WorldWideScience

Sample records for chart review analysis

  1. Digital Mapping Charting and Geodesy analysis Program (DMAP) Review of Technical Initiatives for FY03

    National Research Council Canada - National Science Library

    Breckenridge, John

    2003-01-01

    The Naval DMAP serves as a technical representative for the Oceanographer of the Navy, NO96 to address significant issues relevant to the Navy's use and development of digital Mapping, Charting & Geodesy (MC&G) data...

  2. Review of "Charting New Territory"

    Science.gov (United States)

    Trujillo, Tina

    2011-01-01

    "Charting New Territory: Tapping Charter Schools to Turn Around the Nation's Dropout Factories" argues for a more prominent role for charter operators in turning around perennially low-performing high schools. However, the report's ultimate findings and conclusions are out of proportion to the strength of the research evidence on school…

  3. The art and science of chart review.

    Science.gov (United States)

    Allison, J J; Wall, T C; Spettell, C M; Calhoun, J; Fargason, C A; Kobylinski, R W; Farmer, R; Kiefe, C

    2000-03-01

    Explicit chart review was an integral part of an ongoing national cooperative project, "Using Achievable Benchmarks of Care to Improve Quality of Care for Outpatients with Depression," conducted by a large managed care organization (MCO) and an academic medical center. Many investigators overlook the complexities involved in obtaining high-quality data. Given a scarcity of advice in the quality improvement (QI) literature on how to conduct chart review, the process of chart review was examined and specific techniques for improving data quality were proposed. The abstraction tool was developed and tested in a prepilot phase; perhaps the greatest problem detected was abstractor assumption and interpretation. The need for a clear distinction between symptoms of depression or anxiety and physician diagnosis of major depression or anxiety disorder also became apparent. In designing the variables for the chart review module, four key aspects were considered: classification, format, definition, and presentation. For example, issues in format include use of free-text versus numeric variables, categoric variables, and medication variables (which can be especially challenging for abstraction projects). Quantitative measures of reliability and validity were used to improve and maintain the quality of chart review data. Measuring reliability and validity offers assistance with development of the chart review tool, continuous maintenance of data quality throughout the production phase of chart review, and final documentation of data quality. For projects that require ongoing abstraction of large numbers of clinical records, data quality may be monitored with control charts and the principles of statistical process control. The chart review module, which contained 140 variables, was built using MedQuest software, a suite of tools designed for customized data collection. The overall interrater reliability increased from 80% in the prepilot phase to greater than 96% in the final

  4. Dupuytren's disease presentation, referral pathways and resource utilisation in Europe: regional analysis of a surgeon survey and patient chart review.

    Science.gov (United States)

    Dahlin, L B; Bainbridge, C; Leclercq, C; Gerber, R A; Guerin, D; Cappelleri, J C; Szczypa, P P; Dias, J

    2013-03-01

    We explored the management of Dupuytren's disease (DD) using a surgeon survey and patient chart review. Twelve countries participated: Denmark, Finland, Sweden (Nordic region); Czech Republic, Hungary, Poland (East); France, Germany, the Netherlands, United Kingdom (West); Italy, Spain (Mediterranean). A random sample of orthopaedic/plastic surgeons (N = 687) with 3-30 years' experience was asked about Dupuytren's contracture procedures performed during the previous 12 months. Information ≤ 5 consecutive patients per surgeon was extracted from patient charts (N = 3357). Overall, 84% of participants were orthopaedic surgeons; 56% of surgeons were hand specialists. Deciding factors for fasciectomy and dermofasciectomy were consistent across regions: metacarpophalangeal (MP) or proximal interphalangeal contracture > 45°, recurrent contracture, and high expectations for success. Deciding factors for percutaneous needle fasciotomy were less consistent across regions, but the leading factor was MP flexion patterns. Understanding current diagnosis and treatment patterns, in relation to regional differences in health economics, may improve physicians' diagnosis of DD and guide patients towards appropriate, customised management plans. © 2013 Blackwell Publishing Ltd.

  5. Surgical management of Dupuytren's contracture in Europe: regional analysis of a surgeon survey and patient chart review.

    Science.gov (United States)

    Dias, J; Bainbridge, C; Leclercq, C; Gerber, R A; Guerin, D; Cappelleri, J C; Szczypa, P P; Dahlin, L B

    2013-03-01

    We explored regional variations in the surgical management of patients with Dupuytren's contracture (DC) in 12 European countries using a surgeon survey and patient chart review. Twelve countries participated: Denmark, Finland, Sweden (Nordic region); Czech Republic, Hungary, Poland (East); France, Germany, the Netherlands, UK (West); Italy, Spain (Mediterranean). For the survey, a random sample of orthopaedic/plastic surgeons (n = 687) with 3-30 years' experience was asked about DC procedures performed during the previous 12 months. For the chart review (n = 3357), information from up to five consecutive patients was extracted. Descriptive statistics are reported. Ninety-five per cent of all surgeons used fasciectomy for DC, followed by fasciotomy (70%), dermofasciectomy (38%) and percutaneous needle fasciotomy (35%). Most surgeons were satisfied with fasciectomy over other procedures. Recommended time away from work and duration of physical therapy increased with the invasiveness of the procedure. The intra-operative complication rate was 4.0%; the postoperative complication rate was 34%. Overall, ≥ 97% of the procedures were rated by surgeons as having a positive outcome. Across all regions, 54% of patients had no nodules or contracture after the procedures. Only 2% of patients required retreatment within the first year of surgery. Important inter- and intraregional differences in these aspects of patient management are described. Understanding current regional treatment patterns and their relationships to country-specific health systems may facilitate earlier identification of, and intervention for, DD and help to optimise the overall treatment for patients with this chronic condition. © 2013 Blackwell Publishing Ltd.

  6. Monitoring and switching patterns of patients with chronic myeloid leukemia treated with imatinib in community settings: a chart review analysis.

    Science.gov (United States)

    Chen, Lei; Guérin, Annie; Xie, Jipan; Wu, Eric Q; Yu, Andrew P; Ericson, Solveig G; Jabbour, Elias

    2012-11-01

    Monitoring treatment response is an integral part of chronic myeloid leukemia (CML) treatment. The guidelines recommend regular monitoring using standard methods (e.g., real-time quantitative polymerase chain reaction based on the international scale for molecular response) and treatment adjustment when failure is detected among patients treated with imatinib. The objective of this study was to assess the real-world monitoring and therapy adjustment in this patient population in the US. Twenty-nine physicians from community practices across the US participated in an online chart review. Adult patients with chronic phase CML who initiated imatinib as first-line therapy during 2006-2010 were selected. Information was collected up to 36 months after imatinib initiation, including response monitoring, response status, and therapy adjustment upon treatment failure. The study included 297 eligible patients. By 18 months, 47% of patients had received cytogenetic response assessment continuously as recommended by the guidelines. The corresponding proportion was 39% for continuous molecular response assessment. Among patients who experienced treatment failure by 18 months, only 14%-38% of patients switched to a second-generation tyrosine kinase inhibitor as recommended by the National Comprehensive Cancer Network and the European Leukemia Net guidelines. Major limitations included limited generalizability and the inability to accurately assess molecular response due to the variations in testing methods during the study period. Based on the guidelines, the rates of treatment monitoring and switching upon failure were low, demonstrating the need for improvement in CML care in community settings in the US.

  7. Intrathecal Baclofen Dosing Regimens: A Retrospective Chart Review.

    Science.gov (United States)

    Clearfield, Jacob S; Nelson, Mary Elizabeth S; McGuire, John; Rein, Lisa E; Tarima, Sergey

    2016-08-01

    To examine dosing patterns in patients receiving baclofen via intrathecal baclofen pumps to assess for common patterns by diagnosis, ambulation ability, and affected limbs distribution. This trial study included 25 patients with baclofen pumps selected from the 356 patients enrolled in our center's baclofen pump program. Selection was done by splitting all patients into diagnostic categories of stroke, multiple sclerosis, traumatic/anoxic brain injury, cerebral palsy, and spinal cord injury, and then, five patients were randomly selected from each diagnosis.A systematic chart review was then conducted for each patient from Jan 1, 2008, through September 16, 2013, to look at factors including mean daily dose at end of study, and among those implanted during the study mean initial stable dose and time to initial stable dose. Analysis of mean daily dose across diagnoses found significant differences, with brain injury, cerebral palsy, and spinal cord injury patients having higher doses while multiple sclerosis and stroke patients required lower doses. Nonambulatory patients strongly trended to have higher daily doses than ambulatory patients. Similar trends of mean initial stable dose being higher in a similar pattern as that of end mean daily dose were seen according to diagnoses and ambulatory status, although statistical significance could not be achieved with the small sample size. Significant differences in dosing were found between diagnoses and trended to differ by ambulatory status at the end of the study, and similar trends could be observed in achieving initial stable dose. © 2015 International Neuromodulation Society.

  8. Impact of timely switching from imatinib to a second-generation tyrosine kinase inhibitor after 12-month complete cytogenetic response failure: a chart review analysis.

    Science.gov (United States)

    DeAngelo, Daniel J; Chen, Lei; Guerin, Annie; Styles, Amy; Giguere-Duval, Philippe; Wu, Eric Q

    2014-06-01

    In this study, cytogenetic response rate after timely switching to a second-generation tyrosine kinase inhibitor (TKI) was evaluated among patients with CML-CP, after failure to achieve CCyR 1 year after imatinib initiation. An online physician-administered medical chart review was used to retrospectively collect information from 108 US-based hematologists and oncologists on CML-CP patients who initiated imatinib as first-line therapy and failed to achieve CCyR at 12 months after imatinib initiation. Patients who switched to a second-generation TKI within 3 months after the CCyR failure were defined as timely switchers, and those who continued taking imatinib for at least 3 months after the CCyR failure were defined as nonswitchers. CCyR achievement was compared between timely switchers and nonswitchers using multivariate Cox proportional hazard models. Physicians provided information on 593 patients, with 306 defined as timely switchers and 287 defined as nonswitchers. Among the nonswitchers, 78 switched to a second-generation TKI at a later date. After adjusting for potential confounding factors, timely switchers had statistically significantly greater likelihood of achieving CCyR (hazard ratio, 1.80; P = .002) compared with nonswitchers. Timely switching from imatinib to a second-generation TKI after CCyR failure 1 year after imatinib initiation was associated with a greater likelihood of achieving CCyR compared with delaying the switch or not switching to a second-generation TKI. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. EXIT Chart Analysis of Binary Message-Passing Decoders

    DEFF Research Database (Denmark)

    Lechner, Gottfried; Pedersen, Troels; Kramer, Gerhard

    2007-01-01

    Binary message-passing decoders for LDPC codes are analyzed using EXIT charts. For the analysis, the variable node decoder performs all computations in the L-value domain. For the special case of a hard decision channel, this leads to the well know Gallager B algorithm, while the analysis can...

  10. Stability of infliximab dosing in inflammatory bowel disease: results from a multicenter US chart review.

    Science.gov (United States)

    Waters, Heidi; Vanderpoel, Julie; McKenzie, Scott; Lunacsek, Orsolya; Franklin, Meg; Lennert, Barbara; Goff, John; Augustyn, Damian H

    2011-01-01

    Infliximab dosing for inflammatory bowel disease (IBD) is based on patient weight and treatment response. Understanding dosing patterns may provide insight into treatment response and predictability of treatment cost. The purpose of this medical record review was to assess dose and dose frequency of infliximab maintenance treatment in patients with IBD using patient chart data. A retrospective chart review was conducted at 14 community gastroenterology clinics (GI clinics). Patients were aged ≥18 years, diagnosed with Crohn's disease (CD) or ulcerative colitis (UC), and had a first infliximab administration (index date) between January 1, 2005 and September 30, 2007. At least 24 months of continuous data availability were required with dosing data collected for 12 months after initiation of infliximab therapy. Patients with biologic use and/or participation in an IBD clinical trial within 12 months before the index date were excluded. Charts from 182 CD patients and 86 UC patients were analyzed. About half of the patients were female. Over 90% of patients initiated treatment with infliximab 5 mg/kg. Among CD patients and UC patients, respectively, 79% and 61% continued receiving this dose for maintenance therapy at stable intervals. This retrospective descriptive study is limited by the type and quantity of information available in patient charts from 14 GI clinics during the first year of infliximab treatment. Further, non-anti-tumor necrosis factor medication data were intermittently collected in some charts and, therefore, did not allow for analysis. Weight-based dosing and, presumably, patient response enabled providers to find the effective infliximab dose for IBD patients. The maintenance dose and administration frequency remained stable during the initial year.

  11. Effectiveness of pharmacotherapy for pathological gambling: a chart review.

    Science.gov (United States)

    Grant, Jon E; Kim, Suck Won

    2002-09-01

    Although pathological gambling is a relatively common disorder, there exists only limited information regarding the effectiveness of pharmacotherapy for this illness. This study examines which medications may be effective, dose and duration of medication trials needed to achieve response, and possible predictors of response. Using a chart review, 50 adult outpatients with DSM-IV pathological gambling treated in clinical practice were assessed regarding response to a variety of medications, including augmentation strategies, and response to concomitant psychotherapy. All subjects received pharmacotherapy for gambling symptoms. Thirty-nine (78%) achieved response to medication treatment. Mean duration of treatment needed for response was 104.9 +/- 85.0 days. Of those treated with an adequate trial of naltrexone as monotherapy, 90.9% were responders, whereas only 45.5% of those treated with an adequate trial of an SSRI achieved response. Patients with poorer social and occupational functioning due to urges and thoughts about gambling were less likely to respond to medication. These findings from a clinical setting suggest that a majority of pathological gamblers improve with medication treatment. Naltrexone, or augmentation of naltrexone with an SSRI, appears to be most effective in relieving gambling symptoms.

  12. Is fasting safe? A chart review of adverse events during medically supervised, water-only fasting.

    Science.gov (United States)

    Finnell, John S; Saul, Bradley C; Goldhamer, Alan C; Myers, Toshia R

    2018-02-20

    Evidence suggests that fasting, during which only water is consumed, results in potentially health promoting physiological effects. However, peer-reviewed research assessing the safety of water-only fasting is lacking. To address this, we conducted a chart review to describe adverse events (AEs) that occurred during medically supervised, water-only fasting. Electronic charts from patient visits to a residential medical facility from 2006 to 2011 were reviewed. Patients who were at least 21 years of age and water-only fasted for ≥2 consecutive days with a refeeding period equal to half of the fast length were included. Out of 2539 charts, 768 visits met our inclusion and exclusion criteria. AEs were abstracted from chart notes and classified according to CTCAE (v4.03) and MedDRA (v12.1) terminology. Descriptive analysis of AEs is reported. During the protocol period, the highest grade AE (HGAE) in 555 visits was a grade 2 event or lower, in 212 visits it was a grade 3 event, in 1 visit it was a grade 4 event, and there were no grade 5 events. There were 2 (0.002%) visits with a serious adverse event (SAE). The majority of AEs identified were mild (n = 4490, 75%) in nature and known reactions to fasting. To our knowledge, this is the most comprehensive analysis of AEs experienced during medically supervised, water-only fasting conducted to date. Overall, our data indicate that the majority of AEs experienced were mild to moderate and known reactions to fasting. This suggests that the protocol used in this study can be safely implemented in a medical setting with minimal risk of a SAE.

  13. Diagnostic value of run chart analysis: using likelihood ratios to compare run chart rules on simulated data series.

    Directory of Open Access Journals (Sweden)

    Jacob Anhøj

    Full Text Available Run charts are widely used in healthcare improvement, but there is little consensus on how to interpret them. The primary aim of this study was to evaluate and compare the diagnostic properties of different sets of run chart rules. A run chart is a line graph of a quality measure over time. The main purpose of the run chart is to detect process improvement or process degradation, which will turn up as non-random patterns in the distribution of data points around the median. Non-random variation may be identified by simple statistical tests including the presence of unusually long runs of data points on one side of the median or if the graph crosses the median unusually few times. However, there is no general agreement on what defines "unusually long" or "unusually few". Other tests of questionable value are frequently used as well. Three sets of run chart rules (Anhoej, Perla, and Carey rules have been published in peer reviewed healthcare journals, but these sets differ significantly in their sensitivity and specificity to non-random variation. In this study I investigate the diagnostic values expressed by likelihood ratios of three sets of run chart rules for detection of shifts in process performance using random data series. The study concludes that the Anhoej rules have good diagnostic properties and are superior to the Perla and the Carey rules.

  14. Diagnostic value of run chart analysis: using likelihood ratios to compare run chart rules on simulated data series.

    Science.gov (United States)

    Anhøj, Jacob

    2015-01-01

    Run charts are widely used in healthcare improvement, but there is little consensus on how to interpret them. The primary aim of this study was to evaluate and compare the diagnostic properties of different sets of run chart rules. A run chart is a line graph of a quality measure over time. The main purpose of the run chart is to detect process improvement or process degradation, which will turn up as non-random patterns in the distribution of data points around the median. Non-random variation may be identified by simple statistical tests including the presence of unusually long runs of data points on one side of the median or if the graph crosses the median unusually few times. However, there is no general agreement on what defines "unusually long" or "unusually few". Other tests of questionable value are frequently used as well. Three sets of run chart rules (Anhoej, Perla, and Carey rules) have been published in peer reviewed healthcare journals, but these sets differ significantly in their sensitivity and specificity to non-random variation. In this study I investigate the diagnostic values expressed by likelihood ratios of three sets of run chart rules for detection of shifts in process performance using random data series. The study concludes that the Anhoej rules have good diagnostic properties and are superior to the Perla and the Carey rules.

  15. Clinical experience of baclofen in alcohol dependence: A chart review.

    Science.gov (United States)

    Rozatkar, Abhijit R; Kapoor, Abhishek; Sidana, Ajeet; Chavan, Bir Singh

    2016-01-01

    Craving is recognized as a formidable barrier in the management of patients with alcohol dependence. Among pharmacological agents that have been used in experimental studies for reduction in craving, baclofen appears to have a significant advantage over other agents. The study is retrospective chart review of patients ( n = 113) who have been treated with baclofen for alcohol dependence in a tertiary hospital of North India. Baseline assessments included sociodemography, motivation, quantity-frequency of alcohol use, and other alcohol-related clinical parameters. Weekly assessments, for a period of 4 weeks, were extracted from records which included dose of baclofen, craving intensity, and alcohol consumption. The study sample was predominantly male, mean age of 41.49 (±9.75) years, most having a family history of substance use (70.97%), and many reporting binge use pattern in last year (49.46%). Baseline assessment revealed 48.7% of the sample was in precontemplation phase for alcohol use and 70% reported severe and persistent craving. This persistent craving was reported by only 15% of the sample by the end of 4 weeks treatment with baclofen (20-40 mg/day). Thirty-four percent of patients reported continued problematic use of alcohol by the end of 4 weeks. Our clinical experience suggests that baclofen reduces craving and alcohol consumption including in those with poor motivation. The drug causes few side effects and does not add to the intoxication effect of alcohol. Considering that baclofen is safe in those with liver cirrhosis and reduces withdrawal symptoms due to alcohol, a controlled trial comparing it with standard treatment is required.

  16. Clinical experience of baclofen in alcohol dependence: A chart review

    Directory of Open Access Journals (Sweden)

    Abhijit R Rozatkar

    2016-01-01

    Full Text Available Introduction: Craving is recognized as a formidable barrier in the management of patients with alcohol dependence. Among pharmacological agents that have been used in experimental studies for reduction in craving, baclofen appears to have a significant advantage over other agents. Methodology: The study is retrospective chart review of patients (n = 113 who have been treated with baclofen for alcohol dependence in a tertiary hospital of North India. Baseline assessments included sociodemography, motivation, quantity-frequency of alcohol use, and other alcohol-related clinical parameters. Weekly assessments, for a period of 4 weeks, were extracted from records which included dose of baclofen, craving intensity, and alcohol consumption. Results: The study sample was predominantly male, mean age of 41.49 (±9.75 years, most having a family history of substance use (70.97%, and many reporting binge use pattern in last year (49.46%. Baseline assessment revealed 48.7% of the sample was in precontemplation phase for alcohol use and 70% reported severe and persistent craving. This persistent craving was reported by only 15% of the sample by the end of 4 weeks treatment with baclofen (20–40 mg/day. Thirty-four percent of patients reported continued problematic use of alcohol by the end of 4 weeks. Conclusion: Our clinical experience suggests that baclofen reduces craving and alcohol consumption including in those with poor motivation. The drug causes few side effects and does not add to the intoxication effect of alcohol. Considering that baclofen is safe in those with liver cirrhosis and reduces withdrawal symptoms due to alcohol, a controlled trial comparing it with standard treatment is required.

  17. Streamlining the Medication Review Process by Use of a New Review Tool: CHART.

    Science.gov (United States)

    Ostrem, Quincy; Carlson, Stephen; Hamilton, Brady

    2018-01-01

    The Carlson-Hamilton Adult Medication Review Tool (CHART) represents an effort to improve the approach to geriatric care by streamlining the medication review process and identifying potential medication issues that may be relevant to patient's cognitive presentation and impact clinical decision making. CHART was created at a behavioral health facility. The most common primary diagnoses on this unit include new onset psychosis and recent mental status changes. This facility contains 155 beds divided into six units. The geriatric unit has an average census of 10 patients, with an average length of stay of 10 to 12 days. This site is working to improve geriatric patient care by simplifying and streamlining the medication review process. The pharmacy team evaluated change in medication burden and change in medication review requests. Following implementation, this facility saw both a decreased medication burden and an increase in medication review requests. CHART is a tool that allows pharmacists and student pharmacists to streamline the review of medications and make recommendations.

  18. TerCharts: a VBA-MS Excel multiternary and multipurpose charting utility for data analysis, presentation, and modeling in environmental and earth sciences

    Science.gov (United States)

    Esawi, E. K.

    2009-03-01

    TerCharts is a comprehensive, fast, flexible, and versatile ternary charting utility that can be used for ternary data presentation analysis and modeling across many scientific disciplines. TerCharts is developed using Microsoft (MS) Excel 2003 and Visual Basic for Applications (VBA) which is an object oriented programming language developed by MS as a tool to enhance the capabilities of MS products. The Excel-VBA interface is important because normally chemical, geochemical, and mineralogical data used in teaching and basic research are processed using Excel spreadsheets, making TerCharts a more convenient tool for generating ternary charts which in turn can be used for data presentation and analysis. Ternary charts generated by this utility can be improved, edited, and modified utilizing MS Excel’s powerful charting and editing techniques.

  19. External validation of medicare claims for breast cancer chemotherapy compared with medical chart reviews.

    Science.gov (United States)

    Du, Xianglin L; Key, Charles R; Dickie, Lois; Darling, Ronald; Geraci, Jane M; Zhang, Dong

    2006-02-01

    Although Medicare claims data have been increasingly used to examine the patterns and outcomes of cancer chemotherapy, their external validity has not been well studied. We sought to validate Medicare claims for chemotherapy compared with medical chart reviews. We completed medical chart reviews for 1228 women who were diagnosed with breast cancer at age 65 and older between 1993 and 1999 in New Mexico that were linked with Medicare claims data, achieving an estimated sensitivity of more than 90% and a 0.05 level of precision. Of the 150 subjects identified by Medicare claims as receiving chemotherapy within 6 months of diagnosis, 75% were confirmed by medical records as having received chemotherapy. Of the remaining 25% of cases without chart verification, (1) 33 cases had 7 or more claims for chemotherapy and also had specific chemotherapy drugs indicated in Medicare data, representing 22% (33/150) of all cases that received chemotherapy according to Medicare claims and (2) 4 cases had 1 to 6 claims for chemotherapy, representing 3% (4/150) of all cases with claims for chemotherapy. Of those 1078 subjects who did not receive chemotherapy according to Medicare claims, more than 99% were confirmed by chart reviews. Observed agreement on chemotherapy between Medicare claims and chart reviews was 94% and overall reliability (kappa) was 0.69 (95% confidence interval = 0.63-0.76). Of cases identified as receiving chemotherapy by Medicare claims, 97% had strong evidence and only 3% had weak evidence for receiving this therapy.

  20. Comparison of Onsite Versus Online Chart Reviews as Part of the American College of Radiation Oncology Accreditation Program.

    Science.gov (United States)

    Hepel, Jaroslaw T; Heron, Dwight E; Mundt, Arno J; Yashar, Catheryn; Feigenberg, Steven; Koltis, Gordon; Regine, William F; Prasad, Dheerendra; Patel, Shilpen; Sharma, Navesh; Hebert, Mary; Wallis, Norman; Kuettel, Michael

    2017-05-01

    Accreditation based on peer review of professional standards of care is essential in ensuring quality and safety in administration of radiation therapy. Traditionally, medical chart reviews have been performed by a physical onsite visit. The American College of Radiation Oncology Accreditation Program has remodeled its process whereby electronic charts are reviewed remotely. Twenty-eight radiation oncology practices undergoing accreditation had three charts per practice undergo both onsite and online review. Onsite review was performed by a single reviewer for each practice. Online review consisted of one or more disease site-specific reviewers for each practice. Onsite and online reviews were blinded and scored on a 100-point scale on the basis of 20 categories. A score of less than 75 was failing, and a score of 75 to 79 was marginal. Any failed charts underwent rereview by a disease site team leader. Eighty-four charts underwent both onsite and online review. The mean scores were 86.0 and 86.9 points for charts reviewed onsite and online, respectively. Comparison of onsite and online reviews revealed no statistical difference in chart scores ( P = .43). Of charts reviewed, 21% had a marginal (n = 8) or failing (n = 10) score. There was no difference in failing charts ( P = .48) or combined marginal and failing charts ( P = .13) comparing onsite and online reviews. The American College of Radiation Oncology accreditation process of online chart review results in comparable review scores and rate of failing scores compared with traditional on-site review. However, the modern online process holds less potential for bias by using multiple reviewers per practice and allows for greater oversight via disease site team leader rereview.

  1. An analysis of common patterns in aggregated causation charts from intersection crashes.

    Science.gov (United States)

    Sandin, Jesper

    2009-05-01

    Intersection crashes are a major traffic problem. Greater knowledge of causation is required in order to prevent them with the implementation of active safety measures. Causation charts were aggregated to establish whether common patterns of interlinked factors could be found. The data used comprised causation charts for 52 drivers involved in 26 in-depth investigated urban intersection crashes. The charts were compiled by means of the Driving Reliability and Error Analysis Method (DREAM) version 2.1, in which contributing factors are systematically analysed, classified and linked in a causation chart. The charts were aggregated for six defined risk situations, four for drivers without the right of way and two for those with the right of way. In two risk situations, one for drivers with and one for the drivers without the right of way, common patterns showed that the drivers had not seen the other vehicle due to distractions and/or sight obstructions. A frequently occurring pattern for the drivers with the right of way was that they had not expected another vehicle to cross their path. The absence of clear patterns in three risk situations for the drivers without the right of way was due to the low number of charts and rather unique circumstances. Parts of the aggregated charts showed an unwarranted variation, identified as a consequence of inconsistent charts. The present study shows that the rather unique approach of aggregating causation charts has potential, provided that the charts are consistent.

