Gardner, Andrew; Forson, Paa Kobina; Oduro, George; Stewart, Barclay; Dike, Nkechi; Glover, Paul; Maio, Ronald F
The Kampala Trauma Score (KTS) has been proposed as a triage tool for use in low- and middle-income countries (LMICs). This study aimed to examine the diagnostic accuracy of KTS in predicting emergency department outcomes using timely injury estimation with Abbreviated Injury Scale (AIS) score and physician opinion to calculate KTS scores. This was a diagnostic accuracy study of KTS among injured patients presenting to Komfo Anokye Teaching Hospital A&E, Ghana. South African Triage Scale (SATS); KTS component variables, including AIS scores and physician opinion for serious injury quantification; and ED disposition were collected. Agreement between estimated AIS score and physician opinion were analyzed with normal, linear weighted, and maximum kappa. Receiver operating characteristic (ROC) analysis of KTS-AIS and KTS-physician opinion was performed to evaluate each measure's ability to predict A&E mortality and need for hospital admission to the ward or theatre. A total of 1053 patients were sampled. There was moderate agreement between AIS criteria and physician opinion by normal (κ=0.41), weighted (κ lin =0.47), and maximum (κ max =0.53) kappa. A&E mortality ROC area for KTS-AIS was 0.93, KTS-physician opinion 0.89, and SATS 0.88 with overlapping 95% confidence intervals (95%CI). Hospital admission ROC area for KTS-AIS was 0.73, KTS-physician opinion 0.79, and SATS 0.71 with statistical similarity. When evaluating only patients with serious injuries, KTS-AIS (ROC 0.88) and KTS-physician opinion (ROC 0.88) performed similarly to SATS (ROC 0.78) in predicting A&E mortality. The ROC area for KTS-AIS (ROC 0.71; 95%CI 0.66-0.75) and KTS-physician opinion (ROC 0.74; 95%CI 0.69-0.79) was significantly greater than SATS (ROC 0.57; 0.53-0.60) with regard to need for admission. KTS predicted mortality and need for admission from the ED well when early estimation of the number of serious injuries was used, regardless of method (i.e. AIS criteria or physician opinion
KINGMA, J; TENVERGERT, E; WERKMAN, HA; TENDUIS, HJ; KLASEN, HJ
Diagnoses of injuries as a result Of trauma are commonly coded by means of the International Classification of Diseases (9th rev.) Clinical Modification (ICD-9CM). The Abbreviated Injury Scale (AIS) is frequently employed to assess the severity of injury per body region. The Injury Severity Score
One of the more often used measures of multiple injuries is the injury severity score (ISS). Determination of the ISS is based on the abbreviated injury scale (AIS). This paper suggests a new algorithm to sort the AISs for each case and calculate ISS. The program uses unsorted abbreviated injury scale (AIS) levels for each case and rearranges them in descending order. The first three sorted AISs representing the three most severe injuries of a person are then used to calculate injury severity score (ISS). This algorithm should be useful for analyses of clusters of injuries especially when more patients have multiple injuries.
R.M. Emanuel (Robyn); A.C. Dueck (Amylou); H.L. Geyer (Holly); J.J. Kiladjian; S. Slot (Stefanie); S. Zweegman (Sonja); P.A.W. te Boekhorst (Peter); S. Commandeur (Suzan); H. Schouten (Harry); F. Sackmann (Federico); A.K. Fuentes (Ana Kerguelen); D. Hernández-Maraver (Dolores); C. Pahl (Clemens); M. Griesshammer (Martin); F. Stegelmann (Frank); K. Doehner (Konstanze); T. Lehmann (Thomas); K. Bonatz (Karin); A. Reiter (Alfred); F. Boyer (Francoise); J. Etienne (Jerome); J.-C. Ianotto (Jean-Christophe); D. Ranta (Dana); L. Roy (Lydia); J.-Y. Cahn (Jean-Yves); C.N. Harrison (Claire); D. Radia (Deepti); P. Muxi (Pablo); N. Maldonado (Norman); C. Besses (Carlos); F. Cervantes (Francisco); P.L. Johansson (Peter); T. Barbui (Tiziano); G. Barosi (Giovanni); A.M. Vannucchi (Alessandro); F. Passamonti (Francesco); B. Andreasson (Bjorn); M.L. Ferarri (Maria); A. Rambaldi (Alessandro); J. Samuelsson (Jan); G. Birgegard (Gunnar); A. Tefferi (Ayalew); A.A. Mesa
textabstractPurpose: Myeloproliferative neoplasm (MPN) symptoms are troublesome to patients, and alleviation of this burden represents a paramount treatment objective in the development of MPN-directed therapies. We aimed to assess the utility of an abbreviated symptom score for the most pertinent
Full Text Available The present study reports the psychometric properties of a short measure of self-leadership in the Turkish context: the Abbreviated Self-Leadership Questionnaire (ASLQ. The ASLQ was examined using two samples and showed sound psychometric properties. Confirmatory factor analysis showed that nine-item ASLQ measured a single construct of self-leadership. The results supported the convergent and discriminant validity of the one-factor model of the ASLQ in relation to the 35-item Revised Self-Leadership Questionnaire and General Self-Efficacy scale, respectively. With regard to internal consistency and test-retest reliability, the ASLQ showed acceptable results. Furthermore, the results provided evidence that scores on the ASLQ positively predicted individual's self-reported task performance and self-efficacy mediated this relationship. Taken together, these findings suggest that the Turkish version of the ASLQ is a reliable and valid measure that can be used to measure self-leadership as one variable of interest in the future studies.
Hagiwara, Shuichi; Oshima, Kiyohiro; Murata, Masato; Kaneko, Minoru; Aoki, Makoto; Kanbe, Masahiko; Nakamura, Takuro; Ohyama, Yoshio; Tamura, Jun'ichi
To determine the formula that predicts the injury severity score from parameters that are obtained in the emergency department at arrival. We reviewed the medical records of trauma patients who were transferred to the emergency department of Gunma University Hospital between January 2010 and December 2010. The injury severity score, age, mean blood pressure, heart rate, Glasgow coma scale, hemoglobin, hematocrit, red blood cell count, platelet count, fibrinogen, international normalized ratio of prothrombin time, activated partial thromboplastin time, and fibrin degradation products, were examined in those patients on arrival. To determine the formula that predicts the injury severity score, multiple linear regression analysis was carried out. The injury severity score was set as the dependent variable, and the other parameters were set as candidate objective variables. IBM spss Statistics 20 was used for the statistical analysis. Statistical significance was set at P Watson ratio was 2.200. A formula for predicting the injury severity score in trauma patients was developed with ordinary parameters such as fibrin degradation products and mean blood pressure. This formula is useful because we can predict the injury severity score easily in the emergency department.
Full Text Available Abstract Many injury severity scoring tools have been developed over the past few decades. These tools include the Injury Severity Score (ISS, New ISS (NISS, Trauma and Injury Severity Score (TRISS and International Classification of Diseases (ICD-based Injury Severity Score (ICISS. Although many studies have endeavored to determine the ability of these tools to predict the mortality of injured patients, their results have been inconsistent. We conducted a systematic review to summarize the predictive performances of these tools and explore the heterogeneity among studies. We defined a relevant article as any research article that reported the area under the Receiver Operating Characteristic curve as a measure of predictive performance. We conducted an online search using MEDLINE and Embase. We evaluated the quality of each relevant article using a quality assessment questionnaire consisting of 10 questions. The total number of positive answers was reported as the quality score of the study. Meta-analysis was not performed due to the heterogeneity among studies. We identified 64 relevant articles with 157 AUROCs of the tools. The median number of positive answers to the questionnaire was 5, ranging from 2 to 8. Less than half of the relevant studies reported the version of the Abbreviated Injury Scale (AIS and/or ICD (37.5%. The heterogeneity among the studies could be observed in a broad distribution of crude mortality rates of study data, ranging from 1% to 38%. The NISS was mostly reported to perform better than the ISS when predicting the mortality of blunt trauma patients. The relative performance of the ICSS against the AIS-based tools was inconclusive because of the scarcity of studies. The performance of the ICISS appeared to be unstable because the performance could be altered by the type of formula and survival risk ratios used. In conclusion, high-quality studies were limited. The NISS might perform better in the mortality prediction
Collins, N J; Prinsen, C A C; Christensen, R
in participants with knee injuries and/or osteoarthritis (OA). Methodological quality was evaluated using the COSMIN checklist. Where possible, meta-analysis of extracted data was conducted for all studies and stratified by age and knee condition; otherwise narrative synthesis was performed. RESULTS: KOOS has...... adequate internal consistency, test-retest reliability and construct validity in young and old adults with knee injuries and/or OA. The ADL subscale has better content validity for older patients and Sport/Rec for younger patients with knee injuries, while the Pain subscale is more relevant for painful......OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties...
Sears, Jeanne M; Blanar, Laura; Bowman, Stephen M
Acute work-related trauma is a leading cause of death and disability among U.S. workers. Occupational health services researchers have described the pressing need to identify valid injury severity measures for purposes such as case-mix adjustment and the construction of appropriate comparison groups in programme evaluation, intervention, quality improvement, and outcome studies. The objective of this study was to compare the performance of several injury severity scores and scoring methods in the context of predicting work-related disability and medical cost outcomes. Washington State Trauma Registry (WTR) records for injuries treated from 1998 to 2008 were linked with workers' compensation claims. Several Abbreviated Injury Scale (AIS)-based injury severity measures (ISS, New ISS, maximum AIS) were estimated directly from ICD-9-CM codes using two software packages: (1) ICDMAP-90, and (2) Stata's user-written ICDPIC programme (ICDPIC). ICDMAP-90 and ICDPIC scores were compared with existing WTR scores using the Akaike Information Criterion, amount of variance explained, and estimated effects on outcomes. Competing risks survival analysis was used to evaluate work disability outcomes. Adjusted total medical costs were modelled using linear regression. The linked sample contained 6052 work-related injury events. There was substantial agreement between WTR scores and those estimated by ICDMAP-90 (kappa=0.73), and between WTR scores and those estimated by ICDPIC (kappa=0.68). Work disability and medical costs increased monotonically with injury severity, and injury severity was a significant predictor of work disability and medical cost outcomes in all models. WTR and ICDMAP-90 scores performed better with regard to predicting outcomes than did ICDPIC scores, but effect estimates were similar. Of the three severity measures, maxAIS was usually weakest, except when predicting total permanent disability. Injury severity was significantly associated with work disability
Emanuel, Robyn M.; Dueck, Amylou C.; Geyer, Holly L.; Kiladjian, Jean-Jacques; Slot, Stefanie; Zweegman, Sonja; te Boekhorst, Peter A.W.; Commandeur, Suzan; Schouten, Harry C.; Sackmann, Federico; Kerguelen Fuentes, Ana; Hernández-Maraver, Dolores; Pahl, Heike L.; Griesshammer, Martin; Stegelmann, Frank; Doehner, Konstanze; Lehmann, Thomas; Bonatz, Karin; Reiter, Andreas; Boyer, Francoise; Etienne, Gabriel; Ianotto, Jean-Christophe; Ranta, Dana; Roy, Lydia; Cahn, Jean-Yves; Harrison, Claire N.; Radia, Deepti; Muxi, Pablo; Maldonado, Norman; Besses, Carlos; Cervantes, Francisco; Johansson, Peter L.; Barbui, Tiziano; Barosi, Giovanni; Vannucchi, Alessandro M.; Passamonti, Francesco; Andreasson, Bjorn; Ferarri, Maria L.; Rambaldi, Alessandro; Samuelsson, Jan; Birgegard, Gunnar; Tefferi, Ayalew; Mesa, Ruben A.
Purpose Myeloproliferative neoplasm (MPN) symptoms are troublesome to patients, and alleviation of this burden represents a paramount treatment objective in the development of MPN-directed therapies. We aimed to assess the utility of an abbreviated symptom score for the most pertinent and representative MPN symptoms for subsequent serial use in assessing response to therapy. Patients and Methods The Myeloproliferative Neoplasm Symptom Assessment Form total symptom score (MPN-SAF TSS) was calculated as the mean score for 10 items from two previously validated scoring systems. Questions focus on fatigue, concentration, early satiety, inactivity, night sweats, itching, bone pain, abdominal discomfort, weight loss, and fevers. Results MPN-SAF TSS was calculable for 1,408 of 1,433 patients with MPNs who had a mean score of 21.2 (standard deviation [SD], 16.3). MPN-SAF TSS results significantly differed among MPN disease subtypes (P < .001), with a mean of 18.7 (SD, 15.3), 21.8 (SD, 16.3), and 25.3 (SD, 17.2) for patients with essential thrombocythemia, polycythemia vera, and myelofibrosis, respectively. The MPN-SAF TSS strongly correlated with overall quality of life (QOL; r = 0.59; P < .001) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) functional scales (all P < .001 and absolute r ≥ 0.50 except social functioning r = 0.48). No significant trends were present when comparing therapy subgroups. The MPN-SAF TSS had excellent internal consistency (Cronbach's α = .83). Factor analysis identified a single underlying construct, indicating that the MPN-SAF TSS is an appropriate, unified scoring method. Conclusion The MPN-SAF TSS is a concise, valid, and accurate assessment of MPN symptom burden with demonstrated clinical utility in the largest prospective MPN symptom study to date. This new prospective scoring method may be used to assess MPN symptom burden in both clinical practice and trial settings. PMID
Coelho, Filipe Utuari de Andrade; Watanabe, Mirian; Fonseca, Cassiane Dezoti da; Padilha, Katia Grillo; Vattimo, Maria de Fátima Fernandes
to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI). A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively. A total of 190 patients were included. Patients who developed AKI (44.2%) had higher NAS when compared to those without AKI (43.7% vs 40.7%), p terapia intensiva com lesão renal aguda (LRA). estudo quantitativo, em Unidade de Terapia Intensiva, no período de abril a agosto de 2015. O Nursing Activities Score (NAS) e o Kidney Disease Improving Global Outcomes (KDIGO) foram utilizados para medir a carga de trabalho de enfermagem e classificar o estágio da LRA, respectivamente. foram incluídos 190 pacientes. Os pacientes que desenvolveram LRA (44,2%) possuíam NAS superiores quando comparados aos sem LRA (43,7% vs 40,7%), p<0,001. Os pacientes com LRA nos estágios 1, 2 e 3 de LRA demonstraram NAS superiores aos sem LRA, houve relação entre os estágios 2 e 3 com os sem LRA, p=0,002 e p<0,001. o NAS apresentou associação com a existência de LRA, visto que seu valor aumenta com a progressão dos estágios, tendo associação com os estágios 2 e 3 de LRA.
Spence, Richard Trafford; Zargaran, Eiman; Hameed, S Morad; Navsaria, Pradeep; Nicol, Andrew
The burden of data collection associated with injury severity scoring has limited its application in areas of the world with the highest incidence of trauma. Since January 2014, electronic records (electronic Trauma Health Records [eTHRs]) replaced all handwritten records at the Groote Schuur Hospital Trauma Unit in South Africa. Data fields required for Glasgow Coma Scale, Revised Trauma Score, Kampala Trauma Score, Injury Severity Score (ISS), and Trauma Score-Injury Severity Score calculations are now prospectively collected. Fifteen months after implementation of eTHR, the injury severity scores were compared as predictors of mortality on three accounts: (1) ability to discriminate (area under receiver operating curve, ROC); (2) ability to calibrate (observed versus expected ratio, O/E); and (3) feasibility of data collection (rate of missing data). A total of 7460 admissions were recorded by eTHR from April 1, 2014 to July 7, 2015, including 770 severely injured patients (ISS > 15) and 950 operations. The mean age was 33.3 y (range 13-94), 77.6% were male, and the mechanism of injury was penetrating in 39.3% of cases. The cohort experienced a mortality rate of 2.5%. Patient reserve predictors required by the scores were 98.7% complete, physiological injury predictors were 95.1% complete, and anatomic injury predictors were 86.9% complete. The discrimination and calibration of Trauma Score-Injury Severity Score was superior for all admissions (ROC 0.9591 and O/E 1.01) and operatively managed patients (ROC 0.8427 and O/E 0.79). In the severely injured cohort, the discriminatory ability of Revised Trauma Score was superior (ROC 0.8315), but no score provided adequate calibration. Emerging mobile health technology enables reliable and sustainable injury severity scoring in a high-volume trauma center in South Africa. Copyright © 2016 Elsevier Inc. All rights reserved.
Brown, Joshua B; Gestring, Mark L; Leeper, Christine M; Sperry, Jason L; Peitzman, Andrew B; Billiar, Timothy R; Gaines, Barbara A
The Injury Severity Score (ISS) is the most commonly used injury scoring system in trauma research and benchmarking. An ISS greater than 15 conventionally defines severe injury; however, no studies evaluate whether ISS performs similarly between adults and children. Our objective was to evaluate ISS and Abbreviated Injury Scale (AIS) to predict mortality and define optimal thresholds of severe injury in pediatric trauma. Patients from the Pennsylvania trauma registry 2000-2013 were included. Children were defined as younger than 16 years. Logistic regression predicted mortality from ISS for children and adults. The optimal ISS cutoff for mortality that maximized diagnostic characteristics was determined in children. Regression also evaluated the association between mortality and maximum AIS in each body region, controlling for age, mechanism, and nonaccidental trauma. Analysis was performed in single and multisystem injuries. Sensitivity analyses with alternative outcomes were performed. Included were 352,127 adults and 50,579 children. Children had similar predicted mortality at ISS of 25 as adults at ISS of 15 (5%). The optimal ISS cutoff in children was ISS greater than 25 and had a positive predictive value of 19% and negative predictive value of 99% compared to a positive predictive value of 7% and negative predictive value of 99% for ISS greater than 15 to predict mortality. In single-system-injured children, mortality was associated with head (odds ratio, 4.80; 95% confidence interval, 2.61-8.84; p 0.05). For multisystem injury, all body region AIS scores were associated with mortality except extremities. Sensitivity analysis demonstrated ISS greater than 23 to predict need for full trauma activation, and ISS greater than 26 to predict impaired functional independence were optimal thresholds. An ISS greater than 25 may be a more appropriate definition of severe injury in children. Pattern of injury is important, as only head and chest injury drive mortality
Full Text Available Abstract Background Injury scoring is important to formulate prognoses for trauma patients. Although scores based on empirical estimation allow for better prediction, those based on expert consensus, e.g. the New Injury Severity Score (NISS are widely used. We describe how the addition of a variable quantifying the number of injuries improves the ability of NISS to predict mortality. Methods We analyzed 2488 injury cases included into the trauma registry of the Italian region Emilia-Romagna in 2006-2008 and assessed the ability of NISS alone, NISS plus number of injuries, and the maximum Abbreviated Injury Scale (AIS to predict in-hospital mortality. Hierarchical logistic regression was used. We measured discrimination through the C statistics, and calibration through Hosmer-Lemeshow statistics, Akaike's information criterion (AIC and calibration curves. Results The best discrimination and calibration resulted from the model with NISS plus number of injuries, followed by NISS alone and then by the maximum AIS (C statistics 0.775, 0.755, and 0.729, respectively; AIC 1602, 1635, and 1712, respectively. The predictive ability of all the models improved after inclusion of age, gender, mechanism of injury, and the motor component of Glasgow Coma Scale (C statistics 0.889, 0.898, and 0.901; AIC 1234, 1174, and 1167. The model with NISS plus number of injuries still showed the best performances, this time with borderline statistical significance. Conclusions In NISS, the same weight is assigned to the three worst injuries, although the contribution of the second and third to the probability of death is smaller than that of the worst one. An improvement of the predictive ability of NISS can be obtained adjusting for the number of injuries.
Stewart, Kenneth E; Cowan, Linda D; Thompson, David M
The Abbreviated Injury Scale (AIS) recently underwent a major revision from AIS 98 to AIS 05. AIS injury codes form the basis of widely used injury severity scores such as the injury severity score (ISS). ISS thresholds are often used in trauma case definitions and ISS is widely used in injury research to adjust for injury severity. This study evaluated changes from AIS 98 to AIS 05, the changes' effect on ISS distributions, and presents an application of the results. Injury descriptions from medical records of 137 randomly selected patients in the Oklahoma Trauma Registry (OTR) were obtained. A single trained coder used AIS 98 and AIS 05 to code each injury. ISS values were calculated and grouped into 4 categories: 1-8, 9-14, 16-24, >24. Paired ISS was compared using Kappa statistics and tests of symmetry. We identified common injury diagnoses for which AIS severity changed between versions. Estimates of the proportion of patients changing ISS groups were applied to the entire OTR to assess the impact on reporting and on a model for reimbursement. OTR AIS 98 and manual AIS 98-based ISS values had a weighted Kappa of 0.71. OTR AIS 98 and manual AIS 05-based ISS values had a Kappa of 0.58. Manual AIS 98 and manual AIS 05 ISS had the highest Kappa of 0.81, however, though the scores differed by only 1 ISS category, there were 30 discordant pairs. The distribution of these discordant pairs was not symmetrical (Bowker's S=30; df=6; p<0.0001) with AIS 05-based ISS values consistently shifted to a lower ISS category. Reductions in AIS severity and ISS values using AIS 05 were common for extremity fractures and thorax injuries. The results suggest fewer patients would be reported to the OTR or be eligible for reimbursement. Changing from AIS 98 to AIS 05 injury coding resulted in systematic changes in AIS codes and ISS. Specific injuries and body regions were differentially affected. Trauma registries and injury researchers that use AIS based injury coding can use this
Andrei F Joaquim
Full Text Available Introduction: The Subaxial Injury Classification (SLIC system and severity score has been developed to help surgeons in the decision-making process of treatment of subaxial cervical spine injuries. A detailed description of all potential scored injures of the SLIC is lacking. Materials and Methods: We performed a systematic review in the PubMed database from 2007 to 2014 to describe the relationship between the scored injuries in the SLIC and their eventual treatment according to the system score. Results: Patients with an SLIC of 1-3 points (conservative treatment are neurologically intact with the spinous process, laminar or small facet fractures. Patients with compression and burst fractures who are neurologically intact are also treated nonsurgically. Patients with an SLIC of 4 points may have an incomplete spinal cord injury such as a central cord syndrome, compression injuries with incomplete neurologic deficits and burst fractures with complete neurologic deficits. SLIC of 5-10 points includes distraction and rotational injuries, traumatic disc herniation in the setting of a neurological deficit and burst fractures with an incomplete neurologic deficit. Conclusion: The SLIC injury severity score can help surgeons guide fracture treatment. Knowledge of the potential scored injures and their relationships with the SLIC are of paramount importance for spine surgeons who treated subaxial cervical spine injuries.
Ay, Nurettin; Alp, Vahhaç; Aliosmanoğlu, İbrahim; Sevük, Utkan; Kaya, Şafak; Dinç, Bülent
This study aims to determine the factors that affect morbidity and mortality in colon and rectum injuries related with trauma, the use of trauma scoring systems in predicting mortality and morbidity. Besides patient demographic characteristics, the mechanism of injury, the time between injury and surgery, accompanying body injuries, admittance Glasgow coma scale (GCS), findings at surgery and treatment methods were also recorded. With the obtained data, the abbreviated injury scale (AIS), injury severity score (ISS), revised trauma score (RTS) and trauma-ISS (TRISS) scores of each patient were calculated by using the 2008 revised AIS. Of the patients, 172 (88.7 %) were male, 22 (11.3 %) were female and the mean age was 29.15 ± 12.392 (15-89) years. The morbidity of our patients were 32 % and mortality were 12.4 %. ISS (p < 0.001), RTS (p < 0.001), and the TRISS (p < 0.001) on mortality were found to be significant. TRISS (p = 0.008), the ISS (p < 0.001), the RTS (p = 0.03), the trauma surgery interval (TSI, p < 0.001) were observed to have significant effects on morbidity. Regression analysis showed that the ISS (OR 1.1; CI 95 % 1.01-1.2; p = 0.02), the RTS (OR 0.37; CI 95 % 0.21-0.67; p = 0.001) had significant effects on mortality. While the effects of TSI (OR 5.3; CI 95 % 1.5-18.8; p = 0.01) on morbidity were found to be significant. Predicting mortality by using scoring systems and close postoperative follow up of patients in the risk group may ensure decreases in the rates of morbidity and mortality.
Roos, Ewa M.; Lohmander, L Stefan
: Pain, other Symptoms, Function in daily living (ADL), Function in Sport and Recreation (Sport/Rec), and knee-related Quality of Life (QOL). The KOOS has been validated for several orthopaedic interventions such as anterior cruciate ligament reconstruction, meniscectomy and total knee replacement......The Knee injury and Osteoarthritis Outcome Score (KOOS) was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales....... In addition the instrument has been used to evaluate physical therapy, nutritional supplementation and glucosamine supplementation. The effect size is generally largest for the subscale QOL followed by the subscale Pain. The KOOS is a valid, reliable and responsive self-administered instrument that can...
Pendlebury, S T; Klaus, S P; Mather, M; de Brito, M; Wharton, R M
Routine cognitive screening for in-patients aged ≥75 years is recommended, but there is uncertainty around how this should be operationalised. We therefore determined the feasibility and reliability of the Abbreviated mental test score (AMTS/10) and its relationship to subjective memory complaint, Montreal Cognitive Assessment (MoCA/30) and informant report in unselected older admissions. Consecutive acute general medicine patients aged ≥75 years admitted over 10 weeks (March-May 2013) had AMTS and a question regarding subjective memory complaint (if no known dementia/delirium). At ≥72 h, the 30-point Montreal Cognitive Assessment (MoCA) and Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) were done. Cognitive impairment was defined as AMTS Subjective memory complaint agreed poorly with objective cognitive deficit (39% denying a memory problem had AMTS well with the MoCA albeit with a ceiling effect. Objective cognitive deficits were prevalent in patients without known dementia or delirium but were not reliably identified by subjective cognitive complaint or informant report. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society.
Shroff, Geeta; Barthakur, Jitendra Kumar
To develop a new scoring system, nutech functional scores (NFS) for assessing the patients with spinal cord injury (SCI). The conventional scale, American Spinal Injury Association's (ASIA) impairment scale is a measure which precisely describes the severity of the SCI. However, it has various limitations which lead to incomplete assessment of SCI patients. We have developed a 63 point scoring system, i . e ., NFS for patients suffering with SCI. A list of symptoms either common or rare that were found to be associated with SCI was recorded for each patient. On the basis of these lists, we have developed NFS. These lists served as a base to prepare NFS, a 63 point positional (each symptom is sub-graded and get points based on position) and directional (moves in direction BAD → GOOD) scoring system. For non-progressive diseases, 1, 2, 3, 4, 5 denote worst, bad, moderate, good and best (normal), respectively. NFS for SCI has been divided into different groups based on the affected part of the body being assessed, i . e ., motor assessment (shoulders, elbow, wrist, fingers-grasp, fingers-release, hip, knee, ankle and toe), sensory assessment, autonomic assessment, bed sore assessment and general assessment. As probability based studies required a range of (-1, 1) or at least the range of (0, 1) to be useful for real world analysis, the grades were converted to respective numeric values. NFS can be considered as a unique tool to assess the improvement in patients with SCI as it overcomes the limitations of ASIA impairment scale.
Aiming at the phenomena that more and more abbreviations occur in maritime English correspondences, the composing laws of the abbreviations in maritime English correspondence are analyzed, and the correct methods to answer the abbreviations are pointed out, and the translation method of abbreviations are summarized in this article, and the…
Roos Ewa M
Full Text Available Abstract The Knee injury and Osteoarthritis Outcome Score (KOOS was developed as an extension of the WOMAC Osteoarthritis Index with the purpose of evaluating short-term and long-term symptoms and function in subjects with knee injury and osteoarthritis. The KOOS holds five separately scored subscales: Pain, other Symptoms, Function in daily living (ADL, Function in Sport and Recreation (Sport/Rec, and knee-related Quality of Life (QOL. The KOOS has been validated for several orthopaedic interventions such as anterior cruciate ligament reconstruction, meniscectomy and total knee replacement. In addition the instrument has been used to evaluate physical therapy, nutritional supplementation and glucosamine supplementation. The effect size is generally largest for the subscale QOL followed by the subscale Pain. The KOOS is a valid, reliable and responsive self-administered instrument that can be used for short-term and long-term follow-up of several types of knee injury including osteoarthritis. The measure is relatively new and further use of the instrument will add knowledge and suggest areas that need to be further explored and improved.
Van der Sluis, C.K.; Ten Duis, H.J.; Geertzen, J.H.B.
To measure the functional outcome we analyzed 723 consecutive patients with multiple injuries (Abbreviated Injury Scale (AIS)/Injury Severity Score (ISS) greater than or equal to 16, mean ISS 30.1) treated at the University Hospital Groningen, the Netherlands, between 1985 and 1989. Age, sex, type
U.S. Department of Health & Human Services — The FDA Acronyms and Abbreviations database provides a quick reference to acronyms and abbreviations related to Food and Drug Administration (FDA) activities
The US Nuclear Regulatory Commission (NRC) staff collected this list of abbreviations from NRC documents and nuclear industry documents, both foreign and domestic. Readers can use the collection, which is not all inclusive, to identify the terms from which the abbreviations are formed. The Editorial Section of the Division of Freedom of Information and Publications Services compiled this collection. In the introduction, the editorial staff offers suggestions for using abbreviations but does not recommend the use of one abbreviation over another
Xu, Yun; Wang, ZhiHao; Lei, YiMing; Zhao, YuZhong; Xue, Yu
The exploding growth of the biomedical literature presents many challenges for biological researchers. One such challenge is from the use of a great deal of abbreviations. Extracting abbreviations and their definitions accurately is very helpful to biologists and also facilitates biomedical text analysis. Existing approaches fall into four broad categories: rule based, machine learning based, text alignment based and statistically based. State of the art methods either focus exclusively on acronym-type abbreviations, or could not recognize rare abbreviations. We propose a systematic method to extract abbreviations effectively. At first a scoring method is used to classify the abbreviations into acronym-type and non-acronym-type abbreviations, and then their corresponding definitions are identified by two different methods: text alignment algorithm for the former, statistical method for the latter. A literature mining system MBA was constructed to extract both acronym-type and non-acronym-type abbreviations. An abbreviation-tagged literature corpus, called Medstract gold standard corpus, was used to evaluate the system. MBA achieved a recall of 88% at the precision of 91% on the Medstract gold-standard EVALUATION Corpus. We present a new literature mining system MBA for extracting biomedical abbreviations. Our evaluation demonstrates that the MBA system performs better than the others. It can identify the definition of not only acronym-type abbreviations including a little irregular acronym-type abbreviations (e.g., ), but also non-acronym-type abbreviations (e.g., ).
Chang, Jeffrey T; Schütze, Hinrich; Altman, Russ B
The growth of the biomedical literature presents special challenges for both human readers and automatic algorithms. One such challenge derives from the common and uncontrolled use of abbreviations in the literature. Each additional abbreviation increases the effective size of the vocabulary for a field. Therefore, to create an automatically generated and maintained lexicon of abbreviations, we have developed an algorithm to match abbreviations in text with their expansions. Our method uses a statistical learning algorithm, logistic regression, to score abbreviation expansions based on their resemblance to a training set of human-annotated abbreviations. We applied it to Medstract, a corpus of MEDLINE abstracts in which abbreviations and their expansions have been manually annotated. We then ran the algorithm on all abstracts in MEDLINE, creating a dictionary of biomedical abbreviations. To test the coverage of the database, we used an independently created list of abbreviations from the China Medical Tribune. We measured the recall and precision of the algorithm in identifying abbreviations from the Medstract corpus. We also measured the recall when searching for abbreviations from the China Medical Tribune against the database. On the Medstract corpus, our algorithm achieves up to 83% recall at 80% precision. Applying the algorithm to all of MEDLINE yielded a database of 781,632 high-scoring abbreviations. Of all the abbreviations in the list from the China Medical Tribune, 88% were in the database. We have developed an algorithm to identify abbreviations from text. We are making this available as a public abbreviation server at \\url[http://abbreviation.stanford.edu/].
Zwingmann, J; Schmal, H; Mehlhorn, A
including the detailed diagnose, the lethality and the severity of the injuries were analyzed. The AIS (Abbreviated Injury Scale) and ISS (Injury Severity Score) were used to classify the severity of injuries in different body regions. Moreover the number and the kind of operation as a consequence...
Rau, Cheng-Shyuan; Kuo, Pao-Jen; Wu, Shao-Chun; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua
Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study population comprised 7855 patients aged ≥40 years who were hospitalized for treatment of isolated moderate and severe TBI (an Abbreviated Injury Scale (AIS) ≥3 points only in the head and not in other regions of the body) between 1 January 2009 and 31 December 2014. Patients were categorized as high-risk (OSTA score -1; n = 5359). Two-sided Pearson's chi-squared, or Fisher's exact tests were used to compare categorical data. Unpaired Student's t -test and Mann-Whitney U test were performed to analyze normally and non-normally distributed continuous data, respectively. Propensity score-matching in a 1:1 ratio was performed using NCSS software, with adjustment for covariates. Results: Compared to low-risk patients, high- and medium-risk patients were significantly older and injured more severely. The high- and medium-risk patients had significantly higher mortality rates, longer hospital length of stay, and a higher proportion of admission to the intensive care unit than low-risk patients. Analysis of propensity score-matched patients with adjusted covariates, including gender, co-morbidity, blood alcohol concentration level, Glasgow Coma Scale score, and Injury Severity Score revealed that high- and medium-risk patients still had a 2.4-fold (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.39-4.15; p = 0.001) and 1.8-fold (OR, 1.8; 95% CI, 1.19-2.86; p = 0.005) higher mortality, respectively, than low-risk patients. However, further addition of age as a covariate for the propensity score-matching demonstrated that there was no significant difference between high-risk and low-risk patients or between medium-risk and low-risk patients, implying that older age
Osler, Turner; Glance, Laurent G; Hosmer, David W
: Generations of clinicians have used the Baux score, defined as the sum of age in years and percent body burn, to predict percent mortality after trauma, but advances in burn care have rendered the predictions of this score too pessimistic. Additionally, this score does not include the effects of inhalation injury. : We revised the Baux score to include inhalation injury and recalibrated its predictions using a single-term logistic regression model developed using data on 39,888 burned patients provided by the national burn repository. We compared this revised Baux score to a more complex logistic regression model derived from the same data set and predictors. : A preliminary logistic regression model showed that age and percent burn contribute almost equally to mortality and further that the presence of inhalation injury added the equivalent of 17 years (or 17% burn). These observations suggested a revised Baux Score:Age + Percent Burn + 17 * (Inhalation Injury, 1 = yes, 0 = no)A logistic model based on the Revised Baux Score performed well, but a more complex model obtained using modern statistical model building tools had better discrimination and calibration. : Our proposed revised Baux score is simple enough for mental calculation, and its inverse logit transformation (provided with a calculator or nomogram) can provide precise predictions of mortality. Better predictions can be obtained using our more complex statistical model. Burn surgeons and nurses accustomed to using the original Baux score may welcome an updated version.
Lai, Wilson C; Wang, Dean; Chen, James B; Vail, Jeremy; Rugg, Caitlin M; Hame, Sharon L
Functional movement tests that are predictive of injury risk in National Collegiate Athletic Association (NCAA) athletes are useful tools for sports medicine professionals. The Lower Quarter Y-Balance Test (YBT-LQ) measures single-leg balance and reach distances in 3 directions. To assess whether the YBT-LQ predicts the laterality and risk of sports-related lower extremity (LE) injury in NCAA athletes. Case-control study; Level of evidence, 3. The YBT-LQ was administered to 294 NCAA Division I athletes from 21 sports during preparticipation physical examinations at a single institution. Athletes were followed prospectively over the course of the corresponding season. Correlation analysis was performed between the laterality of reach asymmetry and composite scores (CS) versus the laterality of injury. Receiver operating characteristic (ROC) analysis was used to determine the optimal asymmetry cutoff score for YBT-LQ. A multivariate regression analysis adjusting for sex, sport type, body mass index, and history of prior LE surgery was performed to assess predictors of earlier and higher rates of injury. Neither the laterality of reach asymmetry nor the CS correlated with the laterality of injury. ROC analysis found optimal cutoff scores of 2, 9, and 3 cm for anterior, posteromedial, and posterolateral reach, respectively. All of these potential cutoff scores, along with a cutoff score of 4 cm used in the majority of prior studies, were associated with poor sensitivity and specificity. Furthermore, none of the asymmetric cutoff scores were associated with earlier or increased rate of injury in the multivariate analyses. YBT-LQ scores alone do not predict LE injury in this collegiate athlete population. Sports medicine professionals should be cautioned against using the YBT-LQ alone to screen for injury risk in collegiate athletes.
Roos, Ewa M.; Roos, H P; Ekdahl, C
The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent...... arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations...
Ingelsrud, Lina Holm; Terwee, Caroline B; Terluin, Berend
BACKGROUND: Meaningful change scores in the Knee injury and Osteoarthritis Outcome Score (KOOS) in patients undergoing anterior cruciate ligament (ACL) reconstruction have not yet been established. PURPOSE: To define the minimal important change (MIC) for the KOOS after ACL reconstruction. STUDY....... Presurgery KOOS scores were retrieved from the registry. The MIC for improvement was calculated with anchor-based approaches using the predictive modeling method adjusted for the proportion of improved patients, the mean change method, and the receiver operating characteristic (ROC) method. RESULTS: Complete......% to 10% of patients reported subscale-specific worsening, MIC deterioration calculations were not possible. The ROC MIC values were associated with high degrees of misclassification. Values obtained by the mean change method were considered less reliable because these estimates are derived from subgroups...
Bilgin, Sevil; Guclu-Gunduz, Arzu; Oruckaptan, Hakan; Kose, Nezire; Celik, Bülent
Fifty-one patients with mild (n = 14), moderate (n = 10) and severe traumatic brain injury (n = 27) received early rehabilitation. Level of consciousness was evaluated using the Glasgow Coma Score. Functional level was determined using the Glasgow Outcome Score, whilst mobility was evaluated using the Mobility Scale for Acute Stroke. Activities of daily living were assessed using the Barthel Index. Following Bobath neurodevelopmental therapy, the level of consciousness was significantly improved in patients with moderate and severe traumatic brain injury, but was not greatly influenced in patients with mild traumatic brain injury. Mobility and functional level were significantly improved in patients with mild, moderate and severe traumatic brain injury. Gait recovery was more obvious in patients with mild traumatic brain injury than in patients with moderate and severe traumatic brain injury. Activities of daily living showed an improvement but this was insignificant except for patients with severe traumatic brain injury. Nevertheless, complete recovery was not acquired at discharge. Multiple regression analysis showed that gait and Glasgow Coma Scale scores can be considered predictors of functional outcomes following traumatic brain injury.
Shiran, S I; Weinstein, M; Sirota-Cohen, C; Myers, V; Ben Bashat, D; Fattal-Valevski, A; Green, D; Schertz, M
Brain MR imaging is recommended in children with cerebral palsy. Descriptions of MR imaging findings lack uniformity, due to the absence of a validated quantitative approach. We developed a quantitative scoring method for brain injury based on anatomic MR imaging and examined the reliability and validity in correlation to motor function in children with hemiplegia. Twenty-seven children with hemiplegia underwent MR imaging (T1, T2-weighted sequences, DTI) and motor assessment (Manual Ability Classification System, Gross Motor Functional Classification System, Assisting Hand Assessment, Jebsen Taylor Test of Hand Function, and Children's Hand Experience Questionnaire). A scoring system devised in our center was applied to all scans. Radiologic score covered 4 domains: number of affected lobes, volume and type of white matter injury, extent of gray matter damage, and major white matter tract injury. Inter- and intrarater reliability was evaluated and the relationship between radiologic score and motor assessments determined. Mean total radiologic score was 11.3 ± 4.5 (range 4-18). Good inter- (ρ = 0.909, P classification systems (ρ = 0.708, P high inter- and intrarater reliability and significant associations with manual ability classification systems and motor evaluations. This score provides a standardized radiologic assessment of brain injury extent in hemiplegic patients with predominantly unilateral injury, allowing comparison between groups, and providing an additional tool for counseling families. © 2014 by American Journal of Neuroradiology.
Mestrović, Julije; Mestrović, Marija; Polić, Branka; Markić, Josko; Kardum, Goran; Gunjaca, Grgo; Matas, Anita; Catipović, Tatjana; Radonić, Marija
The aim of the study was to explore the association between Glasgow Coma Scale (GCS), Paediatric Index of Mortality (PIM2) and Injury Severity Score (ISS), and the long-term outcome of children with injuries. The health related quality of life (HRQL) was assessed by using the Royal Alexandra Hospital for children Measure of Function (RAHC MOF), 12 months post discharge. Out of 118 children with injuries (9% of all patients), 75 had injury of the head as the leading injury. There were no significant differences at admission in the severity of clinical condition, as expressed by PIM2 and ISS, between patients with head injuries and patients with other injured leading body regions. Children with head injuries had significantly worse HRQOL than children with other leading injured body region (p children from road traffic accidents had significantly worse HRQL (p = 0.004), compared to other mechanisms of injury. HRQL correlated significantly with GCS (p = 0.027), but not with ISS and PIM2. As the conclusion, among all scoring systems applied, only GCS, which demonstrates severity of head injury, showed significant impact on long-term outcome of injured children.
The early warning score derived from 198,755 vital sign sets in the Vitalpac™ database (ViEWS) has an area under the receiver operator characteristic curve (AUROC) for death of acute unselected medical patients within 24h of 88%.
Peng, Jin; Wheeler, Krista; Shi, Junxin; Groner, Jonathan Ira; Haley, Kathryn Jo; Xiang, Huiyun
Trauma patients with an ISS=75 have been deliberately excluded from some trauma studies because they were assumed to have "unsurvivable injuries." This study aimed to assess the true mortality among patients with an ISS=75, and to examine the characteristics and primary diagnoses of these patients. Retrospective review of the 2006-2010 U.S. Nationwide Emergency Department Sample (NEDS) generated 2,815 patients with an ISS=75 for analysis, representing an estimated 13,569 patients in the country. Dispositions from the emergency department and hospital for these patients were tabulated by trauma center level. Survivors and non-survivors were compared using Pearson's chi-square test. Primary diagnosis codes of these patients were tabulated by mortality status. Overall, about 48.6% of patients with an ISS=75 were discharged alive, 25.8% died and 25.6% had unknown mortality status. The mortality risks of these patients did not vary significantly across different levels of trauma centers (15.6% vs. 13.0%, P = 0.16). Non-survivors were more likely than survivors to: be male (81.2% vs. 74.4%, P wound into cavity). Our results revealed that at least half of patients with an ISS=75 survived, demonstrating that the rationale for excluding patients with an ISS=75 from analysis is not always justified. To avoid bias and inaccurate results, trauma researchers should examine the mortality status of patients with an ISS=75 before exclusion, and explicitly describe their method of generating ISS scores.
Prichayudh, Supparerk; Verananvattna, Aumpavan; Sriussadaporn, Suvit; Sriussadaporn, Sukanya; Kritayakirana, Kritaya; Pak-art, Rattaplee; Capin, Allan; Pereira, Bruno; Tsunoyama, Taichiro; Pena, Diego
The Mangled Extremity Severity Score (MESS) is an objective criterion for amputation prediction after lower extremity injury as well as for amputation prediction after upper extremity injury. A MESS of >or=7 has been utilized as a cutoff point for amputation prediction. In this study, we examined the result of upper extremity vascular injurty (UEVI) management in terms of the amputation rate as related to the MESS. During January 2002 to July 2007, we reviewed patients with UEVIs at our institution. Data collections included demographic data, mechanism of injuries, injury severity score (ISS), ischemic time, MESS, pathology of UEVI, operative management, and amputation rate. Decisions to amputate the injured limbs at our institution were made individually by clinically assessing limb viability (i.e., color and capillary refill of skin; color, consistency, and contractility of muscles) regardless of the MESS. The outcome was analyzed in terms of the amputation rate related to the MESS. There were 52 patients with UEVIs in this study: 25 (48%) suffered blunt injuries and 27 (52%) suffered penetrating injuries. The age ranged from 15 to 59 years (mean 28.7 years). The mean ischemia time was 10.07 h. The mean ISS was 17.52. There were 12 patients (23%) with subclavian artery injuries, 3 patients (5.76%) with axillary artery injuries, 18 patients (34.61%) with brachial artery injuries, and 19 patients (36.54%) with radial artery and/or ulnar artery injuries. Primary repairs were performed in 45 patients (86.54%), with ligations in 3 patients (5.77%). An endovascular stent-graft was used in one patient (1.92%). Primary amputations were performed in three patients (5.77%). Secondary amputations (amputation after primary operation) were done in 4 of 49 patients (secondary amputation rate 8.16%). All amputation patients suffered blunt injuries and had a MESS of >or=7 (range 7-11). The overall amputation rate in this study was 13.46% (7/52 patients). Multivariate analysis
Roos, Ewa M.; Roos, H P; Lohmander, L S
-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport...... and recreation function, and knee-related quality of life. In this clinical study, the KOOS proved reliable, responsive to surgery and physical therapy, and valid for patients undergoing anterior cruciate ligament reconstruction. The KOOS meets basic criteria of outcome measures and can be used to evaluate...... the course of knee injury and treatment outcome....
Ege, Tolga; Unlu, Aytekin; Tas, Huseyin; Bek, Dogan; Turkan, Selim; Cetinkaya, Aytac
Decision of limb salvage or amputation is generally aided with several trauma scoring systems such as the mangled extremity severity score (MESS). However, the reliability of the injury scores in the settling of open fractures due to explosives and missiles is challenging. Mortality and morbidity of the extremity trauma due to firearms are generally associated with time delay in revascularization, injury mechanism, anatomy of the injured site, associated injuries, age and the environmental circumstance. The purpose of the retrospective study was to evaluate the extent of extremity injuries due to ballistic missiles and to detect the reliability of mangled extremity severity score (MESS) in both upper and lower extremities. Between 2004 and 2014, 139 Gustillo Anderson Type III open fractures of both the upper and lower extremities were enrolled in the study. Data for patient age, fire arm type, transporting time from the field to the hospital (and the method), injury severity scores, MESS scores, fracture types, amputation levels, bone fixation methods and postoperative infections and complications retrieved from the two level-2 trauma center's data base. Sensitivity, specificity, positive and negative predictive values of the MESS were calculated to detect the ability in deciding amputation in the mangled limb. Amputation was performed in 39 extremities and limb salvage attempted in 100 extremities. The mean followup time was 14.6 months (range 6-32 months). In the amputated group, the mean MESS scores for upper and lower extremity were 8.8 (range 6-11) and 9.24 (range 6-11), respectively. In the limb salvage group, the mean MESS scores for upper and lower extremities were 5.29 (range 4-7) and 5.19 (range 3-8), respectively. Sensitivity of MESS in upper and lower extremities were calculated as 80% and 79.4% and positive predictive values detected as 55.55% and 83.3%, respectively. Specificity of MESS score for upper and lower extremities was 84% and 86.6%; negative
Trivedi, Shamik B.; Vesoulis, Zachary A.; Rao, Rakesh; Liao, Steve M.; Mathur, Amit M. [Washington University School of Medicine, Division of Newborn Medicine, Edward Mallinckrodt Department of Pediatrics, St. Louis, MO (United States); Shimony, Joshua S.; McKinstry, Robert C. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States)
Deep nuclear gray matter injury in neonatal hypoxic-ischemic encephalopathy (HIE) is associated with worse neurodevelopmental outcomes. We previously published a qualitative MRI injury scoring system utilizing serial T1-weighted, T2-weighted and diffusion-weighted imaging (DWI), weighted for deep nuclear gray matter injury. To establish the validity of the MRI scoring system with neurodevelopmental outcome at 18-24 months. MRI scans from neonates with moderate to severe HIE treated with therapeutic hypothermia were evaluated. Signal abnormality was scored on T1-weighted, T2-weighted and DWI sequences and assessed using an established system in five regions: (a) subcortical: caudate nucleus, globus pallidus and putamen, thalamus and the posterior limb of the internal capsule; (b) white matter; (c) cortex, (d) cerebellum and (e) brainstem. MRI injury was graded as none, mild, moderate or severe. Inter-rater reliability was tested on a subset of scans by two independent and blinded neuroradiologists. Surviving infants underwent the Bayley Scales of Infant and Toddler Development-III (Bayley-III) at 18-24 months. Data were analyzed using univariate and multivariate linear and logistic regression. Fifty-seven eligible neonates underwent at least one MRI scan in the first 2 weeks of life. Mean postnatal age at scan 1 was 4±2 days in 50/57 (88%) neonates and 48/54 (89%) surviving infants underwent scan 2 at 10±2 days. In 54/57 (95%) survivors, higher MRI injury grades were significantly associated with worse outcomes in the cognitive, motor and language domains of the Bayley-III. A qualitative MRI injury scoring system weighted for deep nuclear gray matter injury is a significant predictor of neurodevelopmental outcome at 18-24 months in neonates with HIE. (orig.)
Trivedi, Shamik B.; Vesoulis, Zachary A.; Rao, Rakesh; Liao, Steve M.; Mathur, Amit M.; Shimony, Joshua S.; McKinstry, Robert C.
Deep nuclear gray matter injury in neonatal hypoxic-ischemic encephalopathy (HIE) is associated with worse neurodevelopmental outcomes. We previously published a qualitative MRI injury scoring system utilizing serial T1-weighted, T2-weighted and diffusion-weighted imaging (DWI), weighted for deep nuclear gray matter injury. To establish the validity of the MRI scoring system with neurodevelopmental outcome at 18-24 months. MRI scans from neonates with moderate to severe HIE treated with therapeutic hypothermia were evaluated. Signal abnormality was scored on T1-weighted, T2-weighted and DWI sequences and assessed using an established system in five regions: (a) subcortical: caudate nucleus, globus pallidus and putamen, thalamus and the posterior limb of the internal capsule; (b) white matter; (c) cortex, (d) cerebellum and (e) brainstem. MRI injury was graded as none, mild, moderate or severe. Inter-rater reliability was tested on a subset of scans by two independent and blinded neuroradiologists. Surviving infants underwent the Bayley Scales of Infant and Toddler Development-III (Bayley-III) at 18-24 months. Data were analyzed using univariate and multivariate linear and logistic regression. Fifty-seven eligible neonates underwent at least one MRI scan in the first 2 weeks of life. Mean postnatal age at scan 1 was 4±2 days in 50/57 (88%) neonates and 48/54 (89%) surviving infants underwent scan 2 at 10±2 days. In 54/57 (95%) survivors, higher MRI injury grades were significantly associated with worse outcomes in the cognitive, motor and language domains of the Bayley-III. A qualitative MRI injury scoring system weighted for deep nuclear gray matter injury is a significant predictor of neurodevelopmental outcome at 18-24 months in neonates with HIE. (orig.)
Siahaan, A. M. P.; Akbar, T. Y. M.; Nasution, M. D.
Traumatic brain injury (TBI) remains one of the leading causes of mortality and morbidity, especially in the young population. To predict the outcome of TBI, Marshall, and Rotterdam–CT Scan based scoring was mostly used. As many studies showed conflicting results regarding of the usage of both scoring, this study aims to determine the correlation between Rotterdam and Marshall scoring system with outcome in 30 days and found correlation among them. In 120 subjects with TBI that admitted to Adam Malik General Hospital, we found a significant association of both scorings with the 30-day Glasgow Outcome Score. Therefore, we recommend the use of Marshall and Rotterdam CT Score in initial assessment as a good predictor for patients with TBI.
Full Text Available Introduction. Mild traumatic brain injury (mTBI has been widely studied and the effects of injury can be long term or even lifelong. This research aims to characterize the sleep problems of patients following acute mTBI. Methods. A total of 171 patients with mTBI within one month and 145 non-mTBI controls were recruited in this study. The questionnaire, Pittsburgh Sleep Quality Index (PSQI, was used to evaluate seven aspects of sleep problems. A propensity score method was used to generate a quasirandomized design to account for the background information, including gender, age, Beck’s Anxiety Index, Beck’s Depression Index, and Epworth Sleepiness Scale. The effect was evaluated via cumulative logit regression including propensity scores as a covariate. Results. Before adjustment, about 60% mTBI patients and over three quarters of control subjects had mild sleep disturbance while one third mTBI patients had moderate sleep disturbance. After adjusting by the propensity scores, the scores of sleep quality and duration were significant between mTBI and control groups. Conclusion. Our study supports that sleep problem is common in mTBI group. After adjusting the confounders by propensity score, sleep duration and subjective sleep quality are the most frequently reported problems in mTBI patients within one month after the injury.
Full Text Available Objective To evaluate the predictive value of ocular trauma score(OTS in mechanical ocular injuries occurring in military forces,and compare the difference of OTS application between ocular injury caused by military training and non-military training.Methods The data of 633 inpatients from armed forces suffering from injury of 665 eyes were retrospectively reviewed.Of the 665 injured eyes,326 were injured during military training and 339 during non-military training.The likelihood of final visual acuity(VA calculated with the OTS score was compared with that by the present OTS study,and the correlation between the score and final VA was then analyzed.Results Compared with the distribution of final VA in standard OTS score,the ratio in category 1 was statistically different in present study(P 0.05.There were significant differences in ratio of category 3 between eyes injured by military and non-military training(P < 0.05,and both ratios in category 1 were significantly different compared with those in standard OTS(P < 0.01,e.g.the ratio of NLP was lower(50% vs 73%,P < 0.01;43% vs 73%,P < 0.01;and the ratio in category 2 was significantly different between the eyes injured by non-military training and standard OTS(P < 0.05.However,the OTS showed positive correlation with final VA in present study(P < 0.0001.Conclusion OTS calculated at initial examination may primarily provide a piece of prognostic information of mechanical ocular injuries,and is of special benefit for deciding a prompt management or for evacuation decision for severe ocular injuries caused by military training.
Xing, Xue-Zhong; Wang, Hai-Jun; Huang, Chu-Lin; Yang, Quan-Hui; Qu, Shi-Ning; Zhang, Hao; Wang, Hao; Gao, Yong; Xiao, Qing-Ling; Sun, Ke-Lin
Several risk scoures have been used in predicting acute kidney injury (AKI) of patients undergoing general or specific operations such as cardiac surgery. This study aimed to evaluate the use of two AKI risk scores in patients who underwent non-cardiac surgery but required intensive care. The clinical data of patients who had been admitted to ICU during the first 24 hours of ICU stay between September 2009 and August 2010 at the Cancer Institute, Chinese Academy of Medical Sciences & Peking Union Medical College were retrospectively collected and analyzed. AKI was diagnosed based on the acute kidney injury network (AKIN) criteria. Two AKI risk scores were calculated: Kheterpal and Abelha factors. The incidence of AKI was 10.3%. Patients who developed AKI had a increased ICU mortality of 10.9% vs. 1.0% and an in-hospital mortality of 13.0 vs. 1.5%, compared with those without AKI. There was a significant difference between the classification of Kheterpal's AKI risk scores and the occurrence of AKI (PAbelha's AKI risk scores and the occurrence of AKI (P=0.499). Receiver operating characteristic curves demonstrated an area under the curve of 0.655±0.043 (P=0.001, 95% confidence interval: 0.571-0.739) for Kheterpal's AKI risk score and 0.507±0.044 (P=0.879, 95% confidence interval: 0.422-0.592) for Abelha's AKI risk score. Kheterpal's AKI risk scores are more accurate than Abelha's AKI risk scores in predicting the occurrence of AKI in patients undergoing non-cardiac surgery with moderate predictive capability.
Yao, Shun; Song, Jian; Li, Shun; Cao, Chenglong; Fang, Li; Wang, Chaohu; Xu, Guozheng
The Helsinki computed tomography (CT) scoring system was developed to predict long-term outcome in patients with traumatic brain injury (TBI) 2 years ago; however, it has not yet been external validated. This study aimed to determine whether this system could be used as an independent predictor for TBI. This retrospective cohort study was performed on 302 consecutive patients with TBI. Univariate and multivariate logistic regressions and receiver operating characteristic curve analyses were used to determine the relationship between initial Helsinki CT scores and mortality and unfavorable neurologic outcome at 6 months after injury. Outcomes were assessed using the Glasgow Outcome Scale (scores of 1-3 defined as unfavorable outcome). Of all patients, mortality was 17.9% and unfavorable outcome was 41.4%. The Helsinki CT score was significantly associated with the 6-month outcome in univariate analyses (P < 0.05). After adjustment for other factors in the multivariate regression analysis, the Helsinki CT score remained an independent predictor for mortality (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.08-1.39; P = 0.002) and unfavorable outcome (OR, 1.14; 95% CI, 1.04-1.26; P = 0.007). Receiver operating characteristic curve analyses showed that the Helsinki CT score possessed good discrimination ability for mortality (area under the curve, 0.81; 95% CI, 0.75-0.87; P < 0.001) and moderate discrimination ability for unfavorable outcome (area under the curve, 0.74; 95% CI, 0.69-0.80; P < 0.001). Moreover, at 1.9 hours after TBI, the Helsinki CT score was most accurate for predicting mortality (accuracy, 74.5%) and unfavorable outcome (accuracy, 71.5%). The Helsinki CT score showed good prognostic discrimination and can be used as an independent predictor for long-term outcome prediction in patients with TBI. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available The inflammatory response has been shown to be a major contributor to acute kidney injury. Considering that laparoscopic surgery is beneficial in reducing the inflammatory response, we compared the incidence of postoperative acute kidney injury between laparoscopic liver resection and open liver resection. Among 1173 patients who underwent liver resection surgery, 222 of 926 patients who underwent open liver resection were matched with 222 of 247 patients who underwent laparoscopic liver resection, by using propensity score analysis. The incidence of postoperative acute kidney injury assessed according to the creatinine criteria of the Kidney Disease: Improving Global Outcomes definition was compared between those 1:1 matched groups. A total 77 (6.6% cases of postoperative acute kidney injury occurred. Before matching, the incidence of acute kidney injury after laparoscopic liver resection was significantly lower than that after open liver resection [1.6% (4/247 vs. 7.9% (73/926, P < 0.001]. After 1:1 matching, the incidence of postoperative acute kidney injury was still significantly lower after laparoscopic liver resection than after open liver resection [1.8% (4/222 vs. 6.3% (14/222, P = 0.008; odds ratio 0.273, 95% confidence interval 0.088-0.842, P = 0.024]. The postoperative inflammatory marker was also lower in laparoscopic liver resection than in open liver resection in matched set data (white blood cell count 12.7 ± 4.0 × 103/μL vs. 14.9 ± 3.9 × 103/μL, P < 0.001. Our findings suggest that the laparoscopic technique, by decreasing the inflammatory response, may reduce the occurrence of postoperative acute kidney injury during liver resection surgery.
