Time-resolved 3D pulmonary perfusion MRI: comparison of different k-space acquisition strategies at 1.5 and 3 T.

PubMed

Attenberger, Ulrike I; Ingrisch, Michael; Dietrich, Olaf; Herrmann, Karin; Nikolaou, Konstantin; Reiser, Maximilian F; Schönberg, Stefan O; Fink, Christian

2009-09-01

Time-resolved pulmonary perfusion MRI requires both high temporal and spatial resolution, which can be achieved by using several nonconventional k-space acquisition techniques. The aim of this study is to compare the image quality of time-resolved 3D pulmonary perfusion MRI with different k-space acquisition techniques in healthy volunteers at 1.5 and 3 T. Ten healthy volunteers underwent contrast-enhanced time-resolved 3D pulmonary MRI on 1.5 and 3 T using the following k-space acquisition techniques: (a) generalized autocalibrating partial parallel acquisition (GRAPPA) with an internal acquisition of reference lines (IRS), (b) GRAPPA with a single "external" acquisition of reference lines (ERS) before the measurement, and (c) a combination of GRAPPA with an internal acquisition of reference lines and view sharing (VS). The spatial resolution was kept constant at both field strengths to exclusively evaluate the influences of the temporal resolution achieved with the different k-space sampling techniques on image quality. The temporal resolutions were 2.11 seconds IRS, 1.31 seconds ERS, and 1.07 VS at 1.5 T and 2.04 seconds IRS, 1.30 seconds ERS, and 1.19 seconds VS at 3 T.Image quality was rated by 2 independent radiologists with regard to signal intensity, perfusion homogeneity, artifacts (eg, wrap around, noise), and visualization of pulmonary vessels using a 3 point scale (1 = nondiagnostic, 2 = moderate, 3 = good). Furthermore, the signal-to-noise ratio in the lungs was assessed. At 1.5 T the lowest image quality (sum score: 154) was observed for the ERS technique and the highest quality for the VS technique (sum score: 201). In contrast, at 3 T images acquired with VS were hampered by strong artifacts and image quality was rated significantly inferior (sum score: 137) compared with IRS (sum score: 180) and ERS (sum score: 174). Comparing 1.5 and 3 T, in particular the overall rating of the IRS technique (sum score: 180) was very similar at both field strengths. At 1.5 T the peak signal-to-noise ratio of the ERS was significantly lower in comparison to the IRS and the VS technique (14.6 vs. 26.7 and 39.6 respectively, P < 0.004). Using the IRS sampling algorithm comparable image quality and SNR can be achieved at 1.5 and 3 T. At 1.5 T VS offers the best possible solution for the conflicting requirements between a further increased temporal resolution and image quality. In consequence the gain of increased scanning efficiency from advanced k[r]-space sampling acquisition techniques can be exploited for a further improvement of image quality of pulmonary perfusion MRI.

Sugar snack consumption in Ugandan schoolchildren: Validity and reliability of a food frequency questionnaire.

PubMed

Kiwanuka, S N; Astrøm, A N; Trovik, T A

2006-10-01

This study assessed the reproducibility and relative validity of an eight-item self-administered food frequency questionnaire (FFQ) on intake of sugared snacks in Ugandan schoolchildren. A 5-day precoded food behaviour checklist (FBC) was used as validation criteria. Sociodemographic correlates of a sum frequency sugar score were explored. The study was conducted in Kampala, Uganda, in 2004. Six hundred and fourteen schoolchildren (mean age 12.4 years) completed the FFQ on cakes/biscuits, chocolate, ice sticks, soft drinks, coffee, tea, sugared desserts and sweets/candies at school. They were examined clinically for dental caries. Forty students completed the FFQ twice, 1 week apart and 325 students completed the 5 day FBC at school. The mean decayed, missing and filled tooth index score was 0.98 (SD 1.6, range 0-15). Reproducibility scores (Cohen's kappa) for the sugar items ranged from 0.17 (ice sticks) to 0.55 (biscuits). No differences were seen between the average intakes at test and retest. Higher intake was reported in FFQ than in FBC across all sugar items. Crude agreement between students reporting intake at least 3-5 times a week/less than three times a week ranged from 50% to 55% (e.g. biscuits, chocolate) to 87% (tea). Spearman's correlation coefficients ranged from 0.14 (desserts) to 0.27 (sweets). anova revealed significant increase (P = 0.001) in the mean FBC sum scores by increasing quartiles of the FFQ sum scores. The average sum FFQ sugar scores were higher in girls than in boys and higher in older than in younger students. Fair reproducibility was established for the FFQ sugar items. The FFQ was acceptable in classifying individuals into broad categories of low and high sugar consumption.

Summed and Weighted Summary Scores for the Medsger Disease Severity Scale Compared with the Physician's Global Assessment of Disease Severity in Systemic Sclerosis.

PubMed

Harel, Daphna; Hudson, Marie; Iliescu, Alexandra; Baron, Murray; Steele, Russell

2016-08-01

To develop a weighted summary score for the Medsger Disease Severity Scale (DSS) and to compare its measurement properties with those of a summed DSS score and a physician's global assessment (PGA) of severity score in systemic sclerosis (SSc). Data from 875 patients with SSc enrolled in a multisite observational research cohort were extracted from a central database. Item response theory was used to estimate weights for the DSS weighted score. Intraclass correlation coefficients (ICC) and convergent, discriminative, and predictive validity of the 3 summary measures in relation to patient-reported outcomes (PRO) and mortality were compared. Mean PGA was 2.69 (SD 2.16, range 0-10), mean DSS summed score was 8.60 (SD 4.02, range 0-36), and mean DSS weighted score was 8.11 (SD 4.05, range 0-36). ICC were similar for all 3 measures [PGA 6.9%, 95% credible intervals (CrI) 2.1-16.2; DSS summed score 2.5%, 95% CrI 0.4-6.7; DSS weighted score 2.0%, 95% CrI 0.1-5.6]. Convergent and discriminative validity of the 3 measures for PRO were largely similar. In Cox proportional hazards models adjusting for age and sex, the 3 measures had similar predictive ability for mortality (adjusted R(2) 13.9% for PGA, 12.3% for DSS summed score, and 10.7% DSS weighted score). The 3 summary scores appear valid and perform similarly. However, there were some concerns with the weights computed for individual DSS scales, with unexpected low weights attributed to lung, heart, and kidney, leading the PGA to be the preferred measure at this time. Further work refining the DSS could improve the measurement properties of the DSS summary scores.

Generalization of the Lord-Wingersky Algorithm to Computing the Distribution of Summed Test Scores Based on Real-Number Item Scores

ERIC Educational Resources Information Center

Kim, Seonghoon

2013-01-01

With known item response theory (IRT) item parameters, Lord and Wingersky provided a recursive algorithm for computing the conditional frequency distribution of number-correct test scores, given proficiency. This article presents a generalized algorithm for computing the conditional distribution of summed test scores involving real-number item…

Summarizing techniques that combine three non-parametric scores to detect disease-associated 2-way SNP-SNP interactions.

PubMed

Sengupta Chattopadhyay, Amrita; Hsiao, Ching-Lin; Chang, Chien Ching; Lian, Ie-Bin; Fann, Cathy S J

2014-01-01

Identifying susceptibility genes that influence complex diseases is extremely difficult because loci often influence the disease state through genetic interactions. Numerous approaches to detect disease-associated SNP-SNP interactions have been developed, but none consistently generates high-quality results under different disease scenarios. Using summarizing techniques to combine a number of existing methods may provide a solution to this problem. Here we used three popular non-parametric methods-Gini, absolute probability difference (APD), and entropy-to develop two novel summary scores, namely principle component score (PCS) and Z-sum score (ZSS), with which to predict disease-associated genetic interactions. We used a simulation study to compare performance of the non-parametric scores, the summary scores, the scaled-sum score (SSS; used in polymorphism interaction analysis (PIA)), and the multifactor dimensionality reduction (MDR). The non-parametric methods achieved high power, but no non-parametric method outperformed all others under a variety of epistatic scenarios. PCS and ZSS, however, outperformed MDR. PCS, ZSS and SSS displayed controlled type-I-errors (<0.05) compared to GS, APDS, ES (>0.05). A real data study using the genetic-analysis-workshop 16 (GAW 16) rheumatoid arthritis dataset identified a number of interesting SNP-SNP interactions. © 2013 Elsevier B.V. All rights reserved.

Predictors for mechanical ventilation and short-term prognosis in patients with Guillain-Barré syndrome.

PubMed

Wu, Xiujuan; Li, Chunrong; Zhang, Bing; Shen, Donghui; Li, Ting; Liu, Kangding; Zhang, Hong-Liang

2015-09-02

Guillain-Barré syndrome (GBS) is an immune-mediated disorder of the peripheral nervous system. Respiratory failure requiring mechanical ventilation (MV) is a serious complication of GBS. Identification of modifiable risk factors for MV and poor short-term prognosis in mechanically ventilated patients with GBS may contribute to the individualized management and may help improve the outcome of the patients. We retrospectively analyzed the clinical data of 541 patients who were diagnosed with GBS from 2003 to 2014. Independent predictors for MV and short-term prognosis in mechanically ventilated patients were identified via multivariate logistic regression analysis. The mean age was 41.6 years with a male predilection (61.2%). Eighty patients (14.8%) required MV. Multivariate analysis revealed that shorter interval from onset to admission (p < 0.05), facial nerve palsy (p < 0.01), glossopharyngeal and vagal nerve deficits (p < 0.01) and lower Medical Research Council (MRC) sum score at nadir (p < 0.01) were risk factors for MV; disease occurrence in summer (p < 0.01) was a protective factor. As to prognostic factors, absence of antecedent infections (p < 0.01) and lower MRC sum score at nadir (p < 0.01) were predictors of poor short-term prognosis in mechanically ventilated patients regardless of treatment modality. We further investigated the predictors of poor short-term prognosis in patients requiring MV with different nadir MRC sum scores. Combined use of intravenous corticosteroids with intravenous immunoglobulin (odds ratio 10.200, 95% confidence interval 1.068-97.407, p < 0.05) was an independent predictor of poor short-term prognosis in mechanically ventilated patients with a nadir MRC sum score from 0 to 12 points, regardless of existence of antecedent infection. Clinical predictors of MV and poor short-term prognosis in mechanically ventilated GBS patients were distinct. Add-on use of intravenous corticosteroids was a risk factor for poor short-term prognosis in mechanically ventilated patients with a nadir MRC sum score from 0 to 12 points.

Influence of angiographic collateral circulation on myocardial perfusion in patients with chronic total occlusion of a single coronary artery and no prior myocardial infarction.

PubMed

Aboul-Enein, Fatma; Kar, Saibal; Hayes, Sean W; Sciammarella, Maria; Abidov, Aiden; Makkar, Raj; Friedman, John D; Eigler, Neal; Berman, Daniel S

2004-06-01

The functional role of various angiographic grades for coronary collaterals remains controversial. The aim of this study was to assess the influence of the Rentrop angiographic grading of coronary collaterals on myocardial perfusion in patients with single-vessel chronic total occlusion (CTO) and no prior myocardial infarction (MI). The study included 56 patients with single-vessel CTO and no prior MI who underwent rest-stress myocardial perfusion SPECT and coronary angiography within 6 mo. All patients had angiographic evidence of coronary collaterals. Patients were divided according to the Rentrop classification: Group I had grade 1 or 2 (n = 25) and group II had grade 3 collaterals (n = 31). Group I had a higher frequency of resting regional wall motion abnormalities on left ventriculography (52.6% vs. 19.2% [P = 0.019]). The mean perfusion scores of the overall population showed severe and extensive stress perfusion defects (summed stress score of 14.1 +/- 7.1 and summed difference score of 12.9 +/- 6.9) but minimal resting perfusion defects (summed rest score of 1.0 +/- 2.7). No perfusion scores differed between the 2 groups. The perfusion findings suggested that chronic stunning rather than hibernation is the principal cause of regional wall motion abnormalities in these patients. In the setting of single-vessel CTO and no prior MI, coronary collaterals appear to protect against resting perfusion defects. Excellent angiographic collaterals may prevent resting regional wall motion abnormalities but do not appear to protect against stress-induced perfusion defects.

siMS Score: Simple Method for Quantifying Metabolic Syndrome.

PubMed

Soldatovic, Ivan; Vukovic, Rade; Culafic, Djordje; Gajic, Milan; Dimitrijevic-Sreckovic, Vesna

2016-01-01

To evaluate siMS score and siMS risk score, novel continuous metabolic syndrome scores as methods for quantification of metabolic status and risk. Developed siMS score was calculated using formula: siMS score = 2*Waist/Height + Gly/5.6 + Tg/1.7 + TAsystolic/130-HDL/1.02 or 1.28 (for male or female subjects, respectively). siMS risk score was calculated using formula: siMS risk score = siMS score * age/45 or 50 (for male or female subjects, respectively) * family history of cardio/cerebro-vascular events (event = 1.2, no event = 1). A sample of 528 obese and non-obese participants was used to validate siMS score and siMS risk score. Scores calculated as sum of z-scores (each component of metabolic syndrome regressed with age and gender) and sum of scores derived from principal component analysis (PCA) were used for evaluation of siMS score. Variants were made by replacing glucose with HOMA in calculations. Framingham score was used for evaluation of siMS risk score. Correlation between siMS score with sum of z-scores and weighted sum of factors of PCA was high (r = 0.866 and r = 0.822, respectively). Correlation between siMS risk score and log transformed Framingham score was medium to high for age groups 18+,30+ and 35+ (0.835, 0.707 and 0.667, respectively). siMS score and siMS risk score showed high correlation with more complex scores. Demonstrated accuracy together with superior simplicity and the ability to evaluate and follow-up individual patients makes siMS and siMS risk scores very convenient for use in clinical practice and research as well.

Using Patterns of Summed Scores in Paper-and-Pencil Tests and Computer-Adaptive Tests to Detect Misfitting Item Score Patterns

ERIC Educational Resources Information Center

Meijer, Rob R.

2004-01-01

Two new methods have been proposed to determine unexpected sum scores on sub-tests (testlets) both for paper-and-pencil tests and computer adaptive tests. A method based on a conservative bound using the hypergeometric distribution, denoted p, was compared with a method where the probability for each score combination was calculated using a…

A language-based sum score for the course and therapeutic intervention in primary progressive aphasia.

PubMed

Semler, Elisa; Anderl-Straub, Sarah; Uttner, Ingo; Diehl-Schmid, Janine; Danek, Adrian; Einsiedler, Beate; Fassbender, Klaus; Fliessbach, Klaus; Huppertz, Hans-Jürgen; Jahn, Holger; Kornhuber, Johannes; Landwehrmeyer, Bernhard; Lauer, Martin; Muche, Rainer; Prudlo, Johannes; Schneider, Anja; Schroeter, Matthias L; Ludolph, Albert C; Otto, Markus

2018-04-25

With upcoming therapeutic interventions for patients with primary progressive aphasia (PPA), instruments for the follow-up of patients are needed to describe disease progression and to evaluate potential therapeutic effects. So far, volumetric brain changes have been proposed as clinical endpoints in the literature, but cognitive scores are still lacking. This study followed disease progression predominantly in language-based performance within 1 year and defined a PPA sum score which can be used in therapeutic interventions. We assessed 28 patients with nonfluent variant PPA, 17 with semantic variant PPA, 13 with logopenic variant PPA, and 28 healthy controls in detail for 1 year. The most informative neuropsychological assessments were combined to a sum score, and associations between brain atrophy were investigated followed by a sample size calculation for clinical trials. Significant absolute changes up to 20% in cognitive tests were found after 1 year. Semantic and phonemic word fluency, Boston Naming Test, Digit Span, Token Test, AAT Written language, and Cookie Test were identified as the best markers for disease progression. These tasks provide the basis of a new PPA sum score. Assuming a therapeutic effect of 50% reduction in cognitive decline for sample size calculations, a number of 56 cases is needed to find a significant treatment effect. Correlations between cognitive decline and atrophy showed a correlation up to r = 0.7 between the sum score and frontal structures, namely the superior and inferior frontal gyrus, as well as with left-sided subcortical structures. Our findings support the high performance of the proposed sum score in the follow-up of PPA and recommend it as an outcome measure in intervention studies.

Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women.

PubMed

Ma, Linlin; Lin, Shouqing; Chen, Rong; Wang, Xiuli

2010-08-01

To assess efficacy of the extract of Vitex agnus castus (VAC, BNO 1095) in the treatment of Chinese women suffering from moderate to severe premenstrual syndrome (PMS). It was a prospective randomised double-blind placebo-controlled study conducted in Chinese women. Eligible patients were randomly assigned into VAC or placebo group. Symptoms were documented with a daily rating scale with four symptom factors (negative affect, water retention, food cravings and pain). Sixty-seven patients were enrolled and randomly assigned to receive one tablet of VAC or placebo once a day. The premenstrual syndrome diary (PMSD) sum score decreased from 29.38 +/- 7.63 score points at baseline to 4.28 +/- 5.76 at the 3rd cycle in the treatment group, while it decreased from 28.76 +/- 8.23 to 11.79 +/- 11.78 in the placebo group. All the four symptom factor scores were significantly reduced by the 3rd treatment cycle. There was significant difference in PMSD sum score, score of negative affect and water retention between two groups at cycle 3 (P < 0.05). PMSD sum scores decreased 60% was defined as efficacy, and the efficacy rate in treatment group was significantly higher than that in placebo group at the 3rd treatment cycle. Vitex agnus castus extract BNO 1095 shows effective in treating moderate to severe PMS in Chinese women, especially in symptoms of negative affect and water retention.

Construction of an Exome-Wide Risk Score for Schizophrenia Based on a Weighted Burden Test.

PubMed

Curtis, David

2018-01-01

Polygenic risk scores obtained as a weighted sum of associated variants can be used to explore association in additional data sets and to assign risk scores to individuals. The methods used to derive polygenic risk scores from common SNPs are not suitable for variants detected in whole exome sequencing studies. Rare variants, which may have major effects, are seen too infrequently to judge whether they are associated and may not be shared between training and test subjects. A method is proposed whereby variants are weighted according to their frequency, their annotations and the genes they affect. A weighted sum across all variants provides an individual risk score. Scores constructed in this way are used in a weighted burden test and are shown to be significantly different between schizophrenia cases and controls using a five-way cross-validation procedure. This approach represents a first attempt to summarise exome sequence variation into a summary risk score, which could be combined with risk scores from common variants and from environmental factors. It is hoped that the method could be developed further. © 2017 John Wiley & Sons Ltd/University College London.

Reliability of Summed Item Scores Using Structural Equation Modeling: An Alternative to Coefficient Alpha

ERIC Educational Resources Information Center

Green, Samuel B.; Yang, Yanyun

2009-01-01

A method is presented for estimating reliability using structural equation modeling (SEM) that allows for nonlinearity between factors and item scores. Assuming the focus is on consistency of summed item scores, this method for estimating reliability is preferred to those based on linear SEM models and to the most commonly reported estimate of…

Effects of enamel fluorosis and dental caries on quality of life.

PubMed

Onoriobe, U; Rozier, R G; Cantrell, J; King, R S

2014-10-01

The objectives of this study were to determine the impact of enamel fluorosis and dental caries on oral health-related quality of life (OHRQoL) in North Carolina schoolchildren and their families. Students (n = 7,686) enrolled in 398 classrooms in grades K-12 were recruited for a onetime survey. Parents of students in grades K-3 and 4-12 completed the Early Childhood Oral Health Impact Scale (ECOHIS) and Family Impact Scale (FIS), respectively. Students in grades 4-12 completed the Child Perceptions Questionnaire (CPQ8-10 in grades 4-5; CPQ11-14 in grades 6-12). All students were examined for fluorosis (Dean's index) and caries experience (d2-3fs or D2-3MFS indices). OHRQoL scores (sum response codes) were analyzed for their association with fluorosis categories and sum of d2-3fs and D2-3MFS according to ordinary least squares regression with SAS procedures for multiple imputation and analysis of complex survey data. Differences in OHRQoL scores were evaluated against statistical and minimal important difference (MID) thresholds. Of 5,484 examined students, 71.8% had no fluorosis; 24.4%, questionable to very mild fluorosis; and 3.7%, mild, moderate, or severe fluorosis. Caries categories were as follows: none (43.1%), low (28.6%), and moderate to high (28.2%). No associations between fluorosis and any OHRQoL scales met statistical or MID thresholds. The difference (5.8 points) in unadjusted mean ECOHIS scores for the no-caries and moderate-to-high caries groups exceeded the MID estimate (2.7 points) for that scale. The difference in mean FIS scores (1.5 points) for the no-caries and moderate-to-high groups exceeded the MID value (1.2 points). The sum of d2-3fs and D2-3MFS scores was positively associated with CPQ11-14 (B = 0.240, p < .001), ECOHIS (B = 0.252, p ≤ .001), and FIS (B = 0.096, p ≤ .01) scores in ordinary least squares regression models. A child's caries experience negatively affects OHRQoL, while fluorosis has little impact. © International & American Associations for Dental Research.

The effect of time-of-flight and point spread function modeling on 82Rb myocardial perfusion imaging of obese patients.

PubMed

Dasari, Paul K R; Jones, Judson P; Casey, Michael E; Liang, Yuanyuan; Dilsizian, Vasken; Smith, Mark F

2018-06-15

The effect of time-of-flight (TOF) and point spread function (PSF) modeling in image reconstruction has not been well studied for cardiac PET. This study assesses their separate and combined influence on 82 Rb myocardial perfusion imaging in obese patients. Thirty-six obese patients underwent rest-stress 82 Rb cardiac PET. Images were reconstructed with and without TOF and PSF modeling. Perfusion was quantitatively compared using the AHA 17-segment model for patients grouped by BMI, cross-sectional body area in the scanner field of view, gender, and left ventricular myocardial volume. Summed rest scores (SRS), summed stress scores (SSS), and summed difference scores (SDS) were compared. TOF improved polar map visual uniformity and increased septal wall perfusion by up to 10%. This increase was greater for larger patients, more evident for patients grouped by cross-sectional area than by BMI, and more prominent for females. PSF modeling increased perfusion by about 1.5% in all cardiac segments. TOF modeling generally decreased SRS and SSS with significant decreases between 2.4 and 3.0 (P < .05), which could affect risk stratification; SDS remained about the same. With PSF modeling, SRS, SSS, and SDS were largely unchanged. TOF and PSF modeling affect regional and global perfusion, SRS, and SSS. Clinicians should consider these effects and gender-dependent differences when interpreting 82 Rb perfusion studies.

Figure-associated text summarization and evaluation.

PubMed

Polepalli Ramesh, Balaji; Sethi, Ricky J; Yu, Hong

2015-01-01

Biomedical literature incorporates millions of figures, which are a rich and important knowledge resource for biomedical researchers. Scientists need access to the figures and the knowledge they represent in order to validate research findings and to generate new hypotheses. By themselves, these figures are nearly always incomprehensible to both humans and machines and their associated texts are therefore essential for full comprehension. The associated text of a figure, however, is scattered throughout its full-text article and contains redundant information content. In this paper, we report the continued development and evaluation of several figure summarization systems, the FigSum+ systems, that automatically identify associated texts, remove redundant information, and generate a text summary for every figure in an article. Using a set of 94 annotated figures selected from 19 different journals, we conducted an intrinsic evaluation of FigSum+. We evaluate the performance by precision, recall, F1, and ROUGE scores. The best FigSum+ system is based on an unsupervised method, achieving F1 score of 0.66 and ROUGE-1 score of 0.97. The annotated data is available at figshare.com (http://figshare.com/articles/Figure_Associated_Text_Summarization_and_Evaluation/858903).

Figure-Associated Text Summarization and Evaluation

PubMed Central

Polepalli Ramesh, Balaji; Sethi, Ricky J.; Yu, Hong

2015-01-01

Biomedical literature incorporates millions of figures, which are a rich and important knowledge resource for biomedical researchers. Scientists need access to the figures and the knowledge they represent in order to validate research findings and to generate new hypotheses. By themselves, these figures are nearly always incomprehensible to both humans and machines and their associated texts are therefore essential for full comprehension. The associated text of a figure, however, is scattered throughout its full-text article and contains redundant information content. In this paper, we report the continued development and evaluation of several figure summarization systems, the FigSum+ systems, that automatically identify associated texts, remove redundant information, and generate a text summary for every figure in an article. Using a set of 94 annotated figures selected from 19 different journals, we conducted an intrinsic evaluation of FigSum+. We evaluate the performance by precision, recall, F1, and ROUGE scores. The best FigSum+ system is based on an unsupervised method, achieving F1 score of 0.66 and ROUGE-1 score of 0.97. The annotated data is available at figshare.com (http://figshare.com/articles/Figure_Associated_Text_Summarization_and_Evaluation/858903). PMID:25643357

Effect of Microwave Wi-Fi Radiation at Frequency of 2.4 GHz on Epileptic Behavior of Rats.

PubMed

A, Mahmoudi; M B, Shojaeifard; S, Nematollahii; S M J, Mortazavi; A R, Mehdizadeh

2018-06-01

Electromagnetic fields (EMF) with different intensities are widely used at home, offices and public places.Today, there is a growing global concern about the effects of human exposure to EMFs. Epilepsy is one of the most common chronic neurological diseases, affecting 50 million people of all ages worldwide. We aimed to investigate the effect of exposure to Wi-Fi radiation on epileptic behavior of rats. 147 male rats, weighing 200-250 g, were divided into seven groups; negative control (no intervention), sham 1(distilled water), positive control (Pentylentetrazol [PTZ]), intervention group 1 (PTZ + Wi-Fi "off"), sham 2 (distilled water + Wi-Fi "off"), sham 3 (distilled water + Wi-Fi "on"), and intervention group 2 (PTZ + Wi-Fi "on"). The rats were exposed to Wi-Fi for 2h at a distance of 30cm from a commercial Wi-Fi router. Convulsive behaviors of rats were monitored and scored based on the intensity and type by measuring latency/threshold time, number of convulsions, sum of scores and durations of seizure, and duration of score 6 seizure. Kruskal-Wallis and Mann-Whitney U-tests were used to analyze the data. Convulsion was observed in interventions Group 4 and Group 7, and positive control. The mean number of events, and sum of scores were significantly different in intervention 2 than other two groups. However, the differences in mean threshold, mean sum of durations and " time to show convulsion with score 6 " were not statistically significant (P>0.05). Due to limitations of our study including the sample size, these findings should be interpreted with caution. In this study, exposure to 2.4 GHz Wi-Fi radiation showed significant beneficial effects on the epileptic behaviour of rats. More experiments are needed to verify if these exposures can be used as a therapeutic approach for amelioration of seizures in epilepsy.

Effect of Microwave Wi-Fi Radiation at Frequency of 2.4 GHz on Epileptic Behavior of Rats

PubMed Central

A., Mahmoudi; M.B., Shojaeifard; S., Nematollahii; S.M.J., Mortazavi; A.R., Mehdizadeh

2018-01-01

Background: Electromagnetic fields (EMF) with different intensities are widely used at home, offices and public places.Today, there is a growing global concern about the effects of human exposure to EMFs. Epilepsy is one of the most common chronic neurological diseases, affecting 50 million people of all ages worldwide. We aimed to investigate the effect of exposure to Wi-Fi radiation on epileptic behavior of rats. Materials and Methods: 147 male rats, weighing 200-250 g, were divided into seven groups; negative control (no intervention), sham 1(distilled water), positive control (Pentylentetrazol [PTZ]), intervention group 1 (PTZ + Wi-Fi “off”), sham 2 (distilled water + Wi-Fi “off”), sham 3 (distilled water + Wi-Fi “on”), and intervention group 2 (PTZ + Wi-Fi “on”). The rats were exposed to Wi-Fi for 2h at a distance of 30cm from a commercial Wi-Fi router. Convulsive behaviors of rats were monitored and scored based on the intensity and type by measuring latency/threshold time, number of convulsions, sum of scores and durations of seizure, and duration of score 6 seizure. Kruskal-Wallis and Mann-Whitney U-tests were used to analyze the data. Results: Convulsion was observed in interventions Group 4 and Group 7, and positive control. The mean number of events, and sum of scores were significantly different in intervention 2 than other two groups. However, the differences in mean threshold, mean sum of durations and “ time to show convulsion with score 6 ” were not statistically significant (P>0.05). Conclusion: Due to limitations of our study including the sample size, these findings should be interpreted with caution. In this study, exposure to 2.4 GHz Wi-Fi radiation showed significant beneficial effects on the epileptic behaviour of rats. More experiments are needed to verify if these exposures can be used as a therapeutic approach for amelioration of seizures in epilepsy. PMID:29951445

Elderly fall risk prediction using static posturography

PubMed Central

2017-01-01

Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity—0.114 x Eyes Closed Vector Sum Magnitude Velocity—2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older people at risk of multiple falls. PMID:28222191

Elderly fall risk prediction using static posturography.

PubMed

Howcroft, Jennifer; Lemaire, Edward D; Kofman, Jonathan; McIlroy, William E

2017-01-01

Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 years) stood quietly with eyes open and then eyes closed while Wii Balance Board data were collected. Range in anterior-posterior (AP) and medial-lateral (ML) center of pressure (CoP) motion; AP and ML CoP root mean square distance from mean (RMS); and AP, ML, and vector sum magnitude (VSM) CoP velocity were calculated. Romberg Quotients (RQ) were calculated for all parameters. Participants reported six-month fall history and six-month post-assessment fall occurrence. Groups were retrospective fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant functions were clinically viable for multi-faller classification and provided better accuracy than single-faller classification. RQ AP range with cut-off score 1.64 could be used to screen for older people who may fall once. Prospective multi-faller classification with a discriminant function (-1.481 + 0.146 x Eyes Closed AP Velocity-0.114 x Eyes Closed Vector Sum Magnitude Velocity-2.027 x RQ AP Velocity + 2.877 x RQ Vector Sum Magnitude Velocity) and cut-off score 0.541 achieved an accuracy of 84.9% and is viable as a screening tool for older people at risk of multiple falls.

Lod scores for gene mapping in the presence of marker map uncertainty.

PubMed

Stringham, H M; Boehnke, M

2001-07-01

Multipoint lod scores are typically calculated for a grid of locus positions, moving the putative disease locus across a fixed map of genetic markers. Changing the order of a set of markers and/or the distances between the markers can make a substantial difference in the resulting lod score curve and the location and height of its maximum. The typical approach of using the best maximum likelihood marker map is not easily justified if other marker orders are nearly as likely and give substantially different lod score curves. To deal with this problem, we propose three weighted multipoint lod score statistics that make use of information from all plausible marker orders. In each of these statistics, the information conditional on a particular marker order is included in a weighted sum, with weight equal to the posterior probability of that order. We evaluate the type 1 error rate and power of these three statistics on the basis of results from simulated data, and compare these results to those obtained using the best maximum likelihood map and the map with the true marker order. We find that the lod score based on a weighted sum of maximum likelihoods improves on using only the best maximum likelihood map, having a type 1 error rate and power closest to that of using the true marker order in the simulation scenarios we considered. Copyright 2001 Wiley-Liss, Inc.

An Isotonic Partial Credit Model for Ordering Subjects on the Basis of Their Sum Scores

ERIC Educational Resources Information Center

Ligtvoet, Rudy

2012-01-01

In practice, the sum of the item scores is often used as a basis for comparing subjects. For items that have more than two ordered score categories, only the partial credit model (PCM) and special cases of this model imply that the subjects are stochastically ordered on the common latent variable. However, the PCM is very restrictive with respect…

Evaluation of primary prostate cancer using 11C-methionine-PET/CT and 18F-FDG-PET/CT.

PubMed

Shiiba, Masato; Ishihara, Keiichi; Kimura, Go; Kuwako, Tomoyuki; Yoshihara, Hisashi; Yoshihara, Naohisa; Sato, Hidetaka; Kondo, Yukihiro; Tsuchiya, Shin-ichi; Kumita, Shin-ichiro

2012-02-01

The objective of this study was to evaluate the capability of (11)C-methionine (MET)-PET/CT and (18)F-2-deoxy-2-fluoro-D: -glucose (FDG)-PET/CT to diagnose primary prostate cancer using recently developed Gemini TF PET/CT (Philips Healthcare, Cleveland, OH). Twenty men who had been referred for a diagnostic work-up for prostate cancer were enrolled in this study. MET- and FDG-PET/CT by high-resolution mode were carried out on the same day prior to prostate biopsy and each maximum standardized uptake value (SUVmax) was compared with the pathological findings. The regions of interest (about 100 mm(2) small round) were placed at standard 6 points of the peripheral zone and 4 points in the apex of the transitional zone in cases that had undergone biopsy of the internal gland. We summed two scores if a specimen had inhomogeneous Gleason scores (e.g. GS 7; 4 + 3) and doubled the score when the Gleason score was the same (e.g. GS 8; 4 × 2). We divided the tumors into three groups. If the summed Gleason score of the specimens was 5 or less, they were grouped as NG (no grade with the Gleason score). If the summed Gleason score was 6 or 7, the tumors were defined as LG (low Gleason score group), and if the summed Gleason score was 8, 9 or 10, the tumors were classified as HG (high Gleason score group). The mean SUVmax was calculated and one-way analysis of variance or Kruskal-Wallis test and the Tukey post hoc test were performed for statistical comparisons. The capabilities of MET and FDG for diagnosing prostate cancer were evaluated through analysis of the area under the curve of the receiver operating characteristic (ROC) curve. The cut-off levels of SUVmax for the highest accuracy were determined by the results of the ROC analysis, and the sensitivity, specificity and accuracy were calculated. The PET images, obtained with Gemini TF PET/CT, allowed visual identification of anatomical locations within the prostate gland. Among the mean SUVmax of MET, FDG early phase and FDG delayed phase, the differences between NG and HG were all statistically significant (P < 0.01). With MET the difference between NG and LG was also significant (P < 0.05). And for the elevation rate from FDG early to delayed phase, the difference between NG and HG was significant (P < 0.05). The cut-off SUVmax, sensitivity, specificity, accuracy for distinguishing between NG and LG + HG by MET, FDG early and delayed phase were 3.15/78.7/75.6/78.3, 2.81/61.7/80.0/70.7 and 3.00/62.8/78.9/70.7, respectively. And the same factors between NG + LG and HG were 3.76/70.1/89.7/82.6, 2.88/70.1/82.9/78.3 and 3.47/62.7/86.3/77.7, respectively. In terms of the capability to diagnose prostate cancer of high Gleason score (≥8), there was no significant difference between MET and FDG. MET appears to be useful for detecting prostate cancer of both low and high Gleason score.

The influence of applying insurance medicine guidelines for depression on disability assessments

PubMed Central

2013-01-01

Background In the current study we report on the effects of an implementation strategy in the form of a training programme on the assessed work limitations of a client with depression by insurance physicians (IPs) participating in a RCT. These assessed work limitations of a client were in the form of scores on the List of Functional Abilities (LFA). Method We conducted a randomised controlled trial (RCT) for IPs in which we compared the intervention of a specially developed training programme with the usual methods of implementation and training currently used. The outcome was the mean sum score and the inter-rater reliability (Intraclass Correlation Coefficient, ICC) of the LFA scores. These LFA scores were scored by the IPs participating in the RCT for the work limitations of the cases presented in different videos, two videos before the training and two after the training of the intervention group. Results At baseline, the intervention group (IG) consisted of 21 IPs and the control group (CG) of 19. For one participant of the IG and for one of the CG the LFAs of the two case reports after training were not available. Before training the sum scores for the first case report did not differ significantly between the groups, while the mean sum score was higher in the IG than in the CG for the second case report. For both case reports after training a higher score was found in the IG than in the CG. The inter-rater reliability measured for the two case reports before training was about the same in the IG and the CG: 0.64 and 0.65, respectively. For the two case reports after training, the ICC was higher in the IG than in the CG: 0.69 and 0.54, respectively. This difference was not significant however. Conclusion It would appear that the implementation of a specially designed training programme on guidelines for depression may lead to greater inter-rater reliability in the assessments by insurance physicians of the work limitations of clients with depression. It is, however, important to note that insurance physicians who receive training may find more work limitations than those who do not. Trial registration Netherlands’ Trial Register NTR1863 PMID:23758690

Automatically rating trainee skill at a pediatric laparoscopic suturing task.

PubMed

Oquendo, Yousi A; Riddle, Elijah W; Hiller, Dennis; Blinman, Thane A; Kuchenbecker, Katherine J

2018-04-01

Minimally invasive surgeons must acquire complex technical skills while minimizing patient risk, a challenge that is magnified in pediatric surgery. Trainees need realistic practice with frequent detailed feedback, but human grading is tedious and subjective. We aim to validate a novel motion-tracking system and algorithms that automatically evaluate trainee performance of a pediatric laparoscopic suturing task. Subjects (n = 32) ranging from medical students to fellows performed two trials of intracorporeal suturing in a custom pediatric laparoscopic box trainer after watching a video of ideal performance. The motions of the tools and endoscope were recorded over time using a magnetic sensing system, and both tool grip angles were recorded using handle-mounted flex sensors. An expert rated the 63 trial videos on five domains from the Objective Structured Assessment of Technical Skill (OSATS), yielding summed scores from 5 to 20. Motion data from each trial were processed to calculate 280 features. We used regularized least squares regression to identify the most predictive features from different subsets of the motion data and then built six regression tree models that predict summed OSATS score. Model accuracy was evaluated via leave-one-subject-out cross-validation. The model that used all sensor data streams performed best, achieving 71% accuracy at predicting summed scores within 2 points, 89% accuracy within 4, and a correlation of 0.85 with human ratings. 59% of the rounded average OSATS score predictions were perfect, and 100% were within 1 point. This model employed 87 features, including none based on completion time, 77 from tool tip motion, 3 from tool tip visibility, and 7 from grip angle. Our novel hardware and software automatically rated previously unseen trials with summed OSATS scores that closely match human expert ratings. Such a system facilitates more feedback-intensive surgical training and may yield insights into the fundamental components of surgical skill.

A Strategy for Replacing Sum Scoring

ERIC Educational Resources Information Center

Ramsay, James O.; Wiberg, Marie

2017-01-01

This article promotes the use of modern test theory in testing situations where sum scores for binary responses are now used. It directly compares the efficiencies and biases of classical and modern test analyses and finds an improvement in the root mean squared error of ability estimates of about 5% for two designed multiple-choice tests and…

Healthcare teams as complex adaptive systems: Focus on interpersonal interaction.

PubMed

Pype, Peter; Krystallidou, Demi; Deveugele, Myriam; Mertens, Fien; Rubinelli, Sara; Devisch, Ignaas

2017-11-01

The aim of this study is to test the feasibility of a tool to objectify the functioning of healthcare teams operating in the complexity zone, and to evaluate its usefulness in identifying areas for team quality improvement. We distributed The Complex Adaptive Leadership (CAL™) Organisational Capability Questionnaire (OCQ) to all members of one palliative care team (n=15) and to palliative care physicians in Flanders, Belgium (n=15). Group discussions were held on feasibility aspects and on the low scoring topics. Data was analysed calculating descriptive statistics (sum score, mean and standard deviation). The one sample T-Test was used to detect differences within each group. Both groups of participants reached mean scores ranging from good to excellent. The one sample T test showed statistically significant differences between participants' sum scores within each group (p<0,001). Group discussion led to suggestions for quality improvement e.g. enhanced feedback strategies between team members. The questionnaire used in our study shows to be a feasible and useful instrument for the evaluation of the palliative care teams' day-to-day operations and to identify areas for quality improvement. The CAL™OCQ is a promising instrument to evaluate any healthcare team functioning. A group discussion on the questionnaire scores can serve as a starting point to identify targets for quality improvement initiatives. Copyright © 2017 Elsevier B.V. All rights reserved.

Predicting Functional Capacity From Measures of Muscle Mass in Postmenopausal Women.

PubMed

Orsatti, Fábio Lera; Nunes, Paulo Ricardo Prado; Souza, Aletéia de Paula; Martins, Fernanda Maria; de Oliveira, Anselmo Alves; Nomelini, Rosekeila Simões; Michelin, Márcia Antoniazi; Murta, Eddie Fernando Cândido

2017-06-01

Menopause increases body fat and decreases muscle mass and strength, which contribute to sarcopenia. The amount of appendicular muscle mass has been frequently used to diagnose sarcopenia. Different measures of appendicular muscle mass have been proposed. However, no studies have compared the most salient measure (appendicular muscle mass corrected by body fat) of the appendicular muscle mass to physical function in postmenopausal women. To examine the association of 3 different measurements of appendicular muscle mass (absolute, corrected by stature, and corrected by body fat) with physical function in postmenopausal women. Cross-sectional descriptive study. Outpatient geriatric and gynecological clinic. Forty-eight postmenopausal women with a mean age (standard deviation [SD]) of 62.1 ± 8.2 years, with mean (SD) length of menopause of 15.7 ± 9.8 years and mean (SD) body fat of 43.6% ± 9.8%. Not applicable. Appendicular muscle mass measure was measured with dual-energy x-ray absorptiometry. Physical function was measured by a functional capacity questionnaire, a short physical performance battery, and a 6 minute-walk test. Muscle quality (leg extensor strength to lower-body mineral-free lean mass ratio) and sum of z scores (sum of each physical function tests z score) were performed to provide a global index of physical function. The regression analysis showed that appendicular muscle mass corrected by body fat was the strongest predictor of physical function. Each increase in the standard deviation of appendicular muscle mass corrected by body fat was associated with a mean sum of z score increase of 59% (standard deviation), whereas each increase in absolute appendicular muscle mass and appendicular muscle mass corrected by stature were associated with a mean sum of z scores decrease of 23% and 36%, respectively. Muscle quality was associated with appendicular muscle mass corrected by body fat. These findings indicate that appendicular muscle mass corrected by body fat is a better predictor of physical function than the other measures of appendicular muscle mass in postmenopausal women. I. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Quantitative evaluation improves specificity of myocardial perfusion SPECT in the assessment of functionally significant intermediate coronary artery stenoses: a comparative study with fractional flow reserve measurements.

PubMed

Sahiner, Ilgin; Akdemir, Umit O; Kocaman, Sinan A; Sahinarslan, Asife; Timurkaynak, Timur; Unlu, Mustafa

2013-02-01

Myocardial perfusion SPECT (MPS) is a noninvasive method commonly used for assessment of the hemodynamic significance of intermediate coronary stenoses. Fractional flow reserve (FFR) measurement is a well-validated invasive method used for the evaluation of intermediate stenoses. We aimed to determine the association between MPS and FFR findings in intermediate degree stenoses and evaluate the added value of quantification in MPS. Fifty-eight patients who underwent intracoronary pressure measurement in the catheterization laboratory to assess the physiological significance of intermediate (40-70%) left anterior descending (LAD) artery lesions, and who also underwent stress myocardial perfusion SPECT either for the assessment of an intermediate stenosis or for suspected coronary artery disease were analyzed retrospectively in the study. Quantitative analysis was performed using the 4DMSPECT program, with visual assessment performed by two experienced nuclear medicine physicians blinded to the angiographic findings. Summed stress scores (SSS) and summed difference scores (SDS) in the LAD artery territory according to the 20 segment model were calculated. A summed stress score of ≥ 3 and an SDS of ≥ 2 were assumed as pathologic, indicating significance of the lesion; a cutoff value of 0.75 was used to define abnormal FFR. Both visual and quantitative assessment results were compared with FFR using Chi-square (χ²) test. The mean time interval between two studies was 13 ± 11 days. FFR was normal in 45 and abnormal in 13 patients. Considering the FFR results as the gold standard method for assessing the significance of the lesion, the sensitivity and specificity of quantitative analysis determining the abnormal flow reserve were 85 and 84%, respectively, while visual analysis had a sensitivity of 77% and a specificity of 51%. There was a good agreement between the observers (κ = 0.856). Summed stress and difference scores demonstrated moderate inverse correlations with FFR values (r = -0.542, p < 0.001 and r = -0.506, p < 0.001, respectively). Quantitative analysis of the myocardial perfusion SPECT increases the specificity in evaluating the significance of intermediate degree coronary lesions.

Histomorphological differentiation of non-erosive reflux disease and functional heartburn in patients with PPI-refractory heartburn.

PubMed

Kandulski, A; Jechorek, D; Caro, C; Weigt, J; Wex, T; Mönkemüller, K; Malfertheiner, P

2013-09-01

Proton pump inhibitor (PPI)-refractory heartburn may be due to persistent gastro-oesophageal reflux, oesophageal hypersensitivity or functional heartburn (FH). The differentiation between non-erosive reflux disease (NERD) and FH may be very difficult. However, this differentiation is important for appropriate therapeutic management. Dilated intercellular spaces (DIS), papillary elongation (PE) and basal cell hyperplasia (BCH) can be all assessed by light microscopy. Whether these mucosal abnormalities allow the differentiation of NERD from FH in PPI-refractory patients is uncertain. To assess histopathological findings by light microscopy in patients with refractory heartburn to differentiate NERD from FH. Sixty-two patients with PPI-refractory symptoms underwent EGD and MII-pH after pausing PPI medication for 2 weeks before investigation. Twenty-five subjects without upper gastrointestinal symptoms were included as controls. Symptom assessment was based on the reflux disease questionnaire (RDQ). Biopsies were taken 3-5 cm above the gastro-oesophageal junction. DIS, PE, BCH and infiltration of immune cells were evaluated and a sum score was calculated. Based on endoscopy and MII-pH, GERD was diagnosed in 43 patients (NERD: 20; ERD: 23) and FH in 19 patients. There was no difference in symptoms between the groups. Each individual histopathological item was different between the groups (P < 0.0001). Between NERD and FH, the most significant difference was found for DIS and the histopathological sum score (P < 0.001). These findings suggest that oesophageal biopsies are useful to differentiate NERD from FH. Increased DIS and a histological sum score are the most significant histopathological abnormalities in NERD as compared with FH. © 2013 John Wiley & Sons Ltd.

www.common-metrics.org: a web application to estimate scores from different patient-reported outcome measures on a common scale.

PubMed

Fischer, H Felix; Rose, Matthias

2016-10-19

Recently, a growing number of Item-Response Theory (IRT) models has been published, which allow estimation of a common latent variable from data derived by different Patient Reported Outcomes (PROs). When using data from different PROs, direct estimation of the latent variable has some advantages over the use of sum score conversion tables. It requires substantial proficiency in the field of psychometrics to fit such models using contemporary IRT software. We developed a web application ( http://www.common-metrics.org ), which allows estimation of latent variable scores more easily using IRT models calibrating different measures on instrument independent scales. Currently, the application allows estimation using six different IRT models for Depression, Anxiety, and Physical Function. Based on published item parameters, users of the application can directly estimate latent trait estimates using expected a posteriori (EAP) for sum scores as well as for specific response patterns, Bayes modal (MAP), Weighted likelihood estimation (WLE) and Maximum likelihood (ML) methods and under three different prior distributions. The obtained estimates can be downloaded and analyzed using standard statistical software. This application enhances the usability of IRT modeling for researchers by allowing comparison of the latent trait estimates over different PROs, such as the Patient Health Questionnaire Depression (PHQ-9) and Anxiety (GAD-7) scales, the Center of Epidemiologic Studies Depression Scale (CES-D), the Beck Depression Inventory (BDI), PROMIS Anxiety and Depression Short Forms and others. Advantages of this approach include comparability of data derived with different measures and tolerance against missing values. The validity of the underlying models needs to be investigated in the future.

Alexithymia in the German general population.

PubMed

Franz, Matthias; Popp, Kerstin; Schaefer, Ralf; Sitte, Wolfgang; Schneider, Christine; Hardt, Jochen; Decker, Oliver; Braehler, Elmar

2008-01-01

The Toronto-Alexithymia-Scale (TAS-20) is used worldwide as a valid measurement of alexithymia. Until now, population-based standardization and cut-off values of the German TAS-20 version have not been available. This study provides these by means of a representative German sample and by investigating the factorial structure of the TAS-20. Data were generated from a representative random sample of the German general population (1,859 subjects aged between 20 and 69). The TAS-20 sum score was normally distributed. The mean value was 49.5 (SD=9.3) in men and 48.2 (SD=9.2) in women. Divorce, single and low social status were associated with enhanced sum scores. Ten percent of the population exceeded the TAS-20 sum score threshold of >or=61. The 66th percentile reached 53 for men and 52 for women. Factor analysis identified three factors that match the scales of the English original version. An additional fourth factor ("importance of emotional introspection") was extracted. Total explanation of variance by these four factors was 52.27%. The sum score of the German TAS-20 version is suited for the standardized measure of alexithymia. For selecting alexithymic individuals in experimental studies, the cut-off >or=61 is possibly too restrictive. Therefore, we propose the 66th percentile for the identification of high alexithymics. The TAS-20 sum score is associated with important socio-demographic variables. The factorial structure is reliable; the fourth factor ("importance of emotional introspection") provides differentiation of content and allows for enhanced explanation of variance.

Factor structure of the functional movement screen in marine officer candidates.

PubMed

Kazman, Josh B; Galecki, Jeffrey M; Lisman, Peter; Deuster, Patricia A; OʼConnor, Francis G

2014-03-01

Functional movement screening (FMS) is a musculoskeletal assessment that is intended to fill a gap between preparticipation examinations and performance tests. Functional movement screening consists of 7 standardized movements involving multiple muscle groups that are rated 0-3 during performance; scores are combined into a final score, which is intended to predict injury risk. This use of a sum-score in this manner assumes that the items are unidimensional and scores are internally consistent, which are measures of internal reliability. Despite research into the FMS' predictive value and interrater reliability, research has not assessed its psychometric properties. The present study is a standard psychometric analysis of the FMS and is the first to assess the internal consistency and factor structure of the FMS, using Cronbach's alpha and exploratory factor analysis (EFA). Using a cohort of 877 male and 57 female Marine officer candidates who performed the FMS, EFA of polychoric correlations with varimax rotation was conducted to explore the structure of the FMS. Tests were repeated on the original scores, which integrated feelings of pain during movement (0-3), and then on scores discounting the pain instruction and based only on the performance (1-3), to determine whether pain ratings affected the factor structure. The average FMS score was 16.7 ± 1.8. Cronbach's alpha was 0.39. Exploratory factor analysis availed 2 components accounting for 21 and 17% and consisting of separate individual movements (shoulder mobility and deep squat, respectively). Analysis on scores discounting pain showed similar results. The factor structures were not interpretable, and the low Cronbach's alpha suggests a lack of internal consistency in FMS sum scores. Results do not offer support for validity of the FMS sum score as a unidimensional construct. In the absence of additional psychometric research, caution is warranted when using the FMS sum score.

The sumLINK statistic for genetic linkage analysis in the presence of heterogeneity.

PubMed

Christensen, G B; Knight, S; Camp, N J

2009-11-01

We present the "sumLINK" statistic--the sum of multipoint LOD scores for the subset of pedigrees with nominally significant linkage evidence at a given locus--as an alternative to common methods to identify susceptibility loci in the presence of heterogeneity. We also suggest the "sumLOD" statistic (the sum of positive multipoint LOD scores) as a companion to the sumLINK. sumLINK analysis identifies genetic regions of extreme consistency across pedigrees without regard to negative evidence from unlinked or uninformative pedigrees. Significance is determined by an innovative permutation procedure based on genome shuffling that randomizes linkage information across pedigrees. This procedure for generating the empirical null distribution may be useful for other linkage-based statistics as well. Using 500 genome-wide analyses of simulated null data, we show that the genome shuffling procedure results in the correct type 1 error rates for both the sumLINK and sumLOD. The power of the statistics was tested using 100 sets of simulated genome-wide data from the alternative hypothesis from GAW13. Finally, we illustrate the statistics in an analysis of 190 aggressive prostate cancer pedigrees from the International Consortium for Prostate Cancer Genetics, where we identified a new susceptibility locus. We propose that the sumLINK and sumLOD are ideal for collaborative projects and meta-analyses, as they do not require any sharing of identifiable data between contributing institutions. Further, loci identified with the sumLINK have good potential for gene localization via statistical recombinant mapping, as, by definition, several linked pedigrees contribute to each peak.

Methods and statistics for combining motif match scores.

PubMed

Bailey, T L; Gribskov, M

1998-01-01

Position-specific scoring matrices are useful for representing and searching for protein sequence motifs. A sequence family can often be described by a group of one or more motifs, and an effective search must combine the scores for matching a sequence to each of the motifs in the group. We describe three methods for combining match scores and estimating the statistical significance of the combined scores and evaluate the search quality (classification accuracy) and the accuracy of the estimate of statistical significance of each. The three methods are: 1) sum of scores, 2) sum of reduced variates, 3) product of score p-values. We show that method 3) is superior to the other two methods in both regards, and that combining motif scores indeed gives better search accuracy. The MAST sequence homology search algorithm utilizing the product of p-values scoring method is available for interactive use and downloading at URL http:/(/)www.sdsc.edu/MEME.

Self and near relative ratings of functional level one year after traumatic brain injury.

PubMed

Sandhaug, Maria; Andelic, Nada; Berntsen, Svein A; Seiler, Stephen; Mygland, Aase

2012-01-01

To quantify traumatic brain injury (TBI) patients' perceptions of own function by the Patient Competency Rating Scale (PCRS) one year after injury, and to examine self-awareness of functional deficits by comparing PCRS ratings from patients (PCRS-P) and PCRS ratings from near relatives (PCRS-R), and to identify predictors of awareness deficits. A cohort of 50 severe (n = 33) and moderate (n = 17) TBI patients. Awareness of deficits was investigated by subtracting PCRS relative ratings from PCRS patient ratings. Predictors of PCRS ratings and differences were assessed by stepwise multiple regression analyses. The average patient PCRS sum score was 122/150 (95% CI = 115; 129) as compared to a sum score of 117/150 (95% CI = 110; 125), given by their relatives (p = 0.93). The patients scored themselves slightly higher than their relatives in the domains of activities of daily living (ADL) and cognitive function (p < 0.001, p < 0.001). Regression analyses showed that Glasgow Coma Scale (GCS)score at admission to rehabilitation was the strongest predictor of patient PCRS (B = 3.314, p = 0.008). The strongest predictor of differences between patient and relative PCRS was GCS acute (B = -3.530, p = 0.001). TBI patients demonstrated a slight "awareness gap" in ADL and cognitive function. Low GCS in the acute phase and high age were the strongest predictors of self- awareness deficits.

Donepezil for treatment of cognitive dysfunction in children with Down syndrome aged 10-17.

PubMed

Kishnani, Priya S; Heller, James H; Spiridigliozzi, Gail A; Lott, Ira; Escobar, Luis; Richardson, Sharon; Zhang, Richard; McRae, Thomas

2010-12-01

The objective of this 10-week, randomized, double-blind, placebo-controlled multicenter study was to assess the efficacy and safety of donepezil for the treatment of cognitive dysfunction exhibited by children with Down syndrome (DS). Intervention comprised donepezil (2.5-10 mg/day) in children (aged 10-17 years) with DS of mild-to-moderate severity. The primary measures were the Vineland-II Adaptive Behavior Scales (VABS-II) Parent/Caregiver Rating Form (PCRF) the sum of nine subdomain standardized scores and standard safety measures. Secondary measures included the VABS-II/PCRF scores on the following domains and their respective individual subdomains: Communication (receptive, expressive, and written); Daily Living Skills (personal, domestic, and community); Socialization (interpersonal relationships, play and leisure time, and coping skills), and scores on the Test of Verbal Expression and Reasoning, a subject-performance-based measure of expressive language. At baseline, 129 participants were assigned treatment with donepezil or placebo. During the double-blind phase, VABS II/PCRF sum of the nine subdomain standardized scores, called v-scores, improved significantly from baseline in both groups (P < 0.0001), with no significant between-group differences. This trial failed to demonstrate any benefit for donepezil versus placebo in children and adolescents with DS, although donepezil appeared to be well tolerated. © 2010 Wiley-Liss, Inc.

Rotigotine improves restless legs syndrome: a 6-month randomized, double-blind, placebo-controlled trial in the United States.

PubMed

Hening, Wayne A; Allen, Richard P; Ondo, William G; Walters, Arthur S; Winkelman, John W; Becker, Philip; Bogan, Richard; Fry, June M; Kudrow, David B; Lesh, Kurt W; Fichtner, Andreas; Schollmayer, Erwin

2010-08-15

This randomized, double-blinded, placebo-controlled trial (NCT00135993) assessed efficacy and safety of the dopamine agonist rotigotine in the treatment of idiopathic restless legs syndrome (RLS) over a 6-month maintenance period. A total of 505 eligible participants with moderate to severe RLS (IRLS sum score >or= 15) were randomly assigned to five groups to receive either placebo or rotigotine (0.5, 1, 2, or 3 mg/24 hr) delivered by once-daily transdermal patch (fixed-dose regimen). The two co-primary efficacy parameters decreased from baseline to end of maintenance in IRLS sum score and in clinical global impressions (CGI-1) score. On both primary measures, 2 and 3 mg/24 hr rotigotine was superior to placebo (P < 0.001). Adjusted treatment differences to placebo for the IRLS sum score were -4.5 (95% CI: -6.9, -2.2) for 2 mg/24 hr rotigotine, -5.2 (95% CI: -7.5, -2.9) for 3 mg/24 hr rotigotine, and for CGI item 1 -0.65 (95% CI: -1.0, -0.3) and -0.9 (95% CI: -1.3, -0.5) for the 2 and 3 mg/24 hr doses, respectively. Skin reactions (27%) and known dopaminergic side effects such as nausea (18.1%) and headache (11.6%) were mostly mild or moderate in rotigotine subjects. Rotigotine transdermal patches releasing 2 to 3 mg/24 hr significantly reduced the severity of RLS symptoms. Treatment efficacy was maintained throughout the 6-month double-blind period.

Associations of low grade inflammation and endothelial dysfunction with depression - The Maastricht Study.

PubMed

van Dooren, Fleur E P; Schram, Miranda T; Schalkwijk, Casper G; Stehouwer, Coen D A; Henry, Ronald M A; Dagnelie, Pieter C; Schaper, Nicolaas C; van der Kallen, Carla J H; Koster, Annemarie; Sep, Simone J S; Denollet, Johan; Verhey, Frans R J; Pouwer, Frans

2016-08-01

The pathogenesis of depression may involve low-grade inflammation and endothelial dysfunction. We aimed to evaluate the independent associations of inflammation and endothelial dysfunction with depressive symptoms and depressive disorder, and the role of lifestyle factors in this association. In The Maastricht Study, a population-based cohort study (n=852, 55% men, m=59.8±8.5years), depressive symptoms were assessed with the Patient Health Questionnaire-9 and (major and minor) depressive disorder with the Mini-International Neuropsychiatric Interview. Plasma biomarkers of inflammation (hsCRP, SAA, sICAM-1, IL-6, IL-8, TNF-α) and endothelial dysfunction (sVCAM-1, sICAM-1, sE-selectin, vWF) were measured with sandwich immunoassays and combined into two standardized sum scores. Biomarkers of inflammation (hsCRP, TNF-α, SAA, sICAM-1) and endothelial dysfunction (sICAM-1, sE-Selectin) were univariately associated with depressive symptoms and depressive disorder. The sum scores of inflammation and endothelial dysfunction were associated with depressive disorder after adjustment for age, sex, type 2 diabetes, kidney function and prior cardiovascular disease (OR 1.54, p=0.001 and 1.40, p=0.006). Both sum scores remained significantly associated with depressive disorder after additional adjustment for lifestyle factors smoking, alcohol consumption and body mass index. The sum score of inflammation was also independently associated with depressive symptoms, while the sum score of endothelial dysfunction was not. Inflammation and endothelial dysfunction are both associated with depressive disorder, independent of lifestyle factors. Our results might suggest that inflammation and endothelial dysfunction are involved in depression. Copyright © 2016. Published by Elsevier Inc.

What the "Overall" Doesn't Tell about World University Rankings: Examples from ARWU, QSWUR, and THEWUR in 2013

ERIC Educational Resources Information Center

Soh, Kaycheng

2015-01-01

In the various world university ranking schemes, the "Overall" is a sum of the weighted indicator scores. As the indicators are of a different nature from each other, "Overall" conceals important differences. Factor analysis of the data from three prominent ranking schemes reveals that there are two factors in each of the…

Dirichlet Component Regression and its Applications to Psychiatric Data.

PubMed

Gueorguieva, Ralitza; Rosenheck, Robert; Zelterman, Daniel

2008-08-15

We describe a Dirichlet multivariable regression method useful for modeling data representing components as a percentage of a total. This model is motivated by the unmet need in psychiatry and other areas to simultaneously assess the effects of covariates on the relative contributions of different components of a measure. The model is illustrated using the Positive and Negative Syndrome Scale (PANSS) for assessment of schizophrenia symptoms which, like many other metrics in psychiatry, is composed of a sum of scores on several components, each in turn, made up of sums of evaluations on several questions. We simultaneously examine the effects of baseline socio-demographic and co-morbid correlates on all of the components of the total PANSS score of patients from a schizophrenia clinical trial and identify variables associated with increasing or decreasing relative contributions of each component. Several definitions of residuals are provided. Diagnostics include measures of overdispersion, Cook's distance, and a local jackknife influence metric.

A new discussion of the cutaneous vascular reactivity in sensitive skin: A sub-group of SS?

PubMed

Chen, S Y; Yin, J; Wang, X M; Liu, Y Q; Gao, Y R; Liu, X P

2018-02-02

Sensitive skin (SS) seems not to be a one-dimensional condition and many scholars concentrate on skin barrier disruption or sensorineural change, but few focus on its increased vascular reactivity. This study explored the possibility of using the different selection methods and measurement methods to verify a high vascular reactivity in SS without an impaired cutaneous barrier function. Sixty "self-perceived sensitive skin" volunteers were enlisted and each one completed three kinds of screening tests: assess cutaneous sensory using questionnaire survey and Lactic Acid Sting Test (LAST); assess barrier function using Sodium lauryl sulphate (SLS) skin irritation test and assess cutaneous vascular reactivity using 98% DMSO test and non-invasive measurement. Volunteers were divided into different groups based on response to SLS. The DMSO clinical score and the biophysical parameters obtained by non-invasive measurement were subsequently analysed. (1) The positive correlations could be seen between sum LAST score and sum DMSO score regardless of the observation time; (2) The biological parameters (CBF、a*values and L* values) are all keeping with DMSO score; (3) If the participants were divided into SLS reactors and non-reactors, a composition ratio of DMSO score was significant difference in these two groups and in SLS non-reactors, there were still seven participants showed high reaction to DMSO. There is a sub-group of SS for characteristics of a high vascular reactivity without an impaired cutaneous barrier function. The DMSO test and novel non-invasive measurements which are conducive to assess cutaneous vascular reactivity, combined with SLS skin irritation test could help us to screen this kind of SS. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Comparison of Three Different Scoring Methods for Self-Report Measures of Psychological Aggression in a Sample of College Females

PubMed Central

Shorey, Ryan C.; Brasfield, Hope; Febres, Jeniimarie; Cornelius, Tara L.; Stuart, Gregory L.

2012-01-01

Psychological aggression in females’ dating relationships has received increased empirical attention in recent years. However, researchers have used numerous measures of psychological aggression, and various scoring methods with these measures, making it difficult to compare across studies on psychological aggression. In addition, research has yet to examine whether different scoring methods for psychological aggression measures may affect the psychometric properties of these instruments. The current study examined three self-report measures of psychological aggression within a sample of female college students (N = 108), including their psychometric properties when scored using frequency, sum, and variety scores. Results showed that the Revised Conflict Tactics Scales (CTS2) had variable internal consistency depending on the scoring method used and good validity; the Multidimensional Measure of Emotional Abuse (MMEA) and the Follingstad Psychological Aggression Scale (FPAS) both had good internal consistency and validity across scoring methods. Implications of these findings for the assessment of psychological aggression and future research are discussed. PMID:23393957

A comparison of three different scoring methods for self-report measures of psychological aggression in a sample of college females.

PubMed

Shorey, Ryan C; Brasfield, Hope; Febres, Jeniimarie; Cornelius, Tara L; Stuart, Gregory L

2012-01-01

Psychological aggression in females' dating relationships has received increased empirical attention in recent years. However, researchers' have used numerous measures of psychological aggression and various scoring methods with these measures, making it difficult to compare across studies on psychological aggression. In addition, research has yet to examine whether different scoring methods for psychological aggression measures may affect the psychometric properties of these instruments. This study examined three self-report measures of psychological aggression within a sample of female college students (N = 108), including their psychometric properties when scored using frequency, sum, and variety scores. Results showed that the Revised Conflict Tactics Scales (CTS2) had variable internal consistency depending on the scoring method used and good validity; the Multidimensional Measure of Emotional Abuse (MMEA) and the Follingstad Psychological Aggression Scale (FPAS) both had good internal consistency and validity across scoring methods. Implications of these findings for the assessment of psychological aggression and future research are discussed.

Development and assessment of a composite score for memory in the Alzheimer's Disease Neuroimaging Initiative (ADNI).

PubMed

Crane, Paul K; Carle, Adam; Gibbons, Laura E; Insel, Philip; Mackin, R Scott; Gross, Alden; Jones, Richard N; Mukherjee, Shubhabrata; Curtis, S McKay; Harvey, Danielle; Weiner, Michael; Mungas, Dan

2012-12-01

We sought to develop and evaluate a composite memory score from the neuropsychological battery used in the Alzheimer's Disease (AD) Neuroimaging Initiative (ADNI). We used modern psychometric approaches to analyze longitudinal Rey Auditory Verbal Learning Test (RAVLT, 2 versions), AD Assessment Schedule - Cognition (ADAS-Cog, 3 versions), Mini-Mental State Examination (MMSE), and Logical Memory data to develop ADNI-Mem, a composite memory score. We compared RAVLT and ADAS-Cog versions, and compared ADNI-Mem to RAVLT recall sum scores, four ADAS-Cog-derived scores, the MMSE, and the Clinical Dementia Rating Sum of Boxes. We evaluated rates of decline in normal cognition, mild cognitive impairment (MCI), and AD, ability to predict conversion from MCI to AD, strength of association with selected imaging parameters, and ability to differentiate rates of decline between participants with and without AD cerebrospinal fluid (CSF) signatures. The second version of the RAVLT was harder than the first. The ADAS-Cog versions were of similar difficulty. ADNI-Mem was slightly better at detecting change than total RAVLT recall scores. It was as good as or better than all of the other scores at predicting conversion from MCI to AD. It was associated with all our selected imaging parameters for people with MCI and AD. Participants with MCI with an AD CSF signature had somewhat more rapid decline than did those without. This paper illustrates appropriate methods for addressing the different versions of word lists, and demonstrates the additional power to be gleaned with a psychometrically sound composite memory score.

No Association Between Time of Onset of Hearing Loss (Childhood Versus Adulthood) and Self-Reported Hearing Handicap in Adults.

PubMed

Aarhus, Lisa; Tambs, Kristian; Engdahl, Bo

2015-12-01

This study examined the association between time of onset of hearing loss (childhood vs. adulthood) and self-reported hearing handicap in adults. This is a population-based cohort study of 2,024 adults (mean = 48 years) with hearing loss (binaural pure-tone average 0.5-4 kHz ≥ 20 dB HL) who completed a hearing handicap questionnaire. In childhood, the same persons (N = 2,024) underwent audiometry in a school investigation (at ages 7, 10, and 13 years), in which 129 were diagnosed with sensorineural hearing loss (binaural pure-tone average 0.5-4 kHz ≥ 20 dB HL), whereas 1,895 had normal hearing thresholds. Hearing handicap was measured in adulthood as the sum-score of various speech perception and social impairment items (15 items). The sum-score increased with adult hearing threshold level (p < .001). After adjustment for adult hearing threshold level, hearing aid use, adult age, sex, and socioeconomic status, there was no significant difference in hearing handicap sum-score between the group with childhood-onset hearing loss (n = 129) and the group with adult-onset hearing loss (n = 1,895; p = .882). Self-reported hearing handicap in adults increased with hearing threshold level. After adjustment for adult hearing threshold level, this cohort study revealed no significant association between time of onset of hearing loss (childhood vs. adulthood) and self-reported hearing handicap.

No Association Between Time of Onset of Hearing Loss (Childhood Versus Adulthood) and Self-Reported Hearing Handicap in Adults

PubMed Central

Tambs, Kristian; Engdahl, Bo

2015-01-01

Purpose This study examined the association between time of onset of hearing loss (childhood vs. adulthood) and self-reported hearing handicap in adults. Methods This is a population-based cohort study of 2,024 adults (mean = 48 years) with hearing loss (binaural pure-tone average 0.5–4 kHz ≥ 20 dB HL) who completed a hearing handicap questionnaire. In childhood, the same persons (N = 2,024) underwent audiometry in a school investigation (at ages 7, 10, and 13 years), in which 129 were diagnosed with sensorineural hearing loss (binaural pure-tone average 0.5–4 kHz ≥ 20 dB HL), whereas 1,895 had normal hearing thresholds. Results Hearing handicap was measured in adulthood as the sum-score of various speech perception and social impairment items (15 items). The sum-score increased with adult hearing threshold level (p < .001). After adjustment for adult hearing threshold level, hearing aid use, adult age, sex, and socioeconomic status, there was no significant difference in hearing handicap sum-score between the group with childhood-onset hearing loss (n = 129) and the group with adult-onset hearing loss (n = 1,895; p = .882). Conclusion Self-reported hearing handicap in adults increased with hearing threshold level. After adjustment for adult hearing threshold level, this cohort study revealed no significant association between time of onset of hearing loss (childhood vs. adulthood) and self-reported hearing handicap. PMID:26649831

Application of a modified selection index for honey bees (Hymenoptera: Apidae).

PubMed

van Engelsdorp, D; Otis, G W

2000-12-01

Nine different genetic families of honey bees (Apis mellifera L.) were compared using summed z-scores (phenotypic values) and a modified selection index (Imod). Imod values incorporated both the phenotypic scores of the different traits and the economic weightings of these traits, as determined by a survey of commercial Ontario beekeepers. Largely because of the high weight all beekeepers place on honey production, a distinct difference between line rankings based on phenotypic scores and Imod scores was apparent, thereby emphasizing the need to properly weight the traits being evaluated to select bee stocks most valuable for beekeepers. Furthermore, when beekeepers who made >10% of their income from queen and nucleus colony sales assigned relative values to the traits used in the Imod calculations, the results differed from those based on weightings assigned by honey producers. Our results underscore the difficulties the North American beekeeping industry must overcome to devise effective methods of evaluating colonies for breeding purposes.

Analysis of chemosensory function in patients with chronic Eustachian tube dysfunction prior to and after balloon dilatation.

PubMed

Ute, Walliczek-Dworschak; Lisa, Schmierer; Brandon, Greene; Robert, Pellegrino; Philipp, Dworschak; Stuck, Boris Alexander; Christian, Güldner

2018-10-01

Eustachian tube dysfunction (ETD) affects approximately 1% of adults in the general population. Non treated Eustachian tube dysfunction can result in chronic middle ear diseases, which have been shown to significantly affect taste sensitivity. A promising treatment is balloon dilatation of the Eustachian tube. The primary aim of the present study was to investigate whether individuals with ETD had impairment in chemosensory functions, and the changes of the chemosensory function after balloon dilatation of the Eustachian tube. 26 patients (17 female, 9 male) (=56 ears) suffering from ETD with a mean age of 39±15years were included in the present study. 20 patients (76%) returned to be evaluated at the follow up (=40 ears) 51±22days after balloon dilatation. For pre- and post operation, gustatory function was measured with a lateralized gustatory test with the taste strips and olfactory function was tested by means of the Sniffin' Sticks test battery (threshold, discrimination and identification (ID)). Patients' baseline taste function (summed taste score 9.8±3.5 (mean±SD)) was significantly impaired compared to normative data (summed taste score 12.4±2.3; p=0.002). After balloon dilatation of the Eustachian tube, the taste function remained stable (summed taste score 9.4±4.3; p=0.814). Olfactory function (odor ID, summed score (TDI)) improved postoperatively (TDI 32.4±3.6) compared to pre-operative scores (TDI 33.6±4.0; p=0.012), but not to a clinically relevant extent. This study suggests, that patients suffering from ETD exhibit reduced taste scores. Balloon dilatation of the Eustachian tube does not seem to influence gustatory function, but olfactory function showed improvement. Copyright © 2018 Elsevier B.V. All rights reserved.

How Effective Are Military Academy Admission Standards

DTIC Science & Technology

2016-07-22

curriculum) 60 Leadership Composite Called the extracurricular composite; includes activities , leadership, and résumé 20 Selection Panel Score Consists of...score 60 Community Leadership Score Composite of the athletic activities score, the extracurricular activities score, and the faculty appraisal...promotion. Both the candidate fitness assessment and the athletic activities score are statistically significant predictors of graduation. The candidate

Within-Subject Comparison of Changes in a Pretest-Posttest Design

ERIC Educational Resources Information Center

Hennig, Christian; Mullensiefen, Daniel; Bargmann, Jens

2010-01-01

The authors propose a method to compare the influence of a treatment on different properties within subjects. The properties are measured by several Likert-type-scaled items. The results show that many existing approaches, such as repeated measurement analysis of variance on sum and mean scores, a linear partial credit model, and a graded response…

High blood pressure and cognitive decline in mild cognitive impairment.

PubMed

Goldstein, Felicia C; Levey, Allan I; Steenland, N Kyle

2013-01-01

To determine whether high blood pressure (BP) levels are associated with faster decline in specific cognitive domains. Prospective longitudinal cohort. Uniform Data Set of the National Institutes of Health, National Institute on Aging Alzheimer's Disease Centers. One thousand three hundred eighty-five participants with a diagnosis of mild cognitive impairment (MCI) and measured BP values at baseline and two annual follow-up visits. Neuropsychological test scores and Clinical Dementia Rating Sum of Boxes (CDR Sum) score. Participants with MCI with two or three annual occasions of high BP values (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) had significantly faster decline on neuropsychological measures of visuomotor sequencing, set shifting, and naming than those who were normotensive on all three occasions. High systolic BP values were associated as well with faster decline on the CDR Sum score. Hypertension is associated with faster cognitive decline in persons at risk for dementia. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

High Blood Pressure and Cognitive Decline in Mild Cognitive Impairment

PubMed Central

Goldstein, Felicia C.; Levey, Allan I.; Steenland, N. Kyle

2013-01-01

Objectives To determine whether high blood pressure (BP) levels are associated with faster decline in specific cognitive domains. Design Prospective longitudinal cohort. Setting Uniform Data Set of the National Institutes of Health, National Institute on Aging Alzheimer's Disease Centers. Participants One thousand three hundred eighty-five participants with a diagnosis of mild cognitive impairment (MCI) and measured BP values at baseline and two annual follow-up visits. Measurements Neuropsychological test scores and Clinical Dementia Rating Sum of Boxes (CDR Sum) score. Results Participants with MCI with two or three annual occasions of high BP values (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) had significantly faster decline on neuropsychological measures of visuomotor sequencing, set shifting, and naming than those who were normotensive on all three occasions. High systolic BP values were associated as well with faster decline on the CDR Sum score. Conclusion Hypertension is associated with faster cognitive decline in persons at risk for dementia. PMID:23301925

Dirichlet Component Regression and its Applications to Psychiatric Data

PubMed Central

Gueorguieva, Ralitza; Rosenheck, Robert; Zelterman, Daniel

2011-01-01

Summary We describe a Dirichlet multivariable regression method useful for modeling data representing components as a percentage of a total. This model is motivated by the unmet need in psychiatry and other areas to simultaneously assess the effects of covariates on the relative contributions of different components of a measure. The model is illustrated using the Positive and Negative Syndrome Scale (PANSS) for assessment of schizophrenia symptoms which, like many other metrics in psychiatry, is composed of a sum of scores on several components, each in turn, made up of sums of evaluations on several questions. We simultaneously examine the effects of baseline socio-demographic and co-morbid correlates on all of the components of the total PANSS score of patients from a schizophrenia clinical trial and identify variables associated with increasing or decreasing relative contributions of each component. Several definitions of residuals are provided. Diagnostics include measures of overdispersion, Cook’s distance, and a local jackknife influence metric. PMID:22058582

A comparison of statistical criteria for setting optimally discriminating MCAT and GPA thresholds in medical school admissions.

PubMed

Albanese, Mark A; Farrell, Philip; Dottl, Susan L

2005-01-01

Using Medical College Admission Test-grade point average (MCAT-GPA) scores as a threshold has the potential to address issues raised in recent Supreme Court cases, but it introduces complicated methodological issues for medical school admissions. To assess various statistical indexes to determine optimally discriminating thresholds for MCAT-GPA scores. Entering classes from 1992 through 1998 (N = 752) are used to develop guidelines for cut scores that optimize discrimination between students who pass and do not pass the United States Medical Licensing Examination (USMLE) Step 1 on the first attempt. Risk differences, odds ratios, sensitivity, and specificity discriminated best for setting thresholds. Compensatory versus noncompensatory procedures both accounted for 54% of Step 1 failures, but demanded different performance requirements (noncompensatory MCAT-biological sciences = 8, physical sciences = 7, verbal reasoning = 7--sum of scores = 22; compensatory MCAT total = 24). Rational and defensible intellectual achievement thresholds that are likely to comply with recent Supreme Court decisions can be set from MCAT scores and GPAs.

Psychometric Evaluation of the Brachial Assessment Tool Part 1: Reproducibility.

PubMed

Hill, Bridget; Williams, Gavin; Olver, John; Ferris, Scott; Bialocerkowski, Andrea

2018-04-01

To evaluate reproducibility (reliability and agreement) of the Brachial Assessment Tool (BrAT), a new patient-reported outcome measure for adults with traumatic brachial plexus injury (BPI). Prospective repeated-measure design. Outpatient clinics. Adults with confirmed traumatic BPI (N=43; age range, 19-82y). People with BPI completed the 31-item 4-response BrAT twice, 2 weeks apart. Results for the 3 subscales and summed score were compared at time 1 and time 2 to determine reliability, including systematic differences using paired t tests, test retest using intraclass correlation coefficient model 1,1 (ICC 1,1 ), and internal consistency using Cronbach α. Agreement parameters included standard error of measurement, minimal detectable change, and limits of agreement. BrAT. Test-retest reliability was excellent (ICC 1,1 =.90-.97). Internal consistency was high (Cronbach α=.90-.98). Measurement error was relatively low (standard error of measurement range, 3.1-8.8). A change of >4 for subscale 1, >6 for subscale 2, >4 for subscale 3, and >10 for the summed score is indicative of change over and above measurement error. Limits of agreement ranged from ±4.4 (subscale 3) to 11.61 (summed score). These findings support the use of the BrAT as a reproducible patient-reported outcome measure for adults with traumatic BPI with evidence of appropriate reliability and agreement for both individual and group comparisons. Further psychometric testing is required to establish the construct validity and responsiveness of the BrAT. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A Chronic Fatigue Syndrome (CFS) severity score based on case designation criteria.

PubMed

Baraniuk, James N; Adewuyi, Oluwatoyin; Merck, Samantha Jean; Ali, Mushtaq; Ravindran, Murugan K; Timbol, Christian R; Rayhan, Rakib; Zheng, Yin; Le, Uyenphuong; Esteitie, Rania; Petrie, Kristina N

2013-01-01

Chronic Fatigue Syndrome case designation criteria are scored as physicians' subjective, nominal interpretations of patient fatigue, pain (headaches, myalgia, arthralgia, sore throat and lymph nodes), cognitive dysfunction, sleep and exertional exhaustion. Subjects self-reported symptoms using an anchored ordinal scale of 0 (no symptom), 1 (trivial complaints), 2 (mild), 3 (moderate), and 4 (severe). Fatigue of 3 or 4 distinguished "Fatigued" from "Not Fatigued" subjects. The sum of the 8(Sum8) ancillary criteria was tested as a proxy for fatigue. All subjects had history and physical examinations to exclude medical fatigue, and ensure categorization as healthy or CFS subjects. Fatigued subjects were divided into CFS with ≥4 symptoms or Chronic Idiopathic Fatigue (CIF) with ≤3 symptoms. ROC of Sum8 for CFS and Not Fatigued subjects generated a threshold of 14 (specificity=0.934; sensitivity=0.928). CFS (n=256) and CIF (n=55) criteria were refined to include Sum8≥14 and ≤13, respectively. Not Fatigued subjects had highly skewed Sum8 responses. Healthy Controls (HC; n=269) were defined by fatigue≤2 and Sum8≤13. Those with Sum8≥14 were defined as CFS-Like With Insufficient Fatigue Syndrome (CFSLWIFS; n=20). Sum8 and Fatigue were highly correlated (R(2)=0.977; Cronbach's alpha=0.924) indicating an intimate relationship between symptom constructs. Cluster analysis suggested 4 clades each in CFS and HC. Translational utility was inferred from the clustering of proteomics from cerebrospinal fluid. Plotting Fatigue severity versus Sum8 produced an internally consistent classifying system. This is a necessary step for translating symptom profiles into fatigue phenotypes and their pathophysiological mechanisms.

A Chronic Fatigue Syndrome (CFS) severity score based on case designation criteria

PubMed Central

Baraniuk, James N; Adewuyi, Oluwatoyin; Merck, Samantha Jean; Ali, Mushtaq; Ravindran, Murugan K; Timbol, Christian R; Rayhan, Rakib; Zheng, Yin; Le, Uyenphuong; Esteitie, Rania; Petrie, Kristina N

2013-01-01

Background: Chronic Fatigue Syndrome case designation criteria are scored as physicians’ subjective, nominal interpretations of patient fatigue, pain (headaches, myalgia, arthralgia, sore throat and lymph nodes), cognitive dysfunction, sleep and exertional exhaustion. Methods: Subjects self-reported symptoms using an anchored ordinal scale of 0 (no symptom), 1 (trivial complaints), 2 (mild), 3 (moderate), and 4 (severe). Fatigue of 3 or 4 distinguished “Fatigued” from “Not Fatigued” subjects. The sum of the 8(Sum8) ancillary criteria was tested as a proxy for fatigue. All subjects had history and physical examinations to exclude medical fatigue, and ensure categorization as healthy or CFS subjects. Results: Fatigued subjects were divided into CFS with ≥4 symptoms or Chronic Idiopathic Fatigue (CIF) with ≤3 symptoms. ROC of Sum8 for CFS and Not Fatigued subjects generated a threshold of 14 (specificity=0.934; sensitivity=0.928). CFS (n=256) and CIF (n=55) criteria were refined to include Sum8≥14 and ≤13, respectively. Not Fatigued subjects had highly skewed Sum8 responses. Healthy Controls (HC; n=269) were defined by fatigue≤2 and Sum8≤13. Those with Sum8≥14 were defined as CFS–Like With Insufficient Fatigue Syndrome (CFSLWIFS; n=20). Sum8 and Fatigue were highly correlated (R2=0.977; Cronbach’s alpha=0.924) indicating an intimate relationship between symptom constructs. Cluster analysis suggested 4 clades each in CFS and HC. Translational utility was inferred from the clustering of proteomics from cerebrospinal fluid. Conclusions: Plotting Fatigue severity versus Sum8 produced an internally consistent classifying system. This is a necessary step for translating symptom profiles into fatigue phenotypes and their pathophysiological mechanisms. PMID:23390566

Oral health-related quality of life and somatization in the elderly.

PubMed

Hassel, Alexander J; Rolko, Claudia; Leisen, Joachim; Schmitter, Marc; Rexroth, Walter; Leckel, Michael

2007-03-01

Somatization disorders are frequent in the elderly, and previous studies have revealed that psychological factors affect the outcome of measurement of oral health-related quality of life (OHRQoL). The objective of this study was, therefore, to investigate the correlation between OHRQoL and somatization. One-hundred and twenty-five participants aged 60 years or older (mean age 76.6 years; 40 males) from a primary geriatric medical hospital participated in this cross-sectional study. OHRQoL was assessed by using the Oral Health Impact Profile (OHIP), somatization by using the somatization subscale of the Symptom Check List (SCL-90-R). To obtain dental data we performed a clinical dental examination. In bivariate analyses the most consistent correlation with somatization was found for overall OHIP sum score and the subscales physical pain and functional limitation (r > 0.4). Participants with high somatization scores had high OHIP sum scores. In multivariate analysis somatization led to additional explanation of the variance of the OHIP sum score and of all OHIP subscales. There is consistent correlation between OHRQoL and somatization. When evaluating OHRQoL in the elderly (using the OHIP) further evaluation of somatization should be considered for thorough interpretation of the results.

Assessment of Health-Related Quality of Life after TBI: Comparison of a Disease-Specific (QOLIBRI) with a Generic (SF-36) Instrument

PubMed Central

von Steinbuechel, Nicole; Covic, Amra; Polinder, Suzanne; Kohlmann, Thomas; Cepulyte, Ugne; Poinstingl, Herbert; Backhaus, Joy; Bakx, Wilbert; Bullinger, Monika; Christensen, Anne-Lise; Formisano, Rita; Gibbons, Henning; Höfer, Stefan; Koskinen, Sanna; Maas, Andrew; Neugebauer, Edmund; Powell, Jane; Sarajuuri, Jaana; Sasse, Nadine; Schmidt, Silke; Mühlan, Holger; von Wild, Klaus; Zitnay, George; Truelle, Jean-Luc

2016-01-01

Psychosocial, emotional, and physical problems can emerge after traumatic brain injury (TBI), potentially impacting health-related quality of life (HRQoL). Until now, however, neither the discriminatory power of disease-specific (QOLIBRI) and generic (SF-36) HRQoL nor their correlates have been compared in detail. These aspects as well as some psychometric item characteristics were studied in a sample of 795 TBI survivors. The Shannon H ' index absolute informativity, as an indicator of an instrument's power to differentiate between individuals within a specific group or health state, was investigated. Psychometric performance of the two instruments was predominantly good, generally higher, and more homogenous for the QOLIBRI than for the SF-36 subscales. Notably, the SF-36 “Role Physical,” “Role Emotional,” and “Social Functioning” subscales showed less satisfactory discriminatory power than all other dimensions or the sum scores of both instruments. The absolute informativity of disease-specific as well as generic HRQoL instruments concerning the different groups defined by different correlates differed significantly. When the focus is on how a certain subscale or sum score differentiates between individuals in one specific dimension/health state, the QOLIBRI can be recommended as the preferable instrument. PMID:27022207

Development and validation of the Dutch version of the London Handicap Scale.

PubMed

Groothuis-Oudshoorn, Catharina G M; Chorus, Astrid M J; Verrips, G H W; Detmar, Symone B

2015-01-01

The London Handicap Scale (LHS) was found to be a valid and reliable scale for measuring participation restrictions in adults. This paper describes the development and assesses the construct-related validity of a Dutch version of the London Handicap Scale (DLHS). The DLHS was tested in 798 adults (mean age: 50.7 years, SD=14.5, range 16 to 85) and validated with the 'Impact on Participation and Autonomy' (IPA) questionnaire, the Dutch version of the EQ-5D and questions concerning comorbidity and use of medical devices. The study population consisted of patients with rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), epilepsy, laryngectomy and multiple sclerosis. Feasibility was satisfactory. Large correlations (ρ > 0.6) for the DLHS sum score were found with the IPA subscales 'autonomy outdoors', 'perceiving problems', 'family role', autonomy indoors', 'work and education' and with the EQ-5D. The DLHS sum score differs significantly between subgroups based on the number of chronic diseases, number of medical devices and self-reported burden of disease or handicap (p< 0.001). Based on this evaluation the questionnaire seems feasible and valid for assessing differences in level of participation between subgroups of chronically ill or disabled persons in the Netherlands.

