by enhanced AVSH compared to standard AVSH (4.0% vs 5.5%, P < 0.001), particularly in patients with a history of AV block (21.4% vs 25.5%, P < 0.001). The primary study hypothesis that 25% of all patients would experience > 20% relative %VP reduction was not met as 46 (25.8%) patients (95% confidence interval, 20.5-31.8%) presented such relative reduction. The enhanced AVSH algorithm reduces %VP compared with standard AVSH in patients with intermittent AV block. ©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.

Newborn birth-weight of pregnant women on methadone or buprenorphine maintenance treatment: A national contingency management approach trial.

PubMed

Peles, Einat; Sason, Anat; Schreiber, Shaul; Adelson, Miriam

2017-03-01

Methadone maintenance treatment (MMT) is the gold standard for pregnant women with opioid use disorders. Still, low birth-weights were reported, in particular of mothers who became pregnant before admission to MMT. We studied whether an escalating incentive contingency-management approach may contribute to better newborn birth-weights. A nationwide controlled randomized trial among all Israeli methadone/buprenorphine maintenance treatment (MBMT), newly or already in treatment pregnant women was performed. A modified contingency-management protocol with coupons of escalating value depending upon reduction of drug use, cigarette smoking, and alcohol consumption was compared to standard care arm. Drugs in urine, smoking (Fagerstrom score), alcohol use, and depression were monitored. Thirty-five women had 46 pregnancies. In their first pregnancy, 19 from the contingency-management and 16 from the standard care arms were studied. Contingency-management group as compared to the standard care arm included more newly admitted women (36.8% vs. 6.3%, p = .05), with benzodiazepine and cannabis onset at a younger age, and higher proportion of any drug abuse while pregnant (100% vs. 68.8%, p = .01). Fifteen of the contingency-management and 14 of the control arm gave birth (78.9% vs. 87.5%, p = .3) with similar proportions of normal (>2,500 g) birth-weight (71.4% vs. 61.5%, p = .8). Newborns' birth-weight was comparable among the two study arms indicating no contribution of the contingency-management approach. Small sample and baseline differences between arms might have influenced results. Intensive intervention should be evaluated on a larger scale of participants. (Am J Addict 2017;26:167-175). © 2017 American Academy of Addiction Psychiatry.

Short Implants Versus Standard Implants: Midterm Outcomes of a Clinical Study.

PubMed

Benlidayi, M Emre; Ucar, Yurdanur; Tatli, Ufuk; Ekren, Orhun; Evlice, Burcu; Kisa, Halil Ibrahim; Baksi, Uygar

2018-02-01

The aim of this study was to evaluate the midterm survival rate, marginal bone resorption (MBR), and stability of short implants and to compare the results with standard length implants. A total of 38 patients were included. In total, 147 implants (Nucleoss Implants, Izmir, Turkey) were placed (86 short implants and 61 standard implants). Cement-retained metal-ceramic prostheses were fabricated. MBR was evaluated on periapical radiographs taken at implant placement, at the time of crown insertion and annually thereafter. The stability of the implants was evaluated by resonance frequency analysis. The 3- and 5-year cumulative survival rates for standard implants was 98.4% and for short implants was 96.5% (P = 0.644). The MBR of the short implants was significantly lower than that of the standard implants after 1, 2, and 3 years of loading (P < 0.05). No significant differences were found between 2 groups after 6 and 12 months of loading in terms of implant stability (implant stability quotient values) (P > 0.05). Within the limits of this study, it is concluded that short implants achieved similar results as standard implants after 3 to 5 years of loading.

Use of a web-based educational intervention to improve knowledge of healthy diet and lifestyle in women with Gestational Diabetes Mellitus compared to standard clinic-based education.