Eric Peter Thelin
Full Text Available Traumatic brain injury (TBI is a major contributor to morbidity and mortality. Computerized tomography (CT scanning of the brain is essential for diagnostic screening of intracranial injuries in need of neurosurgical intervention, but may also provide information concerning patient prognosis and enable baseline risk stratification in clinical trials. Novel CT scoring systems have been developed to improve current prognostic models, including the Stockholm and Helsinki CT scores, but so far have not been extensively validated. The primary aim of this study was to evaluate the Stockholm and Helsinki CT scores for predicting functional outcome, in comparison with the Rotterdam CT score and Marshall CT classification. The secondary aims were to assess which individual components of the CT scores best predict outcome and what additional prognostic value the CT scoring systems contribute to a clinical prognostic model.TBI patients requiring neuro-intensive care and not included in the initial creation of the Stockholm and Helsinki CT scoring systems were retrospectively included from prospectively collected data at the Karolinska University Hospital (n = 720 from 1 January 2005 to 31 December 2014 and Helsinki University Hospital (n = 395 from 1 January 2013 to 31 December 2014, totaling 1,115 patients. The Marshall CT classification and the Rotterdam, Stockholm, and Helsinki CT scores were assessed using the admission CT scans. Known outcome predictors at admission were acquired (age, pupil responsiveness, admission Glasgow Coma Scale, glucose level, and hemoglobin level and used in univariate, and multivariable, regression models to predict long-term functional outcome (dichotomizations of the Glasgow Outcome Scale [GOS]. In total, 478 patients (43% had an unfavorable outcome (GOS 1-3. In the combined cohort, overall prognostic performance was more accurate for the Stockholm CT score (Nagelkerke's pseudo-R2 range 0.24-0.28 and the Helsinki CT score
Results and conclusions: There were a total of 25 initial candidates, of which only 17 were able to complete the survey. Using the Quick DASH Outcome Measure, our 17 patients had a mean score of 29.5 (range 5.0– 56.8. When compared to the standardized Quick DASH outcomes (no work limitation at 27.5 vs. work limited by injury at 52.6 the non-physician clinicians appear to be performing upper extremity repairs with good outcomes. The key variable to successful repair was the initial injury type. Although accommodations needed to be made to the standard Quick DASH protocol, the tool appears to be usable in non-traditional settings.
Prediction of final visual outcome in ocular injuries is of paramount importance and various prognostic models have been proposed to predict final visual outcome. The objective of this study was to validate the predictive value of ocular trauma score (OTS) in patients with combat related open globe injuries and to evaluate the factors affecting the final visual outcome. Methods: Data of 93 patients admitted in AFIO Rawalpindi between Jan 2010 to June 2014 with combat related open globe ocular injuries was analysed. Initial and final best corrected visual acuity (BCVA) was categorized as No Light Perception (NLP), Light Perception (LP) to Hand Movement (HM), 1/200-19/200, 20/200-20/50, and =20/40. OTS was calculated for each eye by assigning numerical raw points to six variables and then scores were stratified into five OTS categories. Results: Mean age of study population was 28.77 ± 8.37 years. Presenting visual acuity was <20/200 (6/60) in 103 (96.23%) eyes. However, final BCVA of =20/40 (6/12) was achieved in 18 (16.82%) eyes, while 72 (67.28%) eyes had final BCVA of <20/200 (6/60). Final visual outcome in our study were similar to those in OTS study, except for NLP in category 1 (81% vs. 74%) and =20/40 in category 3 (30% vs. 41%). The OTS model predicted visual survival (LP or better) with a sensitivity of 94.80% and predicted no vision (NLP) with a specificity of 100%. Conclusion: OTS is a reliable tool for assessment of ocular injuries and predicting final visual outcome at the outset. (author)
Comins, J; Brodersen, J; Krogsgaard, M
The knee injury and Osteoarthritis Outcome Score (KOOS), based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), is widely used to evaluate subjective outcome in anterior cruciate ligament (ACL) reconstructed patients. However, the validity of KOOS has not been assessed...... and subsequent rehabilitation. Rasch analysis showed that of the five proposed subscales in KOOS, only knee-related quality of life (QoL) and sport and recreational related function (Sport/Rec) fulfilled the criteria of a unidimensional measurement scale when applied to these patients. The three subdomains...
Campbell, Justin S; Pulos, Steven; Haran, F Jay; Tsao, Jack W; Alphonso, Aimee L
This study describes the psychometric investigation of an 11-item symptom checklist, the Abbreviated Concussion Symptom Inventory (ACSI). The ACSI is a dichotomously scored list of postconcussive symptoms associated with mild traumatic brain injury. The ACSI was administered to Marines (N = 1,435) within the 1st month of their return from combat deployments to Afghanistan. Psychometric analyses based upon nonparametric item response theory supported scoring the ACSI via simple summation of symptom endorsements; doing so produced a total score with good reliability (α = .802). Total scores were also found to significantly differentiate between different levels of head injury complexity during deployment, F(3, 1,431) = 100.75, p < .001. The findings support the use of the ASCI in research settings requiring a psychometrically reliable measure of postconcussion symptoms.
Jacome, Tomas; Tatum, Danielle
Systemic inflammatory response syndrome (SIRS) is frequently observed after various types of acute cerebral injury and has been linked to clinical deterioration in non-traumatic brain injury (TBI). SIRS scores have also been shown to be predictive of length of stay and mortality in trauma patients. We aimed to determine the prognostic utility of SIRS present at admission in trauma patients with isolated TBI. This was a 5-year retrospective cohort study of adults (≥18 years) with isolated TBI admitted to a Level II trauma center. The prognostic value of SIRS, total SIRS scores, and each SIRS criterion was examined by Χ 2 and logistic regression analyses. Of the 330 patients identified, 50 (15.2%) met SIRS criteria. SIRS was significantly associated with poor outcome (P SIRS score of 2 on admission (P = 0.007) and increased significantly to 6.5 times in patients with a SIRS score of 3 (P = 0.002). Logistic regression demonstrated SIRS and each criterion to be significant independent prognostic factors (SIRS, P = 0.030; body temperature, P = 0.006; tachypnea, P = 0.022, tachycardia P = 0.023). SIRS at admission is an independent predictor of poor outcome in isolated TBI patients. These data demonstrate SIRS to be an important clinical tool that may be used in facilitating prognostication, particularly in elderly trauma patients. Future prospective studies aimed at therapeutic interventions to mitigate SIRS in TBI patients are warranted. Prognostic, Level III.
Cain, Kelli L; Gavand, Kavita A; Conway, Terry L; Geremia, Carrie M; Millstein, Rachel A; Frank, Lawrence D; Saelens, Brian E; Adams, Marc A; Glanz, Karen; King, Abby C; Sallis, James F
Macroscale built environment factors (e.g., street connectivity) are correlated with physical activity. Less-studied but more modifiable microscale elements (e.g., sidewalks) may also influence physical activity, but shorter audit measures of microscale elements are needed to promote wider use. This study evaluated the relation of an abbreviated 54-item streetscape audit tool with multiple measures of physical activity in four age groups. We developed a 54-item version from the original 120-item Microscale Audit of Pedestrian Streetscapes (MAPS). Audits were conducted on 0.25-0.45 mile routes from participant residences toward the nearest nonresidential destination for children (N=758), adolescents (N=897), younger adults (N=1,655), and older adults (N=367). Active transport and leisure physical activity were measured with surveys, and objective physical activity was measured with accelerometers. Items to retain from original MAPS were selected primarily by correlations with physical activity. Mixed linear regression analyses were conducted for MAPS-Abbreviated summary scores, adjusting for demographics, participant clustering, and macroscale walkability. MAPS-Abbreviated and original MAPS total scores correlated r=.94 The MAPS-Abbreviated tool was related similarly to physical activity outcomes as the original MAPS. Destinations and land use, streetscape and walking path characteristics, and overall total scores were significantly related to active transport in all age groups. Street crossing characteristics were related to active transport in children and older adults. Aesthetics and social characteristics were related to leisure physical activity in children and younger adults, and cul-de-sacs were related with physical activity in youth. Total scores were related to accelerometer-measured physical activity in children and older adults. MAPS-Abbreviated is a validated observational measure for use in research. The length and related cost of implementation has
Full Text Available Background: The most widely used methods of describing traumatic brain injury (TBI are the Glasgow Coma Scale (GCS and the Abbreviated Injury Scale (AIS. Recent evidence suggests that presenting GCS in older patients may be higher than that in younger patients for an equivalent anatomical severity of TBI. This study aimed to assess these observations with a propensity-score matching approach using the data from Trauma Registry System in a Level I trauma center. Methods: We included all adult patients (aged ≥20 years old with moderate to severe TBI from 1 January 2009 to 31 December 2016. Patients were categorized into elderly (aged ≥65 years and young adults (aged 20–64 years. The severity of TBI was defined by an AIS score in the head (AIS 3‒4 and 5 indicate moderate and severe TBI, respectively. We examined the differences in the GCS scores by age at each head AIS score. Unpaired Student’s t- and Mann–Whitney U-tests were used to analyze normally and non-normally distributed continuous data, respectively. Categorical data were compared using either the Pearson chi-square or two-sided Fisher’s exact tests. Matched patient populations were allocated in a 1:1 ratio according to the propensity scores calculated using NCSS software with the following covariates: sex, pre-existing chronic obstructive pulmonary disease, systolic blood pressure, hemoglobin, sodium, glucose, and alcohol level. Logistic regression was used to evaluate the effects of age on the GCS score in each head AIS stratum. Results: The study population included 2081 adult patients with moderate to severe TBI. These patients were categorized into elderly (n = 847 and young adults (n = 1234: each was exclusively further divided into three groups of patients with head AIS of 3, 4, or 5. In the 162 well-balanced pairs of TBI patients with head AIS of 3, the elderly demonstrated a significantly higher GCS score than the young adults (14.1 ± 2.2 vs. 13.1 ± 3
Full Text Available Background: Patients with head injury continue to improve over time and a minimum follow-up of six months is considered necessary to evaluate outcome. However, this may be difficult to assess due to lack of follow-up. It is also well known that operated patients who return for cranioplasty usually have the best outcome. Aims and Objectives: To assess the outcome following severe head injury using cranioplasty as a surrogate marker for good outcome. Materials and Methods: This was a retrospective study carried out from January 2009 to December 2010. All patients with severe head injury who underwent decompressive craniectomy (DC in the study period were included. Patients who came back for cranioplasty in the same period were also included. Case records, imaging and follow up visit data from all patients were reviewed. Glasgow Coma Score (GCS on admission and Glasgow Outcome Score (GOS at discharge were assessed. Observations and Results: Of the 273 patients, 84.25% (n=230 were males and 15.75% (n= 43 were females. The mean age was 34.3 years (range 2-81 years, SD 16.817. The mean GCS on admission was 5.615 (range 3-8, SD 1.438. The in-hospital mortality was 54% (n=149. Good outcome (GOS of 4 or 5 at discharge was attained in 22% (n=60 patients. Sixty five patients returned for cranioplasty (with a GOS of 4 or 5 during the study period. There was no statistical difference in the number of patients discharged with good outcome and those coming back for cranioplasty in the study period (P>0.5. Patients who came back for cranioplasty were younger in age (mean age 28.815 years SD 13.396 with better admission GCS prior to DC (mean GCS 6.32 SD1.39. Conclusions: In operated severe head injury patients significant number of patients (24% in our study have excellent outcome. However, insignificant number of patients had further improvement to GOS 4 or 5 (good outcome from the time of initial discharge. This suggests that due to lack of intensive
Dawkins, Ross L; Miller, Joseph H; Ramadan, Omar I; Lysek, Michael C; Kuhn, Elizabeth N; Rocque, Brandon G; Conklin, Michael J; Tubbs, R Shane; Walters, Beverly C; Agee, Bonita S; Rozzelle, Curtis J
OBJECTIVE There are many classification systems for injuries of the thoracolumbar spine. The recent Thoracolumbar Injury Classification and Severity Score (TLICS) has been shown to be a reliable tool for adult patients. The aim of this study was to assess the reliability of the TLICS system in pediatric patients. The validity of the TLICS system is assessed in a companion paper. METHODS The medical records of pediatric patients with acute, traumatic thoracolumbar fractures at a single Level 1 trauma center were retrospectively reviewed. A TLICS was calculated for each patient using CT and MRI, along with the neurological examination recorded in the patient's medical record. TLICSs were compared with the type of treatment received. Five raters scored all patients separately to assess interrater reliability. RESULTS TLICS calculations were completed for 81 patients. The mean patient age was 10.9 years. Girls represented 51.8% of the study population, and 80% of the study patients were white. The most common mechanisms of injury were motor vehicle accidents (60.5%), falls (17.3%), and all-terrain vehicle accidents (8.6%). The mean TLICS was 3.7 ± 2.8. Surgery was the treatment of choice for 33.3% of patients. The agreement between the TLICS-suggested treatment and the actual treatment received was statistically significant (p reliability of the TLICS system ranged from moderate to very good, with a Fleiss' generalized kappa (κ) value of 0.69 for the TLICS treatment suggestion among all patients; however, interrater reliability decreased when MRI was used to contribute to the TLICS. The κ value decreased from 0.73 to 0.57 for patients with CT only vs patients with CT/MRI or MRI only, respectively (p reliability among physicians assessing thoracolumbar fracture treatment in pediatric patients. Physicians should be cautious when using MRI to aid in the surgical decision-making process.
Talari, Hamid Reza; Fakharian, Esmaeil; Mousavi, Nooshin; Abedzadeh-Kalahroudi, Masoumeh; Akbari, Hossein; Zoghi, Sommayeh
Predicting outcomes in patients with traumatic brain injury is critically important for making sound clinical decisions. This study aimed at determining the prognostic value of the Rotterdam scoring system to predict early death among these patients. This study was performed prospectively on 150 patients with traumatic brain injury hospitalized in Shahid Beheshti Hospital, Kashan, Iran. Patients' demographic and clinical characteristics such as age, sex, mechanism of trauma, initial Glasgow Coma Scale score, and accompanying lesions were documented. A brain computed tomography was performed for each patient and scored by use of the Rotterdam system. Patients were monitored for 2 weeks after hospital discharge, and their outcomes were documented. Univariate and multiple logistic regression analysis and prognostic values of Rotterdam system were conducted by SPSS software. Nineteen patients (12.7%) died during the course of the study. The mean age of the dead patients was significantly greater than those who survived (P = 0.037). The sensitivity and the specificity of the Rotterdam scoring system at the cutoff score of 4 were 84.2% and 96.2%, respectively. Rotterdam score was significantly correlated with patient outcomes (P patient outcomes. Rotterdam score is an independent factor for predicting outcomes among patients with traumatic brain injury. At the cutoff score of 4, the Rotterdam system can predict outcomes among patients suffering from traumatic brain injury with acceptable sensitivity and specificity. Copyright © 2016 Elsevier Inc. All rights reserved.
Baunsgaard, C B; Nissen, U V; Christensen, K B; Biering-Sørensen, F
Intra- and inter-rater reliability study. To assess intra- and inter-rater reliability of the Modified Ashworth Scale (MAS) and Spasm Frequency Score (SFS) in lower extremities in a population of spinal cord-injured persons, as well as correlations between the two scales. Clinic for Spinal Cord Injuries, Rigshospitalet, Hornbaek, Denmark. Thirty-one persons participated in the study and were tested four times in total with MAS and SFS by three experienced raters. Cohen's kappa (κ), simple and quadratic weighted (nominal and ordinal scale level of measurement), was used as a measure of reliability and Spearman's rank correlation coefficient for correlation between MAS and SFS. Neurological level ranged from C2 to L2 and American Spinal Injury Association impairment scale A to D. Time since injury was (mean±s.d.) 3.4±6.5 years. Age was 48.3±20.2 years. Cause of injury was traumatic in 55% and non-traumatic for 45% of the participants. Antispastic medication was used by 61%. MAS showed intra-rater κsimple=-0.11 to 0.46 and κweighted=-0.11 to 0.83. Inter-rater κsimple=-0.06 to 0.32 and κweighted=0.08 to 0.74. SFS showed intra-rater κweighted=0.94 and inter-rater κweighted=0.93. Correlation between MAS and SFS showed non-significant correlation coefficients from-0.11 to 0.90. Reliability of MAS is highly affected by the weighting scheme. With a weighted-κ it was overall reliable and simple-κ overall unreliability. Repeated tests should always be performed by the same rater and in a very standardized manner. SFS was found reliable. MAS and SFS are poorly correlated, and ratings were inversely distributed and suggest that it assesses different aspects of spasticity.
Fan, Pei-Chun; Chen, Tien-Hsing; Lee, Cheng-Chia; Tsai, Tsung-Yu; Chen, Yung-Chang; Chang, Chih-Hsiang
Acute kidney injury (AKI), a common and crucial complication of acute coronary syndrome (ACS) after receiving percutaneous coronary intervention (PCI), is associated with increased mortality and adverse outcomes. This study aimed to develop and validate a risk prediction model for incident AKI after PCI for ACS. We included 82,186 patients admitted for ACS and receiving PCI between 1997 and 2011 from the Taiwan National Health Insurance Research Database and randomly divided them into a training cohort (n = 57,630) and validation cohort (n = 24,656) for risk model development and validation, respectively. Risk factor analysis revealed that age, diabetes mellitus, ventilator use, prior AKI, number of intervened vessels, chronic kidney disease (CKD), intra-aortic balloon pump (IABP) use, cardiogenic shock, female sex, prior stroke, peripheral arterial disease, hypertension, and heart failure were significant risk factors for incident AKI after PCI for ACS. The reduced model, ADVANCIS, comprised 8 clinical parameters (age, diabetes mellitus, ventilator use, prior AKI, number of intervened vessels, CKD, IABP use, cardiogenic shock), with a score scale ranging from 0 to 22, and performed comparably with the full model (area under the receiver operating characteristic curve, 87.4% vs 87.9%). An ADVANCIS score of ≥6 was associated with higher in-hospital mortality risk. In conclusion, the ADVANCIS score is a novel, simple, robust tool for predicting the risk of incident AKI after PCI for ACS, and it can aid in risk stratification to monitor patient care.
Full Text Available 【Abstract】Objective: An accurate scoring system for intra-abdominal injury (IAI based on clinical manifestation and examination may decrease unnecessary CT scans, save time, and reduce healthcare cost. This study is designed to provide a new scoring system for a better diagno- sis of IAI after blunt trauma. Methods: This prospective observational study was performed from April 2011 to October 2012 on patients aged above 18 years and suspected with blunt abdominal trauma (BAT admitted to the emergency department (ED of Imam Hussein Hospital and Shohadaye Hafte Tir Hospital. All patients were assessed and treated based on Advanced Trauma Life Support and ED protocol. Diagnosis was done according to CT scan findings, which was considered as the gold standard. Data were gathered based on patient's history, physical exam, ultrasound and CT scan findings by a general practitioner who was not blind to this study. Chisquare test and logistic regression were done. Factors with significant relationship with CT scan were imported in multivariate regression models, where a coefficient (β was given based on the contribution of each of them. Scoring system was developed based on the obtained total βof each factor. Results: Altogether 261 patients (80.1% male were enrolled (48 cases of IAI. A 24-point blunt abdominal trauma scoring system (BATSS was developed. Patients were divided into three groups including low (score<8, moderate (8≤score<12 and high risk (score≥12. In high risk group immediate laparotomy should be done, moderate group needs further assessments, and low risk group should be kept under observation. Low risk patients did not show positive CT-scans (specificity 100%. Conversely, all high risk patients had positive CT-scan findings (sensitivity 100%. The receiver operating characteristic curve indicated a close relationship between the results of CT scan and BATSS (sensitivity=99.3%. Conclusion: The present scoring system furnishes a
Cabral, Felipe Cezar; Ramos Garcia, Pedro Celiny; Mattiello, Rita; Dresser, Daiane; Fiori, Humberto Holmer; Korb, Cecilia; Dalcin, Tiago Chagas; Piva, Jefferson Pedro
To evaluate the predictive value of the pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease criteria for disease course severity in patients with or without acute kidney injury admitted to a PICU. Retrospective cohort study. A 12-bed PICU at a tertiary referral center in Southern Brazil. All patients admitted to the study unit over a 1-year period. A database of all eligible patients was analyzed retrospectively. Patients were classified by pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease score at admission and worst pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease score during PICU hospitalization. The outcomes of interest were length of PICU stay, duration of mechanical ventilation, duration of vasoactive drug therapy, and mortality. The Pediatric Index of Mortality 2 was used to assess overall disease severity at the time of PICU admission. Of 375 patients, 169 (45%) presented acute kidney injury at the time of admission and 37 developed acute kidney injury during PICU stay, for a total of 206 of 375 patients (55%) diagnosed with acute kidney injury during the study period. The median Pediatric Index of Mortality 2 score predicted a mortality rate of 9% among non-acute kidney injury patients versus a mortality rate of 16% among acute kidney injury patients (p = 0.006). The mortality of patients classified as pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease F was double that predicted by Pediatric Index of Mortality 2 (7 vs 3.2). Patients classified as having severe acute kidney injury (pediatric-modified Risk, Injury, Failure, Loss, End-stage renal disease I + F) exhibited higher mortality (14.1%; p = 0.001) and prolonged PICU length of stay (median, 7 d; p = 0.001) when compared with other patients. Acute kidney injury is a very frequent occurrence among patients admitted to PICUs. The degree of acute kidney injury severity, as assessed by the pediatric-modified Risk
John E. Buonora
Full Text Available Important challenges for the diagnosis and monitoring of mild traumatic brain injury (mTBI include the development of plasma biomarkers for assessing neurologic injury, monitoring pathogenesis and predicting vulnerability for the development of untoward neurologic outcomes. While several biomarker proteins have shown promise in this regard, used individually, these candidates lack adequate sensitivity and/or specificity for making a definitive diagnosis or identifying those at risk of subsequent pathology. The objective for this study was to evaluate a panel of six recognized and novel biomarker candidates for the assessment of TBI in adult patients. The biomarkers studied were selected on the basis of their relative brain-specificities and potentials to reflect distinct features of TBI mechanisms including: neuronal damage assessed by neuron-specific enolase (NSE and brain derived neurotrophic factor (BDNF; oxidative stress assessed by peroxiredoxin 6 (PRDX6; glial damage and gliosis assessed by glial fibrillary acidic protein (GFAP and S100 calcium binding protein beta (S100b; (4 immune activation assessed by monocyte chemoattractant protein 1/chemokine (C-C motif ligand 2 (MCP1/CCL2; and disruption of the intercellular adhesion apparatus assessed by intercellular adhesion protein-5 (ICAM-5. The combined fold changes in plasma levels of PRDX6, S100b, MCP1, NSE and BDNF resulted in the formulation of a TBI assessment score (TBIAS that identified mTBI with a receiver operator characteristic area under the curve of 0.97, when compared to healthy controls. This research demonstrates that a profile of biomarker responses can be used to formulate a diagnostic score that is sensitive for the detection of mTBI. Ideally, this multivariate assessment strategy will be refined with additional biomarkers that can effectively assess the spectrum of TBI and identify those at particular risk for developing neuropathologies as consequence of a mTBI event.
Leschied, Jessica R.; Smith, Ethan A.; Ladino-Torres, Maria F.; Dillman, Jonathan R. [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Mazza, Michael B.; Chong, Suzanne T.; Hoff, Carrie N. [University of Michigan Health System, Department of Radiology, Division of Emergency Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Davenport, Matthew S. [University of Michigan Health System, Department of Radiology, Division of Abdominal Imaging, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Khalatbari, Shokoufeh [University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, MI (United States); Ehrlich, Peter F. [University of Michigan Health System, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States)
The American Pediatric Surgical Association (APSA) advocates for the use of a clinical practice guideline to direct management of hemodynamically stable pediatric spleen injuries. The clinical practice guideline is based on the CT score of the spleen injury according to the American Association for the Surgery of Trauma (AAST) CT scoring system. To determine the potential effect of radiologist agreement for CT scoring of pediatric spleen injuries on an established APSA clinical practice guideline. We retrospectively analyzed blunt splenic injuries occurring in children from January 2007 to January 2012 at a single level 1 trauma center (n = 90). Abdominal CT exams performed at clinical presentation were reviewed by four radiologists who documented the following: (1) splenic injury grade (AAST system), (2) arterial extravasation and (3) pseudoaneurysm. Inter-rater agreement for AAST injury grade was assessed using the multi-rater Fleiss kappa and Kendall coefficient of concordance. Inter-rater agreement was assessed using weighted (AAST injury grade) or prevalence-adjusted bias-adjusted (binary measures) kappa statistics; 95% confidence intervals were calculated. We evaluated the hypothetical effect of radiologist disagreement on an established APSA clinical practice guideline. Inter-rater agreement was good for absolute AAST injury grade (kappa: 0.64 [0.59-0.69]) and excellent for relative AAST injury grade (Kendall w: 0.90). All radiologists agreed on the AAST grade in 52% of cases. Based on an established clinical practice guideline, radiologist disagreement could have changed the decision for intensive care management in 11% (10/90) of children, changed the length of hospital stay in 44% (40/90), and changed the time to return to normal activity in 44% (40/90). Radiologist agreement when assigning splenic AAST injury grades is less than perfect, and disagreements have the potential to change management in a substantial number of pediatric patients. (orig.)
Airaksinen, N; Nurmi-Lüthje, I; Lüthje, P
The coverage of the official statistics is poor in motorcycle and moped accidents. The aim of this study was to analyze the severity of motorcycle and moped crashes, and to define the degree of under-reporting in official statistics. All first attendances due to an acute motorcyclist or moped driver injury registered in the emergency department between June 2004 and May 2006 were analyzed. The severity of the injuries was classified using the Abbreviated Injury Scale score and the New Injury Severity Score. The hospital injury data were compared to the traffic accident statistics reported by the police and compiled and maintained by Statistics Finland. A total of 49 motorcyclists and 61 moped drivers were involved in crashes, leading to a total of 94 and 109 injuries, respectively. There were slightly more vertebral and midfoot fractures among motorcyclists than among moped drivers (p = 0.038 and 0.016, respectively). No significant differences were found between the severity (maximum Abbreviated Injury Scale and median New Injury Severity Scores) of the motorcycle and moped crashes. There was no in-hospital mortality. The degree of agreement (overlap) between the hospital dataset and the official statistics was 32%. The rate of under-reporting was 68%. According to the maximum Abbreviated Injury Scale and New Injury Severity Scores, the injury severity was equal for motorcycle and moped crashes. The degree of agreement between the hospital dataset and the official statistics was 32%. © The Finnish Surgical Society 2015.
Pagnozzi, Alex M. [Royal Brisbane and Women' s Hospital, CSIRO Digital Productivity and Services Flagship, The Australian e-Health Research Centre, Herston, QLD (Australia); The University of Queensland, School of Medicine, Brisbane (Australia); Fiori, Simona [Stella Maris Scientific Institute, Pisa (Italy); Boyd, Roslyn N. [The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Brisbane (Australia); Guzzetta, Andrea [Stella Maris Scientific Institute, Pisa (Italy); University of Pisa, Department of Clinical and Experimental Medicine, Pisa (Italy); Doecke, James; Rose, Stephen; Dowson, Nicholas [Royal Brisbane and Women' s Hospital, CSIRO Digital Productivity and Services Flagship, The Australian e-Health Research Centre, Herston, QLD (Australia); Gal, Yaniv [The University of Queensland, Centre for Medical Diagnostic Technologies in Queensland, Brisbane (Australia)
Several scoring systems for measuring brain injury severity have been developed to standardize the classification of MRI results, which allows for the prediction of functional outcomes to help plan effective interventions for children with cerebral palsy. The aim of this study is to use statistical techniques to optimize the clinical utility of a recently proposed template-based scoring method by weighting individual anatomical scores of injury, while maintaining its simplicity by retaining only a subset of scored anatomical regions. Seventy-six children with unilateral cerebral palsy were evaluated in terms of upper limb motor function using the Assisting Hand Assessment measure and injuries visible on MRI using a semiquantitative approach. This cohort included 52 children with periventricular white matter injury and 24 with cortical and deep gray matter injuries. A subset of the template-derived cerebral regions was selected using a data-driven region selection algorithm. Linear regression was performed using this subset, with interaction effects excluded. Linear regression improved multiple correlations between MRI-based and Assisting Hand Assessment scores for both periventricular white matter (R squared increased to 0.45 from 0, P < 0.0001) and cortical and deep gray matter (0.84 from 0.44, P < 0.0001) cohorts. In both cohorts, the data-driven approach retained fewer than 8 of the 40 template-derived anatomical regions. The equal or better prediction of the clinically meaningful Assisting Hand Assessment measure using fewer anatomical regions highlights the potential of these developments to enable enhanced quantification of injury and prediction of patient motor outcome, while maintaining the clinical expediency of the scoring approach. (orig.)
Pagnozzi, Alex M; Fiori, Simona; Boyd, Roslyn N; Guzzetta, Andrea; Doecke, James; Gal, Yaniv; Rose, Stephen; Dowson, Nicholas
Several scoring systems for measuring brain injury severity have been developed to standardize the classification of MRI results, which allows for the prediction of functional outcomes to help plan effective interventions for children with cerebral palsy. The aim of this study is to use statistical techniques to optimize the clinical utility of a recently proposed template-based scoring method by weighting individual anatomical scores of injury, while maintaining its simplicity by retaining only a subset of scored anatomical regions. Seventy-six children with unilateral cerebral palsy were evaluated in terms of upper limb motor function using the Assisting Hand Assessment measure and injuries visible on MRI using a semiquantitative approach. This cohort included 52 children with periventricular white matter injury and 24 with cortical and deep gray matter injuries. A subset of the template-derived cerebral regions was selected using a data-driven region selection algorithm. Linear regression was performed using this subset, with interaction effects excluded. Linear regression improved multiple correlations between MRI-based and Assisting Hand Assessment scores for both periventricular white matter (R squared increased to 0.45 from 0, P < 0.0001) and cortical and deep gray matter (0.84 from 0.44, P < 0.0001) cohorts. In both cohorts, the data-driven approach retained fewer than 8 of the 40 template-derived anatomical regions. The equal or better prediction of the clinically meaningful Assisting Hand Assessment measure using fewer anatomical regions highlights the potential of these developments to enable enhanced quantification of injury and prediction of patient motor outcome, while maintaining the clinical expediency of the scoring approach.
Full Text Available AIM : To evaluate the prognostic value of OTS in open globe injuries. MATERIAL METHOD : Retrospective analysis of 77 eyes with open globe injuries was done from 01/07/2013 to 31/12/2014. Patients were assigned raw score sum based on initial V/A, and ocular findings then classified into 5 categories for predicting final visual outcome based on ocular Trauma score (OTS. RESULT : We estimated final V/A in 77 cases of open globe injuries (64.93% had raw sc ore between 65.91 (category 3, 4 Six months after the injury, 42.85% patients of categories 1 (raw score 0 - 44 achieved V/A of PL/HM as compared to 17% in OTS study. 16 patients with raw compared to OTS study. We reported comparable visual outcome with OT S study except in category 1 & 2. CONCLUSION: OTS score is valuable in triage, patient counseling and decision making for the management of ocular trauma. We recommend that OTS should be used routinely for open globe injuries as it is a simple guide
McGill, Stuart M; Andersen, Jordan T; Horne, Arthur D
The purpose of this study was to see if specific tests of fitness and movement quality could predict injury resilience and performance in a team of basketball players over 2 years (2 playing seasons). It was hypothesized that, in a basketball population, movement and fitness scores would predict performance scores and that movement and fitness scores would predict injury resilience. A basketball team from a major American university (N = 14) served as the test population in this longitudinal trial. Variables linked to fitness, movement ability, speed, strength, and agility were measured together with some National Basketball Association (NBA) combine tests. Dependent variables of performance indicators (such as games and minutes played, points scored, assists, rebounds, steal, and blocks) and injury reports were tracked for the subsequent 2 years. Results showed that better performance was linked with having a stiffer torso, more mobile hips, weaker left grip strength, and a longer standing long jump, to name a few. Of the 3 NBA combine tests administered here, only a faster lane agility time had significant links with performance. Some movement qualities and torso endurance were not linked. No patterns with injury emerged. These observations have implications for preseason testing and subsequent training programs in an attempt to reduce future injury and enhance playing performance.
Reliability assessment of AOSpine thoracolumbar spine injury classification system and Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries: results of a multicentre study.
Kaul, Rahul; Chhabra, Harvinder Singh; Vaccaro, Alexander R; Abel, Rainer; Tuli, Sagun; Shetty, Ajoy Prasad; Das, Kali Dutta; Mohapatra, Bibhudendu; Nanda, Ankur; Sangondimath, Gururaj M; Bansal, Murari Lal; Patel, Nishit
The aim of this multicentre study was to determine whether the recently introduced AOSpine Classification and Injury Severity System has better interrater and intrarater reliability than the already existing Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries. Clinical and radiological data of 50 consecutive patients admitted at a single centre with a diagnosis of an acute traumatic thoracolumbar spine injury were distributed to eleven attending spine surgeons from six different institutions in the form of PowerPoint presentation, who classified them according to both classifications. After time span of 6 weeks, cases were randomly rearranged and sent again to same surgeons for re-classification. Interobserver and intraobserver reliability for each component of TLICS and new AOSpine classification were evaluated using Fleiss Kappa coefficient (k value) and Spearman rank order correlation. Moderate interrater and intrarater reliability was seen for grading fracture type and integrity of posterior ligamentous complex (Fracture type: k = 0.43 ± 0.01 and 0.59 ± 0.16, respectively, PLC: k = 0.47 ± 0.01 and 0.55 ± 0.15, respectively), and fair to moderate reliability (k = 0.29 ± 0.01 interobserver and 0.44+/0.10 intraobserver, respectively) for total score according to TLICS. Moderate interrater (k = 0.59 ± 0.01) and substantial intrarater reliability (k = 0.68 ± 0.13) was seen for grading fracture type regardless of subtype according to AOSpine classification. Near perfect interrater and intrarater agreement was seen concerning neurological status for both the classification systems. Recently proposed AOSpine classification has better reliability for identifying fracture morphology than the existing TLICS. Additional studies are clearly necessary concerning the application of these classification systems across multiple physicians at different level of training and trauma centers to evaluate not
... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Abbreviations. 300.4 Section 300.4... Introduction § 300.4 Abbreviations. (a) Department and Agency Title Abbreviations: ATSDR—Agency for Toxic... the abbreviation “NRC” only with respect to the National Response Center. (b) Operational...
... 49 Transportation 2 2010-10-01 2010-10-01 false Authorized abbreviations. 172.308 Section 172.308... SECURITY PLANS Marking § 172.308 Authorized abbreviations. (a) Abbreviations may not be used in a proper shipping name marking except as authorized in this section. (b) The abbreviation “ORM” may be used in place...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.094-3 Section 86.094...-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.094-3 Abbreviations. (a) The abbreviations in § 86.090-3 remain effective. The abbreviations in this section apply beginning with the 1994 model year. (b...
... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Abbreviations. 86.1703-99 Section 86....1703-99 Abbreviations. (a) The abbreviations in subpart A of this part apply to this subpart. (b) In addition, the following abbreviations shall apply to this subpart: ASTR—All States Trading Region HEV...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.090-3 Section 86.090...-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.090-3 Abbreviations. (a) The abbreviations in § 86.078-3 remain effective. The abbreviations in this section apply beginning with the 1990 model year. (b...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Abbreviations. 88.103-94 Section 88...) CLEAN-FUEL VEHICLES Emission Standards for Clean-Fuel Vehicles § 88.103-94 Abbreviations. The abbreviations of part 86 also apply to this subpart. The abbreviations in this section apply to all of part 88...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Abbreviations. 88.303-93 Section 88...) CLEAN-FUEL VEHICLES Clean-Fuel Fleet Program § 88.303-93 Abbreviations. The abbreviations in subpart A of this part and in 40 CFR part 86 apply to this subpart. The abbreviations in this section apply to...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.000-3 Section 86.000...-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.000-3 Abbreviations. The abbreviations in § 86.098-3 continue to apply to 1998 and later model year vehicles. The abbreviations in this section apply beginning...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.098-3 Section 86.098...-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.098-3 Abbreviations. (a) The abbreviations in § 86.096-3 continue to apply. The abbreviations in this section apply beginning with the 1998 model year...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.096-3 Section 86.096...-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.096-3 Abbreviations. (a) The abbreviations in § 86.094-3 continue to apply. The abbreviation in this section applies beginning with the 1996 model year...
Chang, Chih-Hsiang; Fan, Pei-Chun; Chang, Ming-Yang; Tian, Ya-Chung; Hung, Cheng-Chieh; Fang, Ji-Tseng; Yang, Chih-Wei; Chen, Yung-Chang
Introduction Acute kidney injury (AKI) is a common and serious complication in intensive care unit (ICU) patients and also often part of a multiple organ failure syndrome. The sequential organ failure assessment (SOFA) score is an excellent tool for assessing the extent of organ dysfunction in critically ill patients. This study aimed to evaluate the outcome prediction ability of SOFA and Acute Physiology and Chronic Health Evaluation (APACHE) III score in ICU patients with AKI. Methods A tot...
Moran, Robert W; Schneiders, Anthony G; Mason, Jesse; Sullivan, S John
This paper aims to systematically review studies investigating the strength of association between FMS composite scores and subsequent risk of injury, taking into account both methodological quality and clinical and methodological diversity. Systematic review with meta-analysis. A systematic search of electronic databases was conducted for the period between their inception and 3 March 2016 using PubMed, Medline, Google Scholar, Scopus, Academic Search Complete, AMED (Allied and Complementary Medicine Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Health Source and SPORTDiscus. Inclusion criteria: (1) English language, (2) observational prospective cohort design, (3) original and peer-reviewed data, (4) composite FMS score, used to define exposure and non-exposure groups and (5) musculoskeletal injury, reported as the outcome. (1) data reported in conference abstracts or non-peer-reviewed literature, including theses, and (2) studies employing cross-sectional or retrospective study designs. 24 studies were appraised using the Quality of Cohort Studies assessment tool. In male military personnel, there was 'strong' evidence that the strength of association between FMS composite score (cut-point ≤14/21) and subsequent injury was 'small' (pooled risk ratio=1.47, 95% CI 1.22 to 1.77, p<0.0001, I 2 =57%). There was 'moderate' evidence to recommend against the use of FMS composite score as an injury prediction test in football (soccer). For other populations (including American football, college athletes, basketball, ice hockey, running, police and firefighters), the evidence was 'limited' or 'conflicting'. The strength of association between FMS composite scores and subsequent injury does not support its use as an injury prediction tool. PROSPERO registration number CRD42015025575. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted
Tara K Sigdel
Full Text Available Whole genome microarray meta-analyses of 1030 kidney, heart, lung and liver allograft biopsies identified a common immune response module (CRM of 11 genes that define acute rejection (AR across different engrafted tissues. We evaluated if the CRM genes can provide a molecular microscope to quantify graft injury in acute rejection (AR and predict risk of progressive interstitial fibrosis and tubular atrophy (IFTA in histologically normal kidney biopsies.Computational modeling was done on tissue qPCR based gene expression measurements for the 11 CRM genes in 146 independent renal allografts from 122 unique patients with AR (n = 54 and no-AR (n = 92. 24 demographically matched patients with no-AR had 6 and 24 month paired protocol biopsies; all had histologically normal 6 month biopsies, and 12 had evidence of progressive IFTA (pIFTA on their 24 month biopsies. Results were correlated with demographic, clinical and pathology variables.The 11 gene qPCR based tissue CRM score (tCRM was significantly increased in AR (5.68 ± 0.91 when compared to STA (1.29 ± 0.28; p < 0.001 and pIFTA (7.94 ± 2.278 versus 2.28 ± 0.66; p = 0.04, with greatest significance for CXCL9 and CXCL10 in AR (p <0.001 and CD6 (p<0.01, CXCL9 (p<0.05, and LCK (p<0.01 in pIFTA. tCRM was a significant independent correlate of biopsy confirmed AR (p < 0.001; AUC of 0.900; 95% CI = 0.705-903. Gene expression modeling of 6 month biopsies across 7/11 genes (CD6, INPP5D, ISG20, NKG7, PSMB9, RUNX3, and TAP1 significantly (p = 0.037 predicted the development of pIFTA at 24 months.Genome-wide tissue gene expression data mining has supported the development of a tCRM-qPCR based assay for evaluating graft immune inflammation. The tCRM score quantifies injury in AR and stratifies patients at increased risk of future pIFTA prior to any perturbation of graft function or histology.
Uchino, Y.; Saeki, N.; Yamaura, A.; Okimura, Y.; Tanaka, M.
Objective. The purpose of this study is to examine the relation between Glasgow coma scale (GCS) score and findings on computed tomography (CT) and magnetic resonance (MR) imaging of patients with mild head injury presenting GCS Scores between 13 and 15. Methods. Data were collected from all consecutive patients with mild head injury who were referred to our hospital between July 1 and October 31, 1999. All patients were recommended to undergo CT and MR imaging examinations. Patients younger than 14 years of age were excluded. Results. Ninety patients were recruited into this study. CT scans were obtained in 88 patients and MR imaging were obtained in 65 patients. Of those 90 patients, 2 patients scored 13 points, 5 scored 14 points and 83 (92.2 %) 15 points. Patients with GCS score of 13 points demonstrated parenchymal lesions an both CT and MR imaging. Those with 14 points revealed absence of parenchymal abnormality an CT, but presence of parenchymal lesions an MR imaging. Patients in advanced age (chi square test, p < 0.0001), and those with amnesia (p = 0005, not significant), although scoring 15 points, revealed a tendency to abnormal intracranial lesions on CT scans. Conclusion. It is doubtful whether patients with GCS score 13 should be included in the mild head injury category, due to obvious brain damage on CT scans. MR imaging should be performed on patients with GCS score 14, since the parenchymal lesions are not clearly demonstrated an CT scans. Even if patients scored GCS 15, patients which amnesia or of advanced age should undergo CT scans at minimum, and MR imaging when available. (author)
Malhotra, Rakesh; Kashani, Kianoush B; Macedo, Etienne; Kim, Jihoon; Bouchard, Josee; Wynn, Susan; Li, Guangxi; Ohno-Machado, Lucila; Mehta, Ravindra
Acute kidney injury (AKI) is common in critically ill patients and is associated with high morbidity and mortality. Early identification of high-risk patients provides an opportunity to develop strategies for prevention, early diagnosis and treatment of AKI. We undertook this multicenter prospective cohort study to develop and validate a risk score for predicting AKI in patients admitted to an intensive care unit (ICU). Patients were screened for predictor variables within 48 h of ICU admission. Baseline and acute risk factors were recorded at the time of screening and serum creatinine was measured daily for up to 7 days. A risk score model for AKI was developed with multivariate regression analysis combining baseline and acute risk factors in the development cohort (573 patients) and the model was further evaluated on a test cohort (144 patients). Validation was performed on an independent prospective cohort of 1300 patients. The discriminative ability of the risk model was assessed by the area under the receiver operating characteristic curve (AUROC) and model calibration was evaluated by Hosmer-Lemeshow statistic. AKI was defined by the Kidney Disease: Improving Global Outcomes criteria (absolute change of 0.3 mg/dL or relative change of 50% from baseline serum creatinine in 48 h to 7 days, respectively). AKI developed in 754 (37.2%) patients. In the multivariate model, chronic kidney disease, chronic liver disease, congestive heart failure, hypertension, atherosclerotic coronary vascular disease, pH ≤ 7.30, nephrotoxin exposure, sepsis, mechanical ventilation and anemia were identified as independent predictors of AKI and the AUROC for the model in the test cohort was 0.79 [95% confidence interval (CI) 0.70-0.89]. On the external validation cohort, the AUROC value was 0.81 (95% CI 0.78-0.83). The risk model demonstrated good calibration in both cohorts. Positive and negative predictive values for the optimal cutoff value of ≥ 5 points in test
Full Text Available Abstract Background Traumatic paediatric arterial injuries are a great challenge due to low incidence and specific characteristics of paediatric anatomy and physiology. The aim of the present study was to investigate their epidemiology, diagnostic and therapeutic options and complications. Furthermore, the prognostic value of the Mangled Extremity Severity Score (MESS was evaluated. Methods In a retrospective clinical study 44 children aged 9.0 ± 3.2 years treated for traumatic extremity arterial lesions in our Level I trauma center between 1971 and 2006 were enrolled. Exclusion criteria were age > 14, venous and iatrogenic vascular injury. Demographic data, mechanism of injury, severity of arterial lesions (by Vollmar and MESS, diagnostic and therapeutic management, complications and outcome were evaluated. Results The most commonly injured vessel was the femoral artery (25% followed by the brachial artery (22.7%. The mechanism of injury was penetrating (31.8%, isolated severe blunt extremity trauma (29.6%, multiple trauma (25% and humeral supracondylar fractures (13.6%. In 63.6% no specific vascular diagnostic procedure was performed in favour of emergency surgery. Surgical reconstructive strategies were preferred (68.2%. A MESS Conclusions Traumatic paediatric vascular injuries are very rare. The most common situations of vascular lesions in childhood were penetrating injuries and fractures of the extremities either as isolated injuries or in multiply injured patients. In paediatric patients, the MESS could serve as a basis for decision making for limb salvage or amputation.
Kreiner, David S; Davis, Danielle L
The relationships of self-reported text messaging frequency and knowledge of text message abbreviations with spelling ability were investigated. Two studies were conducted in which the college student participants provided self-reports of text messaging frequency, responded to a test of knowledge of text message abbreviations, and completed a standardized spelling test. In both studies, self-reported text messaging frequency was not predictive of scores on the spelling test. Knowledge of text message abbreviations was positively correlated with spelling scores. In the second study, spelling ability was positively correlated with processing time to identify abbreviations as real. The results were not consistent with the idea that better knowledge of text messaging is predictive of lower spelling ability. Instead, individuals with better knowledge of abbreviations tended to be better spellers.
Lu, Brandy R; Zhang, Song; Narkewicz, Michael R; Belle, Steven H; Squires, Robert H; Sokol, Ronald J
To examine the predictive value of the Liver Injury Units (LIU) and admission values (aLIU) of bilirubin and prothrombin time and international normalized ratio scores in a large cohort from the Pediatric Acute Liver Failure (PALF) Study Group, a multinational prospective study. LIU and aLIU scores were calculated for 461 and 579 individuals, respectively, enrolled in the PALF study from 1999 to 2008. Receiver operator characteristic curves were used to evaluate the scores with respect to survival without liver transplantation (LT), death, or LT by 21 days after enrollment. At 21 days, 50.3% of participants were alive without LT, 36.2% underwent LT, and 13.4% died. The c-indices for transplant-free survival were 0.81 based on the LIU score with the international normalized ratio (95% CI, 0.78-0.85) and 0.76 based on the aLIU score (95% CI, 0.72-0.79). The LIU score predicted LT better than it predicted death (c-index for LT 0.84, c-index for death 0.76). Based on data from a large, multicenter cohort of patients with PALF, the LIU score was a better predictor of transplant-free survival than was the aLIU score. The LIU score might be a helpful, dynamic tool to predict clinical outcomes in patients with PALF. Copyright © 2013 Mosby, Inc. All rights reserved.
Girbes, A C; Girbes, A R J
Abbreviations are used more and more in physician common parlance and it seems they are on the way to becoming a new jargon. However, identical abbreviations may have different meanings, especially in different medical specialties. Moreover, many physicians do not know the meaning of specific abbreviations or are attributing the wrong meaning to the abbreviation. This will lead to misunderstanding and therefore danger to the patient. The authors are calling for a stop on the use of spoken abbreviations and for minimising the use of abbreviations in clinical notes and medical prescriptions.
Woodard, C.T. [Oak Ridge National Lab., TN (United States); Stoss, F.W. [Univ. of Tennessee, Knoxville, TN (United States). Energy, Environment and Resources Center
This list of acronyms and abbreviations is compiled to provide the user with a ready reference to dicipher the linguistic initialisms and abridgements for the study of global change. The terms included in this first edition were selected from a wide variety of sources: technical reports, policy documents, global change program announcements, newsletters, and other periodicals. The disciplinary interests covered by this document include agriculture, atmospheric science, ecology, environmental science, oceanography, policy science, and other fields. In addition to its availability in hard copy, the list of acronyms and abbreviations is available in DOS-formatted diskettes and through CDIAC`s anonymous File Transfer Protocol (FTP) area on the Internet.
Luria, Shai; Rivkin, Gurion; Avitzour, Malka; Liebergall, Meir; Mintz, Yoav; Mosheiff, Ram
Explosion injuries to the upper extremity have specific clinical characteristics that differ from injuries due to other mechanisms. To evaluate the upper extremity injury pattern of attacks on civilian targets, comparing bomb explosion injuries to gunshot injuries and their functional recovery using standard outcome measures. Of 157 patients admitted to the hospital between 2000 and 2004, 72 (46%) sustained explosion injuries and 85 (54%) gunshot injuries. The trauma registry files were reviewed and the patients completed the DASH Questionnaire (Disabilities of Arm, Shoulder and Hand) and SF-12 (Short Form-12) after a minimum period of 1 year. Of the 157 patients, 72 (46%) had blast injuries and 85 (54%) had shooting injuries. The blast casualties had higher Injury Severity Scores (47% vs. 22% with a score of > 16, P = 0.02) and higher percent of patients treated in intensive care units (47% vs. 28%, P = 0.02). Although the Abbreviated Injury Scale score of the upper extremity injury was similar in the two groups, the blast casualties were found to have more bilateral and complex soft tissue injuries and were treated surgically more often. No difference was found in the SF-12 or DASH scores between the groups at follow up. The casualties with upper extremity blast injuries were more severely injured and sustained more bilateral and complex soft tissue injuries to the upper extremity. However, the rating of the local injury to the isolated limb is similar, as was the subjective functional recovery.
Nakaharai, Kazuhiko; Sakamoto, Yohei; Yaita, Kenichiro; Yoshimura, Yukihiro; Igarashi, Shun; Tachikawa, Natsuo
Ceftriaxone has been recognized as a well-tolerated drug; however, in some instances, liver dysfunction occurs after using high-dose ceftriaxone. We aimed to assess the incidence of liver injury due to high-dose ceftriaxone and to determine whether there is a dose-dependent risk of liver injury with this drug. We conducted a retrospective cohort study of hospitalized adult patients treated with ceftriaxone at a tertiary care hospital from January 2012 to October 2013. We collected demographic and clinical data by reviewing their medical records. The incidence of liver injury based on biochemical criteria, defined as a primary outcome, was compared between patients treated with high-dose ceftriaxone (4 g/day) and those treated with a normal dose of ceftriaxone (2 g/day) for ≥5 consecutive days. A propensity score for the use of high-dose ceftriaxone was calculated from five factors. We identified 37 patients treated with high-dose ceftriaxone and 434 patients treated with a normal dose of ceftriaxone. Among these 471 patients, 15 patients (3.2 %) experienced liver injury, of whom six patients (6/37, 16.2 %) had received high-dose ceftriaxone and nine patients (9/434, 2.1 %) had received normal doses of ceftriaxone. In the multivariate analysis adjusted for the propensity score, high-dose ceftriaxone was independently associated with liver injury (odds ratio, 7.23; 95 % confidence interval, 2.01-26.0). The present study revealed that high-dose ceftriaxone was associated with a significantly higher incidence of liver injury compared with the normal-dose regimen. Therefore, clinicians should carefully observe for signs of liver injury after high-dose ceftriaxone use.
Ehrlich, Peter F; Brown, J Kristine; Sochor, Mark R; Wang, Stewart C; Eichelberger, Martin E
Motor vehicle crashes account for more than 50% of pediatric injuries. Triage of pediatric patients to appropriate centers can be based on the crash/injury characteristics. Pediatric motor vehicle crash/injury characteristics can be determined from an in vitro laboratory using child crash dummies. However, to date, no detailed data with respect to outcomes and crash mechanism have been presented with a pediatric in vivo model. The Crash Injury Research Engineering Network is comprised of 10 level 1 trauma centers. Crashes were examined with regard to age, crash severity (DeltaV), crash direction, restraint use, and airbag deployment. Multiple logistic regression analysis was performed with Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) as outcomes. Standard age groupings (0-4, 5-9, 10-14, and 15-18) were used. The database is biases toward a survivor population with few fatalities. Four hundred sixty-one motor vehicle crashes with 2500 injuries were analyzed (242 boys, 219 girls). Irrespective of age, DeltaV > 30 mph resulted in increased ISS and decreased GCS (eg, for 0-4 years, DeltaV 30: ISS = 19.5, GCS = 10.6; P 15) injuries than did backseat passengers (odds ratio, 1.7; 95% confidence interval, 0.7-3.4). A trend was noted for children younger than 12 years sitting in the front seat to have increased ISS and decreased GCS with airbag deployment but was limited by case number. A reproducible pattern of increased ISS and lower GCS characterized by high severity, lateral crashes in children was noted. Further analysis of the specific injuries as a function and the crash characteristic can help guide management and prevention strategies.
Roemer, Frank W; Frobell, Richard; Lohmander, L Stefan; Niu, Jingbo; Guermazi, Ali
To develop a whole joint scoring system, the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS), for magnetic resonance imaging (MRI)-based assessment of acute anterior cruciate ligament (ACL) injury and follow-up of structural sequelae, and to assess its reliability. Baseline and follow-up 1.5 T MRI examinations from 20 patients of the KANON study, a randomized controlled study comparing a surgical and non-surgical treatment strategy, were assessed for up to six longitudinal visits using a novel MRI scoring system incorporating acute structural tissue damage and longitudinal changes including osteoarthritis (OA) features. Joint features assessed were acute osteochondral injury, traumatic and degenerative bone marrow lesions (BMLs), meniscus morphology and extrusion, osteophytes, collateral and cruciate ligaments including ACL graft, Hoffa-synovitis and effusion-synovitis. Cross-sectional (baseline) and longitudinal (all time points and change) intra- and inter-observer reliability was calculated using weighted (w) kappa statistics and overall percent agreement on a compartmental basis (medial tibio-femoral, lateral tibio-femoral, patello-femoral). Altogether 87 time points were evaluated. Intra-observer reliability ranged between 0.52 (baseline, Hoffa-synovitis) and 1.00 (several features), percent agreement between 52% (all time points, Hoffa-synovitis) and 100% (several features). Inter-observer reliability ranged between 0.00 and 1.00, which is explained by low frequency of some of the features. Altogether, 73% of all assessed 142 parameters showed w-kappa values between 0.80 and 1.00 and 92% showed agreement above 80%. ACLOAS allows reliable scoring of acute ACL injury and longitudinal changes. This novel scoring system incorporates features that may be relevant for structural outcome not covered by established OA scoring instruments. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Methods: This prospective study conducted between June 2005 and August 2006, examined clinical and radiological data of 173 consecutive patients admitted to the emergency surgical ward at Mbarara Regional Referral Hospital with road traffic injuries. Only patients presenting within 24 hours of injury and with 3 or more ...
Jose D Charry
Full Text Available Introduction: Traumatic brain injury (TBI is a public health problem. It is a pathology that causes significant mortality and disability in Colombia. Different calculators and prognostic models have been developed to predict the neurological outcomes of these patients. The Rotterdam computed tomography (CT score was developed for prognostic purposes in TBI. We aimed to examine the accuracy of the prognostic discrimination and prediction of mortality of the Rotterdam CT score in a cohort of trauma patients with severe TBI in a university hospital in Colombia. Materials and Methods: We analyzed 127 patients with severe TBI treated in a regional trauma center in Colombia over a 2-year period. Bivariate and multivariate analyses were used. The discriminatory power of the score, its accuracy, and precision were assessed by logistic regression and as the area under the receiver operating characteristic curve. Shapiro–Wilk, Chi-square, and Wilcoxon tests were used to compare the real outcomes in the cohort against the predicted outcomes. Results: The median age of the patient cohort was 33 years, and 84.25% were male. The median injury severity score was 25, the median Glasgow Coma Scale motor score was 3, the basal cisterns were closed in 46.46% of the patients, and a midline shift of >5 mm was seen in 50.39%. The 6-month mortality was 29.13%, and the Rotterdam CT score predicted a mortality of 26% (P < 0.0001 (area under the curve: 0.825; 95% confidence interval: 0.745–0.903. Conclusions: The Rotterdam CT score predicted mortality at 6 months in patients with severe head trauma in a university hospital in Colombia. The Rotterdam CT score is useful for predicting early death and the prognosis of patients with TBI.
Charen, Thelma; Gillespie, Constantine J.
The National Library of Medicine announces its adoption of the Anglo-American standard for the formulation of journal title abbreviations according to the American National Standard for the Abbreviation of Titles of Periodicals (1969), with individual words abbreviated, in turn, according to the International List of Periodical Title Word Abbreviations (1970). The history of the activity of the specific Z39 Committee of USASI (now ANSI) concerned with journal title abbreviations is reviewed, covering the period from 1962 to the present. A history of the National Clearinghouse for Periodical Title Word Abbreviations and of the International List is also given. Former NLM usage is compared with the forms of the present International List and examples show the major changes in NLM abbreviations. The NLM Rules for Abbreviation of Periodical Titles as derived from the new standard are appended. PMID:5146764
Unal, Melih H; Aydin, Ali; Sonmez, Murat; Ayata, Ali; Ersanli, Dilaver
To evaluate the prognostic value of the Ocular Trauma Score (OTS) in cases of deadly weapon-related open-globe injuries with intraocular foreign bodies. A retrospective, interventional case series included 20 eyes of 20 patients who had deadly weapon-related open-globe injuries with intraocular foreign bodies. The OTS was calculated for each patient by adding the determined numbers of OTS variables at presentation (initial visual acuity, rupture, endophthalmitis, perforating injury, retinal detachment, and afferent pupillary defect). Patients were categorized based on their score (category 1 through 5). Final visual acuities in the OTS categories were calculated and compared to those in OTS study group. No statistically significant difference was found between the categorical distributions of the study patients and those in the OTS study group. No patient in the study was in category 5. The OTS, which was designed to predict visual outcomes of general ocular trauma, may also provide reliable information about the prognosis of deadly weapon-related open-globe injuries with intraocular foreign bodies.
Allen, Casey J; Wagenaar, Amy E; Horkan, Davis B; Baldor, Daniel J; Hannay, William M; Tashiro, Jun; Namias, Nicholas; Sola, Juan E
Injury severity scoring tools allow systematic comparison of outcomes in trauma research and quality improvement by indexing an expected mortality risk for certain injuries. This study investigated the predictive value of the empirically derived ICD9-derived Injury Severity Score (ICISS) compared to expert consensus-derived scoring systems for trauma mortality in a pediatric population. 1935 consecutive trauma patients aged <18 years from 1/2000 to 12/2012 were reviewed. Mechanism of injury (MOI), Injury Severity Score (ISS), Revised Trauma Score (RTS), Trauma Score ISS (TRISS), and ICISS were compared using univariate and multivariate logistic regression analysis and receiver operator characteristic analysis. The population was a median age of 11 ± 6 year, 70 % male, and 76 % blunt injury. Median ISS 13 ± 12 and overall mortality 3.5 %. Independent predictors of mortality were initial hematocrit [odds ratio (OR) 0.83 (0.73-0.95)], HCO3 [OR 0.82 (0.67-0.98)], Glasgow Coma Scale score [OR 0.75 (0.62-0.90)], and ISS [OR 1.10 (1.04-1.15)]. TRISS was superior to ICISS in predicting survival [area under receiver operator curve: 0.992 (0.982-1.000) vs 0.888 (0.838-0.938)]. ICISS was inferior to existing injury scoring tools at predicting mortality in pediatric trauma patients.
... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Abbreviations. 129.3 Section 129.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS TOXIC POLLUTANT EFFLUENT STANDARDS Toxic Pollutant Effluent Standards and Prohibitions § 129.3 Abbreviations. The abbreviations used...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.503-78 Section 86.503-78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Later New Motorcycles; Test Procedures § 86.503-78 Abbreviations. (a) The abbreviations in § 86.403-78...
... 7 Agriculture 13 2010-01-01 2009-01-01 true Abbreviations. 1945.5 Section 1945.5 Agriculture... REGULATIONS (CONTINUED) EMERGENCY Disaster Assistance-General § 1945.5 Abbreviations. The following abbreviations are used in this subpart. (a) ASCS—Agricultural Stabilization and Conservation Service. (b) DAR...
... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Abbreviations. 600.003-77 Section 600.003-77 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL... Model Year Automobiles-General Provisions § 600.003-77 Abbreviations. (a) The abbreviations used in this...
... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Abbreviations. 600.503-78 Section 600... Automobiles)-Procedures for Determining Manufacturer's Average Fuel Economy § 600.503-78 Abbreviations. The abbreviations in § 600.003 apply to this subpart. ...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Abbreviations. 94.3 Section 94.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF... Compression-Ignition Marine Engines § 94.3 Abbreviations. The abbreviations of this section apply to all...
... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Abbreviations. 600.203-77 Section 600... Model Year Automobiles-Procedures for Calculating Fuel Economy Values § 600.203-77 Abbreviations. The abbreviations in § 600.003 apply to this subpart. ...
... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Abbreviations. 86.1503 Section 86.1503 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF... Abbreviations. The abbreviations in § 86.084-3 or in § 86.1804-01, as applicable, apply to this subpart. [64 FR...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Abbreviations. 92.3 Section 92.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR... Locomotives and Locomotive Engines § 92.3 Abbreviations. The abbreviations of this section apply to all...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations. 500.22 Section 500.22 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENT OF GENERAL POLICY OR... PACKAGING AND LABELING ACT § 500.22 Abbreviations. The following abbreviations and none other may be...
... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Abbreviations. 86.884-3 Section 86.884... New Diesel Heavy-Duty Engines; Smoke Exhaust Test Procedure § 86.884-3 Abbreviations. The abbreviations in § 86.078-3 apply to this subpart. ...
... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Abbreviations. 86.703-94 Section 86.703-94 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... § 86.703-94 Abbreviations. The abbreviations in subparts A and B of this part apply to this subpart. ...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.103 Section 86.103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF...; Test Procedures § 86.103 Abbreviations. The abbreviations in subpart A apply to this subpart. [45 FR...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.078-3 Section 86.078-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED...-Fueled and Methanol-Fueled Heavy-Duty Vehicles § 86.078-3 Abbreviations. The abbreviations in this...
... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Abbreviations. 34.2 Section 34.2... EXHAUST EMISSION REQUIREMENTS FOR TURBINE ENGINE POWERED AIRPLANES General Provisions § 34.2 Abbreviations. The abbreviations used in this part have the following meanings in both upper and lower case: COCarbon...
... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Abbreviations. 3002.270 Section 3002.270 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY, HOMELAND SECURITY ACQUISITION REGULATION (HSAR) GENERAL DEFINITIONS OF WORDS AND TERMS Abbreviations 3002.270 Abbreviations...
... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Abbreviations. 86.1303-84 Section 86.1303-84 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED....1303-84 Abbreviations. The abbreviations in § 86.084-3 apply to this subpart. ...
... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Abbreviations. 600.103-78 Section 600.103-78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL... Model Year Automobiles-Test Procedures § 600.103-78 Abbreviations. The abbreviations in § 600.003 apply...
... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Abbreviations. 600.403-77 Section 600... Model Year Automobiles-Dealer Availability of Fuel Economy Information § 600.403-77 Abbreviations. The abbreviations in § 600.003 apply to this subpart. ...
... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Abbreviations. 52.18 Section 52.18 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS General Provisions § 52.18 Abbreviations. Abbreviations used in this part...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Abbreviations. 88.203-94 Section 88.203-94 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CLEAN-FUEL VEHICLES California Pilot Test Program § 88.203-94 Abbreviations. The abbreviations in...
... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Abbreviations. 86.1203-85 Section 86.1203-85 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Methanol-Fueled Heavy-Duty Vehicles § 86.1203-85 Abbreviations. The abbreviations in § 86.079-3 apply to...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.403-78 Section 86.403-78 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Later New Motorcycles, General Provisions § 86.403-78 Abbreviations. The abbreviations used in this...
... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Abbreviations. 600.303-77 Section 600.303-77 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL... Model Year Automobiles-Labeling § 600.303-77 Abbreviations. The abbreviations in § 600.003 apply to this...
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.303-79 Section 86.303-79 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Abbreviations. The abbreviations in § 86.078-3 apply to this subpart. ...
... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Abbreviations. 86.1403 Section 86.1403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF... Short Test Procedures § 86.1403 Abbreviations. The abbreviations in § 86.096-3 apply to this subpart. ...
A comparison of global rating scale and checklist scores in the validation of an evaluation tool to assess performance in the resuscitation of critically ill patients during simulated emergencies (abbreviated as "CRM simulator study IB").
Kim, John; Neilipovitz, David; Cardinal, Pierre; Chiu, Michelle
Crisis resource management (CRM) skills are a set of nonmedical skills required to manage medical emergencies. There is currently no gold standard for evaluation of CRM performance. A prior study examined the use of a global rating scale (GRS) to evaluate CRM performance. This current study compared the use of a GRS and a checklist as formal rating instruments to evaluate CRM performance during simulated emergencies. First-year and third-year residents participated in two simulator scenarios each. Three raters then evaluated resident performance in CRM using edited video recordings using both a GRS and a checklist. The Ottawa GRS provides a seven-point anchored ordinal scale for performance in five categories of CRM, and an overall performance score. The Ottawa CRM checklist provides 12 items in the five categories of CRM, with a maximum cumulative score of 30 points. Construct validity was measured on the basis of content validity, response process, internal structure, and response to other variables. T-test analysis of Ottawa GRS scores was conducted to examine response to the variable of level of training. Intraclass correlation coefficient (ICC) scores were used to measure inter-rater reliability for both scenarios. Thirty-two first-year and 28 third-year residents participated in the study. Third-year residents produced higher mean scores for overall CRM performance than first-year residents (P CRM checklist (P CRM checklist. Users indicated a strong preference for the Ottawa GRS given ease of scoring, presence of an overall score, and the potential for formative evaluation. Construct validity seems to be present when using both the Ottawa GRS and CRM checklist to evaluate CRM performance during simulated emergencies. Data also indicate the presence of moderate inter-rater reliability when using both the Ottawa GRS and CRM checklist.
Greenberg, Jacob K; Yan, Yan; Carpenter, Christopher R; Lumba-Brown, Angela; Keller, Martin S; Pineda, Jose A; Brownson, Ross C; Limbrick, David D
The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006. We included patients younger than 18 years with mTBI (Glasgow Coma Scale [GCS] score, 13-15) and ICI on computed tomography. The data analysis was conducted from May 2015 to October 2016. The primary outcome was the composite of neurosurgical intervention, intubation for more than 24 hours for TBI, or death from TBI. Multivariate logistic regression was used to predict the outcome. The C statistic was used to quantify discrimination, and model performance was internally validated using 10-fold cross-validation. Based on this modeling, the Children's Intracranial Injury Decision Aid score was created. Among 15 162 children with GCS 13 to 15 head injuries who received head computed tomographic imaging in the emergency department, 839 (5.5%) had ICI. The median ages of those with and without a composite outcome were 7 and 5 years, respectively. Among those patients with ICI, 8.7% (n = 73) experienced the primary outcome, including 8.3% (n = 70) who had a neurosurgical intervention. The only clinical variable significantly associated with outcome was GCS score (odds ratio [OR], 3.4; 95% CI, 1.5-7.4 for GCS score 13 vs 15). Significant radiologic predictors included midline shift (OR, 6.8; 95% CI, 3.4-13.8), depressed skull fracture (OR, 6.5; 95% CI, 3.7-11.4), and epidural hematoma (OR, 3.4; 95% CI, 1.8-6.2). The model C statistic was 0.84 (95% CI, 0.79-0.88); the 10-fold cross-validated C statistic
Administration of catechins decreased NSS through inhibiting inflammation and apoptosis, as well as induced the neurotrophic factors in rat brain injury. Catechins may serve as a potential intervention for TBI.
Full Text Available The author of the article treats the process of abbreviations, which he explored forty years ago in his master thesis. The article is based on the corpus created on the basis of Télématin broadcast on French television network TV5. According to the author, clipping is a widespread process that occurs primarily in various forms of oral communication.
Olthof, Dominique C.; Joosse, Pieter; Bossuyt, Patrick M. M.; de Rooij, Philippe P.; Leenen, Loek P. H.; Wendt, Klaus W.; Bloemers, Frank W.; Goslings, J. Carel
Non-operative management (NOM) is the standard of care in hemodynamically stable patients with blunt splenic injury after trauma. Splenic artery embolization (SAE) is reported to increase observation success rate. Studies demonstrating improved splenic salvage rates with SAE primarily compared SAE
Olthof, Dominique C.; Joosse, Pieter; Bossuyt, Patrick M. M.; de Rooij, Philippe P.; Leenen, Loek P. H.; Wendt, Klaus W.; Bloemers, Frank W.; Goslings, J. Carel
Non-operative management (NOM) is the standard of care in hemodynamically stable patients with blunt splenic injury after trauma. Splenic artery embolization (SAE) is reported to increase observation success rate. Studies demonstrating improved splenic salvage rates with SAE primarily compared SAE
autoimmune processes mediating neuropathology. These include multiple sclerosis, myasthenia gravis, systemic lupus erythematosus, Guillain Barre ...the hypothesis that immune-based therapies may have a place in treating injuries of the CNS, particularly in conjunction with stem cell repair (38; 46...followed by centrifugation (3000 x g, 5 min, room temp) (35). Delipidated proteins were physically recovered as a pad positioned at the aqueous
Ortqvist, Maria; Iversen, Maura D; Janarv, Per-Mats
was developed. This study aims to evaluate psychometric properties of the final KOOS-Child when used in children with knee disorders. METHODS: 115 children (boys/girls 51/64, 7-16 years) with knee disorders were recruited. All children (n=115) completed the KOOS-Child, the Child-Health Assessment Questionnaire......BACKGROUND: The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered valid and reliable questionnaire for adults with joint injury or degenerative disease. Recent data indicate a lack of comprehensibility when this is used with children. Thus, a preliminary KOOS-Child...... to evaluate responsiveness and interpretability. RESULTS: After item reduction, the final KOOS-Child consists of 39 items divided into five subscales. No floor or ceiling effects (≤15%) were found. An exploratory factor analysis on subscale level demonstrated that items in all subscales except for Symptoms...
Ortqvist, M.; Roos, E. M.; Brostrom, E. W.
of separate subscale scores as a profile. However, its applicability in children has not been established. In this study, we examined how well the KOOS could be understood in a cohort of children with knee injury, with a view to preparing a pediatric version (KOOS-Child). Material and methods A trained...... researcher conducted cognitive interviews with 34 Swedish children who had symptomatic knee injuries (either primary or repeated). They were 10-16 years of age, and were selected to allow for equal group representation of age and sex. All the interviews were recorded. 4 researchers analyzed the data...... and modified the original KOOS questionnaire. Results Many children (n = 14) had difficulty in tracking items based on the time frame and an equivalent number of children had trouble in understanding several terms. Mapping errors resulted from misinterpretation of items and from design issues related...
Gedeborg, Rolf; Warner, Margaret; Chen, Li-Hui; Gulliver, Pauline; Cryer, Colin; Robitaille, Yvonne; Bauer, Robert; Ubeda, Clotilde; Lauritsen, Jens; Harrison, James; Henley, Geoff; Langley, John
The International Statistical Classification of Diseases, 10th Revision (ICD-10)-based Injury Severity Score (ICISS) performs well but requires diagnosis-specific survival probabilities (DSPs), which are empirically derived, for its calculation. The objective was to examine if DSPs based on data pooled from several countries could increase accuracy, precision, utility, and international comparability of DSPs and ICISS. Australia, Argentina, Austria, Canada, Denmark, New Zealand, and Sweden provided ICD-10-coded injury hospital discharge data, including in-hospital mortality status. Data from the seven countries were pooled using four different methods to create an international collaborative effort ICISS (ICE-ICISS). The ability of the ICISS to predict mortality using the country-specific DSPs and the pooled DSPs was estimated and compared. The pooled DSPs were based on a total of 3,966,550 observations of injury diagnoses from the seven countries. The proportion of injury diagnoses having at least 100 discharges to calculate the DSP varied from 12% to 48% in the country-specific data set and was 66% in the pooled data set. When compared with using a country's own DSPs for ICISS calculation, the pooled DSPs resulted in somewhat reduced discrimination in predicting mortality (difference in c statistic varied from 0.006 to 0.04). Calibration was generally good when the predicted mortality risk was less than 20%. When Danish and Swedish data were used, ICISS was combined with age and sex in a logistic regression model to predict in-hospital mortality. Including age and sex improved both discrimination and calibration substantially, and the differences from using country-specific or pooled DSPs were minor. Pooling data from seven countries generated empirically derived DSPs. These pooled DSPs facilitate international comparisons and enables the use of ICISS in all settings where ICD-10 hospital discharge diagnoses are available. The modest reduction in performance of
Full Text Available Acute kidney injury (AKI is a common and serious complication in intensive care unit (ICU patients and also often part of a multiple organ failure syndrome. The sequential organ failure assessment (SOFA score is an excellent tool for assessing the extent of organ dysfunction in critically ill patients. This study aimed to evaluate the outcome prediction ability of SOFA and Acute Physiology and Chronic Health Evaluation (APACHE III score in ICU patients with AKI.A total of 543 critically ill patients were admitted to the medical ICU of a tertiary-care hospital from July 2007 to June 2008. Demographic, clinical and laboratory variables were prospectively recorded for post hoc analysis as predictors of survival on the first day of ICU admission.One hundred and eighty-seven (34.4% patients presented with AKI on the first day of ICU admission based on the risk of renal failure, injury to kidney, failure of kidney function, loss of kidney function, and end-stage renal failure (RIFLE classification. Major causes of the ICU admissions involved respiratory failure (58%. Overall in-ICU mortality was 37.9% and the hospital mortality was 44.7%. The predictive accuracy for ICU mortality of SOFA (areas under the receiver operating characteristic curves: 0.815±0.032 was as good as APACHE III in the AKI group. However, cumulative survival rates at 6-month follow-up following hospital discharge differed significantly (p<0.001 for SOFA score ≤10 vs. ≥11 in these ICU patients with AKI.For patients coexisting with AKI admitted to ICU, this work recommends application of SOFA by physicians to assess ICU mortality because of its practicality and low cost. A SOFA score of ≥ "11" on ICU day 1 should be considered an indicator of negative short-term outcome.
Sinha, Richa; Slavin, Mary D; Kisala, Pamela A; Ni, Pengsheng; Tulsky, David S; Jette, Alan M
To develop functional ability levels for the Spinal Cord Injury Functional Index (SCI-FI) and to validate them using calibration and reliability samples. Three-phase strategy involved (1) performing quantitative synthesis of SCI-FI data to create item maps; (2) using a panel of experts to identify functional ability levels after the bookmarking and Delphi consensus-building process; and (3) performing quantitative analyses to examine demographic characteristics across 2 samples, assessing the distribution pattern across functional ability levels, and examining concurrent validity using the self-reported functional measure and the observer-rated FIM. Inpatient and community settings. People 18 years or older with traumatic spinal cord injury (N=1124) were recruited from the Spinal Cord Injury Model Systems programs and stratified by diagnosis, severity, and time since injury (n=855 and n=269 for calibration and reliability samples, respectively). Not applicable. SCI-FI. Five functional ability levels were identified for all SCI-FI domains, except fine motor having 4 functional ability levels. Statistical test results indicated no significant differences in the distribution pattern across the 2 samples across functional ability levels for all domains except for ambulation. Known-group comparisons were able to discern the spinal cord injury population as expected. Basic mobility, self-care, and wheelchair mobility domains had a cluster of persons with paraplegia and incomplete lesions at higher functional ability levels and persons with tetraplegia and complete lesions at lower functional ability levels. For the ambulation domain, the distribution was skewed to the lower end, with a relatively small percentage of persons with incomplete lesions (paraplegia and tetraplegia) at higher functional ability levels. For the fine motor domain, the distribution was skewed to higher functional ability levels, with a high percentage of persons with paraplegia at the highest
This book deals with abbreviation of nuclear energy terms, which are in alphabetical order. List of abbreviation of nuclear energy term can be used in various field like the medical world, power plant and research center of researchers and students. This book contains a lot of abbreviation of nuclear energy term like LWR, PWR, SG, MGE, MNE, MNF, AINS, AMS, ATWS, CARE, EOF, MCR, RIMS, SMS and TRF.
Baunsgaard, C. B.; Nissen, U. V.; Christensen, K. B.
STUDY DESIGN: Intra- and inter-rater reliability study. OBJECTIVES: To assess intra- and inter-rater reliability of the Modified Ashworth Scale (MAS) and Spasm Frequency Score (SFS) in lower extremities in a population of spinal cord-injured persons, as well as correlations between the two scales...
"AB" The official French logo for certified organic produce ("Agriculture Biologique") CF Conventional farming EF Ecological farming IFS Integrated farming systems LIF Low-input farming OF Organic farming OFgc Organic farming under group certification AFSAA Agence Française de Sécurité Sanitaire des Aliments (French food safety agency) AMAP Association pour le Maintien d'une Agriculture Paysanne (Association for the maintenance of small-scale farming – there is a network of such associations ...
Reports contain a large number of abbreviations which have not yet been included in the current specialized dictionaries or lists of abbreviations. It is therefore often time-consuming or even fruitless to search for such abbreviations. The present alphabetical list of more than 4,000 abbreviations gathered from the report inventory of the Central Library of the KFA Juelich in the period from 1982-1986, taking into consideration all the scientific and technical disciplines, is intended to remedy a deficiency and to offer assistance which will undoubtedly be welcomed by scientists and engineers. (orig./HP) [de
Matsumoto, Shokei; Jung, Kyoungwon; Smith, Alan; Coimbra, Raul
Ligation can be used as part of damage-control operations under critical conditions after IVC injury. Inferior vena cava ligation could potentially yield greater survival benefit compared with repair after injury. We hypothesized that ligation significantly improves outcomes compared with repair. The National Trauma Data Bank dataset for 2007-2014 was reviewed. Eligible patients included those sustaining IVC injury who underwent surgical ligation or repair. Data on demographics, outcomes, and complications were collected. Comparative analysis of demographic characteristics, complications and outcomes were performed. There were 4,865 patients identified in the National Trauma Data Bank with IVC injury. A total of 1,316 patients met inclusion criteria. Four hundred and forty-seven patients (34.0%) underwent ligation and 869 (66.0%) underwent repair. Before matching, the ligation group was sicker than the repair group and the in-hospital mortality was significantly higher in the ligation group (43.8% vs 36.2%; odds ratio [OR] 1.37; 95% CI 1.09 to 1.73). One to one propensity score matching generated 310 pairs. After propensity score matching, in-hospital mortality was similar (41.3% vs 39.0%; OR 1.10; 95% CI 0.80 to 1.52). However, IVC ligation was associated with significantly higher complication rates of extremity compartment syndrome (OR 5.23; 95% CI 1.50 to 18.24), pneumonia (OR 1.76; 95% CI 1.08 to 2.86), deep venous thrombosis (OR 2.83 95% CI 1.70 to 4.73), pulmonary embolism (OR 3.63; 95% CI 1.18 to 11.17), and longer hospital length of stay (17.0 days [interquartile range 1.0 to 35.0 days] vs 9.0 days [interquartile range 1.0 to 22.0 days]; p = 0.002). Inferior vena cava ligation is not superior to repair in terms of decreasing mortality in patients with IVC injury, but it is associated with higher complication rates and hospital LOS. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Farnsworth, James L; McElhiney, Danielle; David, Shannon; Sinha, Gaurav; Ragan, Brian G
To describe the potential benefit of using a global positioning system (GPS) and accelerometry as an objective functional-activity measure after concussion by creating Movement and Activity in Physical Space (MAPS) scores. A 21-year-old female soccer player suffered a blow to the back of the head from an opponent's shoulder during an away match. No athletic trainer was present. She played the remainder of the match and reported to the athletic training facility the next day for evaluation. Concussion. The athlete was removed from all athletic activities. Her symptoms were monitored based on the Zurich guidelines. She was also instructed to wear an accelerometer on her hip and to carry an on-person GPS receiver at all times for 10 days. Her total symptom scores for the 4 symptomatic days were 82, 39, 49, and 36. Her mean MAPS functional score for symptomatic days 3 through 5 was 900.9 and for asymptomatic days 6 through 11 was 2734.9. We monitored the patient's function during the concussion-recovery process using an on-person GPS receiver and accelerometer to calculate personalized MAPS scores. This novel approach to measuring function after injury may provide a useful complementary tool to help with return-to-play decisions. An on-person GPS receiver and accelerometer were used to observe the patient's physical activity in a free-living environment, allowing for an objective measure of function during recovery. Her MAPS scores were low while she was symptomatic and increased as she became asymptomatic. We saw the expected inverse relationship between symptoms and function. In situations where accuracy of reported symptoms may be a concern, this measure may provide a way to verify the validity of, or raise doubts about, self-reported symptoms.
Yeh, T-S; Huang, Y-P; Wang, H-I; Pan, S-L
To investigate whether patients with spinal cord injury (SCI) are at an increased risk of developing Parkinson's disease (PD). A population-based, propensity score-matched, longitudinal follow-up cohort study. The study was conducted using the National Health Insurance (NHI) Research Database. A total of 10 125 patients with at least 2 ambulatory visits with a diagnosis of SCI in 2001 were enrolled in the SCI group. The non-SCI group comprised 10 125 propensity score-matched patients without SCI. The propensity scores were computed using a logistic regression model that included age, sex, comorbidities and socioeconomic status. The PD-free survival rates of the two groups were estimated using the Kaplan-Meier method. Stratified Cox proportional hazard regression was used to estimate the effect of SCI on subsequent occurrence of PD. During the 3-year follow-up period, 99 subjects in the SCI group and 59 in the non-SCI group developed PD. The hazard ratio of PD for the SCI group compared with the non-SCI group was 1.65 (95% confidence interval 1.16-2.33, P=0.0049). The PD-free survival rate for the SCI group was lower than that for the non-SCI group (P=0.0017). This study shows that SCI is associated with a subsequent increased risk of PD. Further studies are needed to elucidate the mechanism underlying this association.
Full Text Available Objective The objective of this study is to determine the correlation of Apgar score with asphyxial hepatic injury and neonatal mortality in moderately and severely asphyxiated newborns. Material and Methods This is a secondary analysis of our prospective observational case-controlled study. Sixteen neonates with severe birth asphyxia (five-minute Apgar ≤3 were compared with either 54 moderate asphyxia neonates (five-minute Apgar >3 or 30 normal neonates. Liver function tests were measured on postnatal days 1, 3, and 10 in the study and control groups. Neonatal mortality was observed in the study and control population. Results Correlation of Apgar score in severely asphyxiated neonates compared with normal Apgar score neonates and moderately asphyxiated neonates for deranged hepatic function showed significant correlation (odds ratio [OR] 4.88, 95% CI 3.26–5.84, P = 0.01 and OR 2.46, 95% CI 1.94–3.32, P = 0.02, respectively. There was a significant increase in serum lactate dehydrogenase (LDH and total bilirubin on day 1 and serum LDH at age of 10th postnatal life in severely asphyxiated neonates when compared to moderately asphyxiated neonates, whereas there was a significant decrease in total bilirubin and serum albumin on day 3 in severely asphyxiated neonates. There was a significant increase in serum alanine transaminase, serum LDH, and total bilirubin on day 1, serum aspartate transaminase, serum LDH, and total bilirubin on day 3, and International Normalized Ratio on day 10 of postnatal life when severely asphyxiated neonates were compared with normal neonates. There was a significant reduction in total protein and serum albumin on day 1 and direct bilirubin on day 3 in severely asphyxiated neonates when compared with normal neonates. There was a significant increase in neonatal mortality in severely asphyxiated neonates when compared to the other two groups. Correlation of Apgar score in severely asphyxiated neonates compared with
Tolman, B.J. [comp.
This document lists acronyms used in technical writing. The immense list is supplemented by an appendix containing chemical elements, classified information access, common abbreviations used for functions, conversion factors for selected SI units, a flowcharting template, greek alphabet, metrix terminology, proofreader`s marks, signs and symbols, and state abbreviations.
... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Abbreviations. 117.2 Section 117.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS DETERMINATION OF REPORTABLE QUANTITIES FOR HAZARDOUS SUBSTANCES General Provisions § 117.2 Abbreviations. NPDES equals...
... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Abbreviations. 116.2 Section 116.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS DESIGNATION OF HAZARDOUS SUBSTANCES § 116.2 Abbreviations. ppm=parts per million mg=milligram(s) kg=kilogram(s) mg/l=milligrams(s) per...
... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Abbreviations. 995.5 Section 995.5 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC... HYDROGRAPHIC PRODUCTS General § 995.5 Abbreviations. CEDCertified NOAA ENC Distributor CEVADCertified NOAA ENC...
... 32 National Defense 3 2010-07-01 2010-07-01 true Abbreviations. 552.162 Section 552.162 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND NATIONAL..., and Camp Bonneville § 552.162 Abbreviations. See appendix F to this subpart. ...
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Abbreviations 1302.170 Section 1302.170 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE GENERAL DEFINTIONS OF WORDS AND TERMS Definitions 1302.170 Abbreviations AIRAdditional Item Requirements BPOSenior Bureau...
Delahunt, Eamonn; Fitzpatrick, Helen; Blake, Catherine
To determine if pre-season adductor squeeze test and HAGOS function, sport and recreation subscale scores can identify Gaelic football players at risk of developing groin injury. Prospective study. Senior inter-county Gaelic football team. Fifty-five male elite Gaelic football players (age = 24.0 ± 2.8 years, body mass = 84.48 ± 7.67 kg, height = 1.85 ± 0.06 m, BMI = 24.70 ± 1.77 kg/m 2 ) from a single senior inter-county Gaelic football team. Occurrence of groin injury during the season. Ten time-loss groin injuries were registered representing 13% of all injuries. The odds ratio for sustaining a groin injury if pre-season adductor squeeze test score was below 225 mmHg, was 7.78. The odds ratio for sustaining a groin injury if pre-season HAGOS function, sport and recreation subscale score was football players at risk of developing groin injury. Copyright © 2016 Elsevier Ltd. All rights reserved.
Malec, James F; Whiteneck, Gale G; Bogner, Jennifer A
To integrate previous approaches to scoring the Participation Assessment with Recombined Tools-Objective (PART-O) in a unidimensional scale. Retrospective analysis of PART-O data from the Traumatic Brain Injury Model Systems. Community. Data from individuals (N=469) selected randomly from participants who completed 1-year follow-up in the Traumatic Brain Injury Model Systems were used in Rasch model development. The model was subsequently tested on data from additional random samples of similar size at 1-, 2-, 5-, 10-, and >15-year follow-ups. Not applicable. PART-O. After combining items for productivity and social interaction, the initial analysis at 1-year follow-up indicated relatively good fit to the Rasch model (person reliability=.80) but also suggested item misfit and that the 0-to-5 scale used for most items did not consistently show clear separation between rating levels. Reducing item rating scales to 3 levels (except combined and dichotomous items) resolved these issues and demonstrated good item level discrimination, fit, and person reliability (.81), with no evidence of multidimensionality. These results replicated in analyses at each additional follow-up period. Modifications to item scoring for the PART-O resulted in a unidimensional parametric equivalent measure that addresses previous concerns about competing item relations, and it fit the Rasch model consistently across follow-up periods. The person-item map shows a progression toward greater community participation from solitary and dyadic activities, such as leaving the house and having a friend through social and productivity activities, to group activities with others who share interests or beliefs. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Allen, Casey J; Baldor, Daniel J; Schulman, Carl I; Pizano, Louis R; Livingstone, Alan S; Namias, Nicholas
Florida considers the International Classification Injury Severity Score (ICISS) from hospital discharges within a geographic region in the apportionment of trauma centers (TCs). Patients with an ICISS <0.85 are considered to require triage to a TC, yet many are triaged to an emergency department (ED). We assess outcomes of those with an ICISS <0.85 by the actual triage decision of emergency medical services (EMS). From October 2011 to October 2013, 39,021 consecutive admissions with injury ICD-9 codes were analyzed. ICISS was calculated from the product of the survival risk ratios for a patient's three worst injuries. Outcomes were compared between patients with ICISS <0.85 either triaged to the ED or its separate, neighboring, free-standing TC at a large urban hospital. A total of 32,191 (83%) patients were triaged to the ED by EMS and 6,827 (17%) were triaged to the TC. Of these, 2544 had an ICISS <0.85, with 2145 (84%) being triaged to the TC and 399 (16%) to the ED. In these patients, those taken to the TC more often required admission, and those taken to the ED had better outcomes. When the confounders influencing triage to an ED or a TC are eliminated, those triaged by EMS to the ED rather than the TC had better overall outcomes. EMS providers better identified patients at risk for mortality than did the retrospective application of ICISS. ICISS <0.85 does not identify the absolute need for TC as EMS providers were able to appropriately triage a large portion of this population to the ED.
Boender, Z J; Ultee, J; Hovius, S E R
In the recovery process of sensibility after repair of a peripheral nerve injury of the forearm, not only age but also surgical repair techniques are of importance. If regenerating axons are misdirected, reorganisation or other adaptic processes are needed at the level of the somatosensory brain cortex. These processes are thought to be dependent on the patient's cognitive capacity. We conducted a prospective multicentre study to assess the association between cognitive capacity and recovery of sensibility after peripheral nerve damage of the forearm. Patients with a traumatic peripheral nerve lesion of the forearm and consecutive surgical repair were included. After 12 months, the patients were assessed with respect to recovery of sensibility (Semmes-Weinstein monofilaments) and cognitive capacity, with four tests assessing different aspects of cognitive functioning. Twenty-eight patients (25 male, three female; median age: 28.5 years; range: 15-79 years) with median and/or ulnar nerve injury of the forearm were included in the study. Younger age showed a positive association with sensory recovery (beta =-0.845, 95% CI: -1.456 to -0.233; p=0.01). No association was found between the cognitive-capacity tests used and sensory recovery. The present prospective study did not reveal any association between recovery of sensibility measured by Semmes-Weinstein test score and cognitive capacity. Further studies should be performed to confirm these results. 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Rundhaug, Nils Petter; Moen, Kent Gøran; Skandsen, Toril; Schirmer-Mikalsen, Kari; Lund, Stine B; Hara, Sozaburo; Vik, Anne
The influence of alcohol is assumed to reduce consciousness in patients with traumatic brain injury (TBI), but research findings are divergent. The aim of this investigation was to study the effects of different levels of blood alcohol concentration (BAC) on the Glasgow Coma Scale (GCS) scores in patients with moderate and severe TBI and to relate the findings to brain injury severity based on the admission CT scan. In this cohort study, 265 patients (age range 16-70 years) who were admitted to St. Olavs University Hospital with moderate and severe TBI during a 7-year period were prospectively registered. Of these, 217 patients (82%) had measured BAC. Effects of 4 BAC groups on GCS score were examined with ordinal logistic regression analyses, and the GCS scores were inverted to give an OR > 1. The Rotterdam CT score based on admission CT scan was used to adjust for brain injury severity (best score 1 and worst score 6) by stratifying patients into 2 brain injury severity groups (Rotterdam CT scores of 1-3 and 4-6). Of all patients with measured BAC, 91% had intracranial CT findings and 43% had BAC > 0 mg/dl. The median GCS score was lower in the alcohol-positive patients (6.5, interquartile range [IQR] 4-10) than in the alcohol-negative patients (9, IQR 6-13; p brain injury itself seemed to overrun the depressing effect of the alcohol on the CNS. This finding is in agreement with the assumption of many clinicians in the emergency situation.
Hiremath, Shivayogi V; Hogaboom, Nathan S; Roscher, Melissa R; Worobey, Lynn A; Oyster, Michelle L; Boninger, Michael L
To examine (1) differences in quality-of-life scores for groups based on transitions in locomotion status at 1, 5, and 10 years postdischarge in a sample of people with spinal cord injury (SCI); and (2) whether demographic factors and transitions in locomotion status can predict quality-of-life measures at these time points. Retrospective case study of the National SCI Database. Model SCI Systems Centers. Individuals with SCI (N=10,190) from 21 SCI Model Systems Centers, identified through the National SCI Model Systems Centers database between the years 1985 and 2012. Subjects had FIM (locomotion mode) data at discharge and at least 1 of the following: 1, 5, or 10 years postdischarge. Not applicable. FIM-locomotion mode; Severity of Depression Scale; Satisfaction With Life Scale; and Craig Handicap Assessment and Reporting Technique. Participants who transitioned from ambulation to wheelchair use reported lower participation and life satisfaction, and higher depression levels (P.05) or life satisfaction (P>.05) compared with those who transitioned from wheelchair to ambulation. Demographic factors and locomotion transitions predicted quality-of-life scores at all time points (P<.05). The results of this study indicate that transitioning from ambulation to wheelchair use can negatively impact psychosocial health 10 years after SCI. Clinicians should be aware of this when deciding on ambulation training. Further work to characterize who may be at risk for these transitions is needed. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Mi Hye Park
Full Text Available Acute kidney injury (AKI is a frequent complication of liver transplantation and is associated with increased mortality. We identified the incidence and modifiable risk factors for AKI after living-donor liver transplantation (LDLT and constructed risk scoring models for AKI prediction. We retrospectively reviewed 538 cases of LDLT. Multivariate logistic regression analysis was used to evaluate risk factors for the prediction of AKI as defined by the RIFLE criteria (RIFLE = risk, injury, failure, loss, end stage. Three risk scoring models were developed in the retrospective cohort by including all variables that were significant in univariate analysis, or variables that were significant in multivariate analysis by backward or forward stepwise variable selection. The risk models were validated by way of cross-validation. The incidence of AKI was 27.3% (147/538 and 6.3% (34/538 required postoperative renal replacement therapy. Independent risk factors for AKI by multivariate analysis of forward stepwise variable selection included: body-mass index >27.5 kg/m2 [odds ratio (OR 2.46, 95% confidence interval (CI 1.32-4.55], serum albumin 20 (OR 2.01, 95%CI 1.17-3.44, operation time >600 min (OR 1.81, 95%CI 1.07-3.06, warm ischemic time >40 min (OR 2.61, 95%CI 1.55-4.38, postreperfusion syndrome (OR 2.96, 95%CI 1.55-4.38, mean blood glucose during the day of surgery >150 mg/dl (OR 1.66, 95%CI 1.01-2.70, cryoprecipitate > 6 units (OR 4.96, 95%CI 2.84-8.64, blood loss/body weight >60 ml/kg (OR 4.05, 95%CI 2.28-7.21, and calcineurin inhibitor use without combined mycophenolate mofetil (OR 1.87, 95%CI 1.14-3.06. Our risk models performed better than did a previously reported score by Utsumi et al. in our study cohort. Doses of calcineurin inhibitor should be reduced by combined use of mycophenolate mofetil to decrease postoperative AKI. Prospective randomized trials are required to address whether artificial modification of hypoalbuminemia, hyperglycemia
Padua, Darin A; DiStefano, Lindsay J; Beutler, Anthony I; de la Motte, Sarah J; DiStefano, Michael J; Marshall, Steven W
Identifying neuromuscular screening factors for anterior cruciate ligament (ACL) injury is a critical step toward large-scale deployment of effective ACL injury-prevention programs. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment of jump-landing biomechanics. To investigate the ability of the LESS to identify individuals at risk for ACL injury in an elite-youth soccer population. Cohort study. Field-based functional movement screening performed at soccer practice facilities. A total of 829 elite-youth soccer athletes (348 boys, 481 girls; age = 13.9 ± 1.8 years, age range = 11 to 18 years), of whom 25% (n = 207) were less than 13 years of age. Baseline preseason testing for all participants consisted of a jump-landing task (3 trials). Participants were followed prospectively throughout their soccer seasons for diagnosis of ACL injuries (1217 athlete-seasons of follow-up). Landings were scored for "errors" in technique using the LESS. We used receiver operator characteristic curves to determine a cutpoint on the LESS. Sensitivity and specificity of the LESS in predicting ACL injury were assessed. Seven participants sustained ACL injuries during the follow-up period; the mechanism of injury was noncontact or indirect contact for all injuries. Uninjured participants had lower LESS scores (4.43 ± 1.71) than injured participants (6.24 ± 1.75; t1215 = -2.784, P = .005). The receiver operator characteristic curve analyses suggested that 5 was the optimal cutpoint for the LESS, generating a sensitivity of 86% and a specificity of 64%. Despite sample-size limitations, the LESS showed potential as a screening tool to determine ACL injury risk in elite-youth soccer athletes.
Vrbanić, Tea Schnurrer-Luke; Ravlić-Gulan, Jagoda; Gulan, Gordan; Matovinović, Damir
Female athletes participating in high-risk sports suffer anterior cruciate ligament (ACL) knee injury at a 4- to 6-fold greater rate than do male athletes. ACL injuries result either from contact mechanisms or from certain unexplained non-contact mechanisms occurring during daily professional sports activities. The occurrence of non-contact injuries points to the existence of certain factors intrinsic to the knee that can lead to ACL rupture. When knee joint movement overcomes the static and the dynamic constraint systems, non-contact ACL injury may occur. Certain recent results suggest that balance and neuromuscular control play a central role in knee joint stability, protection and prevention of ACL injuries. The purpose of this study is to evaluate balance neuromuscular skills in healthy Croatian female athletes by measuring their balance index score, as well as to estimate a possible correlation between their balance index score and balance effectiveness. This study is conducted in an effort to reduce the risk of future injuries and thus prevent female athletes from withdrawing from sports prematurely. We analysed fifty-two female athletes in the high-risk sports of handball and volleyball, measuring for their static and dynamic balance index scores, using the Sport KAT 2000 testing system. This method may be used to monitor balance and coordination systems and may help to develop simpler measurements of neuromuscular control, which can be used to estimate risk predictors in athletes who withdraw from sports due to lower sports results or ruptured anterior cruciate ligament and to direct female athletes to more effective, targeted preventive interventions. The tested Croatian female athletes with lower sports results and ACL knee injury incurred after the testing were found to have a higher balance index score compared to healthy athletes. We therefore suggest that a higher balance index score can be used as an effective risk predictor for lower sports results
Watson, C. E.; Clous, E. A.; Jaeger, M.; D'Amours, S. K.
Mild traumatic brain injury is a common presentation to Emergency Departments. Early identification of patients with cognitive deficits and provision of discharge advice are important. The Abbreviated Westmead Post-traumatic Amnesia Scale provides an early and efficient assessment of post-traumatic
Dübendorfer, C; Billeter, A T; Seifert, B; Keel, M; Turina, M
Arterial lactate, base excess (BE), lactate clearance, and Sequential Organ Failure Assessment (SOFA) score have been shown to correlate with outcome in severely injured patients. The goal of the present study was to separately assess their predictive value in patients suffering from traumatic brain injury (TBI) as opposed to patients suffering from injuries not related to the brain. A total of 724 adult trauma patients with an Injury Severity Score (ISS) ≥ 16 were grouped into patients without TBI (non-TBI), patients with isolated TBI (isolated TBI), and patients with a combination of TBI and non-TBI injuries (combined injuries). The predictive value of the above parameters was then analyzed using both uni- and multivariate analyses. The mean age of the patients was 39 years (77 % males), with a mean ISS of 32 (range 16-75). Mortality ranged from 14 % (non-TBI) to 24 % (combined injuries). Admission and serial lactate/BE values were higher in non-survivors of all groups (all p analysis revealed lactate to be the best overall predictor for increased mortality and further septic complications, irrespective of the leading injury. Lactate showed the best performance in predicting sepsis or death in all trauma patients except those with isolated TBI, and the differences were greatest in patients with substantial bleeding. Following isolated TBI, SOFA score was the only parameter which could differentiate survivors from non-survivors on admission, although the SOFA score, too, was not an independent predictor of death following multivariate analysis.
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Full Text Available Objective: To evaluate the factors influencing final vision outcome after surgical repair of open globe injuries and to correlate the Ocular trauma score. Materials and Methods: Retrospective case analysis of patients with open globe injuries at a tertiary referral eye care centre in Singapore was performed. Pre-operative factors affecting final vision outcome in patients with open globe injury and correlation of ocular trauma score in our study with international ocular trauma scoring system was performed. Results: Case records of 172 eyes with open globe injury were analyzed. Mean age was 36. 67 years. Mean follow up was 12.26 m. Males were pre-dominantly affected. Initial visual acuity was ≥20/40, 20/50 < 20/200, 20/200- CF, HM- PL and NLP in 24 (14%, 39 (22.7%, 16 (9.3%, 66 (38.4% and 27 (15.7% eyes respectively. Final visual acuity was ≤20/40, 20/50 < 20/200, 20/200- 1/200, HM- PL and NLP in 76 (44.2%, 28 (16.3%, 11 (6.4%, 30 (17.4% and 27 (15.7% eyes respectively. Ocular trauma score in our study correlates with international ocular trauma scoring system. Conclusion: The present study showed pre-operative variables such as mode of injury, pre-operative visual acuity, traumatic cataract, hyphaema, relative afferent papillary defect, vitreous lossand vitreous hemorrhage to be adversely affecting the final vision outcome. Our study showed a good synchrony with international ocular trauma score (OTS and based on this study we were able to validate application of OTS in Singapore population. Recognizing these factors can help the surgeon in evidence based counseling.
Mokha, Monique; Sprague, Peter A; Gatens, Dustin R
Functional Movement Screen (FMS) scores of ≤14 have been used to predict injury in athletic populations. Movement asymmetries and poor-quality movement patterns in other functional tests have been shown to predict musculoskeletal injury (MSI). Therefore, movement asymmetry or poor-quality movement patterns on the FMS may have more utility in predicting MSI than the composite score. To determine if an asymmetry or score of 1 on an individual FMS test would predict MSI in collegiate athletes. Cohort study. National Collegiate Athletic Association Division II university athletic program. A total of 84 Division II rowers, volleyball players, and soccer players (men: n = 20, age = 20.4 ± 1.3 years, height = 1.77 ± 0.04 m, mass = 73.5 ± 4.8 kg; women: n = 64, age = 19.1 ± 1.2 years, height = 1.69 ± 0.09 m, mass = 64.8 ± 9.4 kg). The FMS was administered during preseason preparticipation examinations. Injury-incidence data were tracked for an academic year by each team's certified athletic trainer via computer software. An MSI was defined as physical damage to the body secondary to athletic activity or an event for which the athlete sought medical care, and resulted in modified training or required protective splitting or taping. Composite FMS scores were categorized as low (≤14) or high (>14). Pearson χ(2) analyses were used to determine if MSI could be predicted by the composite FMS score or an asymmetry or score of 1 on an individual FMS test (P Athletes with FMS scores of ≤14 were not more likely to sustain an injury than those with higher scores (relative risk = 0.68, 95% confidence interval = 0.39, 1.19; P = .15). However, athletes with an asymmetry or individual score of 1 were 2.73 times more likely to sustain an injury than those without (relative risk = 2.73, 95% confidence interval = 1.36, 5.4; P = .001). Asymmetry or a low FMS individual test score was a better predictor of MSI than the composite FMS score.
Semler, Joerg; Wellmann, Katharina; Wirth, Felicitas; Stein, Gregor; Angelova, Srebrina; Ashrafi, Mahak; Schempf, Greta; Ankerne, Janina; Ozsoy, Ozlem; Ozsoy, Umut; Schönau, Eckhard; Angelov, Doychin N; Irintchev, Andrey
Precise assessment of motor deficits after traumatic spinal cord injury (SCI) in rodents is crucial for understanding the mechanisms of functional recovery and testing therapeutic approaches. Here we analyzed the applicability to a rat SCI model of an objective approach, the single-frame motion analysis, created and used for functional analysis in mice. Adult female Wistar rats were subjected to graded compression of the spinal cord. Recovery of locomotion was analyzed using video recordings of beam walking and inclined ladder climbing. Three out of four parameters used in mice appeared suitable: the foot-stepping angle (FSA) and the rump-height index (RHI), measured during beam walking, and for estimating paw placement and body weight support, respectively, and the number of correct ladder steps (CLS), assessing skilled limb movements. These parameters, similar to the Basso, Beattie, and Bresnahan (BBB) locomotor rating scores, correlated with lesion volume and showed significant differences between moderately and severely injured rats at 1-9 weeks after SCI. The beam parameters, but not CLS, correlated well with the BBB scores within ranges of poor and good locomotor abilities. FSA co-varied with RHI only in the severely impaired rats, while RHI and CLS were barely correlated. Our findings suggest that the numerical parameters estimate, as intended by design, predominantly different aspects of locomotion. The use of these objective measures combined with BBB rating provides a time- and cost-efficient opportunity for versatile and reliable functional evaluations in both severely and moderately impaired rats, combining clinical assessment with precise numerical measures.
Paradowski, Przemysław T; Witoński, Dariusz; Kęska, Rafał
Knee Injury and Osteoarthritis Outcome Score (KOOS) is available in over 30 languages and a commonly used Patient-Reported Outcome (PRO) for assessment of treatment effects following knee surgery. The aim of the study was to report the linguistic translational process and evaluate the psychometric...
Nielsen, Christian S; Nebergall, Audrey; Huddleston, James
BACKGROUND: The aim of this prospective multicenter study is to investigate the association among (1) tibial site-specific overhang of medial, anterior, and lateral overhang in relation to Knee Injury and Osteoarthritis Outcome Score pain 1 year after surgery (1 Y KOOS pain) and (2) the malalignm...
Vikram, M; Sundaraganesh, K; Justine, M; Kurup, M; Leonard, J H
The main objective of the study was to investigate postural control impairment in athletes with history of ankle injury by using Balance Error Scoring System (BESS) and to compare with the controls. This is a case-control study that compared postural control among subjects with history of ankle injury with the matched controls. A total of sixty subjects (n = 60) were recruited from the department of physical education and sports science from a higher learning institute. Thirty athletes who had history of ankle injury were recruited for case group and the control group had an another thirty participants who were healthy athletes with no history of ankle injury. BESS was used to measure postural control by estimating the errors committed in standing between the two group of athletes. Independent sample t test was used to compare the means between two groups and the level of significance is set at level of 0.05. The athletes with history of ankle injury scored more number of errors in BESS with high mean value of (15.10 +/- 6.52 errors) than the control group (5.63 / 3.81 errors which was significant at p=0.01 level. Postural control impairment was identified among athletes with history of ankle injury when compared with control group.
MRI interrReader and intra-reader reliabilities for assessing injury morphology and posterior ligamentous complex integrity of the spine according to the thoracolumbar injury classification system and severity score
Lee, Guen Young; Lee, Joon Woo; Choi, Seung Woo; Lim, Hyun Jin; Sun, Hye Young; Kang, Yu Suhn; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Chai, Jee Won; Kim, Su Jin [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of)
To evaluate spine magnetic resonance imaging (MRI) inter-reader and intra-reader reliabilities using the thoracolumbar injury classification system and severity score (TLICS) and to analyze the effects of reader experience on reliability and the possible reasons for discordant interpretations. Six radiologists (two senior, two junior radiologists, and two residents) independently scored 100 MRI examinations of thoracolumbar spine injuries to assess injury morphology and posterior ligamentous complex (PLC) integrity according to the TLICS. Inter-reader and intra-reader agreements were determined and analyzed according to the number of years of radiologist experience. Inter-reader agreement between the six readers was moderate (k = 0.538 for the first and 0.537 for the second review) for injury morphology and fair to moderate (k = 0.440 for the first and 0.389 for the second review) for PLC integrity. No significant difference in inter-reader agreement was observed according to the number of years of radiologist experience. Intra-reader agreements showed a wide range (k = 0.538-0.822 for injury morphology and 0.423-0.616 for PLC integrity). Agreement was achieved in 44 for the first and 45 for the second review about injury morphology, as well as in 41 for the first and 38 for the second review of PLC integrity. A positive correlation was detected between injury morphology score and PLC integrity. The reliability of MRI for assessing thoracolumbar spinal injuries according to the TLICS was moderate for injury morphology and fair to moderate for PLC integrity, which may not be influenced by radiologist' experience.
Zachary M. Bauman
Full Text Available Background. Lung injury prediction score (LIPS is valuable for early recognition of ventilated patients at high risk for developing acute respiratory distress syndrome (ARDS. This study analyzes the value of LIPS in predicting ARDS and mortality among ventilated surgical patients. Methods. IRB approved, prospective observational study including all ventilated patients admitted to the surgical intensive care unit at a single tertiary center over 6 months. ARDS was defined using the Berlin criteria. LIPS were calculated for all patients and analyzed. Logistic regression models evaluated the ability of LIPS to predict development of ARDS and mortality. A receiver operator characteristic (ROC curve demonstrated the optimal LIPS value to statistically predict development of ARDS. Results. 268 ventilated patients were observed; 141 developed ARDS and 127 did not. The average LIPS for patients who developed ARDS was 8.8±2.8 versus 5.4±2.8 for those who did not (p<0.001. An ROC area under the curve of 0.79 demonstrates LIPS is statistically powerful for predicting ARDS development. Furthermore, for every 1-unit increase in LIPS, the odds of developing ARDS increase by 1.50 (p<0.001 and odds of ICU mortality increase by 1.22 (p<0.001. Conclusion. LIPS is reliable for predicting development of ARDS and predicting mortality in critically ill surgical patients.
Lövestam, Elin; Velupillai, Sumithra; Kvist, Maria
A list of 266 abbreviations from dieticians' notes in patient records was used to extract the same abbreviations from patient records written by three professions: dieticians, nurses and physicians. A context analysis of 40 of the abbreviations showed that ambiguous meanings were common. Abbreviations used by dieticians were found to be used by other professions, but not always with the same meaning. This ambiguity of abbreviations might cause misunderstandings and put patient safety at risk.
Hodgson, L E; Dimitrov, B D; Roderick, P J; Venn, R; Forni, L G
Hospital-acquired acute kidney injury (HA-AKI) is associated with a high risk of mortality. Prediction models or rules may identify those most at risk of HA-AKI. This study externally validated one of the few clinical prediction rules (CPRs) derived in a general medicine cohort using clinical information and data from an acute hospitals electronic system on admission: the acute kidney injury prediction score (APS). External validation in a single UK non-specialist acute hospital (2013-2015, 12 554 episodes); four cohorts: adult medical and general surgical populations, with and without a known preadmission baseline serum creatinine (SCr). Performance assessed by discrimination using area under the receiver operating characteristic curves (AUCROC) and calibration. HA-AKI incidence within 7 days (kidney disease: improving global outcomes (KDIGO) change in SCr) was 8.1% (n=409) of medical patients with known baseline SCr, 6.6% (n=141) in those without a baseline, 4.9% (n=204) in surgical patients with baseline and 4% (n=49) in those without. Across the four cohorts AUCROC were: medical with known baseline 0.65 (95% CIs 0.62 to 0.67) and no baseline 0.71 (0.67 to 0.75), surgical with baseline 0.66 (0.62 to 0.70) and no baseline 0.68 (0.58 to 0.75). For calibration, in medicine and surgical cohorts with baseline SCr, Hosmer-Lemeshow p values were non-significant, suggesting acceptable calibration. In the medical cohort, at a cut-off of five points on the APS to predict HA-AKI, positive predictive value was 16% (13-18%) and negative predictive value 94% (93-94%). Of medical patients with HA-AKI, those with an APS ≥5 had a significantly increased risk of death (28% vs 18%, OR 1.8 (95% CI 1.1 to 2.9), p=0.015). On external validation the APS on admission shows moderate discrimination and acceptable calibration to predict HA-AKI and may be useful as a severity marker when HA-AKI occurs. Harnessing linked data from primary care may be one way to achieve more accurate
Full Text Available Background: Injury severity scoring systems that quantify and predict trauma outcomes have not been established in Korea. This study was designed to determine the best system for use in the Korean trauma population. Methods: We collected and analyzed the data from trauma patients admitted to our institution from January 2010 to December 2014. Injury Severity Score (ISS, Revised Trauma Score (RTS, and Trauma and Injury Severity Score (TRISS were calculated based on the data from the enrolled patients. Area under the receiver operating characteristic (ROC curve (AUC for the prediction ability of each scoring system was obtained, and a pairwise comparison of ROC curves was performed. Additionally, the cut-off values were estimated to predict mortality, and the corresponding accuracy, positive predictive value, and negative predictive value were obtained. Results: A total of 7,120 trauma patients (6,668 blunt and 452 penetrating injuries were enrolled in this study. The AUCs of ISS, RTS, and TRISS were 0.866, 0.894, and 0.942, respectively, and the prediction ability of the TRISS was significantly better than the others (p < 0.001, respectively. The cut-off value of the TRISS was 0.9082, with a sensitivity of 81.9% and specificity of 92.0%; mortality was predicted with an accuracy of 91.2%; its positive predictive value was the highest at 46.8%. Conclusions: The results of our study were based on the data from one institution and suggest that the TRISS is the best prediction model of trauma outcomes in the current Korean population. Further study is needed with more data from multiple centers in Korea.
Kilshaw, Michael J; Rooker, Jemma; Harding, Ian J
Abbreviations are commonly used in medical literature. Their use has been associated with medical errors and they can be a source of irritation and misunderstanding. There are strict guidelines for their use. This study analysed the use of abbreviations in orthopaedic literature and compared adherence with guidelines in a general orthopaedic and spinal journal. It also examined orthopaedic professionals' understanding of abbreviations. The use of abbreviations in articles over a 3-month period in a general orthopaedic and spinal journal was analysed. The number of abbreviations and adherence with guidelines was recorded. A group of orthopaedic healthcare professionals were tested for their understanding of abbreviations. Almost half of all abbreviations were not properly used and 30% of abbreviations were never defined. Abbreviations were used significantly more often in the spinal journal. Only 40% of abbreviations were correctly defined by the orthopaedic professionals tested. Guidelines regarding the use of abbreviations are not being adhered to by authors or editors. The poor understanding of abbreviations underlines the importance of minimising their use and defining abbreviations when they are used.
Sinha, S; McDermott, F; Srinivas, G; Houghton, P W J
To assess the understanding of commonly used abbreviations in the medical records among healthcare professionals. A selection of abbreviations from surgical inpatient admissions (gathered over a 10 day period in October 2008), in the form of a standard questionnaire, was shown to different members of a multidisciplinary team to examine interpretation and knowledge. 209 questionnaires were analysed. The average correct response was 43%. Foundation Year 1 (F1) doctors scored the highest with 57% correct responses, whereas dieticians fared worst (20% correct). Among different abbreviations, NAD (91%) and SCBU (93%) were most often correctly answered, whereas CIC (3%) and STS (0.5%) were the most incorrectly answered. Certain abbreviations which are mostly used by nurses (eg, OTT) achieved a 75% correct response by them compared to only 11% by F1 and 10% by F2 doctors (pabbreviations such as COBH (p=0.025) and LUTS (pabbreviations. Use of unambiguous and approved list of abbreviations is suggested in order to ensure good communication in patient care.
Colburn, Nona T; Meyer, Richard D
A prospective analysis of the injuries of off-road competition motorcyclist at four International Six Day Enduro (ISDE) events was performed utilizing the injury severity score (ISS) and the abbreviated injury scale (AIS). Of the 1787 participants, approximately 10% received injuries that required attention from a medical response unit. The majority (85%) sustained a mild injury (mean ISS 3.9). Loss of control while jumping and striking immovable objects were important risk determinants for serious injury. Although seasoned in off-road experiences, mean 15.3 years, 54% of those injured were first year rookies to the ISDE event. Speeds were below 50 km/h in the majority of accidents (80%), and were not statistically correlated with severity. The most frequently injured anatomical regions were the extremities (57%). The most common types of injury were ligamentous (50%). Seventy-seven percent of all fractures were AIS grades 1 and 2. The most common fractures were those of the foot and ankle (36%). Multiple fractures involving different anatomical regions, or a combination of serious injuries was seen with only one rider. When compared to the injuries of the street motorcyclist, competition riders had lower AIS grades of head and limb trauma. Off-road motorcycle competition is a relatively safe sport with injury rates comparably less than those of contact sports such as American football and hockey.
Hu, Jia; Guo, Ying-Qiang; Zhang, Er-Yong; Tan, Jin; Shi, Ying-Kang
The goal of this study was to analyze the patterns, therapeutic modalities, and short-term outcomes of patients with chest injuries in the aftermath of the Wen-Chuan earthquake, which occurred on May 12, 2008 and registered 8.0 on the Richter scale. Of the 1522 patients who were referred to the West China Hospital of Sichuan University from May 12 to May 27, 169 patients (11.1%) had suffered major chest injuries. The type of injury, the presence of infection, Abbreviated Injury Score (AIS 2005), New Injury Severity Score (NISS), treatment, and short-term outcome were all documented for each case. Isolated chest injuries were diagnosed in 129 patients (76.3%), while multiple injuries with a major chest trauma were diagnosed in 40 patients (23.7%). The mean AIS and the median NISS of the hospitalized patients with chest injuries were 2.5 and 13, respectively. The mortality rate was 3.0% (5 patients). Most of the chest injuries were classified as minor to moderate trauma; however, coexistent multiple injuries and subsequent infection should be carefully considered in medical response strategies. Coordinated efforts among emergency medical support groups and prior training in earthquake preparedness and rescue in earthquake-prone areas are therefore necessary for efficient evacuation and treatment of catastrophic casualties.
Full Text Available The association between preoperative aspirin use and postoperative acute kidney injury (AKI in cardiovascular surgery is unclear. We sought to evaluate the effect of preoperative aspirin use on postoperative AKI in cardiac surgery.A total of 770 patients who underwent cardiovascular surgery under cardiopulmonary bypass were reviewed. Perioperative clinical parameters including preoperative aspirin administration were retrieved. We matched 108 patients who took preoperative aspirin continuously with patients who stopped aspirin more than 7 days or did not take aspirin for the month before surgery. The parameters used in the matching included variables related to surgery type, patient's demographics, underlying medical conditions and preoperative medications.In the first seven postoperative days, 399 patients (51.8% developed AKI, as defined by the Kidney Disease Improving Global Outcomes (KDIGO criteria and 128 patients (16.6% required hemodialysis. Most patients took aspirin 100 mg once daily (n = 195, 96.5% and the remaining 75 mg once daily. Multivariable analysis showed that preoperative maintenance of aspirin was independently associated with decreased incidence of postoperative AKI (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.21-0.98, P = 0.048; after propensity score matching: OR 0.39, 95% CI 0.22-0.67, P = 0.001. Preoperative maintenance of aspirin was associated with less incidence of AKI defined by KDIGO both in the entire and matched cohort (n = 44 [40.7%] vs. 69 [63.9%] in aspirin and non-aspirin group, respectively in matched sample, relative risk [RR] 0.64, 95% CI 0.49, 0.83, P = 0.001. Preoperative aspirin was associated with decreased postoperative hospital stay after matching (12 [9-18] days vs. 16 [10-25] in aspirin and non-aspirin group, respectively, P = 0.038. Intraoperative estimated or calculated blood loss using hematocrit difference and estimated total blood volume showed no difference according to aspirin
The edition of this English and German list of abbreviations comprises about 5200 entries in English and about 1400 entries in German as well as the most important American, English, German and other foreign Utilities and component manufacturers frequently quoted in nuclear engineering literature and documentation. (orig./HP) [de
... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Abbreviations. 86.203-94 Section 86.203-94 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Later Model Year Gasoline-Fueled New Light-Duty Vehicles, New Light-Duty Trucks and New Medium-Duty...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Symbols/abbreviations. 89.303 Section... Provisions § 89.303 Symbols/abbreviations. (a) The abbreviations in § 86.094-3 or part 89.3 of this chapter apply to this subpart. (b) The abbreviations in table 1 in appendix A of this subpart apply to this...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Symbols/abbreviations. 89.403 Section... Procedures § 89.403 Symbols/abbreviations. (a) The abbreviations in § 86.094-3 or § 89.3 of this chapter apply to this subpart. (b) The abbreviations in Table 1 in appendix A to subpart D also apply to this...