  2. Loxapine for Reversal of Antipsychotic-Induced Metabolic Disturbances: A Chart Review

    Science.gov (United States)

    Jain, Seema; Andridge, Rebecca; Hellings, Jessica A.

    2016-01-01

    Loxapine substitution is a promising option for patients with autism spectrum disorder (ASD) who develop antipsychotic-induced metabolic illness. We performed a chart review of 15 adolescents and adults meeting DSM-IV-TR criteria for ASD, all with antipsychotic-associated weight gain, who received low dose loxapine in an attempt to taper or…

  3. Design and analysis of control charts for standard deviation with estimated parameters

    NARCIS (Netherlands)

    Schoonhoven, M.; Riaz, M.; Does, R.J.M.M.

    2011-01-01

    This paper concerns the design and analysis of the standard deviation control chart with estimated limits. We consider an extensive range of statistics to estimate the in-control standard deviation (Phase I) and design the control chart for real-time process monitoring (Phase II) by determining the

  4. Analysis of inadequate cervical smears using Shewhart control charts

    Directory of Open Access Journals (Sweden)

    Wall Michael K

    2004-06-01

    Full Text Available Abstract Background Inadequate cervical smears cannot be analysed, can cause distress to women, are a financial burden to the NHS and may lead to further unnecessary procedures being undertaken. Furthermore, the proportion of inadequate smears is known to vary widely amongst providers. This study investigates this variation using Shewhart's theory of variation and control charts, and suggests strategies for addressing this. Methods Cervical cytology data, from six laboratories, serving 100 general practices in a former UK Health Authority area were obtained for the years 2000 and 2001. Control charts of the proportion of inadequate smears were plotted for all general practices, for the six laboratories and for the practices stratified by laboratory. The relationship between proportion of inadequate smears and the proportion of negative, borderline, mild, moderate or severe dyskaryosis as well as the positive predictive value of a smear in each laboratory was also investigated. Results There was wide variation in the proportion of inadequate smears with 23% of practices showing evidence of special cause variation and four of the six laboratories showing evidence of special cause variation. There was no evidence of a clinically important association between high rates of inadequate smears and better detection of dyskaryosis (R2 = 0.082. Conclusions The proportion of inadequate smears is influenced by two distinct sources of variation – general practices and cytology laboratories, which are classified by the control chart methodology as either being consistent with common or special cause variation. This guidance from the control chart methodology appears to be useful in delivering the aim of continual improvement.

  5. Diagnostic Value of Run Chart Analysis: Using Likelihood Ratios to Compare Run Chart Rules on Simulated Data Series

    OpenAIRE

    Anh?j, Jacob

    2015-01-01

    Run charts are widely used in healthcare improvement, but there is little consensus on how to interpret them. The primary aim of this study was to evaluate and compare the diagnostic properties of different sets of run chart rules. A run chart is a line graph of a quality measure over time. The main purpose of the run chart is to detect process improvement or process degradation, which will turn up as non-random patterns in the distribution of data points around the median. Non-random variati...

  6. Serotonergic antidepressants and linezolid: a retrospective chart review and presentation of cases.

    Science.gov (United States)

    Lorenz, Raymond A; Vandenberg, Amy M; Canepa, Elizabeth A

    2008-01-01

    To report the results from a retrospective chart review looking at the combination of linezolid and serotonergic antidepressants and to report two cases of serotonin syndrome which were identified at our hospital. During the retrospective chart review one case of serotonin syndrome was identified. A 65-year-old female was receiving escitalopram for the treatment of depression prior to admission. Linezolid therapy was initiated on admission and two days later the patient had a tonic-clonic seizure. Escitalopram was discontinued and the patient did not have any further seizure activity. In a second case, a 37-year-old male was receiving citalopram during hospitalization and was started on concomitant linezolid. The patient had myoclonus and was observed to be tremulous throughout therapy with linezolid. Ten days after discontinuation of linezolid the patient continued to have symptoms until the withdrawal of citalopram. The Naranjo probability scale scores the first case as possibly related and the second case as probably related to the combination. It has been well documented in the literature that the combination of linezolid and serotonergic antidepressants may cause serotonin syndrome. In this retrospective chart review only one patient of 53 (1.8%) had symptoms highly suggestive of serotonin syndrome. A second patient continued to have symptoms of serotonin syndrome even after withdrawal of linezolid. This retrospective review and subsequent case reports confirm the rare, but serious, potential of serotonin syndrome associated with the combination of linezolid and serotonergic antidepressants.

  7. Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

    OpenAIRE

    Cindy L. Lamerson; Kristina Eaton; Joel L. Sax; Mohammed Kashani-Sabet

    2012-01-01

    This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N = 201) in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist), personal or family history of skin cancer, skin...

  8. Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

    OpenAIRE

    Mosam Phirke; Harshal Sathe; Nilesh Shah; Sushma Sonavane; Anup Bharati; Avinash DeSousa

    2015-01-01

    Background: Electroconvulsive therapy (ECT) is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014...

  9. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

    OpenAIRE

    Slothower Molly P; Anbar Ran D

    2006-01-01

    Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if...

  10. Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study.

    Science.gov (United States)

    Reissing, Elke D; Armstrong, Heather L; Allen, Caroline

    2013-01-01

    Pelvic floor physical therapy is used in the treatment of sexual pain disorders; however, women with lifelong vaginismus have not yet been included in treatment studies or have not been differentiated from women with acquired vaginismus and/or dyspareunia. This retrospective chart review and interview study was intended to obtain initial information on physical therapy interventions, course, and outcome in women who have never been able to experience vaginal intercourse. The files of 53 women, consecutively treated at one physical therapy clinic, were included in the chart review; 13 of these women volunteered to be interviewed. The chart review revealed significant pelvic floor pathology and an average treatment course of 29 sessions. Internal manual techniques were found to be most effective, followed by patient education, dilatation exercises, and home exercises. Although participants were very satisfied with the physical therapy, some symptoms, such as pain, anxiety/fear, and pelvic floor tension remained and scores on the Female Sexual Distress Scale and Female Sexual Function Index indicated clinical levels of sexual distress and impaired sexual function after treatment. Although there appears to be no linear relation between symptom reduction and healthy sexual function, this initial information suggests that physical therapy may be a promising treatment option for some women with lifelong vaginismus and merits further evaluation.

  11. Patterns of skin disease in a sample of the federal prison population: a retrospective chart review.

    Science.gov (United States)

    Gavigan, Geneviève; McEvoy, Alana; Walker, James

    2016-01-01

    Dermatology in vulnerable populations is under-researched. Our objective was to analyze the most commonly referred skin diseases affecting the Correctional Service Canada inmates in Ontario. An observational, cross-sectional, retrospective chart review of inmate patients seen from 2008 until 2013 was performed. Two groups of patients were included in the analysis: those assessed in-person, and those evaluated by e-consult. In the in-person patient group, the 3 most common diagnoses were acne, psoriasis and other superficial mycoses. For the e-consult group, the 3 most frequent diagnoses were acne, psoriasis and rosacea. There was a clear bias toward more inmates being seen in-person where the service was provided (Collins Bay Institution) than from other correctional institutions in Eastern Ontario. Most of the skin diseases that affected the incarcerated population studied were common afflictions, similar to those affecting the general population, which is in agreement with other studies. Future studies investigating skin diseases in male and female inmates across Canada would bestow more generalizable data.

  12. Medication burden in bipolar disorder: a chart review of patients at psychiatric hospital admission.

    Science.gov (United States)

    Weinstock, Lauren M; Gaudiano, Brandon A; Epstein-Lubow, Gary; Tezanos, Katherine; Celis-Dehoyos, Cintly E; Miller, Ivan W

    2014-04-30

    Individuals with bipolar disorder (BD) often receive complex polypharmacy regimens as part of treatment, yet few studies have sought to evaluate patient characteristics associated with this high medication burden. This retrospective chart review study examined rates of complex polypharmacy (i.e., ≥4 psychotropic medications), patterns of psychotropic medication use, and their demographic and clinical correlates in a naturalistic sample of adults with bipolar I disorder (BDI; N=230) presenting for psychiatric hospital admission. Using a computer algorithm, a hospital administrator extracted relevant demographic, clinical, and community treatment information for analysis. Patients reported taking an average of 3.31 (S.D.=1.46) psychotropic medications, and 5.94 (S.D.=3.78) total medications at intake. Overall, 82 (36%) met criteria for complex polypharmacy. Those receiving complex polypharmacy were significantly more likely to be female, to be depressed, to have a comorbid anxiety disorder, and to have a history of suicide attempt. Women were significantly more likely than men to be prescribed antidepressants, benzodiazepines, and stimulants, even after controlling for mood episode polarity. Study data highlight the high medication burden experienced by patients with BD, especially those who are acutely symptomatic. Data also highlight the particularly high medication burden experienced by women with BD; a burden not fully accounted for by depression. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review.

    Science.gov (United States)

    Lamerson, Cindy L; Eaton, Kristina; Sax, Joel L; Kashani-Sabet, Mohammed

    2012-01-01

    This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N = 201) in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist), personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P < 0.0005), and more likely present on the chest, back, and legs (P < 0.01). Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P < 0.01). In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

  14. Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

    Directory of Open Access Journals (Sweden)

    Cindy L. Lamerson

    2012-01-01

    Full Text Available This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N=201 in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist, personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P<0.0005, and more likely present on the chest, back, and legs (P<0.01. Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01. In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

  15. Ileus in children presenting with diarrhea and severe acute malnutrition: A chart review.

    Science.gov (United States)

    Chisti, Mohammod Jobayer; Shahid, Abu Smsb; Shahunja, K M; Bardhan, Pradip Kumar; Faruque, Abu Syeed Golam; Shahrin, Lubaba; Das, Sumon Kumar; Barua, Dipesh Kumar; Hossain, Md Iqbal; Ahmed, Tahmeed

    2017-05-01

    Severely malnourished children aged under five years requiring hospital admission for diarrheal illness frequently develop ileus during hospitalization with often fatal outcomes. However, there is no data on risk factors and outcome of ileus in such children. We intended to evaluate predictive factors for ileus during hospitalization and their outcomes. This was a retrospective chart review that enrolled severely malnourished children under five years old with diarrhea, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh between April 2011 and August 2012. We used electronic database to have our chart abstraction from previously admitted children in the hospital. The clinical and laboratory characteristics of children with (cases = 45), and without ileus (controls = 261) were compared. Cases were first identified by observation of abnormal bowel sounds on physical examination and confirmed with abdominal radiographs. For this comparison, Chi-square test was used to measure the difference in proportion, Student's t-test to calculate the difference in mean for normally distributed data and Mann-Whitney test for data that were not normally distributed. Finally, in identifying independent risk factors for ileus, logistical regression analysis was performed. Ileus was defined if a child developed abdominal distension and had hyperactive or sluggish or absent bowel sound and a radiologic evidence of abdominal gas-fluid level during hospitalization. Logistic regression analysis adjusting for potential confounders revealed that the independent risk factors for admission for ileus were reluctance to feed (odds ratio [OR] = 3.22, 95% confidence interval [CI] = 1.24-8.39, p = 0.02), septic shock (OR = 3.62, 95% CI = 1.247-8.95, pfeed, hypokalemia, hypocalcemia, and blood transfusion, septic shock (OR = 168.84, 95% CI = 19.27-1479.17, pchildren. This study suggests that the identification of simple independent admission risk

  16. Patterns of skin prick test positivity in allergic patients: usefulness of a nationwide SPT chart review.

    Science.gov (United States)

    Larenas-Linnemann, D E; Fogelbach, G A Guidos; Alatorre, A Monteverde; Cruz, A Arias; Colín, D D Hernández; Pech, J A Luna; Hernández, A Medina; Imperial, D Alberto García; del Prado, M L Cid; Zapién, F J Linares; Huerta, R E; Martell, J A Ortega

    2011-01-01

    A previous survey on allergens used by Mexican allergists in their skin prick test (SPT) panel showed wide variation. Humidity varies in different zones of Mexico. This might lead to differences in natural exposure and allergic sensitisation throughout the country. We aim to describe the SPT sensitivity patterns in the different climatic zones in Mexico and to show the usefulness of a structured SPT chart-review including multiple clinics in obtaining these allergen sensitisation patterns. A retrospective, structured chart-review of SPT results was undertaken in allergy clinics throughout Mexico. Ratios of SPT positivity were calculated for individual allergens, per climatic zone and nation-wide. Per allergen group the most important allergens were identified. Statistically significant differences between zones and the nation-wide data were tested with Pearson's Chi-squares test. 4169 skin test charts were recollected. The most important allergens causing sensitisation were very similar in different zones, despite climate variation. The allergen with highest ratio of SPT positivity was Dermatophagoides pteronyssinus (51%), with trees (Ash-27%, Alder-22%, Oak19%), and Bermuda grass (26%) as second and third. In the hot zones (humid and dry) Aspergillus was statistically significant more frequently than in more temperate zones. Cockroaches thrive in big cities and humid zones and Mesquite and Poplar in dry zones. Weeds are less important. Mexico has its own SPT sensitisation pattern, which is different from America and Europe. A structured chart-review of SPT results is able to show this and might be a tool for allergists in other countries. Copyright © 2010 SEICAP. Published by Elsevier Espana. All rights reserved.

  17. Risk factors, microbiological findings and outcomes of necrotizing fasciitis in New Zealand: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Das Dilip Kumar

    2012-12-01

    Full Text Available Abstract Background The incidence and mortality from necrotizing fasciitis (NF are increasing in New Zealand (NZ. Triggered by a media report that traditional Samoan tattooing was causing NF, we conducted a chart review to investigate the role of this and other predisposing and precipitating factors and to document NF microbiology, complications and interventions in NZ. Methods We conducted a retrospective review of 299 hospital charts of patients discharged with NF diagnosis codes in eight hospitals in NZ between 2000 and 2006. We documented and compared by ethnicity the prevalence of predisposing and precipitating conditions, bacteria isolated, complications and interventions used. Results Out of 299 charts, 247 fulfilled the case definition. NF was most common in elderly males. Diabetes was the most frequent co-morbid condition, followed by obesity. Nearly a quarter of patients were taking non-steroidal anti-inflammatory drugs (NSAID. Traditional Samoan tattooing was an uncommon cause. Streptococcus pyogenes and Staphylococcus aureus were the two commonly isolated bacteria. Methicillin-resistant Staphylococcus aureus was implicated in a relatively small number of cases. Shock, renal failure, coagulation abnormality and multi-organ dysfunction were common complications. More than 90% of patients underwent surgical debridement, 56% were admitted to an intensive care unit (ICU and slightly less than half of all patients had blood product transfusion. One in six NF cases had amputations and 23.5% died. Conclusion This chart review found that the highest proportion of NF cases was elderly males with co-morbidities, particularly diabetes and obesity. Tattooing was an uncommon precipitating event. The role of NSAID needs further exploration. NF is a serious disease with severe complications, high case fatality and considerable use of health care resources.

  18. Pathways to Suicide in Australian Farmers: A Life Chart Analysis.

    Science.gov (United States)

    Kunde, Lisa; Kõlves, Kairi; Kelly, Brian; Reddy, Prasuna; De Leo, Diego

    2017-03-28

    Farmers have been found to be at increased risk of suicide in Australia. The Interpersonal-Psychological Theory of Suicidal Behaviour suggests that the proximal factors leading to the suicidal desire or ideation include an individual's experiences of both perceived burdensomeness and thwarted belongingness. Suicidal desire with acquired capability to engage in lethal self-injury is predictive of suicidal behaviour. This study investigates the pathways to suicide of 18 Australian male farmers in order to understand the suicidal process and antecedents to suicide in Australian male farmers. The psychological autopsy (PA) method was used to generate life charts. Two pathways with distinct suicidal processes were identified: acute situational (romantic relationship problems and financial concerns/pending retirement) and protracted (long-term psychiatric disorder). Long working hours, interpersonal conflicts, physical illnesses and pain, alcohol abuse, access to firearms, and exposure to drought were additional common factors identified. An understanding of the interrelatedness of diverse distal and proximal risk factors on suicidal pathways in the wider environmental context for male farmers is required when developing and implementing rural suicide prevention activities.

  19. SU-E-T-408: Evaluation of the Type and Frequency of Variations Discovered During Routine Secondary Patient Chart Review

    International Nuclear Information System (INIS)

    Hardin, M; Harrison, A; Lockamy, V; Li, J; Peng, C; Potrebko, P; Yu, Y; Doyle, L; Cao, J

    2015-01-01

    Purpose: Desire to improve efficiency and throughput inspired a review of our physics chart check procedures. Departmental policy mandates plan checks pre-treatment, after first treatment and weekly every 3–5 days. This study examined the effectiveness of the “after first” check with respect to improving patient safety and clinical efficiency. Type and frequency of variations discovered during this redundant secondary review was examined over seven months. Methods: A community spreadsheet was created to record variations in care discovered during chart review following the first fraction of treatment and before the second fraction (each plan reviewed prior to treatment). Entries were recorded from August 2014 through February 2015, amounting to 43 recorded variations out of 906 reviewed charts. The variations were divided into categories and frequencies were assessed month-to-month. Results: Analysis of recorded variations indicates an overall variation rate of 4.7%. The initial rate was 13.5%; months 2–7 average 3.7%. The majority of variations related to discrepancies in documentation at 46.5%, followed by prescription, plan deficiency, and dose tracking related variations at 25.5%, 12.8%, and 12.8%, respectively. Minor variations (negligible consequence on patient treatment) outweighed major variations 3 to 1. Conclusion: This work indicates that this redundant secondary check is effective. The first month spike in rates could be due to the Hawthorne/observer effect, but the consistent 4% variation rate suggests the need for periodical re-training on variations noted as frequent to improve awareness and quality of the initial chart review process, which may lead to improved treatment quality, patient safety and increased clinical efficiency. Utilizing these results, a continuous quality improvement process following Deming’s Plan-Do-Study-Act (PDSA) methodology was generated. The first iteration of this PDSA was adding a specific dose tracking

  20. Automated chart review utilizing natural language processing algorithm for asthma predictive index.

    Science.gov (United States)

    Kaur, Harsheen; Sohn, Sunghwan; Wi, Chung-Il; Ryu, Euijung; Park, Miguel A; Bachman, Kay; Kita, Hirohito; Croghan, Ivana; Castro-Rodriguez, Jose A; Voge, Gretchen A; Liu, Hongfang; Juhn, Young J

    2018-02-13

    Thus far, no algorithms have been developed to automatically extract patients who meet Asthma Predictive Index (API) criteria from the Electronic health records (EHR) yet. Our objective is to develop and validate a natural language processing (NLP) algorithm to identify patients that meet API criteria. This is a cross-sectional study nested in a birth cohort study in Olmsted County, MN. Asthma status ascertained by manual chart review based on API criteria served as gold standard. NLP-API was developed on a training cohort (n = 87) and validated on a test cohort (n = 427). Criterion validity was measured by sensitivity, specificity, positive predictive value and negative predictive value of the NLP algorithm against manual chart review for asthma status. Construct validity was determined by associations of asthma status defined by NLP-API with known risk factors for asthma. Among the eligible 427 subjects of the test cohort, 48% were males and 74% were White. Median age was 5.3 years (interquartile range 3.6-6.8). 35 (8%) had a history of asthma by NLP-API vs. 36 (8%) by abstractor with 31 by both approaches. NLP-API predicted asthma status with sensitivity 86%, specificity 98%, positive predictive value 88%, negative predictive value 98%. Asthma status by both NLP and manual chart review were significantly associated with the known asthma risk factors, such as history of allergic rhinitis, eczema, family history of asthma, and maternal history of smoking during pregnancy (p value NLP-API and abstractor, and the effect sizes were similar between the reviews with 4.4 vs 4.2 respectively. NLP-API was able to ascertain asthma status in children mining from EHR and has a potential to enhance asthma care and research through population management and large-scale studies when identifying children who meet API criteria.

  1. Ileus in children presenting with diarrhea and severe acute malnutrition: A chart review.

    Directory of Open Access Journals (Sweden)

    Mohammod Jobayer Chisti

    2017-05-01

    Full Text Available Severely malnourished children aged under five years requiring hospital admission for diarrheal illness frequently develop ileus during hospitalization with often fatal outcomes. However, there is no data on risk factors and outcome of ileus in such children. We intended to evaluate predictive factors for ileus during hospitalization and their outcomes.This was a retrospective chart review that enrolled severely malnourished children under five years old with diarrhea, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh between April 2011 and August 2012. We used electronic database to have our chart abstraction from previously admitted children in the hospital. The clinical and laboratory characteristics of children with (cases = 45, and without ileus (controls = 261 were compared. Cases were first identified by observation of abnormal bowel sounds on physical examination and confirmed with abdominal radiographs. For this comparison, Chi-square test was used to measure the difference in proportion, Student's t-test to calculate the difference in mean for normally distributed data and Mann-Whitney test for data that were not normally distributed. Finally, in identifying independent risk factors for ileus, logistical regression analysis was performed. Ileus was defined if a child developed abdominal distension and had hyperactive or sluggish or absent bowel sound and a radiologic evidence of abdominal gas-fluid level during hospitalization. Logistic regression analysis adjusting for potential confounders revealed that the independent risk factors for admission for ileus were reluctance to feed (odds ratio [OR] = 3.22, 95% confidence interval [CI] = 1.24-8.39, p = 0.02, septic shock (OR = 3.62, 95% CI = 1.247-8.95, p<0.01, and hypokalemia (OR = 1.99, 95% CI = 1.03-3.86, p = 0.04. Mortality was significantly higher in cases compared to controls (22% vs. 8%, p<0.01 in univariate analysis; however

  2. Patterns in Patient Access and Utilization of Online Medical Records: Analysis of MyChart.

    Science.gov (United States)

    Redelmeier, Donald A; Kraus, Nicole C

    2018-02-06

    Electronic patient portals provide a new method for sharing personal medical information with individual patients. Our aim was to review utilization patterns of the largest online patient portal in Canada's largest city. We conducted a 4-year time-trend analysis of aggregated anonymous utilization data of the MyChart patient portal at Sunnybrook Health Sciences Centre in Ontario, Canada, from January 1, 2012, through December 31, 2015. Prespecified analyses examined trends related to day (weekend vs weekday), season (July vs January), year (2012 vs 2015), and an extreme adverse weather event (ice storm of December 20-26, 2013). Primary endpoints included three measures of patient portal activity: registrations, logins, and pageviews. We identified 32,325 patients who registered for a MyChart account during the study interval. Time-trend analysis showed no sign of attenuating registrations over time. Logins were frequent, averaged 734 total per day, and showed an increasing trend over time. Pageviews mirrored logins, averaged about 3029 total per day, and equated to about 5 pageviews during the average login. The most popular pageviews were clinical notes, followed by laboratory results and medical imaging reports. All measures of patient activity were lower on weekends compared to weekdays (Pmalware attack, or software failure occurred during the study. Online patient portals can provide a popular and reliable system for distributing personal medical information to active patients and may merit consideration for hospitals. ©Donald A Redelmeier, Nicole C Kraus. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 06.02.2018.

  3. Clozapine Treatment and Cannabis Use in Adolescents with Psychotic Disorders – A Retrospective Cohort Chart Review

    Science.gov (United States)

    Tang, Sephora M.; Ansarian, Aylar; Courtney, Darren B.

    2017-01-01

    Objectives To examine the association between clozapine treatment and frequency of cannabis use in adolescents with co-occurring psychotic and cannabis use disorder in a retrospective cohort chart review. Method We conducted a retrospective cohort chart review of patients diagnosed with a psychotic disorder and concurrent cannabis use disorder admitted to a tertiary care youth inpatient unit from 2010–2012. Longitudinal exposure and outcome data was coded month-by-month. Frequency of cannabis use was measured using a 7-point ordinal scale. Severity of psychosis was measured on a 3-point ordinal scale. Mixed effects regression modeling was used to describe the relationship between exposure and outcome variables. Results Thirteen patients had exposure to clozapine and fourteen had no exposure to clozapine. Cannabis use decreased in patients treated with clozapine, compared to patients treated with other antipsychotics (OR 2.8; 95% CI 0.97–7.9). Compared to no medication, clozapine exposure was associated with significantly less cannabis use (OR 7.1; 95% CI 2.3–22.3). Relative to treatment with other antipsychotics, clozapine exposure was significantly associated with lower severity of psychotic symptoms (OR 3.7; 95% CI 1.2–11.8). Conclusions Clozapine may lead to decreased cannabis use and psychotic symptoms in adolescents with concurrent psychosis and substance use. Clinical trials are warranted. PMID:28331504

  4. Clozapine Treatment and Cannabis Use in Adolescents with Psychotic Disorders - A Retrospective Cohort Chart Review.

    Science.gov (United States)

    Tang, Sephora M; Ansarian, Aylar; Courtney, Darren B

    2017-01-01

    To examine the association between clozapine treatment and frequency of cannabis use in adolescents with co-occurring psychotic and cannabis use disorder in a retrospective cohort chart review. We conducted a retrospective cohort chart review of patients diagnosed with a psychotic disorder and concurrent cannabis use disorder admitted to a tertiary care youth inpatient unit from 2010-2012. Longitudinal exposure and outcome data was coded month-by-month. Frequency of cannabis use was measured using a 7-point ordinal scale. Severity of psychosis was measured on a 3-point ordinal scale. Mixed effects regression modeling was used to describe the relationship between exposure and outcome variables. Thirteen patients had exposure to clozapine and fourteen had no exposure to clozapine. Cannabis use decreased in patients treated with clozapine, compared to patients treated with other antipsychotics (OR 2.8; 95% CI 0.97-7.9). Compared to no medication, clozapine exposure was associated with significantly less cannabis use (OR 7.1; 95% CI 2.3-22.3). Relative to treatment with other antipsychotics, clozapine exposure was significantly associated with lower severity of psychotic symptoms (OR 3.7; 95% CI 1.2-11.8). Clozapine may lead to decreased cannabis use and psychotic symptoms in adolescents with concurrent psychosis and substance use. Clinical trials are warranted.