A computational method for computing an Alzheimer’s Disease Progression Score; experiments and validation with the ADNI dataset

PubMed Central

Jedynak, Bruno M.; Liu, Bo; Lang, Andrew; Gel, Yulia; Prince, Jerry L.

2014-01-01

Understanding the time-dependent changes of biomarkers related to Alzheimer’s disease (AD) is a key to assessing disease progression and to measuring the outcomes of disease-modifying therapies. In this paper, we validate an Alzheimer’s disease progression score model which uses multiple biomarkers to quantify the AD progression of subjects following three assumptions: (1) there is a unique disease progression for all subjects, (2) each subject has a different age of onset and rate of progression, and (3) each biomarker is sigmoidal as a function of disease progression. Fitting the parameters of this model is a challenging problem which we approach using an alternating least squares optimization algorithm. In order to validate this optimization scheme under realistic conditions, we use the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort. With the help of Monte Carlo simulations, we show that most of the global parameters of the model are tightly estimated, thus enabling an ordering of the biomarkers that fit the model well, ordered as: the Rey auditory verbal learning test with 30 minutes delay, the sum of the two lateral hippocampal volumes divided by the intra-cranial volume, followed by (the clinical dementia rating sum of boxes score and the mini mental state examination score) in no particular order and lastly the Alzheimer’s disease assessment scale-cognitive subscale. PMID:25444605

Computed Tomographic Distinction of Intimal and Medial Calcification in the Intracranial Internal Carotid Artery.

PubMed

Kockelkoren, Remko; Vos, Annelotte; Van Hecke, Wim; Vink, Aryan; Bleys, Ronald L A W; Verdoorn, Daphne; Mali, Willem P Th M; Hendrikse, Jeroen; Koek, Huiberdina L; de Jong, Pim A; De Vis, Jill B

2017-01-01

Intracranial internal carotid artery (iICA) calcification is associated with stroke and is often seen as a proxy of atherosclerosis of the intima. However, it was recently shown that these calcifications are predominantly located in the tunica media and internal elastic lamina (medial calcification). Intimal and medial calcifications are thought to have a different pathogenesis and clinical consequences and can only be distinguished through ex vivo histological analysis. Therefore, our aim was to develop CT scoring method to distinguish intimal and medial iICA calcification in vivo. First, in both iICAs of 16 cerebral autopsy patients the intimal and/or medial calcification area was histologically assessed (142 slides). Brain CT images of these patients were matched to the corresponding histological slides to develop a CT score that determines intimal or medial calcification dominance. Second, performance of the CT score was assessed in these 16 patients. Third, reproducibility was tested in a separate cohort. First, CT features of the score were circularity (absent, dot(s), <90°, 90-270° or 270-360°), thickness (absent, ≥1.5mm, or <1.5mm), and morphology (indistinguishable, irregular/patchy or continuous). A high sum of features represented medial and a lower sum intimal calcifications. Second, in the 16 patients the concordance between the CT score and the dominant calcification type was reasonable. Third, the score showed good reproducibility (kappa: 0.72 proportion of agreement: 0.82) between the categories intimal, medial or absent/indistinguishable. The developed CT score shows good reproducibility and can differentiate reasonably well between intimal and medial calcification dominance in the iICA, allowing for further (epidemiological) studies on iICA calcification.

A new approach for modeling patient overall radiosensitivity and predicting multiple toxicity endpoints for breast cancer patients.

PubMed

Mbah, Chamberlain; De Ruyck, Kim; De Schrijver, Silke; De Sutter, Charlotte; Schiettecatte, Kimberly; Monten, Chris; Paelinck, Leen; De Neve, Wilfried; Thierens, Hubert; West, Catharine; Amorim, Gustavo; Thas, Olivier; Veldeman, Liv

2018-05-01

Evaluation of patient characteristics inducing toxicity in breast radiotherapy, using simultaneous modeling of multiple endpoints. In 269 early-stage breast cancer patients treated with whole-breast irradiation (WBI) after breast-conserving surgery, toxicity was scored, based on five dichotomized endpoints. Five logistic regression models were fitted, one for each endpoint and the effect sizes of all variables were estimated using maximum likelihood (MLE). The MLEs are improved with James-Stein estimates (JSEs). The method combines all the MLEs, obtained for the same variable but from different endpoints. Misclassification errors were computed using MLE- and JSE-based prediction models. For associations, p-values from the sum of squares of MLEs were compared with p-values from the Standardized Total Average Toxicity (STAT) Score. With JSEs, 19 highest ranked variables were predictive of the five different endpoints. Important variables increasing radiation-induced toxicity were chemotherapy, age, SATB2 rs2881208 SNP and nodal irradiation. Treatment position (prone position) was most protective and ranked eighth. Overall, the misclassification errors were 45% and 34% for the MLE- and JSE-based models, respectively. p-Values from the sum of squares of MLEs and p-values from STAT score led to very similar conclusions, except for the variables nodal irradiation and treatment position, for which STAT p-values suggested an association with radiosensitivity, whereas p-values from the sum of squares indicated no association. Breast volume was ranked as the most significant variable in both strategies. The James-Stein estimator was used for selecting variables that are predictive for multiple toxicity endpoints. With this estimator, 19 variables were predictive for all toxicities of which four were significantly associated with overall radiosensitivity. JSEs led to almost 25% reduction in the misclassification error rate compared to conventional MLEs. Finally, patient characteristics that are associated with radiosensitivity were identified without explicitly quantifying radiosensitivity.

Do Neurocognitive SCAT3 Baseline Test Scores Differ Between Footballers (Soccer) Living With and Without Disability? A Cross-Sectional Study.

PubMed

Weiler, Richard; van Mechelen, Willem; Fuller, Colin; Ahmed, Osman Hassan; Verhagen, Evert

2018-01-01

To determine if baseline Sport Concussion Assessment Tool, third Edition (SCAT3) scores differ between athletes with and without disability. Cross-sectional comparison of preseason baseline SCAT3 scores for a range of England international footballers. Team doctors and physiotherapists supporting England football teams recorded players' SCAT 3 baseline tests from August 1, 2013 to July 31, 2014. A convenience sample of 249 England footballers, of whom 185 were players without disability (male: 119; female: 66) and 64 were players with disability (male learning disability: 17; male cerebral palsy: 28; male blind: 10; female deaf: 9). Between-group comparisons of median SCAT3 total and section scores were made using nonparametric Mann-Whitney-Wilcoxon ranked-sum test. All footballers with disability scored higher symptom severity scores compared with male players without disability. Male footballers with learning disability demonstrated no significant difference in the total number of symptoms, but recorded significantly lower scores on immediate memory and delayed recall compared with male players without disability. Male blind footballers' scored significantly higher for total concentration and delayed recall, and male footballers with cerebral palsy scored significantly higher on balance testing and immediate memory, when compared with male players without disability. Female footballers with deafness scored significantly higher for total concentration and balance testing than female footballers without disability. This study suggests that significant differences exist between SCAT3 baseline section scores for footballers with and without disability. Concussion consensus guidelines should recognize these differences and produce guidelines that are specific for the growing number of athletes living with disability.

Type I Error Inflation in DIF Identification with Mantel-Haenszel: An Explanation and a Solution

ERIC Educational Resources Information Center

Magis, David; De Boeck, Paul

2014-01-01

It is known that sum score-based methods for the identification of differential item functioning (DIF), such as the Mantel-Haenszel (MH) approach, can be affected by Type I error inflation in the absence of any DIF effect. This may happen when the items differ in discrimination and when there is item impact. On the other hand, outlier DIF methods…

Perceptions of organizational justice among nurses working in university hospitals of shiraz: a comparison between general and specialty settings.

PubMed

Hatam, Nahid; Fardid, Mozhgan; Kavosi, Zahra

2013-12-01

Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems. The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals. In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item questionnaire was applied to measure distributive, procedural and interactional justice. Data analysis was performed using descriptive statistics, including percentage, frequency, mean, and standard deviation. Also, the t-test and one way ANOVA were used to measure the differences between different hospitals and wards. Of 400 nurses, 66% perceived a high level of organizational justice. In this study the mean scores of total perceived organizational justice (P = 0.035), procedural justice (P = 0.031), and interactional justice (P = 0.046) in specialty hospitals were higher than general ones. Furthermore, the mean score of interactional justice was higher than the other components of organizational justice, respectively 3.58 ± 1.02 for general and 3.76 ± 0.86 for specialty hospitals. Significant differences were observed between overall perceived justice (P = 0.013) and its components (P = 0.024, P = 0.013, and P = 0.036) in different wards. Most nurses who participated in this study had a high perception of organizational justice. The mean score of organizational justice was higher in specialty hospitals. Health care policy makers and hospital managers should support their employees, especially nurses through fairness in distributions, procedures, and interactions.

Perceptions of Organizational Justice Among Nurses Working in University Hospitals of Shiraz: A Comparison Between General and Specialty Settings

PubMed Central

Hatam, Nahid; Fardid, Mozhgan; Kavosi, Zahra

2013-01-01

Background: Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems. Objectives: The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals. Materials and Methods: In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item questionnaire was applied to measure distributive, procedural and interactional justice. Data analysis was performed using descriptive statistics, including percentage, frequency, mean, and standard deviation. Also, the t-test and one way ANOVA were used to measure the differences between different hospitals and wards. Results: Of 400 nurses, 66% perceived a high level of organizational justice. In this study the mean scores of total perceived organizational justice (P = 0.035), procedural justice (P = 0.031), and interactional justice (P = 0.046) in specialty hospitals were higher than general ones. Furthermore, the mean score of interactional justice was higher than the other components of organizational justice, respectively 3.58 ± 1.02 for general and 3.76 ± 0.86 for specialty hospitals. Significant differences were observed between overall perceived justice (P = 0.013) and its components (P = 0.024, P = 0.013, and P = 0.036) in different wards. Conclusions: Most nurses who participated in this study had a high perception of organizational justice. The mean score of organizational justice was higher in specialty hospitals. Health care policy makers and hospital managers should support their employees, especially nurses through fairness in distributions, procedures, and interactions. PMID:25414883

Comparison of exercise and pharmacological stress gated SPECT in detecting transient left ventricular dysfunction.

PubMed

Demir, Hakan; Tan, Yusuf Z; Isgoren, Serkan; Gorur, Gozde D; Kozdag, Guliz; Ural, Ertan; Berk, Fatma

2008-06-01

Transient left ventricular contractile dysfunction (TLVD) is observed owing to post-exercise stunning in patients with coronary artery disease (CAD). Pharmacological stimulation differs from exercise stress because it does not cause demand ischemia. The aim of this study was to determine whether TLVD could also be seen after pharmacological stress (dipyridamole). Of the patients in whom gated single-photon emission computed tomography (GSPECT) was performed in our institution from January 2004 to April 2007, 439 subjects with known or suspected CAD were included in the study. GSPECT was performed for all patients following exercise (group I, n = 220) or pharmacological stress (group II, n = 219) according to a 2-day (stress-rest) protocol after injection of Tc-99m methoxyisobutyl-isonitrile (MIBI). Stress, rest, and difference (stress-rest value) left ventricular ejection fractions (SLVEF, RLVEF, and DLVEF) and transient ischemic dilatation (TID) ratio were derived automatically. Summed stress score, summed rest score, and summed difference score (SDS) for myocardial perfusion were calculated using a 20-segment model and a five-point scoring system. An SDS > 3 was considered as ischemic. On the basis of the perfusion findings, patients were subdivided into a normal (group A, n = 216) and ischemia group (group B, n = 223). DLVEF and perfusion scores of all groups were compared. Relationships between DLVEF and perfusion, and between TID ratio and DLVEF were also evaluated. Stress-induced ischemia was observed in 223 of 439 patients (50.8%). In group A, the difference between stress and rest LVEF values was not significant (P = 0.670 and P = 0.200 for groups IA and IIA, respectively). However, LVEF was significantly decreased after stress compared with rest values for group B (P < 0.0001 for groups IB and IIB). TLVD (< or =-5% for DLVEF) was observed in 20 of 216 (9%) and 81 of 223 subjects (36%) in patients in groups A and B, respectively (P < 0.0001). In group I, we found TLVD in 46 of 119 (39%) and 12 of 101 (12%) subjects, in patients with and without ischemia, respectively (P < 0.0001). On the other hand, in group II, TLVD was detected in 35 of 104 (34%) and 8 of 115 (7%) patients with and without ischemia, respectively (P < 0.0001). And also, we found significant good correlations between TID ratios and DLVEF values in four subgroups (r = -0.55, r = -0.62, r = -0.59, and r = -0.41; for groups IA, IB, IIA, and IIB, respectively, P < 0.0001 for all). Dipyridamole is believed to be less likely than exercise to induce ischemia. However, in this study, TLVD after stress was observed following not only exercise but also pharmacological stress, consistent with ischemia.

Limited potential of genetic predisposition scores to predict muscle mass and strength performance in Flemish Caucasians between 19 and 73 years of age.

PubMed

Charlier, Ruben; Caspers, Maarten; Knaeps, Sara; Mertens, Evelien; Lambrechts, Diether; Lefevre, Johan; Thomis, Martine

2017-03-01

Since both muscle mass and strength performance are polygenic in nature, the current study compared four genetic predisposition scores (GPS) in their ability to predict these phenotypes. Data were gathered within the framework of the first-generation Flemish Policy Research Centre "Sport, Physical Activity and Health" (2002-2004). Results are based on muscle characteristics data of 565 Flemish Caucasians (19-73 yr, 365 men). Skeletal muscle mass was determined from bioelectrical impedance. The Biodex dynamometer was used to measure isometric (PT static120° ) and isokinetic strength (PT dynamic60° and PT dynamic240° ), ballistic movement speed (S 20% ), and muscular endurance (Work) of the knee extensors. Genotyping was done for 153 gene variants, selected on the basis of a literature search and the expression quantitative trait loci of selected genes. Four GPS were designed: a total GPS (based on the sum of all 153 variants, each favorable allele = score 1), a data-driven and weighted GPS [respectively, the sum of favorable alleles of those variants with significant b-coefficients in stepwise regression (GPS dd ), and the sum of these variants weighted with their respective partial r 2 (GPS w )], and an elastic net GPS (based on the variants that were selected by an elastic net regularization; GPS en ). It was found that four different models for a GPS were able to significantly predict up to ~7% of the variance in strength performance. GPS en made the best prediction of SMM and Work. However, this was not the case for the remaining strength performance parameters, where best predictions were made by GPS dd and GPS w . Copyright © 2017 the American Physiological Society.

Lateral asymmetry of the Hoffmann reflex: relation to cortical laterality.

PubMed Central

Goode, D J; Glenn, S; Manning, A A; Middleton, J F

1980-01-01

Lateral asymmetry of the Hoffmann reflex (H-reflex) recovery curve was found in seven subjects with no personal or family history of neurological or psychiatric disorder. Differences between recovery curves from the right and left leg were larger than differences in the same leg on two successive test days. In a group of 27 psychiatric inpatients, lateral asymmetry of the later portion of the recovery curve was correlated with cortical laterality, as measured by selective identification of differing verbal stimuli presented simultaneously to both ears (DL) and to total laterality scores, a sum of visual half-field, DL, and motor laterality scores. Asymmetry of the recovery curve is related in part to cortical laterality, possibly through selective activation of cortical motor centres on the preferred side. PMID:7420106

Detecting Intervention Effects in a Cluster-Randomized Design Using Multilevel Structural Equation Modeling for Binary Responses

PubMed Central

Cho, Sun-Joo; Preacher, Kristopher J.; Bottge, Brian A.

2015-01-01

Multilevel modeling (MLM) is frequently used to detect group differences, such as an intervention effect in a pre-test–post-test cluster-randomized design. Group differences on the post-test scores are detected by controlling for pre-test scores as a proxy variable for unobserved factors that predict future attributes. The pre-test and post-test scores that are most often used in MLM are summed item responses (or total scores). In prior research, there have been concerns regarding measurement error in the use of total scores in using MLM. To correct for measurement error in the covariate and outcome, a theoretical justification for the use of multilevel structural equation modeling (MSEM) has been established. However, MSEM for binary responses has not been widely applied to detect intervention effects (group differences) in intervention studies. In this article, the use of MSEM for intervention studies is demonstrated and the performance of MSEM is evaluated via a simulation study. Furthermore, the consequences of using MLM instead of MSEM are shown in detecting group differences. Results of the simulation study showed that MSEM performed adequately as the number of clusters, cluster size, and intraclass correlation increased and outperformed MLM for the detection of group differences. PMID:29881032

Detecting Intervention Effects in a Cluster-Randomized Design Using Multilevel Structural Equation Modeling for Binary Responses.

PubMed

Cho, Sun-Joo; Preacher, Kristopher J; Bottge, Brian A

2015-11-01

Multilevel modeling (MLM) is frequently used to detect group differences, such as an intervention effect in a pre-test-post-test cluster-randomized design. Group differences on the post-test scores are detected by controlling for pre-test scores as a proxy variable for unobserved factors that predict future attributes. The pre-test and post-test scores that are most often used in MLM are summed item responses (or total scores). In prior research, there have been concerns regarding measurement error in the use of total scores in using MLM. To correct for measurement error in the covariate and outcome, a theoretical justification for the use of multilevel structural equation modeling (MSEM) has been established. However, MSEM for binary responses has not been widely applied to detect intervention effects (group differences) in intervention studies. In this article, the use of MSEM for intervention studies is demonstrated and the performance of MSEM is evaluated via a simulation study. Furthermore, the consequences of using MLM instead of MSEM are shown in detecting group differences. Results of the simulation study showed that MSEM performed adequately as the number of clusters, cluster size, and intraclass correlation increased and outperformed MLM for the detection of group differences.

Mining HIV protease cleavage data using genetic programming with a sum-product function.

PubMed

Yang, Zheng Rong; Dalby, Andrew R; Qiu, Jing

2004-12-12

In order to design effective HIV inhibitors, studying and understanding the mechanism of HIV protease cleavage specification is critical. Various methods have been developed to explore the specificity of HIV protease cleavage activity. However, success in both extracting discriminant rules and maintaining high prediction accuracy is still challenging. The earlier study had employed genetic programming with a min-max scoring function to extract discriminant rules with success. However, the decision will finally be degenerated to one residue making further improvement of the prediction accuracy difficult. The challenge of revising the min-max scoring function so as to improve the prediction accuracy motivated this study. This paper has designed a new scoring function called a sum-product function for extracting HIV protease cleavage discriminant rules using genetic programming methods. The experiments show that the new scoring function is superior to the min-max scoring function. The software package can be obtained by request to Dr Zheng Rong Yang.

Measuring efficiency of university-industry Ph.D. projects using best worst method.

PubMed

Salimi, Negin; Rezaei, Jafar

A collaborative Ph.D. project, carried out by a doctoral candidate, is a type of collaboration between university and industry. Due to the importance of such projects, researchers have considered different ways to evaluate the success, with a focus on the outputs of these projects. However, what has been neglected is the other side of the coin-the inputs. The main aim of this study is to incorporate both the inputs and outputs of these projects into a more meaningful measure called efficiency. A ratio of the weighted sum of outputs over the weighted sum of inputs identifies the efficiency of a Ph.D. The weights of the inputs and outputs can be identified using a multi-criteria decision-making (MCDM) method. Data on inputs and outputs are collected from 51 Ph.D. candidates who graduated from Eindhoven University of Technology. The weights are identified using a new MCDM method called Best Worst Method (BWM). Because there may be differences in the opinion of Ph.D. candidates and supervisors on weighing the inputs and outputs, data for BWM are collected from both groups. It is interesting to see that there are differences in the level of efficiency from the two perspectives, because of the weight differences. Moreover, a comparison between the efficiency scores of these projects and their success scores reveals differences that may have significant implications. A sensitivity analysis divulges the most contributing inputs and outputs.

Using the Free-Response Scoring Tool To Automatically Score the Formulating-Hypotheses Item. GRE Board Professional Report No. 90-02bP.

ERIC Educational Resources Information Center

Kaplan, Randy M.; Bennett, Randy Elliot

This study explores the potential for using a computer-based scoring procedure for the formulating-hypotheses (F-H) item. This item type presents a situation and asks the examinee to generate explanations for it. Each explanation is judged right or wrong, and the number of creditable explanations is summed to produce an item score. Scores were…

Diagnostic Performance of Artificial Neural Network for Detecting Ischemia in Myocardial Perfusion Imaging.

PubMed

Nakajima, Kenichi; Matsuo, Shinro; Wakabayashi, Hiroshi; Yokoyama, Kunihiko; Bunko, Hisashi; Okuda, Koichi; Kinuya, Seigo; Nyström, Karin; Edenbrandt, Lars

2015-01-01

The purpose of this study was to apply an artificial neural network (ANN) in patients with coronary artery disease (CAD) and to characterize its diagnostic ability compared with conventional visual and quantitative methods in myocardial perfusion imaging (MPI). A total of 106 patients with CAD were studied with MPI, including multiple vessel disease (49%), history of myocardial infarction (27%) and coronary intervention (30%). The ANN detected abnormal areas with a probability of stress defect and ischemia. The consensus diagnosis based on expert interpretation and coronary stenosis was used as the gold standard. The left ventricular ANN value was higher in the stress-defect group than in the no-defect group (0.92±0.11 vs. 0.25±0.32, P<0.0001) and higher in the ischemia group than in the no-ischemia group (0.70±0.40 vs. 0.004±0.032, P<0.0001). Receiver-operating characteristics curve analysis showed comparable diagnostic accuracy between ANN and the scoring methods (0.971 vs. 0.980 for stress defect, and 0.882 vs. 0.937 for ischemia, both P=NS). The relationship between the ANN and defect scores was non-linear, with the ANN rapidly increased in ranges of summed stress score of 2-7 and summed defect score of 2-4. Although the diagnostic ability of ANN was similar to that of conventional scoring methods, the ANN could provide a different viewpoint for judging abnormality, and thus is a promising method for evaluating abnormality in MPI.

Rasch Analysis of the General Self-Efficacy Scale in Workers with Traumatic Limb Injuries.

PubMed

Wu, Tzu-Yi; Yu, Wan-Hui; Huang, Chien-Yu; Hou, Wen-Hsuan; Hsieh, Ching-Lin

2016-09-01

Purpose The purpose of this study was to apply Rasch analysis to examine the unidimensionality and reliability of the General Self-Efficacy Scale (GSE) in workers with traumatic limb injuries. Furthermore, if the items of the GSE fitted the Rasch model's assumptions, we transformed the raw sum ordinal scores of the GSE into Rasch interval scores. Methods A total of 1076 participants completed the GSE at 1 month post injury. Rasch analysis was used to examine the unidimensionality and person reliability of the GSE. The unidimensionality of the GSE was verified by determining whether the items fit the Rasch model's assumptions: (1) item fit indices: infit and outfit mean square (MNSQ) ranged from 0.6 to 1.4; and (2) the eigenvalue of the first factor extracted from principal component analysis (PCA) for residuals was <2. Person reliability was calculated. Results The unidimensionality of the 10-item GSE was supported in terms of good item fit statistics (infit and outfit MNSQ ranging from 0.92 to 1.32) and acceptable eigenvalues (1.6) of the first factor of the PCA, with person reliability = 0.89. Consequently, the raw sum scores of the GSE were transformed into Rasch scores. Conclusions The results indicated that the items of GSE are unidimensional and have acceptable person reliability in workers with traumatic limb injuries. Additionally, the raw sum scores of the GSE can be transformed into Rasch interval scores for prospective users to quantify workers' levels of self-efficacy and to conduct further statistical analyses.

A Comparison of Item-Level and Scale-Level Multiple Imputation for Questionnaire Batteries

ERIC Educational Resources Information Center

Gottschall, Amanda C.; West, Stephen G.; Enders, Craig K.

2012-01-01

Behavioral science researchers routinely use scale scores that sum or average a set of questionnaire items to address their substantive questions. A researcher applying multiple imputation to incomplete questionnaire data can either impute the incomplete items prior to computing scale scores or impute the scale scores directly from other scale…

A new color vision test to differentiate congenital and acquired color vision defects.

PubMed

Shin, Young Joo; Park, Kyu Hyung; Hwang, Jeong-Min; Wee, Won Ryang; Lee, Jin Hak

2007-07-01

To investigate the efficacy of a novel computer-controlled color test for the differentiation of congenital and acquired color vision deficiency. Observational cross-sectional study. Thirty-one patients with congenital color vision deficiency and 134 patients with acquired color vision deficiency with a Snellen visual acuity better than 20/30 underwent an ophthalmologic examination including the Ishihara color test, Hardy-Rand-Rittler test, Nagel anomaloscopy, and the Seohan computerized hue test between June, 2003, and January, 2004. To investigate the type of color vision defect, a graph of the Seohan computerized hue test was divided into 4 quadrants and error scores in each quadrant were summated. The ratio between the sums of error scores of quadrants I and III (Q1+Q3) and those of quadrants II and IV (Q2+Q4) was calculated. Error scores and ratio in quadrant analysis of the Seohan computerized hue test. The Seohan computerized hue test showed that the sum of Q2+Q4 was significantly higher than the sum of Q1+Q3 in congenital color vision deficiency (P<0.01, paired t test) and that the sum of Q2+Q4 was significantly lower than the sum of Q1+Q3 in acquired color vision deficiency (P<0.01, paired t test). In terms of discriminating congenital and acquired color vision deficiency, the ratio in quadrant analysis had 93.3% sensitivity and 98.5% specificity with a reference value of 1.5 by the Seohan computerized hue test (95% confidence interval). The quadrant analysis and ratio of (Q2+Q4)/(Q1+Q3) using the Seohan computerized hue test effectively differentiated congenital and acquired color vision deficiency.

Nerve ultrasound normal values - Readjustment of the ultrasound pattern sum score UPSS.

PubMed

Grimm, Alexander; Axer, Hubertus; Heiling, Bianka; Winter, Natalie

2018-07-01

Reference values are crucial for nerve ultrasound. Here, we reevaluated normal nerve and fascicle cross-sectional area (CSA) values in humans and compared them to published values. Based on these data, ultrasound pattern sum score (UPSS) boundary values were revisited and readjusted. Ultrasound of different peripheral nerves was performed in 100 healthy subjects at anatomically defined landmarks. Correlations with age, gender, height and weight were calculated. Overall, correspondence to other published reference values was high. Gender-dependency was found for the proximal median nerve. Dependency from height occurred in the tibial nerve (TN). Weight-dependency was not found. However, the most obvious differences were found in the TN between men >60 years and women <60 years. Thus, general boundary values were defined using the mean plus the twofold standard deviation for all subjects and nerve segments except for the TN, in which different cut-offs were proposed for elder men. Accordingly, the cut-offs for the UPSS were re-adjusted, none of the individuals revealed more than 2 points at maximum. The influence of distinct epidemiological factors on nerve size is most prominent in the TN, for which thus several normal values are useful. Adjusted reference values improve the accuracy of the UPSS. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

[A Measure of Participation and Social Inclusion for Use in People with a Chronic Mental Disorder (F-INK)].

PubMed

Schützwohl, Matthias; Souza, Paula M L; Rackel, Yvonne

2017-03-01

Objective To develop and test the psychometric properties of a measure of participation and social inclusion for individuals with a chronic mental disorder - the F-INK. Methods Within a cross-sectional design, mental health patients from different institutional settings (n = 106) and adults from the general population (n = 19) completed the questionnaire in an individual interview with a researcher. To estimate the reliability of two sum-scores on social inclusion and participation, Cronbach's α was computed. To appraise the validity, mean scale scores were compared across different study groups. Results For both scales, reliability was qualified as substantial (α > 0.70). Study groups showed expected differences in mean scores. Conclusion Preliminary findings suggest that the F-INK may be a useful tool for the assessment of social inclusion and social participation in individuals with a chronic mental disorder. However, further testing of the psychometric properties on a larger population is needed. © Georg Thieme Verlag KG Stuttgart · New York.

Psychosocial correlates of depressive symptoms among 12-14-year-old Norwegian adolescents.

PubMed

Sund, Anne Mari; Larsson, Bo; Wichstrøm, Lars

2003-05-01

The aim of the study was to examine the relationships between various psychosocial factors and depressive symptoms in early adolescence. A representative sample of 2,465 12-14-year-old adolescents comprising 50.8% girls and 49.2% boys, with a mean age of 13.7 years, was recruited in two counties in Norway. The participation rate was 88.3%. Depressive symptoms were measured by the Mood and Feelings Questionnaire (MFQ). Correlations between the total sum of stressful events/daily hassles and the total sum of MFQ were moderately high, rs = .49 and rs = .53, respectively. Depressive symptoms were more strongly correlated with school-related stress among boys than girls, whereas the correlation between daily hassles and depressive symptoms was higher for girls than boys. The results of univariate analyses showed significantly higher mean total MFQ scores among adolescents not living with both natural parents, those who had moved more than twice and those with more than 3 siblings orhaving fewer than 2 close friends. Further, adolescents from Third World societies and adopted adolescents, those from lower SES groups, having unemployed parents or living in coastal areas had higher mean depressive symptom scores. The results of multiple regression analyses yielded the following six significant predictors of total MFQ scores in order of importance: Sum of daily hassles and sum of stressful life events, gender, number of friends, ethnicity and mother's employment status. Altogether, these variables accounted for 43% of the total variance in MFQ scores. It is concluded that these psychosocial predictors should be addressed when assessing depressive symptoms in early adolescence. The findings of the study are discussed in view of previous research in the field and their clinical significance.

Nerve Ultrasound Predicts Treatment Response in Chronic Inflammatory Demyelinating Polyradiculoneuropathy-a Prospective Follow-Up.

PubMed

Härtig, Florian; Ross, Marlene; Dammeier, Nele Maria; Fedtke, Nadin; Heiling, Bianka; Axer, Hubertus; Décard, Bernhard F; Auffenberg, Eva; Koch, Marilin; Rattay, Tim W; Krumbholz, Markus; Bornemann, Antje; Lerche, Holger; Winter, Natalie; Grimm, Alexander

2018-04-01

As reliable biomarkers of disease activity are lacking, monitoring of therapeutic response in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) remains a challenge. We sought to determine whether nerve ultrasound and electrophysiology scoring could close this gap. In CIDP patients (fulfilling EFNS/PNS criteria), we performed high-resolution nerve ultrasound to determine ultrasound pattern sum scores (UPSS) and predominant echotexture nerve conduction study scores (NCSS) as well as Medical Research Council sum scores (MRCSS) and inflammatory neuropathy cause and treatment disability scores (INCAT) at baseline and after 12 months of standard treatment. We retrospectively correlated ultrasound morphology with nerve histology when available. 72/80 CIDP patients featured multifocal nerve enlargement, and 35/80 were therapy-naïve. At baseline, clinical scores correlated with NCSS (r 2  = 0.397 and r 2  = 0.443, p < 0.01), but not or hardly with UPSS (Medical Research Council sum scores MRCSS r 2  = 0.013, p = 0.332; inflammatory neuropathy cause and treatment disability scores INCAT r 2  = 0.053, p = 0.048). Longitudinal changes in clinical scores, however, correlated significantly with changes in both UPSS and NCSS (r 2  = 0.272-0.414, p < 0.0001). Combining nerve/fascicle size with echointensity and histology at baseline, we noted 3 distinct classes: 1) hypoechoic enlargement, reflecting active inflammation and onion bulbs; 2) nerve enlargement with additional hyperechogenic fascicles/perifascicular tissue in > 50% of measured segments, possibly reflecting axonal degeneration; and 3) almost no enlargement, reflecting "burned-out" or "cured" disease without active inflammation. Clinical improvement after 12 months was best in patients with pattern 1 (up to 75% vs up to 43% in pattern 2/3, Fisher's exact test p < 0.05). Nerve ultrasound has additional value not only for diagnosis, but also for classification of disease state and may predict treatment response.

Design with limited anthropometric data: A method of interpreting sums of percentiles in anthropometric design.

PubMed

Albin, Thomas J

2017-07-01

Occasionally practitioners must work with single dimensions defined as combinations (sums or differences) of percentile values, but lack information (e.g. variances) to estimate the accommodation achieved. This paper describes methods to predict accommodation proportions for such combinations of percentile values, e.g. two 90th percentile values. Kreifeldt and Nah z-score multipliers were used to estimate the proportions accommodated by combinations of percentile values of 2-15 variables; two simplified versions required less information about variance and/or correlation. The estimates were compared to actual observed proportions; for combinations of 2-15 percentile values the average absolute differences ranged between 0.5 and 1.5 percentage points. The multipliers were also used to estimate adjusted percentile values, that, when combined, estimate a desired proportion of the combined measurements. For combinations of two and three adjusted variables, the average absolute difference between predicted and observed proportions ranged between 0.5 and 3.0 percentage points. Copyright © 2017 Elsevier Ltd. All rights reserved.

Use of non-parametric item response theory to develop a shortened version of the Positive and Negative Syndrome Scale (PANSS).

PubMed

Khan, Anzalee; Lewis, Charles; Lindenmayer, Jean-Pierre

2011-11-16

Nonparametric item response theory (IRT) was used to examine (a) the performance of the 30 Positive and Negative Syndrome Scale (PANSS) items and their options ((levels of severity), (b) the effectiveness of various subscales to discriminate among differences in symptom severity, and (c) the development of an abbreviated PANSS (Mini-PANSS) based on IRT and a method to link scores to the original PANSS. Baseline PANSS scores from 7,187 patients with Schizophrenia or Schizoaffective disorder who were enrolled between 1995 and 2005 in psychopharmacology trials were obtained. Option characteristic curves (OCCs) and Item Characteristic Curves (ICCs) were constructed to examine the probability of rating each of seven options within each of 30 PANSS items as a function of subscale severity, and summed-score linking was applied to items selected for the Mini-PANSS. The majority of items forming the Positive and Negative subscales (i.e. 19 items) performed very well and discriminate better along symptom severity compared to the General Psychopathology subscale. Six of the seven Positive Symptom items, six of the seven Negative Symptom items, and seven out of the 16 General Psychopathology items were retained for inclusion in the Mini-PANSS. Summed score linking and linear interpolation was able to produce a translation table for comparing total subscale scores of the Mini-PANSS to total subscale scores on the original PANSS. Results show scores on the subscales of the Mini-PANSS can be linked to scores on the original PANSS subscales, with very little bias. The study demonstrated the utility of non-parametric IRT in examining the item properties of the PANSS and to allow selection of items for an abbreviated PANSS scale. The comparisons between the 30-item PANSS and the Mini-PANSS revealed that the shorter version is comparable to the 30-item PANSS, but when applying IRT, the Mini-PANSS is also a good indicator of illness severity.

Use of NON-PARAMETRIC Item Response Theory to develop a shortened version of the Positive and Negative Syndrome Scale (PANSS)

PubMed Central

2011-01-01

Background Nonparametric item response theory (IRT) was used to examine (a) the performance of the 30 Positive and Negative Syndrome Scale (PANSS) items and their options ((levels of severity), (b) the effectiveness of various subscales to discriminate among differences in symptom severity, and (c) the development of an abbreviated PANSS (Mini-PANSS) based on IRT and a method to link scores to the original PANSS. Methods Baseline PANSS scores from 7,187 patients with Schizophrenia or Schizoaffective disorder who were enrolled between 1995 and 2005 in psychopharmacology trials were obtained. Option characteristic curves (OCCs) and Item Characteristic Curves (ICCs) were constructed to examine the probability of rating each of seven options within each of 30 PANSS items as a function of subscale severity, and summed-score linking was applied to items selected for the Mini-PANSS. Results The majority of items forming the Positive and Negative subscales (i.e. 19 items) performed very well and discriminate better along symptom severity compared to the General Psychopathology subscale. Six of the seven Positive Symptom items, six of the seven Negative Symptom items, and seven out of the 16 General Psychopathology items were retained for inclusion in the Mini-PANSS. Summed score linking and linear interpolation was able to produce a translation table for comparing total subscale scores of the Mini-PANSS to total subscale scores on the original PANSS. Results show scores on the subscales of the Mini-PANSS can be linked to scores on the original PANSS subscales, with very little bias. Conclusions The study demonstrated the utility of non-parametric IRT in examining the item properties of the PANSS and to allow selection of items for an abbreviated PANSS scale. The comparisons between the 30-item PANSS and the Mini-PANSS revealed that the shorter version is comparable to the 30-item PANSS, but when applying IRT, the Mini-PANSS is also a good indicator of illness severity. PMID:22087503

Psychometric Properties of IRT Proficiency Estimates

ERIC Educational Resources Information Center

Kolen, Michael J.; Tong, Ye

2010-01-01

Psychometric properties of item response theory proficiency estimates are considered in this paper. Proficiency estimators based on summed scores and pattern scores include non-Bayes maximum likelihood and test characteristic curve estimators and Bayesian estimators. The psychometric properties investigated include reliability, conditional…

Flow void of cerebrospinal fluid in idiopathic normal pressure hydrocephalus of the elderly: can it predict outcome after shunting?

PubMed

Krauss, J K; Regel, J P; Vach, W; Jüngling, F D; Droste, D W; Wakhloo, A K

1997-01-01

We investigate the predictive value of cerebrospinal fluid (CSF) flow void on outcome after shunting in a prospective series of patients with idiopathic normal pressure hydrocephalus (NPH). The degree and extension of CSF flow void were examined on T2-weighted magnetic resonance imaging scans of 37 elderly patients with idiopathic NPH who underwent subsequent shunting. The degree of flow void was assessed in comparison with the signal of large cerebral arteries. The extension was evaluated via the calculation of sum scores for the occurrence of flow void in different locations of the ventricular system. Those parameters were not considered in the decision to perform shunting. CSF flow void in the aqueduct and the adjacent third and fourth ventricles of the 37 patients with idiopathic NPH was compared with that of 37 age-matched control patients. CSF flow void scores in patients with idiopathic NPH were investigated for correlations between postoperative outcome scores and ventricular width indices. No difference was found between the occurrence of aqueductal CSF flow void in patients with idiopathic NPH and the control group. A significant difference, however, was noted for the extension of the CSF flow void, which was greater in the NPH group. Postoperative improvement was found in 33 of 37 patients with idiopathic NPH at a mean follow-up of 15.6 months. Only small, statistically not significant correlations were found between CSF flow void and postoperative outcome. Flow void sum scores, however, correlated significantly with ventricular width indices. The degree and extension of CSF flow void on T2-weighted magnetic resonance imaging scans have little predictive value for outcome after shunting in patients with idiopathic NPH. The greater extension of the CSF flow void in patients with NPH is most likely related to increased ventricular width. It is not useful to consider CSF flow void findings on conventional magnetic resonance imaging scans in making the decision to offer shunting in patients with idiopathic NPH.

Minimizing rubidium-82 tracer activity for relative PET myocardial perfusion imaging.

PubMed

Huizing, Eline D; van Dijk, Joris D; van Dalen, Jorn A; Timmer, Jorik R; Arkies, Hester; Slump, Cees H; Jager, Pieter L

2017-08-01

Recommended rubidium-82 activities for relative myocardial perfusion imaging (MPI) using present-generation PET scanners may be unnecessarily high. Our aim was to derive the minimum activity for a reliable relative PET MPI assessment. We analyzed 140 scans from 28 consecutive patients who underwent rest-stress MPI-PET (Ingenuity TF). Scans of 852, 682, 511, and 341 MBq were simulated from list-mode data and compared with a reference scan using 1023 MBq. Differences in the summed rest score, total perfusion deficit, and image quality were obtained between the reference and each of the simulated rest scans. Combined stress-rest scans obtained at a selected activity of 682 MBq were diagnostically interpreted by experts and outcome was compared with the reference scan interpretation. Differences in summed rest score more than or equal to 3 were found using 682, 511, and 341 MBq in two (7%), four (14%), and five (18%) patients, respectively. Differences in total perfusion deficit more than 7% were only found at 341 MBq in one patient. Image quality deteriorated significantly only for the 341 MBq scans (P<0.001). Interpretation of stress-rest scans did not differ between 682 and 1023 MBq scans. A significant reduction in administered Rb-82 activity is feasible in relative MPI. An activity of 682 MBq resulted in reliable diagnostic outcomes and image quality, and can therefore be considered for clinical adoption.

[The contribution of different cochlear insertion region to Mandarin speech perception in users of cochlear implant].

PubMed

Qi, Beier; Liu, Bo; Liu, Sha; Liu, Haihong; Dong, Ruijuan; Zhang, Ning; Gong, Shusheng

2011-05-01

To study the effect of cochlear electrode coverage and different insertion region on speech recognition, especially tone perception of cochlear implant users whose native language is Mandarin Chinese. Setting seven test conditions by fitting software. All conditions were created by switching on/off respective channels in order to simulate different insertion position. Then Mandarin CI users received 4 Speech tests, including Vowel Identification test, Consonant Identification test, Tone Identification test-male speaker, Mandarin HINT test (SRS) in quiet and noise. To all test conditions: the average score of vowel identification was significantly different, from 56% to 91% (Rank sum test, P < 0.05). The average score of consonant identification was significantly different, from 72% to 85% (ANOVNA, P < 0.05). The average score of Tone identification was not significantly different (ANOVNA, P > 0.05). However the more channels activated, the higher scores obtained, from 68% to 81%. This study shows that there is a correlation between insertion depth and speech recognition. Because all parts of the basement membrane can help CI users to improve their speech recognition ability, it is very important to enhance verbal communication ability and social interaction ability of CI users by increasing insertion depth and actively stimulating the top region of cochlear.

Body mass index is associated with lumbar disc degeneration in young Finnish males: subsample of Northern Finland birth cohort study 1986

PubMed Central

2013-01-01

Background The role of environmental factors in lumbar intervertebral disc degeneration (DD) in young adults is largely unknown. Therefore, we investigated whether body mass index (BMI), smoking, and physical activity are associated with lumbar DD among young adults. Methods The Oulu Back Study (OBS) is a subpopulation of the 1986 Northern Finland Birth Cohort (NFBC 1986) and it originally included 2,969 children. The OBS subjects received a postal questionnaire, and those who responded (N = 1,987) were invited to the physical examination. The participants (N = 874) were invited to lumbar MRI study. A total of 558 young adults (325 females and 233 males) underwent MRI that used a 1.5-T scanner at the mean age of 21. Each lumbar intervertebral disc was graded as normal (0), mildly (1), moderately (2), or severely (3) degenerated. We calculated a sum score of the lumbar DD, and analyzed the associations between environmental risk factors (smoking, physical activity and weight-related factors assessed at 16 and 19 years) and DD using ordinal logistic regression, the results being expressed as cumulative odds ratios (COR). All analyses were stratified by gender. Results Of the 558 subjects, 256 (46%) had no DD, 117 (21%) had sum score of one, 93 (17%) sum score of two, and 92 (17%) sum score of three or higher. In the multivariate ordinal logistic regression model, BMI at 16 years (highest vs. lowest quartile) was associated with DD sum score among males (COR 2.35; 95% CI 1.19-4.65) but not among females (COR 1.29; 95% CI 0.72-2.32). Smoking of at least four pack-years was associated with DD among males, but not among females (COR 2.41; 95% CI 0.99-5.86 and 1.59; 95% 0.67-3.76, respectively). Self-reported physical activity was not associated with DD. Conclusions High BMI at 16 years was associated with lumbar DD at 21 years among young males but not among females. High pack-years of smoking showed a comparable association in males, while physical activity had no association with DD in either gender. These results suggest that environmental factors are associated with DD among young males. PMID:23497297

Dental practice during a world cruise: characterisation of oral health at sea.

PubMed

Sobotta, Bernhard A J; John, Mike T; Nitschke, Ina

2006-01-01

To describe oral health of passengers and crew attending the dental service aboard during a two months world cruise. In a retrospective, descriptive epidemiologic study design the routine documentation of all dental treatment provided at sea was analysed after the voyage. Subjects were n = 57 passengers (3.5 % of 1619) with a mean age of 71 (+/- 9.8) years and n =56 crew (5.6 % of 999) with a mean age of 37 (+/- 12.0) years. Age, gender, nationality, number of natural teeth and implants were extracted. The prosthetic status was described by recording the number of teeth replaced by fixed prosthesis and number of teeth replaced by removable prosthesis. Oral health-related quality of life (OHRQoL) was measured using the 14-item Oral Health Impact Profile (OHIP-14) and characterised by the OHIP sum score. Women attended for treatment more often than men. Passengers had a mean number of 20 natural teeth plus substantial fixed and removable prosthodontics. Crew had a mean of 26 teeth. British crew and Australian passengers attended the dental service above average. Crew tended to have a higher average OHIP-14 sum score than passengers indicating an increased rate of perceived problems. Emergency patients from both crew and passengers have a higher sum score than patients attending for routine treatment. In passengers the average number of teeth appears to be higher than that of an age matched population of industrialized countries. However, the passengers' socioeconomic status was higher which has an effect on this finding. Socioeconomic factors also serve to explain the high standard of prosthetic care in passengers. Crew in general present with less sophisticated prosthetic devices. This is in line with their different socioeconomic status and origin from developing countries. The level of dental fees aboard in comparison to treatment costs in home countries may explain some of the differences in attendance. Passengers have enjoyed high standards of prosthetic care in the past and will expect a similarly high standard from ship based facilities. The ease of access to quality dental care may explain the relatively low level of perceived problems as characterised by oral health-related quality of life scores. The dental officer aboard has to be prepared to care for very varied diagnostic and treatment needs.

Staging dementia using Clinical Dementia Rating Scale Sum of Boxes scores: a Texas Alzheimer's research consortium study.

PubMed

O'Bryant, Sid E; Waring, Stephen C; Cullum, C Munro; Hall, James; Lacritz, Laura; Massman, Paul J; Lupo, Philip J; Reisch, Joan S; Doody, Rachelle

2008-08-01

The Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) score is commonly used, although the utility regarding this score in staging dementia severity is not well established. To investigate the effectiveness of CDR-SOB scores in staging dementia severity compared with the global CDR score. Retrospective study. Texas Alzheimer's Research Consortium minimum data set cohort. A total of 1577 participants (110 controls, 202 patients with mild cognitive impairment, and 1265 patients with probable Alzheimer disease) were available for analysis. Receiver operating characteristic curves were generated from a derivation sample to determine optimal cutoff scores and ranges, which were then applied to the validation sample. Optimal ranges of CDR-SOB scores corresponding to the global CDR scores were 0.5 to 4.0 for a global score of 0.5, 4.5 to 9.0 for a global score of 1.0, 9.5 to 15.5 for a global score of 2.0, and 16.0 to 18.0 for a global score of 3.0. When applied to the validation sample, kappa scores ranged from 0.86 to 0.94 (P < .001 for all), with 93.0% of the participants falling within the new staging categories. The CDR-SOB score compares well with the global CDR score for dementia staging. Owing to the increased range of values, the CDR-SOB score offers several advantages over the global score, including increased utility in tracking changes within and between stages of dementia severity. Interpretive guidelines for CDR-SOB scores are provided.

Staging Dementia Using Clinical Dementia Rating Scale Sum of Boxes Scores

PubMed Central

O'Bryant, Sid E.; Waring, Stephen C.; Cullum, C. Munro; Hall, James; Lacritz, Laura; Massman, Paul J.; Lupo, Philip J.; Reisch, Joan S.; Doody, Rachelle

2012-01-01

Background The Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) score is commonly used, although the utility regarding this score in staging dementia severity is not well established. Obiective To investigate the effectiveness of CDRSOB scores in staging dementia severity compared with the global CDR score. Design Retrospective study. Setting Texas Alzheimer's Research Consortium minimum data set cohort. Participants A total of 1577 participants (110 controls, 202 patients with mild cognitive impairment, and 1265 patients with probable Alzheimer disease) were available for analysis. Main Outcome Measures Receiver operating characteristic curves were generated from a derivation sample to determine optimal cutoff scores and ranges, which were then applied to the validation sample. Results Optimal ranges of CDR-SOB scores corresponding to the global CDR scores were 0.5 to 4.0 for a global score of 0.5, 4.5 to 9.0 for a global score of 1.O, 9.5 to 15.5 for a global score of 2.0, and 16.0 to 18.0 for a global score of 3.0. When applied to the validation sample, κ scores ranged from 0.86 to 0.94 (P <.001 for all), with 93.0% of the participants falling within the new staging categories. Conclusions The CDR-SOB score compares well with the global CDR score for dementia staging. Owing to the increased range of values, the CDR-SOB score offers several advantages over the global score, including increased utility in tracking changes within and between stages of dementia severity. Interpretive guidelines for CDR-SOB scores are provided. PMID:18695059

Relation of anosognosia to frontal lobe dysfunction in Alzheimer's disease.

PubMed

Michon, A; Deweer, B; Pillon, B; Agid, Y; Dubois, B

1994-07-01

A self-rating scale of memory functions was administered to 24 non-depressed patients with probable Alzheimer's disease, divided into two groups according to the overall severity of dementia (mild, mini-mental state (MMS) > 21; moderate, MMS between 10 and 20). These groups did not significantly differ in their self-rating of memory functions. The same questionnaire was submitted to a member of each patient's family, who had to rate the patient's memory. An "anosognosia score" was defined as the difference between patient's and family's ratings. This score was highly variable, and covered, in the two groups, the full range between complete awareness of deficits and total anosognosia. Correlations between the anosognosia score and several neuropsychological data were searched for. No significant correlation was found with either the Wechsler memory scale, the MMS, or linguistic abilities and gestures. In contrast, this score was highly correlated with the "frontal score", defined as the sum of scores on the Wisconsin card sorting test (WCST), verbal fluency, Luria's graphic series, and "frontal behaviours" (prehension, utilisation, imitation behaviours, inertia, indifference). Among these tests of executive functions, the highest correlation with the anosognosia score was obtained on the WCST. This suggests that anosognosia in Alzheimer's disease is not related to the degree of cognitive deterioration but results, at least in part, from frontal dysfunction.

Validation of the urinary sensation scale (USS).

PubMed

Coyne, Karin S; Margolis, Mary Kay; Hsieh, Ray; Vats, Vasudha; Chapple, Christopher R

2011-03-01

The purpose of this study was to assess the validity of the Urinary Sensation Scale (USS) in men with overactive bladder and voiding symptoms (OAB-LUTS) and women with overactive bladder (OAB). Data from two OAB clinical trials of tolterodine were used. The USS, a 5-point scale, assesses the amount of urinary urgency associated with each urination. Three methods to calculate the USS are: mean urgency (Mean USS); mode urgency (Mode USS); and sum urgency (sum USS). The validity and responsiveness of the scoring methods was assessed using Spearman's correlations, general linear models, and effect sizes. Data from 650 men (Study 1) and 413 women (Study 2) were analyzed. Mean age was 65.2 (men) and 47.8 (women); 70% were Caucasian in both studies. Correlations of USS scores with bladder diary variables were small to moderate and higher among Sum USS than Mean USS (r=0.02-0.64). Correlations among the USS and patient-reported outcomes (PROs) were again small to moderate and higher with Sum USS (r=0.05-0.41). Both the Mean USS and Sum USS significantly discriminated (all P<0.001) among all bladder diary variables (except nocturia and UUI in men) when grouped as improved/not improved as well as by the PROs. Effect sizes for men and women, respectively, were -0.52 and -1.09 for Mean USS and -0.72 and -1.36 for Sum USS. The USS is a valid and highly responsive measure of urinary urgency in men with OAB-LUTS and women with OAB. Copyright © 2011 Wiley-Liss, Inc.

A modified method for measuring antibiotic use in healthcare settings: implications for antibiotic stewardship and benchmarking.

PubMed

Aldeyab, Mamoon A; McElnay, James C; Scott, Michael G; Lattyak, William J; Darwish Elhajji, Feras W; Aldiab, Motasem A; Magee, Fidelma A; Conlon, Geraldine; Kearney, Mary P

2014-04-01

To determine whether adjusting the denominator of the common hospital antibiotic use measurement unit (defined daily doses/100 bed-days) by including age-adjusted comorbidity score (100 bed-days/age-adjusted comorbidity score) would result in more accurate and meaningful assessment of hospital antibiotic use. The association between the monthly sum of age-adjusted comorbidity and monthly antibiotic use was measured using time-series analysis (January 2008 to June 2012). For the purposes of conducting internal benchmarking, two antibiotic usage datasets were constructed, i.e. 2004-07 (first study period) and 2008-11 (second study period). Monthly antibiotic use was normalized per 100 bed-days and per 100 bed-days/age-adjusted comorbidity score. Results showed that antibiotic use had significant positive relationships with the sum of age-adjusted comorbidity score (P = 0.0004). The results also showed that there was a negative relationship between antibiotic use and (i) alcohol-based hand rub use (P = 0.0370) and (ii) clinical pharmacist activity (P = 0.0031). Normalizing antibiotic use per 100 bed-days contributed to a comparative usage rate of 1.31, i.e. the average antibiotic use during the second period was 31% higher than during the first period. However, normalizing antibiotic use per 100 bed-days per age-adjusted comorbidity score resulted in a comparative usage rate of 0.98, i.e. the average antibiotic use was 2% lower in the second study period. Importantly, the latter comparative usage rate is independent of differences in patient density and case mix characteristics between the two studied populations. The proposed modified antibiotic measure provides an innovative approach to compare variations in antibiotic prescribing while taking account of patient case mix effects.

Adverse life events in elderly patients with major depression or dysthymic disorder and in healthy-control subjects.

PubMed

Devanand, D P; Kim, Min Kyung; Paykina, Natalya; Sackeim, Harold A

2002-01-01

The authors compared elderly outpatients (> or =60 years) with major depression or dysthymic disorder and healthy-control subjects on the type and subjective impact of adverse life events. The Geriatric Adverse Life Events Scale (GALES) was developed for this purpose. Fifty patients with major depression, 79 patients with dysthymic disorder, and 40 healthy controls completed the GALES. Adverse life events during two time periods were assessed: the year before the evaluation, and the year before onset of the index episode (patients only). During the year before evaluation, patients with major depression reported more life events with greater negative impact, particularly for interpersonal conflicts, and dysthymic patients scored intermediate between patients and controls. Sum scores for perceived stress and negative impact on mood differed significantly among the groups: highest for major depression, intermediate for dysthymic disorder, and lowest for controls. During the year before onset, patients with major depression reported significantly higher sum scores for negative impact on mood than patients with dysthymic disorder. On several measures, patients with major depression perceived greater negative impact of life events than patients with dysthymic disorder and healthy controls, particularly for interpersonal conflicts. The subjective impact of adverse life events may play an important role in the expression of depressive illness in elderly patients, particularly in major depression, and it needs to be considered in clinical management.

Bifactor Structure for the Categorical Chinese Rosenberg Self-Esteem Scale.

PubMed

Xu, Menglin; Leung, Shing-On

2016-10-11

Recently, the bifactor model was suggested for the latent structure of the Rosenberg Self-Esteem Scale (RSES). The present paper investigates (i) the differences among bifactor, bifactor negative and other models; (ii) the effects of treating data as both categorical vs continuous; (iii) whether a problematic item in the Chinese RSES should be removed; and (iv) whether the final scoring would be affected. With a sample of 1.734 grade 4-6 school pupils in Hong Kong, we used BIC differences in addition to the usual model fit indices, and found that there was strong evidence for using the bifactor model (RMSEA = .052, 90% CI [.043, .062], CFI = .992, TLI = .984 for 9-item RSES categorical). Little difference is found between treating data as categorical or continuous for fit indices, but the factor loading patterns are better in categorical case. Keeping a problematic item has little effect on fit indices, but would lead to unexpected negative loading. The ranking of loadings within positive and negative items across different conditions are the same, which has important effects on scoring. Loadings in the method effects in the bifactor models are all positive (p < .001), which is different from previous research. All models show similar results on scoring, and support the usual simple sum score in most practice.

Resident training for eclampsia and magnesium toxicity management: simulation or traditional lecture?

PubMed

Fisher, Nelli; Bernstein, Peter S; Satin, Andrew; Pardanani, Setul; Heo, Hye; Merkatz, Irwin R; Goffman, Dena

2010-10-01

To compare eclampsia and magnesium toxicity management among residents randomly assigned to lecture or simulation-based education. Statified by year, residents (n = 38) were randomly assigned to 3 educational intervention groups: Simulation→Lecture, Simulation, and Lecture. Postintervention simulations were performed for all and scored using standardized lists. Maternal, fetal, eclampsia management, and magnesium toxcity scores were assigned. Mann-Whitney U, Wilcoxon rank sum and χ(2) tests were used for analysis. Postintervention maternal (16 and 15 vs 12; P < .05) and eclampsia (19 vs 16; P < .05) scores were significantly better in simulation based compared with lecture groups. Postintervention magnesium toxcitiy and fetal scores were not different among groups. Lecture added to simulation did not lead to incremental benefit when eclampsia scores were compared between Simulation→Lecture and Simulation (19 vs 19; P = nonsignificant). Simulation training is superior to traditional lecture alone for teaching crucial skills for the optimal management of both eclampsia and magnesium toxicity, 2 life-threatening obstetric emergencies. Published by Mosby, Inc.

Dimensionality and summary measures of the SF-36 v1.6: comparison of scale- and item-based approach across ECRHS II adults population.

PubMed

Grassi, Mario; Nucera, Andrea

2010-01-01

The objective of this study was twofold: 1) to confirm the hypothetical eight scales and two-component summaries of the questionnaire Short Form 36 Health Survey (SF-36), and 2) to evaluate the performance of two alternative measures to the original physical component summary (PCS) and mental component summary (MCS). We performed principal component analysis (PCA) based on 35 items, after optimal scaling via multiple correspondence analysis (MCA), and subsequently on eight scales, after standard summative scoring. Item-based summary measures were planned. Data from the European Community Respiratory Health Survey II follow-up of 8854 subjects from 25 centers were analyzed to cross-validate the original and the novel PCS and MCS. Overall, the scale- and item-based comparison indicated that the SF-36 scales and summaries meet the supposed dimensionality. However, vitality, social functioning, and general health items did not fit data optimally. The novel measures, derived a posteriori by unit-rule from an oblique (correlated) MCA/PCA solution, are simple item sums or weighted scale sums where the weights are the raw scale ranges. These item-based scores yielded consistent scale-summary results for outliers profiles, with an expected known-group differences validity. We were able to confirm the hypothesized dimensionality of eight scales and two summaries of the SF-36. The alternative scoring reaches at least the same required standards of the original scoring. In addition, it can reduce the item-scale inconsistencies without loss of predictive validity.

Comparison of multianalyte proficiency test results by sum of ranking differences, principal component analysis, and hierarchical cluster analysis.

PubMed

Škrbić, Biljana; Héberger, Károly; Durišić-Mladenović, Nataša

2013-10-01

Sum of ranking differences (SRD) was applied for comparing multianalyte results obtained by several analytical methods used in one or in different laboratories, i.e., for ranking the overall performances of the methods (or laboratories) in simultaneous determination of the same set of analytes. The data sets for testing of the SRD applicability contained the results reported during one of the proficiency tests (PTs) organized by EU Reference Laboratory for Polycyclic Aromatic Hydrocarbons (EU-RL-PAH). In this way, the SRD was also tested as a discriminant method alternative to existing average performance scores used to compare mutlianalyte PT results. SRD should be used along with the z scores--the most commonly used PT performance statistics. SRD was further developed to handle the same rankings (ties) among laboratories. Two benchmark concentration series were selected as reference: (a) the assigned PAH concentrations (determined precisely beforehand by the EU-RL-PAH) and (b) the averages of all individual PAH concentrations determined by each laboratory. Ranking relative to the assigned values and also to the average (or median) values pointed to the laboratories with the most extreme results, as well as revealed groups of laboratories with similar overall performances. SRD reveals differences between methods or laboratories even if classical test(s) cannot. The ranking was validated using comparison of ranks by random numbers (a randomization test) and using seven folds cross-validation, which highlighted the similarities among the (methods used in) laboratories. Principal component analysis and hierarchical cluster analysis justified the findings based on SRD ranking/grouping. If the PAH-concentrations are row-scaled, (i.e., z scores are analyzed as input for ranking) SRD can still be used for checking the normality of errors. Moreover, cross-validation of SRD on z scores groups the laboratories similarly. The SRD technique is general in nature, i.e., it can be applied to any experimental problem in which multianalyte results obtained either by several analytical procedures, analysts, instruments, or laboratories need to be compared.

Significance of worsening renal function and nuclear cardiology for predicting cardiac death in patients with known or suspected coronary artery disease.

PubMed

Yoda, Shunichi; Nakanishi, Kanae; Tano, Ayako; Hori, Yusuke; Suzuki, Yasuyuki; Matsumoto, Naoya; Hirayama, Atsushi

2015-11-01

Estimated glomerular filtration rates (eGFRs) at baseline are useful to determine the severity of renal function and to predict cardiac events. However, no studies aimed to demonstrate significance of eGFRs measured during follow-up and usefulness of combination with nuclear cardiology for prediction of cardiac death in patients with coronary artery disease (CAD). We retrospectively investigated 1739 patients with known/suspected CAD who underwent myocardial perfusion single photon emission computed tomography (SPECT), who had eGFRs measured at baseline and after one year and who underwent a three-year follow-up. The SPECT images were analyzed with the visual scoring model to estimate summed defect scores. Reduction in eGFRs (ΔeGFR) was defined as the difference between eGFRs measured after one year and at baseline. The endpoint of the follow-up was cardiac deaths within three years after the SPECT, which were identified with medical records or responses to posted questionnaires. Cardiac death was observed in 54 of 1739 patients during the follow-up period (45.6±9.1 months). The multivariate Cox regression analysis showed baseline eGFRs, ΔeGFR, and summed stress scores to be significant independent variables for prediction of cardiac death. The area under receiver operating characteristic curves for detection of cardiac death was 0.677 for the baseline eGFR and 0.802 for the follow-up eGFR. Sensitivity of detection of cardiac death was significantly higher in the follow-up eGFR than in the baseline eGFR (p=0.0002). Combination of the best cut-off values, i.e. 9 for the summed stress scores and 10 for the ΔeGFR, which were suggested by receiver operating characteristic analysis, was useful for risk stratification of cardiac death both in patients with and without chronic kidney disease. Baseline and follow-up eGFRs as well as nuclear variables are useful to predict cardiac death in patients with known/suspected CAD. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Change to either a nonandrogenic or androgenic progestin-containing oral contraceptive preparation is associated with improved sexual function in women with oral contraceptive-associated sexual dysfunction.

PubMed

Davis, Susan R; Bitzer, Johannes; Giraldi, Annamaria; Palacios, Santiago; Parke, Susanne; Serrani, Marco; Mellinger, Uwe; Nappi, Rossella E

2013-12-01

It is a commonly held belief that combined oral contraceptive (COC) pills containing an androgenic progestin may be less likely to impair sexual function than COCs containing an anti-androgenic progestin. The study aims to compare the effects of a COC containing a progestin with an anti-androgenic profile (estradiol valerate [E2 V]/dienogest [DNG]) to that of one with an androgenic progestin (ethinyl estradiol [EE]/levonorgestrel [LNG]) on sexual function in women with COC-associated sexual dysfunction. In this multicenter, randomized, double-blind, noninferiority study, women with COC-associated female sexual dysfunction (FSD) were randomized to E2 V/DNG or EE/LNG for six cycles. The primary outcome was the change in the sum of Female Sexual Function Index (FSFI) desire and arousal component scores between baseline and cycle 6. Secondary outcome measures included changes to the FSFI domains, the Female Sexual Distress Scale (FSDS-R), Vaginal Health Assessment, the Atrophy Symptom Questionnaire, and the Psychological General Well Being Index over six treatment cycles. The main outcome is the change in the sum of FSFI desire and arousal component scores between baseline and cycle 6. Of 276 women screened, 213 received treatment and 191 completed the study. The mean increase in the sum of FSFI desire and arousal component scores was 5.90 (standard deviation [SD] 5.45) for E2 V/DNG and 5.79 (SD 6.17) for EE/LNG (change from baseline P < 0.0001, both groups). Both treatments showed equal efficacy and were associated with improvements in all domains of the FSFI, with no between-group differences. Both COCs reduced the distress associated with FSD, as indicated by reduced FSDS-R scores. In women with COC-associated FSD, switching to either E2 V/DNG or EE/LNG was associated with equivalent improvements in symptoms, challenging the perception that COCs containing anti-androgenic progestins have a detrimental effect on sexual function relative to those containing androgenic progestins. © 2013 International Society for Sexual Medicine.

Differentiation of prostatitis and prostate cancer using the Prostate Imaging-Reporting and Data System (PI-RADS).

PubMed

Meier-Schroers, Michael; Kukuk, Guido; Wolter, Karsten; Decker, Georges; Fischer, Stefan; Marx, Christian; Traeber, Frank; Sprinkart, Alois Martin; Block, Wolfgang; Schild, Hans Heinz; Willinek, Winfried

2016-07-01

To determine if prostate cancer (PCa) and prostatitis can be differentiated by using PI-RADS. 3T MR images of 68 patients with 85 cancer suspicious lesions were analyzed. The findings were correlated with histopathology. T2w imaging (T2WI), diffusion weighted imaging (DWI), dynamic contrast enhancement (DCE), and MR-Spectroscopy (MRS) were acquired. Every lesion was given a single PI-RADS score for each parameter, as well as a sum score and a PI-RADS v2 score. Furthermore, T2-morphology, ADC-value, perfusion type, citrate/choline-level, and localization were evaluated. 44 of 85 lesions showed PCa (51.8%), 21 chronic prostatitis (24.7%), and 20 other benign tissue such as hyperplasia or fibromuscular tissue (23.5%). The single PI-RADS score for T2WI, DWI, DCE, as well as the aggregated score including and not including MRS, and the PI-RADS v2-score were all significantly higher for PCa than for prostatitis or other tissue (p<0.001). The single PI-RADS score for MRS and the PI-RADS sum score including MRS were significantly higher for prostatitis than for other tissue (p=0.029 and p=0.020), whereas the other parameters were not different. Prostatitis usually presented borderline pathological PI-RADS scores, showed restricted diffusion with ADC≥900mm(2)/s in 100% of cases, was more often indistinctly hypointense on T2WI (66.7%), and localized in the transitional zone (57.1%). An ADC≥900mm(2)/s achieved the highest predictive value for prostatitis (AUC=0.859). Prostatitis can be differentiated from PCa using PI-RADS, since all available parameters are more distinct in cases of cancer. However, there is significant overlap between prostatitis and other benign findings, thus PI-RADS is only suitable to a limited extent for the primary assessment of prostatitis. Restricted diffusion with ADC≥900mm(2)/s is believed to be a good indicator for prostatitis. MRS can help to distinguish between prostatitis and other tissue. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center (SIST-M): development, reliability, and cross-sectional validation of a brief structured clinical dementia rating interview.

PubMed

Okereke, Olivia I; Copeland, Maura; Hyman, Bradley T; Wanggaard, Taylor; Albert, Marilyn S; Blacker, Deborah

2011-03-01

The Clinical Dementia Rating (CDR) and CDR Sum-of-Boxes can be used to grade mild but clinically important cognitive symptoms of Alzheimer disease. However, sensitive clinical interview formats are lengthy. To develop a brief instrument for obtaining CDR scores and to assess its reliability and cross-sectional validity. Using legacy data from expanded interviews conducted among 347 community-dwelling older adults in a longitudinal study, we identified 60 questions (from a possible 131) about cognitive functioning in daily life using clinical judgment, inter-item correlations, and principal components analysis. Items were selected in 1 cohort (n=147), and a computer algorithm for generating CDR scores was developed in this same cohort and re-run in a replication cohort (n=200) to evaluate how well the 60 items retained information from the original 131 items. Short interviews based on the 60 items were then administered to 50 consecutively recruited older individuals, with no symptoms or mild cognitive symptoms, at an Alzheimer's Disease Research Center. Clinical Dementia Rating scores based on short interviews were compared with those from independent long interviews. In the replication cohort, agreement between short and long CDR interviews ranged from κ=0.65 to 0.79, with κ=0.76 for Memory, κ=0.77 for global CDR, and intraclass correlation coefficient for CDR Sum-of-Boxes=0.89. In the cross-sectional validation, short interview scores were slightly lower than those from long interviews, but good agreement was observed for global CDR and Memory (κ≥0.70) as well as for CDR Sum-of-Boxes (intraclass correlation coefficient=0.73). The Structured Interview & Scoring Tool-Massachusetts Alzheimer's Disease Research Center is a brief, reliable, and sensitive instrument for obtaining CDR scores in persons with symptoms along the spectrum of mild cognitive change.

Evaluation of the theory of mind in autism spectrum disorders with the Strange Stories test.

PubMed

Velloso, Renata de Lima; Duarte, Cintia Perez; Schwartzman, José Salomão

2013-11-01

To evaluate the theory of mind in autism spectrum disorders (ASD) and control individuals by applying the Strange Stories test that was translated and adapted to the Portuguese language. Twenty-eight children with ASD and 56 controls who were all male and aged between 6 and 12 years participated in the study. There were significant differences between the median scores of the groups for each of the 12 stories of the test and for the sum total of all the median scores. The median scores for all stories were significantly greater in the control group than those in the experimental group (children with ASD). In addition, the protocol had excellent internal consistency. The theory of mind skills assessed with the Strange Stories test indicated alterations in children with ASD compared with children in the control group.

A Note on Stochastic Ordering of the Latent Trait Using the Sum of Polytomous Item Scores

ERIC Educational Resources Information Center

van der Ark, L. Andries; Bergsma, Wicher P.

2010-01-01

In contrast to dichotomous item response theory (IRT) models, most well-known polytomous IRT models do not imply stochastic ordering of the latent trait by the total test score (SOL). This has been thought to make the ordering of respondents on the latent trait using the total test score questionable and throws doubt on the justifiability of using…

Multicolinearity and Indicator Redundancy Problem in World University Rankings: An Example Using Times Higher Education World University Ranking 2013-2014 Data

ERIC Educational Resources Information Center

Kaycheng, Soh

2015-01-01

World university ranking systems used the weight-and-sum approach to combined indicator scores into overall scores on which the universities are then ranked. This approach assumes that the indicators all independently contribute to the overall score in the specified proportions. In reality, this assumption is doubtful as the indicators tend to…

Examining Children's Healthcare Experiences through Drawings

ERIC Educational Resources Information Center

Burns-Nader, Sherwood

2017-01-01

This study examines children's anxieties about healthcare experiences using drawings. Fifty children, either experiencing a doctor's appointment or hospitalization, completed a drawing of a person in the hospital. Using the Child Drawing: Hospital (CD:H), drawings were scored on individual items which were summed for a total score of projected…

Health-related Quality of Life as Studied by EORTC QLQ and Voice Handicap Index Among Various Patients With Laryngeal Disease.

PubMed

Karlsen, Tom; Sandvik, Lorentz; Heimdal, John-Helge; Hjermstad, Marianne Jensen; Aarstad, Anne Kari Hersvik; Aarstad, Hans Jørgen

2017-03-01

Patients with voice-related disorders are often treated by a multidisciplinary team including assessment by patient-reported outcome measures. The present paper aims at documenting the importance of including general health-related quality of life (HRQoL) measures to clinical investigations. The participants (N = 80 larynx cancer, N = 32 recurrent palsy, N = 23 dysfunctional, N = 75 degenerative/inflammation, N = 19 various) were included consecutively at the laryngology clinic at Haukeland University Hospital. In addition, HRQoL data were included from one national group with laryngectomies (N = 105), one group with various patients formerly treated for head and neck squamous cell carcinoma (N = 96), and one population-based reference group (N = 1956). Obtained were the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ), the Voice Handicap Index (VHI), and the Eysenck Personality Inventory (EPI) neuroticism scores. By analysis of variance, we have determined significant dependence of groups analyzing the sum global QoL/health index (F = 9.47; P <0.001), the functional HRQoL sum score (F 5,2373  = 7.14, P <0.001), and the symptom sum HRQoL scores (F 7,2381  = 8.13; P <0.001). In particular, patients with recurrent palsy and laryngeal cancer had lowered HRQoL. At the index levels, in particular dyspnea scores, were scored depending on larynx disease group (F 7,2288  = 24.4; P <0.001). The VHI score correlated with the EORTC H&N35 "speech" index with a common variance of 52%. VHI scores correlated with level of neuroticism with 8% common variance (P <0.001) and EORTC scores with 22% (P <0.001). In particular, among patients with voice-related disease, those with recurrent palsy and laryngeal cancer had lower HRQoL. Furthermore, the HRQoL and VHI scores were inversely tied to neuroticism. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Severity of Neuropsychiatric Symptoms in Nursing Home Residents.

PubMed

Helvik, Anne-Sofie; Engedal, Knut; Wu, Bei; Benth, Jūratė Šaltytė; Corazzini, Kirsten; Røen, Irene; Selbæk, Geir

2016-01-01

We aimed at assessing time shift in the severity of neuropsychiatric symptoms (NPS) in nursing home residents between 2004/2005 and 2010/2011 and associations between NPS and socio-demographic variables, physical health status, dementia severity, and the use of psychotropic drugs. The Neuropsychiatric Inventory Nursing Home Version was used in 2004/2005 (n = 1,163) and 2010/2011 (n = 1,858). Linear mixed model analysis was applied. There was no time shift in the severity of apathy, psychosis, and affective symptoms, but agitation did exhibit a time shift. Agitation was less severe in 2010/2011 than in 2004/2005 in residents with a Clinical Dementia Rating (CDR) sum of boxes score ≤4, and more severe in residents with a CDR sum of boxes score >16. Higher CDR sum of boxes scores and use of psychotropic medication were associated with more severe apathy, agitation, psychosis, and affective symptoms. Poor physical health was associated with more severe apathy, psychosis, and affective symptoms. Women had more severe agitation and less severe affective symptoms than men. A longer stay in a nursing home was associated with more severe agitation and less severe affective symptoms. In conclusion, agitation was less severe in 2010/2011 than in 2004/2005 among nursing home residents with a milder degree of dementia, and more severe in residents with severe dementia.

Identifying Factors That Predict Promotion Time to E-4 and Re-Enlistment Eligibility for U.S. Marine Corps Field Radio Operators

DTIC Science & Technology

2014-12-01

Primary Military Occupational Specialty PRO Proficiency Q-Q Quantile - Quantile RSS Residual Sum of Squares SI Shop Information T&R Training and...construct multivariate linear regression models to estimate Marines’ Computed Tier Score and time to achieve E-4 based on their individual personal...Science (GS) score, ASVAB Mathematics Knowledge (MK) score, ASVAB Paragraph Comprehension (PC) score, weight , and whether a Marine receives a weight

The Association Between the Levels of Thyroid Hormones and Peripheral Nerve Conduction in Patients with Type 2 Diabetes Mellitus.

PubMed

Zhu, Fan-Fan; Yang, Li-Zhen

2018-06-26

Type 2 diabetes has an underlying pathology with thyroid dysfunction. However, few studies have investigated the association between thyroid hormones and diabetic peripheral neuropathy. Our aim was to evaluate the relationship between thyroid hormones and electrophysiological properties of peripheral nerves in type 2 diabetes. The medical records of 308 patients with type 2 diabetes were enrolled in this study. Subjects stratified by sex were divided into subgroups based on the diagnosis of nerve conduction study. The nerve conduction parameters were separately described with the spectrum of thyroid hormones. Multivariate regression models to analyze the potential links between thyroid hormones and nerve conduction parameters. The serum free triiodine thyronine levels between normal and abnormal nerve conduction groups were statistically different in total (4.55±0.65 vs 4.37±0.63, P<0.05) and female diabetic patients (4.46±0.50 vs 4.14±0.57, P<0.01). Moreover, the summed amplitude and velocity Z score of female and male increased with free triiodine thyronine levels (P<0.05). Sex-specific binary logistic regression models showed that free triiodine thyronine levels were associated with decreased odds of abnormal nerve conduction diagnosis (odds ratio [95%CI]=0.151[0.047-0.186]) and low tertile of summed amplitude Z score (odds ratio [95%CI]=0.283[0.099-0.809]) in female. In total patients, free triiodine thyronine level was negatively associated with odds of abnormal nerve conduction (odds ratio [95%CI]=0.436 [0.226-0.842]), low tertile of summed velocity (odds ratio [95%CI]=0.44[0.226-0.858]) and amplitude (odds ratio [95%CI]=0.436[0.227-0.838) Z score. Serum free triiodine thyronine level is associated with nerve conduction in diabetes. Low free triiodine thyronine may be a potential risk for diabetic peripheral neuropathy. © Georg Thieme Verlag KG Stuttgart · New York.

Office immunotherapy in chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy.

PubMed

Dyck, Peter J; Taylor, Bruce V; Davies, Jenny L; Mauermann, Michelle L; Litchy, William J; Klein, Christopher J; Dyck, P James B

2015-10-01

Intravenous immunoglobulin [IVIg], plasma exchange [PE], and corticosteroids are efficacious treatment in chronic inflammatory demyelinating polyneuropathy [CIDP]. IVIg is effective in multifocal motor neuropathy [MMN]. NIS, NIS-weakness, sum scores of raw amplitudes of motor fiber (CMAPs) amplitudes, and Dyck/Rankin score provided reliable measures to detect and scale abnormality and reflect change; they are therefore ideal for office management of response-based immunotherapy (R-IRx) of CIDP. Using efficacious R-IRx, a large early and late therapeutic response (≥ one-fourth were in remission or had recovered) was demonstrated in CIDP. In MMN only an early improvement with late non-significant worsening was observed. The difference in immunotherapy response supports a fundamental difference between CIDP (immune attack on Schwann cells and myelin) and MMN (attack on nodes of Ranvier and axons). © 2015 Wiley Periodicals, Inc.

Office Immunotherapy in Chronic Inflammatoryh Demyelinating Polyneuropathy and Multifocal Motor Neuropathy

PubMed Central

Dyck, Peter J.; Taylor, Bruce V.; Davies, Jenny L.; Mauermann, Michelle L.; Litchy, William J.; Klein, Christopher J.; Dyck, P. James B.

2015-01-01

Background Intravenous immunoglobulin [IVIg], plasma exchange [PE], and corticosteroids are efficacious treatment in chronic inflammatory demyelinating polyneuropathy [CIDP]. IVIg is effective in multifocal motor neuropathy [MMN]. Objective and Methods Results and Conclusions NIS, NIS-weakness, sum scores of raw amplitudes of motor fiber (CMAPs) amplitudes, and Dyck/Rankin score provided reliable measures to detect and scale abnormality and reflect change; they are therefore ideal for office management of response-basedimmunotherapy (R-IRx) of CIDP. Using efficacious R-IRx, a large early and late therapeutic response (≥ one-fourth were in remission or had recovered) was demonstrated in CIDP. In MMN only an early improvement with late non-significant worsening was observed. The difference in immunotherapy response supports a fundamental difference between CIDP (immune attack on Schwann cells and myelin) and MMN (attack on nodes of Ranvier and axons). PMID:25976871

Ethnicity influences disease characteristics and symptom severity in allergic rhinitis patients in Malaysia.

PubMed

Amini, Peyman; Abdullah, Maha; Seng, Lee Sing; Karunakaran, Thanusha; Hani, Norzhafarina; Bakar, Saraiza Abu; Latiff, Amir Hamzah Abdul; Fong, Seow Heng; Yeow, Yap Yoke

2016-06-01

The number of available reports regarding the influence of ethnicity on clinical features of allergic rhinitis (AR), especially disease severity in tropical climates, is limited. We aimed to compare clinical parameters and disease severity in AR patients of different ethnicities. Malay, Chinese, and Indian AR patients (n = 138) with confirmed sensitivity to Dermatophagoides pteronyssinus, Dematophagoides farinae, and Blomia tropicalis were tested for mite-specific immunoglobulin E (sIgE) levels. A detailed questionnaire was used to collect data on nasal symptom score (NSS), ocular symptom score (OSS), sum of symptoms score (SSS), quality of life score (QLS), symptomatic control score (SCS), and total sum of scores (TSS) and correlate the derived data with patients' demography, mite-polysensitivity, and sIgE levels. AR-related symptoms were most severe in Malays and least in Chinese (p < 0.01). Age (r = 0.516 to 0.673, p < 0.05) and duration of AR (r = 0.635 to 0.726, p < 0.01) correlated positively with severity domains (NSS, SSS, QLS, and TSS) in Chinese. Duration of concurrent allergies was highest in Malays (p < 0.05). Polysensitivity predicted increased sIgE levels in Malays (r = 0.464 to 0.551, p < 0.01) and Indians (r = 0.541 to 0.645, p < 0.05) but affected NSS, SSS, and TSS only in Indians (r = 0.216 to 0.376, p < 0.05). sIgE levels were lowest among Chinese but correlated strongly with NSS, OSS, SSS, and TSS (r = 0408 to 0.898, p < 0.05). Clinical parameters in AR may be influenced by race. Symptoms were most severe among Malays but did not correlate with other variables examined. Although Indian ethnicity did not impact disease severity, duration of concurrent allergies and mite-polysensitivity was associated with more severe disease. Age, duration of disease, and sIgE levels may be useful indicators of disease severity in Chinese. © 2016 ARS-AAOA, LLC.

Assessing for suicidal behavior in youth using the Achenbach System of Empirically Based Assessment.

PubMed

Van Meter, Anna R; Algorta, Guillermo Perez; Youngstrom, Eric A; Lechtman, Yana; Youngstrom, Jen K; Feeny, Norah C; Findling, Robert L

2018-02-01

This study investigated the clinical utility of the Achenbach System of Empirically Based Assessment (ASEBA) for identifying youth at risk for suicide. Specifically, we investigated how well the Total Problems scores and the sum of two suicide-related items (#18 "Deliberately harms self or attempts suicide" and #91 "Talks about killing self") were able to distinguish youth with a history of suicidal behavior. Youth (N = 1117) aged 5-18 were recruited for two studies of mental illness. History of suicidal behavior was assessed by semi-structured interviews (K-SADS) with youth and caregivers. Youth, caregivers, and a primary teacher each completed the appropriate form (YSR, CBCL, and TRF, respectively) of the ASEBA. Areas under the curve (AUCs) from ROC analyses and diagnostic likelihood ratios (DLRs) were used to measure the ability of both Total Problems T scores, as well as the summed score of two suicide-related items, to identify youth with a history of suicidal behavior. The Suicide Items from the CBCL and YSR performed well (AUCs = 0.85 and 0.70, respectively). The TRF Suicide Items did not perform better than chance, AUC = 0.45. The AUCs for the Total Problems scores were poor-to-fair (0.33-0.65). The CBCL Suicide Items outperformed all other scores (ps = 0.04 to <0.0005). Combining the CBCL and YSR items did not lead to incremental improvement in prediction over the CBCL alone. The sum of two questions from a commonly used assessment tool can offer important information about a youth's risk for suicidal behavior. The low burden of this approach could facilitate wide-spread screening for suicide in an increasingly at-risk population.

Trail Making Test: normative data for Turkish elderly population by age, sex and education.

PubMed

Cangoz, Banu; Karakoc, Ebru; Selekler, Kaynak

2009-08-15

Trail Making Test (TMT) is a neuropsychological test, which has parts A and B that can precisely measure executive functions, like complex visual-motor conceptual screening, planning, organization, abstract thinking and response inhibition. The main purpose of this study is to standardize TMT for Turkish adults and/or elderly population. This study primarily consists of two main parts; norm determination study and reliability/validity studies, respectively. The standardization study was carried on 484 participants (238 female and 246 male). Participants at the age of 50 years and older were selected from a pool of people employed in or retired from governmental and/or private institutions. The research design of this study involves the following variables mainly; age (7 subgroups), sex (2 subgroups) and education (3 subgroups). Age, sex and education variables have significant influence on eight different kinds of TMT scores. Statistical analysis by ANOVA revealed a major effect of age (p<0.001) and education (p<0.001) on time spent in Part A or B, or time difference between Parts B and A, or sum of Parts A and B. Similarly, influence of sex (p<0.05) on time spent on Part A or B, or sum of Parts A and B was shown to be significant. Kruskal-Wallis Test was performed and chi-square (chi(2)) values revealed that, correction scores for Part A and B were found to be influenced by age groups (p<0.001). Test-retest reliability and inter-rater reliability coefficients for time scores of Parts A and B were estimated as 0.78, 0.99 and 0.73, 0.93, respectively. This study provides normative data for a psychometric tool that reliably measures the executive functions in Turkish elderly population at the age of 50 and over.

Predicting children with pervasive developmental disorders using the Wechsler Intelligence Scale for Children-Third Edition.

PubMed

Koyama, Tomonori; Inada, Naoko; Tsujii, Hiromi; Kurita, Hiroshi

2008-08-01

An original combination score (i.e. the sum of Vocabulary and Comprehension subtracted from the sum of Block Design and Digit Span) was created from the four Wechsler Intelligence Scale for Children-Third Edition (WISC-III) subtests identified by discriminant analysis on WISC-III data from 139/129 children with/without pervasive developmental disorders (PDD; mean, 8.3/8.1 years) and its utility examined for predicting PDD. Its best cut-off was 2/3, with sensitivity, specificity, positive and negative predictive values of 0.68, 0.61, 0.65 and 0.64, respectively. The score seems useful, so long as clinicians are aware of its limitations and use it only as a supplemental measure in PDD diagnosis.

Comparison of Reliability Measures under Factor Analysis and Item Response Theory

ERIC Educational Resources Information Center

Cheng, Ying; Yuan, Ke-Hai; Liu, Cheng

2012-01-01

Reliability of test scores is one of the most pervasive psychometric concepts in measurement. Reliability coefficients based on a unifactor model for continuous indicators include maximal reliability rho and an unweighted sum score-based omega, among many others. With increasing popularity of item response theory, a parallel reliability measure pi…

Non-linearities in Theory-of-Mind Development.

PubMed

Blijd-Hoogewys, Els M A; van Geert, Paul L C

2016-01-01

Research on Theory-of-Mind (ToM) has mainly focused on ages of core ToM development. This article follows a quantitative approach focusing on the level of ToM understanding on a measurement scale, the ToM Storybooks, in 324 typically developing children between 3 and 11 years of age. It deals with the eventual occurrence of developmental non-linearities in ToM functioning, using smoothing techniques, dynamic growth model building and additional indicators, namely moving skewness, moving growth rate changes and moving variability. The ToM sum-scores showed an overall developmental trend that leveled off toward the age of 10 years. Within this overall trend two non-linearities in the group-based change pattern were found: a plateau at the age of around 56 months and a dip at the age of 72-78 months. These temporary regressions in ToM sum-score were accompanied by a decrease in growth rate and variability, and a change in skewness of the ToM data, all suggesting a developmental shift in ToM understanding. The temporary decreases also occurred in the different ToM sub-scores and most clearly so in the core ToM component of beliefs. It was also found that girls had an earlier growth spurt than boys and that the underlying developmental path was more salient in girls than in boys. The consequences of these findings are discussed from various theoretical points of view, with an emphasis on a dynamic systems interpretation of the underlying developmental paths.