He, J.; Chen, J.; Hellwich, K. H.; Hess, M.; Horie, K.; Jones, R. G.; Kahovec, Jaroslav; Kitayama, T.; Kratochvíl, Pavel; Meille, S. V.; Mita, I.; dos Santos, C.; Vert, M.; Vohlídal, J.
Roč. 86, č. 6 (2014), s. 1003-1015 ISSN 0033-4545 Institutional support: RVO:61389013 Keywords : abbreviations * IUPAC Polymer Division * polymer names Subject RIV: CD - Macromolecular Chemistry Impact factor: 2.492, year: 2014
Michalitsis, Sotirios; Vlychou, Mariana; Malizos, Konstantinos N; Thriskos, Paschal; Hantes, Michael E
Anterior cruciate ligament (ACL) rupture is associated with meniscal tears and/or articular cartilage damage. The aim of this study was twofold: (a) to report and correlate the incidence of meniscal and cartilage lesions in ACL-deficient knees with time from injury and (b) to correlate lesions of menisci and cartilage with widely used knee scores. Data were analysed from 109 consecutive patients with ACL rupture. Meniscal and articular cartilage lesions were documented during the arthroscopic reconstruction of the ACL. Patients were distributed into 3 groups according to time from injury; group A: 0-3 months (35 patients), group B: 3-12 months (39 patients) and group C: more than 12 months (35 patients). Lysholm, KOOS and IKDC rating scales were recorded preoperatively. Logistic regression analyses were applied to correlate the concomitant intra-articular pathologies with the time from injury and knee-rating scales. Of 109 patients, 32 (29%) had a medial meniscus tear, 20 (19%) had a lateral meniscus tear, 17 (15%) had both menisci torn and 40 (37%) had no meniscal tear. Analysis revealed that time from injury was not a significant factor for the presence of a meniscal lesion. The odds of development of a high-grade cartilage lesion in an ACL-deficient knee reconstructed more than 12 months from time from injury are 5.5 and 12.5 times higher when compared with knees that underwent ACL reconstruction less than 3 months and between 3 and 12 months after knee injury, respectively. No association was found between intra-articular pathology and the KOOS and Lysholm scores. A positive correlation between the IKDC score and patients without any intra-articular pathology was found. The presence of high-grade cartilage lesions is significantly increased in an ACL-deficient knee when reconstruction is performed more than 12 months after injury. However, the incidence of meniscal tears is not increased significantly. Correlation of intra-articular pathology in ACL
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 91.303 Section 91.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS....303 Acronyms and abbreviations. (a) The acronyms and abbreviations in § 91.5 apply to this subpart. (b...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and... Trading Program General Provisions § 97.203 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III are defined as follows: Btu...
... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Units and abbreviations. 60.3 Section...) STANDARDS OF PERFORMANCE FOR NEW STATIONARY SOURCES General Provisions § 60.3 Units and abbreviations. Used in this part are abbreviations and symbols of units of measure. These are defined as follows: (a...
... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Acronyms and abbreviations. 86.1804-01..., and Complete Otto-Cycle Heavy-Duty Vehicles § 86.1804-01 Acronyms and abbreviations. The following abbreviations apply to this subpart: A/C—Air conditioning. AECD—Auxiliary emission control device. A/F—Air/Fuel...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 91.4...) CONTROL OF EMISSIONS FROM MARINE SPARK-IGNITION ENGINES General § 91.4 Acronyms and abbreviations. The following acronyms and abbreviations apply to this part 91. AECD—Auxiliary emission control device ASME...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Symbols, acronyms, and abbreviations... Gaseous Exhaust Test Procedures § 90.403 Symbols, acronyms, and abbreviations. (a) The acronyms and abbreviations in § 90.5 apply to this subpart. (b) The symbols in Table 1 in Appendix A to Subpart D apply to...
... 7 Agriculture 7 2010-01-01 2010-01-01 false Abbreviations and definitions. 766.2 Section 766.2... AGRICULTURE SPECIAL PROGRAMS DIRECT LOAN SERVICING-SPECIAL Overview § 766.2 Abbreviations and definitions. Abbreviations and definitions for terms used in this part are provided in § 761.2 of this chapter. ...
... 7 Agriculture 15 2010-01-01 2010-01-01 false Definitions and abbreviations. 4274.302 Section 4274... Relending Program (IRP) § 4274.302 Definitions and abbreviations. (a) General definitions. The following..., the Federated States of Micronesia, and the Republic of the Marshall Islands. (b) Abbreviations. The...
... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Units and abbreviations. 61.03 Section...) NATIONAL EMISSION STANDARDS FOR HAZARDOUS AIR POLLUTANTS General Provisions § 61.03 Units and abbreviations. Used in this part are abbreviations and symbols of units of measure. These are defined as follows: (a...
... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 72.3 Section 72.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows...
... 7 Agriculture 7 2010-01-01 2010-01-01 false Abbreviations and definitions. 762.102 Section 762.102 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS GUARANTEED FARM LOANS § 762.102 Abbreviations and definitions. Abbreviations and...
... 7 Agriculture 7 2010-01-01 2010-01-01 false Abbreviations and definitions. 770.2 Section 770.2... AGRICULTURE SPECIAL PROGRAMS INDIAN TRIBAL LAND ACQUISITION LOANS § 770.2 Abbreviations and definitions. (a) Abbreviations. FSA Farm Service Agency, an Agency of the United States Department of Agriculture, including its...
... 7 Agriculture 7 2010-01-01 2010-01-01 false Abbreviations and definitions. 765.2 Section 765.2... AGRICULTURE SPECIAL PROGRAMS DIRECT LOAN SERVICING-REGULAR Overview § 765.2 Abbreviations and definitions. Abbreviations and definitions for terms used in this part are provided in § 761.2 of this chapter. ...
... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Units and abbreviations. 63.3 Section 63.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Units and abbreviations. Used in this part are abbreviations and symbols of units of measure. These are...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 89.3 Section 89.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... abbreviations. The following acronyms and abbreviations apply to part 89. AECD Auxiliary emission control device...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 96.303 Section 96.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR..., abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBBB...
... 32 National Defense 2 2010-07-01 2010-07-01 false Abbreviations and acronyms. 245.6 Section 245.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED... Abbreviations § 245.6 Abbreviations and acronyms. AADC—Area Air Defense Commander ADE—Air Defense Emergency ADIZ...
... 7 Agriculture 7 2010-01-01 2010-01-01 false Abbreviations and definitions. 767.2 Section 767.2... AGRICULTURE SPECIAL PROGRAMS INVENTORY PROPERTY MANAGEMENT Overview § 767.2 Abbreviations and definitions. Abbreviations and definitions for terms used in this part are provided in § 761.2 of this chapter. ...
... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Measurements, abbreviations, and acronyms. 60.4103 Section 60.4103 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR....4103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this...
... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Terms and abbreviations. 50.2... Terms and abbreviations. (a) The definitions for most of the key terms or phrases contained in this part... for HUD assistance or insurance. (b) The following abbreviations are used throughout this part: AS/CPD...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 90.5 Section 90.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... and abbreviations. The following acronyms and abbreviations apply to part 90. AECD—Auxiliary emission...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and... Trading Program General Provisions § 97.3 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows: Btu-British thermal unit. CO2-carbon...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and... IMPLEMENTATION PLANS NOX Budget Trading Program General Provisions § 96.3 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this part are defined as follows: Btu—British...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Symbols, acronyms, abbreviations. 90.303 Section 90.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Equipment Provisions § 90.303 Symbols, acronyms, abbreviations. (a) The acronyms and abbreviations in § 90.5...
... 7 Agriculture 7 2010-01-01 2010-01-01 false Abbreviations and Definitions. 772.2 Section 772.2... AGRICULTURE SPECIAL PROGRAMS SERVICING MINOR PROGRAM LOANS § 772.2 Abbreviations and Definitions. (a) Abbreviations. AMPAssociation-Type Minor Program loan; CFRCode of Federal Regulations; FOFarm Ownership Loan...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and... IMPLEMENTATION PLANS CAIR SO2 Trading Program General Provisions § 96.203 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBB through III are...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and... IMPLEMENTATION PLANS CAIR NOX Annual Trading Program General Provisions § 96.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II are...
... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Terms, abbreviations and... RESPONSIBILITIES Purpose, Legal Authority, Federal Laws and Authorities § 58.2 Terms, abbreviations and definitions... means a habitable structure that has been vacant for more than one year. (b) The following abbreviations...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and... Ozone Season Trading Program General Provisions § 97.303 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BBBB through IIII are defined as...
... 7 Agriculture 7 2010-01-01 2010-01-01 false Abbreviations and definitions. 764.2 Section 764.2 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS DIRECT LOAN MAKING Overview § 764.2 Abbreviations and definitions. Abbreviations...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Acronyms and abbreviations. 87.2 Section 87.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... abbreviations. The abbreviations used in this part have the following meanings in both upper and lower case...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Symbols and abbreviations. 91.403 Section 91.403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Symbols and abbreviations. (a) The abbreviations in § 91.5 apply to this subpart. (b) The symbols in Table...
... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Measurements, abbreviations, and... Annual Trading Program General Provisions § 97.103 Measurements, abbreviations, and acronyms. Measurements, abbreviations, and acronyms used in this subpart and subparts BB through II are defined as...
... the number of carbon atoms in a molecule of that compound. Precision means the standard deviation of... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Definitions and abbreviations. 92.102... Definitions and abbreviations. The definitions and abbreviations of subpart A of this part apply to this...
Roaldsen, Kirsti Skavberg; Måøy, Åsa Blad; Jørgensen, Vivien; Stanghelle, Johan Kvalvik
Translation of the Spinal Cord Injury Falls Concern Scale (SCI-FCS), and investigation of test-retest reliability on item-level and total-score-level. Translation, adaptation and test-retest study. A specialized rehabilitation setting in Norway. Fifty-four wheelchair users with a spinal cord injury. The median age of the cohort was 49 years, and the median number of years after injury was 13. Interventions/measurements: The SCI-FCS was translated and back-translated according to guidelines. Individuals answered the SCI-FCS twice over the course of one week. We investigated item-level test-retest reliability using Svensson's rank-based statistical method for disagreement analysis of paired ordinal data. For relative reliability, we analyzed the total-score-level test-retest reliability with intraclass correlation coefficients (ICC2.1), the standard error of measurement (SEM), and the smallest detectable change (SDC) for absolute reliability/measurement-error assessment and Cronbach's alpha for internal consistency. All items showed satisfactory percentage agreement (≥69%) between test and retest. There were small but non-negligible systematic disagreements among three items; we recovered an 11-13% higher chance for a lower second score. There was no disagreement due to random variance. The test-retest agreement (ICC2.1) was excellent (0.83). The SEM was 2.6 (12%), and the SDC was 7.1 (32%). The Cronbach's alpha was high (0.88). The Norwegian SCI-FCS is highly reliable for wheelchair users with chronic spinal cord injuries.
Full Text Available Introduction: Traumatic brain injury (TBI is a leading cause of death and disability all over the world. It is associated with diversities of outcomes including cognitive deficits. The worse cognitive outcome is often associated with more severe degree of TBI as measured by initial Glasgow Coma Scale (GCS score. Materials and Methods: Present study compared the cognitive function of TBI patients having initial GCS score 9-10 with those having the initial GCS score 11-12. The assessment on Postgraduate Institute battery of brain dysfunction was conducted when the patients came for their follow-up visit at a tertiary health care facility between 6 months and 12 months of sustaining TBI. Results: There was moderate degree of cognitive dysfunction in the group with initial GCS score of 9-10 and no dysfunction in the group with initial GCS score of 11-12. Conclusion: The initial GCS score of 10 may be critical to predict cognitive deficits among TBI patients during 6-12 months of recovery period.
Haque, Ashraful; Scultetus, Anke H; Arnaud, Francoise; Dickson, Leonora J; Chun, Steve; McNamee, George; Auker, Charles R; McCarron, Richard M; Mahon, Richard T
Perfluorocarbons (PFCs) can transport 50 times more oxygen than human plasma. Their properties may be advantageous in preservation of tissue viability in oxygen-deprived states, such as in acute lung injury. We hypothesized that an intravenous dose of the PFC emulsion Oxycyte ® would improve tissue oxygenation and thereby mitigate the effects of acute lung injury. Intravenous oleic acid (OA) was used to induce lung injury in anesthetized and instrumented Yorkshire swine assigned to three experimental groups: (1) PFC post-OA received Oxycyte ® (5 ml/kg) 45 min after oleic acid-induced lung injury (OALI); (2) PFC pre-OA received Oxycyte ® 45 min before OALI; and (3) Controls which received equivalent dose of normal saline. Animals were observed for 3 h after OALI began, and then euthanized. The median survival times for PFC post-OA, PFC pre-OA, and control were 240, 87.5, and 240 min, respectively (p = 0.001). Mean arterial pressure and mean pulmonary arterial pressure were both higher in the PFC post-OA (p lung injury indicated that edema and congestion was significantly less severe in the PFC post-OA compared to control (p = 0.001). The intravenous PFC Oxycyte ® improves blood oxygen content and lung histology when used as a treatment after OALI, while Oxycyte ® used prior to OALI was associated with increased mortality. Further exploration in other injury models is indicated.
Is the Thoracolumbar Injury Classification and Severity Score (TLICS) Superior to the AO Thoracolumbar Injury Classification System for Guiding the Surgical Management of Unstable Thoracolumbar Burst Fractures without Neurological Deficit?
Yuksel, Mehmet Onur; Gurbuz, Mehmet Sabri; Is, Merih; Somay, Hakan
To determine whether the Thoracolumbar Injury Classification and Severity Score (TLICS) and the Arbeitsgemeinschaft für Osteosynthesefragen (AO) Spine Thoracolumbar Injury Classification System have any superiority to each other regarding the reliability of their recommendations in the surgical management of unstable thoracolumbar burst fractures. Fifty-five consecutive patients with thoracolumbar burst fractures undergoing instrumentation between 2010 and 2015 were analyzed retrospectively. TLICS and AO systems were compared based on patients" American Spinal Injury Association (ASIA) scores and they were analyzed for their safety and reliability. A total of 55 patients were studied. Neurological deficits were detected in 18 patients and the remaining 37 patients had normal neurological functions. All the patients with neurological deficits received > 4 points according to TLICS. There were 14 patients with incomplete spinal cord injury and all of them received > 4 points according to TLICS (p AO system. None of the 37 patients without neurological deficit received AO points, to whom AO recommends conservative treatment despite the fact that they had unstable burst fractures (p AO particularly for guiding the surgical management of unstable thoracolumbar burst fractures without neurological deficit. However, this conclusion needs to be verified with further multicenter prospective studies.
Dinh, Michael M; Kastelein, Christopher; Hopkins, Roy; Royle, Timothy J; Bein, Kendall J; Chalkley, Dane R; Ivers, Rebecca
The objectives of the present study were to describe the injury profiles of cyclists presenting to an ED and determine the risk of significant head injury associated with bicycle helmet use. This was a retrospective single trauma centre study of all adult cyclists presenting to an inner city ED and undergoing a trauma team review between January 2012 and June 2014. The outcome of interest was significant head injury defined as any head injury with an Abbreviated Injury Scale score of two or more. Variables analysed included demographic characteristics, helmet use at time of incident, location, time and the presence of intoxication. The most common body regions were upper limb injuries (57%), followed by head injuries (43%), facial injuries (30%) and lower limb injuries (24%). A lower proportion of people wearing helmets had significant head injury (17% vs 31%, P = 0.018) or facial injury (26% vs 48%, P = 0.0017) compared with non-helmet users. After adjustment for important covariates, helmet use was associated with a 70% decrease in the odds of significant head injury (odds ratio 0.34, 95% confidence interval 0.15, 0.76, P = 0.008). Head injuries were common after inner city cycling incidents. The use of helmets was associated with a reduction in significant head injury. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Carroll, Christopher P; Cochran, Joseph A; Price, Janet P; Guse, Clare E; Wang, Marjorie C
The Abbreviated Injury Scale (AIS) is commonly used to score injury severity and describe types of injuries. In 2005, the AIS-Head section was revised to capture more detailed information about head injuries and to better reflect their clinical severity, but the impact of these changes is largely unknown. The purpose of this study was to compare AIS-1998 and AIS-2005 coding of traumatic brain injuries (TBI) using medical records at a single Level I trauma center. We included patients with severe TBI (Glasgow Coma Scale 3-8) after blunt injury, excluding those who were missing medical records. Detailed descriptions of injuries were collected, then manually coded into AIS-1998 and AIS-2005 by the same Certified AIS Specialist. Compared to AIS-1998, AIS-2005 coded the same injuries with lower severity scores [pconsciousness cases due to changes in criteria for coding concussive injury. In conclusion, changes from AIS-1998 to AIS-2005 result in significant differences in severity scores and types of injuries captured. This may complicate future TBI research by precluding direct comparison to datasets using AIS-1998. TBIs should be coded into the same AIS-version for comparison or evaluation of trends, and specify which AIS-version is used.
Scivoletto, G; Tamburella, F; Laurenza, L; Molinari, M
Although the psychometric properties and statistical significance of the International Standards for Neurological Classification of Spinal Cord Injury Patients (ISNCSCI) have been widely examined, the clinical significance of motor and sensory scores (i.e., the improvement in score that has a meaningful impact on patients) is unknown. To calculate the clinical significance of the International Standards for Neurological Classification of Spinal Cord Injury Patients (ISNCSCI). Analysis of prospectively collected data. Spinal Cord Unit of a rehabilitation hospital in the centre of Italy. Analysis of the data of 600 patients with registration of the ISNCSCI Motor scores (total score and separately upper and lower extremity scores) and ISNCSCI Sensory scores. Clinical significance was calculated per several distribution-based approaches: minimal important differences, effect size-based estimates for small and substantial changes, standard error of measurement, and minimal detectable change. The calculated clinical significance was compared with improvements by the patients to determine the percentage of patients who achieved significant improvement. Furthermore, the functional status (as evaluated by the Spinal Cord Independence measure [SCIM III]) was studied in patients who achieved significant improvement compared to those who did not achieve them. The results of the study showed that motor scores were more amenable to change than sensory scores. A 5-point change in motor score resulted in a clinically significant improvement of 0.2 standard deviation units, and an 11-point change in motor score was associated with an improvement of 0.5 standard deviation units. The percentages of patients with a significant improvement varied from 8 to 80% according to the level and severity of the lesion. In some AIS grade/level of lesion groups, patients who achieved clinical significant scores also showed a better functional status with significantly higher SCIM III scores than
Boender, Z. J.; Ultee, J.; Hovius, S. E. R.
In the recovery process of sensibility after repair of a peripheral nerve injury of the forearm, not only age but also surgical repair techniques are of importance. If regenerating axons are misdirected, reorganisation or other adaptic processes are needed at the level of the somatosensory brain
Karina Tavares Weber
Full Text Available ABSTRACT Objective To verify correlations between age, injury severity, length of stay (LOS, cognition, functional capacity and quality of life (QOL six months after hospital discharge (HD of victims of traumatic brain injury (TBI. Method 50 patients consecutively treated in a Brazilian emergency hospital were assessed at admission, HD and six months after HD. The assessment protocol consisted in Abbreviated Injury Scale, Injury Severity Score, Glasgow Coma Scale (GCS, Revised Trauma Score (RTS, Mini Mental Test, Barthel Index and World Health Organization QOL - Brief. Results Strong negative correlation was observed between LOS and GCS and LOS and RTS. An almost maximal correlation was found between RTS and GCS and functional capacity and GCS at HD. Age and LOS were considered independent predictors of QOL. Conclusion Age and LOS are independent predictors of QOL after moderate to severe TBI.
Hansen, Maria Swennergren; Christensen, Marianne; Budolfsen, T
PURPOSE: To investigate how the Achilles tendon Total Rupture Score (ATRS) at 3 months and 1 year after injury is associated with a patient's ability to return to work and sports as well as to investigate whether sex and age influence ATRS after 3 months and 1 year. METHOD: This is a retrospective...... study analysing the data from the Danish Achilles tendon Database. A total of 366 patients were included. Logistic regression was conducted to describe the effect of ATRS on return to work and sports. The effect of age and sex on ATRS was analysed by linear regression. RESULTS: Three months after injury...... patients had a significantly increased chance of return to sport after 1 year with an increased ATRS (OR 1.06, p = 0.001) but a non-significant effect on return to work. After 1 year, patients had a significantly increased probability of having returned to sport (OR 1.11, p
Kamínek, Miroslav; Březinová, Alena; Gaudinová, Alena; Motyka, Václav; Vaňková, Radomíra; Zažímalová, Eva
Roč. 32, - (2001), s. 253-256 ISSN 0167-6903 R&D Projects: GA AV ČR IAA6038002; GA ČR GA522/00/1346; GA ČR GA522/99/1130 Institutional research plan: CEZ:AV0Z5038910 Keywords : cytokinin abbreviations * cytokinins * plant nomenclature Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 0.761, year: 2001
Rozbacher, Adrian; Selci, Erin; Leiter, Jeff; Ellis, Michael; Russell, Kelly
Concussion often results in symptoms, including difficulty concentrating, focusing, and remembering, that are typically managed with cognitive and physical rest. Often, the school environment is not conducive to cognitive rest and may lead to worsening or prolonged symptoms that can contribute to impaired academic performance. The objective of the review was to identify and summarize literature concerning the effects of concussion or mild traumatic brain injury (mTBI) on academic outcomes. MEDLINE, Embase, Scopus, and CINAHL were searched until June 1, 2016. Studies must have been primary literature examining students enrolled in primary, secondary, or post-secondary education, have received a physician diagnosis of concussion or mTBI, and have post-injury academic outcomes assessed in numeric or alphabet grade/grade point average (GPA), school attendance records, or national examination scores. Data were extracted and checked by a second reviewer for accuracy and completeness. Nine studies were included. Among four studies that examined grades, one found a significant difference in pre- and post-grades only in the subject Afrikaans. Three examined national test scores and no significant differences were found between cases and controls. Four examined school absenteeism and found that students who developed post-concussion syndrome missed significantly more school days and took longer to return to school than students with extremity injuries. Although mTBI or concussion is associated with missed school, the results demonstrate minimal impact on school grades and national examination scores at a group level. Further research is needed to identify risk factors for impaired school functioning following mTBI and concussion in individual patients.
Hanschen, Marc; Kanz, Karl-Georg; Kirchhoff, Chlodwig; Khalil, Philipe N; Wierer, Matthias; van Griensven, Martijn; Laugwitz, Karl-Ludwig; Biberthaler, Peter; Lefering, Rolf; Huber-Wagner, Stefan
Blunt cardiac injury is a rare trauma entity. Here, we sought to evaluate the relevance and prognostic significance of blunt cardiac injury in severely injured patients. In a retrospective multicentre study, using data collected from 47,580 patients enrolled to TraumaRegister DGU (1993-2009), characteristics of trauma, prehospital / hospital trauma management, and outcome analysis were correlated to the severity of blunt cardiac injury. The severity of cardiac injury was assessed according to the abbreviated injury score (AIS score 1-6), the revised injury severity score (RISC) allowed comparison of expected outcome with injury severity-dependent outcome. N = 1.090 had blunt cardiac trauma (AIS 1-6) (2.3% of patients). Predictors of blunt cardiac injury could be identified. Sternal fractures indicate a high risk of the presence of blunt cardiac injury (AIS 0 [control]: 3.0%; AIS 1: 19.3%; AIS 2-6: 19.1%). The overall mortality rate was 13.9%, minor cardiac injury (AIS 1) and severe cardiac injury (AIS 2-6) are associated with higher rates. Severe blunt cardiac injury (AIS 4 and AIS 5-6) is associated with a higher mortality (OR 2.79 and 4.89, respectively) as compared to the predicted average mortality (OR 2.49) of the study collective. Multiple injured patients with blunt cardiac trauma are at high risk to be underestimated. Careful evaluation of trauma patients is able to predict the presence of blunt cardiac injury. The severity of blunt cardiac injury needs to be stratified according to the AIS score, as the patients' outcome is dependent on the severity of cardiac injury.
Hanschen, Marc; Kanz, Karl-Georg; Kirchhoff, Chlodwig; Khalil, Philipe N.; Wierer, Matthias; van Griensven, Martijn; Laugwitz, Karl-Ludwig; Biberthaler, Peter; Lefering, Rolf; Huber-Wagner, Stefan
Background Blunt cardiac injury is a rare trauma entity. Here, we sought to evaluate the relevance and prognostic significance of blunt cardiac injury in severely injured patients. Methods In a retrospective multicentre study, using data collected from 47,580 patients enrolled to TraumaRegister DGU (1993-2009), characteristics of trauma, prehospital / hospital trauma management, and outcome analysis were correlated to the severity of blunt cardiac injury. The severity of cardiac injury was assessed according to the abbreviated injury score (AIS score 1-6), the revised injury severity score (RISC) allowed comparison of expected outcome with injury severity-dependent outcome. N = 1.090 had blunt cardiac trauma (AIS 1-6) (2.3% of patients). Results Predictors of blunt cardiac injury could be identified. Sternal fractures indicate a high risk of the presence of blunt cardiac injury (AIS 0 [control]: 3.0%; AIS 1: 19.3%; AIS 2-6: 19.1%). The overall mortality rate was 13.9%, minor cardiac injury (AIS 1) and severe cardiac injury (AIS 2-6) are associated with higher rates. Severe blunt cardiac injury (AIS 4 and AIS 5-6) is associated with a higher mortality (OR 2.79 and 4.89, respectively) as compared to the predicted average mortality (OR 2.49) of the study collective. Conclusion Multiple injured patients with blunt cardiac trauma are at high risk to be underestimated. Careful evaluation of trauma patients is able to predict the presence of blunt cardiac injury. The severity of blunt cardiac injury needs to be stratified according to the AIS score, as the patients’ outcome is dependent on the severity of cardiac injury. PMID:26136126
Full Text Available Blunt cardiac injury is a rare trauma entity. Here, we sought to evaluate the relevance and prognostic significance of blunt cardiac injury in severely injured patients.In a retrospective multicentre study, using data collected from 47,580 patients enrolled to TraumaRegister DGU (1993-2009, characteristics of trauma, prehospital / hospital trauma management, and outcome analysis were correlated to the severity of blunt cardiac injury. The severity of cardiac injury was assessed according to the abbreviated injury score (AIS score 1-6, the revised injury severity score (RISC allowed comparison of expected outcome with injury severity-dependent outcome. N = 1.090 had blunt cardiac trauma (AIS 1-6 (2.3% of patients.Predictors of blunt cardiac injury could be identified. Sternal fractures indicate a high risk of the presence of blunt cardiac injury (AIS 0 [control]: 3.0%; AIS 1: 19.3%; AIS 2-6: 19.1%. The overall mortality rate was 13.9%, minor cardiac injury (AIS 1 and severe cardiac injury (AIS 2-6 are associated with higher rates. Severe blunt cardiac injury (AIS 4 and AIS 5-6 is associated with a higher mortality (OR 2.79 and 4.89, respectively as compared to the predicted average mortality (OR 2.49 of the study collective.Multiple injured patients with blunt cardiac trauma are at high risk to be underestimated. Careful evaluation of trauma patients is able to predict the presence of blunt cardiac injury. The severity of blunt cardiac injury needs to be stratified according to the AIS score, as the patients' outcome is dependent on the severity of cardiac injury.
Silk-Eglit, Graham M; Lynch, Julie K; McCaffrey, Robert J
The Victoria Symptom Validity Test (VSVT) is one of the most accurate performance validity tests. Previous research has recommended several cutoffs for performance invalidity classification on the VSVT. However, only one of these studies used a known groups design and no study has investigated these cutoffs in an exclusively mild traumatic brain injury (mTBI) medico-legal sample. The current study used a known groups design to validate VSVT cutoffs among mild traumatic brain injury litigants and explored the best approach for using the multiple recommended cutoffs for this test. Cutoffs of 6, and <5 items correct on any block yielded the strongest classification accuracy. Using multiple cutoffs in conjunction reduced classification accuracy. Given convergence across studies, a cutoff of <18 Hard items correct is the most appropriate for use with mTBI litigants. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Faget, Claire; Taourel, Patrice; Ruyer, Alban; Alili, Chakib; Millet, Ingrid [CHU Lapeyronie, Department of Medical Imaging, Montpellier (France); Charbit, Jonathan [CHU Lapeyronie, Department of Intensive Care and Anesthesiology, Montpellier (France); Molinari, Nicolas [UMR 729 MISTEA, CHU Montpellier, Department of Medical Information and Statistics, Montpellier (France)
To evaluate the performance of a computed tomography (CT) diagnostic score to predict surgical treatment for blunt bowel and/or mesentery injury (BBMI) in consecutive abdominal trauma. This was a retrospective observational study of 805 consecutive abdominal traumas with 556 patients included and screened by an abdominal radiologist blinded to the patient outcome, to evaluate numerous CT findings and calculate their diagnostic performances. These CT findings were compared using univariate and multivariate analysis between patients who had a laparotomy-confirmed BBMI requiring surgical repair, and those without BBMI requiring surgery. A CT score was obtained with an internal bootstrap validation. Fifty-six patients (10.1 %) had BBMI requiring surgery. Nine CT signs were independently associated with BBMI requiring surgery and were used to develop a CT diagnostic score. The AUC of our model was 0.98 (95 % CI 0.96-100), with a ≥5 cut-off. Its diagnostic performance was determined by internal validation: sensitivity 91.1-100 %, specificity 85.7-97.6 %, positive predictive value 41.4-82.3 % and negative predictive value 98.9-100 %. Bowel wall discontinuity and mesenteric pneumoperitoneum had the strongest association with BBMI requiring surgery (OR = 128.9 and 140.5, respectively). We developed a reliable CT scoring system which is easy to implement and highly predictive of BBMI requiring surgery. (orig.)
Erdem, D.; Hava, D.; Keskinoglu, P.
Study design: Psychometrics study. Objectives: The aim of this study is to investigate the validity, reliability and sensitivity to change of neurogenic bowel dysfunction (NBD) score. Setting: Dokuz Eylul University Faculty of Medicine, Turkey. Methods: The study included 42 patients with spinal ...
Kim, Youngjun; Hurdle, John; Meystre, Stéphane M
Clinical text is rich in acronyms and abbreviations, and they are highly ambiguous. As a pre-processing step before subsequent NLP analysis, we are developing and evaluating clinical abbreviation disambiguation methods. The evaluation of two sequential steps, the detection and the disambiguation of abbreviations, is reported here, for various types of clinical notes. For abbreviations detection, our result indicated the SPECIALIST Lexicon LRABR needed to be revised for better abbreviation detection. Our semi-supervised method using generated training data based on expanded form matching for 12 frequent abbreviations in our clinical notes reached over 90% accuracy in five-fold cross validation and unsupervised approach produced comparable results with the semi-supervised methods.
Lieutaud, Thomas; Ndiaye, Amina; Frost, Fanny; Chiron, Mireille
Fatalities or injuries following motorized and non-motorized vehicle accidents (MNMVA) are reported by police or health care systems. However, limited data exist for spinal injuries. Using an epidemiological database of road accidents occurring in a defined geographic area, we measured the incidence of major spinal trauma (MST, Abbreviated Injury Scale [AIS] score 2 or more), spinal cord injury (SCI, AIS score 4 or more), and associated lesions over a 10-year period (1997-2006). Among the 97,341 victims included, 21,623 (22.2%) suffered spinal trauma, but only 1523 (1.6%) and 144 (0.2%) sustained an MST or SCI, respectively, and among those 10% and 43% died, respectively, before reaching hospital facilities. Men were more likely to have SCI and die. Cervical injuries were more frequently observed for SCI (58%) than for MST (39%; p spinal trauma, and SCI after MNMVA.
This article explores the use of abbreviations in health care. It considers the current advice of the Nursing and Midwifery Council against the use of any abbreviations and suggests, in the interests of using time effectively, that it would be wise for directorates within trusts to create a list of approved abbreviations and symbols so that the dangers of misunderstandings are removed. It also considers how the problem of illegibility should be dealt with as a clinical governance issue.
implement’,d in Orange County, simple triage criteria were devised: BP less than 90; cardiac arrest in the field; severe cardio-pulmonary distress. The BP...Physiologic score CNS + Cardiorespiratory variables b. Anatomic variables, e.g. penetration torso chin to knees c. Co-morbid factors, e.g. age, renal, hepatic...automatically go to a resource center; (1) cardiac arrest , (2) uncontrolled respiratory distress (including flail chest, defined as a respiratory rate of
Abbreviated Guide: Pneumatic Conveying Design Guide describes the selection, design, and specification of conventional pneumatic conveying systems. The design procedure uses previous test data on the materials to be conveyed. The book also discusses system economics, operating costs, the choice of appropriate components or systems, system control, and system flexibility. The design system involves the type of conveying system for installation, the pipeline parameters, and also the plant components. System selection covers the properties of the material to be conveyed, plant layout, material pr
Schwartz, Dagan; Glassberg, Elon; Nadler, Roy; Hirschhorn, Gil; Marom, Ophir Cohen; Aharonson-Daniel, Limor
In the second Lebanon war in 2006, the Israeli Defense Forces fought against well-prepared and well-equipped paramilitary forces. The conflict took place near the Israeli border and major Israeli medical centers. Good data records were maintained throughout the campaign, allowing accurate analysis of injury characteristics. This study is an in-depth analysis of injury mechanisms, severity, and anatomic locations. Data regarding all injured soldiers were collected from all care points up to the definitive care hospitals and were cross-referenced. In addition, trauma branch physicians and nurses interviewed medical teams to validate data accuracy. Injuries were analyzed using Injury Severity Score (ISS) (when precise anatomic data were available) and multiple injury patterns scoring for all. A total of 833 soldiers sustained combat-related injury during the study period, including 119 fatalities (14.3%). Although most soldiers (361) sustained injury only to one Abbreviated Injury Scale (AIS) region, the average number of regions per soldier was 2.0 but was 1.5 for survivors versus 4.2 for fatalities. Current war injury classifications have limitations that hinder valid comparisons between campaigns and settings. In addition, limitation on full autopsy in war fatalities further hinders data use. To partly compensate for those limitations, we have looked at the correlation between fatality rates and number of involved anatomic regions and found it to be strong. We have also found high fatality rates in some "combined" injuries such as head and chest injuries (71%) or in the abdomen and an extremity (75%). The use of multiinjury patterns analysis may help understand fatality rates and improve the utility of war injury analysis. Epidemiologic study, level III.
Keeley, Jessica; Koopmann, Matthew; Yan, Huan; DeVirgilio, Christian; Putnam, Brant; Y Kim, Dennis; Plurad, David
Popliteal artery trauma has the highest rate of limb loss of all peripheral vascular injuries. The objectives of this study were to evaluate outcomes after popliteal vascular injury and to identify predictors of amputation. Retrospective data over a 14-year period were collected for patients with popliteal artery with or without vein injuries. Patient demographics, mechanism of injury, Injury Severity Score (ISS), Mangled Extremity Severity Score (MESS), and physiologic parameters were extracted. Time to operative intervention, operative time, type of vascular repair, need for concomitant orthopedic procedures, and outcomes including amputation rate, and in-hospital mortality were recorded. Fifty-one patients were found to have popliteal artery injuries, with a median age of 25 (range 10-70 years). The median ISS was 9, and the mean extremity Abbreviated Injury Severity score was 3. The mechanism of injury was blunt for 43% and penetrating for 57%. Fasciotomies were performed in 74% of patients and 64% of patients underwent combined orthopedic and vascular procedures. Overall, 66% of these patients had their vascular procedure performed first. Ten patients required amputation: 1 immediate and 9 after attempted limb salvage (20%). We found that those patients requiring amputation had a higher incidence of blunt trauma (80% vs. 35%, P = 0.014) and higher MESS score (7.1 vs. 4.7, P = 0.02). There was no difference in the incidence of amputation for those who underwent orthopedic fixation before vascular repair (P = 0.68). Popliteal vascular injuries continue to be associated with a high risk of amputation. Those patients undergoing attempted limb salvage should be revascularized expediently, but selected patients may undergo orthopedic stabilization before vascular repair without increased risk of limb loss. Copyright © 2016 Elsevier Inc. All rights reserved.
Moutzouri, Maria; Tsoumpos, Pantelis; Billis, Evdokia; Papoutsidakis, Antonis; Gliatis, John
Aim of this study is to assess the psychometric properties of the developed Greek version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in total knee replacement (TKR) patients. Psychometric properties of the Greek version of KOOS were evaluated according to the Consensus-based Standards Measurements Instruments (COSMIN) checklist. Patients' pre-operative clinical status and post-operative outcomes at two occasions (at discharge and 10-12 days post-operatively) were evaluated using the KOOS, KOS-ADL and SF-12 Health Survey. A comprehensive Greek KOOS was piloted and well accepted by patients and therefore administered to 60 consecutive TKR patients (mean age 72.2 ± 7.2 years, 39 women). Excellent Internal consistency, good test-retest reliability of KOOS and KOOS 5 subdomains, respectively [ICC(2-1) 0.76, 95% CI = 0.235-0.902 and 0.89, 95% CI = 0.843-0.927] was yielded. A priori hypotheses for construct validity were confirmed with KOOS score and subdomains for pain, symptoms and Everyday Living function (ADL) correlating moderately with KOS-ADL. Responsiveness for KOOS subdomains of Pain and Symptoms yielded moderate effect size (ES = 0.4). The Greek KOOS was found to be a practical and comprehensible self-reported measure for TKR patients with acceptable psychometric properties. It is therefore, recommendable for usage in future clinical trials and clinical practice. Implications for Rehabilitation The Greek version of KOOS is an essential assessment scale to evaluate not only acute injuries but also chronic knee associated conditions in a holistic perspective. The Greek KOOS has been found to be a practical and comprehensible self-reported measure for TKR patients with acceptable psychometric properties, recommendable for usage in future clinical trials and clinical practice. KOOS Greek version (downloadable at the official site http://www.koos.nu/koosgreek.pdf ) was used in the validity study.
Alam, Murad; Dover, Jeffrey S; Alam, Murad; Goldman, Mitchel P; Kaminer, Michael S; Orringer, Jeffrey; Waldorf, Heidi; Alam, Murad; Avram, Mathew; Cohen, Joel L; Draelos, Zoe Diana; Dover, Jeffrey S; Hruza, George; Kilmer, Suzanne; Lawrence, Naomi; Lupo, Mary; Metelitsa, Andrei; Nestor, Mark; Ross, E Victor
Many devices used in dermatology lack generic names. If investigators use commercial device names, they risk the appearance of bias. Alternatively, reliance on ad-hoc names and abbreviations may confuse readers who do not recognize these. To develop a system for assigning abbreviations to denote devices commonly used in dermatology. Secondarily, to use this system to create abbreviations for FDA-approved neurotoxins and prepackaged injectable soft-tissue augmentation materials. The American Society for Dermatologic Surgery convened a Lexicon Task Force in March 2012. One charge of this Task Force was to develop criteria for assigning abbreviations to medical devices. A modified consensus process was used. Abbreviations to denote devices were to be: based on a standardized approach; transparent to the casual reader; markedly brief; and in all cases, different than the commercial names. Three-letter all caps abbreviations, some with subscripts, were assigned to denote each of the approved neurotoxins and fillers. A common system of abbreviations for medical devices in dermatology may avoid the appearance of bias while ensuring effective communication. The proposed system may be expanded to name other devices, and the ensuing abbreviations may be suitable for journal articles, continuing medical education lectures, or other academic or clinical purposes. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.
... 32 National Defense 6 2010-07-01 2010-07-01 false Abbreviations and Acronyms B Appendix B to Part 806 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ADMINISTRATION AIR FORCE FREEDOM OF INFORMATION ACT PROGRAM Pt. 806, App. B Appendix B to Part 806—Abbreviations and...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations, ditto marks, and asterisks. 300.9 Section 300.9 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER THE WOOL PRODUCTS LABELING ACT OF 1939 Labeling § 300.9 Abbreviations...
... 32 National Defense 3 2010-07-01 2010-07-01 true Abbreviations F Appendix F to Subpart M of Part 552 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY MILITARY RESERVATIONS...—Abbreviations AAOArea Access Officer ARArmy Regulation CBRCCamp Bonneville Range Control DEHDirector of...
... 7 Agriculture 6 2010-01-01 2010-01-01 false Definitions and abbreviations. 635.1 Section 635.1 Agriculture Regulations of the Department of Agriculture (Continued) NATURAL RESOURCES CONSERVATION SERVICE... abbreviations. The following terms apply to this part: Covered program means a natural resource conservation...
... 49 Transportation 2 2010-10-01 2010-10-01 false Definitions and abbreviations. 179.2 Section 179.2 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY... Introduction, Approvals and Reports § 179.2 Definitions and abbreviations. (a) The following apply in part 179...
Full Text Available Abbreviations are used to improve the speed of note keeping and to simplify patient notes. However studies have shown that they can reduce clarity, increase mistakes and cause confusion in management plans. Our review highlights the misuse of abbreviations in surgical note keeping.
Collard, B; Royal, A
Abbreviations are used to improve the speed of note keeping and to simplify patient notes. However studies have shown that they can reduce clarity, increase mistakes and cause confusion in management plans. Our review highlights the misuse of abbreviations in surgical note keeping.
... 7 Agriculture 7 2010-01-01 2010-01-01 false Definitions and abbreviations. 718.302 Section 718.302 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF... MULTIPLE PROGRAMS Equitable Relief From Ineligibility § 718.302 Definitions and abbreviations. In addition...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations or ditto marks prohibited. 301.4 Section 301.4 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER FUR PRODUCTS LABELING ACT Regulations § 301.4 Abbreviations or ditto...
... 7 Agriculture 10 2010-01-01 2010-01-01 false Applicability and abbreviations. 1421.400 Section 1421.400 Agriculture Regulations of the Department of Agriculture (Continued) COMMODITY CREDIT... Associations for Peanuts § 1421.400 Applicability and abbreviations. (a) This subpart sets forth the terms and...
Hacker, David; Jones, Christopher A; Clowes, Zoe; Belli, Antonio; Su, Zhangjie; Sitaraman, Murugan; Davies, David; Taylor, Ross; Flahive, Elizabeth; Travis, Clare; O'Neil, Nicci; Pettigrew, Yvonne
This study examines the validity of the NAB Screening Module (screening module of the neuropsychological assessment battery, S-NAB) in an acute traumatic brain injury (TBI) inpatient population and provides psychometric evaluation of an original index sensitive to TBI impairment. The utility of the S-NAB as a TBI screen was examined using a between groups design. One-hundred and four patients with mild complicated to severe TBI were recruited from a consecutive cohort of patients admitted as inpatients to a UK Major Trauma Centre. Ninety-eight control participants were selected from the S-NAB normative sample. All TBI patients completed the S-NAB during their inpatient stay. Control participants scored significantly higher than TBI participants on the Total Screening index (t = 3.626, p injury. The S-NAB TBI index is a robust, reliable screening index for use with acute TBI patients, which is sensitive to the effects of acute TBI. It affords a briefer cognitive screen than the S-NAB and demonstrates a dose response relationship to TBI severity. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: email@example.com.
Miyata, Kei; Ohnishi, Hirofumi; Maekawa, Kunihiko; Mikami, Takeshi; Akiyama, Yukinori; Iihoshi, Satoshi; Wanibuchi, Masahiko; Mikuni, Nobuhiro; Uemura, Shuji; Tanno, Katsutoshi; Narimatsu, Eichi; Asai, Yasufumi
In patients with severe traumatic brain injury (TBI), a randomized controlled trial revealed that outcomes did not significantly improve after therapeutic hypothermia (TH) or normothermia (TN). However, avoiding pyrexia, which is often associated with intracranial disorders, might improve clinical outcomes. The objective of this study was to compare neurological outcomes among patients with moderate and severe TBI after therapeutic temperature modulation (TTM) in the absence of other interventions. Data from 1091 patients were obtained from the Japan Neurotrauma Data Bank Project 2009, a cohort observational study. Patients with cardiac arrest, those with a Glasgow Coma Scale score of 3 and dilated fixed pupils, and those whose cause of death was injury to another area of the body were excluded, leaving 687 patients aged 16 years or older in this study. The patients were divided into 2 groups: the TTM group underwent TN (213 patients) or TH (82 patients), and the control group (392 patients) did not receive TTM. The primary end point for this study was the rate of poor outcome at hospital discharge, and the secondary end point was in-hospital death. Out of the 208 total items in the database, 29 variables that could potentially affect outcome were matched using the propensity score (PS) method in order to reduce selection bias and balance the baseline characteristics. From each group, 141 patients were extracted using the PS-matching process. Among the patients in the TTM group, 29 had undergone TH and 112 had undergone TN. In a log-rank test using Kaplan-Meier survival curves, no significant differences in patient outcome or death were observed between the 2 groups (poor outcome, p = 0.83; death, p = 0.18). A Cox proportional-hazards regression analysis established the HR for poor outcome and mortality at 1.03 (95% CI 0.78-1.36, p = 0.83) and 1.34 (95% CI 0.87-2.07, p = 0.18), respectively. There was no clear improvement in neurological outcomes after TTM in
Roberts, Derek J.; Faris, Peter D.; Ball, Chad G.; Kubes, Paul; Tiruta, Corina; Xiao, Zhengwen; Holodinsky, Jessalyn K.; McBeth, Paul B.; Doig, Christopher J.; Jenne, Craig N.
Objective: To determine whether active negative pressure peritoneal therapy with the ABThera temporary abdominal closure device reduces systemic inflammation after abbreviated laparotomy. Background: Excessive systemic inflammation after abdominal injury or intra-abdominal sepsis is associated with poor outcomes. Methods: We conducted a single-center, randomized controlled trial. Forty-five adults with abdominal injury (46.7%) or intra-abdominal sepsis (52.3%) were randomly allocated to the ABThera (n = 23) or Barker's vacuum pack (n = 22). On study days 1, 2, 3, 7, and 28, blood and peritoneal fluid were collected. The primary endpoint was the difference in the plasma concentration of interleukin-6 (IL-6) 24 and 48 hours after temporary abdominal closure application. Results: There was a significantly lower peritoneal fluid drainage from the ABThera at 48 hours after randomization. Despite this, there was no difference in plasma concentration of IL-6 at baseline versus 24 (P = 0.52) or 48 hours (P = 0.82) between the groups. There was also no significant intergroup difference in the plasma concentrations of IL-1β, −8, −10, or −12 p70 or tumor necrosis factor α between these time points. The cumulative incidence of primary fascial closure at 90 days was similar between groups (hazard ratio, 1.6; 95% confidence interval, 0.82–3.0; P = 0.17). However, 90-day mortality was improved in the ABThera group (hazard ratio, 0.32; 95% confidence interval, 0.11–0.93; P = 0.04). Conclusions: This trial observed a survival difference between patients randomized to the ABThera versus Barker's vacuum pack that did not seem to be mediated by an improvement in peritoneal fluid drainage, fascial closure rates, or markers of systemic inflammation. Trial Registration: ClinicalTrials.gov identifier NCT01355094. PMID:25536308
Predicted Unfavorable Neurologic Outcome Is Overestimated by the Marshall Computed Tomography Score, Corticosteroid Randomization After Significant Head Injury (CRASH), and International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) Models in Patients with Severe Traumatic Brain Injury Managed with Early Decompressive Craniectomy.
Charry, Jose D; Tejada, Jorman H; Pinzon, Miguel A; Tejada, Wilson A; Ochoa, Juan D; Falla, Manuel; Tovar, Jesus H; Cuellar-Bahamón, Ana M; Solano, Juan P
Traumatic brain injury (TBI) is of public health interest and produces significant mortality and disability in Colombia. Calculators and prognostic models have been developed to establish neurologic outcomes. We tested prognostic models (the Marshall computed tomography [CT] score, International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT), and Corticosteroid Randomization After Significant Head Injury) for 14-day mortality, 6-month mortality, and 6-month outcome in patients with TBI at a university hospital in Colombia. A 127-patient cohort with TBI was treated in a regional trauma center in Colombia over 2 years and bivariate and multivariate analyses were used. Discriminatory power of the models, their accuracy, and precision was assessed by both logistic regression and area under the receiver operating characteristic curve (AUC). Shapiro-Wilk, χ 2 , and Wilcoxon test were used to compare real outcomes in the cohort against predicted outcomes. The group's median age was 33 years, and 84.25% were male. The injury severity score median was 25, and median Glasgow Coma Scale motor score was 3. Six-month mortality was 29.13%. Six-month unfavorable outcome was 37%. Mortality prediction by Marshall CT score was 52.8%, P = 0.104 (AUC 0.585; 95% confidence interval [CI] 0 0.489-0.681), the mortality prediction by CRASH prognosis calculator was 59.9%, P < 0.001 (AUC 0.706; 95% CI 0.590-0.821), and the unfavorable outcome prediction by IMPACT was 77%, P < 0.048 (AUC 0.670; 95% CI 0.575-0.763). In a university hospital in Colombia, the Marshall CT score, IMPACT, and Corticosteroid Randomization After Significant Head Injury models overestimated the adverse neurologic outcome in patients with severe head trauma. Copyright © 2017 Elsevier Inc. All rights reserved.
Simpson, Joanna P; Taylor, Andrew; Sudhan, Nazneen; Menon, David K; Lavinio, Andrea
High-volume fluid resuscitation and the administration of sodium bicarbonate and diuretics have a theoretical renoprotective role in patients at high risk of acute kidney injury (AKI) following rhabdomyolysis. Abnormally elevated creatine kinase has previously been used as a biological marker for the identification of patients at high risk of AKI following rhabdomyolysis. To assess the sensitivity and specificity of plasma creatine kinase (admission and peak values) for the prediction of AKI requiring renal replacement therapy (RRT) or of death in patients with confirmed rhabdomyolysis. To compare the diagnostic performance of creatine kinase with the McMahon score. Retrospective observational study. Data collection included McMahon and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores; daily creatine kinase; daily creatinine and electrolytes; ICU length of stay and mortality. Neurosciences and Trauma Critical Care Unit (Cambridge, UK). In total, 232 adults with confirmed rhabdomyolysis (creatine kinase > 1000 Ul) admitted to Neurosciences and Trauma Critical Care Unit between 2002 and 2012. AKI, RRT and mortality. Forty-five (19%) patients developed AKI and 29 (12.5%) patients required RRT. Mortality was significantly higher in patients who developed AKI (62 vs. 18%, P rhabdomyolysis. Although a PEAK creatine kinase of at least 5000 Ul has sensitivity acceptable for screening purposes, this is often a delayed finding. A McMahon score of at least 6 calculated on admission allows for a more sensitive, specific and timely identification of patients who may benefit from high-volume fluid resuscitation.
Full Text Available Objective: To achieve a reliable tool for measuring health related quality of life among Iranians with knee osteoarthritis, by translating and culturally adapting the Knee injury and Osteoarthritis Outcome Score(KOOS to Persian and testing the reliability and internal consistency of the Iranian version. Materials & Methods: It was a non experimental methodology study. KOOS was translated and adapted culturally to Persian language and culture in three phases with respect to IQOLA project. For examining test-retest reliability Iranians version of KOOS was corresponded twice with in at least two days or at most one week interval, by 30 Iranian people with knee OA whom were referred to Municipality and 110 physiotherapy clinics of Tehran with PT order by physicians. It was a non experimental methodological research and we used sample of convenience and non probability design for sampling. Psychometric evaluation: the collected data from the questionnaires was rated and analyzed with SPSS software from the aspects of test-retest reliability, absolute reliability, subscale and item internal consistency. Results: Internal consistency which was calculated by Cronbach '&alpha was high for all the subscales (at least 0.76, except for "symptom" subscale which was moderate, and showed that items of each subscale measured the same construct. Item internal consistency after correction for overlap, was higher than optimal value (0.4, except for the items of" symptom" subscale , which demonstrated good item internal consistency. SEM and ICC which were used for evaluating the absolute and test-retest reliability in respect showed that all the subscales had good test-retest reliability (0.7 and the absolute reliability was also very good in such away that the highest calculated SEM for Persian version was 7.44 which was less than Minimal Perceptible Clinical Improvement (MPCI that is estimated 8 to 10 for the KOOS questionnaire. Conclusion: With the Persian
Background Murray score is the result of an equation that gives all its variables the same linear contribution and weight and makes use of consented cut-offs. Everyday physicians' vocabulary is full of terms (adjectives) like: little, small, low, high, etc. that they handle in an intuitive and not always linear way to make therapeutic decisions. The purpose of this paper is to develop a fuzzy logic (FL) vision of Murray's score variables to enable the measurement of physicians' knowledge, experience and intuition in diagnosing lung injury and test if they followed Murray's equation predictions. Methods For a prospective survey carried out among a team of professionals (aged 29 to 53) in a University Hospital Intensive Care Unit, twelve physicians filled in two questionnaires. In the first one they had to define the ranks which should be categorized as normal, moderate and severe for three of four Murray variables. In another questionnaire, which represented all probable combinations of those categories, they had to tick the pulmonary condition as: no injury, mild, moderate, and ARDS. This procedure gave rise to a Fuzzy Inference System designed to provide the degree of severity as sensed by the group. Results The survey showed fuzzy frontiers for the categories and fuzzy diagnosis. In all, 45% of the hypothetical patients (n 18,013) were equally diagnosed by the survey and Murray's equation, whereas another 51% was overestimated in one level by the survey. Physicians agreed with 96.5% of ARDS cases according to Murray's test but only 11.6% of its mild cases were equally diagnosed by the survey. Nonlinearity of the survey reasoning (high relevance to gas exchange and chest film) was apparent. Conclusions The contiguous categories of the variables confirm the existence of fuzzy frontiers. An overestimation was found in the surveyed group's interpretation of severity. This overestimation was mainly due to the different weight assigned to PO2/FiO2 and chest film
Bassano, Carlo; Bovio, Emanuele; Uva, Floriano; Iacobelli, Simona; Iasevoli, Nicola; Farinaccio, Andrea; Ruvolo, Giovanni
Anaortic coronary artery bypass proved to prevent early neurologic injury compared to on-pump CABG. The Cardica PAS-Port(®) is a fully automated device that might be able to perform proximal aorto-venous anastomoses without an increased embolic risk. We evaluated early post-operative neurologic outcome in a matched population following clampless OPCAB (CCAB: either "all-arterial" or with automatically anastomosed venous grafts) or on-pump CABG. 366 consecutive patients were submitted to isolated coronary bypass by a single surgeon experienced in both off and on-pump procedures between January 2009 and December 2013. Of these patients, 223 underwent a clampless off-pump revascularization. After propensity score matching, 143 pairs were selected, who received either off-pump or on-pump surgery. In the off-pump group, CCAB was performed with an all-arterial approach (n = 33) or with automated proximal anastomosis of the venous graft(s) by means of the Cardica PAS-Port(®) connector (n = 110). Neurologic injury was defined as non-reversible (NRNI: lethal coma or stroke) or reversible (RNI: TIA or delirium). Operative mortality was 2.4 % (CCAB 1.4 %; CABG 3.5 %; p = 0.14). The global rate of early neurologic injury was 5.6 % (CCAB 2.1 vs. CABG 9.1 %; p = 0.006). Incidence was 1.4 % for NRNI (CCAB 0 vs. CABG 2.8 %; p = 0.04) and 4.2 % for RNI (CCAB 2.1 vs. CABG 6.3 %; p = 0.06). No differences were found among other major perioperative outcomes. CCAB prevents both early post-operative RNI and NRNI. This result can be achieved with a totally anaortic strategy and also with the aid of a fully automated device for proximal aorto-venous anastomoses.
Baldwin, J N; McKay, M J; Simic, M; Hiller, C E; Moloney, N; Nightingale, E J; Burns, J
To develop normative reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS) and KOOS-Child, as well as investigate socio-demographic, psychological and physical factors associated with knee pain and disability among healthy adults. The KOOS or KOOS-Child (each containing five subscales) was administered to participants aged 8-101 years within the 1000 Norms Project, an observational study of 1000 self-reported healthy individuals. Self-efficacy, physical activity, body mass index (BMI), lower limb alignment, knee frontal plane projection angle (FPPA), knee range of motion (ROM), knee and hip strength, six-minute walk, 30-second chair stand and timed up and down stairs tests were collected. KOOS data were dichotomised using established cut-off scores and logistic regression analyses were conducted for each subscale. Socio-demographic characteristics were similar to the Australian population. Normative reference data were generated for children (8-17 years) and adults (18-101 years). Female adults were up to twice as likely to report knee pain, symptoms and sport/recreation (Sport/Rec) limitations compared to males (P disability among adults. Age- and gender-stratified reference data for the KOOS and KOOS-Child have been developed to guide interpretation of results in practice and research for individuals with knee disorders. Psychological and physical factors are linked with self-reported knee pain/disability among adults, and longitudinal studies to investigate causation are required. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
... Definitions and Other Reference Information § 1042.905 Symbols, acronyms, and abbreviations. The following... Archives and Records Administration. NMHCnonmethane hydrocarbons. NOXoxides of nitrogen (NO and NO2.... SCRselective catalytic reduction. THCtotal hydrocarbon. THCEtotal hydrocarbon equivalent. ULSDultra low-sulfur...
Wieten, R. W.; Leenstra, T.; van Thiel, P. P. A. M.; van Vugt, M.; Stijnis, C.; Goorhuis, A.; Grobusch, M. P.
Rabies is a deadly disease, and current preexposure vaccination schedules are lengthy and expensive. We identified nine studies investigating abbreviated schedules. Although initial responses were lower, accelerated adequate immune responses were elicited after booster vaccinations. Lower-dose (and
Full Text Available Aim of the study : One of the basic issues discussed in forensic literature regarding falls from a height is determination of fall heights and differentiation between suicidal and accidental falls. The aim of the study was to verify the usefulness of the available methods for the purposes of forensic expertises. Material and methods : The study encompassed fatalities of falls from a height whose autopsies were performed in the Department of Forensic Medicine in Lublin. Results : Similarly to other authors, the severity of injuries was assessed using the Abbreviated Injury Scale (AIS and injury severity score (ISS. The study findings demonstrated a statistically significant correlation between the fall height and the severity of injuries according to ISS and a statistically significant difference in fall heights between the groups of accidents and suicides.
Franceschini, Marco; Massimiani, Maria Pia; Paravati, Stefano; Agosti, Maurizio
Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery) between admission and discharge was assessed by Functional Independent Measure (FIM) gain, through the Montebello Rehabilitation Factor Score (MRFS), which was obtained as follows: (discharge FIM-admission FIM)/(Maximum possible FIM-Admission FIM) x 100. The cut-off value (criterion) deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%). Considering the Mini Mental State Examination (MMSE) and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself.
Full Text Available Return to work (RTW for people with acquired brain injury (ABI represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery between admission and discharge was assessed by Functional Independent Measure (FIM gain, through the Montebello Rehabilitation Factor Score (MRFS, which was obtained as follows: (discharge FIM-admission FIM/(Maximum possible FIM-Admission FIM x 100. The cut-off value (criterion deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%. Considering the Mini Mental State Examination (MMSE and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself.
PINTO, Andressa dos Santos; GRIGOLETTI, Shana Souza; MARCADENTI, Aline
INTRODUCTION: The abbreviation of perioperative fasting among candidates to elective surgery have been associated with shorter hospital stay and decreased postoperative complications. OBJECTIVE: To conduct a systematic review from randomized controlled trials to detect whether the abbreviation of fasting is beneficial to patients undergoing cancer surgery compared to traditional fasting protocols. METHOD: A literature search was performed in electronic databases: MEDLINE (PubMed), SciELO...