PubMed

Sayakhot, Padaphet; Carolan-Olah, Mary; Steele, Cheryl

2016-08-05

This study introduced a web-based educational intervention for Australian women with gestational diabetes mellitus (GDM). The aim was to improve knowledge on healthy diet and lifestyle in GDM. Evaluation of the intervention explored women's knowledge and understanding of GDM, healthy diet, healthy food, and healthy lifestyle, after using the web-based program compared to women receiving standard clinic-based GDM education. A total of 116 women, aged 18-45 years old, newly diagnosed with GDM, participated (Intervention (n) = 56 and control (n) = 60). Women were randomly allocated to the intervention or control groups and both groups attended a standard GDM education class. Group 1(Intervention) additionally used an online touch screen/computer program. All women completed a questionnaire following the computer program and/or the education class. All questions evaluating levels of knowledge had more than one correct answer and scores were graded from 0 to 1, with each correct component receiving a score, eg. 0.25 per each correct answer in a 4 answer question. Chi-square test was performed to compare the two groups regarding knowledge of GDM. Findings indicated that the majority of women in the intervention group reported correct answers for "types of carbohydrate foods" for pregnant women with GDM, compared to the control group (62.5 % vs 58.3 %, respectively). Most women in both groups had an excellent understanding of "fruits and vegetables" (98.2 % vs 98.3 %), and the majority of women in the intervention group understood that they should exercise daily for 30 min, compared to the control group (92.9 % vs 91.7 %). Both groups had a good understanding across all categories, however, the majority of women in the intervention group scored all correct answers (score = 1) in term of foetal effects (17.9 % vs 13.3 %, respectively), maternal predictors (5.4 % vs 5 %), care requirements (39.3 % vs 23.3 %), GDM perceptions (48.2 % vs 46.7 %) and GDM treatment (67.9 % vs 61.7 %), compared to women in the control group. The study suggested that both approaches, standard education and standard education plus web-based program, resulted in excellent knowledge scores, but not statistically significant difference between groups. Multiple and immediate access to the web-based education program at home may prove useful as a source of reference for women with GDM. Future study comparing results pre and post intervention is needed. ACTRN12615000697583 ; Date registered: 03/07/2015; Retrospectively registered.

The Psychophysiology of Posttraumatic Stress Disorder: A Meta-Analysis

ERIC Educational Resources Information Center

Pole, Nnamdi

2007-01-01

This meta-analysis of 58 resting baseline studies, 25 startle studies, 17 standardized trauma cue studies, and 22 idiographic trauma cue studies compared adults with and without posttraumatic stress disorder (PTSD) on psychophysiological variables: facial electromyography (EMG), heart rate (HR), skin conductance (SC), and blood pressure.…

Hemodynamic directed cardiopulmonary resuscitation improves short-term survival from ventricular fibrillation cardiac arrest.

PubMed

Friess, Stuart H; Sutton, Robert M; Bhalala, Utpal; Maltese, Matthew R; Naim, Maryam Y; Bratinov, George; Weiland, Theodore R; Garuccio, Mia; Nadkarni, Vinay M; Becker, Lance B; Berg, Robert A

2013-12-01

During cardiopulmonary resuscitation, adequate coronary perfusion pressure is essential for establishing return of spontaneous circulation. Current American Heart Association guidelines recommend standardized interval administration of epinephrine for patients in cardiac arrest. The objective of this study was to compare short-term survival using a hemodynamic directed resuscitation strategy versus chest compression depth-directed cardiopulmonary resuscitation in a porcine model of cardiac arrest. Randomized interventional study. Preclinical animal laboratory. Twenty-four 3-month-old female swine. After 7 minutes of ventricular fibrillation, pigs were randomized to receive one of three resuscitation strategies: 1) Hemodynamic directed care (coronary perfusion pressure-20): chest compressions with depth titrated to a target systolic blood pressure of 100 mm Hg and titration of vasopressors to maintain coronary perfusion pressure greater than 20 mm Hg; 2) Depth 33 mm: target chest compression depth of 33 mm with standard American Heart Association epinephrine dosing; or 3) Depth 51 mm: target chest compression depth of 51 mm with standard American Heart Association epinephrine dosing. All animals received manual cardiopulmonary resuscitation guided by audiovisual feedback for 10 minutes before first shock. Forty-five-minute survival was higher in the coronary perfusion pressure-20 group (8 of 8) compared to depth 33 mm (1 of 8) or depth 51 mm (3 of 8) groups; p equals to 0.002. Coronary perfusion pressures were higher in the coronary perfusion pressure-20 group compared to depth 33 mm (p = 0.004) and depth 51 mm (p = 0.006) and in survivors compared to nonsurvivors (p < 0.01). Total epinephrine dosing and defibrillation attempts were not different. Hemodynamic directed resuscitation targeting coronary perfusion pressures greater than 20 mm Hg during 10 minutes of cardiopulmonary resuscitation for ventricular fibrillation cardiac arrest improves short-term survival, when compared to resuscitation with depth of compressions guided to 33 mm or 51 mm and standard American Heart Association vasopressor dosing.