Non-linearities in Theory-of-Mind Development

PubMed Central

Blijd-Hoogewys, Els M. A.; van Geert, Paul L. C.

2017-01-01

Research on Theory-of-Mind (ToM) has mainly focused on ages of core ToM development. This article follows a quantitative approach focusing on the level of ToM understanding on a measurement scale, the ToM Storybooks, in 324 typically developing children between 3 and 11 years of age. It deals with the eventual occurrence of developmental non-linearities in ToM functioning, using smoothing techniques, dynamic growth model building and additional indicators, namely moving skewness, moving growth rate changes and moving variability. The ToM sum-scores showed an overall developmental trend that leveled off toward the age of 10 years. Within this overall trend two non-linearities in the group-based change pattern were found: a plateau at the age of around 56 months and a dip at the age of 72–78 months. These temporary regressions in ToM sum-score were accompanied by a decrease in growth rate and variability, and a change in skewness of the ToM data, all suggesting a developmental shift in ToM understanding. The temporary decreases also occurred in the different ToM sub-scores and most clearly so in the core ToM component of beliefs. It was also found that girls had an earlier growth spurt than boys and that the underlying developmental path was more salient in girls than in boys. The consequences of these findings are discussed from various theoretical points of view, with an emphasis on a dynamic systems interpretation of the underlying developmental paths. PMID:28101065

On the Effectiveness of Security Countermeasures for Critical Infrastructures.

PubMed

Hausken, Kjell; He, Fei

2016-04-01

A game-theoretic model is developed where an infrastructure of N targets is protected against terrorism threats. An original threat score is determined by the terrorist's threat against each target and the government's inherent protection level and original protection. The final threat score is impacted by the government's additional protection. We investigate and verify the effectiveness of countermeasures using empirical data and two methods. The first is to estimate the model's parameter values to minimize the sum of the squared differences between the government's additional resource investment predicted by the model and the empirical data. The second is to develop a multivariate regression model where the final threat score varies approximately linearly relative to the original threat score, sectors, and threat scenarios, and depends nonlinearly on the additional resource investment. The model and method are offered as tools, and as a way of thinking, to determine optimal resource investments across vulnerable targets subject to terrorism threats. © 2014 Society for Risk Analysis.

Association of Symptom Network Structure With the Course of [corrected] Depression.

PubMed

van Borkulo, Claudia; Boschloo, Lynn; Borsboom, Denny; Penninx, Brenda W J H; Waldorp, Lourens J; Schoevers, Robert A

2015-12-01

Major depressive disorder (MDD) is a heterogeneous condition in terms of symptoms, course, and underlying disease mechanisms. Current classifications do not adequately address this complexity. In novel network approaches to psychopathology, psychiatric disorders are conceptualized as complex dynamic systems of mutually interacting symptoms. This perspective implies that a more densely connected network of symptoms is indicative of a poorer prognosis, but, to date, no previous study has examined whether network structure is indeed associated with the longitudinal course of MDD. To examine whether the baseline network structure of MDD symptoms is associated with the longitudinal course of MDD. In this prospective study, in which remittent and persistent MDD was defined on the basis of a follow-up assessment after 2 years, 515 patients from the Netherlands Study of Depression and Anxiety with past-year MDD (established with the Composite International Diagnostic Interview) and at least moderate depressive symptoms (assessed with the Inventory of Depressive Symptomatology [IDS]) at baseline were studied. Baseline starting and ending dates were September 1, 2004, through February 28, 2007. Follow-up starting and ending dates were September 1, 2006, through February 28, 2009. Analysis was conducted August 2015. The MDD was considered persistent if patients had at least moderate depressive symptoms (IDS) at 2-year follow-up; otherwise, the MDD was considered remitted. Sparse network structures of baseline MDD symptoms assessed via IDS were computed. Global and local connectivity of network structures were compared across persisters and remitters using a permutation test. Among the 515 patients, 335 (65.1%) were female, mead (SD) age was 40.9 (12.1) years, and 253 (49.1%) had persistent MDD at 2-year follow-up. Persisters (n = 253) had a higher baseline IDS sum score than remitters (n = 262) (mean [SD] score, 40.2 [8.9] vs 35.1 [7.1]; the test statistic for the difference in IDS sum score was 22 027; P < .001). The test statistic for the difference in network connectivity was 1.79 (P = .01) for the original data, 1.55 for data matched on IDS sum score (P = .04), and 1.65 for partialed out data (P = .02). At the symptom level, fatigue or loss of energy and feeling guilty had the largest difference in importance in persisters' network compared with that of remitters (Cohen d = 1.13 and 1.18, respectively). This study reports that symptom networks of patients with MDD are related to longitudinal course: persisters exhibited a more densely connected network at baseline than remitters. More pronounced associations between symptoms may be an important determinant of persistence in MDD.

Effect of the treadmill training factors on the locomotor ability after space flight

NASA Astrophysics Data System (ADS)

Lysova, Nataliya; Fomina, Elena

Training on the treadmill constitutes the central component of the Russian system of countermeasures against the negative effects of microgravity. Effectiveness of the treadmill training is influenced by three main factors. Namely, these are intensity (velocity and regularity), axial loading with the use of elastic bungee cords and percentage of time for training on the non-motorized treadmill within the overall training program. Previously we have demonstrated the significance of each factor separately: intensity (Kozlovskaya I.B. et al., 2011), passive mode (Fomina E.V. et al., 2012) and axial loading (Fomina E.V. et al., 2013). The Russian system of in-flight countermeasures gives preference to interval training sessions in which walking alternates with short episodes of intensive running. Locomotion on the non-motorized treadmill should make approx. 30% of the total time of locomotor training. The ISS RS treadmill can be utilized with the motor in motion (active mode) or out of motion so that the cosmonaut has to push the belt with his feet (passive mode). Axial loading of the cosmonaut must be 60-70% of his body weight. However, there is a huge variety of strategies cosmonauts choose of when they exercise on the treadmill in the course of long-duration ISS missions. Purpose of the investigation was comparative analysis of different locomotion training regimens from the standpoint of their effectiveness in microgravity. Criteria of effectiveness evaluation were the results of the locomotion test that includes walking along the fixed support at the preset rate of 90 steps/min. Peak amplitude on the m. soleus electromyogram was analyzed. The experiment was performed with participation of 18 Russian members of extended ISS missions. Each locomotion training factors was rated using the score scale from 0 to 10: Intensity (0 to 10), Percentage of passive mode training (recommended 30% was taken as 10 and could go down to 0 if the passive mode was not applied) and Axial loading (10 was taken as recommended 70% of the body weight). Significant differences in the m. soleus peak amplitude were found between groups of cosmonauts with different sums of the rating scores. On the third day post landing, myogram amplitudes in the group with the rating score sums < 11 were much higher in comparison with the group in which the rating score sums exceeded 12. These data strongly supported high preventive effectiveness of the locomotor training with the optimal combination of the factors of intensity, percentage of passive mode training and axial loading. Besides, they brought out the possibility of training regimen individualization by “tailoring” two factors, i.e. passive mode and axial loading.

The effects of cognitive-behavioral therapy on depression, anger, and self-control for Korean soldiers.

PubMed

Hyun, Myung-Sun; Chung, Hyang-In C; De Gagne, Jennie C; Kang, Hee Sun

2014-02-01

This quasi-experimental study examined the effects of cognitive-behavioral therapy (CBT) to control depression, anger, and self-control in soldiers from South Korea. Using a pretest-posttest design, the sample was composed of an experimental group (n = 16) and a control group (n = 12). The experimental group participated in four sessions of CBT. No significant differences were found between the groups with regard to demographic characteristics. Changes in the variables after the intervention were analyzed using Wilcoxon's signed-rank sum test. The depression scores decreased significantly after the intervention (z = -3.05, p = 0.002); whereas, the scores of state-trait anger and self-control did not change. In the control group, none of the outcome variable scores changed significantly. The results indicate that the developed CBT program might be an effective modality to decrease the depression of soldiers who are in military service. Copyright 2014, SLACK Incorporated.

Plaque autofluorescence as potential diagnostic targets for oral malodor

NASA Astrophysics Data System (ADS)

Lee, Eun-Song; Yim, Hyun-Kyung; Lee, Hyung-Suk; Choi, Jong-Hoon; Kwon, Ho-Keun; Kim, Baek-Il

2016-08-01

The aim of this study was to determine whether the degree of tongue and interdental plaque can be used to assess oral malodor by quantifying their fluorescence as detected using quantitative light-induced fluorescence (QLF) technology. Ninety-nine subjects who complained of oral malodor were included. The level of oral malodor was quantified using the organoleptic score (OLS) and the concentration of volatile sulfur compounds (VSCs). The fluorescence properties of tongue and interdental plaque were quantified as scores calculated by multiplying the intensity and area of fluorescence in QLF-digital images, and the combined plaque fluorescence (CPF) score was obtained by summing the scores for the two regions. The associations of the scores with malodor levels and the diagnostic accuracy of the CPF score were analyzed. The two plaque fluorescence scores and their combined score differed significantly with the level of oral malodor (p<0.001). The CPF score was moderately correlated with OLS (r=0.64) and VSC levels (r=0.54), and its area under the receiver operating characteristic curve was 0.77 for identifying subjects with definite oral malodor (OLS≥2). In conclusion, plaque fluorescence from tongue and interdental sites as detected using QLF technology can be used to assess the level of oral malodor.

Alternative Matching Scores to Control Type I Error of the Mantel-Haenszel Procedure for DIF in Dichotomously Scored Items Conforming to 3PL IRT and Nonparametric 4PBCB Models

ERIC Educational Resources Information Center

Monahan, Patrick O.; Ankenmann, Robert D.

2010-01-01

When the matching score is either less than perfectly reliable or not a sufficient statistic for determining latent proficiency in data conforming to item response theory (IRT) models, Type I error (TIE) inflation may occur for the Mantel-Haenszel (MH) procedure or any differential item functioning (DIF) procedure that matches on summed-item…

Cost calculation and prediction in adult intensive care: a ground-up utilization study.

PubMed

Moran, J L; Peisach, A R; Solomon, P J; Martin, J

2004-12-01

The ability of various proxy cost measures, including therapeutic activity scores (TISS and Omega) and cumulative daily severity of illness scores, to predict individual ICU patient costs was assessed in a prospective "ground-up" utilization costing study over a six month period in 1991. Daily activity (TISS and Omega scores) and utilization in consecutive admissions to three adult university associated ICUs was recorded by dedicated data collectors. Cost prediction used linear regression with determination (80%) and validation (20%) data sets. The cohort, 1333 patients, had a mean (SD) age 57.5 (19.4) years, (41% female) and admission APACHE III score of 58 (27). ICU length of stay and mortality were 3.9 (6.1) days and 17.6% respectively. Mean total TISS and Omega scores were 117 (157) and 72 (113) respectively. Mean patient costs per ICU episode (1991 dollar AUS) were dollar 6801 (dollar 10311), with median costs of dollar 2534, range dollar 106 to dollar 95,602. Dominant cost fractions were nursing 43.3% and overheads 16.9%. Inflation adjusted year 2002 (mean) costs were dollar 9343 (dollar AUS). Total costs in survivors were predicted by Omega score, summed APACHE III score and ICU length of stay; determination R2, 0.91; validation 0.88. Omega was the preferred activity score. Without the Omega score, predictors were age, summed APACHE III score and ICU length of stay; determination R2, 0.73; validation 0.73. In non-survivors, predictors were age and ICU length of stay (plus interaction), and Omega score (determination R2, 0.97; validation 0.91). Patient costs may be predicted by a combination of ICU activity indices and severity scores.

Universality in the distance between two teams in a football tournament

NASA Astrophysics Data System (ADS)

da Silva, Roberto; Dahmen, Silvio R.

2014-03-01

Is football (soccer) a universal sport? Beyond the question of geographical distribution, where the answer is most certainly yes, when looked at from a mathematical viewpoint the scoring process during a match can be thought of, in a first approximation, as being modeled by a Poisson distribution. Recently, it was shown that the scoring of real tournaments can be reproduced by means of an agent-based model (da Silva et al. (2013) [24]) based on two simple hypotheses: (i) the ability of a team to win a match is given by the rate of a Poisson distribution that governs its scoring during a match; and (ii) such ability evolves over time according to results of previous matches. In this article we are interested in the question of whether the time series represented by the scores of teams have universal properties. For this purpose we define a distance between two teams as the square root of the sum of squares of the score differences between teams over all rounds in a double-round-robin-system and study how this distance evolves over time. Our results suggest a universal distance distribution of tournaments of different major leagues which is better characterized by an exponentially modified Gaussian (EMG). This result is corroborated by our agent-based model.

The impact of fatigue on the non-technical skills performance of critical care air ambulance clinicians.

PubMed

Myers, J A; Powell, D M C; Aldington, S; Sim, D; Psirides, A; Hathaway, K; Haney, M F

2017-11-01

The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design). Trained assessors blinded to participants' fatigue status performed detailed structured assessments based on expected behaviours in four non-technical skills domains: teamwork, situational awareness, task management, and decision making. Participants also provided self-ratings of their performance. The primary endpoint was the sum score of overall non-technical performance. The main finding, the overall non-technical skills performance rating of the clinicians, was better in rested than fatigued states (mean difference with 95% CI, 2.8 [2.2-3.4]). The findings remained consistent across individual non-technical skills domains; also when controlling for an order effect and examining the impact of a number of possible covariates. There was no difference in self-ratings of clinical performance between rested and fatigued states. Non-technical performance of critical care air transfer clinicians is degraded when they are fatigued. Fatigued clinicians may fail to recognise the degree to which their performance is compromised. These findings represent risk to clinical care quality and patient safety in the dynamic and isolated environment of air ambulance transfer. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Comparison of Dynamic Balance in Collegiate Field Hockey and Football Players Using Star Excursion Balance Test

PubMed Central

Bhat, Rashi; Moiz, Jamal Ali

2013-01-01

Purpose The preliminary study aimed to compare dynamic balance between collegiate athletes competing or training in football and hockey using star excursion balance test. Methods A total thirty university level players, football (n = 15) and field hockey (n = 15) were participated in the study. Dynamic balance was assessed by using star excursion balance test. The testing grid consists of 8 lines each 120 cm in length extending from a common point at 45° increments. The subjects were instructed to maintain a stable single leg stance with the test leg with shoes off and to reach for maximal distance with the other leg in each of the 8 directions. A pencil was used to point and read the distance to which each subject's foot reached. The normalized leg reach distances in each direction were summed for both limbs and the total sum of the mean of summed normalized distances of both limbs were calculated. Results There was no significant difference in all the directions of star excursion balance test scores in both the groups. Additionally, composite reach distances of both groups also found non-significant (P=0.5). However, the posterior (P=0.05) and lateral (P=0.03) normalized reach distances were significantly more in field hockey players. Conclusion Field hockey players and football players did not differ in terms of dynamic balance. PMID:24427482

Comparison of dynamic balance in collegiate field hockey and football players using star excursion balance test.

PubMed

Bhat, Rashi; Moiz, Jamal Ali

2013-09-01

The preliminary study aimed to compare dynamic balance between collegiate athletes competing or training in football and hockey using star excursion balance test. A total thirty university level players, football (n = 15) and field hockey (n = 15) were participated in the study. Dynamic balance was assessed by using star excursion balance test. The testing grid consists of 8 lines each 120 cm in length extending from a common point at 45° increments. The subjects were instructed to maintain a stable single leg stance with the test leg with shoes off and to reach for maximal distance with the other leg in each of the 8 directions. A pencil was used to point and read the distance to which each subject's foot reached. The normalized leg reach distances in each direction were summed for both limbs and the total sum of the mean of summed normalized distances of both limbs were calculated. There was no significant difference in all the directions of star excursion balance test scores in both the groups. Additionally, composite reach distances of both groups also found non-significant (P=0.5). However, the posterior (P=0.05) and lateral (P=0.03) normalized reach distances were significantly more in field hockey players. Field hockey players and football players did not differ in terms of dynamic balance.

Outlier removal, sum scores, and the inflation of the Type I error rate in independent samples t tests: the power of alternatives and recommendations.

PubMed

Bakker, Marjan; Wicherts, Jelte M

2014-09-01

In psychology, outliers are often excluded before running an independent samples t test, and data are often nonnormal because of the use of sum scores based on tests and questionnaires. This article concerns the handling of outliers in the context of independent samples t tests applied to nonnormal sum scores. After reviewing common practice, we present results of simulations of artificial and actual psychological data, which show that the removal of outliers based on commonly used Z value thresholds severely increases the Type I error rate. We found Type I error rates of above 20% after removing outliers with a threshold value of Z = 2 in a short and difficult test. Inflations of Type I error rates are particularly severe when researchers are given the freedom to alter threshold values of Z after having seen the effects thereof on outcomes. We recommend the use of nonparametric Mann-Whitney-Wilcoxon tests or robust Yuen-Welch tests without removing outliers. These alternatives to independent samples t tests are found to have nominal Type I error rates with a minimal loss of power when no outliers are present in the data and to have nominal Type I error rates and good power when outliers are present. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Urinary tract-related quality of life after radical prostatectomy: open retropubic versus robot-assisted laparoscopic approach.

PubMed

Froehner, Michael; Koch, Rainer; Leike, Steffen; Novotny, Vladimir; Twelker, Lars; Wirth, Manfred P

2013-01-01

The best technique of radical prostatectomy--open retropubic versus robot-assisted surgery--is a subject of controversy. Between January 1st, 2007 and December 31st, 2011, 2,177 men underwent radical prostatectomy at our department. 252 (12%) cases were laparoscopic robot-assisted, the remainder open retropubic procedures. In Germany, certified prostate cancer centers are required to collect urinary tract-related outcome data after radical prostatectomy using the International Consultation of Incontinence Questionnaire Male Lower Urinary Tract Symptoms. The questionnaire data were used to compare both surgical approaches concerning the urinary tract-related outcome 1, 2 and 3 years postoperatively. Neither the voiding score nor the incontinence score or the bother scale sum differed between the two cohorts at any of the measurement times. Concerning continence recovery, in this series, there were no detectable differences between robot-assisted and open radical prostatectomy. Copyright © 2012 S. Karger AG, Basel.

Functional Diagnosis as a Tool in Rehabilitation: A Comparison of Teachers and Other Employees.

ERIC Educational Resources Information Center

Berg, John E.; Berg, Ottar; Reiten, Tor; Kostveit, Svein

1998-01-01

A study compared 100 Norwegian teachers with a matched group of non-teachers who were attending a four-week vocational rehabilitation program on work environment, family relations, health, personal economy, and leisure-time activity. Teachers scored significantly lower than nonteachers on the family relations axis and on a sum score of all…

77 FR 18109 - Assessments, Large Bank Pricing

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... higher-risk assets to Tier 1 capital and reserves.\\7\\ Higher-risk assets are defined as the sum of... defined as the higher of: (a) The higher-risk assets to Tier 1 capital and reserves score or (b) the... higher of: (a) The higher-risk assets to Tier 1 capital and reserves score or (b) the largest or top 20...

Cross-cultural validation of the German and Turkish versions of the PHQ-9: an IRT approach.

PubMed

Reich, Hanna; Rief, Winfried; Brähler, Elmar; Mewes, Ricarda

2018-06-05

The Patient Health Questionnaire's depression module (PHQ-9) is a widely used screening tool to assess depressive disorders. However, cross-linguistic and cross-cultural validation of the PHQ-9 is mostly lacking. This study investigates whether scores on the German and Turkish versions of the PHQ-9 are comparable. Data from Germans without a migration background (German version, n = 1670) and Turkish immigrants in Germany (either German or Turkish version, n = 307) were used. Differential Item Functioning (DIF) was assessed using Item Response Theory (IRT) models. Several items of the PHQ-9 were found to exhibit DIF related to language or ethnicity, e.g. 'sleep problems', 'appetite changes' and 'anhedonia'. However, PHQ-9 sum scores were found to be unbiased, i.e., DIF had no notable impact on scale levels. PHQ-9 sum scores can be compared between Turkish immigrants and Germans without a migration background without any adjustments, regardless of whether they complete the German or the Turkish version.

Enamel Hypomineralization in Children With Clefts and the Relationship to Treatment: A Cross-sectional Retrospective Study.

PubMed

Allam, Eman; Ghoneima, Ahmed; Tholpady, Sunil S; Kula, Katherine

2018-06-19

The aim of this study was to determine whether molar incisor hypomineralization (MIH) is greater in patients with cleft lip and palate (CLP) who underwent primary alveolar grafting (PAG) as compared with CLP waiting for secondary alveolar grafting (SAG) and with controls. A retrospective analysis of intraoral photographs of 13 CLP patients who underwent a PAG, 28 CLP prior to SAG, and 60 controls without CLP was performed. Mantel-Haenszel χ tests were used to compare the 3 groups for differences in MIH scores, and Wilcoxon rank sum tests were used to compare the groups for differences in average MIH scores. A 5% significance level was used for all tests. Molar incisor hypomineralization scores were significantly higher for the PAG and SAG groups compared with the control group (P < 0.001). The PAG group had significantly higher incisor MIH (P = 0.016) compared with the SAG group. Molar incisor hypomineralization average scores were significantly higher for the 2 graft groups compared with the controls (P < 0.0001). The PAG group had significantly higher average MIH score and average MIH score for incisors compared with the SAG group (P = 0.03). Cleft lip and palate patients have significantly greater MIH compared with controls, and CLP patients with PAGs have significantly greater MIH in the incisor region compared with CLP patients with SAGs, indicating that subjects with PAGs have more severely affected dentition.

Effect of study partner on the conduct of Alzheimer disease clinical trials

PubMed Central

Raman, Rema; Ernstrom, Karin; Aisen, Paul; Karlawish, Jason

2013-01-01

Objective: Alzheimer disease (AD) dementia clinical trials require 2 participants: a patient and a study partner. We assessed the prevalence of study partner types and how these types associate with patient-related outcome measures. Methods: Retrospective analyses of 6 Alzheimer’s Disease Cooperative Study (ADCS) randomized clinical trials were conducted. Study partners were categorized as spouse, adult child, or other. Prevalence of study partner type and associations between study partner type and trial outcomes including study completion and placebo decline on the Mini-Mental State Examination, the Alzheimer’s Disease Assessment Scale–cognitive subscale, the Clinical Dementia Rating scale Sum of the Boxes score, and the ADCS–Activities of Daily Living were examined. Results: More participants (67%) enrolled with spouses than adult children (26%) or other study partners (7%). Participants with spouse partners had a lower dropout rate (25%) than those with adult child (32%) or other study partners (34%); only the difference vs others was statistically significant. Participants with adult child and other partners randomized to placebo performed worse at baseline than those with spouse partners on the ADCS–Activities of Daily Living (p = 0.04), but were not different at 18 months. There were no differences at baseline for the Mini-Mental State Examination, Clinical Dementia Rating scale Sum of the Boxes score, or Alzheimer’s Disease Assessment Scale–cognitive subscale. In multivariate models of the rates of change over time among placebo participants, no differences among study partner groups reached statistical significance. Conclusions: Patients with nonspouse caregivers less frequently participate in AD dementia trials. Increased enrollment of AD patients with nonspouse caregivers may require additional recruitment and retention strategies. PMID:23255824

46 CFR 45.65 - Excess sheer limitations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Midship 1 _______ Sum of Aft Products After Standard Sheer .2665L+26.651 _______ Difference: Sum-STD... 1 _______ Sum of Fwd Products Fwd Standard Sheer .5330L+53.301 _______ Difference: Sum-STD...

46 CFR 45.65 - Excess sheer limitations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Midship 1 _______ Sum of Aft Products After Standard Sheer .2665L+26.651 _______ Difference: Sum-STD... 1 _______ Sum of Fwd Products Fwd Standard Sheer .5330L+53.301 _______ Difference: Sum-STD...

46 CFR 45.65 - Excess sheer limitations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Midship 1 _______ Sum of Aft Products After Standard Sheer .2665L+26.651 _______ Difference: Sum-STD... 1 _______ Sum of Fwd Products Fwd Standard Sheer .5330L+53.301 _______ Difference: Sum-STD...

46 CFR 45.65 - Excess sheer limitations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Midship 1 _______ Sum of Aft Products After Standard Sheer .2665L+26.651 _______ Difference: Sum-STD... 1 _______ Sum of Fwd Products Fwd Standard Sheer .5330L+53.301 _______ Difference: Sum-STD...

46 CFR 45.65 - Excess sheer limitations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Midship 1 _______ Sum of Aft Products After Standard Sheer .2665L+26.651 _______ Difference: Sum-STD... 1 _______ Sum of Fwd Products Fwd Standard Sheer .5330L+53.301 _______ Difference: Sum-STD...

Sum-Difference Numbers

ERIC Educational Resources Information Center

Shi, Yixun

2010-01-01

Starting with an interesting number game sometimes used by school teachers to demonstrate the factorization of integers, "sum-difference numbers" are defined. A positive integer n is a "sum-difference number" if there exist positive integers "x, y, w, z" such that n = xy = wz and x ? y = w + z. This paper characterizes all sum-difference numbers…

A comparison of health utility scores calculated using United Kingdom and Canadian preference weights in persons with alzheimer's disease and their caregivers.

PubMed

Fang, Mingying; Oremus, Mark; Tarride, Jean-Eric; Raina, Parminder

2016-07-18

The use of the EQ-5D to asses the economic benefits of health technologies has led to questions about the cross-population transferability of preference weights to calculate health utility scores. The aim of this study is to investigate whether the use of UK and Canadian preference weights will lead to the calculation of different health utility scores in a sample of persons with Alzheimer's disease (AD) and their primary informal caregivers. We recruited 216 patient-caregiver dyads from nine geriatric and memory clinics across Canada. Participants used the EQ-5D-3L to rate their health-related quality-of-life (HRQoL). EQ-5D-3L responses were transformed into health utility scores using UK and Canadian preference weights. The levels of agreement between the two sets of scores were assessed using intraclass correlation coefficients (ICCs). Bland-Altman plots depicted individual-level differences between the two sets of scores. Differences in health utility scores were tested using the Wilcoxon signed rank sum test. A generalized linear model with a gamma distribution was used to examine whether participants' socio-demographic characteristics were associated with their health utility scores. The distributions of health utility scores derived from both the UK and Canadian preference weights were skewed to the left. The intraclass correlation coefficient was 0.94 (95 % CI: 0.92, 0.95) for persons with AD and 0.92 (95 % CI: 0.88, 0.94) for the caregivers. The Canadian weights yielded slightly higher median health utility scores than the UK weights for caregivers (median difference: 0.009; 95 % confidence interval: 0.007, 0.013). This finding persisted after stratifying by disease severity. Few socio-demographic characteristics were associated with the two sets of health utility scores. Health utility scores exhibited small and clinically unimportant differences when calculated with UK versus Canadian preference weights in persons with AD and their caregivers. The original UK and Canadian population samples used to obtain the preference weights valued health states similarly.

Lower Bounds to the Reliabilities of Factor Score Estimators.

PubMed

Hessen, David J

2016-10-06

Under the general common factor model, the reliabilities of factor score estimators might be of more interest than the reliability of the total score (the unweighted sum of item scores). In this paper, lower bounds to the reliabilities of Thurstone's factor score estimators, Bartlett's factor score estimators, and McDonald's factor score estimators are derived and conditions are given under which these lower bounds are equal. The relative performance of the derived lower bounds is studied using classic example data sets. The results show that estimates of the lower bounds to the reliabilities of Thurstone's factor score estimators are greater than or equal to the estimates of the lower bounds to the reliabilities of Bartlett's and McDonald's factor score estimators.

[Definition of the Diagnosis Osteomyelitis-Osteomyelitis Diagnosis Score (ODS)].

PubMed

Schmidt, H G K; Tiemann, A H; Braunschweig, R; Diefenbeck, M; Bühler, M; Abitzsch, D; Haustedt, N; Walter, G; Schoop, R; Heppert, V; Hofmann, G O; Glombitza, M; Grimme, C; Gerlach, U-J; Flesch, I

2011-08-01

The disease "osteomyelitis" is characterised by different symptoms and parameters. Decisive roles in the development of the disease are played by the causative bacteria, the route of infection and the individual defense mechanisms of the host. The diagnosis is based on different symptoms and findings from the clinical history, clinical symptoms, laboratory results, diagnostic imaging, microbiological and histopathological analyses. While different osteomyelitis classifications have been published, there is to the best of our knowledge no score that gives information how sure the diagnosis "osteomyelitis" is in general. For any scientific study of a disease a valid definition is essential. We have developed a special osteomyelitis diagnosis score for the reliable classification of clinical, laboratory and technical findings. The score is based on five diagnostic procedures: 1) clinical history and risk factors, 2) clinical examination and laboratory results, 3) diagnostic imaging (ultrasound, radiology, CT, MRI, nuclear medicine and hybrid methods), 4) microbiology, and 5) histopathology. Each diagnostic procedure is related to many individual findings, which are weighted by a score system, in order to achieve a relevant value for each assessment. If the sum of the five diagnostic criteria is 18 or more points, the diagnosis of osteomyelitis can be viewed as "safe" (diagnosis class A). Between 8-17 points the diagnosis is "probable" (diagnosis class B). Less than 8 points means that the diagnosis is "possible, but unlikely" (class C diagnosis). Since each parameter can score six points at a maximum, a reliable diagnosis can only be achieved if at least 3 parameters are scored with 6 points. The osteomyelitis diagnosis score should help to avoid the false description of a clinical presentation as "osteomyelitis". A safe diagnosis is essential for the aetiology, treatment and outcome studies of osteomyelitis. © Georg Thieme Verlag KG Stuttgart · New York.

Depression, insight, and personality changes in Alzheimer's disease and vascular dementia.

PubMed

Verhey, F R; Ponds, R W; Rozendaal, N; Jolles, J

1995-01-01

Although it is generally believed that depression, retained insight, and preserved personality occur more frequently in vascular dementia than in Alzheimer's disease, there is little empiric evidence for this presumption. Most studies on this subject have been carried out with severely demented inpatients, and confounding factors such as age, sex, and severity of dementia have not been sufficiently taken into account. We compared 48 patients with relatively mild vascular dementia with 48 patients with Alzheimer's disease, matched for age, sex, and stage of dementia, to investigate if depression, lack of insight, and personality changes were related to the cause of dementia. The two groups did not differ regarding the incidence of major depression, the mean depression score, the awareness score, or the sum of scores on the items of the Blessed Dementia Scale concerning personality changes. We conclude that depression, lack of insight, and personality changes do not favor an etiology of vascular dementia over that of Alzheimer's disease. The present findings underscore the notion that the severity of the dementia should be considered in studies on the differences between vascular dementia and Alzheimer's disease.

Preliminary validation of 2 magnetic resonance image scoring systems for osteoarthritis of the hip according to the OMERACT filter.

PubMed

Maksymowych, Walter P; Cibere, Jolanda; Loeuille, Damien; Weber, Ulrich; Zubler, Veronika; Roemer, Frank W; Jaremko, Jacob L; Sayre, Eric C; Lambert, Robert G W

2014-02-01

Development of a validated magnetic resonance image (MRI) scoring system is essential in hip OA because radiographs are insensitive to change. We assessed the feasibility and reliability of 2 previously developed scoring methods: (1) the Hip Inflammation MRI Scoring System (HIMRISS) and (2) the Hip Osteoarthritis MRI Scoring System (HOAMS). Six readers (3 radiologists, 3 rheumatologists) participated in 2 reading exercises. In Reading Exercise 1, MRI of the hip of 20 subjects were read at a single time point followed by further standardization of methodology. In Reading Exercise 2, MRI of the hip of 18 subjects from a randomized controlled trial, assessed at 2 timepoints, and 27 subjects from a cross-sectional study were read for HIMRISS and HOAMS bone marrow lesions (BML) and synovitis. Reliability was assessed using intraclass correlation coefficient (ICC) and kappa statistics. Both methods were considered feasible. For Reading 1, HIMRISS ICC were 0.52, 0.61, 0.70, and 0.58 for femoral BML, acetabular BML, effusion, and total scores, respectively; and for HOAMS, summed BML and synovitis ICC were 0.52 and 0.46, respectively. For Reading 2, HIMRISS and HOAMS ICC for BML and synovitis-effusion improved substantially. Interobserver reliability for change scores was 0.81 and 0.71 for HIMRISS femoral and HOAMS summed BML, respectively. Responsiveness and discrimination was moderate to high for synovitis-effusion. Significant associations were noted between BML or synovitis scores and Western Ontario and McMaster Universities Osteoarthritis Index pain scores for baseline values (p ≤ 0.001). The BML and synovitis-effusion components of both HIMRISS and HOAMS scoring systems are feasible and reliable, and should be validated further.

Prenatal phthalate exposure and reduced masculine play in boys.

PubMed

Swan, S H; Liu, F; Hines, M; Kruse, R L; Wang, C; Redmon, J B; Sparks, A; Weiss, B

2010-04-01

Foetal exposure to antiandrogens alters androgen-sensitive development in male rodents, resulting in less male-typical behaviour. Foetal phthalate exposure is also associated with male reproductive development in humans, but neurodevelopmental outcomes have seldom been examined in relation to phthalate exposure. To assess play behaviour in relation to phthalate metabolite concentration in prenatal urine samples, we recontacted participants in the Study for Future Families whose phthalate metabolites had been measured in mid-pregnancy urine samples. Mothers completed a questionnaire including the Pre-School Activities Inventory, a validated instrument used to assess sexually dimorphic play behaviour. We examined play behaviour scores (masculine, feminine and composite) in relationship to (log(10)) phthalate metabolite concentrations in mother's urine separately for boys (N = 74) and girls (N = 71). Covariates (child's age, mother's age and education and parental attitude towards atypical play choices) were controlled using multivariate regression models. Concentrations of dibutyl phthalate metabolites, mono-n-butyl phthalate (MnBP) and mono-isobutyl phthalate (MiBP) and their sum, were associated with a decreased (less masculine) composite score in boys (regression coefficients -4.53,-3.61 and -4.20, p = 0.01, 0.07 and 0.04 for MnBP, MiBP and their sum respectively). Concentrations of two urinary metabolites of di(2-ethylhexyl) phthalate (DEHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and the sum of these DEHP metabolites plus mono(2-ethylhexyl) phthalate were associated with a decreased masculine score (regression coefficients -3.29,-2.94 and -3.18, p = 0.02, 0.04 and 0.04) for MEHHP, MEOHP and the sum respectively. No strong associations were seen between behaviour and urinary concentrations of any other phthalate metabolites in boys, or between girls' scores and any metabolites. These data, although based on a small sample, suggest that prenatal exposure to antiandrogenic phthalates may be associated with less male-typical play behaviour in boys. Our findings suggest that these ubiquitous environmental chemicals have the potential to alter androgen-responsive brain development in humans.

Effectiveness of clinical supervision of physiotherapists: a survey.

PubMed

Snowdon, David A; Millard, Geraldine; Taylor, Nicholas F

2015-04-01

Limited literature exists on the practice of clinical supervision (CS) of professional physiotherapists despite current Australian safety and quality health standards stating that CS is to be provided to all physiotherapists. The aim of the present study was to evaluate the effectiveness of CS of physiotherapists working in an Australian public health service. CS was measured using the allied health-specific 26-item modified Manchester Clinical Supervision Scale (MCSS-26). Subscales of the MCSS-26 were summed for three domain scores (normative, restorative and formative) and a total score was calculated, which was compared with the reported threshold score of 73 for effective supervision. Sixty registered physiotherapists (response rate 92%), working for a large metropolitan public health service, with six different site locations, completed the survey. The mean (± s.d.) total MCSS-26 score was 71.0 ± 14.3 (95% confidence interval (CI) 67.4-74.6). Hospital site was the only variable that had a significant effect on total MCSS-26 score (P=0.005); there was no effect for supervisor or supervisee experience, or hospital setting (acute vs subacute). Physiotherapists scored a significantly lower mean percentage MCSS-26 score on the normative domain compared with the restorative domain (mean difference 7.8%; 95% CI 2.9-12.7; P=0.002) and the formative domain (mean difference 9.6%; 95% CI 6.3-13.0; P<0.001). Of the two subscales that form the normative domain, 'finding time' had a significantly lower mean percentage MCSS-26 score than 'importance/value of CS' (mean difference 35.4%; 95% CI 31.3-39.4; P<0.001). Within this publicly funded physiotherapy department there was uncertainty about the effectiveness of CS, with more than half the physiotherapists rating their supervision as less than effective, suggesting there is opportunity for improvement in the practice of physiotherapy CS. Physiotherapists scored lowest in the normative domain, indicating that they found it difficult to find time for CS.

Lord-Wingersky Algorithm Version 2.0 for Hierarchical Item Factor Models with Applications in Test Scoring, Scale Alignment, and Model Fit Testing. CRESST Report 830

ERIC Educational Resources Information Center

Cai, Li

2013-01-01

Lord and Wingersky's (1984) recursive algorithm for creating summed score based likelihoods and posteriors has a proven track record in unidimensional item response theory (IRT) applications. Extending the recursive algorithm to handle multidimensionality is relatively simple, especially with fixed quadrature because the recursions can be defined…

Evaluation of Two Methods for Modeling Measurement Errors When Testing Interaction Effects with Observed Composite Scores

ERIC Educational Resources Information Center

Hsiao, Yu-Yu; Kwok, Oi-Man; Lai, Mark H. C.

2018-01-01

Path models with observed composites based on multiple items (e.g., mean or sum score of the items) are commonly used to test interaction effects. Under this practice, researchers generally assume that the observed composites are measured without errors. In this study, we reviewed and evaluated two alternative methods within the structural…

Topical photodynamic therapy with 5-aminolevulinic acid in the treatment of actinic keratoses: a first clinical study

NASA Astrophysics Data System (ADS)

Karrer, Sigrid; Szeimies, Rolf-Markus; Sauerwald, Angela; Landthaler, Michael

1996-01-01

In this first clinical study performed according to GCP- (good clinical practice) guidelines, efficacy, and tolerability of topical photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) were tested in the treatment of actinic keratoses. Ten patients (6 f, 4 m) with 36 lesions (19 located on hands and arms, 17 on the head) received ALA-PDT once. Five to six hours after occlusive application of ALA (water-in-oil-emulsion containing 10% ALA) irradiation was performed with an incoherent light source. Up to 3 months after treatment patients were monitored. A score evaluating infiltration and keratosis of treated actinic keratoses allowed us to estimate therapeutic efficacy. Compared to the initial score (100%) significantly lower score-sums were observed at the 28 day follow-up at both localizations (head: 15%; hand: 67%). Complete remission (score sum 0) resulted in 71% of actinic keratoses localized on the head. Except for slight pain and burning sensations during and after irradiation there were no notable side effects. This study proved good efficacy and tolerability of topical PDT in the treatment of actinic keratoses. Whether PDT is able to compete with established treatment modalities remains to be shown in further studies.

Correlation between systolic transvalvular flow and proximal aortic wall changes in bicuspid aortic valve stenosis.

PubMed

Girdauskas, Evaldas; Rouman, Mina; Disha, Kushtrim; Scholle, Thorsten; Fey, Beatrix; Theis, Bernhard; Petersen, Iver; Borger, Michael A; Kuntze, Thomas

2014-08-01

The purpose of this study was to analyse the correlation between preoperative systolic transvalvular flow patterns and proximal aortic wall lesions in patients undergoing surgery for bicuspid aortic valve (BAV) stenosis. A total of 48 consecutive patients with BAV stenosis (mean age 58 ± 9 years, 65% male) underwent aortic valve replacement (AVR) ± proximal aortic surgery from January 2012 through February 2013. Preoperative cardiac phase-contrast cine magnetic resonance imaging (MRI) assessment was performed in all patients in order to detect the area of maximal flow-induced stress in the proximal aorta. Based on these MRI data, two aortic wall samples (i.e. area of the maximal stress (jet sample) and the opposite aortic wall (control sample)) were collected during AVR surgery. Aortic wall changes were graded based on a summation of seven histological criteria (each scored from 0 to 3). Histological sum score (0-21) was separately calculated and compared between the two aortic samples (i.e. jet sample vs control sample). An eccentric transvalvular flow jet hitting the proximal aortic wall could be identified in all 48 (100%) patients. The mean histological sum score was significantly higher in the jet sample vs control sample areas of the aorta (i.e. 4.1 ± 1.8 vs 2.2 ± 1.5, respectively) (P = 0.02). None of the patients had a higher sum score value in the control sample. Our study demonstrates a strong correlation between the systolic pattern of the transvalvular flow jet and asymmetric proximal aortic wall changes in patients undergoing AVR for BAV stenosis. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Connecting impairment, disability, and handicap in immune mediated polyneuropathies

PubMed Central

Merkies, I; Schmitz, P; van der Meche, F G A; Samijn, J; van Doorn, P A

2003-01-01

Background: In the World Health Organisation (WHO) International Classification of Impairments, Disabilities, and Handicaps (ICIDH), it is suggested that various levels of outcome are associated with one another. However, the ICIDH has been criticised on the grounds that it only represents a general, non-specific relation between its entities. Objective: To examine the significance of the ICIDH in immune mediated polyneuropathies. Methods: Four impairment measures (fatigue severity scale, MRC sum score, "INCAT" sensory sum score, grip strength with the Vigorimeter), five disability scales (nine hole peg test, 10 metres walking test, an overall disability sum score (ODSS), Hughes functional grading scale, Rankin scale), and a handicap scale (Rotterdam nine items handicap scale (RIHS9)) were assessed in 113 clinically stable patients (83 with Guillain–Barré syndrome, 22 with chronic inflammatory demyelinating polyneuropathy, eight with a gammopathy related polyneuropathy). Regression analyses with backward and forward stepwise strategies were undertaken to determine the correlation between the various levels of outcome (impairment on disability, impairment on handicap, disability leading to handicap, and impairment plus disability on handicap). Results: Impairment measures explained a substantial part of disability (R2 = 0.64) and about half of the variance in handicap (R2 = 0.52). Disability measures showed a stronger association with handicap (R2 = 0.76). Combining impairment and disability scales accounted for 77% of the variance in handicap (RIHS9) scores. Conclusions: In contrast to some suggestions, support for the ICIDH model is found in the current study because significant associations were shown between its various levels in patients with immune mediated polyneuropathies. Further studies are required to examine other possible contributors to deficits in daily life and social functioning in these conditions. PMID:12486276

Satisfaction with dental care and its role in dental health-related behaviour among lithuanian university employees.

PubMed

Sakalauskienė, Zana; Machiulskiene, Vita; Murtomaa, Heikki; Vehkalahti, Miira M

2015-01-01

To assess factors related to satisfaction with dental care and its role in dental health-related behaviour among Lithuanian university employees. Our cross-sectional survey collected data on respondents' satisfaction with dental care using 24 statements. The self-administered questionnaire also inquired about dental attendance, dental health-related behaviour and attitudes, self-assessed dental status and background details. All 35- to 44-year-old employees (n = 862) of four universities in Lithuania were invited to participate; 64% (n = 553) responded, 78% of them were women. Statements on satisfaction with technical, personal and organisational dimensions of the dental surgery were assessed using a five-point scale, ranging from entirely agree to entirely disagree, with higher scores indicating stronger agreement. Overall satisfaction scores were summed and subjects divided into tertiles to evaluate dental health-related behaviour. For the logistic regression model, subjects were divided into two groups of satisfaction level (below and above the mean of the sum score). Subjects were highly satisfied with dental care, with the mean sum score being 99.5 (SD = 12.62, range 59-120). Stronger satisfaction was reported by those visiting private practices (p < 0.001) and the same dentist longer (p = 0.006) and by those who entirely agreed with the statements on dental health-related attitudes (p ≤ 0.001). The logistic regression model showed that higher satisfaction with dental care level was more likely for those who indicated check-up-based regular dental attendance (OR = 1.7) and brushing their teeth at least twice daily (OR = 1.6). Satisfaction with dental care is positively related to individuals' dental health-related attitudes and behaviour among highly-educated subjects in particular.

Lawton IADL scale in dementia: can item response theory make it more informative?

PubMed

McGrory, Sarah; Shenkin, Susan D; Austin, Elizabeth J; Starr, John M

2014-07-01

impairment of functional abilities represents a crucial component of dementia diagnosis. Current functional measures rely on the traditional aggregate method of summing raw scores. While this summary score provides a quick representation of a person's ability, it disregards useful information on the item level. to use item response theory (IRT) methods to increase the interpretive power of the Lawton Instrumental Activities of Daily Living (IADL) scale by establishing a hierarchy of item 'difficulty' and 'discrimination'. this cross-sectional study applied IRT methods to the analysis of IADL outcomes. Participants were 202 members of the Scottish Dementia Research Interest Register (mean age = 76.39, range = 56-93, SD = 7.89 years) with complete itemised data available. a Mokken scale with good reliability (Molenaar Sijtsama statistic 0.79) was obtained, satisfying the IRT assumption that the items comprise a single unidimensional scale. The eight items in the scale could be placed on a hierarchy of 'difficulty' (H coefficient = 0.55), with 'Shopping' being the most 'difficult' item and 'Telephone use' being the least 'difficult' item. 'Shopping' was the most discriminatory item differentiating well between patients of different levels of ability. IRT methods are capable of providing more information about functional impairment than a summed score. 'Shopping' and 'Telephone use' were identified as items that reveal key information about a patient's level of ability, and could be useful screening questions for clinicians. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@ oup.com.

Exercise may cause myocardial ischemia at the anaerobic threshold in cardiac rehabilitation programs.

PubMed

Fuchs, A R C N; Meneghelo, R S; Stefanini, E; De Paola, A V; Smanio, P E P; Mastrocolla, L E; Ferraz, A S; Buglia, S; Piegas, L S; Carvalho, A A C

2009-03-01

Myocardial ischemia may occur during an exercise session in cardiac rehabilitation programs. However, it has not been established whether it is elicited when exercise prescription is based on heart rate corresponding to the anaerobic threshold as measured by cardiopulmonary exercise testing. Our objective was to determine the incidence of myocardial ischemia in cardiac rehabilitation programs according to myocardial perfusion SPECT in exercise programs based on the anaerobic threshold. Thirty-nine patients (35 men and 4 women) diagnosed with coronary artery disease by coronary angiography and stress technetium-99m-sestamibi gated SPECT associated with a baseline cardiopulmonary exercise test were assessed. Ages ranged from 45 to 75 years. A second cardiopulmonary exercise test determined training intensity at the anaerobic threshold. Repeat gated-SPECT was obtained after a third cardiopulmonary exercise test at the prescribed workload and heart rate. Myocardial perfusion images were analyzed using a score system of 6.4 at rest, 13.9 at peak stress, and 10.7 during the prescribed exercise (P < 0.05). The presence of myocardial ischemia during exercise was defined as a difference > or = 2 between the summed stress score and summed rest score. Accordingly, 25 (64%) patients were classified as ischemic and 14 (36%) as nonischemic. MIBI-SPECT showed myocardial ischemia during exercise within the anaerobic threshold. The 64% prevalence of ischemia observed in the study should not be looked on as representative of the whole population of patients undergoing exercise programs. Changes in patient care and exercise programs were implemented as a result of our finding of ischemia during the prescribed exercise.

[Can Psychometric Tests Predict Success in the Selection Interview for Medical School? A Cross-Sectional Study at One German Medical School].

PubMed

Kötter, T; Obst, K U; Brüheim, L; Eisemann, N; Voltmer, E; Katalinic, A

2017-07-01

Background The final exam grade is the main selection criterion for medical school application in Germany. For academic success, it seems to be a reliable predictor. Its use as the only selection criterion is, however, criticised. At some universities, personal interviews are part of the selection process. However, these are very time consuming and are of doubtful validity. The (additional) use of appropriate psychometric instruments could reduce the cost and increase the validity. This study investigates the extent to which psychometric instruments can predict the outcome of a personal selection interview. Methods This is a cross-sectional study on the correlation of the results of psychometric instruments with those of the personal selection interview as part of the application process. As the outcome, the score of the selection interview was used. The NEO - Five Factor Inventory, the Hospital Anxiety and Depression Scale (HADS) and the questionnaire to identify work-related behaviour and experience patterns (AVEM) were used as psychometric interviews. Results There was a statistically significant correlation with the results of the personal selection interview for the sum score of the depression scale from the HADS and the sum score for the dimension of life satisfaction of the AVEM. In addition, those participants who did not previously complete an application training achieved a better result in the selection interview. Conclusion The instruments used measure different aspects than the interviews and cannot replace them. It remains to be seen whether the selected parameters are able to predict academic success. © Georg Thieme Verlag KG Stuttgart · New York.

Surgical management of congenital heart disease: evaluation according to the Aristotle score.

PubMed

Heinrichs, Jutta; Sinzobahamvya, Nicodème; Arenz, Claudia; Kallikourdis, Antonios; Photiadis, Joachim; Schindler, Ehrenfried; Hraska, Vicktor; Asfour, Boulos

2010-01-01

The Aristotle basic complexity (ABC) score (1.5-15 points) is the sum of potentials for early mortality, morbidity and anticipated surgical technique difficulty. The Aristotle comprehensive complexity (ACC) score (1.5-25 points) is the sum of ABC score and patient-adjusted complexity score; it comprises six complexity levels. We used the ACC score to evaluate quality in surgical management of congenital heart disease. Procedures performed in year 2002 and 2007 were analysed. Proportion of procedures requiring at least 1 week of stay in the intensive care unit was chosen as the marker of morbidity. We adopted threshold duration of 120 min for cardio-pulmonary bypass (CPB) cases and the same duration for operations without CPB as surrogate of surgical technical difficulty. The ACC scores were correlated to mortality, morbidity and technical difficulty. This study included 758 patients who underwent 787 primary procedures. The mean ABC and ACC scores amounted to 7.61+/-2.46 and 9.51+/-3.84. Early mortality was 3.05% (24/787), 95% confidence interval (CI): 1.97-4.51%. Zero at ACC levels 1 and 2, it increased from 1.2% (2/161) for level 3 up to 22.2% (2/9) for level 6. Morbidity index was evaluated at 25.9% (204/787), 95% CI: 22.9-29.1%. 1.9% at level 1, it escalated up to 77.8% at level 6. Index of technique difficulty was estimated at 35.2% (277/787), 95% CI: 31.8-38.6%, ranging from 4.8% for level 1 to 66.7% for level 6. A high correlation was found between the ACC scores and mortality, indices of morbidity and technique difficulty, Spearman's correlation coefficient r being 0.9856, 1 and 0.9429, respectively. Mortality (p=0.037) and morbidity (p=0.041) were lower in year 2007 than in 2002 with ABC (p=0.18) and ACC (p=0.37) surgical performance being not significantly different. The Aristotle score is still under development. Morbidity evaluation should be ideally based on observed postoperative complications; estimation of surgical technical difficulty chosen in this study may not be generalised. Nevertheless, the actual Aristotle comprehensive complexity score, as evaluated in its three components, accurately determined the outcome of surgical management of congenital heart disease. It appears to be an adequate tool to evaluate quality in paediatric cardiac surgery, over time. Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Quality Assurance in Military Hospitals - A Proposal for Reform

DTIC Science & Technology

1988-04-01

a score of 0, 1, or 2. The sum of the five scores is the APGAR score. K. Niswander, Manual of Obstetrics: Diagnosis and Therapy 396-397 (1980). A...in accrediting military hospitals. It does this through use of an Accreditation Manual for Hospitals (AMH) which is updated annually. The manual also...serves as the basis for the survey report from which inspectors report on- site findings.ൗ The manual is in outline format. 1 5 ’ Each standard and

Predictive value of the korean academy of family medicine in-training examination for certifying examination.

PubMed

Cho, Jung-Jin; Kim, Ji-Yong

2011-09-01

In-training examination (ITE) is a cognitive examination similar to the written test, but it is different from the Clinical Practice Examination of the Korean Academy of Family Medicine (KAFM) Certification Examination (CE). The objective of this is to estimate the positive predictive value of the KAFM-ITE for identifying residents at risk for poor performance on the three types of KAFM-CE. 372 residents who completed the KAFM-CE in 2011 were included. We compared the mean KAFM-CE scores with ITE experience. We evaluated the correlation and the positive predictive value (PPV) of ITE for the multiple choice question (MCQ) scores of 1st written test & 2nd slide examination, the total clinical practice examination scores, and the total sum of 2nd test. 275 out of 372 residents completed ITE. Those who completed ITE had significantly higher MCQ scores of 1st written test than those who did not. The correlation of ITE scores with 1st written MCQ (0.627) was found to be the highest among the other kinds of CE. The PPV of the ITE score for 1st written MCQ scores was 0.672. The PPV of the ITE score ranged from 0.376 to 0.502. The score of the KAFM ITE has acceptable positive predictive value that could be used as a part of comprehensive evaluation system for residents in cognitive field.

Comparison of scoring approaches for the NEI VFQ-25 in low vision.

PubMed

Dougherty, Bradley E; Bullimore, Mark A

2010-08-01

The aim of this study was to evaluate different approaches to scoring the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) in patients with low vision including scoring by the standard method, by Rasch analysis, and by use of an algorithm created by Massof to approximate Rasch person measure. Subscale validity and use of a 7-item short form instrument proposed by Ryan et al. were also investigated. NEI VFQ-25 data from 50 patients with low vision were analyzed using the standard method of summing Likert-type scores and calculating an overall average, Rasch analysis using Winsteps software, and the Massof algorithm in Excel. Correlations between scores were calculated. Rasch person separation reliability and other indicators were calculated to determine the validity of the subscales and of the 7-item instrument. Scores calculated using all three methods were highly correlated, but evidence of floor and ceiling effects was found with the standard scoring method. None of the subscales investigated proved valid. The 7-item instrument showed acceptable person separation reliability and good targeting and item performance. Although standard scores and Rasch scores are highly correlated, Rasch analysis has the advantages of eliminating floor and ceiling effects and producing interval-scaled data. The Massof algorithm for approximation of the Rasch person measure performed well in this group of low-vision patients. The validity of the subscales VFQ-25 should be reconsidered.

The Predictive Utility of a Brief Kindergarten Screening Measure of Child Behavior Problems

PubMed Central

Racz, Sarah Jensen; King, Kevin M.; Wu, Johnny; Witkiewitz, Katie; McMahon, Robert J.

2013-01-01

Objective Kindergarten teacher ratings, such as those from the Teacher Observation of Classroom Adaptation–Revised (TOCA-R), are a promising cost- and time-effective screening method to identify children at risk for later problems. Previous research with the TOCA-R has been mainly limited to outcomes in a single domain measured during elementary school. The goal of the current study was to examine the ability of TOCA-R sum scores to predict outcomes in multiple domains across distinct developmental periods (i.e., late childhood, middle adolescence, late adolescence). Method We used data from the Fast Track Project, a large multisite study with children at risk for conduct problems (n = 752; M age at start of study = 6.55 years; 57.7% male; 49.9% Caucasian, 46.3% African American). Kindergarten TOCA-R sum scores were used as the predictor in regression analyses; outcomes included school difficulties, externalizing diagnoses and symptom counts, and substance use. Results TOCA-R sum scores predicted school outcomes at all time points, diagnosis of ADHD in 9th grade, several externalizing disorder symptom counts, and cigarette use in 12th grade. Conclusions The findings demonstrate the predictive utility of the TOCA-R when examining outcomes within the school setting. Therefore, these results suggest the 10-item TOCA-R may provide a quick and accurate screening of children at risk for later problems. Implications for prevention and intervention programs are discussed. PMID:23544679

Scoring sensor observations to facilitate the exchange of space surveillance data

NASA Astrophysics Data System (ADS)

Weigel, M.; Fiedler, H.; Schildknecht, T.

2017-08-01

In this paper, a scoring metric for space surveillance sensor observations is introduced. A scoring metric allows for direct comparison of data quantity and data quality, and makes transparent the effort made by different sensor operators. The concept might be applied to various sensor types like tracking and surveillance radar, active optical laser tracking, or passive optical telescopes as well as combinations of different measurement types. For each measurement type, a polynomial least squares fit is performed on the measurement values contained in the track. The track score is the average sum over the polynomial coefficients uncertainties and scaled by reference measurement accuracy. Based on the newly developed scoring metric, an accounting model and a rating model are introduced. Both models facilitate the exchange of observation data within a network of space surveillance sensors operators. In this paper, optical observations are taken as an example for analysis purposes, but both models can also be utilized for any other type of observations. The rating model has the capability to distinguish between network participants with major and minor data contribution to the network. The level of sanction on data reception is defined by the participants themselves enabling a high flexibility. The more elaborated accounting model translates the track score to credit points earned for data provision and spend for data reception. In this model, data reception is automatically limited for participants with low contribution to the network. The introduced method for observation scoring is first applied for transparent data exchange within the Small Aperture Robotic Telescope Network (SMARTnet). Therefore a detailed mathematical description is presented for line of sight measurements from optical telescopes, as well as numerical simulations for different network setups.

Validity and sensitivity to change of the semi-quantitative OMERACT ultrasound scoring system for tenosynovitis in patients with rheumatoid arthritis.

PubMed

Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Naredo, Esperanza; Terslev, Lene

2016-12-01

The aim was to evaluate the metric properties of the semi-quantitative OMERACT US scoring system vs a novel quantitative US scoring system for tenosynovitis, by testing its intra- and inter-reader reliability, sensitivity to change and comparison with clinical tenosynovitis scoring in a 6-month follow-up study. US and clinical assessments of the tendon sheaths of the clinically most affected hand and foot were performed at baseline, 3 and 6 months in 51 patients with RA. Tenosynovitis was assessed using the semi-quantitative scoring system (0-3) proposed by the OMERACT US group and a new quantitative US evaluation (0-100). A sum for US grey scale (GS), colour Doppler (CD) and pixel index (PI), respectively, was calculated for each patient. In 20 patients, intra- and inter-observer agreement was established between two independent investigators. A binary clinical tenosynovitis score was performed, calculating a sum score per patient. The intra- and inter-observer agreements for US tenosynovitis assessments were very good at baseline and for change for GS and CD, but less good for PI. The smallest detectable change was 0.97 for GS, 0.93 for CD and 30.1 for PI. The sensitivity to change from month 0 to 6 was high for GS and CD, and slightly higher than for clinical tenosynovitis score and PI. This study demonstrated an excellent intra- and inter-reader agreement between two investigators for the OMERACT US scoring system for tenosynovitis and a high ability to detect changes over time. Quantitative assessment by PI did not add further information. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The US7 score is sensitive to change in a large cohort of patients with rheumatoid arthritis over 12 months of therapy

PubMed Central

Backhaus, Tina M; Ohrndorf, Sarah; Kellner, Herbert; Strunk, Johannes; Hartung, Wolfgang; Sattler, Horst; Iking-Konert, Christof; Burmester, Gerd R; Schmidt, Wolfgang A; Backhaus, Marina

2013-01-01

Purpose To determine the sensitivity to change of the US7 score among RA patients under various therapies and to analyze the effect of each therapeutic option over 1 year. To estimate predictors for development of destructive bone changes. Methods Musculoskeletal ultrasound (US7 score), DAS28, CRP and ESR were performed in 432 RA patients at baseline and after 3, 6 and 12 months. The cohort was divided into four sub-groups: first-line DMARDs (Group 1; 27.3%), therapy switch: DMARDs to second DMARDs (Group 2; 25.0%), first-line biologic after DMARDs therapy (Group 3; 35.4%) and therapy change from biologic to second biologic (Group 4; 12.3%). Results The US7 synovitis and tenosynovitis sum scores in grey-scale (GSUS) and power Doppler ultrasound (PDUS) as well as ESR, CRP decreased significantly (p<0.05) after 12 months in group 1 to 3. Group 1+2 also illustrated a significant change of DAS28 after 1 year (p<0.001). Only in Group 4, the US7 erosion sum score decreased significantly from 4.3 to 3.6 (p=0.008) after 1 year. Predictors capable of forecasting US erosions after one year were: higher score of US7 synovitis (p<0.001), of US7 erosions in GSUS (p<0.001), as well as of DAS28 (p<0.001) at baseline. Conclusions The comparable developments of the US7 score with clinical and laboratory data illustrates its potential to reflect therapeutic response. Therefore, the novel US7 score is sensitive to change. Patients who switched from one biologic to another exhibited a significant decline in erosions after 12 months, while the erosions scores in the other groups were stable. PMID:22956596

A method to score radiographic change in psoriatic arthritis.

PubMed

Wassenberg, S; Fischer-Kahle, V; Herborn, G; Rau, R

2001-06-01

Radiographic features of psoriatic arthritis (PsA) are very characteristic and differ from those observed in rheumatoid arthritis, especially in two aspects: 1) the distribution of affected joints (i.e. DIP joints), 2) the presence of destructive changes and bone proliferation at the same time. A scoring method for PsA, therefore, has to account for these characteristics of PsA. To develop, describe and validate a method for scoring radiographic changes in patients with PsA. Forty joints of the hands and feet are scored for destruction and proliferation. In the destruction score (DS) grading on a 0-5 scale is based on the amount of joint surface destruction: 0 = normal, 1 = one or more erosions with an interruption of the cortical plate of > 1 mm with destruction of the total joint surface up to 10%, 2 = 11-25%, 3 = 26-50%, 4 = 51-75%, 5 = > 75% joint surface destruction. The proliferation score (PS) sums up any kind of bony proliferation typical for PsA; graded 0-4: 0 = normal, 1 = bony proliferation of 1-2 mm or bone growth < 25% of the original size (diameter), 2 = bony proliferation 2-3 mm or bone growth 25-50%, 3 = bony proliferation > 3 mm or bone growth > 50%, 4 = bony ankylosis. The DS (0-200) and the PS (0-160) can be summed up to the total score (0-360). VALIDATION OF THE METHOD: To validate the method x-rays of 20 patients with active PsA taken 3 years apart were read twice in pairs, knowing the chronological order but not knowing demographic, clinical or laboratory data of the patients. The data were analyzed with a hierarchical analysis of variance model. There was good agreement between the first and the second reading of the same rater and between the two raters regarding the destruction score. The agreement regarding the proliferation score was lower but still acceptable. The reliability of the method to describe change over time--relation of progression (intra-patient variance) to the measurement error (inter-rater variance)--was 3.9 for the DS, 2.8 for the PS and 4.1 for the total score. The minimal detectable change when the readings of two raters were compared (inter-rater MDC) was 5.8, 5.0 and 4.6%, respectively of the maximum possible score for the destruction, the proliferation and the total score. These data compare very well with the results of standard scoring methods in rheumatoid arthritis. We propose a method for scoring radiographic change in psoriatic arthritis which reliably quantifies the progression of the disease seen on radiographs.

Effects of early pregnancy BMI, mid-gestational weight gain, glucose and lipid levels in pregnancy on offspring's birth weight and subcutaneous fat: a population-based cohort study.

PubMed

Sommer, Christine; Sletner, Line; Mørkrid, Kjersti; Jenum, Anne Karen; Birkeland, Kåre Inge

2015-04-03

Maternal glucose and lipid levels are associated with neonatal anthropometry of the offspring, also independently of maternal body mass index (BMI). Gestational weight gain, however, is often not accounted for. The objective was to explore whether the effects of maternal glucose and lipid levels on offspring's birth weight and subcutaneous fat were independent of early pregnancy BMI and mid-gestational weight gain. In a population-based, multi-ethnic, prospective cohort of 699 women and their offspring, maternal anthropometrics were collected in gestational week 15 and 28. Maternal fasting plasma lipids, fasting and 2-hour glucose post 75 g glucose load, were collected in gestational week 28. Maternal risk factors were standardized using z-scores. Outcomes were neonatal birth weight and sum of skinfolds in four different regions. Mean (standard deviation) birth weight was 3491 ± 498 g and mean sum of skinfolds was 18.2 ± 3.9 mm. Maternal fasting glucose and HDL-cholesterol were predictors of birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain as well as early pregnancy BMI, gestational week at inclusion, maternal age, parity, smoking status, ethnic origin, gestational age and offspring's sex. However, weight gain was the strongest independent predictor of both birth weight and neonatal sum of skinfolds, with a 0.21 kg/week increased weight gain giving a 110.7 (95% confidence interval 76.6-144.9) g heavier neonate, and with 0.72 (0.38-1.06) mm larger sum of skinfolds. The effect size of mother's early pregnancy BMI on birth weight was higher in non-Europeans than in Europeans. Maternal fasting glucose and HDL-cholesterol were predictors of offspring's birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain. Mid-gestational weight gain was a stronger predictor of both birth weight and neonatal sum of skinfolds than early pregnancy BMI, maternal glucose and lipid levels.

What parents want from emails with their pediatrician: implications for teaching communication skills.

PubMed

Schiller, Jocelyn H; Christner, Jennifer G; Stansfield, Robert Brent; Watnick, Caroline S; Mullan, Patricia B

2013-07-01

Physician-patient email communication is increasing but trainees receive no education on this communication medium. Research eliciting patient preferences about email communication could inform training. Investigators elicited parents' perspectives on physician-parent email communication and compared parent and faculty assessments of medical students' emails. This mixed methods study explored physician-parent email communication in 5 parent focus groups using qualitative analyses to identify themes. Differences between faculty and parent assessment scores for students' email responses were calculated using univariate general linear modeling. Themes that emerged were: (1) Building the Relationship, (2) Clarity of Communication and (3) Expectations. Parents criticized student's statements as condescending. The sum of assessment scores by parents and faculty were moderately correlated (r(44)=.407, P<.01), but parents gave students lower scores on "acknowledges validity/expresses empathy" (P=.01) and higher scores on "provides next steps" (P<.01) and "identifies issues" (P<.01). Parents place value on students' abilities to communicate clearly and convey respect and empathy in email. Parent and faculty perspectives on email communication are similar but not the same. Differences between parental and faculty assessments of medical students' emails supports the need for the involvement of patients and families in email communication curriculum development. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Does gender and experience influence shade matching quality?

PubMed

Haddad, Helene J; Jakstat, Holger A; Arnetzl, Gerwin; Borbely, Judit; Vichi, Alessandro; Dumfahrt, Herbert; Renault, Patrick; Corcodel, Nicoleta; Pohlen, Bostjan; Marada, Gyula; de Parga, Juan A Martinez Vazquez; Reshad, Mamaly; Klinke, Thomas U; Hannak, Wolfgang B; Paravina, Rade D

2009-01-01

To evaluate the influence of gender and level of experience on shade matching quality. A study was simultaneously performed at 15 universities located in 9 countries. A total of 614 color normal participants completed all phases of the experiment. Among them, there were 305 females and 309 males, 319 dental students and 295 dental professionals. A lecture on color matching in dentistry was given to all participants. Initial training was performed using Toothguide Trainer software (TT), while Toothguide Training Box (TTB) was used for both training and testing of participants' shade matching results. The test task was to successively match 15 shade guide tabs with the corresponding shade guide. The shade matching score for each participant was computed as a sum of color differences (SigmaDeltaE(ab)(*) score) between target tabs and selected tabs. Lower scores corresponded to better shade matching results and vice versa. Means and standard deviations were calculated. Mann-Whitney U test was used for statistical analysis of the data (alpha=0.05). The mean shade matching score (S.D.) for all participants was 41 (21). The score for female and male participants was 38 (20) and 44 (21), respectfully (p<0.001). The difference in scores between dental students, 42 (20), and dental professionals, 39 (21), was not statistically significant. Within the limitations of this study, females achieved significantly better shade matching results than males, indicating that gender plays an important role in shade matching. The level of experience was not found to be significant factor in shade matching.

PubMed Central

FARNETI, D.; FATTORI, B.; NACCI, A.; MANCINI, V.; SIMONELLI, M.; RUOPPOLO, G.; GENOVESE, E.

2014-01-01

SUMMARY This study evaluated the intra- and inter-rater reliability of the Pooling score (P-score) in clinical endoscopic evaluation of severity of swallowing disorder, considering excess residue in the pharynx and larynx. The score (minimum 4 - maximum 11) is obtained by the sum of the scores given to the site of the bolus, the amount and ability to control residue/bolus pooling, the latter assessed on the basis of cough, raclage, number of dry voluntary or reflex swallowing acts (< 2, 2-5, > 5). Four judges evaluated 30 short films of pharyngeal transit of 10 solid (1/4 of a cracker), 11 creamy (1 tablespoon of jam) and 9 liquid (1 tablespoon of 5 cc of water coloured with methlyene blue, 1 ml in 100 ml) boluses in 23 subjects (10 M/13 F, age from 31 to 76 yrs, mean age 58.56±11.76 years) with different pathologies. The films were randomly distributed on two CDs, which differed in terms of the sequence of the films, and were given to judges (after an explanatory session) at time 0, 24 hours later (time 1) and after 7 days (time 2). The inter- and intra-rater reliability of the P-score was calculated using the intra-class correlation coefficient (ICC; 3,k). The possibility that consistency of boluses could affect the scoring of the films was considered. The ICC for site, amount, management and the P-score total was found to be, respectively, 0.999, 0.997, 1.00 and 0.999. Clinical evaluation of a criterion of severity of a swallowing disorder remains a crucial point in the management of patients with pathologies that predispose to complications. The P-score, derived from static and dynamic parameters, yielded a very high correlation among the scores attributed by the four judges during observations carried out at different times. Bolus consistencies did not affect the outcome of the test: the analysis of variance, performed to verify if the scores attributed by the four judges to the parameters selected, might be influenced by the different consistencies of the boluses, was not significant. These initial data validate the clinical use of the P-score in the management of patients with deglutition disorders by a multidisciplinary team. PMID:24843220

Aortic Wall Extracellular Matrix Proteins Correlate with Syntax Score in Patients Undergoing Coronary Artery Bypass Surgery

PubMed Central

Chiong, Terri; Cheow, Esther S. H.; Woo, Chin C.; Lin, Xiao Y.; Khin, Lay W.; Lee, Chuen N.; Hartman, Mikael; Sze, Siu K.; Sorokin, Vitaly A.

2016-01-01

Aims: The SYNTAX score correlate with major cardiovascular events post-revascularization, although the histopathological basis is unclear. We aim to evaluate the association between syntax score and extracellular matrix histological characteristics of aortic punch tissue obtained during coronary artery bypass surgery (CABG). This analysis compares coronary artery bypass surgery patients with High and Low syntax score which were followed up for one year period. Methods and Results: Patients with High (score ≥ 33, (n=77)) and Low Syntax Scores (score ≤ 22, (n=71)) undergoing elective CABG were recruited prospectively. Baseline clinical characteristics and surgical risks were well matched. At 1 year, EMACCE (Sum of cardiovascular death, stroke, congestive cardiac failure, and limb, gut and myocardial ischemia) was significantly elevated in the High syntax group (P=0.022). Mass spectrometry (MS)-based quantitative iTRAQ proteomic results validated on independent cohort by immunohistochemistry (IHC) revealed that the High syntax group had significantly upraised Collagen I (P<0.0001) and Elastin (P<0.0001) content in ascending aortic wall. Conclusion: This study shows that aortic extracellular matrix (ECM) differ between High and Low syntax groups with up-regulation of Collagen I and Elastin level in High Syntax Score group. This identifies aortic punches collected during CABG as another biomarker source related with atherosclerosis severity and possible clinical outcome. PMID:27347220

Lord-Wingersky Algorithm Version 2.0 for Hierarchical Item Factor Models with Applications in Test Scoring, Scale Alignment, and Model Fit Testing.

PubMed

Cai, Li

2015-06-01

Lord and Wingersky's (Appl Psychol Meas 8:453-461, 1984) recursive algorithm for creating summed score based likelihoods and posteriors has a proven track record in unidimensional item response theory (IRT) applications. Extending the recursive algorithm to handle multidimensionality is relatively simple, especially with fixed quadrature because the recursions can be defined on a grid formed by direct products of quadrature points. However, the increase in computational burden remains exponential in the number of dimensions, making the implementation of the recursive algorithm cumbersome for truly high-dimensional models. In this paper, a dimension reduction method that is specific to the Lord-Wingersky recursions is developed. This method can take advantage of the restrictions implied by hierarchical item factor models, e.g., the bifactor model, the testlet model, or the two-tier model, such that a version of the Lord-Wingersky recursive algorithm can operate on a dramatically reduced set of quadrature points. For instance, in a bifactor model, the dimension of integration is always equal to 2, regardless of the number of factors. The new algorithm not only provides an effective mechanism to produce summed score to IRT scaled score translation tables properly adjusted for residual dependence, but leads to new applications in test scoring, linking, and model fit checking as well. Simulated and empirical examples are used to illustrate the new applications.

Cumulative sum analysis score and phacoemulsification competency learning curve.

PubMed

Vedana, Gustavo; Cardoso, Filipe G; Marcon, Alexandre S; Araújo, Licio E K; Zanon, Matheus; Birriel, Daniella C; Watte, Guilherme; Jun, Albert S

2017-01-01

To use the cumulative sum analysis score (CUSUM) to construct objectively the learning curve of phacoemulsification competency. Three second-year residents and an experienced consultant were monitored for a series of 70 phacoemulsification cases each and had their series analysed by CUSUM regarding posterior capsule rupture (PCR) and best-corrected visual acuity. The acceptable rate for PCR was <5% (lower limit h) and the unacceptable rate was >10% (upper limit h). The acceptable rate for best-corrected visual acuity worse than 20/40 was <10% (lower limit h) and the unacceptable rate was >20% (upper limit h). The area between lower limit h and upper limit h is called the decision interval. There was no statistically significant difference in the mean age, sex or cataract grades between groups. The first trainee achieved PCR CUSUM competency at his 22 nd case. His best-corrected visual acuity CUSUM was in the decision interval from his third case and stayed there until the end, never reaching competency. The second trainee achieved PCR CUSUM competency at his 39 th case. He could reach best-corrected visual acuity CUSUM competency at his 22 nd case. The third trainee achieved PCR CUSUM competency at his 41 st case. He reached best-corrected visual acuity CUSUM competency at his 14 th case. The learning curve of competency in phacoemulsification is constructed by CUSUM and in average took 38 cases for each trainee to achieve it.

Plasma levels of acylated ghrelin in patients with functional dyspepsia

PubMed Central

Kim, Yeon Soo; Lee, Joon Seong; Lee, Tae Hee; Cho, Joo Young; Kim, Jin Oh; Kim, Wan Jung; Kim, Hyun Gun; Jeon, Seong Ran; Jeong, Hoe Su

2012-01-01

AIM: To investigate the relationship between plasma acylated ghrelin levels and the pathophysiology of functional dyspepsia. METHODS: Twenty-two female patients with functional dyspepsia and twelve healthy volunteers were recruited for the study. The functional dyspepsia patients were each diagnosed based on the Rome III criteria. Eligible patients completed a questionnaire concerning the severity of 10 symptoms. Plasma acylated ghrelin levels before and after a meal were determined in the study participants using a commercial human acylated enzyme immunoassay kit; electrogastrograms were performed for 50 min before and after a standardized 10-min meal containing 265 kcal. RESULTS: There were no significant differences in plasma acylated ghrelin levels between healthy volunteers and patients with functional dyspepsia. However, in patients with functional dyspepsia, there was a negative correlation between fasting plasma acylated ghrelin levels and the sum score of epigastric pain (r = -0.427, P = 0.047) and a positive correlation between the postprandial/fasting plasma acylated ghrelin ratio and the sum score of early satiety (r = 0.428, P =0.047). Additionally, there was a negative correlation between fasting acylated ghrelin plasma levels and fasting normogastria (%) (r = -0.522, P = 0.013). Interestingly, two functional dyspepsia patients showed paradoxically elevated plasma acylated ghrelin levels after the meal. CONCLUSION: Abnormal plasma acylated ghrelin levels before or after a meal may be related to several of the dyspeptic symptoms seen in patients with functional dyspepsia. PMID:22611317

Depression is more than the sum-score of its parts: individual DSM symptoms have different risk factors

PubMed Central

Fried, Eiko I.; Nesse, Randolph M.; Zivin, Kara; Guille, Constance; Sen, Srijan

2014-01-01

Background For diagnostic purposes, the nine symptoms that compose the DSM-5 criteria for Major Depressive Disorder (MDD) are assumed to be interchangeable indicators of one underlying disorder, implying that they should all have similar risk factors. The present study investigates this hypothesis, utilizing a population cohort that shifts from low to elevated depression levels. Methods We assessed the nine DSM-5 MDD criterion symptoms and seven depression risk factors (personal and family MDD history, sex, childhood stress, neuroticism, work hours, and stressful life events) in a longitudinal study of medical interns prior to and throughout internship (n=1289). We tested if risk factors varied across symptoms, and whether a latent disease model could account for heterogeneity between symptoms. Results All MDD symptoms increased significantly during residency training. Four risk factors predicted increases in unique subsets of PHQ-9 symptoms over time (depression history, childhood stress, sex, and stressful life events), while neuroticism and work hours predicted increases in all symptoms, albeit to varying magnitudes. MDD family history did not predict increases in any symptom. The strong heterogeneity of associations persisted after controlling for a latent depression factor. Conclusions The influence of risk factors varies substantially across DSM depression criterion symptoms. Since symptoms are etiologically heterogeneous, considering individual symptoms in addition to depression diagnosis might offer important insights obfuscated by symptom sum-scores. PMID:24289852

The associations between a polygenic score, reproductive and menstrual risk factors and breast cancer risk.

PubMed

Warren Andersen, Shaneda; Trentham-Dietz, Amy; Gangnon, Ronald E; Hampton, John M; Figueroa, Jonine D; Skinner, Halcyon G; Engelman, Corinne D; Klein, Barbara E; Titus, Linda J; Newcomb, Polly A

2013-07-01

We evaluated whether 13 single nucleotide polymorphisms (SNPs) identified in genome-wide association studies interact with one another and with reproductive and menstrual risk factors in association with breast cancer risk. DNA samples and information on parity, breastfeeding, age at menarche, age at first birth, and age at menopause were collected through structured interviews from 1,484 breast cancer cases and 1,307 controls who participated in a population-based case-control study conducted in three US states. A polygenic score was created as the sum of risk allele copies multiplied by the corresponding log odds estimate. Logistic regression was used to test the associations between SNPs, the score, reproductive and menstrual factors, and breast cancer risk. Nonlinearity of the score was assessed by the inclusion of a quadratic term for polygenic score. Interactions between the aforementioned variables were tested by including a cross-product term in models. We confirmed associations between rs13387042 (2q35), rs4973768 (SLC4A7), rs10941679 (5p12), rs2981582 (FGFR2), rs3817198 (LSP1), rs3803662 (TOX3), and rs6504950 (STXBP4) with breast cancer. Women in the score's highest quintile had 2.2-fold increased risk when compared to women in the lowest quintile (95 % confidence interval: 1.67-2.88). The quadratic polygenic score term was not significant in the model (p = 0.85), suggesting that the established breast cancer loci are not associated with increased risk more than the sum of risk alleles. Modifications of menstrual and reproductive risk factors associations with breast cancer risk by polygenic score were not observed. Our results suggest that the interactions between breast cancer susceptibility loci and reproductive factors are not strong contributors to breast cancer risk.

Respiratory Inductance Plethysmography Improved Diagnostic Sensitivity and Specificity of Obstructive Sleep Apnea.

PubMed

Kogan, Dmitriy; Jain, Arad; Kimbro, Shawn; Gutierrez, Guillermo; Jain, Vivek

2016-08-01

Respiratory inductance plethysmography (RIP) is a tool used during a polysomnogram (PSG), which serves as a surrogate of respiratory effort and can help detect inspiratory air-flow limitation. We hypothesize that RIP can improve the sensitivity and specificity of scoring hypopneas when compared with both the recommended and acceptable criteria of the American Academy of Sleep Medicine. We retrospectively analyzed a cohort of 12 subjects who had no obstructive sleep apnea (OSA) or mild OSA on PSG when scored by the American Academy of Sleep Medicine acceptable criteria for hypopneas but had high clinical suspicion for a diagnosis of OSA. These subjects were rescored using the American Academy of Sleep Medicine recommended criteria as well as RIP. Hypopnea was scored when there was a 50% decrease in the amplitude of the RIP sum channel (which combined input from chest and abdominal belts). OSA was diagnosed if the subjects had >5 respiratory events/h of sleep. The subject's response to CPAP was assessed by using a short questionnaire called the post-PSG sleep assessment. which evaluated subjective sleep quality. A positive response was considered an improvement in the post-PSG sleep assessment score after CPAP use. When scored using the American Academy of Sleep Medicine acceptable criteria, 10 subjects had a negative study, and 2 subjects had mild OSA for a sensitivity of 11% and specificity of 50%. When scored using the recommended criteria, 10 subjects had OSA, and 2 were negative, for a sensitivity of 78% and specificity of 70%. By RIP scoring, all 12 subjects had >5 respiratory events/h for a sensitivity of 100% and specificity of 75%. This small retrospective pilot study showed improved sensitivity and specificity when scoring hypopneas by RIP sum channel. Copyright © 2016 by Daedalus Enterprises.

Prospective study of Dietary Approaches to Stop Hypertension- and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging.

PubMed

Wengreen, Heidi; Munger, Ronald G; Cutler, Adele; Quach, Anna; Bowles, Austin; Corcoran, Christopher; Tschanz, Joann T; Norton, Maria C; Welsh-Bohmer, Kathleen A

2013-11-01

Healthy dietary patterns may protect against age-related cognitive decline, but results of studies have been inconsistent. We examined associations between Dietary Approaches to Stop Hypertension (DASH)- and Mediterranean-style dietary patterns and age-related cognitive change in a prospective, population-based study. Participants included 3831 men and women ≥65 y of age who were residents of Cache County, UT, in 1995. Cognitive function was assessed by using the Modified Mini-Mental State Examination (3MS) ≤4 times over 11 y. Diet-adherence scores were computed by summing across the energy-adjusted rank-order of individual food and nutrient components and categorizing participants into quintiles of the distribution of the diet accordance score. Mixed-effects repeated-measures models were used to examine 3MS scores over time across increasing quintiles of dietary accordance scores and individual food components that comprised each score. The range of rank-order DASH and Mediterranean diet scores was 1661-25,596 and 2407-26,947, respectively. Higher DASH and Mediterranean diet scores were associated with higher average 3MS scores. People in quintile 5 of DASH averaged 0.97 points higher than those in quintile 1 (P = 0.001). The corresponding difference for Mediterranean quintiles was 0.94 (P = 0.001). These differences were consistent over 11 y. Higher intakes of whole grains and nuts and legumes were also associated with higher average 3MS scores [mean quintile 5 compared with 1 differences: 1.19 (P < 0.001), 1.22 (P < 0.001), respectively]. Higher levels of accordance with both the DASH and Mediterranean dietary patterns were associated with consistently higher levels of cognitive function in elderly men and women over an 11-y period. Whole grains and nuts and legumes were positively associated with higher cognitive functions and may be core neuroprotective foods common to various healthy plant-centered diets around the globe.

Two-Dice Horse Race

ERIC Educational Resources Information Center

Foster, Colin; Martin, David

2016-01-01

We analyse the "two-dice horse race" task often used in lower secondary school, in which two ordinary dice are thrown repeatedly and each time the sum of the scores determines which horse (numbered 1 to 12) moves forwards one space.

Super-sensitive two-wavelength fringe projection profilometry with 2-sensitivities temporal unwrapping

NASA Astrophysics Data System (ADS)

Servin, Manuel; Padilla, Moises; Garnica, Guillermo

2018-07-01

Since the early 1970s, optical two-wavelength phase-metrology (TWPM) has been used in a wide variety of experimental set ups. In TWPM one may compute the phase-sum and the phase-difference of two close phase measurements. Early TWPM optically computed the phase difference and phase sum by double exposure holography. However soon after, TWPM became almost synonymous to calculating the phase-difference only. The more sensitive phase-sum was largely forgotten. The standard application for phase-difference TWPM is to extend the phase measurement depth without phase-unwrapping for discontinuous phase-objects. This phase-difference, while non-wrapped, decreases however the signal-to-noise ratio (SNR) of the estimated phase. On the other hand, the phase-sum increases the phase sensitivity, and the SNR of the estimated phase. In spite of these two great advantages, the use of the phase-sum in TWPM has been almost ignored. In this paper we review and set the stage for digital TWPM for super-sensitive phase-sum estimation. This is coupled with two-sensitivity phase-unwrapping to obtain extended-range super-sensitive fringe-projection profilometry estimations. Here we mathematically prove, and experimentally show that using the phase-sum one obtains a huge increase in SNR with respect to using the phase-difference alone. The pioneer works on double exposure TWPM holography that uses the phase-difference and phase-sum are also properly acknowledged. Finally, two experimental results from fringe-projection profilometry that clearly show the huge SNR gain of the phase-sum, with respect to the phase-difference is now mathematically well established.

FigSum: automatically generating structured text summaries for figures in biomedical literature.

PubMed

Agarwal, Shashank; Yu, Hong

2009-11-14

Figures are frequently used in biomedical articles to support research findings; however, they are often difficult to comprehend based on their legends alone and information from the full-text articles is required to fully understand them. Previously, we found that the information associated with a single figure is distributed throughout the full-text article the figure appears in. Here, we develop and evaluate a figure summarization system - FigSum, which aggregates this scattered information to improve figure comprehension. For each figure in an article, FigSum generates a structured text summary comprising one sentence from each of the four rhetorical categories - Introduction, Methods, Results and Discussion (IMRaD). The IMRaD category of sentences is predicted by an automated machine learning classifier. Our evaluation shows that FigSum captures 53% of the sentences in the gold standard summaries annotated by biomedical scientists and achieves an average ROUGE-1 score of 0.70, which is higher than a baseline system.

FigSum: Automatically Generating Structured Text Summaries for Figures in Biomedical Literature

PubMed Central

Agarwal, Shashank; Yu, Hong

2009-01-01

Figures are frequently used in biomedical articles to support research findings; however, they are often difficult to comprehend based on their legends alone and information from the full-text articles is required to fully understand them. Previously, we found that the information associated with a single figure is distributed throughout the full-text article the figure appears in. Here, we develop and evaluate a figure summarization system – FigSum, which aggregates this scattered information to improve figure comprehension. For each figure in an article, FigSum generates a structured text summary comprising one sentence from each of the four rhetorical categories – Introduction, Methods, Results and Discussion (IMRaD). The IMRaD category of sentences is predicted by an automated machine learning classifier. Our evaluation shows that FigSum captures 53% of the sentences in the gold standard summaries annotated by biomedical scientists and achieves an average ROUGE-1 score of 0.70, which is higher than a baseline system. PMID:20351812

The Probability of Exceedance as a Nonparametric Person-Fit Statistic for Tests of Moderate Length

ERIC Educational Resources Information Center

Tendeiro, Jorge N.; Meijer, Rob R.

2013-01-01

To classify an item score pattern as not fitting a nonparametric item response theory (NIRT) model, the probability of exceedance (PE) of an observed response vector x can be determined as the sum of the probabilities of all response vectors that are, at most, as likely as x, conditional on the test's total score. Vector x is to be considered…

Prognosis of Treatment Outcomes by Cognitive and Physical Scales.