Torjussen, J; Bahr, R
Although snowboarding is already established as an Olympic sport, it is still a developing sport, with new disciplines, more demanding snow installations, and spectacular tricks. A recent study on subjects at Norwegian national elite level showed that injury risk is high and that injuries among competitive snowboarders differ from those seen in recreational snowboarders, with fewer wrist injuries and more knee and back injuries. To describe the incidence and type of injuries among female and male snowboarders at international elite level. At the last race of the Fédération Internationale de Ski Snowboard World Cup, acute injuries resulting in missed participation and overuse injuries influencing performance, were recorded during a retrospective interview (91% response rate). The registration period was from April 2002 (end of season) until March 2003. Exposure was recorded as the number of runs in all disciplines, and the incidence was calculated as number of injuries per 1000 runs. The 258 athletes interviewed reported 3193 competition days (n = 46 879 runs) in all disciplines. In total, 135 acute injuries were recorded; 62 (46%) during competition in the official disciplines. Of the 135 acute injuries, the most common injury locations were knee (n = 24; 18%), shoulder (n = 18; 13%), back (n = 17; 13%), and wrist (n = 11; 8%). The overall incidence during competition was 1.3 (95% confidence interval 1.0 to 1.7) injuries per 1000 runs; 2.3 (0.9 to 3.8) for big air (n = 10), 1.9 (1.1 to 2.8) for halfpipe (n = 21), 2.1 (1.2 to 3.0) for snowboard cross (n = 20), 0.6 (0.2 to 1.0) for parallel giant slalom (n = 8), and 0.3 (0.0 to 0.7) for parallel slalom (n = 3). The severity of injuries was graded based on time loss (27% lost >21 days) and score on the Abbreviated Injury Scale (AIS) (38% AIS 1, 61% AIS 2 and 1% AIS 3). There were 122 overuse injuries, 38 (31%) of these to the knee. The injury risk for big air, snowboard cross, and halfpipe disciplines is high, while
Nnamani, Nina S; Janak, Judson C; Hudak, Steven J; Rivera, Jessica C; Lewis, Eluned A; Soderdahl, Douglas W; Orman, Jean A
In Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), genitourinary (GU) wounds have occurred in unprecedented numbers. Severe concomitant injuries, including extremity amputations, are common. The epidemiology of GU injury and extremity amputation in OEF/OIF has not been described. The Department of Defense Trauma Registry was queried from October 2001 through August 2013 to identify all surviving US male service members with GU injuries sustained in OEF/OIF. Genitourinary injury was defined as sustaining one or more injuries to any organ or structure within the genitourinary and/or reproductive system(s) based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Injury severity was quantified based on Abbreviated Injury Scale scores and overall Injury Severity Scores. The incidence, nature, and severity of GU injuries and extremity amputations are described. Of the 1,367 service members with GU injury included in this analysis, 433 (31.7%) had one or more extremity amputations. Most GU injuries were to the external genitalia [scrotum (55.6%), testes (33.0%), penis (31.0%), and urethra (9.1%)] vs. the kidneys (21.1%). Those with amputation(s) had greater GU injury severity (Abbreviated Injury Scale score ≥ 3) than those without amputations (50.1% vs. 30.5%, respectively; p injury had an upper extremity amputation only, 8.9% had both lower and upper extremity amputation(s), and 19.4% had lower extremity amputation(s) only. Of the 387 patients with GU injury and lower extremity amputations, 87 (22.5%) had amputations below the knee and 300 (77.5%) had amputation(s) at/above the knee. In OEF/OIF, concomitant GU injury and extremity amputation are common and have serious implications for health and quality of life. This wounding pattern presents new challenges to the military medical and research and development communities to prevent, mitigate, and treat these battlefield injuries. Epidemiologic
Majercik, Sarah; Bledsoe, Joseph; Ryser, David; Hopkins, Ramona O; Fair, Joseph E; Brock Frost, R; MacDonald, Joel; Barrett, Ryan; Horn, Susan; Pisani, David; Bigler, Erin D; Gardner, Scott; Stevens, Mark; Larson, Michael J
Day-of-injury (DOI) brain lesion volumes in traumatic brain injury (TBI) patients are rarely used to predict long-term outcomes in the acute setting. The purpose of this study was to investigate the relationship between acute brain injury lesion volume and rehabilitation outcomes in patients with TBI at a level one trauma center. Patients with TBI who were admitted to our rehabilitation unit after the acute care trauma service from February 2009-July 2011 were eligible for the study. Demographic data and outcome variables including cognitive and motor Functional Independence Measure (FIM) scores, length of stay (LOS) in the rehabilitation unit, and ability to return to home were obtained. The DOI quantitative injury lesion volumes and degree of midline shift were obtained from DOI brain computed tomography scans. A multiple stepwise regression model including 13 independent variables was created. This model was used to predict postrehabilitation outcomes, including FIM scores and ability to return to home. A p value less than 0.05 was considered significant. Ninety-six patients were enrolled in the study. Mean age was 43 ± 21 years, admission Glasgow Coma Score was 8.4 ± 4.8, Injury Severity Score was 24.7 ± 9.9, and head Abbreviated Injury Scale score was 3.73 ± 0.97. Acute hospital LOS was 12.3 ± 8.9 days, and rehabilitation LOS was 15.9 ± 9.3 days. Day-of-injury TBI lesion volumes were inversely associated with cognitive FIM scores at rehabilitation admission (p = 0.004) and discharge (p = 0.004) and inversely associated with ability to be discharged to home after rehabilitation (p = 0.006). In a cohort of patients with moderate to severe TBI requiring a rehabilitation unit stay after the acute care hospital stay, DOI brain injury lesion volumes are associated with worse cognitive FIM scores at the time of rehabilitation admission and discharge. Smaller-injury volumes were associated with eventual discharge to home. Volumetric neuroimaging in the acute
Strandroth, Johan; Sternlund, Simon; Lie, Anders; Tingvall, Claes; Rizzi, Matteo; Kullgren, Anders; Ohlin, Maria; Fredriksson, Rikard
Pedestrians and bicyclists account for a significant share of deaths and serious injuries in the road transport system. The protection of pedestrians in car-to-pedestrian crashes has therefore been addressed by friendlier car fronts and since 1997, the European New Car Assessment Program (Euro NCAP) has assessed the level of protection for most car models available in Europe. In the current study, Euro NCAP pedestrian scoring was compared with real-life injury outcomes in car-to-pedestrian and car-tobicyclist crashes occurring in Sweden. Approximately 1200 injured pedestrians and 2000 injured bicyclists were included in the study. Groups of cars with low, medium and high pedestrian scores were compared with respect to pedestrian injury severity on the Maximum Abbreviated Injury Scale (MAIS)-level and risk of permanent medical impairment (RPMI). Significant injury reductions to both pedestrians and bicyclists were found between low and high performing cars. For pedestrians, the reduction of MAIS2+, MAIS3+, RPMI1+ and RPMI10+ ranged from 20-56% and was significant on all levels except for MAIS3+ injuries. Pedestrian head injuries had the highest reduction, 80-90% depending on level of medical impairment. For bicyclist, an injury reduction was only observed between medium and high performing cars. Significant injury reductions were found for all body regions. It was also found that cars fitted with autonomous emergency braking including pedestrian detection might have a 60-70% lower crash involvement than expected. Based on these results, it was recommended that pedestrian protection are implemented on a global scale to provide protection for vulnerable road users worldwide.
Full Text Available INTRODUCTION: This study aimed to cross-culturally adapt a Malay version of Knee Injury and Osteoarthritis Outcome Score (KOOS and to evaluate its psychometric properties in patients with knee osteoarthritis (OA. MATERIALS AND METHODS: The English version KOOS was translated into a Malay version using forward and backward translation process, followed by face validity and content validity. Two hundred and twenty-six knee OA patients attending the Outpatient and Orthopaedic Clinics, Universiti Sains Malaysia Hospital, completed the Malay version KOOS. Construct validity using confirmatory factor analysis and internal reliability assessment were performed. RESULTS: The results showed that the original five-factor model with 42 items failed to achieve acceptable values of the goodness of fit indices, indicating poor model fit. A new five-factor model of 26 items demonstrated acceptable level of goodness of fit (comparative fit index= 0.929, incremental fit index= 0.930, Tucker Lewis fit index= 0.920, root mean square error of approximation= 0.073 and Chisquared/ degree of freedom= 2.183 indices to signify a model fit. The Cronbach’s alpha value for the new model ranged from 0.776 to 0.946. The composite reliability values of each construct ranged between 0.819 and 0.921, indicating satisfactory to high level of convergent validity. CONCLUSION: The five-factor model with 26 items in the Malay version of KOOS questionnaire demonstrated a good degree of goodness of fit and was found to be valid, reliable and simple as an assessment tool for symptoms, pain, activity of daily living, sports and recreational activity and quality of life for Malaysian adults suffering from knee osteoarthritis.
Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua
Background: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. This study was designed to investigate the outcome of patients with polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS) ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension [systolic blood pressure ≤ 90 mmHg], unconsciousness [Glasgow Coma Scale score ≤ 8], acidosis [base excess ≤ -6.0], coagulopathy [partial thromboplastin time ≥ 40 s or international normalized ratio ≥ 1.4], and age [≥70 years]). Methods: We retrieved detailed data on 369 polytrauma patients and 1260 non-polytrauma patients with an overall Injury Severity Score (ISS) ≥ 18 who were hospitalized between 1 January 2009 and 31 December 2015 for the treatment of all traumatic injuries, from the Trauma Registry System at a level I trauma center. Patients with burn injury or incomplete registered data were excluded. Categorical data were compared with two-sided Fisher exact or Pearson chi-square tests. The unpaired Student t -test and the Mann-Whitney U -test was used to analyze normally distributed continuous data and non-normally distributed data, respectively. Propensity-score matched cohort in a 1:1 ratio was allocated using the NCSS software with logistic regression to evaluate the effect of polytrauma on patient outcomes. Results: The polytrauma patients had a significantly higher ISS than non-polytrauma patients (median (interquartile range Q1-Q3), 29 (22-36) vs. 24 (20-25), respectively; p sex, age, co-morbidity, AIS ≥ 3, and Injury Severity Score (ISS), the polytrauma patients had a significantly higher mortality rate (OR 17.5, 95% CI 4.21-72.76; p definition of polytrauma is feasible and applicable for trauma patients.
Wu, Yonghui; Rosenbloom, S Trent; Denny, Joshua C; Miller, Randolph A; Mani, Subramani; Giuse, Dario A; Xu, Hua
Recognition and identification of abbreviations is an important, challenging task in clinical natural language processing (NLP). A comprehensive lexical resource comprised of all common, useful clinical abbreviations would have great applicability. The authors present a corpus-based method to create a lexical resource of clinical abbreviations using machine-learning (ML) methods, and tested its ability to automatically detect abbreviations from hospital discharge summaries. Domain experts manually annotated abbreviations in seventy discharge summaries, which were randomly broken into a training set (40 documents) and a test set (30 documents). We implemented and evaluated several ML algorithms using the training set and a list of pre-defined features. The subsequent evaluation using the test set showed that the Random Forest classifier had the highest F-measure of 94.8% (precision 98.8% and recall of 91.2%). When a voting scheme was used to combine output from various ML classifiers, the system achieved the highest F-measure of 95.7%.
Shilo, L; Shilo, G
There are abbreviations that are used daily such as BP for blood pressure and ECG for electrocardiogram, but many of the abbreviations found in medical documents are unclear. The purpose of this study was to assess the frequency, type and comprehension of abbreviations in admission notes and discharge letters composed by orthopedic surgery and medical residents. Abbreviations were extracted from discharge letters and admission notes composed by residents from orthopedic surgery and medical wards. The frequency of use of the abbreviations was determined. Additionally, the fifty commonest abbreviations from each specialty were graded by three medical and three orthopedic surgery senior physicians as 1. understandable or 2. Ambiguous or unknown. The number of abbreviations found in the documents composed by medical and orthopedic surgery residents was 1525 with 80 different abbreviations and 493 with 51 different abbreviations respectively (9.3% and 4.9% of the total word number respectively). Analysis revealed that 14% of the abbreviations from medical ward documents were graded as ambiguous or unknown by medical senior physicians compared with 25% by senior orthopedic surgeons. When abbreviations from orthopedic surgery documents were presented to both groups, senior orthopedic surgeons graded 8% as ambiguous or unknown compared with 21% by the medical senior physicians. In order to prevent impairment of patient care, only standard abbreviations should be used in medical documents. Measures should be taken to decrease the use of non standard abbreviations such as the incorporation of authorized abbreviations to the electronic medical record.
Bilker, Warren B; Wierzbicki, Michael R; Brensinger, Colleen M; Gur, Raquel E; Gur, Ruben C
The ability to reason with language is a highly valued cognitive capacity that correlates with IQ measures and is sensitive to damage in language areas. The Penn Verbal Reasoning Test (PVRT) is a 29-item computerized test for measuring abstract analogical reasoning abilities using language. The full test can take over half an hour to administer, which limits its applicability in large-scale studies. We previously described a procedure for abbreviating a clinical rating scale and a modified procedure for reducing tests with a large number of items. Here we describe the application of the modified method to reducing the number of items in the PVRT to a parsimonious subset of items that accurately predicts the total score. As in our previous reduction studies, a split sample is used for model fitting and validation, with cross-validation to verify results. We find that an 8-item scale predicts the total 29-item score well, achieving a correlation of .9145 for the reduced form for the model fitting sample and .8952 for the validation sample. The results indicate that a drastically abbreviated version, which cuts administration time by more than 70%, can be safely administered as a predictor of PVRT performance. © The Author(s) 2014.
Bilker, Warren B.; Wierzbicki, Michael R.; Brensinger, Colleen M.; Gur, Raquel E.; Gur, Ruben C.
The ability to reason with language is a highly valued cognitive capacity that correlates with IQ measures and is sensitive to damage in language areas. The Penn Verbal Reasoning Test (PVRT) is a 29-item computerized test for measuring abstract analogical reasoning abilities using language. The full test can take over half an hour to administer, which limits its applicability in large-scale studies. We previously described a procedure for abbreviating a clinical rating scale and a modified procedure for reducing tests with a large number of items. Here we describe the application of the modified method to reducing the number of items in the PVRT to a parsimonious subset of items that accurately predicts the total score. As in our previous reduction studies, a split sample is used for model fitting and validation, with cross-validation to verify results. We find that an 8-item scale predicts the total 29-item score well, achieving a correlation of .9145 for the reduced form for the model fitting sample and .8952 for the validation sample. The results indicate that a drastically abbreviated version, which cuts administration time by more than 70%, can be safely administered as a predictor of PVRT performance. PMID:24577310
Niebuhr, Tobias; Junge, Mirko; Achmus, Stefanie
Assessment of the effectiveness of advanced driver assistance systems (ADAS) plays a crucial role in accident research. A common way to evaluate the effectiveness of new systems is to determine the potentials for injury severity reduction. Because injury risk functions describe the probability of an injury of a given severity conditional on a technical accident severity (closing speed, delta V, barrier equivalent speed, etc.), they are predestined for such evaluations. Recent work has stated an approach on how to model the pedestrian injury risk in pedestrian-to-passenger car accidents as a family of functions. This approach gave explicit and easily interpretable formulae for the injury risk conditional on the closing speed of the car. These results are extended to injury risk functions for pedestrian body regions. Starting with a double-checked German In-depth Accident Study (GIDAS) pedestrian-to-car accident data set (N = 444) and a functional-anatomical definition of the body regions, investigations on the influence of specific body regions on the overall injury severity will be presented. As the measure of injury severity, the ISSx, a rescaled version of the well-known Injury Severity Score (ISS), was used. Though traditional ISS is computed by summation of the squares of the 3 most severe injured body regions, ISSx is computed by the summation of the exponentials of the Abbreviated Injury Scale (AIS) severities of the 3 most severely injured body regions. The exponentials used are scaled to fit the ISS range of values between 0 and 75. Three body regions (head/face/neck, thorax, hip/legs) clearly dominated abdominal and upper extremity injuries; that is, the latter 2 body regions had no influence at all on the overall injury risk over the range of technical accident severities. Thus, the ISSx is well described by use of the injury codes from the same body regions for any pedestrian injury severity. As a mathematical consequence, the ISSx becomes explicitly
Kreuzthaler, Markus; Schulz, Stefan
In Western languages the period character is highly ambiguous, due to its double role as sentence delimiter and abbreviation marker. This is particularly relevant in clinical free-texts characterized by numerous anomalies in spelling, punctuation, vocabulary and with a high frequency of short forms. The problem is addressed by two binary classifiers for abbreviation and sentence detection. A support vector machine exploiting a linear kernel is trained on different combinations of feature sets for each classification task. Feature relevance ranking is applied to investigate which features are important for the particular task. The methods are applied to German language texts from a medical record system, authored by specialized physicians. Two collections of 3,024 text snippets were annotated regarding the role of period characters for training and testing. Cohen's kappa resulted in 0.98. For abbreviation and sentence boundary detection we can report an unweighted micro-averaged F-measure using a 10-fold cross validation of 0.97 for the training set. For test set based evaluation we obtained an unweighted micro-averaged F-measure of 0.95 for abbreviation detection and 0.94 for sentence delineation. Language-dependent resources and rules were found to have less impact on abbreviation detection than on sentence delineation. Sentence detection is an important task, which should be performed at the beginning of a text processing pipeline. For the text genre under scrutiny we showed that support vector machines exploiting a linear kernel produce state of the art results for sentence boundary detection. The results are comparable with other sentence boundary detection methods applied to English clinical texts. We identified abbreviation detection as a supportive task for sentence delineation.
Kimberly B. Bjugstad
Full Text Available There are few reliable markers for assessing traumatic brain injury (TBI. Elevated levels of oxidative stress have been observed in TBI patients. We hypothesized that oxidation-reduction potential (ORP could be a potent biomarker in TBI. Two types of ORP were measured in patient plasma samples: the static state of oxidative stress (sORP and capacity for induced oxidative stress (icORP. Differences in ORP values as a function of time after injury, severity, and hospital discharge were compared using ANOVAs with significance at p≤0.05. Logit regression analyses were used to predict acute outcome comparing ORP, Injury Severity Score (ISS, Abbreviated Injury Scale (AIS, and Glasgow Coma Scale (GCS. Antioxidant capacity (icORP on day 4 was prognostic for acute outcomes (p 7.25 μC. IcORP was a better predictor than ISS, AIS, or GCS scores. sORP increased in those with the highest ISS values (p<0.05. Based on these findings ORP is useful biomarker for severity and acute outcome in TBI patients. Changes in ORP values on day 4 after injury were the most prognostic, suggesting that patients’ response to brain injury over time is a factor that determines outcome.
Glascock, M.D.; Neff, H.; Stryker, K.S.; Jonhson, T.N.
An abbreviated NAA procedure has been developed to fingerprint obsidian artifacts in the Mesoamerican region. Despite the large number of available sources, an NAA procedure, which relies on producing short-lived isotopes, has been applied with a success rate greater than 90 percent. The abbreviated NAA procedure is rapid and cost competitive with the XRF technique more often applied in obsidian sourcing. Results from the analysis of over 1,200 obsidian artifacts from throughout Mesoamerica are presented. (author) 8 refs.; 6 figs.; 2 tabs
Van Gent, Jan-Michael; Bandle, Jesse; Calvo, Richard Y; Zander, Ashley L; Olson, Erik J; Shackford, Steven R; Peck, Kimberly A; Sise, C Beth; Sise, Michael J
Traumatic brain injury (TBI) is considered an independent risk factor of venous thromboembolism (VTE). However, the role of TBI severity in VTE risk has not been determined. We hypothesized that increased severity of brain injury in patients with isolated TBI (iTBI) is associated with an increased incidence of VTE. The records of patients admitted from June 2006 to December 2011 were reviewed for injury data, VTE risk factors, results of lower extremity surveillance ultrasound, and severity of TBI. Patients were identified by DRG International Classification of Diseases-9th Rev. codes for TBI, and only those with a nonhead Abbreviated Injury Scale (AIS) score of 1 or lower, indicating minimal associated injury, were included. The association of iTBI and VTE was determined using a case-control design. Among iTBI patients, those diagnosed with VTE (cases) were matched for age, sex, and admission year to those without VTE (controls). Data were analyzed using conditional logistic regression. There were 345 iTBI patients: 41 cases (12%) and 304 controls (88%). A total of 151 controls could not be matched to an appropriate case and were excluded. Of the remaining 153 controls, 1 to 16 controls were matched to each of the 41 VTE cases. Compared with the controls, the cases had a higher mean head-AIS score (4.4 vs. 3.9, p = 0.001) and overall Injury Severity Score (20.4 vs. 16.8, p = 0.001). Following adjustment for all factors found to be associated with VTE (ventilator days, central line placement, operative time > 2 hours, chemoprophylaxis, history of VTE, and history of cancer), the cases were significantly more likely to have a greater head injury severity (head-AIS score ≥ 5; odds ratio, 5.25; 95% confidence interval, 1.59-17.30; p = 0.006). The incidence of VTE in iTBI patients was significantly associated with the severity of TBI. VTE surveillance protocols may be warranted in these high-risk patients, as early detection of VTE could guide subsequent therapy
Schroeppel, Thomas J; Sharpe, John P; Magnotti, Louis J; Weinberg, Jordan A; Clement, L Paige; Croce, Martin A; Fabian, Timothy C
Dysautonomia in traumatic brain injury patients may contribute to secondary injury. We hypothesize that propranolol is the best β-blocker (BB) to block the excess catecholamines and improve mortality in this patient population. Patients with traumatic brain injury admitted during a 48-month period who received BB were compared with those who did not after excluding patients who received preinjury BB, deaths within 48 hours, and head Abbreviated Injury Scale (AIS) score of less than 3 or greater than 5. In addition, propranolol was also compared with all other BBs. A total of 1,755 patients with traumatic brain injury were identified during the study period after exclusions. Patients who received BB (427) were older (49 years vs. 40 years; p < 0.0001), were more severely injured (Injury Severity Score [ISS], 30 vs. 24; p < 0.001), and had a more severe head injury (head AIS score, 4.2 vs. 4.0; p < 0.001). By univariate analysis, BB patients had a higher mortality (13% vs. 6%; p < 0.001); after adjusted analysis, no difference was identified (adjusted odds ratio, 0.850; 95% confidence interval, 0.536-1.348). Seventy-eight patients (18%) received propranolol during the study period. Propranolol patients were younger (30 years vs. 53 years; p < 0.001) but more severely injured (ISS, 33 vs. 29; p = 0.01; head AIS, 4.5 vs. 4.2; p < 0.001), with longer stay (44 days vs. 26 days, p < 0.001). Mortality was less in the propranolol group (3% vs. 15%, p = 0.002). Adjusted analysis confirmed the protective effect of propranolol (adjusted odds ratio, 0.199; 95% confidence interval, 0.043-0.920). Propranolol is the best BB to limit secondary injury and decrease mortality in patients with traumatic brain injury. Therapeutic, study level III.
Lin, Chia-Wei; Huang, Ya-Ping; Pan, Shin-Liang
Multiple sclerosis (MS) is a demyelinating autoimmune disease of the central nervous system (CNS). Trauma to the CNS has been postulated to play a role in triggering CNS autoimmune disease. Although the association between traumatic brain injury and MS has been suggested in previous studies, epidemiological data on the association between spinal cord injury (SCI) and MS is still lacking. The aim of the present population-based, propensity score–matched, longitudinal follow-up study was theref...
Glossary of Spanish Military and general acronyms and abbreviations. This Reference Aid is a first attempt at making a systematic compilation of Spanish acronyms and abbreviations, particularly in the military field...
Brown, Jennifer L.; Sifuentes, Lucía Macías
With growing numbers of Hispanic students enrolling in post-secondary school, there is a need to increase retention and graduation rates. The purpose of this study was to validate the Spanish adaptation of the Abbreviated Math Anxiety Scale (AMAS). The AMAS was translated and administered to 804 freshman students at a post-secondary institution in…
The Abbreviated Pandemic Influenza Plan Template for Primary Care Provider Offices is intended to assist primary care providers and office managers with preparing their offices for quickly putting a plan in place to handle an increase in patient calls and visits, whether during the 2009-2010 influenza season or future influenza seasons.
... RESPONSE TO HAZARDOUS SUBSTANCE RELEASES General Information § 310.4 What abbreviations should I know? The.... 11000-11050). LEPC—Local Emergency Planning Committee. NCP—National Oil and Hazardous Substances... Response Center. OMB—Office of Management and Budget. PRP—Potentially Responsible Party. SARA—The Superfund...
Abstract: This paper looks at how abbreviations and acronyms are treated in African language dictionaries in general compared to selected mainstream English dictionaries. Specifically, the study looks at their treatment in T.J. Otlogetswe's (2012) Tlhalosi ya Medi ya Setswana dictionary. Altogether, a survey of twenty ...
Kemp, N.; Bushnell, C.
This study investigated the effects of mobile phone text-messaging method (predictive and multi-press) and experience (in texters and non-texters) on children's textism use and understanding. It also examined popular claims that the use of text-message abbreviations, or "textese" spelling, is associated with poor literacy skills. A sample of 86…
Pennington, Britney O.; Sears, Duane; Clegg, Dennis O.
We developed an interactive exercise to teach students how to draw the structures of the 20 standard amino acids and to identify the one-letter abbreviations by modifying the familiar game of "Hangman." Amino acid structures were used to represent single letters throughout the game. To provide additional practice in identifying…
... 32 National Defense 4 2010-07-01 2010-07-01 true Explanation of abbreviations and terms. 634.3 Section 634.3 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS MOTOR VEHICLE TRAFFIC SUPERVISION Introduction § 634.3 Explanation of...
[Spanish versions of the Simplified Motor Score and the Glasgow Coma Scale in out-of-hospital treatment of head injury in adults: a preliminary study of each scale's ability to predict adverse events].
Roca, Guillem; Mayol, Sergi; García, Esteban; Casajuana, Edgar; Quintana, Salvador
To determine the ability of the modified (Spanish) version of the Simplified Motor Score (mSMS) to predict adverse events during hospitalization and to compare its predictive ability to that of the Glasgow Coma Scale (GCS) in adults with head injuries treated outside the hospital. Observational study of retrospective cohorts including all patients over the age of 14 years attended for head injuries occurring within 24 hours of treatment by an advanced life-support unit staffed by nurses between May 1, 2013, and May 1, 2014. The mSMS was a translation of the English original, created through a process of discussions of direct and back translations to arrive at consensus. Out-of-hospital patient records were searched to find GCS and mSMS scores. To predict the ability of each scale to predict brain injuries, neurosurgery, intubation, and/or inhospital death, we calculated the area under the receiving operator characteristic curves (AUCs). Of the total of 115 head-injury patients attended, 64 met the inclusion criteria. The mean (SD) age was 47 (24) years. Twelve (18.8%) patients developed some form of adverse event during hospitalization; 91.6% had brain damage, 58.3% required intubation, 8.3% required surgery, and 41.6% died. The AUC for the GCS was 0.907 (95% CI, 0.81-1.00; P<.001); the AUC for the mSMS was 0.796 (95% CI, 0.64-0.95; P=.001). Although the ability of the mSMS to predict in-hospital adverse outcomes is good, it is inferior to the GCS in adults with head injuries attended outside the hospital.
Kugler, Nathan W; Carver, Thomas W; Milia, David; Paul, Jasmeet S
Thoracic trauma resulting in hemothorax (HTx) is typically managed with thoracostomy tube (TT) placement; however, up to 20% of patients develop retained HTx which may necessitate further intervention for definitive management. Although optimal management of retained HTx has been extensively researched, little is known about prevention of this complication. We hypothesized that thoracic irrigation at the time of TT placement would significantly decrease the rate of retained HTx necessitating secondary intervention. A prospective, comparative study of patients with traumatic HTx who underwent bedside TT placement was conducted. The control group consisted of patients who underwent standard TT placement, whereas the irrigation group underwent standard TT placement with immediate irrigation using 1 L of warmed sterile 0.9% saline. Patients who underwent emergency thoracotomy, those with TTs removed within 24 hours, or those who died within 30 days of discharge were excluded. The primary end point was secondary intervention defined by additional TT placement or operative management for retained HTx. A propensity-matched analysis was performed with scores estimated using a logistic regression model based on age, sex, mechanism of injury, Abbreviated Injury Scale chest score, and TT size. In over a 30-month period, a total of 296 patients underwent TT placement for the management of traumatic HTx. Patients were predominantly male (79.6%) at a median age of 40 years and were evenly split between blunt (48.8%) and penetrating (51.2%) mechanisms. Sixty (20%) patients underwent thoracic irrigation at time of initial TT placement. The secondary intervention rate was significantly lower within the study group (5.6% vs. 21.8%; OR, 0.16; p irrigation and control cohort. Thoracic irrigation at the time of initial TT placement for traumatic HTx significantly reduced the need for secondary intervention for retained HTx. Therapeutic Study, Level III.
Capraro, Andrew; Stack, Anne; Harper, Marvin B; Kimia, Amir
At an emergency department (ED) in a tertiary care children's hospital with a level 1 pediatric trauma designation, unapproved abbreviations (UAAs) within electronic medical records (EMRs) were identified, and feedback was provided to providers regarding their types and use rates. Existing EMRs, including the ED physicians' patient notes were used as templates to develop a UAA list and an abbreviation detector. The detector was validated against human-screened samples of electronic ED notes from 2003 and then applied to all existing data to generate baseline rates of UAA, before intervention/implementation. Next, the validated abbreviation detector was applied prospectively in screening all EMRs monthly during a six-month period. In validation, the abbreviation detector had a sensitivity of 89%, a specificity of 99.9%, and a positive predictive value of 89%. Some 475,613 EMRs were screened, with UAAs identified at a rate of 26.4 +/- 4 per 1,000 EMRs. The most common nonmedication UAA was "qd" [11.8/1,000 EMRs], and the most common medication UAA was "PCN" [4.2/1,000 EMRs]. A total of 27,282 patient notes from 74 physicians were screened between January 1, 2007, and June 30, 2007, and 392 monthly reports were generated. Aggregate UAA use decreased by 8% (95% confidence interval [CI]: 6%-14%) per month-from 19.3 to > 12.1/100 charts, for a 37.3% decrease in UAA use in the six-month period. The estimated monthly decrease per physician was 0.9/100 (95% CI: 0.86-0.94, p abbreviation detector for surveillance of newly created EMRs, followed by consistent education and feedback, led to a significant decrease in UAA use in the study period.
Terrier, Jean-Etienne; Paparel, Philippe; Gadegbeku, Blandine; Ruffion, Alain; Jenkins, Lawrence C; N'Diaye, Amina
Traffic accidents are the most frequent cause of genitourinary injuries (GUI). Kidney injuries after trauma have been well described. However, there exists a paucity of data on other traumatic GUI after traffic accidents. The objective of this study was to analyze the frequency and type of all GUI, by user category, after traffic accidents. Patient cases were extracted from the trauma registry of the French department of Rhone from 1996 to 2013. We assessed the urogenital injuries presented by each of road user's categories. Severity injuries were coded with the Abbreviated Injury Scale and the Injury Severity Score. Kidney trauma was mapped with the classification of the American Association for the Surgery of Trauma. Multivariate prediction models were used for analysis of data. Of 162,690 victims, 963 presented with GUI (0.59%). 47% were motorcyclists, 22% were in a car, 18% on bicycles, and 9% were pedestrians. The most common organ injury was kidney (41%) followed by testicular (23%). Among the 208 motorists with a GUI, kidney (70%), bladder (10%), and adrenal gland (9%) were the most frequent lesions. Among the 453 motorcyclist victims with GUI, kidney (35%) and testicular (38%) traumas were the most frequent and 62% of injuries involved external genitalia. There were 175 cyclists with GUI, 70% of injuries involved external genitalia; penile traumas (23%) were the most frequent. In total, there were 395 kidney injuries, most being low grade. According to the American Association for the Surgery of Trauma kidney injuries were grade I, 59%; grade II, 11%; grade III, 16%; grade IV, 9%; grade V, 3%; and indeterminate, 2%. GUI is an infrequent trauma after traffic accidents, with kidneys being the most commonly injured. Physicians must maintain a high awareness for external genitalia injuries in motorcyclists and cyclists. Prognostic and epidemiologic study, level III.
Phillips, Bradley; Turco, Lauren; McDonald, Dan; Mause, Elizabeth; Walters, Ryan W
This study is the first to analyze penetrating injuries to the pancreas within subgroups of severe traumatic brain injury (TBI), early deaths, and potential survivors. Our objectives were to identify national patterns of injury, predictors of mortality, and to validate the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) pancreas injury grades by mortality. Secondary outcomes included hospital and intensive care unit length of stay and days on mechanical ventilation. Using the Abbreviated Injury Scale 2005 and ICD-9-CM E-codes, we identified 777 penetrating pancreatic trauma patients from the National Trauma Data Bank that occurred between 2010 and 2014. Severe TBI was identified by ICD-9-CM diagnosis codes and Glasgow Coma Score (GCS; n = 7), early deaths were those that occurred within 24 h of admission (n = 82), and potential survivors included patients without severe TBI who survived longer than 24 h following admission (n = 690). We estimated multivariable generalized linear mixed models to predict mortality to account for the nesting of potential survivors within trauma centers. Our results indicated that overall mortality decreased from 16.9% to 6.8% after excluding severe TBI and early deaths. Approximately, 11% of patients died within 24 h of admission, of whom 78% died in the first 6 h. Associated injuries to the stomach, liver, and major vasculature occurred in approximately 50% of patients; rates of associated injuries were highest in patients who died within 6 h of admission. In potential survivors, mortality increased by AAST-OIS grade: 3.5% I/II; 8.3% III; 9.6% IV; and 13.8% V. Predictors of mortality with significantly increased odds of death were patients with increasing age, lower admission GCS, higher admission pulse rate, and more severe injuries as indicated by Organ Injury Scale grade. From 777 patients, we identified national patterns of injury, predictors of outcome, and mortality by AAST-OIS grade within
Cook, Alan; Osler, Turner; Gaudet, Matthew; Berne, John; Norwood, Scott
Traumatic blunt cerebrovascular injury (BCVI) may portend catastrophic complications if untreated. Who should be screened for BCVI is controversial. The purpose of this study was to develop and validate a prediction score (pBCVI) to identify those at sufficient risk to warrant dedicated screening. We conducted a cohort study using data for years 2002-2007 from the National Trauma Data Bank. Blunt trauma patients aged 16 years and older were randomly divided into two groups for score creation and validation. Final prediction model included age, sex, Trauma Mortality Prediction Model p(death), traumatic intracranial hemorrhage, cerebellar/brain stem injury, malar/maxillary fracture, mandible fracture, cervical spine fracture, cervical spinal cord injury, thoracic spinal cord injury, and chest Abbreviated Injury Scale ≥3. pBCVI was evaluated using receiver operating characteristic curve area and the Hosmer-Lemeshow statistic. The Youden Index estimated an optimal cut-point (J) of the pBCVI. The cohort numbered 1,398,310 patients, including 2,125 with BCVI. The overall incidence of BCVI was 0.15%. Cervical spine fracture had the strongest association with BCVI (odds ratio 4.82, p < 0.001). The receiver operating characteristic curve for pBCVI was 0.93 and the Hosmer-Lemeshow statistic was 206.3, p < 0.01. The optimal cut-point (J) of pBCVI was 0.0013 (sensitivity 0.91, specificity 0.82) and would miss 186 (8.8%) injuries in our cohort. To identify all BCVI using this model, an unrealistic 96% of the cohort would require screening. A model based on a pattern of other injuries cannot be used as a stand-alone instrument to determine screening for BCVI. "Optimal" model cut-points are not ideal for all injuries. Clinical suspicion that integrates energy of mechanism and associated injuries remains essential to effectively screen for BCVI and minimize patient risk for a catastrophic missed injury.
Full Text Available Abstract Background Despite the recent proliferation in research on patient trust, it is seldom a primary outcome, and is often a peripheral area of interest. The length of our original scales to measure trust may limit their use because of the practical needs to minimize both respondent burden and research cost. The objective of this study was to develop three abbreviated scales to measure trust in: (1 a physician, (2 a health insurer, and (3 the medical profession. Methods Data from two samples were used. The first was a telephone survey of English-speaking adults in the United States (N = 1117 and the second was a telephone survey of English-speaking adults residing in North Carolina who were members of a health maintenance organization (N = 1024. Data were analyzed to examine data completeness, scaling assumptions, internal consistency properties, and factor structure. Results Abbreviated measures (5-items were developed for each of the three scales. Cronbach's alpha was 0.87 for trust in a physician (test-retest reliability = 0.71, 0.84 for trust in a health insurer (test-retest reliability = 0.73, and 0.77 for trust in the medical profession. Conclusion Assessment of data completeness, scale score dispersion characteristics, reliability and validity test results all provide evidence for the soundness of the abbreviated 5-item scales.
Skjerven-Martinsen, Marianne; Naess, Paal Aksel; Hansen, Trond Boye; Gaarder, Christine; Lereim, Inggard; Stray-Pedersen, Arne
The implementation of the compulsory wearing of seat belts (SBs) for children and improvements in child restraint systems have reduced the number of deaths and severe injuries among children involved in motor vehicle (MV) collisions (MVCs). Establishing the characteristics predictive of such injuries may provide the basis for targeted safety campaigns and lead to a further reduction in mortality and morbidity among children involved in MVCs. This study performed a multidisciplinary investigation among child occupants involved in MVCs to elucidate injury mechanisms, evaluate the safety measures used and determine the characteristics that are predictive of injury. A prospective study was conducted of all child occupants aged children were medically examined. Supplementary information was obtained from witnesses, the crash victims, police reports, medical records and reconstructions. Each case was reviewed by a multidisciplinary team to assess the mechanism of injury. In total, 158 child occupants involved in 100 MVCs were investigated, of which 27 (17%) exhibited Abbreviated Injury Scale (AIS) scores of 2+ injuries and 15 (9%) exhibited AIS 3+ injuries. None of the children died. Of those with AIS 2+ injuries (n=27), 89% (n=24) were involved in frontal impact collisions and 11% (3/27) were involved in side impacts. Multivariate analysis revealed that restraint misuse, age, the prevailing lighting conditions and ΔV were all independently correlated with AIS 2+ injuries. Safety errors were found in 74% (20/27) of those with AIS 2+ injuries and 93% (14/15) of those with AIS 3+ injuries. The most common safety error was misuse of restraints, and in particular loose and/or improperly positioned SBs. The risk of injury among child occupants is significantly higher when the child occupants are exposed to safety errors within the interior of the vehicle. Future campaigns should focus on the prevention of restraint misuse and unsecured objects in the passenger compartment or
Ha, Ninh Thi; Ederer, David; Vo, Van Anh Ha; Pham, An Van; Mounts, Anthony; Nolen, Leisha D; Sugerman, David
Our study measured the change in head injuries and deaths among motorcycle users in Cu Chi district, a suburban district of Ho Chi Minh City. Hospital records for road traffic injuries (RTIs) were collected from the Cu Chi Trauma Centre and motorcycle-related death records were obtained from mortality registries in commune health offices. Head injury severity was categorized using the Abbreviated Injury Score (AIS). Rate ratios (RRs) were used to compare rates pre- and post-law (2005/2006-2009/2010). Cu Chi's population, stratified by year, age, and sex, was used as the denominator. Of records identifying the transportation mode at the time of injury, motorcyclists accounted for most injuries (3,035, 87%) and deaths (238, 90%). Head injuries accounted for 70% of motorcycle-related hospitalizations. Helmet use was not recorded in any death records and not in 97% of medical records. Males accounted for most injuries (73%) and deaths (88%). The median age was 28 years and 32 years for injuries and deaths, respectively. Compared to the pre-law period, rates of motorcycle injuries (RR = 0.53; 95% confidence interval [CI], 0.49-0.58), head injuries (RR = 0.35; 95% CI, 0.31-0.39), severe head injuries (RR = 0.47; 95% CI, 0.34-0.63), and deaths (RR = 0.69; 95% CI, 0.53-0.89) significantly decreased in the post-law period. Rates of head injuries and deaths among motorcycle riders decreased significantly after implementation of the mandatory helmet law in Vietnam. To further examine the impact of the motorcycle helmet law, including compliance and helmet quality, further emphasis should be placed on gathering helmet use data from injured motorcyclists.
Luellen, Jason K.; Shadish, William R.; Clark, M. H.
Propensity score analysis is a relatively recent statistical innovation that is useful in the analysis of data from quasi-experiments. The goal of propensity score analysis is to balance two non-equivalent groups on observed covariates to get more accurate estimates of the effects of a treatment on which the two groups differ. This article…
Orozco-Cabal, Luis; Rodríguez, Maritza; Herin, David V.; Gempeler, Juanita; Uribe, Miguel
Objective This study determined the validity and reliability of a new, abbreviated version of the Spanish Barratt Impulsiveness Scale (BIS-15S) in Colombian subjects. Method The BIS-15S was tested in non-clinical (n=283) and clinical (n=164) native Spanish-speakers. Intra-scale reliability was calculated using Cronbach’s α, and test-retest reliability was measured with Pearson correlations. Psychometric properties were determined using standard statistics. A factor analysis was performed to determine BIS-15S factor structure. Results 447 subjects participated in the study. Clinical subjects were older and more educated compared to non-clinical subjects. Impulsivity scores were normally distributed in each group. BIS-15S total, motor, non-planning and attention scores were significantly lower in non-clinical vs. clinical subjects. Subjects with substance-related disorders had the highest BIS-15S total scores, followed by subjects with bipolar disorders and bulimia nervosa/binge eating. Internal consistency was 0.793 and test-retest reliability was 0.80. Factor analysis confirmed a three-factor structure (attention, motor, non-planning) accounting for 47.87% of the total variance in BIS-15S total scores. Conclusions The BIS-15S is a valid and reliable self-report measure of impulsivity in this population. Further research is needed to determine additional components of impulsivity not investigated by this measure. PMID:21152412
Pennington, BO; Sears, D; Clegg, DO
© 2014 by The International Union of Biochemistry and Molecular Biology, 42(6):495-500, 2014. We developed an interactive exercise to teach students how to draw the structures of the 20 standard amino acids and to identify the one-letter abbreviations by modifying the familiar game of "Hangman." Amino acid structures were used to represent single letters throughout the game. To provide additional practice in identifying structures, hints to the answers were written in "amino acid sentences" f...
Tanizaki, Shinsuke; Maeda, Shigenobu; Matano, Hideyuki; Sera, Makoto; Nagai, Hideya; Nakanishi, Taizo; Ishida, Hiroshi
The efficacy of nonoperative management of blunt thoracic aortic injury (BTAI) was evaluated in patients with pseudoaneurysm. A retrospective review was done for patients with BTAI at Fukui Prefectural Hospital during a 9-year period. Charts were reviewed for age, gender, Injury Severity Score, Abbreviated Injury Scale for each body area, initial type of aortic injury, site of aortic injury, type of definitive management, complications, and outcomes. Eighteen patients with BTAI were treated at Fukui Prefectural Hospital. Of 18 patients with pseudoaneurysm, seven patients were hemodynamically unstable and four patients died because of associated injuries; there were no aortic-related deaths. All 14 surviving patients were followed up for an average of 40.9 months. Only two patients with pseudoaneurysm required operative management because of the progression of the pseudoaneurysm. The pseudoaneurysm/normal aortic diameter ratio of those with any intervention was higher than that of those with nonoperative management. BTAI with pseudoaneurysm can be managed nonoperatively, with about 10% risk of progression to require surgical repair. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.
Boyd, D.W.; Cohan, D.; Regulinski, S.G.
A workbook for implementing an abbreviated version of the RD and D portfolio selection methodology described in A Resource Allocation Methodology for Establishing RD and D Budgetary Priorities is presented. The purpose of the abbreviated methodology is to allow a fast, first-cut analysis of a set of programs and to provide a means of discovering important issues that deserve more detailed analysis. The use of the abbreviated methodology in the overall process of evaluating RD and D programs is outlined. The effect of the program on a process is represented by the process model. Those process cost and performance characteristics that are important to the market for an energy product are described. The product cost model takes the cost and performance characteristics and the feedstock price and calculates the cost of producing a unit of energy using the technology in question. The market model takes this cost, the demand for the energy product, and the characteristics of alternative sources of the same product, and specifies the market share captured by the new technology. From this point it is relatively straightforward to infer the impacts of the new technology on the energy system. The benefit model evaluates the impacts in a consistent way, given the cost of the Federal support.
Hui, Xuan; Haider, Adil H; Hashmi, Zain G; Rushing, Amy P; Dhiman, Nitasha; Scott, Valerie K; Selvarajah, Shalini; Haut, Elliott R; Efron, David T; Schneider, Eric B
Patients with traumatic brain injury (TBI) frequently require mechanical ventilation (MV). The objective of this study was to examine the association between time spent on MV and the development of pneumonia among patients with TBI. Patients older than 18 y with head abbreviated injury scale (AIS) scores coded 1-6 requiring MV in the National Trauma Data Bank 2007-2010 data set were included. The study was limited to hospitals reporting pneumonia cases. AIS scores were calculated using ICDMAP-90 software. Patients with injuries in any other region with AIS score >3, significant burns, or a hospital length of stay >30 d were excluded. A generalized linear model was used to determine the approximate relative risk of developing all-cause pneumonia (aspiration pneumonia, ventilator-associated pneumonia [VAP], and infectious pneumonia identified by the International Classification of Disease, Ninth Revision, diagnosis code) for each day of MV, controlling for age, gender, Glasgow coma scale motor score, comorbidity (Charlson comorbidity index) score, insurance status, and injury type and severity. Among the 24,525 patients with TBI who required MV included in this study, 1593 (6.5%) developed all-cause pneumonia. After controlling for demographic and injury factors, each additional day on the ventilator was associated with a 7% increase in the risk of pneumonia (risk ratio 1.07, 95% confidence interval 1.07-1.08). Patients who have sustained TBIs and require MV are at higher risk for VAP than individuals extubated earlier; therefore, shortening MV exposure will likely reduce the risk of VAP. As patients with TBI frequently require MV because of neurologic impairment, it is key to develop aggressive strategies to expedite ventilator independence. Copyright © 2013 Elsevier Inc. All rights reserved.
Bloom, Matthew B; Ley, Eric J; Liou, Douglas Z; Tran, Tri; Chung, Rex; Melo, Nicolas; Margulies, Daniel R
Although it is assumed that obese patients are naturally protected against anterior abdominal stab wounds, the relationship has never been formally studied. We sought to examine the impact of body mass index (BMI) on severity of sustained injury, need for operation, and patient outcomes. We conducted a review of all patients presenting with abdominal stab wounds at an urban level I trauma center from January 2000-December 2012. Patients were divided into groups based on their BMI (35). Data abstracted included baseline demographics, physiologic data, and characterization of whether the stab wound had violated the peritoneum, caused intra-abdominal injury, or required an operation that was therapeutic. The one-sided Cochran-Armitage trend test was used for significance testing of the protective effect. Of 281 patients with abdominal stab wounds, 249 had complete data for evaluation. Chest and abdomen abbreviated injury scale trends decreased with increasing BMI, as did overall injury severity score, the percent of patients severely injured (injury severity score ≥ 25), and length of intensive care unit stay. Rates of peritoneal violation (100%, 84%, 77%, and 74%; P = 0.077), visceral injury (83%, 56%, 50%, and 30%; P = 0.022), and injury requiring a therapeutic operation (67%, 45%, 40%, and 20%; P = 0.034) all decreased with increasing BMI. Patients in the thinnest group required an operation three times more often than those in the most obese. Increased BMI protects patients with abdominal stab wounds and is associated with lower incidence of severe injury and need for operation. Heavier patients may be more suitable to observation and serial examinations, whereas very thin patients are more likely to require an operation and be critically injured. Copyright © 2015 Elsevier Inc. All rights reserved.
Grivna, Michal; Barss, Peter; Stanculescu, Cristina; Eid, Hani O; Abu-Zidan, Fikri M
A trauma registry in the United Arab Emirates was used to ascertain nontraffic injuries of 0- to 19-year-olds. The registry's value for prevention was assessed. A total of 292 children and youth with nontraffic injuries were admitted for >24 hours at surgical wards of the main trauma hospital in Al Ain region during 36 months in 2003-2006. Injuries were analyzed by external cause, location, body part, and severity. Nontraffic represented 60% (n = 292) of child and youth injuries. Incidence/100 000 person-years was 91 for males, 43 for females. Unintentional included falls 65% (n = 191), burns 17% (n = 49), animal-related (mainly camel) 3% (n = 10), and others 10% (n = 29). Intentional accounted for 4% (n = 13). Falls affected all ages, burns mainly 1- to 4-year-olds. Of the injuries, 70% occurred at home. Most frequent and severe injuries measured by the Injury Severity Score and Abbreviated Injury Scale involved extremities. Prevention of home falls for all ages and burns of 1- to 4-year-olds are priorities. Registries should cover pediatric wards and include data on fall locations and hazardous products. © 2011 APJPH.
Ornetti, P; Parratte, S; Gossec, L
). The psychometric properties evaluated were feasibility: percentage of responses, floor and ceiling effects; construct validity: internal consistency using Cronbach's alpha, correlations with osteoarthritis knee and hip quality of life domains using Spearman's rank test, and known group comparison between medicine......, mean age=70+/-10 years) and 30 in the surgery group (73% women, mean age=71+/-10 years). The percentage of responses was excellent. Neither a floor nor a ceiling effect was observed, except for the sport and recreation subscale (20.6% of patients with the worst possible score in the medicine group, 40...
Roč. 20, č. 6 (2010), s. 793-798 ISSN 1210-0552 R&D Projects: GA ČR GA205/09/1079 Institutional research plan: CEZ:AV0Z10300504 Keywords : score function * correlation * rank correlation coefficient * heavy tails Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.511, year: 2010
Chen, Chen; Zhang, Yi; An, Jin-gang; He, Yang; Gong, Xi
To select a scoring system suitable for the scoring of maxillofacial trauma by comparing 4 commonly used scoring systems according to expert scoring. Twenty-eight subjects who had experienced maxillofacial trauma constituted the study cohort. Four commonly used systems were selected: New Injury Severity Score (NISS), Facial Injury Severity Scale (FISS), Maxillofacial Injury Severity Score (MFISS), and Maxillofacial Injury Severity Score (MISS). Each patient was graded using these 4 systems. From the experience of our trauma center, an expert scoring table was created. After the purpose and scheme of the study had been explained, 35 experts in maxillofacial surgery were invited to grade the injury of the 28 patients using the expert scoring table according to their clinical experience. The results of the 4 scoring systems and expert score were compared. The results of the 4 scoring systems and expert score demonstrated a normal distribution. All results demonstrated significant differences (P expert score was the greatest (0.801). The correlation coefficient between the NISS, FISS, and MISS and the expert score was 0.714, 0.699, and 0.729, respectively. Agreement between the standardized scores and the expert score was evaluated using Bland-Altman plots; the agreement between the standardized MFISS and expert score was the best. Compared with the other 3 scoring systems, the correlation and agreement between the MFISS and expert score was greater. This finding suggests that the MFISS is more suitable for scoring maxillofacial injuries. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Bouvard, M; Aulard-Jaccod, J; Pessonneaux, S; Hautekeete, M; Rogé, B
The aim of this paper is to examine the short questionnaire of the Eysenck Personality Questionnaire Revised (the Eysenck Personality Questionnaire Revised-Abbreviated [EPQR-A]) among a student population. University students were invited, in groups, to fill in the forms proposed. Three sites were compared, representing a sample of 346 participants (Chambéry=118 subjects [44 males and 74 females]; Lille=110 subjects [50 males and 60 females] and Toulouse=118 subjects [60 males and 58 females]). The three groups of students have comparable scores on the EPQR-A wherever they live (Chambéry, Lille or Toulouse). Moreover, neither the age nor the gender allowed the detection of differences between subjects. Our sample of students is situated in the range of a "normal" group of students. Regarding the internal consistency coefficients, the French version we used of the neuroticism and the extraversion scales of the EPQR-A obtained a satisfactory result. The internal consistency coefficient of psychoticism was rather low (<70). This unsatisfactory level of internal reliability for the psychoticism is also found in the English version . The four-factor model of the EPQR-A is judged to be an adequate explanation of the data. In the end, self-esteem correlated positively with extraversion and negatively with neuroticism. On the other hand, there is no link between psychoticism and self-esteem. Copyright © 2010 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.
Hantschel, Jochen; Seiffert, Joerg [E.ON New Build and Technology GmbH, Gelsenkirchen (Germany); Froehner, Joerg [ct.e Controltechnology Engineering GmbH, Herne (Germany)
The objective of the VGB Standard for power plant technology VGB-S-891-00 (abbreviation catalogue) is to regulate the systematic creation of abbreviations. The determination of abbreviations for terms related to power plants provides a common basis for planners, erectors, and operators of power plants and their systems. In combination with VGB-B 108 ''Rules for the creation of denominations and their application for power plant engineering'' the abbreviation catalogue is the basis for the creation of denominations.
Komi, Masanori; Shiraishi, Junji
A large number of abbreviations have been created for various special terms, and used in magnetic resonance (MR) study. However, the use of these abbreviations in the paper title has been restricted by the majority of societies and journals. In this study, we investigated the use of various abbreviations for special terms in MR study in order to clarify which abbreviation could be used in the paper title without spelling. We used two journals, Magnetic Resonance in Medicine (MRM) and Journal of Magnetic Resonance Imaging (JMRI) published by the International Society for Magnetic Resonance in Medicine (ISMRM), which has been considered to be the most advanced society for MR study in the world, as the reference standard for use of the abbreviations. Except for some basic abbreviations and specific abbreviations that were used on a long-term basis, the majority of abbreviations were used in the paper title with its full spelling in order to ensure generality. It is preferable that abbreviations not be used in the title of the or title of the paper.
Smoot Dustin L
Full Text Available Abstract Background Our American College of Surgeons Level 1 Trauma Center serves a rural population. As a result, there is a unique set of accidents that are not present in an urban environment such as deer related motor vehicle crashes (dMVC. We characterized injury patterns between motorcycle/all-terrain vehicles (MCC and automobile (MVC crashes related to dMVC (deer motor vehicle crash with the hypotheses that MCC will present with higher Injury Severity Score (ISS and that it would be related to whether the driver struck the deer or swerved. Methods The records of 157 consecutive patients evaluated at our institution for injury related to dMVC from January 1st, 1997 to December 31st, 2006 were reviewed from our prospectively collected trauma database. Demographic, clinical, and crash specific parameters were abstracted. Injury severity was analyzed by the Abbreviated Injury Scale score for each body region as well as the overall Injury Severity Score (ISS. Results Motorcycle crashes presented with a higher median ISS than MVCs (14 vs 5, p Within the MVC group, there was no difference between swerving and hitting the deer in any AIS group. Forty-seven percent of drivers were not wearing seat belts which resulted in similar median ISS (6 vs 5 and AIS of all body regions. Conclusions Motorcycle operators suffered higher ISS. There were no significant differences in median ISS if a driver involved in a deer-related motor vehicle crash swerved rather than collided, was helmeted, or restrained.
Stewart, Ian J; Faulk, Tarra I; Sosnov, Jonathan A; Clemens, Michael S; Elterman, Joel; Ross, James D; Howard, Jeffrey T; Fang, Raymond; Zonies, David H; Chung, Kevin K
Rhabdomyolysis has been associated with poor outcomes in patients with traumatic injury, especially in the setting of acute kidney injury (AKI). However, rhabdomyolysis has not been systematically examined in a large cohort of combat casualties injured in the wars in Iraq and Afghanistan. We conducted a retrospective study of casualties injured during combat operations in Iraq and Afghanistan who were initially admitted to the intensive care unit from February 1, 2002, to February 1, 2011. Information on age, sex, Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), mechanism of injury, shock index, creatine kinase, and serum creatinine were collected. These variables were examined via multivariate logistic and Cox regression analyses to determine factors independently associated with rhabdomyolysis, AKI, and death. Of 6,011 admissions identified, a total of 2,109 patients met inclusion criteria and were included for analysis. Rhabdomyolysis, defined as creatine kinase greater than 5,000 U/L, was present in 656 subjects (31.1%). Risk factors for rhabdomyolysis identified on multivariable analysis included injuries to the abdomen and extremities, increased ISS, male sex, explosive mechanism of injury, and shock index greater than 0.9. After adjustment, patients with rhabdomyolysis had a greater than twofold increase in the odds of AKI. In the analysis for mortality, rhabdomyolysis was significantly associated with death until AKI was added, at which point it lost statistical significance. We found that rhabdomyolysis is associated with the development of AKI in combat casualties. While rhabdomyolysis was strongly associated with mortality on the univariate model and in conjunction with both ISS and age, it was not associated with mortality after the inclusion of AKI. This suggests that the effect of rhabdomyolysis on mortality may be mediated by AKI. Prognostic and epidemiologic study, level III.
The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice. Copyright © 2016 Elsevier Ltd. All rights reserved.
Heim, Dominik; Altgeld, Katrin; Hasler, Rebecca M; Aghayev, Emin; Exadaktylos, Aristomenis K
Winter sports have evolved from an upper class activity to a mass industry. Especially sledging regained popularity at the start of this century, with more and more winter sports resorts offering sledge runs. This study investigated the rates of sledging injuries over the last 13 years and analysed injury patterns specific for certain age groups, enabling us to make suggestions for preventive measures. We present a retrospective analysis of prospectively collected data. From 1996/1997 to 2008/2009, all patients involved in sledging injuries were recorded upon admission to a Level III trauma centre. Injuries were classified into body regions according to the Abbreviated Injury Scale (AIS). The Injury Severity Score (ISS) was calculated. Patients were stratified into 7 age groups. Associations between age and injured body region were tested using the chi-squared test. The slope of the linear regression with 95% confidence intervals was calculated for the proportion of patients with different injured body regions and winter season. 4956 winter sports patients were recorded. 263 patients (5%) sustained sledging injuries. Sledging injury patients had a median age of 22 years (interquartile range [IQR] 14-38 years) and a median ISS of 4 (IQR 1-4). 136 (51.7%) were male. Injuries (AIS ≥ 2) were most frequent to the lower extremities (n=91, 51.7% of all AIS ≥ 2 injuries), followed by the upper extremities (n=48, 27.3%), the head (n=17, 9.7%), the spine (n=7, 4.0%). AIS ≥ 2 injuries to different body regions varied from season to season, with no significant trends (p>0.19). However, the number of patients admitted with AIS ≥ 2 injuries increased significantly over the seasons analysed (p=0.031), as did the number of patients with any kind of sledging injury (p=0.004). Mild head injuries were most frequent in the youngest age group (1-10 years old). Injuries to the lower extremities were more often seen in the age groups from 21 to 60 years (p<0.001). Mild head
Liu, Zilong; Liu, Liang; Fan, Zebing; Chen, Xiaorui; Zhao, Xiaohong; Zhang, Lingli; Rao, Guangxun; Li, Haixia
This study explored the possibility of using event-related potentials (ERP) for the measurement of picture-recognition memory and examined its correlation with the Chinese Wechsler Memory Scale-revised (WMS-RC) in patients with memory disorder caused by severe traumatic brain injury (sTBI). The subjects included 20 sTBI patients with memory disorder and 22 healthy individuals. Memory function was measured by using WMS-RC. Behavioral and ERP responses were recorded on-line during performance on a battery of picture recognition and the responses were analyzed off-line for recognition memory effects. Mean memory quotient (MQ) of patients with sTBI was significantly lower than that of the control group. Mean reaction time (RT) was significantly longer and the mean correctness rate (CR) of picture recognition was significantly lower in sTBI group than that of the controls. In controls, the main components of average ERP of picture recognition includes two positive-going waves, designated as P(170) and P(500), that appear 170 ms and 500 ms after stimulation when the subject could later successfully recall and recognize the pictures. P(500) amplitude of target stimulus was significantly higher than that of non-target stimulus. Compared to controls, P(500) responses of sTBI group were significantly delayed in latency (PWMS-RC. ERP of picture recognition provides a neurophysiological approach to directly assess memory impairment, and P(500) may serve as a helpful index for memory disorder caused by sTBI in forensic practice.