  5. Timing of Physical Therapy Referral in Adolescent Athletes With Acute Spondylolysis: A Retrospective Chart Review.

    Science.gov (United States)

    Selhorst, Mitchell; Fischer, Anastasia; Graft, Kristine; Ravindran, Reno; Peters, Eric; Rodenberg, Richard; Welder, Eric; MacDonald, James

    2017-05-01

    The purposes of this study were (1) to determine whether the duration of rest before referral to physical therapy (PT) affects the time to make a full return to activity for patients with an acute spondylolysis, (2) to assess the safety of an early referral to PT in patients with an acute spondylolysis. Retrospective chart review. Hospital-based sports medicine clinic. The medical charts of 196 adolescent athletes (mean age = 14.3 ± 1.8 years) with an acute spondylolytic injury met the inclusion criteria and were reviewed. Patients were subgrouped based on physician referral to PT. An aggressive referral group (10 weeks). Duration of rest before clearance to a full return to activity and the frequency of adverse reactions during the course of treatment. Safety was assessed by calculating the risk of experiencing an adverse reaction in each group. Median days to a full return to activity for aggressive referral group (115.5 days, interquartile range 98-150 days) and conservative referral group (140.0 days, interquartile range 114.5-168 days) were significantly different (P = 0.002). Eleven patients had adverse reactions during the course of treatment. The risk of adverse reaction was not statistically significant between groups (P = 0.509). Patients with acute spondylolysis in the aggressive referral group were able to make a full return activity almost 25 days sooner. No differences in the risk of adverse reactions were noted between aggressive and conservative referral groups.

  6. Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review.

    Science.gov (United States)

    Jusela, Cheryl; Struble, Laura; Gallagher, Nancy Ambrose; Redman, Richard W; Ziemba, Rosemary A

    2017-03-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review" found on pages 19-28, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until February 29, 2020. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Discuss problematic barriers during care transitions

  7. A critical review of the hypothesis of a medieval origin for portolan charts

    NARCIS (Netherlands)

    Nicolai, R.

    2014-01-01

    Portolan charts are nautical charts, which appear suddenly in the thirteenth century Mediterranean world, without any discernable development path or predecessors. These charts are remarkable for the high degree of realism and accuracy with which they render the coastlines of their core coverage

  8. A scoping review of the potential for chart stimulated recall as a clinical research method.

    Science.gov (United States)

    Sinnott, Carol; Kelly, Martina A; Bradley, Colin P

    2017-08-22

    Chart-stimulated recall (CSR) is a case-based interviewing technique, which is used in the assessment of clinical decision-making in medical education and professional certification. Increasingly, clinical decision-making is a concern for clinical research in primary care. In this study, we review the prior application and utility of CSR as a technique for research interviews in primary care. Following Arksey & O'Malley's method for scoping reviews, we searched seven databases, grey literature, reference lists, and contacted experts in the field. We excluded studies on medical education or competence assessment. Retrieved citations were screened by one reviewer and full texts were ordered for all potentially relevant abstracts. Two researchers independently reviewed full texts and performed data extraction and quality appraisal if inclusion criteria were met. Data were collated and summarised using a published framework on the reporting of qualitative interview techniques, which was chosen a priori. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines informed the review report. From an initial list of 789 citations, eight studies using CSR in research interviews were included in the review: six from North America, one from the Netherlands, and one from Ireland. The most common purpose of included studies was to examine the influence of guidelines on physicians' decisions. The number of interviewees ranged from seven to twenty nine, while the number of charts discussed per interview ranged from one to twelve. CSR gave insights into physicians' reasoning for actions taken or not taken; the unrecorded social and clinical influences on decisions; and discrepancies between physicians' real and perceived practice. Ethical concerns and the training and influence of the researcher were poorly discussed in most of the studies. Potential pitfalls included the risk of recall, selection and observation biases. Despite the proven validity

  9. Supracricoid hemilaryngopharyngectomy for selected pyriform sinus carcinoma patients – a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Yiotakis Ioannis E

    2009-08-01

    Full Text Available Abstract Background The aim of this study is to assess the functional and oncologic results of supracricoid hemilaryngopharyngectomy and report our experience in the technique, local control and overall survival rates. Materials and methods 18 selected patients with pyriform sinus cancer treated by supracricoid hemilaryngopharyngectomy in a University Hospital setting. Retrospective chart review was used to assess functional and oncologic results of the procedure. Results The actuarial 5 year survival rate in our study was 55.56% and the actuarial neck recurrence rate was 16.67%. All patients were successfully decannulated. Aspiration pneumonia was the most common postoperative complication (22.23% and was treated mostly conservatively. One patient required a temporary gastrostomy but no patient needed total laryngectomy in the postoperative period. Conclusion Supracricoid hemilaryngopharyngectomy in experienced hands is a reliable technique for selected patients with pyriform sinus cancer.

  10. A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study

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    Carl Magnus Sköld

    2016-07-01

    Full Text Available Background: Idiopathic pulmonary fibrosis (IPF is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. Methods: This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs were collected from medical charts. Results: Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1 [mean (SD], diffusion capacity (DLco was 45.1% (13.8 of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1 to FVC was 0.78 (0.1. The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Conclusion: Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a

  11. A retrospective chart review study to describe selected zoonotic and arboviral etiologies in hospitalized febrile patients in the Republic of Armenia.

    Science.gov (United States)

    Paronyan, Lusine; Zardaryan, Eduard; Bakunts, Vahe; Gevorgyan, Zaruhi; Asoyan, Vigen; Apresyan, Hripsime; Hovhannisyan, Alvard; Palayan, Karo; Bautista, Christian T; Kuchuloria, Tinatin; Rivard, Robert G

    2016-08-24

    Scant information is available on the infectious causes of febrile illnesses in Armenia. The goal of this study was to describe the most common causes, with a focus on zoonotic and arboviral infections and related epidemiological and clinical patterns for hospitalized patients with febrile illnesses of infectious origin admitted to Nork Infectious Diseases Clinical Hospital, the referral center for infectious diseases in the capital city, Yerevan. A chart review study was conducted in 2014. Data were abstracted from medical charts of adults (≥18 years) with a fever (≥38 °C), who were hospitalized (for ≥24 h) in 2010-2012. Of the 600 patients whose charts were analyzed, 76 % were from Yerevan and 51 % were male; the mean age (± standard deviation) was 35.5 (±16) years. Livestock exposure was recorded in 5 % of charts. Consumption of undercooked meat and unpasteurized dairy products were reported in 11 and 8 % of charts, respectively. Intestinal infections (51 %) were the most frequently reported final medical diagnoses, followed by diseases of the respiratory system (11 %), infectious mononucleosis (9.5 %), chickenpox (8.3 %), brucellosis (8.3 %), viral hepatitis (3.2 %), and erysipelas (1.5 %). Reviewed medical charts included two cases of fever of unknown origin (FUO), two cutaneous anthrax cases, two leptospirosis cases, three imported malaria cases, one case of rickettsiosis, and one case of rabies. Engagement in agricultural activities, exposure to animals, consumption of raw or unpasteurized milk, and male gender were significantly associated with brucellosis. Our analysis indicated that brucellosis was the most frequently reported zoonotic disease among hospitalized febrile patients. Overall, these study results suggest that zoonotic and arboviral infections were not common etiologies among febrile adult patients admitted to the Nork Infectious Diseases Clinical Hospital in Armenia.

  12. Aging Chart: a community resource for rapid exploratory pathway analysis of age-related processes.

    Science.gov (United States)

    Moskalev, Alexey; Zhikrivetskaya, Svetlana; Shaposhnikov, Mikhail; Dobrovolskaya, Evgenia; Gurinovich, Roman; Kuryan, Oleg; Pashuk, Aleksandr; Jellen, Leslie C; Aliper, Alex; Peregudov, Alex; Zhavoronkov, Alex

    2016-01-04

    Aging research is a multi-disciplinary field encompassing knowledge from many areas of basic, applied and clinical research. Age-related processes occur on molecular, cellular, tissue, organ, system, organismal and even psychological levels, trigger the onset of multiple debilitating diseases and lead to a loss of function, and there is a need for a unified knowledge repository designed to track, analyze and visualize the cause and effect relationships and interactions between the many elements and processes on all levels. Aging Chart (http://agingchart.org/) is a new, community-curated collection of aging pathways and knowledge that provides a platform for rapid exploratory analysis. Building on an initial content base constructed by a team of experts from peer-reviewed literature, users can integrate new data into biological pathway diagrams for a visible, intuitive, top-down framework of aging processes that fosters knowledge-building and collaboration. As the body of knowledge in aging research is rapidly increasing, an open visual encyclopedia of aging processes will be useful to both the new entrants and experts in the field. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

  13. Treatment patterns in patients with osteoporosis at high risk of fracture in Japan: retrospective chart review.

    Science.gov (United States)

    Fujiwara, Saeko; Miyauchi, Akimitsu; Hamaya, Etsuro; Nicholls, Rebecca Jayne; Weston, Adele; Baidya, Santwona; Pinto, Lionel; Barron, Rich; Takada, Junichi

    2018-03-22

    Osteoporosis (OP) causes reduced bone strength and increases risk of fractures. Medical records from specialist clinics in Japan of postmenopausal women with OP and high risk of fracture were analysed. Majority of patients were treated for OP as recommended and were prescribed OP medications soon after high-risk OP diagnosis. The incidence of osteoporosis (OP) in Japan is predicted to increase significantly in coming decades. Resultant osteoporotic fractures are a significant contributor of economic and social burden among elderly osteoporosis patients. This retrospective chart review was conducted as a response to the current evidence gap in the treatment patterns for OP patients with high risk of fracture in Japan. This was a multi-centre retrospective chart review that analysed data extracted from the medical records of postmenopausal OP patients at high risk for fracture who received care at 11 specialist clinics and medical centers in Japan for at least 18 to 24 months. Main outcome was OP treatment patterns. The study included 709 eligible patients of whom 623 (87.9%) were prescribed OP medication during the study period. The most common reason for not taking OP medication was patient unwillingness to take medication. The most common OP medications prescribed initially were minodronic acid (20.1%), alendronate (19.9%), raloxifene (14.1%), weekly teriparatide acetate (12.4%) and eldecalcitol (11.4%). Majority of patients (62.1%) were still taking their initial medication at the end of the 18-24 month follow-up. A high percentage of patients (87.9%) in Japan received OP medications soon after their high-risk diagnosis, with bisphosphonates, selective estrogen receptor modulators and teriparatide being the predominant treatment options.

  14. "Waiting for DAAs": A retrospective chart review of patients with untreated hepatitis C in Rwanda.

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    Neil Gupta

    Full Text Available Access to treatment for hepatitis C virus (HCV in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs, highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs.We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda. Patient charts at these centers were reviewed, and routinely collected data were recorded and analyzed. Overall, 253 patients were identified; median age was 56 years (IQR: 43, 65, and 149 (58.9% were female. Median viral load was 688,736 IU/ml and 96.7% were HCV genotype 4. As classified by FIB-4 score, 64.8% of the patients had moderate to severe fibrosis. Fibrosis stage was associated with age (OR 1.12, CI 1.09-1.17, but not with time since diagnosis, gender, treatment center, or type of insurance. There was a low frequency of documented co-morbid conditions, including hypertension, diabetes, HIV, and hepatitis B virus.Compared to an estimated 55,000 patients eligible for HCV treatment in Rwanda, this study identified only 253 patients currently diagnosed and engaged in care, highlighting an immense treatment gap in HCV, likely due to the lack of accessible and affordable screening, diagnostic, and treatment modalities. The patients that were enrolled in care had a disproportionately advanced fibrosis stage, possibly indicating late presentation to care or lack of treatment options. In the context of newly available and effective treatment options, this study supports the overall need to accelerate access to HCV screening, diagnostics, and care and treatment services in resource-limited settings in sub-Saharan Africa.

  15. High risk use of OTC NSAIDs and ASA in family medicine: A retrospective chart review.

    Science.gov (United States)

    Hamilton, Kevin; Davis, Christine; Falk, Jamie; Singer, Alex; Bugden, Shawn

    2015-01-01

    Complications associated with the use of NSAIDs, antiplatelet agents, and anticoagulants are among the top causes of preventable drug-related ER visits, hospitalizations and death. Although over-the-counter (OTC) NSAIDs and ASA also contribute to this preventable risk, it is unclear how well these medications are documented in primary care records. A retrospective electronic and paper chart review was conducted to evaluate the prevalence of 13 evidence-based high-risk prescriptions and the contribution of OTC NSAIDs and ASA to these potentially inappropriate prescriptions (PIPs). Of the 148 patients included in the review, ASA was taken by 117 patients (79%) while OTC NSAIDs were taken by 36 (24%). OTC NSAIDs were never documented within the "medication" section of the electronic record, whereas ASA was documented in 65 (56%) cases. Eighty percent (118/148) taking either OTC NSAIDs or ASA were identified as having at least one PIP. OTC NSAIDs and ASA are widely available and are commonly taken without the knowledge of the prescriber. These medications contribute to the overall risk of bleeding. Review and documentation of OTC NSAIDs and ASA use should be part of all relevant patient encounters when prescribing NSAIDs, antiplatelets and anticoagulants.

  16. Reading charts in ophthalmology.

    Science.gov (United States)

    Radner, W

    2017-08-01

    A new generation of logarithmic reading charts has sparked interest in standardized reading performance analyses. Such reading charts have been developed according to the standards of the International Council of Ophthalmology. The print size progression in these calibrated charts is in accordance with the mathematical background of EN ISO 8596. These reading charts are: the Bailey-Lovie Word Reading Chart, the Colenbrander English Continuous Text Near Vision Cards, the Oculus Reading Probe II, the MNREAD Charts, the SKread Charts, and the RADNER Reading Charts. The test items used for these reading charts differ among the charts and are standardized to various extents. The Bailey-Lovie Charts, MNREAD Charts, SKread Charts, and RADNER Charts are also meant to measure reading speed and allow determination of further reading parameters such as reading acuity, reading speed based on reading acuity, critical print size, reading score, and logMAR/logRAD ratio. Such calibrated reading charts have already provided valuable insights into the reading performance of patients in many research studies. They are available in many languages and thus facilitate international communication about near visual performance. In the present review article, the backgrounds of these modern reading charts are presented, and their different levels of test-item standardization are discussed. Clinical research studies are mentioned, and a discussion about the immoderately high number of reading acuity notations is included. Using the logReading Acuity Determination ([logRAD] = reading acuity equivalent of logMAR) measure for research purposes would give reading acuity its own identity as a standardized reading parameter in ophthalmology.

  17. Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy.

    Science.gov (United States)

    F, Linda; Lutfiyya, May N; Cha, Isaac; El-Khabiry, Ehab

    2007-01-01

    To determine the prescribing patterns of family medicine residents for patients aged more than 60 years with 2 or more chronic diseases and seen at least twice in a 12 month timeframe. This is a descriptive analysis which was based on chart reviews. The setting was the University of Illinois-Rockford Family Practice Residency. Patients aged 60 years with 2 or more chronic diseases who were seen at least twice by second and third year residents. FINDINGS FROM THIS CHART REVIEW INCLUDE: 28.8% of the prescribed medications were not effective for the documented condition, 26.3% of the prescribed doses were incorrect, and 44.5% of the drugs prescribed were not the least expensive alternative. This preliminary study suggests a need for a focused intervention with family medicine residents regarding inappropriate polypharmacy issues with older patients.

  18. Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy

    Directory of Open Access Journals (Sweden)

    Chang LF

    2007-06-01

    Full Text Available Objective: To determine the prescribing patterns of family medicine residents for patients aged more than 60 years with 2 or more chronic diseases and seen at least twice in a 12 month timeframe.Methods: This is a descriptive analysis which was based on chart reviews. The setting was the University of Illinois-Rockford Family Practice Residency. Patients aged 60 years with 2 or more chronic diseases who were seen at least twice by second and third year residents.Results: Findings from this chart review include: 28.8% of the prescribed medications were not effective for the documented condition, 26.3% of the prescribed doses were incorrect, and 44.5% of the drugs prescribed were not the least expensive alternative.Discussion: This preliminary study suggests a need for a focused intervention with family medicine residents regarding inappropriate polypharmacy issues with older patients.

  19. Control Charts in Healthcare Quality Improvement A Systematic Review on Adherence to Methodological Criteria

    NARCIS (Netherlands)

    Koetsier, A.; van der Veer, S. N.; Jager, K. J.; Peek, N.; de Keizer, N. F.

    2012-01-01

    Objectives: Use of Shewhart control charts in quality improvement (QI) initiatives is increasing. These charts are typically used in one or more phases of the Plan Do Study Act (PDSA) cycle to monitor summaries of process and outcome data, abstracted from clinical information systems, over time. We

  20. Mapping Long Noncoding RNA Chromatin Occupancy Using Capture Hybridization Analysis of RNA Targets (CHART).

    Science.gov (United States)

    Vance, Keith W

    2017-01-01

    Capture Hybridization Analysis of RNA Targets (CHART) has recently been developed to map the genome-wide binding profile of chromatin-associated RNAs. This protocol uses a small number of 22-28 nucleotide biotinylated antisense oligonucleotides, complementary to regions of the target RNA that are accessible for hybridization, to purify RNAs from a cross-linked chromatin extract. RNA-chromatin complexes are next immobilized on beads, washed, and specifically eluted using RNase H. Associated genomic DNA is then sequenced using high-throughput sequencing technologies and mapped to the genome to identify RNA-chromatin associations on a large scale. CHART-based strategies can be applied to determine the nature and extent of long noncoding RNA (long ncRNA) association with chromatin genome-wide and identify direct long ncRNA transcriptional targets.

  1. Parenteral nutrition prescribing pattern: a medical chart review of 191 preterm infants.

    Science.gov (United States)

    Turpin, Robin S; Liu, Frank Xiaoqing; Prinz, Matt; Macahilig, Cynthia; Malinoski, Frank

    2013-04-01

    In 2005, the European Society for Clinical Nutrition and Metabolism released guidelines for the use of pediatric parenteral nutrition (PN). The purpose of this study was to compare PN prescribing patterns in preterm infants with current guideline recommendations. Six neonatologists in Germany conducted observational, retrospective medical chart reviews on preterm infants <28 days postnatal, hospitalized from October 2009 to April 2011. Infants with a complete medical record who received PN for a minimum of 4 days were enrolled. Patient weight and the change in daily amino acids and intravenous fat emulsion (IVFE) doses administered for the first 7 days of life were abstracted. Median data were used to determine quartiles to compare study results with the current guidelines. Only 30% of patients met current guidelines that recommend all preterm infants receive amino acids on the first day of life. When amino acids were given, the dose was lower than recommended in the current guidelines. The start of IVFE by day 3 of life was given only to 34% of patients despite the guideline recommendation of 100%. This study identified several gaps between the current guidelines and patient care that should be explored further.

  2. A Retrospective Chart Review of 10 Hz Versus 20 Hz Repetitive Transcranial Magnetic Stimulation for Depression

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    Kristie L. DeBlasio

    2012-12-01

    Full Text Available We performed a retrospective chart review to examine the progress of patients with depression who received different frequencies of repetitive transcranial magnetic stimulation (rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC. rTMS is a safe and effective alternative treatment for patients with various psychological and medical conditions. During treatment, a coil delivering a time-varying magnetic pulse placed over the scalp penetrates the skull, resulting in clinical improvement. There were 47 patients and three distinct treatment groups found: 10 Hz, 20 Hz, and a separate group who received both frequencies (10/20 Hz. The primary outcome indicator was the difference in Beck Depression Inventory–II (BDI-II scores. Secondary outcomes included categorical indicators of remission, response, and partial response rates as assessed with the BDI-II. In all 3 groups, the majority of patients had depression that remitted, with the highest rate occurring in the 20 Hz group. There were similar response rates in the 10 Hz and 20 Hz groups. There were no patients in the 10/20 Hz group whose depression responded and the highest partial response and nonresponse rates occurred in this group. Although within-group differences were significant from baseline to end of treatment, there were no between-group differences.

  3. Baclofen as prophylaxis and treatment for alcohol withdrawal: a retrospective chart review.

    Science.gov (United States)

    Stallings, William; Schrader, Stuart

    2007-09-01

    Current standard of care for alcohol withdrawal is accomplished using benzodiazepines. There are no recommendations for prophylaxis of alcohol withdrawal in high risk populations. Baclofen has been studied for the treatment of alcohol withdrawal, but current research is limited. To determine if baclofen is an effective measure for prophylaxis and treatment of alcohol withdrawal in high risk populations upon admission to hospital wards. Design, Setting, Patients - Retrospective chart review of 42 inpatients at St. Anthony Hospital from November 2004 to April 2005. Patients were included if they were determined to be at risk for alcohol withdrawal. Patients were then divided into categories of prophylactic success versus failure and treatement success versus failure based on DSM-IV criteria for alcohol withdrawal. 17 patients were included in the study. 12 were categorized as prophylactic success and 2 were categorized as prophylactic failure. There was one treatment success and two treatment failures. The result was an 86% prophylactic success rate. Baclofen has potential in the prophylaxis of alcohol withdrawal. It is difficult to determine the clinical significance for the numbers found in this study. There are no prior studies for alcohol prophylaxis to compare what would be an acceptable success rate. Further studies that are double-blinded placebo controlled are needed to support or refute the usefulness of baclofen for alcohol withdrawal.

  4. Methadone for the treatment of Prescription Opioids Dependence. A retrospective chart review.

    Science.gov (United States)

    Barrio, Pablo; Ezzeldin, Mohamed; Bruguera, Pol; Pérez, Ana; Mansilla, Sara; Fàbrega, Marina; Lligoña, Anna; Mondón, Sílvia; Balcells, Mercè

    2016-06-14

    Prescription opioids (PO) addiction is increasing to an epidemic level. Few studies exist regarding its treatment. Although buprenorphine has been the mainstay so far, other treatment options might be considered, such as methadone. We conducted a retrospective assessment of all patients admitted to a psychiatry ward for PO detoxification using methadone between 2010 and 2013. The assessment and description was carried out during a 3-month follow-up period after their discharge. Although this is a retrospective chart review, our exploration included sociodemographic and treatment variables in addition to the abstinence rates for the whole sample. Eleven patients were included, mostly women (81.8%), with a median age of 50 years. The median duration of dependence was 8 years. Dependence on other substances and psychiatric comorbidities were high. Eight patients were monitored during three months. Of these, 7 (87.5%) were abstinent after that period. The results suggest that methadone deserves further exploration as a potentially efficacious treatment option for PO dependence.

  5. Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

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    Mosam Phirke

    2015-01-01

    Full Text Available Background: Electroconvulsive therapy (ECT is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014, and it was observed that 23 elderly patients (aged ≥60 years had received ECT. Results: The patients received modified bitemporal ECT using a brief pulse ECT machine and had no major complications. A total of 184 ECT treatments were administered at an average of 8 treatments per case. The major diagnoses of patients were schizophrenia and major depression. The main indications of ECT were intolerance to medication, suicidal behavior and aggression. Out of the 23 elderly patients, 18 (78.26% showed a good response to ECT. The only complication noted was memory loss and confusion in 3 cases. Patients with medical illnesses like hypertension, diabetes and both together received ECT without any complications. Conclusions: This study adds to the scarce database on the use of ECT in elderly patients in India and adds evidence to the fact that ECT is a safe and effective treatment in the elderly.

  6. Treatment Changes in Patients With Moderate to Severe Psoriasis: A Retrospective Chart Review.

    Science.gov (United States)

    Smith, Jaclyn A; Wehausen, Brooke; Richardson, Irma; Zhao, Yang; Li, Yunfeng; Herrera, Vivian; Feldman, Steven R

    Psoriasis treatment involves topical medications, oral medications, phototherapy, and/or biologics. The treatments used depend on a myriad of factors that change over time. To characterise the frequency of and reasons for treatment changes in patients with moderate to severe psoriasis. A chart review examined treatment changes at 902 visits by 116 patients seen between January 1, 2010, and June 30, 2015, for moderate to severe psoriasis and the physicians' justifications for those changes. 'Treatment change' was defined as switching between, adding, or removing medication classes or switching within the oral or biologic class. There were 221 visits with treatment changes identified, and a change occurred every 4.1 visits. On average, there were 1.2 treatment changes per year. Patients treated for at least 1 year averaged 1 treatment change every 16 months. The most common type of change was from one biologic to another biologic (24.9%), followed by adding a nonbiologic to a biologic (18.6%). The most common reason for switching was poor control or flare of psoriasis. Affordability was a more common problem for biologics than for nonbiologic treatments. Biologic treatment options provide a major improvement over older systemic treatments, but patients still undergo frequent treatment changes to help control their disease.

  7. Analgesic requirements and postoperative recovery after scheduled compared to unplanned cesarean delivery: a retrospective chart review.

    Science.gov (United States)

    Carvalho, B; Coleman, L; Saxena, A; Fuller, A J; Riley, E T

    2010-01-01

    Studies examining the effects of various analgesics and anesthetics on postoperative pain following cesarean delivery conventionally use the scheduled cesarean population. This study compares postoperative analgesic requirements and recovery profiles in women undergoing scheduled cesarean compared to unplanned cesarean delivery following labor. We postulated that unplanned cesarean deliveries may increase postoperative analgesic requirements. We conducted a retrospective chart review of 200 cesarean deliveries at Lucile Packard Children's Hospital, California. We examined the records of 100 patients who underwent scheduled cesarean delivery under spinal anesthesia (hyperbaric bupivacaine 12 mg with intrathecal fentanyl 10 microg and morphine 200 microg) and 100 patients that following a trail of labor required unplanned cesarean under epidural anesthesia (10-25 mL 2% lidocaine top-up with epidural morphine 4 mg after clamping of the umbilical cord). We recorded pain scores, analgesic consumption, time to first analgesic request, side effects, and length of hospital stay. We found no differences in postoperative pain scores and analgesic consumption between scheduled and unplanned cesarean deliveries for up to five days postoperatively. There were no differences in treatment of side effects such as nausea, vomiting, or pruritus (P>0.05). The results indicate that women experience similar pain and analgesic requirements after scheduled compared to unplanned cesarean delivery. This suggests that the non-scheduled cesarean population may be a suitable pain model to study pain management strategies; and that alterations in pain management are not necessary for the unplanned cesarean delivery population. Copyright 2009 Elsevier Ltd. All rights reserved.

  8. Charlson comorbidity index derived from chart review or administrative data: agreement and prediction of mortality in intensive care patients.

    Science.gov (United States)

    Stavem, Knut; Hoel, Henrik; Skjaker, Stein Arve; Haagensen, Rolf

    2017-01-01

    This study compared the Charlson comorbidity index (CCI) information derived from chart review and administrative systems to assess the completeness and agreement between scores, evaluate the capacity to predict 30-day and 1-year mortality in intensive care unit (ICU) patients, and compare the predictive capacity with that of the Simplified Acute Physiology Score (SAPS) II model. Using data from 959 patients admitted to a general ICU in a Norwegian university hospital from 2007 to 2009, we compared the CCI score derived from chart review and administrative systems. Agreement was assessed using % agreement, kappa, and weighted kappa. The capacity to predict 30-day and 1-year mortality was assessed using logistic regression, model discrimination with the c -statistic, and calibration with a goodness-of-fit statistic. The CCI was complete (n=959) when calculated from chart review, but less complete from administrative data (n=839). Agreement was good, with a weighted kappa of 0.667 (95% confidence interval: 0.596-0.714). The c -statistics for categorized CCI scores from charts and administrative data were similar in the model that included age, sex, and type of admission: 0.755 and 0.743 for 30-day mortality, respectively, and 0.783 and 0.775, respectively, for 1-year mortality. Goodness-of-fit statistics supported the model fit. The CCI scores from chart review and administrative data showed good agreement and predicted 30-day and 1-year mortality in ICU patients. CCI combined with age, sex, and type of admission predicted mortality almost as well as the physiology-based SAPS II.