Optimizing Blood Transfusion Practices Through Bundled Intervention Implementation in Patients With Gynecologic Cancer Undergoing Laparotomy.

PubMed

Wallace, Sumer K; Halverson, Jessica W; Jankowski, Christopher J; DeJong, Stephanie R; Weaver, Amy L; Weinhold, Megan R; Borah, Bijan J; Moriarty, James P; Cliby, William A; Kor, Daryl J; Higgins, Andrew A; Otto, Hilary A; Dowdy, Sean C; Bakkum-Gamez, Jamie N

2018-05-01

To examine blood transfusion practices and develop a standardized bundle of interventions to address the high rate of perioperative red blood cell transfusion among patients with ovarian and endometrial cancer. This was a retrospective cohort study. Our primary aim was to determine whether an implemented bundled intervention was associated with a reduction in perioperative red blood cell transfusions among cases of laparotomy for cancer. Secondary aims included comparing perioperative demographic, surgical, complication, and cost data. Interventions included blood transfusion practice standardization using American Society of Anesthesiologists guidelines, an intraoperative hemostasis checklist, standardized intraoperative fluid status communication, and evidence-based use of tranexamic acid. Prospective data from women undergoing laparotomy for ovarian or endometrial cancer from September 28, 2015, to May 31, 2016, defined the study cohort and were compared with historical controls (September 1, 2014, to September 25, 2015). Outcomes were compared in the full unadjusted cohorts and in propensity-matched cohorts. In the intervention and historical cohorts, respectively, 89 and 184 women underwent laparotomy for ovarian cancer (n=74 and 152) or advanced endometrial cancer (n=15 and 32). Tranexamic acid was administered in 54 (60.7%) patients. The perioperative transfusion rate was lower for the intervention group compared with historical controls (18.0% [16/89] vs 41.3% [76/184], P<.001), a 56.4% reduction. This improvement in the intervention group remained significant after propensity matching (16.2% [13/80] vs 36.2% [29/80], P=.004). The hospital readmission rate was also lower for the intervention group compared with historical controls (1.1% [1/89] vs 12.5% [23/184], P=.002); however, this improvement did not attain statistical significance after propensity matching (1.2% [1/80] vs 7.5% [6/80], P=.12). Cost analysis demonstrated that this intervention was cost-neutral during index hospitalization plus 30-day follow-up. Application of a standardized bundle of evidence-based interventions was associated with reduced blood use in our gynecologic oncology practice.

Doping assessment in GaAs nanowires.

PubMed

Goktas, N Isik; Fiordaliso, E M; LaPierre, R R

2018-06-08

Semiconductor nanowires (NWs) are a candidate technology for future optoelectronic devices. One of the critical issues in NWs is the control of impurity doping for the formation of p-n junctions. In this study, beryllium (p-type dopant) and tellurium (n-type dopant) in self-assisted GaAs NWs was studied. The GaAs NWs were grown on (111) Si by molecular beam epitaxy using the self-assisted method. The dopant incorporation in the self-assisted GaAs NWs was investigated using Raman spectroscopy, photoluminescence, secondary ion mass spectrometry and electron holography. Be-doped NWs showed similar carrier concentration as compared to thin film (TF) standards. However, Te-doped NWs showed at least a one order of magnitude lower carrier concentration as compared to TF standards. Dopant incorporation mechanisms in NWs are discussed.