Freyaldenhoven, Melinda C; Nabelek, Anna K; Tampas, Joanna W
This study investigated the relationship between acceptable noise levels (ANLs) and the Abbreviated Profile of Hearing Aid Benefit (APHAB; R. M. Cox & G. C. Alexander, 1995). This study further examined the APHAB's ability to predict hearing aid use. ANL and APHAB data were collected for 191 listeners with impaired hearing, separated into 3 groups based on hearing aid use: full-time, part-time, or nonuse. Results demonstrated ANLs were not correlated with APHAB scores. Results further demonstrated 2 of the 4 APHAB subscales (Ease of Communication [EC] and Background Noise [BN]) predicted hearing aid success with 60% accuracy, which is 25% poorer than that observed using the ANL alone. When combining the ANL with the EC and BN subscales, accuracy of the prediction increased to 91%. Lastly, 3 of the 4 APHAB subscales (EC, BN, and Reverberation) enhanced the present prediction of hearing aid use for patients with mid-range ANLs. These results indicate that ANLs and APHAB scores provide unique information regarding hearing aid use. These results further indicate that the prediction can be enhanced by administering both the ANL and the EC and BN APHAB subscales. Lastly, some of the ambiguity of the prediction of hearing aid use for listeners with mid-range ANLs may be eliminated.
..., reference marks and symbols. 221.200 Section 221.200 Aeronautics and Space OFFICE OF THE SECRETARY... § 221.200 Content and explanation of abbreviations, reference marks and symbols. (a) Content. The format..., reference marks and symbols. Abbreviations, reference marks and symbols which are used in the tariff shall...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Abbreviations, ditto marks, and asterisks... Abbreviations, ditto marks, and asterisks prohibited. (a) In disclosing required information, words or terms shall not be designated by ditto marks or appear in footnotes referred to by asterisks or other symbols...
A list of two letter abbreviations for all genera and three letter abbreviations for all subgenera of mosquitoes (family Culicidae, order Diptera) is given. This information on generic-level taxa of mosquitoes is useful in reducing printed space in publications, tables and lists. The work was comp...
The use of acronyms and abbreviations is increasing profoundly in the clinical domain in large part due to the greater adoption of electronic health record (EHR) systems and increased electronic documentation within healthcare. A single acronym or abbreviation may have multiple different meanings or senses. Comprehending the proper meaning of an…
Sylvia Miranda Carneiro
Full Text Available Objective: to evaluate the use of abbreviations in nursing records of a teaching hospital and describing their profile in different sectors, work shifts and professional nursing categories. Methods: documentary study that analyzed 627 nursing records in 24 patient charts using a systematic observation script. Results: we identified 1,792 abbreviations, and 35.8% were nonstandard. The incidence of abbreviations was higher in the Intensive Care Unit, used by nurses and in the night shift. Conclusion: abbreviations are part of the day-to-day of nursing records. The use of nonstandard abbreviations make difficult to understand the note content, can generate misinterpretations, put at risk the users’ safety and impair the continuity of labor work.
Combination of Mean Platelet Volume/Platelet Count Ratio and the APACHE II Score Better Predicts the Short-Term Outcome in Patients with Acute Kidney Injury Receiving Continuous Renal Replacement Therapy.
Li, Junhui; Li, Yingchuan; Sheng, Xiaohua; Wang, Feng; Cheng, Dongsheng; Jian, Guihua; Li, Yongguang; Feng, Liang; Wang, Niansong
Both the Acute physiology and Chronic Health Evaluation (APACHE II) score and mean platelet volume/platelet count Ratio (MPR) can independently predict adverse outcomes in critically ill patients. This study was aimed to investigate whether the combination of them could have a better performance in predicting prognosis of patients with acute kidney injury (AKI) who received continuous renal replacement therapy (CRRT). Two hundred twenty-three patients with AKI who underwent CRRT between January 2009 and December 2014 in a Chinese university hospital were enrolled. They were divided into survivals group and non-survivals group based on the situation at discharge. Receiver Operating Characteristic (ROC) curve was used for MPR and APACHE II score, and to determine the optimal cut-off value of MPR for in-hospital mortality. Factors associated with mortality were identified by univariate and multivariate logistic regression analysis. The mean age of the patients was 61.4 years, and the overall in-hospital mortality was 48.4%. Acute cardiorenal syndrome (ACRS) was the most common cause of AKI. The optimal cut-off value of MPR for mortality was 0.099 with an area under the ROC curve (AUC) of 0.636. The AUC increased to 0.851 with the addition of the APACHE II score. The mortality of patients with of MPR > 0.099 was 56.4%, which was significantly higher than that of the control group with of ≤ 0.099 (39.6%, P= 0.012). Logistic regression analysis showed that average number of organ failure (OR = 2.372), APACHE II score (OR = 1.187), age (OR = 1.028) and vasopressors administration (OR = 38.130) were significantly associated with poor prognosis. Severity of illness was significantly associated with prognosis of patients with AKI. The combination of MPR and APACHE II score may be helpful in predicting the short-term outcome of AKI. © 2018 The Author(s). Published by S. Karger AG, Basel.
Combination of Mean Platelet Volume/Platelet Count Ratio and the APACHE II Score Better Predicts the Short-Term Outcome in Patients with Acute Kidney Injury Receiving Continuous Renal Replacement Therapy
Full Text Available Background/Aims: Both the Acute physiology and Chronic Health Evaluation (APACHE II score and mean platelet volume/platelet count Ratio (MPR can independently predict adverse outcomes in critically ill patients. This study was aimed to investigate whether the combination of them could have a better performance in predicting prognosis of patients with acute kidney injury (AKI who received continuous renal replacement therapy (CRRT. Methods: Two hundred twenty-three patients with AKI who underwent CRRT between January 2009 and December 2014 in a Chinese university hospital were enrolled. They were divided into survivals group and non-survivals group based on the situation at discharge. Receiver Operating Characteristic (ROC curve was used for MPR and APACHE II score, and to determine the optimal cut-off value of MPR for in-hospital mortality. Factors associated with mortality were identified by univariate and multivariate logistic regression analysis. Results: The mean age of the patients was 61.4 years, and the overall in-hospital mortality was 48.4%. Acute cardiorenal syndrome (ACRS was the most common cause of AKI. The optimal cut-off value of MPR for mortality was 0.099 with an area under the ROC curve (AUC of 0.636. The AUC increased to 0.851 with the addition of the APACHE II score. The mortality of patients with of MPR > 0.099 was 56.4%, which was significantly higher than that of the control group with of ≤ 0.099 (39.6%, P= 0.012. Logistic regression analysis showed that average number of organ failure (OR = 2.372, APACHE II score (OR = 1.187, age (OR = 1.028 and vasopressors administration (OR = 38.130 were significantly associated with poor prognosis. Conclusion: Severity of illness was significantly associated with prognosis of patients with AKI. The combination of MPR and APACHE II score may be helpful in predicting the short-term outcome of AKI.
O'Neill, Stephen; Brady, Richard R; Kerssens, Jan J; Parks, Rowan W
Elderly trauma is increasing in incidence and is associated with significant morbidity and mortality. The primary objective of the study was to identify factors associated with survival or mortality in the elderly following trauma. The secondary objective was to compare the epidemiology of trauma in the elderly with younger patients. A retrospective analysis was performed of data that was obtained from a prospectively collected multi-centre trauma database maintained by The Scottish Trauma Audit Group (STAG) containing details of 52,887 trauma patients admitted to 25 participating Scottish Hospitals over an 11-year period. Elderly trauma patients (aged >80 years) were separately analyzed and compared to younger trauma patients (aged 13-80). Of 52,887 trauma patients identified, 4791 were elderly (9.1%). Elderly patients had a higher absolute mortality rate following traumatic injury (9.9% versus 4%, pelderly was higher in males, following a high fall, with lower Glasgow Coma Scale (GCS), in those with higher Abbreviated Injury Scale (AIS)/Injury Severity Score (ISS), in those with concomitant injuries, hemodynamic compromise and following delayed presentation. Multiple logistic regression analysis confirmed an independent relationship between mortality and low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) in the elderly. In conclusion, trauma in elderly patients is associated with significantly higher mortality. Low GCS, male gender, higher ISS, higher AIS of spinal injury, hemodynamic compromise and concomitant minor leg/arm injury(ies) have the strongest independent relationships with mortality after trauma in the elderly population. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Yamamoto, Yasunori; Yamaguchi, Atsuko; Bono, Hidemasa; Takagi, Toshihisa
Many abbreviations are used in the literature especially in the life sciences, and polysemous abbreviations appear frequently, making it difficult to read and understand scientific papers that are outside of a reader's expertise. Thus, we have developed Allie, a database and a search service of abbreviations and their long forms (a.k.a. full forms or definitions). Allie searches for abbreviations and their corresponding long forms in a database that we have generated based on all titles and abstracts in MEDLINE. When a user query matches an abbreviation, Allie returns all potential long forms of the query along with their bibliographic data (i.e. title and publication year). In addition, for each candidate, co-occurring abbreviations and a research field in which it frequently appears in the MEDLINE data are displayed. This function helps users learn about the context in which an abbreviation appears. To deal with synonymous long forms, we use a dictionary called GENA that contains domain-specific terms such as gene, protein or disease names along with their synonymic information. Conceptually identical domain-specific terms are regarded as one term, and then conceptually identical abbreviation-long form pairs are grouped taking into account their appearance in MEDLINE. To keep up with new abbreviations that are continuously introduced, Allie has an automatic update system. In addition, the database of abbreviations and their long forms with their corresponding PubMed IDs is constructed and updated weekly. Database URL: The Allie service is available at http://allie.dbcls.jp/.
Hamiel, Uri; Hecht, Idan; Nemet, Achia; Pe'er, Liron; Man, Vitaly; Hilely, Assaf; Achiron, Asaf
Abbreviations are common in the medical record. Their inappropriate use may ultimately lead to patient harm, yet little is known regarding the extent of their use and their comprehension. Our aim was to assess the extent of their use, their comprehension and physicians' attitudes towards them, using ophthalmology consults in a tertiary hospital as a model. We first mapped the frequency with which English abbreviations were used in the departments' computerised databases. We then used the most frequently used abbreviations as part of a cross-sectional survey designed to assess the attitudes of non-ophthalmologist physicians towards the abbreviations and their comprehension of them. Finally, we tested whether an online lecture would improve comprehension. 4375 records were screened, and 235 physicians responded to the survey. Only 42.5% knew at least 10% of the abbreviations, and no one knew them all. Ninety-two per cent of respondents admitted to searching online for the meanings of abbreviations, and 59.1% believe abbreviations should be prohibited in medical records. A short online lecture improved the number of respondents answering correctly at least 50% of the time from 1.2% to 42% (PAbbreviations are common in medical records and are frequently misinterpreted. Online teaching is a valuable tool for physician education. The majority of respondents believed that misinterpreting abbreviations could negatively impact patient care, and that the use of abbreviations should be prohibited in medical records. Due to low rates of comprehension and negative attitudes towards abbreviations in medical communications, we believe their use should be discouraged. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Yamamoto, Yasunori; Yamaguchi, Atsuko; Bono, Hidemasa; Takagi, Toshihisa
Many abbreviations are used in the literature especially in the life sciences, and polysemous abbreviations appear frequently, making it difficult to read and understand scientific papers that are outside of a reader’s expertise. Thus, we have developed Allie, a database and a search service of abbreviations and their long forms (a.k.a. full forms or definitions). Allie searches for abbreviations and their corresponding long forms in a database that we have generated based on all titles and abstracts in MEDLINE. When a user query matches an abbreviation, Allie returns all potential long forms of the query along with their bibliographic data (i.e. title and publication year). In addition, for each candidate, co-occurring abbreviations and a research field in which it frequently appears in the MEDLINE data are displayed. This function helps users learn about the context in which an abbreviation appears. To deal with synonymous long forms, we use a dictionary called GENA that contains domain-specific terms such as gene, protein or disease names along with their synonymic information. Conceptually identical domain-specific terms are regarded as one term, and then conceptually identical abbreviation-long form pairs are grouped taking into account their appearance in MEDLINE. To keep up with new abbreviations that are continuously introduced, Allie has an automatic update system. In addition, the database of abbreviations and their long forms with their corresponding PubMed IDs is constructed and updated weekly. Database URL: The Allie service is available at http://allie.dbcls.jp/. PMID:21498548
Stewart, M.E.; Fussell, J.B.; Crump, R.J.
Fault tree analysis is being widely used for reliability and safety analysis of systems encountered in the nuclear industry and elsewhere. A disadvantage of the fault tree method is the voluminous fault tree graphical representation that conventionally results from analysis of a complex system. Previous methods for shortening the fault tree graphical representation include (1) transfers within the fault tree, and (2) the use of the SAMPLE (K out of N logic) gate, the MATRIX gate, and the SUMMATION gate. The purpose of this presentation is to introduce TABULATION gates as a method to abbreviate the fault tree graphical representation. These new gates reduce the cost of analysis and generally increase the system behavior visibility that is inherent in the fault tree technique
Torii, Manabu; Liu, Hongfang
In the biomedical domain, a terminology knowledge base that associates acronyms/abbreviations (denoted as SFs) with the definitions (denoted as LFs) is highly needed. For the construction such terminology knowledge base, we investigate the feasibility to build a system automatically assigning semantic categories to LFs extracted from text. Given a collection of pairs (SF,LF) derived from text, we i) assess the coverage of LFs and pairs (SF,LF) in the UMLS and justify the need of a semantic category assignment system; and ii) automatically derive name phrases annotated with semantic category and construct a system using machine learning. Utilizing ADAM, an existing collection of (SF,LF) pairs extracted from MEDLINE, our system achieved an f-measure of 87% when assigning eight UMLS-based semantic groups to LFs. The system has been incorporated into a web interface which integrates SF knowledge from multiple SF knowledge bases. Web site: http://gauss.dbb.georgetown.edu/liblab/SFThesurus.
The dictionary comprises about 3000 acronyms and abbreviations, with explanations in German and English. Subjects: Chemistry, medicine, geology, air, water, soil, waste, air pollution and noise abatement, chemicals and pollutants, agriculture and food, conservation and landscaping, energy, immission protection, radiation protection and nuclear safety, industry and biotechnology, environmental pollution, waste management and recycling. It is intended as a working and communication tool for a wide range of users in industry, administration, universities, scientists and students, journalists, translators and interested laymen. There is an appendix with supplementary information, i.e. mass, volume, SI units, chemical compounds and formulas, occupational pollutant exposure, food additives, environmental disasters, environmental laws, regulations and specifications, international programmes and organisations for environmental protection, and guidelines of environmental and international law. (orig.) [de
Koh, K C; Lau, K M; Yusof, S A M; Mohamad, A I; Shahabuddin, F S A; Ahmat, N H; Teh, P C
Misinterpretation of abbreviations by healthcare professionals has been reported to compromise patient safety. This study was done to determine the prevalence of abbreviations usage among medical doctors and nurses and their ability to interpret commonly used abbreviations in medical practice. Seventy-seven medical doctors and eighty nurses answered a self-administered questionnaire designed to capture demographic data and information regarding abbreviation use in medical practice. Comparisons were made between doctors and nurses with regards to frequency and reasons for using abbreviations; from where abbreviations were learned; frequency of encountering abbreviations in medical practice; prevalence of medical errors due to misinterpretation of abbreviations; and their ability to correctly interpret commonly used abbreviations. The use of abbreviations was highly prevalent among doctors and nurses. Time saving, avoidance of writing sentences in full and convenience, were the main reasons for using abbreviations. Doctors learned abbreviations from fellow doctors while nurses learned from fellow nurses and doctors. More doctors than nurses reported encountering abbreviations. Both groups reported no difficulties in interpreting abbreviations although nurses reported often resorting to guesswork. Both groups felt abbreviations were necessary and an acceptable part of work. Doctors outperformed nurses in correctly interpreting commonly used standard and non-standard abbreviations. The use of standard and non-standard abbreviation in clinical practice by doctors and nurses was highly prevalent. Significant variability in interpretation of abbreviations exists between doctors and nurses.
Fortney, Luke; Luchterhand, Charlene; Zakletskaia, Larissa; Zgierska, Aleksandra; Rakel, David
Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influence on health care. Interventions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and compassion among primary care clinicians. A total of 30 primary care clinicians participated in an abbreviated mindfulness course. We used a single-sample, pre-post design. At 4 points in time (baseline, and 1 day, 8 weeks, and 9 months postintervention), participants completed a set of online measures assessing burnout, anxiety, stress, resilience, and compassion. We used a linear mixed-effects model analysis to assess changes in outcome measures. Participants had improvements compared with baseline at all 3 follow-up time points. At 9 months postintervention, they had significantly better scores (1) on all Maslach Burnout Inventory burnout subscales-Emotional Exhaustion (P =.009), Depersonalization (P = .005), and Personal Accomplishment (P primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety, and stress. Modified mindfulness training may be a time-efficient tool to help support clinician health and well-being, which may have implications for patient care.
Full Text Available Concomitant use of multiple acetaminophen medications is associated with overdose. To help patients identify acetaminophen medications and thus avoid concomitant use, an icon with an abbreviation for “acetaminophen” has been proposed for all acetaminophen medications. This study assessed pharmacists’ and physicians’ use and interpretation of abbreviations for “acetaminophen”, to identify abbreviations with other meanings that might cause confusion. Physicians (n = 150 reported use and interpretation of candidate abbreviations Ac and Acm. Pharmacists (n = 150 interpretations of prescription orders using the candidate abbreviations APAP, Ac, Ace and Acm in typed, handwritten or spoken form, were judged for critical confusions likely to cause patient harm. Critical confusion was rare, except for omission by pharmacists of the acetaminophen dose for Hydrocodone/APAP prescriptions (10%. Ac was in common use to indicate “before meals”, and was interpreted as such, but some physicians (8% said they use Ac to indicate anticoagulant drugs. Most pharmacists (54% interpreted Ace as acetaminophen, and none interpreted it as referring to ACE-inhibitors. Acm was rarely used in prescriptions, had no common interfering meanings, and was often (63% interpreted as acetaminophen, especially when prescribed in combination with an opiate (85%. The data validated concerns about abbreviations in prescribing: all abbreviations resulted in some misinterpretations. However, Acm was rarely misinterpreted, was readily associated with “acetaminophen”, and seemed appropriate for use in a graphic icon to help consumers/patients identify acetaminophen medications.
Full Text Available Introduction: A short screening tool for high-risk individuals with personality disorder (PD is useful both for clinicians and researchers. The aim of this study was to assess the validity and reliability of the Farsi version of the Standardized Assessment of Personality-Abbreviated Scale (SAPAS. Methods: The original English version of the SAPAS questionnaire was translated into Farsi, and then, translated back into English by two professionals. A survey was then conducted using the questionnaire on 150 clients of primary health care centers in Tabriz, Iran. A total of 235 medical students were also studied for the reliability assessment of the questionnaire. The SAPAS was compared to the short form of Minnesota Multiphasic Personality Inventory (MMPI. The data analysis was performed using receiver operating characteristic (ROC curve technique, operating characteristic for diagnostic efficacy, Cronbach's alpha, and test-retest for reliability evaluation. Results: We found an area under the curve (AUC of 0.566 [95% confidence intervals (CI: 0.455-0.677]; sensitivity of 0.89 and specificity of 0.26 at the cut-off score of 2 and higher. The total Cronbach's alpha coefficient was 0.38 and Cohen's kappa ranged between 0.5 and 0.8. Conclusion: The current study showed that the Farsi version of the SAPAS was relatively less efficient, in term of validity and reliability, in the screening of PD in the population.
Moon, Sungrim; Pakhomov, Serguei; Liu, Nathan; Ryan, James O; Melton, Genevieve B
To create a sense inventory of abbreviations and acronyms from clinical texts. The most frequently occurring abbreviations and acronyms from 352,267 dictated clinical notes were used to create a clinical sense inventory. Senses of each abbreviation and acronym were manually annotated from 500 random instances and lexically matched with long forms within the Unified Medical Language System (UMLS V.2011AB), Another Database of Abbreviations in Medline (ADAM), and Stedman's Dictionary, Medical Abbreviations, Acronyms & Symbols, 4th edition (Stedman's). Redundant long forms were merged after they were lexically normalized using Lexical Variant Generation (LVG). The clinical sense inventory was found to have skewed sense distributions, practice-specific senses, and incorrect uses. Of 440 abbreviations and acronyms analyzed in this study, 949 long forms were identified in clinical notes. This set was mapped to 17,359, 5233, and 4879 long forms in UMLS, ADAM, and Stedman's, respectively. After merging long forms, only 2.3% matched across all medical resources. The UMLS, ADAM, and Stedman's covered 5.7%, 8.4%, and 11% of the merged clinical long forms, respectively. The sense inventory of clinical abbreviations and acronyms and anonymized datasets generated from this study are available for public use at http://www.bmhi.umn.edu/ihi/research/nlpie/resources/index.htm ('Sense Inventories', website). Clinical sense inventories of abbreviations and acronyms created using clinical notes and medical dictionary resources demonstrate challenges with term coverage and resource integration. Further work is needed to help with standardizing abbreviations and acronyms in clinical care and biomedicine to facilitate automated processes such as text-mining and information extraction.
Isolated severe blunt duodenal injuries are rare. We present an American Association for the Surgery of Trauma grade IV duodenal injury in a paediatric patient. The strategic use of damage control surgical principles, involving an initial abbreviated laparotomy followed by a delayed reconstruction, resulted in a successful ...
Leeper, Christine M; Lin, Elizabeth; Hoffman, Marcus; Fombona, Anisleidy; Zhou, Tianhua; Kutcher, Matthew; Rosengart, Matthew; Watson, Gregory; Billiar, Timothy; Peitzman, Andrew; Zuckerbraun, Brian; Sperry, Jason
Older adult trauma patients are at increased risk of poor outcome, both immediately after injury and beyond hospital discharge. Identifying patients early in the hospital stay who are at increased risk of death after discharge can be challenging. Retrospective analysis was performed using our trauma registry linked with the social security death index from 2010 to 2014. Age was categorized as 18 to 64 and 65 years or older. We calculated mortality rates by age category then selected elderly patients with mechanism of injury being a fall for further analysis. Computed Tomography Abbreviated Assessment of Sarcopenia for Trauma (CAAST) was obtained by measuring psoas muscle cross-sectional area adjusted for height and weight. Kaplan-Meier survival analysis was performed, and proportional hazards regression modeling was used to determine independent risk factors for in-hospital and out-of-hospital mortality. A total of 23,622 patients were analyzed (16,748, aged 18-64 years; and 6,874, aged 65 or older). In-hospital mortality was 1.96% for ages 18 to 64 and 7.19% for age 65 or older (p older (p older group included injury characteristics such as ISS, admission vitals, and head injury. Predictors of postdischarge mortality for age 65or older included skilled nursing before admission, disposition, and mechanism of injury being a fall. A total of 57.5% (n = 256) of older patients who sustained a fall met criteria for sarcopenia. Sarcopenia was the strongest predictor of out-of-hospital mortality in this cohort with a hazard ratio of 4.77 (95% confidence interval, 2.71-8.40; p older adults. The CAAST measurement is an efficient and inexpensive measure that can allow clinicians to target older trauma patients at risk of poor outcome for early intervention and/or palliative care services. Prognostic and epidemiologic study, level III.
Several studies have shown that motorcycle antilock braking systems (ABS) reduce crashes and injuries. However, it has been suggested that the improved stability provided by ABS would make upright crashes more frequent, thus changing the injury distributions among motorcyclists and increasing the risk of leg injuries. The overall motorcycle design can vary across different categories and manufacturers. For instance, some motorcycles are equipped with boxer-twin engines; that is, with protruding cylinder heads. A previous study based on a limited material has suggested that these could provide some leg protection; therefore, the aim of this research was to analyze injury distributions in crashes involving ABS-equipped motorcycles with boxer-twin engines compared to similar ABS-equipped motorcycles with other engine configurations. Swedish hospital and police records from 2003-2014 were used. Crashes involving ABS-equipped motorcycles with boxer-twin engines (n = 55) were compared with similar ABS-equipped motorcycles with other engines configurations (n = 127). The distributions of Abbreviated Injury Scale (AIS) 1+ and AIS 2+ were compared. Each subject's injury scores were also converted to the risk for permanent medical impairment (RPMI), which shows the risk of different levels of permanent medical impairment given the severity and location and of injuries. To compare injury severity, the mean RPMI 1+ and RPMI 10+ were analyzed for each body region and in overall for each group of motorcyclists. It was found that AIS 1+, AIS 2+, and PMI 1+ leg injuries were reduced by approximately 50% among riders with boxer engines. These results were statistically significant. The number of injuries to the upper body did not increase; the mean RPMI to the head and upper body were similar across the 2 groups, suggesting that the severity of injuries did not increase either. Indications were found suggesting that the overall mean RPMI 1+ was lower among riders with boxer engines
Cadotte, David W; Vachhrajani, Shobhan; Pirouzmand, Farhad
This study documents the epidemiology of head injury over the course of 22 years in the largest Level I adult trauma center in Canada. This information defines the current state, changing pattern, and relative distribution of demographic factors in a defined group of trauma patients. It will aid in hypothesis generation to direct etiological research, administrative resource allocation, and preventative strategies. Data on all the trauma patients treated at Sunnybrook Health Sciences Centre (SHSC) from 1986 to 2007 were collected in a consecutive, prospective fashion. The authors reviewed these data from the Sunnybrook Trauma Registry Database in a retrospective fashion. The aggregate data on head injury included demographic data, cause of injury, and Injury Severity Score (ISS). The collected data were analyzed using univariate techniques to depict the trend of variables over years. The authors used the length of stay (LOS) and number of deaths per year (case fatality rate) as crude measures of outcome. A total of 16,678 patients were treated through the Level I trauma center at SHSC from January 1986 to December 2007. Of these, 9315 patients met the inclusion criteria (ISS > 12, head Abbreviated Injury Scale score > 0). The median age of all trauma patients was 36 years, and 69.6% were male. The median ISS of the head-injury patients was 27. The median age of this group of patients increased by 12 years over the study period. Motorized vehicle accidents accounted for the greatest number of head injuries (60.3%) although the relative percentage decreased over the study period. The median transfer time of patients sustaining a head injury was 2.58 hours, and there was an approximately 45 minute improvement over the 22-year study period. The median LOS in our center decreased from 19 to 10 days over the study period. The average case fatality rate was 17.4% over the study period. In multivariate analysis, more severe injuries were associated with increased LOS as
Keenan, Jeffrey E; Gulack, Brian C; Nussbaum, Daniel P; Green, Cindy L; Vaslef, Steven N; Shapiro, Mark L; Scarborough, John E
Controversy exists over optimal timing of tracheostomy in patients with respiratory failure after blunt trauma. The study aimed to determine whether the timing of tracheostomy affects mortality in this population. The 2008-2011 National Trauma Data Bank was queried to identify blunt trauma patients without concomitant head injury who required tracheostomy for respiratory failure between hospital days 4 and 21. Restricted cubic spline analysis was performed to evaluate the relationship between tracheostomy timing and the odds of inhospital mortality. The cohort was stratified based on this analysis. Unadjusted characteristics and outcomes were compared. Multivariable logistic regression was used to evaluate the effect of tracheostomy timing on mortality after adjustment for age, gender, race, payor status, level of trauma center, injury severity score, presentation Glasgow coma scale, and thoracic and abdominal abbreviated injury score. There were 9662 patients included in the study. Restricted cubic spline analysis demonstrated a nonlinear relationship between timing of tracheostomy and mortality, with higher odds of mortality occurring with tracheostomy placement within 10 d of admission compared with later time points. The cohort was therefore stratified into early and delayed tracheostomy groups relative to this time point. The resulting groups contained 5402 (55.9%) and 4260 (44.1%) patients, respectively. After multivariable adjustment, the delayed tracheostomy group continued to have significantly reduced odds of mortality (Adjusted odds ratio, 0.82, 95% confidence interval, 0.71-0.95, C-statistic, 0.700). Among non-head injured blunt trauma patients with prolonged respiratory failure, tracheostomy placement within 10 d of admission may result in increased mortality compared with later time points. Copyright © 2015 Elsevier Inc. All rights reserved.
Karanci, A Nuray; Dirik, Gülay; Yorulmaz, Orçun
The aim of the present study was to examine the reliability and the validity of the Turkish translation of the Eysneck Personality Questionnaire Revised-abbreviated Form (EPQR-A) (Francis et al., 1992), which consists of 24 items that assess neuroticism, extraversion, psychoticism, and lying. The questionnaire was first translated into Turkish and then back translated. Subsequently, it was administered to 756 students from 4 different universities. The Fear Survey Inventory-III (FSI-III), Rosenberg Self-Esteem Scales (RSES), and Egna Minnen Betraffande Uppfostran (EMBU-C) were also administered in order to assess the questionnaire's validity. The internal consistency, test-retest reliability, and validity were subsequently evaluated. Factor analysis, similar to the original scale, yielded 4 factors; the neuroticism, extraversion, psychoticism, and lie scales. Kuder-Richardson alpha coefficients for the extraversion, neuroticism, psychoticism, and lie scales were 0.78, 0.65, 0.42, and 0.64, respectively, and the test-retest reliability of the scales was 0.84, 0.82, 0.69, and 0.69, respectively. The relationships between EPQR-A-48, FSI-III, EMBU-C, and RSES were examined in order to evaluate the construct validity of the scale. Our findings support the construct validity of the questionnaire. To investigate gender differences in scores on the subscales, MANOVA was conducted. The results indicated that there was a gender difference only in the lie scale scores. Our findings largely supported the reliability and validity of the questionnaire in a Turkish student sample. The psychometric characteristics of the Turkish version of the EPQR-A were discussed in light of the relevant literature.
Full Text Available Abstract Background There are several well established scores for the assessment of the prognosis of major trauma patients that all have in common that they can be calculated at the earliest during intensive care unit stay. We intended to develop a sequential trauma score (STS that allows prognosis at several early stages based on the information that is available at a particular time. Study design In a retrospective, multicenter study using data derived from the Trauma Registry of the German Trauma Society (2002-2006, we identified the most relevant prognostic factors from the patients basic data (P, prehospital phase (A, early (B1, and late (B2 trauma room phase. Univariate and logistic regression models as well as score quality criteria and the explanatory power have been calculated. Results A total of 2,354 patients with complete data were identified. From the patients basic data (P, logistic regression showed that age was a significant predictor of survival (AUCmodel p, area under the curve = 0.63. Logistic regression of the prehospital data (A showed that blood pressure, pulse rate, Glasgow coma scale (GCS, and anisocoria were significant predictors (AUCmodel A = 0.76; AUCmodel P + A = 0.82. Logistic regression of the early trauma room phase (B1 showed that peripheral oxygen saturation, GCS, anisocoria, base excess, and thromboplastin time to be significant predictors of survival (AUCmodel B1 = 0.78; AUCmodel P +A + B1 = 0.85. Multivariate analysis of the late trauma room phase (B2 detected cardiac massage, abbreviated injury score (AIS of the head ≥ 3, the maximum AIS, the need for transfusion or massive blood transfusion, to be the most important predictors (AUCmodel B2 = 0.84; AUCfinal model P + A + B1 + B2 = 0.90. The explanatory power - a tool for the assessment of the relative impact of each segment to mortality - is 25% for P, 7% for A, 17% for B1 and 51% for B2. A spreadsheet for the easy calculation of the sequential trauma
Nordin, Sayed Kushairi Sayed; Samat, Khairul Fadzli; Sultan, Al Amin Mohamed; Halim, Bushra Abdul; Ismail, Siti Fatimah; Mafazi, Nurul Wirdah
Mathematics is an essential and fundamental tool used by engineers to analyse and solve problems in their field. Due to this, most engineering education programs involve a concentration of study in mathematics courses whereby engineering students have to take mathematics courses such as numerical methods, differential equations and calculus in the first two years and continue to do so until the completion of the sequence. However, the students struggled and had difficulties in learning courses that require mathematical abilities. Hence, this study presents the factors that caused mathematics anxiety among engineering students using Abbreviated Mathematics Anxiety Rating Scale (AMARS) through 95 students of Universiti Teknikal Malaysia Melaka (UTeM). From 25 items in AMARS, principal component analysis (PCA) suggested that there are four mathematics anxiety factors, namely experiences of learning mathematics, cognitive skills, mathematics evaluation anxiety and students' perception on mathematics. Minitab 16 software was used to analyse the nonparametric statistics. Kruskal-Wallis Test indicated that there is a significant difference in the experience of learning mathematics and mathematics evaluation anxiety among races. The Chi-Square Test of Independence revealed that the experience of learning mathematics, cognitive skills and mathematics evaluation anxiety depend on the results of their SPM additional mathematics. Based on this study, it is recommended to address the anxiety problems among engineering students at the early stage of studying in the university. Thus, lecturers should play their part by ensuring a positive classroom environment which encourages students to study mathematics without fear.
Shultz, Jonas; Strosher, Lisa; Nathoo, Shaheen Nenshi; Manley, Jim
Pharmaceutical companies use a variety of abbreviations to denote short- and long-acting medications. Errors involving the administration of these medications are frequently reported. To evaluate comprehension rates for abbreviations used to denote short- and long-acting medications and to evaluate whether changes to medication labels could reduce potential errors in the selection and administration of medications. In phase 1 of the study, nursing staff were asked to define 4 abbreviations and then to categorize them by release rate. In phase 2, a simulation exercise, nursing staff were asked if it would be appropriate to administer a medication illustrated in a photograph (oxycodone CR 5-mg blister pack) on the basis of information highlighted in a screen shot of an electronic medication administration record (order for oxycodone 5 mg). Three different presentations were used to identify the medication in the medication administration record and on the drug label. In phase 1, 10 (28%) of 36 nursing staff members knew what all 4 abbreviations meant, and 14 (39%) correctly classified all 4 abbreviations as indicating a short- or a long-acting medication. In the simulation exercise (phase 2), labelling changes reduced the likelihood of a potential medication administration error. Most abbreviations used to indicate short- versus long-acting medications were not correctly understood by study participants. Of more concern was the incorrect interpretation of some abbreviations as indicating the opposite release rate (e.g., "ER" interpreted as meaning "emergency release", rather than "extended release", with incorrect classification as a short-acting medication). This evaluation highlighted the potential consequences of using non-intuitive abbreviations to differentiate high-risk medications having different release rates.
Osterhoff, Georg; Scheyerer, Max J; Fritz, Yannick; Bouaicha, Samy; Wanner, Guido A; Simmen, Hans-Peter; Werner, Clément M L
Radiology-based classifications of pelvic ring injuries and their relevance for the prognosis of morbidity and mortality are disputed in the literature. The purpose of this study was to evaluate potential differences between the pelvic ring injury classification systems by Tile and by Young and Burgess with regard to their predictive value on mortality, transfusion/infusion requirement and concomitant injuries. Two-hundred-and-eighty-five consecutive patients with pelvic ring fractures were analyzed for mortality within 30 days after admission, number of blood units and total volume of fluid infused during the first 24h after trauma, the Abbreviated Injury Severity (AIS) scores for head, chest, spine, abdomen and extremities as a function of the Tile and the Young-Burgess classifications. There was no significant relationship between occurrence of death and fracture pattern but a significant relationship between fracture pattern and need for blood units/total fluid volume for Tile (p<.001/p<.001) and Young-Burgess (p<.001/p<.001). In both classifications, open book fractures were associated with more fluid requirement and more severe injuries of the abdomen, spine and extremities (p<.05). When divided into the larger subgroups "partially stable" and "unstable", unstable fractures were associated with a higher mortality rate in the Young-Burgess system (p=.036). In both classifications, patients with unstable fractures required significantly more blood transfusions (p<.001) and total fluid infusion (p<.001) and higher AIS scores. In this first direct comparison of both classifications, we found no clinical relevant differences with regard to their predictive value on mortality, transfusion/infusion requirement and concomitant injuries. Copyright © 2013 Elsevier Ltd. All rights reserved.
Hsu, L-F; Hung, C-L; Kuo, L-J; Tsai, P-S
No instrument is available to assess the impact of faecal incontinence (FI) of quality of life for Chinese-speaking population. The purpose of the study was to adapt the Faecal Incontinence Quality of Life Scale (FIQL) for patients with colorectal cancer, assess the factor structure and reduce the items for brevity. A sample of 120 participants were enrolled. Internal consistency, test-retest reliability, and convergent and contrasted-groups validity were assessed. Construct validity was analysed using an exploratory and confirmatory factor analyses (CFA). The internal consistency (Cronbach's α of the total scale and four subscales = 0.98 and 0.97, 0.96, 0.92, 0.82 respectively), test-retest reliability (intraclass correlation coefficients ≥.98 for all scales with p < .001) and significant correlations of all scales with selected subscales of the Medical Outcomes Study 36-Item Short-Form Health Survey and the Wexner scale suggested satisfactory reliability and validity. The severe FI group (with a Wexner score ≥9) scored significantly lower on the scale than the less severe FI group (with a Wexner score <9) did (p < .001). The CFA supported a two-factor structure and demonstrated an excellent model fit of the 15-item abbreviated version of the FIQL-Chinese. The FIQL-Chinese has satisfactory validity and reliability and the abbreviated version may be more practical and applicable. © 2016 John Wiley & Sons Ltd.
Strandroth, Johan; Rizzi, Matteo; Sternlund, Simon; Lie, Anders; Tingvall, Claes
The aim of the present study was to estimate the correlation between Euro NCAP pedestrian rating scores and injury outcome in real-life car-to-pedestrian crashes, with special focus on long-term disability. Another aim was to determine whether brake assist (BA) systems affect the injury outcome in real-life car-to-pedestrian crashes and to estimate the combined effects in injury reduction of a high Euro NCAP ranking score and BA. In the current study, the Euro NCAP pedestrian scoring was compared with the real-life outcome in pedestrian crashes that occurred in Sweden during 2003 to 2010. The real-life crash data were obtained from the data acquisition system Swedish Traffic Accident Data Acquisition (STRADA), which combines police records and hospital admission data. The medical data consisted of International Classification of Diseases (ICD) diagnoses and Abbreviated Injury Scale (AIS) scoring. In all, approximately 500 pedestrians submitted to hospital were included in the study. Each car model was coded according to Euro NCAP pedestrian scores. In addition, the presence or absence of BA was coded for each car involved. Cars were grouped according to their scoring. Injury outcomes were analyzed with AIS and, at the victim level, with permanent medical impairment. This was done by translating the injury scores for each individual to the risk of serious consequences (RSC) at 1, 5, and 10 percent risk of disability level. This indicates the total risk of a medical disability for each victim, given the severity and location of injuries. The mean RSC (mRSC) was then calculated for each car group and t-tests were conducted to falsify the null hypothesis at p ≤ .05 that the mRSC within the groups was equal. The results showed a significant reduction of injury severity for cars with better pedestrian scoring, although cars with a high score could not be studied due to lack of cases. The reduction in RSC for medium-performing cars in comparison with low-performing cars
Kasch, Helge; Hjorth, Tine; Svensson, Peter
to a motor vehicle accident involving a rear collision participated in a study of TMD. The control group consisted of 20 age- and gender-matched ankle-injury patients. Participants were seen within 4 weeks and again at 6 months post-injury. The masticatory system was examined in accordance with the research...... obtained at each visit. Results: One whiplash patient and I ankle-injury patient bad jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ......, TMD symptoms and signs, MVOF and PDT, I were not significantly different in whiplash-injury and ankle-injury patients after 4 weeks and 6 months. Conclusion: TMD pain after whiplash injury and ankle injury is rare, suggesting that whiplash injury is not a major risk factor for the development of TMD...
Samaranayake, Nithushi R; Cheung, Dixon S T; Lam, May P S; Cheung, Tommy T; Chui, William C M; Wong, Ian C K; Cheung, Bernard M Y
The use of error-prone abbreviations has led to medication errors. Many safety organisations have introduced 'Do Not Use' lists (lists of error-prone abbreviations that should be avoided by prescribers), but the effectiveness of these lists have not been studied. We assessed the effectiveness of the 'Do Not Use' list introduced to the study hospital, and sought the attitudes of healthcare professionals on other potentially dangerous abbreviations (not included in the 'Do Not Use' list) used in prescriptions. The study was conducted in a university affiliated tertiary hospital in Hong Kong. An uncontrolled observational study was conducted. In-patient prescriptions were reviewed to assess the use of error-prone abbreviations included in the 'Do Not Use' list before, after its introduction, and following the first reinforcement. An on-line survey was also conducted among prescribers, pharmacists and nurses. Rate of using error-prone abbreviations and other unapproved abbreviations among reviewed prescriptions. 3,238 prescriptions (23,398 drug items) were reviewed. The use of abbreviations in the 'Do Not Use' list decreased from 7.8 to 3.3 % after its introduction (P abbreviations were used to denote prescribing instructions in 19.2 % of the drugs prescribed. 49 different types of unapproved abbreviations were used for drug names. A 'Do Not Use' list is effective in reducing error-prone abbreviations. Reinforcements of the 'Do Not Use' list further improves prescriber adherence. However, many other unapproved abbreviations (not included in current 'Do Not Use' lists) are used when prescribing. Periodic reminders on error-prone abbreviations and education of prescribers on associated risks may help to reduce the use of error-prone abbreviations in hospitals.
Bosarge, Patrick L; Shoultz, Thomas H; Griffin, Russell L; Kerby, Jeffrey D
An association between stress-induced hyperglycemia (SIH) and increased mortality has been demonstrated following trauma. Experimental animal model data regarding the association between hyperglycemia and outcomes following traumatic brain injury (TBI) are inconsistent, suggesting that hyperglycemia may be harmful, neutral, or beneficial. The purpose of this study was to examine the effects of SIH versus diabetic hyperglycemia (DH) on severe TBI. Admission glycosylated hemoglobin (HbA1c), glucose levels, and comorbidity data were collected during a 4-year period from September 2009 to December 2013 for patients with severe TBI (i.e., admission Glasgow Coma Scale [GCS] score of 3-8 and head Abbreviated Injury Scale [AIS] score ≥ 3). Diabetes mellitus was determined by patient history or admission HbA1c of 6.5% or greater. SIH was determined by the absence of diabetes mellitus and admission glucose of 200 mg/dL or greater. A Cox proportional hazards model adjusted for age, sex, injury mechanism, and Injury Severity Score (ISS) was used to calculate hazard ratios (HRs) and associated 95% confidence intervals (CIs) for the association between SIH and the outcomes of interest. During the study period, a total of 626 patients were included in the study group, having severe TBI defined by both GCS score of 3 to 8 and head AIS score being 3 or greater and also had available HbA1c and admission glucose levels. A total of 184 patients were admitted with hyperglycemia; 152 patients (82.6%) were diagnosed with SIH, and 32 patients (17.4%) were diagnosed with DH. When comparing patients with severe TBI adjusted for age, sex, injury mechanism, ISS, Revised Trauma Score (RTS), and lactic acid greater than 2.5 mmol/L, patients with SIH had a 50% increased mortality (HR, 1.49; 95% CI, 1.13-1.95) compared with the nondiabetic normoglycemia patients. DH patients did not have a significant increase in mortality (HR, 0.94; 95% CI, 0.56-1.58). SIH is associated with higher mortality
Schoell, Samantha L; Weaver, Ashley A; Talton, Jennifer W; Baker, Gretchen; Doud, Andrea N; Barnard, Ryan T; Stitzel, Joel D; Zonfrillo, Mark R
The objective of the study was to develop a disability-based metric for motor vehicle crash (MVC) injuries, with a focus on head injuries, and compare the functional outcomes between the pediatric and adult populations. Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank-Research Data System (NTDB-RDS) for the top 95% most frequently occurring Abbreviated Injury Scale (AIS) 3, 4, and 5 head injuries in NASS-CDS 2000-2011. Pediatric (ages 7-18), adult (19-45), middle-aged (46-65), and older adult (66+) patients with an FIM score available who were alive at discharge and had an AIS 3, 4, or 5 injury were included in the study. The NTDB-RDS contains a truncated form of the FIM instrument, including 3 items (self-feed, locomotion, and verbal expression), each graded on a scale of 1 (full functional dependence) to 4 (full functional independence). Patients within each age group were classified as disabled or not disabled based on the FIM scale. The DR was calculated for each age group by dividing the number of patients who sustained a specific injury and were disabled by the number of patients who sustained the specific injury. To account for the impact of more severe associated coinjuries, a maximum AIS (MAIS) adjusted DR (DRMAIS) was also calculated for each injury. DR and DRMAIS ranged from 0 (0% disability risk) to 1 (100% disability risk). An analysis of the most frequent FIM components associated with disabling MVC head injuries revealed that disability across all 3 items (self-feed, locomotion, and expression) was the most frequent for pediatric and adult patients. Only locomotion was the most frequent for middle-aged and older adults. The mean DRMAIS for MVC head injuries was 35% for pediatric patients, 36% for adults, 38% for middle-aged adults, and 44% for older adults. Further analysis was conducted by grouping the head injuries into 8 groups based on the structure of injury and injury
Piper, Brian J; Gray, Hilary M; Raber, Jacob; Birkett, Melissa A
The parent form of the 113-item Child Behavior Checklist (CBCL) is widely utilized by child psychiatrists and psychologists. This report examines the reliability and validity of a recently developed abbreviated version of the CBCL, the Brief Problem Monitor (BPM). Caregivers (n = 567) completed the CBCL online and the 19 BPM items were examined separately. Internal consistency of the BPM was high (Cronbach's alpha = 0.91) and satisfactory for the Internalizing (0.78), Externalizing (0.86), and Attention (0.87) scales. High correlations between the CBCL and BPM were identified for the total score (r = 0.95) as well as the Internalizing (0.86), Externalizing (0.93), and Attention (0.97) scales. The BPM and scales were sensitive and identified significantly higher behavioral and emotional problems among children whose caregiver reported a psychiatric diagnosis of attention-deficit hyperactivity disorder, bipolar disorder, depression, anxiety, developmental disabilities, or autism spectrum disorders relative to a comparison group that had not been diagnosed with these disorders. BPM ratings also differed by the socioeconomic status and education of the caregiver. Mothers with higher annual incomes rated their children as having 38.8% fewer total problems (Cohen's d = 0.62) as well as 42.8% lower Internalizing (d = 0.53), 44.1% less Externalizing (d = 0.62), and 30.9% decreased Attention (d = 0.39). A similar pattern was evident for maternal education (d = 0.30-0.65). Overall, these findings provide strong psychometric support for the BPM, although the differences based on the characteristics of the parent indicate that additional information from other sources (e.g., teachers) should be obtained to complement parental reports. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.
Lyoo, Younghyun C; Ju, Sejin; Kim, Eunjung; Kim, Jieun E; Lee, Junghyun H
Over half of all suicides worldwide occur in Asia. Given the close association between suicide and depression, it is quite unexpected that depression is least frequently diagnosed in Asia. This is, in part, due to the fact that Asians somatize depression. Young adults including college and graduate students are no exceptions. Therefore, a somatic symptom-focused screening tool would be useful in detecting depression in Asian college and graduate students. The purpose of this study was to evaluate the psychometric properties of the Patient Health Questionnaire-15 (PHQ-15) in screening for depression among Korean college and graduate students. In addition, we developed an abbreviated version of the PHQ-15 (aPHQ-15) and studied validity measures. Three-hundred and fifty Korean college and graduate students were screened with the PHQ-15. Of all participants, 176 were interviewed using the Structured Clinical Interview for DSM-IV to diagnose major depressive episode, while the other 174 were evaluated with the Beck Depression Inventory-II (BDI-II) and the Inventory of Depressive Symptomatology-Self-Report (IDS-SR). Reliability and validity measures including the internal consistency, test-retest reliability, and criterion, convergent, and divergent validity were tested. Principal component analysis was used in developing the abbreviated version of the PHQ-15. The PHQ-15 showed good internal consistency and test-retest reliability (Cronbach's alpha 0.82, intra-class correlation coefficient 0.87). The optimal cut-off point for detecting depression was estimated to be 8. There were strong correlations between the PHQ-15 total scores and self-report measures of depressive symptom severity (BDI-II: r=0.69 and pdepression. Copyright © 2014 Elsevier Inc. All rights reserved.
Dooley, M J; Wiseman, M; Gu, G
The use of error-prone abbreviations in prescribing is a potential cause of misinterpretation that may lead to medication error. This study determined frequency and type of error-prone abbreviations in inpatient medication prescribing across three Australian hospitals. Three hundred and sixty-nine (76.9%) patients had one or more error-prone abbreviations used in prescribing, with 8.4% of orders containing at least one error-prone abbreviation and 29.6% of these considered to be high risk for causing significant harm. © 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.
Xu, Hua; Stetson, Peter D; Friedman, Carol
Abbreviations are widely used in clinical notes and are often ambiguous. Word sense disambiguation (WSD) for clinical abbreviations therefore is a critical task for many clinical natural language processing (NLP) systems. Supervised machine learning based WSD methods are known for their high performance. However, it is time consuming and costly to construct annotated samples for supervised WSD approaches and sense frequency information is often ignored by these methods. In this study, we proposed a profile-based method that used dictated discharge summaries as an external source to automatically build sense profiles and applied them to disambiguate abbreviations in hospital admission notes via the vector space model. Our evaluation using a test set containing 2,386 annotated instances from 13 ambiguous abbreviations in admission notes showed that the profile-based method performed better than two baseline methods and achieved a best average precision of 0.792. Furthermore, we developed a strategy to combine sense frequency information estimated from a clustering analysis with the profile-based method. Our results showed that the combined approach largely improved the performance and achieved a highest precision of 0.875 on the same test set, indicating that integrating sense frequency information with local context is effective for clinical abbreviation disambiguation.
Baron, David Marek; Hochrieser, Helene; Metnitz, Philipp G H; Mauritz, Walter
Data regarding the impact and timing of tracheostomy in patients with isolated traumatic brain injury (TBI) are ambiguous. Our goal was to evaluate the impact of tracheostomy on hospital mortality in patients with moderate or severe isolated TBI. We performed a retrospective cohort analysis of data prospectively collected at 87 Austrian intensive care units (ICUs). All patients continuously admitted between 1998 and 2010 were evaluated for the study. In total, 4,735 patients were admitted to ICUs with isolated TBI. Of these patients, 2,156 had a moderate or severe TBI (1,603 patients were endotracheally intubated only, 553 patients underwent tracheostomy). Epidemiological data (trauma severity, treatment, and outcome) of the two groups were compared. Patients with moderate or severe isolated TBI undergoing tracheostomy had a similar Glasgow Coma Scale score, median (interquartile range): 6 (3-8) vs 6 (3-8); p = 0.90, and Simplified Acute Physiology Score II, 45 (37-54) vs 45 (35-56); p = 0.86, compared with intubated patients not undergoing tracheostomy. Furthermore, patients undergoing tracheostomy exhibited higher Abbreviated Injury Scale Head scores and had a longer ICU stay for survivors, 30 (22-42) vs 9 (3-17) days; p tracheostomy compared with patients who remained intubated, observed-to-expected mortality ratio (95 % confidence interval): 0.62 (0.53-0.72) vs 1.00 (0.95-1.05) respectively. Despite the greater severity of head injury, patients with isolated TBI who underwent tracheostomy had a lower risk-adjusted mortality than patients who remained intubated. Reasons for this difference in outcome may be multifactorial and require further investigation.
Cheung, Stephanie; Hoi, Sannifer; Fernandes, Olavo; Huh, Jin; Kynicos, Sara; Murphy, Laura; Lowe, Donna
Dangerous abbreviations on the Institute for Safe Medication Practices Canada's "Do Not Use" list have resulted in medication errors leading to harm. Data comparing rates of use of dangerous abbreviations in paper and electronic medication orders are limited. To compare rates of use of dangerous abbreviations from the "Do Not Use" list, in paper and electronic medication orders. Secondary objectives include determining the proportion of patients at risk for medication errors due to dangerous abbreviations and the most commonly used dangerous abbreviations. One-day cross-sectional audits of medication orders were conducted at a 6-site hospital network in Toronto, Canada, between December 2013 and January 2014. Proportions of paper and electronic medication orders containing dangerous abbreviation(s) were compared using a χ 2 test. The proportion of patients with at least 1 medication order containing dangerous abbreviation(s) and the top 5 dangerous abbreviations used were described. Overall, 255 patient charts were reviewed. The proportions of paper and electronic medication orders containing dangerous abbreviation(s) were 172/714 (24.1%) and 9/2207 (0.4%), respectively ( P abbreviation(s). The proportions of patients with at least 1 medication order during the audit period containing dangerous abbreviation(s) for patients with paper only, electronic only, or a hybrid of paper and electronic medication orders were 50.5%, 5%, and 47.2%, respectively. Those most commonly used were "D/C", drug name abbreviations, "OD," "cc," and "U." Electronic medication orders have significantly lower rates of dangerous abbreviation use compared to paper medication orders.
Cohan, Deborah; Gomez, Elvira; Greenberg, Mara; Washington, Sierra; Charlebois, Edwin D
In the US, an unacceptably high percentage of pregnant women do not undergo prenatal HIV testing. Previous studies have found increased uptake of prenatal HIV testing with abbreviated pre-test counseling, however little is known about patient decision making, testing satisfaction and knowledge in this setting. A randomized-controlled, non-inferiority trial was conducted from October 2006 through February 2008 at San Francisco General Hospital (SFGH), the public teaching hospital of the City and County of San Francisco. A total of 278 English- and Spanish-speaking pregnant women were randomized to receive either abbreviated or standard nurse-performed HIV test counseling at the initial prenatal visit. Patient decision making experience was compared between abbreviated versus standard HIV counseling strategies among a sample of low-income, urban, ethnically diverse prenatal patients. The primary outcome was the decisional conflict score (DCS) using O'Connor low-literacy scale and secondary outcomes included satisfaction with test decision, basic HIV knowledge and HIV testing uptake. We conducted an intention-to-treat analysis of 278 women--134 (48.2%) in the abbreviated arm (AA) and 144 (51.8%) in the standard arm (SA). There was no significant difference in the proportion of women with low decisional conflict (71.6% in AA vs. 76.4% in SA, p = .37), and the observed mean difference between the groups of 3.88 (95% CI: -0.65, 8.41) did not exceed the non-inferiority margin. HIV testing uptake was very high (97. 8%) and did not differ significantly between the 2 groups (99.3% in AA vs. 96.5% in SA, p = .12). Likewise, there was no difference in satisfaction with testing decision (97.8% in AA vs. 99.3% in SA, p = .36). However, women in AA had significantly lower mean HIV knowledge scores (78.4%) compared to women in SA (83.7%, pprocess, while associated with slightly lower knowledge, does not compromise patient decision making or satisfaction regarding HIV testing
Zonfrillo, Mark R; Elliott, Michael R; Flannagan, Carol A; Durbin, Dennis R
To determine the association between weight and the risk of injury in motor vehicle crashes (MVCs) for children 1 through 8 years of age who were using child restraints. This was a cross-sectional study of children 1 to 8 years of age in MVCs, in which cases from the National Automotive Sampling System Crashworthiness Data System were used. Abbreviated Injury Scale scores of ≥2 indicated clinically significant injuries. The National Automotive Sampling System Crashworthiness Data System study sample included 650 children 1 to 5 years of age in forward-facing child restraints who weighed 20 to 65 lb and 344 children 3 to 8 years of age in belt-positioning booster seats who weighed 30 to 100 lb. With adjustment for seating position, type of vehicle, direction of impact, crash severity, and vehicle model year, there was no association between absolute weight and clinically significant injuries in either age group (odds ratio: 1.17 [95% confidence interval: 0.96-1.42] for children 1-5 years of age in forward-facing child restraints and 1.22 [95% confidence interval: 0.96-1.55] for children 3-8 years of age in belt-positioning booster seats). The risk of clinically significant injuries was not associated with weight across a broad weight range in this sample of children in MVCs who were using child restraint systems. Parents should continue to restrain their children according to current recommendations from the American Academy of Pediatrics and the National Highway Traffic Safety Administration.
Full Text Available Math anxiety has an important impact on mathematical development and performance. However, although math anxiety is supposed to be a transcultural trait, assessment instruments are scarce and are validated mainly for Western cultures so far. Therefore, we aimed at examining the transcultural generality of math anxiety by a thorough investigation of the validity of math anxiety assessment in Eastern Europe. We investigated the validity and reliability of a Polish adaptation of the Abbreviated Math Anxiety Scale (AMAS, known to have very good psychometric characteristics in its original, American-English version as well as in its Italian and Iranian adaptations.We also observed high reliability, both for internal consistency and test-retest stability of the AMAS in the Polish sample. The results also show very good construct, convergent and discriminant validity: The factorial structure in Polish adult participants (n = 857 was very similar to the one previously found in other samples; AMAS scores correlated moderately in expected directions with state and trait anxiety, self-assessed math achievement and skill as well temperamental traits of emotional reactivity, briskness, endurance and perseverance. Average scores obtained by participants as well as gender differences and correlations with external measures were also similar across cultures. Beyond the cultural comparison, we used path model analyses to show that math anxiety relates to math grades and self-competence when controlling for trait anxiety.The current study shows transcultural validity of math anxiety assessment with the AMAS.
Schnettler, Berta; Grunert, Klaus G; Miranda-Zapata, Edgardo; Orellana, Ligia; Sepúlveda, José; Lobos, Germán; Hueche, Clementina; Höger, Yesli
The aims of this study were to test the relationships between food neophobia, satisfaction with food-related life and food technology neophobia, distinguishing consumer segments according to these variables and characterizing them according to willingness to purchase food produced with novel technologies. A survey was conducted with 372 university students (mean aged=20.4years, SD=2.4). The questionnaire included the Abbreviated version of the Food Technology Neophobia Scale (AFTNS), Satisfaction with Life Scale (SWLS), and a 6-item version of the Food Neophobia Scale (FNS). Using confirmatory factor analysis, it was confirmed that SWFL correlated inversely with FNS, whereas FNS correlated inversely with AFTNS. No relationship was found between SWFL and AFTNS. Two main segments were identified using cluster analysis; these segments differed according to gender and family size. Group 1 (57.8%) possessed higher AFTNS and FNS scores than Group 2 (28.5%). However, these groups did not differ in their SWFL scores. Group 1 was less willing to purchase foods produced with new technologies than Group 2. The AFTNS and the 6-item version of the FNS are suitable instruments to measure acceptance of foods produced using new technologies in South American developing countries. The AFTNS constitutes a parsimonious alternative for the international study of food technology neophobia. Copyright © 2017 Elsevier Ltd. All rights reserved.
Gregory, Ellyn; Soderman, Melinda; Ward, Christy; Beukelman, David R; Hux, Karen
This study investigated the accuracy with which 30 young adults without disabilities learned abbreviation expansion codes associated with specific vocabulary items that were stored in an AAC device with two accessing methods: mouse access and keyboard access. Both accessing methods utilized a specialized computer application, called AAC Menu, which allowed for errorless practice. Mouse access prompted passive learning, whereas keyboard access prompted active learning. Results revealed that participants who accessed words via a keyboard demonstrated significantly higher mastery of abbreviation-expansion codes than those who accessed words via a computer mouse.