  9. Benefits and risk of sodium oxybate in idiopathic hypersomnia versus narcolepsy type 1: a chart review.

    Science.gov (United States)

    Leu-Semenescu, Smaranda; Louis, Pauline; Arnulf, Isabelle

    2016-01-01

    Few stimulants have been evaluated for the treatment of idiopathic hypersomnia (IH). Sodium oxybate (indicated in narcolepsy type 1, NT1) has not been tested in IH patients. The aim of this study is to retrospectively evaluate the benefit/risk ratio of sodium oxybate in IH versus NT1 using a chart review. We reviewed the files of 46 patients with IH (35.7 ± 12.6 years old, 78% women) and 47 patients with NT1 (44.1 ± 18 years old, 47% women) and evaluated the benefits of sodium oxybate using the Epworth sleepiness scale (ESS) and a four-point scale assessing the global benefit, sleep inertia, sleepiness, sleep duration, and sleep onset latency. The spontaneously reported side effects were collected. Sodium oxybate was prescribed at a lower dose in IH than in NT1 (4.3 ± 2.2 vs. 6.6 ± 2.8 g/night, p inertia was improved in 24/34 (71%) patients with IH. During the follow-up period (15.8 months in IH vs. 35 months in NT1 groups), 53% IH and 68% NT1 patients dropped out. The side effects were as frequent in the IH group as in the NT1 group (67% vs. 52%), but nausea (40% vs. 13%) and dizziness (34.3% vs. 4.3%) were more frequent in the IH group. The benefit/risk ratio of sodium oxybate in IH- was similar to NT1-associated sleepiness, with additional benefits on severe morning inertia, despite using smaller doses in more refractory patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. High-dose estrogen as salvage hormonal therapy for highly refractory metastatic breast cancer: a retrospective chart review.

    Science.gov (United States)

    Mahtani, Reshma L; Stein, Alisha; Vogel, Charles L

    2009-01-01

    High-dose estrogens (HDEs) are an efficacious but widely overlooked treatment option for patients with metastatic breast cancer (MBC). This is due in part to the introduction of tamoxifen in the 1970s, which was proven to be equivalent in efficacy and associated with fewer adverse events (AEs). The aim of this study was to report our experience with the use of HDE in postmenopausal women with advanced breast cancer. Local institutional review board approval was obtained to conduct a retrospective chart review of patients with MBC treated with HDEs at the Boca Raton Comprehensive Cancer Center, Boca Raton, Florida, from 2001 through March 2009. Demographic information, response rates, and tolerability profiles were collected. Of the 426 patients with MBC identified, we found 26 patients with MBC who were prescribed HDEs as a treatment in any line of therapy for advanced breast cancer. The median age at the start of HDE therapy was 59 years (range, 42-92 years). Three of the 26 patients (11.5%) were human epidermal growth factor receptor 2-positive determined via fluorescent in situ hybridization analysis. With the exception of 1 patient who had received no prior systemic treatment for metastatic disease, all patients received multiple lines of treatment (both chemotherapy and hormonal treatments) in the advanced setting (median, 7 lines; range, 0-12) prior to the initiation of HDE. Five of 20 patients (25%) with measurable metastatic disease (visceral and/or soft tissue metastases) had objective antitumor responses defined as either a partial response (PR) or a complete response (CR). Four additional patients (20%) had prolonged stable disease (SD) for > or =6 months. Three of 6 patients (50%) with nonmeasurable metastatic disease (bone-only) had prolonged SD for > or =6 months. Clinical benefit rate (defined as CR + PR + SD > or =6 months) for all patients was 46% (12/26), with a median duration of 10 months. Overall median progression-free survival for the 26

  11. A retrospective chart review: adolescents with borderline personality disorder, borderline personality traits, and controls.

    Science.gov (United States)

    Jopling, Ellen N; Khalid-Khan, Sarosh; Chandrakumar, Shivani F; Segal, Shira C

    2016-07-21

    With an estimated lifetime prevalence as high as 5.9% in the general population, borderline personality disorder (BPD) is a psychiatric disorder characterized by marked impulsivity as well as difficulties in interpersonal relationships, self-image, and affects. The burden on the health care system is immense with BPD patients accounting for 10%-20% of the patients in mental health outpatient facilities and 15%-40% in mental health inpatient facilities. Further, while 75%-80% of BPD patients attempt to commit suicide, 10% succeed; this mortality rate exceeds even that of anorexia nervosa which, with a weighted mortality rate of 5.1%, has often been considered to have the highest mortality rate of any mental disorder. In order to provide treatment and to implement preventative measures, a risk profile as well as clinical features must be identified within the adolescent population. This is presently crucial, as the current criteria for BPD are not developmentally focused, and as a result, criteria initially developed for the adult population are being applied in diagnoses of adolescents. A population of adolescents (n=80) between 16 and 19 years of age meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria either for BPD traits (n=46) or for BPD (n=36) were included in a retrospective chart review; a control group consisting of n=30 mood and anxiety control subjects were included to allow for further comparisons. Complex significant differences were discovered between the three groups in the following areas: history of sexual abuse, suicidal ideation, internalizing/externalizing symptoms, interpersonal difficulties, impulsivity, pre-perinatal stress, bullying, substance abuse, anxiety disorders, disruptive disorders, and finally, learning disorders.

  12. Difficulties indiagnosis of Asperger’s syndrome – aretrospective chart review

    Directory of Open Access Journals (Sweden)

    Magdalena Grygo

    2013-06-01

    Full Text Available Asperger’s syndrome is a neurodevelopmental disorder from the group of autistic spectrum disorders. Objective: The authors describe the group of children diagnosed with Asperger’s syndrome, treated in the Department of Child Psychiatry or in the Child Psychiatry Outpatient Clinic. The aim of the study was to evaluate the patients’ age when they were diagnosed and the reason for seeking the clinician’s help by parents. Method: A retrospective chart review of children (n = 35 diagnosed with Asperger’s syndrome. Age and reason for the first contact with the specialist, number of health facilities where the patient was treated before diagnosis, age at which the diagnosis was made, the period between the patient’s first contact with the specialist and diagnosis, and the first diagnoses in hospitalized children were analysed. Results: The median age of diagnosis was 11.75 ± 3.29 years, 5 ± 3.44 years after the chil‑ dren’s first contact with the specialist (psychiatrist or psychologist. Before the diagnosis, the patients were treated in different health facilities and often diagnosed with attention deficit/hyperactivity disorder or disruptive behaviour. Conclusions: The results may indicate the major diagnostic difficulties which clinicians are facing or may be the result of insufficient knowledge among various groups of specialists on the Asperger’s syndrome. The results were compared to the results of the research conducted in the USA and Great Britain.

  13. Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Slothower Molly P

    2006-08-01

    Full Text Available Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7–17. When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. Results Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. Conclusion Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

  14. Turnaround time for early infant HIV diagnosis in rural Zambia: a chart review.

    Science.gov (United States)

    Sutcliffe, Catherine G; van Dijk, Janneke H; Hamangaba, Francis; Mayani, Felix; Moss, William J

    2014-01-01

    Early infant HIV diagnosis is challenging in sub-Saharan Africa, particularly in rural areas where laboratory capacity is limited. Specimens must be transported to central laboratories for testing, leading to delays in diagnosis and initiation of antiretroviral therapy. This study was undertaken in rural Zambia to measure the turnaround time for confirmation of HIV infection and identify delays in diagnosis. Chart reviews were conducted from 2010-2012 for children undergoing early infant HIV diagnosis at Macha Hospital in Zambia. Relevant dates, receipt of drugs by mother and child for the prevention of mother-to-child transmission (PMTCT), and test results were abstracted. 403 infants provided 476 samples for early infant diagnosis. The median age at the "6-week" and "6-month" assessments was 8.1 weeks and 7.0 months, respectively. The majority of mothers (80%) and infants (67%) received PMTCT. The median time between sample collection and arrival at the central laboratory in Lusaka was 17 days (IQR: 10, 28); arrival at the central laboratory to testing was 6 days (IQR: 5, 11); testing to return of results to the clinic was 29 days (IQR: 17, 36); arrival of results at the clinic to return of results to the caregiver was 45 days (IQR: 24, 79). The total median time from sample collection to return of results to the caregiver was 92 days (IQR: 84, 145). The proportion of HIV PCR positive samples was 12%. The total median turnaround time was shorter for HIV PCR positive as compared to negative or invalid samples (85 vs. 92 days; p = 0.08). Delays in processing and communicating test results were identified, particularly in returning results from the central laboratory to the clinic and from the clinic to the caregiver. A more efficient process is needed so that caregivers can be provided test results more rapidly, potentially resulting in earlier treatment initiation and better outcomes for HIV-infected infants.

  15. Retrospective chart review for obesity and associated interventions among rural Mexican-American adolescents accessing healthcare services.

    Science.gov (United States)

    Champion, Jane Dimmitt; Collins, Jennifer L

    2013-11-01

    To report a retrospective analysis of data routinely collected in the course of healthcare services at a rural health clinic and to assess obesity incidence and associated interventions among rural Mexican-American adolescents. Two hundred and twelve charts reviewed; 98 (46.2%) males and 114 (53.8%) females. Data extracted included Medicaid exams conducted at the clinic within 5 years. Equal overweight or obese (n = 105, 49.5%), versus normal BMI categorizations (n = 107, 50.5%) documented overall and by gender. Female obesity higher (25.4%) than national norms (17.4%); male rates (25.5%) were within national norm. Interventions provided by nurse practitioners (94%) for 34.8%-80% of overweight/obese had limited follow-up (4%). Obesity incidence markedly increased between 13 and 18 years of age without associated interventions; 51.4%-75.6% without interventions. Obesity is a healthcare problem among rural Mexican-American adolescents accessing care at the rural health clinic. Obesity intervention and follow-up was suboptimal within this setting. Rural and ethnic minority adolescents experience health disparities concerning obesity prevalence and remote healthcare access. Obesity prevention and treatment during adolescence is a national health priority given physiologic and psychological tolls on health and potential for obesity into adulthood. Obesity assessment and translation of evidence-based interventions for rural Mexican-American adolescents at rural health clinics is implicated. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  16. A Systematic Chart Review of Inpatient Population with Childhood Dissociative Disorder

    Science.gov (United States)

    Prabhuswamy, Mukesh; Jairam, Rajeev; Srinath, Shoba; Girimaji, Satish; Seshadri, Shekhar P.

    2006-01-01

    Objective: To study the socio-demographic factors, clinical characteristics, and long-term outcome of dissociative disorders in inpatient children and adolescents. Methods: Chart data of forty-four subjects (8-15 years) with a diagnosis of dissociative disorder admitted to a specialist Child and Adolescent Psychiatry (CAP) unit between September…

  17. Electroconvulsive therapy for treating schizophrenia: a chart review of patients from two catchment areas

    DEFF Research Database (Denmark)

    Kristensen, Diana; Bauer, Jeanett; Pedersen, Ida Hageman

    2011-01-01

    To examine disease and treatment characteristics of patients with schizophrenia treated with electroconvulsive therapy (ECT). We examined charts from 79 patients diagnosed with schizophrenia (n = 55), persistent delusional disorders (n = 7), and schizoaffective disorders (n = 17) between 2003...

  18. A European chart review study on early rheumatoid arthritis treatment patterns, clinical outcomes, and healthcare utilization.

    Science.gov (United States)

    Emery, Paul; Solem, Caitlyn; Majer, Istvan; Cappelleri, Joseph C; Tarallo, Miriam

    2015-11-01

    This retrospective medical chart review aimed to provide a current, real-world overview of biologic usage in patients with rheumatoid arthritis (RA) in Germany, Spain, and the UK, and estimate clinical and healthcare utilization outcomes associated with early versus late treatment. Adults (≥18 years) with a confirmed RA diagnosis between January 2008 and December 2010, who received biologic treatment for ≥3 months and had ≥12 months of follow-up were included. Early treatment was receipt of biologic agent ≤1 year after RA diagnosis. Outcomes included 28-joint disease activity score (DAS28) reduction of ≥1.2 from biologic start and remission (DAS28 < 2.6). Time to outcome was evaluated using Kaplan-Meier curves and log-rank tests. Of 328 patients enrolled (Germany [n = 111], Spain [n = 106], UK [n = 111]), 58.2 % received early biologic (Germany: 55.0 %, UK: 55.9 %, Spain: 64.2 %; p = 0.321). First-line biologics were more frequent in Spain (26.4 %) and Germany (19.8 %) versus the UK (7.2 %; p < 0.001). Late-treated patients were hospitalized more often than early-treated patients (10.5 vs 2.9 % [p = 0.006] for 9.0 vs 5.4 mean inpatient days [p = 0.408]). DAS28 was 5.1 at biologic initiation (n = 310); 73.5 % of patients had a DAS28 decrease of ≥1.2 and 44.5 % achieved remission. More patients had DAS28 decrease of ≥1.2 (79.2 vs 65.9 %; p = 0.009) and remission (51.1 vs 35.6 %; p = 0.007) with early versus late treatment, with a significant difference in Kaplan-Meier curves when indexing on time since diagnosis (p < 0.001) and biologic start (p = 0.024). In RA patients receiving biologic therapy, over half received biologic therapy early. Early initiation was associated with improved clinical outcomes and reduced hospitalization rates versus late treatment.

  19. Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Correia-Melo FS

    2017-06-01

    Full Text Available Fernanda S Correia-Melo,1 Felipe C Argolo,1 Lucas Araújo-de-Freitas,1,2 Gustavo Carneiro Leal,1 Flávio Kapczinski,3 Acioly Luiz Lacerda,4 Lucas C Quarantini1,2 1Psychiatry Service, University Hospital, Federal University of Bahia, Salvador, Brazil; 2Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; 3Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; 4Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Background: This study evaluated efficacy and safety of intravenous subanesthetic doses of esketamine using an administration time of 10 minutes in patients with treatment-resistant depression and bipolar depression.Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant depression and bipolar depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and these patients received rapid infusion of esketamine between June 2012 and December 2015. The Montgomery–Åsberg Depression Rating Scale (MADRS was administered to measure and score depressive symptom severity before infusion and at 24 hours, 72 hours, and 7 days after infusion. In addition, Clinical Global Impression scale was administered before and 7 days after esketamine infusion.Results: Esketamine was administered to 30 patients. A total of 27 patients met the inclusion criteria and had MADRS evaluation data, which showed that 23 had unipolar and 4 had bipolar depression. Thirteen patients (48.1% showed therapeutic response (MADRS reduction ≥50% within 1 week (7 days of intervention. Remission (MADRS <7 was observed in 10 patients (37.0% in the same period. Therapeutic response and remission frequencies were seen in 16 (59.3% and 11 (40.7% patients, respectively, within 24 hours following drug infusion. The most relevant side effect observed during

  20. Clozapine Titration for People in Early Psychosis: A Chart Review and Treatment Guideline.

    Science.gov (United States)

    Ballon, Jacob S; Ashfaq, Hera; Noordsy, Douglas L

    2018-06-01

    The use of clozapine, particularly in young people, is often limited by early treatment-emergent adverse effects including drowsiness and lethargy. Concerns about adverse effects, medication adherence, and the need for blood monitoring often impede the use of clozapine in this population, leading to repeated trials of less effective medications. Current clozapine dosing recommendations are based on people further in the course of their illness and thus reflect different responsiveness and sensitivities to antipsychotic medication. As such, there is a need for evidence-based guidelines for titration and dosing of clozapine among people in early psychosis. We performed a chart review of 14 people treated with clozapine within our early psychosis team. Data regarding dose titration, response, time to discontinuation, symptom severity, weight gain, and other adverse effects were gathered at clozapine initiation, 3 months, and last available visit on clozapine. People treated with slow titration within their first year of psychosis onset achieved sustained response at very low maintenance doses (mean dose = 81 mg/d, mean duration of treatment = 200 weeks) compared with slow titration with longer duration of illness (mean dose = 350 mg/d, mean duration of treatment = 68 weeks) or standard dose titration in early psychosis (mean dose = 112 mg/d, mean duration of treatment = 38 weeks). The most common adverse effects in all groups were weight gain and sedation, with the groups requiring higher mean doses reporting a broader range of adverse effects. There was no apparent difference in the clinical global impression for severity or improvement between the slow titration and standard titration groups in people with early psychosis. These observations are synthesized into a proposed treatment guideline for use of clozapine among people in early psychosis. We describe development of a slow titration approach to initiating clozapine among people in early psychosis. This

  1. Quality Assurance Peer Review Chart Rounds in 2011: A Survey of Academic Institutions in the United States

    International Nuclear Information System (INIS)

    Lawrence, Yaacov Richard; Whiton, Michal A.; Symon, Zvi; Wuthrick, Evan J.; Doyle, Laura; Harrison, Amy S.; Dicker, Adam P.

    2012-01-01

    Purpose: In light of concerns regarding the quality of radiation treatment delivery, we surveyed the practice of quality assurance peer review chart rounds at American academic institutions. Methods and Materials: An anonymous web-based survey was sent to the chief resident of each institution across the United States. Results: The response rate was 80% (57/71). The median amount of time spent per patient was 2.7 minutes (range, 0.6–14.4). The mean attendance by senior physicians and residents was 73% and 93%, respectively. A physicist was consistently present at peer review rounds in 66% of departments. There was a close association between attendance by senior physicians and departmental organization: in departments with protected time policies, good attendance was 81% vs. 31% without protected time (p = 0.001), and in departments that documented attendance, attending presence was 69% vs. 29% in departments without documentation (p 75% of institutions, whereas dosimetric details (beams, wedges), isodose coverage, intensity-modulated radiation therapy constraints, and dose–volume histograms were always peer reviewed in 63%, 59%, 42%, and 50% of cases, respectively. Chart rounds led to both minor (defined as a small multileaf collimator change/repeated port film) and major (change to dose prescription or replan with dosimetry) treatment changes. Whereas at the majority of institutions changes were rare (<10% of cases), 39% and 11% of institutions reported that minor and major changes, respectively, were made to more than 10% of cases. Conclusion: The implementation of peer review chart rounds seems inconsistent across American academic institutions. Brachytherapy and radiosurgical procedures are rarely reviewed. Attendance by senior physicians is variable, but it improves when scheduling clashes are avoided. The potential effect of a more thorough quality assurance peer review on patient outcomes is not known.

  2. MIXMAX charts

    NARCIS (Netherlands)

    Albers, Willem/Wim

    2012-01-01

    For attribute data with (very) small failure rates control charts based on subsequent groups of r failure times, for some r >= 1, have been shown to be attractive. This especially holds for charts which stop once the maximum (MAX) of such a group is sufficiently small, as this choice allows a

  3. Results of chart reviews conducted to evaluate primary care patients seen by second and third year family medicine residents for potential adverse polypharmacy

    OpenAIRE

    Chang LF; Lutfiyya MN; Cha I; El-Khabiry E

    2007-01-01

    Objective: To determine the prescribing patterns of family medicine residents for patients aged more than 60 years with 2 or more chronic diseases and seen at least twice in a 12 month timeframe.Methods: This is a descriptive analysis which was based on chart reviews. The setting was the University of Illinois-Rockford Family Practice Residency. Patients aged 60 years with 2 or more chronic diseases who were seen at least twice by second and third year residents.Results: Findings from thi...

  4. Infliximab dosing patterns in a sample of patients with Crohn's disease: results from a medical chart review.

    Science.gov (United States)

    Tkacz, Joseph; Lofland, Jennifer H; Vanderpoel, Julie; Ruetsch, Charles

    2014-04-01

    Infliximab, a monoclonal antibody tumor necrosis factor-alpha inhibitor, is an effective therapy that is indicated for the treatment of patients with Crohn's disease. Although dose escalation from 5 mg/kg to 10 mg/kg is allowed according to the prescribing label of infliximab, conflicting results exist regarding the rate at which this escalation may occur, which may affect payers and providers. The goal of this exploratory study was to characterize and quantify the rate of infliximab dose escalation in a sample of patients with Crohn's disease. Administrative claims data from patients with Crohn's disease in a large mid-Atlantic managed care organization were collected and used to target and recruit providers into a chart review study of infliximab dosing. Data from the charts of 161 patients with Crohn's disease who were receiving infliximab between 2006 and 2010 were extracted. Patients were grouped into an infliximab dose-escalation group or a dose-stable group based on these data. The evidence of any infliximab dose ≥7.5 mg/kg or evidence of a mean maintenance interval of 42 days or less resulted in the placement of a patient in the dose-escalation group, with the balance of patients comprising the stable-dose group. A total of 925 infliximab infusions were captured from 161 patients. Of the 161 patients identified, 110 had at least 4 infusions, and 4 had missing data; therefore, only 106 (66%) patients were qualified for the final infliximab dosing analysis. A total of 18 (17%) of these patients had evidence of infliximab dose escalation (dose-escalation group), and the remaining 88 (83%) patients had a consistent 5-mg/kg dose and schedule (stable-dose group). Of the 18 patients in the dose-escalation group, 9 (50%) had a decrease in maintenance interval, whereas 12 (66.7%) patients had an increase in their dosage. A total of 3 (16.7%) patients had both an increase in dose and a reduction in maintenance interval. Infliximab has been shown to be a cost

  5. The current level safety analysis of the nuclear power plant units based on the safety control charts using

    International Nuclear Information System (INIS)

    Aronov, I.Z.; Biryukova, N.F.; Grozovskij, G.I.

    1994-01-01

    The methodology of graphic analysis of current safery of a NPP unit using the safety control charts, on which the values of unit safety reiting and its statistical characteristics are plotted, is suggested. The conclusions about the current safety level are made basing on the reiting change dynamics analysis. Examples of the analysis are discussed

  6. Measuring severe adverse events and medication selection using a "PEER Report" for nonpsychotic patients: a retrospective chart review.

    Science.gov (United States)

    Hoffman, Daniel A; Debattista, Charles; Valuck, Robert J; Iosifescu, Dan V

    2012-01-01

    We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG) normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER]), which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania) with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment. This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression - Improvement and Quality of Life Enjoyment and Satisfaction - Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices. The PEER Report may be useful, particularly in treatment-resistant patients, in helping to guide medication selection. Based on the preliminary data obtained from this chart review, additional studies are warranted to establish the safety and efficacy of adding PEER data when making medication decisions.

  7. Medication documentation in a primary care network serving North Carolina medicaid patients: results of a cross-sectional chart review

    Directory of Open Access Journals (Sweden)

    Olson Matthew D

    2012-08-01

    Full Text Available Abstract Background Medical records that do not accurately reflect the patient’s current medication list are an open invitation to errors and may compromise patient safety. Methods This cross-sectional study compares primary care provider (PCP medication lists and pharmacy claims for 100 patients seen in 8 primary care practices and examines the association of congruence with demographic, clinical, and practice characteristics. Medication list congruence was measured as agreement of pharmacy claims with the entire PCP chart, including current medication list, visit notes, and correspondence sections. Results Congruence between pharmacy claims and the PCP chart was 65%. Congruence was associated with large chronic disease burden, frequent PCP visits, group practice, and patient age ≥45 years. Conclusion Agreement of medication lists between the PCP chart and pharmacy records is low. Medication documentation was more accurate among patients who have more chronic conditions, those who have frequent PCP visits, those whose practice has multiple providers, and those at least 45 years of age. Improved congruence among patients with multiple chronic conditions and in group practices may reflect more frequent visits and reviews by providers.

  8. Radar Chart

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Radar Chart collection is an archived product of summarized radar data. The geographic coverage is the 48 contiguous states of the United States. These hourly...

  9. Chart Series

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) offers several different Chart Series with data on beneficiary health status, spending, operations, and quality...

  10. Retrospective chart review of a referenced EEG database in assisting medication selection for treatment of depression in patients with eating disorders

    Directory of Open Access Journals (Sweden)

    Greenblatt JM

    2011-09-01

    Full Text Available James M Greenblatt1, Craig Sussman1, Mariko Jameson1, Lee Yuan1, Daniel A Hoffman2, Dan V Iosifescu31Comprehensive Psychiatric Resources, Waltham, MA, USA; 2Neuro-Therapy Clinic Inc, Denver, CO, USA; 3Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USABackground: A retrospective chart review was undertaken in a private clinic to examine the clinical outcomes for patients with an eating disorder comorbid with depression or bipolar illness who underwent a referenced electroencephalographic (EEG database analysis to help guide medication selection.Method: We examined 33 charts for patients with the primary psychiatric diagnosis of an eating disorder and comorbid major depressive disorder or bipolar disorder who underwent a quantitative EEG database assessment to provide additional information for choices of medication. The current analysis includes data from 22 subjects who accepted treatments based on information from the referenced-EEG medication database. Hamilton Depression Rating Scale, Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and hospitalization data were examined for these patients.Results: Patients whose EEG data was used for clinical treatment reported significant decreases in associated depressive symptoms (HDRS scores, overall severity of illness (Clinical Global Impression-Severity, and overall clinical global improvement (Clinical Global Impression-Improvement. This cohort also reported fewer inpatient, residential, and partial hospitalization program days following referenced-EEG compared with the two-year period prior to treatment.Conclusion: These findings are consistent with previously reported data for patients with eating disorders and suggest the need for future studies using EEG data correlated with those from other patients with similar quantitative EEG features.Keywords: eating disorders, anorexia, bulimia, depression, referenced-EEG, chart review

  11. [The key parameters of design research and analysis of the Chinese reading visual acuity chart].