PubMed

Jakavonytė-Akstinienė, Agnė; Dikčius, Vytautas; Macijauskienė, Jūratė

2018-01-01

The aim of this study was to assess the possibility of using scales for measuring cognitive and physical functions for a prognosis of care outcomes in elderly patients. The survey was carried out in one of the Vilnius City Hospitals for Nursing and Support Treatment. A total number of 177 respondents were involved in the study. The Mini-Mental State Examination (MMSE), The Barthel Index (BI) and The Morse Fall Scale were used. A statistically significant correlation was revealed between the scores of MMSE and BI (Pearson R = 0.41, p < 0.01); those with severe cognitive impairment were more dependent. A statistically significant correlation (Pearson R = -0.181, p < 0.01) was reported between the scores of MMSE and the Morse Fall Scale - the risk of falling was higher in patients with severe cognitive impairment. The Morse Fall Scale was not suitable for the prognosis of outcomes. The MMSE was suitable for the prognosis of a patient's discharge. The Barthel Index should be considered as the most suitable tool for the prognosis of care outcomes: the sum-score of the Barthel Index above 25 may suggest that the patient would be discharged home; the sum-score below this level was associated with a higher likelihood of patient death.

Postprandial Levels of Branch Chained and Aromatic Amino Acids Associate with Fasting Glycaemia.

PubMed

Ottosson, Filip; Ericson, Ulrika; Almgren, Peter; Nilsson, Jeanette; Magnusson, Martin; Fernandez, Céline; Melander, Olle

2016-01-01

High fasting plasma concentrations of isoleucine, phenylalanine, and tyrosine have been associated with increased risk of hyperglycaemia and incidence of type 2 diabetes. Whether these associations are diet or metabolism driven is unknown. We examined how the dietary protein source affects the postprandial circulating profile of these three diabetes associated amino acids (DMAAs) and tested whether the postprandial DMAA profiles are associated with fasting glycaemia. We used a crossover design with twenty-one healthy individuals and four different isocaloric test meals, containing proteins from different dietary sources (dairy, fish, meat, and plants). Analysis of the postprandial DMAAs concentrations was performed using targeted mass spectrometry. A DMAA score was defined as the sum of all the three amino acid concentrations. The postprandial area under the curve (AUC) of all the three amino acids and the DMAA score was significantly greater after intake of the meal with dairy protein compared to intake of the three other meals. The postprandial AUC for the DMAA score and all the three amino acids strongly associated with fasting glucose level and insulin resistance. This indicates the importance of the postprandial kinetics and metabolism of DMAAs in understanding the overall association between DMAAs and glycaemia.

Predictive value of Tokuhashi scoring systems in spinal metastases, focusing on various primary tumor groups: evaluation of 448 patients in the Aarhus spinal metastases database.

PubMed

Wang, Miao; Bünger, Cody Eric; Li, Haisheng; Wu, Chunsen; Høy, Kristian; Niedermann, Bent; Helmig, Peter; Wang, Yu; Jensen, Anders Bonde; Schättiger, Katrin; Hansen, Ebbe Stender

2012-04-01

We conducted a prospective cohort study of 448 patients with spinal metastases from a variety of cancer groups. To determine the specific predictive value of the Tokuhashi scoring system (T12) and its revised version (T15) in spinal metastases of various primary tumors. The life expectancy of patients with spinal metastases is one of the most important factors in selecting the treatment modality. Tokuhashi et al formulated a prognostic scoring system with a total sum of 12 points for preoperative prediction of life expectancy in 1990 and revised it in 2005 to a total sum of 15 points. There is a lack of knowledge about the specific predictive value of those scoring systems in patients with spinal metastases from a variety of cancer groups. We included 448 patients with vertebral metastases who underwent surgical treatment during November 1992 to November 2009 in Aarhus University Hospital NBG. Data were retrieved from Aarhus Metastases Database. Scores based on T12 and T15 were calculated prospectively for each patient. We divided all the patients into different groups dictated by the site of their primary tumor. Predictive value and accuracy rate of the 2 scoring systems were compared in each cancer group. Both the T12 and T15 scoring systems showed statistically significant predictive value when the 448 patients were analyzed in total (T12, P < 0.0001; T15, P < 0.0001). The accuracy rate was significantly higher in T15 (P < 0.0001) than in T12. The further analyses by primary cancer groups showed that the predictive value of T12 and T15 was primarily determined by the prostate (P = 0.0003) and breast group (P = 0.0385). Only T12 displayed predictive value in the colon group (P = 0.0011). Neither of the scoring systems showed significant predictive value in the lung (P > 0.05), renal (P > 0.05), or miscellaneous primary tumor groups (P > 0.05). The accuracy rate of prognosis in T15 was significantly improved in the prostate (P = 0.0032) and breast group (P < 0.0001). Both T12 and T15 showed significant predictive value in patients with spinal metastases. T15 has a statistically higher accuracy rate than T12. Among the various cancer groups, the 2 scoring systems are especially reliable in prostate and breast metastases groups. T15 is recommended as superior to T12 because of its higher accuracy rate.

Quantitative prediction of drug side effects based on drug-related features.

PubMed

Niu, Yanqing; Zhang, Wen

2017-09-01

Unexpected side effects of drugs are great concern in the drug development, and the identification of side effects is an important task. Recently, machine learning methods are proposed to predict the presence or absence of interested side effects for drugs, but it is difficult to make the accurate prediction for all of them. In this paper, we transform side effect profiles of drugs as their quantitative scores, by summing up their side effects with weights. The quantitative scores may measure the dangers of drugs, and thus help to compare the risk of different drugs. Here, we attempt to predict quantitative scores of drugs, namely the quantitative prediction. Specifically, we explore a variety of drug-related features and evaluate their discriminative powers for the quantitative prediction. Then, we consider several feature combination strategies (direct combination, average scoring ensemble combination) to integrate three informative features: chemical substructures, targets, and treatment indications. Finally, the average scoring ensemble model which produces the better performances is used as the final quantitative prediction model. Since weights for side effects are empirical values, we randomly generate different weights in the simulation experiments. The experimental results show that the quantitative method is robust to different weights, and produces satisfying results. Although other state-of-the-art methods cannot make the quantitative prediction directly, the prediction results can be transformed as the quantitative scores. By indirect comparison, the proposed method produces much better results than benchmark methods in the quantitative prediction. In conclusion, the proposed method is promising for the quantitative prediction of side effects, which may work cooperatively with existing state-of-the-art methods to reveal dangers of drugs.

Does Cardiorespiratory Fitness Attenuate the Adverse Effects of Severe/Morbid Obesity on Cardiometabolic Risk and Insulin Resistance in Children? A Pooled Analysis.

PubMed

Nyström, Christine Delisle; Henriksson, Pontus; Martínez-Vizcaíno, Vicente; Medrano, María; Cadenas-Sanchez, Cristina; Arias-Palencia, Natalia María; Löf, Marie; Ruiz, Jonatan R; Labayen, Idoia; Sánchez-López, Mairena; Ortega, Francisco B

2017-11-01

To investigate 1 ) differences in cardiometabolic risk and HOMA of insulin resistance (HOMA-IR) across BMI categories (underweight to morbid obesity), 2 ) whether fit children have lower cardiometabolic risk/HOMA-IR than unfit children in each BMI category, and 3 ) differences in cardiometabolic risk/HOMA-IR in normal-weight unfit children and obese fit children. A pooled study including cross-sectional data from three projects ( n = 1,247 children aged 8-11 years). Cardiometabolic risk was assessed using the sum of the sex- and age-specific z scores for triglycerides, HDL cholesterol, glucose, and the average of systolic and diastolic blood pressure and HOMA-IR. A significant linear association was observed between the risk score and BMI categories ( P trend ≤0.001), with every incremental rise in BMI category being associated with a 0.5 SD higher risk score (standardized β = 0.474, P < 0.001). A trend was found showing that as BMI categories rose, cardiorespiratory fitness (CRF) attenuated the risk score, with the biggest differences observed in the most obese children (-0.8 SD); however, this attenuation was significant only in mild obesity (-0.2 SD, P = 0.048). Normal-weight unfit children had a significantly lower risk score than obese fit children ( P < 0.001); however, a significant reduction in the risk score was found in obese fit compared with unfit children (-0.4 SD, P = 0.027). Similar results were obtained for HOMA-IR. As BMI categories rose so did cardiometabolic risk and HOMA-IR, which highlights the need for obesity prevention/treatment programs in childhood. Furthermore, CRF may play an important role in lowering the risk of cardiometabolic diseases in obese children. © 2017 by the American Diabetes Association.

Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience--a randomised controlled trial.

PubMed

Rouhe, Hanna; Salmela-Aro, Katariina; Toivanen, Riikka; Tokola, Maiju; Halmesmäki, Erja; Ryding, Elsa-Lena; Saisto, Terhi

2015-01-01

Previous studies on the treatment of women with fear of childbirth have focused on the delivery mode. Women with fear of childbirth often suffer from anxiety and/or depression, and treatment therefore also needs to target postnatal psychological well-being and the early mother-infant relationship. Three hundred and seventy-one nulliparous women out of 4575 scored ≥100 in prospective screening (Wijma Delivery Expectancy Questionnaire, W-DEQ-A), indicating severe fear of childbirth. These women were randomised to psychoeducative group intervention with relaxation (n = 131; six sessions during pregnancy, one postnatal) or to conventional care (n = 240) by community nurses (referral if necessary). Psycho-emotional and psychosocial evaluations [Edinburgh Postnatal Depression Scale (EPDS), social support, Maternal Adjustment and Attitudes (MAMA), Traumatic Events Scale (TES) and the Wijma Delivery Experience Questionnaire (W-DEQ-B)] were completed twice during pregnancy and/or 3 months postpartum. Postnatal maternal adjustment (MAMA mean score 38.1 ± 4.3 versus 35.7 ± 5.0, p = 0.001) and childbirth experience (mean W-DEQ-B sum score 63.0 ± 29 versus 73.7 ± 32, p = 0.008) were better in the intervention group compared with controls. In hierarchical regression, social support, participating in intervention, and less fearful childbirth experience predicted better maternal adjustment. The level of postnatal depressive symptoms was significantly lower in the intervention group (mean sum score 6.4 ± 5.4 versus 8.0 ± 5.9 p = 0.04). There were no differences in the frequency of post-traumatic stress symptoms between the groups. In nulliparous women with severe fear of childbirth, participation in a targeted psychoeducative group resulted in better maternal adjustment, a less fearful childbirth experience and fewer postnatal depressive symptoms, compared with conventional care.

An optimized swine dysentery murine model to characterize shedding and clinical disease associated with "Brachyspira hampsonii" infection.

PubMed

Ek, Courtney E; Nosach, Roman; Fernando, Champika; Huang, Yanyun; Perez, Jason Byron D S; Costa, Matheus O; Ekanayake, Samantha; Hill, Janet E; Harding, John C S

2017-08-22

The development of a mouse model as an in vivo pathogenicity screening tool for Brachyspira spp. has advanced the study of these economically important pathogens in recent years. However, none of the murine models published to date have been used to characterize the clinical signs of disease in mice, instead focusing on pathology following oral inoculation with various Brachyspira spp. The experiments described herein explore modifications of published models to characterize faecal consistency, faecal shedding and pathology in mice challenged with "Brachyspira hampsonii" clade II (Bhamp). In Experiment 1, 24 CF-1 mice were randomly allocated to one of three inoculation groups: sham (Ctrl), Bhamp, or B. hyodysenteriae (Bhyo; positive control). Half of each group was fed normal mouse chow (RMH) while the other received a low-zinc diet (TD85420). In Experiment 2, eight CF-1 mice and nine C3H/HeN mice were divided into Ctrl or Bhamp inoculation groups, and all fed TD85420. In Experiment 1, mice fed TD85420 demonstrated more severe mucoid faeces (P = 0.001; Kruskal Wallis) and faecal shedding for a significantly greater number of days (P = 0.005; Kruskal Wallis). Mean faecal scores of Bhamp inoculated mice trended higher than Ctrl (P = 0.06; Wilcoxon rank-sum) as did those of Bhyo mice (P = 0.0; Wilcoxon rank-sum). In Experiment 2, mean faecal scores of inoculated CF-1 mice were significantly greater than in C3H mice (P = 0.049; Kruskal Wallis) but no group differences in faecal shedding were observed. In both experiments, mice clustered based on the severity of colonic and caecal histopathology but high lesion scores were not always concurrent with high fecal scores. In our laboratory, CF-1 mice and the lower-zinc TD85420 diet provide a superior murine challenge model of "Brachyspira hampsonii" clade II.

Articulation handicap index: an instrument for quantifying psychosocial consequences of impaired articulation.

PubMed

Keilmann, Annerose; Konerding, Uwe; Oberherr, Constantin; Nawka, Tadeus

2016-12-01

Structural, neurological and muscular diseases can lead to impairments of articulation. These impairments can severely impact social life. To judge health status comprehensively, this impact must be adequately quantified. For this purpose, the articulation handicap index (AHI) has been developed. Psychometric analyses referring to this index are presented here. The AHI was completed by 113 patients who had undergone treatment of tumours of the head or neck. The patients also gave a general self-assessment of their impairments due to articulation problems. Furthermore, tumour size, tumour location and kind of therapy were recorded. Missing data were analysed and replaced by multiple imputation. Internal structure was investigated using principal component analysis (PCA); reliability using Cronbach's alpha. Validity was investigated by analysing the relationship between AHI and general self-assessment of impairments. Moreover, the relationships with tumour size, tumour location and kind of therapy were analysed. Only 0.12 % of the answers to the AHI were missing. The Scree test performed with the PCA results suggested one-dimensionality with the first component explaining 49.6 % of the item variance. Cronbach's alpha was 0.96. Kendall's tau between the AHI sum score and the general self-assessment was 0.69. The intervals of AHI sum scores for the self-assessment categories were determined with 0-13 for no, 14-44 for mild, 46-76 for moderate, and 77-120 for severe impairment. The AHI sum score did not systematically relate to tumour size, tumour location or kind of therapy. The results are evidence for high acceptance, reliability and validity.

Depression is not a consistent syndrome: An investigation of unique symptom patterns in the STAR*D study.

PubMed

Fried, Eiko I; Nesse, Randolph M

2015-02-01

The DSM-5 encompasses a wide range of symptoms for Major Depressive Disorder (MDD). Symptoms are commonly added up to sum-scores, and thresholds differentiate between healthy and depressed individuals. The underlying assumption is that all patients diagnosed with MDD have a similar condition, and that sum-scores accurately reflect the severity of this condition. To test this assumption, we examined the number of DSM-5 depression symptom patterns in the "Sequenced Treatment Alternatives to Relieve Depression" (STAR*D) study. We investigated the number of unique symptom profiles reported by 3703 depressed outpatients at the beginning of the first treatment stage of STAR*D. Overall, we identified 1030 unique symptom profiles. Of these profiles, 864 profiles (83.9%) were endorsed by five or fewer subjects, and 501 profiles (48.6%) were endorsed by only one individual. The most common symptom profile exhibited a frequency of only 1.8%. Controlling for overall depression severity did not reduce the amount of observed heterogeneity. Symptoms were dichotomized to construct symptom profiles. Many subjects enrolled in STAR*D reported medical conditions for which prescribed medications may have affected symptom presentation. The substantial symptom variation among individuals who all qualify for one diagnosis calls into question the status of MDD as a specific consistent syndrome and offers a potential explanation for the difficulty in documenting treatment efficacy. We suggest that the analysis of individual symptoms, their patterns, and their causal associations will provide insights that could not be discovered in studies relying on only sum-scores. Copyright © 2014 Elsevier B.V. All rights reserved.

Nebulized hypertonic-saline vs epinephrine for bronchiolitis; proof of concept study of cumulative sum (CUSUM) analysis.

PubMed

Gupta, Neeraj; Puliyel, Ashish; Manchanda, Ayush; Puliyel, Jacob

2012-07-01

To apply cumulative sum (CUSUM) to monitor a drug trial of nebulized hypertonic-saline in bronchiolitis. To test if monitoring with CUSUM control lines is practical and useful as a prompt to stop the drug trial early, if the study drug performs significantly worse than the comparator drug. Prospective, open label, controlled trial using standard therapy (epinephrine) and study drug (hypertonic-saline) sequentially in two groups of patients. Hospital offering tertiary-level pediatric care. Children, 2 months to 2 years, with first episode of bronchiolitis, excluding those with cardiac disease, immunodeficiency and critical illness at presentation. Nebulized epinephrine in first half of the bronchiolitis season (n = 35) and hypertonic saline subsequently (n = 29). Continuous monitoring of response to hypertonic-saline using CUSUM control charts developed with epinephrine-response data. Clinical score, tachycardia and total duration of hospital stay. In the epinephrine group, the maximum CUSUM was +2.25 (SD 1.34) and minimum CUSUM was -2.26 (SD 1.34). CUSUM score with hypertonic saline group stayed above the zero line throughout the study. There was no statistical difference in the post-treatment clinical score at 24 hours between the treatment groups {Mean (SD) 3.516 (2.816): 3.552 (2.686); 95% CI: -1.416 to 1.356}, heart rate {Mean (SD) 136 (44): 137(12); 95% CI: -17.849 to 15.849) or duration of hospital stay (Mean (SD) 96.029 (111.41): 82.914 (65.940); 95% CI: -33.888 to 60.128}. The software we developed allows for drawing of control lines to monitor study drug performance. Hypertonic saline performed as well or better than nebulized epinephrine in bronchiolitis.

Trajectories of depressive symptoms in the acute phase of psychosis: Implications for treatment.

PubMed

Kjelby, E; Gjestad, R; Sinkeviciute, I; Kroken, R A; Løberg, E-M; Jørgensen, H A; Johnsen, E

2018-06-02

Depression is common in schizophrenia and associated with negative outcomes. Previous studies have identified heterogeneity in treatment response in schizophrenia. We aimed to investigate different trajectories of depression in patients suffering from psychosis and predictors of change in depressive symptoms during antipsychotic treatment. Two hundred and twenty-six patients >18 years acutely admitted due to psychosis were consecutively included and the follow-up was 27 weeks. The Calgary Depression Scale for Schizophrenia (CDSS) sum score was the primary outcome. Latent growth curve (LGCM) and Growth Mixture Models (GMM) were conducted. Predictors were the Positive sum score of the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), Schizophrenia spectrum/non-spectrum psychoses, gender and being antipsychotic naive at inclusion. We found support for three depression-trajectories, including a high- (14.7%), a low depression-level (69.6%) class and a third depressed class quickly decreasing to a low level (15.7%). Change in CDSS was associated with change in PANSS positive score in all time intervals (4 weeks: b = 0.18, p < 0.001, 3 months: 0.21, p < 0.023, 6 months: 0.43, p < 0.001) and with a diagnosis within schizophrenia spectrum but not with antipsychotic naivety or gender. The schizophrenia-spectrum patients had less depressive symptoms at inclusion (-2.63, p < 0.001). In conclusion, an early responding and a treatment refractory group were identified. The treatment-refractory patients are candidates for enhanced anti-depressive treatment, for which current evidence is limited. The post-psychotic depression group was characterized by depressive symptoms in the acute phase as well. We could not identify differentiating characteristics of the depression trajectories. Copyright © 2018 Elsevier Ltd. All rights reserved.

Quality of life in the patients with central diabetes insipidus assessed by Nagasaki Diabetes Insipidus Questionnaire.

PubMed

Nozaki, Aya; Ando, Takao; Akazawa, Satoru; Satoh, Tsuyoshi; Sagara, Ikuko; Horie, Ichiro; Imaizumi, Misa; Usa, Toshiro; Yanagisawa, Robert T; Kawakami, Atsushi

2016-01-01

Central diabetes insipidus (CDI) is characterized by polyuria and polydipsia due to a deficiency of vasopressin. Currently, the treatment goal for CDI is improvement of quality of life (QOL) by desmopressin (DDAVP) without developing hyponatremia. However, there is no reliable measure for QOL in CDI patients. We evaluate our original questionnaire for QOL, consisting of 12 questions focusing on polyuria, polydipsia, and DDAVP treatment, in CDI patients who underwent a switch from nasal spray to oral disintegrating tablets of DDAVP. Twenty-five CDI patients under nasal DDAVP treatment, six with newly developed CDI, and 18 healthy individuals without known polyuric/polydipsic disorders as control subjects were enrolled. QOL scores were determined by our questionnaire at the enrollment and 3 months after the start of oral DDAVP treatment and were examined by the Wilcoxon signed-rank test. Eleven questions detected improvement in QOL. The sum of the QOL scores of the eleven questions increased from 29.2 ± 5.6 under nasal to 36.8 ± 4.5 under oral DDAVP (p < 0.001). There were no clinically relevant changes in serum levels of Na. After eliminating two questions about DDAVP treatment, the sum of QOL scores was 15.3 ± 6.5 in untreated CDI patients, 24.4 ± 5.2 in those with nasal treatment, 28.9 ± 4.9 in those with oral DDAVP, and 29.5 ± 3.6 in healthy controls. The difference among groups was significant (p < 0.05 in Steel-Dwass test) except between patients treated with oral DDAVP and healthy controls. Our questionnaire can be used to accurately assess QOL in CDI patients.

Variation in Aptitude of Trainees in Endoscopic Ultrasonography, Based on Cumulative Sum Analysis

PubMed Central

Wani, Sachin; Hall, Matthew; Keswani, Rajesh N.; Aslanian, Harry R.; Casey, Brenna; Burbridge, Rebecca; Chak, Amitabh; Chen, Ann M.; Cote, Gregory; Edmundowicz, Steven A.; Faulx, Ashley L.; Hollander, Thomas G.; Lee, Linda S.; Mullady, Daniel; Murad, Faris; Muthusamy, Raman; Pfau, Patrick R.; Scheiman, James M.; Tokar, Jeffrey; Wagh, Mihir S.; Watson, Rabindra; Early, Dayna

2017-01-01

BACKGROUND & AIMS Studies have reported substantial variation in the competency of advanced endoscopy trainees, indicating a need for more supervised training in endoscopic ultrasound (EUS). We used a standardized, validated, data collection tool to evaluate learning curves and measure competency in EUS among trainees at multiple centers. METHODS In a prospective study performed at 15 centers, 17 trainees with no prior EUS experience were evaluated by experienced attending endosonographers at the 25th and then every 10th upper EUS examination, over a 12-month training period. A standardized data collection form was used (using a 5-point scoring system) to grade the EUS examination. Cumulative sum analysis was applied to produce a learning curve for each trainee; it tracked the overall performance based on median scores at different stations and also at each station. Competency was defined by a median score of 1, with acceptable and unacceptable failure rates of 10% and 20%, respectively. RESULTS Twelve trainees were included in the final analysis. Each of the trainees performed 265 to 540 EUS examinations (total, 4257 examinations). There was a large amount of variation in their learning curves: 2 trainees crossed the threshold for acceptable performance (at cases 225 and 245), 2 trainees had a trend toward acceptable performance (after 289 and 355 cases) but required continued observation, and 8 trainees needed additional training and observation. Similar results were observed at individual stations. CONCLUSIONS A specific case load does not ensure competency in EUS; 225 cases should be considered the minimum caseload for training because we found that no trainee achieved competency before this point. Ongoing training should be provided for trainees until competency is confirmed using objective measures. PMID:25460557

Variation in Aptitude of Trainees in Endoscopic Ultrasonography, Based on Cumulative Sum Analysis.

PubMed

Wani, Sachin; Hall, Matthew; Keswani, Rajesh N; Aslanian, Harry R; Casey, Brenna; Burbridge, Rebecca; Chak, Amitabh; Chen, Ann M; Cote, Gregory; Edmundowicz, Steven A; Faulx, Ashley L; Hollander, Thomas G; Lee, Linda S; Mullady, Daniel; Murad, Faris; Muthusamy, V Raman; Pfau, Patrick R; Scheiman, James M; Tokar, Jeffrey; Wagh, Mihir S; Watson, Rabindra; Early, Dayna

2015-07-01

Studies have reported substantial variation in the competency of advanced endoscopy trainees, indicating a need for more supervised training in endoscopic ultrasound (EUS). We used a standardized, validated, data collection tool to evaluate learning curves and measure competency in EUS among trainees at multiple centers. In a prospective study performed at 15 centers, 17 trainees with no prior EUS experience were evaluated by experienced attending endosonographers at the 25th and then every 10th upper EUS examination, over a 12-month training period. A standardized data collection form was used (using a 5-point scoring system) to grade the EUS examination. Cumulative sum analysis was applied to produce a learning curve for each trainee; it tracked the overall performance based on median scores at different stations and also at each station. Competency was defined by a median score of 1, with acceptable and unacceptable failure rates of 10% and 20%, respectively. Twelve trainees were included in the final analysis. Each of the trainees performed 265 to 540 EUS examinations (total, 4257 examinations). There was a large amount of variation in their learning curves: 2 trainees crossed the threshold for acceptable performance (at cases 225 and 245), 2 trainees had a trend toward acceptable performance (after 289 and 355 cases) but required continued observation, and 8 trainees needed additional training and observation. Similar results were observed at individual stations. A specific case load does not ensure competency in EUS; 225 cases should be considered the minimum caseload for training because we found that no trainee achieved competency before this point. Ongoing training should be provided for trainees until competency is confirmed using objective measures. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

A Novel Noncircular MUSIC Algorithm Based on the Concept of the Difference and Sum Coarray.

PubMed

Chen, Zhenhong; Ding, Yingtao; Ren, Shiwei; Chen, Zhiming

2018-01-25

In this paper, we propose a vectorized noncircular MUSIC (VNCM) algorithm based on the concept of the coarray, which can construct the difference and sum (diff-sum) coarray, for direction finding of the noncircular (NC) quasi-stationary sources. Utilizing both the NC property and the concept of the Khatri-Rao product, the proposed method can be applied to not only the ULA but also sparse arrays. In addition, we utilize the quasi-stationary characteristic instead of the spatial smoothing method to solve the coherent issue generated by the Khatri-Rao product operation so that the available degree of freedom (DOF) of the constructed virtual array will not be reduced by half. Compared with the traditional NC virtual array obtained in the NC MUSIC method, the diff-sum coarray achieves a higher number of DOFs as it comprises both the difference set and the sum set. Due to the complementarity between the difference set and the sum set for the coprime array, we choose the coprime array with multiperiod subarrays (CAMpS) as the array model and summarize the properties of the corresponding diff-sum coarray. Furthermore, we develop a diff-sum coprime array with multiperiod subarrays (DsCAMpS) whose diff-sum coarray has a higher DOF. Simulation results validate the effectiveness of the proposed method and the high DOF of the diff-sum coarray.

A Novel Noncircular MUSIC Algorithm Based on the Concept of the Difference and Sum Coarray

PubMed Central

Chen, Zhenhong; Ding, Yingtao; Chen, Zhiming

2018-01-01

In this paper, we propose a vectorized noncircular MUSIC (VNCM) algorithm based on the concept of the coarray, which can construct the difference and sum (diff–sum) coarray, for direction finding of the noncircular (NC) quasi-stationary sources. Utilizing both the NC property and the concept of the Khatri–Rao product, the proposed method can be applied to not only the ULA but also sparse arrays. In addition, we utilize the quasi-stationary characteristic instead of the spatial smoothing method to solve the coherent issue generated by the Khatri–Rao product operation so that the available degree of freedom (DOF) of the constructed virtual array will not be reduced by half. Compared with the traditional NC virtual array obtained in the NC MUSIC method, the diff–sum coarray achieves a higher number of DOFs as it comprises both the difference set and the sum set. Due to the complementarity between the difference set and the sum set for the coprime array, we choose the coprime array with multiperiod subarrays (CAMpS) as the array model and summarize the properties of the corresponding diff–sum coarray. Furthermore, we develop a diff–sum coprime array with multiperiod subarrays (DsCAMpS) whose diff–sum coarray has a higher DOF. Simulation results validate the effectiveness of the proposed method and the high DOF of the diff–sum coarray. PMID:29370138

Predictive Value of the Korean Academy of Family Medicine In-Training Examination for Certifying Examination

PubMed Central

Kim, Ji-Yong

2011-01-01

Background In-training examination (ITE) is a cognitive examination similar to the written test, but it is different from the Clinical Practice Examination of the Korean Academy of Family Medicine (KAFM) Certification Examination (CE). The objective of this is to estimate the positive predictive value of the KAFM-ITE for identifying residents at risk for poor performance on the three types of KAFM-CE. Methods 372 residents who completed the KAFM-CE in 2011 were included. We compared the mean KAFM-CE scores with ITE experience. We evaluated the correlation and the positive predictive value (PPV) of ITE for the multiple choice question (MCQ) scores of 1st written test & 2nd slide examination, the total clinical practice examination scores, and the total sum of 2nd test. Results 275 out of 372 residents completed ITE. Those who completed ITE had significantly higher MCQ scores of 1st written test than those who did not. The correlation of ITE scores with 1st written MCQ (0.627) was found to be the highest among the other kinds of CE. The PPV of the ITE score for 1st written MCQ scores was 0.672. The PPV of the ITE score ranged from 0.376 to 0.502. Conclusion The score of the KAFM ITE has acceptable positive predictive value that could be used as a part of comprehensive evaluation system for residents in cognitive field. PMID:22745873

Two Simple and Efficient Algorithms to Compute the SP-Score Objective Function of a Multiple Sequence Alignment.

PubMed

Ranwez, Vincent

2016-01-01

Multiple sequence alignment (MSA) is a crucial step in many molecular analyses and many MSA tools have been developed. Most of them use a greedy approach to construct a first alignment that is then refined by optimizing the sum of pair score (SP-score). The SP-score estimation is thus a bottleneck for most MSA tools since it is repeatedly required and is time consuming. Given an alignment of n sequences and L sites, I introduce here optimized solutions reaching O(nL) time complexity for affine gap cost, instead of O(n2L), which are easy to implement.

Detection of Patient Subgroups with Differential Expression in Omics Data: A Comprehensive Comparison of Univariate Measures

PubMed Central

Ahrens, Maike; Turewicz, Michael; Casjens, Swaantje; May, Caroline; Pesch, Beate; Stephan, Christian; Woitalla, Dirk; Gold, Ralf; Brüning, Thomas; Meyer, Helmut E.

2013-01-01

Detection of yet unknown subgroups showing differential gene or protein expression is a frequent goal in the analysis of modern molecular data. Applications range from cancer biology over developmental biology to toxicology. Often a control and an experimental group are compared, and subgroups can be characterized by differential expression for only a subgroup-specific set of genes or proteins. Finding such genes and corresponding patient subgroups can help in understanding pathological pathways, diagnosis and defining drug targets. The size of the subgroup and the type of differential expression determine the optimal strategy for subgroup identification. To date, commonly used software packages hardly provide statistical tests and methods for the detection of such subgroups. Different univariate methods for subgroup detection are characterized and compared, both on simulated and on real data. We present an advanced design for simulation studies: Data is simulated under different distributional assumptions for the expression of the subgroup, and performance results are compared against theoretical upper bounds. For each distribution, different degrees of deviation from the majority of observations are considered for the subgroup. We evaluate classical approaches as well as various new suggestions in the context of omics data, including outlier sum, PADGE, and kurtosis. We also propose the new FisherSum score. ROC curve analysis and AUC values are used to quantify the ability of the methods to distinguish between genes or proteins with and without certain subgroup patterns. In general, FisherSum for small subgroups and -test for large subgroups achieve best results. We apply each method to a case-control study on Parkinson's disease and underline the biological benefit of the new method. PMID:24278130

The Pooling-score (P-score): inter- and intra-rater reliability in endoscopic assessment of the severity of dysphagia.

PubMed

Farneti, D; Fattori, B; Nacci, A; Mancini, V; Simonelli, M; Ruoppolo, G; Genovese, E

2014-04-01

This study evaluated the intra- and inter-rater reliability of the Pooling score (P-score) in clinical endoscopic evaluation of severity of swallowing disorder, considering excess residue in the pharynx and larynx. The score (minimum 4 - maximum 11) is obtained by the sum of the scores given to the site of the bolus, the amount and ability to control residue/bolus pooling, the latter assessed on the basis of cough, raclage, number of dry voluntary or reflex swallowing acts (< 2, 2-5, > 5). Four judges evaluated 30 short films of pharyngeal transit of 10 solid (1/4 of a cracker), 11 creamy (1 tablespoon of jam) and 9 liquid (1 tablespoon of 5 cc of water coloured with methlyene blue, 1 ml in 100 ml) boluses in 23 subjects (10 M/13 F, age from 31 to 76 yrs, mean age 58.56±11.76 years) with different pathologies. The films were randomly distributed on two CDs, which differed in terms of the sequence of the films, and were given to judges (after an explanatory session) at time 0, 24 hours later (time 1) and after 7 days (time 2). The inter- and intra-rater reliability of the P-score was calculated using the intra-class correlation coefficient (ICC; 3,k). The possibility that consistency of boluses could affect the scoring of the films was considered. The ICC for site, amount, management and the P-score total was found to be, respectively, 0.999, 0.997, 1.00 and 0.999. Clinical evaluation of a criterion of severity of a swallowing disorder remains a crucial point in the management of patients with pathologies that predispose to complications. The P-score, derived from static and dynamic parameters, yielded a very high correlation among the scores attributed by the four judges during observations carried out at different times. Bolus consistencies did not affect the outcome of the test: the analysis of variance, performed to verify if the scores attributed by the four judges to the parameters selected, might be influenced by the different consistencies of the boluses, was not significant. These initial data validate the clinical use of the P-score in the management of patients with deglutition disorders by a multidisciplinary team.

Development of an Itemwise Efficiency Scoring Method: Concurrent, Convergent, Discriminant, and Neuroimaging-Based Predictive Validity Assessed in a Large Community Sample

PubMed Central

Moore, Tyler M.; Reise, Steven P.; Roalf, David R.; Satterthwaite, Theodore D.; Davatzikos, Christos; Bilker, Warren B.; Port, Allison M.; Jackson, Chad T.; Ruparel, Kosha; Savitt, Adam P.; Baron, Robert B.; Gur, Raquel E.; Gur, Ruben C.

2016-01-01

Traditional “paper-and-pencil” testing is imprecise in measuring speed and hence limited in assessing performance efficiency, but computerized testing permits precision in measuring itemwise response time. We present a method of scoring performance efficiency (combining information from accuracy and speed) at the item level. Using a community sample of 9,498 youths age 8-21, we calculated item-level efficiency scores on four neurocognitive tests, and compared the concurrent, convergent, discriminant, and predictive validity of these scores to simple averaging of standardized speed and accuracy-summed scores. Concurrent validity was measured by the scores' abilities to distinguish men from women and their correlations with age; convergent and discriminant validity were measured by correlations with other scores inside and outside of their neurocognitive domains; predictive validity was measured by correlations with brain volume in regions associated with the specific neurocognitive abilities. Results provide support for the ability of itemwise efficiency scoring to detect signals as strong as those detected by standard efficiency scoring methods. We find no evidence of superior validity of the itemwise scores over traditional scores, but point out several advantages of the former. The itemwise efficiency scoring method shows promise as an alternative to standard efficiency scoring methods, with overall moderate support from tests of four different types of validity. This method allows the use of existing item analysis methods and provides the convenient ability to adjust the overall emphasis of accuracy versus speed in the efficiency score, thus adjusting the scoring to the real-world demands the test is aiming to fulfill. PMID:26866796

Comparison between the summed difference score and myocardial blood flow measured by 13N-ammonia.

PubMed

Giubbini, Raffaele; Peli, Alessia; Milan, Elisa; Sciagrà, Roberto; Camoni, Luca; Albano, Domenico; Bertoli, Mattia; Bonacina, Mattia; Motta, Federica; Statuto, Massimo; Rodella, Carlo Alberto; De Agostini, Antonio; Calabretta, Raffaella; Bertagna, Francesco

2017-02-03

Both the myocardial perfusion pattern and myocardial blood flow (MBF) are used to assess patients with suspected coronary artery disease (CAD). The aim of this study was to compare the perfusion pattern (using the summed difference score [SDS]) to MBF in a consecutive group of patients undergoing PET/CT with 13 N-ammonia ( 13 NH 3 ). 47 consecutive patients, aged 65 ± 12 years (42 men) with known or suspected CAD, underwent vasodilator stress/rest PET/CT with 13 NH 3 for clinical indications. The SDS was determined by a commercially available software based on a 17-segment model. MBF was measured at rest and during hyperemia by dynamic acquisition and single-compartment model analysis. From the rest and stress MBF, the absolute difference (stress-rest) in myocardial blood flow defined as difference in myocardial blood flow (DMBF) was derived. There were no significant differences between patients with no ischemia (SDS ≤ 1) and those with ischemia (SDS > 1) in CFR (2.84 ± 0.73 vs 2.63 ± 0.89, P = NS) and DMBF (1.34 ± 0.45 vs 1.24 ± 0.53 mL·minute -1 ·g -1 , P = NS). There were however significant regional differences (141 different vascular territories in 47 patients) between these two groups (CFR: 2.84 ± 0.95 vs 2.16 ± 0.57, P < .001 and DMBF: 1.39 ± 0.6 vs 0.87 ± 0.39, P < .0001). The correlation between regional CFR and regional DMBF with SDS was significant (y = 2.7145e -0.059x R = 0.358 and y = 1.2769e -0.119x R = 0.44) CONCLUSION: The SDS is the difference between two measurements (stress-rest) and it correlates better with regional DMBF, which is another measurement that reflects the difference between stress and rest. The correlation is better on regional than global basis.

The Ultrasound pattern sum score - UPSS. A new method to differentiate acute and subacute neuropathies using ultrasound of the peripheral nerves.

PubMed

Grimm, Alexander; Décard, Bernhard F; Axer, Hubertus; Fuhr, Peter

2015-11-01

Ultrasound differentiation of neuropathies is a great challenge. We, therefore, suggest a standardized score to operationalize differentiation between several acute and subacute onset neuropathies. We retrospectively analyzed the ultrasound data of 61 patients with acute or subacute neuropathies, e.g. chronic immune-mediated neuropathies, Guillain-Barré syndrome (GBS), and axonal/vasculitic neuropathies. We compared these data to 28 healthy controls. Based on these results an ultrasound pattern sum score (UPSS) with three sub-scores (UPS-A for the sensorimotor nerves, UPS-B for the cervical roots and the vagal nerve and UPS-C for the sural nerve) was developed. Afterwards, the applicability of the score was prospectively validated in 10 patients with chronic neuropathies and in 14 patients with unknown acute and subacute PNP before performing additional tests. UPS-A and UPSS were significantly higher in CIDP than in other neuropathies and controls (p<0.001). UPS-B was significantly more often pathologic in GBS than in CIDP and other neuropathies (p<0.001). Using receiver operation characteristics curve analysis boundary values for each score were defined. Positive predictive value (PPV) of these scores for CIDP and GBS was >85%. Vasculitic neuropathies showed an intermediate type of UPSS compared to other axonal neuropathies (p<0.001). In the prospective application the pattern score could be used with good accuracy in several types of neuropathy. UPS-A and UPSS operationalize to diagnose acute and subacute-onset CIDP and its variants with high sensitivity, specificity, and PPV. An increased UPS-B with normal UPSS and other sub scores may point to the diagnosis of GBS with high PPV and enables the differentiation from CIDP. Using the UPSS and its sub-scores gives a new diagnostic power to the method of the peripheral nerve ultrasound. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Peripheral nerve ultrasound scoring systems: benchmarking and comparative analysis.

PubMed

Grimm, Alexander; Rattay, Tim W; Winter, Natalie; Axer, Hubertus

2017-02-01

Ultrasound of the nerves is an additive diagnostic tool to evaluate polyneuropathy. Recently, the need for standardized scoring systems has widely been discussed; different scores are described so far. Therefore, 327 patients with polyneuropathy were analyzed by ultrasound in our laboratory. Consequently, several ultrasound scoring tools were applied, i.e., the nerve pattern classification according to Padua et al. in all patients with CIDP and variants, the Bochum ultrasound score (BUS) and the neuritis ultrasound protocol in immune-mediated neuritis, the ultrasound pattern sum score, the homogeneity score, and the nerve enlargement distribution score in all neuropathies if possible. For all scores good accuracy was found. Most patients with CIDP revealed hypoechoic enlarged nerves (Class 1), the BUS/NUP was useful to identify GBS (sensitivity >85%), MMN (100%) and CIDP (>70%), while the UPSS showed high sensitivity and positive/negative predictive values (N/PPV) in the diagnosis of GBS (>70%), CIDP (>85%) and axonal non-inflammatory neuropathies (>90%). Homogeneous nerves were found in most CMT1 patients (66.7%), while immune-mediated neuropathies mostly show regional nerve enlargement. The HS was suitable to identify CMT patients with an HS ≥5 points. All scores were easily applicable with high accuracy. The former-reported results could be similarly confirmed. However, all sores have some incompleteness concerning unselected polyneuropathy population, particularly rare and focal types. Scoring systems are useful and easily applicable. They show high accuracy in certain neuropathies, but also offer some gaps and can, therefore, only be used in addition to standard diagnostic routines such as electrophysiology.

Exploratory factor analysis of the functional movement screen in elite athletes.

PubMed

Li, Yongming; Wang, Xiong; Chen, Xiaoping; Dai, Boyi

2015-01-01

The functional movement screen is developed to examine individuals' movement patterns through 7 functional tasks. The purpose of this study was to identify the internal consistency and factor structure of the 7 tasks of the functional movement screen in elite athletes; 290 elite athletes from a variety of Chinese national teams were assessed using the functional movement screen. Cronbach's alpha was calculated for the scores of the 7 tasks. Exploratory factor analysis was performed to explore the factor structure of the functional movement screen. The mean and standard deviation of the sum score were 15.2 ± 3.0. A low Cronbach's alpha (0.58) was found for the scores of the 7 tasks. Exploratory factor analysis extracted 2 factors with eigenvalues greater than 1, and these 2 factors explained 47.3% of the total variance. The first factor had a high loading on the rotatory stability (loading = 0.99) and low loadings on the other 6 tasks (loading range: 0.04-0.34). The second factor had high loadings on the deep squat, hurdle step and inline lunge (loading range: 0.46-0.61) and low loadings on the other 3 tasks (loading range: 0.12-0.32). The 7 tasks of the functional movement screen had low internal consistency and were not indicators of a single factor. Evidence for unidimensionality was not found for the functional movement screen in elite athletes. More attention should be paid to the score of each task rather than the sum score when we interpret the functional movement screen scores.

The Bay Area Verbal Learning Test (BAVLT): Normative Data and the Effects of Repeated Testing, Simulated Malingering, and Traumatic Brain Injury

PubMed Central

Woods, David L.; Wyma, John M.; Herron, Timothy J.; Yund, E. William

2017-01-01

Verbal learning tests (VLTs) are widely used to evaluate memory deficits in neuropsychiatric and developmental disorders. However, their validity has been called into question by studies showing significant differences in VLT scores obtained by different examiners. Here we describe the computerized Bay Area Verbal Learning Test (BAVLT), which minimizes inter-examiner differences by incorporating digital list presentation and automated scoring. In the 10-min BAVLT, a 12-word list is presented on three acquisition trials, followed by a distractor list, immediate recall of the first list, and, after a 30-min delay, delayed recall and recognition. In Experiment 1, we analyzed the performance of 195 participants ranging in age from 18 to 82 years. Acquisition trials showed strong primacy and recency effects, with scores improving over repetitions, particularly for mid-list words. Inter-word intervals (IWIs) increased with successive words recalled. Omnibus scores (summed over all trials except recognition) were influenced by age, education, and sex (women outperformed men). In Experiment 2, we examined BAVLT test-retest reliability in 29 participants tested with different word lists at weekly intervals. High intraclass correlation coefficients were seen for omnibus and acquisition scores, IWIs, and a categorization index reflecting semantic reorganization. Experiment 3 examined the performance of Experiment 2 participants when feigning symptoms of traumatic brain injury. Although 37% of simulated malingerers showed abnormal (p < 0.05) omnibus z-scores, z-score cutoffs were ineffective in discriminating abnormal malingerers from control participants with abnormal scores. In contrast, four malingering indices (recognition scores, primacy/recency effects, learning rate across acquisition trials, and IWIs) discriminated the two groups with 80% sensitivity and 80% specificity. Experiment 4 examined the performance of a small group of patients with mild or severe TBI. Overall, both patient groups performed within the normal range, although significant performance deficits were seen in some patients. The BAVLT improves the speed and replicability of verbal learning assessments while providing comprehensive measures of retrieval timing, semantic organization, and primacy/recency effects that clarify the nature of performance. PMID:28127280

Power and sample size evaluation for the Cochran-Mantel-Haenszel mean score (Wilcoxon rank sum) test and the Cochran-Armitage test for trend.

PubMed

Lachin, John M

2011-11-10

The power of a chi-square test, and thus the required sample size, are a function of the noncentrality parameter that can be obtained as the limiting expectation of the test statistic under an alternative hypothesis specification. Herein, we apply this principle to derive simple expressions for two tests that are commonly applied to discrete ordinal data. The Wilcoxon rank sum test for the equality of distributions in two groups is algebraically equivalent to the Mann-Whitney test. The Kruskal-Wallis test applies to multiple groups. These tests are equivalent to a Cochran-Mantel-Haenszel mean score test using rank scores for a set of C-discrete categories. Although various authors have assessed the power function of the Wilcoxon and Mann-Whitney tests, herein it is shown that the power of these tests with discrete observations, that is, with tied ranks, is readily provided by the power function of the corresponding Cochran-Mantel-Haenszel mean scores test for two and R > 2 groups. These expressions yield results virtually identical to those derived previously for rank scores and also apply to other score functions. The Cochran-Armitage test for trend assesses whether there is an monotonically increasing or decreasing trend in the proportions with a positive outcome or response over the C-ordered categories of an ordinal independent variable, for example, dose. Herein, it is shown that the power of the test is a function of the slope of the response probabilities over the ordinal scores assigned to the groups that yields simple expressions for the power of the test. Copyright © 2011 John Wiley & Sons, Ltd.

Applying novel nutrient drink to clinical trial of functional dyspepsia.

PubMed

Lim, Chul-Hyun; Choi, Myung-Gyu; Baeg, Myong Ki; Moon, Sung Jin; Kim, Jin Su; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Kyu Yong

2014-04-30

The drink test has been regarded as a surrogate marker of gastric accommodation. The aims of this study were to develop a novel nutrient drink test (NDT) protocol and investigate its potential for application to a clinical trial of functional dyspepsia (FD). A novel NDT was designed, involving drinking 125 mL of nutrient 4 times at 5-minute intervals or until maximal tolerability. Healthy volunteers and patients with FD rated their symptoms every 5 minutes for 20 minutes in a developmental study. Patients with FD were enrolled in an open trial of itopride for 4 weeks. NDT was performed before and after treatment. Improvement of integrative symptoms score during NDT after treatment for more than 50% compared with baseline was de-fined as responder. Total aggregate symptom scores, sum of symptom scores measured during NDT, were higher in FD patients (n = 40, 368.1 ± 245.3) than in controls (n = 19, 215.9 ± 171.2) (P = 0.018) in a developmental study. In an open trial of itopride, symp-tom scores measured during NDT decreased significantly at all time points after treatment in responders (n = 49), whereas did not in non-responders (n = 25). Total aggregate symptom score for NDT correlated significantly with integrative dyspeptic symptom score, sum of 8 symptom scores of NDI questionnaire, at baseline (r = 0.374, P = 0.001) and after treatment (r = 0.480, P ＜ 0.001). Our novel NDT can quantify dyspeptic symptoms and reflected therapeutic effects of itopride treatment in a clinical trial of FD patients. This NDT can be used as an effective parameter in clinical trials or drug development programs for assessing effects of novel therapies on postprandial symptoms.

Applying Novel Nutrient Drink to Clinical Trial of Functional Dyspepsia

PubMed Central

Lim, Chul-Hyun; Choi, Myung-Gyu; Baeg, Myong Ki; Moon, Sung Jin; Kim, Jin Su; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Kyu Yong

2014-01-01

Background/Aims The drink test has been regarded as a surrogate marker of gastric accommodation. The aims of this study were to develop a novel nutrient drink test (NDT) protocol and investigate its potential for application to a clinical trial of functional dyspepsia (FD). Methods A novel NDT was designed, involving drinking 125 mL of nutrient 4 times at 5-minute intervals or until maximal tolerability. Healthy volunteers and patients with FD rated their symptoms every 5 minutes for 20 minutes in a developmental study. Patients with FD were enrolled in an open trial of itopride for 4 weeks. NDT was performed before and after treatment. Improvement of integrative symptoms score during NDT after treatment for more than 50% compared with baseline was defined as responder. Results Total aggregate symptom scores, sum of symptom scores measured during NDT, were higher in FD patients (n = 40, 368.1 ± 245.3) than in controls (n = 19, 215.9 ± 171.2) (P = 0.018) in a developmental study. In an open trial of itopride, symptom scores measured during NDT decreased significantly at all time points after treatment in responders (n = 49), whereas did not in non-responders (n = 25). Total aggregate symptom score for NDT correlated significantly with integrative dyspeptic symptom score, sum of 8 symptom scores of NDI questionnaire, at baseline (r = 0.374, P = 0.001) and after treatment (r = 0.480, P < 0.001). Conclusions Our novel NDT can quantify dyspeptic symptoms and reflected therapeutic effects of itopride treatment in a clinical trial of FD patients. This NDT can be used as an effective parameter in clinical trials or drug development programs for assessing effects of novel therapies on postprandial symptoms. PMID:24840374

The sum of all fears: conceptual challenges with measuring fear of cancer recurrence.

PubMed

Costa, Daniel S J; Smith, Allan Ben; Fardell, Joanna E

2016-01-01

Fear of cancer recurrence (FCR) is increasingly recognised as a major concern for people with cancer once active treatment is completed. Several instruments have been designed to assess FCR; however, no gold standard has emerged. Many instruments conceptualise FCR as a multidimensional construct. However, this potentially conflates FCR as an outcome with its antecedents and consequences. This is problematic when an aggregate of distinct dimensions is calculated, as is commonly recommended. For example, the total score on the Fear of Cancer Recurrence Inventory is an aggregate of items from seven sub-scales: triggers, severity, psychological distress, coping strategies, functioning impairments, insight and reassurance. Similarly, the total score on the Fear of Progression Questionnaire is an aggregate of affective reaction, partnership/family, work and loss of autonomy. Arguably, the severity and affective reaction domains represent fear, and the other sub-scales represent related concepts, rather than "dimensions" of FCR. The total score represents a combination of concepts whose meaning is unclear. The same total score could be produced by patients with very different experiences, and patients with the same level of fear could have very different total scores. Therefore, we argue that although the level of FCR may be determined by a complex network of antecedents and modifiers and have variable consequences, FCR itself may be a simple concept, which can be assessed using a smaller number of items. Conceptual clarity in its research infancy should prevent FCR becoming a construct that is vaguely operationalised and interpreted.

Articular cartilage scores in cranial cruciate ligament-deficient dogs with or without bucket handle tears of the medial meniscus.

PubMed

Kaufman, Kathryn; Beale, Brian S; Thames, Howard D; Saunders, W Brian

2017-01-01

To compare articular cartilage scores in cranial cruciate ligament (CCL)-deficient dogs with or without concurrent bucket handle tears (BHT) of the medial meniscus. Retrospective case series. Client-owned dogs treated with arthroscopy and tibial plateau leveling osteotomy or extracapsular repair for complete CCL rupture (290 stifles from 264 dogs). Medical records and arthroscopic images were reviewed. Medial femoral condyle (MFC) and medial tibial plateau (MTP) cartilage was scored using the modified Outerbridge scale. Periarticular osteophytosis (PAO) and injury to the medial meniscus were recorded. Data were analyzed using Student's t-tests, Wilcoxon rank-sum test, and Fisher's exact test for changes in the stifle based on meniscal condition, body weight, and duration of lameness. PAO, MFC, and MTP articular cartilage scores were not significantly different in dogs with or without BHT. There were no significant differences in MFC or MTP scores when dogs were evaluated based on bodyweight and the presence or absence of a BHT. However, PAO formation was significantly increased in dogs weighing >13.6 kg and concurrent meniscal injury vs. dogs weighing <13.6 kg and concurrent meniscal injury (P < .001). Significantly more stifles with chronic lameness (40 of 89; 44.9%) had the highest PAO score of 2 reported compared to only 42 of 182 stifles (23.1%) with acute lameness (P < .001). The presence of a BHT of the medial meniscus was not associated with more severe arthroscopic articular cartilage lesions in the medial joint compartment at the time of surgery. © 2016 The American College of Veterinary Surgeons.

Optimizing EEMCO guidance for the assessment of dry skin (xerosis) for pharmacies.

PubMed

Kang, B C; Kim, Y E; Kim, Y J; Chang, M J; Choi, H D; Li, K; Shin, W G

2014-02-01

People with dry skin (xerosis) are common in community pharmacies, but there is no consistent guidance for community pharmacists to evaluate and alleviate dry skin. Through evaluating any difference of the clinical scoring systems of EEMCO guidance between a dermatologist and pharmacists and the efficacy of moisturizers for the treatment of dry skin recommended by community pharmacists, we aim to validate a dry skin guidance through the help of community pharmacists. These results provide insight into how community pharmacists can help patients with dry skin. The clinical scoring systems of EEMCO guidance used in this study comprised analog scales, the overall dry skin score (ODS), and the specific symptom sum score (SRRC) system. All pictures of the dry skin scored by pharmacists were visually evaluated by a dermatologist. The efficacy of the moisturizers was determined by the difference of the scales on day 0 and on day 28. In this study, 387 patients with dry skin from 157 community pharmacies were evaluated by pharmacists. Visual scale with divisions, ODS and SRRC that were evaluated by pharmacists on day 0 and day 28 were moderately reliable by a dermatologist. All parameters of dry skin were significantly improved by the moisturizers which were recommended by community pharmacists on day 28. Visual scale, ODS and SRRC can be generally measured to evaluate dry skin in community pharmacies with moderate degree of reliability. This finding has possible applications for investigating the assessment of the community pharmacists on clinical scoring system of dry skin and moisturizers. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Baltic Sea Diet Score: a tool for assessing healthy eating in Nordic countries.

PubMed

Kanerva, Noora; Kaartinen, Niina E; Schwab, Ursula; Lahti-Koski, Marjaana; Männistö, Satu

2014-08-01

The health-related effects of the Nordic diet remain mostly unidentified. We created a Baltic Sea Diet Score (BSDS) for epidemiological research to indicate adherence to a healthy Nordic diet. We examined associations between the score and nutrient intakes that are considered important in promoting public health. We also examined the performance of the BSDS under two different cut-off strategies. The cross-sectional study included two phases of the National FINRISK 2007 Study. Diet was assessed using a validated FFQ. Food and nutrient intakes were calculated using in-house software. Nine components were selected for the score. Each component was scored according to both sex-specific consumption quartiles (BSDS-Q) and medians (BSDS-M), and summed to give the final score values. A large representative sample of the Finnish population. Men (n 2217) and women (n 2493) aged 25 to 74 years. In the age- and energy-adjusted model, adherence to the diet was associated with a higher intake of carbohydrates (E%), and lower intakes of SFA (E%) and alcohol (E%, where E% is percentage of total energy intake; P < 0·01). Furthermore, the intakes of fibre, Fe, vitamins A, C and D, and folate were higher among participants who adhered to the diet (P < 0·05). After further adjustments, the results remained significant (P < 0·05) and did not differ remarkably between BSDS-Q and BSDS-M. The BSDS can be used as a measure of a healthy Nordic diet to assess diet-health relationships in public health surveys in Nordic countries.

Comparison of oral robenacoxib and carprofen for the treatment of osteoarthritis in dogs: a randomized clinical trial.

PubMed

Edamura, Kazuya; King, Jonathan N; Seewald, Wolfgang; Sakakibara, Nobuhiro; Okumura, Masahiro

2012-09-01

The efficacy and tolerability of robenacoxib for the treatment of osteoarthritis in dogs were evaluated in a prospective, multicenter, randomized, noninferiority design clinical trial. A total of 32 dogs presenting with osteoarthritis were allocated randomly to receive, orally once daily for 28 days, either 1-2 mg/kg robenacoxib (n=21) or 3.5-5 mg/kg carprofen (n=11). Dogs were assessed by clinicians and owners using numerical rating scale scores at baseline and days 14 and 28. The primary efficacy endpoint was the global functional disability score, which was the sum of clinician scores for standing posture, lameness at walk, lameness at trot, willingness to raise the contralateral limb and pain at palpation. There was a good to excellent level of efficacy in both treatment groups. Differences between days 14 and 28 compared to day 0 were significant for all 11 clinician and owner scores for robenacoxib, and for 6 of 11 scores for carprofen. The efficacy of robenacoxib was numerically superior to carprofen for all 13 endpoints, but differences were not statistically significant. For the global functional disability score, the estimated efficacy of robenacoxib was 1.244 (95% confidence interval 0.555-2.493) relative to carprofen. The tolerability of both treatments was good as assessed from adverse events, clinical signs, and hematology and serum biochemistry variables. In conclusion, once daily administration of robenacoxib tablets had noninferior efficacy and tolerability compared to carprofen for the treatment of the clinical signs of osteoarthritis in dogs.

Quantitative analysis of the text and graphic content in ophthalmic slide presentations.

PubMed

Ing, Edsel; Celo, Erdit; Ing, Royce; Weisbrod, Lawrence; Ing, Mercedes

2017-04-01

To determine the characteristics of ophthalmic digital slide presentations. Retrospective quantitative analysis. Slide presentations from a 2015 Canadian primary eye care conference were analyzed for their duration, character and word count, font size, words per minute (wpm), lines per slide, words per slide, slides per minute (spm), text density product (wpm × spm), proportion of graphic content, and Flesch Reading Ease (FRE) score using Microsoft PowerPoint and Word. The median audience evaluation score for the lectures was used to dichotomize the higher scoring lectures (HSL) from the lower scoring lectures (LSL). A priori we hypothesized that there would be a difference in the wpm, spm, text density product, and FRE score between HSL and LSL. Wilcoxon rank-sum tests with Bonferroni correction were utilized. The 17 lectures had medians of 2.5 spm, 20.3 words per slide, 5.0 lines per slide, 28-point sans serif font, 36% graphic content, and text density product of 136.4 words × slides/minute 2 . Although not statistically significant, the HSL had more wpm, fewer words per slide, more graphics per slide, greater text density, and higher FRE score than LSL. There was a statistically significant difference in the spm of the HSL (3.1 ± 1.0) versus the LSL (2.2 ± 1.0) at p = 0.0124. All presenters showed more than 1 slide per minute. The HSL showed more spm than the LSL. The descriptive statistics from this study may aid in the preparation of slides used for teaching and conferences. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Identifying best-fitting inputs in health-economic model calibration: a Pareto frontier approach.

PubMed

Enns, Eva A; Cipriano, Lauren E; Simons, Cyrena T; Kong, Chung Yin

2015-02-01

To identify best-fitting input sets using model calibration, individual calibration target fits are often combined into a single goodness-of-fit (GOF) measure using a set of weights. Decisions in the calibration process, such as which weights to use, influence which sets of model inputs are identified as best-fitting, potentially leading to different health economic conclusions. We present an alternative approach to identifying best-fitting input sets based on the concept of Pareto-optimality. A set of model inputs is on the Pareto frontier if no other input set simultaneously fits all calibration targets as well or better. We demonstrate the Pareto frontier approach in the calibration of 2 models: a simple, illustrative Markov model and a previously published cost-effectiveness model of transcatheter aortic valve replacement (TAVR). For each model, we compare the input sets on the Pareto frontier to an equal number of best-fitting input sets according to 2 possible weighted-sum GOF scoring systems, and we compare the health economic conclusions arising from these different definitions of best-fitting. For the simple model, outcomes evaluated over the best-fitting input sets according to the 2 weighted-sum GOF schemes were virtually nonoverlapping on the cost-effectiveness plane and resulted in very different incremental cost-effectiveness ratios ($79,300 [95% CI 72,500-87,600] v. $139,700 [95% CI 79,900-182,800] per quality-adjusted life-year [QALY] gained). Input sets on the Pareto frontier spanned both regions ($79,000 [95% CI 64,900-156,200] per QALY gained). The TAVR model yielded similar results. Choices in generating a summary GOF score may result in different health economic conclusions. The Pareto frontier approach eliminates the need to make these choices by using an intuitive and transparent notion of optimality as the basis for identifying best-fitting input sets. © The Author(s) 2014.

Identifying best-fitting inputs in health-economic model calibration: a Pareto frontier approach

PubMed Central

Enns, Eva A.; Cipriano, Lauren E.; Simons, Cyrena T.; Kong, Chung Yin

2014-01-01

Background To identify best-fitting input sets using model calibration, individual calibration target fits are often combined into a single “goodness-of-fit” (GOF) measure using a set of weights. Decisions in the calibration process, such as which weights to use, influence which sets of model inputs are identified as best-fitting, potentially leading to different health economic conclusions. We present an alternative approach to identifying best-fitting input sets based on the concept of Pareto-optimality. A set of model inputs is on the Pareto frontier if no other input set simultaneously fits all calibration targets as well or better. Methods We demonstrate the Pareto frontier approach in the calibration of two models: a simple, illustrative Markov model and a previously-published cost-effectiveness model of transcatheter aortic valve replacement (TAVR). For each model, we compare the input sets on the Pareto frontier to an equal number of best-fitting input sets according to two possible weighted-sum GOF scoring systems, and compare the health economic conclusions arising from these different definitions of best-fitting. Results For the simple model, outcomes evaluated over the best-fitting input sets according to the two weighted-sum GOF schemes were virtually non-overlapping on the cost-effectiveness plane and resulted in very different incremental cost-effectiveness ratios ($79,300 [95%CI: 72,500 – 87,600] vs. $139,700 [95%CI: 79,900 - 182,800] per QALY gained). Input sets on the Pareto frontier spanned both regions ($79,000 [95%CI: 64,900 – 156,200] per QALY gained). The TAVR model yielded similar results. Conclusions Choices in generating a summary GOF score may result in different health economic conclusions. The Pareto frontier approach eliminates the need to make these choices by using an intuitive and transparent notion of optimality as the basis for identifying best-fitting input sets. PMID:24799456

Clinical predictors of older driver performance on a standardized road test.

PubMed

Classen, Sherrilene; Horgas, Ann; Awadzi, Kezia; Messinger-Rapport, Barbara; Shechtman, Orit; Joo, Yongsung

2008-10-01

To determine the relationship between clinical variables (demographics, cognitive testing, comorbidities, and medications) and failing a standardized road test in older adults. Analysis of on-the road studies performed in optimal weather conditions, between January 1, 2005, and May 1, 2007. The standardized testing was held at the National Older Driver Research and Training Center (NODRTC), Florida, and included 127 adults aged 65 and older with current driver licenses, recruited by advertisement from the Gainesville, Florida, community. Measurements consist of demographics, self-reported medications and medical conditions, cognitive testing including Trail Making Part B, global rating score (pass/fail), and driver maneuver score (0-273, with 273 indicating perfect driving or zero errors). A total of 127 older adults completed the protocol. Mean age was 74.8 years (SD = 6.3); 46.5% females. Mean time for Trail Making Part B was 114.3 seconds (SD of 83). Among the 127 drivers, the mean Sum of Maneuvers Score was 238.9 (SD of 25.0) and 24 (19%) failed the driver test. Odds ratio estimates for failing the test included advanced age (6.7, 95% CI 2.2 to 19.8), presence of a neurological disease (2.8, 95% CI 1.2 to 6.5), and prolonged time to complete the Trail Making Part B cognitive test (2.5, 95% CI 1.0 to 5.9). Conversely, odds ratio estimates lowering the risk of failure included taking a non-diabetic hormonal medications (e.g., thyroid and estrogen drugs; 0.3, 95% CI .09 to 0.7) and having a musculoskeletal diagnosis (0.3, 95% CI .1 to 0.7). To our knowledge, this is the first study to examine the medical predictors of failing a standardized road test. Advanced age and prolonged time on Trail Making Part B were the two major predictors of test failure and a lower Sum of Maneuvers Score. Our study also found that having a neurological diagnosis (primarily cerebrovascular and Parkinson's disease) predicted test failure. Medications from neurological class also predicted a lower Sum of Maneuvers Score. Further study needs to be done to explain the apparent protective effect of musculoskeletal conditions and hormonal medications.

International Comparisons of the Dysregulation Profile Based on Reports by Parents, Adolescents, and Teachers.

PubMed

Rescorla, Leslie A; Blumenfeld, Mary C; Ivanova, Masha Y; Achenbach, Thomas M; International Aseba Consortium

2018-06-14

Our objective was to examine international similarities and differences in the Dysregulation Profile (DP) of the Child Behavior Checklist (CBCL), Teacher's Report Form (TRF), and Youth Self-Report (YSR) via comparisons of data from many societies. Primary samples were those studied by Rescorla et al. (2012): CBCL: N = 69,866, 42 societies; YSR: N = 38,070, 34 societies; TRF: N = 37,244, 27 societies. Omnicultural Q correlations of items composing the DP (from the Anxious/Depressed, Attention Problems, and Aggressive Behavior syndromes) indicated considerable consistency across diverse societies with respect to which of the DP items tended to receive low, medium, or high ratings, whether ratings were provided by parents (M Q = .70), adolescents (M Q = .72), or teachers (M Q = .68). Omnicultural mean item ratings indicated that, for all 3 forms, the most common items on the DP reflect a mix of problems from all 3 constituent scales. Cross-informant analyses for the CBCL-YSR and CBCL-TRF supported these results. Aggregated DP scores, derived by summing ratings on all DP items, varied significantly by society. Age and gender differences were minor for all 3 forms, but boys scored higher than girls on the TRF. Many societies differing in ethnicity, religion, political/economic system, and geographical region manifested very similar DP scores. The most commonly reported DP problems reflected the mixed symptom picture of the DP, with dysregulation in mood, attention, and aggression. Overall, societies were more similar than different on DP scale scores and item ratings.

Development and Application of a Plant-Based Diet Scoring System for Japanese Patients with Inflammatory Bowel Disease

PubMed Central

Chiba, Mitsuro; Nakane, Kunio; Takayama, Yuko; Sugawara, Kae; Ohno, Hideo; Ishii, Hajime; Tsuda, Satoko; Tsuji, Tsuyotoshi; Komatsu, Masafumi; Sugawara, Takeshi

2016-01-01

Context Plant-based diets (PBDs) are a healthy alternative to westernized diets. A semivegetarian diet, a PBD, has been shown to prevent a relapse in Crohn disease. However, there is no way to measure adherence to PBDs. Objective To develop a simple way of evaluating adherence to a PBD for Japanese patients with inflammatory bowel disease (IBD). Design PBD scores were assigned according to the frequency of consumption provided on a food-frequency questionnaire, obtained on hospitalization for 159 patients with ulcerative colitis and 70 patients with Crohn disease. Eight items considered to be preventive factors for IBD were scored positively, and 8 items considered to be IBD risk factors were scored negatively. The PBD score was calculated from the sum of plus and minus scores. Higher PBD scores indicated greater adherence to a PBD. The PBD scores were evaluated on hospitalization and 2 years after discharge for 22 patients with Crohn disease whose dietary pattern and prognosis were established. Main Outcome Measure Plant-Based Diet score. Results The PBD scores differed significantly, in descending order, by dietary type: pro-Japanese diet, mixed type, and pro-westernized diet (Wilcoxon/Kruskal-Wallis test). The PBD scores in the ulcerative colitis and Crohn disease groups were 10.9 ± 9.5 and 8.2 ± 8.2, respectively. For patients with Crohn disease, those with long-term remission and normal C-reactive protein concentration were significantly more likely to have PBD scores of 25 or greater than below 25 (χ2). Conclusion The PBD score is a valid assessment of PBD dietary adherence. PMID:27768566

Relationships between depression, anxiety, and pain in a group of university music students.

PubMed

Wristen, Brenda W; Fountain, Sarah E

2013-09-01

There is emerging interest in studying the incidence of music-related injuries and problems among students. The current study drew on a data set collected from 287 music majors and minors at a large US midwestern university school of music in order to determine if correlations existed between anxiety and/or depression and the reported presence of physical pain, and to understand the nature of any such relationships. Physical pain symptoms were scored on a scale of 0 (none) to 10 (excruciating) and summed across 21 body regions. Depression and anxiety symptoms were scored as none (0), mild (1), moderate (2), or severe (3), and each summed across either 13 symptoms for depression or 8 symptoms for anxiety. The potential linear relationship among these variables was evaluated using F-tests (as part of ANOVAs) and linear regression parameter estimation techniques. The explanatory value of these relationships was evaluated using R² values. Results indicate a clear positive linear relationship between both depression and pain, and anxiety and pain. However, the presence of depression and/or anxiety symptoms was insufficient to explain variability in pain scores of these participants.

Adolescent Trajectories of Aerobic Fitness and Adiposity as Markers of Cardiometabolic Risk in Adulthood.

PubMed

Jackowski, S A; Eisenmann, J C; Sherar, L B; Bailey, D A; Baxter-Jones, A D G

2017-01-01

The aim of this study was to investigate whether adolescent growth trajectories of aerobic fitness and adiposity were associated with mid-adulthood cardiometabolic risk (CMR). Participants were drawn from the Saskatchewan Growth and Development Study (1963-1973). Adolescent growth trajectories for maximal aerobic capacity (absolute VO 2 (AbsVO 2 )), skinfolds (SF), representing total body (Sum6SF) and central adiposity (TrunkSF), and body mass index (BMI) were determined from 7 to 17 years of age. In mid-adulthood (40 to 50 years of age), 61 individuals (23 females) returned for follow-ups. A CMR score was calculated to group participants as displaying either high or a low CMR. Multilevel hierarchical models were constructed, comparing the adolescent growth trajectories of AbsVO 2, Sum6SF, TrunkSF, and BMI between CMR groupings. There were no significant differences in the adolescent development of AbsVO 2, Sum6SF, TrunkSF, and BMI between adult CMR groupings ( p > 0.05). Individuals with high CMR accrued 62% greater adjusted total body fat percentage from adolescence to adulthood ( p =0.03). Growth trajectories of adolescent aerobic fitness and adiposity do not appear to be associated with mid-adulthood CMR. Individuals should be encouraged to participate in behaviours that promote healthy aerobic fitness and adiposity levels throughout life to reduce lifelong CMR.

Adolescent Trajectories of Aerobic Fitness and Adiposity as Markers of Cardiometabolic Risk in Adulthood

PubMed Central

Eisenmann, J. C.; Sherar, L. B.; Bailey, D. A.; Baxter-Jones, A. D. G.

2017-01-01

Purpose The aim of this study was to investigate whether adolescent growth trajectories of aerobic fitness and adiposity were associated with mid-adulthood cardiometabolic risk (CMR). Methods Participants were drawn from the Saskatchewan Growth and Development Study (1963–1973). Adolescent growth trajectories for maximal aerobic capacity (absolute VO2 (AbsVO2)), skinfolds (SF), representing total body (Sum6SF) and central adiposity (TrunkSF), and body mass index (BMI) were determined from 7 to 17 years of age. In mid-adulthood (40 to 50 years of age), 61 individuals (23 females) returned for follow-ups. A CMR score was calculated to group participants as displaying either high or a low CMR. Multilevel hierarchical models were constructed, comparing the adolescent growth trajectories of AbsVO2, Sum6SF, TrunkSF, and BMI between CMR groupings. Results There were no significant differences in the adolescent development of AbsVO2, Sum6SF, TrunkSF, and BMI between adult CMR groupings (p > 0.05). Individuals with high CMR accrued 62% greater adjusted total body fat percentage from adolescence to adulthood (p=0.03). Conclusions Growth trajectories of adolescent aerobic fitness and adiposity do not appear to be associated with mid-adulthood CMR. Individuals should be encouraged to participate in behaviours that promote healthy aerobic fitness and adiposity levels throughout life to reduce lifelong CMR. PMID:29279776

Randomized trial investigating zirconia electroplated telescopic retainers: quality of life outcomes.

PubMed

Schwindling, Franz Sebastian; Deisenhofer, Ulrich Karl; Séché, Anne-Christiane; Lehmann, Franziska; Rammelsberg, Peter; Stober, Thomas

2017-05-01

The study aims to evaluate the effect of electroplated telescopic removable dental prostheses (E-RDPs) with zirconia primary crowns on oral-health-related quality of life (OHRQoL). For E-RDPs, electroplating is used to produce precisely fitting gold copings on telescopic primary crowns. These copings are bonded intra-orally to the denture framework. Fifty-six participants in need of 60 removable restorations were randomly allocated one of two materials for the primary crowns: cobalt-chromium alloy or zirconia. OHRQoL was assessed by use of the 49-item Oral Health Impact Profile (OHIP-49) and by additional patient self-rating at baseline before treatment, and after 6 and 12 months. Statistical analysis was performed by use of one- and two-sample t-tests and analysis of covariance. Mean OHIP sum score at baseline was 53.4 (SD 37.4, 95 % CI 41.3-62). At follow-ups, it decreased significantly (after 6 months: mean 20, SD 26, 95 % CI 13-27.1; after 12 months: mean 16.4, SD 17.9, 95 % CI 11.6-21.2). The mean reduction in OHIP sum score after 12 months was 25 (SD 31.2, 95 % CI 13.1-36.9) for cobalt-chromium alloy and 44.4 (SD 32.3, 95 % CI 31.1-57.8) for zirconia. However, no statistically significant difference of the two materials on OHIP change or patient self-rating was detected. Although OHRQoL was improved by using both cobalt-chromium alloy and zirconia primary crowns for E-RDPs, post-treatment differences between the groups were not statistically significant. Zirconia E-RDPs enhance OHRQoL. However, zirconia primary crowns do not outperform cobalt-chromium alloy crowns regarding patient satisfaction-despite their tooth-like color.

Rotigotine vs ropinirole in advanced stage Parkinson's disease: a double-blind study.

PubMed

Mizuno, Yoshikuni; Nomoto, Masahiro; Hasegawa, Kazuko; Hattori, Nobutaka; Kondo, Tomoyoshi; Murata, Miho; Takeuchi, Masahiro; Takahashi, Masayoshi; Tomida, Takayuki

2014-12-01

To confirm the superiority of transdermal rotigotine up to 16 mg/24 h over placebo, and non-inferiority to ropinirole, in Japanese Parkinson's disease (PD) patients on concomitant levodopa therapy. This trial was a randomized, double-blind, double-dummy, three-arm parallel group placebo- and ropinirole-controlled trial. Four-hundred and twenty PD patients whose motor symptoms were not well controlled by levodopa treatment were randomized 2:2:1 to receive rotigotine, ropinirole (up to 15 mg/day) or placebo during a 16-week treatment period followed by a 4-week taper period. The primary variable was change in the Unified Parkinson's Disease Rating Scale (UPDRS) Part III (ON state) sum score from baseline to the end of the treatment period. The difference in the change in the UPDRS Part III (ON state) sum score from baseline to the end of treatment between rotigotine and placebo groups was -6.4 ± 1.2 (95% CI: -8.7 to -4.1; p < 0.001), indicating superiority of rotigotine over placebo. The difference between rotigotine and ropinirole groups was -1.4 ± 1.0 (95% CI: -3.2 to 0.5), below the non-inferiority margin, indicating the non-inferiority of rotigotine to ropinirole. Application site reaction was seen in 57.7% of the patients in the rotigotine group and in 18.6% in the ropinirole group (P < 0.001). No other safety issue was noted. Rotigotine was well tolerated at doses up to 16 mg/24 h and showed similar efficacy to ropinirole except that the application site reaction was much higher in the rotigotine group. Copyright © 2014. Published by Elsevier Ltd.

Score distributions of gapped multiple sequence alignments down to the low-probability tail

NASA Astrophysics Data System (ADS)

Fieth, Pascal; Hartmann, Alexander K.

2016-08-01

Assessing the significance of alignment scores of optimally aligned DNA or amino acid sequences can be achieved via the knowledge of the score distribution of random sequences. But this requires obtaining the distribution in the biologically relevant high-scoring region, where the probabilities are exponentially small. For gapless local alignments of infinitely long sequences this distribution is known analytically to follow a Gumbel distribution. Distributions for gapped local alignments and global alignments of finite lengths can only be obtained numerically. To obtain result for the small-probability region, specific statistical mechanics-based rare-event algorithms can be applied. In previous studies, this was achieved for pairwise alignments. They showed that, contrary to results from previous simple sampling studies, strong deviations from the Gumbel distribution occur in case of finite sequence lengths. Here we extend the studies to multiple sequence alignments with gaps, which are much more relevant for practical applications in molecular biology. We study the distributions of scores over a large range of the support, reaching probabilities as small as 10-160, for global and local (sum-of-pair scores) multiple alignments. We find that even after suitable rescaling, eliminating the sequence-length dependence, the distributions for multiple alignment differ from the pairwise alignment case. Furthermore, we also show that the previously discussed Gaussian correction to the Gumbel distribution needs to be refined, also for the case of pairwise alignments.

Direct comparison of rest and adenosine stress myocardial perfusion CT with rest and stress SPECT

PubMed Central

Okada, David R.; Ghoshhajra, Brian B.; Blankstein, Ron; Rocha-Filho, Jose A.; Shturman, Leonid D.; Rogers, Ian S.; Bezerra, Hiram G.; Sarwar, Ammar; Gewirtz, Henry; Hoffmann, Udo; Mamuya, Wilfred S.; Brady, Thomas J.; Cury, Ricardo C.

2010-01-01

Introduction We have recently described a technique for assessing myocardial perfusion using adenosine-mediated stress imaging (CTP) with dual source computed tomography. SPECT myocardial perfusion imaging (SPECT-MPI) is a widely utilized and extensively validated method for assessing myocardial perfusion. The aim of this study was to determine the level of agreement between CTP and SPECT-MPI at rest and under stress on a per-segment, per-vessel, and per-patient basis. Methods Forty-seven consecutive patients underwent CTP and SPECT-MPI. Perfusion images were interpreted using the 17 segment AHA model and were scored on a 0 (normal) to 3 (abnormal) scale. Summed rest and stress scores were calculated for each vascular territory and patient by adding corresponding segmental scores. Results On a per-segment basis (n = 799), CTP and SPECT-MPI demonstrated excellent correlation: Goodman-Kruskall γ = .59 (P < .0001) for stress and .75 (P < .0001) for rest. On a per-vessel basis (n = 141), CTP and SPECT-MPI summed scores demonstrated good correlation: Pearson r = .56 (P < .0001) for stress and .66 (P < .0001) for rest. On a per-patient basis (n = 47), CTP and SPECT-MPI demonstrated good correlation: Pearson r = .60 (P < .0001) for stress and .76 (P < .0001) for rest. Conclusions CTP compares favorably with SPECT-MPI for detection, extent, and severity of myocardial perfusion defects at rest and stress. PMID:19936863

Power analysis to detect treatment effects in longitudinal clinical trials for Alzheimer's disease.

PubMed

Huang, Zhiyue; Muniz-Terrera, Graciela; Tom, Brian D M

2017-09-01

Assessing cognitive and functional changes at the early stage of Alzheimer's disease (AD) and detecting treatment effects in clinical trials for early AD are challenging. Under the assumption that transformed versions of the Mini-Mental State Examination, the Clinical Dementia Rating Scale-Sum of Boxes, and the Alzheimer's Disease Assessment Scale-Cognitive Subscale tests'/components' scores are from a multivariate linear mixed-effects model, we calculated the sample sizes required to detect treatment effects on the annual rates of change in these three components in clinical trials for participants with mild cognitive impairment. Our results suggest that a large number of participants would be required to detect a clinically meaningful treatment effect in a population with preclinical or prodromal Alzheimer's disease. We found that the transformed Mini-Mental State Examination is more sensitive for detecting treatment effects in early AD than the transformed Clinical Dementia Rating Scale-Sum of Boxes and Alzheimer's Disease Assessment Scale-Cognitive Subscale. The use of optimal weights to construct powerful test statistics or sensitive composite scores/endpoints can reduce the required sample sizes needed for clinical trials. Consideration of the multivariate/joint distribution of components' scores rather than the distribution of a single composite score when designing clinical trials can lead to an increase in power and reduced sample sizes for detecting treatment effects in clinical trials for early AD.

Ethics rounds do not improve the handling of ethical issues by psychiatric staff.

PubMed

Silén, Marit; Haglund, Kristina; Hansson, Mats G; Ramklint, Mia

2015-08-01

One way to support healthcare staff in handling ethically difficult situations is through ethics rounds that consist of discussions based on clinical cases and are moderated by an ethicist. Previous research indicates that the handling of ethically difficult situations in the workplace might have changed after ethics rounds. This, in turn, would mean that the "ethical climate", i.e. perceptions of how ethical issues are handled, would have changed. To investigate whether ethics rounds could improve the ethical climate perceived by staff working in psychiatry outpatient clinics. In this quasi-experimental study, six inter-professional ethics rounds led by a philosopher/ethicist were conducted at two psychiatry outpatient clinics. Changes in ethical climate were measured at these clinics as well as at two control clinics at baseline and after the intervention period using the instrument Hospital Ethical Climate Survey. Within-groups comparisons of median sum scores of ethical climate showed that no statistically significant differences were found in the intervention group before or after the intervention period. The median sum scores for ethical climate were significantly higher, both at baseline and after the intervention period (P ≤ 0.001; P = 0.046), in the intervention group. Ethics rounds in psychiatric outpatient clinics did not result in significant changes in ethical climate. Outcomes of ethics rounds might, to a higher degree, be directed towards patient-related outcomes rather than towards the staff's working environment, as the questions brought up for discussion during the ethics rounds concerned patient-related issues.

Oral Health-related Quality of Life in Children and Preadolescents with Caries, Malocclusions or Temporomandibular Disorders.

PubMed

Barbosa, Taís de Souza; Gavião, Maria Beatriz Duarte; Leme, Marina Severi; Castelo, Paula Midori

To compare the oral health-related quality of life (OHRQoL) of children (8- to 10-year-olds) and preadolescents (11- to 14-year-olds) with different oral conditions and to identify concepts associated with their perceptions of oral health (OH) and overall well being (OWB). A cross-sectional study was conducted with 264 students who were distributed into four groups: caries, with the sum of the decayed, missing and filled teeth in the primary (dmft) and permanent dentitions (DMFT) ≥ 1 (n = 72); malocclusion, with the Dental Aesthetic Index (DAI) ≥ 26 (n = 40); temporomandibular disorders (TMD) with at least one sign and one symptom of TMD (n = 89); control, with dmft/DMFT = 0, DAI < 26 and without signs and symptoms of TMD (n = 63). OHRQoL was measured using Portuguese versions of Child Perceptions Questionnaires (CPQ) for children (CPQ8-10) and preadolescents (CPQ11-14). Differences in CPQ scores and in the frequency of responses to global ratings were assessed using Kruskal-Wallis and chi-square/Fisher's exact tests. Multiple linear regression analyses were used to identify items associated with CPQ and global scores. The OHRQoL of the TMD group was statistically different from controls. The malocclusion group reported more oral symptoms and social impacts compared to controls. The variables associated with CPQ scores varied according to clinical condition. OHRQoL was significantly different between clinical groups and controls for both age groups. However, when comparing clinical groups, TMD and caries differed only for preadolescents. The items associated with higher OHRQoL scores were mainly psychosocial for caries and TMD groups, and physical/functional and psychosocial for children and preadolescents with malocclusions, respectively.

Health-related quality of life, personality and choice of coping are related in renal cell carcinoma patients.

PubMed

Beisland, Elisabeth; Beisland, Christian; Hjelle, Karin M; Bakke, August; Aarstad, Anne K H; Aarstad, Hans J

2015-01-01

To investigate whether health-related quality of life (HRQoL) depends on psychosocial factors, rather than on factors related to the cancer treatment, this study explored the associations between HRQoL, personality, choice of coping and clinical parameters in surgically treated renal cell carcinoma (RCC) patients. After exclusions (e.g. death, dementia), 260 patients were found to be eligible and invited to participate. The response rate was 71%. HRQoL was determined by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), personality by the Eysenck Personality Inventory and coping by the COPE Questionnaire. Given tumour treatment, TNM stage and patient-reported comorbidity were also determined. The HRQoL indices were also summarized in general quality of life/health, functional sum and symptom sum scores. EORTC C30 sum scores were negatively associated with the personality trait of neuroticism [common variance (CV) 19-36%]. Avoidant choice of coping inversely accounted for 9-18% of the total HRQoL variance, while reported coping by humour was to some extent negatively associated with HRQoL score (CVmax 4%). Indeed, all of the quality of life indices except for one were significantly negatively correlated with neuroticism and avoidance coping. Patients with low HRQoL due to treatment, secondary to flank or open surgery, reported a closer association between problem-focused choice of coping and HRQoL than the other patients. Moreover, present comorbidities were uniquely associated with a lowered HRQoL. HRQoL is related to treatment-related factors in RCC patients, but shown here to be more strongly associated with psychological factors and present comorbidity. These findings suggest that attention should be paid to supportive treatment of RCC patients.

Development and validation of a new screening questionnaire for dysphagia in early stages of Parkinson's disease.

PubMed

Simons, Janine A; Fietzek, Urban M; Waldmann, Annika; Warnecke, Tobias; Schuster, Tibor; Ceballos-Baumann, Andrés O

2014-09-01

Dysphagia in patients with Parkinson's disease (PD) significantly reduces quality of life and predicted lifetime. Current screening procedures are insufficiently evaluated. We aimed to develop and validate a patient-reported outcome questionnaire for early diagnosis of dysphagia in patients with PD. The two-phased project comprised the questionnaire, diagnostic scales construction (N = 105), and a validation study (N = 82). Data for the project were gathered from PD patients at a German Movement Disorder Center. For validation purposes, a clinical evaluation focusing on swallowing tests, tests of sensory reflexes, and fiberoptic endoscopic evaluation of swallowing (FEES) was performed that yielded a criteria sum score against which the results of the questionnaire were compared. Specificity and sensitivity were evaluated for the detection of noticeable dysphagia and for the risk of aspiration. The Munich Dysphagia Test - Parkinson's disease (MDT-PD) consists of 26 items that show high internal consistency (α = 0.91). For the validation study, 82 patients, aged 70.9 ± 8.7 (mean ± SD), with a median Hoehn & Yahr stage of 3, were assessed. 73% of patients had dysphagia with noticeable oropharyngeal symptoms (44%) or with penetration/aspiration (29%). The criteria sum score correlated positively with the screening result (r = 0.70, p < 0.001). The MDT-PD sum score classified not noticeable dysphagia vs. risk of aspiration (noticeable dysphagia) with a sensitivity of 90% (82%) and a specificity of 86% (71%), and yielded similar results in cross-validation, respectively. MDT-PD is a valid screening tool for early diagnosis of swallowing problems and aspiration risk, as well as initial graduation of dysphagia severity in PD patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

Myocardial scintigraphy using a fatty acid analogue detects coronary artery disease in hemodialysis patients.