Mango, Victoria L., E-mail: firstname.lastname@example.org [Columbia University Medical Center, Herbert Irving Pavilion, 161 Fort Washington Avenue, 10th Floor, New York, NY 10032 (United States); Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Morris, Elizabeth A., E-mail: email@example.com [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); David Dershaw, D., E-mail: firstname.lastname@example.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Abramson, Andrea, E-mail: email@example.com [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Fry, Charles, E-mail: firstname.lastname@example.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); New York Medical College, 40 Sunshine Cottage Rd, Valhalla, NY 10595 (United States); Moskowitz, Chaya S. [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Hughes, Mary, E-mail: email@example.com [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Kaplan, Jennifer, E-mail: firstname.lastname@example.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Jochelson, Maxine S., E-mail: email@example.com [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States)
Highlights: • Abbreviated breast MR demonstrates high sensitivity for breast carcinoma detection. • Time to perform/interpret the abbreviated exam is shorter than a standard MRI exam. • An abbreviated breast MRI could reduce costs and make MRI screening more available. - Abstract: Objective: To evaluate the ability of an abbreviated breast magnetic resonance imaging (MRI) protocol, consisting of a precontrast T1 weighted (T1W) image and single early post-contrast T1W image, to detect breast carcinoma. Materials and methods: A HIPAA compliant Institutional Review Board approved review of 100 consecutive breast MRI examinations in patients with biopsy proven unicentric breast carcinoma. 79% were invasive carcinomas and 21% were ductal carcinoma in situ. Four experienced breast radiologists, blinded to carcinoma location, history and prior examinations, assessed the abbreviated protocol evaluating only the first post-contrast T1W image, post-processed subtracted first post-contrast and subtraction maximum intensity projection images. Detection and localization of tumor were compared to the standard full diagnostic examination consisting of 13 pre-contrast, post-contrast and post-processed sequences. Results: All 100 cancers were visualized on initial reading of the abbreviated protocol by at least one reader. The mean sensitivity for each sequence was 96% for the first post-contrast sequence, 96% for the first post-contrast subtraction sequence and 93% for the subtraction MIP sequence. Within each sequence, there was no significant difference between the sensitivities among the 4 readers (p = 0.471, p = 0.656, p = 0.139). Mean interpretation time was 44 s (range 11–167 s). The abbreviated imaging protocol could be performed in approximately 10–15 min, compared to 30–40 min for the standard protocol. Conclusion: An abbreviated breast MRI protocol allows detection of breast carcinoma. One pre and post-contrast T1W sequence may be adequate for detecting
Mango, Victoria L.; Morris, Elizabeth A.; David Dershaw, D.; Abramson, Andrea; Fry, Charles; Moskowitz, Chaya S.; Hughes, Mary; Kaplan, Jennifer; Jochelson, Maxine S.
Highlights: • Abbreviated breast MR demonstrates high sensitivity for breast carcinoma detection. • Time to perform/interpret the abbreviated exam is shorter than a standard MRI exam. • An abbreviated breast MRI could reduce costs and make MRI screening more available. - Abstract: Objective: To evaluate the ability of an abbreviated breast magnetic resonance imaging (MRI) protocol, consisting of a precontrast T1 weighted (T1W) image and single early post-contrast T1W image, to detect breast carcinoma. Materials and methods: A HIPAA compliant Institutional Review Board approved review of 100 consecutive breast MRI examinations in patients with biopsy proven unicentric breast carcinoma. 79% were invasive carcinomas and 21% were ductal carcinoma in situ. Four experienced breast radiologists, blinded to carcinoma location, history and prior examinations, assessed the abbreviated protocol evaluating only the first post-contrast T1W image, post-processed subtracted first post-contrast and subtraction maximum intensity projection images. Detection and localization of tumor were compared to the standard full diagnostic examination consisting of 13 pre-contrast, post-contrast and post-processed sequences. Results: All 100 cancers were visualized on initial reading of the abbreviated protocol by at least one reader. The mean sensitivity for each sequence was 96% for the first post-contrast sequence, 96% for the first post-contrast subtraction sequence and 93% for the subtraction MIP sequence. Within each sequence, there was no significant difference between the sensitivities among the 4 readers (p = 0.471, p = 0.656, p = 0.139). Mean interpretation time was 44 s (range 11–167 s). The abbreviated imaging protocol could be performed in approximately 10–15 min, compared to 30–40 min for the standard protocol. Conclusion: An abbreviated breast MRI protocol allows detection of breast carcinoma. One pre and post-contrast T1W sequence may be adequate for detecting
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Walk Score measures the walkability of any address using a patented system developed by the Walk Score company. For each 2010 Census Tract centroid, Walk Score...
Made, C; Borg, H; Thelander, D; Elmqvist, L G
This study evaluated telemark injuries in a Swedish ski area in terms of injury ratio, location, and causes over time. During the seasons of 1989-2000 all injured telemark skiers ( n=94) who attended the medical center in Tärnaby, Sweden, within 48 h after the accident were registered and asked to fill in an injury form. A control group of noninjured telemark skiers were interviewed in the season of 1999-2000. The most common cause of injury was fall (70%) and the injury ratio was 1.2. There was a higher proportion of beginners in the injured population, and they had a fall/run ratio of 0.7, compared with 0.3 for average and advanced skiers. Ankle/foot injuries were most common (28% of injuries) followed by knee (20%) and head/neck (17%). The ankle/foot injuries decreased from 35% to 22% in the seasons 1989-1995 to 1995-2000. Beginners had more ankle/foot injuries than skilled participants. The severity of ankle/foot injuries classified as the Abbreviated Injury Scale group 2 or higher decreased from 33% to 21% during the study period. Twenty-seven percent used plastic and 73% leather boots. We found no association between boot material and ankle/foot injuries. The proportion of high boots with two or more buckles was 51%. High boots appeared to be protective against ankle/foot injuries. The proportion of high boots increased from 24% to 67% during the study period. Thus ankle/foot injuries were the most common injury location, but have decreased over time. The severity of these injuries has also decreased. A possible explanation could be the increased use of high boots.
... or abbreviated application, including investigational new drug applications, drug master files under... or abbreviated application before an approval letter is sent to the applicant under § 314.105 or tentative approval letter is sent to the applicant under § 314.107, unless the existence of the application...
Gaines, Katy D; Soper, Henry V; Berenji, Gholam R
This study investigates neuropsychological deficits in recently deployed veterans with mild traumatic brain injury (mTBI). Veterans discharged from 2007 to 2012 were recruited from Veterans Affairs clinics. Independent groups of participants with mTBI (n = 57) and those without TBI (n = 57) were administered the Beck Depression Inventory-II, Combat Exposure Scale, Word Memory Test, and the Self-Awareness of Deficits Interview. Neuropsychological instruments included the Rey-Osterrieth Complex Figure Test, Letter and Category Fluency, Trail-Making Test-Parts A and B, Christiansen H-abbreviated, Soper Neuropsychology Screen, Wechsler Memory Scale subtests Logical Memory I and II, and the Street Completion Test. The mTBI group performed significantly worse on all of the executive and nonexecutive measurements with the exception of Category Fluency, after controlling for age, depression effort, and combat exposure. Depression and combat exposure were greater for the mTBI group. The mTBI group scored poorer on effort, but only the Multiple Choice subtest was significant. The mTBI group had good awareness of their deficits.
Jovanovic, Bojan; Milan, Zoka; Markovic-Denic, Ljiljana; Djuric, Olivera; Radinovic, Kristina; Doklestic, Krstina; Velickovic, Jelena; Ivancevic, Nenad; Gregoric, Pavle; Pandurovic, Milena; Bajec, Djordje; Bumbasirevic, Vesna
The aims of this study were (1) to assess the incidence of ventilator-associated pneumonia (VAP) in patients with traumatic brain injury (TBI), (2) to identify risk factors for developing VAP, and (3) to assess the prevalence of the pathogens responsible. The following data were collected prospectively from patients admitted to a 24-bed intensive care unit (ICU) during 2013/14: the mechanism of injury, trauma distribution by system, the Acute Physiology and Chronic Health Evaluation (APACHE) II score, the Abbreviated Injury Scale (AIS) score, the Injury Severity Score (ISS), underlying diseases, Glasgow Coma Scale (GCS) score, use of vasopressors, need for intubation or cardiopulmonary resuscitation upon admission, and presence of pulmonary contusions. All patients were managed with a standardized protocol if VAP was suspected. The Sequential Organ Failure Assessment (SOFA) score and the Clinical Pulmonary Infection Score (CPIS) were measured on the day of VAP diagnosis. Of the 144 patients with TBI who underwent mechanical ventilation for >48h, 49.3% did not develop VAP, 24.3% developed early-onset VAP, and 26.4% developed late-onset VAP. Factors independently associated with early-onset VAP included thoracic injury (odds ratio (OR) 8.56, 95% confidence interval (CI) 2.05-35.70; p=0.003), ISS (OR 1.09, 95% CI 1.03-1.15; p=0.002), and coma upon admission (OR 13.40, 95% CI 3.12-57.66; passociated with late-onset VAP (Nagelkerke r(2)=0.371, area under the curve (AUC) 0.815, 95% CI 0.733-0.897; p<0.001). The 28-day survival rate was 69% in the non-VAP group, 45.7% in the early-onset VAP group, and 31.6% in the late-onset VAP group. Acinetobacter spp was the most common pathogen in patients with early- and late-onset VAP. These results suggest that the extent of TBI and trauma of other organs influences the development of early VAP, while the extent of TBI and age influences the development of late VAP. Patients with early- and late-onset VAP harboured the same
Martin, Grace E; Carroll, Christopher P; Plummer, Zachary J; Millar, D A; Pritts, Timothy A; Makley, Amy T; Joseph, Bellal A; Ngwenya, Laura B; Goodman, Michael D
Patients with mild to moderate traumatic brain injury (TBI) are often primarily managed by emergency medicine and trauma/acute care physicians. The Brain Injury Guidelines (BIG) were developed at an American College of Surgeons-accredited Level 1 trauma center to triage mild to moderate TBI patients and help identify patients who warrant neurosurgical consultation. The BIG have not been validated at a Level III trauma center. We hypothesized that BIG criteria can be safely adapted to an American College of Surgeons-accredited Level III trauma center to guide transfers to a higher echelon of care. We reviewed the trauma registry at a Level III trauma center to identify TBI patients who presented with an Abbreviated Injury Severity-Head score greater than zero. Demographic data, injury details, and clinical outcomes were abstracted with primary outcome measures of worsening on second computed tomography of the head, neurosurgical intervention, transfer to a Level I trauma center, and in-hospital mortality. Patients were classified using the BIG criteria. After validating the BIG in our cohort, we reclassified patients using updated BIG criteria. Updated criteria included mechanism of injury, reclassification of anticoagulation or antiplatelet use, and replacement of the neurologic examination component with stratification by admission Glasgow Coma Scale (GCS) score. From July 2013 to June 2016, 332 TBI patients were identified: 115 BIG-1, 25 BIG-2, and 192 BIG-3. Patients requiring neurosurgical intervention (n = 30) or who died (n = 29) were BIG-3 with one exception. Patients with GCS score of less than 12 had worse outcomes than those with a GCS score of 12 or greater, regardless of BIG classification. Anticoagulant or antiplatelet use was not associated with worsened outcomes in patients not meeting other BIG-3 criteria. The updated BIG resulted in more patients in BIG-1 (n = 109) and BIG-2 (n = 100) without negatively affecting outcomes. The BIG can be applied in
Bergman, Åke; Rydén, Andreas; Law, Robin J.; de Boer, Jacob; Covaci, Adrian; Alaee, Mehran; Birnbaum, Linda; Petreas, Myrto; Rose, Martin; Sakai, Shinichi; Van den Eede, Nele; van der Veen, Ike
Ever since the interest in organic environmental contaminants first emerged 50 years ago, there has been a need to present discussion of such chemicals and their transformation products using simple abbreviations so as to avoid the repetitive use of long chemical names. As the number of chemicals of concern has increased, the number of abbreviations has also increased dramatically, sometimes resulting in the use of different abbreviations for the same chemical. In this article, we propose abbreviations for flame retardants (FRs) substituted with bromine or chlorine atoms or including a functional group containing phosphorus, i.e. BFRs, CFRs and PFRs, respectively. Due to the large number of halogenated and organophosphorus FRs, it has become increasingly important to develop a strategy for abbreviating the chemical names of FRs. In this paper, a two step procedure is proposed for deriving practical abbreviations (PRABs) for the chemicals discussed. In the first step, structural abbreviations (STABs) are developed using specific STAB criteria based on the FR structure. However, since several of the derived STABs are complicated and long, we propose instead the use of PRABs. These are, commonly, an extract of the most essential part of the STAB, while also considering abbreviations previously used in the literature. We indicate how these can be used to develop an abbreviation that can be generally accepted by scientists and other professionals involved in FR related work. Tables with PRABs and STABs for BFRs, CFRs and PFRs are presented, including CAS (Chemical Abstract Service) numbers, notes of abbreviations that have been used previously, CA (Chemical Abstract) name, common names and trade names, as well as some fundamental physico-chemical constants. PMID:22982223
Background. This study used data from a large prospectively entered database to assess the efficacy of the motor score (M score) component of the Glasgow Coma Scale (GCS) and the Simplified Motor Score (SMS) in predicting overall outcome in patients with traumatic brain injury (TBI). Objective. To safely and reliably ...
This paper examines whether an abbreviated panel of 37 single nucleotide polymorphisms (SNPs) has the same power as a larger and more expensive panel of 95 SNPs to assign ancestry of honeybees (Apis mellifera) to three ancestral lineages. We selected 37 SNPs from the original 95 SNP panel using alle...
... Definitions and Other Reference Information § 1051.805 What symbols, acronyms, and abbreviations does this... per meter-square per test day. HC—hydrocarbon. Hg—mercury. hr—hours. km—kilometer. kW—kilowatt. LPG... and Records Administration. NMHC—nonmethane hydrocarbons. NOX—oxides of nitrogen (NO and NOX). psig...
... ENGINES Definitions and Other Reference Information § 1048.805 What symbols, acronyms, and abbreviations... hydrocarbons. NOXoxides of nitrogen (NO and NO2). psipounds per square inch of absolute pressure. psigpounds.... SIspark-ignition. THCtotal hydrocarbon. THCEtotal hydrocarbon equivalent. U.S.C.United States Code. [67 FR...
Grigoriy Valeryevich Tokarev
Full Text Available The article is devoted to the semiotic aspect of the functioning of the abbreviated title of the postmodern artwork. The authors analyze the relationship of title-sign to the object which it replaces. The title is considered from the perspective of three main features peculiar of the sign in accordance with the Charles S. Peirce's theory. This fact allows us to conclude that, being a sign, the abbreviated title replaces a literary text, which is also expressed in symbolic form of the author's knowledge of reality. In this aspect the title becomes the metasign of its text. It is shown that in this connection, decoding and interpretation process take place in two stages – before reading the text and in the process of its reading and interpretation. It is alleged that the result of the interpretation of the title depends on the reader's competence which is determined by their individual literary scope, as well as by the skills of productive work with the text. On the basis of the classification of signs created by Charles Pierce, it was found that the abbreviated title has a complex semiotic nature combining the features of indexicality, conventionality, and iconicity, the latter of which may be present only in the abbreviated title.
Leblanc, Marie-Pierre; Ricciardi, Joseph N.; Luiselli, James K.
We evaluated an abbreviated performance feedback intervention as a training strategy to improve discrete trial instruction of children with autism by three paraprofessional staff (assistant teachers) at a specialized day school. Feedback focused on 10 discrete trial instructional skills demonstrated by the staff during teaching sessions. Following…
Méndez, David I.; Alcaraz, M. Ángeles
In this study, we carry out a qualitative and quantitative analysis of abbreviations in 300 randomly collected research paper titles published in the most prestigious European and US-based Astrophysics journals written in English. Our main results show that the process of shortening words and groups of words is one of the most characteristic and…
Quinnell, Lorna; Carter, Merilyn
The language of mathematics is unique and complex. One feature of the mathematical register is the use of symbols and abbreviations. Whilst it may be possible for a student to think mathematically in the absence of symbols, the written communication of mathematical ideas cannot be achieved concisely without the use of mathematical symbols.…
Veater, Helen M.; Plester, Beverly; Wood, Clare
This small-scale study compared 10 to 13-year-old dyslexic children's use of text message abbreviations with that of reading age- and chronological age-matched controls. There were no significant differences in the proportion of textisms used between the dyslexic children and the two control groups, although a preference for non-phonetic text…
De Jonge, Sarah; Kemp, Nenagh
This study investigated the use of text-message abbreviations (textisms) in Australian adolescents and young adults, and relations between textism use and literacy abilities. Fifty-two high school students aged 13-15 years, and 53 undergraduates aged 18-24 years, all users of predictive texting, translated conventional English sentences into…
Herring, Susan C.; Zelenkauskaite, Asta
This study analyzes gender variation in nonstandard typography--specifically, abbreviations and insertions--in mobile phone text messages (SMS) posted to a public Italian interactive television (iTV) program. All broadcast SMS were collected for a period of 2 days from the Web archive for the iTV program, and the frequency and distribution of…
Jones, Kevin M.; Swearer, Susan M.; Friman, Patrick C.
A study evaluated the effectiveness of an abbreviated habit reversal procedure to reduce maladaptive oral self-biting in an adolescent boy in residential care. Treatment involved a combination of relaxation and two competing responses (gum chewing and tongue-lip rubbing). The intervention eliminated the biting and the tissue damage it caused.…
... National Park Service Record of Decision, Long Walk National Historic Trail Feasibility Study/Abbreviated... Environmental Impact Statement for the Long Walk National Historic Trail Feasibility Study. SUMMARY: Pursuant to... Statement for the Long Walk National Historic Trail Feasibility Study, prepared by National Trails...
... Trademark Office that, in the opinion of the applicant and to the best of its knowledge, claims the... listed drug. (v) Licensing agreements. If the abbreviated new drug application is for a drug or method of using a drug claimed by a patent and the applicant has a licensing agreement with the patent owner, a...
... leukapheresis; (3) Blood component processing solutions and shelf life extenders; and (4) Oxygen carriers. [50... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Addresses for applications and abbreviated applications. 314.440 Section 314.440 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND...
Figler, Bradley D; Mack, Christopher D; Kaufman, Robert; Wessells, Hunter; Bulger, Eileen; Smith, Thomas G; Voelzke, Bryan
The National Highway Traffic Safety Administration's New Car Assessment Program (NCAP) implemented side-impact crash testing on all new vehicles since 1998 to assess the likelihood of major thoracoabdominal injuries during a side-impact crash. Higher crash test rating is intended to indicate a safer car, but the real-world applicability of these ratings is unknown. Our objective was to determine the relationship between a vehicle's NCAP side-impact crash test rating and the risk of major thoracoabdominal injury among the vehicle's occupants in real-world side-impact motor vehicle crashes. The National Automotive Sampling System Crashworthiness Data System contains detailed crash and injury data in a sample of major crashes in the United States. For model years 1998 to 2010 and crash years 1999 to 2010, 68,124 occupants were identified in the Crashworthiness Data System database. Because 47% of cases were missing crash severity (ΔV), multiple imputation was used to estimate the missing values. The primary predictor of interest was the occupant vehicle's NCAP side-impact crash test rating, and the outcome of interest was the presence of major (Abbreviated Injury Scale [AIS] score ≥ 3) thoracoabdominal injury. In multivariate analysis, increasing NCAP crash test rating was associated with lower likelihood of major thoracoabdominal injury at high (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7-0.9; p crash severity (ΔV), but not at low ΔV (OR, 0.95; 95% CI, 0.8-1.2; p = 0.55). In our model, older age and absence of seat belt use were associated with greater likelihood of major thoracoabdominal injury at low and medium ΔV (p crashes, a higher NCAP side-impact crash test rating is associated with a lower likelihood of major thoracoabdominal trauma. Epidemiologic study, level III.
Full Text Available Abstract Background Intracranial bleeding (IB is a common and serious consequence of traumatic brain injury (TBI. IB can be classified according to the location into: epidural haemorrhage (EDH subdural haemorrhage (SDH intraparenchymal haemorrhage (IPH and subarachnoid haemorrhage (SAH. Studies involving repeated CT scanning of TBI patients have found that IB can develop or expand in the 48 hours after injury. If IB enlarges after hospital admission and larger bleeds have a worse prognosis, this would provide a therapeutic rationale for treatments to prevent increase in the extent of bleeding. We analysed data from the Trauma Audit & Research Network (TARN, a large European trauma registry, to evaluate the association between the size of IB and mortality in patients with TBI. Methods We analysed 13,962 patients presenting to TARN participating hospitals between 2001 and 2008 with a Glasgow Coma Score (GCS less than 15 at presentation or any head injury with Abbreviated Injury Scale (AIS severity code 3 and above. The extent of intracranial bleeding was determined by the AIS code. Potential confounders were age, presenting Glasgow Coma Score, mechanism of injury, presence and nature of other brain injuries, and presence of extra-cranial injuries. The outcomes were in-hospital mortality and haematoma evacuation. We conducted a multivariable logistic regression analysis to evaluate the independent effect of large and small size of IB, in comparison with no bleeding, on patient outcomes. We also conducted a multivariable logistic regression analysis to assess the independent effect on mortality of large IB in comparison with small IB. Results Almost 46% of patients had at some type of IB. Subdural haemorrhages were present in 30% of the patients, with epidural and intraparenchymal present in approximately 22% each. After adjusting for potential confounders, we found that large IB, wherever located, was associated with increased mortality in
OBJECTIVE: The aim of this study was to analyse the socioeconomic costs of traffic injuries in Denmark, notably the healthcare costs and the productivity costs related to traffic injuries, in a bottom-up, register-based perspective. METHOD: Traffic injury victims were identified using national...... emergency room data and police records. Victims were matched with five controls per case by means of propensity score, nearest-neighbour matching. In the cohort, consisting of the 52 526 individuals that experienced a traffic injury in 2000 and 262 630 matched controls, attributable healthcare costs were...... assessed using Danish national healthcare registers. Productivity costs were computed using duration analysis (Cox regression models). In a subanalysis, cost per severe traffic injury was computed for the 12 995 individuals that experienced a severe injury. RESULTS: The socioeconomic cost of a traffic...
Liu, Hang-Tsung; Rau, Cheng-Shyuan; Wu, Shao-Chun; Chen, Yi-Chun; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua
The adverse effects of obesity on the physical health have been extensively studied in the general population, but not in motorcycle riders (includes both drivers and pillions). The aim of this study was to compare injury patterns, injury severities, mortality rates, and in-hospital or intensive care unit (ICU) length of stay (LOS) between obese and normal-weight patients who were hospitalized for the treatment of trauma following motorcycle accidents in a level I trauma center. Detailed data of 466 obese adult patients with a body mass index (BMI) ≥30 kg/m(2) and 2701 normal-weight patients (25 > BMI ≥18.5 kg/m(2)) who had sustained motorcycle accident-related injuries were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2013. We used the Pearson's chi-squared test, Fisher's exact test, and independent Student's t-test to analyze differences between the two groups. Compared to normal-weight motorcycle riders, more obese riders were men and drivers as opposed to pillions. In addition, fewer obese motorcycle riders showed alcohol intoxication. Analyses of the patients' Abbreviated Injury Scale (AIS) scores revealed that obese motorcycle riders presented with a higher rate of injury to the thorax, but a lower rate of injury to the face than normal-weight patients. In addition, obese motorcycle riders had a 2.7-fold greater incidence of humeral, 1.9-fold greater incidence of pelvic, and 1.5-fold greater incidence of rib fractures. In contrast, normal-weight motorcycle riders sustained a significantly higher rate of maxillary and clavicle fractures. Obese motorcycle riders had a significant longer in-hospital LOS than normal-weight motorcycle riders did (10.6 days vs. 9.5 days, respectively; p = 0.044), with an increase in in-hospital LOS of 0.82 days associated with every 10-unit increase in BMI. No statistically significant differences in Injury Severity Score (ISS), New Injury Severity Score (NISS), Trauma-Injury
Haltmeier, Tobias; Schnüriger, Beat; Benjamin, Elizabeth; Brodmann Maeder, Monika; Künzler, Michael; Siboni, Stefano; Inaba, Kenji; Demetriades, Demetrios
The ideal prehospital management of patients with severe traumatic brain injury (TBI) including the impact of endotracheal intubation (ETI) and physicians on scene is unclear. Prehospital management differs substantially in Switzerland and the United States: in Switzerland, there is usually a physician on scene who may provide ETI and other advanced life support procedures, whereas in the United States, prehospital management (including ETI) is performed by paramedics. This is a retrospective cohort-matched study of patients with isolated blunt severe TBI (head Abbreviated Injury Scale [AIS] score, 4-5) and no major extracranial injuries, using Bern University Hospital data from the Swiss PEBITA [Patient-relevant Endpoints after Brain Injury from Traumatic Accidents] (TBI-specific) database and the US National Trauma Data Bank from 2009 to 2010. A 1:4 cohort matching of Bern and US patients was performed. Matching criteria were sex, age (±10 years), exact field Glasgow Coma Scale (GCS) score, exact head AIS score, and injury type (subdural hematoma, epidural hematoma, intraparenchymal hemorrhage, intraventricular hemorrhage, brain edema/swelling, brain stem injury). The matched cohorts were compared with univariable analysis (Fisher's exact test and Mann-Whitney U-test). Matching of the Bern (n = 128) and US (n = 86,375) cohort resulted in 355 matched cases (71 Bern and 284 US patients). Bern patients had significantly longer scene times (median, 23.0 minutes vs. 9.0 minutes, p < 0.001) and more frequent prehospital ETI (31.0% vs. 18.7%, p = 0.034) and air transportation (39.4% vs. 19.4%, p < 0.001). No significant difference in procedures (craniotomy/craniectomy, intracranial pressure monitoring, tracheotomy), intensive care unit and total hospital lengths of stay, ventilator days, and in-hospital mortality (14.1% vs. 15.8%, p = 0.855) was found between the two cohorts. When taking into account the limitation that patient- and injury-related factors, but not in
Dijkers, Marcel P; Whiteneck, Gale G; Gassaway, Julie
Comparative effectiveness research (CER) has been receiving much attention (and government funding) in recent years, stemming from dissatisfaction with much medical and health care research, which does not produce actionable evidence that can be used by clinicians, patients, and policymakers. Rehabilitation research has been characterized by similar weaknesses and by often inadequate research designs. The SCIRehab study of the outcomes of inpatient spinal cord injury rehabilitation is one of a small number of rehabilitation practice-based evidence (PBE) studies in recent years that allows for the comparison of interventions by all disciplines for relevant real-life outcomes. This introduction to a series of articles resulting from the SCIRehab project discusses the need for and the nature of CER, and places the SCIRehab study and other PBE studies in the light of CER. After a description of the highlights of the analyses in this supplement, we provide a preliminary evaluation of SCIRehab, counting the articles and presentations from the study, the resources that went into this vast project, and the lessons learned that may benefit future rehabilitation PBE investigators. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Weiss, Harold; Agimi, Yll; Steiner, Claudia
Twenty-seven states have youth-specific helmet laws even though such laws have been shown to decrease helmet use and increase youth mortality compared with all-age (universal) laws. Our goal was to quantify the impact of age-specific helmet laws on youth under age 20 hospitalized with traumatic brain injury (TBI). Our cross-sectional ecological group analysis compared TBI proportions among US states with different helmet laws. We examined the following null hypothesis: If age-specific helmet laws are as effective as universal laws, there will be no difference in the proportion of hospitalized young motorcycle riders with TBI in the respective states. The data are derived from the 2005 to 2007 State Inpatient Databases of the Healthcare Cost and Utilization Project. We examined data for 17 states with universal laws, 6 states with laws for ages laws for children younger than 18 (9287 motorcycle injury discharges). In states with a law, serious TBI among youth was 38% higher than in universal-law states. Motorcycle riders aged 12 to 17 in 18 helmet-law states had a higher proportion of serious/severe TBI and higher average Abbreviated Injury Scores for head-region injuries than riders from universal-law states. States with youth-specific laws had an increased risk of TBI that required hospitalization, serious and severe TBI, TBI-related disability, and in-hospital death among the youth they are supposed to protect. The only method known to keep motorcycle-helmet use high among youth is to adopt or maintain universal helmet laws.
Airaksinen, Noora K; Nurmi-Lüthje, Ilona S; Kataja, J Matti; Kröger, Heikki P J; Lüthje, Peter M J
Most of the cycling accidents that occur in Finland do not end up in the official traffic accident statistics. Thus, there is minimal information on these accidents and their consequences, particularly in cases in which alcohol was involved. The focus of the present study is on cycling accidents and injuries involving alcohol in particular. Data on patients visiting the emergency department at North Kymi Hospital because of a cycling accident was prospectively collected for two years, from June 1, 2004 to May 31, 2006. Blood alcohol concentration (BAC) was measured on admission with a breath analyser. The severity of the cycling injuries was classified according to the Abbreviated Injury Scale (AIS). A total of 217 cycling accidents occurred. One third of the injured cyclists were involved with alcohol at the time of visiting the hospital. Of these, 85% were males. A blood alcohol concentration of ≥ 1.2 g/L was measured in nearly 90% of all alcohol-related cases. A positive BAC result was more common among males than females (p < 0.001), and head injuries were more common among cyclists where alcohol was involved (AI) (60%) than among sober cyclists (29%) (p < 0.001). Two thirds (64%) of the cyclists with AI were not wearing a bicycle helmet. The figure for serious injuries (MAIS ≥ 3) was similar in both groups. Intoxication with an alcohol level of more than 1.5 g/L and the age of 15 to 24 years were found to be risk factors for head injuries. The mean cost of treatment was higher among sober cyclists than among cyclists with AI (€2143 vs. €1629), whereas in respect of the cost of work absence, the situation was the opposite (€1348 vs. €1770, respectively). Cyclists involved with alcohol were, in most cases, heavily intoxicated and were not wearing a bicycle helmet. Head injuries were more common among these cyclists than among sober cyclists. As cycling continues to increase, it is important to monitor cycling accidents, improve
Irwanto; Rehatta, Nancy Margarita; Hartini, Sri; Takada, Satoshi
Sleep problems are associated with problems of cognitive functioning, learning, attention and school performance. It has been found that sleep problems are highly prevalent in children with Autistic spectrum disorders (ASD), with rates ranging from 40% to 80%. We aimed to identify the prevalence of sleep problems on children with ASD in Indonesia and Japan. A cross-sectional study was conducted in Surabaya, Indonesia and Kobe, Japan. Children aged 4 -10 years old were enrolled using stratified cluster sampling. Children's Sleep Habits Questionnaire-Abbreviated (CSHQ-A) was used in this research to assess the sleep problems, consisted of 22 questions (NICHD SECCYD-Wisconsin). Data were analyzed with Mann-Whitney U test to compare the CSHQ-A scores between Indonesian and Japanese children, while the proportion of sleep problems was evaluated by chi-square test with 95% confidence interval. Fifty children with ASD were included in this study, 25 children from Kobe, Japan and 25 children from Surabaya, Indonesia. The prevalence of sleep problems on children with ASD was 60% (15 children) in Indonesia and 16% (4 children) in Japan respectively. There were significant differences in total waking during the night and in morning wake for the CSHQ-A between children from Indonesia and Japan (psleep problems on children with ASD was higher in children from Indonesia than from Japan.
Zhao, Ting; Mejaddam, Ali Y; Chang, Yuchiao; DeMoya, Marc A; King, David R; Yeh, Daniel D; Kaafarani, Haytham M A; Alam, Hasan B; Velmahos, George C
Isolated nonoperative mild head injuries (INOMHI) occur with increasing frequency in an aging population. These patients often have multiple social, discharge, and rehabilitation issues, which far exceed the acute component of their care. This study was aimed to compare the outcomes of patients with INOMHI admitted to three services: trauma surgery, neurosurgery, and neurology. Retrospective case series (January 1, 2009 to August 31, 2013) at an academic Level I trauma center. According to an institutional protocol, INOMHI patients with Glasgow Coma Scale (GCS) of 13 to 15 were admitted on a weekly rotational basis to trauma surgery, neurosurgery, and neurology. The three populations were compared, and the primary outcomes were survival rate to discharge, neurological status at hospital discharge as measured by the Glasgow Outcome Score (GOS), and discharge disposition. Four hundred eighty-eight INOMHI patients were admitted (trauma surgery, 172; neurosurgery, 131; neurology, 185). The mean age of the study population was 65.3 years, and 58.8% of patients were male. Seventy-seven percent of patients has a GCS score of 15. Age, sex, mechanism of injury, Charlson Comorbidity Index, Injury Severity Score, Abbreviated Injury Scale in head and neck, and GCS were similar among the three groups. Patients who were admitted to trauma surgery, neurosurgery and neurology services had similar proportions of survivors (98.8% vs 95.7% vs 94.7%), and discharge disposition (home, 57.0% vs 61.6% vs 55.7%). The proportion of patients with GOS of 4 or 5 on discharge was slightly higher among patients admitted to trauma (97.7% vs 93.0% vs 92.4%). In a logistic regression model adjusting for Charlson Comorbidity Index CCI and Abbreviated Injury Scale head and neck scores, patients who were admitted to neurology or neurosurgery had significantly lower odds being discharged with GOS 4 or 5. While the trauma group had the lowest proportion of repeats of brain computed tomography (61
Ball, Chad G; Ball, Jill E; Kirkpatrick, Andrew W; Mulloy, Robert H
Horseback riding is more dangerous than motorcycle riding, skiing, football, and rugby. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with severe equestrian trauma. All patients with major equestrian injuries (injury severity score > or = 12) admitted between 1995 and 2005 were reviewed. A 46-question survey outlining potential rider, animal, and environmental risk factors was administered. Among 7941 trauma patients, 151 (2%) were injured on horseback (mean injury severity score, 20; mortality rate, 7%). Injuries included the chest (54%), head (48%), abdomen (22%), and extremities (17%). Forty-five percent required surgery. Survey results (55%) indicated that riders and horses were well trained, with a 47% recidivism rate. Only 9% of patients wore helmets, however, 64% believed the accident was preventable. Chest trauma previously has been underappreciated. This injury pattern may be a result of significant rider experience. Helmet and vest use will be targeted in future injury prevention strategies.
Risk of surgical site infection, acute kidney injury, and Clostridium difficile infection following antibiotic prophylaxis with vancomycin plus a beta-lactam versus either drug alone: A national propensity-score-adjusted retrospective cohort study.
Full Text Available The optimal regimen for perioperative antimicrobial prophylaxis is controversial. Use of combination prophylaxis with a beta-lactam plus vancomycin is increasing; however, the relative risks and benefits associated with this strategy are unknown. Thus, we sought to compare postoperative outcomes following administration of 2 antimicrobials versus a single agent for the prevention of surgical site infections (SSIs. Potential harms associated with combination regimens, including acute kidney injury (AKI and Clostridium difficile infection (CDI, were also considered.Using a multicenter, national Veterans Affairs (VA cohort, all patients who underwent cardiac, orthopedic joint replacement, vascular, colorectal, and hysterectomy procedures during the period from 1 October 2008 to 30 September 2013 and who received planned manual review of perioperative antimicrobial prophylaxis regimen and manual review for the 30-day incidence of SSI were included. Using a propensity-adjusted log-binomial regression model stratified by type of surgical procedure, the association between receipt of 2 antimicrobials (vancomycin plus a beta-lactam versus either single agent alone (vancomycin or a beta-lactam and SSI was evaluated. Measures of association were adjusted for age, diabetes, smoking, American Society of Anesthesiologists score, preoperative methicillin-resistant Staphylococcus aureus (MRSA status, and receipt of mupirocin. The 7-day incidence of postoperative AKI and 90-day incidence of CDI were also measured. In all, 70,101 procedures (52,504 beta-lactam only, 5,089 vancomycin only, and 12,508 combination with 2,466 (3.5% SSIs from 109 medical centers were included. Among cardiac surgery patients, combination prophylaxis was associated with a lower incidence of SSI (66/6,953, 0.95% than single-agent prophylaxis (190/12,834, 1.48%; crude risk ratio [RR] 0.64, 95% CI 0.49, 0.85; adjusted RR 0.61, 95% CI 0.46, 0.83. After adjusting for SSI risk, no
Risk of surgical site infection, acute kidney injury, and Clostridium difficile infection following antibiotic prophylaxis with vancomycin plus a beta-lactam versus either drug alone: A national propensity-score-adjusted retrospective cohort study.
Branch-Elliman, Westyn; Ripollone, John E; O'Brien, William J; Itani, Kamal M F; Schweizer, Marin L; Perencevich, Eli; Strymish, Judith; Gupta, Kalpana
The optimal regimen for perioperative antimicrobial prophylaxis is controversial. Use of combination prophylaxis with a beta-lactam plus vancomycin is increasing; however, the relative risks and benefits associated with this strategy are unknown. Thus, we sought to compare postoperative outcomes following administration of 2 antimicrobials versus a single agent for the prevention of surgical site infections (SSIs). Potential harms associated with combination regimens, including acute kidney injury (AKI) and Clostridium difficile infection (CDI), were also considered. Using a multicenter, national Veterans Affairs (VA) cohort, all patients who underwent cardiac, orthopedic joint replacement, vascular, colorectal, and hysterectomy procedures during the period from 1 October 2008 to 30 September 2013 and who received planned manual review of perioperative antimicrobial prophylaxis regimen and manual review for the 30-day incidence of SSI were included. Using a propensity-adjusted log-binomial regression model stratified by type of surgical procedure, the association between receipt of 2 antimicrobials (vancomycin plus a beta-lactam) versus either single agent alone (vancomycin or a beta-lactam) and SSI was evaluated. Measures of association were adjusted for age, diabetes, smoking, American Society of Anesthesiologists score, preoperative methicillin-resistant Staphylococcus aureus (MRSA) status, and receipt of mupirocin. The 7-day incidence of postoperative AKI and 90-day incidence of CDI were also measured. In all, 70,101 procedures (52,504 beta-lactam only, 5,089 vancomycin only, and 12,508 combination) with 2,466 (3.5%) SSIs from 109 medical centers were included. Among cardiac surgery patients, combination prophylaxis was associated with a lower incidence of SSI (66/6,953, 0.95%) than single-agent prophylaxis (190/12,834, 1.48%; crude risk ratio [RR] 0.64, 95% CI 0.49, 0.85; adjusted RR 0.61, 95% CI 0.46, 0.83). After adjusting for SSI risk, no association
Hájková, H; Pesl, T
The authors discuss the classification and evaluation of child injuries. In our literature so far no uniform conclusion was reached how classify injuries; the term "polytraumatism" or "multiple" is not accurately defined and is not used in the Anglo Saxon literature. The authors recommend therefore to differentiate only isolated injuries and "associated" injuries (injuries of two or more areas of the body). The severity of "associated" injuries can then be determined by some scoring system. For paediatric traumatological practice the Pediatric Trauma Score (PTS) is most suitable because it takes into account also the child's body weight, and thus indirectly his age, and is very simple.
Krisa, Laura; Mulcahey, M J; Gaughan, John P; Smith, Brian; Vogel, Lawrence C
For young children with spinal cord injury (SCI), the sensory exam of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) is long and arduous, often making it impossible to complete. In this study, we determine whether an abbreviated sensory exam provides comparable information to the full 56-dermatome exam. A total of 726 56-dermatome sensory exams were completed with 190 children and youth with SCI ranging in age from 3 to 21 years. The cohort was randomly split into test and validation groups. For the test group, a principal component analysis (PCA) was carried out separately for pin prick (PP) and light touch (LT) scores. From the PCA, a hierarchical cluster analysis was performed to identify the most influential set of 4, 8, 12, and 16 dermatomes. From the sensory exam data obtained from the validation group, a linear regression was performed to compare the limited-dermatome composite scores to the total 56-dermatome scores. For both LT and PP, the 16-dermatome test resulted in the best fit (0.86 and 0.87, respectively) with the 56-dermatome test and was comprised of dermatomes from both the left (7 dermatomes) and right (9 dermatomes) sides and at least 1 dermatome from each vertebral region bilaterally (cervical, thoracic, lumbar, sacral). A 16-dermatome sensory exam provided a good correlation to the 56-dermatome exam. The shortened exam may be useful for evaluating children with SCI who cannot tolerate the full examination.
Babu, Maya A; Nahed, Brian V; Demoya, Marc A; Curry, William T
The Emergency Medical Treatment and Active Labor Act was meant to provide access to emergency medical care irrespective of financial resources. Yet, many Level I trauma Centers have raised concerns about the financial drivers influencing transfer. : To study the relationship between insurance status and transfer, we focused on patients with mild head injury to tease apart the medical necessity for transfer from other potential drivers, such as financial factors. Using the 2002 to 2006 American College of Surgeons National Trauma Databank and Massachusetts General Hospital's Trauma Databank from 1993 to 2009, we conducted a retrospective study and limited our population to patients with mild head injuries and mild to moderate systemic injuries as determined by the Glasgow Coma Scale, Abbreviated Injury Scale, or Injury Severity Score. Statistical analyses were conducted with STATA software. In a nationalized database, (1) uninsured patients with mild head injury are more likely to be transferred out of a Level II or III facility (adjusted odds ratio [OR]: 2.07; P = .000) compared with privately insured patients and (2) uninsured patients are less likely to be accepted by a Level II or III facility for transfer compared with privately insured patients (adjusted OR: = .143; P = .000l). For transfers received by 1 Level I trauma center (Massachusetts General Hospital), uninsured patients are more likely to be transferred to (1) Massachusetts General Hospital between midnight and 6 am (adjusted OR: 5.201; P = .000) compared with other time periods throughout the day and (2) Massachusetts General Hospital on Sunday (adjusted OR: 1.09; P = .000) compared with other days of the week. Insurance status appears to influence transfer patterns.
Glissmeyer, Eric W; Metzger, Ryan R; Bolte, Robert
The objective of this study was to compare demographic injury and treatment characteristics of hospitalized pediatric cases of falls from chair lifts to cases of other ski and snowboarding injuries and identify potential interventions for preventing falls from chair lifts. Retrospective query of the trauma registry of Utah's only pediatric trauma center for children younger than 18 years requiring hospitalization for a ski or snowboarding injury from November 2004 to February 2014. There were 443 cases of hospitalized ski and snowboarding injuries during the study period. Twenty-nine cases (7%) fell from height while riding a chair lift. Children falling from chair lifts were more likely to be younger (6.9 years vs 12.1, P chair lift falls with a significant injury (abbreviated injury scale, ≥3) was lower extremity (4/29, all femur fractures). Patient age discriminated chair lift falls well (area under the receiver operating characteristic curve, 0.87) with age of 7 years and below predicting chair lift fall with a sensitivity of 76% and a specificity of 91%. Injuries requiring hospitalization after falls from chair lifts occur at regulated facilities and are more common in younger female children when compared with other ski and snowboarding injuries. Interventions for reducing falls from chair lifts may be most effective applied to children 7 years and younger.
Kongerslev, Mickey; Bo, Sune; Simonsen, Erik
prisons and secure institutions Within one week a clinical psychologist administered the Structured Clinical Inter-view for DSM-IV Personality Disorders (SCID-II) and the Psychopathy Checklist: Youth Version (PCL:YV) to assess for personality disorders and psychopathy In order to control for confounding......, including assessment of the sensitivity and specificity of the SAPAS for various cut-off scores, will be presented Conclusions: The study provides a basis for preliminary conclusions regarding the validity of SAPAS as a brief routine screen for personality disorders amongst incarcerated male youth......Aims: To test the validity of an age-appropriate adaptation of the Standardised Assessment of Personality - Abbreviated Scale (SAPAS) in a sample of incarcerated male youth Method: A sample of incarcerated boys, age 15 to 18, were administered the SAPAS by social workers from the participating...
Weaver, Ashley A; Talton, Jennifer W; Barnard, Ryan T; Schoell, Samantha L; Swett, Katrina R; Stitzel, Joel D
Injury risk curves estimate motor vehicle crash (MVC) occupant injury risk from vehicle, crash, and/or occupant factors. Many vehicles are equipped with event data recorders (EDRs) that collect data including the crash speed and restraint status during a MVC. This study's goal was to use regulation-required data elements for EDRs to compute occupant injury risk for (1) specific injuries and (2) specific body regions in frontal MVCs from weighted NASS-CDS data. Logistic regression analysis of NASS-CDS single-impact frontal MVCs involving front seat occupants with frontal airbag deployment was used to produce 23 risk curves for specific injuries and 17 risk curves for Abbreviated Injury Scale (AIS) 2+ to 5+ body region injuries. Risk curves were produced for the following body regions: head and thorax (AIS 2+, 3+, 4+, 5+), face (AIS 2+), abdomen, spine, upper extremity, and lower extremity (AIS 2+, 3+). Injury risk with 95% confidence intervals was estimated for 15-105 km/h longitudinal delta-Vs and belt status was adjusted for as a covariate. Overall, belted occupants had lower estimated risks compared to unbelted occupants and the risk of injury increased as longitudinal delta-V increased. Belt status was a significant predictor for 13 specific injuries and all body region injuries with the exception of AIS 2+ and 3+ spine injuries. Specific injuries and body region injuries that occurred more frequently in NASS-CDS also tended to carry higher risks when evaluated at a 56 km/h longitudinal delta-V. In the belted population, injury risks that ranked in the top 33% included 4 upper extremity fractures (ulna, radius, clavicle, carpus/metacarpus), 2 lower extremity fractures (fibula, metatarsal/tarsal), and a knee sprain (2.4-4.6% risk). Unbelted injury risks ranked in the top 33% included 4 lower extremity fractures (femur, fibula, metatarsal/tarsal, patella), 2 head injuries with less than one hour or unspecified prior unconsciousness, and a lung contusion (4
Chamarrita Farkas Klein
Full Text Available The McArthur-Bates Communicative Development Inventories (CDI assesses language development en children, through a significant caregiver report. The first inventory assesses verbal and non verbal language in infants who are from 8 to 18 months old and it is composed of 949 items distributed in 6 scales. This study proposes an abbreviate form of this instrument, and was tested on families and educators of 130 Chilean children of 11-15 months old. Analyses related to the items, reliability and validity of the instrument and factorial analyses of subscales were realized. The abbreviate version consider 241 items distributed in 4 scales. The evaluation of the psychometric properties of the instrument was acceptable, demonstrating adequate reliability and validity.
Farrokhi, Farhat; Jassal, Sarbjit V
Poor functional status is associated with reduced survival and poor outcomes in older dialysis patients. The Geriatric Nephrology Advisory Group recommends routine evaluation of functional status on all older patients; however, assessments can be time consuming and burdensome to clinical care providers. The objective of this study was to validate an abbreviated 4-item self-report screening tool for use in elderly hemodialysis patients. The functional dependence of community-dwelling hemodialysis patients, aged ≥65 years, was measured by trained evaluators. The accuracy of a 4-item self-report activities of daily living (ADL) score was compared against formal evaluation by the Barthel Index and the outcomes using agreement statistics and Cox regression analysis. The cohort included 167 patients with a mean age of 74.8 ± 5.9 years (57 % males). The 4-item scale correctly identified 83 % of the patients dependent in ≥1 ADL. Those incorrectly identified as independent on the abbreviated scale were uniformly unable to climb stairs without assistance. The sensitivity and specificity, and coefficient for agreement between the 4-item scale and the Barthel Index were 83.2, 100 and 0.78 %, respectively. The positive and negative predictive values of the 4-item scale were 100 and 76.9 %, respectively. Using the 4-item scale, the presence of severe disability was predictive of increased mortality (HR 12.5; 95 % CI 2.5-65.0; P = 0.03). The 4-item scale is a simple, valid screening test for disability which can be used in the elderly population on dialysis as a screening tool. Difficulties with stair climbing may be overlooked using this score.
Langner, G.H. Jr.
The US Department of Energy (DOE) Office of Remedial Action and Waste Technology established the Technical Measurements Center at the DOE Grand Junction, Colorado, Projects Office to standardize, calibrate, and compare measurements made in support of DOE remedial action programs. Indoor radon-daughter concentration measurements are made to determine whether a structure is in need of remedial action. The Technical Measurements Center conducted this study to validate an abbreviated Radon Progeny Integrated Sampling Unit (RPISU) method of making indoor radon-daughter measurements to determine whether a structure has a radon-daughter concentration (RDC) below the levels specified in various program standards. The Technical Measurements Center established a criterion against which RDC measurements made using the RPISU sampling method are evaluated to determine if sampling can be terminated or whether further measurements are required. This abbreviated RPISU criterion was tested against 317 actual sets of RPISU data from measurements made over an eight-year period in Mesa County, Colorado. The data from each location were tested against a standard that was assumed to be the same as the actual annual average RDC from that location. At only two locations was the criterion found to fail. Using the abbreviated RPISU method, only 0.6% of locations sampled can be expected to be falsely indicated as having annual average RDC levels below a given standard
Grevel, J; Kahan, B D
Abbreviated kinetic profiles can reduce the number of phlebotomies and drug assays, and thereby the cost of area-under-the-curve (AUC) monitoring. In the present investigation, we used two independent data sets: group 1, 101 AUC profiles from 77 stable renal-transplant patients, which included a 5-h sample in addition to the usual 0-, 2-, 4-, 6-, 10-, 14-, and 24-h samples; and group 2, 100 profiles from 50 stable renal-transplant patients before and after a change in their daily oral dose of cyclosporine. Group I demonstrated a fair correlation between cyclosporine trough concentrations and the AUC calculated from a complete set of seven concentrations (r2 = 0.820 and 0.758 for the 24- and 0-h samples, respectively). Stepwise multiple linear-regression analysis revealed that the abbreviated set of three time points (2, 6, and 14 h) explained 96% of the variance in AUC values calculated from the full set of seven samples; additional time points increased the accuracy only slightly. For group 2, we examined the difference between the observed and the predicted concentrations by linear extrapolation; the error in the observed AUC value, compared with the predicted value calculated from seven time points (-13.2% to -1.2%), was similar to the error from just three time points (-11.5% to 4.5%). Abbreviated AUC profiles involving three time points used with a model equation seem to provide a reliable alternative to full seven-point profiles.
Tansu, Nelson; Chan, Helen M; Vinci, Richard P; Ee, Yik-Khoon; Biser, Jeffrey
The use of an abbreviated GaN growth mode on nano-patterned AGOG sapphire substrates, which utilizes a process of using 15 nm low temperature GaN buffer and bypassing etch-back and recovery processes during epitaxy, enables the growth of high-quality GaN template on nano-patterned AGOG sapphire. The GaN template grown on nano-patterned AGOG sapphire by employing abbreviated growth mode has two orders of magnitude lower threading dislocation density than that of conventional GaN template grown on planar sapphire. The use of abbreviated growth mode also leads to significant reduction in cost of the epitaxy. The growths and characteristics of InGaN quantum wells (QWs) light emitting diodes (LEDs) on both templates were compared. The InGaN QWs LEDs grown on the nano-patterned AGOG sapphire demonstrated at least a 24% enhancement of output power enhancement over that of LEDs grown on conventional GaN templates.
Feguri, Gibran Roder; Lima, Paulo Ruiz Lúcio; Lopes, Andréa Mazoni; Roledo, Andréa; Marchese, Miriam; Trevisan, Mônica; Ahmad, Haitham; Freitas, Bruno Baranhuk de; Aguilar-Nascimento, José Eduardo de
Limited information is available about preoperative fasting abbreviation with administration of liquid enriched with carbohydrates (CHO) in cardiovascular surgeries. To evaluate clinical variables, security of the method and effects on the metabolism of patients undergoing fasting abbreviation in coronary artery bypass graft (CABG) surgery. Forty patients undergoing CABG were randomized to receive 400 ml (6 hours before) and 200 ml (2 hours before) of maltodextrin at 12.5% (Group I, n=20) or just water (Group II, n=20) before anesthetic induction. Perioperative clinical variables were evaluated. Insulin resistance (IR) was evaluated by Homa-IR index and also by the need of exogenous insulin; pancreatic beta-cell excretory function by Homa-Beta index and glycemic control by tests of capillary glucose. Deaths, bronchoaspiration, mediastinitis, stroke and acute myocardial infarction did not occur. Atrial fibrillation occurred in two patients of each group and infectious complications did not differ among groups (P=0.611). Patients of Group I presented two days less of hospital stay (P=0.025) and one day less in the ICU (P0.05). A decline in the endogenous production of insulin was observed in both groups (P<0.001). Preoperative fasting abbreviation with the administration of CHO in the CABG was safe. The glycemic control improved in the ICU; there was less time in the use of dobutamine and length of hospital and ICU stay was reduced. However, neither IR nor morbimortality during hospital phase were influenced.
Full Text Available Abstract The Brief Cognitive Battery (BCB developed by our group for cognitive assessment of low educated individuals has also shown to be highly accurate in diagnosing dementia of individuals with medium or high levels of education, making it a useful tool for populations with heterogeneous educational background. The application of BCB takes around eight minutes, a rather long period for a screening test. Objectives: Our aim was to evaluate whether the exclusion of items of the BCB could reduce its application time without losing accuracy. Methods: Patients with Alzheimer's disease with mild or moderate dementia (N=20, and 30 control subjects were submitted to an abbreviated version of the BCB in which the clock drawing test was not included as an interference test for the delayed recall test. Data from another 22 control individuals who were submitted to the original BCB in another study were also included for comparison. A mathematical formula was employed to compare the two versions of the BCB. Descriptive statistics and ROC (receiver operator characteristic curves were used (alpha=0.05. Results: Using the abbreviated version, the delayed recall test also had high accuracy in diagnosing dementia and the mathematical formula results did not differ to those obtained using the original version, while mean time was reduced by 2 minutes and 37 seconds. Conclusions: This abbreviated form of the BCB is a potentially valuable tool for screening dementia in population studies as well as in busy clinical practices in countries with heterogeneous educational backgrounds.
Castro, Stephanie; Damin, Antonio Eduardo; Porto, Cláudia Sellitto; Caramelli, Paulo; Nitrini, Ricardo
The Brief Cognitive Battery (BCB) developed by our group for cognitive assessment of low educated individuals has also shown to be highly accurate in diagnosing dementia of individuals with medium or high levels of education, making it a useful tool for populations with heterogeneous educational background. The application of BCB takes around eight minutes, a rather long period for a screening test. Our aim was to evaluate whether the exclusion of items of the BCB could reduce its application time without losing accuracy. Patients with Alzheimer's disease with mild or moderate dementia (N=20), and 30 control subjects were submitted to an abbreviated version of the BCB in which the clock drawing test was not included as an interference test for the delayed recall test. Data from another 22 control individuals who were submitted to the original BCB in another study were also included for comparison. A mathematical formula was employed to compare the two versions of the BCB. Descriptive statistics and ROC (receiver operator characteristic) curves were used (alpha=0.05). Using the abbreviated version, the delayed recall test also had high accuracy in diagnosing dementia and the mathematical formula results did not differ to those obtained using the original version, while mean time was reduced by 2 minutes and 37 seconds. This abbreviated form of the BCB is a potentially valuable tool for screening dementia in population studies as well as in busy clinical practices in countries with heterogeneous educational backgrounds.
Pope, Daniel J
In the aftermath of the London '7/7' attacks in 2005, UK government agencies required the development of a quick-running tool to predict the weapon and injury effects caused by the initiation of a person borne improvised explosive device (PBIED) within crowded metropolitan environments. This prediction tool, termed the HIP (human injury predictor) code, was intended to:--assist the security services to encourage favourable crowd distributions and densities within scenarios of 'sensitivity'; --provide guidance to security engineers concerning the most effective location for protection systems; --inform rescue services as to where, in the case of such an event, individuals with particular injuries will be located; --assist in training medical personnel concerning the scope and types of injuries that would be sustained as a consequence of a particular attack; --assist response planners in determining the types of medical specialists (burns, traumatic amputations, lungs, etc.) required and thus identify the appropriate hospitals to receive the various casualty types. This document describes the algorithms used in the development of this tool, together with the pertinent underpinning physical processes. From its rudimentary beginnings as a simple spreadsheet, the HIP code now has a graphical user interface (GUI) that allows three-dimensional visualization of results and intuitive scenario set-up. The code is underpinned by algorithms that predict the pressure and momentum outputs produced by PBIEDs within open and confined environments, as well as the trajectories of shrapnel deliberately placed within the device to increase injurious effects. Further logic has been implemented to transpose these weapon effects into forms of human injury depending on where individuals are located relative to the PBIED. Each crowd member is subdivided into representative body parts, each of which is assigned an abbreviated injury score after a particular calculation cycle. The injury
This randomized phase II trial studies how well abbreviated breast magnetic resonance imaging (MRI) and digital tomosynthesis mammography work in detecting cancer in women with dense breasts. Abbreviated breast MRI is a low cost procedure in which radio waves and a powerful magnet linked to a computer and used to create detailed pictures of the breast in less than 10 minutes. These pictures can show the difference between normal and diseased tissue. |
Hamner, Chad E; Groner, Jonathon I; Caniano, Donna A; Hayes, John R; Kenney, Brian D
The epidemiology of pediatric blunt intraabdominal arterial injury is ill defined. We analyzed a multiinstitutional trauma database to better define injury patterns and predictors of outcome. The American College of Surgeons National Trauma Database was evaluated for all patients younger than 16 years with blunt intraabdominal arterial injury from 2000 to 2004. Injury distribution, operative treatment, and variables associated with mortality were considered. One hundred twelve intraabdominal arterial injuries were identified in 103 pediatric blunt trauma patients. Single arterial injury (92.2%) occurred most frequently: renal (36.9%), mesenteric (24.3%), and iliac (23.3%). Associated injuries were present in 96.1% of patients (abdominal visceral, 75.7%; major extraabdominal skeletal/visceral, 77.7%). Arterial control was obtained operatively (n = 46, 44.7%) or by endovascular means (n = 6, 5.8%) in 52 patients. Overall mortality was 15.5%. Increased mortality was associated with multiple arterial injuries (P = .049), intraabdominal venous injury (P = .011), head injury (P = .05), Glasgow Coma Score less than 8 (P cardiac arrest (P Trauma Score [P Injury Severity Score [P = .001], and TRISS [P = .002]). Blunt intraabdominal arterial injury in children usually affects a single vessel. Associated injuries appear to be nearly universal. The high mortality rate is influenced by serious associated injuries and is reflected by overall injury severity scores.