    Science.gov (United States)

    Wang, Chen-xiao; Liu, Zhi-hui; Gao, Ji-tuo; Guo, Ying-xuan; He, Ji-cang; Qu, Jia; Lü, Fan

    2013-06-01

    Reading is a visual function human being used to understand environmental events based on writing materials. This study investigated the feasibility of reading visual acuity chart in assessment of reading ability by analysis of the key factors involved in the design of the visual acuity chart. The reading level was determined as grade 3 primary school with Song as the font and 30 characters included in the sentences. Each of the sentences consisted of 27 commonly-used Chinese characters (9 characters between any two punctuations) and 3 punctuations. There were no contextual clues between the 80 sentences selected. The characters had 13 different sizes with an increment of 0.1 log unit (e.g.1.2589) and 2.5 pt was determined as the critical threshold. Readable test for visual target was followed as (1) 29 candidates with a raw or corrected visual acuity (VA)of at least 1.0 were selected to read 80 selected sentences with the size of characters of 2.5 pt at a distance of 40 cm, (2) the time used for reading with the number of characters wrongly read was recorded, (3) 39 sentences were selected as visual targets based on reading speed, effective reading position and total number of character strokes, (4) The 39 selected sentences were then randomly divided into 3 groups with no significant difference among the groups in the 3 factors listed at (3) with paired t-test. This reading visual chart was at level of Grade 3 primary school with a total stroke number of 165-210(Mean 185 ± 10), 13 font sizes a 0.1 log unit increment, a song pattern and 2.5 pt as the critical threshold. All candidates achieved 100% correct in reading test under 2.5 pt with an effective reading speed as 120.65-162 wpm (Mean 142.93 ± 11.80) and effective reading position as 36.03-61.48(Mean 48.85 ± 6.81). The reading test for the 3 groups of sentences showed effective reading speed as (142.49 ± 12.14) wpm,(142.86 ± 12.55) wpm and (143.44 ± 11.63) wpm respectively(t1-2 = -0.899, t2-3 = -1

  12. prepare_taxa_charts

    Science.gov (United States)

    Lakhujani, Vijay; Badapanda, Chandan

    2017-06-01

    QIIME (Quantitative Insights Into Microbial Ecology) is one of the most popular open-source bioinformatics suite for performing metagenome, 16S rRNA amplicon and Internal Transcribed Spacer (ITS) data analysis. Although, it is very comprehensive and powerful tool, it lacks a method to provide publication ready taxonomic pie charts. The script plot_taxa_summary . py bundled with QIIME generate a html file and a folder containing taxonomic pie chart and legend as separate images. The images have randomly generated alphanumeric names. Therefore, it is difficult to associate the pie chart with the legend and the corresponding sample identifier. Even if the option to have the legend within the html file is selected while executing plot_taxa_summary . py , it is very tedious to crop a complete image (having both the pie chart and the legend) due to unequal image sizes. It requires a lot of time to manually prepare the pie charts for multiple samples for publication purpose. Moreover, there are chances of error while identifying the pie chart and legend pair due to random alphanumeric names of the images. To bypass all these bottlenecks and make this process efficient, we have developed a python based program, prepare_taxa_charts . py , to automate the renaming, cropping and merging of taxonomic pie chart and corresponding legend image into a single, good quality publication ready image. This program not only augments the functionality of plot_taxa_summary . py but is also very fast in terms of CPU time and user friendly.

  13. Premature return to play and return to learn after a sport-related concussion: physician's chart review.

    Science.gov (United States)

    Carson, James D; Lawrence, David W; Kraft, Sari A; Garel, Alisha; Snow, Catherine L; Chatterjee, Ananda; Libfeld, Paula; MacKenzie, Heather M; Thornton, Jane S; Moineddin, Rahim; Frémont, Pierre

    2014-06-01

    To determine what proportion of patients experience an exacerbation of their symptoms as a result of premature return to play (RTP) and return to learn (RTL) following sport-related concussions. Retrospective study of electronic medical records from the office-based practice of one family and sport medicine physician who had systematically provided recommendations for cognitive and physical rest based on existing consensus recommendations. Two blinded authors independently reviewed each chart, which included Sport Concussion Assessment Tool (SCAT) and SCAT2 symptom self-report forms to determine whether an athlete had returned to play or learn prematurely. If there was a discrepancy between the 2 reviewers then a third author reviewed the charts. A sport medicine and family practice in Ontario. The physician assessed sport-related concussions after self-referral or referral from other primary care physicians, teams, and schools. A total of 170 charts of 159 patients were assessed for sport-related concussion during a 5-year period (April 2006 to March 2011). All participants were students who were participating in sports at the time of injury. There were 41 concussions in elementary students, 95 concussions in high school students, and 34 concussions in college or university students. Premature RTP and RTL were defined as chart records documenting the recurrence or worsening of symptoms that accompanied the patients' RTP or RTL. Measures were compared using the earliest available SCAT forms and self-reporting. In 43.5% of concussion cases, the patient returned to sport too soon and in 44.7% of concussion cases, the patient returned to school too soon. Patients with a history of previous concussion required more days of rest before being permitted to participate in any physical activity than those patients without a previous history of concussion. Elementary school students required fewer days of rest before being permitted to return to any physical activity

  14. Health IT Usability Focus Section: Data Use and Navigation Patterns among Medical ICU Clinicians during Electronic Chart Review.

    Science.gov (United States)

    Nolan, Matthew E; Siwani, Rizwan; Helmi, Haytham; Pickering, Brian W; Moreno-Franco, Pablo; Herasevich, Vitaly

    2017-10-01

    Background A detailed understanding of electronic health record (EHR) workflow patterns and information use is necessary to inform user-centered design of critical care information systems. While developing a longitudinal medical record visualization tool to facilitate electronic chart review (ECR) for medical intensive care unit (MICU) clinicians, we found inadequate research on clinician–EHR interactions. Objective We systematically studied EHR information use and workflow among MICU clinicians to determine the optimal selection and display of core data for a revised EHR interface. Methods We conducted a direct observational study of MICU clinicians performing ECR for unfamiliar patients during their routine daily practice at an academic medical center. Using a customized manual data collection instrument, we unobtrusively recorded the content and sequence of EHR data reviewed by clinicians. Results We performed 32 ECR observations among 24 clinicians. The median (interquartile range [IQR]) chart review duration was 9.2 (7.3–14.7) minutes, with the largest time spent reviewing clinical notes (44.4%), laboratories (13.3%), imaging studies (11.7%), and searching/scrolling (9.4%). Historical vital sign and intake/output data were never viewed in 31% and 59% of observations, respectively. Clinical notes and diagnostic reports were browsed ≥10 years in time for 60% of ECR sessions. Clinicians viewed a median of 7 clinical notes, 2.5 imaging studies, and 1.5 diagnostic studies, typically referencing a select few subtypes. Clinicians browsed a median (IQR) of 26.5 (22.5–37.25) data screens to complete their ECR, demonstrating high variability in navigation patterns and frequent back-and-forth switching between screens. Nonetheless, 47% of ECRs begin with review of clinical notes, which were also the most common navigation destination. Conclusion Electronic chart review centers around the viewing of clinical notes among MICU clinicians. Convoluted

  15. Sertraline May Improve Language Developmental Trajectory in Young Children with Fragile X Syndrome: A Retrospective Chart Review

    Directory of Open Access Journals (Sweden)

    Tri Indah Winarni

    2012-01-01

    Full Text Available Young children with fragile X syndrome (FXS often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99 and from 12 to 50 months (mean 29.94, SD 8.64 for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (<0.0001 and =0.0071, resp.. This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

  16. Sertraline may improve language developmental trajectory in young children with fragile x syndrome: a retrospective chart review.

    Science.gov (United States)

    Indah Winarni, Tri; Chonchaiya, Weerasak; Adams, Evan; Au, Jacky; Mu, Yi; Rivera, Susan M; Nguyen, Danh V; Hagerman, Randi J

    2012-01-01

    Young children with fragile X syndrome (FXS) often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12-50 months old, using the Mullen Scales of Early Learning (MSEL) for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC) scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD) was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99) and from 12 to 50 months (mean 29.94, SD 8.64) for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (P < 0.0001 and P = 0.0071, resp.). This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

  17. Measuring severe adverse events and medication selection using a “PEER Report” for nonpsychotic patients: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Hoffman DA

    2012-06-01

    Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be

  18. Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review

    Directory of Open Access Journals (Sweden)

    Tybor David J

    2005-12-01

    Full Text Available Abstract Background The condition of obesity has become a significant public health problem in the United States. In children and adolescents, the prevalence of overweight has tripled in the last 20 years, with approximately 16.0% of children ages 6–19, and 10.3% of 2–5 year olds being considered overweight. Considerable research is underway to understand obesity in the general pediatric population, however little research is available on the prevalence of obesity in children with developmental disorders. The purpose of our study was to determine the prevalence of overweight among a clinical population of children diagnosed with attention deficit hyperactivity disorder (ADHD and autism spectrum disorders (ASD. Methods Retrospective chart review of 140 charts of children ages 3–18 years seen between 1992 and 2003 at a tertiary care clinic that specializes in the evaluation and treatment of children with developmental, behavioral, and cognitive disorders. Diagnostic, medical, and demographic information was extracted from the charts. Primary diagnoses of either ADHD or ASD were recorded, as was information on race/ethnicity, age, gender, height, and weight. Information was also collected on medications that the child was taking. Body mass index (BMI was calculated from measures of height and weight recorded in the child's chart. The Center for Disease Control's BMI growth reference was used to determine an age- and gender-specific BMI z-score for the children. Results The prevalence of at-risk-for-overweight (BMI >85th%ile and overweight (BMI > 95th%ile was 29% and 17.3% respectively in children with ADHD. Although the prevalence appeared highest in the 2–5 year old group (42.9%ile, differences among age groups were not statistically significant. Prevalence did not differ between boys and girls or across age groups (all p > 0.05. For children with ASD, the overall prevalence of at-risk-for-overweight was 35.7% and prevalence of overweight

  19. A retrospective chart review to identify perinatal factors associated with food allergies

    Science.gov (United States)

    2012-01-01

    Background Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Methods Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Results Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02) were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005). Conclusions Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers. PMID:23078601

  20. A retrospective chart review to identify perinatal factors associated with food allergies

    Directory of Open Access Journals (Sweden)

    Karpa Kelly

    2012-10-01

    Full Text Available Abstract Background Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Methods Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Results Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02 were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005. Conclusions Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

  1. A retrospective chart review to identify perinatal factors associated with food allergies.

    Science.gov (United States)

    Dowhower Karpa, Kelly; Paul, Ian M; Leckie, J Alexander; Shung, Sharon; Carkaci-Salli, Nurgul; Vrana, Kent E; Mauger, David; Fausnight, Tracy; Poger, Jennifer

    2012-10-19

    Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02) were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005). Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

  2. Participation restriction in childhood phenotype of myotonic dystrophy type 1: a systematic retrospective chart review.

    Science.gov (United States)

    Gagnon, Cynthia; Kierkegaard, Marie; Blackburn, Catherine; Chrestian, Nicolas; Lavoie, Mélissa; Bouchard, Marie-Frédéric; Mathieu, Jean

    2017-03-01

    Myotonic dystrophy type 1 (DM1), a neuromuscular disorder, is divided into four clinical phenotypes: congenital; childhood; adult-onset, and late-onset. Publications about the childhood phenotype, especially the long-term outcome, are scarce. The aims of this study were to assess and describe participation outcomes in adults with the childhood phenotype. A retrospective chart methodology. Data were extracted from health records for 63 adults with childhood DM1 (32 males, 31 females; mean age 34y, standard deviation [SD] 11y 6mo; range 18-54y) who had attended the Saguenay Neuromuscular Clinic, Canada. Thirty-four adults (54%) lived with their parents or in foster homes, and most patients needed services or help to live independently. A significant proportion (22%) were isolated in regard to friendship. Very few adults had children, although 33% lived with a spouse. The majority of patients (86%) relied on social security and only one person was currently working. Financial responsibilities were often an issue and 13 (21%) were under legal guardianship. This study showed that patients with the childhood phenotype present a guarded prognosis regarding long-term social participation. These participation restrictions could be related to behavioural, cognitive, and social stigma problems in childhood. This study illustrates the absolute necessity to pursue an interdisciplinary follow-up of these patients when they are reaching adulthood. © 2016 Mac Keith Press.

  3. Outcomes of childhood hemangiomas treated with the pulsed-dye laser with dynamic cooling: a retrospective chart analysis.

    Science.gov (United States)

    Rizzo, Carina; Brightman, Lori; Chapas, Anne M; Hale, Elizabeth K; Cantatore-Francis, Julie L; Bernstein, Leonard J; Geronemus, Roy G

    2009-12-01

    Laser treatment of childhood hemangiomas remains controversial. Previous studies have used outdated technology, resulting in a potential overrepresentation of adverse outcomes. To evaluate outcomes of hemangiomas treated with the most current laser technology. A retrospective chart analysis of 90 patients with a median age of 3.0 months and a total of 105 hemangiomas were enrolled over a 2.5-year period. All were treated with the 595-nm long-pulse pulsed-dye laser (LP-PDL) with dynamic epidermal cooling at 2- to 8-week intervals depending on the stage of growth. Exclusion criteria were previous laser, surgical, or corticosteroid treatment. Three reviewers assessed outcomes. Near-complete or complete clearance in color were achieved for 85 (81%) and in thickness for 67 (64%) hemangiomas. There was no scarring or atrophy. Ulceration occurred in one case and resolved during treatment. Hyperpigmentation and hypopigmentation occurred in 4% and 14% of hemangiomas, respectively. Early treatment of childhood hemangiomas with the 595-nm LP-PDL with dynamic cooling may reduce the proliferative phase and result in excellent rates of clearing and few adverse events.

  4. Does the obesity paradox apply to early postoperative complications after hip surgery? A retrospective chart review.

    Science.gov (United States)

    Shaparin, Naum; Widyn, James; Nair, Singh; Kho, Irene; Geller, David; Delphin, Ellise

    2016-08-01

    There is evidence that very obese patients (body mass index [BMI] >40 kg/m(2)) undergoing hip replacement have longer average hospital stays, as well as higher rates of complications and readmission compared with patients with normal BMI. However, there are sparse data describing how overweight and obese patients fare in the period immediately after hip replacement surgery compared with patients with low or normal BMI. In this study, we sought to explore the association of BMI with the rate of early postoperative complications in patients undergoing total hip arthroplasty. A proprietary hospital software program, Clinical Looking Glass was used to query the Montefiore Medical Center database and create a list of patients with International Classification of Diseases, Ninth Revision code 81.51 (hip replacement) from the period of January 1, 2010, through December 31, 2012. The medical records of patients with length of stay 5 or more days were reviewed to evaluate the reason for the extended stay. The primary outcome studied was the association between BMI and occurrence of early complications in patients who had undergone total hip replacement surgery. Logistic regression was used to calculate adjusted odds ratio (OR) and 95% confidence interval (CI) for the association of BMI and early postoperative complications. Of the 802 patients undergoing hip replacement surgery within our time frame, 142 patient medical records were reviewed due to their length of stay of ≥5 days. Overall complication rate in the analyzed patients demonstrated a J-curve distribution pattern, with the highest morbidity being 23.5% in the underweight group, the second highest in the normal-weight group (17.3%), and decreasing to nadir in the overweight (8.0%) and obese class I (10.0%) and then higher again in classes II (14.3%) and III (16.7%). Adjusted ORs demonstrated the same J distribution pattern similar to the pattern observed in the univariate analysis. Of the variables studied

  5. Excel Data Analysis your visual blueprint for creating and analyzing data, charts and PivotTables

    CERN Document Server

    Etheridge, Denise

    2010-01-01

    Advanced techniques for Excel power users. Crunch and analyze Excel data the way the professionals do with this clean, uncluttered, visual guide to advanced Excel techniques. Using numerous screenshots and easy-to-follow numbered steps, this book clearly shows you how to perform professional-level modeling, charting, data access, data slicing, and other functions. You'll find super techniques for getting the most out of Excel's statistical and financial functions, Excel PivotTables and PivotCharts, Excel Solver and BackSolver, and more.: Provides a clear look at power-using Excel, the world's

  6. Assessment of Treatment Patterns and Patient Outcomes in Levodopa-Induced Dyskinesias (ASTROID): A US Chart Review Study.

    Science.gov (United States)

    Lennert, Barb; Bibeau, Wendy; Farrelly, Eileen; Sacco, Patricia; Schoor, Tessa

    2012-09-01

    No curative therapy is available for Parkinson's disease; therefore, one of the main goals of treatment is to control motor symptoms, often via the use of levodopa (also known as L-dopa). However, prolonged levodopa treatment in Parkinson's disease has been associated with the development of motor fluctuations and the occurrence of levodopa-induced dyskinesias (LIDs). To gain a clear, empirical understanding of the current real-world approach to treatment and patient outcomes associated with Parkinson's disease and LIDs. This study used a mixed methodology, combining a cross-sectional survey of neurologists practicing in the United States, a retrospective chart review of patients with Parkinson's disease and LIDs, and cross-sectional surveys of health-related quality of life (QOL) and physical functioning in patients with Parkinson's disease. The surveys included the 39-item Parkinson's Disease Questionnaire, the Unified Parkinson's Disease Rating Scale, the Parkinson Disease Dyskinesia 26-item Scale, and the modified Abnormal Involuntary Movement Scale (mAIMS). Survey and chart data were collected between May 2010 and July 2011. Descriptive analyses were used to evaluate the distribution of study variables, treatment patterns, patient QOL, and patient physical functioning. Data from 7 neurologists and from 172 patients with Parkinson's disease and LIDs were collected. Results from the physician survey indicate that prescribing patterns depend largely on the severity of LIDs, assessed via mAIMS. Most patients (88%) received pharmacologic therapy as first-line treatment for LIDs, with monotherapy favored in patients with mild LIDs and combination therapy in patients with moderate-to-severe LIDs. The mean time from the diagnosis of LID to the administration of first-line treatment for the condition was 10.7 months (standard deviation, 14.0 months). The study population reflects a mean time from levodopa initiation to the onset of LIDs of slightly more than 5 years

  7. Grammar Charts Analysis: A Tool to Promote Students' Visual Literacy and Autonomous Learning

    Science.gov (United States)

    Nausa T., Ricardo A.

    2007-01-01

    This reflection paper attempts to show how we foreign language (FL) teachers can help our students develop their visual literacy concerning the use of grammar charts to help them to make better sense of the grammar information presented in their textbooks. In the first part, this reflection overviews the concept of visual literacy (VL), its…

  8. Screening diabetic and hypertensive patients for ocular pathology using telemedicine technology in rural West Virginia: a retrospective chart review.

    Science.gov (United States)

    Ahmed, Rezwan; Petrany, Stephen; Fry, Russell; Krasnow, Michael

    2013-01-01

    There is a disparity between the number of people who need healthcare and availability of medical services in rural areas. This paper describes the experience of using telemedicine technologies for ophthalmologic evaluation in diabetic and hypertensive patients presenting to a community health center in rural West Virginia. A registered nurse at a community health center in McDowell County, WV was trained to use a retinal camera to capture high-resolution digital images of the retina. Patients with diabetes or hypertension were screened during their routine primary care visits. Retinal photos were transmitted to an ophthalmologist for review and reports from the screenings were returned with instruction for follow-up care or specialist referral when indicated. A retrospective chart review of 643 patients with diabetes or hypertension who were screened for ocular problems from October 2003 to December 2009 was completed. 44.8% of patients who were screened in the primary care center were identified as having 1 of 34 types of eye pathology that were previously unknown, of which 33% of patients were recommended to seek prompt attention by a retina consultant or glaucoma specialist for suspected ocular pathology. Our review demonstrates the actual benefits of telemedicine in the effective screening of diabetic and hypertensive patients for eye pathology, and our experience suggests that using distance medicine and telemedicine technologies is valuable for screening rural populations.

  9. The HTA Risk Analysis Chart: Visualising the Need for and Potential Value of Managed Entry Agreements in Health Technology Assessment.

    Science.gov (United States)

    Grimm, Sabine Elisabeth; Strong, Mark; Brennan, Alan; Wailoo, Allan J

    2017-12-01

    Recent changes to the regulatory landscape of pharmaceuticals may sometimes require reimbursement authorities to issue guidance on technologies that have a less mature evidence base. Decision makers need to be aware of risks associated with such health technology assessment (HTA) decisions and the potential to manage this risk through managed entry agreements (MEAs). This work develops methods for quantifying risk associated with specific MEAs and for clearly communicating this to decision makers. We develop the 'HTA risk analysis chart', in which we present the payer strategy and uncertainty burden (P-SUB) as a measure of overall risk. The P-SUB consists of the payer uncertainty burden (PUB), the risk stemming from decision uncertainty as to which is the truly optimal technology from the relevant set of technologies, and the payer strategy burden (PSB), the additional risk of approving a technology that is not expected to be optimal. We demonstrate the approach using three recent technology appraisals from the UK National Institute for Health and Clinical Excellence (NICE), each of which considered a price-based MEA. The HTA risk analysis chart was calculated using results from standard probabilistic sensitivity analyses. In all three HTAs, the new interventions were associated with substantial risk as measured by the P-SUB. For one of these technologies, the P-SUB was reduced to zero with the proposed price reduction, making this intervention cost effective with near complete certainty. For the other two, the risk reduced substantially with a much reduced PSB and a slightly increased PUB. The HTA risk analysis chart shows the risk that the healthcare payer incurs under unresolved decision uncertainty and when considering recommending a technology that is not expected to be optimal given current evidence. This allows the simultaneous consideration of financial and data-collection MEA schemes in an easily understood format. The use of HTA risk analysis charts will

  10. A 12 year chart review of childhood and adolescent onset psychosis ...

    African Journals Online (AJOL)

    Objectives: To review the profile of children and adolescents presenting with psychosis at a specialist mental health facility, and to compare childhood with adolescent onset psychosis. Method: Hospital records of all children and adolescents over a 12-year period (1999–2010) were perused to identify those falling under the ...

  11. A novel income security intervention to address poverty in a primary care setting: a retrospective chart review.

    Science.gov (United States)

    Jones, Marcella K; Bloch, Gary; Pinto, Andrew D

    2017-08-17

    To examine the development and implementation of a novel income security intervention in primary care. A retrospective, descriptive chart review of all patients referred to the Income Security Heath Promotion service during the first year of the service (December 2013-December 2014). A multisite interdisciplinary primary care organisation in inner city Toronto, Canada, serving over 40 000 patients. The study population included 181 patients (53% female, mean age 48 years) who were referred to the Income Security Health Promotion service and engaged in care. The Income Security Health Promotion service consists of a trained health promoter who provides a mixture of expert advice and case management to patients to improve income security. An advisory group, made up of physicians, social workers, a community engagement specialist and a clinical manager, supports the service. Sociodemographic information, health status, referral information and encounter details were collected from patient charts. Encounters focused on helping patients with increasing their income (77.4%), reducing their expenses (58.6%) and improving their financial literacy (26.5%). The health promoter provided an array of services to patients, including assistance with taxes, connecting to community services, budgeting and accessing free services. The service could be improved with more specific goal setting, better links to other members of the healthcare team and implementing routine follow-up with each patient after discharge. Income Security Health Promotion is a novel service within primary care to assist vulnerable patients with a key social determinant of health. This study is a preliminary look at understanding the functioning of the service. Future research will examine the impact of the Income Security Health Promotion service on income security, financial literacy, engagement with health services and health outcomes. © Article author(s) (or their employer(s) unless otherwise stated in

  12. Growth charts of human development

    NARCIS (Netherlands)

    Buuren, S. van

    2014-01-01

    This article reviews and compares two types of growth charts for tracking human development over age. Both charts assume the existence of a continuous latent variable, but relate to the observed data in different ways. The D-score diagram summarizes developmental indicators into a single aggregate

  13. Symptoms of the anxiety disorders in a perinatal psychiatric sample: a chart review.

    Science.gov (United States)

    Schofield, Casey A; Battle, Cynthia L; Howard, Margaret; Ortiz-Hernandez, Samia

    2014-02-01

    Symptoms of anxiety are a central feature of perinatal mental health, yet the anxiety disorders have received considerably less attention than depression in both perinatal research and practice. The present investigation involved a retrospective review of the clinical records of 334 patients seen at a psychiatric day hospital program serving pregnant and postpartum women. We examined the frequency with which the patients in this setting reported symptoms of anxiety, clinical correlates of elevated anxiety, and patterns of diagnosis in the clinical record. The results suggest that anxiety symptoms are very common in this population and that the presence of anxiety is associated with a more severe clinical profile, including higher rates of suicidality and increased use of psychotropic medications during pregnancy and postpartum. Although anxiety symptom levels were markedly elevated in this sample, anxiety disorders were diagnosed at relatively low rates. Implications for clinical practice, including discharge and treatment planning, are discussed.

  14. Group Education and Multidisciplinary Management for Chronic Headaches Among Adolescents in a Military Treatment Facility: A Retrospective Chart Review.

    Science.gov (United States)

    Ormond, Andrew; Faux, Brian M; Zickefoose, Betty A; Aden, James; Kapunan, Patricia E; Roberts, Timothy A

    2018-02-07

    To assess the effect of group education on the frequency of chronic headaches among adolescents. Chronic headaches are a common problem among adolescents with significant psychosocial morbidity. Brief education on lifestyle interventions to decrease headache frequency has established benefits among adult patients but is less proven among adolescents. This study is a chart review examining our experience with a group education program for 155 adolescents, aged 12-17 years old, enrolled in the U.S. military medical system with at least 3 months of chronic headaches who were referred to a headache evaluation clinic. The primary outcome of our study was self-reported number of days with a headache in the previous 30 days based on patient recall. We used a paired samples t-test to measure the change in headache frequency between the frequency reported at the headache class and follow-up more than 6 months after the class. Most of the adolescents seen in the program were female (114/155 [73.5%]) and suffered from migraine headaches (108/155 [69.8%]). Severe headache-related disability was reported by 40.6% of subjects (63/155). Subjects reported an average of 19 days with headache during the previous 30 days. Females and patients with higher headache-related disability reported a higher number of days with headache. Participation in the group education was associated with an 11.5 (SD 11.9, P < .001) day decrease in the frequency of headaches during the previous 30 days at follow-up at least 6 months after the class, with largest decline seen in patients with the highest level of migraine-related disability at baseline. Based on our retrospective chart review study, group education on headache evaluation and lifestyle management has potential as an effective, low-cost intervention for treatment of chronic headaches among adolescents. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  15. Opioid prescribing patterns after Mohs micrographic surgery and standard excision: a survey of American Society for Dermatologic Surgery members and a chart review at a single institution.

    Science.gov (United States)

    Harris, Kalynne; Calder, Scott; Larsen, Brooke; Duffy, Keith; Bowen, Glen; Tristani-Firouzi, Payam; Hadley, Michael; Endo, Justin

    2014-08-01

    Little is known about postoperative opioid prescribing patterns among dermatologic surgeons. To better understand postoperative opioid prescribing patterns among dermatologic surgeons in the United States. Two-part analysis consisting of a retrospective chart review of 233 dermatologic surgery patients at a single institution and an e-mail survey of American Society for Dermatologic Surgery (ASDS) members. (1) Retrospective review: 35% (82/233) of the patients received an opioid prescription. Larger defect size, repair of the defect, perioral and nasal site, and surgeon A or B performing surgery predicted opioid prescription. (2) E-mail survey: 556 ASDS members practicing within the United States responded. Sixty-four percent (357/556) reported prescribing opioids after ≤10% of cases. Surgeons younger than 55 years old, male surgeons, and surgeons in the southern and western United States were more likely to prescribe opioids after >10% of cases. Seventy-six percent (397/520) believed patients used ≤50% of the opioid pills prescribed. The retrospective review suggests that opioid prescribing is predicted by characteristics of the surgery (i.e., size, defect repair type, and anatomic location) and characteristics of the surgeon (i.e., age, sex, and practice location) with significant heterogeneity in prescribing habits. The national survey results raise the possibility that patients might not take all prescribed opioid pills after dermatologic surgery. Further investigation is warranted to determine how patients are actually using prescription pain pills to balance pain control with patient safety.