PubMed

Nishimura, Masato; Hashimoto, Tetsuya; Kobayashi, Hiroyuki; Fukuda, Toyofumi; Okino, Koji; Yamamoto, Noriyuki; Fujita, Hiroshi; Inoue Tsunehiko Nishimura, Naoto; Ono, Toshihiko

2004-08-01

Coronary artery disease contributes significantly to mortality in end-stage renal disease (ESRD) patients. Single-photon emission computed tomography (SPECT) using an iodinated fatty acid analogue, iodine-123-methyl iodophenylpentadecanoic acid (123I-BMIPP), can assess fatty acid metabolism in the myocardium. We investigated the ability of 123I-BMIPP SPECT to detect coronary artery disease in hemodialysis patients compared with 201thallium chloride (201Tl) SPECT. We prospectively studied 130 ESRD patients undergoing hemodialysis for a mean of 88.6 months (male/female, 77/53; mean age, 63.8 years). Dual SPECT using 123I-BMIPP and 201Tl was performed, followed by coronary angiography. SPECT findings were graded in 17 segments on a five-point scale (0, normal uptake; 4, none) and assessed as a summed score. By coronary angiography, 71.5% of patients (93/130) had significant coronary stenosis (> or =75%), and five patients showed coronary spasm without coronary stenosis. When a BMIPP summed score of 6 or more was defined as abnormal, sensitivity, specificity, and accuracy for detecting coronary artery disease by BMIPP SPECT were 98.0%, 65.6%, and 90.0%, respectively; in contrast, these parameters for detecting coronary artery disease by Tl SPECT were 84.7%, 46.9%, and 75.0%, respectively, when a Tl summed score of 1 or more was defined as abnormal. In receiver operating characteristic analysis, the area under the curve was 0.895 in BMIPP and 0.727 in Tl SPECT, respectively. Resting BMIPP SPECT is superior to Tl SPECT for detecting coronary lesions, and provides safe screening for coronary artery disease among maintenance hemodialysis patients.

Influence of dominant- as compared with nondominant-side symptoms on Disabilities of the Arm, Shoulder and Hand and Western Ontario Rotator Cuff scores in patients with rotator cuff tendinopathy.

PubMed

Christiansen, David Høyrup; Michener, Lori; Roy, Jean-Sébastien

2018-02-13

The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Western Ontario Rotator Cuff (WORC) index are 2 widely used patient-reported questionnaires in individuals with rotator cuff (RC) tendinopathy. In contrast to the WORC index, for which the items are specific to the affected shoulder, the items of the DASH questionnaire assess the ability to perform activities regardless of the arm used. The objective of this study is to determine whether scores on the DASH questionnaire and WORC index are affected if the symptoms are on the dominant or nondominant side in individuals with RC tendinopathy. Given the number of items that can be influenced by dominance, the hypothesis is that DASH scores will be impacted by the side of the symptoms. Individuals with RC tendinopathy (N = 149) completed questions on symptomatology and hand dominance, the DASH questionnaire, and the WORC index. Differences in total scores (independent t test) and single items (Wilcoxon rank sum test) were compared between groups of participants with dominant-side symptoms and those without dominant-side symptoms. No significant differences were observed for WORC or DASH total scores when comparing participants with and without symptoms on their dominant side. Single-item comparison revealed more items being affected by symptom side on the DASH questionnaire (6 of 30 items) than on the WORC index (2 of 21 items). The side of the symptoms does not influence the DASH and WORC total scores, as there are no systematic differences between individuals with and without symptoms in their dominant shoulder. However, the presence of dominant symptoms does influence item scores more on the DASH questionnaire than on the WORC index. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

UAE population reference standard charts for body mass index and skinfold thickness, at ages 0-18 years.

PubMed

Abdulrazzaq, Yousef M; Nagelkerke, Nico; Moussa, Mohamed A

2011-11-01

To determine a range of anthropometric measurements including skinfold thickness measurements in four different areas of the body, to construct population growth charts for body mass index (BMI), skinfolds, and to compare these with growth charts from other countries. One aim was also to validate body fat charts derived from skinfold thickness. A national cross-sectional growth survey of children, 0-18 years old, was conducted using multistage stratified random sampling. The sample size included at least 200 children in each age-sex group. Height, weight, biceps skinfold, triceps skinfold, subscapular skinfold, suprailiac skinfold, and mid-upper-arm circumference were measured in each child. We describe correlation, standard deviation scores relative to the other standards, and calculation of body density in the United Arab Emirates population. We determined whether any of the above is a good indicator of fatness in children. BMI, upper-arm circumference, sum of four skinfolds, and percentage body fat charts were constructed using the LMS method of smoothing. BMI was very significantly correlated with sum of skinfold thicknesses, and mid-upper-arm circumference. Prevalence of obesity and overweight in ages 13-17 years was respectively 9.94% and 15.16% in females and 6.08% and 14.16% in males. Derived body fat charts were found not to be accurate. A national BMI, upper-arm circumference, and sum of four skinfolds chart has been constructed that can be used as a reference standard for the United Arab Emirates. Sum of four skinfold thickness charts can be used as crude determinants of adiposity in children, but derived body fat charts were shown to be inaccurate.

Hepatic encephalopathy before and neurological complications after liver transplantation have no impact on the employment status 1 year after transplantation

PubMed Central

Pflugrad, Henning; Tryc, Anita B; Goldbecker, Annemarie; Strassburg, Christian P; Barg-Hock, Hannelore; Klempnauer, Jürgen; Weissenborn, Karin

2017-01-01

AIM To investigate the impact of hepatic encephalopathy before orthotopic liver transplantation (OLT) and neurological complications after OLT on employment after OLT. METHODS One hundred and fourteen patients with chronic liver disease aged 18-60 years underwent neurological examination to identify neurological complications, neuropsychological tests comprising the PSE-Syndrome-Test yielding the psychometric hepatic encephalopathy score, the critical flicker frequency and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), completed a questionnaire concerning their occupation and filled in the short form 36 (SF-36) to assess health-related quality of life before OLT and 12 mo after OLT, if possible. Sixty-eight (59.6%) patients were recruited before OLT, while on the waiting list for OLT at Hannover Medical School [age: 48.7 ± 10.2 years, 45 (66.2%) male], and 46 (40.4%) patients were included directly after OLT. RESULTS Before OLT 43.0% of the patients were employed. The patients not employed before OLT were more often non-academics (employed: Academic/non-academic 16 (34.0%)/31 vs not employed 10 (17.6%)/52, P = 0.04), had more frequently a history of hepatic encephalopathy (HE) (yes/no; employed 15 (30.6%)/34 vs not employed 32 (49.2%)/33, P = 0.05) and achieved worse results in psychometric tests (RBANS sum score mean ± SD employed 472.1 ± 44.5 vs not employed 443.1 ± 56.7, P = 0.04) than those employed. Ten patients (18.2%), who were not employed before OLT, resumed work afterwards. The patients employed after OLT were younger [age median (range, min-max) employed 47 (42, 18-60) vs not employed 50 (31, 29-60), P = 0.01], achieved better results in the psychometric tests (RBANS sum score mean ± SD employed 490.7 ± 48.2 vs not employed 461.0 ± 54.5, P = 0.02) and had a higher health-related quality of life (SF 36 sum score mean ± SD employed 627.0 ± 138.1 vs not employed 433.7 ± 160.8; P < 0.001) compared to patients not employed after OLT. Employment before OLT (P < 0.001), age (P < 0.01) and SF-36 sum score 12 mo after OLT (P < 0.01) but not HE before OLT or neurological complications after OLT were independent predictors of the employment status after OLT. CONCLUSION HE before and neurological complications after OLT have no impact on the employment status 12 mo after OLT. Instead younger age and employment before OLT predict employment one year after OLT. PMID:28443157

Evaluation of changes in perfusion defect and left ventricular systolic function using Tc-99m Tetrofosmin single photon emission computed tomography over 3 month period in patients of Acute Myocardial Infarction undergoing primary angioplasty.

PubMed

Kumar, Avs Anil; Kumar, P G; Swami, Ajay; Dinker, Yateendra

2018-01-01

After a primary transluminal coronary angioplasty (PTCA) following AMI (acute myocardial infarction), the perfusion defect and LV (left ventricular) function recover/change over a period of time. The analysis immediately after the procedure may not be true depiction of the exact success of the procedure. There is varying and scanty information available on the natural course of changes in these parameters after a successful PTCA. We hypothesized that majority of change occurs at 3-4 month period. Hence, we undertook this study on the natural course of recovery/changes occurring in perfusion defect size and LV function in first 3 months after primary angioplasty MATERIAL AND METHODS: 30 consecutive cases of first AMI who were taken up for Primary angioplasty were enrolled into the study. Resting MPI(Myocardial perfusion imaging) was done within 24-72 hrs of admission using Tc-99m-Tetrofosmin and after 10-14 weeks. Analysis of LVEF (left ventricular ejection fraction), summed segmental score and extent of perfusion defect was done. Images were processed using autocardiac software of emory tool box and quantification was done using QPS (quantitative perfusion SPECT) and QGS (qualitative perfusion SPECT) softwares. 20 segment scoring method was used for quantification on bull's eye images. Student t test (two tailed, dependent) was used to find the significance of study parameters on continuous scale within each group. Effect size was computed to find the effect. Pearson correlation between perfusion defect and LVEF was performed at acute stage and after 10-14 weeks. The average acute perfusion defect extent was 19.76 ± 12.89% which after 3months became 16.79 ± 12.61%. The summed segmental score changed from 14.31 ± 10.58 to 11.38 ± 10.03 and LVEF improved from 48.40 ± 13.15% to 53.37 ± 12.8%. There was significant improvement in LVEF from acute setting to 10-14 weeks (p = 0.001). There was significant lowering of summed score (p = 0.007). Perfusion defect size showed significant reduction (p = 0.030). Three patients showed deterioration in perfusion defect size and in summed score with reduction in LVEF. Four patients had no change in any of the parameters. Correlation between perfusion defect and LVEF was strong both at baseline (r = -0.705, p < 0.001) and after 10-18 weeks (r = -0.766, p < 0.001). The changes we found in 3 months are similar to earlier studies and also to studies using follow up at 6 months to 1 year. We feel that 3 months is a good enough time to accurately assess the success of primary angioplasty.

The Impact of Massage and Reading on Children's Pain and Anxiety After Cardiovascular Surgery: A Pilot Study.

PubMed

Staveski, Sandra L; Boulanger, Karen; Erman, Lee; Lin, Li; Almgren, Christina; Journel, Chloe; Roth, Stephen J; Golianu, Brenda

2018-06-14

The purpose of this pilot study was three-fold: 1) to evaluate the safety and feasibility of instituting massage therapy in the immediate postoperative period after congenital heart surgery, 2) to examine the preliminary results on effects of massage therapy versus standard of care plus three reading visits on postoperative pain and anxiety, and 3) to evaluate preliminary effects of opioid and benzodiazepine exposure in patients receiving massage therapy compared with reading controls. Prospective, randomized controlled trial. An academic children's hospital. Sixty pediatric heart surgery patients between ages 6 and 18 years. Massage therapy and reading. There were no adverse events related to massage or reading interventions in either group. Our investigation found no statistically significant difference in Pain or State-Trait Anxiety scores in the initial 24 hours after heart surgery (T1) and within 48 hours of transfer to the acute care unit (T2) after controlling for age, gender, and Risk Adjustment for Congenital Heart Surgery 1 score. However, children receiving massage therapy had significantly lower State-Trait Anxiety scores after receiving massage therapy at time of discharge (T3; p = 0.0075) than children receiving standard of care plus three reading visits. We found no difference in total opioid exposure during the first 3 postoperative days between groups (median [interquartile range], 0.80 mg/kg morphine equivalents [0.29-10.60] vs 1.13 mg/kg morphine equivalents [0.72-6.14]). In contrast, children receiving massage therapy had significantly lower total benzodiazepine exposure in the immediate 3 days following heart surgery (median [interquartile range], 0.002 mg/kg lorazepam equivalents [0-0.03] vs 0.03 mg/kg lorazepam equivalents [0.02-0.09], p = 0.0253, Wilcoxon rank-sum) and number of benzodiazepine PRN doses (0.5 [0-2.5] PRN vs 2 PRNs (1-4); p = 0.00346, Wilcoxon rank-sum). Our pilot study demonstrated the safety and feasibility of implementing massage therapy in the immediate postoperative period in pediatric heart surgery patients. We found decreased State-Trait Anxiety scores at discharge and lower total exposure to benzodiazepines. Preventing postoperative complications such as delirium through nonpharmacologic interventions warrants further evaluation.

Disease progression model for Clinical Dementia Rating–Sum of Boxes in mild cognitive impairment and Alzheimer’s subjects from the Alzheimer’s Disease Neuroimaging Initiative

PubMed Central

Samtani, Mahesh N; Raghavan, Nandini; Novak, Gerald; Nandy, Partha; Narayan, Vaibhav A

2014-01-01

Background The objective of this analysis was to develop a nonlinear disease progression model, using an expanded set of covariates that captures the longitudinal Clinical Dementia Rating Scale–Sum of Boxes (CDR–SB) scores. These were derived from the Alzheimer’s Disease Neuroimaging Initiative ADNI-1 study, of 301 Alzheimer’s disease and mild cognitive impairment patients who were followed for 2–3 years. Methods The model describes progression rate and baseline disease score as a function of covariates. The covariates that were tested fell into five groups: a) hippocampal volume; b) serum and cerebrospinal fluid (CSF) biomarkers; c) demographics and apolipoprotein Epsilon 4 (ApoE4) allele status; d) baseline cognitive tests; and e) disease state and comedications. Results Covariates associated with baseline disease severity were disease state, hippocampal volume, and comedication use. Disease progression rate was influenced by baseline CSF biomarkers, Trail-Making Test part A score, delayed logical memory test score, and current level of impairment as measured by CDR–SB. The rate of disease progression was dependent on disease severity, with intermediate scores around the inflection point score of 10 exhibiting high disease progression rate. The CDR–SB disease progression rate in a typical patient, with late mild cognitive impairment and mild Alzheimer’s disease, was estimated to be approximately 0.5 and 1.4 points/year, respectively. Conclusions In conclusion, this model describes disease progression in terms of CDR–SB changes in patients and its dependency on novel covariates. The CSF biomarkers included in the model discriminate mild cognitive impairment subjects as progressors and nonprogressors. Therefore, the model may be utilized for optimizing study designs, through patient population enrichment and clinical trial simulations. PMID:24926196

The AIMS65 score compared with the Glasgow-Blatchford score in predicting outcomes in upper GI bleeding.

PubMed

Hyett, Brian H; Abougergi, Marwan S; Charpentier, Joseph P; Kumar, Navin L; Brozovic, Suzana; Claggett, Brian L; Travis, Anne C; Saltzman, John R

2013-04-01

We previously derived and validated the AIMS65 score, a mortality prognostic scale for upper GI bleeding (UGIB). To validate the AIMS65 score in a different patient population and compare it with the Glasgow-Blatchford risk score (GBRS). Retrospective cohort study. Adults with a primary diagnosis of UGIB. inpatient mortality. composite clinical endpoint of inpatient mortality, rebleeding, and endoscopic, radiologic or surgical intervention; blood transfusion; intensive care unit admission; rebleeding; length of stay; timing of endoscopy. The area under the receiver-operating characteristic curve (AUROC) was calculated for each score. Of the 278 study patients, 6.5% died and 35% experienced the composite clinical endpoint. The AIMS65 score was superior in predicting inpatient mortality (AUROC, 0.93 vs 0.68; P < .001), whereas the GBRS was superior in predicting blood transfusions (AUROC, 0.85 vs 0.65; P < .01) The 2 scores were similar in predicting the composite clinical endpoint (AUROC, 0.62 vs 0.68; P = .13) as well as the secondary outcomes. A GBRS of 10 and 12 or more maximized the sum of the sensitivity and specificity for inpatient mortality and rebleeding, respectively. The cutoff was 2 or more for the AIMS65 score for both outcomes. Retrospective, single-center study. The AIMS65 score is superior to the GBRS in predicting inpatient mortality from UGIB, whereas the GBRS is superior for predicting blood transfusion. Both scores are similar in predicting the composite clinical endpoint and other outcomes in clinical care and resource use. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

FOUR Score Predicts Early Outcome in Patients After Traumatic Brain Injury.

PubMed

Nyam, Tee-Tau Eric; Ao, Kam-Hou; Hung, Shu-Yu; Shen, Mei-Li; Yu, Tzu-Chieh; Kuo, Jinn-Rung

2017-04-01

The aim of the study was to determine whether the Full Outline of UnResponsiveness (FOUR) score, which includes eyes opening (E), motor function (M), brainstem reflex (B), and respiratory pattern (R), can be used as an alternate method to the Glasgow Coma Scale (GCS) in predicting intensive care unit (ICU) mortality in traumatic brain injury (TBI) patients. From January 2015 to June 2015, patients with isolated TBI admitted to the ICU were enrolled. Three advanced practice nurses administered the FOUR score, GCS, Acute Physiology and Chronic Health Evaluation II (APACHE II), and Therapeutic Intervention Scoring System (TISS) concurrently from ICU admissions. The endpoint of observation was mortality when the patients left the ICU. Data are presented as frequency with percentages, mean with standard deviation, or median with interquartile range. Each measurement tool used area under the receiver operating characteristic curve to compare the predictive power between these four tools. In addition, the difference between survival and death was estimated using the Wilcoxon rank sum test. From 55 TBI patients, males (72.73 %) were represented more than females, the mean age was 63.1 ± 17.9, and 19 of 55 observations (35 %) had a maximum FOUR score of 16. The overall mortality rate was 14.6 %. The area under the receiver operating characteristic curve was 74.47 % for the FOUR score, 74.73 % for the GCS, 81.78 % for the APACHE II, and 53.32 % for the TISS. The FOUR score has similar predictive power of mortality compared to the GCS and APACHE II. Each of the parameters-E, M, B, and R-of the FOUR score showed a significant difference between mortality and survival group, while the verbal and eye-opening components of the GCS did not. Having similar predictive power of mortality compared to the GCS and APACHE II, the FOUR score can be used as an alternative in the prediction of early mortality in TBI patients in the ICU.

Analytical Determinations of the Phenolic Content of Dissolved Organic Matter

NASA Astrophysics Data System (ADS)

Pagano, T.; Kenny, J. E.

2010-12-01

Indicators suggest that the amount of dissolved organic matter (DOM) in natural waters is increasing. Climate Change has been proposed as a potential contributor to the trend, and under this mechanism, the phenolic content of DOM may also be increasing. We have explored the possibility of assessing the phenolic character of DOM using fluorescence spectroscopy as a more convenient alternative to wet chemistry methods. In this work, parallel factor analysis (PARAFAC) was applied to fluorescence excitation emission matrices (EEMs) of humic samples in an attempt to analyze their phenolic content. The PARAFAC results were correlated with phenol concentrations derived from the Folin-Ciocalteau reagent-based method. The reagent-based method showed that the phenolic content of five International Humic Substance Society (IHSS) DOM samples vary from approximately 5 to 22 ppm Tannic Acid Equivalents (TAE) in phenol concentration. A five-component PARAFAC fit was applied to the EEMs of the IHSS sample dataset and it was determined by PARAFAC score correlations with phenol concentrations from the reagent-based method that components C1 (R2=0.78), C4 (R2=0.82), and C5 (R2=0.88) have the highest probability of containing phenolic groups. Furthermore, when the scores of components C4 and C5 were summed, the correlation improved (R2=0.99). Likewise, when the scores of C1, C4, and C5 were summed, their correlations were stronger than their individual parts (R2=0.89). Since the reagent-based method is providing an indicator of “total phenol” amount, regardless of the exact molecular structure of C1, C4, and C5, it seems reasonable that each of these components individually contributes a portion to the summed “total phenol” profile, and that the sum of their phenol-related spectral parts represents a larger portion of the “total phenol” index. However, when the sum of all five components were plotted against the reagent-based phenol concentrations, due to the considerable impact of largely non-phenolic components C2 (R2=0.23) and C3 (R2=0.35), the correlation was quite poor (or no correlation at all with R2=0.10). The results show the potential for PARAFAC analysis of multidimensional fluorescence data to be a tool for monitoring the phenolic content of DOM. Applications include assessing the potential for formation of disinfection byproducts in the treatment of drinking water and monitoring the impact of Climate Change on the phenolic character of DOM.

Investigating diagnostic bias in autism spectrum conditions: An item response theory analysis of sex bias in the AQ-10.

PubMed

Murray, Aja Louise; Allison, Carrie; Smith, Paula L; Baron-Cohen, Simon; Booth, Tom; Auyeung, Bonnie

2017-05-01

Diagnostic bias is a concern in autism spectrum conditions (ASC) where prevalence and presentation differ by sex. To ensure that females with ASC are not under-identified, it is important that ASC screening tools do not systematically underestimate autistic traits in females relative to males. We evaluated whether the AQ-10, a brief screen for ASC recommended by the National Institute of Clinical Excellence in cases of suspected ASC, exhibits such a bias. Using an item response theory approach, we evaluated differential item functioning and differential test functioning. We found that although individual items showed some sex bias, these biases at times favored males and at other times favored females. Thus, at the level of test scores the item-level biases cancelled out to give an unbiased overall score. Results support the continued use of the AQ-10 sum score in its current form; however, suggest that caution should be exercised when interpreting responses to individual items. The nature of the item level biases could serve as a guide for future research into how ASC affects males and females differently. Autism Res 2017, 10: 790-800. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

The Effect of Spinal Tap Test on Different Sensory Modalities of Postural Stability in Idiopathic Normal Pressure Hydrocephalus.

PubMed

Abram, Katrin; Bohne, Silvia; Bublak, Peter; Karvouniari, Panagiota; Klingner, Carsten M; Witte, Otto W; Guntinas-Lichius, Orlando; Axer, Hubertus

2016-01-01

Postural instability in patients with normal pressure hydrocephalus (NPH) is a most crucial symptom leading to falls with secondary complications. The aim of the current study was to evaluate the therapeutic effect of spinal tap on postural stability in these patients. Seventeen patients with clinical symptoms of NPH were examined using gait scale, computerized dynamic posturography (CDP), and neuropsychological assessment. Examinations were done before and after spinal tap test. The gait score showed a significant improvement 24 h after spinal tap test in all subtests and in the sum score (p < 0.003), while neuropsychological assessment did not reveal significant differences 72 h after spinal tap test. CDP showed significant improvements after spinal tap test in the Sensory Organization Tests 2 (p = 0.017), 4 (p = 0.001), and 5 (p = 0.009) and the composite score (p = 0.01). Patients showed best performance in somatosensory and worst performance in vestibular dominated tests. Vestibular dominated tests did not improve significantly after spinal tap test, while somatosensory and visual dominated tests did. Postural stability in NPH is predominantly affected by deficient vestibular functions, which did not improve after spinal tap test. Conditions which improved best were mainly independent from visual control and are based on proprioceptive functions.

[Be in role. Examination of dissociative experiences of theatrical actors].

PubMed

Docsa, Viktória Pálma; Szemán-Nagy, Anita

2012-01-01

In spite of the fact that acting makes great demands on the personality, there is lack of research dealing with the psychological status of actors. Resulted from their profession actors often experience dissociation, since absorption and changing of their identity is a routine task for them. They are acting on the stage, and they are acting in private. 36 theatrical actors completed the DISQ-H version of the Dissociation Questionnaire measuring four subscales: Identity Confusion, Amnesia, Loss of Control and Absorption. In order to understand their experiences deeper, nine actors were interviewed. The sample consisted of 21 men and 15 women and their ages ranged from 23 to 60. Higher ages implied longer career as an actor, thus the youngest subject had been working for 2 years, while the oldest one had been working for 39 years. DISQ-H total score results of the actors were significantly higher compared to the Hungarian standard scores. As we expected, the two non-pathological subscales (Loss of Control and Absorption) showed significant differences compared to the standard scores of the subscales. In the case of Identity Confusion subscale we found no significant differences, however the results indicate that the tendency observed emphasizes the importance of further research of this phenomenon. To sum up, dissociative experiences proved to be important elements of acting.

Do medical student stress, health, or quality of life foretell step 1 scores? A comparison of students in traditional and revised preclinical curricula.

PubMed

Tucker, Phebe; Jeon-Slaughter, Haekyung; Sener, Ugur; Arvidson, Megan; Khalafian, Andrey

2015-01-01

We explored the theory that measures of medical students' well-being and stress from different types of preclinical curricula are linked with performance on standardized assessment. Self-reported stress and quality of life among sophomore medical students having different types of preclinical curricula will vary in their relationships to USMLE Step 1 scores. Voluntary surveys in 2010 and 2011 compared self-reported stress, physical and mental health, and quality of life with Step 1 scores for beginning sophomore students in the final year of a traditional, discipline-based curriculum and the 1st year of a revised, systems-based curriculum with changed grading system. Wilcoxon rank sum tests and Spearman rank correlations were used to analyze data, significant at p <.05. New curriculum students reported worse physical health, subjective feelings, leisure activities, social relationships and morale, and more depressive symptoms and life stress than traditional curriculum students. However, among curriculum-related stressors, few differences emerged; revised curriculum sophomores reported less stress working with real and standardized patients than traditional students. There were no class differences in respondents' Step 1 scores. Among emotional and physical health measures, only feelings of morale correlated negatively with Step 1 performance. Revised curriculum students' Step 1 scores correlated negatively with stress from difficulty of coursework. Although revised curriculum students reported worse quality of life, general stress, and health and less stress from patient interactions than traditional students, few measures were associated with performance differences on Step 1. Moreover, curriculum type did not appear to either hinder or help students' Step 1 performance. To identify and help students at risk for academic problems, future assessments of correlates of Step 1 performance should be repeated after the new curriculum is well established, relating them also to performance on other standardized assessments of communication skills, professionalism, and later clinical evaluations in clerkships or internships.

Prospective study of Dietary Approaches to Stop Hypertension– and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging123

PubMed Central

Munger, Ronald G; Cutler, Adele; Quach, Anna; Bowles, Austin; Corcoran, Christopher; Tschanz, JoAnn T; Norton, Maria C; Welsh-Bohmer, Kathleen A

2013-01-01

Background: Healthy dietary patterns may protect against age-related cognitive decline, but results of studies have been inconsistent. Objective: We examined associations between Dietary Approaches to Stop Hypertension (DASH)– and Mediterranean-style dietary patterns and age-related cognitive change in a prospective, population-based study. Design: Participants included 3831 men and women ≥65 y of age who were residents of Cache County, UT, in 1995. Cognitive function was assessed by using the Modified Mini-Mental State Examination (3MS) ≤4 times over 11 y. Diet-adherence scores were computed by summing across the energy-adjusted rank-order of individual food and nutrient components and categorizing participants into quintiles of the distribution of the diet accordance score. Mixed-effects repeated-measures models were used to examine 3MS scores over time across increasing quintiles of dietary accordance scores and individual food components that comprised each score. Results: The range of rank-order DASH and Mediterranean diet scores was 1661–25,596 and 2407–26,947, respectively. Higher DASH and Mediterranean diet scores were associated with higher average 3MS scores. People in quintile 5 of DASH averaged 0.97 points higher than those in quintile 1 (P = 0.001). The corresponding difference for Mediterranean quintiles was 0.94 (P = 0.001). These differences were consistent over 11 y. Higher intakes of whole grains and nuts and legumes were also associated with higher average 3MS scores [mean quintile 5 compared with 1 differences: 1.19 (P < 0.001), 1.22 (P < 0.001), respectively]. Conclusions: Higher levels of accordance with both the DASH and Mediterranean dietary patterns were associated with consistently higher levels of cognitive function in elderly men and women over an 11-y period. Whole grains and nuts and legumes were positively associated with higher cognitive functions and may be core neuroprotective foods common to various healthy plant-centered diets around the globe. PMID:24047922

Score Normalization for Keyword Search

DTIC Science & Technology

2016-06-23

Anahtar Sözcük Arama için Skor Düzgeleme Score Normalization for Keyword Search Leda Sarı, Murat Saraçlar Elektrik ve Elektronik Mühendisliği Bölümü...skor düzgeleme. Abstract—In this work, keyword search (KWS) is based on a symbolic index that uses posteriorgram representation of the speech data...For each query, sum-to-one normalization or keyword specific thresholding is applied to the search results. The effect of these methods on the proposed

Pulmonary edema predictive scoring index (PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty.

PubMed

Inami, Takumi; Kataoka, Masaharu; Shimura, Nobuhiko; Ishiguro, Haruhisa; Yanagisawa, Ryoji; Taguchi, Hiroki; Fukuda, Keiichi; Yoshino, Hideaki; Satoh, Toru

2013-07-01

This study sought to identify useful predictors for hemodynamic improvement and risk of reperfusion pulmonary edema (RPE), a major complication of this procedure. Percutaneous transluminal pulmonary angioplasty (PTPA) has been reported to be effective for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH). PTPA has not been widespread because RPE has not been well predicted. We included 140 consecutive procedures in 54 patients with CTEPH. The flow appearance of the target vessels was graded into 4 groups (Pulmonary Flow Grade), and we proposed PEPSI (Pulmonary Edema Predictive Scoring Index) = (sum total change of Pulmonary Flow Grade scores) × (baseline pulmonary vascular resistance). Correlations between occurrence of RPE and 11 variables, including hemodynamic parameters, number of target vessels, and PEPSI, were analyzed. Hemodynamic parameters significantly improved after median observation period of 6.4 months, and the sum total changes in Pulmonary Flow Grade scores were significantly correlated with the improvement in hemodynamics. Multivariate analysis revealed that PEPSI was the strongest factor correlated with the occurrence of RPE (p < 0.0001). Receiver-operating characteristic curve analysis demonstrated PEPSI to be a useful marker of the risk of RPE (cutoff value 35.4, negative predictive value 92.3%). Pulmonary Flow Grade score is useful in determining therapeutic efficacy, and PEPSI is highly supportive to reduce the risk of RPE after PTPA. Using these 2 indexes, PTPA could become a safe and common therapeutic strategy for CTEPH. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Plantar fascia-specific stretching versus radial shock-wave therapy as initial treatment of plantar fasciopathy.

PubMed

Rompe, Jan D; Cacchio, Angelo; Weil, Lowell; Furia, John P; Haist, Joachim; Reiners, Volker; Schmitz, Christoph; Maffulli, Nicola

2010-11-03

Whether plantar fascia-specific stretching or shock-wave therapy is effective as an initial treatment for proximal plantar fasciopathy remains unclear. The aim of this study was to test the null hypothesis of no difference in the effectiveness of these two forms of treatment for patients who had unilateral plantar fasciopathy for a maximum duration of six weeks and which had not been treated previously. One hundred and two patients with acute plantar fasciopathy were randomly assigned to perform an eight-week plantar fascia-specific stretching program (Group I, n = 54) or to receive repetitive low-energy radial shock-wave therapy without local anesthesia, administered weekly for three weeks (Group II, n = 48). All patients completed the seven-item pain subscale of the validated Foot Function Index and a patient-relevant outcome questionnaire. Patients were evaluated at baseline and at two, four, and fifteen months after baseline. The primary outcome measures were a mean change in the Foot Function Index sum score at two months after baseline, a mean change in item 2 (pain during the first few steps of walking in the morning) on this index, and satisfaction with treatment. No difference in mean age, sex, weight, or duration of symptoms was found between the groups at baseline. At two months after baseline, the Foot Function Index sum score showed significantly greater changes for the patients managed with plantar fascia-specific stretching than for those managed with shock-wave therapy (p < 0.001), as well as individually for item 2 (p = 0.002). Thirty-five patients (65%) in Group I versus fourteen patients (29%) in Group II were satisfied with the treatment (p < 0.001). These findings persisted at four months. At fifteen months after baseline, no significant between-group difference was measured. A program of manual stretching exercises specific to the plantar fascia is superior to repetitive low-energy radial shock-wave therapy for the treatment of acute symptoms of proximal plantar fasciopathy.

White Matter Correlates of Neuropsychological Dysfunction in Systemic Lupus Erythematosus

PubMed Central

Jung, Rex E.; Chavez, Robert S.; Flores, Ranee A.; Qualls, Clifford; Sibbitt, Wilmer L.; Roldan, Carlos A.

2012-01-01

Patients diagnosed with Systemic Lupus Erythematosus have similar levels of neuropsychological dysfunction (i.e., 20–50%) as those with Neuropsychiatric Systemic Lupus Erythematosus (NPSLE). We hypothesized a gradient between cognition and white matter integrity, such that strongest brain-behavior relationships would emerge in NPSLE, intermediate in non-NPSLE, and minimal in controls. We studied thirty-one patients (16 non-NPSLE; 15 NPSLE), ranging in age from 18 to 59 years old (100% female), and eighteen age and gender matched healthy controls. DTI examinations were performed on a 1.5T scanner. A broad neuropsychological battery was administered, tapping attention, memory, processing speed, and executive functioning. The Total z-score consisted of the combined sum of all neuropsychological measures. In control subjects, we found no significant FA-Total z-score correlations. NPSLE, non-NPSLE, and control subjects differed significantly in terms of Total z-score (NPSLE = −2.25+/−1.77, non-NPSLE = −1.22+/−1.03, Controls = −0.10+/−.57; F = 13.2, p<.001). In non-NPSLE subjects, FA within the right external capsule was significantly correlated with Total z-score. In NPSLE subjects, the largest FA-Total z-score clusters were observed within the left anterior thalamic radiation and right superior longitudinal fasciculus. In subsequent analyses the largest number of significant voxels linked FA with the Processing Speed z-score in NPSLE. The current results reflect objective white matter correlates of neuropsychological dysfunction in both NPSLE and (to a lesser degree) in non-NPSLE. non-NPSLE and NPSLE subjects did not differ significantly in terms of depression, as measured by the GDI; thus, previous hypotheses suggesting moderating effects of depression upon neuropsychological performance do not impact the current FA results. PMID:22291880

Developing a testing battery for measuring dogs' stifle functionality: the Finnish Canine Stifle Index (FCSI).

PubMed

Hyytiäinen, Heli K; Mölsä, Sari H; Junnila, Jouni J T; Laitinen-Vapaavuori, Outi M; Hielm-Björkman, Anna K

2018-05-19

This study aimed at developing a quantitative testing battery for dogs' stifle functionality, as, unlike in human medicine, currently none is available in the veterinary field. Forty-three dogs with surgically treated unilateral cranial cruciate ligament rupture and 21 dogs with no known musculoskeletal problems were included. Eight previously studied tests: compensation in sitting and lying positions, symmetry of thrust in hindlimbs when rising from lying and sitting, static weight bearing, stifle flexion and extension and muscle mass symmetry, were summed into the Finnish Canine Stifle Index (FCSI). Sensitivities and specificities of the dichotomised FCSI score were calculated against orthopaedic examination, radiological and force platform analysis and a conclusive assessment (combination of previous). One-way analysis of variance (ANOVA)was used to evaluate FCSI score differences between the groups. Cronbach's alpha for internal consistency was calculated. The range of the index score was 0-263, with a proposed cut-off value of 60 between 'adequate' and 'compromised' functional performance. In comparison to the conclusive assessment, the sensitivity and specificity of the FCSI were 90 per cent and 90.5 per cent, respectively. Cronbach's alpha for internal reliability of the FCSI score was 0.727. An estimate of the surgically treated and control dogs' FCSI scores were 105 (95 per cent CI 93 to 116) and 20 (95 per cent CI 4 to 37), respectively. The difference between the groups was significant (P<0.001). © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Microbial Contamination Level Profiles Attributed to Contamination of Beef Carcasses, Personnel, and Equipment: Case of Small and Medium Enterprise Slaughterhouses.

PubMed

Wambui, Joseph; Lamuka, Peter; Karuri, Edward; Matofari, Joseph; Njage, Patrick Murigu Kamau

2018-04-01

The microbial contamination level profiles (MCLPs) attributed to contamination of beef carcasses, personnel, and equipment in five Kenyan small and medium enterprise slaughterhouses were determined. Aerobic plate counts, Enterobacteriaceae, Staphylococcus, and Salmonella were used to determine contamination at four different slaughter stages, namely, dehiding, evisceration, splitting, and dispatch. Microbiological criteria of the four microorganisms were used to score contamination levels (CLs) as poor (0), poor to average (1), average (2), or good (3). MCLPs were further assigned to carcasses, personnel, and equipment at each stage by summing up the CL scores. The CL score attributed to aerobic plate count contamination was 2 or 3 for carcasses but 0 for personnel and equipment in almost all slaughterhouses. A score of 0 on carcasses was mostly attributed to Enterobacteriaceae at evisceration and to Salmonella at dehiding and evisceration. In addition, a score of 0 was mostly attributed to Staphylococcus contamination of personnel at dehiding. A score of 3 was attributed mostly to Enterobacteriaceae on hands at splitting, whereas a score of 2 was mostly attributed to the clothes at dehiding and evisceration. A CL score of 3 was mostly attributed to Enterobacteriaceae and Salmonella contamination of equipment at dehiding and splitting, respectively. Although CLs attributed to contamination of carcasses, personnel, and equipment ranged from 0 to 3, the maximum MCLP score of 9 was only attained in carcasses from two slaughterhouses at dehiding and from one slaughterhouse at dispatch. There is, therefore, a lot of room for small and medium enterprise slaughterhouses to improve their food safety objectives by improving food safety management systems at the points characterized by low CL scores.

New DSM-V neurocognitive disorders criteria and their impact on diagnostic classifications of mild cognitive impairment and dementia in a memory clinic setting.

PubMed

Tay, Laura; Lim, Wee Shiong; Chan, Mark; Ali, Noorhazlina; Mahanum, Shariffah; Chew, Pamela; Lim, June; Chong, Mei Sian

2015-08-01

To examine diagnostic agreement between Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) Neurocognitive Disorders (NCDs) criteria and DSM, Fourth Edition (DSM-IV) criteria for dementia and International Working Group (IWG) criteria for mild cognitive impairment (MCI) and DSM-V's impact on diagnostic classifications of NCDs. The authors further examined clinical factors for discrepancy in diagnostic classifications between the different operational definitions. Using a cross-sectional study in tertiary memory clinic, the authors studied consecutive new patients aged 55 years or older who presented with cognitive symptoms. Dementia severity was scored based on the Clinical Dementia Rating scale (CDR). All patients completed neuropsychological evaluation. Agreement in diagnostic classifications between DSM-IV/IWG and DSM-V was examined using the kappa test and AC1 statistic, with multinomial logistic regression for factors contributing to MCI reclassification as major NCDs as opposed to diagnostically concordant MCI and dementia groups. Of 234 patients studied, 166 patients achieved concordant diagnostic classifications, with overall kappa of 0.41. Eighty-six patients (36.7%) were diagnosed with MCI and 131 (56.0%) with DSM-IV-defined dementia. With DSM-V, 40 patients (17.1%) were classified as mild NCDs and 183 (78.2%) as major NCDs, representing a 39.7% increase in frequency of dementia diagnoses. CDR sum-of-boxes score contributed independently to differentiation of MCI patients reclassified as mild versus major NCDs (OR: 0.01; 95% CI: 0-0.09). CDR sum-of-boxes score (OR: 5.18; 95% CI: 2.04-13.15), performance in amnestic (OR: 0.14; 95% CI: 0.06-0.34) and language (Boston naming: OR: 0.52; 95% CI: 0.29-0.94) tests, were independent determinants of diagnostically concordant dementia diagnosis. The authors observed moderate agreement between the different operational definitions and a 40% increase in dementia diagnoses with operationalization of the DSM-V criteria. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Polygenic risk scores for smoking: predictors for alcohol and cannabis use?

PubMed

Vink, Jacqueline M; Hottenga, Jouke Jan; de Geus, Eco J C; Willemsen, Gonneke; Neale, Michael C; Furberg, Helena; Boomsma, Dorret I

2014-07-01

A strong correlation exists between smoking and the use of alcohol and cannabis. This paper uses polygenic risk scores to explore the possibility of overlapping genetic factors. Those scores reflect a combined effect of selected risk alleles for smoking. Summary-level P-values were available for smoking initiation, age at onset of smoking, cigarettes per day and smoking cessation from the Tobacco and Genetics Consortium (n between 22,000 and 70,000 subjects). Using different P-value thresholds (0.1, 0.2 and 0.5) from the meta-analysis, sets of 'risk alleles' were defined and used to generate a polygenic risk score (weighted sum of the alleles) for each subject in an independent target sample from the Netherlands Twin Register (n = 1583). The association between polygenic smoking scores and alcohol/cannabis use was investigated with regression analysis. The polygenic scores for 'cigarettes per day' were associated significantly with the number of glasses alcohol per week (P = 0.005, R2 = 0.4-0.5%) and cannabis initiation (P = 0.004, R2 = 0.6-0.9%). The polygenic scores for 'age at onset of smoking' were associated significantly with 'age at regular drinking' (P = 0.001, R2 = 1.1-1.5%), while the scores for 'smoking initiation' and 'smoking cessation' did not significantly predict alcohol or cannabis use. Smoking, alcohol and cannabis use are influenced by aggregated genetic risk factors shared between these substances. The many common genetic variants each have a very small individual effect size. © 2014 Society for the Study of Addiction.

A cluster version of the GGT sum rule

NASA Astrophysics Data System (ADS)

Hencken, Kai; Baur, Gerhard; Trautmann, Dirk

2004-03-01

We discuss the derivation of a "cluster sum rule" from the Gellmann-Goldberger-Thirring (GGT) sum rule as an alternative to the Thomas-Reiche-Kuhn (TRK) sum rule, which was used as the basis up to now. We compare differences in the assumptions and approximations. Some applications of the sum rule for halo nuclei, as well as, nuclei with a pronounced cluster structure are discussed.

Application of multi-criteria decision-making to risk prioritisation in tidal energy developments

NASA Astrophysics Data System (ADS)

Kolios, Athanasios; Read, George; Ioannou, Anastasia

2016-01-01

This paper presents an analytical multi-criterion analysis for the prioritisation of risks for the development of tidal energy projects. After a basic identification of risks throughout the project and relevant stakeholders in the UK, classified through a political, economic, social, technological, legal and environmental analysis, relevant questionnaires provided scores to each risk and corresponding weights for each of the different sectors. Employing an extended technique for order of preference by similarity to ideal solution as well as the weighted sum method based on the data obtained, the risks identified are ranked based on their criticality, drawing attention of the industry in mitigating the ones scoring higher. Both methods were modified to take averages at different stages of the analysis in order to observe the effects on the final risk ranking. A sensitivity analysis of the results was also carried out with regard to the weighting factors given to the perceived expertise of participants, with different results being obtained whether a linear, squared or square root regression is used. Results of the study show that academics and industry have conflicting opinions with regard to the perception of the most critical risks.

40,000 memories in young teenagers: Psychometric properties of the Autobiographical Memory Test in a UK cohort study

PubMed Central

Heron, Jon; Crane, Catherine; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J. Mark G.

2012-01-01

Although the Autobiographical Memory Test (AMT) is widely used its psychometric properties have rarely been investigated. This paper utilises data gathered from a 10-item written version of the AMT, completed by 5792 adolescents participating in the Avon Longitudinal Study of Parents and Children, to examine the psychometric properties of the measure. The results show that the scale derived from responses to the AMT operates well over a wide range of scores, consistent with the aim of deriving a continuous measure of over-general memory. There was strong evidence of group differences in terms of gender, low negative mood, and IQ, and these were in agreement when comparing an item response theory (IRT) approach with that based on a sum score. One advantage of the IRT model is the ability to assess and consequently allow for differential item functioning. This additional analysis showed evidence of response bias for both gender and mood, resulting in attenuation in the mean differences in AMT across these groups. Implications of the findings for the use of the AMT measure in different samples are discussed. PMID:22348421

Utility of proverb interpretation measures with cardiac transplant candidates.

PubMed

Dugbartey, A T

1998-12-01

To assess metaphorical understanding and proverb interpretation in cardiac transplant candidates, the neuropsychological assessment records of 22 adults with end-stage cardiac disease under consideration for transplantation were analyzed. Neuropsychological tests consisted of the Controlled Oral Word Association Test, Halstead Category Test, Rey-Osterrieth Complex Figure Test (Copy), Trial Making Test, and summed scores for the proverb items of the WAIS-R Comprehension subtest. Analysis showed that the group tended to interpret proverbs literally. Proverb scores were significantly associated with scores on the Similarities and Picture Arrangement subtests of the WAIS-R. There was a moderate negative association between number of reported heart attacks and Proverb scores. The need for brief yet robust assessments including measures of inferential thinking and conceptualization in transplant candidates are highlighted.

Clinical assessment of patients with recalcitrant psoriasis in a randomized, observer-blind, vehicle-controlled trial using indigo naturalis.

PubMed

Lin, Yin-Ku; Chang, Chee-Jen; Chang, Ya-Ching; Wong, Wen-Rou; Chang, Shu-Chen; Pang, Jong-Hwei Su

2008-11-01

To evaluate the efficacy and safety of treatment with indigo naturalis in patients with recalcitrant plaque-type psoriasis. Randomized, observer-blind, vehicle-controlled, intrapatient comparison study. Ambulatory department of a hospital. Forty-two outpatients with chronic plaque psoriasis were enrolled in the study from May 1, 2004, to April 30, 2005. The patients applied either indigo naturalis ointment or vehicle ointment topically to each of 2 bilaterally symmetrical psoriatic plaque lesions for 12 weeks (depending on the date of enrollment in the study). The outcomes were assessed using the following criteria: the sum of erythema, scaling, and induration scores and the clearing percentage of the target plaque lesion assessed by 2 blinded observers. Significant reductions in the sum of scaling, erythema, and induration scores (P < .001) (mean score, 6.3 after indigo naturalis treatment vs 12.8 in control subjects) and plaque area percentage (P < .001) (mean percentage, 38.5% after indigo naturalis treatment vs 90% in controls) were achieved with topical application of indigo naturalis ointment. Approximately 31 of 42 patients (74%) experienced clearance or near clearance of their psoriasis in the indigo ointment-treated lesion. Topical indigo naturalis ointment was a novel, safe, and effective therapy for plaque-type psoriasis.

A Psychometric Review of Measures Assessing Discrimination Against Sexual Minorities.

PubMed

Morrison, Todd G; Bishop, C J; Morrison, Melanie A; Parker-Taneo, Kandice

2016-08-01

Discrimination against sexual minorities is widespread and has deleterious consequences on victims' psychological and physical wellbeing. However, a review of the psychometric properties of instruments measuring lesbian, gay, and bisexual (LGB) discrimination has not been conducted. The results of this review, which involved evaluating 162 articles, reveal that most have suboptimal psychometric properties. Specifically, myriad scales possess questionable content validity as (1) items are not created in collaboration with sexual minorities; (2) measures possess a small number of items and, thus, may not sufficiently represent the domain of interest; and (3) scales are "adapted" from measures designed to examine race- and gender-based discrimination. Additional limitations include (1) summed scores are computed, often in the absence of scale score reliability metrics; (2) summed scores operate from the questionable assumption that diverse forms of discrimination are necessarily interrelated; (3) the dimensionality of instruments presumed to consist of subscales is seldom tested; (4) tests of criterion-related validity are routinely omitted; and (5) formal tests of measures' construct validity are seldom provided, necessitating that one infer validity based on the results obtained. The absence of "gold standard" measures, the attendant difficulty in formulating a coherent picture of this body of research, and suggestions for psychometric improvements are noted.

Leadership behaviors of athletic training leaders compared with leaders in other fields.

PubMed

Laurent, Timothy G; Bradney, Debbie A

2007-01-01

Athletic trainers are in positions of leadership. To determine self-reported leadership practices of head athletic trainers (HATCs) and program directors (PDs). Cross-sectional study. Respondents' academic institutions. A total of 238 athletic training leaders completed the Leadership Practices Inventory. Of these, 50.4% (n = 120) were HATCs and 49.6% (n = 118) were PDs; 69.3% (n = 165) were men and 30.7% (n = 73) were women; almost all respondents (97.1%, n = 231) were white. Respondents typically reported having 11 to 15 years of experience as an athletic trainer (n = 57, 23.9%) and being between the ages of 30 and 39 years (n = 109, 45.8%). Categories of leadership behaviors (ie, Model, Inspire, Challenge, Encourage, and Enable) were scored from 1 (almost never) to 10 (almost always). Item scores were summed to compute mean category scores. We analyzed demographic information; used t ratios to compare the data from athletic training leaders (PDs and HATCs) with normative data; compared sex, age, position, ethnicity, and years of experience with leadership practices; and computed mean scores. Athletic training leaders reported using leadership behaviors similar to those of other leaders. The PDs reported using inspiring, challenging, enabling, and encouraging leadership behaviors more often than did the HATCs. No differences were found by ethnicity, age, years of experience, or leadership practices. Athletic training leaders are transformational leaders. Athletic training education program accreditation requirements likely account for the difference in leadership practices between PDs and HATCs.

Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma.

PubMed

Chang, Kao-Ping; Lai, Chung-Sheng; Hsieh, Tung-Ying; Wu, Yi-Chia; Chang, Chih-Hau

2012-07-13

This study describes 2-year impact on quality of life (QOL) in relation to the anatomical discrepancy among T4a oral cancer patients after free flap reconstruction in Taiwan. Thirty-two patients who underwent tumor ablation with simultaneous microvascular free flap transfer at 2-year follow-up were recruited. They were divided into six subgroups, according to the resected area, consisting of: (1) buccal/retromolar trigone; (2) cheek; (3) commissure; (4) lip; (5) mandible; and (6) tongue. Functional disturbances and daily activity were analyzed using the Version-1 UW QOL Questionnaire with one more specific category: 'Drooling'. Kruskal-Wallis rank sums analysis was used to test differences in average QOL scores between these subgroups. Post-hoc analysis was applied to assess influence of dominant categories between subgroups. The category 'Pain' revealed the highest average score and reached significant statistical difference (P = 0.019) among all the categories, however, the category 'Employment' averaged the lowest score. Regarding 'Pain', there existed a statistical significance (P = 0.0032) between the commissure- and cheek-involved groups, which described the former showed poorer pain quality of life. The commissure-involved group had the lowest average score, which might imply the worst QOL in our study, especially for the categories 'Pain' and 'Drooling'. This present study of T4a patients was the first carried out in Taiwan implementing the QOL questionnaire, and its results may serve for future reference.

Fitting and Testing Conditional Multinormal Partial Credit Models

ERIC Educational Resources Information Center

Hessen, David J.

2012-01-01

A multinormal partial credit model for factor analysis of polytomously scored items with ordered response categories is derived using an extension of the Dutch Identity (Holland in "Psychometrika" 55:5-18, 1990). In the model, latent variables are assumed to have a multivariate normal distribution conditional on unweighted sums of item…

Stochastic Ordering Using the Latent Trait and the Sum Score in Polytomous IRT Models.

ERIC Educational Resources Information Center

Hemker, Bas T.; Sijtsma, Klaas; Molenaar, Ivo W.; Junker, Brian W.

1997-01-01

Stochastic ordering properties are investigated for a broad class of item response theory (IRT) models for which the monotone likelihood ratio does not hold. A taxonomy is given for nonparametric and parametric models for polytomous models based on the hierarchical relationship between the models. (SLD)

Factor Analysis for Clustered Observations.

ERIC Educational Resources Information Center

Longford, N. T.; Muthen, B. O.

1992-01-01

A two-level model for factor analysis is defined, and formulas for a scoring algorithm for this model are derived. A simple noniterative method based on decomposition of total sums of the squares and cross-products is discussed and illustrated with simulated data and data from the Second International Mathematics Study. (SLD)

Predicting Recidivism with the Psychopathy Checklist: Are Factor Score Composites Really Necessary?

ERIC Educational Resources Information Center

Walters, Glenn D.; Wilson, Nick J.; Glover, Anthony J. J.

2011-01-01

In two previous studies on general and violent recidivism (Walters & Heilbrun, 2010; Walters, Knight, Grann, & Dahle, 2008), the summed composite antisocial facet of the Psychopathy Checklist displayed incremental validity relative to the other 3 facets (interpersonal, affective, lifestyle), whereas the other 3 facets generally failed to…

An Assessment of the Dimensionality of SAT-Mathematical.

ERIC Educational Resources Information Center

Lawrence, Ida M.; Dorans, Neil J.

Six editions of Scholastic Aptitude Test-Mathematical (SAT-M) were factor analyzed using confirmatory and exploratory methods. Confirmatory factor analyses (using the LISREL VI program) were conducted on correlation matrices among item parcels--sums of scores on a small subset of items. Item parcels were constructed to yield correlation matrices…

Obstructive sleep apnea and neurocognitive function in a Hispanic/Latino population.

PubMed

Ramos, Alberto R; Tarraf, Wassim; Rundek, Tatjana; Redline, Susan; Wohlgemuth, William K; Loredo, Jose S; Sacco, Ralph L; Lee, David J; Arens, Raanan; Lazalde, Patricia; Choca, James P; Mosley, Thomas; González, Hector M

2015-01-27

We evaluated the association between obstructive sleep apnea (OSA) and neurocognitive function among community-dwelling Hispanic/Latino individuals in the United States. Cross-sectional analysis of the Hispanic Community Health Study/Study of Latinos middle-aged and older adults, aged 45 to 74 years, with neurocognitive test scores at baseline measurements from 2008 to 2011. Neurocognitive scores were measured using the Word Fluency (WF) Test, the Brief-Spanish English Verbal Learning Test (SEVLT), and the Digit Symbol Substitution (DSS) Test. OSA was defined by the apnea-hypopnea index (AHI). Multivariable linear regression models were fit to evaluate relations between OSA and neurocognitive scores. The analysis consisted of 8,059 participants, mean age of 56 years, 55% women, and 41% with less than high school education. The mean AHI was 9.0 (range 0-142; normal AHI <5/h). There was an association between the AHI and all 4 neurocognitive test scores: Brief-SEVLT-sum (β = -0.022) and -recall (β = -0.010), WF (β = -0.023), and DSS (β = -0.050) at p < 0.01 that was fully attenuated by age. In the fully adjusted regression model, female sex was a moderating factor between the AHI and WF (β = -0.027, p < 0.10), SVELT-sum (β = -0.37), SVELT-recall (β = -0.010), and DSS (β = -0.061) at p < 0.01. OSA was associated with worse neurocognitive function in a representative sample of Hispanic/Latino women in the United States. © 2014 American Academy of Neurology.

Initial evaluation of an ultrasound measure for assessing the activity of skin lesions in juvenile localized scleroderma.

PubMed

Li, S C; Liebling, M S; Haines, K A; Weiss, J E; Prann, A

2011-05-01

To evaluate the construct validity of 2 proposed measures (the Ultrasound Disease Activity [U-DA] and the Tissue Thickness Score [TTS]) for evaluating sonographic differences in juvenile localized scleroderma skin lesions. We conducted a retrospective review of juvenile localized scleroderma patients who had ultrasound scans of their skin lesions between October 2005 and February 2009. Imaged lesions were classified as active or inactive based upon clinical assessment. Lesions had to have been imaged within 1 month of a clinic visit or have the same clinical assessment during both the visit before and the visit after the scan. Two physicians scored the scans using the U-DA, which scores for differences in lesion echogenicity and vascularity compared with normal tissue. Tissue thickness differences were evaluated by percent differences and by using the TTS. Wilcoxon's rank sum test was performed to assess differences. We studied 52 scans from 21 patients, 32 scans of active skin lesions and 20 scans of inactive skin lesions. Features reported by clinicians as indicative of active disease included erythema, warmth, violaceous color, new lesion, expansion of lesion, and induration. The U-DA was significantly different between active and inactive skin lesions (P = 0.0010) with significant differences found for the parameters of total echogenicity, hypodermis echogenicity, and deep tissue layer vascularity (P = 0.0014, P = 0.0023, and P = 0.0374, respectively). No significant differences were found for tissue layer thickness or TTS. The U-DA may be a useful tool in the identification of localized scleroderma activity. Further study is needed to prospectively evaluate the validity, reliability, and sensitivity of this potential monitoring tool. Copyright © 2011 by the American College of Rheumatology.

Quality of care for remote orthopaedic consultations using telemedicine: a randomised controlled trial.

PubMed

Buvik, Astrid; Bugge, Einar; Knutsen, Gunnar; Småbrekke, Arvid; Wilsgaard, Tom

2016-09-08

Decentralised services using outreach clinics or modern technology are methods to reduce both patient transports and costs to the healthcare system. Telemedicine consultations via videoconference are one such modality. Before new technologies are implemented, it is important to investigate both the quality of care given and the economic impact from the use of this new technology. The aim of this clinical trial was to study the quality of planned remote orthopaedic consultations by help of videoconference. We performed a randomised controlled trial (RCT) with two parallel groups: video-assisted remote consultations at a regional medical centre (RMC) as an intervention versus standard consultation in the orthopaedic outpatient clinic at the University Hospital of North Norway (UNN) as a control. The participants were patients referred to or scheduled for a consultation at the orthopaedic outpatient clinic. The orthopaedic surgeons evaluated each consultation they performed by completing a questionnaire. The primary outcome measurement was the difference in the sum score calculated from this questionnaire, which was evaluated by the non-inferiority of the intervention group. The study design was based on the intention to treat principle. Ancillary analyses regarding complications, the number of consultations per patient, operations, patients who were referred again and the duration of consultations were performed. Four-hundred patients were web-based randomised. Of these, 199 (98 %) underwent remote consultation and 190 (95 %) underwent standard consultation. The primary outcome, the sum score of the specialist evaluation, was significantly lower (i.e. 'better') at UNN compared to RMC (1.72 versus 1.82, p = 0.0030). The 90 % confidence interval (CI) for the difference in score (0.05, 0.17) was within the non-inferiority margin. The orthopaedic surgeons involved evaluated 98 % of the video-assisted consultations as 'good' or 'very good'. In the ancillary analyses, there was no significant difference between the two groups. This study supports the argument that it is safe to offer video-assisted consultations for selected orthopaedic patients. We did not find any serious events related to the mode of consultation. Further assessments of the economic aspects and patient satisfaction are needed before we can recommend its wider application. ClinicalTrials.gov identifier: NCT00616837.

Psychosocial problems of children whose parents visit the emergency department due to intimate partner violence, substance abuse or a suicide attempt.

PubMed

Hoytema van Konijnenburg, E M M; van der Lee, J H; Teeuw, A H; Lindeboom, R; Brilleslijper-Kater, S N; Sieswerda-Hoogendoorn, T; van Goudoever, J B; Lindauer, R J L

2017-05-01

High levels of maltreatment are found in children who are identified because their parents visit the emergency department due to partner violence, substance abuse or suicide attempt. However, it is unknown if these children experience psychosocial problems. This study aims to assess their levels of post-traumatic stress, anxiety, depression, behavioural problems and health-related quality of life. A cross-sectional study was conducted in six hospitals. All consecutive families of which a parent visited the emergency department due to partner violence, substance abuse or suicide attempt between 1 July 2012 and 1 March 2014 with children aged 1.5-17 years were approached for participation. Parents and children aged 8 years and older filled out questionnaires measuring post-traumatic stress [13-item version of Children's Revised Impact of Event Scale (CRIES-13)], anxiety, depression (Revised Child Anxiety and Depression Scale), behavioural problems [Child Behavior Checklist (CBCL) and Youth Self-Report (YSR)] and health-related quality of life (PedsQL). Scores of participants were compared with reference data obtained in children in similar age ranges from representative Dutch community samples (CRIES-13, Revised Child Anxiety and Depression Scale, PedsQL and CBCL) and to a normed cutoff score (CRIES-13). Of 195 eligible families, 89 (46%) participated in the study. Participating children did not score different from community children, both on child-reported and parent-reported instruments. Standardized mean differences of total sum scores were 0 (CRIES-13 and CBCL 1.5-5), 0.1 (YSR), 0.2 (CBCL 6-18) and -0.3 (PedsQL) and not statistically different from community children. Thirty-five percent of the participating children scored above the cutoff score on the CRIES-13, indicating post-traumatic stress disorder, but this difference was not statistically significant from community children (mean difference 8%; 95% CI -4-22%). We found no differences in psychosocial problems between children whose parents visited the emergency department due to partner violence, substance abuse or suicide attempt and children from community samples. Because 35% of the children scored in the range of post-traumatic stress disorder, we advise healthcare providers to pay attention to post-traumatic stress symptoms. © 2016 John Wiley & Sons Ltd.

Comparative Effectiveness Study of Patient-Reported Outcomes following Proton Therapy or IMRT for Prostate Cancer

PubMed Central

Hoppe, Bradford S.; Michalski, Jeff M.; Mendenhall, Nancy P.; Morris, Christopher G.; Henderson, Randal H.; Nichols, Romaine C.; Mendenhall, William M.; Williams, Christopher; Regan, Meredith M.; Chipman, Jonathan; Crociani, Catrina; Sandler, Howard M.; Sanda, Martin G.; Hamstra, Daniel A.

2014-01-01

Background Data continues to emerge on the relative merits of different treatment modalities for prostate cancer. The purpose of this study is to compare patient-reported quality-of-life outcomes (QOL) after proton therapy (PT) and intensity-modulated radiation therapy (IMRT) for prostate cancer. Methods A comparison was performed of prospectively collected QOL data using the expanded prostate cancer index (EPIC) questionnaire. QOL data was collected during the first 2 years following treatment for men treated with PT and IMRT. PT was delivered to 1,243 men at a single center to 76-82Gy. IMRT was delivered to 204 men included in the Prostate Cancer Quality Assurance Study (PROSTQA) in doses of 75.6-79.4Gy.The Wilcoxon rank sum test was used to compare EPIC outcomes by modality using baseline-adjusted scores at different time points. Individual questions were assessed by converting to binary outcomes and testing with generalized estimating equations. Results No differences in changes in summary scores for bowel, urinary incontinence, urinary irritative/obstructive, and sexual domains were seen between the two cohorts. However, more men treated with IMRT reported moderate/big problems with rectal urgency (p=0.02) and frequent bowel movements (p=0.05) than men treated with PT. Conclusions There were no differences in QOL summary scores between the IMRT and PT cohorts during early follow-up up to 2-years. Response to individual questions suggests possible differences in specific bowel symptoms between the two cohorts. These outcomes highlight the need for further comparative studies of PT and IMRT. PMID:24382757

Swallowing Changes in Community-Dwelling Older Adults.

PubMed

Mulheren, Rachel W; Azola, Alba M; Kwiatkowski, Stephanie; Karagiorgos, Eleni; Humbert, Ianessa; Palmer, Jeffrey B; González-Fernández, Marlís

2018-06-08

Older adults may evidence changes in swallowing physiology. Our goals were to identify dysphagia risk in community-dwelling older adults with no history of dysphagia, and to compare swallowing physiology and safety between older and younger adults. Thirty-two older adults with no history of dysphagia were prospectively recruited and completed the Dysphagia Handicap Index (DHI), two trials of a 3 oz. swallow screen, and videofluoroscopy (VFSS). Self-ratings of swallowing function were compared to published norms by paired t tests, and multivariate logistic regression models were generated to determine whether these ratings and VFSS analysis of swallowing function were associated with failure of one or both swallow screen trials. Archived VFSS of 33 younger adults were compared to older adults with Wilcoxon rank-sum tests. The DHI scores of older adults were higher than published non-dysphagic adults but lower than dysphagic adults. Older participants with greater Oral Residue scores were more likely to fail both swallow screen trials. Older adults received higher median MBSImP™© scores for select pharyngeal components than younger adults. The two age groups did not differ on Penetration-Aspiration Scale scores, and no aspiration was observed. Measures of swallowing in older individuals may reflect age-related sensory and motor changes in the context of functional swallowing and adequate airway protection.

Interrater and Intrarater Reliability of the Tuck Jump Assessment by Health Professionals of Varied Educational Backgrounds

PubMed Central

Dudley, Lisa A.; Smith, Craig A.; Olson, Brandon K.; Chimera, Nicole J.

2013-01-01

Objective. The Tuck Jump Assessment (TJA), a clinical plyometric assessment, identifies 10 jumping and landing technique flaws. The study objective was to investigate TJA interrater and intrarater reliability with raters of different educational and clinical backgrounds. Methods. 40 participants were video recorded performing the TJA using published protocol and instructions. Five raters of varied educational and clinical backgrounds scored the TJA. Each score of the 10 technique flaws was summed for the total TJA score. Approximately one month later, 3 raters scored the videos again. Intraclass correlation coefficients determined interrater (5 and 3 raters for first and second session, resp.) and intrarater (3 raters) reliability. Results. Interrater reliability with 5 raters was poor (ICC = 0.47; 95% confidence intervals (CI) 0.33–0.62). Interrater reliability between 3 raters who completed 2 scoring sessions improved from 0.52 (95% CI 0.35–0.68) for session one to 0.69 (95% CI 0.55–0.81) for session two. Intrarater reliability was poor to moderate, ranging from 0.44 (95% CI 0.22–0.68) to 0.72 (95% CI 0.55–0.84). Conclusion. Published protocol and training of raters were insufficient to allow consistent TJA scoring. There may be a learned effect with the TJA since interrater reliability improved with repetition. TJA instructions and training should be modified and enhanced before clinical implementation. PMID:26464881

Age differences between the controlled force exertion measured by a computer-generated sinusoidal and a bar chart display.

PubMed

Nagasawa, Yoshinori; Demura, Shinichi; Takahashi, Kenji

2013-01-01

It is important to develop an accurate method of measuring controlled force exertion. This study examined the age differences between the controlled force exertion measured by a sinusoidal waveform and a bar chart display. The participants comprised 175 right-handed male adults aged 20-86 years. The participants were divided into three age groups: young (n=53), middle-aged (n=71), and elderly (n=51). They matched the submaximal grip strength exerted by their dominant hand to changing demand values displayed as either a sinusoidal waveform or a bar chart appearing on a personal computer screen. The participants performed the controlled force exertion test three times with a 1-min inter-trial interval using their dominant hand. The dependent variable was the total sum of the percentage values of the differences between the demand value and grip exertion value for more than 25s. The coefficient of variance had almost the same range in all age groups in both displays (CVSW=28.0-36.9, CVBC=29.1-32.6), but the elderly group showed a somewhat higher value with the sinusoidal waveform. Significant correlations were found between the scores with sinusoidal waveform and bar chart displays in the young, middle-aged, and elderly groups (r=0.47-0.68), but the correlations did not differ significantly between the age groups. Scores over 1500% in sinusoidal and bar chart display were found in one and two participants, respectively, in the middle-aged group and in 12% and 16% of the participants, respectively, in the elderly group. Furthermore, among all participants, only 8% of participants in the elderly group scored over 1500% in both displays. Scores over 1500% in both displays are considered to be considerably worse in controlled force exertion than lower scores. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Safety and efficacy of extracorporeal shock wave myocardial revascularization therapy for refractory angina pectoris.

PubMed

Cassar, Andrew; Prasad, Megha; Rodriguez-Porcel, Martin; Reeder, Guy S; Karia, Darshak; DeMaria, Anthony N; Lerman, Amir

2014-03-01

To assess the safety and efficacy of extracorporeal shockwave myocardial revascularization (ESMR) therapy in treating patients with refractory angina pectoris. A single-arm multicenter prospective trial to assess safety and efficacy of the ESMR therapy in patients with refractory angina (class III/IV angina) was performed. Screening exercise treadmill tests and pharmacological single-photon emission computed tomography (SPECT) were performed for all patients to assess exercise capacity and ischemic burden. Patients were treated with 9 sessions of ESMR to ischemic areas over 9 weeks. Efficacy end points were exercise capacity by using treadmill test as well as ischemic burden on pharmacological SPECT at 4 months after the last ESMR treatment. Safety measures included electrocardiography, echocardiography, troponin, creatine kinase, and brain natriuretic peptide testing, and pain questionnaires. Fifteen patients with medically refractory angina and no revascularization options were enrolled. There was a statistically significant mean increase of 122.3±156.9 seconds (38% increase compared with baseline; P=.01) in exercise treadmill time from baseline (319.8±157.2 seconds) to last follow-up after the ESMR treatment (422.1±183.3 seconds). There was no improvement in the summed stress perfusion scores after pharmacologically induced stress SPECT at 4 months after the last ESMR treatment in comparison to that at screening; however, SPECT summed stress score revealed that untreated areas had greater progression in ischemic burden vs treated areas (3.69±6.2 vs 0.31±4.5; P=.03). There was no significant change in the mean summed echo score from baseline to posttreatment (0.4±5.1; P=.70). The ESMR therapy was performed safely without any adverse events in electrocardiography, echocardiography, troponins, creatine kinase, or brain natriuretic peptide. Pain during the ESMR treatment was minimal (a score of 0.5±1.2 to 1.1±1.2 out of 10). In this multicenter feasibility study, ESMR seems to be a safe and efficacious treatment for patients with refractory angina pectoris. However, larger sham-controlled trials will be required to confirm these findings. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

The effect of a physical activity intervention on preschoolers' fundamental motor skills - A cluster RCT.

PubMed

Wasenius, Niko S; Grattan, Kimberly P; Harvey, Alysha L J; Naylor, Patti-Jean; Goldfield, Gary S; Adamo, Kristi B

2018-07-01

To assess the effect of a physical activity intervention delivered in the childcare centres (CC), with or without a parent-driven home physical activity component, on children's fundamental motor skills (FMS). Six-month 3-arm cluster randomized controlled trial. Preschoolers were recruited from 18 licensed CC. CC were randomly assigned to a typical curriculum comparison group (COM), childcare intervention alone (CC), or childcare intervention with parental component (CC+HOME). FMS was measured with the Test of Gross Motor Development-2. Linear mixed models were performed at the level of the individual while accounting for clustering. Raw locomotor skills score increased significantly in the CC group (mean difference=2.5 units, 95% Confidence Intervals, CI, 1.0-4.1, p<0.001) and the CC+HOME group (mean difference=2.4 units, 95% CI, 0.8-4.0, p<0.001) compared to the COM group. No significant (p>0.05) between group differences were observed in the raw object control skills, sum of raw scores, or gross motor quotient. No significant sex differences were found in any of the measured outcomes. A physical activity intervention delivered in childcare with or without parents' involvement was effective in increasing locomotor skills in preschoolers. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Multiple composite grafts (k, π or double-Y) in coronary artery surgery: a choice or a necessity?

PubMed

Mannacio, Vito; Cirillo, Plinio; Mannacio, Luigi; Antignano, Anita; Mottola, Michele; Vosa, Carlo

2015-01-01

Composite grafts allow complete arterial revascularization with minimal aortic manipulations. The Y-T configuration supplies all distal branches adequately, whereas it is unclear whether complex composite configurations (K, Π or double-Y) are equally at rest or when challenged by maximal requirements. Forty-seven patients who underwent off-pump coronary artery revascularization by multiple arterial composite grafts (K, Π or double-Y) were retrospectively evaluated. Indication for this surgical option was porcelain aorta or conduit unavailability. Composite systems were evaluated by intraoperative flow measurements and perioperative transthoracic Doppler ultrasonography, 12 months later also by exercise test, sestamibi scintigraphy at rest and during induced hyperaemia and by 64-slice multidetector CT angiography. A total of 141 distal anastomoses were implanted as composite grafts. Perioperative flow measurements and 12-month Doppler ultrasonography were adequate at rest. At stress test, chest pain and/or induced ECG evidence of ischaemia are found in 16 patients (39%). During dipyridamole-induced hyperaemia, single-photon emission computed tomography image revealed that mean summed stress score was 7.2 ± 5.7, summed difference score 5.3 ± 4.2 and coronary flow reserve 1.7 ± 0.2. Multiple composite grafts, albeit adequate at rest, were unable to meet flow requirements during maximal hyperaemia. In daily practice, their use must be not a choice but rather a necessity in those patients without alternative options. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

A sex-specific association between incident radiographic osteoarthritis of hip or knee and incident peripheral arterial calcifications: 8-year prospective data from Cohort Hip and Cohort Knee (CHECK).

PubMed

Gielis, W P; Welsing, P M J; van Spil, W E; Runhaar, J; Weinans, H; de Jong, P A

2017-11-01

There is sparse evidence for a relationship between cardiovascular disease (CVD) and osteoarthritis (OA). We investigated the association between incidence of arterial calcifications and incidence of radiographic knee and/or hip OA. We used baseline and 8-year follow-up data of Cohort Hip and Cohort Knee (CHECK). Knees and hips were either Kellgren-Lawrence (KL) grade 0 or 1 at baseline. Arterial calcifications were scored on hip and knee radiographs using a four-grade scale. Scores were summed for patient-level analyses. To investigate incidence, participants with arterial calcifications at baseline or missing follow-up were excluded. Incident OA was defined per joint as KL ≥ 2 or prosthesis at year eight. The association between incidenct of arterial calcifications and incident OA was studied using mixed-effects logistic regression. Of 763 participants included, 623 (82%) were women. Mean (sd) age was 56 (5.1) years, mean (sd) body mass index (BMI) 26.2 (4.1) kg/m 2 . Arterial calcifications developed in 174 participants (283 joints). OA developed in 456 participants (778 joints). Sex modified the association between arterial calcification and OA. In women, incident arterial calcification around a joint was positively associated with incident OA in that joint (adjusted OR 2.51 (95% CI 1.57-4.03)). In men, no association was observed on joint-level, but at patient-level the arterial calcification sum score was negatively associated with incident OA (adjusted OR per point increase 0.70 (95% CI 0.54-0.90)) indicating a systemic effect. We observed sex-dependent associations between incident arterial calcification and incident radiographic knee and/or hip OA, which differs between joint- and patient-level. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Effects of a home-based physical rehabilitation program on physical disability after hip fracture: a randomized controlled trial.

PubMed

Edgren, Johanna; Salpakoski, Anu; Sihvonen, Sanna E; Portegijs, Erja; Kallinen, Mauri; Arkela, Marja; Jäntti, Pirkko; Vanhatalo, Jukka; Pekkonen, Mika; Rantanen, Taina; Heinonen, Ari; Sipilä, Sarianna

2015-04-01

Fewer than half of the patients with hip fracture will regain the prefracture level of physical functioning. This secondary analysis of a randomized controlled trial investigated the effects of a multicomponent home-based rehabilitation program (ProMo) on physical disability after hip fracture. Randomized, controlled, parallel-group trial. Rehabilitation in participants' homes; measurements in university-based laboratory and local hospital. Population-based clinical sample of community-dwelling people older than 60 years (n = 81) operated for hip fracture were randomized into intervention and control groups. The year-long intervention aimed at restoring mobility. It included evaluation and modification of environmental hazards, guidance for safe walking, pain management, home exercise, physical activity counseling, and standard care. Physical disability was assessed by a questionnaire at baseline, and 3, 6, and 12 months thereafter. Sum scores were computed for basic (ADLs) and instrumental activities of daily living (IADLs). A higher score indicated more difficulty. GEE models were constructed to analyze the effect of the intervention. In the intention-to-treat analysis, no intervention effect was observed for sum scores. For the single disability items, borderline significant positive effects were observed for preparing food and handling medication (interaction P = .061 and P = .061, respectively). In the per-protocol analysis, the mean differences between groups were -0.4 points (SE 0.5), -1.7 (0.7), and -1.2 (0.7) at 3, 6, and 12 months for ADLs and -1.0 (1.2), -3.2 (1.5), and -2.5 (1.4) for IADLs, correspondingly. The current analyses suggest that home-based rehabilitation may reduce disability among older people after hip fracture. The present results need to be confirmed in a study with larger sample size. Potentially a more task-oriented rehabilitation approach might gain more benefits. Current Controlled Trials (ISRCTN53680197). Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Symptoms related to glaucomatous visual field abnormalities among male Japanese workers in a population-based setting.

PubMed

Tatemichi, Masayuki; Nakano, Tadashi; Hayashi, Takeshi; Tanaka, Katsutoshi; Hiro, Hisanori; Miyamoto, Toshiaki; Aratake, Miho; Nishinoue, Norihide; Yamazaki, Akira; Nakadate, Toshio; Sugita, Minoru

2012-09-01

To identify symptoms potentially related to glaucomatous visual field abnormalities (VFAs) in a population-based setting, and to assess the applicability of using these symptoms to identify persons at risk of developing glaucoma. In this study, 10,214 Japanese male general workers (mean age, 45.3±8.8 years) filled out a self-administered questionnaire and underwent frequency doubling technology (FDT) perimetry testing. The questionnaire inquired about whether the participant was suffering from any of nine symptoms, with scores for each response graded on a four-item Likert scale: 0 (none), 1 (rarely), 2 (sometimes), and 3 (always). Results from the questionnaire were compared among three groups: participants without any VFAs (9767), participants with VFAs as determined by the FDT test (FDT-VFA; 447), and 227 participants (of the 447 FDT-VFA participants) with glaucomatous VFAs who were newly diagnosed by ophthalmologic examinations. The mean summed scores for the total items were significantly (p<0.01) higher in FDT- and glaucomatous VFA groups than in normal subjects. In particular, responses citing the symptoms 'feeling of something in the front of the eye' and 'feeling of hardness to see in dark places' were significantly (p<0.05) more frequent in subjects with FDT- and glaucomatous VFAs than among normal participants. However, the respective areas under the receiver operating characteristic curve of summed scores for the nine total items and for the two items which showed significant differences for the glaucoma groups were 0.57 (95% confidence interval=0.53-0.60) and 0.58 (95% confidence interval=0.54-0.61). Although the symptoms 'feeling of hardness to see in dark places' and 'feeling of something in the front of the eye' could be associated with glaucomatous VFA in a population-based setting, inquiring about symptoms is of little aid in identifying subjects with glaucomatous VFA as a strategy for public health. © 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.

Factors in Patient Empowerment: A Survey of an Online Patient Research Network.

PubMed

Chiauzzi, Emil; DasMahapatra, Pronabesh; Cochin, Elisenda; Bunce, Mikele; Khoury, Raya; Dave, Purav

2016-12-01

Providers and healthcare organizations have begun recognizing the importance of patient empowerment as a driver of patient-centered care. Unfortunately, most studies have investigated empowerment with single diseases. Identifying factors of empowerment across conditions and populations would enable a greater understanding of this construct. The purpose of this study was to understand empowerment in relation to health information-seeking, interactions with providers and peers, and healthcare access in chronic disease patients. This study also sought to identify key empowerment factors and their association with patient characteristics. Participants were recruited through PatientsLikeMe, an online research platform where patients share their personal and medical history data. Patients completed an online survey that assessed self-reported health behavior (e.g. knowledge-seeking, experiences with healthcare providers, and peer interactions) and healthcare access. An exploratory factor analysis identified key empowerment domains. Domain level sum scores and sum of all domains (total score) were compared across patient characteristics and diseases. Overall, 3988 participants were included in the study, with the majority actively involved in their healthcare, but many cited difficulties with matching their treatment goals with those of their physician (34 %) and spending sufficient time with the physician (36 %). Factor analysis identified two domains-Positive Patient-Provider Interaction, and Knowledge and Personal Control-that explained >60 % of the overall variance in the observed variables. Mean total empowerment scores for patients with a primary complaint of Parkinson's disease (61.8) and multiple sclerosis (60.3) were significantly greater than fibromyalgia (55.3) and chronic fatigue syndrome (54.8). Patients who were older, male, more educated, and insured also reported significantly greater levels of empowerment. The two domains of empowerment identified in this study are consistent with previous studies, but the differences in empowerment levels across diseases suggest a need for further studies on disease-related attributes of empowerment. Future research should examine the pathways for empowerment, as well as the relationship between empowerment domains and clinical outcomes.

Efficacy of vitamins C, E, and their combination for treatment of restless legs syndrome in hemodialysis patients: a randomized, double-blind, placebo-controlled trial.

PubMed

Sagheb, Mohammad Mahdi; Dormanesh, Banafshe; Fallahzadeh, Mohammad Kazem; Akbari, Hamideh; Sohrabi Nazari, Sahar; Heydari, Seyed Taghi; Behzadi, Saeed

2012-05-01

Restless legs syndrome (RLS) is a common disorder in hemodialysis patients that leads to insomnia and impaired quality of life. Because high oxidative stress has been implicated in the pathogenesis of RLS, we sought to evaluate the efficacy of vitamins C and E and their combination in reducing the severity of RLS symptoms in hemodialysis patients in this randomized, double-blind, placebo-controlled, four-arm parallel trial. Sixty stable hemodialysis patients who had all four diagnostic criteria for RLS developed by the International Restless Legs Syndrome Group with no acute illness or history of renal stone were randomly allocated to four fifteen-patient parallel groups to receive vitamin C (200 mg) and vitamin E (400 mg), vitamin C (200 mg) and placebo, vitamin E (400 mg) and placebo, and double placebo daily for eight weeks. International Restless Legs Scale (IRLS) scores were measured for all patients at baseline and at the end of treatment phase. The primary outcome was absolute change in IRLS sum score from baseline to the end of treatment phase. Means of IRLS sum score decreased significantly in the vitamins C and E (10.3 ± 5.3, 95% CI: 7.4-13.3), vitamin C and placebo (10 ± 3.5, 95% CI: 8.1-11.9), and vitamin E and placebo groups (10.1 ± 6, 95% CI: 6.8-13.5) compared with the double placebo group (3.1 ± 3, 95% CI: 1.5-4.8), (P<0.001); however, no differences were observed between these treatment groups. Vitamins C and E and their combination are safe and effective treatments for reducing the severity of RLS in hemodialysis patients over the short-term. Copyright © 2012 Elsevier B.V. All rights reserved.

Fetal and Childhood Exposure to Phthalate Diesters and Cognitive Function in Children Up to 12 Years of Age: Taiwanese Maternal and Infant Cohort Study

PubMed Central

Huang, Han-Bin; Chen, Hsin-Yi; Su, Pen-Hua; Huang, Po-Chin; Sun, Chien-Wen; Wang, Chien-Jen; Chen, Hsiao-Yen

2015-01-01

Few studies have examined the association between environmental phthalate exposure and children’s neurocognitive development. This longitudinal study examined cognitive function in relation to pre-and postnatal phthalate exposure in children 2–12 years old. We recruited 430 pregnant women in their third trimester in Taichung, Taiwan from 2001–2002. A total of 110, 79, 76, and 73 children were followed up at ages 2, 5, 8, and 11, respectively. We evaluated the children’s cognitive function at four different time points using the Bayley and Wechsler tests for assessing neurocognitive functions and intelligence (IQ). Urine samples were collected from mothers during pregnancy and from children at each follow-up visit. They were analyzed for seven metabolite concentrations of widely used phthalate esters. These esters included monomethyl phthalate, monoethyl phthalate, mono-butyl phthalate, mono-benzyl phthalate, and three metabolites of di(2-ethylhexyl) phthalate, namely, mono-2-ethylhexyl phthalate, mono(2-ethyl-5-hydroxyhexyl) phthalate, and mono(2-ethyl-5-oxohexyl) phthalate. We constructed a linear mixed model to examine the relationships between the phthalate metabolite concentrations and the Bayley and IQ scores. We found significant inverse associations between the children’s levels of urinary mono(2-ethyl-5-oxohexyl) phthalate and the sum of the three metabolites of di(2-ethylhexyl) phthalate and their IQ scores (β = -1.818; 95% CI: -3.061, -0.574, p = 0.004 for mono(2-ethyl-5-oxohexyl) phthalate; β = -1.575; 95% CI: -3.037, -0.113, p = 0.035 for the sum of the three metabolites) after controlling for maternal phthalate levels and potential confounders. We did not observe significant associations between maternal phthalate exposure and the children’s IQ scores. Children’s but not prenatal phthalate exposure was associated with decreased cognitive development in the young children. Large-scale prospective cohort studies are needed to confirm these findings in the future. PMID:26121592

Exact p-values for pairwise comparison of Friedman rank sums, with application to comparing classifiers.

PubMed

Eisinga, Rob; Heskes, Tom; Pelzer, Ben; Te Grotenhuis, Manfred

2017-01-25

The Friedman rank sum test is a widely-used nonparametric method in computational biology. In addition to examining the overall null hypothesis of no significant difference among any of the rank sums, it is typically of interest to conduct pairwise comparison tests. Current approaches to such tests rely on large-sample approximations, due to the numerical complexity of computing the exact distribution. These approximate methods lead to inaccurate estimates in the tail of the distribution, which is most relevant for p-value calculation. We propose an efficient, combinatorial exact approach for calculating the probability mass distribution of the rank sum difference statistic for pairwise comparison of Friedman rank sums, and compare exact results with recommended asymptotic approximations. Whereas the chi-squared approximation performs inferiorly to exact computation overall, others, particularly the normal, perform well, except for the extreme tail. Hence exact calculation offers an improvement when small p-values occur following multiple testing correction. Exact inference also enhances the identification of significant differences whenever the observed values are close to the approximate critical value. We illustrate the proposed method in the context of biological machine learning, were Friedman rank sum difference tests are commonly used for the comparison of classifiers over multiple datasets. We provide a computationally fast method to determine the exact p-value of the absolute rank sum difference of a pair of Friedman rank sums, making asymptotic tests obsolete. Calculation of exact p-values is easy to implement in statistical software and the implementation in R is provided in one of the Additional files and is also available at http://www.ru.nl/publish/pages/726696/friedmanrsd.zip .

Structure-property correlation study through sum-over-state approach

NASA Astrophysics Data System (ADS)

Nandi, P. K.; Hatua, K.; Bansh, A. K.; Panja, N.; Ghanty, T. K.

2015-01-01

The use of Thomas Kuhn (TK) sum rule in the expanded sum-over-state (SOS) expression of hyperpolarizabilities leads to various relationships between different order of polarizabilities and ground state dipole moment etc.

Spectacle wear in children reduces parental health-related quality of life

PubMed Central

Yamada, Tomohiko; Hatt, Sarah R.; Leske, David A.; Holmes, Jonathan M.

2011-01-01

Purpose To investigate whether spectacle wear in children affects responses on the Intermittent Exotropia Questionnaire (IXTQ) or the Pediatric Quality of Life Inventory (PedsQL). Methods We recruited 49 children, median age 8 years (range, 5–13), presenting with visual acuity 20/40 or better and an otherwise normal eye examination (no strabismus), who either had no refractive error (n = 29) or had refractive error corrected with spectacles (n = 20). The IXTQ and PedsQL were completed, each comprising a child report (Child IXTQ, Child PedsQL) and a parent proxy report (Proxy IXTQ, Proxy PedsQL). In addition, the IXTQ contains a parent self-report (Parent IXTQ). Each questionnaire is scored from 0 (worst health-related quality of life [HRQOL]) to 100 (best HRQOL). Median scores were compared using Wilcoxon rank-sum tests. Results Child IXTQ and Proxy IXTQ scores were similar between groups; nevertheless, Parent IXTQ scores were lower for spectacle wearers (90.4 vs 97.1, p = 0.01). Parent IXTQ questions that scored lower in the spectacle group were related to parental worry about permanent damage to their child’s eyes, longterm eyesight, surgery, self-consciousness, and teasing. The PedsQL composite scores and all subscale scores were similar between spectacle wearers and nonspectacle wearers, both for Child PedsQL and Proxy PedsQL. Conclusions Parental HRQOL, measured using the Parent IXTQ, was lower for children wearing spectacles than for children who did not wear spectacles. There was no difference between spectacle and no-spectacle groups using either Child IXTQ, Proxy IXTQ, Child PedsQL, or Proxy PedsQL. PMID:21315631

Diagnostic accuracy of the Patient Health Questionnaire-9 for assessment of depression in type II diabetes mellitus and/or coronary heart disease in primary care.