Yoganandan, Narayan; Arun, Mike W J; Pintar, Frank A; Szabo, Aniko
Derive optimum injury probability curves to describe human tolerance of the lower leg using parametric survival analysis. The study reexamined lower leg postmortem human subjects (PMHS) data from a large group of specimens. Briefly, axial loading experiments were conducted by impacting the plantar surface of the foot. Both injury and noninjury tests were included in the testing process. They were identified by pre- and posttest radiographic images and detailed dissection following the impact test. Fractures included injuries to the calcaneus and distal tibia-fibula complex (including pylon), representing severities at the Abbreviated Injury Score (AIS) level 2+. For the statistical analysis, peak force was chosen as the main explanatory variable and the age was chosen as the covariable. Censoring statuses depended on experimental outcomes. Parameters from the parametric survival analysis were estimated using the maximum likelihood approach and the dfbetas statistic was used to identify overly influential samples. The best fit from the Weibull, log-normal, and log-logistic distributions was based on the Akaike information criterion. Plus and minus 95% confidence intervals were obtained for the optimum injury probability distribution. The relative sizes of the interval were determined at predetermined risk levels. Quality indices were described at each of the selected probability levels. The mean age, stature, and weight were 58.2±15.1 years, 1.74±0.08 m, and 74.9±13.8 kg, respectively. Excluding all overly influential tests resulted in the tightest confidence intervals. The Weibull distribution was the most optimum function compared to the other 2 distributions. A majority of quality indices were in the good category for this optimum distribution when results were extracted for 25-, 45- and 65-year-olds at 5, 25, and 50% risk levels age groups for lower leg fracture. For 25, 45, and 65 years, peak forces were 8.1, 6.5, and 5.1 kN at 5% risk; 9.6, 7.7, and 6.1 k
Full Text Available Business English is commonly understood language, yet Harvard Business Review called business jargon “The Silent Killer of Big Companies”. As we all have been taught in school, we are aware of the fact that in communication we must comply with linguistic rules so that our message gets across succinctly. Yet, there is one place where all these rules can be omitted (at least in the recent decades: the corporate office. Here, one can use euphemisms and clichés, can capitalize any word that is considered important, the passive voice is used wherever possible and abbreviations occur in every sentence. The worst part is that all of these linguistic enormities are carried out deliberately. The purpose of this paper is to analyse to what extent business jargon and abbreviations have affected business communication (which most of the time, it is filled with opaque language to mask different activities and operations and the reasons for which these linguistic phenomena have become so successful in the present. One of the reasons for the research is that in business English, jargon can be annoying because it overcomplicates. It is frequently unnecessary and it can transform a simple idea or instruction into something very confusing. It is true that every field has its jargon. Education, journalism, law, politics, medicine, urban planning – no filed is immune. Yet, it seems that business jargon has been described as “the most annoying”. Another reason is that jargon tends to be elitist. Those who do not understand the terms feel confused and uncertain. The paper starts with defining these two concepts, business jargon and abbreviations, and then it attempts to explain the “unusual” pervasion of these, both in business communication and in everyday communication. For this, the paper includes a list with the most common business jargon and abbreviations. In this view, the authors have accessed different economic blogs and specialty journals
Kuhl, Christiane K; Bruhn, Robin; Krämer, Nils; Nebelung, Sven; Heidenreich, Axel; Schrading, Simone
Purpose To determine the diagnostic accuracy for clinically significant prostate cancer achieved with abbreviated biparametric prostate magnetic resonance (MR) imaging in comparison with full multiparametric contrast material-enhanced prostate MR imaging in men with elevated prostate-specific antigen (PSA) and negative transrectal ultrasonography (US)-guided biopsy findings; to determine the significant cancer detection rate of biparametric versus full multiparametric contrast-enhanced MR imaging and between-reader agreement for interpretation of biparametric MR imaging. Materials and Methods In this institutional review board-approved retrospective review of prospectively acquired data, men with PSA greater than or equal to 3 ng/mL after negative transrectal US-guided biopsy findings underwent state-of-the-art, full multiparametric contrast-enhanced MR imaging at 3.0-T including high-spatial-resolution structural imaging in several planes, diffusion-weighted imaging at 0, 800, 1000, and 1400 mm 2 /sec, and dynamic contrast-enhanced MR imaging, obtained without endorectal coil within 34 minutes 19 seconds. One of four radiologists with different levels of expertise (1-9 years) first reviewed only a fraction of the full multiparametric contrast-enhanced MR images, consisting of single-plane (axial) structural imaging (T2-weighted turbo spin-echo and diffusion-weighted imaging), acquired within 8 minutes 45 seconds (referred to as biparametric MR imaging), and established a diagnosis according to the Prostate Imaging Reporting and Data System (PI-RADS) version 2; only thereafter, the remaining full multiparametric contrast-enhanced MR images were read. Men with PI-RADS categories 3-5 underwent MR-guided targeted biopsy. Men with PI-RADS categories 1-2 remained in urologic follow-up for at least 2 years, with rebiopsy (transrectal US-guided or transperineal saturation) where appropriate. McNemar test was used to compare diagnostic accuracies. To investigate between
Nyström, Harriet; Dring, Ann M.; Svenningsson, Anders; Piehl, Fredrik; Nelson, David W.; Bellander, Bo-Michael
Traumatic brain injury (TBI) is a common cause of death and disability, worldwide. Early determination of injury severity is essential to improve care. Neurofilament light (NF-L) has been introduced as a marker of neuroaxonal injury in neuroinflammatory/-degenerative diseases. In this study we determined the predictive power of serum (s-) and cerebrospinal fluid (CSF-) NF-L levels towards outcome, and explored their potential correlation to diffuse axonal injury (DAI). A total of 182 patients suffering from TBI admitted to the neurointensive care unit at a level 1 trauma center were included. S-NF-L levels were acquired, together with S100B and neuron-specific enolase (NSE). CSF-NF-L was measured in a subcohort (n = 84) with ventriculostomies. Clinical and neuro-radiological parameters, including computerized tomography (CT) and magnetic resonance imaging, were included in the analyses. Outcome was assessed 6 to 12 months after injury using the Glasgow Outcome Score (1-5). In univariate proportional odds analyses mean s-NF-L, -S100B and -NSE levels presented a pseudo-R2 Nagelkerke of 0.062, 0.214 and 0.074 in correlation to outcome, respectively. In a multivariate analysis, in addition to a model including core parameters (pseudo-R2 0.33 towards outcome; Age, Glasgow Coma Scale, pupil response, Stockholm CT score, abbreviated injury severity score, S100B), S-NF-L yielded an extra 0.023 pseudo-R2 and a significantly better model (p = 0.006) No correlation between DAI or CT assessed-intracranial damage and NF-L was found. Our study thus demonstrates that S-NF-L correlates to TBI outcome, even if used in models with S100B, indicating an independent contribution to the prediction, perhaps by reflecting different pathophysiological processes, not possible to monitor using conventional neuroradiology. Although we did not find a predictive value of NF-L for DAI, this cannot be completely excluded. We suggest further studies, with volume quantification of axonal injury
Faiez Al Nimer
Full Text Available Traumatic brain injury (TBI is a common cause of death and disability, worldwide. Early determination of injury severity is essential to improve care. Neurofilament light (NF-L has been introduced as a marker of neuroaxonal injury in neuroinflammatory/-degenerative diseases. In this study we determined the predictive power of serum (s- and cerebrospinal fluid (CSF- NF-L levels towards outcome, and explored their potential correlation to diffuse axonal injury (DAI. A total of 182 patients suffering from TBI admitted to the neurointensive care unit at a level 1 trauma center were included. S-NF-L levels were acquired, together with S100B and neuron-specific enolase (NSE. CSF-NF-L was measured in a subcohort (n = 84 with ventriculostomies. Clinical and neuro-radiological parameters, including computerized tomography (CT and magnetic resonance imaging, were included in the analyses. Outcome was assessed 6 to 12 months after injury using the Glasgow Outcome Score (1-5. In univariate proportional odds analyses mean s-NF-L, -S100B and -NSE levels presented a pseudo-R2 Nagelkerke of 0.062, 0.214 and 0.074 in correlation to outcome, respectively. In a multivariate analysis, in addition to a model including core parameters (pseudo-R2 0.33 towards outcome; Age, Glasgow Coma Scale, pupil response, Stockholm CT score, abbreviated injury severity score, S100B, S-NF-L yielded an extra 0.023 pseudo-R2 and a significantly better model (p = 0.006 No correlation between DAI or CT assessed-intracranial damage and NF-L was found. Our study thus demonstrates that S-NF-L correlates to TBI outcome, even if used in models with S100B, indicating an independent contribution to the prediction, perhaps by reflecting different pathophysiological processes, not possible to monitor using conventional neuroradiology. Although we did not find a predictive value of NF-L for DAI, this cannot be completely excluded. We suggest further studies, with volume quantification of axonal
Cheever, Chong Sherry; Barbosa-Leiker, Celestina
The aims of this study were to determine the prevalence and describe the importance of alcohol screening for all patients with traumatic brain injury (TBI) and examine the relationship between gender, age, Abbreviated Injury Scale (AIS), emergent decompressive craniectomy, Glasgow Coma Scale (GCS) from the emergency department (ED), and the length of stay with alcohol screening. This is a retrospective analysis of de-identified data from the 2012 TBI registry of a level 1 trauma center in the Pacific Northwest. Of 1591 patients with TBI, 1273 (80%) were screened for alcohol use and 318 (20%) were not screened. There was a significant association between alcohol screening and AIS (χ(5) = 15.46, P < .001), ED GCS (χ(12) = 22.13, P = .04), sex (χ(1) = 7.86, P ≤ .001), and age (r = 0.23, P < .001). Women and patients with high AIS (critical), low (mild) AIS, and midrange GCS scores were less likely to be screened, as were younger patients. Urgent decompressive craniectomy (χ(1) = 1.94, P = .16) and length of stay (r = -0.04, P = .14) did not display a significant association with alcohol screening. This study uncovered a systemic bias per sex and age for alcohol screening, as well as skewed AIS and GCS scores due to an unknown alcohol intoxication status. An updated ED's triage process and screening tool is recommended to achieve a targeted 100% alcohol screening rate for all head trauma patients in the ED before admission to the neurosurgical intensive care unit.
Kamal Hosam Mustafa
Full Text Available 【Abstract】Objective: Trauma is the leading cause of mortality and morbidity among young age groups in Saudi Arabia and developed countries. This study aimed to evaluate the fall of platelet count in children with traumatic brain injury (TBI as a potential predictor for clinical severity and outcome. Methods: Totally 74 patients with TBI were admitted to the Pediatric Intensive Care Unit (PICU of our hospital from the beginning of January 2008 to the end of March 2010 (27 months. Baseline enrolling criteria were age ≤12 years, admission within 4 hours after trauma event, and abbreviated injury scale (AIS<3 for extracranial injuries. Injury severity was classified as mild, moderate and severe according to their Glasgow Coma Scale (GCS scores. Clinical outcomes at discharge were defined as poor (death, severe neurological morbidity and favorable (moderate disability and good recovery. Platelet count was taken 2-3 times on the first day after admission and thereafter once daily. The percentage fall of platelet count (PFP was calculated and taken as an index of change. PFP was considered zero if the platelet count was higher than the initial value. Results: PFP was significantly higher in patients with poor outcomes (mean 56.0%?.8%, median 55.5% compared to those with favorable outcomes (mean 25.3%?.2%, median 20.5%, P<0.01. PFP was also closely related to the severity of TBI, GCS score, clinical outcome and length of stay for survivors (P<0.01 for each. The frequency of thrombocytopenia was significantly higher in poor outcome patients than in favorable outcome patients (P<0.05. The validity of thrombocytopenia as a risk factor to predict poor outcome after TBI was: specificity, 77.4%; odd ratio (OR, 3.1; relative risk (RR, 2.15. Receiver operating characteristic (ROC curve and Youden index showed that the optimum cutoff point of PFP was at 51.5%. Conclusion: PFP is increased with the severity of TBI and it can be taken as a significant
Nov 18, 2014 ... suitability of the rapid macroinvertebrate biomonitoring tool (the South African Scoring System) was investigated by determining the ... for 80% (SASS score) and 75% (NOT) of the variation in the regression model. Consequently ... et al., 2012), while settled sediments can alter habitat (Wood and Armitage ...
SLACK, CHARLES W.
REINFORCEMENT AND ROLE-REVERSAL TECHNIQUES ARE USED IN THE SCORE PROJECT, A LOW-COST PROGRAM OF DELINQUENCY PREVENTION FOR HARD-CORE TEENAGE STREET CORNER BOYS. COMMITTED TO THE BELIEF THAT THE BOYS HAVE THE POTENTIAL FOR ETHICAL BEHAVIOR, THE SCORE WORKER FOLLOWS B.F. SKINNER'S THEORY OF OPERANT CONDITIONING AND REINFORCES THE DELINQUENT'S GOOD…
The structure of your face helps protect your eyes from injury. Still, injuries can damage your eye, sometimes severely enough that you could lose your vision. Most eye injuries are preventable. If you play sports or ...
... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper ... can also lead to injuries. The most common sports injuries are Sprains and strains Knee injuries Swollen ...
The diagnosis of syncope poses unique challenges. Syncope has multiple etiologies, with most carrying benign prognoses, and a few less common causes carrying a risk of serious morbidity or death. The history at first glance carries few clues. Faced with this many patients are heavily investigated with tests known to be both useless and expensive. For these reasons considerable emphasis has been placed on developing evidence-based and quantitative histories that might distinguish among the main causes of syncope. Quantitative histories were first developed in populations of several hundred patients with definite diagnoses of various losses of consciousness. Their derivation and use mirror those of experienced clinicians. The first score - the Calgary Syncope Seizures Score - discriminates between epileptic convulsions and syncope with a sensitivity and specificity of about 94%. The second score, the Calgary Syncope Score for normal hearts, discriminates between vasovagal syncope and other causes of syncope with a sensitivity and specificity of about 90%. The third score, the Calgary Syncope Score for Structural Heart Disease, diagnoses ventricular tachycardia with 98% sensitivity and 71% specificity. It also accurately predicts serious arrhythmic outcomes and all cause death. Gaps in the accuracy of the second score have been identified and are being addressed. These scores are proving useful in the clinic, and as entry criteria for observation studies, genetic studies, and randomized clinical trials. A very simple score predicts vasovagal syncope recurrences, based on the number of faints in the preceding year. Work from several centres indicates that scores will distinguish among competing causes of syncope in select populations, such as those with bifascicular heart block, Brugada syndrome, and Long QT syndrome. Copyright © 2013 Elsevier Inc. All rights reserved.
Cho, Jin H; Adams, Susan; Holland, Andrew J A
To determine the incidence, type and severity of furniture-related injuries in children in the Sydney region. Retrospective analysis of presentations to the emergency departments of two paediatric tertiary hospitals in Sydney over a 4-year period from January 2000 to December 2003 with furniture-related injuries. Deaths of children because of furniture-related injuries reported to the Coroner, from 2000-2002, were also reviewed. The main outcome measures were circumstances of injury, type and number of injuries, morbidity, and mortality. 52 children presented with furniture-related injuries. The median age was 2.5 years (range 9 months-15 years), with a male-to-female ratio of 3:2. Falling televisions accounted for 22 (42%) of the injuries. Median Injury Severity Score was 1 (range 1-25). One child died. The most common regions injured were the limbs and the head. Thirty-one children (60%) required medical imaging, 28 (54%) required admission to hospital and 6 were allowed home in under 12 h. Of the 22 patients admitted for longer than 12 h, 14% required intensive care. Median length of stay was 1 day (range 0-15 days). Eighteen patients (35%) suffered scarring or long-term limitations as a result of their injuries. From 2000 to 2002 there were four additional deaths in NSW because of furniture-related injuries, two because of a falling television. Furniture-related injuries represent a cause of serious trauma and death in Australian children. There remains a need for the stability and security of televisions and large furniture items to be improved.
Louw, Adriaan; Puentedura, Emilio Louie; Mintken, Paul
Chronic low back pain (CLBP) remains prevalent in society, and conservative treatment strategies appear to have little effect. It is proposed that patients with CLBP may have altered cognition and increased fear, which impacts their ability to move, perform exercise, and partake in activities of daily living. Neuroscience education (NE) aims to change a patient's cognition regarding their pain state, which may result in decreased fear, ultimately resulting in confrontation of pain barriers and a resumption of normal activities. A 64-year-old female with history of CLBP was the patient for this case report. A physical examination, the Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire (FABQ), and Zung Depression Scale were assessed during her initial physical therapy visit, immediately after her first physical therapy session, and at 7-month follow-up. Treatment consisted of an abbreviated NE approach, exercises (range of motion, stretches, and cardiovascular), and aquatic therapy. She attended twice a week for 4 weeks, or 8 visits total. Pre-NE, the patient reported NPRS = 9/10; ODI = 54%; FABQ-W = 25/42,; FABQ-PA = 20/24, and Zung = 58. Immediately following the 75-minute evaluation and NE session, the patient reported improvement in all four outcome measures, most notably a reduction in the FABQ-W score to 2/42 and the FABQ-PA to 1/24. At a 7-month follow-up, all outcome measures continued to be improved. NE aimed at decreasing fear associated with movement may be a valuable adjunct to movement-based therapy, such as exercise, for patients with CLBP.
Rudolf, Frauke; Joaquim, Luis Carlos; Vieira, Cesaltina
Background: This study was carried out in Guinea-Bissau ’ s capital Bissau among inpatients and outpatients attending for tuberculosis (TB) treatment within the study area of the Bandim Health Project, a Health and Demographic Surveillance Site. Our aim was to assess the variability between 2...... physicians in performing the Bandim tuberculosis score (TBscore), a clinical severity score for pulmonary TB (PTB), and to compare it to the Karnofsky performance score (KPS). Method : From December 2008 to July 2009 we assessed the TBscore and the KPS of 100 PTB patients at inclusion in the TB cohort and...
Ahmad, Rizwan; Hu, Houchun Harry; Krishnamurthy, Ramkumar; Krishnamurthy, Rajesh
Magnetic resonance imaging (MRI) is an established diagnostic imaging tool for investigating pediatric disease. MRI allows assessment of structure, function, and morphology in cardiovascular imaging, as well as tissue characterization in body imaging, without the use of ionizing radiation. For MRI in children, sedation and general anesthesia (GA) are often utilized to suppress patient motion, which can otherwise compromise image quality and diagnostic efficacy. However, evidence is emerging that use of sedation and GA in children might have long-term neurocognitive side effects, in addition to the short-term procedure-related risks. These concerns make risk-benefit assessment of sedation and GA more challenging. Therefore, reducing or eliminating the need for sedation and GA is an important goal of imaging innovation and research in pediatric MRI. In this review, the authors focus on technical and clinical approaches to reducing and eliminating the use of sedation in the pediatric population based on image acquisition acceleration and imaging protocols abbreviation. This paper covers important physiological and technical considerations for pediatric body MR imaging and discusses MRI techniques that offer the potential of recovering diagnostic-quality images from accelerated scans. In this review, the authors also introduce the concept of reporting elements for important indications for pediatric body MRI and use this as a basis for abbreviating the MR protocols. By employing appropriate accelerated and abbreviated approaches based on an understanding of the imaging needs and reporting elements for a given clinical indication, it is possible to reduce sedation and GA for pediatric chest, cardiovascular and abdominal MRI. (orig.)
Amos O. Adeleye
Full Text Available ObjectivesAfrica and other Asian low middle-income countries account for the greatest burden of the global road-traffic injury (RTI-related head injury (HI. This study set out to describe the incidence, causation, and severity of RTI-related HI and associated injuries in a Nigerian academic neurosurgical practice.MethodsThis is a retrospective cross-sectional analysis of RTI-related HI from a prospective HI registry in an academic neurosurgery practice in Nigeria.ResultsAll-terrain RTI accounted for 80.6% (833/1,034 of HI over a 7-year study period. All age groups were involved, mean 33.06 years (SD 18.30, mode 21–30, 231/833 (27.7%. The male:female ratio was 631:202, ≈3:1. The road trauma occurred exclusively from motorcycle-and motor-vehicle crash (MCC/MVC, MCC caused 56.8% (473/833 of these; the victims were vulnerable road users (VRU in 74%, and >90% belong in the low socioeconomic class. Using the Glasgow Coma Scale grading, the HI was moderate/severe in 52%; loss of consciousness occurred in 93%, the Abbreviated Injury Severity-head > 3 in 74%, and computed tomography (CT Rotterdam score > 3 in 52%. Significant extracranial injuries occurred in many organ systems, 421/833 (50.5% having Injury Severity Score (ISS > 25. Surgical lesions included extensive brain contusions in 157 (18.8%; acute extradural hematoma in 34 (4.1%; acute subdural hematoma in 32 (3.8%; and traumatic intracerebral hemorrhage in 27 (3.2%, but only 97 (11.6% received operative care for various logistic reasons. The in-hospital outcome was good in 71.3% and poor in 28.7%; the statistically significant (p < 0.001 determinants of this outcome profile were the severity of the HI, the CT Rotterdam score, and the ISS.ConclusionIn this study from Nigeria, RTI-related HI emanates from significant trauma to vulnerable road users and are caused exclusively by motorcycles and motor vehicles.
Brumbelow, Matthew L; Farmer, Charles M
This study investigated the relationship between the peak sternal deflection measurements recorded by the Hybrid III 50th percentile male anthropometric test device (ATD) in frontal crash tests and injury and fatality outcomes for drivers in field crashes. ATD sternal deflection data were obtained from the Insurance Institute for Highway Safety's 64 km/h, 40 percent overlap crashworthiness evaluation tests for vehicles with seat belt crash tensioners, load limiters, and good-rated structure. The National Automotive Sampling System Crashworthiness Data System (NASS-CDS) was queried for frontal crashes of these vehicles in which the driver was restrained by a seat belt and air bag. Injury probability curves were calculated by frontal crash type using the injuries coded in NASS-CDS and peak ATD sternal deflection data. Fatality Analysis Reporting System (FARS) front-to-front crashes with exactly one driver death were also studied to determine whether the difference in measured sternal deflections for the 2 vehicles was related to the odds of fatality. For center impacts, moderate overlaps, and large overlaps in NASS-CDS, the probability of the driver sustaining an Abbreviated Injury Scale (AIS) score ≥ 3 thoracic injury, or any nonextremity AIS ≥ 3 injury, increased with increasing ATD sternal deflection measured in crash tests. For small overlaps, however, these probabilities decreased with increasing deflection. For FARS crashes, the fatally injured driver more often was in the vehicle with the lower measured deflection in crash tests (55 vs. 45%). After controlling for other factors, a 5-mm difference in measured sternal deflections between the 2 vehicles was associated with a fatality odds ratio of 0.762 for the driver in the vehicle with the greater deflection (95% confidence interval = 0.373, 1.449). Restraint systems that reduce peak Hybrid III sternal deflection in a moderate overlap crash test are beneficial in real-world crashes with similar or greater
Guidelines are given for using abbreviations, acronyms, and initialisms (AAIs) in documents prepared by US Department of Energy facilities managed by Martin Marietta Energy Systems, Inc., in Oak Ridge, Tennessee. The more than 10,000 AAIs listed represent only a small portion of those found in recent documents prepared by contributing editors of the Information Management Services organization of Oak Ridge National Laboratory, the Oak Ridge K-25 Site, and the Oak Ridge Y-12 Plant. This document expands on AAIs listed in the Document Preparation Guide and is intended as a companion document
Full Text Available The paper describes the defendant rights in the new Chilean Criminal Procedure Code of 2000. Also describes how the Code allowed in a very limited expression the possibility of the waiver of the judgment guarantees through the abbreviated procedure. Finally it describes a new law that expanded substantially the use and the incentives for negotiation just in property offences. This last development has divided the Chilean criminal procedure in two subsystems, one in which the oral trial is still the center of the procedure and another in which the trial will becomes exceptional.
Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun
The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)
Inhalation injuries are acute injuries to your respiratory system and lungs. They can happen if you breathe in toxic substances, such as smoke (from fires), chemicals, particle pollution, and gases. Inhalation injuries can also be caused by extreme heat; these are a type of thermal injuries. ...
post-traumatic amnesia, neurologic signs of brain. 3 injury or skull fractures. The Glasgow coma score and the Revised trauma scores (RTS) are commonly used in grading the severity of head injury into mild, moderate, and severe. The RTS is a triage tool and the score is inferred from physiologic derangement on initial.
Kamal, Hosam-Mustafa; Sammou, Habeeb; Mardini, Ahmad-Adnan; Zaitoni, Ahmad
Trauma is the leading cause of mortality and morbidity among young age groups in Saudi Arabia and developed countries. This study aimed to evaluate the fall of platelet count in children with traumatic brain injury (TBI) as a potential predictor for clinical severity and outcome. Totally 74 patients with TBI were admitted to the Pediatric Intensive Care Unit (PICU) of our hospital from the beginning of January 2008 to the end of March 2010 (27 months). Baseline enrolling criteria were age less than or equal to 12 years, admission within 4 hours after trauma event, and abbreviated injury scale (AIS) less than 3 for extracranial injuries. Injury severity was classified as mild, moderate and severe according to their Glasgow Coma Scale (GCS) scores. Clinical outcomes at discharge were defined as poor (death, severe neurological morbidity) and favorable (moderate disability and good recovery). Platelet count was taken 2-3 times on the first day after admission and thereafter once daily. The percentage fall of platelet count (PFP) was calculated and taken as an index of change. PFP was considered zero if the platelet count was higher than the initial value. PFP was significantly higher in patients with poor outcomes (mean 56.0%+/-3.8%, median 55.5%) compared to those with favorable outcomes (mean 25.3%+/-3.2%, median 20.5%, P less than 0.01). PFP was also closely related to the severity of TBI, GCS score, clinical outcome and length of stay for survivors (P less than 0.01 for each). The frequency of thrombocytopenia was significantly higher in poor outcome patients than in favorable outcome patients (P less than 0.05). The validity of thrombocytopenia as a risk factor to predict poor outcome after TBI was: specificity, 77.4%; odd ratio (OR), 3.1; relative risk (RR), 2.15. Receiver operating characteristic (ROC) curve and Youden index showed that the optimum cutoff point of PFP was at 51.5%. PFP is increased with the severity of TBI and it can be taken as a significant
Chen, Chien-Chang; Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua
Background : A cross-sectional study to investigate the association of Osteoporosis Self-Assessment Tool for Asians (OSTA) score with clinical presentation and expenditure of hospitalized adult trauma patients with femoral fractures. Methods : According to the data retrieved from the Trauma Registry System between 1 January 2009 and 31 December 2015, a total of 2086 patients aged ≥40 years and hospitalized for treatment of traumatic femoral bone fracture were categorized as high-risk patients (OSTA -1, n = 638). Two-sided Pearson's, chi-squared, or Fisher's exact tests were used to compare categorical data. Unpaired Student's t -test and Mann-Whitney U -test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed using Number Crunching Statistical Software (NCSS) software (NCSS 10; NCSS Statistical Software, Kaysville, UT, USA), with adjusted covariates including mechanism and Glasgow Coma Scale (GCS); injuries were assessed based on the Abbreviated Injury Scale (AIS), and Injury Severity Score (ISS) was used to evaluate the effect of OSTA-related grouping on a patient's outcome. Results : High-risk and medium-risk patients were predominantly female, presented with significantly older age and higher incidences of co-morbidity, and were injured in a fall accident more frequently than low-risk patients. High-risk patients and medium-risk patients had a different pattern of femoral fracture and a significantly lower ISS. Although high-risk and medium-risk patients had significantly shorter lengths hospital of stay (LOS) and less total expenditure than low-risk patients did, similar results were not found in the selected propensity score-matched patients, implying that the difference may be attributed to the associated injury severity of the patients with femoral fracture. However, the charge of surgery is significantly lower in high-risk and medium-risk patients than in low
Get to grips with a new technology, understand what it is and what it can do for you, and then get to work with the most important features and tasks. Instant MuseScore is written in an easy-to follow format, packed with illustrations that will help you get started with this music composition software.This book is for musicians who would like to learn how to notate music digitally with MuseScore. Readers should already have some knowledge about musical terminology; however, no prior experience with music notation software is necessary.
Miranda, DR; Nap, R; de Rijk, A; Schaufeli, W; Lapichino, G
Objectives. The instruments used for measuring nursing workload in the intensive care unit (e.g., Therapeutic Intervention Scoring System-28) are based on therapeutic interventions related to severity of illness. Many nursing activities are not necessarily related to severity of illness, and
Kleibergen, F.R.; Kleijn, R.; Paap, R.
We propose a novel Bayesian test under a (noninformative) Jeffreys'priorspecification. We check whether the fixed scalar value of the so-calledBayesian Score Statistic (BSS) under the null hypothesis is aplausiblerealization from its known and standardized distribution under thealternative. Unlike
We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.
Nov 18, 2014 ... for 80% (SASS score) and 75% (NOT) of the variation in the regression model. Consequently, SASS ... further investigation: spatial analyses of macroinvertebrate assemblages; and the use of structural and functional metrics. Keywords: .... conductivity levels was assessed using multiple linear regres- sion.
Full Text Available Automated Essay Scoring Semire DIKLI Florida State University Tallahassee, FL, USA ABSTRACT The impacts of computers on writing have been widely studied for three decades. Even basic computers functions, i.e. word processing, have been of great assistance to writers in modifying their essays. The research on Automated Essay Scoring (AES has revealed that computers have the capacity to function as a more effective cognitive tool (Attali, 2004. AES is defined as the computer technology that evaluates and scores the written prose (Shermis & Barrera, 2002; Shermis & Burstein, 2003; Shermis, Raymat, & Barrera, 2003. Revision and feedback are essential aspects of the writing process. Students need to receive feedback in order to increase their writing quality. However, responding to student papers can be a burden for teachers. Particularly if they have large number of students and if they assign frequent writing assignments, providing individual feedback to student essays might be quite time consuming. AES systems can be very useful because they can provide the student with a score as well as feedback within seconds (Page, 2003. Four types of AES systems, which are widely used by testing companies, universities, and public schools: Project Essay Grader (PEG, Intelligent Essay Assessor (IEA, E-rater, and IntelliMetric. AES is a developing technology. Many AES systems are used to overcome time, cost, and generalizability issues in writing assessment. The accuracy and reliability of these systems have been proven to be high. The search for excellence in machine scoring of essays is continuing and numerous studies are being conducted to improve the effectiveness of the AES systems.
Hoffman, Jeanne M.; Brown, Elena Donoso; Chan, Leighton; Dikmen, Sureyya; Temkin, Nancy; Bell, Kathleen R.
Objective To evaluate the impact of Medicare’s inpatient rehabilitation facility (IRF) prospective payment system (PPS) on use of inpatient rehabilitation for individuals with traumatic brain injury (TBI). Design Retrospective cohort study of patients with TBI. Setting One hundred twenty-three level I and II trauma centers across the U.S. who contributed data to the National Trauma Data Bank. Participants Patients (N = 135,842) with TBI and an Abbreviated Injury Score of the head of 2 or greater admitted to trauma centers between 1995 and 2004. Interventions None. Main Outcome Measure Discharge location: IRF, skilled nursing facility, home, and other hospitals. Results Compared with inpatient rehabilitation admissions before IRF PPS came into effect, demographic characteristics of admitted patients changed. Those admitted to acute care trauma centers after PPS was enacted (January 2002) were older and nonwhite. No differences were found in rates of injury between men and women. Over time, there was a significant drop in the percent of patients being discharged to inpatient rehabilitation, which varied by region, but was found across all insurance types. In a logistic regression, after controlling for patient characteristics (age, sex, race), injury characteristics (cause, severity), insurance type, and facility, the odds of being discharged to an IRF after a TBI decreased 16% after Medicare’s IRF PPS system was enacted. Conclusions The enactment of the Medicare PPS appears to be associated with a reduction in the chance that patients receive inpatient rehabilitation treatment after a TBI. The impact of these changes on the cost, quality of care, and patient outcome is unknown and should be addressed in future studies. PMID:22840827
... numbness in the arms or legs. Loss of consciousness. Seizures. What causes a head injury? There are ... Aid and Injury Prevention Crisis Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight ...
Yildiz, Bulent O; Bolour, Sheila; Woods, Keslie; Moore, April; Azziz, Ricardo
Hirsutism is the presence of excess body or facial terminal (coarse) hair growth in females in a male-like pattern, affects 5-15% of women, and is an important sign of underlying androgen excess. Different methods are available for the assessment of hair growth in women. We conducted a literature search and analyzed the published studies that reported methods for the assessment of hair growth. We review the basic physiology of hair growth, the development of methods for visually quantifying hair growth, the comparison of these methods with objective measurements of hair growth, how hirsutism may be defined using a visual scoring method, the influence of race and ethnicity on hirsutism, and the impact of hirsutism in diagnosing androgen excess and polycystic ovary syndrome. Objective methods for the assessment of hair growth including photographic evaluations and microscopic measurements are available but these techniques have limitations for clinical use, including a significant degree of complexity and a high cost. Alternatively, methods for visually scoring or quantifying the amount of terminal body and facial hair growth have been in use since the early 1920s; these methods are semi-quantitative at best and subject to significant inter-observer variability. The most common visual method of scoring the extent of body and facial terminal hair growth in use today is based on a modification of the method originally described by Ferriman and Gallwey in 1961 (i.e. the mFG method). Overall, the mFG scoring method is a useful visual instrument for assessing excess terminal hair growth, and the presence of hirsutism, in women.
Vojtek, Martin; Kočenda, Evžen
Roč. 56, 3-4 (2006), s. 152-167 ISSN 0015-1920 R&D Projects: GA ČR GA402/05/0931 Institutional research plan: CEZ:AV0Z70850503 Keywords : banking sector * credit scoring * discrimination analysis Subject RIV: AH - Economics Impact factor: 0.190, year: 2006 http://journal.fsv.cuni.cz/storage/1050_s_152_167.pdf
Montag, Jessica M.; Willis, Carolyn J.; Glavin, Levi W.
Energy development of all types continues to grow in the Rocky Mountain Region of the western United States. Federal resource managers increasingly need to balance energy demands, effects on the natural landscape and public perceptions towards these issues. To assist in efficient access to valuable information, this abbreviated bibliography provides citations to relevant information for myriad of issues for which resource managers must contend. The bibliography is organized by seven large topics with various sup-topics: broad energy topics (energy crisis, conservation, supply and demand, etc.); energy sources (fossil fuel, nuclear, renewable, etc.); natural landscape effects (climate change, ecosystem, mitigation, restoration, and reclamation, wildlife, water, etc.); human landscape effects (attitudes and perceptions, economics, community effects, health, Native Americans, etc.); research and technology; international research; and, methods and modeling. A large emphasis is placed on the natural and human landscape effects.
Bukh, Jens Drachmann; Bock, Camilla; Vinberg, Maj
for comorbid personality disorder among patients suffering from depression would be of clinical use. METHOD: The present study aimed to assess the utility of the Standardised Assessment of Personality - Abbreviated Scale (SAPAS) as a screen for personality disorder in a population of patients recently......BACKGROUND: Personality disorder frequently co-occurs with depression and seems to be associated with a poorer outcome of treatment and increased risk for recurrences. However, the diagnosing of personality disorder can be lengthy and requires some training. Therefore, a brief screening interview...... diagnosed with first episode depression. A total number of 394 patients with an ICD-10 diagnosis of a single depressive episode were sampled consecutively via the Danish Psychiatric Central Research Register during a 2years inclusion period and assessed by the screening interview and, subsequently...
Digges, Kennerly; Eigen, Ana; Tahan, Fadi; Grzebieta, Raphael
The design of countermeasures to reduce serious chest injuries for belted occupants involved in rollover crashes requires an understanding of the cause of these injuries and of the test conditions to assure the effectiveness of the countermeasures. This study defines rollover environments and occupant-to-vehicle interactions that cause chest injuries for belted drivers. The NASS-CDS was examined to determine the frequency and crash severity for belted drivers with serious (Abbreviated Injury Scale [AIS] 3+) chest injuries in rollovers. Case studies of NASS crashes with serious chest injuries sustained by belted front occupants were undertaken and damage patterns were determined. Vehicle rollover tests with dummies were examined to determine occupant motion in crashes with damage similar to that observed in the NASS cases. Computer simulations were performed to further explore factors that could contribute to chest injury. Finite element model (FEM) vehicle models with both the FEM Hybrid III dummy and THUMS human model were used in the simulations. Simulation of rollovers with 6 quarter-turns or less indicated that increases in the vehicle pitch, either positive or negative, increased the severity of dummy chest loadings. This finding was consistent with vehicle damage observations from NASS cases. For the far-side occupant, the maximum chest loadings were caused by belt and side interactions during the third quarter-turn and by the center console loading during the fourth quarter-turn. The results showed that the THUMS dummy produced more realistic kinematics and improved insights into skeletal and chest organ loadings compared to the Hybrid III dummy. These results suggest that a dynamic rollover test to encourage chest injury reduction countermeasures should induce a roll of at least 4 quarter-turns and should also include initial vehicle pitch and/or yaw so that the vehicle's axis of rotation is not aligned with its inertial roll axis during the initial stage
A classroom activity is presented in which students are challenged to find matches between the United States two-letter postal abbreviations for states and chemical element symbols. The activity aims to lessen negative apprehensions students might have when the periodic table of the elements with its more than 100 combinations of letters is first…
Bergman, A.; Rydén, A.; Law, R.J.; de Boer, J.; Covaci, A.; Alaee, M.; Birnbaum, L.; Petreas, M.; Rose, M.; Sakai, S.; Van den Eede, N.; van der Veen, I.
Ever since the interest in organic environmental contaminants first emerged 50. years ago, there has been a need to present discussion of such chemicals and their transformation products using simple abbreviations so as to avoid the repetitive use of long chemical names. As the number of chemicals
Massumi, Mohammad; Pourasgari, Farzaneh; Nalla, Amarnadh
developed an abbreviated five-stage protocol (25-30 days) to generate human Embryonic Stem Cell-Derived Beta-like Cells (ES-DBCs). We showed that Geltrex, as an extracellular matrix, could support the generation of ES-DBCs more efficiently than that of the previously described culture systems...
Scholte, R.H.J.; Bruyn, E.E.J. De
This study examines the full-length, short and abbreviated forms of the Revised Junior Eysenck Personality Questionnaire (JEPQ-R) in a Dutch sample of 215 boys and 207 girls, aged 12–14. The reliability and concurrent validity of the scales of the full-length form (JEPQ-R, 81 items), short form
ABSTRACT: Following the publication of our article [Inferior alveolar nerve injury with laryngeal mask airway: a case report. Journal of Medical Case Reports 2011, 5:122] it was brought to our attention that we inadvertently used the registered trademark of the Laryngeal Mask Company Limited (LMA) as the abbreviation for laryngeal mask airway. A Portex(R) Soft Seal(R) Laryngeal Mask was used and not a device manufactured by the Laryngeal Mask Company.
Joosse, Pieter; de Jong, Willem-Jan J.; Reitsma, Johannes B.; Wendt, Klaus W.; Schep, Niels W.; Goslings, J. Carel
The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base excess, and
Joosse, Pieter; de Jong, Willem-Jan J.; Wendt, Klaus W.; Schep, Niels W.; Goslings, J. Carel; Reitsma, J.
Objectives: The Emergency Trauma Score has been developed for early estimation of mortality risk in adult trauma patients with an Injury Severity Score of 16 or higher. Emergency Trauma Score combines four early predictors available at the trauma resuscitation room: age, Glasgow Coma Scale, base
Full Text Available ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ...
Full Text Available ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ... Cord Injury What is a Spinal Cord Injury Levels of Injury and What They Mean Animated Spinal ...
Abdelgawad, A A; Maxfield, D; Tran, S; Mclean, S; Kanlic, E M
Dirt bike riding is becoming a more popular recreational activity among children. Injuries associated with this recreational activity did not gain attention in the medical literature. The purpose of this study is to assess orthopedic injuries associated with dirt bike riding. We retrospectively studied injuries occurring in children less than 18 years old, while riding dirt bikes, that required admission to the trauma department in our level one trauma center during the period 2000-2010. There were 24 admissions (23 patients). The mean age was 13. Fourteen patients had brain injuries. Six patients had abdominal injuries. One patient died shortly after arriving to the emergency department. Fourteen patients had face and neck injuries. The average injury severity score was 8.5. Thirteen patients' admissions (54 %) had orthopedic fractures. Five of 13 patients (38 %) suffered more than one fracture. Eight patients needed orthopedic intervention (seven of these were in operating room under general anesthesia and one in the emergency department under conscious sedation). Femur fracture was the most common cause for performing surgery in this group of patients. Riding dirt bikes is not a safe recreational activity. Orthopedic injuries constitute a major component of the injuries affecting children riding dirt bikes. Orthopedic surgeons (being responsible for treating most of these children) have the obligation to warn the community against the possible dangers facing children who ride dirt bikes.
Lucas, Charles E; Ledgerwood, Anna M
This study highlights the inherent challenges of achieving psychomotor skills in an era of nonoperative therapy for solid organ injuries. Technical procedures on the liver, the most frequent intra-abdominal solid organ injured, were assessed in five decades. Guided by prospective assessment and registry data, all patients with liver injury seen during 24 months in five consecutive decades were reviewed. Initially (1960s), all injuries were explored; currently (2000s), most injuries are observed. The number of patients was 235 (1960s), 228 (1970s), 79 (1980s), 116 (1990s), and 64 (2000s). The greater number in the 1990s reflects the diagnosis of minor, clinically insignificant, blunt injuries after abdominal CAT scan became available. Each injury was categorized by cause, severity (Abbreviated Injury Scale), associated shock, and primary therapy (observe [OBS], operation alone [OR], hepatorrhaphy [SUT], tractotomy [TRACT] with intraparenchymal hemostasis, hepatic dearterialization [HAL], and resection [RESECT]). Packing, used in each decade, was placed in one of the above primary treatment groups. The primary techniques for hemostasis are shown in the text table.Shock and Abbreviated Injury Scale correlated with mortality averaged 16%; 40 of 116 deaths (34%) exsanguinated from hepatic injury. During training, a resident performed an average of 12.0, 12.0, 2.4, 4.0, and 1.3 procedures for hemostasis. Reduced incidence and decreased therapeutic laparotomies for liver injury have created a training vacuum for future trauma surgeons. Surgical residents will need to supplement their clinical experience with solid organ hemostasis by practice on appropriate animal models of injury and cadaver dissections.
McBeth, Paul B; Ball, Chad G; Mulloy, Robert H; Kirkpatrick, Andrew W
Alpine skiing and snowboarding are popular winter sports in Canada. Every year participation in these activities results in traumatic injury. The purpose of this study was to identify the incidence and injury patterns, as well as risk factors associated with ski and snowboarding injuries. A comprehensive 10-year retrospective review of Alpine ski and snowboarding injuries from 1996 to 2006 was conducted. The Alberta Trauma Registry was used as the primary source of data. A total of 196 patients (56.6% skiers, 43.4% snowboarders) were identified as having major traumatic injuries (Injury Severity Score, >or=12). Forty-three patients required intensive care unit support. The majority of injuries were related to falls and collisions with natural objects. Head injuries were most common, followed by chest, spinal, and extremity trauma. Seventy-nine patients required emergency surgery. Skiing and snowboarding represent activities with high potential for traumatic injury. Safety initiatives should be developed to target this population.
Chan, Jeffrey C Y; Ong, Joshua C Y; Avalos, Gloria; Regan, Padraic J; McCann, Jack; Groarke, AnnMarie; Kelly, John L
Differences in illness perception about hand injury may partly explain the variation in health behaviours such as adherence to post-operative therapy, coping strategy, emotional response and eventual clinical outcome. This study examined the illness perception of patients with hand injuries in the acute trauma setting. The disability and severity of injury were assessed using the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and the Hand Injury Severity Score (HISS). The revised Illness Perception Questionnaire (IPQ-R) was used to explore patients' illness beliefs and perception on hand injury. Fifty seven patients were recruited over the 2 month period. The IPQ-R showed good internal reliability (Cronbach's alpha, 0.68-0.86). There was no correlation between the DASH or HISS scores and the various components of the IPQ-R scores, suggesting that illness perceptions were not influenced by the recent trauma experience. Patients with dominant hand injuries and females reported significantly higher subjective disability. Younger patients believed their injury would last for a limited duration but reported a significantly higher number of related symptoms. Overall, the cohort was optimistic about their treatment and duration of recovery (high treatment control score and low time line score). Beliefs of negative consequences, chronic/cyclical duration and low illness coherence were linked with negative emotional response. High illness identity was associated with perception of pessimistic outcome (high consequences score) and negative emotional response. The lack of correlations suggests that illness perceptions of patients do not necessarily relate to the recent trauma experience or the severity of their hand injury. Patients in this cohort were optimistic about treatment and their recovery. There was some evidence to suggest that patients with severe injury were over-optimistic about recovery. These findings suggest that there could be a role for
Methods. A retrospective observational review of the Pietermaritzburg Metropolitan Trauma Service hybrid electronic medical registry database was performed during the period January 2013 - December 2015. Patients were classified into three groups using their GCS as an injury severity score. These were mild TBI (GCS ...
Fabian, Leslie A; Thygerson, Steven M; Merrill, Ray M
As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU) length of stay (LOS), Injury Severity Score (ISS), patient treatment options, disposition, and outcome) were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI), and intracranial hemorrhage (ICH) were significantly more common among longboard patients than skateboarders (P skateboarders (P skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population.
Thornton, Jane S; Vinther, Anders; Wilson, Fiona
understanding in pre-participation screening, training load, emerging concepts surrounding back and rib injury, and relative energy deficiency in sport. Through a better understanding of the nature of the sport and mechanisms of injury, physicians and other healthcare providers will be better equipped to treat......-rowing populations. It has further expanded beyond its traditional flatwater format to include the discipline of open-water or coastal rowing, and an increased focus on indoor rowing. Rowing-specific injury research has similarly increased over the last decade since our last review, revealing areas of improved...... and prevent injuries in rowers....
... Certification Import Surveillance International Recall Guidance Civil and Criminal Penalties Federal Court Orders & Decisions Research & Statistics Research & Statistics Technical Reports Injury Statistics NEISS ...
Grivna, Michal; Barss, Peter; Stanculescu, Cristina; Eid, Hani O; Abu-Zidan, Fikri M
Traffic-related injuries are the main cause of death during childhood and youth in the United Arab Emirates (UAE), use of safety restraints by citizens is uncommon, rollovers are frequent, and current legislation does not protect rear-seat occupants. Because little was known about the circumstances of hospitalizations for traffic injuries to guide prevention, a trauma registry was used to assess causes and determinants for traffic-related injuries during childhood and youth (children and youth with traffic injuries were admitted for more than 24 h at surgical wards of the main trauma hospital in the Al-Ain region during a 36-month period (2003-2006). Injuries were analyzed by age, nationality, road user and vehicle types, severity, anatomical region, and the presence of head injury using Injury Severity Scores (ISS) and the Abbreviated Injury Scale (AIS). Traffic injuries represented 40 percent (n = 193) of injuries to 0- to 19-year-olds, followed by falls (39 percent). Among 15- to 19-year-olds, who accounted for 46 percent of child and youth victims, the incidence was 150/100,000 person years, compared to an incidence of 15 to 51 for younger age groups. Overall, 53 percent were vehicle occupants, 23 percent were pedestrians, 14 percent were bicyclists, 6 percent were motorcyclists, with 4 percent other. The ratio of male-to-female victims was 6.7:1; for drivers it was 33:0; and for pedestrians, bicyclists, and motorcyclists it was between 10:1 and 12:1; injured females were mainly rear-seat passengers and the male: female ratio was 1.4:1. Seventy-one percent of pedestrians were ≤9 years old. Although the ratio of UAE children to foreign children was estimated at 0.7:1 in the community, 58 percent of the injured were UAE citizens. The ratio of injured UAE: non-UAE citizens was 1.4:1 overall but 5.6:1 for drivers and 4.5:1 for motorcyclists. Forty-one percent of citizens were injured in 4-wheel drive sport utility vehicles compared to 13 percent of non
Full Text Available It is generally easier to predict defaults accurately if a large data set (including defaults is available for estimating the prediction model. This puts not only small banks, which tend to have smaller data sets, at disadvantage. It can also pose a problem for large banks that began to collect their own historical data only recently, or banks that recently introduced a new rating system. We used a Bayesian methodology that enables banks with small data sets to improve their default probability. Another advantage of the Bayesian method is that it provides a natural way for dealing with structural differences between a bank’s internal data and additional, external data. In practice, the true scoring function may differ across the data sets, the small internal data set may contain information that is missing in the larger external data set, or the variables in the two data sets are not exactly the same but related. Bayesian method can handle such kind of problem.
Theunissen, P T; Schulpen, S H W; van Dartel, D A M; Hermsen, S A B; van Schooten, F J; Piersma, A H
Alternative assays are highly desirable to reduce the extensive experimental animal use in developmental toxicity testing. In the present study, we developed an improved test system for assessing neurodevelopmental toxicity using differentiating embryonic stem cells. We advanced previously established methods by merging, modifying and abbreviating the original 20-day protocol into a more efficient 13-day neural differentiation protocol. Using morphological observation, immunocytochemistry, gene expression and flow cytometry, it was shown predominantly multiple lineages of neuroectodermal cells were formed in our protocol and to a lower extent, endodermal and mesodermal differentiated cell types. This abbreviated protocol should lead to an advanced screening method using morphology in combination with selected differentiation markers aimed at predicting neurodevelopmental toxicity. Finally, the assay was shown to express differential sensitivity to a model developmental neurotoxicant, methyl mercury.
Objective: To determine the prognostic value and reliability of revised trauma score (RTS) in polytraumatized patients. Subjects and Methods: Thirty adult patients of road traffic accidents sustaining multisystem injuries due to high energy blunt trauma were managed according to the protocols of advanced trauma life support (ATLS) and from their first set of data RTS was calculated. Score of each patient was compared with his final outcome at the time of discharge from the hospital. Results: The revised trauma score was found to be a reliable predictor of prognosis of polytraumatized patients but a potentially weak predictor for those patients having severe injury involving a single anatomical region. The higher the RTS the better the prognosis of polytrauma patient and vice versa. Revised trauma score <8 turned out to be an indicator of severe injury with high mortality and morbidity and overall mortality in polytraumatized patients was 26.66%. However, RTS-6 was associated with 50% mortality. Conclusion: The revised trauma score is a reliable indicator of prognosis of polytraumatized patients. Therefore, it can be used for field and emergency room triage. (author)
M. S. Parvez
Full Text Available Injuries during cultivation of land are the significant causes of recession for an agricultural country like Bangladesh. Thousands of tools are used in agricultural farm having much probability of getting injury at their workplaces. For the injury prevention, proper hand tool designs need to be recommended with ergonomic evaluations. This paper represents the main causes of agricultural injuries among the Bangladeshi farmers. Effective interventions had been discussed in this paper to reduce the rate of injury. This study was carried out in the Panchagarh district of Bangladesh. Data on 434 agricultural injuries were collected and recorded. About 67% injuries of all incidents were due to hand tools, and the remaining 33% were due to machinery or other sources. Though most of the injuries were not serious, about 22% injuries were greater than or equal to AIS 2 (Abbreviated Injury Scale. The practical implication of this study is to design ergonomically fit agricultural hand tools for Bangladeshi farmers in order to avoid their injuries.
Xu, Hui; Tracey, Terence J G
The current study developed an abbreviated version of the Career Indecision Profile-65 (CIP-65; Hacker, Carr, Abrams, & Brown, 2013) by using item response theory. In order to improve the efficiency of the CIP-65 in measuring career indecision, the individual item performance of the CIP-65 was examined with respect to the ordering of response occurrence and gender differential item functioning. The best 5 items of each scale of the CIP-65 (i.e., neuroticism/negative affectivity, choice/commitment anxiety, lack of readiness, and interpersonal conflicts) were retained in the CIP-Short using a sample of 588 college students. A validation sample (N = 174) supported the reliability and structural validity of the CIP-Short. The convergent and divergent validity of the CIP-Short was additionally supported in the findings of a hypothesized differential relational pattern in a separate sample (N = 360). While the current study supported the CIP-Short being a sound brief measure of career indecision, the limitations of this study and suggestions for future research were discussed as well. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Finkbeiner, Kristin M; Russell, Paul N; Helton, William S
The abbreviated vigilance task can quickly generate vigilance decrements, which has been argued is due to depletion of cognitive resources needed to sustain performance. Researchers suggest inclusion of rest breaks within vigilance tasks improve overall performance (Helton & Russell, 2015; Ross, Russell, & Helton, 2014), while different types of breaks demonstrate different effects. Some literature suggests exposure to natural movements/stimuli helps restore attention (Herzog, Black, Fountaine, & Knotts, 1997; Kaplan, 1995). Participants were randomly assigned to one experimental condition: dog video breaks, robot video breaks, countdown breaks or continuous vigilance. We assessed task performance and subjective reports of stress/workload. The continuous group displayed worst performance, suggesting breaks help restore attention. The dog videos did not affect performance, however, decreased reports of distress. These results support the importance of rest breaks and acknowledge the benefit of natural stimuli for promoting wellbeing/stress relief, overall suggesting performance and wellbeing may be independent, which warrants future studies. Copyright © 2016 Elsevier Inc. All rights reserved.
Thorborg, Kristian; Branci, Sonia; Stensbirk, Frederik
included 444 groin injury-free soccer players from 40 clubs (divisions 1-4) in Eastern Denmark, mean age (SD) 23.6 (4.4), training soccer 3.4 (1) times per week. All players were hip and groin injury-free at the time of inclusion (beginning of season, 2011). RESULTS: Of the 444 hip and groin injury......BACKGROUND/AIM: Reference values are needed in order to interpret the Copenhagen Hip and Groin Outcome Score (HAGOS) in male soccer players with hip and groin pain. The aim of this study was to establish reference values for HAGOS in hip and groin injury-free male soccer players. METHODS: We...... HAGOS subscales (pinjury-free soccer players, with no pain in the previous or present season (n=301), are: pain: 80.1-100, symptoms: 64.3-100, activities of daily living: 80...
Islamaj Doğan, Rezarta; Comeau, Donald C; Yeganova, Lana; Wilbur, W John
BioC is a recently created XML format to share text data and annotations, and an accompanying input/output library to promote interoperability of data and tools for natural language processing of biomedical text. This article reports the use of BioC to address a common challenge in processing biomedical text information-that of frequent entity name abbreviation. We selected three different abbreviation definition identification modules, and used the publicly available BioC code to convert these independent modules into BioC-compatible components that interact seamlessly with BioC-formatted data, and other BioC-compatible modules. In addition, we consider four manually annotated corpora of abbreviations in biomedical text: the Ab3P corpus of 1250 PubMed abstracts, the BIOADI corpus of 1201 PubMed abstracts, the old MEDSTRACT corpus of 199 PubMed(®) citations and the Schwartz and Hearst corpus of 1000 PubMed abstracts. Annotations in these corpora have been re-evaluated by four annotators and their consistency and quality levels have been improved. We converted them to BioC-format and described the representation of the annotations. These corpora are used to measure the three abbreviation-finding algorithms and the results are given. The BioC-compatible modules, when compared with their original form, have no difference in their efficiency, running time or any other comparable aspects. They can be conveniently used as a common pre-processing step for larger multi-layered text-mining endeavors. Database URL: Code and data are available for download at the BioC site: http://bioc.sourceforge.net. Published by Oxford University Press 2014. This work is written by US Government employees and is in the public domain in the US.
Assessment of executive functions in children and adolescents with acquired brain injury (ABI) using a novel complex multi-tasking computerised task: The Jansari assessment of Executive Functions for Children (JEF-C©).
Gilboa, Yafit; Jansari, Ashok; Kerrouche, Bernadette; Uçak, Emel; Tiberghien, Anne; Benkhaled, Ouarda; Aligon, Delphine; Mariller, Aude; Verdier, Valentine; Mintegui, Amaia; Abada, Geneviève; Canizares, Céline; Goldstein, Andrew; Chevignard, Mathilde
The Jansari assessment of Executive Functions for Children (JEF-C © ) is a new non-immersive computerised assessment of executive functions. The objectives of the study were to test the feasibility and validity of JEF-C © in children and adolescents with acquired brain injury (ABI). Twenty-nine patients with ABI aged 10-18 years and 30 age-and gender-matched controls were tested. Participants performed JEF-C © , Wechsler Abbreviated Scale of Intelligence (WASI) and the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C), while parents completed the Behaviour Rating Inventory of Executive Function (BRIEF) questionnaire. The JEF-C © task proved feasible in patients with ABI. The internal consistency was medium (Cronbach's alpha = 0.62 and significant intercorrelations between individual JEF-C © constructs). Patients performed significantly worse than controls on most of the JEF-C © subscales and total score, with 41.4% of participants with ABI classified as having severe executive dysfunction. No significant correlations were found between JEF-C © total score, the BRIEF indices, and the BADS-C. Significant correlations were found between JEF-C © and demographic characteristics of the sample and intellectual ability, but not with severity/medical variables. JEF-C © is a playful complex task that appears to be a sensitive and ecologically valid assessment tool, especially for relatively high-functioning individuals.
... U.S. Soccer have seen positive results and fewer injuries with PEP. The Santa Monica Sports Medicine Foundation (SMSMF) created this program. There is no clear evidence that use of a knee brace prevents ACL injuries. There also is no ...
Kesmarky, Klara; Delhumeau, Cecile; Zenobi, Marie; Walder, Bernhard
The Glasgow Coma Scale (GCS) and the Abbreviated Injury Score of the head region (HAIS) are validated prognostic factors in traumatic brain injury (TBI). The aim of this study was to compare the prognostic performance of an alternative predictive model including motor GCS, pupillary reactivity, age, HAIS, and presence of multi-trauma for short-term mortality with a reference predictive model including motor GCS, pupil reaction, and age (IMPACT core model). A secondary analysis of a prospective epidemiological cohort study in Switzerland including patients after severe TBI (HAIS >3) with the outcome death at 14 days was performed. Performance of prediction, accuracy of discrimination (area under the receiver operating characteristic curve [AUROC]), calibration, and validity of the two predictive models were investigated. The cohort included 808 patients (median age, 56; interquartile range, 33-71), median GCS at hospital admission 3 (3-14), abnormal pupil reaction 29%, with a death rate of 29.7% at 14 days. The alternative predictive model had a higher accuracy of discrimination to predict death at 14 days than the reference predictive model (AUROC 0.852, 95% confidence interval [CI] 0.824-0.880 vs. AUROC 0.826, 95% CI 0.795-0.857; p predictive model had an equivalent calibration, compared with the reference predictive model Hosmer-Lemeshow p values (Chi2 8.52, Hosmer-Lemeshow p = 0.345 vs. Chi2 8.66, Hosmer-Lemeshow p = 0.372). The optimism-corrected value of AUROC for the alternative predictive model was 0.845. After severe TBI, a higher performance of prediction for short-term mortality was observed with the alternative predictive model, compared with the reference predictive model.
Riecke, B. F.; Christensen, Robin Daniel Kjersgaard; Torp-Pedersen, S.
Objective: To develop standardized musculoskeletal ultrasound (MUS) procedures and scoring for detecting knee osteoarthritis (OA) and test the MUS score's ability to discern various degrees of knee OA, in comparison with plain radiography and the 'Knee injury and Osteoarthritis Outcome Score' (KO...... of the knees, the score detected all aspects of knee OA with relevant precision. (C) 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved....
José Luis Ayuso-Mateos
Full Text Available The Day Reconstruction Method (DRM was developed to assess affective states as measures of experienced well-being. The present study aimed to validate an abbreviated version of the DRM in a representative sample of the population in seven countries (China, Ghana, India, Mexico, Russia, South Africa, and Spain, and to examine whether there are country differences in affect and in the relationships among the activities based on the similarity of the affect associated with each of them.Interviews were conducted with 47,222 non-institutionalized adults from seven countries, using an abbreviated version of the DRM. A cluster analysis was carried out to classify activities on the basis of the similarity of the associated affect. In each country, the factorial structure of the affect adjectives was tested through Confirmatory Factor Analysis. Internal consistency and construct validity were also assessed. Moreover, the differences in affect across countries and the diurnal cycles of affect were evaluated.The DRM showed adequate psychometric properties regarding reliability and construct validity in all countries. Respondents from Ghana and South Africa reported more positive net affect whereas Indian respondents reported less positive net affect. Most of the countries showed a similar diurnal variation of affect, which tended to improve throughout the day.The results show that this abbreviated version of the DRM is a useful tool for multi-country evaluation of experienced well-being.