  16. IAEA, EU Senior Officials Review Nuclear-Related Cooperation, Chart Way Ahead

    International Nuclear Information System (INIS)

    Amano, Y.

    2014-01-01

    International Atomic Energy Agency (IAEA) and European Union officials met this week for the second annual Senior Officials Meeting to review and further strengthen their nuclear-related cooperation. In the past year, the two institutions have improved collaboration in nuclear safety, security, safeguards and peaceful use of nuclear energy through implementing a number of initiatives. In 2013, new contracts for projects have been signed amounting to approximately 24 million euros. These included an EU Council decision to support IAEA nuclear security and verification activities worth of 8.05 million euros. Furthermore, a Memorandum of Understanding establishing a framework for cooperation to help improve nuclear safety was signed, as well as the Practical Arrangement on technical nuclear security issues. The EU and the IAEA have also worked to explore and identify new areas for cooperation such as using nuclear applications for socio-economic development. The meeting addressed enhanced cooperation in the areas of nuclear safety, nuclear security, nuclear applications, nuclear energy and safeguards. Participants agreed on the following steps, including holding a Senior Officials Meeting planned in early 2015 in the premises of the European Commission in Luxembourg

  17. Management of eight labor and delivery patients dependent on buprenorphine (Subutex™: A retrospective chart review [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Solina Tith

    2018-02-01

    Full Text Available Background: Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by “The American College of Obstetrics and Gynecology” as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists’ unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia. We reviewed our management and outcomes in this medically complex population. Methods: An Institutional Review Board (IRB approved retrospective chart review was conducted of women admitted to the University of Washington Medical Center Labor and Delivery unit from July 2012 to November 2013 using buprenorphine. All deliveries, including intrauterine fetal demise, were included. Results: Eight women were admitted during this period to our L&D floor on buprenorphine. All required peri-partum anesthetic management either for labor and/or cesarean delivery management. Analgesic management included dilaudid or fentanyl PCA and/or continued epidural infusion, and in one instance ketamine infusion, while the pre-admission buprenorphine regimen was continued. Five babies were viable, two women experienced intrauterine fetal death at 22 and 36 weeks gestational age (GSA, respectively, and one neonate died shortly after delivery due to a congenital diaphragmatic hernia. Conclusions: This case series illuminates the medical complexity of parturients using buprenorphine. Different treatment modalities in the absence of evidence-based guidelines included additional opioid administration and continued epidural analgesia. The management of post-cesarean pain in patients on partial μ-opioid agonists remains complex and variable, and evidence-based guidelines could be useful for clinicians to direct care.

  18. Chart review of electroconvulsive therapy practice from a tertiary care geriatric mental health set up

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    Akanksha Sonal

    2017-01-01

    Full Text Available Introduction: Electroconvulsive therapy (ECT is frequently used treatment procedure, and is utilized more often for severe, treatment-resistant, or refractory psychiatric disorders. However, published data on the use of ECT is limited, more so for special population like older adults. Aim: The aim of the study was to explore the clinical, demographic, and diagnostic profiles of older adults, and the parameters of ECT treatment, in a tertiary care Geriatric Mental Health set up. Materials and Methods: Approval to review the case notes was obtained from the Institutional Ethical Committee. The individuals were aged 60 years and above and had received ECT between January 2014 and May 2017. The relevant details pertaining to the aims of the study were recorded in a spreadsheet. Results: Twenty-five courses (absolute number = 191 of ECT were given to 21 patients (mean age = 67.44 ± 9.8 years with mean of 7.64 ± 3.6 ECT per patient. Majority of the patients belonged to age group 60–69 years, and were male (81%. Depression was the most common diagnosis for giving ECT (43% in these individuals, and poor response to pharmacological treatment (81% was the most common indication. The mean duration of the seizure elicited was 28.8 ± 13.2 s, and a therapeutic response was seen in 86% of cases. No major complications were noted during ECT treatment. Conclusion: When used judiciously and with trained staff, ECT is an effective and relatively safe mode of treatment even in older adults.

  19. End-of-life practice patterns at U.S. adult cystic fibrosis care centers: A national retrospective chart review.

    Science.gov (United States)

    Chen, Elaine; Homa, Karen; Goggin, Jessica; Sabadosa, Kathryn A; Hempstead, Sarah; Marshall, Bruce C; Faro, Albert; Dellon, Elisabeth P

    2017-09-13

    There are many challenges to providing end-of-life care (EOLC) to people with cystic fibrosis (CF). Chart abstraction was used to examine EOLC in adults with CF who died between 2011 and 2013. We reviewed 248 deaths from 71 CF care centers. Median age at death was 29years (range 18-73). While median FEV1 was in the severe lung disease category (FEV1<40%), 38% had mild or moderate lung disease in the year preceding death. The most common location of death was the intensive care unit (ICU, 39%), and 12% of decedents were listed for lung transplant. Fewer of those dying in the ICU personally participated in advance care planning or utilized hospice or Palliative Care Services (p<0.05). Adults dying with CF in the United States most commonly die in an ICU, with limited and variable use of hospice and Palliative Care Services. Palliative care and advance care planning are recommended as a routine part of CF care. Copyright © 2017 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  20. Prevalence, incidence and associated factors of pressure ulcers in home palliative care patients: A retrospective chart review.

    Science.gov (United States)

    Artico, Marco; Dante, Angelo; D'Angelo, Daniela; Lamarca, Luciano; Mastroianni, Chiara; Petitti, Tommasangelo; Piredda, Michela; De Marinis, Maria Grazia

    2018-01-01

    Terminally ill patients are at high risk of pressure ulcers, which have a negative impact on quality of life. Data about pressure ulcers' prevalence, incidence and associated factors are largely insufficient. To document the point prevalence at admission and the cumulative incidence of pressure ulcers in terminally ill patients admitted to an Italian home palliative care unit, and to analyse the patients' and caregivers' characteristics associated with their occurrence. Retrospective chart review. Patients ( n = 574) with a life expectancy ⩽6 months admitted to a palliative home care service were included in this study. The prevalence and incidence rates were 13.1% and 13.0%, respectively. The logistic regression models showed body mass index ( p 70 and >1 caregiver at home as the dichotomous variables predictors of presenting with a pressure ulcer at time of admission and during home palliative care. The notable pressure ulcers' incidence and prevalence rates suggest the need to include this issue among the main outcomes to pursue during home palliative care. The accuracy of body mass index, Braden Scale and Karnofsky Performance Scale in predicting the pressure ulcers risk is confirmed. Therefore, they appear as essential tools, in combination with nurses' clinical judgment, for a structured approach to pressure ulcers prevention. Further research is needed to explore the home caregivers' characteristics and attitudes associated with the occurrence of pressure ulcers and the relations between their strategies for pressure ulcer prevention and gender-related patient's needs.

  1. Donepezil, an Acetylcholinesterase Inhibitor, Can Attenuate Gabapentinoid-Induced Somnolence in Patients with Neuropathic Pain: A Retrospective Chart Review.

    Science.gov (United States)

    Kogure, Takamichi; Sumitani, Masahiko; Ikegami, Kiyoshi; Abe, Hiroaki; Hozumi, Jun; Inoue, Reo; Kawahara, Kazuo; Yamada, Yoshitsugu

    2017-03-01

    Donepezil, an oral acetylcholinesterase inhibitor, is used to treat Alzheimer's disease and reportedly attenuates opioid-induced sedation in patients with cancer pain. Neuropathic pain is often treated with gabapentinoids (pregabalin, gabapentin), but gabapentinoid-induced somnolence sometimes prevents patients from using these agents. We conducted a retrospective chart review of patients with neuropathic pain to examine whether donepezil is useful for gabapentinoid-induced somnolence. We investigated pain severity in 13 patients before and after taking gabapentinoids and donepezil, the degree of gabapentinoid-induced somnolence before and after starting donepezil, and gabapentinoid dose escalation after taking donepezil. Donepezil was started at 3-5 mg/day upon experiencing gabapentinoid-induced somnolence. Likert-scale scores for somnolence (0 = no somnolence; 4 = severe somnolence with stumbling) improved significantly after starting donepezil (before: 2.3 ± 0.9, after: 0.5 ± 0.7; Wilcoxon's signed-rank test, P Donepezil could be an alternative to psychostimulants for gabapentinoid-induced somnolence. The analgesic effect of gabapentinoids remained uncompromised by donepezil, which could enhance the dose-dependent analgesic effect of gabapentinoids.

  2. Does pre-ordering tests enhance the value of the periodic examination? Study Design - Process implementation with retrospective chart review

    Directory of Open Access Journals (Sweden)

    Stroebel Robert J

    2011-09-01

    Full Text Available Abstract Background To evaluate the value of a pre-ordering process for the pro-active scheduling and completion of appropriate preventive and chronic disease monitoring tests prior to a periodic health examination (PHE. Methods A standardized template was developed and used by our nursing staff to identify and schedule appropriate tests prior to the patients PHE. Chart reviews were completed on all 602 PHE visits for a 3-month interval in a primary care setting. A patient satisfaction survey was administered to a convenience sample of the PHE patients. Results Of all the patients with tests pre-ordered, 87.8% completed the tests. All providers in the division used the process, but some evolved from one template to another over time. Most patients (61% preferred to get their tests done prior to their PHE appointment. Many of our patients had abnormal test results. With this process, patients were able to benefit from face-to-face discussion of these results directly with their provider. Conclusions A pre-order process was successfully implemented to improve the value of the PHE visit in an internal medicine primary care practice using a standardized approach that allowed for provider autonomy. The process was accepted by patients and providers and resulted in improved office efficiency through reduced message handling. Completion of routine tests before the PHE office visit can help facilitate face-to-face discussions about abnormal results and subsequent management that otherwise may only occur by telephone.

  3. Evaluation narcotic analgesic use and survival time in terminal stage liver diseases compared with lung cancer: a retrospective chart review

    Science.gov (United States)

    Nakashita, Shunya; Eguchi, Yuichiro; Mizuta, Toshihiko; Kuroki, Shigetaka; Ono, Naofumi; Eguchi, Takahisa; Anzai, Keizo; Fujimoto, Kazuma

    2013-01-01

    Hepatocellular carcinoma (HCC) and liver cirrhosis are fatal diseases. This study aimed to investigate survival time and palliative care in terminal HCC and/or liver cirrhosis compared with lung cancer. Between January 2004 and December 2010, we enrolled 116 patients with terminal cirrhosis and/or HCC or lung cancer admitted to a municipal hospital in Japan; 48 had liver cirrhosis, 35 HCC and 33 lung cancer. By retrospective chart review, we evaluated: (i) rate of usage of narcotic analgesics and (ii) survival time from onset of coma (Glasgow Coma Scale less than 8). Time between coma and death was significantly shorter in the liver disease patients (cirrhosis and/or HCC: 7.0 h) than in lung cancer (44.0 h, p = 0.045). Total bilirubin was higher in HCC compared with cirrhosis (p<0.01). Rate of usage of narcotic analgesics was higher in lung cancer (20/33: 60.6%) than in liver disease (17/83: 20.5%, p<0.01); analgesics were used more frequently in HCC than in liver cirrhosis (p<0.01). These results suggest that liver cirrhosis and HCC patients do not always require palliative care and that survival time from onset of coma due to liver disease was not prolonged compared with lung cancer. PMID:23704814

  4. Clinical and programming pattern of patients with impending deep brain stimulation power failure: a retrospective chart review.

    Science.gov (United States)

    Mehanna, Raja; Wilson, Kathy M; Cooper, Scott E; Machado, Andre G; Fernandez, Hubert H

    2014-01-01

    It is important to prevent complications of implanted pulse generators (IPG) depletion by replacing the IPG in time. We reviewed the charts of all patients with deep brain stimulation treated movement disorders who were seen at our institution over a period of 6 months. Among these, we retained for analyses those who had undergone IPG replacement within the previous 3 years. A total of 55 IPG replacements (from 38 patients) were reviewed. Electrodes were implanted in the subthalamic nucleus in all Parkinson's disease patients, in the ventral intermedius nucleus of the thalamus in all essential tremor patients and in the globus pallidus interna in all dystonia patients. Replacements were preceded by a voltage increase due to worsened symptoms in 27.3% (15/55); 25.5% (14/55) had full IPG depletion or had too low IPG reserve to allow for any voltage adjustment; and 21.7% (12/55) did not get a needed voltage increase either for safety reasons (eg: concern for increase in falls with higher voltages) or because the surgery date for IPG replacement was close. Only 25.5% (14/55) remained clinically well-controlled prior to IPG replacement, all of whom had IPG longevity estimates available. Clinical deterioration was noted prior to IPG replacement in 100% of patients without available longevity estimates versus 61% of patients with available longevity estimates (p < 0.001). Despite best efforts, clinical deterioration prior to IPG replacement can be seen frequently. Routine estimation of IPG life, along with symptom assessment at every follow-up visit may prevent it.

  5. TU-D-201-02: Medical Physics Practices for Plan and Chart Review: Results of AAPM Task Group 275 Survey

    Energy Technology Data Exchange (ETDEWEB)

    Fong de los Santos, L [Mayo Clinic, Rochester, MN (United States); Dong, L [Scripps Proton Therapy Center, San Diego, CA (United States); Greener, A [VA Medical Center, East Orange, NJ (United States); Johnson, J [UT MD Anderson Cancer Center, Houston, TX (United States); Johnson, P [University of Miami, Miami, FL (United States); Kim, G [University of California, San Diego, La Jolla, CA (United States); Mechalakos, J; Yorke, E [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Napolitano, B [Massachusetts General Hospital, Boston, MA (United States); Parker, S [Novant Health, Winston Salem, NC (United States); Schofield, D [Saint Vincent Hospital, Acton, MA (United States); Wells, M [Piedmont Hospital, Atlanta, GA (United States); Ford, E [Mayo Clinic, Rochester, MN (United States); Scripps Proton Therapy Center, San Diego, CA (United States)

    2016-06-15

    Purpose: AAPM Task Group (TG) 275 is charged with developing riskbased guidelines for plan and chart review clinical processes. As part of this work an AAPM-wide survey was conducted to gauge current practices. Methods: The survey consisted of 103 multiple-choice questions covering the following review processes for external beam including protons: 1) Initial Plan Check, 2) On-Treatment and 3) End-of-Treatment Chart Check. The survey was designed and validated by TG members with the goal of providing an efficient and easy response process. The survey, developed and deployed with the support of AAPM headquarters, was released to all AAPM members who have self-reported as working in the radiation oncology field and it was kept open for 7 weeks. Results: There are an estimated 4700 eligible participants. At the time of writing, 962 completed surveys have been collected with an average completion time of 24 minutes. Participants are mainly from community hospitals (40%), academicaffiliated hospitals (31%) and free-standing clinics (18%). Among many other metrics covered on the survey, results so far indicate that manual review is an important component on the plan and chart review process (>90%) and that written procedures and checklists are widely used (>60%). However, the details of what is reviewed or checked are fairly heterogeneous among the sampled medical physics community. Conclusion: The data gathered from the survey gauging current practices will be used by TG 275 to develop benchmarks and recommendations for the type and extent of checks to perform effective physics plan and chart review processes.

  6. Patient aberrant drug taking behaviors in a large family medicine residency program: a retrospective chart review of screening practices, incidence, and predictors.

    Science.gov (United States)

    Lewis, Matthew; Herndon, Christopher M; Chibnall, John T

    2014-01-01

    Potentially aberrant drug-taking behaviors (pADTB) are described as any departure from strict adherence to prescribed use of medications for their intended indication. There are several validated instruments, processes, and databases available to assist the clinician in screening and stratifying risk for patients in which controlled substances are being prescribed or considered. Actual utilization of these tools in nonspecialist healthcare settings is largely unknown. The primary objective of this retrospective chart review was to describe utilization patterns of these common tools within a 56 physician family medicine training program. Secondary objectives included identification of site-specific predictors of pADTB and correlation of prescribing patterns with documented aberrant behaviors. A total of 202 chronic pain patients were identified for inclusion based on prior 12-month prescription and refill records within the electronic health record (EHR) from March 2008 through March 2009. Each patient included had at least one opioid for 30 days within the study period and had chronic pain symptoms for at least 90 days. Each chart was reviewed for predefined pADTB, controlled substance refill request, prescription drug monitoring profile, and post hoc investigator completion of the Opioid Risk Tool Clinician Form. Descriptive statistics and regression analysis was used to report results. Clinician documentation of risk-screening tool use of any type was limited to one patient of the 202 records reviewed. Within this sample, 203 unique pADTB were documented in the EHR records of 89 (44.1 percent) patients. Patients prescribed morphine or tramadol appeared to exhibit less use of multiple prescribers and multiple pharmacies while an association between this behavior and two or more concurrent opioid prescriptions became apparent. Those taking fentanyl or morphine exhibited unsanctioned dose escalations more frequently. These results suggest that routine evaluation of

  7. Drug poisoning and associated factors in western Saudi Arabia: A five-year retrospective chart review (2011-2016).

    Science.gov (United States)

    Alzahrani, Sami H; Alqahtani, Ali H; Farahat, Fayssal Mostafa; Elnour, Mohammed Abdel Galil; Bashawri, Jamil

    2017-01-01

    Drug poisoning is a globally common cause of emergency-room admissions. This study explores drug-poisoning prevalence patterns, associated risk factors (gender, age and exposure circumstances), and outcomes in western Saudi Arabia. Retrospective analysis of Clinical drug poisoning cases (2011-2016). The data were retrieved from the Saudi Ministry of Health's record and Patients' medical charts were analyzed. The Ministry of Health received 1,474 reports of drug poisoning during 2011-2016. More than half involved females (n=885, 60%) or young children (0-4 years old) (n=764, 51.8%) and occurred accidentally (n=786, 53.3%); almost all had an oral route of poisoning (n=1,466, 99.5%). The cases most frequently involved analgesic and non-steroidal anti-inflammatory drugs (n=373, 25.2%); antiepileptic, antipsychotic, psychoactive, and anxiolytic drugs (n=229, 16.3%); antihistamine, asthma, flu, and cough drugs (n=157, 12.0%); and antibiotic, anti-fungal; and antiprotozoal drugs (n=74, 5.0%). Antidotes were administered in only 2.2% of cases, and no deaths were reported. The drug poisoning cases involved females and young children (younger than 5 years old) and the most cases were accidental, and the most commonly used drugs were analgesics (Panadol), followed by antipsychotics, antihistamines, and antiepileptics (Tegretol).

  8. Influence of proton pump inhibitors and histamine H2receptor antagonists on serum phosphorus level control by calcium carbonate in patients undergoing hemodialysis: a retrospective medical chart review.

    Science.gov (United States)

    Tatsuzawa, Masaomi; Ogawa, Ryuichi; Ohkubo, Atsushi; Shimojima, Kazuyo; Maeda, Kunimi; Echizen, Hirotoshi; Miyazaki, Akihisa

    2016-01-01

    Hyperphosphatemia is one of the common complications in patients undergoing hemodialysis. Although calcium carbonate (CaC) is often used to control serum inorganic phosphorus level in dialysis patients, co-administration of gastric acid reducers (ARs) may interfere with the phosphate binding effect of CaC. We performed a retrospective medical chart review to study whether ARs attenuate the hypophosphatemic effect of CaC in patients undergoing hemodialysis. One hundred and eight chronic hemodialysis patients receiving either CaC alone or CaC concomitant with one of the ARs (proton pump inhibitors and histamine H 2 -receptor antagonists) were retrieved from the medical charts in Juntendo University Nerima Hospital. The patients were subdivided according to the interval between hemodialysis sessions (interdialysis interval of 48 or 72 h). A multivariate analysis was performed to identify clinical covariates associated with the variability of serum inorganic phosphorus levels. The study protocol was approved by the Institutional Review Board before the study was begun. Among patients on hemodialysis with a 72-h interdialysis interval, the magnitude of increase in serum inorganic phosphorus concentration in patients receiving CaC and AR was significantly greater than in those receiving CaC alone. While a similar trend was observed among patients with a 48-h interdialysis interval, the difference did not reach a significant level. A multivariate regression analysis revealed that concomitant administration of ARs with CaC and a longer interdialysis interval (72 h) were significantly and independently associated with the magnitude of increase in serum phosphorus concentration between dialysis sessions. No significant differences in albumin-corrected serum calcium concentrations and incidence of pathological fractures were observed between patients receiving CaC alone and those receiving CaC with ARs. Concomitant use of ARs with CaC may attenuate the hypophosphatemic

  9. Reasons physicians do not recommend and patients refuse adjuvant chemotherapy for stage III colon cancer: a population based chart review.

    Science.gov (United States)

    El Shayeb, Mohamed; Scarfe, Andrew; Yasui, Yutaka; Winget, Marcy

    2012-06-07

    Surgery followed by adjuvant chemotherapy has been the standard of care for the treatment of stage III colon cancer since the early 1990's. Despite this, large proportions of patients do not receive adjuvant chemotherapy. We aimed to identify physicians' and patients' reasons for treatment decisions. A retrospective population based study was conducted that included all surgically treated stage III colon cancer patients diagnosed in Alberta between 2002 and 2005 who had an oncologist-consult to discuss post-surgical treatment options. Patient demographics and stage were obtained from the Alberta Cancer Registry. Chart reviews were conducted to extract treatment details, the oncologists' reasons for not recommending chemotherapy, and patients' reasons for refusing chemotherapy. The number and proportion of patients who were not recommended or refused chemotherapy were calculated. A total of 613 patients had surgery followed by an oncologist-consult. Overall, 168 (27%) patients did not receive chemotherapy. It was not recommended for 111 (18%) patients; the most frequent reason was presence of one or more co-morbidities (34%) or combination of co-morbidity and age or frailty (22%). Fifty-eight (9%) patients declined chemotherapy, 22% of whom declined due to concerns about toxicity. Some co-morbidities are clinical indications for not receiving adjuvant chemotherapy, however, the high percentage of patients who were not recommended adjuvant chemotherapy due to co-morbidities according to clinical notes but who had a low Charlson co-morbidity score suggests variation in practice patterns of consulting oncologists. In addition, patients' reasons for refusing treatment need to be systematically assessed to ensure patients' preferences and treatment benefits are properly weighed when making treatment decisions.

  10. Early repolarization in young children with attention-deficit/hyperactivity disorder versus normal controls: a retrospective preliminary chart review study.

    Science.gov (United States)

    Nahshoni, Eitan; Sclarovsky, Samuel; Spitzer, Sara; Zalsman, Gil; Strasberg, Boris; Weizman, Abraham

    2009-12-01

    Early repolarization (ER), considered a common and benign electrocardiographic pattern on the surface 12-lead electrocardiogram (ECG), was recently found to be prevalent among patients with idiopathic ventricular fibrillation. It is also highly predominant in physically active young males. Reports on sudden cardiac death (SCD) of children and adolescents treated with psychotropic agents have raised concerns regarding the need for cardiovascular monitoring and risk stratification schedules. The rate of ER pattern has not been estimated in children with attention deficit/hyperactivity disorder (ADHD). Thus, in the present retrospective chart review study, we estimated the rate of ER pattern, as well as RR, QT, and QTc intervals, from ECG tracings of physically healthy children with ADHD versus physically and mentally healthy controls. The ECG tracings of 50 children (aged 8.7 +/- 1.4 years; 12 girls, 44 boys) diagnosed as suffering from ADHD were compared to 55 physically and mentally healthy controls (aged 8.25 +/- 2.1 years; 20 girls, 35 boys). ER was defined as an elevation of the QRS-ST junction (J point) of at least 0.1 mV from baseline with slurring or notching of the QRS complex, and assessed separately by two senior cardiologists who were blind to all other data relating to the study participants. The rate of ER pattern was significantly higher in ADHD children compared to normal controls (32% vs. 13%, respectively, P = 0.012; relative risk [RR] = 1.68, 95% confidence interval [CI] 1.16-2.44), irrespective of stimulant treatment or gender. All other standard ECG measures (heart rate, QT and QTc intervals) were within normal range. The rate of ER in children with ADHD is significantly higher than in normal controls. Its clinical significance awaits further research.

  11. Off-label use of transmucosal ketamine as a rapid-acting antidepressant: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Nguyen L

    2015-10-01

    Full Text Available Linda Nguyen,1,2 Patrick J Marshalek,2 Cory B Weaver,1 Kathy J Cramer,2,3 Scott E Pollard,2,4 Rae R Matsumoto1,2,5 1Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV, USA; 2Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV, USA; 3Doctor of Nursing Practice Program, Robert Morris University, Moon Township, PA, USA; 4Department of Behavioral Health, West Park Hospital, Cody, WY, USA; 5College of Pharmacy, Touro University California, Vallejo, CA, USA Objective: This study evaluated the effectiveness and safety of subanesthetic doses of ketamine using an off-label, transmucosal administration route in patients with treatment-resistant depression.Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant major depressive disorder. Seventeen such patients who received subanesthetic doses of ketamine were included. Patient demographics, efficacy (drug refill, clinician notes, side effects, and concurrent medications were assessed.Results: Benefit from low-dose transmucosal ketamine was noted in 76% of subjects (average age 48 years, 88% female, with a dose duration lasting 7–14 days. No notable side effects were noted. The most common classes of concurrent medications to which ketamine was added were serotonin–norepinephrine reuptake inhibitors (59%, stimulants (47%, folate replacement (47%, and benzodiazepines (47%.Conclusion: Our results provide preliminary evidence of the effectiveness and safety of low-dose transmucosal ketamine in treatment-resistant patients. A controlled, prospective pilot study is warranted to validate these findings. Keywords: ketamine, depression, treatment resistance, NMDA receptor, glutamate, mood disorder 

  12. Failure-specific prognostic factors after continuous hyperfractionated accelerated radiotherapy (CHART) or conventional radiotherapy in locally advanced non-small-cell lung cancer: A competing risks analysis

    OpenAIRE

    Ataman, ? U; Bentzen, S M; Saunders, M I; Dische, S

    2001-01-01

    The aim of this study was to identify possible failure-specific prognostic factors in non-small-cell lung cancer. Clinical outcome was analysed in 549 patients participating in the randomized controlled trial of CHART vs conventional radiotherapy. Local failure and distant failure with or without concurrent local relapse were subjected to a competing risk analysis using an accelerated failure-time model with a log-logistic hazard function. Randomization to CHART (2 P = 0.005), increasing age ...