PubMed

van der Zwaan, G Lennart; van Dijk, Susan E M; Adriaanse, Marcel C; van Marwijk, Harm W J; van Tulder, Maurits W; Pols, Alide D; Bosmans, Judith E

2016-01-15

Depression is common among type 2 diabetes mellitus (DM2)/coronary heart disease (CHD) patients and is associated with adverse health effects. A promising strategy to reduce burden of disease is to identify patients at risk for depression in order to offer indicated prevention. This study aims to assess the diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) to be used as a tool to identify high risk patients. In this cross-sectional study, 586 consecutive DM2/CHD patients aged >18 were recruited through 23 general practices. PHQ-9 outcomes were compared to the Mini International Neuropsychiatric Interview (MINI), which was considered the reference standard. Diagnostic accuracy was evaluated for minor and major depression, comparing both sum- and algorithm based PHQ-9 scores. For minor depression, the optimal cut-off score was 8 (sensitivity 71%, specificity 71% and an AUC of 0.74). For major depression, the optimal cut-off score was 10 resulting in a sensitivity of 84%, a specificity of 82%, and an AUC of 0.88. The positive predictive value of the PHQ-9 algorithm for diagnosing minor and major depression was 25% and 33%, respectively. Two main limitations apply. MINI Interviewers were not blinded for PHQ-9 scores and less than 10% of all invited patients could be included in the analyses. This could have resulted in biased outcomes. The PHQ-9 sum score performs well in identifying patients at high risk of minor and major depression. However, the PHQ-9 showed suboptimal results for diagnostic purposes. Therefore, it is recommended to combine the use of the PHQ-9 with further diagnostics to identify depression. Copyright © 2015 Elsevier B.V. All rights reserved.

[Measurement of physical activity in older adults. Correlation between the PRISCUS-PAQ and accelerometry].

PubMed

Trampisch, U S; Platen, P; Moschny, A; Wilm, S; Thiem, U; Hinrichs, T

2012-04-01

The German questionnaire PRISCUS-PAQ was developed to measure actual physical activity of older adults in a telephone interview. PRISCUS-PAQ consists of ten main questions to assess the time spend in domestic activities (e.g., housework, gardening), sporting activities (e.g., riding a bicycle), and inactivity (e.g., sedentary activity, sleeping during the day) during the prior week. By assessing the number of days for each activity and the mean duration of performing this activity, a total score can be calculated. The total score corresponds to the energy consumption for 1 week. The aim of this study is to estimate the correlation of the PRISCUS-PAQ total score and accelerometry as an objective measurement method for the assessment of physical activity. A total of 114 participants (58% women) with a mean age of 76 years participated in the study. PRISCUS-PAQ was initially analyzed descriptively. To assess the validity of PRISCUS-PAQ, the correlation (correlation coefficient of Spearman) was calculated between the total score of the questionnaire PRISCUS-PAQ and the 95% trimmed sum of an accelerometer with a measurement period of 1 week. The correlation coefficient for the association of the PRISCUS-PAQ total score and the 95% trimmed sum of the acceleration values was r = 0.28 (95% confidence interval 0.10–0.44). Activities of daily life like cleaning and other domestic activities highly contributed to the weekly energy consumption of the participants. The association between the PRISCUS-PAQ questionnaire and accelerometry measured physical activity is comparable to other validated and established international questionnaires. The PRISCUS-PAQ is the first German questionnaire that allows the measurement of physical activity of older adults in a telephone interview.

Preventability of early vs. late readmissions in an academic medical center

PubMed Central

Graham, Kelly L.; Dike, Ogechi; Doctoroff, Lauren; Jupiter, Marisa; Vanka, Anita

2017-01-01

Background It is unclear if the 30-day unplanned hospital readmission rate is a plausible accountability metric. Objective Compare preventability of hospital readmissions, between an early period [0–7 days post-discharge] and a late period [8–30 days post-discharge]. Compare causes of readmission, and frequency of markers of clinical instability 24h prior to discharge between early and late readmissions. Design, setting, patients 120 patient readmissions in an academic medical center between 1/1/2009-12/31/2010 Measures Sum-score based on a standard algorithm that assesses preventability of each readmission based on blinded hospitalist review; average causation score for seven types of adverse events; rates of markers of clinical instability within 24h prior to discharge. Results Readmissions were significantly more preventable in the early compared to the late period [median preventability sum score 8.5 vs. 8.0, p = 0.03]. There were significantly more management errors as causative events for the readmission in the early compared to the late period [mean causation score [scale 1–6, 6 most causal] 2.0 vs. 1.5, p = 0.04], and these errors were significantly more preventable in the early compared to the late period [mean preventability score 1.9 vs 1.5, p = 0.03]. Patients readmitted in the early period were significantly more likely to have mental status changes documented 24h prior to hospital discharge than patients readmitted in the late period [12% vs. 0%, p = 0.01]. Conclusions Readmissions occurring in the early period were significantly more preventable. Early readmissions were associated with more management errors, and mental status changes 24h prior to discharge. Seven-day readmissions may be a better accountability measure. PMID:28622384

Impairment of perception and recognition of faces, mimic expression and gestures in schizophrenic patients.

PubMed

Berndl, K; von Cranach, M; Grüsser, O J

1986-01-01

The perception and recognition of faces, mimic expression and gestures were investigated in normal subjects and schizophrenic patients by means of a movie test described in a previous report (Berndl et al. 1986). The error scores were compared with results from a semi-quantitative evaluation of psychopathological symptoms and with some data from the case histories. The overall error scores found in the three groups of schizophrenic patients (paranoic, hebephrenic, schizo-affective) were significantly increased (7-fold) over those of normals. No significant difference in the distribution of the error scores in the three different patient groups was found. In 10 different sub-tests following the movie the deficiencies found in the schizophrenic patients were analysed in detail. The error score for the averbal test was on average higher in paranoic patients than in the two other groups of patients, while the opposite was true for the error scores found in the verbal tests. Age and sex had some impact on the test results. In normals, female subjects were somewhat better than male. In schizophrenic patients the reverse was true. Thus female patients were more affected by the disease than male patients with respect to the task performance. The correlation between duration of the disease and error score was small; less than 10% of the error scores could be attributed to factors related to the duration of illness. Evaluation of psychopathological symptoms indicated that the stronger the schizophrenic defect, the higher the error score, but again this relationship was responsible for not more than 10% of the errors. The estimated degree of acute psychosis and overall sum of psychopathological abnormalities as scored in a semi-quantitative exploration did not correlate with the error score, but with each other. Similarly, treatment with psychopharmaceuticals, previous misuse of drugs or of alcohol had practically no effect on the outcome of the test data. The analysis of performance and test data of schizophrenic patients indicated that our findings are most likely not due to a "non-specific" impairment of cognitive function in schizophrenia, but point to a fairly selective defect in elementary cognitive visual functions necessary for averbal social communication. Some possible explanations of the data are discussed in relation to neuropsychological and neurophysiological findings on "face-specific" cortical areas located in the primate temporal lobe.

Prognostic validation of a 17-segment score derived from a 20-segment score for myocardial perfusion SPECT interpretation.

PubMed

Berman, Daniel S; Abidov, Aiden; Kang, Xingping; Hayes, Sean W; Friedman, John D; Sciammarella, Maria G; Cohen, Ishac; Gerlach, James; Waechter, Parker B; Germano, Guido; Hachamovitch, Rory

2004-01-01

Recently, a 17-segment model of the left ventricle has been recommended as an optimally weighted approach for interpreting myocardial perfusion single photon emission computed tomography (SPECT). Methods to convert databases from previous 20- to new 17-segment data and criteria for abnormality for the 17-segment scores are needed. Initially, for derivation of the conversion algorithm, 65 patients were studied (algorithm population) (pilot group, n = 28; validation group, n = 37). Three conversion algorithms were derived: algorithm 1, which used mid, distal, and apical scores; algorithm 2, which used distal and apical scores alone; and algorithm 3, which used maximal scores of the distal septal, lateral, and apical segments in the 20-segment model for 3 corresponding segments of the 17-segment model. The prognosis population comprised 16,020 consecutive patients (mean age, 65 +/- 12 years; 41% women) who had exercise or vasodilator stress technetium 99m sestamibi myocardial perfusion SPECT and were followed up for 2.1 +/- 0.8 years. In this population, 17-segment scores were derived from 20-segment scores by use of algorithm 2, which demonstrated the best agreement with expert 17-segment reading in the algorithm population. The prognostic value of the 20- and 17-segment scores was compared by converting the respective summed scores into percent myocardium abnormal. Conversion algorithm 2 was found to be highly concordant with expert visual analysis by the 17-segment model (r = 0.982; kappa = 0.866) in the algorithm population. In the prognosis population, 456 cardiac deaths occurred during follow-up. When the conversion algorithm was applied, extent and severity of perfusion defects were nearly identical by 20- and derived 17-segment scores. The receiver operating characteristic curve areas by 20- and 17-segment perfusion scores were identical for predicting cardiac death (both 0.77 +/- 0.02, P = not significant). The optimal prognostic cutoff value for either 20- or derived 17-segment models was confirmed to be 5% myocardium abnormal, corresponding to a summed stress score greater than 3. Of note, the 17-segment model demonstrated a trend toward fewer mildly abnormal scans and more normal and severely abnormal scans. An algorithm for conversion of 20-segment perfusion scores to 17-segment scores has been developed that is highly concordant with expert visual analysis by the 17-segment model and provides nearly identical prognostic information. This conversion model may provide a mechanism for comparison of studies analyzed by the 17-segment system with previous studies analyzed by the 20-segment approach.

Mobile Visual Search Based on Histogram Matching and Zone Weight Learning

NASA Astrophysics Data System (ADS)

Zhu, Chuang; Tao, Li; Yang, Fan; Lu, Tao; Jia, Huizhu; Xie, Xiaodong

2018-01-01

In this paper, we propose a novel image retrieval algorithm for mobile visual search. At first, a short visual codebook is generated based on the descriptor database to represent the statistical information of the dataset. Then, an accurate local descriptor similarity score is computed by merging the tf-idf weighted histogram matching and the weighting strategy in compact descriptors for visual search (CDVS). At last, both the global descriptor matching score and the local descriptor similarity score are summed up to rerank the retrieval results according to the learned zone weights. The results show that the proposed approach outperforms the state-of-the-art image retrieval method in CDVS.

The Beast of Aggregating Cognitive Load Measures in Technology-Based Learning

ERIC Educational Resources Information Center

Leppink, Jimmie; van Merriënboer, Jeroen J. G.

2015-01-01

An increasing part of cognitive load research in technology-based learning includes a component of repeated measurements, that is: participants are measured two or more times on the same performance, mental effort or other variable of interest. In many cases, researchers aggregate scores obtained from repeated measurements to one single sum or…

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2013 CFR

2013-01-01

... follows: (1) The rural population of a core coverage area must be calculated. The rural population of a county is calculated by subtracting the county's urban population(s) from the total county population. If the core coverage area consists of multiple counties, the rural population is the sum of all included...

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2014 CFR

2014-01-01

... follows: (1) The rural population of a core coverage area must be calculated. The rural population of a county is calculated by subtracting the county's urban population(s) from the total county population. If the core coverage area consists of multiple counties, the rural population is the sum of all included...

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2012 CFR

2012-01-01

... follows: (1) The rural population of a core coverage area must be calculated. The rural population of a county is calculated by subtracting the county's urban population(s) from the total county population. If the core coverage area consists of multiple counties, the rural population is the sum of all included...

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2011 CFR

2011-01-01

... follows: (1) The rural population of a core coverage area must be calculated. The rural population of a county is calculated by subtracting the county's urban population(s) from the total county population. If the core coverage area consists of multiple counties, the rural population is the sum of all included...

Evaluation of Scale Reliability with Binary Measures Using Latent Variable Modeling

ERIC Educational Resources Information Center

Raykov, Tenko; Dimitrov, Dimiter M.; Asparouhov, Tihomir

2010-01-01

A method for interval estimation of scale reliability with discrete data is outlined. The approach is applicable with multi-item instruments consisting of binary measures, and is developed within the latent variable modeling methodology. The procedure is useful for evaluation of consistency of single measures and of sum scores from item sets…

Large Sample Confidence Intervals for Item Response Theory Reliability Coefficients

ERIC Educational Resources Information Center

Andersson, Björn; Xin, Tao

2018-01-01

In applications of item response theory (IRT), an estimate of the reliability of the ability estimates or sum scores is often reported. However, analytical expressions for the standard errors of the estimators of the reliability coefficients are not available in the literature and therefore the variability associated with the estimated reliability…

On the Relationship between Individual Creativity and Time Management

ERIC Educational Resources Information Center

Zampetakis, Leonidas A.; Bouranta, Nancy; Moustakis, Vassilis S.

2010-01-01

The article investigates the relationship between time management behaviours and attitudes with measures of creativity, as assessed by self-rated creativity and a measure of creative personality. Additionally, total creativity is examined, as the sum of the two creativity constructs when z-scored. Using data from a survey of 186 participants,…

Impact of Dose to the Bladder Trigone on Long-Term Urinary Function After High-Dose Intensity Modulated Radiation Therapy for Localized Prostate Cancer

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

Ghadjar, Pirus; Zelefsky, Michael J.; Spratt, Daniel E.

2014-02-01

Purpose: To determine the potential association between genitourinary (GU) toxicity and planning dose–volume parameters for GU pelvic structures after high-dose intensity modulated radiation therapy in localized prostate cancer patients. Methods and Materials: A total of 268 patients who underwent intensity modulated radiation therapy to a prescribed dose of 86.4 Gy in 48 fractions during June 2004-December 2008 were evaluated with the International Prostate Symptom Score (IPSS) questionnaire. Dose–volume histograms of the whole bladder, bladder wall, urethra, and bladder trigone were analyzed. The primary endpoint for GU toxicity was an IPSS sum increase ≥10 points over baseline. Univariate and multivariate analysesmore » were done by the Kaplan-Meier method and Cox proportional hazard models, respectively. Results: Median follow-up was 5 years (range, 3-7.7 years). Thirty-nine patients experienced an IPSS sum increase ≥10 during follow-up; 84% remained event free at 5 years. After univariate analysis, lower baseline IPSS sum (P=.006), the V90 of the trigone (P=.006), and the maximal dose to the trigone (P=.003) were significantly associated with an IPSS sum increase ≥10. After multivariate analysis, lower baseline IPSS sum (P=.009) and increased maximal dose to the trigone (P=.005) remained significantly associated. Seventy-two patients had both a lower baseline IPSS sum and a higher maximal dose to the trigone and were defined as high risk, and 68 patients had both a higher baseline IPSS sum and a lower maximal dose to the trigone and were defined as low risk for development of an IPSS sum increase ≥10. Twenty-one of 72 high-risk patients (29%) and 5 of 68 low-risk patients (7%) experienced an IPSS sum increase ≥10 (P=.001; odds ratio 5.19). Conclusions: The application of hot spots to the bladder trigone was significantly associated with relevant changes in IPSS during follow-up. Reduction of radiation dose to the lower bladder and specifically the bladder trigone seems to be associated with a reduction in late GU toxicity.« less

The quality of nutrition and physical activity environments of child-care centers across three states in the southern U.S.

PubMed

Erinosho, Temitope; Vaughn, Amber; Hales, Derek; Mazzucca, Stephanie; Gizlice, Ziya; Treadway, Cayla; Kelly, Alexandra; Ward, Dianne

2018-04-29

This cross-sectional study assessed the quality of nutrition and physical activity environments of child-care centers in three southern states and examined differences by rural versus urban location, participation in the Child and Adult Care Food Program, and Head Start status. The sample included 354 centers that enroll children aged 2-5: 154 centers from Georgia, 103 from Kentucky, and 97 centers from Mississippi. Directors and 1-2 teachers per center completed the Environment and Policy Assessment and Observation Self-Report (EPAO-SR) tool that assesses nutrition and physical activity environments of child-care centers. The EPAO-SR items were scored to capture six nutrition domains and six physical activity domains that were averaged and then summed to create a combined nutrition and physical activity environment score (range = 0-36); higher scores indicated that centers met more best practices, which translated to higher-quality environments. Overall, the centers had an average combined nutrition and physical activity environment score of 20.2 out of 36. The scores did not differ between rural and urban centers (mean = 20.3 versus 20.2, p = 0.98). Centers in the Child and Adult Care Food Program had higher combined nutrition and physical activity environment scores than non-participating centers (mean = 20.6 versus 19.1, p < 0.01). Head Start centers also had higher combined environment scores than non-Head Start centers (mean = 22.3 versus 19.6, p < 0.01). Findings highlight the vital role of federal programs in supporting healthy child-care environments. Providing technical assistance and training to centers that are not enrolled in well-regulated, federally-funded programs might help to enhance the quality of their nutrition and physical activity environments. Copyright © 2017. Published by Elsevier Inc.

Utilization of case presentations in medical microbiology to enhance relevance of basic science for medical students.

PubMed

Chamberlain, Neal R; Stuart, Melissa K; Singh, Vineet K; Sargentini, Neil J

2012-01-01

Small-group case presentation exercises (CPs) were created to increase course relevance for medical students taking Medical Microbiology (MM) and Infectious Diseases (ID) METHODS: Each student received a unique paper case and had 10 minutes to review patient history, physical exam data, and laboratory data. Students then had three minutes to orally present their case and defend why they ruled in or out each of the answer choices provided, followed by an additional three minutes to answer questions. Exam scores differed significantly between students who received the traditional lecture-laboratory curriculum (Group I) and students who participated in the CPs (Group II). In MM, median unit exam and final exam scores for Group I students were 84.4% and 77.8%, compared to 86.0% and 82.2% for Group II students (P<0.018; P<0.001; Mann-Whitney Rank Sum Test). Median unit and final ID exam scores for Group I students were 84.0% and 80.0%, compared to 88.0% and 86.7% for Group II students (P<0.001; P<0.001). Students felt that the CPs improved their critical thinking and presentation skills and helped to prepare them as future physicians.

[Traditional Chinese medicine syndrome factors of patients with HIV infection or AIDS in China].

PubMed

Jiang, Feng; Fu, Lin-chun; Ma, Jian-ping; Zhou, Qing; Peng, Bo; Xie, Shi-ping; Guo, Hui-jun; Dong, Yong-xin; Ma, Xiu-lan; Guo, Xuan-xian; Xie, Zhong-li; Hu, Yan-ping; Li, Qing-ya; Li, Hua-wei; Jin, Yan-tao

2011-09-01

To study the characteristics of traditional Chinese medicine (TCM) syndrome factors of patients from different areas of China with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS). A cross-sectional investigation study was conducted in Henan, Guangdong and Yunnan Provinces and Xinjiang Uygur Autonomous Region of China from October 2008 to August 2010. Based on literature review and expert opinion, a clinical questionnaire of TCM syndromes was drawn up. This survey was carried out after the investigators were professionally trained. Wenfeng III Auxiliary Diagnosis and Treat System of TCM was used to analyze the frequencies of AIDS patients' signs and symptoms with scores above 70 of syndrome factors respectively. Based on this work, syndrome factors of AIDS were analyzed in different areas. There were 608 HIV/AIDS cases investigated from October 2008 to August 2010 in total; among them, 276 cases were from Henan, 126 cases from Guangdong, 120 cases from Xinjiang and 86 cases from Yunnan. The results of syndrome factor analysis indicated that the syndromes of four provinces were similar. HIV/AIDS patients in the four areas exhibited qi deficiency, blood deficiency, yin deficiency, yang deficiency, dampness, phlegm, qi stagnation and essence deficiency syndromes. Patients in each area also had their own characteristics, such as that the scores of dampness of Guangdong and yin deficiency of Xinjiang were higher than the other syndromes, whereas the scores of Henan Province were higher than the other areas. AIDS patients had higher scores of syndromes than HIV-infected patients. HIV/AIDS patients from different areas had similar syndrome elements. The theory of "AIDS toxin injuring primordial qi" can sum up the TCM etiology and pathogenesis of HIV/AIDS.

Establishing robust cognitive dimensions for characterization and differentiation of patients with Alzheimer's disease, mild cognitive impairment, frontotemporal dementia and depression.

PubMed

Beck, Irene R; Schmid, Nicole S; Berres, Manfred; Monsch, Andreas U

2014-06-01

The diagnosis of mild cognitive impairment (MCI) and dementia requires detailed neuropsychological examinations. These examinations typically yield a large number of outcome variables, which may complicate the interpretation and communication of results. The purposes of this study were the following: (i) to reduce a large data set of interrelated neuropsychological variables to a smaller number of cognitive dimensions; (ii) to create a common metric for these dimensions (z-scores); and (iii) to study the ability of the cognitive dimensions to distinguish between groups of patients with different types of cognitive impairment. We tested 1646 patients with different forms of dementia or with a major depression with a standard (n = 632) or, if cognitively less affected, a challenging neuropsychological battery (n = 1014). To identify the underlying cognitive dimensions of the two test batteries, maximum likelihood factor analyses with a promax rotation were conducted. To interpret the sum scores of the factors as standard scores, we divided them by the standard deviation of a cognitively healthy sample (n = 1145). The factor analyses yielded seven factors for each test battery. The cognitive dimensions in both test batteries distinguished patients with different forms of dementia (MCI, Alzheimer's dementia or frontotemporal dementia) and patients with major depression. Furthermore, patients with stable MCI could be separated from patients with progressing MCI. Discriminant analyses with an independent new sample of patients (n = 306) revealed that the new dimension scores distinguished new samples of patients with MCI from patients with Alzheimer's dementia with high accuracy. These findings suggest that these cognitive dimensions may benefit neuropsychological diagnostics. © 2013 The Authors International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.

Establishing robust cognitive dimensions for characterization and differentiation of patients with Alzheimer's disease, mild cognitive impairment, frontotemporal dementia and depression

PubMed Central

Beck, Irene R; Schmid, Nicole S; Berres, Manfred; Monsch, Andreas U

2014-01-01

Objective The diagnosis of mild cognitive impairment (MCI) and dementia requires detailed neuropsychological examinations. These examinations typically yield a large number of outcome variables, which may complicate the interpretation and communication of results. The purposes of this study were the following: (i) to reduce a large data set of interrelated neuropsychological variables to a smaller number of cognitive dimensions; (ii) to create a common metric for these dimensions (z-scores); and (iii) to study the ability of the cognitive dimensions to distinguish between groups of patients with different types of cognitive impairment. Methods We tested 1646 patients with different forms of dementia or with a major depression with a standard (n = 632) or, if cognitively less affected, a challenging neuropsychological battery (n = 1014). To identify the underlying cognitive dimensions of the two test batteries, maximum likelihood factor analyses with a promax rotation were conducted. To interpret the sum scores of the factors as standard scores, we divided them by the standard deviation of a cognitively healthy sample (n = 1145). Results The factor analyses yielded seven factors for each test battery. The cognitive dimensions in both test batteries distinguished patients with different forms of dementia (MCI, Alzheimer's dementia or frontotemporal dementia) and patients with major depression. Furthermore, patients with stable MCI could be separated from patients with progressing MCI. Discriminant analyses with an independent new sample of patients (n = 306) revealed that the new dimension scores distinguished new samples of patients with MCI from patients with Alzheimer's dementia with high accuracy. Conclusion These findings suggest that these cognitive dimensions may benefit neuropsychological diagnostics. PMID:24227657

Physique and Performance of Young Wheelchair Basketball Players in Relation with Classification

PubMed Central

Zancanaro, Carlo

2015-01-01

The relationships among physical characteristics, performance, and functional ability classification of younger wheelchair basketball players have been barely investigated to date. The purpose of this work was to assess anthropometry, body composition, and performance in sport-specific field tests in a national sample of Italian younger wheelchair basketball players as well as to evaluate the association of these variables with the players’ functional ability classification and game-related statistics. Several anthropometric measurements were obtained for 52 out of 91 eligible players nationwide. Performance was assessed in seven sport-specific field tests (5m sprint, 20m sprint with ball, suicide, maximal pass, pass for accuracy, spot shot and lay-ups) and game-related statistics (free-throw points scored per match, two- and three-point field-goals scored per match, and their sum). Association between variables, and predictivity was assessed by correlation and regression analysis, respectively. Players were grouped into four Classes of increasing functional ability (A-D). One-way ANOVA with Bonferroni’s correction for multiple comparisons was used to assess differences between Classes. Sitting height and functional ability Class especially correlated with performance outcomes, but wheelchair basketball experience and skinfolds did not. Game-related statistics and sport-specific field-test scores all showed significant correlation with each other. Upper arm circumference and/or maximal pass and lay-ups test scores were able to explain 42 to 59% of variance in game-related statistics (P<0.001). A clear difference in performance was only found for functional ability Class A and D. Conclusion: In younger wheelchair basketball players, sitting height positively contributes to performance. The maximal pass and lay-ups test should be carefully considered in younger wheelchair basketball training plans. Functional ability Class reflects to a limited extent the actual differences in performance. PMID:26606681

Comparison of two barium suspensions for dedicated small-bowel series.

PubMed

Davidson, J C; Einstein, D M; Herts, B R; Balfe, D M; Koehler, R E; Morgan, D E; Lieber, M; Baker, M E

1999-02-01

The in vivo radiographic features of two commercially available formulations of barium used as contrast media in dedicated small-bowel series were compared. Fifty-six consecutive outpatients referred for a dedicated small-bowel series were randomly administered either E-Z-Paque or Entrobar. Representative survey radiographs from each examination were randomized and reviewed by six gastrointestinal radiologists from three institutions. Each observer assigned a numeric score (1 = poor, 2 = fair, 3 = good, and 4 = excellent) that rated the quality of the radiograph with respect to these characteristics: definition of fold pattern, translucency, distention, and integrity of the barium column. Statistical analysis was performed for each characteristic using Wilcoxon's two-sample rank sum test. All six observers found a statistically significant difference between the two barium formulations for mean scores for definition of fold pattern and translucency. Mean scores for fold pattern were 3.3, 3.0, 3.2, 3.6, 3.3, and 3.4 for Entrobar and 2.1, 2.3, 2.4, 3.2, 2.6, and 2.7 for E-Z-Paque. Mean scores for translucency were 2.5, 2.7, 2.8, 3.1, 2.7, and 3.3 for Entrobar and 1.6, 1.7, 2.1, 2.3, 1.9, and 2.7 for E-Z-Paque. No statistically significant difference was found for mean score for distention or integrity of the barium column. On radiographs, Entrobar was found to have superior characteristics for visualization of fold pattern and translucency but offered no advantages for distention or integrity of the barium column. Improved translucency and definition of fold pattern may translate into improved sensitivity and confidence in diagnosing small-bowel abnormality.

Value of the cumulative sum test for the assessment of a learning curve: Application to the introduction of patient-specific instrumentation for total knee arthroplasty in an academic department.

PubMed

De Gori, Marco; Adamczewski, Benjamin; Jenny, Jean-Yves

2017-06-01

The purpose of the study was to use the cumulative summation (CUSUM) test to assess the learning curve during the introduction of a new surgical technique (patient-specific instrumentation) in total knee arthroplasty (TKA) in an academic department. The first 50TKAs operated on at an academic department using patient-specific templates (PSTs) were scheduled to enter the study. All patients had a preoperative computed tomography scan evaluation to plan bone resections. The PSTs were positioned intraoperatively according to the best-fit technique and their three-dimensional orientation was recorded by a navigation system. The position of the femur and tibia PST was compared to the planned position for four items for each component: coronal and sagittal orientation, medial and lateral height of resection. Items were summarized to obtain knee, femur and tibia PST scores, respectively. These scores were plotted according to chronological order and included in a CUSUM analysis. The tested hypothesis was that the PST process for TKA was immediately under control after its introduction. CUSUM test showed that positioning of the PST significantly differed from the target throughout the study. There was a significant difference between all scores and the maximal score. No case obtained the maximal score of eight points. The study was interrupted after 20 cases because of this negative evaluation. The CUSUM test is effective in monitoring the learning curve when introducing a new surgical procedure. Introducing PST for TKA in an academic department may be associated with a long-lasting learning curve. The study was registered on the clinical.gov website (Identifier NCT02429245). Copyright © 2017 Elsevier B.V. All rights reserved.

Objective assessment of operator performance during ultrasound-guided procedures.

PubMed

Tabriz, David M; Street, Mandie; Pilgram, Thomas K; Duncan, James R

2011-09-01

Simulation permits objective assessment of operator performance in a controlled and safe environment. Image-guided procedures often require accurate needle placement, and we designed a system to monitor how ultrasound guidance is used to monitor needle advancement toward a target. The results were correlated with other estimates of operator skill. The simulator consisted of a tissue phantom, ultrasound unit, and electromagnetic tracking system. Operators were asked to guide a needle toward a visible point target. Performance was video-recorded and synchronized with the electromagnetic tracking data. A series of algorithms based on motor control theory and human information processing were used to convert raw tracking data into different performance indices. Scoring algorithms converted the tracking data into efficiency, quality, task difficulty, and targeting scores that were aggregated to create performance indices. After initial feasibility testing, a standardized assessment was developed. Operators (N = 12) with a broad spectrum of skill and experience were enrolled and tested. Overall scores were based on performance during ten simulated procedures. Prior clinical experience was used to independently estimate operator skill. When summed, the performance indices correlated well with estimated skill. Operators with minimal or no prior experience scored markedly lower than experienced operators. The overall score tended to increase according to operator's clinical experience. Operator experience was linked to decreased variation in multiple aspects of performance. The aggregated results of multiple trials provided the best correlation between estimated skill and performance. A metric for the operator's ability to maintain the needle aimed at the target discriminated between operators with different levels of experience. This study used a highly focused task model, standardized assessment, and objective data analysis to assess performance during simulated ultrasound-guided needle placement. The performance indices were closely related to operator experience.

Influence of Teaching Strategies and its Order of Exposure on Pre-Clinical Teeth Arrangement – A Pilot Study

PubMed Central

Mani, Uma Maheswari; Christian, Jayanth; Seenivasan, Madhan Kumar; Natarajan, Parthasarathy; Vaidhyanathan, Anand Kumar

2016-01-01

Introduction Teeth arrangement is a vital skill for the undergraduate dental student. The attainment of skills depends largely on the methodology of teaching. In a dental curriculum, the students are exposed to a wide variety of inputs and teaching methodologies from different sources. The educational unit in dental school must identify the sequence of teaching methods that enhance the learning and practising ability of students. Aim The aim of this study was to evaluate the effectiveness of three different teaching methodologies for teeth arrangement and compare the differences between the orders of exposure to each teaching methodology on the development of teeth arrangement skills. Materials and Methods The first year B.D.S students were study participants and were divided into three groups A, B, C. They were exposed to three teaching patterns namely live demonstration with video assisted teaching, group discussion with hand-outs and lectures with power point presentation. After each teaching methodology, their skill was assessed. The groups were exposed to three methodologies in different order for three arrangements. The scores obtained were analysed using Kruskal Wallis rank sum test and Dunn test for statistical significance. Results Significantly higher scores in the teeth arrangement procedure were obtained by the Group A students who were exposed initially to live demonstration with video-assisted teaching. Difference in the scores was noted among and within the groups. The difference between Group A and Group C was statistically significant after both first and third teeth arrangement (p=0.0031, p=0.0057). Conclusion The study suggests each pre-clinical practice should begin with a live demonstration to enhance immediate learning absorption followed by lectures with power point presentation and group discussion for retention of knowledge and memory retrieval. PMID:27891468

Influence of Teaching Strategies and its Order of Exposure on Pre-Clinical Teeth Arrangement - A Pilot Study.

PubMed

Jeyapalan, Karthigeyan; Mani, Uma Maheswari; Christian, Jayanth; Seenivasan, Madhan Kumar; Natarajan, Parthasarathy; Vaidhyanathan, Anand Kumar

2016-10-01

Teeth arrangement is a vital skill for the undergraduate dental student. The attainment of skills depends largely on the methodology of teaching. In a dental curriculum, the students are exposed to a wide variety of inputs and teaching methodologies from different sources. The educational unit in dental school must identify the sequence of teaching methods that enhance the learning and practising ability of students. The aim of this study was to evaluate the effectiveness of three different teaching methodologies for teeth arrangement and compare the differences between the orders of exposure to each teaching methodology on the development of teeth arrangement skills. The first year B.D.S students were study participants and were divided into three groups A, B, C. They were exposed to three teaching patterns namely live demonstration with video assisted teaching, group discussion with hand-outs and lectures with power point presentation. After each teaching methodology, their skill was assessed. The groups were exposed to three methodologies in different order for three arrangements. The scores obtained were analysed using Kruskal Wallis rank sum test and Dunn test for statistical significance. Significantly higher scores in the teeth arrangement procedure were obtained by the Group A students who were exposed initially to live demonstration with video-assisted teaching. Difference in the scores was noted among and within the groups. The difference between Group A and Group C was statistically significant after both first and third teeth arrangement (p=0.0031, p=0.0057). The study suggests each pre-clinical practice should begin with a live demonstration to enhance immediate learning absorption followed by lectures with power point presentation and group discussion for retention of knowledge and memory retrieval.

The Association between Cardiovascular Disease Risk and Parental Educational Level in Portuguese Children

PubMed Central

Duncan, Michael J.; Vale, Susana; Santos, Maria Paula; Ribeiro, José Carlos; Mota, Jorge

2012-01-01

The aim of this study was to examine any differences in cardiovascular disease (CVD) risk in Portuguese children split by parental educational level. A cross-sectional school-based study was conducted in 2011 on 359 Portuguese children (202 girls and 157 boys) aged 10 to 17 years (mean age ± SD = 13.9 ± 1.98 years). Height and body mass were assessed to determine body mass index (BMI). Parental education level (PEL) was used as a surrogate for socioeconomic status (SES). Capillary blood sampling was used to determine: Total Cholesterol (TC), Triglycerides (TG), Fasting Glucos (GLUC), High and Low Density Lipoprotein (HDL/LDL). These measurements were combined with measures of systolic blood pressure and cardiorespiratory fitness as z-scores. CVD risk was constructed by summing the z-scores. Analysis of covariance, controlling for BMI, indicated that CVD risk was significantly different across PEL groups (p = 0.01), with CVD risk score being significantly lower in low (p = 0.04) and middle (p = 0.008) PEL groups, compared to high PEL. Moreover, the covariate, BMI was also significant (p = 0.0001, β = 0.023), evidencing a significant positive association between BMI and CVD risk, with higher BMI associated with greater CVD risk. In Portuguese children, significantly greater CVD risk was found for children of high PEL, while higher BMI was associated with greater CVD risk. PMID:23330223

Association Between Dietary Intake and Function in Amyotrophic Lateral Sclerosis.

PubMed

Nieves, Jeri W; Gennings, Chris; Factor-Litvak, Pam; Hupf, Jonathan; Singleton, Jessica; Sharf, Valerie; Oskarsson, Björn; Fernandes Filho, J Americo M; Sorenson, Eric J; D'Amico, Emanuele; Goetz, Ray; Mitsumoto, Hiroshi

2016-12-01

There is growing interest in the role of nutrition in the pathogenesis and progression of amyotrophic lateral sclerosis (ALS). To evaluate the associations between nutrients, individually and in groups, and ALS function and respiratory function at diagnosis. A cross-sectional baseline analysis of the Amyotrophic Lateral Sclerosis Multicenter Cohort Study of Oxidative Stress study was conducted from March 14, 2008, to February 27, 2013, at 16 ALS clinics throughout the United States among 302 patients with ALS symptom duration of 18 months or less. Nutrient intake, measured using a modified Block Food Frequency Questionnaire (FFQ). Amyotrophic lateral sclerosis function, measured using the ALS Functional Rating Scale-Revised (ALSFRS-R), and respiratory function, measured using percentage of predicted forced vital capacity (FVC). Baseline data were available on 302 patients with ALS (median age, 63.2 years [interquartile range, 55.5-68.0 years]; 178 men and 124 women). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALSFRS-R scores or percentage FVC. Empirically weighted indices using the weighted quantile sum regression method of "good" micronutrients and "good" food groups were positively associated with ALSFRS-R scores (β [SE], 2.7 [0.69] and 2.9 [0.9], respectively) and percentage FVC (β [SE], 12.1 [2.8] and 11.5 [3.4], respectively) (all P < .001). Positive and significant associations with ALSFRS-R scores (β [SE], 1.5 [0.61]; P = .02) and percentage FVC (β [SE], 5.2 [2.2]; P = .02) for selected vitamins were found in exploratory analyses. Antioxidants, carotenes, fruits, and vegetables were associated with higher ALS function at baseline by regression of nutrient indices and weighted quantile sum regression analysis. We also demonstrated the usefulness of the weighted quantile sum regression method in the evaluation of diet. Those responsible for nutritional care of the patient with ALS should consider promoting fruit and vegetable intake since they are high in antioxidants and carotenes.

A comparison of simulation-based education versus lecture-based instruction for toxicology training in emergency medicine residents.

PubMed

Maddry, Joseph K; Varney, Shawn M; Sessions, Daniel; Heard, Kennon; Thaxton, Robert E; Ganem, Victoria J; Zarzabal, Lee A; Bebarta, Vikhyat S

2014-12-01

Simulation-based teaching (SIM) is a common method for medical education. SIM exposes residents to uncommon scenarios that require critical, timely actions. SIM may be a valuable training method for critically ill poisoned patients whose diagnosis and treatment depend on key clinical findings. Our objective was to compare medical simulation (SIM) to traditional lecture-based instruction (LEC) for training emergency medicine (EM) residents in the acute management of critically ill poisoned patients. EM residents completed two pre-intervention questionnaires: (1) a 24-item multiple-choice test of four toxicological emergencies and (2) a questionnaire using a five-point Likert scale to rate the residents' comfort level in diagnosing and treating patients with specific toxicological emergencies. After completing the pre-intervention questionnaires, residents were randomized to SIM or LEC instruction. Two toxicologists and three EM physicians presented four toxicology topics to both groups in four 20-min sessions. One group was in the simulation center, and the other in a lecture hall. Each group then repeated the multiple-choice test and questionnaire immediately after instruction and again at 3 months after training. Answers were not discussed. The primary outcome was comparison of immediate mean post-intervention test scores and final scores 3 months later between SIM and LEC groups. Test score outcomes between groups were compared at each time point (pre-test, post-instruction, 3-month follow-up) using Wilcoxon rank sum test. Data were summarized by descriptive statistics. Continuous variables were characterized by means (SD) and tested using t tests or Wilcoxon rank sum. Categorical variables were summarized by frequencies (%) and compared between training groups with chi-square or Fisher's exact test. Thirty-two EM residents completed pre- and post-intervention tests and comfort questionnaires on the study day. Both groups had higher post-intervention mean test scores (p < 0.001), but the LEC group showed a greater improvement compared to the SIM group (5.6 [2.3] points vs. 3.6 [2.4], p = 0.02). At the 3-month follow-up, 24 (75 %) tests and questionnaires were completed. There was no improvement in 3-month mean test scores in either group compared to immediate post-test scores. The SIM group had higher final mean test scores than the LEC group (16.6 [3.1] vs. 13.3 [2.2], p = 0.009). SIM and LEC groups reported similar diagnosis and treatment comfort level scores at baseline and improved equally after instruction. At 3 months, there was no difference between groups in comfort level scores for diagnosis or treatment. Lecture-based teaching was more effective than simulation-based instruction immediately after intervention. At 3 months, the SIM group showed greater retention than the LEC group. Resident comfort levels for diagnosis and treatment were similar regardless of the type of education.

Quality of Life and Patient Satisfaction Following Male-to-Female Sex Reassignment Surgery.

PubMed

Papadopulos, Nikolaos A; Lellé, Jean-Daniel; Zavlin, Dmitry; Herschbach, Peter; Henrich, Gerhard; Kovacs, Laszlo; Ehrenberger, Benjamin; Kluger, Anna-Katharina; Machens, Hans-Guenther; Schaff, Juergen

2017-05-01

Surveys on quality of life (QOL) of male-to-female (MTF) transsexuals have found low QOL scores before and increased satisfaction scores after sex-reassignment surgery (SRS). To our knowledge, many of them lack standardized questionnaires and comparisons with normative data to evaluate different vaginoplasty techniques. To analyze patient satisfaction and QOL after SRS. Forty-seven patients participated in this study. All patients had surgery with our self-developed combined technique on average 19 months before the survey. They completed a self-developed indication-specific questionnaire concerning demographic and socioeconomic issues and postoperative satisfaction. Furthermore, a standardized self-assessment questionnaire on satisfaction and QOL (Fragen zur Lebenszufriedenheit Module [FLZ M ]; Questions on Life Satisfaction Modules ) was used. The FLZ M consists of three modules (general life satisfaction, satisfaction with health, and satisfaction with body image) with scores of weighted satisfaction for each item. Results of the general and health modules were compared with normative data. Demographics, QOL, general life satisfaction, satisfaction with health, and satisfaction with body image. The self-developed indication-specific questionnaire showed that 91% experienced an improvement of QOL. All patients stated they would undergo SRS again and did not regret it at all. Patients stated their femininity significantly increased. For the FLZ M , the sum score for general life satisfaction (P < .001) was significantly lower than the normative data, whereas the sum score of the satisfaction with health module (P = .038) did not reach statistical significance. The two modules also showed positive trends for different items. Values of the body image module showed a significant increase in satisfaction with breasts (P < .001) and genitals (P = .002). The findings of this survey emphasize the importance of SRS in the interdisciplinary gender-reassignment process. The detailed description of our combined technique could help to improve the surgical outcome and patient satisfaction of this complex and non-standardized surgery. This is the first description of a new surgical technique (combined technique) for MTF SRS. QOL was assessed by a large number of patients by standardized questionnaires and could be compared with normative data. Because this is a retrospective study, we can draw only careful conclusions for pre- and postoperative changes. Our self-developed combined surgical technique seemed to have a positive influence on QOL after SRS. Satisfaction with breasts, genitals, and femininity increased significantly and show the importance of surgical treatment as a key therapeutic option for MTF transsexuals. Papadopulos NA, Lellé J-D, Zavlin D, et al. Quality of Life and Patient Satisfaction Following Male-to-Female Sex Reassignment Surgery. J Sex Med 2017;14:721-730. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Optimizing data collection for public health decisions: a data mining approach

PubMed Central

2014-01-01

Background Collecting data can be cumbersome and expensive. Lack of relevant, accurate and timely data for research to inform policy may negatively impact public health. The aim of this study was to test if the careful removal of items from two community nutrition surveys guided by a data mining technique called feature selection, can (a) identify a reduced dataset, while (b) not damaging the signal inside that data. Methods The Nutrition Environment Measures Surveys for stores (NEMS-S) and restaurants (NEMS-R) were completed on 885 retail food outlets in two counties in West Virginia between May and November of 2011. A reduced dataset was identified for each outlet type using feature selection. Coefficients from linear regression modeling were used to weight items in the reduced datasets. Weighted item values were summed with the error term to compute reduced item survey scores. Scores produced by the full survey were compared to the reduced item scores using a Wilcoxon rank-sum test. Results Feature selection identified 9 store and 16 restaurant survey items as significant predictors of the score produced from the full survey. The linear regression models built from the reduced feature sets had R2 values of 92% and 94% for restaurant and grocery store data, respectively. Conclusions While there are many potentially important variables in any domain, the most useful set may only be a small subset. The use of feature selection in the initial phase of data collection to identify the most influential variables may be a useful tool to greatly reduce the amount of data needed thereby reducing cost. PMID:24919484

Optimizing data collection for public health decisions: a data mining approach.

PubMed

Partington, Susan N; Papakroni, Vasil; Menzies, Tim

2014-06-12

Collecting data can be cumbersome and expensive. Lack of relevant, accurate and timely data for research to inform policy may negatively impact public health. The aim of this study was to test if the careful removal of items from two community nutrition surveys guided by a data mining technique called feature selection, can (a) identify a reduced dataset, while (b) not damaging the signal inside that data. The Nutrition Environment Measures Surveys for stores (NEMS-S) and restaurants (NEMS-R) were completed on 885 retail food outlets in two counties in West Virginia between May and November of 2011. A reduced dataset was identified for each outlet type using feature selection. Coefficients from linear regression modeling were used to weight items in the reduced datasets. Weighted item values were summed with the error term to compute reduced item survey scores. Scores produced by the full survey were compared to the reduced item scores using a Wilcoxon rank-sum test. Feature selection identified 9 store and 16 restaurant survey items as significant predictors of the score produced from the full survey. The linear regression models built from the reduced feature sets had R2 values of 92% and 94% for restaurant and grocery store data, respectively. While there are many potentially important variables in any domain, the most useful set may only be a small subset. The use of feature selection in the initial phase of data collection to identify the most influential variables may be a useful tool to greatly reduce the amount of data needed thereby reducing cost.

Sum Rule for a Schiff-Like Dipole Moment

NASA Astrophysics Data System (ADS)

Raduta, A. A.; Budaca, R.

The energy-weighted sum rule for an electric dipole transition operator of a Schiff type differs from the Thomas-Reiche-Kuhn (TRK) sum rule by several corrective terms which depend on the number of system components, N. For illustration the formalism was applied to the case of Na clusters. One concludes that the random phase approximation (RPA) results for Na clusters obey the modified TRK sum rule.

Trauma, poverty and mental health among Somali and Rwandese refugees living in an African refugee settlement – an epidemiological study

PubMed Central

Onyut, Lamaro P; Neuner, Frank; Ertl, Verena; Schauer, Elisabeth; Odenwald, Michael; Elbert, Thomas

2009-01-01

Background The aim of this study was to establish the prevalence of posttraumatic stress disorder (PTSD) and depression among Rwandese and Somali refugees resident in a Ugandan refugee settlement, as a measure of the mental health consequences of armed conflict, as well as to inform a subsequent mental health outreach program. The study population comprised a sample from 14400 (n = 519 Somali and n = 906 Rwandese) refugees resident in Nakivale refugee settlement in South Western Uganda during the year 2003. Methods The Posttraumatic Diagnostic Scale (PDS) and the Hopkins Symptom Checklist 25 were used to screen for posttraumatic stress disorder and depression. Results Thirty two percent of the Rwandese and 48.1% of the Somali refugees were found to suffer from PTSD. The Somalis refugees had a mean of 11.95 (SD = 6.17) separate traumatic event types while the Rwandese had 8.86 (SD = 5.05). The Somalis scored a mean sum score of 21.17 (SD = 16.19) on the PDS while the Rwandese had a mean sum score of 10.05 (SD = 9.7). Conclusion Mental health consequences of conflict remain long after the events are over, and therefore mental health intervention is as urgent for post-conflict migrant populations as physical health and other emergency interventions. A mental health outreach program was initiated based on this study. PMID:19470171

Competition-Level Differences on the Lower Quarter Y-Balance Test in Baseball Players

PubMed Central

Butler, Robert J.; Bullock, Garrett; Arnold, Todd; Plisky, Phillip; Queen, Robin

2016-01-01

Context: Decreased performance in dynamic balance has previously been associated with a history of ulnar collateral ligament injury in baseball players. Previous research on dynamic balance in soccer players has shown that test performance depends on competition level. However, dynamic balance has yet to be examined in baseball players. Objective: To understand normative values and determine differences in dynamic balance, as measured by the Lower Quarter Y-Balance Test, across competition levels in baseball players. Design: Cross-sectional study. Setting: Preseason physical examinations. Patients or Other Participants: Dynamic balance was measured in 88 high school (HS), 78 collegiate (COL), and 90 professional (PRO) baseball players. Main Outcome Measure(s): All participants completed the Lower Quarter Y-Balance Test using the standard protocol. In unilateral stance, they reached with 1 foot in the anterior, posteromedial, and posterolateral directions. We calculated 1-way analyses of variance to compare performance, composite score, and reach asymmetry for each direction as well as the sum of the asymmetry values (P < .05). Composite score was calculated by averaging the maximum normalized reach scores. Reach asymmetry was determined by calculating bilateral differences in reach ability. Results: In comparison with the HS and COL groups, the PRO players exhibited greater posteromedial (P < .01; effect size index [ESI]HS = 1.06, ESICOL = 0.95) and posterolateral reach (P < .01; ESIHS = 0.82, ESICOL = 0.84) as well as a greater composite score (P < .01; ESIHS = 0.60, ESICOL = 0.87). In contrast, HS baseball players exhibited increased anterior reach (P < .01; ESICOL = 0.60, ESIPRO = 0.39) compared with the COL and PRO cohorts. No significant differences in reach asymmetry were observed among groups. Conclusions: Lower extremity dynamic balance performance differed based on the baseball players' competition level. These baseline data may be helpful in identifying low-performing athletes who might benefit from neuromuscular interventions. PMID:27849388

Competition-Level Differences on the Lower Quarter Y-Balance Test in Baseball Players.

PubMed

Butler, Robert J; Bullock, Garrett; Arnold, Todd; Plisky, Phillip; Queen, Robin

2016-12-01

Decreased performance in dynamic balance has previously been associated with a history of ulnar collateral ligament injury in baseball players. Previous research on dynamic balance in soccer players has shown that test performance depends on competition level. However, dynamic balance has yet to be examined in baseball players. To understand normative values and determine differences in dynamic balance, as measured by the Lower Quarter Y-Balance Test, across competition levels in baseball players. Cross-sectional study. Preseason physical examinations. Dynamic balance was measured in 88 high school (HS), 78 collegiate (COL), and 90 professional (PRO) baseball players. All participants completed the Lower Quarter Y-Balance Test using the standard protocol. In unilateral stance, they reached with 1 foot in the anterior, posteromedial, and posterolateral directions. We calculated 1-way analyses of variance to compare performance, composite score, and reach asymmetry for each direction as well as the sum of the asymmetry values (P < .05). Composite score was calculated by averaging the maximum normalized reach scores. Reach asymmetry was determined by calculating bilateral differences in reach ability. In comparison with the HS and COL groups, the PRO players exhibited greater posteromedial (P < .01; effect size index [ESI] HS = 1.06, ESI COL = 0.95) and posterolateral reach (P < .01; ESI HS = 0.82, ESI COL = 0.84) as well as a greater composite score (P < .01; ESI HS = 0.60, ESI COL = 0.87). In contrast, HS baseball players exhibited increased anterior reach (P < .01; ESI COL = 0.60, ESI PRO = 0.39) compared with the COL and PRO cohorts. No significant differences in reach asymmetry were observed among groups. Lower extremity dynamic balance performance differed based on the baseball players' competition level. These baseline data may be helpful in identifying low-performing athletes who might benefit from neuromuscular interventions.

[Observation on the clinical application effects of skin distractor on the treatment of scars].

PubMed

Gui, W L; Yang, E; Zhang, H S

2017-03-20

Objective: To explore clinical application effects of skin distractor on the treatment of scars and to observe effects of skin distractor with different pull speeds on different parts scars of human body. Methods: One hundred and four patients with scars, conforming to the study criteria, were hospitalized in our unit from January 2014 to June 2015. Patients were divided into 2 mm/d group and 4 mm/d group according to the random number table, with 52 patients in each group. After admission, skin distractors were pasted on scars in face and neck, trunk, and extremities of patients in 2 groups, with inner edges of pasteboards close to outside edges of longer sides of scars. Skin distractors in 2 mm/d group and 4 mm/d group were pulled to scars axis direction as speeds of 2 mm/d and 4 mm/d, respectively. Pull time equals values of pull speeds divided by width of scars. Scars were resected after finishing pulling. Immediately after scars resection, skin distractors were pasted again with inner edges of pasteboards close to outside edges of longer sides of incision and removed when stitches were taken out. Scars of patients were scored by Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) was used to record scores of patient scar assessment scale (PSAS), observer scar assessment scale (OSAS) and overall scores of patients and observers of scars of patients before and one year after scars resection. Data were processed with χ (2) test, independent samples t test, paired samples t test, independent samples non-parametric rank-sum test and paired samples non-parametric rank-sum test. Results: (1) Scores of all scars of patients in 2 groups before scars resection were close (with t values from -1.384 to 0.622, P values above 0.05), obviously higher than those of one year post scars resection (with t values from 11.085 to 24.835, P values below 0.01). Scores of scars in face and neck, trunk and extremities in 2 groups before scars resection were close (with Z values from -1.651 to -0.035, t values from -1.549 to 0.219, P values above 0.05), significantly higher than those of one year post scar resection (with Z values from -2.992 to -2.555, t values from 8.739 to 19.076, P values below 0.01). (2) Scores of all scars of patients in 2 mm/d group of one year post scars resection were lower than those in 4 mm/d group (with t values from -2.583 to -2.018, P values below 0.05). PSAS scores of scars in face and neck and trunk in 2 mm/d group of one year post scars resection were lower than those in 4 mm/d group (with Z values respectively -2.385 and -2.198, P values below 0.05), other scores of scars in face and neck and trunk of patients in 2 groups of one year post scars resection were close (with Z values from -1.841 to -0.363, P values above 0.05). VSS scores, PSAS scores, OSAS scores, patients' overall scores, and observers' overall scores in 2 mm/d groups were (4.6±0.8), (28±4), (28±4), (4.7±0.7), (4.8±1.4) points, respectively, lower than those in 4 mm/d group[(5.2±0.8), (32±4), (31±6), (5.5±1.2), (5.5±1.0) points, respectively, with t values from -3.712 to -2.105, P <0.05 or P <0.01]. Conclusions: Skin distractor has better effects on the treatment of scars, and treatment effects of skin distractor in extremities pulled by 2 mm/d are better than those pulled by 4 mm/d.

A novel early risk assessment tool for detecting clinical outcomes in patients with heat-related illness (J-ERATO score): Development and validation in independent cohorts in Japan.

PubMed

Hayashida, Kei; Kondo, Yutaka; Hifumi, Toru; Shimazaki, Junya; Oda, Yasutaka; Shiraishi, Shinichiro; Fukuda, Tatsuma; Sasaki, Junichi; Shimizu, Keiki

2018-01-01

We sought to develop a novel risk assessment tool to predict the clinical outcomes after heat-related illness. Prospective, multicenter observational study. Patients who transferred to emergency hospitals in Japan with heat-related illness were registered. The sample was divided into two parts: 60% to construct the score and 40% to validate it. A binary logistic regression model was used to predict hospital admission as a primary outcome. The resulting model was transformed into a scoring system. A total of 3,001 eligible patients were analyzed. There was no difference in variables between development and validation cohorts. Based on the result of a logistic regression model in the development phase (n = 1,805), the J-ERATO score was defined as the sum of the six binary components in the prehospital setting (respiratory rate≥22 /min, Glasgow coma scale<15, systolic blood pressure≤100 mmHg, heart rate≥100 bpm, body temperature≥38°C, and age≥65 y), for a total score ranging from 0 to 6. In the validation phase (n = 1,196), the score had excellent discrimination (C-statistic 0.84; 95% CI 0.79-0.89, p<0.0001) and calibration (P>0.2 by Hosmer-Lemeshow test). The observed proportion of hospital admission increased with increasing J-ERATO score (score = 0, 5.0%; score = 1, 15.0%; score = 2, 24.6%; score = 3, 38.6%; score = 4, 68.0%; score = 5, 85.2%; score = 6, 96.4%). Multivariate analyses showed that the J-ERATO score was an independent positive predictor of hospital admission (adjusted OR, 2.43; 95% CI, 2.06-2.87; P<0.001), intensive care unit (ICU) admission (3.73; 2.95-4.72; P<0.001) and in-hospital mortality (1.65; 1.18-2.32; P = 0.004). The J-ERATO score is simply assessed and can facilitate the identification of patients with higher risk of heat-related hospitalization. This scoring system is also significantly associated with the higher likelihood of ICU admission and in-hospital mortality after heat-related hospitalization.

Application of the newly developed Japanese adenosine normal database for adenosine stress myocardial scintigraphy.

PubMed

Harata, Shingo; Isobe, Satoshi; Morishima, Itsuro; Suzuki, Susumu; Tsuboi, Hideyuki; Sone, Takahito; Ishii, Hideki; Murohara, Toyoaki

2015-10-01

The currently available Japanese normal database (NDB) in stress myocardial perfusion scintigraphy recommended by the Japanese Society of Nuclear Medicine (JSNM-NDB) is created based on the data from exercise tests. The newly developed adenosine normal database (ADS-NDB) remains to be validated for patients undergoing adenosine stress test. We tested whether the diagnostic accuracy of adenosine stress test is improved by the use of ADS-NDB (Kanazawa University). Of 233 consecutive patients undergoing (99m)Tc-MIBI adenosine stress test, 112 patients were tested. The stress/rest myocardial (99m)Tc-MIBI single-photon emission computed tomography (SPECT) images were analyzed by AutoQUANT 7.2 with both ADS-NDB and JSNM-NDB. The summed stress score (SSS) and summed difference score (SDS) were calculated. The agreements of the post-stress defect severity between ADS-NDB and JSNM-NDB were assessed using a weighted kappa statistic. In all patients, mean SSSs of all, right coronary artery (RCA), left anterior descending (LAD), and left circumflex (LCx) territories were significantly lower with ADS-NDB than those with JSNM-NDB. Mean SDSs in all, RCA, and LAD territories were significantly lower with ADS-NDB than those with JSNM-NDB. In 28 patients with significant coronary stenosis, the mean SSS in the RCA territory was significantly lower with ADS-NDB than that with JSNM-NDB. In 84 patients without ischemia, both mean SSSs and SDSs in all, RCA, LAD, and LCx territories were significantly lower with ADS-NDB than those with JSNM-NDB. Weighted kappa values of all patients, patients with significant stenosis, and patients without ischemia were 0.89, 0.83, and 0.92, respectively. Differences were observed between results from ADS-NDB and JSNM-NDB. The diagnostic accuracy of adenosine stress myocardial perfusion scintigraphy may be improved by reducing false-positive results.

Psychometric properties of the Albanian version of the Orofacial Esthetic Scale: OES-ALB.

PubMed

Bimbashi, Venera; Čelebić, Asja; Staka, Gloria; Hoxha, Flurije; Peršić, Sanja; Petričević, Nikola

2015-08-26

The aim was to adapt the Orofacial Esthetic Scale (OES) and to test psychometric properties of the Albanian language version in the cultural environment of the Republic of Kosovo. The OES questionnaire was translated from the original English version according to the accepted techniques. The reliability (internal consistency), and validity (construct, convergent and discriminative) were tested in 169 subjects, test-retest in 61 dental students (DS), and responsiveness in 51 prosthodontic patients with treatment needs (PPTN). The corrected item correlation coefficients of OES-ALB ranged from 0.686 to 0.909. The inter-item correlation coefficient ranged between 0.572 and 0.919. The Cronbach's alpha was 0.961 and IIC 0.758. Test- retest was confirmed by good ICCs and by no significant differences of the OES scores through the period of 14 days without any orofacial changes (p > 0.05). Construct validity was proved by the presence of one-factor composition that assumed 79.079% of the variance. Convergent validity showed significant correlation between one general question about satisfaction with orofacial esthetics and the OES summary score, as well as between the sum of the 3 OHIP-ALB49 questions related to orofacial aesthetics and the OES summary score. Discriminative validity was confirmed with statistically significant differences between DS, prosthodontic patients without treatment need and PPTN (p < 0.01). Responsiveness was confirmed by a significant increase of OES scores after PPTN patients received new fixed partial or removable dentures (P < 0.001). The results proved excellent psychometric properties of the OES-ALB questionnaire in the Republic of Kosovo.

Perceived benefits and barriers to exercise among persons with physical disabilities or chronic health conditions within action or maintenance stages of exercise.

PubMed

Malone, Laurie A; Barfield, J P; Brasher, Joel D

2012-10-01

Information regarding factors that affect the initial step to exercise behavior change among persons with physical disabilities or chronic health conditions is available in the literature but much less is known regarding perceived benefits and barriers to exercise among those who are regularly active. The purpose of this study was to examine the perceived benefits and barriers to exercise among persons with physical disabilities or chronic health conditions within action or maintenance stages of exercise. Participants (n = 152) completed the Exercise Benefits and Barriers Scale (EBBS). For data analyses, disabilities and health conditions were grouped as neuromuscular, orthopedic, cardiovascular/pulmonary, or multiple conditions. Multivariate analysis of variance (MANOVA) was conducted to determine if mean differences on EBBS benefits and barriers scores existed among disability types, between sexes, among age groups, and between physical activity levels. Sum scores were computed to determine the strongest benefit and barrier responses. No significant mean differences in EBBS scores were found between disability types, sexes, age groups, or physical activity levels (p > 0.05). Strongest benefit responses varied by group. Strongest barrier responses were the same for all demographic groups: "Exercise tires me," "Exercise is hard work for me," and "I am fatigued by exercise." EBBS scores were similar across disability/health condition, sex, age, and physical activity level. Primary benefits reported were in the areas of improved physical performance and psychological outlook whereas the primary barriers were in the area of physical exertion. Copyright © 2012 Elsevier Inc. All rights reserved.

Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma

PubMed Central

2012-01-01

Background This study describes 2-year impact on quality of life (QOL) in relation to the anatomical discrepancy among T4a oral cancer patients after free flap reconstruction in Taiwan. Methods Thirty-two patients who underwent tumor ablation with simultaneous microvascular free flap transfer at 2-year follow-up were recruited. They were divided into six subgroups, according to the resected area, consisting of: (1) buccal/retromolar trigone; (2) cheek; (3) commissure; (4) lip; (5) mandible; and (6) tongue. Functional disturbances and daily activity were analyzed using the Version-1 UW QOL Questionnaire with one more specific category: ‘Drooling’. Kruskal-Wallis rank sums analysis was used to test differences in average QOL scores between these subgroups. Post-hoc analysis was applied to assess influence of dominant categories between subgroups. Results The category ‘Pain’ revealed the highest average score and reached significant statistical difference (P = 0.019) among all the categories, however, the category ‘Employment’ averaged the lowest score. Regarding ‘Pain’, there existed a statistical significance (P = 0.0032) between the commissure- and cheek-involved groups, which described the former showed poorer pain quality of life. Conclusions The commissure-involved group had the lowest average score, which might imply the worst QOL in our study, especially for the categories ‘Pain’ and ‘Drooling’. This present study of T4a patients was the first carried out in Taiwan implementing the QOL questionnaire, and its results may serve for future reference. PMID:22789070

Leadership Behaviors of Athletic Training Leaders Compared With Leaders in Other Fields

PubMed Central

Laurent, Timothy G; Bradney, Debbie A

2007-01-01

Context: Athletic trainers are in positions of leadership. Objective: To determine self-reported leadership practices of head athletic trainers (HATCs) and program directors (PDs). Design: Cross-sectional study. Setting: Respondents' academic institutions. Patients or Other Participants: A total of 238 athletic training leaders completed the Leadership Practices Inventory. Of these, 50.4% (n = 120) were HATCs and 49.6% (n = 118) were PDs; 69.3% (n = 165) were men and 30.7% (n = 73) were women; almost all respondents (97.1%, n = 231) were white. Respondents typically reported having 11 to 15 years of experience as an athletic trainer (n = 57, 23.9%) and being between the ages of 30 and 39 years (n = 109, 45.8%). Main Outcome Measure(s): Categories of leadership behaviors (ie, Model, Inspire, Challenge, Encourage, and Enable) were scored from 1 (almost never) to 10 (almost always). Item scores were summed to compute mean category scores. We analyzed demographic information; used t ratios to compare the data from athletic training leaders (PDs and HATCs) with normative data; compared sex, age, position, ethnicity, and years of experience with leadership practices; and computed mean scores. Results: Athletic training leaders reported using leadership behaviors similar to those of other leaders. The PDs reported using inspiring, challenging, enabling, and encouraging leadership behaviors more often than did the HATCs. No differences were found by ethnicity, age, years of experience, or leadership practices. Conclusions: Athletic training leaders are transformational leaders. Athletic training education program accreditation requirements likely account for the difference in leadership practices between PDs and HATCs. PMID:17597953

Comparison of American Academy of Sleep Medicine (AASM) versus Center for Medicare and Medicaid Services (CMS) polysomnography (PSG) scoring rules on AHI and eligibility for continuous positive airway pressure (CPAP) treatment.

PubMed

Korotinsky, Arkady; Assefa, Samson Z; Diaz-Abad, Montserrat; Wickwire, Emerson M; Scharf, Steven M

2016-12-01

Obstructive sleep apnea (OSA) is an important clinical condition. Eligibility for treatment usually depends on disease severity, measured as the apnea-hypopnea index (AHI), equal to the sum of apneas plus hypopneas per hour of sleep. There is divergence on scoring rules for hypopneas between the recommendations of the American Academy of Sleep Medicine (AASM) and the Center for Medicare Services (CMS), the latter being more restrictive. Thus, patients could be eligible for treatment under AASM rules, but not under CMS rules. Sleep laboratory records of 112 consecutive patients were reviewed (85 < 65, 27 ≥ 65 years old). AHI was calculated both by AASM and by CMS criteria. Information on demographics, and important comorbidities, was also reviewed. AHI was lower in younger patients using CMS criteria. However, differences in AHI using the two sets of criteria were not significantly different in the older patients. Incorporating all criteria for eligibility (severity, presence of certain comorbid conditions) for treatment, we found that fewer younger patients would be eligible using CMS criteria, but among the older patients, eligibility for treatment was the same whether AASM or CMS criteria were used. Use of CMS criteria for scoring hypopneas results in lower estimates of OSA severity, with fewer younger patients eligible for treatment. However, among Medicare age patients, the rate of treatment eligibility was the same whether AASM or CMS scoring rules were used.

Validating new summary indices for the Childhood Trauma Interview: associations with first onsets of major depressive disorder and anxiety disorders.

PubMed

Vrshek-Schallhorn, Suzanne; Wolitzky-Taylor, Kate; Doane, Leah D; Epstein, Alyssa; Sumner, Jennifer A; Mineka, Susan; Zinbarg, Richard E; Craske, Michelle G; Isaia, Ashley; Hammen, Constance; Adam, Emma K

2014-09-01

Childhood and adolescent adversity is of great interest in relation to risk for psychopathology, and interview measures of adversity are thought to be more reliable and valid than their questionnaire counterparts. One interview measure, the Childhood Trauma Interview (CTI; Fink et al., 1995), has been positively evaluated relative to similar measures, but there are some psychometric limitations to an existing scoring approach that limit the full potential of this measure. We propose several new summary indices for the CTI that permit examination of different types of adversity and different developmental periods. Our approach creates several summary indices: one sums the severity scores of adversities endorsed; another utilizes the number of minor and major (moderate to severe) adversities. The new indices were examined in association with first onsets of major depressive disorder (MDD) and anxiety disorders across a 5-year period using annual clinical diagnostic interviews (Structured Clinical Interview for DSM-IV-TR). Summary scores derived with the previously used approach were also examined for comparison. Data on 332 participants came from the Youth Emotion Project, a longitudinal study of risk for emotional disorders. Results support the predictive validity of the proposed summary scoring methods and indicate that several forms of major (but typically not minor) adversity are significantly associated with first onsets of MDD and anxiety disorders. Finally, multivariate regression models show that, in many instances, the new indices contributed significant unique variance predicting disorder onsets over and above the previously used summary indices. PsycINFO Database Record (c) 2014 APA, all rights reserved.

[Eppendorf Schizophrenia Inventory (ESI) vs. Frankfurt Complaint Questionnaire (FCQ). Direct comparison in a clinical trial].

PubMed

Mass, R

2005-09-01

This study is the first to directly compare two clinical questionnaires which are both aimed at self-experienced cognitive dysfunctions of schizophrenia: Eppendorf Schizophrenia Inventory (ESI) and Frankfurt Complaint Questionnaire (FCQ). Evaluated were (a) diagnostic validity, (b) psychometric properties, (c) scale intercorrelations, and (d) factor analytic stability. Ad (a): schizophrenic subjects (n=36) show highly significant increases in the ESI scales and sum score when compared to other clinical groups (patients with depression, alcohol dependence, or obsessive-compulsive disorder, n>30, respectively); on the other hand, the FCQ yields no systematic group differences. Ad (b): mean of reliability coefficients (Cronbach alpha) of the ESI scales is r(tt)=0.86, mean of reliability coefficients of the FCQ scales is significantly lower. Ad (c): the mean intercorrelation between ESI and FCQ scales amounts to r(xy)=0.56 (minimum 0.29, maximum 0.73), corresponding to an average shared variance of about 31%. Ad (d): factor analysis yielded an ESI factor and a FBF factor; one-way ANOVA with the factor scores confirms the diagnostic validity of the ESI. ESI and FCQ measure essentially different aspects of schizophrenic psychopathology. Regarding reliability and diagnostic validity, the ESI is superior to the FCQ.

Functional and physical abilities in the early continuum of cognitive decline.

PubMed

Shin, Joon-Ho; Lim, Jae-Young; Kim, Ki Woong; Kim, Suyoung; Lee, Jaebong; Paik, Nam-Jong

2015-01-01

The early cognitive continuum has been emphasized recently. We sought to characterize the functional and physical aspects of the cognitive continuum in subjects with no cognitive impairment (NCI), subjective cognitive impairment (SCI), nonamnestic (NA-MCI), and amnestic mild cognitive impairment (A-MCI). Furthermore, we identified the potential diagnostic utility of specific functional tasks. A total of 702 participants, aged ≥65 years and defined as NCI, SCI, NA-MCI, and A-MCI according to the original Petersen criteria, were included. They completed the Korean basic (K-ADL) and Instrumental Activities of Daily Living Scales (K-IADL) and the Performance-Oriented Mobility Assessment (POMA). Significant differences were observed between the different cognitive status groups in three items and total scores on the K-ADL, six items and total scores on the K-IADL and POMA. Controlling for confounding factors revealed that subjects from the A-MCI group performed poorly at bathing, shopping, handling money, and the sum of assorted functional items. These findings demonstrated the declining feature of functional and physical performance according to the cognitive continuum, with A-MCI being discriminative with respect to specific functional tasks as compared to milder cognitive statuses. © 2014 S. Karger AG, Basel.

Prevalence and Factors Associated with Substance Use and Misuse among Kosovar Adolescents; Cross Sectional Study of Scholastic, Familial-, and Sports-Related Factors of Influence.

PubMed

Tahiraj, Enver; Cubela, Mladen; Ostojic, Ljerka; Rodek, Jelena; Zenic, Natasa; Sekulic, Damir; Lesnik, Blaz

2016-05-16

Adolescence is considered to be the most important period for the prevention of substance use and misuse (SUM). The aim of this study was to investigate the problem of SUM and to establish potentially important factors associated with SUM in Kosovar adolescents. Multi-stage simple random sampling was used to select participants. At the end of their high school education, 980 adolescents (623 females) ages 17 to 19 years old were enrolled in the study. The prevalence of smoking, alcohol consumption (measured by Alcohol Use Disorder Identification Test-AUDIT), and illegal drug use (dependent variables), as well as socio-demographic, scholastic, familial, and sports-related factors (independent variables), were assessed. Boys smoke cigarettes more often than girls with daily-smoking prevalence of 16% among boys and 9% among girls (OR = 1.85, 95% = CI 1.25-2.75). The prevalence of harmful drinking (i.e., AUDIT scores of >10) is found to be alarming (41% and 37% for boys and girls, respectively; OR = 1.13, 95% CI = 0.87-1.48), while 17% of boys and 9% of girls used illegal drugs (OR = 2.01, 95% CI = 1.35-2.95). The behavioral grade (observed as: excellent-average-poor) is the factor that was most significantly correlated with SUM both in boys and girls, with lower behavioral grades among those adolescents who consume substances. In girls, lower maternal education levels were associated with a decreased likelihood of SUM, whereas sports achievement was negatively associated with risky drinking. In boys, sports achievement decreased the likelihood of daily smoking. Information on the factors associated with SUM should be disseminated among sports and school authorities.

Preliminary investigation comparing a detomidine continuous rate infusion combined with either morphine or buprenorphine for standing sedation in horses.

PubMed

Potter, Joanna J; MacFarlane, Paul D; Love, Emma J; Tremaine, Henry; Taylor, Polly M; Murrell, Joanna C

2016-03-01

To compare sedative and analgesic properties of buprenorphine or morphine for standing procedures combined with a detomidine continuous rate infusion (CRI). Blinded, prospective, randomized clinical pilot study. Ten horses presented for dental or sinus procedures. Horses received 0.02 mg kg(-1) acepromazine intravenously (IV), followed 30 minutes later by detomidine 10 μg kg(-1) IV. Five minutes later, buprenorphine 0.01 mg kg(-1) (n = 6) or morphine 0.1 mg kg(-1) (n = 4) was administered IV. Detomidine was administered by CRI (0.2 μg kg(-1) minute(-1)) and adjusted to maintain appropriate sedation. Heart rate, respiratory frequency, gastrointestinal motility and rectal temperature were measured; pain, ataxia and sedation were scored. Sedation, pain scores and ataxia scores were analysed using a mixed linear model. Detomidine dose and procedure success scores were compared using Wilcoxon's rank sum test. Complications between groups were analysed using Fisher's exact test. Two horses had incomplete data. Weights and ages were not different between groups (p = 0.15 and p = 0.42, respectively). The dose rate for detomidine was not different between groups (0.33 ± 0.02 μg kg(-1) minute(-1) in the buprenorphine group and 0.33 ± 0.05 μg kg(-1) minute(-1), in the morphine group p = 0.89). Intraoperative visual analogue scale scores were greater after buprenorphine than morphine (mean ± SD, buprenorphine 48 ± 4, morphine 40 ± 5, p = 0.0497). Procedure duration was not different between groups (buprenorphine 142 ± 33, morphine 140 ± 12 minutes). All horses treated with buprenorphine experienced complications compared with none in the morphine group (p = 0.0286). At the doses used, buprenorphine produced greater sedation but more post-operative complications than morphine. However, Type I or Type II errors cannot be excluded and larger studies are required to confirm these findings. © 2015 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

Differences in health-related quality of life between European and Asian patients with hepatocellular carcinoma.

PubMed

Chie, Wei-Chu; Blazeby, Jane M; Hsiao, Chin-Fu; Chiu, Herng-Chia; Poon, Ronnie T; Mikoshiba, Naoko; Al-Kadhim, Gillian; Heaton, Nigel; Calara, Jozer; Collins, Peter; Caddick, Katharine; Costantini, Anna; Vilgrain, Valerie

2017-10-01

The aim of this study is to explore the possible effects of clinical and cultural characteristics of hepatocellular carcinoma on patients' health-related quality of life (HRQoL). Patients with hepatocellular carcinoma from Asian and European countries completed the EORTC QLQ-C30 and the EORTC QLQ-HCC18. Comparisons were made using Student's t-test and Wilcoxon rank-sum test with method of false discovery to correct multiple comparisons. Multiway analysis of variance and model selection were used to assess the effects of clinical characteristics and geographic areas. Two hundred and twenty-seven patients with hepatocellular carcinoma completed questionnaires. After adjusting for demographic and clinical characteristics, Asian patients still had significantly better HRQoL scores in emotional functioning, insomnia, (QLQ-C30) and in sexual interest (QLQ-HCC18). We also found an interaction in physical functioning (QLQ-C30) and fatigue (QLQ-HCC18) between geographic region and marital status, married European had worse HRQoL scores than Asian singles. Both clinical characteristics and geographic areas affected the HRQoL in with hepatocellular carcinoma. Cultural differences and clinical differences in the pattern of disease due to active surveillance of Asian countries may explain the results. © 2016 John Wiley & Sons Australia, Ltd.

Meditation Breath Attention Scores (MBAS): Development and investigation of an internet-based assessment of focused attention during meditation practice.

PubMed

Frewen, Paul; Hargraves, Heather; DePierro, Jonathan; D'Andrea, Wendy; Flodrowski, Les

2016-07-01

Meditation Breath Attention Scores (MBAS) represent a self-report, state measure of focused attention (FA) during the practice of meditation. The MBAS assessment procedure involves sounding a bell at periodic intervals during meditation practice, at which times participants indicate if they were attending toward breathing (scored 1) or if instead they had become distracted (e.g., by mind wandering; scored 0); scores are then tallied to yield participants' MBAS for that meditation. The current study developed and evaluated a fully automated and Internet-based version of MBAS in 1,101 volunteers. Results suggested that: (a) MBAS are internally consistent across bell rings; (b) MBAS total scores exhibit a non-normal distribution identifying subgroups of participants with particularly poor or robust FA during meditation; (c) MBAS decrease linearly with the duration of meditation practices, indicating that participants tend to experience less FA later as opposed to earlier in the meditation; (d) in the case of eyes-open meditation, MBAS are higher when the amount of time between bells is shorter; (e) MBAS correlate with various self-reported subjective experiences occurring during meditation; and (f) MBAS are weakly associated with higher trait mindful "acting with awareness," lesser ADHD-related symptoms of inattentiveness, and estimated minutes of meditation practiced in the past month. In sum, results provide further support for the construct validity of MBAS and serve to further characterize the dynamics of individual differences in FA during meditation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Distribution of concussion related symptoms after whiplash injury in risk strata.

PubMed

Kasch, Helge; Jensen, Troels S

2017-12-29

Background/aims The presence and severity of concussion related symptoms after acute whiplash injury are debatable. In this study we examine the distribution and development of the burden of concussion related symptoms in whiplash patients. Methods Consecutively 141 acute whiplash patients and 40 ankle injured controls were recruited from emergency units and were examined after 1 week, 1, 3, 6, 12 months obtaining neck/head VAS score, number-of-non-painful complaints, epidemiological, social, psychological data and neurological examination, active neck mobility, and furthermore muscle tenderness and pain response, strength and duration of neck muscles. Risk factors derived (reduced CROM, intense neckpain/headache, multiple non-pain complaints) were applied in a Risk Assessment Score and divided into 7 risk-strata (refer Kasch et al., Spine 2011). After 1 week and 6 months whiplash patients fulfilled the Rivermead Oxford Head Injury questionnaire (10 items, score from 0 = no change to 4 = very marked change, Danish Version, total score range from 0 to 40). Results 138 acute whiplash patients fulfilled the Rivermead Oxford Head Injury questionnaire after 1 week and 111 after 6 months. The distribution was markedly different in the risk strata, in stratum 7 the sum score was a factor 10 higher than stratum 1 after 1 week (Kruskal-Wallis, p < 1.4 × 10-7) and remained high 6 months after injury (p < 0.05). Conclusion Mild concussion symptoms do not necessarily reflect eventual concussion, but are found after injuries with no direct head trauma and amnesia e.g. whiplash injuries. The Risk Assessment Score fits nicely with the burden of concussion related symptoms after whiplash injury.

Some Considerations on the Partial Credit Model

ERIC Educational Resources Information Center

Verhelst, N. D.; Verstralen, H. H. F. M.

2008-01-01

The Partial Credit Model (PCM) is sometimes interpreted as a model for stepwise solution of polytomously scored items, where the item parameters are interpreted as difficulties of the steps. It is argued that this interpretation is not justified. A model for stepwise solution is discussed. It is shown that the PCM is suited to model sums of binary…

A Simplified Technique for Scoring DSM-IV Personality Disorders with the Five-Factor Model

ERIC Educational Resources Information Center

Miller, Joshua D.; Bagby, R. Michael; Pilkonis, Paul A.; Reynolds, Sarah K.; Lynam, Donald R.

2005-01-01

The current study compares the use of two alternative methodologies for using the Five-Factor Model (FFM) to assess personality disorders (PDs). Across two clinical samples, a technique using the simple sum of selected FFM facets is compared with a previously used prototype matching technique. The results demonstrate that the more easily…

Use of Item Parceling in Structural Equation Modeling with Missing Data

ERIC Educational Resources Information Center

Orcan, Fatih

2013-01-01

Parceling is referred to as a procedure for computing sums or average scores across multiple items. Parcels instead of individual items are then used as indicators of latent factors in the structural equation modeling analysis (Bandalos 2002, 2008; Little et al., 2002; Yang, Nay, & Hoyle, 2010). Item parceling may be applied to alleviate some…

Multi-Item Direct Behavior Ratings: Dependability of Two Levels of Assessment Specificity

ERIC Educational Resources Information Center

Volpe, Robert J.; Briesch, Amy M.

2015-01-01

Direct Behavior Rating-Multi-Item Scales (DBR-MIS) have been developed as formative measures of behavioral assessment for use in school-based problem-solving models. Initial research has examined the dependability of composite scores generated by summing all items comprising the scales. However, it has been argued that DBR-MIS may offer assessment…

Neutrino mass sum-rule

NASA Astrophysics Data System (ADS)

Damanik, Asan

2018-03-01

Neutrino mass sum-rele is a very important research subject from theoretical side because neutrino oscillation experiment only gave us two squared-mass differences and three mixing angles. We review neutrino mass sum-rule in literature that have been reported by many authors and discuss its phenomenological implications.

Perceived Medical School stress of undergraduate medical students predicts academic performance: an observational study.

PubMed

Kötter, Thomas; Wagner, Josefin; Brüheim, Linda; Voltmer, Edgar

2017-12-16

Medical students are exposed to high amounts of stress. Stress and poor academic performance can become part of a vicious circle. In order to counteract this circularity, it seems important to better understand the relationship between stress and performance during medical education. The most widespread stress questionnaire designed for use in Medical School is the "Perceived Medical School Stress Instrument" (PMSS). It addresses a wide range of stressors, including workload, competition, social isolation and financial worries. Our aim was to examine the relation between the perceived Medical School stress of undergraduate medical students and academic performance. We measured Medical School stress using the PMSS at two different time points (at the end of freshman year and at the end of sophomore year) and matched stress scores together with age and gender to the first medical examination (M1) grade of the students (n = 456). PMSS scores from 2 and 14 months before M1 proved to be significant predictors for medical students' M1 grade. Age and gender also predict academic performance, making older female students with high stress scores a potential risk group for entering the vicious circle of stress and poor academic performance. PMSS sum scores 2 and 14 months before the M1 exam seem to have an independent predictive validity for medical students' M1 grade. More research is needed to identify potential confounders.

Impact of non-specific normal databases on perfusion quantification of low-dose myocardial SPECT studies.

PubMed

Scabbio, Camilla; Zoccarato, Orazio; Malaspina, Simona; Lucignani, Giovanni; Del Sole, Angelo; Lecchi, Michela

2017-10-17

To evaluate the impact of non-specific normal databases on the percent summed rest score (SR%) and stress score (SS%) from simulated low-dose SPECT studies by shortening the acquisition time/projection. Forty normal-weight and 40 overweight/obese patients underwent myocardial studies with a conventional gamma-camera (BrightView, Philips) using three different acquisition times/projection: 30, 15, and 8 s (100%-counts, 50%-counts, and 25%-counts scan, respectively) and reconstructed using the iterative algorithm with resolution recovery (IRR) Astonish TM (Philips). Three sets of normal databases were used: (1) full-counts IRR; (2) half-counts IRR; and (3) full-counts traditional reconstruction algorithm database (TRAD). The impact of these databases and the acquired count statistics on the SR% and SS% was assessed by ANOVA analysis and Tukey test (P < 0.05). Significantly higher SR% and SS% values (> 40%) were found for the full-counts TRAD databases respect to the IRR databases. For overweight/obese patients, significantly higher SS% values for 25%-counts scans (+19%) are confirmed compared to those of 50%-counts scan, independently of using the half-counts or the full-counts IRR databases. Astonish TM requires the adoption of the own specific normal databases in order to prevent very high overestimation of both stress and rest perfusion scores. Conversely, the count statistics of the normal databases seems not to influence the quantification scores.

The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters.

PubMed

Galetta, K M; Barrett, J; Allen, M; Madda, F; Delicata, D; Tennant, A T; Branas, C C; Maguire, M G; Messner, L V; Devick, S; Galetta, S L; Balcer, L J

2011-04-26

Sports-related concussion has received increasing attention as a cause of short- and long-term neurologic symptoms among athletes. The King-Devick (K-D) test is based on measurement of the speed of rapid number naming (reading aloud single-digit numbers from 3 test cards), and captures impairment of eye movements, attention, language, and other correlates of suboptimal brain function. We investigated the K-D test as a potential rapid sideline screening for concussion in a cohort of boxers and mixed martial arts fighters. The K-D test was administered prefight and postfight. The Military Acute Concussion Evaluation (MACE) was administered as a more comprehensive but longer test for concussion. Differences in postfight K-D scores and changes in scores from prefight to postfight were compared for athletes with head trauma during the fight vs those without. Postfight K-D scores (n = 39 participants) were significantly higher (worse) for those with head trauma during the match (59.1 ± 7.4 vs 41.0 ± 6.7 seconds, p < 0.0001, Wilcoxon rank sum test). Those with loss of consciousness showed the greatest worsening from prefight to postfight. Worse postfight K-D scores (r(s) = -0.79, p = 0.0001) and greater worsening of scores (r(s) = 0.90, p < 0.0001) correlated well with postfight MACE scores. Worsening of K-D scores by ≥5 seconds was a distinguishing characteristic noted only among participants with head trauma. High levels of test-retest reliability were observed (intraclass correlation coefficient 0.97 [95% confidence interval 0.90-1.0]). The K-D test is an accurate and reliable method for identifying athletes with head trauma, and is a strong candidate rapid sideline screening test for concussion.

The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters

PubMed Central

Galetta, K.M.; Barrett, J.; Allen, M.; Madda, F.; Delicata, D.; Tennant, A.T.; Branas, C.C.; Maguire, M.G.; Messner, L.V.; Devick, S.; Galetta, S.L.

2011-01-01

Objective: Sports-related concussion has received increasing attention as a cause of short- and long-term neurologic symptoms among athletes. The King-Devick (K-D) test is based on measurement of the speed of rapid number naming (reading aloud single-digit numbers from 3 test cards), and captures impairment of eye movements, attention, language, and other correlates of suboptimal brain function. We investigated the K-D test as a potential rapid sideline screening for concussion in a cohort of boxers and mixed martial arts fighters. Methods: The K-D test was administered prefight and postfight. The Military Acute Concussion Evaluation (MACE) was administered as a more comprehensive but longer test for concussion. Differences in postfight K-D scores and changes in scores from prefight to postfight were compared for athletes with head trauma during the fight vs those without. Results: Postfight K-D scores (n = 39 participants) were significantly higher (worse) for those with head trauma during the match (59.1 ± 7.4 vs 41.0 ± 6.7 seconds, p < 0.0001, Wilcoxon rank sum test). Those with loss of consciousness showed the greatest worsening from prefight to postfight. Worse postfight K-D scores (rs = −0.79, p = 0.0001) and greater worsening of scores (rs = 0.90, p < 0.0001) correlated well with postfight MACE scores. Worsening of K-D scores by ≥5 seconds was a distinguishing characteristic noted only among participants with head trauma. High levels of test-retest reliability were observed (intraclass correlation coefficient 0.97 [95% confidence interval 0.90–1.0]). Conclusions: The K-D test is an accurate and reliable method for identifying athletes with head trauma, and is a strong candidate rapid sideline screening test for concussion. PMID:21288984

The educational needs of people with systemic sclerosis: a cross-sectional study using the Dutch version of the Educational Needs Assessment Tool (D-ENAT).