[Comparative study of combined local treatment (sulfadimidine, metronidazole and nystatin) and the standard monotherapy in uncomplicated bacterial vaginosis].

PubMed

Milánkovits, Márton; Baksay, László; Plachy, János

2002-12-22

Comparative, in vivo, human, prospective, single blind, clinical and microbiological diagnoses based and randomised study of the treatment of uncomplicated bacterial vaginosis with two forms of combined (metronidazole + nystatin + sulfadimidin) vaginal suppositories (laminated and mixed containing the same ingredients) and the standard preparations available in the Hungarian market (Dalacin vaginal cream and Klion vaginal suppository). The examinations involved 60 volunteers and were performed in the Gynecological Outpatient Clinic of the Council of Erd, the microbiological samples were examined at Saint Rókus Hospital in Budapest. The combined treatment was better tolerated and resulted in normal vaginal pH significantly more often at the same rate of recovery. The combined treatment is simultaneously effective in cases of the most prevalent coinfections too.

[Breast cancer screening process indicators in Mexico: a case study].

PubMed

Uscanga-Sánchez, Santos; Torres-Mejía, Gabriela; Ángeles-Llerenas, Angélica; Domínguez-Malpica, Raúl; Lazcano-Ponce, Eduardo

2014-01-01

To identify, measure and compare the performance indicators of productivity, effective access and quality service for the early detection breast cancer program in Mexico. By means of a study case based on the 2011 Women Cancer Information System (SICAM), the indicators were measured and compared with the Mexican official standard NOM-041-SSA2-2011 and international standards. The analysis showed insufficient installed capacity (37%), low coverage in screening (15%), diagnostic evaluation (16%), biopsy (44%) and treatment (57%), and very low effectiveness in confirmed cases by the total number of screening mammograms performed (0.04%). There was no information available, from SICAM, to estimate the rest of the indicators proposed. Efficient health information systems are required in order to monitor indicators and generate performance observatories of screening programs.

Doping assessment in GaAs nanowires

NASA Astrophysics Data System (ADS)

Isik Goktas, N.; Fiordaliso, E. M.; LaPierre, R. R.

2018-06-01

Semiconductor nanowires (NWs) are a candidate technology for future optoelectronic devices. One of the critical issues in NWs is the control of impurity doping for the formation of p–n junctions. In this study, beryllium (p-type dopant) and tellurium (n-type dopant) in self-assisted GaAs NWs was studied. The GaAs NWs were grown on (111) Si by molecular beam epitaxy using the self-assisted method. The dopant incorporation in the self-assisted GaAs NWs was investigated using Raman spectroscopy, photoluminescence, secondary ion mass spectrometry and electron holography. Be-doped NWs showed similar carrier concentration as compared to thin film (TF) standards. However, Te-doped NWs showed at least a one order of magnitude lower carrier concentration as compared to TF standards. Dopant incorporation mechanisms in NWs are discussed.

Comparing English, Mandarin, and Russian Hydrographic and Terrain Categories

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

Feng, Chen-Chieh; Sorokine, Alexandre

The paper compares hydrographic and terrain categories in the geospatial data standards of the US, Taiwan, and Russian Federation where the dominant languages used are from di erent language families. It aims to identify structural and semantic di erences between similar categories across three geospatial data standards. By formalizing the data standard structures and identifying the properties that di erentiate sibling categories in each geospatial data standard using well-known formal relations and quality universals, we develop a common basis on which hydrographic and terrain categories in the three data standards can be compared. The result suggests that all three datamore » standards structure categories with a mixture of relations with di erent meaning even though most of them are well-known relations in top-level ontologies. Similar categories can be found across all three standards but exact match between similar categories are rare.« less