  13. Sensitivity analysis and stability charts for uniform slopes computed via the MLD methods in the frame of the limit equilibrium theory

    Science.gov (United States)

    Ausilia Paparo, Maria; Tinti, Stefano

    2013-04-01

    Stability charts represent a graphical solution to derive the safety factor (F) without incurring the difficulties of mathematical and numerical methods for the analysis of slope stability, widely used in the engineering field: employed in a preliminary phase of analysis, the consultation of charts allows one to determine the approximate equilibrium conditions. The first to develop this method is Taylor (1948) who made them of common use: his stability charts are the relationships between the height and the inclination of a schematic slope, for particular types of failure surface (toe circle, circle slope, and midpoint circle) and for different values of friction angle. Thereafter the charts have become more detailed and complete (Janbu, 1968), thanks to the continuous introduction of new methods, like the limit equilibrium method (LEM), the limit analysis method and the finite element method (FEM). The aim of this work is to compare sets of stability charts found in literature (Michalowski, 1997; 2002; Li et alii, 2009; Steward et alii, 2011; Zhang et alii, 2011) with new charts obtained with the results obtained by means of the method of minimum lithostatic deviation (MLD) introduced by Tinti and Manucci (2006 and 2008) for 2D problems: the slope is a homogenous body and we analyze different cases, by varying the geometry (e.g. the slope angle and height), the geotechnical parameters (such as cohesion and angle of friction), the pore pressure and the external loads (as seismic or hydrostatic loadings) treated as quasi-static forcing.

  14. Antibiotic prescribing patterns in the pediatric emergency department at Georgetown Public Hospital Corporation: a retrospective chart review.

    Science.gov (United States)

    Sharma, Suparna; Bowman, Clive; Alladin-Karan, Bibi; Singh, Narendra

    2016-04-19

    The increase in antimicrobial-resistant infections has led to significant morbidity, mortality, and healthcare costs. The impact of antimicrobial resistance is greatest on low-income countries, which face the double burden of fewer antibiotic choices and higher rates of infectious diseases. Currently, Guyana has no national policy on rational prescribing. This study aims to characterize antibiotic prescribing patterns in children discharged from the emergency department at Georgetown Public Hospital Corporation (GPHC), as per the World Health Organization (WHO) prescribing indicators. A retrospective chart review of pediatric patients (aged 1 month-13 years) seen in the GPHC emergency department between January and December 2012 was conducted. Outpatient prescriptions for eligible patients were reviewed. Patient demographics, diagnosis, and drugs prescribed were recorded. The following WHO Prescribing Indicators were calculated: i) average number of drugs prescribed per patient encounter, ii) percentage of encounters with an antibiotic prescribed, iii) percentage of antibiotics prescribed by generic name, and iv) percentage of antibiotics prescribed from essential drugs list or formulary. Eight hundred eleven patient encounters were included in the study. The mean patient age was 5.55 years (s = 3.98 years). 59.6 % (n = 483) patients were male. An average of 2.5 drugs were prescribed per encounter (WHO standard is 2.0). One or more antibiotic was prescribed during 36.9 % (n = 299) of all encounters (WHO standard is 30 %). 90.83 % of antibiotics were prescribed from the essential drugs formulary list and 30 % of the prescriptions included the drug's generic name. The average duration of antibiotic therapy was 5.73 days (s = 3.53 days). Of the 360 antibiotics prescribed, 74.7 % (n = 269) were broad-spectrum. B-lactam penicillins were prescribed most frequently (51.4 %), with amoxicillin being the most popular choice (33.9 %). The

  15. Patterns of paediatric end-of-life care: a chart review across different care settings in Switzerland.

    Science.gov (United States)

    Zimmermann, Karin; Cignacco, Eva; Engberg, Sandra; Ramelet, Anne-Sylvie; von der Weid, Nicolas; Eskola, Katri; Bergstraesser, Eva; Ansari, Marc; Aebi, Christoph; Baer, Reta; Popovic, Maja Beck; Bernet, Vera; Brazzola, Pierluigi; Bucher, Hans Ulrich; Buder, Regula; Cagnazzo, Sandra; Dinten, Barbara; Dorsaz, Anouk; Elmer, Franz; Enriquez, Raquel; Fahrni-Nater, Patricia; Finkbeiner, Gabi; Frey, Bernhard; Frey, Urs; Greiner, Jeannette; Hassink, Ralph-Ingo; Keller, Simone; Kretschmar, Oliver; Kroell, Judith; Laubscher, Bernard; Leibundgut, Kurt; Malaer, Reta; Meyer, Andreas; Stuessi, Christoph; Nelle, Mathias; Neuhaus, Thomas; Niggli, Felix; Perrenoud, Geneviève; Pfammatter, Jean-Pierre; Plecko, Barbara; Rupf, Debora; Sennhauser, Felix; Stade, Caroline; Steinlin, Maja; Stoffel, Lilian; Thomas, Karin; Vonarburg, Christian; von Vigier, Rodo; Wagner, Bendicht; Wieland, Judith; Wernz, Birgit

    2018-02-16

    Paediatric end-of-life care is challenging and requires a high level of professional expertise. It is important that healthcare teams have a thorough understanding of paediatric subspecialties and related knowledge of disease-specific aspects of paediatric end-of-life care. The aim of this study was to comprehensively describe, explore and compare current practices in paediatric end-of-life care in four distinct diagnostic groups across healthcare settings including all relevant levels of healthcare providers in Switzerland. In this nationwide retrospective chart review study, data from paediatric patients who died in the years 2011 or 2012 due to a cardiac, neurological or oncological condition, or during the neonatal period were collected in 13 hospitals, two long-term institutions and 10 community-based healthcare service providers throughout Switzerland. Ninety-three (62%) of the 149 reviewed patients died in intensive care units, 78 (84%) of them following withdrawal of life-sustaining treatment. Reliance on invasive medical interventions was prevalent, and the use of medication was high, with a median count of 12 different drugs during the last week of life. Patients experienced an average number of 6.42 symptoms. The prevalence of various types of symptoms differed significantly among the four diagnostic groups. Overall, our study patients stayed in the hospital for a median of six days during their last four weeks of life. Seventy-two patients (48%) stayed at home for at least one day and only half of those received community-based healthcare. The study provides a wide-ranging overview of current end-of-life care practices in a real-life setting of different healthcare providers. The inclusion of patients with all major diagnoses leading to disease- and prematurity-related childhood deaths, as well as comparisons across the diagnostic groups, provides additional insight and understanding for healthcare professionals. The provision of specialised palliative

  16. Pathways to Suicide in Lesbian and Gay Populations in Australia: A Life Chart Analysis.

    Science.gov (United States)

    Skerrett, Delaney M; Kõlves, Kairi; De Leo, Diego

    2017-07-01

    Given the continued paucity of research into suicide in lesbian and gay (LG) people, there is a need to investigate the characteristics of those LG suicides that are able to be identified. The aim of this article was to analyze pathways to suicide in lesbian and gay individuals by way of life charts. Data were gathered through of 24 psychological autopsy interviews with next-of-kin of an LG person who had died by suicide. The female (n = 5) and male (n = 19) cases in this study clustered into younger and older suicides. The defining feature of the younger suicides was lack of acceptance by family and, to a lesser extent, self, and that of the older suicides was romantic relationship conflict, although this was also common in younger suicides. There appears to have been, furthermore, an accumulation of risk factors, particularly in the period prior to death where these specific risk factors combined with other life stressors, such as work problems. Initiatives to reduce stigma around diversity in sexuality and to support families and young people through the "coming out" process as well as services designed to assist those experiencing problems in same-sex relationships, in particular, would appear to be the most relevant within the trajectories presented.

  17. Factors Associated with Length of Stay at Home in the Final Month of Life among Advanced Cancer Patients: A Retrospective Chart Review.

    Science.gov (United States)

    Otsuka, Masatomo

    2017-08-01

    Living at home is an important factor for maintaining high quality of life among patients. Many studies have discussed parameters associated with place of death, but no studies have yet clarified which factors influence the length of stay at home during the end of life. The aim of this study was to identify factors influencing the amount of time spent at home during the final month of life among patients with advanced cancer. A retrospective chart review was conducted for 415 patients with advanced cancer. Multivariate multiple linear regression analysis was used to examine relationships between the length of stay at home during the final month of life and variables measuring patient's background (four indicators), family structure (three indicators) cancer type (four types), chief complaint at initial palliative care referral (seven indicators), and medical interventions (three factors). The multiple linear regression predicting time spent at home in the last month of life yielded partial regression coefficients of 4.2 for past outpatient palliative care services (OPCS) (p life was a history of OPCS. Many patients with advanced cancer who receive chemotherapy without OPCS spend time as inpatients after an initial period at home. Palliative care interventions for outpatients effectively enable patients with advanced cancer to adapt and continue living at home.

  18. Fecal occult blood testing as a diagnostic test in symptomatic patients is not useful: a retrospective chart review.

    Science.gov (United States)

    Narula, Neeraj; Ulic, Diana; Al-Dabbagh, Raed; Ibrahim, Ali; Mansour, Maged; Balion, Cynthia; Marshall, John K

    2014-09-01

    The fecal occult blood test (FOBT) is a screening tool designed for the early detection of colorectal cancer in primary care. Although not validated for use in hospitalized patients, it is often used by hospital physicians for reasons other than asymptomatic screening. To profile the in-hospital use of the FOBT and assess its impact on patient care. Patient charts were retrospectively reviewed for all FOBTs conducted over a three-month period in 2011 by the central laboratory supporting the three acute care campuses of Hamilton Health Sciences (Hamilton, Ontario). A total of 229 patients underwent 351 tests; 52% were female and the mean age was 49 years (range one to 104 years). A total of 80 (34.9%) patients had at least one positive test. The most common indications for testing were anemia (51.0%) and overt gastrointestinal bleeding (19.2%). Only one patient had testing performed for asymptomatic colorectal cancer screening. In only 20 (8.7%) cases medications were modified before testing and diet was modified in only 21 (9.2%) cases. Most patients (85.2%) were taking one or more medications that could result in a false-positive result. Only 18 (7.9%) patients had a digital rectal examinations documented, of which seven were positive. All patients with a positive digital rectal examination underwent endoscopic procedures that revealed a source of bleeding. Among 44 patients with overt gastrointestinal bleeding, 12 (27.3%) had endoscopic investigations delayed to await results of the FOBT. Four patients were referred despite a negative FOBT due to a high degree of suspicion of gastrointestinal bleeding. The FOBT is often used inappropriately in the hospital setting. Confounding factors, such as diet and medication use, which may lead to false positives, are often ignored. Use of the FOBT in-hospital may lead to inappropriate management of patients, increased length of stay and increased direct medical costs. Use of the FOBT should be limited to validated

  19. Treatment Patterns and Early Outcomes of ALK-Positive Non-Small Cell Lung Cancer Patients Receiving Ceritinib: A Chart Review Study.

    Science.gov (United States)

    Bendaly, Edmond; Dalal, Anand A; Culver, Kenneth; Galebach, Philip; Bocharova, Iryna; Foster, Rebekah; Sasane, Medha; Macalalad, Alexander R; Guérin, Annie

    2017-05-01

    This study aimed to provide the first real-world description of the characteristics, treatments, dosing patterns, and early outcomes of patients with ALK-positive non-small cell lung cancer (NSCLC) who received ceritinib in US clinical practice. US oncologists provided data from medical charts of adult patients diagnosed with locally advanced or metastatic ALK-positive NSCLC who received ceritinib following crizotinib. Patient characteristics, treatment patterns, ceritinib dosing, early outcomes, and occurrence of gastrointestinal adverse events (AEs) by dose and instructions on food intake were assessed, and Kaplan-Meier analysis was used to describe clinician-defined progression-free survival (PFS) on ceritinib. Medical charts of 58 ALK-positive NSCLC patients treated with ceritinib were reviewed (median age 63 years; 41% male; 21% with prior chemotherapy experience). At ceritinib initiation, 44 patients had multiple distant metastases, most commonly in the liver (60%), bone (53%), and brain (38%). Initial ceritinib dose varied: 71% received 750 mg, 19% 600 mg, and 10% 450 mg. Although median follow-up after ceritinib initiation was short (3.8 months), most patients achieved either a complete or partial response (69%) on ceritinib, regardless of metastatic sites present at initiation or initial dose. Median PFS on ceritinib was 12.9 months. 17% of patients had a gastrointestinal AE reported during follow-up. The majority of events occurred in patients instructed to fast; no patients instructed to take a lower dose of ceritinib with food reported gastrointestinal AEs. These early findings of ceritinib use in clinical practice suggest that ceritinib is effective at treating crizotinib-experienced ALK-positive NSCLC patients, regardless of metastatic sites or initial dose, and dosing ceritinib with food may lead to fewer gastrointestinal AEs. Future studies with larger sample size and longer follow-up are warranted, including an ongoing randomized trial to

  20. SU-E-T-138: Automated Chart Review Module Including Cross-Vendor Data Transfer Verification Developed for IHE-RO Initiative

    International Nuclear Information System (INIS)

    Brewer, M; Gordon, C; Tien, C

    2015-01-01

    Purpose: To follow the Integrating Healthcare Enterprise - Radiation Oncology (IHE-RO) initiative of proper cross-vendor technology integration, an automated chart checker (ACC) was developed. ACC compares extracted data from an approved patient plan in the Eclipse treatment planning system (TPS) against data existing in the Mosaiq treatment management system (TMS). ACC automatically analyzes these parameters using built-in quality checklists to provide further aid in chart review. Methods: Eclipse TPS data are obtained using Eclipse scripting API (ESAPI) while Mosaiq TMS data are obtained from a radiotherapy-treatment-planning (RTP) file. Using this information, ACC identifies TPS-TMS discrepancies in 18 primary beam parameters including MU, energy, jaw positions, gantry angle, table angle, accessories, and bolus for up to 31 beams. Next, approximately 40 items from traditional quality checklists are evaluated such as prescription consistency, DRR graticule placement, plan approval status, global max dose, and dose tracking coefficients. Parameters were artificially modified to determine if ACC would detect an error in data transfer and to test each component of quality checklists. Results: Using ESAPI scripting and RTP file-processing, ACC was able to properly aggregate data from TPS and TMS for up to 31 beams. Errors were artificially introduced into each plan parameter, and ACC was able to successfully detect all of them within seconds. Next, ACC was able to successfully detect mistakes in the chart by identifying deviations with its quality checklists, within seconds. Conclusion: ACC effectively addresses the potential issue of faulty cross-vendor data transfer, as described by IHE-RO. In addition, ACC was also able to detect deviations from its built-in quality checklists. ACC is already an invaluable tool for efficient and standardized chart review and will continue to improve as its incorporated checklists become more comprehensive

  1. Excel 2007 Charts

    CERN Document Server

    Walkenbach, John

    2008-01-01

    Excel, the top number-crunching tool, now offers a vastly improved charting function to help you give those numbers dimension and relativity. John Walkenbach, a.k.a. Mr. Spreadsheet, clearly explains all these charting features and shows you how to choose the right chart for your needs. You'll learn to modify data within the chart, deal with missing data, format your chart, use trend lines, construct "impossible" charts, create charts from pivot tables, dress them up with graphics, and more. Note: CD-ROM/DVD and other supplementary materials are not included as part of eBook file.

  2. Charting the trends in nuclear techniques for analysis of inorganic environmental pollutants

    International Nuclear Information System (INIS)

    Braun, T.

    1986-01-01

    Publications in Analytical Abstracts in the period 1975-1984 and papers presented at the Modern Trends in Activation Analysis international conferences series in the period 1961-1986 have been used as an empirical basis for assessing general trends in research and publication activity. Some ebbs and flows in the speciality of instrumental techniques for analysis of environmental trace pollutants are revealed by a statistical analysis of the publications. (author)

  3. Patterns of care among patients receiving sequential targeted therapies for advanced renal cell carcinoma: A retrospective chart review in the USA.

    Science.gov (United States)

    Pal, Sumanta K; Signorovitch, James E; Li, Nanxin; Zichlin, Miriam L; Liu, Zhimei; Ghate, Sameer R; Perez, Jose Ricardo; Vogelzang, Nicholas J

    2017-04-01

    To assess real-world treatment patterns of targeted therapies after failure of first-line tyrosine kinase inhibitors in patients with advanced renal cell carcinoma. A large, retrospective review of medical charts of patients with advanced renal cell carcinoma in the USA was carried out. Descriptive statistics were used to summarize physicians' and patients' characteristics, treatment sequences, and reasons for treatment choices. P-values were calculated using χ 2 -tests for categorical variables and Wilcoxon rank-sum tests for continuous variables. A descriptive comparison was carried out between current results and those of a previous treatment pattern study conducted in 2012 to identify changes in treatment patterns over time. Sunitinib and everolimus remained the most commonly-used first and second targeted therapies, respectively. Among patients who continued to a third targeted therapy, everolimus and axitinib were the most commonly-used treatments after second targeted therapy with a tyrosine kinase inhibitor and a mammalian target of rapamycin inhibitor, respectively. The use of pazopanib as first targeted therapy, and of axitinib and sorafenib as second targeted therapies, increased over time. Efficacy, treatment guidelines and a different mechanism of action were the main reasons given by physicians for choosing among second targeted therapies after failure of a first tyrosine kinase inhibitor. The results of the present study document patterns of care during a period of rapid and ongoing therapeutic advancement in advanced renal cell carcinoma. Sequencing of therapies warrants ongoing analysis in light of new agents entering the advanced renal cell carcinoma treatment landscape. © 2017 The Japanese Urological Association.

  4. Clinical significance of coryneform Gram-positive rods from blood identified by MALDI-TOF mass spectrometry and their susceptibility profiles - a retrospective chart review.

    Science.gov (United States)

    Mushtaq, Ammara; Chen, Derrick J; Strand, Gregory J; Dylla, Brenda L; Cole, Nicolynn C; Mandrekar, Jayawant; Patel, Robin

    2016-07-01

    With the advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), most Gram-positive rods (GPRs) are readily identified; however, their clinical relevance in blood cultures remains unclear. Herein, we assessed the clinical significance of GPRs isolated from blood and identified in the era of MALDI-TOF MS. A retrospective chart review of patients presenting to the Mayo Clinic, Rochester, MN, from January 1, 2013, to October 13, 2015, was performed. Any episode of a positive blood culture for a GPR was included. We assessed the number of bottles positive for a given isolate, time to positivity of blood cultures, patient age, medical history, interpretation of culture results by the healthcare team and whether infectious diseases consultation was obtained. We also evaluated the susceptibility profiles of a larger collection of GPRs tested in the clinical microbiology laboratory of the Mayo Clinic, Rochester, MN from January 1, 2013, to October 31, 2015. There were a total of 246 GPRs isolated from the blood of 181 patients during the study period. 56% (n = 101) were deemed contaminants by the healthcare team and were not treated; 33% (n = 59) were clinically determined to represent true bacteremia and were treated; and 8% (n = 14) were considered of uncertain significance, with patients prescribed treatment regardless. Patient characteristics associated with an isolate being treated on univariate analysis included younger age (P = 0.02), identification to the species level (P = 0.02), higher number of positive blood culture sets (P blood culture sets (P = 0.0005) and lower time to positivity (P = 0.03) were associated with an isolate being treated. 100, 83, 48 and 34% of GPRs were susceptible to vancomycin, meropenem, penicillin and ceftriaxone, respectively. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Development and validation of a medical chart review checklist for symptom management performance of oncologists in the routine care of patients with advanced cancer.

    Science.gov (United States)

    Blum, David; Rosa, Daniel; deWolf-Linder, Susanne; Hayoz, Stefanie; Ribi, Karin; Koeberle, Dieter; Strasser, Florian

    2014-12-01

    Oncologists perform a range of pharmacological and nonpharmacological interventions to manage the symptoms of outpatients with advanced cancer. The aim of this study was to develop and test a symptom management performance checklist (SyMPeC) to review medical charts. First, the content of the checklist was determined by consensus of an interprofessional team. The SyMPeC was tested using the data set of the SAKK 96/06 E-MOSAIC (Electronical Monitoring of Symptoms and Syndromes Associated with Cancer) trial, which included six consecutive visits from 247 patients. In a test data set (half of the data) of medical charts, two people extracted and quantified the definitions of the parameters (content validity). To assess the inter-rater reliability, three independent researchers used the SyMPeC on a random sample (10% of the test data set), and Fleiss's kappa was calculated. To test external validity, the interventions retrieved by the SyMPeC chart review were compared with nurse-led assessment of patient-perceived oncologists' palliative interventions. Five categories of symptoms were included: pain, fatigue, anorexia/nausea, dyspnea, and depression/anxiety. Interventions were categorized as symptom specific or symptom unspecific. In the test data set of 123 patients, 402 unspecific and 299 symptom-specific pharmacological interventions were detected. Nonpharmacological interventions (n = 242) were mostly symptom unspecific. Fleiss's kappa for symptom and intervention detections was K = 0.7 and K = 0.86, respectively. In 1003 of 1167 visits (86%), there was a match between SyMPeC and nurse-led assessment. Seventy-nine percent (195 of 247) of patients had no or one mismatch. Chart review by SyMPeC seems reliable to detect symptom management interventions by oncologists in outpatient clinics. Nonpharmacological interventions were less symptom specific. A template for documentation is needed for standardization. Copyright © 2014 American Academy of Hospice and

  6. Prenatal Genetic Testing Chart

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Prenatal Genetic Testing Chart (Infographic) Home For Patients Search FAQs Prenatal Genetic Testing Chart (Infographic) PFSI010 ››› Weeks 1–4 ...

  7. Surface Prognostic Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Surface Prognostic Charts are historical surface prognostic (forecast) charts created by the United States Weather Bureau. They include fronts, isobars, cloud, and...

  8. A dispersion control chart

    NARCIS (Netherlands)

    Riaz, M.

    2008-01-01

    The study proposes a Shewhart-type control chart, namely Q chart, based on inter-quartile range, for monitoring changes (especially of moderate and large amounts which is major concern of Shewhart-type control charts) in process dispersion assuming normality of quality characteristic to be

  9. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

    Science.gov (United States)

    Schrem, Harald; Schneider, Valentin; Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

    2016-01-01

    The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (pcancer during aftercare with no significant relation to identified risk factors for cancer-free survival (pcancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers.

  10. Medication use is associated with fatigue in a sample of community-living individuals who have a spinal cord injury: a chart review.

    Science.gov (United States)

    Lee, A K Y; Miller, W C; Townson, A F; Anton, H A

    2010-05-01

    To investigate the relationship between medications known to cause fatigue in spinal cord injury (SCI) and fatigue severity and to describe the pattern of prescription of these medications. Retrospective chart review. GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada. Medical charts of 136 individuals admitted to the GF Strong Outpatient SCI Program between December 2004 and May 2007 were reviewed. Data collected included information on medications, clinical and demographic characteristics and Fatigue Severity Scale (FSS) scores. Multiple linear regression techniques were used to analyse the data. Fifty-two percent of the subjects had clinically relevant fatigue. As a group, the subjects were taking 147 different medications; 41/147 medications were identified as causing fatigue. The two most commonly prescribed categories of medications were antispasticity medications (75 subjects) and analgesic medications (61 subjects). Although several variables were found to contribute to the FSS scores including the use of fatigue-causing medications, the presence of pain (7.6% of variance) and the use of fatigue-causing analgesics (4.2% of variance) explained the most variance in the scores. Fatigue is prevalent in outpatients with SCI. Fatigue-causing medications contribute to a higher FSS score. Clinicians treating persons with SCI should be aware that fatigue is a common and significant problem. Clinicians should be aware that fatigue may be exacerbated by the use of medication and should enquire about the effects of medication on fatigue when assessing and prescribing new medications.

  11. AMDIS and CHART update. 1

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, I.; Kato, T. [National Inst. for Fusion Science, Toki, Gifu (Japan); Igarashi, A. [Miyazaki Univ., Miyazaki (JP)] [and others

    2002-10-01

    A working group for updating atomic and molecular collision data in the NIFS database AMDIS (electron scattering) and CHART (ion scattering) has been organized. This group has searched and reviewed literatures for collecting relevant atomic data with are to be included into the database. This is a summary report of the activities of this working group. (author)

  12. S-CHART - SCHEDULING CHART PROGRAM

    Science.gov (United States)

    Klinkner, E. R.

    1994-01-01

    The Scheduling Chart Program (S-Chart) uses simple menu choices to produce high quality Gantt type scheduling and production time-line charts with minimal data entry requirements. The software produces high quality charts (20, 40, and 80 day options) in 10-20 minutes including start up, data entry, and printing. Reprints take less than one minute. Some of the more significant features are as follows: speed and ease of use with menu driven selections from start to finish, storage and catalogs of all data sets for rapid access and manipulation, compact program size to permit storage of dozens of data sets on the program disc, and creation of ASCII text files of graphs for rapid printing. The final product of the plot routine is an extended ASCII character file which shows the events scheduled and actual work dates. This file may be printed from the program, from DOS, or imported to a word processor for customizing. S-Chart is not intended to take the place of commercial scheduling/project management software. However, it is a simple, somewhat limited Gantt chart plotter and scheduling tracking program with an emphasis on straightforward data entry. There is no complex relationship building between the scheduled events. Dates are entered as dates, not as algebraic functions. All the files of S-Chart, except for the graph picture and the stand-alone executable, were written in 100% dBASE III compatible code. The executable code was created with CLIPPER and the graph picture files are written in ASCII code. S-Chart was implemented on an IBM PC series machine under DOS and requires 215k bytes of memory. The program was developed in 1988.

  13. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

    Directory of Open Access Journals (Sweden)

    Harald Schrem

    Full Text Available The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers.1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences.Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21. Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46, post-transplant lymphoproliferative disorder (SIR = 8.36, prostate cancer (SIR = 2.22, bladder cancer (SIR = 3.24, thyroid cancer (SIR = 10.13 and melanoma (SIR = 3.08. Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29, polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD (p = 0.001, HR: 0.68, high body mass index in kg/m2 (p<0.001, HR: 1.04, ADPKD (p = 0.008, HR: 1.26 and diabetic nephropathy (p = 0.004, HR = 1.51. G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05.Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes

  14. Differential medical and surgical house staff involvement in end-of-life decisions: A retrospective chart review.

    Science.gov (United States)

    Kelley, Amy S; Gold, Heather T; Roach, Keith W; Fins, Joseph J

    2006-08-01

    To quantify the house officer's role in end-of-life decisions, the authors abstracted charts for documentation of end-of-life discussions for 100 patients withdrawn from life-sustaining treatment. They assessed the proportion of end-of-life care notes written by house officers, controlling for service, length of stay, outpatient physician involvement, race, and diagnostic category. Patients on the medical service were 22 times more likely to have house officer end-of-life notes than patients on the surgical service (P house officer (P House officers on the medical service wrote a significantly greater proportion of notes regarding withdrawal of care than surgical house officers (41% vs. 10%, P house officers in primary end-of-life discussions with a complex patient population undergoing withdrawal of life-sustaining therapy. Team structure and professional culture may account for some of the observed differences between the medical and surgical services. These findings have significant implications for the education of house officers on end-of-life communication.