PubMed

Schouffoer, Anne; Ndosi, Mwidimi E; Vliet Vlieland, Thea P M; Meesters, Jorit J L

2016-02-01

The Dutch Educational Needs Assessment Tool (D-ENAT) systematically assesses educational needs of patients with rheumatic diseases. The present study aims to describe the educational needs of Dutch patients with systemic sclerosis (SSc). The D-ENAT was sent to 155 SSc patients registered at the outpatient clinic of a university hospital. The D-ENAT consists of 39 items in seven domains. "Each domain has different number of items therefore we normalized each domain score: (domain score/maximum) × 100) and expressed in percentage to enable comparisons between domains." A total D-ENAT score (0-156) is calculated by summing all 39 items. In addition, age, disease duration, gender, educational level, present information need (yes/no) and information need (1-4; wanting to know nothing-everything) were recorded. Univariate regression analysis was used to examine factors associated with the D-ENAT scores. The response rate was 103 out of 155 (66 %). The mean % of educational needs scores (0-100 %; lowest-highest) were 49 % for "D-ENAT total score," 46 % for "Managing pain," 41 % for "Movement," 43 % for "Feelings," 59 % for "Disease process," 44 % for "Treatments from health professionals," 61 % for "Self-help measures" and 51 % for "Support systems." No associations between the D-ENAT total score and age, disease duration, gender and educational level were found. The D-ENAT demonstrated its ability to identify educational needs of Dutch SSc patients. SSc patients demonstrated substantial educational needs, especially in the domains: "Disease process" and "Self-help measures." The validity and practical applicability of the D-ENAT to make an inventory of SSc patients' educational needs require further investigation.

The genetic association between personality and major depression or bipolar disorder. A polygenic score analysis using genome-wide association data

PubMed Central

Middeldorp, C M; de Moor, M H M; McGrath, L M; Gordon, S D; Blackwood, D H; Costa, P T; Terracciano, A; Krueger, R F; de Geus, E J C; Nyholt, D R; Tanaka, T; Esko, T; Madden, P A F; Derringer, J; Amin, N; Willemsen, G; Hottenga, J-J; Distel, M A; Uda, M; Sanna, S; Spinhoven, P; Hartman, C A; Ripke, S; Sullivan, P F; Realo, A; Allik, J; Heath, A C; Pergadia, M L; Agrawal, A; Lin, P; Grucza, R A; Widen, E; Cousminer, D L; Eriksson, J G; Palotie, A; Barnett, J H; Lee, P H; Luciano, M; Tenesa, A; Davies, G; Lopez, L M; Hansell, N K; Medland, S E; Ferrucci, L; Schlessinger, D; Montgomery, G W; Wright, M J; Aulchenko, Y S; Janssens, A C J W; Oostra, B A; Metspalu, A; Abecasis, G R; Deary, I J; Räikkönen, K; Bierut, L J; Martin, N G; Wray, N R; van Duijn, C M; Smoller, J W; Penninx, B W J H; Boomsma, D I

2011-01-01

The relationship between major depressive disorder (MDD) and bipolar disorder (BD) remains controversial. Previous research has reported differences and similarities in risk factors for MDD and BD, such as predisposing personality traits. For example, high neuroticism is related to both disorders, whereas openness to experience is specific for BD. This study examined the genetic association between personality and MDD and BD by applying polygenic scores for neuroticism, extraversion, openness to experience, agreeableness and conscientiousness to both disorders. Polygenic scores reflect the weighted sum of multiple single-nucleotide polymorphism alleles associated with the trait for an individual and were based on a meta-analysis of genome-wide association studies for personality traits including 13 835 subjects. Polygenic scores were tested for MDD in the combined Genetic Association Information Network (GAIN-MDD) and MDD2000+ samples (N=8921) and for BD in the combined Systematic Treatment Enhancement Program for Bipolar Disorder and Wellcome Trust Case–Control Consortium samples (N=6329) using logistic regression analyses. At the phenotypic level, personality dimensions were associated with MDD and BD. Polygenic neuroticism scores were significantly positively associated with MDD, whereas polygenic extraversion scores were significantly positively associated with BD. The explained variance of MDD and BD, ∼0.1%, was highly comparable to the variance explained by the polygenic personality scores in the corresponding personality traits themselves (between 0.1 and 0.4%). This indicates that the proportions of variance explained in mood disorders are at the upper limit of what could have been expected. This study suggests shared genetic risk factors for neuroticism and MDD on the one hand and for extraversion and BD on the other. PMID:22833196

Repetitive behavior profiles: Consistency across autism spectrum disorder cohorts and divergence from Prader-Willi syndrome.

PubMed

Flores, Cindi G; Valcante, Gregory; Guter, Steve; Zaytoun, Annette; Wray, Emily; Bell, Lindsay; Jacob, Suma; Lewis, Mark H; Driscoll, Daniel J; Cook, Edwin H; Kim, Soo-Jeong

2011-12-01

Restricted and repetitive behavior (RRB) is a group of heterogeneous maladaptive behaviors. RRB is one of the key diagnostic features of autism spectrum disorders (ASDs) and also commonly observed in Prader-Willi syndrome (PWS). In this study, we assessed RRB using the Repetitive Behavior Scale-Revised (RBS-R) in two ASD samples (University of Illinois at Chicago [UIC] and University of Florida [UF]) and one PWS sample. We compared the RBS-R item endorsements across three ASD cohorts (UIC, UF and an ASD sample from Lam, The Repetitive Behavior Scale-Revised: independent validation and the effect of subject variables, PhD thesis, 2004), and a PWS sample. We also compared the mean RBS-R subscale/sum scores across the UIC, UF and PWS samples; across the combined ASD (UIC + UF), PWS-deletion and PWS-disomy groups; and across the combined ASD sample, PWS subgroup with a Social Communication Questionnaire (SCQ) score ≥15, and PWS subgroup with a SCQ score <15. Despite the highly heterogeneous nature, the three ASD samples (UIC, UF and Lam's) showed a similar pattern of the RBS-R endorsements, and the mean RBS-R scores were not different between the UIC and UF samples. However, higher RRB was noted in the ASD sample compared with the PWS sample, as well as in the PWS subgroup with a SCQ score ≥15 compared with the PWS subgroup with a SCQ score <15. Study limitations include a small sample size, a wide age range of our participants, and not controlling for potential covariates. A future replication study using a larger sample and further investigation into the genetic bases of overlapping ASD and RRB phenomenology are needed, given the higher RRB in the PWS subgroup with a SCQ score ≥15.

Effects of asenapine on agitation and hostility in adults with acute manic or mixed episodes associated with bipolar I disorder.

PubMed

Citrome, Leslie; Landbloom, Ronald; Chang, Cheng-Tao; Earley, Willie

2017-01-01

Bipolar disorder is associated with an increased risk of aggression. However, effective management of hostility and/or agitation symptoms may prevent patients from becoming violent. This analysis investigated the efficacy of the antipsychotic asenapine on hostility and agitation in patients with bipolar I disorder. Data were pooled from three randomized, double-blind, placebo-controlled, Phase III trials of asenapine in adults with manic or mixed episodes of bipolar I disorder (NCT00159744, NCT00159796, and NCT00764478). Post hoc analyses assessed the changes from baseline to day 21 on the Young Mania Rating Scale (YMRS) and the Positive and Negative Syndrome Scale (PANSS) hostility-related item scores in asenapine- or placebo-treated patients with at least minimal or mild symptom severity and on the PANSS-excited component (PANSS-EC) total score in agitated patients. Changes were adjusted for improvements in overall mania symptoms to investigate direct effects on hostility. Significantly greater changes in favor of asenapine versus placebo were observed in YMRS hostility-related item scores (irritability: least squares mean difference [95% confidence interval] =-0.5 [-0.87, -0.22], P =0.001; disruptive-aggressive behavior: -0.7 [-0.99, -0.37], P <0.0001), PANSS hostility item score (-0.2 [-0.44, -0.04]; P =0.0181), and PANSS-EC total score (-1.4 [-2.4, -0.4]; P =0.0055). Changes in the YMRS disruptive-aggressive behavior score and the sum of the hostility-related items remained significant after adjusting for improvements in other YMRS item scores. Asenapine significantly reduced hostility and agitation in patients with bipolar I disorder; improvement was at least partially independent of overall improvement on mania symptoms.

Impact of an Acceptance Facilitating Intervention on Patients' Acceptance of Internet-based Pain Interventions: A Randomized Controlled Trial.

PubMed

Baumeister, Harald; Seifferth, Holger; Lin, Jiaxi; Nowoczin, Lisa; Lüking, Marianne; Ebert, David

2015-06-01

Results from clinical trials indicate that Internet-based psychological pain interventions are effective in treating chronic pain. However, little is known about patients' acceptance of these programs and how to positively influence patients' intention to engage in them. Therefore, the present study aimed (1) to assess patients' acceptance of Internet-based interventions, and (2) to examine whether patients' acceptance can be increased by an acceptance facilitating intervention. A total of 104 patients with chronic pain from 2 pain units were randomly allocated to an intervention group (IG) and a no-intervention control group (CG). The IG was shown a short informational video about Internet-based psychological pain interventions before receiving a questionnaire on patients' acceptance of Internet-based psychological pain interventions and predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, Internet usage, and Internet anxiety). The CG filled out the questionnaire immediately. Patients' acceptance was measured with a 4-item scale (sum score ranging from 4 to 20). Baseline acceptance of Internet-based interventions was reported as low (sum-score:4-9) by 53.8%, moderate (10 to 15) by 42.3%, and high (16 to 20) by 3.9% of the patients with chronic pain in the CG. The IG showed a significantly higher acceptance (M = 12.17, SD = 4.22) than the CG (M = 8.94, SD = 3.71) with a standardized mean difference of d = 0.81 (95% CI, 0.41, 1.21). All predictor variables were significantly improved in the IG compared with the CG, except for Internet usage. Patients with chronic pain display a relatively low acceptance of Internet-based psychological pain interventions, which can be substantially increased by a short informational video.

Fundamental movement skills in preschoolers: a randomized controlled trial targeting object control proficiency.

PubMed

Donath, L; Faude, O; Hagmann, S; Roth, R; Zahner, L

2015-11-01

Adequately developed fundamental movement skills, particularly object control dimensions, are considered essential to learn more complex movement patterns and to increase the likelihood to successfully participate in organized and non-organized sports during later years. Thus, the present randomized controlled trial aimed at improving object control dimensions at an early state in a kindergarten setting. Catching, throwing, kicking, rolling and stationary dribbling were assessed via gross motor development 2 (TGMD-2) testing in 41 normally developed preschoolers. On a cluster-randomized basis [strata: age, sex and body mass index (BMI)], three kindergartens were randomly assigned to an intervention group (n = 22, INT, age: 4.6 ± 1.0 years; BMI: 16.2 ± 1.1 kg/m(2) ) and three to a control group (n = 19, CON: age: 4.5 ± 1.2 years; BMI: 16.8 ± 1.2 kg/m(2) ). Twelve structured training sessions were given within 6 weeks (12 sessions). The total training volume was 330 min. Moderate time × group interaction were observed for the total sum score (Δ+22%, P = 0.05) and dribbling (Δ+41%, P = 0.002). Adjusting for baseline differences analyses of covariance did not affect these results. Interestingly, likely to most likely practically worthwhile effects were detected for the total sum score, catching and dribbling. Object control dimensions such as dribbling and catching that apparently rely on rhythmical movement patterns and anticipatory eye-hand coordination seem to benefit from short-term object control training. These skills are considered important for successful team-sport participation and appropriate sportive motor development. © 2015 John Wiley & Sons Ltd.

Neurofibrillary Tangle Stage and the Rate of Progression of Alzheimer Symptoms: Modeling Using an Autopsy Cohort and Application to Clinical Trial Design

PubMed Central

Qian, Jing; T.Hyman, Bradley; Betensky, Rebecca A.

2017-01-01

Importance The heterogeneity of rate of clinical progression among patients with Alzheimer disease leads to difficulty in providing clinical counseling and diminishes the power of clinical trials using disease-modifying agents. Objective To gain a better understanding of the factors that affect the natural history of progression in Alzheimer disease for the purpose of improving both clinical care and clinical trial design. Design, Setting, and Participants A longitudinal cohort study of aging from 2005 to 2014 in the National Alzheimer Coordinating Center. Clinical evaluation of the participants was conducted in 31 National Institute on Aging’s Alzheimer Disease Centers. Nine hundred eighty-four participants in the National Alzheimer Coordinating Center cohort study who died and underwent autopsy and met inclusion and exclusion criteria. Main Outcomes and Measures We sought to model the possibility that knowledge of neurofibrillary tangle burden in the presence of moderate or frequent plaques would add to the ability to predict clinical rate of progression during the ensuing 2 to 3 years. We examined the National Alzheimer Coordinating Center autopsy data to evaluate the effect of different neurofibrillary tangle stages on the rates of progression on several standard clinical instruments: the Clinical Dementia Rating Scale sum of boxes, a verbal memory test (logical memory), and a controlled oral word association task (vegetable naming), implementing a reverse-time longitudinal modeling approach in conjunction with latent class estimation to adjust for unmeasured sources of heterogeneity. Results Several correlations between clinical variables and neurocognitive performance suggest a basis for heterogeneity: Higher education level was associated with lower Clinical Dementia Rating Scale sum of boxes (β = −0.19; P < .001), and frequent vs moderate neuritic plaques were associated with higher Clinical Dementia Rating Scale sum of boxes (β = 1.64; P < .001) and lower logical memory score (β = −1.07; P = .005). The rate of change of the clinical and cognitive scores varied depending on Braak stage, when adjusting for plaques, age of death, sex, education, and APOE genotype. For example, comparing high vs low Braak stage with other variables fixed, the logical memory score decreased a substantial 0.38 additional units per year (95% CI, −0.70 to −0.06; P = .02). Using these data, we estimate that a 300-participant clinical trial with end point of a 20% improvement in slope in rate of change of Clinical Dementia Rating Scale sum of boxes has 89% power when all participants in the trial are from the high Braak stage, compared with 29% power if Braak stage had not used for eligibility. Conclusions and Relevance We found that knowledge of neurofibrillary tangle stage, modeled as the sort of information that could be available from tau positron-emission tomography scans and its use to determine eligibility to a trial, could dramatically improve the power of clinical trials and equivalently reduce the required sample sizes of clinical trials. PMID:28288263

Heart Rate Variability in Nonlinear Rats with Different Orientation and Exploratory Activity in the Open Field.

PubMed

Kur'yanova, E V; Teplyi, D L; Zhukova, Yu D; Zhukovina, N V

2015-12-01

The basic behavioral activity of nonlinear rats was evaluated from the sum of crossed peripheral and central squares and peripheral and central rearing postures in the open fi eld test. This index was low (<20 episodes), intermediate (20-29 episodes), or high (>30 episodes). Male rats with high score of orientation and exploratory activity were characterized by higher indexes of total heart rate variability than rats with low or intermediate activity. Specimens with a greater contribution of VLF waves into the total power spectrum of heart rate variability were shown to dominate among the rats with high behavioral activity. Our results are consistent with the notions of a suprasegmental nature of VLF waves.

Patients' perception of Parkinson's disease-associated pain following initiation of rotigotine: a multicenter non-interventional study.

PubMed

Timmermann, Lars; Oehlwein, Christian; Ransmayr, Gerhard; Fröhlich, Holger; Will, Edgar; Schroeder, Hanna; Lauterbach, Thomas; Bauer, Lars; Kassubek, Jan

2017-01-01

To evaluate Parkinson's disease (PD)-associated pain as perceived by the patients (subjective characterization), and how this may change following initiation of rotigotine transdermal patch. SP1058 was a non-interventional study conducted in routine clinical practice in Germany and Austria in patients experiencing PD-associated pain (per the physician's assessment). Data were collected at baseline (ie, before rotigotine initiation) and at a routine visit after ≥25 days (-3 days allowed) of treatment on a maintenance dose of rotigotine (end of study [EoS]). Pain perception was assessed using the 12-item Pain Description List of the validated German Pain Questionnaire (each item ranked 0 = 'not true' to 3 = 'very true'). Primary effectiveness variable: change from baseline to EoS in the sum score of the 4 'affective dimension' items of the Pain Description List. Secondary effectiveness variables: change from baseline to EoS in Unified Parkinson's Disease Rating Scale (UPDRS) II, III, and II+III scores, and Parkinson's Disease Questionnaire (PDQ-8) total score (PD-related quality-of-life). Other variables included scores of the eight 'sensory dimension' items of the Pain Description List. Of 93 enrolled patients (mean [SD] age: 71.1 [9.0] years; male: 48 [52%]), 77 (83%) completed the study, and 70 comprised the full analysis set. The mean (SD) change from baseline in the sum score of the four 'affective dimension' items was -1.3 (2.8) indicating a numerical improvement (baseline: 3.9 [3.4]). In the 'sensory dimension', pain was mostly perceived as 'pulling' at baseline (49/70 [70%]); 'largely true'/'very true'). Numerical improvements were observed in all UPDRS scores (mean [SD] change in UPDRS II+III: -5.3 [10.5]; baseline: 36.0 [15.9]), and in PDQ-8 total score (-2.0 [4.8]; baseline: 10.7 [5.9]). Adverse drug reactions were consistent with dopaminergic stimulation and transdermal administration. The perception of the 'affective dimension' of PD-associated pain numerically improved in patients treated with rotigotine. ClinicalTrials.gov identifier: NCT01606670; https://clinicaltrials.gov/ct2/show/NCT01606670?term=NCT01606670&rank=1.

A comparison of 12-gene colon cancer assay gene expression in African American and Caucasian patients with stage II colon cancer.

PubMed

Govindarajan, Rangaswamy; Posey, James; Chao, Calvin Y; Lu, Ruixiao; Jadhav, Trafina; Javed, Ahmed Y; Javed, Awais; Mahmoud, Fade A; Osarogiagbon, Raymond U; Manne, Upender

2016-06-18

African American (AA) colon cancer patients have a worse prognosis than Caucasian (CA) colon cancer patients, however, reasons for this disparity are not well understood. To determine if tumor biology might contribute to differential prognosis, we measured recurrence risk and gene expression using the Oncotype DX® Colon Cancer Assay (12-gene assay) and compared the Recurrence Score results and gene expression profiles between AA patients and CA patients with stage II colon cancer. We retrieved demographic, clinical, and archived tumor tissues from stage II colon cancer patients at four institutions. The 12-gene assay and mismatch repair (MMR) status were performed by Genomic Health (Redwood City, California). Student's t-test and the Wilcoxon rank sum test were used to compare Recurrence Score data and gene expression data from AA and CA patients (SAS Enterprise Guide 5.1). Samples from 122 AA and 122 CA patients were analyzed. There were 118 women (63 AA, 55 CA) and 126 men (59 AA, 67 CA). Median age was 66 years for AA patients and 68 for CA patients. Age, gender, year of surgery, pathologic T-stage, tumor location, the number of lymph nodes examined, lymphovascular invasion, and MMR status were not significantly different between groups (p = 0.93). The mean Recurrence Score result for AA patients (27.9 ± 12.8) and CA patients (28.1 ± 11.8) was not significantly different and the proportions of patients with high Recurrence Score values (≥41) were similar between the groups (17/122 AA; 15/122 CA). None of the gene expression variables, either single genes or gene groups (cell cycle group, stromal group, BGN1, FAP, INHBA1, Ki67, MYBL2, cMYC and GADD45B), was significantly different between the racial groups. After controlling for clinical and pathologic covariates, the means and distributions of Recurrence Score results and gene expression profiles showed no statistically significant difference between patient groups. The distribution of Recurrence Score results and gene expression data was similar in a cohort of AA and CA patients with stage II colon cancer and similar clinical characteristics, suggesting that tumor biology, as represented by the 12-gene assay, did not differ between patient groups.

The Infant Version of the Laboratory Temperament Assessment Battery (Lab-TAB): Measurement Properties and Implications for Concepts of Temperament

PubMed Central

Planalp, Elizabeth M.; Van Hulle, Carol; Gagne, Jeffrey R.; Goldsmith, H. Hill

2017-01-01

We describe large-sample research using the Infant Laboratory Temperament Assessment Battery (Lab-TAB; Goldsmith and Rothbart, 1996) in 1,076 infants at 6 and 12 months of age. The Lab-TAB was designed to assess temperament dimensions through a series of episodes that mimic everyday situations. Our goal is to provide guidelines for scoring Lab-TAB episodes to derive temperament composites. We also present a set of analyses examining mean differences and stability of temperament in early infancy, gender differences in infant temperament, as well as a validation of Lab-TAB episodes and composites with parent reported Infant Behavior Questionnaire (IBQ; Rothbart, 1981) scales. In general, laboratory observed temperament was only modestly related to parent reported temperament. However, temperament measures were significantly stable across time and several gender differences that align with previous research emerged. In sum, the Lab-TAB usefully assesses individual differences in infant emotionality. PMID:28596748

Children's drawings as a measure of anxiety level: a clinical pilot study.

PubMed

Puura, Arto; Puura, Kaija; Rorarius, Michael; Annila, Päivi; Viitanen, Hanna; Baer, Gerhard

2005-03-01

No simple method exists to distinguish children in need for premedication. The present study was planned to detect preoperative anxiety levels of children by rating their drawings. Sixty ASA I children aged 4-7 years undergoing adenoidectomy were divided into AGIT and CALM groups according to agitation level observed during venous cannulation. All children drew a picture at three different times: (i) just after arrival in the day-case unit, (ii) 10 min before operation and, (iii) prior to leaving for home. The children were also randomized to three premedication groups: group D, rectal diazepam 0.5 mg x kg(-1); group P, 0.9% NaCl 0.1 ml x kg(-1) rectally; group NT, no premedication. Five features (size of the drawing, form of the drawing line, colors used, mark of the pen and clarity of the picture) from the children's drawings were rated with a 3-point scale. The ratings of each feature were made to form a sum score of anxiety ranging from 0 to 10. In the analysis of variance for repeated measures both the premedication group and agitation score were taken into the model as factors. The anxiety score of the drawings of the agitated children (during venous cannulation) was significantly higher already after arrival in the hospital [AGIT 4.76 (95% CI: 3.56-5.96) Vs CALM 3.67 (95% CI: 2.97-4.37) P = 0.029], but there were no statistical differences between the different premedication groups. When routine sedative premedication is not used the drawings of the children might detect the children needing sedative premedication.

Trajectories of depressive symptoms and their relationship to the progression of dementia.

PubMed

Barca, Maria Lage; Persson, Karin; Eldholm, Rannveig; Benth, Jūratė Šaltytė; Kersten, Hege; Knapskog, Anne-Brita; Saltvedt, Ingvild; Selbaek, Geir; Engedal, Knut

2017-11-01

The relationship between progression of Alzheimer's disease and depression and its underlying mechanisms has scarcely been studied. A sample of 282 outpatients with Alzheimer's disease (AD; 105 with amnestic AD and 177 with Alzheimer's dementia) from Norway were followed up for an average of two years. Assessment included Cornell Scale for Depression in Dementia and Clinical Dementia Rating Scale (CDR) at baseline and follow-up to examine the relationship between AD and depression. Additionally, MRI of the brain, CSF dementia biomarkers and APOE status were assessed at baseline. Progression of dementia was defined as the difference between CDR sum of boxes at follow-up and baseline (CDR-SB change). Trajectories of depressive symptoms on the Cornell Scale were identified using growth mixture modeling. Differences between the trajectories in regard to patients' characteristics were investigated. Three distinct trajectories of depressive symptoms were identified: 231 (82.8%) of the patients had stable low-average scores on the Cornell Scale (Class 1); 11 (3.9%) had high and decreasing scores (Class 2); and 37 (13.3%) had moderate and increasing scores (Class 3). All classes had average probabilities over 80%, and confidence intervals were non-overlapping. The only significant characteristic associated with membership in class 3 was CDR-SB change. Not all patients screened for participation were included in the study, but the included and non-included patients did not differ significantly. Some patients with amnestic MCI might have been misdiagnosed. A more rapid progression of dementia was found in a group of patients with increasing depressive symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

Disparities in Oral Cancer Awareness: a Population Survey in Tehran, Iran.

PubMed

Azimi, Somayyeh; Ghorbani, Zahra; Ghasemi, Erfan; Tennant, Marc; Kruger, Estie

2018-03-10

Oral cancer is a life-threatening disease with low survival rates, especially when diagnosed in an advanced stage. Lack of awareness about this cancer among the population is proposed as a possible reason for this diagnostic delay. The aim of this study was to evaluate oral cancer awareness, as well as the association of this with sociodemographic status in Tehran. In this cross-sectional population-based survey, 1800 self-administered questionnaires (collecting sociodemographic data, questions regarding oral cancer awareness and the source of information) were distributed through multistage stratified random sampling. Scores for questions ranged from 0 to 4, and totals were summed. The outcome of question responses was also analyzed separately. In total, 1312 questionnaires were available for analysis, from 788 females and 489 males (37.8 ± 9.02 years). Only 30% of the respondents were aware of oral cancer. The average score for awareness was 1.09 ± 1.6 with no significant differences between age groups and genders. Almost 6.5% of participants had complete awareness about oral cancer. A significant difference was found between mean scores in different levels of education and occupation (p = 0.0001). From 585 responses to the "source of information" question, "public media" was the most important source (almost 50%). Only 2% mentioned "dentists" as a source of information. This study indicated an alarming lack of oral cancer awareness and literacy in Tehran, Iran. Dentists should be obliged to practice their pivotal role in informing the public about oral cancer.

Nonlinear generation of sum and difference frequency waves by two helicon waves in a semiconductor

NASA Astrophysics Data System (ADS)

Salimullah, M.; Ferdous, T.

1984-05-01

This paper presents a theoretical investigation of the nonlinear generation of electrostatic waves at the sum and the difference frequency when two high amplitude elliptically polarized helicon waves propagate along the direction of the externally applied static magnetic field in an n-type semiconductor. The nonlinearity arises through the ponderomotive force on electrons. It is noticed that the power conversion efficiency of the difference frequency generation is much larger than that of the sum frequency generation. The power conversion efficiency may be easily increased by increasing the density of electrons in the semiconductor.

A New Lease of Life for Thomson's Bonds Model of Intelligence

ERIC Educational Resources Information Center

Bartholomew, David J.; Deary, Ian J.; Lawn, Martin

2009-01-01

Modern factor analysis is the outgrowth of Spearman's original "2-factor" model of intelligence, according to which a mental test score is regarded as the sum of a general factor and a specific factor. As early as 1914, Godfrey Thomson realized that the data did not require this interpretation and he demonstrated this by proposing what became…

Two Approaches to Estimation of Classification Accuracy Rate under Item Response Theory

ERIC Educational Resources Information Center

Lathrop, Quinn N.; Cheng, Ying

2013-01-01

Within the framework of item response theory (IRT), there are two recent lines of work on the estimation of classification accuracy (CA) rate. One approach estimates CA when decisions are made based on total sum scores, the other based on latent trait estimates. The former is referred to as the Lee approach, and the latter, the Rudner approach,…

Differences in Physicians' Verbal and Nonverbal Communication With Black and White Patients at the End of Life.

PubMed

Elliott, Andrea M; Alexander, Stewart C; Mescher, Craig A; Mohan, Deepika; Barnato, Amber E

2016-01-01

Black patients are more likely than white patients to die in the intensive care unit with life-sustaining treatments. Differences in patient- and/or surrogate-provider communication may contribute to this phenomenon. To test whether hospital-based physicians use different verbal and/or nonverbal communication with black and white simulated patients and their surrogates. We conducted a randomized factorial trial of the relationship between patient race and physician communication using high-fidelity simulation. Using a combination of probabilistic and convenience sampling, we recruited 33 hospital-based physicians in western Pennsylvania who completed two encounters with prognostically similar, critically and terminally ill black and white elders with identical treatment preferences. We then conducted detailed content analysis of audio and video recordings of the encounters, coding verbal emotion-handling and shared decision-making behaviors, and nonverbal behaviors (time interacting with the patient and/or surrogate, with open vs. closed posture, and touching the patient and physical proximity). We used a paired t-test to compare each subjects' summed verbal and nonverbal communication scores with the black patient compared to the white patient. Subject physicians' verbal communication scores did not differ by patient race (black vs. white: 8.4 vs. 8.4, P-value = 0.958). However, their nonverbal communication scores were significantly lower with the black patient than with the white patient (black vs. white: 2.7 vs. 2.9, P-value 0.014). In this small regional sample, hospital-based physicians have similar verbal communication behaviors when discussing end-of-life care for otherwise similar black and white patients but exhibit significantly fewer positive, rapport-building nonverbal cues with black patients. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Differences in Physicians’ Verbal and Nonverbal Communication With Black and White Patients at the End of Life

PubMed Central

Elliott, Andrea M.; Alexander, Stewart C.; Mescher, Craig A.; Mohan, Deepika; Barnato, Amber E.

2015-01-01

Context Black patients are more likely than white patients to die in the intensive care unit with life-sustaining treatments. Differences in patient- and/or surrogate-provider communication may contribute to this phenomenon. Objectives To test whether hospital-based physicians use different verbal and/or nonverbal communication with black and white simulated patients and their surrogates. Methods We conducted a randomized factorial trial of the relationship between patient race and physician communication using high-fidelity simulation. Using a combination of probabilistic and convenience sampling, we recruited 33 hospital-based physicians in western Pennsylvania who completed two encounters with prognostically similar, critically and terminally ill black and white elders with identical treatment preferences. We then conducted detailed content analysis of audio and video recordings of the encounters, coding verbal emotion-handling and shared decision-making behaviors, and nonverbal behaviors (time interacting with the patient and/or surrogate, with open vs. closed posture, and touching the patient and physical proximity). We used a paired t-test to compare each subjects’ summed verbal and nonverbal communication scores with the black patient compared to the white patient. Results Subject physicians’ verbal communication scores did not differ by patient race (black vs. white: 8.4 vs. 8.4, P-value = 0.958). However, their nonverbal communication scores were significantly lower with the black patient than with the white patient (black vs. white: 2.7 vs. 2.9, P-value 0.014). Conclusion In this small regional sample, hospital-based physicians have similar verbal communication behaviors when discussing end-of-life care for otherwise similar black and white patients but exhibit significantly fewer positive, rapport-building nonverbal cues with black patients. PMID:26297851

Chlamydia pneumoniae antibody titers and cardiac calcifications: a cross-sectional serological-echocardiographic correlative study.

PubMed

Atar, Shaul; Tolstrup, Kirsten; Cercek, Bojan; Siegel, Robert J

2007-07-01

Chlamydia pneumoniae has previously been associated with higher prevalence of valvular and cardiac calcifications. To investigate a possible association of seropositivity for C. pneumoniae and the presence of cardiac calcifications (mitral annular or aortic root calcification, and aortic valve sclerosis). We retrospectively analyzed serological data (immunoglobulin G TWAR antibodies) from the AZACS trial (Azithromycin in Acute Coronary Syndromes), and correlated the serological findings according to titer levels with the presence of cardiac calcifications as detected by transthoracic echocardiography. In 271 patients, age 69 +/- 13 years, who underwent both serological and echocardiographic evaluation, we found no significant association between the "calcification sum score" (on a scale of 0-3) in seropositive compared to seronegative patients (1.56 +/- 1.15 vs.1.35 +/- 1.15, respectively, P = 0.26). The median calcification sum score was 1 (interquartile range 0-3) for the seronegative group, and 2 (interquartile range 0-3) for the seropositive group (P = 0.2757). In addition, we did not find a significant correlation of any of the individual sites of cardiac calcification and C. pneumoniae seropositivity. Our findings suggest that past C. pneumoniae infection may not be associated with the pathogenesis of valvular and cardiac calcifications.

Relationship between lower limb muscle strength and 6-minute walk test performance in stroke patients.

PubMed

Pradon, Didier; Roche, Nicolas; Enette, Lievyn; Zory, Raphaël

2013-01-01

The aim of this study was to determine if lower limb muscle strength and/or spasticity are related to performance in the 6-min walk test (6MWT) in stroke patients. A total of 24 patients (12 males and 12 females) participated in the study. Muscle strength (Medical Research Council (MRC) scale) and spasticity (modified Ashworth scale) were assessed prior to the 6MWT. Heart rate was recorded at rest and during the 6MWT. Subjects were divided into two groups: (i) those with a high MRC sum score, and (ii) those with a low MRC sum score. The relationship between the 6MWT distance and the other parameters was analysed using a Spearman's rank correlation coefficient. There was a significant and positive relationship between 6MWT distance and lower limb muscle strength (p = 0.001), whereas no significant correlations were found between the 6MWT distance and spasticity, resting heart rate and heart rate during the 6MWT. The 6MWT distance may be a good indicator of lower limb muscle strength, and lower limb strengthening may improve gait capacity in stroke patients.

Myocardial perfusion and left ventricular function indices assessed by gated myocardial perfusion SPECT in methamphetamine abusers.

PubMed

Dadpour, Bita; Dabbagh Kakhki, Vahid R; Afshari, Reza; Dorri-Giv, Masoumeh; Mohajeri, Seyed A R; Ghahremani, Somayeh

2016-12-01

Methamphetamine (MA) is associated with alterations of cardiac structure and function, although it is less known. In this study, we assessed possible abnormality in myocardial perfusion and left ventricular function using gated myocardial perfusion SPECT. Fifteen patients with MA abuse, on the basis of Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) MA dependency determined by Structured Clinical Interview for DSM-IV, underwent 2-day dipyridamole stress/rest Tc-sestamibi gated myocardial perfusion SPECT. An average daily dose of MA use was 0.91±1.1 (0.2-4) g. The duration of MA use was 3.4±2.1 (1-7) years. In visual and semiquantitative analyses, all patients had normal gated myocardial perfusion SPECT, with no perfusion defects. In all gated SPECT images, there was no abnormality in left ventricular wall motion and thickening. All summed stress scores and summed rest scores were below 3. Calculated left ventricular functional indices including the end-diastolic volume, end-systolic volume, and left ventricular ejection fraction were normal. Many cardiac findings because of MA mentioned in previous reports are less likely because of significant epicardial coronary artery stenosis.

Automatic Summarization as a Combinatorial Optimization Problem

NASA Astrophysics Data System (ADS)

Hirao, Tsutomu; Suzuki, Jun; Isozaki, Hideki

We derived the oracle summary with the highest ROUGE score that can be achieved by integrating sentence extraction with sentence compression from the reference abstract. The analysis results of the oracle revealed that summarization systems have to assign an appropriate compression rate for each sentence in the document. In accordance with this observation, this paper proposes a summarization method as a combinatorial optimization: selecting the set of sentences that maximize the sum of the sentence scores from the pool which consists of the sentences with various compression rates, subject to length constrains. The score of the sentence is defined by its compression rate, content words and positional information. The parameters for the compression rates and positional information are optimized by minimizing the loss between score of oracles and that of candidates. The results obtained from TSC-2 corpus showed that our method outperformed the previous systems with statistical significance.

Diabetes Self-Management: A Key for Better Health-related Quality of Life in Patients with Diabetes.

PubMed

Badr, Hanan E; Al-Khaledi, Maha; Al-Dousari, Hussah; Al-Dhufairi, Shaikhah; Al-Mousawi, Taiba; Al-Azemi, Rehab; Al-Azimi, Farah

2018-04-17

This study was aimed at assessing health-related quality of life (HRQOL) among adult patients with diabetes attending primary health care diabetes clinics in Kuwait and to examine the factors associated with patients with the HRQOL of patients with diabetes. This cross-sectional study was conducted among 503 patients with diabetes attending 26 primary healthcare diabetes clinics in Kuwait. A self-administered questionnaire on participants' socio-demographic and clinical characteristics, in addition to the Diabetes Self-Management Questionnaire (DSMQ) to assess patients' DSM was used. SF12 was employed to assess the HRQOL, producing two outcomes: Physical health composite and Mental health composite. The mean age of participants was 52. ± 0.8 years, 53.1% were males, and 49.0% were Kuwaitis. The median DSM sum score was 6.5. Male patients with diabetes showed significantly better median DSM sum score than female patients with diabetes. The overall median score of HRQOL was 61.7/100 with a better median score of PHC than MHC of quality of life (66.7/100 and 56.7/100, respectively). Multivariate analysis revealed a significant direct association between DSM and better primary health composite and mental health composite. It also showed that female gender, and reporting two or more diabetic complications were significantly associated with poor PHC. Kuwaiti patients with diabetes showed a modest level of HRQOL. Patients' DSM, gender, and diabetes complications were significant independent correlates to HRQOL. Appraisal of patients with diabetes' HRQOL as an essential component of diabetes management in clinical settings is suggested. Further studies to examine the impact of good diabetes self-management on HRQOL improvement are needed.

. ©2018The Author(s). Published by S. Karger AG, Basel.

Pretreatment Nomogram to Predict the Risk of Acute Urinary Retention After I-125 Prostate Brachytherapy

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

Roeloffzen, Ellen M., E-mail: e.m.a.roeloffzen@umcutrecht.nl; Vulpen, Marco van; Battermann, Jan J.

Purpose: Acute urinary retention (AUR) after iodine-125 (I-125) prostate brachytherapy negatively influences long-term quality of life and therefore should be prevented. We aimed to develop a nomogram to preoperatively predict the risk of AUR. Methods: Using the preoperative data of 714 consecutive patients who underwent I-125 prostate brachytherapy between 2005 and 2008 at our department, we modeled the probability of AUR. Multivariate logistic regression analysis was used to assess the predictive ability of a set of pretreatment predictors and the additional value of a new risk factor (the extent of prostate protrusion into the bladder). The performance of the finalmore » model was assessed with calibration and discrimination measures. Results: Of the 714 patients, 57 patients (8.0%) developed AUR after implantation. Multivariate analysis showed that the combination of prostate volume, IPSS score, neoadjuvant hormonal treatment and the extent of prostate protrusion contribute to the prediction of AUR. The discriminative value (receiver operator characteristic area, ROC) of the basic model (including prostate volume, International Prostate Symptom Score, and neoadjuvant hormonal treatment) to predict the development of AUR was 0.70. The addition of prostate protrusion significantly increased the discriminative power of the model (ROC 0.82). Calibration of this final model was good. The nomogram showed that among patients with a low sum score (<18 points), the risk of AUR was only 0%-5%. However, in patients with a high sum score (>35 points), the risk of AUR was more than 20%. Conclusion: This nomogram is a useful tool for physicians to predict the risk of AUR after I-125 prostate brachytherapy. The nomogram can aid in individualized treatment decision-making and patient counseling.« less

Prefrontal Transcranial Direct Current Stimulation for Treatment of Schizophrenia With Predominant Negative Symptoms: A Double-Blind, Sham-Controlled Proof-of-Concept Study

PubMed Central

Palm, Ulrich; Keeser, Daniel; Hasan, Alkomiet; Kupka, Michael J.; Blautzik, Janusch; Sarubin, Nina; Kaymakanova, Filipa; Unger, Ina; Falkai, Peter; Meindl, Thomas; Ertl-Wagner, Birgit; Padberg, Frank

2016-01-01

Negative symptoms are highly relevant in the long-term course of schizophrenia and are an important target domain for the development of novel interventions. Recently, transcranial direct current stimulation (tDCS) of the prefrontal cortex has been investigated as a treatment option in schizophrenia. In this proof-of-concept study, 20 schizophrenia patients with predominantly negative symptoms were randomized to either 10 sessions of add-on active (2 mA, 20min) or sham tDCS (anode: left DLPFC/F3; cathode: right supraorbital/F4). Primary outcome measure was the change in the Scale for the Assessment of Negative Symptoms (SANS) sum score; secondary outcomes included reduction in Positive and Negative Syndrome Scale (PANSS) scores and improvement of depressive symptoms, cognitive processing speed, and executive functioning. Sixteen patients underwent 4 functional connectivity magnetic resonance imaging (fcMRI) scans (pre and post 1st and pre and post 10th tDCS) to investigate changes in resting state network connectivity after tDCS. Per-protocol analysis showed a significantly greater decrease in SANS score after active (−36.1%) than after sham tDCS (−0.7%). PANSS sum scores decreased significantly more with active (−23.4%) than with sham stimulation (−2.2%). Explorative analysis of fcMRI data indicated changes in subgenual cortex and dorsolateral prefrontal cortex (DLPFC) connectivity within frontal-thalamic-temporo-parietal networks. The results of this first proof-of-concept study indicate that prefrontal tDCS may be a promising intervention for treatment of schizophrenia with predominant negative symptoms. Large-scale randomized controlled studies are needed to further establish prefrontal tDCS as novel treatment for negative symptoms in schizophrenia. PMID:27098066

Development and Validation of a Novel Scoring System for Predicting Technical Success of Chronic Total Occlusion Percutaneous Coronary Interventions: The PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) Score.

PubMed

Christopoulos, Georgios; Kandzari, David E; Yeh, Robert W; Jaffer, Farouc A; Karmpaliotis, Dimitri; Wyman, Michael R; Alaswad, Khaldoon; Lombardi, William; Grantham, J Aaron; Moses, Jeffrey; Christakopoulos, Georgios; Tarar, Muhammad Nauman J; Rangan, Bavana V; Lembo, Nicholas; Garcia, Santiago; Cipher, Daisha; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

2016-01-11

This study sought to develop a novel parsimonious score for predicting technical success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) performed using the hybrid approach. Predicting technical success of CTO PCI can facilitate clinical decision making and procedural planning. We analyzed clinical and angiographic parameters from 781 CTO PCIs included in PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) using a derivation and validation cohort (2:1 sampling ratio). Variables with strong association with technical success in multivariable analysis were assigned 1 point, and a 4-point score was developed from summing all points. The PROGRESS CTO score was subsequently compared with the J-CTO (Multicenter Chronic Total Occlusion Registry in Japan) score in the validation cohort. Technical success was 92.9%. On multivariable analysis, factors associated with technical success included proximal cap ambiguity (beta coefficient [b] = 0.88), moderate/severe tortuosity (b = 1.18), circumflex artery CTO (b = 0.99), and absence of "interventional" collaterals (b = 0.88). The resulting score demonstrated good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow chi-square = 2.633; p = 0.268, and receiver-operator characteristic [ROC] area = 0.778) and validation (Hosmer-Lemeshow chi-square = 5.333; p = 0.070, and ROC area = 0.720) subset. In the validation cohort, the PROGRESS CTO and J-CTO scores performed similarly in predicting technical success (ROC area 0.720 vs. 0.746, area under the curve difference = 0.026, 95% confidence interval = -0.093 to 0.144). The PROGRESS CTO score is a novel useful tool for estimating technical success in CTO PCI performed using the hybrid approach. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Item Response Theory as an Efficient Tool to Describe a Heterogeneous Clinical Rating Scale in De Novo Idiopathic Parkinson's Disease Patients.

PubMed

Buatois, Simon; Retout, Sylvie; Frey, Nicolas; Ueckert, Sebastian

2017-10-01

This manuscript aims to precisely describe the natural disease progression of Parkinson's disease (PD) patients and evaluate approaches to increase the drug effect detection power. An item response theory (IRT) longitudinal model was built to describe the natural disease progression of 423 de novo PD patients followed during 48 months while taking into account the heterogeneous nature of the MDS-UPDRS. Clinical trial simulations were then used to compare drug effect detection power from IRT and sum of item scores based analysis under different analysis endpoints and drug effects. The IRT longitudinal model accurately describes the evolution of patients with and without PD medications while estimating different progression rates for the subscales. When comparing analysis methods, the IRT-based one consistently provided the highest power. IRT is a powerful tool which enables to capture the heterogeneous nature of the MDS-UPDRS.

[Research on Time-frequency Characteristics of Magneto-acoustic Signal of Different Thickness Medium Based on Wave Summing Method].

PubMed

Zhang, Shunqi; Yin, Tao; Ma, Ren; Liu, Zhipeng

2015-08-01

Functional imaging method of biological electrical characteristics based on magneto-acoustic effect gives valuable information of tissue in early tumor diagnosis, therein time and frequency characteristics analysis of magneto-acoustic signal is important in image reconstruction. This paper proposes wave summing method based on Green function solution for acoustic source of magneto-acoustic effect. Simulations and analysis under quasi 1D transmission condition are carried out to time and frequency characteristics of magneto-acoustic signal of models with different thickness. Simulation results of magneto-acoustic signal were verified through experiments. Results of the simulation with different thickness showed that time-frequency characteristics of magneto-acoustic signal reflected thickness of sample. Thin sample, which is less than one wavelength of pulse, and thick sample, which is larger than one wavelength, showed different summed waveform and frequency characteristics, due to difference of summing thickness. Experimental results verified theoretical analysis and simulation results. This research has laid a foundation for acoustic source and conductivity reconstruction to the medium with different thickness in magneto-acoustic imaging.

Caregiver acceptability and preferences for early childhood caries preventive treatments for Hispanic children.

PubMed

Adams, Sally H; Hyde, Susan; Gansky, Stuart A

2009-01-01

The objective of this study was to determine caregiver treatment acceptability and preferences for five preventive dental treatments for early childhood caries in young Hispanic children. We interviewed 211 parents/caregivers of Hispanic children attending Head Start programs regarding their acceptability of, and preferences for, five standard preventive dental treatments for young children. Treatments assessed were toothbrushing with fluoride toothpaste, fluoride varnish, and xylitol in food for children, and xylitol gum and chlorhexidine rinse for mothers. The interview assessment included presentation of illustrated cards with verbal description of treatment, photograph/video clip, and treatment samples. Parents rated the acceptability of each treatment (1-5 scale) and treatment preferences within each of 10 possible pairs. Individual treatment preferences were summed to create overall preference scores (range 0-4). All treatments were rated as highly acceptable, however, there were differences (range 4.6-4.9; Friedman chi-square = 23.4, P < 0.001). Chlorhexidine, toothbrushing, and varnish were most acceptable, not different from each other, but more acceptable than xylitol in food (P < 0.05). Summed treatment preferences revealed greater variability (means ranged 1.4-2.6; Friedman chi-square = 128.2, P < 0.001). Fluoride varnish (2.6) and toothbrushing (2.5) were most highly preferred, and differences between preferences for xylitol in food (1.4), xylitol gum (1.5), and chlorhexidine (2.1) were all significant (P < 0.001). Preferences for chlorhexidine were also significantly greater than those for the xylitol products (P < 0.001). All five treatments were highly acceptable, however, when choosing among treatments overall, fluoride varnish and toothbrushing were favored over other treatments.

AMSTAR is a reliable and valid measurement tool to assess the methodological quality of systematic reviews.

PubMed

Shea, Beverley J; Hamel, Candyce; Wells, George A; Bouter, Lex M; Kristjansson, Elizabeth; Grimshaw, Jeremy; Henry, David A; Boers, Maarten

2009-10-01

Our purpose was to measure the agreement, reliability, construct validity, and feasibility of a measurement tool to assess systematic reviews (AMSTAR). We randomly selected 30 systematic reviews from a database. Each was assessed by two reviewers using: (1) the enhanced quality assessment questionnaire (Overview of Quality Assessment Questionnaire [OQAQ]); (2) Sacks' instrument; and (3) our newly developed measurement tool (AMSTAR). We report on reliability (interobserver kappas of the 11 AMSTAR items), intraclass correlation coefficients (ICCs) of the sum scores, construct validity (ICCs of the sum scores of AMSTAR compared with those of other instruments), and completion times. The interrater agreement of the individual items of AMSTAR was substantial with a mean kappa of 0.70 (95% confidence interval [CI]: 0.57, 0.83) (range: 0.38-1.0). Kappas recorded for the other instruments were 0.63 (95% CI: 0.38, 0.78) for enhanced OQAQ and 0.40 (95% CI: 0.29, 0.50) for the Sacks' instrument. The ICC of the total score for AMSTAR was 0.84 (95% CI: 0.65, 0.92) compared with 0.91 (95% CI: 0.82, 0.96) for OQAQ and 0.86 (95% CI: 0.71, 0.94) for the Sacks' instrument. AMSTAR proved easy to apply, each review taking about 15 minutes to complete. AMSTAR has good agreement, reliability, construct validity, and feasibility. These findings need confirmation by a broader range of assessors and a more diverse range of reviews.

Physical self-concept and physical fitness in elderly individuals.

PubMed

Amesberger, G; Finkenzeller, T; Würth, S; Müller, E

2011-08-01

This investigation examined the relations between physical self-concept and physical fitness (endurance, balance, muscle strength, muscle power) for gaining knowledge about the interrelationship between subjective ratings and objective fitness scores in the elderly in three steps: (1) detecting correlations and changes in time, (2) clarifying the influence of gender, and (3) of a skiing intervention lasting 12 weeks. Physical self-concept was assessed using a modified version of the Physical Self-Concepts (PSK) scales (Stiller et al., 2004) reflecting three first-order factors (endurance, strength, general sportiness) and one second-order factor (global fitness). Objective fitness scores were obtained by VO(2 max), counter movement jump, concentric muscle strength, and static balance. The results reveal that elderly individuals' global physical self and general sportiness are mainly linked to VO(2 max) and concentric muscle strength. Global physical self is predicted by VO(2 max) in females and by physical strength (concentric muscle strength) in males, indicating gender differences. Over time, correlations between subjective ratings and objective fitness scores become stronger in the sense of convergent validity in the skiing intervention group, whereas convergent and divergent validity cannot be supported by data of the control group. In sum, physical self-concept is an important factor in the context of physical intervention programs in the elderly. © 2011 John Wiley & Sons A/S.

A family longevity selection score: ranking sibships by their longevity, size, and availability for study.

PubMed

Sebastiani, Paola; Hadley, Evan C; Province, Michael; Christensen, Kaare; Rossi, Winifred; Perls, Thomas T; Ash, Arlene S

2009-12-15

Family studies of exceptional longevity can potentially identify genetic and other factors contributing to long life and healthy aging. Although such studies seek families that are exceptionally long lived, they also need living members who can provide DNA and phenotype information. On the basis of these considerations, the authors developed a metric to rank families for selection into a family study of longevity. Their measure, the family longevity selection score (FLoSS), is the sum of 2 components: 1) an estimated family longevity score built from birth-, gender-, and nation-specific cohort survival probabilities and 2) a bonus for older living siblings. The authors examined properties of FLoSS-based family rankings by using data from 3 ongoing studies: the New England Centenarian Study, the Framingham Heart Study, and screenees for the Long Life Family Study. FLoSS-based selection yields families with exceptional longevity, satisfactory sibship sizes and numbers of living siblings, and high ages. Parameters in the FLoSS formula can be tailored for studies of specific populations or age ranges or with different conditions. The first component of the FLoSS also provides a conceptually sound survival measure to characterize exceptional longevity in individuals or families in various types of studies and correlates well with later-observed longevity.

Intravenous immunoglobulin for chronic residual peripheral neuropathy in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome): a multicenter, double-blind trial.

PubMed

Koike, Haruki; Akiyama, Kazuo; Saito, Toyokazu; Sobue, Gen

2015-03-01

Eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss syndrome, frequently affects the peripheral nervous system. We conducted a multicenter, double-blind, three-arm treatment period, randomized, pre-post trial to assess the efficacy of intravenous immunoglobulin (IVIg) administration for residual peripheral neuropathy in patients with EGPA that is in remission, indicated by laboratory indices. Twenty-three patients were randomly assigned into three groups, in which the timing of IVIg and placebo administration was different. Each group received one course of intervention and two courses of placebo at 2-week intervals. Treatment effects were assessed every 2 weeks for 8 weeks. The primary outcome measure, the amount of change in the manual muscle testing sum score 2 weeks after IVIg administration, significantly increased (p = 0.002). The results over time suggested that this effect continued until the last assessment was done 8 weeks later. The number of muscles with manual muscle testing scores of three or less (p = 0.004) and the neuropathic pain scores represented by the visual analogue scale (p = 0.005) also improved significantly 2 weeks after IVIg administration. This study indicates that IVIg treatment for EGPA patients with residual peripheral neuropathy should be considered even when laboratory indices suggest remission of the disease.

Utilization of case presentations in medical microbiology to enhance relevance of basic science for medical students

PubMed Central

Chamberlain, Neal R.; Stuart, Melissa K.; Singh, Vineet K.; Sargentini, Neil J.

2012-01-01

Background Small-group case presentation exercises (CPs) were created to increase course relevance for medical students taking Medical Microbiology (MM) and Infectious Diseases (ID) Methods Each student received a unique paper case and had 10 minutes to review patient history, physical exam data, and laboratory data. Students then had three minutes to orally present their case and defend why they ruled in or out each of the answer choices provided, followed by an additional three minutes to answer questions. Results Exam scores differed significantly between students who received the traditional lecture-laboratory curriculum (Group I) and students who participated in the CPs (Group II). In MM, median unit exam and final exam scores for Group I students were 84.4% and 77.8%, compared to 86.0% and 82.2% for Group II students (P<0.018; P<0.001; Mann-Whitney Rank Sum Test). Median unit and final ID exam scores for Group I students were 84.0% and 80.0%, compared to 88.0% and 86.7% for Group II students (P<0.001; P<0.001). Conclusion Students felt that the CPs improved their critical thinking and presentation skills and helped to prepare them as future physicians. PMID:22435014

Online Module for Carrier Screening in Ashkenazi Jewish Individuals Compared with In-Person Genetics Education: A Randomized Controlled Trial.

PubMed

Fan, Chia Wei; Castonguay, Lysanne; Rummell, Sonja; Lévesque, Sébastien; Mitchell, John J; Sillon, Guillaume

2018-04-01

To increase accessibility to genetics services for low-urgency patients seeking Ashkenazi Jewish (AJ) carrier screening, we designed an interactive computer (IC) module that provides pre-test genetics education and allows genetics professionals to order the test without meeting the patients beforehand. We compared this module with in-person genetic counseling (GC) using a randomized trial. AJ individuals were randomized to undergo genetics education via the IC module (n = 26) or GC (n = 28). We compared post-interventional genetics knowledge, perceived genetic risk, and anxiety between the two groups, after accounting for pre-interventional scores, using ANCOVA. Wilcoxon Rank-Sum test was used to compare post-interventional satisfaction. Post-interventional genetics knowledge, risk perception, or anxiety were not significantly different between the two groups after accounting for baseline scores (p = 0.50-0.54), although the data are inconclusive regarding the module's non-inferiority at a 5% margin. Post-intervention satisfaction scores were generally higher in the GC group than the IC module group. Our IC module has the potential to improve access to clinical genetics services for patients and staff, but it is not suitable for all AJ patients and cannot completely replace the benefits of in-person consultations.

Cognitive-behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial.

PubMed

Goodyer, Ian M; Reynolds, Shirley; Barrett, Barbara; Byford, Sarah; Dubicka, Bernadka; Hill, Jonathan; Holland, Fiona; Kelvin, Raphael; Midgley, Nick; Roberts, Chris; Senior, Rob; Target, Mary; Widmer, Barry; Wilkinson, Paul; Fonagy, Peter

2017-03-01

Although there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years. To determine whether or not either of two specialist psychological treatments, cognitive-behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment. Observer-blind, parallel-group, pragmatic superiority randomised controlled trial. A total of 15 outpatient NHS clinics in the UK from East Anglia, north-west England and North London. Adolescents aged 11-17 years with Diagnostic and Statistical Manual of Mental Disorders -Fourth Edition major depression including those with suicidality, depressive psychosis and conduct disorder. Patients were randomised using stochastic minimisation controlling for age, sex and self-reported depression sum score; 470 patients were randomised and 465 were included in the analyses. In total, 154 adolescents received CBT, 156 received STPP and 155 received BPI. The trial lasted 86 weeks and study treatments were delivered in the first 36 weeks, with 52 weeks of follow-up. Mean sum score on self-reported depressive symptoms (primary outcome) at final study assessment (nominally 86 weeks, at least 52 weeks after end of treatment). Secondary measures were change in mean sum scores on self-reported anxiety symptoms and researcher-rated Health of the Nation scales for children and adolescents measuring psychosocial function. Following baseline assessment, there were a further five planned follow-up reassessments at nominal time points of 6, 12, 52 and 86 weeks post randomisation. There were non-inferiority effects of CBT compared with STPP [treatment effect by final follow-up = -0.578, 95% confidence interval (CI) -2.948 to 4.104; p  = 0.748]. There were no superiority effects for the two specialist treatments (CBT + STPP) compared with BPI (treatment effect by final follow-up = -1.898, 95% CI -4.922 to 1.126; p  = 0.219). At final assessment there was no significant difference in the mean depressive symptom score between treatment groups. There was an average 49-52% reduction in depression symptoms by the end of the study. There were no differences in total costs or quality-of-life scores between treatment groups and prescribing a selective serotonin reuptake inhibitor (SSRI) during treatment or follow-up did not differ between the therapy arms and, therefore, did not mediate the outcome. The three psychological treatments differed markedly in theoretical and clinical approach and are associated with a similar degree of clinical improvement, cost-effectiveness and subsequent maintenance of lowered depressive symptoms. Both STPP and BPI offer an additional patient treatment choice, alongside CBT, for depressed adolescents attending specialist Child and Adolescent Mental Health Services. Further research should focus on psychological mechanisms that are associated with treatment response, the maintenance of positive effects, determinants of non-response and whether or not brief psychotherapies are of use in primary care and community settings. Neither reason for SSRI prescribing or monitoring of medication compliance was controlled for over the course of the study, and the economic results were limited by missing data. Current Controlled Trials ISRCTN83033550. This project was funded by the National Institute for Heath Research Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 21, No. 12. See the National Institute for Heath Research Journals Library website for further project information. Funding was also provided by the Department of Health. The funders had no role in the study design, patient recruitment, data collection, analysis or writing of the study, any aspect pertinent to the study or the decision to submit to The Lancet .

Self-perceived health status following aneurysmal subarachnoid haemorrhage: a cohort study

PubMed Central

Quinn, Audrey C; Bhargava, Deepti; Al-Tamimi, Yahia Z; Clark, Matthew J; Ross, Stuart A; Tennant, Alan

2014-01-01

Objective The objective of the study was to assess the long-term self-reported health status and quality of life (QoL) of patients following an aneurysmal subarachnoid haemorrhage (ASAH) using a self-completed questionnaire booklet. Design A two-cohort study. Setting A regional tertiary neurosurgical centre. Participants 2 cohorts of patients with ASAH treated between 1998 and 2008 and followed up at approximately 1 year. Interventions Routine care. Primary and secondary outcomes A range of standardised scales included: AKC Short Sentences Test, the Barthel Index, the Self-Report Dysexecutive Questionnaire, the Everyday Memory Questionnaire, Stroke Symptom Checklist, Wimbledon Self-Report Scale, Modified Rankin Score (MRS) and a new Stroke-QoL. The data from summated scales were fit to the Rasch measurement model to validate the summed score. Results 214 patients (48%) returned the questionnaires; the majority (76%) had a World Federation of Neurosurgeons grade of 1 or 2. The most frequent aneurysm type was that of the anterior communicating artery (28%) with approximately 90% of aneurysms of the anterior circulation. Of those previously in full or part-time employment, 48.9% were unemployed at follow-up. All summated scales satisfied the Rasch measurement model requirements, such that their summed scores were a sufficient statistic. Given this, one-third of patients were noted to have a significant mood disorder and 25% had significant dysexecutive function. Patients with an MRS of 3, 4 or 5 had significantly worse scores on most outcome measures, but a significant minority of those with a score of zero had failed to return to work and displayed significant mood disorder. Conclusions A range of self-reported cognitive and physical deficits have been highlighted in a cohort of patients with ASAH. While the MRS has been shown to provide a reasonable indication of outcome, in routine clinical follow-up it requires supplementation by instruments assessing dysexecutive function, memory and mood. PMID:24699459

Risk assessment of Pakistani individuals for diabetes (RAPID).

PubMed

Riaz, Musarrat; Basit, Abdul; Hydrie, Muhammad Zafar Iqbal; Shaheen, Fariha; Hussain, Akhtar; Hakeem, Rubina; Shera, Abdus Samad

2012-12-01

To develop and evaluate a risk score to predict people at high risk of developing type 2 diabetes in Pakistan. Cross sectional data regarding primary prevention of diabetes in Pakistan. Diabetes risk score was developed by using simple parameters namely age, waist circumference, and family history of diabetes. Odds ratios of the model were used to assign a score value for each variable and the diabetes risk score was calculated as the sum of those scores. We externally validated the score using two data from 1264 subjects and 856 subjects aged 25 years and above from two separate studies respectively. Validating this score using the first data from the second screening study gave an area under the receive operator characteristics curve [AROC] of 0.758. A cut point of 4 had a sensitivity of 47.0% and specificity of 88% and in the second data AROC is 0.7 with 44% sensitivity and 89% specificity. A simple diabetes risk score, based on a set of variables can be used for the identification of high risk individuals for early intervention to delay or prevent type 2 diabetes in Pakistani population. Copyright © 2012 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Health literacy and health care spending and utilization in a consumer-driven health plan.

PubMed

Hardie, Nancy A; Kyanko, Kelly; Busch, Susan; Losasso, Anthony T; Levin, Regina A

2011-01-01

We examined health literacy and health care spending and utilization by linking responses of three health literacy questions to 2006 claims data of enrollees new to consumer-driven health plans (n = 4,130). Better health literacy on all four health literacy measures (three item responses and their sum) was associated with lower total health care spending, specifically, lower emergency department and inpatient admission spending (p < .05). Similarly, fewer inpatient admissions and emergency department visits were associated with higher adequate health literacy scores and better self-reports of the ability to read and learn about medical conditions (p-value <.05). Members with lower health literacy scores appear to use services more appropriate for advanced health conditions, although office visit rates were similar across the range of health literacy scores.

A Simple Framework for Evaluating Authorial Contributions for Scientific Publications.

PubMed

Warrender, Jeffrey M

2016-10-01

A simple tool is provided to assist researchers in assessing contributions to a scientific publication, for ease in evaluating which contributors qualify for authorship, and in what order the authors should be listed. The tool identifies four phases of activity leading to a publication-Conception and Design, Data Acquisition, Analysis and Interpretation, and Manuscript Preparation. By comparing a project participant's contribution in a given phase to several specified thresholds, a score of up to five points can be assigned; the contributor's scores in all four phases are summed to yield a total "contribution score", which is compared to a threshold to determine which contributors merit authorship. This tool may be useful in a variety of contexts in which a systematic approach to authorial credit is desired.

The Effects of Reflective Training on the Disposition of Critical Thinking for Nursing Students in China: A Controlled Trial.

PubMed

Zhang, Caihong; Fan, Huiying; Xia, Jieqiong; Guo, Honghua; Jiang, Xinjun; Yan, Yane

2017-09-01

The aim of this study was to evaluate the effects of reflective trainings for nursing students on their critical thinking disposition. A total of 157 senior undergraduate nursing students sampled from Hainan Medical University in China participated in this study in 2014. They were randomly divided into experimental and control groups. The experimental group students were provided the reflective training during their entire 12-month clinical internship, whereas students in the control group were requested to keep their reflective diaries but without a formal training. Before and after the intervention, nursing students' critical thinking disposition was rated using the Chinese version of Critical Thinking Disposition Inventory (CTDI-CV). Before the start of the intervention, the critical thinking disposition scores of the two groups had no significant differences. At the end of the intervention, it was found that the experimental students performed better in each subscale of CTDI-CV. These include the search for truth, open mind, analytical ability, systematic ability, critical thinking, self-confidence, curiosity, and cognitive maturity. By summing the scores of all categories, the results showed that the experimental group had a significantly higher total score than that of the control group (p ≤ .044). Evaluating the score difference in each function indicated that there was a range of improvements on the critical thinking disposition because of the reflective training intervention. Reflective training during the internship period improves nursing students' disposition of critical thinking and promotes their readiness for their clinical practices in the rapidly increasing demands of the healthcare field. Copyright © 2017. Published by Elsevier B.V.

Is anatomic complexity associated with renal tumor growth kinetics under active surveillance?

PubMed

Mehrazin, Reza; Smaldone, Marc C; Egleston, Brian; Tomaszewski, Jeffrey J; Concodora, Charles W; Ito, Timothy K; Abbosh, Philip H; Chen, David Y T; Kutikov, Alexander; Uzzo, Robert G

2015-04-01

Linear growth rate (LGR) is the most commonly employed trigger for definitive intervention in patients with renal masses managed with an initial period of active surveillance (AS). Using our institutional cohort, we explored the association between tumor anatomic complexity at presentation and LGR in patients managed with AS. Enhancing renal masses managed expectantly for at least 6 months were included for analysis. The association between Nephrometry Score and LGR was assessed using generalized estimating equations, adjusting for the age, Charlson score, race, sex, and initial tumor size. Overall, 346 patients (401 masses) met the inclusion criteria (18% ≥ cT1b), with a median follow-up of 37 months (range: 6-169). Of these, 44% patients showed progression to definitive intervention with a median duration of 27 months (range: 6-130). On comparing patients managed expectantly to those requiring intervention, no difference was seen in median tumor size at presentation (2.2 vs. 2.2 cm), whereas significant differences in median age (74 vs. 65 y, P < 0.001), Charlson comorbidity score (3 vs. 2, P<0.001), and average LGR (0.23 vs. 0.49 cm/y, P < 0.001) were observed between groups. Following adjustment, for each 1-point increase in Nephrometry Score sum, the average tumor LGR increased by 0.037 cm/y (P = 0.002). Of the entire cohort, 6 patients (1.7%) showed progression to metastatic disease. The demonstrated association between anatomic tumor complexity at presentation and renal masses of LGR of clinical stage 1 under AS may afford a clinically useful cue to tailor individual patient radiographic surveillance schedules and warrants further evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.

Predicting the Individual Risk of Acute Severe Colitis at Diagnosis

PubMed Central

Cesarini, Monica; Collins, Gary S.; Rönnblom, Anders; Santos, Antonieta; Wang, Lai Mun; Sjöberg, Daniel; Parkes, Miles; Keshav, Satish

2017-01-01

Abstract Background and Aims: Acute severe colitis [ASC] is associated with major morbidity. We aimed to develop and externally validate an index that predicted ASC within 3 years of diagnosis. Methods: The development cohort included patients aged 16–89 years, diagnosed with ulcerative colitis [UC] in Oxford and followed for 3 years. Primary outcome was hospitalization for ASC, excluding patients admitted within 1 month of diagnosis. Multivariable logistic regression examined the adjusted association of seven risk factors with ASC. Backwards elimination produced a parsimonious model that was simplified to create an easy-to-use index. External validation occurred in separate cohorts from Cambridge, UK, and Uppsala, Sweden. Results: The development cohort [Oxford] included 34/111 patients who developed ASC within a median 14 months [range 1–29]. The final model applied the sum of 1 point each for extensive disease, C-reactive protein [CRP] > 10mg/l, or haemoglobin < 12g/dl F or < 14g/dl M at diagnosis, to give a score from 0/3 to 3/3. This predicted a 70% risk of developing ASC within 3 years [score 3/3]. Validation cohorts included different proportions with ASC [Cambridge = 25/96; Uppsala = 18/298]. Of those scoring 3/3 at diagnosis, 18/18 [Cambridge] and 12/13 [Uppsala] subsequently developed ASC. Discriminant ability [c-index, where 1.0 = perfect discrimination] was 0.81 [Oxford], 0.95 [Cambridge], 0.97 [Uppsala]. Internal validation using bootstrapping showed good calibration, with similar predicted risk across all cohorts. A nomogram predicted individual risk. Conclusions: An index applied at diagnosis reliably predicts the risk of ASC within 3 years in different populations. Patients with a score 3/3 at diagnosis may merit early immunomodulator therapy. PMID:27647858

Correlation between musical responsiveness and developmental age among early age children as assessed by the Non-Verbal Measurement of the Musical Responsiveness of Children.

PubMed

Matsuyama, Kumi

2005-10-01

The currently-available standardized music tests are not suitable for administration to young children and children with special needs because they are complicated and require verbal instructions and verbal responses. A test that was named the Non-Verbal Measurement of the Musical Responsiveness of Children, was developed to assess the musical responsiveness of young children. This test does not depend on verbal instructions, and is composed of two parts, Rhythm and Melody. Ninety-two children [age, range, 6-69 months; 36.39+/-17.61 (mean +/-standard deviation) months] who attended mainstream pre-schools were studied. Each child was tested to see whether the child correctly imitated 7 different patterns of rhythm and 6 different patterns of melody that were delivered by clapping of hands or the voice of the examiner, respectively. The examiner rated whether the child could imitate each pattern and the total score was the sum of successfully reproduced patterns. Two independent observers viewed videotapes of the testing sessions and assigned scores in a similar manner. The inter-rater reliability among the three raters was assessed. The total score in Melody (R=0.63, p<0.001) and the total score in Rhythm (R=0.81, p<0.001) were each correlated with developmental age. The inter-rater reliability was good (Melody: Kendall's W=0.78, Rhythm: Kendall's W=0.95). The degree of musical responsiveness of normal young children is correlated with general development. This measurement tool is valid and reliable for use in young children who lack sufficient verbal understanding to take standardized music tests. This test may also be administered to children with special needs.

The Importance of Non-accessible Crosslinks and Solvent Accessible Surface Distance in Modeling Proteins with Restraints From Crosslinking Mass Spectrometry*

PubMed Central

Bullock, Joshua Matthew Allen; Schwab, Jannik; Thalassinos, Konstantinos; Topf, Maya

2016-01-01

Crosslinking mass spectrometry (XL-MS) is becoming an increasingly popular technique for modeling protein monomers and complexes. The distance restraints garnered from these experiments can be used alone or as part of an integrative modeling approach, incorporating data from many sources. However, modeling practices are varied and the difference in their usefulness is not clear. Here, we develop a new scoring procedure for models based on crosslink data—Matched and Nonaccessible Crosslink score (MNXL). We compare its performance with that of other commonly-used scoring functions (Number of Violations and Sum of Violation Distances) on a benchmark of 14 protein domains, each with 300 corresponding models (at various levels of quality) and associated, previously published, experimental crosslinks (XLdb). The distances between crosslinked lysines are calculated either as Euclidean distances or Solvent Accessible Surface Distances (SASD) using a newly-developed method (Jwalk). MNXL takes into account whether a crosslink is nonaccessible, i.e. an experimentally observed crosslink has no corresponding SASD in a model due to buried lysines. This metric alone is shown to have a significant impact on modeling performance and is a concept that is not considered at present if only Euclidean distances are used. Additionally, a comparison between modeling with SASD or Euclidean distance shows that SASD is superior, even when factoring out the effect of the nonaccessible crosslinks. Our benchmarking also shows that MNXL outperforms the other tested scoring functions in terms of precision and correlation to Cα-RMSD from the crystal structure. We finally test the MNXL at different levels of crosslink recovery (i.e. the percentage of crosslinks experimentally observed out of all theoretical ones) and set a target recovery of ∼20% after which the performance plateaus. PMID:27150526

A direct-gradient multivariate index of biotic condition

USGS Publications Warehouse

Miranda, Leandro E.; Aycock, J.N.; Killgore, K. J.

2012-01-01

Multimetric indexes constructed by summing metric scores have been criticized despite many of their merits. A leading criticism is the potential for investigator bias involved in metric selection and scoring. Often there is a large number of competing metrics equally well correlated with environmental stressors, requiring a judgment call by the investigator to select the most suitable metrics to include in the index and how to score them. Data-driven procedures for multimetric index formulation published during the last decade have reduced this limitation, yet apprehension remains. Multivariate approaches that select metrics with statistical algorithms may reduce the level of investigator bias and alleviate a weakness of multimetric indexes. We investigated the suitability of a direct-gradient multivariate procedure to derive an index of biotic condition for fish assemblages in oxbow lakes in the Lower Mississippi Alluvial Valley. Although this multivariate procedure also requires that the investigator identify a set of suitable metrics potentially associated with a set of environmental stressors, it is different from multimetric procedures because it limits investigator judgment in selecting a subset of biotic metrics to include in the index and because it produces metric weights suitable for computation of index scores. The procedure, applied to a sample of 35 competing biotic metrics measured at 50 oxbow lakes distributed over a wide geographical region in the Lower Mississippi Alluvial Valley, selected 11 metrics that adequately indexed the biotic condition of five test lakes. Because the multivariate index includes only metrics that explain the maximum variability in the stressor variables rather than a balanced set of metrics chosen to reflect various fish assemblage attributes, it is fundamentally different from multimetric indexes of biotic integrity with advantages and disadvantages. As such, it provides an alternative to multimetric procedures.

Performance and blood monitoring in sports: the artificial intelligence evoking target testing in antidoping (AR.I.E.T.T.A.) project.

PubMed

Manfredini, A F; Malagoni, A M; Litmanen, H; Zhukovskaja, L; Jeannier, P; Dal Follo, D; Felisatti, M; Besseberg, A; Geistlinger, M; Bayer, P; Carrabre, J E

2011-03-01

Substances and methods used to increase oxygen blood transport and physical performance can be detected in the blood, but the screening of the athletes to be tested remains a critical issue for the International Federations. This project, AR.I.E.T.T.A., aimed to develop a software capable of analysing athletes' hematological and performance profiles to detect abnormal patterns. One-hundred eighty athletes belonging to the International Biathlon Union gave written informed consent to have their hematological data, previously collected according to anti-doping rules, used to develop the AR.I.E.T.T.A. software. Software was developed with the included sections: 1) log-in; 2) data-entry: where data are loaded, stored and grouped; 3) analysis: where data are analysed, validated scores are calculated, and parameters are simultaneously displayed as statistics, tables and graphs, and individual or subpopulation profiles; 4) screening: where an immediate evaluation of the risk score of the present sample and/or the athlete under study is obtained. The sample risk score or AR.I.E.T.T.A. score is calculated by a simple computational system combining different parameters (absolute values and intra-individual variations) considered concurrently. The AR.I.E.T.T.A. score is obtained by the sum of the deviation units derived from each parameter, considering the shift of the present value from the reference values, based on the number of standard deviations. AR.I.E.T.T.A. enables a quick evaluation of blood results assisting surveillance programs and perform timely target testing controls on athletes by the International Federations. Future studies aiming to validate the AR.I.E.T.T.A. score and improve the diagnostic accuracy will improve the system.

Community Readiness for the Promotion of Physical Activity in Older Adults-A Cross-Sectional Comparison of Rural and Urban Communities.

PubMed

Gansefort, Dirk; Brand, Tilman; Princk, Christina; Zeeb, Hajo

2018-03-06

Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3-5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): -0.02-0.59). The rural communities showed significantly higher CR scores in the 'Knowledge of efforts' dimension (0.70, 95% CI: 0.26-1.14) and in the 'Knowledge of the issue' (0.37, 95% CI: 0.04-0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels.

Can binary early warning scores perform as well as standard early warning scores for discriminating a patient's risk of cardiac arrest, death or unanticipated intensive care unit admission?

PubMed

Jarvis, Stuart; Kovacs, Caroline; Briggs, Jim; Meredith, Paul; Schmidt, Paul E; Featherstone, Peter I; Prytherch, David R; Smith, Gary B

2015-08-01

Although the weightings to be summed in an early warning score (EWS) calculation are small, calculation and other errors occur frequently, potentially impacting on hospital efficiency and patient care. Use of a simpler EWS has the potential to reduce errors. We truncated 36 published 'standard' EWSs so that, for each component, only two scores were possible: 0 when the standard EWS scored 0 and 1 when the standard EWS scored greater than 0. Using 1564,153 vital signs observation sets from 68,576 patient care episodes, we compared the discrimination (measured using the area under the receiver operator characteristic curve--AUROC) of each standard EWS and its truncated 'binary' equivalent. The binary EWSs had lower AUROCs than the standard EWSs in most cases, although for some the difference was not significant. One system, the binary form of the National Early Warning System (NEWS), had significantly better discrimination than all standard EWSs, except for NEWS. Overall, Binary NEWS at a trigger value of 3 would detect as many adverse outcomes as are detected by NEWS using a trigger of 5, but would require a 15% higher triggering rate. The performance of Binary NEWS is only exceeded by that of standard NEWS. It may be that Binary NEWS, as a simplified system, can be used with fewer errors. However, its introduction could lead to significant increases in workload for ward and rapid response team staff. The balance between fewer errors and a potentially greater workload needs further investigation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Associations Between the Big Five Personality Traits and a Medical School Admission Interview.

PubMed

Lourinho, Isabel; Moreira, André; Mota-Cardoso, Rui; Severo, Milton; Ferreira, Maria Amélia

2016-12-30

Personality has became popular in medical student's selection. However, few research exists about the association between the big five personality traits and the existent medical school selection tools. Our aim was to study which personality traits were selected by a medical school admission interview. One hundred ninety four graduate applicants that had applied to the Faculty of Medicine of the University of Porto through the graduate entry approach, after ranked on previous achievement, were interviewed between the academic years of 2011 and 2013. From these, 181 (93.3%) answered to the NEO Five-Factor Inventory that assesses high order personality traits of openness to experience, conscientiousness, extraversion, agreeableness and neuroticism. Admission interview corresponded to the second phase of the seriation process. Every applicant was interviewed and scored by three interviewers on seven dimensions asesssed by Lickert scale (1-10). Interview score was the sum of the dimensions. Linear mixed effects model and respective regression coefficients were used to estimate the association between personality traits from each interviewer's score. Final models were adjusted for gender, interviewers and previous achievement. Openness to experience (Beta = 0.18: CI 95%: 0.05; 0.30) had the strongest association with interview score followed by the interaction effect between the extraversion and conscientiousness traits (Beta = 0.14; CI 95%: 0.02; 0.25). Also, applicants scored higher when their gender was opposite to the interviewers. Previous achievement and interview score had no association. Our admission interview selected different personality traits when compared to other selection tools. Medical schools should be aware of the implications of the adopted selection tools on the admitted medical student's personality because it can help providing beneficial interventions.

High prevalence of dysfunctional, asymmetrical, and painful movement in elite junior Australian Football players assessed using the Functional Movement Screen.

PubMed

Fuller, Joel T; Chalmers, Samuel; Debenedictis, Thomas A; Townsley, Samuel; Lynagh, Matthew; Gleeson, Cara; Zacharia, Andrew; Thomson, Stuart; Magarey, Mary

2017-02-01

The purpose of this study was to describe the prevalence of dysfunctional, asymmetrical, and painful movement in junior Australian Football players using the Functional Movement Screen (FMS). Cross-sectional study. Elite junior male Australian Football players (n=301) aged 15-18 years completed pre-season FMS testing. The FMS consists of 7 sub-tests: deep squat, hurdle step, in-line lunge, shoulder mobility, active straight leg raise, trunk stability push-up (TSPU) and rotary stability. The shoulder mobility, TSPU, and rotary stability tests were combined with an accompanying clearing test to assess pain. Each sub-test was scored on an ordinal scale from 0 to 3 and summed to give a composite score out of 21. Composite scores ≤14 were operationally defined as indicating dysfunctional movement. Players scoring differently on left and right sides were considered asymmetrical. Players reported whether they missed any games due to injury in the preceding 22 game season. Sixty percent of players (n=182) had composite scores ≤14, 65% of players (n=196) had at least one asymmetrical sub-test, and 38% of players (n=113) had at least one painful sub-test. Forty-two percent of players (n=126) missed at least one game in the previous season due to injury. Previous injury did not influence composite score (p=0.951) or asymmetry (p=0.629). Players reporting an injury during the previous season were more likely to experience pain during FMS testing (odds ratio 1.97, 95% confidence interval 1.23-3.18; p=0.005). Junior Australian Football players demonstrate a high prevalence of dysfunctional, asymmetrical, and painful movement during FMS testing. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Leveraging Genomic Annotations and Pleiotropic Enrichment for Improved Replication Rates in Schizophrenia GWAS

PubMed Central

Wang, Yunpeng; Thompson, Wesley K.; Schork, Andrew J.; Holland, Dominic; Chen, Chi-Hua; Bettella, Francesco; Desikan, Rahul S.; Li, Wen; Witoelar, Aree; Zuber, Verena; Devor, Anna; Nöthen, Markus M.; Rietschel, Marcella; Chen, Qiang; Werge, Thomas; Cichon, Sven; Weinberger, Daniel R.; Djurovic, Srdjan; O’Donovan, Michael; Visscher, Peter M.; Andreassen, Ole A.; Dale, Anders M.

2016-01-01

Most of the genetic architecture of schizophrenia (SCZ) has not yet been identified. Here, we apply a novel statistical algorithm called Covariate-Modulated Mixture Modeling (CM3), which incorporates auxiliary information (heterozygosity, total linkage disequilibrium, genomic annotations, pleiotropy) for each single nucleotide polymorphism (SNP) to enable more accurate estimation of replication probabilities, conditional on the observed test statistic (“z-score”) of the SNP. We use a multiple logistic regression on z-scores to combine information from auxiliary information to derive a “relative enrichment score” for each SNP. For each stratum of these relative enrichment scores, we obtain nonparametric estimates of posterior expected test statistics and replication probabilities as a function of discovery z-scores, using a resampling-based approach that repeatedly and randomly partitions meta-analysis sub-studies into training and replication samples. We fit a scale mixture of two Gaussians model to each stratum, obtaining parameter estimates that minimize the sum of squared differences of the scale-mixture model with the stratified nonparametric estimates. We apply this approach to the recent genome-wide association study (GWAS) of SCZ (n = 82,315), obtaining a good fit between the model-based and observed effect sizes and replication probabilities. We observed that SNPs with low enrichment scores replicate with a lower probability than SNPs with high enrichment scores even when both they are genome-wide significant (p < 5x10-8). There were 693 and 219 independent loci with model-based replication rates ≥80% and ≥90%, respectively. Compared to analyses not incorporating relative enrichment scores, CM3 increased out-of-sample yield for SNPs that replicate at a given rate. This demonstrates that replication probabilities can be more accurately estimated using prior enrichment information with CM3. PMID:26808560

Community Readiness for the Promotion of Physical Activity in Older Adults—A Cross-Sectional Comparison of Rural and Urban Communities

PubMed Central

Brand, Tilman; Princk, Christina; Zeeb, Hajo

2018-01-01

Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3–5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): −0.02–0.59). The rural communities showed significantly higher CR scores in the ‘Knowledge of efforts’ dimension (0.70, 95% CI: 0.26–1.14) and in the ‘Knowledge of the issue’ (0.37, 95% CI: 0.04–0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels. PMID:29509675

[Analyzing the Wechsler Intelligence Scale for Children-Revised (WISC-R) in Children With Attention Deficit and Hyperactivity Disorder: Predictive Value of Subtests, Kaufman, and Bannatyne Categories].

PubMed

Tural Hesapçıoğlu, Selma; Çelik, Cihat; Özmen, Sevim; Yiğit, İbrahim

2016-01-01

The aim of this study is to evaluate the predictive value of intelligence quotients scores (IQs), subtests of Wechsler Intelligence Scale for Children-Revised (WISC-R) and Kaufman's and Bannatyne's categories scores which are the sums of subtests of WISC-R in attention deficit hyperactivity disorder (ADHD). Another aim is to examine the difference of some neurocognitive skills between the children with ADHD and their unaffected peers by WISC-R subtests. WISC-R's subtest and IQ scores, and scores of Kaufman's and Bannatyne's categories of the children who were diagnosed with only ADHD were compared with the same scores of the children who were in healthy control group (N= 111) and were in ADHD with co morbidity group (N= 82). It was found that the subtest scores (vocabulary, comprehension, digit span, picture completion and block design) of the children with only ADHD and ADHD with comorbidity were significantly lower than healthy group. It was observed that subtests of comprehension (Wald= 5.47, df= 1, p=0.05), digit span (Wald= 16.79, df= 1, p=0.001) and picture completion (Wald= 5.25, df= 1, p=0.05) predicted significantly ADHD. In addition, the categories of freedom from distractibility (Wald= 8.22, df= 1, p=0.01) and spatial abilities (Wald= 12.22, df= 1, p<0.0001) were predictive for ADHD in this study. Problem solving abilities in social processes, auditory short-term memories, visual-spatial abilities and visual configuration abilities of the children with ADHD was observed to be lower than their healthy peers. It was thought that in WISC-R's profile analysis, the categories of freedom from distractibility and spatial abilities can be distinctive in ADHD diagnose.

A comparison in Colorado of three methods to monitor breeding amphibians

USGS Publications Warehouse

Corn, P.S.; Muths, E.; Iko, W.M.

2000-01-01

We surveyed amphibians at 4 montane and 2 plains lentic sites in northern Colorado using 3 techniques: standardized call surveys, automated recording devices (frog-loggers), and intensive surveys including capture-recapture techniques. Amphibians were observed at 5 sites. Species richness varied from 0 to 4 species at each site. Richness scores, the sums of species richness among sites, were similar among methods: 8 for call surveys, 10 for frog-loggers, and 11 for intensive surveys (9 if the non-vocal salamander Ambystoma tigrinum is excluded). The frog-logger at 1 site recorded Spea bombifrons which was not active during the times when call and intensive surveys were conducted. Relative abundance scores from call surveys failed to reflect a relatively large population of Bufo woodhousii at 1 site and only weakly differentiated among different-sized populations of Pseudacris maculata at 3 other sites. For extensive applications, call surveys have the lowest costs and fewest requirements for highly trained personnel. However, for a variety of reasons, call surveys cannot be used with equal effectiveness in all parts of North America.

Intercostal nerve blockade with a mixture of bupivacaine and phenol enhance the efficacy of intravenous patient-controlled analgesia in the control of post-cholecystectomy pain.

PubMed

Maidatsi, P; Gorgias, N; Zaralidou, A; Ourailoglou, V; Giala, M

1998-09-01

Prolonged nerve conduction blockade has been proposed to result from the summed effects of charged and neutral local anaesthetics. Thirty-seven patients were randomly allocated to receive intravenous patient-controlled analgesia alone or combined with intercostal blockade (T7-T11) with a mixture of 0.45% bupivacaine and 0.6% phenol for post-cholecystectomy analgesia. Adequacy of pain relief was measured by patient scores on a 10-cm visual analogue scale and by dose-demand ratio, amounts of loading dose and total consumption of morphine and also the duration of patient-controlled analgesia in each group. No differences were found between groups in post-operative scores, dose-demand ratios and loading doses of morphine. However, in the combined treatment group, a significantly lower total consumption of morphine (P < 0.05), associated with a shorter duration of patient-controlled analgesia (P < 0.02) and a decreased mean number of unsuccessful demands (P < 0.001) were recorded. Intercostal blockade with bupivacaine-phenol supplements intravenous patient-controlled analgesia for post-cholecystectomy pain relief.

The Conscientious Responders Scale Helps Researchers Verify the Integrity of Personality Questionnaire Data.

PubMed

Marjanovic, Zdravko; Bajkov, Lisa; MacDonald, Jennifer

2018-01-01

The Conscientious Responders Scale is a five-item embeddable validity scale that differentiates between conscientious and indiscriminate responding in personality-questionnaire data (CR & IR). This investigation presents further evidence of its validity and generalizability across two experiments. Study 1 tests its sensitivity to questionnaire length, a known cause of IR, and tries to provoke IR by manipulating psychological reactance. As expected, short questionnaires produced higher Conscientious Responders Scale scores than long questionnaires, and Conscientious Responders Scale scores were unaffected by reactance manipulations. Study 2 tests concerns that the Conscientious Responders Scale's unusual item content could potentially irritate and baffle responders, ironically increasing rates of IR. We administered two nearly identical questionnaires: one with an embedded Conscientious Responders Scale and one without the Conscientious Responders Scale. Psychometric comparisons revealed no differences across questionnaires' means, variances, interitem response consistencies, and Cronbach's alphas. In sum, the Conscientious Responders Scale is highly sensitive to questionnaire length-a known correlate of IR-and can be embedded harmlessly in questionnaires without provoking IR or changing the psychometrics of other measures.

Association of Mood Disorders with Serum Zinc Concentrations in Adolescent Female Students.

PubMed

Tahmasebi, Kobra; Amani, Reza; Nazari, Zahra; Ahmadi, Kambiz; Moazzen, Sara; Mostafavi, Seyed-Ali

2017-08-01

Among various factors influencing mood disorders, the impact of micronutrient deficiencies has attracted a great attention. Zinc deficiency is considered to play a crucial role in the onset and progression of mood disorders in different stages of life. The main objective of this study was to assess the correlation between serum zinc levels and mood disorders in high school female students. This cross-sectional study was conducted on a random sample of 100 representative high school female students. The participants completed 24-h food recall questionnaires to assess the daily zinc intakes. Serum zinc status was assessed using flame atomic absorption spectrometry, and zinc deficiency was defined accordingly. Mood disorders were estimated by calculating the sum of two test scores including Beck's depression inventory (BDI) and hospital anxiety depression scale (HADS) tests. General linear model (GLM) and Pearson's regression test were applied to show the correlation of serum zinc levels and mood disorder scores and the correlation between zinc serum levels and BDI scores, respectively. Dietary zinc intake was higher in subjects with normal zinc concentrations than that of zinc-deficient group (p = 0.001). Serum zinc levels were inversely correlated with BDI and HADS scores (p < 0.05). Each 10 μg/dL increment in serum zinc levels led to 0.3 and 0.01 decrease in depression and anxiety scores, respectively (p < 0.05). Serum zinc levels were inversely correlated with mood disorders including depression and anxiety in adolescent female students. Increasing serum levels of zinc in female students could improve their mood disorders.

Monte Carlo simulations on marker grouping and ordering.

PubMed

Wu, J; Jenkins, J; Zhu, J; McCarty, J; Watson, C

2003-08-01

Four global algorithms, maximum likelihood (ML), sum of adjacent LOD score (SALOD), sum of adjacent recombinant fractions (SARF) and product of adjacent recombinant fraction (PARF), and one approximation algorithm, seriation (SER), were used to compare the marker ordering efficiencies for correctly given linkage groups based on doubled haploid (DH) populations. The Monte Carlo simulation results indicated the marker ordering powers for the five methods were almost identical. High correlation coefficients were greater than 0.99 between grouping power and ordering power, indicating that all these methods for marker ordering were reliable. Therefore, the main problem for linkage analysis was how to improve the grouping power. Since the SER approach provided the advantage of speed without losing ordering power, this approach was used for detailed simulations. For more generality, multiple linkage groups were employed, and population size, linkage cutoff criterion, marker spacing pattern (even or uneven), and marker spacing distance (close or loose) were considered for obtaining acceptable grouping powers. Simulation results indicated that the grouping power was related to population size, marker spacing distance, and cutoff criterion. Generally, a large population size provided higher grouping power than small population size, and closely linked markers provided higher grouping power than loosely linked markers. The cutoff criterion range for achieving acceptable grouping power and ordering power differed for varying cases; however, combining all situations in this study, a cutoff criterion ranging from 50 cM to 60 cM was recommended for achieving acceptable grouping power and ordering power for different cases.

Association between serum levels of the proinflammatory protein S100A8/A9 and clinical and structural characteristics of patients with established knee, hip, and hand osteoarthritis.

PubMed

Mahler, E A M; Zweers, M C; van Lent, P L; Blom, A B; van den Hoogen, F H; van den Berg, W B; Roth, J; Vogl, T; Bijlsma, J W J; van den Ende, C H M; den Broeder, A A

2015-01-01

To explore the association between S100A8/A9 serum levels with clinical and structural characteristics of patients with established knee, hip, or hand osteoarthritis (OA). A cross-sectional exploratory study was conducted with 162 OA patients. Measures for pain, stiffness, and function included the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire or the Australian Canadian Osteoarthritis Hand (AUSCAN) Index and for structural abnormalities, osteophytes and joint space narrowing grades. The association between S100A8/A9 and clinical or structural characteristics was analysed using linear regression or logistic regression where appropriate. The mean age of the OA patients was 56 years, 71% were female, and 61% had a Kellgren and Lawrence (K&L) score ≥ 2. The serum S100A8/A9 level did not differ between knee, hip, and hand OA patients and no association was found between serum S100A8/A9 and clinical characteristics. The serum S100A8/A9 level was negatively associated with the sum score of osteophytes after adjusting for sex and body mass index (BMI) [adjusted β -0.015, 95% confidence interval (CI) -0.030 to 0.001, p = 0.062] and positively associated with erythrocyte sedimentation rate (ESR) > 12 mm/h (adjusted OR 1.002, 95% CI 1.000-1.004 p = 0.049) for each increase in S100A8/A9 of 1 ng/mL. For hand OA patients, a negative association of S100A8/A9 with sum score of joint space narrowing was found (adjusted β -0.007, 95% CI -0.016 to 0.001, p = 0.099). The results from this cross-sectional exploratory study do not support an important role for serum S100A8/A9 levels as a biomarker for clinical and structural characteristics in established knee, hip, and hand OA patients. The inverse association with structural abnormalities and the positive association with ESR may reflect inflammatory synovial processes in patients with OA before structural abnormalities occur.

Prediction of Ras-effector interactions using position energy matrices.

PubMed

Kiel, Christina; Serrano, Luis

2007-09-01

One of the more challenging problems in biology is to determine the cellular protein interaction network. Progress has been made to predict protein-protein interactions based on structural information, assuming that structural similar proteins interact in a similar way. In a previous publication, we have determined a genome-wide Ras-effector interaction network based on homology models, with a high accuracy of predicting binding and non-binding domains. However, for a prediction on a genome-wide scale, homology modelling is a time-consuming process. Therefore, we here successfully developed a faster method using position energy matrices, where based on different Ras-effector X-ray template structures, all amino acids in the effector binding domain are sequentially mutated to all other amino acid residues and the effect on binding energy is calculated. Those pre-calculated matrices can then be used to score for binding any Ras or effector sequences. Based on position energy matrices, the sequences of putative Ras-binding domains can be scanned quickly to calculate an energy sum value. By calibrating energy sum values using quantitative experimental binding data, thresholds can be defined and thus non-binding domains can be excluded quickly. Sequences which have energy sum values above this threshold are considered to be potential binding domains, and could be further analysed using homology modelling. This prediction method could be applied to other protein families sharing conserved interaction types, in order to determine in a fast way large scale cellular protein interaction networks. Thus, it could have an important impact on future in silico structural genomics approaches, in particular with regard to increasing structural proteomics efforts, aiming to determine all possible domain folds and interaction types. All matrices are deposited in the ADAN database (http://adan-embl.ibmc.umh.es/). Supplementary data are available at Bioinformatics online.

Therapeutic effect of bilastine in Japanese cedar pollinosis using an artificial exposure chamber (OHIO Chamber).

PubMed

Hashiguchi, Kazuhiro; Wakabayashi, Ken-Ichiro; Togawa, Michinori; Saito, Akihiro; Okubo, Kimihiro

2017-01-01

Environmental exposure chambers have been used to expose subjects to aeroallergens to investigate the efficacy of prophylactic treatment with symptomatic agents in Japan. We first examined the therapeutic effect of bilastine (BIL), a novel non-sedative second-generation H 1 -antihistamine, in subjects with Japanese cedar pollinosis using an artificial exposure chamber (OHIO Chamber). This was a randomized, double-blind, four-way crossover, placebo- and active-controlled phase II study (trial registration number JapicCTI-132213). Subjects were exposed to cedar pollen (8000 grains/m 3 ) for 2 h on Day -1 and 4 h each on Day 1 and 2. BIL 10 or 20 mg, placebo, or fexofenadine hydrochloride (FEX) 60 mg was administered orally 1 h after the start of pollen exposure on Day 1. Placebo or FEX was administered 12 h after the first dosing. The primary efficacy endpoint was the sum of total nasal symptom score (TNSS) from 0 to 3 h after the Day 1 dosing. We enrolled 136 subjects and the sum of TNSS on Day 1 of the three active treatments was significantly lower than that of placebo and was maintained up to 26 h after the first dosing (Day 2). The sum of TNSS or sneezing score on Day 1 after BIL 20 mg was more significantly decreased than after FEX. Moreover, BIL showed a faster onset of action than FEX. We demonstrated the efficacy, rapid onset, and long duration of action of BIL in subjects with Japanese cedar pollinosis exposed to cedar pollen using the OHIO Chamber. Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

Disordered eating, amenorrhea, and substance use and misuse among professional ballet dancers: Preliminary analysis.

PubMed

Peric, Mia; Zenic, Natasa; Sekulic, Damir; Kondric, Miran; Zaletel, Petra

2016-01-01

Substance use and misuse (SUM), eating disorders (ED) and consequent amenorrhea (AM) occur frequently in professional ballet dancing. The objective of this study has been to explore the prevalence and association between ED, AM and SUM in ballet. The sample comprised 21 ballet dancers, 23.1±4.5 years old, members of the professional National Ballet Ensemble from Croatia. Variables were collected by questionnaires examining SUM, occurrence of amenorrhea, and corresponding ballet-specific and socio-demographic factors (Questionnaire on Substance Use - QSU) and the level of ED (Brief Eating Disorder in Athletes Questionnaire - BEDA-Q). Smoking is prevalent in 40% of dancers (25% smoke on a daily basis), 36% often use analgesics, and 25% engage in binge drinking at least once a month. Smoking and binge drinking are less frequent in ballerinas with a higher academic level (r = 0.60 and r = 0.54 for binge drinking and smoking, respectively; p < 0.05). Alcohol drinking is higher among dancers who consume analgesics more often and those with a higher BEDA-Q score (r = 0.53 and r = 0.54 for analgesics and BEDA-Q, respectively; p < 0.05). Amenorrhea is more prevalent among those dancers with a higher BEDA-Q score. Women who consume nutritional supplements are less likely to use analgesics (Mann Whitney U test = 2.11; p < 0.05). Efforts seeking to prevent ED in ballet should target dancers who consume alcohol to a greater extent. Future studies should specifically explore the less frequent consumption of analgesics among dancers who consume nutritional supplements. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Calculating three loop ladder and V-topologies for massive operator matrix elements by computer algebra

NASA Astrophysics Data System (ADS)

Ablinger, J.; Behring, A.; Blümlein, J.; De Freitas, A.; von Manteuffel, A.; Schneider, C.

2016-05-01

Three loop ladder and V-topology diagrams contributing to the massive operator matrix element AQg are calculated. The corresponding objects can all be expressed in terms of nested sums and recurrences depending on the Mellin variable N and the dimensional parameter ε. Given these representations, the desired Laurent series expansions in ε can be obtained with the help of our computer algebra toolbox. Here we rely on generalized hypergeometric functions and Mellin-Barnes representations, on difference ring algorithms for symbolic summation, on an optimized version of the multivariate Almkvist-Zeilberger algorithm for symbolic integration, and on new methods to calculate Laurent series solutions of coupled systems of differential equations. The solutions can be computed for general coefficient matrices directly for any basis also performing the expansion in the dimensional parameter in case it is expressible in terms of indefinite nested product-sum expressions. This structural result is based on new results of our difference ring theory. In the cases discussed we deal with iterative sum- and integral-solutions over general alphabets. The final results are expressed in terms of special sums, forming quasi-shuffle algebras, such as nested harmonic sums, generalized harmonic sums, and nested binomially weighted (cyclotomic) sums. Analytic continuations to complex values of N are possible through the recursion relations obeyed by these quantities and their analytic asymptotic expansions. The latter lead to a host of new constants beyond the multiple zeta values, the infinite generalized harmonic and cyclotomic sums in the case of V-topologies.

Evaluation of floating-point sum or difference of products in carry-save domain

NASA Technical Reports Server (NTRS)

Wahab, A.; Erdogan, S.; Premkumar, A. B.

1992-01-01

An architecture to evaluate a 24-bit floating-point sum or difference of products using modified sequential carry-save multipliers with extensive pipelining is described. The basic building block of the architecture is a carry-save multiplier with built-in mantissa alignment for the summation during the multiplication cycles. A carry-save adder, capable of mantissa alignment, correctly positions products with the current carry-save sum. Carry propagation in individual multipliers is avoided and is only required once to produce the final result.

Suggestive Linkage of the Child Behavior Checklist Juvenile Bipolar Disorder Phenotype to 1p21, 6p21, and 8q21

ERIC Educational Resources Information Center

Doyle, Alysa E.; Biederman, Joseph; Ferreira, Manuel A. R.; Wong, Patricia; Smoller, Jordan W.; Faraone, Stephen V.

2010-01-01

Objective: Several studies have documented a profile of elevated scores on the Attention Problems, Aggressive Behavior and Anxious/Depressed scales of the Child Behavior Checklist (CBCL) in youth with bipolar disorder. The sum of these scales, referred to as the CBCL Juvenile Bipolar Disorder (JBD) phenotype, has modest diagnostic utility, and…

Interactive E-learning module in pharmacology: a pilot project at a rural medical college in India.

PubMed

Gaikwad, Nitin; Tankhiwale, Suresh

2014-01-01

Many medical educators are experimenting with innovative ways of E-learning. E-learning provides opportunities to students for self-directed learning in addition to other advantages. In this study, we designed and evaluated an interactive E-learning module in pharmacology for effectiveness, acceptability and feasibility, with the aim of promoting active learning in this fact-filled subject. A quasi-experimental single-group pre-test/post-test study was conducted with fourth-semester students of the second professionals course (II MBBS), selected using non-probability convenience sampling method. An E-learning module in endocrine pharmacology was designed to comprise three units of interactive PowerPoint presentations. The pre-validated presentations were uploaded on the website according to a predefined schedule and the 42 registered students were encouraged to self-learning using these interactive presentations. Cognitive gain was assessed using an online pre- and post-test for each unit. Students' perceptions were recorded using an online feedback questionnaire on a 5-point Likert scale. Finally, focused group discussion was conducted to further explore students' views on E-learning activity. Significant attrition was observed during the E-learning activity. Of the 42 registered students, only 16 students completed the entire E-learning module. The summed average score of all three units (entire module) was increased significantly from 38.42 % (summed average pre-test score: 11.56/30 ± 2.90) to 66.46 % (summed average post-test score: 19.94/30 ± 6.13). The class-average normalized gain for the entire module was 0.4542 (45.42). The students accepted this E-learning activity well as they perceived it to be innovative, convenient, flexible and useful. The average rating was between 4 (agree) and 5 (strongly agree). The interactive E-learning module in pharmacology was moderately effective and well perceived by the students. The simple, cost-effective and readily available Microsoft PowerPoint tool appealed to medical educators to use this kind of simple E-learning technology blended with traditional teaching to encourage active learning among students especially in a rural setup is attractive.

Association Between Dietary Intake and Function in Amyotrophic Lateral Sclerosis

PubMed Central

Nieves, Jeri W.; Gennings, Chris; Factor-Litvak, Pam; Hupf, Jonathan; Singleton, Jessica; Sharf, Valerie; Oskarsson, Björn; Fernandes Filho, J. Americo M.; Sorenson, Eric J.; D’Amico, Emanuele; Goetz, Ray; Mitsumoto, Hiroshi

2017-01-01

IMPORTANCE There is growing interest in the role of nutrition in the pathogenesis and progression of amyotrophic lateral sclerosis (ALS). OBJECTIVE To evaluate the associations between nutrients, individually and in groups, and ALS function and respiratory function at diagnosis. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional baseline analysis of the Amyotrophic Lateral Sclerosis Multicenter Cohort Study of Oxidative Stress study was conducted from March 14, 2008, to February 27, 2013, at 16 ALS clinics throughout the United States among 302 patients with ALS symptom duration of 18 months or less. EXPOSURES Nutrient intake, measured using a modified Block Food Frequency Questionnaire (FFQ). MAIN OUTCOMES AND MEASURES Amyotrophic lateral sclerosis function, measured using the ALS Functional Rating Scale–Revised (ALSFRS-R), and respiratory function, measured using percentage of predicted forced vital capacity (FVC). RESULTS Baseline data were available on 302 patients with ALS (median age, 63.2 years [interquartile range, 55.5–68.0 years]; 178 men and 124 women). Regression analysis of nutrients found that higher intakes of antioxidants and carotenes from vegetables were associated with higher ALSFRS-R scores or percentage FVC. Empirically weighted indices using the weighted quantile sum regression method of “good” micronutrients and “good” food groups were positively associated with ALSFRS-R scores (β [SE], 2.7 [0.69] and 2.9 [0.9], respectively) and percentage FVC (β [SE], 12.1 [2.8] and 11.5 [3.4], respectively) (all P < .001). Positive and significant associations with ALSFRS-R scores (β [SE], 1.5 [0.61]; P = .02) and percentage FVC (β [SE], 5.2 [2.2]; P = .02) for selected vitamins were found in exploratory analyses. CONCLUSIONS AND RELEVANCE Antioxidants, carotenes, fruits, and vegetables were associated with higher ALS function at baseline by regression of nutrient indices and weighted quantile sum regression analysis. We also demonstrated the usefulness of the weighted quantile sum regression method in the evaluation of diet. Those responsible for nutritional care of the patient with ALS should consider promoting fruit and vegetable intake since they are high in antioxidants and carotenes. PMID:27775751

Extracorporeal shock wave therapy vs cryoultrasound therapy in the treatment of chronic lateral epicondylitis. One year follow up study

PubMed Central

Vulpiani, Maria Chiara; Nusca, Sveva Maria; Vetrano, Mario; Ovidi, Serena; Baldini, Rossella; Piermattei, Cristina; Ferretti, Andrea; Saraceni, Vincenzo Maria

2015-01-01

Summary Background the purpose of this study is to compare the therapeutic effects of extracorporeal shock wave therapy (ESWT) to those of cryoultrasound (Cryo-US) therapy in chronic lateral epicondylitis during a 12-month period. Methods single-blinded, randomized, controlled study of 80 participants treated for chronic LE with 3 ESWT sessions at 48/72-hours intervals (n=40) or 12 Cryo-US therapy sessions (4 sessions per week) (n=40). VAS and satisfactory results, considered as the sum of excellent and good scores in the Roles and Maudsley score, were used as outcome measures at baseline and 3, 6 and 12 months post-treatment. Results the results show statistically significant differences in VAS between the two groups at 6 (p<0.001) and 12 months (p<0.001) in favour of the ESWT Group. At 12 months, a difference of more than 2 points in the VAS between the two groups is demonstrated in favour of the ESWT Group. Considering satisfactory results, significant differences between the two groups are observed at 6 (p=0.003) and 12 months (p <0.001) in favour of the ESWT Group where patients achieve a satisfactory rate over 50%. Conclusions ESWT has better clinical therapeutic results at 6- and 12-month follow-up as compared to Cryo-US therapy. Level of Evidence 1B. PMID:26605190

Grandparental education, parental education and child height: evidence from Hong Kong's "Children of 1997" birth cohort.

PubMed

Kwok, Man Ki; Leung, Gabriel M; Lam, Tai Hing; Leung, Shirley S L; Schooling, C Mary

2013-08-01

Adult height is the sum of growth during fetal, infancy, childhood, and puberty, controlled by different biological factors. In long-term developed Western populations, height is positively associated with socioeconomic position, but less clearly so in recently developing populations. We aimed to elucidate socioeconomic influences on height at different growth phases. We examined the associations of parents' education and grandparents' education with birth weight and height gain z-scores during infancy (birth to <2 years), childhood (2 to <8 years), and puberty (8 to <14 years) adjusted for parents' height using generalized estimating equations in Hong Kong's "Children of 1997" birth cohort (n = 8264). Parents' education, but not grandparents', was positively associated with birth weight (z-score, 0.07; 95% confidence interval [CI] 0.01-0.12 for grade ≥12 compared with grade ≤9) and height gain during infancy (0.11; 95% CI, 0.05-0.18), adjusted for gender, gestational age, initial size, parity, parents' age, parents' birthplace, and parents' height. Conversely, similarly adjusted, grandparents' education, but not parents', was associated with height gain during childhood (0.11; 95% CI, 0.04-0.18). Parental education was associated with fetal and infant, but not childhood, linear growth, suggesting the mechanism underlying socioeconomic influences on height at different growth phases may be contextually specific. Copyright © 2013 Elsevier Inc. All rights reserved.

The use of Goal Attainment Scaling in a community health promotion initiative with seniors.

PubMed

Kloseck, Marita

2007-07-03

Evaluating collaborative community health promotion initiatives presents unique challenges, including engaging community members and other stakeholders in the evaluation process, and measuring the attainment of goals at the collective community level. Goal Attainment Scaling (GAS) is a versatile, under-utilized evaluation tool adaptable to a wide range of situations. GAS actively involves all partners in the evaluation process and has many benefits when used in community health settings. The purpose of this paper is to describe the use of GAS as a potential means of measuring progress and outcomes in community health promotion and community development projects. GAS methodology was used in a local community of seniors (n = 2500; mean age = 76 +/- 8.06 SD; 77% female, 23% male) to a) collaboratively set health promotion and community partnership goals and b) objectively measure the degree of achievement, over- or under-achievement of the established health promotion goals. Goal attainment was measured in a variety of areas including operationalizing a health promotion centre in a local mall, developing a sustainable mechanism for recruiting and training volunteers to operate the health promotion centre, and developing and implementing community health education programs. Goal attainment was evaluated at 3 monthly intervals for one year, then re-evaluated again at year 2. GAS was found to be a feasible and responsive method of measuring community health promotion and community development progress. All project goals were achieved at one year or sooner. The overall GAS score for the total health promotion project increased from 16.02 at baseline (sum of scale scores = -30, average scale score = -2) to 54.53 at one year (sum of scale scores = +4, average scale score = +0.27) showing project goals were achieved above the expected level. With GAS methodology an amalgamated score of 50 represents the achievement of goals at the expected level. GAS provides a "participatory", flexible evaluation approach that involves community members, research partners and other stakeholders in the evaluation process. GAS was found to be "user-friendly" and readily understandable by seniors and other community partners not familiar with program evaluation.

PI-RADS version 2 for prediction of pathological downgrading after radical prostatectomy: a preliminary study in patients with biopsy-proven Gleason Score 7 (3+4) prostate cancer.

PubMed

Woo, Sungmin; Kim, Sang Youn; Lee, Joongyub; Kim, Seung Hyup; Cho, Jeong Yeon

2016-10-01

To evaluate PI-RADSv2 for predicting pathological downgrading after radical prostatectomy (RP) in patients with biopsy-proven Gleason score (GS) 7(3+4) PC. A total of 105 patients with biopsy-proven GS 7(3+4) PC who underwent multiparametric prostate MRI followed by RP were included. Two radiologists assigned PI-RADSv2 scores for each patient. Preoperative clinicopathological variables and PI-RADSv2 scores were compared between patients with and without downgrading after RP using the Wilcoxon rank sum test or Fisher's exact test. Logistic regression analyses with Firth's bias correction were performed to assess their association with downgrading. Pathological downgrading was identified in ten (9.5 %) patients. Prostate-specific antigen (PSA), PSA density, percentage of cores with GS 7(3+4), and greatest percentage of core length (GPCL) with GS 7(3+4) were significantly lower in patients with downgrading (p = 0.002-0.037). There was no significant difference in age and clinical stage (p = 0.537-0.755). PI-RADSv2 scores were significantly lower in patients with downgrading (3.8 versus 4.4, p = 0.012). At univariate logistic regression analysis, PSA, PSA density, and PI-RADSv2 scores were significant predictors of downgrading (p = 0.003-0.022). Multivariate analysis revealed only PSA density and PI-RADSv2 scores as independent predictors of downgrading (p = 0.014-0.042). The PI-RADSv2 scoring system was an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4) PC. • PI-RADSv2 was an independent predictor of downgrading in biopsy-proven GS 7(3+4) PC • PSA density was also an independent predictor of downgrading • MRI may assist in identifying AS candidates in biopsy-proven GS 7(3+4) PC patients.

A physical function test for use in the intensive care unit: validity, responsiveness, and predictive utility of the physical function ICU test (scored).

PubMed

Denehy, Linda; de Morton, Natalie A; Skinner, Elizabeth H; Edbrooke, Lara; Haines, Kimberley; Warrillow, Stephen; Berney, Sue

2013-12-01

Several tests have recently been developed to measure changes in patient strength and functional outcomes in the intensive care unit (ICU). The original Physical Function ICU Test (PFIT) demonstrates reliability and sensitivity. The aims of this study were to further develop the original PFIT, to derive an interval score (the PFIT-s), and to test the clinimetric properties of the PFIT-s. A nested cohort study was conducted. One hundred forty-four and 116 participants performed the PFIT at ICU admission and discharge, respectively. Original test components were modified using principal component analysis. Rasch analysis examined the unidimensionality of the PFIT, and an interval score was derived. Correlations tested validity, and multiple regression analyses investigated predictive ability. Responsiveness was assessed using the effect size index (ESI), and the minimal clinically important difference (MCID) was calculated. The shoulder lift component was removed. Unidimensionality of combined admission and discharge PFIT-s scores was confirmed. The PFIT-s displayed moderate convergent validity with the Timed "Up & Go" Test (r=-.60), the Six-Minute Walk Test (r=.41), and the Medical Research Council (MRC) sum score (rho=.49). The ESI of the PFIT-s was 0.82, and the MCID was 1.5 points (interval scale range=0-10). A higher admission PFIT-s score was predictive of: an MRC score of ≥48, increased likelihood of discharge home, reduced likelihood of discharge to inpatient rehabilitation, and reduced acute care hospital length of stay. Scoring of sit-to-stand assistance required is subjective, and cadence cutpoints used may not be generalizable. The PFIT-s is a safe and inexpensive test of physical function with high clinical utility. It is valid, responsive to change, and predictive of key outcomes. It is recommended that the PFIT-s be adopted to test physical function in the ICU.

Longitudinal Associations of Autonomy, Relatedness, and Competence with the Well-being of Nursing Home Residents.

PubMed

Kloos, Noortje; Trompetter, Hester R; Bohlmeijer, Ernst T; Westerhof, Gerben J

2018-02-24

As proposed by the self-determination theory, satisfying nursing home residents' needs for autonomy, relatedness, and competence may improve their well-being. This is the first study to test the longitudinal relations of the satisfaction of these three basic psychological needs to the subjective well-being of nursing home residents and to determine whether a balance among the satisfaction of the three needs is important for well-being. Participants in this longitudinal survey study included 128 physically frail residents (mean age 85 years) at four Dutch nursing homes. Satisfaction of the three basic psychological needs was measured at baseline, and depressive feelings and life satisfaction 5-8 months later. Absolute differences between the three basic need satisfaction scores were summed to create a score of need satisfaction balance. All three needs were related to both well-being measures over time, although autonomy had the strongest relationships. Only autonomy and competence were uniquely associated with depressive feelings, and only autonomy was uniquely associated with life satisfaction. The need satisfaction balance score was related to well-being independent of the autonomy and relatedness scores. These results confirm that all three basic psychological needs are important for nursing home residents' well-being, with autonomy having the strongest and most consistent relationship to their well-being. Additionally, high satisfaction of one need does not compensate for low satisfaction of another. Supporting residents' needs for autonomy, relatedness, and competence should, therefore, have a central role in nursing home culture-change interventions.

Multispectral Palmprint Recognition Using a Quaternion Matrix

PubMed Central

Xu, Xingpeng; Guo, Zhenhua; Song, Changjiang; Li, Yafeng

2012-01-01

Palmprints have been widely studied for biometric recognition for many years. Traditionally, a white light source is used for illumination. Recently, multispectral imaging has drawn attention because of its high recognition accuracy. Multispectral palmprint systems can provide more discriminant information under different illuminations in a short time, thus they can achieve better recognition accuracy. Previously, multispectral palmprint images were taken as a kind of multi-modal biometrics, and the fusion scheme on the image level or matching score level was used. However, some spectral information will be lost during image level or matching score level fusion. In this study, we propose a new method for multispectral images based on a quaternion model which could fully utilize the multispectral information. Firstly, multispectral palmprint images captured under red, green, blue and near-infrared (NIR) illuminations were represented by a quaternion matrix, then principal component analysis (PCA) and discrete wavelet transform (DWT) were applied respectively on the matrix to extract palmprint features. After that, Euclidean distance was used to measure the dissimilarity between different features. Finally, the sum of two distances and the nearest neighborhood classifier were employed for recognition decision. Experimental results showed that using the quaternion matrix can achieve a higher recognition rate. Given 3000 test samples from 500 palms, the recognition rate can be as high as 98.83%. PMID:22666049

Multispectral palmprint recognition using a quaternion matrix.

PubMed

Xu, Xingpeng; Guo, Zhenhua; Song, Changjiang; Li, Yafeng

2012-01-01

Palmprints have been widely studied for biometric recognition for many years. Traditionally, a white light source is used for illumination. Recently, multispectral imaging has drawn attention because of its high recognition accuracy. Multispectral palmprint systems can provide more discriminant information under different illuminations in a short time, thus they can achieve better recognition accuracy. Previously, multispectral palmprint images were taken as a kind of multi-modal biometrics, and the fusion scheme on the image level or matching score level was used. However, some spectral information will be lost during image level or matching score level fusion. In this study, we propose a new method for multispectral images based on a quaternion model which could fully utilize the multispectral information. Firstly, multispectral palmprint images captured under red, green, blue and near-infrared (NIR) illuminations were represented by a quaternion matrix, then principal component analysis (PCA) and discrete wavelet transform (DWT) were applied respectively on the matrix to extract palmprint features. After that, Euclidean distance was used to measure the dissimilarity between different features. Finally, the sum of two distances and the nearest neighborhood classifier were employed for recognition decision. Experimental results showed that using the quaternion matrix can achieve a higher recognition rate. Given 3000 test samples from 500 palms, the recognition rate can be as high as 98.83%.

The Dyad-Adaptive Paced Auditory Serial Addition Test (DA-PASAT): Normative data and the effects of repeated testing, simulated malingering, and traumatic brain injury

PubMed Central

Wyma, John M.; Herron, Timothy J.; Yund, E. William; Reed, Bruce

2018-01-01

The Paced Auditory Serial Addition Test (PASAT) is widely used to evaluate processing speed and executive function in patients with multiple sclerosis, traumatic brain injury, and other neurological disorders. In the PASAT, subjects listen to sequences of digits while continuously reporting the sum of the last two digits presented. Four different stimulus onset asynchronies (SOAs) are usually tested, with difficulty increasing as SOAs are reduced. Ceiling effects are common at long SOAs, while the digit delivery rate often exceeds the subject’s processing capacity at short SOAs, causing some subjects to stop performing altogether. In addition, subjects may adopt an “alternate answer” strategy at short SOAs, which reduces the test’s demands on working-memory and processing speed. Consequently, studies have shown that the number of dyads (consecutive correct answers) is a more sensitive measure of PASAT performance than the overall number of correct sums. Here, we describe a 2.5-minute computerized test, the Dyad-Adaptive PASAT (DA-PASAT), where SOAs are adjusted with a 2:1 staircase, decreasing after each pair of correct responses and increasing after misses. Processing capacity is reflected in the minimum SOA (minSOA) achieved in 54 trials. Experiment 1 gathered normative data in two large populations: 1617 subjects in New Zealand ranging in age from 18 to 65 years, and 214 Californians ranging in age from 18 to 82 years. Minimum SOAs were influenced by age, education, and daily hours of computer-use. Minimum SOA z-scores, calculated after factoring out the influence of these factors, were virtually identical in the two control groups, as were response times (RTs) and dyad ratios (the proportion of hits occurring in dyads). Experiment 2 measured the test-retest reliability of the DA-PASAT in 44 young subjects who underwent three test sessions at weekly intervals. High intraclass correlation coefficients (ICCs) were found for minSOAs (0.87), response times (0.76), and dyad ratios (0.87). Performance improved across test sessions for all measures. Experiment 3 investigated the effects of simulated malingering in 50 subjects: 42% of simulated malingerers produced abnormal (p< 0.05) minSOA z-scores. Simulated malingerers with abnormal scores were distinguished with 87% sensitivity and 69% specificity from control subjects with abnormal scores by excessive differences between training performance and the actual test. Experiment 4 investigated patients with traumatic brain injury (TBI): patients with mild TBI performed within the normal range while patients with severe TBI showed deficits. The DA-PASAT reduces the time and stress of PASAT assessment while gathering sensitive measures of dyad processing that reveal the effects of aging, malingering, and traumatic brain injury on performance. PMID:29677192

Compton scattering from nuclei and photo-absorption sum rules

NASA Astrophysics Data System (ADS)

Gorchtein, Mikhail; Hobbs, Timothy; Londergan, J. Timothy; Szczepaniak, Adam P.

2011-12-01

We revisit the photo-absorption sum rule for real Compton scattering from the proton and from nuclear targets. In analogy with the Thomas-Reiche-Kuhn sum rule appropriate at low energies, we propose a new “constituent quark model” sum rule that relates the integrated strength of hadronic resonances to the scattering amplitude on constituent quarks. We study the constituent quark model sum rule for several nuclear targets. In addition, we extract the α=0 pole contribution for both proton and nuclei. Using the modern high-energy proton data, we find that the α=0 pole contribution differs significantly from the Thomson term, in contrast with the original findings by Damashek and Gilman.

Onset of action of fexofenadine hydrochloride 60 mg/pseudoephedrine hydrochloride 120 mg in subjects aged 12 years with moderate to severe seasonal allergic rhinitis: a pooled analysis of two single-dose, randomized, double-blind, placebo-controlled allergen exposure unit studies.

PubMed

Berkowitz, Robert B; McCafferty, Frank; Lutz, Cheryl; Bazelmans, Donna; Godfrey, Penny; Meeves, Suzanne; Liao, Yuning; Georges, George

2006-10-01

The onset of action of antihistamine-decongestant combinations is an important factor in the treatment of subjects with seasonal allergic rhinitis (SAR). This was a pooled analysis of 2 published studies with identical designs investigating the onset of action of the combination of fexofenadine hydrochloride 60 mg/pseudoephedrine hydrochloride 120 mg (FEX60/PSE120) in subjects with moderate to severe SAR. Subjects aged 12 years received single doses of FEX60/PSE120 or placebo in 2 randomized, double-blind, placebo-controlled, parallel-group, allergen exposure unit studies and recorded their SAR symptoms on diary cards before dosing, at 15-minute intervals for 2 hours after dosing, and at 30-minute intervals for the next 4 hours. The primary efficacy end point was onset of action, assessed in terms of absolute change in the major symptom complex (MSC) score, which was the sum of scores for the individual symptoms of stuffy nose, itchy nose, runny nose, watery eyes, itchy eyes, itchy ears/throat, and sneezing. Secondary end points included the absolute and percent change in the total symptom complex (TSC) score (the sum of the MSC score plus the scores for nose blowing, sniffles, postnasal drip, and cough) and individual symptom scores. Treatment-emergent adverse events (TEAEs) were recorded. Analyses were performed on the modified intention-to-treat (mITT) population, which included all subjects who were randomized to treatment and took the single dose of study medication according to the protocol. A total of 1693 subjects were screened in the 2 studies, and 786 were randomized (298 in study 1, 488 in study 2). Two subjects withdrew from study 2; therefore, the mITT population consisted of 784 subjects. Subjects' mean age was 33.4 years, and 64.4% were female. The onset of action of FEX60/PSE120 was 45 minutes; the least squares mean (SD) treatment difference in the change from baseline in absolute MSC score was 0.8 (0.31) (95% CI, 0.2-1.4; P = 0.008). All subsequent changes from baseline in MSC scores were statistically significant for FEX60/PSE120 compared with placebo (P < 0.001). The absolute and percent change in TSC score and the percent change in MSC score were significantly decreased at all time points from 45 minutes after dosing for FEX60/PSE120 compared with placebo (all, P < 0.05). Individual symptoms (mean of hours 1 to 5) also were significantly improved with FEX60/PSE120 compared with placebo (all, P < 0.05). TEAEs were reported by 2.3% (9/391) and 4.3% (17/393) of subjects receiving FEX60/PSE120 and placebo, respectively. The most commonly occurring TEAS in the FEX60/PSE120 and placebo groups was somnolence (n = 4 and n = 6, respectively). In this pooled analysis of 2 allergen exposure unit studies, FEX60/PSE120 had an onset of action of 45 minutes and a sustained effect throughout the 6-hour study period in subjects with moderate to severe SAR.

Education, material condition and physical functioning trajectories in middle-aged and older adults in Central and Eastern Europe: a cross-country comparison.

PubMed

Hu, Yaoyue; Pikhart, Hynek; Pająk, Andrzej; Kubínová, Růžena; Malyutina, Sofia; Besala, Agnieszka; Peasey, Anne; Marmot, Michael; Bobak, Martin

2016-11-01

Two competing hypotheses, cumulative advantage/disadvantage and age-as-leveller, have been proposed to explain the contradictory findings on socioeconomic differences in health over the lifespan. To test these hypotheses, this investigation examined the influence of educational attainment and material condition on individual trajectories of physical functioning (PF) in unexplored ageing populations in Central and Eastern Europe. 28 783 men and women aged 45-69 years selected from populations in seven Czech towns, Krakow (Poland) and Novosibirsk (Russia). PF was measured by the Physical Functioning Subscale (PF-10) of the Short-Form-36 questionnaire (SF-36) at baseline and three subsequent occasions. The highest educational attainment was self-reported at baseline, and material condition was captured by the sum score of 12 household amenities and assets. In all cohorts, participants with a university degree had the highest PF-10 score at baseline and slowest rate of decline in the score during follow-up, while the lowest baseline scores and fastest decline rate were found in participants with less than secondary education in all cohorts and in Russians with secondary education. Similar disparities in the baseline PF-10 score and decline rate were observed across tertiles of material condition, but differences in decline rates across the three tertiles among Czechs or between the lower two tertiles among Russians were not statistically significant. Disparities in PF by educational attainment and material condition among middle-aged and older adults in Central and Eastern Europe existed at baseline and widened during ∼10 years of follow-up, supporting the cumulative advantage/disadvantage hypothesis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Discordance Between Body Mass Index (BMI) and a Novel Body Composition Change Index (BCCI) as Outcome Measures in Weight Change Interventions.

PubMed

Nugent, Stephen D; Kaats, Gilbert R; Preuss, Harry G

2018-01-01

A general assumption is that the body mass index (BMI) reflects changes in fat mass (FM). However, it fails to distinguish the type of weight that is lost or gained-fat mass (FM) or fat-free mass (FFM). The BMI treats both changes the same although they have opposite health consequences. The objective of this study was to propose a more precise measure, a body composition change index (BCCI), which distinguishes between changes in FM and FFM, and this study compares it with using the BMI as an outcome measure. Data were obtained from 3,870 subjects who had completed dual-energy x-ray absorptiometry (DEXA) total body scans at baseline and end-of-study when participating in a variety of weight-loss interventions. Since height remained constant in this adult cohort, changes in the BMI corresponded with scale weight changes (r = 0.994), allowing BMI changes to be converted to "lbs." to match the statistic used for calculation of the BCCI. The BCCI is calculated by scoring increases in FFM (lbs.) and decreases in FM (lbs.) as positive outcomes and scoring decreases in FFM and increases in FM as negative outcomes. The BCCI is the net sum of these calculations. Differences between scale weight changes and BCCI values were subsequently compared to obtain "discordance scores." Discordance scores ranged from 0.0 lbs. to >30.0 lbs. with a mean absolute value of between the two measures of 7.79 lbs. (99% confidence interval: 7.49-8.10, p <0.00001), SD = 7.4 lbs. Similar discordance scores were also found in subgroups of self-reported gender, ethnicity, and age. A significant difference of 7.79 lbs. was found between the BCCI and the BMI to evaluate the efficacy of weight loss interventions. If assessing changes in body composition is a treatment goal, use of the BMI could result in significantly erroneous conclusions.

Neuromuscular Strain Increases Symptom Intensity in Chronic Fatigue Syndrome

PubMed Central

Rowe, Peter C.; Fontaine, Kevin R.; Lauver, Megan; Jasion, Samantha E.; Marden, Colleen L.; Moni, Malini; Thompson, Carol B.; Violand, Richard L.

2016-01-01

Chronic fatigue syndrome (CFS) is a complex, multisystem disorder that can be disabling. CFS symptoms can be provoked by increased physical or cognitive activity, and by orthostatic stress. In preliminary work, we noted that CFS symptoms also could be provoked by application of longitudinal neural and soft tissue strain to the limbs and spine of affected individuals. In this study we measured the responses to a straight leg raise neuromuscular strain maneuver in individuals with CFS and healthy controls. We randomly assigned 60 individuals with CFS and 20 healthy controls to either a 15 minute period of passive supine straight leg raise (true neuromuscular strain) or a sham straight leg raise. The primary outcome measure was the symptom intensity difference between the scores during and 24 hours after the study maneuver compared to baseline. Fatigue, body pain, lightheadedness, concentration difficulties, and headache scores were measured individually on a 0–10 scale, and summed to create a composite symptom score. Compared to individuals with CFS in the sham strain group, those with CFS in the true strain group reported significantly increased body pain (P = 0.04) and concentration difficulties (P = 0.02) as well as increased composite symptom scores (all P = 0.03) during the maneuver. After 24 hours, the symptom intensity differences were significantly greater for the CFS true strain group for the individual symptom of lightheadedness (P = 0.001) and for the composite symptom score (P = 0.005). During and 24 hours after the exposure to the true strain maneuver, those with CFS had significantly higher individual and composite symptom intensity changes compared to the healthy controls. We conclude that a longitudinal strain applied to the nerves and soft tissues of the lower limb is capable of increasing symptom intensity in individuals with CFS for up to 24 hours. These findings support our preliminary observations that increased mechanical sensitivity may be a contributor to the provocation of symptoms in this disorder. PMID:27428358

An extensive analysis of disease-gene associations using network integration and fast kernel-based gene prioritization methods.

PubMed

Valentini, Giorgio; Paccanaro, Alberto; Caniza, Horacio; Romero, Alfonso E; Re, Matteo

2014-06-01

In the context of "network medicine", gene prioritization methods represent one of the main tools to discover candidate disease genes by exploiting the large amount of data covering different types of functional relationships between genes. Several works proposed to integrate multiple sources of data to improve disease gene prioritization, but to our knowledge no systematic studies focused on the quantitative evaluation of the impact of network integration on gene prioritization. In this paper, we aim at providing an extensive analysis of gene-disease associations not limited to genetic disorders, and a systematic comparison of different network integration methods for gene prioritization. We collected nine different functional networks representing different functional relationships between genes, and we combined them through both unweighted and weighted network integration methods. We then prioritized genes with respect to each of the considered 708 medical subject headings (MeSH) diseases by applying classical guilt-by-association, random walk and random walk with restart algorithms, and the recently proposed kernelized score functions. The results obtained with classical random walk algorithms and the best single network achieved an average area under the curve (AUC) across the 708 MeSH diseases of about 0.82, while kernelized score functions and network integration boosted the average AUC to about 0.89. Weighted integration, by exploiting the different "informativeness" embedded in different functional networks, outperforms unweighted integration at 0.01 significance level, according to the Wilcoxon signed rank sum test. For each MeSH disease we provide the top-ranked unannotated candidate genes, available for further bio-medical investigation. Network integration is necessary to boost the performances of gene prioritization methods. Moreover the methods based on kernelized score functions can further enhance disease gene ranking results, by adopting both local and global learning strategies, able to exploit the overall topology of the network. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Do Different Young Plantation-Grown Species Require Different Biomass Models?

Treesearch

Bryce E. Schlaegel; Harvey E. Kennedy

1985-01-01

Sweetgum and water oak trees sampled from a plantation over 7 years were used to test whether primary tree component (bole wood, bole bark, limb wood, limb bark, and leaves) predictions could be summed to estimate total bole, total limb, and total tree values. Estimations by summing primary component predictions were not significantly different from predictions for the...

What a difference your e-mail makes: effects of informal e-mail addresses in online résumé screening.

PubMed

van Toorenburg, Marlies; Oostrom, Janneke K; Pollet, Thomas V

2015-03-01

Résumés are screened rapidly, with some reports stating that recruiters form their impressions within 10 seconds. Certain résumé characteristics can have a significant impact on the snap judgments these recruiters make. The main goal of the present study was to examine the effect of the e-mail address (formal vs. informal) used in a résumé on the hirability perceptions formed by professional recruiters (N=73). In addition, the effect of the e-mail address on hirability perceptions was compared to the effects of spelling errors and typeface. Participants assessed the cognitive ability, personality, and the hirability of six fictitious applicants for the job of an HR specialist. The hirability ratings for the résumés with informal e-mail addresses were significantly lower than the hirability ratings for résumés that featured a formal e-mail address. The effect of e-mail address was as strong as the effect of spelling errors and stronger than that of typeface. The effect of e-mail address on hirability was mediated by perceptions of conscientiousness and honesty-humility. This study among actual recruiters shows for the first time that the choice of the e-mail address used on a résumé might make a real difference.

Location of unaccessible implant surface areas during debridement in simulated peri-implantitis therapy.

PubMed

Steiger-Ronay, Valerie; Merlini, Andrea; Wiedemeier, Daniel B; Schmidlin, Patrick R; Attin, Thomas; Sahrmann, Philipp

2017-11-28

An in vitro model for peri-implantitis treatment was used to identify areas that are clinically difficult to clean by analyzing the pattern of residual stain after debridement with commonly employed instruments. Original data from two previous publications, which simulated surgical (SA) and non-surgical (NSA) implant debridement on two different implant systems respectively, were reanalyzed regarding the localization pattern of residual stains after instrumentation. Two blinded examiners evaluated standardized photographs of 360 initially ink-stained dental implants, which were cleaned at variable defect angulations (30, 60, or 90°), using different instrument types (Gracey curette, ultrasonic scaler or air powder abrasive device) and treatment approaches (SA or NSA). Predefined implant surface areas were graded for residual stain using scores ranging from one (stain-covered) to six (clean). Score differences between respective implant areas were tested for significance by pairwise comparisons using Wilcoxon-rank-sum-tests with a significance level α = 5%. Best scores were found at the machined surface areas (SA: 5.58 ± 0.43, NSA: 4.76 ± 1.09), followed by the tips of the threads (SA: 4.29 ± 0.44, NSA: 4.43 ± 0.61), and areas between threads (SA: 3.79 ± 0.89, NSA: 2.42 ± 1.11). Apically facing threads were most difficult to clean (SA: 1.70 ± 0.92, NSA: 2.42 ± 1.11). Here, air powder abrasives provided the best results. Machined surfaces at the implant shoulder were well accessible and showed least amounts of residual stain. Apically facing thread surfaces constituted the area with most residual stain regardless of treatment approach.

Video on Diet Before Outpatient Colonoscopy Does Not Improve Quality of Bowel Preparation: A Prospective, Randomized, Controlled Trial.

PubMed

Rice, Sean C; Higginbotham, Tina; Dean, Melanie J; Slaughter, James C; Yachimski, Patrick S; Obstein, Keith L

2016-11-01

Successful outpatient colonoscopy (CLS) depends on many factors including the quality of a patient's bowel preparation. Although education on consumption of the pre-CLS purgative can improve bowel preparation quality, no study has evaluated dietary education alone. We have created an educational video on pre-CLS dietary instructions to determine whether dietary education would improve outpatient bowel preparation quality. A prospective randomized, blinded, controlled study of patients undergoing outpatient CLS was performed. All patients received a 4 l polyethylene glycol-based split-dose bowel preparation and standard institutional pre-procedure instructions. Patients were then randomly assigned to an intervention arm or to a no intervention arm. A 4-min educational video detailing clear liquid diet restriction was made available to patients in the intervention arm, whereas those randomized to no intervention did not have access to the video. Patients randomized to the video were provided with the YouTube video link 48-72 h before CLS. An attending endoscopist blinded to randomization performed the CLS. Bowel preparation quality was scored using the Boston Bowel Preparation Scale (BBPS). Adequate preparation was defined as a BBPS total score of ≥6 with all segment scores ≥2. Wilcoxon rank-sum and Pearson's χ 2 -tests were performed to assess differences between groups. Ninety-two patients were randomized (video: n=42; control: n=50) with 47 total video views being tallied. There were no demographic differences between groups. There was no statistically significant difference in adequate preparation between groups (video=74%; control=68%; P=0.54). The availability of a supplementary patient educational video on clear liquid diet alone was insufficient to improve bowel preparation quality when compared with standard pre-procedure instruction at our institution.

The Quality of Health Information Available on the Internet for Patients With Pelvic Organ Prolapse.

PubMed

Solomon, Ellen R; Janssen, Kristine; Krajewski, Colleen M; Barber, Matthew D

2015-01-01

This study aimed to assess the quality of Web sites that provide information on pelvic organ prolapse using validated quality measurement tools. The Google search engine was used to perform a search of the following 4 terms: "pelvic organ prolapse," "dropped bladder," "cystocele," and "vaginal mesh." The DISCERN appraisal tool and JAMA benchmark criteria were used to determine the quality of health information of each Web site. Cohen κ was performed to determine interrater reliability between reviewers. Kruskal-Wallis and Wilcoxon rank sum tests were used to compare DISCERN scores and JAMA criteria among search terms. Interrater reliability between the two reviewers using DISCERN was κ = 0.71 [95% confidence interval (CI), 0.68-0.74] and using JAMA criteria was κ = 0.98 (95% CI, 0.74-1.0). On the basis of the DISCERN appraisal tool, the search term "vaginal mesh" had significantly lower Web site quality than "pelvic organ prolapse" and "cystocele," respectively [mean difference of DISCERN score, -14.65 (95% CI, -25.50 to 8.50, P < 0.0001) and -12.55 (95% CI, -24.00 to 7.00, P = 0.0007)]. "Dropped bladder" had significantly lower Web site quality compared to "pelvic organ prolapse" and "cystocele," respectively (mean difference of DISCERN score, -9.55 (95% CI, -20.00 to 3.00, P = 0.0098) and -7.80 (95% CI, -18.00 to 1.00, P = 0.0348). Using JAMA criteria, there were no statistically significant differences between Web sites. Web sites queried under search terms "vaginal mesh" and "dropped bladder" are lower in quality compared with the Web sites found using the search terms "pelvic organ prolapse" and "cystocele."

Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial.

PubMed

Yale, Steven H; Liu, Kejian

2004-06-14

Echinacea purpurea stimulates the immune response and is promoted to reduce symptom severity and the duration of upper respiratory tract infections. We sought to determine the efficacy of a standardized preparation of E purpurea in reducing symptom severity and duration of the common cold. A randomized, double-blind, placebo-controlled design was used. Patients received either 100 mg of E purpurea (freeze-dried pressed juice from the aerial portion of the plant) or a lactose placebo 3 times daily until cold symptoms were relieved or until the end of 14 days, whichever came first. Symptoms (sneezing, nasal discharge, nasal congestion, headache, sore or scratchy throat, hoarseness, muscle aches, and cough) were scored subjectively by the patient and recorded daily in a diary. Kaplan-Meier curves were used to estimate the survival function of time to resolution in each group. The Wilcoxon rank sum test was used to compare time to resolution between the 2 groups. One hundred twenty-eight patients were enrolled within 24 hours of cold symptom onset. Group demographic distribution was comparable for sex, age, time from symptom onset to enrollment in the study, average number of colds per year, and smoking history. No statistically significant difference was observed between treatment groups for either total symptom scores (P range,.29-.90) or mean individual symptom scores (P range,.09-.93). The time to resolution of symptoms was not statistically different (P =.73). Some studies have concluded that Echinacea effectively reduces the symptoms and duration of the common cold. We were unable to replicate such findings. Further studies using different preparations and dosages of E purpurea are necessary to validate previous claims.

[Assessment on depressive status and the therapeutic effects of highly active antiretroviral therapy among anti-HIV-1(+) population].

PubMed

Zhang, Li; Yang, Di; Zhao, Hong-xin; Han, Ning; Xiao, Jiang; Chen, Yu-fang; Han, Zhu; Li, Yan-mei; Wei, Kai; Zhang, Wen; Gao, Gui-ju

2013-05-01

To assess the depressive status and its influence on Chinese HIV-1(+) population, and how it was influenced by highly active antiretroviral therapy (HAART) and the CD4(+) T cell count. Anti-HIV-1(+) patients (age between 18 and 65 years old) who had met the criteria to commence the anti-HIV treatment but had not yet started, were selected from the Beijing Ditan Hospital between March 2011 and June 2012. BDI-II (Beck Depression Inventory) and a self-designed questionnaire were used to evaluate the baseline and the status of 48 weeks post the HAART treatment. Statistically, t test and the Wilcoxon rank sum test were used to compare the BDI scores under different conditions and before/after the HAART. (1) Of 100 subjects: male to female ratio was 99:1; the average age was 31.37 ± 5.58 years; the average education background was of 13.13 ± 3.51 years; the unemployed percentage was 4%; time before being identified as anti-HIV-1(+) was 5.0 (1.0 - 21.0) months; the percentage being infected through homosexual contact was 83%. The baseline BDI score was 6.0 (3 - 10.25). (2) There was no significant difference (P > 0.05) in BDI score between those subjects having had education less or more than 12 years; the BDI score of patients whose anti-HIV-1(+) was significantly higher (P < 0.05) among those discovered within the past 6 months than those more than 6 months. The BDI score of patients whose baseline CD4(+) T cell count below 200 cells/µl was significantly higher (P < 0.05) than those with baseline CD4(+) T cell count greater than 200 cells/µl. The CD4(+) T cell count was significantly high (P < 0.001) after 48 weeks of anti-viral treatment, but the BDI score was not significantly different (P > 0.05). There was no significant change (P > 0.05) in the proportion of patients with different degrees of BDI score before and after 48 weeks of antiviral treatment. Depression in HIV patients was most overt in the first six months when they were aware of the infection. The degree of depression was more severe in patients with baseline CD4(+) T cell count less than 200 cells/µl with improvement of immunity after the HAART did not alleviate the level of depression.

Apparatus and method for detecting and measuring changes in linear relationships between a number of high frequency signals

DOEpatents

Bittner, J.W.; Biscardi, R.W.

1991-03-19

An electronic measurement circuit is disclosed for high speed comparison of the relative amplitudes of a predetermined number of electrical input signals independent of variations in the magnitude of the sum of the signals. The circuit includes a high speed electronic switch that is operably connected to receive on its respective input terminals one of said electrical input signals and to have its common terminal serve as an input for a variable-gain amplifier-detector circuit that is operably connected to feed its output to a common terminal of a second high speed electronic switch. The respective terminals of the second high speed electronic switch are operably connected to a plurality of integrating sample and hold circuits, which in turn have their outputs connected to a summing logic circuit that is operable to develop first, second and third output voltages, the first output voltage being proportional to a predetermined ratio of sums and differences between the compared input signals, the second output voltage being proportional to a second summed ratio of predetermined sums and differences between said input signals, and the third output voltage being proportional to the sum of signals to the summing logic circuit. A servo system that is operably connected to receive said third output signal and compare it with a reference voltage to develop a slowly varying feedback voltage to control the variable-gain amplifier in said common amplifier-detector circuit in order to make said first and second output signals independent of variations in the magnitude of the sum of said input signals. 2 figures.

Apparatus and method for detecting and measuring changes in linear relationships between a number of high frequency signals

DOEpatents

Bittner, John W.; Biscardi, Richard W.

1991-01-01

An electronic measurement circuit for high speed comparison of the relative amplitudes of a predetermined number of electrical input signals independent of variations in the magnitude of the sum of the signals. The circuit includes a high speed electronic switch that is operably connected to receive on its respective input terminals one of said electrical input signals and to have its common terminal serve as an input for a variable-gain amplifier-detector circuit that is operably connected to feed its output to a common terminal of a second high speed electronic switch. The respective terminals of the second high speed electronic switch are operably connected to a plurality of integrating sample and hold circuits, which in turn have their outputs connected to a summing logic circuit that is operable to develop first, second and third output voltages, the first output voltage being proportional to a predetermined ratio of sums and differences between the compared input signals, the second output voltage being proportional to a second summed ratio of predetermined sums and differences between said input signals, and the third output voltage being proportional to the sum of signals to the summing logic circuit. A servo system that is operably connected to receive said third output signal and compare it with a reference voltage to develop a slowly varying feedback voltage to control the variable-gain amplifier in said common amplifier-detector circuit in order to make said first and second output signals independent of variations in the magnitude of the sum of said input signals.

Differences in swallow physiology in patients with left and right hemispheric strokes.

PubMed

Wilmskoetter, Janina; Martin-Harris, Bonnie; Pearson, William G; Bonilha, Leonardo; Elm, Jordan J; Horn, Janet; Bonilha, Heather S

2018-05-11

We sought to determine the impact of lesion lateralization and lesion volume on swallow impairment on group-level by comparing patients with left and right hemisphere strokes and on patient-level by analyzing patients individually. We performed a retrospective, observational, cross-sectional study of 46 patients with unilateral (22 left, 24 right), acute, first-ever, ischemic strokes who received a diffusion weighted MRI (DW-MRI) and modified barium swallow study (MBSS) during their acute hospital stay. We determined lesion side on the DW-MRI and measured swallow physiology using the Modified Barium Swallow Impairment Profile (MBSImP™©), Penetration-Aspiration Scale (PAS), swallow timing, distance, area, and speed measures. We performed Pearson's Chi-Square and Wilcoxon Rank-Sum tests to compare patients with left and right hemisphere strokes, and Pearson or Spearman correlation, simple logistic regression, linear, and logistic multivariable regression modeling to assess the relationship between variables. At the group-level, there were no differences in MBSImP oral swallow impairment scores between patients with left and right hemisphere stroke. In adjusted analyses, patients with right hemisphere strokes showed significantly worse MBSImP pharyngeal total scores (p = 0.02), worse MBSImP component specific scores for laryngeal vestibular closure (Bonferroni adjusted alpha p ≤ 0.0029), and worse PAS scores (p = 0.03). Patients with right hemisphere strokes showed worse timing, distance, area, and speed measures. Lesion volume was significantly associated with MBSImP pharyngeal residue (p = 0.03) and pharyngeal total scores (p = 0.04). At the patient-level, 24% of patients (4 left, 7 right) showed opposite patterns of MBSImP oral and pharyngeal swallow impairment than seen at group-level. Our study showed differences in swallow physiology between patients with right and left unilateral strokes with patients with right hemisphere strokes showing worse pharyngeal impairment. Lesion lateralization seems to be a valuable marker for the severity of swallowing impairment at the group-level but less informative at the patient-level. Copyright © 2018 Elsevier Inc. All rights reserved.

Delivering both sum and difference beam distributions to a planar monopulse antenna array

DOEpatents

Strassner, II, Bernd H.

2015-12-22

A planar monopulse radar apparatus includes a planar distribution matrix coupled to a planar antenna array having a linear configuration of antenna elements. The planar distribution matrix is responsive to first and second pluralities of weights applied thereto for providing both sum and difference beam distributions across the antenna array.

Motion video compression system with neural network having winner-take-all function

NASA Technical Reports Server (NTRS)

Fang, Wai-Chi (Inventor); Sheu, Bing J. (Inventor)

1997-01-01

A motion video data system includes a compression system, including an image compressor, an image decompressor correlative to the image compressor having an input connected to an output of the image compressor, a feedback summing node having one input connected to an output of the image decompressor, a picture memory having an input connected to an output of the feedback summing node, apparatus for comparing an image stored in the picture memory with a received input image and deducing therefrom pixels having differences between the stored image and the received image and for retrieving from the picture memory a partial image including the pixels only and applying the partial image to another input of the feedback summing node, whereby to produce at the output of the feedback summing node an updated decompressed image, a subtraction node having one input connected to received the received image and another input connected to receive the partial image so as to generate a difference image, the image compressor having an input connected to receive the difference image whereby to produce a compressed difference image at the output of the image compressor.

Predicting forest dieback in Maine, USA: a simple model based on soil frost and drought

Treesearch

Allan N.D. Auclair; Warren E. Heilman; Blondel Brinkman

2010-01-01

Tree roots of northern hardwoods are shallow rooted, winter active, and minimally frost hardened; dieback is a winter freezing injury to roots incited by frost penetration in the absence of adequate snow cover and exacerbated by drought in summer. High soil water content greatly increases conductivity of frost. We develop a model based on the sum of z-scores of soil...

Transition to Ada

DTIC Science & Technology

1993-02-01

the relative cost effectiveness of Ada and C++ [10]. (An overview of the Air Force report is given in Appendix D.) Surprisingly, the study deter- mined ...support; 5 = excellent support), followed by a total score, a weighted sum of the rankings based on weights deter- mined by an expert panel: Category...International Conference Location: Britannia International Hotel, London Sponsor. Ada Language UK, Ltd. POC: Helen Byard, Administrator, Ada UK, P.O. 322, York

Relating quantum discord with the quantum dense coding capacity

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

Wang, Xin; Qiu, Liang, E-mail: lqiu@cumt.edu.cn; Li, Song

2015-01-15

We establish the relations between quantum discord and the quantum dense coding capacity in (n + 1)-particle quantum states. A necessary condition for the vanishing discord monogamy score is given. We also find that the loss of quantum dense coding capacity due to decoherence is bounded below by the sum of quantum discord. When these results are restricted to three-particle quantum states, some complementarity relations are obtained.

Using clinical vignettes to assess doctors' and medical students' ability to identify sociocultural factors affecting health and health care.

PubMed

Hudelson, Patricia; Perron, N Junod; Perneger, Thomas

2011-01-01

Methods are needed for assessing clinicians' cultural knowledge frameworks. We used a mail survey containing four short clinical vignettes to explore respondents' ability to identify sociocultural factors affecting health and health care. Participants included 299 physicians working at the University Hospitals of Geneva, 156 private physicians, and all 134 local medical students in their clinical years. Twenty-one sociocultural "domains" were identified through inductive coding of responses. For each vignette, we obtained the sum of codes as a measure of the respondent's awareness of sociocultural factors that might affect care in this particular situation. As internal consistency was reasonably high (0.68), we computed a single total score as the sum of responses given to all four vignettes. Reponses correlated with factors that might be expected to impact clinicians' awareness of sociocultural factors affecting care. Medical students, females, respondents who had received cultural competence training, those with greater interest in caring for immigrant patients, and those with high self-assessed skills at exploring psychosocial and migration-related issues scored higher on the vignettes. Brief clinical vignettes appear to be a relevant and feasible method for exploring physicians' knowledge of social and cultural factors affecting health and health care.

Symptomatic Pectus Excavatum in Seniors: An Exploratory Study on Clinical Presentation and Incidence in Daily Practice

PubMed Central

Winkens, Ron A. G.; Guldemond, Frank I.; Hoppener, Paul F. H. M.; Kragten, Hans A.; Knottnerus, J. Andre

2013-01-01

Objectives. Doctors all over the world consider a pectus excavatum usually as an incidental finding. There is some evidence suggesting that a pectus excavatum may cause symptoms in the elderly. It is not known how often a pectus excavatum occurs and how strong the relation is with symptoms. Methods. In hospitals and general practice data, we searched for evidence of a connection between cardiac symptoms and the presence of a pectus excavatum in a retrospective survey among patients in whom a pectus excavatum was found in a chest X-ray. In radiology reports, we searched for “pectus excavat∗ ” in almost 160000 chest X-rays. The identified X-rays were reviewed by 2 radiologists. Reported symptoms were combined to a severity sum score and the relation with pectus excavatum was assessed through logistic regression. Results. Pectus excavatum was found in 1 to 2 per 1000 chest X-rays. In 32% of patients (N = 117), we found symptoms that might reflect the presence of symptomatic pectus excavatum. We found a significant relation between the SPES sum score and the radiological level of pectus excavatum. Conclusions. A pectus excavatum found when examining the patient should not be neglected and should be considered as a possible explanation for symptoms like dyspnoea, fatigue, or palpitations. PMID:24982857

5 CFR 831.682 - Election by a retiree who retired before May 7, 1985, to provide a former spouse annuity.

Code of Federal Regulations, 2014 CFR

2014-01-01

... annuity, the retiree must deposit an amount equal to the sum of the monthly differences between the self... annual interest, computed under § 831.105, from the date to which each monthly difference is attributable... amount equal to the sum of the monthly differences between the self-only annuity and the amount of...

5 CFR 831.682 - Election by a retiree who retired before May 7, 1985, to provide a former spouse annuity.

Code of Federal Regulations, 2011 CFR

2011-01-01

... annuity, the retiree must deposit an amount equal to the sum of the monthly differences between the self... annual interest, computed under § 831.105, from the date to which each monthly difference is attributable... amount equal to the sum of the monthly differences between the self-only annuity and the amount of...

5 CFR 831.682 - Election by a retiree who retired before May 7, 1985, to provide a former spouse annuity.

Code of Federal Regulations, 2013 CFR

2013-01-01

... annuity, the retiree must deposit an amount equal to the sum of the monthly differences between the self... annual interest, computed under § 831.105, from the date to which each monthly difference is attributable... amount equal to the sum of the monthly differences between the self-only annuity and the amount of...

5 CFR 831.682 - Election by a retiree who retired before May 7, 1985, to provide a former spouse annuity.

Code of Federal Regulations, 2010 CFR

2010-01-01

... annuity, the retiree must deposit an amount equal to the sum of the monthly differences between the self... annual interest, computed under § 831.105, from the date to which each monthly difference is attributable... amount equal to the sum of the monthly differences between the self-only annuity and the amount of...

5 CFR 831.682 - Election by a retiree who retired before May 7, 1985, to provide a former spouse annuity.

Code of Federal Regulations, 2012 CFR

2012-01-01

... annuity, the retiree must deposit an amount equal to the sum of the monthly differences between the self... annual interest, computed under § 831.105, from the date to which each monthly difference is attributable... amount equal to the sum of the monthly differences between the self-only annuity and the amount of...

The reliability of the Glasgow Coma Scale: a systematic review.

PubMed

Reith, Florence C M; Van den Brande, Ruben; Synnot, Anneliese; Gruen, Russell; Maas, Andrew I R

2016-01-01

The Glasgow Coma Scale (GCS) provides a structured method for assessment of the level of consciousness. Its derived sum score is applied in research and adopted in intensive care unit scoring systems. Controversy exists on the reliability of the GCS. The aim of this systematic review was to summarize evidence on the reliability of the GCS. A literature search was undertaken in MEDLINE, EMBASE and CINAHL. Observational studies that assessed the reliability of the GCS, expressed by a statistical measure, were included. Methodological quality was evaluated with the consensus-based standards for the selection of health measurement instruments checklist and its influence on results considered. Reliability estimates were synthesized narratively. We identified 52 relevant studies that showed significant heterogeneity in the type of reliability estimates used, patients studied, setting and characteristics of observers. Methodological quality was good (n = 7), fair (n = 18) or poor (n = 27). In good quality studies, kappa values were ≥0.6 in 85%, and all intraclass correlation coefficients indicated excellent reliability. Poor quality studies showed lower reliability estimates. Reliability for the GCS components was higher than for the sum score. Factors that may influence reliability include education and training, the level of consciousness and type of stimuli used. Only 13% of studies were of good quality and inconsistency in reported reliability estimates was found. Although the reliability was adequate in good quality studies, further improvement is desirable. From a methodological perspective, the quality of reliability studies needs to be improved. From a clinical perspective, a renewed focus on training/education and standardization of assessment is required.

ERβ Expression and Breast Cancer Risk Prediction for Women with Atypias

PubMed Central

Hieken, Tina J; Carter, Jodi M; Hawse, John R; Hoskin, Tanya L; Bois, Melanie; Frost, Marlene; Hartmann, Lynn C; Radisky, Derek C; Visscher, Daniel W; Degnim, Amy C

2015-01-01

Estrogen receptor beta (ERβ) is highly expressed in normal breast epithelium and a putative tumor suppressor. Atypical hyperplasia substantially increases breast cancer risk, but identification of biomarkers to further improve risk stratification is needed. We evaluated ERβ expression in breast tissues from women with atypical hyperplasia and association with subsequent breast cancer risk. ERβ expression was examined by immunohistochemistry in a well-characterized 171 women cohort with atypical hyperplasia diagnosed 1967–1991. Nuclear ERβ percent and intensity was scored in the atypia and adjacent normal lobules. An ERβ sum score (percent + intensity) was calculated and grouped as low, moderate or high. Competing risks regression was used to assess associations of ERβ expression with breast cancer risk. After 15 years median follow-up, 36 women developed breast cancer. ERβ expression was lower in atypia lobules than normal lobules, by percent staining and intensity (both p<0.001). Higher ERβ expression in the atypia or normal lobules, evaluated by percent staining, intensity or sum score, decreased the risk of subsequent breast cancer by 2 (p=0.04) and 2.5-fold (p=0.006). High normal lobule ERβ expression conferred the strongest protective effect in pre-menopausal women: the 20-year cumulative incidence of breast cancer was 0% for women

Nutritional status in the era of target therapy: poor nutrition is a prognostic factor in non-small cell lung cancer with activating epidermal growth factor receptor mutations.

PubMed

Park, Sehhoon; Park, Seongyeol; Lee, Se-Hoon; Suh, Beomseok; Keam, Bhumsuk; Kim, Tae Min; Kim, Dong-Wan; Kim, Young Whan; Heo, Dae Seog

2016-11-01

Pretreatment nutritional status is an important prognostic factor in patients treated with conventional cytotoxic chemotherapy. In the era of target therapies, its value is overlooked and has not been investigated. The aim of our study is to evaluate the value of nutritional status in targeted therapy. A total of 2012 patients with non-small cell lung cancer (NSCLC) were reviewed and 630 patients with activating epidermal growth factor receptor (EGFR) mutation treated with EGFR tyrosine kinase inhibitor (TKI) were enrolled for the final analysis. Anemia, body mass index (BMI), and prognostic nutritional index (PNI) were considered as nutritional factors. Hazard ratio (HR), progression-free survival (PFS) and overall survival (OS) for each group were calculated by Cox proportional analysis. In addition, scores were applied for each category and the sum of scores was used for survival analysis. In univariable analysis, anemia (HR, 1.29; p = 0.015), BMI lower than 18.5 (HR, 1.98; p = 0.002), and PNI lower than 45 (HR, 1.57; p < 0.001) were poor prognostic factors for PFS. Among them, BMI and PNI were independent in multi-variable analysis. All of these were also significant prognostic values for OS. The higher the sum of scores, the poorer PFS and OS were observed. Pretreatment nutritional status is a prognostic marker in NSCLC patients treated with EGFR TKI. Hence, baseline nutritional status should be more carefully evaluated and adequate nutrition should be supplied to these patients.

Short-term Forecasting of the Prevalence of Trachoma: Expert Opinion, Statistical Regression, versus Transmission Models

PubMed Central

Liu, Fengchen; Porco, Travis C.; Amza, Abdou; Kadri, Boubacar; Nassirou, Baido; West, Sheila K.; Bailey, Robin L.; Keenan, Jeremy D.; Solomon, Anthony W.; Emerson, Paul M.; Gambhir, Manoj; Lietman, Thomas M.

2015-01-01

Background Trachoma programs rely on guidelines made in large part using expert opinion of what will happen with and without intervention. Large community-randomized trials offer an opportunity to actually compare forecasting methods in a masked fashion. Methods The Program for the Rapid Elimination of Trachoma trials estimated longitudinal prevalence of ocular chlamydial infection from 24 communities treated annually with mass azithromycin. Given antibiotic coverage and biannual assessments from baseline through 30 months, forecasts of the prevalence of infection in each of the 24 communities at 36 months were made by three methods: the sum of 15 experts’ opinion, statistical regression of the square-root-transformed prevalence, and a stochastic hidden Markov model of infection transmission (Susceptible-Infectious-Susceptible, or SIS model). All forecasters were masked to the 36-month results and to the other forecasts. Forecasts of the 24 communities were scored by the likelihood of the observed results and compared using Wilcoxon’s signed-rank statistic. Findings Regression and SIS hidden Markov models had significantly better likelihood than community expert opinion (p = 0.004 and p = 0.01, respectively). All forecasts scored better when perturbed to decrease Fisher’s information. Each individual expert’s forecast was poorer than the sum of experts. Interpretation Regression and SIS models performed significantly better than expert opinion, although all forecasts were overly confident. Further model refinements may score better, although would need to be tested and compared in new masked studies. Construction of guidelines that rely on forecasting future prevalence could consider use of mathematical and statistical models. PMID:26302380

Short-term Forecasting of the Prevalence of Trachoma: Expert Opinion, Statistical Regression, versus Transmission Models.

PubMed

Liu, Fengchen; Porco, Travis C; Amza, Abdou; Kadri, Boubacar; Nassirou, Baido; West, Sheila K; Bailey, Robin L; Keenan, Jeremy D; Solomon, Anthony W; Emerson, Paul M; Gambhir, Manoj; Lietman, Thomas M

2015-08-01

Trachoma programs rely on guidelines made in large part using expert opinion of what will happen with and without intervention. Large community-randomized trials offer an opportunity to actually compare forecasting methods in a masked fashion. The Program for the Rapid Elimination of Trachoma trials estimated longitudinal prevalence of ocular chlamydial infection from 24 communities treated annually with mass azithromycin. Given antibiotic coverage and biannual assessments from baseline through 30 months, forecasts of the prevalence of infection in each of the 24 communities at 36 months were made by three methods: the sum of 15 experts' opinion, statistical regression of the square-root-transformed prevalence, and a stochastic hidden Markov model of infection transmission (Susceptible-Infectious-Susceptible, or SIS model). All forecasters were masked to the 36-month results and to the other forecasts. Forecasts of the 24 communities were scored by the likelihood of the observed results and compared using Wilcoxon's signed-rank statistic. Regression and SIS hidden Markov models had significantly better likelihood than community expert opinion (p = 0.004 and p = 0.01, respectively). All forecasts scored better when perturbed to decrease Fisher's information. Each individual expert's forecast was poorer than the sum of experts. Regression and SIS models performed significantly better than expert opinion, although all forecasts were overly confident. Further model refinements may score better, although would need to be tested and compared in new masked studies. Construction of guidelines that rely on forecasting future prevalence could consider use of mathematical and statistical models. Clinicaltrials.gov NCT00792922.

Late post-AVR progression of bicuspid aortopathy: link to hemodynamics.

PubMed

Naito, Shiho; Gross, Tatiana; Disha, Kushtrim; von Kodolitsch, Yskert; Reichenspurner, Hermann; Girdauskas, Evaldas

2017-05-01

The ascending aortic dilatation may progress after aortic valve replacement (AVR) in bicuspid aortic valve (BAV) patients. Our aim was to evaluate rheological flow patterns and histological characteristics of the aneurysmal aorta in BAV patients at the time of reoperative aortic surgery. 13 patients (mean age: 42 ± 9 years, 10 (77%) male) with significant progression of proximal aortopathy after isolated AVR surgery for BAV disease (i.e., 16.7 ± 8.1 years post-AVR) were identified by cardiac phase-contrast cine magnetic resonance imaging (MRI) in our hospital. A total of nine patients (69%) underwent redo aortic surgery. Based on the MRI data, the aortic area of the maximal flow-induced stress (jet sample) and the opposite site (control sample) were identified and corresponding samples were collected intraoperatively. Histological sum-score values [i.e. aortic wall changes were graded based on a summation of seven histological criteria (each scored from 0 to 3)] were compared between these samples. Mean proximal aortic diameter at MRI follow-up was 55 ± 6 mm (range 47-66mm). Preoperative cardiac MRI demonstrated eccentric systolic flow pattern directed towards right-lateral/right posterior wall of the proximal aorta in 9/13 (69%) patients. Histological sum-score values were significantly higher in the jet sample vs control sample (i.e., 8.3 ± 3.8 vs 5.6 ± 2.4, respectively, p = 0.04). Hemodynamic factors may still be involved in the late progression of bicuspid aortopathy even after isolated AVR surgery for BAV disease.

Compton Scattering and Photo-absorption Sum Rules on Nuclei

NASA Astrophysics Data System (ADS)

Gorshteyn, Mikhail; Hobbs, Timothy; Londergan, J. Timothy; Szczepaniak, Adam P.

2012-03-01

We revisit the photo-absorption sum rule for real Compton scattering from the proton and from nuclear targets. In analogy with the Thomas-Reiche-Kuhn sum rule appropriate at low energies, we propose a new ``constituent quark model'' sum rule that relates the integrated strength of hadronic resonances to the scattering amplitude on constituent quarks. We study the constituent quark model sum rule for several nuclear targets. In addition we extract the J=0 pole contribution for both proton and nuclei. Using the modern high energy proton data we find that the J=0 pole contribution differs significantly from the Thomson term, in contrast with the original findings by Damashek and Gilman. We discuss phenomenological implications of this new result.

Prediction and analysis of protein solubility using a novel scoring card method with dipeptide composition

PubMed Central

2012-01-01

Background Existing methods for predicting protein solubility on overexpression in Escherichia coli advance performance by using ensemble classifiers such as two-stage support vector machine (SVM) based classifiers and a number of feature types such as physicochemical properties, amino acid and dipeptide composition, accompanied with feature selection. It is desirable to develop a simple and easily interpretable method for predicting protein solubility, compared to existing complex SVM-based methods. Results This study proposes a novel scoring card method (SCM) by using dipeptide composition only to estimate solubility scores of sequences for predicting protein solubility. SCM calculates the propensities of 400 individual dipeptides to be soluble using statistic discrimination between soluble and insoluble proteins of a training data set. Consequently, the propensity scores of all dipeptides are further optimized using an intelligent genetic algorithm. The solubility score of a sequence is determined by the weighted sum of all propensity scores and dipeptide composition. To evaluate SCM by performance comparisons, four data sets with different sizes and variation degrees of experimental conditions were used. The results show that the simple method SCM with interpretable propensities of dipeptides has promising performance, compared with existing SVM-based ensemble methods with a number of feature types. Furthermore, the propensities of dipeptides and solubility scores of sequences can provide insights to protein solubility. For example, the analysis of dipeptide scores shows high propensity of α-helix structure and thermophilic proteins to be soluble. Conclusions The propensities of individual dipeptides to be soluble are varied for proteins under altered experimental conditions. For accurately predicting protein solubility using SCM, it is better to customize the score card of dipeptide propensities by using a training data set under the same specified experimental conditions. The proposed method SCM with solubility scores and dipeptide propensities can be easily applied to the protein function prediction problems that dipeptide composition features play an important role. Availability The used datasets, source codes of SCM, and supplementary files are available at http://iclab.life.nctu.edu.tw/SCM/. PMID:23282103

Exact sum rules for inhomogeneous strings

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

Amore, Paolo, E-mail: paolo.amore@gmail.com

2013-11-15

We derive explicit expressions for the sum rules of the eigenvalues of inhomogeneous strings with arbitrary density and with different boundary conditions. We show that the sum rule of order N may be obtained in terms of a diagrammatic expansion, with (N−1)!/2 independent diagrams. These sum rules are used to derive upper and lower bounds to the energy of the fundamental mode of an inhomogeneous string; we also show that it is possible to improve these approximations taking into account the asymptotic behavior of the spectrum and applying the Shanks transformation to the sequence of approximations obtained to the differentmore » orders. We discuss three applications of these results. -- Highlights: •We derive an explicit expression for the sum rules of an inhomogeneous string. •We obtain a diagrammatic representation for the sum rules of a given order. •We obtain precise bounds on the lowest eigenvalue of the string.« less

Sum-Frequency Generation from a Thin Cylindrical Layer

NASA Astrophysics Data System (ADS)

Shamyna, A. A.; Kapshai, V. N.

2018-01-01

In the Rayleigh-Gans-Debye approximation, we have solved the problem of the sum-frequency generation by two plane elliptically polarized electromagnetic waves from the surface of a dielectric particle of a cylindrical shape that is coated by a thin layer possessing nonlinear optical properties. The formulas that describe the sum-frequency field have been presented in the tensor and vector forms for the second-order nonlinear dielectric susceptibility tensor, which was chosen in the general form, containing chiral components. Expressions describing the sum-frequency field from the cylindrical particle ends have been obtained for the case of a nonlinear layer possessing chiral properties. Three-dimensional directivity patterns of the sum-frequency radiation have been analyzed for different combinations of parameters (angles of incidence, degrees of ellipticity, orientations of polarization ellipses, cylindrical particle dimensions). The mathematical properties of the spatial distribution functions of the sum-frequency field, which characterize the symmetry of directivity patterns, have been revealed.

Evaluating the articulation index for auditory-visual input.

PubMed

Grant, K W; Braida, L D

1991-06-01

An investigation of the auditory-visual (AV) articulation index (AI) correction procedure outlined in the ANSI standard [ANSI S3.5-1969 (R1986)] was made by evaluating auditory (A), visual (V), and auditory-visual sentence identification for both wideband speech degraded by additive noise and a variety of bandpass-filtered speech conditions presented in quiet and in noise. When the data for each of the different listening conditions were averaged across talkers and subjects, the procedure outlined in the standard was fairly well supported, although deviations from the predicted AV score were noted for individual subjects as well as individual talkers. For filtered speech signals with AIA less than 0.25, there was a tendency for the standard to underpredict AV scores. Conversely, for signals with AIA greater than 0.25, the standard consistently overpredicted AV scores. Additionally, synergistic effects, where the AIA obtained from the combination of different bandpass-filtered conditions was greater than the sum of the individual AIA's, were observed for all nonadjacent filter-band combinations (e.g., the addition of a low-pass band with a 630-Hz cutoff and a high-pass band with a 3150-Hz cutoff). These latter deviations from the standard violate the basic assumption of additivity stated by Articulation Theory, but are consistent with earlier reports by Pollack [I. Pollack, J. Acoust. Soc. Am. 20, 259-266 (1948)], Licklider [J. C. R. Licklider, Psychology: A Study of a Science, Vol. 1, edited by S. Koch (McGraw-Hill, New York, 1959), pp. 41-144], and Kryter [K. D. Kryter, J. Acoust. Soc. Am. 32, 547-556 (1960)].

[The development of musicality in children after cochlear implantation].

PubMed

Zheng, Yan; Liu, Bo; Dong, Ruijuan; Xu, Tianqiu; Chen, Jing; Chen, Xuejing; Zhong, Yan; Meng, Chao; Wang, Hong; Chen, Xueqing

2014-08-01

The purpose of this study is to analyze the development of musicality in children after cochlear implantation, and provide a clinical database for the evaluation of their musicality. Twenty-six children with cochlear implants (CI group) participated in this research. They received cochlear implants at the age of 11 to 68 months with a mean of 35.6 months. Seventy-six infants as a control group aged from 1 to 24 months with a mean of 6.1 months participated in this study, whose hearing were considered normal by passing the case history collection, high-risk registers for hearing loss and hearing screening using DPOAE. The music and young children with CIs: Musicality Rating Scale was used to evaluate their musicality. The evaluation was performed before cochlear implantation and 1, 3, 6, 9, 12, 24 months after cochlear implantation for children with cochlear implants. The evaluation was also performed at 1, 3, 6, 9, 12, 24 months for children with normal hearing. The mean scores of musicality showed significant improvements with time of CI use for CI group (P<0.05). The mean scores of musicality also showed significant improvements with time for control group (P<0.05). There were no significant differences in mean scores between CI group and control group at 1, 3, 6, 9, 12 months of hearing age by rank sum test (P>0.05). Significant difference was noted between the two groups at 24 months (P<0.05). The musicality of children with cochlear implants improved significantly with time after cochlear implantation. The most rapid growth was found in the first year after cochlear implantation.

Different odor tests contribute differently to the evaluation of olfactory loss.

PubMed

Lötsch, Jörn; Reichmann, Heinz; Hummel, Thomas

2008-01-01

In a clinical context, the importance of the sense of smell has increasingly been recognized, for example, in terms of the evaluation of neurodegenerative disorders. In this study, 2 strategies of olfactory testing, a simple one and a more complex one, were compared with respect to their suitability to assess olfactory dysfunction. Odor threshold (T), discrimination (D), and identification (I) were assessed in a control sample of 916 males and 1160 females, aged 6-90 years, and in 81 men and 21 women, aged 38-80 years, suffering from idiopathic Parkinson's disease (IPD). Sums of the 3 subtest results T, D, and I yielded threshold discrimination identification (TDI) scores reflecting olfactory function. Sensitivity of any of the 3 subtests to confirm the diagnosis established by the composite TDI score was assessed separately for each test. Principal component analyses were applied to determine any common source of variance among the 3 specific subtests. Sensitivities of the subtests to provide the diagnosis established by the composite TDI score were 64% (T), 56% (D), and 47% (I), respectively. In IPD patients, each of the subtests provided the correct diagnosis (sensitivity >90%), as olfaction was impaired in 99% of the patient group. Two principal components emerged in both controls and IPD patients, with eigenvalues >0.5. The first component received high loadings from all factors. The second component received high loadings from odor threshold, whereas loadings from odor discrimination and identification were much smaller. In conclusion, combined testing of several components of olfaction, especially including assessment of thresholds, provides the most significant approach to the diagnosis of smell loss.

“Caregiver Acceptability and Preferences for Early Childhood Caries Preventive Treatments for Hispanic Children”

PubMed Central

Adams, Sally H.; Hyde, Susan; Gansky, Stuart A.

2011-01-01

Objective Determine caregiver treatment acceptability and preferences for five preventive dental treatments for early childhood caries (ECC) in young Hispanic children. Methods We interviewed 211 parents/caregivers of Hispanic children attending Head Start programs regarding their acceptability of and preferences for five standard preventive dental treatments for young children. Treatments assessed were: toothbrushing with fluoride toothpaste, fluoride varnish, xylitol in food for children; and xylitol gum and chlorhexidine rinse for mothers. The interview assessment included presentation of: illustrated cards with verbal description of treatment; picture/video clip; and treatment samples. Parents rated the acceptability of each treatment (1-5 scale) and treatment preferences within each of 10 possible pairs. Individual treatment preferences were summed to create overall preference scores (range 0–4). Results All treatments were rated as highly acceptable, however there were differences (range 4.6-4.9; Friedman Chi Square = 23.4, p< 0.001). Chlorhexidine, toothbrushing, and varnish were most acceptable, not different from each other, but more acceptable than xylitol in food (p< 0.05). Summed treatment preferences revealed greater variability (means ranged 1.4-2.6; Friedman Chi Square=128.2, p< 0.001). Fluoride varnish (2.6) and toothbrushing (2.5) were most highly preferred, and differences between preferences for xylitol in food (1.4), xylitol gum (1.5) and chlorhexidine (2.1) were all significant, p < 0.001. Preferences for chlorhexidine were also significantly greater than those for the xylitol products (p < 0.001). Conclusions All 5 treatments were highly acceptable, however when choosing among treatments overall, fluoride varnish and toothbrushing were favored over other treatments. PMID:19486461