  15. Application of statistical process control charts to monitor changes in animal production systems.

    Science.gov (United States)

    De Vries, A; Reneau, J K

    2010-04-01

    Statistical process control (SPC) is a method of monitoring, controlling, and improving a process through statistical analysis. An important SPC tool is the control chart, which can be used to detect changes in production processes, including animal production systems, with a statistical level of confidence. This paper introduces the philosophy and types of control charts, design and performance issues, and provides a review of control chart applications in animal production systems found in the literature from 1977 to 2009. Primarily Shewhart and cumulative sum control charts have been described in animal production systems, with examples found in poultry, swine, dairy, and beef production systems. Examples include monitoring of growth, disease incidence, water intake, milk production, and reproductive performance. Most applications describe charting outcome variables, but more examples of control charts applied to input variables are needed, such as compliance to protocols, feeding practice, diet composition, and environmental factors. Common challenges for applications in animal production systems are the identification of the best statistical model for the common cause variability, grouping of data, selection of type of control chart, the cost of false alarms and lack of signals, and difficulty identifying the special causes when a change is signaled. Nevertheless, carefully constructed control charts are powerful methods to monitor animal production systems. Control charts might also supplement randomized controlled trials.

  16. Comparison of disease-severity measures within severe and very severe COPD patients: results from a nationally representative chart review and patient survey

    Directory of Open Access Journals (Sweden)

    Solem CT

    2014-09-01

    Full Text Available Caitlyn T Solem,1 Shawn X Sun,2 Sizhu Liu,1 Cynthia Macahilig,3 Monica Katyal,3 Xin Gao,1 Andrew F Shorr4 1Pharmerit International, Bethesda, MD, 2Forest Research Institute, Jersey City, NJ, 3Medical Data Analytics, Parsippany, NJ, 4Pulmonary Critical Care, Washington Hospital Center and Georgetown University, Washington, DC, USA Objective: This study aimed to compare spirometry- and risk + symptom-based classification systems to physician-based severity assessment and find which system is most predictive of patient-reported health status, as measured by the St George's Respiratory Questionnaire for COPD (chronic obstructive pulmonary disease; SGRQ-C.Materials and methods: In this chart review/patient survey, 99 physicians recruited patients with physician-assessed severe or very severe COPD who had recently experienced a moderate or severe exacerbation. A cross-tabulation was undertaken comparing physician report, spirometry (mild/moderate, forced expiratory volume in 1 second [FEV1] ≥50%; severe, 30% ≤ FEV1 <50%; very severe, FEV1 <30% predicted, and risk + symptom-based (A, low risk/fewer symptoms; B, low risk/more symptoms; C, high risk/fewer symptoms; D, high risk/more symptoms severity systems. Analysis of covariance models were run for SGRQ-C, varying COPD-severity systems.Results: Of 244 patients, 58.6% were severe and 34.8% very severe by physician report, 70% had FEV1 ≤50% at their most recent visit, and 86% fell into quadrant D. Spirometry and physician report had 57.4% agreement, with physicians often indicating higher severity. Physician report and risk + symptom agreement was high (81.2% severe/very severe and D. Physician-reported severity, risk + symptoms, exacerbations in the previous year, and symptoms were significant SGRQ-C predictors, while spirometry was not.Conclusion: For recently exacerbating severe or very severe COPD patients, risk + symptoms more closely aligned with physician-reported severity and SGRQ-C versus

  17. Factors Associated with Opioid Dose Increases: A Chart Review of Patients' First Year on Long-Term Opioids.

    Science.gov (United States)

    Bautista, Christopher A; Iosif, Ana-Maria; Wilsey, Barth L; Melnikow, Joy A; Crichlow, Althea; Henry, Stephen G

    2017-05-01

    To examine encounter-level factors associated with opioid dose increases during patients' first year on opioid therapy for chronic pain. Case-control study analyzing all opioid prescriptions for patients with chronic pain during their first year after opioid initiation. Cases were patients who experienced an overall dose escalation of ≥ 30 mg morphine equivalents over the 1-year period; controls did not experience overall dose escalation. Main measures were encounter type, opioid dose change, documented prescribing rationale, documentation of guideline-concordant opioid-prescribing practices. Two coders reviewed all encounters associated with opioid prescriptions. Analysis of factors associated with dose increases and provider documentation of prescribing rationale was conducted using multiple logistic regression. There were 674 encounters coded for 66 patients (22 cases, 44 controls). Fifty-three percent of opioid prescriptions were associated with telephone encounters; 13% were associated with e-mail encounters. No prescribing rationale was documented for 43% of all opioid prescriptions and 25% of dose increases. Likelihood of dose increase and documentation of prescribing rationale did not significantly differ for cases versus controls. Compared with face-to-face encounters, dose increases were significantly less likely for telephone (OR 0.18, 95% CI 0.11-0.28) and e-mail (OR 0.23, 95% CI 0.12-0.47) encounters; documentation of prescribing rationale was significantly more likely for e-mail (OR 5.06, 95% CI 1.87-13.72) and less likely for telephone (OR 0.30, 95% CI 0.18-0.51) encounters. Most opioid prescriptions were written without face-to-face encounters. One quarter of dose increases contained no documented prescribing rationale. Documented encounter-level factors were not significantly associated with overall opioid dose escalation. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  18. Assessing adherence to accepted national guidelines for immigrant and refugee screening and vaccines in an urban primary care practice: a retrospective chart review.

    Science.gov (United States)

    Waldorf, Barbara; Gill, Christopher; Crosby, Sondra S

    2014-10-01

    In the United States, 38.5 million people are foreign-born, one in three arriving since 2000. Health issues include high rates of hepatitis B, humanimmunodeficiency virus infection, parasitic infections, and M. tuberculosis. We sought to determine rates of provider adherence to accepted national guidelines for immigrant and refugee health screening and vaccines done at the primary care clinics at Boston Medical Center. Randomized, retrospective chart review of foreign born patients in the primary care clinics. We found low screening and immunization rates that do not conform to CDC/ACIP guidelines. Only 43 % of immigrant patients had tuberculosis screening, 36 % were screened for HIV and hepatitis B, and 33 % received tetanus vaccinations. Organizational changes incorporating multi-disciplinary approaches such as creative use of nursing staff, protocols, standing orders, EMR reminders, and web based educational tools can contribute to better outcomes by identifying patients and improving utilization of guidelines.

  19. Fractional smith chart theory

    KAUST Repository

    Shamim, Atif

    2011-03-01

    For the first time, a generalized Smith chart is introduced here to represent fractional order circuit elements. It is shown that the standard Smith chart is a special case of the generalized fractional order Smith chart. With illustrations drawn for both the conventional integer based lumped elements and the fractional elements, a graphical technique supported by the analytical method is presented to plot impedances on the fractional Smith chart. The concept is then applied towards impedance matching networks, where the fractional approach proves to be much more versatile and results in a single element matching network for a complex load as compared to the two elements in the conventional approach. © 2010 IEEE.

  20. Treatment patterns, health care utilization, and costs of ovarian cancer in Central and Eastern Europe using a Delphi panel based on a retrospective chart review.

    Science.gov (United States)

    Kim, Kun; Hernlund, Emma; Hernadi, Zoltán; Révész, János; Pete, Imre; Szánthó, András; Bodnar, Lubomir; Madry, Rodoslaw; Timorek-Lemieszczuk, Agnieszka; Bozanovic, Tatjana; Vasovic, Suzana; Tomasevic, Zorica; Zivaljevic, Milica; Pazin, Vladimir; Minárik, Tomáš; Garanová, Hana; Helpianska, Lýdia; Justo, Nahila

    2013-06-01

    Despite the considerable disease burden of ovarian cancer, there were no cost studies in Central and Eastern Europe. This study aimed to describe treatment patterns, health care utilization, and costs associated with treating ovarian cancer in Hungary, Poland, Serbia, and Slovakia. Overall clinical practice for management of epithelial ovarian cancer was investigated through a 3-round Delphi panel. Experts completed a survey based on the chart review (n = 1542). The survey was developed based on clinical guidelines and the International Federation of Gynecology and Obstetrics Annual Report. Means, ranges, and outlier values were discussed with the experts during a telephone interview. Finally, consensus estimates were obtained in face-to-face workshops. Based on these results, overall cost of ovarian cancer was estimated using a Markov model. The patients included in the chart review were followed up from presurgical diagnosis and in each phase of treatment, that is, surgical staging and primary surgery, chemotherapy and chemotherapy monitoring, follow-up, and palliative care. The 5-year overall cost per patient was €14,100 to €16,300 in Hungary, €14,600 to €15,800 in Poland, €7600 to €8100 in Serbia, and €12,400 to €14,500 in Slovakia. The main components were chemotherapy-associated costs (68%-74% of the total cost), followed by cost of primary treatment with surgery (15%-21%) and palliative care (3%-10%). Patients with ovarian cancer consume considerable health care resources and incur substantial costs in Central and Eastern Europe. These findings may prove useful for clinicians and decision makers in understanding the economic implications of managing ovarian cancer in Central and Eastern Europe and the need for innovative therapies.

  1. Characteristics, treatment patterns, and survival among ALK+ non-small cell lung cancer (NSCLC) patients treated with crizotinib: A chart review study.

    Science.gov (United States)

    Cadranel, Jacques; Park, Keunchil; Arrieta, Oscar; Pless, Miklos; Bendaly, Edmond; Patel, Dony; Sasane, Medha; Nosal, Adam; Swallow, Elyse; Galebach, Philip; Kageleiry, Andrew; Stein, Karen; Degun, Ravi; Zhang, Jie

    2016-08-01

    Second-generation ALK inhibitors are recently available for ALK+ non-small cell lung cancer (NSCLC) patients previously treated with crizotinib. This study described characteristics, treatment sequencing, and outcomes among locally advanced/metastatic crizotinib-experienced ALK+ NSCLC patients. From July 2014 to June 2015, a retrospective patient chart review was conducted among physicians from the US, EU, Korea, and Latin America. Participating clinicians identified their ALK+ NSCLC patients who received crizotinib and reported on their clinical characteristics, treatments, and survival using a pre-defined case report form. Kaplan-Meier analyses were used to describe overall survival (OS) and clinician-defined progression-free survival (PFS). Participating clinicians reviewed charts of 158 ALK+ NSCLC patients treated with crizotinib during the study period. Crizotinib was most commonly received in the second-line setting (41% of patients), though this varied across geographical regions. Roughly half (53%) of the patients who discontinued crizotinib received further antineoplastic therapy; second-generation ALK inhibitors (44%) and chemotherapy (42%) regimens were used most frequently. Following crizotinib discontinuation, median OS was 8.2 months. Among patients who did not initiate a second-generation ALK inhibitor following crizotinib, median OS was 4.9 months; among those who did, median OS was not reached. Among patients who received chemotherapy immediately following crizotinib discontinuation, time to clinician-defined PFS from post-crizotinib chemotherapy initiation was 3.6 months. Following crizotinib discontinuation, many patients received no further antineoplastic therapy, and OS was poor among patients who did not receive a second-generation ALK inhibitor. Recently available second-generation ALK inhibitors may provide important treatment options for ALK+ NSCLC patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. The use of the prospective NIMH Life Chart Method as a bipolar mood assessment method in research: a systematic review of different methods, outcome measures and interpretations.

    Science.gov (United States)

    Koenders, M A; Nolen, W A; Giltay, E J; Hoencamp, E; Spijker, A T

    2015-04-01

    The severity of bipolar disorder can be assessed using the daily prospective National Institute of Mental Health׳s Life Chart Method (LCM-p). Also for scientific research the LCM-p, has been used frequently. However, processing and analyzing the LCM-p for research purposes, are challenging because of the multitude of complex measures that can be derived from the data. In the current paper we review the different LCM-p course variables (mood episodes, average severity, proportion of time ill and mood switches) and their definitions. Strengths and limitations and the impact of the use of different LCM-p course measures and definitions on the research results are described. A systematic review of original papers on the LCM was conducted using 9 electronic databases for literature between January 1996 and December 2014. Papers using other prospective charting procedures were not evaluated in the current study. The initial literature search led to 1352 papers of which 21 were eventually selected. A relatively wide variety of definitions of LCM-p course variables was used across the studies. Especially for the calculation of number of episodes and mood switch no univocal definition seems to exist. Across studies several different durations and severity criteria are applied to calculate these variables. We describe which variables and definitions are most suitable for detecting specific bipolar disease course characteristics and patterns. In the absence of a golden standard for the calculation of LCM-p course variables, researchers should report the exact method they applied to their LCM-p data, and clearly motivate why this is their method of first choice considering their research aim. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Are the current Indian growth charts really representative? Analysis of anthropometric assessment of school children in a South Indian district

    Directory of Open Access Journals (Sweden)

    V Kumaravel

    2014-01-01

    Full Text Available Background: India currently is posed by the double threat of thinness and overweight/obesity among children. Different growth charts have taken different population and give different cut-off points to assess these conditions. Objective: The objective of this study is to assess the anthropometry of school children, 5-18 years of age and thereby estimate the prevalence of childhood thinness, overweight and obesity. To analyze how the study population compares with that of Agarwal′s growth chart. Materials and Methods: The anthropometric measurements of all the students who were studying from 1 st to 12 th standards were taken from 27 randomly selected Government and private schools. Prevalence of thinness, overweight and obesity were assessed using two standards - Indian standard given by Agarwal and International Standards given by International Obesity Task Force (IOTF. Results: The prevalence of thinness, overweight and obesity among 18,001 students enrolled as per Indian standard were 12.2%, 9.5% and 3% and as per International standard were 15.3%, 8.1% and 2.6% respectively. The mean and the 95 th percentile values of body mass index for both boys and girls at all ages in this study are falling short of Agarwal′s and IOTF values. Using international cut-offs as well as Indian cut-offs given by Agarwal, underestimate the prevalence of obesity among boys and girls of all age groups. Conclusion: This study shows that under and over-nutrition among school children is in almost equal proportions. There is an underestimation of obesity among children whenever an Indian or an International growth chart is used. Thus, this study brings out the need for a really representative growth chart.

  4. Retrospective chart review of obesity and episodic and chronic illness among rural Mexican-American adolescents accessing rural health clinic services.

    Science.gov (United States)

    Champion, Jane Dimmitt; Pierce, Sherrie; Collins, Jennifer L

    2015-06-01

    Obesity impacts the physical and psychological health of children and adolescents, and is a risk factor for development of episodic and chronic illness. Rural Mexican-American adolescents are at risk for obesity and associated chronic illnesses.The study used a retrospective chart review of data collected routinely in a rural health clinic setting from 1 January 2005 to 31 December 2010 to assess incidence of overweight/obesity status and episodic or chronic illness among Mexican-American adolescents aged 12-18 years. Analyses included body mass index, age, gender, and episodic or chronic illness diagnoses. Two hundred twelve charts were audited; women (n = 114, 53.8%), men (n = 98 46.2%); normal (n = 105, 49.5%), overweight/obese (n = 107, 50.5%). There were more female normal (n = 61, 53.5%) vs. overweight/obese (n = 53, 46.5%). More male overweight/obese (n = 54, 55.1%) than normal weight (n = 44, 44.9%). Age at first documented overweight/obesity status occurred in early adolescence (median = 13 years, mode = 12 years). Chronic illness incidence was higher among men than women, and overweight/obese vs. normal weight adolescents and in sub-categorizations by weight and specific illness. Incidence of episodic illness was higher among women than men, with variation by weight and specific illness. Disproportionately high incidence of episodic or chronic illness and overweight/obesity identified among rural Mexican-American adolescents compels intervention modification to improve effectiveness. © 2014 Wiley Publishing Asia Pty Ltd.

  5. Color Charts, Esthetics, and Subjective Randomness

    Science.gov (United States)

    Sanderson, Yasmine B.

    2012-01-01

    Color charts, or grids of evenly spaced multicolored dots or squares, appear in the work of modern artists and designers. Often the artist/designer distributes the many colors in a way that could be described as "random," that is, without an obvious pattern. We conduct a statistical analysis of 125 "random-looking" art and design color charts and…

  6. Radar chart array analysis to visualize effects of formulation variables on IgG1 particle formation as measured by multiple analytical techniques.

    Science.gov (United States)

    Kalonia, Cavan; Kumru, Ozan S; Kim, Jae Hyun; Middaugh, C Russell; Volkin, David B

    2013-12-01

    This study presents a novel method to visualize protein aggregate and particle formation data to rapidly evaluate the effect of solution and stress conditions on the physical stability of an immunoglobulin G (IgG) 1 monoclonal antibody (mAb). Radar chart arrays were designed so that hundreds of microflow digital imaging (MFI) solution measurements, evaluating different mAb formulations under varying stresses, could be presented in a single figure with minimal loss of data resolution. These MFI radar charts show measured changes in subvisible particle number, size, and morphology distribution as a change in the shape of polygons. Radar charts were also created to visualize mAb aggregate and particle formation across a wide size range by combining data sets from size-exclusion chromatography, Archimedes resonant mass measurements, and MFI. We found that the environmental/mechanical stress condition (e.g., heat vs. agitation) was the most important factor in influencing the particle size and morphology distribution with this IgG1 mAb. Additionally, the presence of NaCl exhibited a pH and stress-dependent behavior resulting in promotion or inhibition mAb particle formation. This data visualization technique provides a comprehensive analysis of the aggregation tendencies of this IgG1 mAb in different formulations with varying stresses as measured by different analytical techniques. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association.

  7. Application of radar chart array analysis to visualize effects of formulation variables on IgG1 particle formation as measured by multiple analytical techniques

    Science.gov (United States)

    Kalonia, Cavan; Kumru, Ozan S.; Kim, Jae Hyun; Middaugh, C. Russell; Volkin, David B.

    2013-01-01

    This study presents a novel method to visualize protein aggregate and particle formation data to rapidly evaluate the effect of solution and stress conditions on the physical stability of an IgG1 monoclonal antibody (mAb). Radar chart arrays were designed so that hundreds of Microflow Digital Imaging (MFI) solution measurements, evaluating different mAb formulations under varying stresses, could be presented in a single figure with minimal loss of data resolution. These MFI radar charts show measured changes in subvisible particle number, size and morphology distribution as a change in the shape of polygons. Radar charts were also created to visualize mAb aggregate and particle formation across a wide size range by combining data sets from size exclusion chromatography (SEC), Archimedes resonant mass measurements, and MFI. We found that the environmental/mechanical stress condition (e.g., heat vs. agitation) was the most important factor in influencing the particle size and morphology distribution with this IgG1 mAb. Additionally, the presence of NaCl exhibited a pH and stress dependent behavior resulting in promotion or inhibition mAb particle formation. This data visualization technique provides a comprehensive analysis of the aggregation tendencies of this IgG1 mAb in different formulations with varying stresses as measured by different analytical techniques. PMID:24122556

  8. The classification of candlestick charts

    OpenAIRE

    Etschberger, Stefan

    2006-01-01

    The classification of candlestick charts : laying the Foundation for Further Empirical Research / C. Klein ... - In: From data and information analysis to knowledge engineering : proc. of the 29th Annual Conference of the Gesellschaft für Klassifikation e.V., Univ. of Magdeburg, March 9-11, 2005 / Myra Spiliopoulou ... eds. - Berlin u.a. : Springer, 2006. - (Studies in classification, data analysis, and knowledge organization)

  9. Software tool for physics chart checks.

    Science.gov (United States)

    Li, H Harold; Wu, Yu; Yang, Deshan; Mutic, Sasa

    2014-01-01

    Physics chart check has long been a central quality assurance (QC) measure in radiation oncology. The purpose of this work is to describe a software tool that aims to accomplish simplification, standardization, automation, and forced functions in the process. Nationally recognized guidelines, including American College of Radiology and American Society for Radiation Oncology guidelines and technical standards, and the American Association of Physicists in Medicine Task Group reports were identified, studied, and summarized. Meanwhile, the reported events related to physics chart check service were analyzed using an event reporting and learning system. A number of shortfalls in the chart check process were identified. To address these problems, a software tool was designed and developed under Microsoft. Net in C# to hardwire as many components as possible at each stage of the process. The software consists of the following 4 independent modules: (1) chart check management; (2) pretreatment and during treatment chart check assistant; (3) posttreatment chart check assistant; and (4) quarterly peer-review management. The users were a large group of physicists in the author's radiation oncology clinic. During over 1 year of use the tool has proven very helpful in chart checking management, communication, documentation, and maintaining consistency. The software tool presented in this work aims to assist physicists at each stage of the physics chart check process. The software tool is potentially useful for any radiation oncology clinics that are either in the process of pursuing or maintaining the American College of Radiology accreditation.

  10. Pregnancy outcomes associated with extended use of the 52-mg 20 μg/day levonorgestrel-releasing intrauterine system beyond 60 months: A chart review of 776 women in Brazil.

    Science.gov (United States)

    Bahamondes, Luis; Fernandes, Arlete; Bahamondes, M Valeria; Juliato, Cassia T; Ali, Moazzam; Monteiro, Ilza

    2018-03-01

    To assess the contraceptive performance of the 52-mg 20 μg/day levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena; Bayer Oy, Turku, Finland) among women who maintain the same device without changes after 60 months. This is a chart review study in which we assessed the charts of 766 women who continue the same LNG-IUS for contraception beyond 60 months. The women were evaluated at the Family Planning clinic, University of Campinas Medical School, Campinas, SP, Brazil, from November 1990 to March 2011. We obtained sociodemographic data, duration of use, continuation and discontinuation rates and reasons, bleeding pattern at the recorded last visit. The statistical analysis was performed using Kaplan-Meier analysis. A total of 776 charts were identified of women who used the LNG-IUS beyond 60 months. The mean age (±S.E.M.) at LNG-IUS placement was 32.0±0.2 years (ranged 15 to 44 years; median was 32 years). The distribution of number of pregnancies was 0-1 (45%); 2-4 (54.1%) and≥5 (0.9%). The median length of the LNG-IUS' use was 73 months after placement (ranged 61-184 months). Zero pregnancies were reported and the main reasons for discontinuation were expiration of approved effective lifespan, menopause and planning pregnancy. The cumulative women-years (W-Y) of exposure were 967 and 1403 up to seven and 15 years, respectively. The main bleeding pattern reported by the women was amenorrhea. The 52-mg 20 μg/day LNG-IUD (Mirena) showed continue contraceptive efficacy beyond 5 years of use with no pregnancies detected over 967 and 1403 W-Y up to seven and 15 years after placement. The 52-mg 20 μg/day LNG-IUD presented a very high contraceptive efficacy beyond the first 5 years of lifetime labeled. Increasing data support that efficacy beyond 5 years of use, and new data suggested efficacy as long as 15 years. Healthcare professionals, policy makers and stakeholders could take advantage of the present information to decide to maintain the same device

  11. Barograms / Barograph Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Barograms are weekly rectangular charts recording barometric pressure at a given station. The barograph is an instrument that makes a continuous pen and ink trace of...

  12. Smart Book Charts

    Science.gov (United States)

    Chinnapongse, Ronald L.

    2015-01-01

    Smart book charts for TPSM: Heatshield for Extreme Entry Environment Technology (HEEET), Conformal Ablative TPS (CA-TPS), 3D Woven Multifunctional Ablative TPS (3D MAT), and Adaptable, Deployable, Entry and Placement Technology (ADEPT).

  13. CDC Child Growth Charts

    Data.gov (United States)

    U.S. Department of Health & Human Services — CDC child growth charts consist of a series of percentile curves that illustrate the distribution of selected body measurements in U.S. children. Pediatric growth...

  14. Great Lakes Ice Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Charts show ice extent and concentration three times weekly during the ice season, for all lakes except Ontario, from the 1973/74 ice season through the 2001/2002...

  15. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control

    Science.gov (United States)

    Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

    2016-01-01

    Background The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. Patients and Methods 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Results Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33–3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (pKaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers. PMID:27398803

  16. Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study.

    Science.gov (United States)

    Adler, Benjamin A; Wink, Logan K; Early, Maureen; Shaffer, Rebecca; Minshawi, Noha; McDougle, Christopher J; Erickson, Craig A

    2015-01-01

    Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drug-refractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain. © The Author(s) 2014.

  17. Quality of caesarean delivery services and documentation in first-line referral facilities in Afghanistan: a chart review

    Directory of Open Access Journals (Sweden)

    Kim Young-Mi

    2012-03-01

    Full Text Available Abstract Background Increasing appropriate use and documentation of caesarean section (CS has the potential to decrease maternal and perinatal mortality in settings with low CS rates. We analyzed data collected as part of a comprehensive needs assessment of emergency obstetric and newborn care (EmONC facilities in Afghanistan to gain a greater understanding of the clinical indications, timeliness, and outcomes of CS deliveries. Methods Records were reviewed at 78 government health facilities expected to function as EmONC providers that were located in secure areas of the country. Information was collected on the three most recent CS deliveries in the preceding 12 months at facilities with at least one CS delivery in the preceding three months. After excluding 16 facilities with no recent CS deliveries, the sample includes 173 CS deliveries at 62 facilities. Results No CS deliveries were performed in the previous three months at 21% of facilities surveyed; all of these were lower-level facilities. Most CS deliveries (88% were classified as emergencies, and only 12% were referrals from another facility. General anesthesia was used in 62% of cases, and spinal or epidural anesthesia in 34%. Only 28% of cases were managed with a partograph. Surgery began less than one hour after the decision for a CS delivery in just 30% of emergency cases. Among the 173 cases, 27 maternal deaths, 28 stillbirths, and 3 early neonatal deaths were documented. In cases of maternal and fetal death, the most common indications for CS delivery were placenta praevia or abruption and malpresentation. In 62% of maternal deaths, the fetus was stillborn or died shortly after birth. In 48% of stillbirths, the fetus had a normal heart rate at the last check. Information on partograph use was missing in 38% of cases, information on parity missing in 23% of cases and indications for cesareans missing in 9%. Conclusions Timely referral within and to EmONC facilities would decrease

  18. Effectiveness of a Medifast meal replacement program on weight, body composition and cardiometabolic risk factors in overweight and obese adults: a multicenter systematic retrospective chart review study.

    Science.gov (United States)

    Coleman, Christopher D; Kiel, Jessica R; Mitola, Andrea H; Langford, Janice S; Davis, Kevin N; Arterburn, Linda M

    2015-08-06

    Recent medical guidelines emphasize the importance of actively treating overweight and obesity with diet and lifestyle intervention to achieve ≥ 5% weight loss in a 6-month period. Commercial programs offer one approach provided there is evidence of their efficacy and safety. This study was conducted to evaluate the effectiveness of the Medifast® 4 & 2 & 1 Plan™ on weight loss, body composition and cardiometabolic risk factors in overweight and obese adults. A systematic retrospective chart review of 310 overweight and obese clients following the Medifast 4 & 2 & 1 Plan at one of 21 Medifast Weight Control Centers® was conducted. Data were recorded electronically and key data points were independently verified. The primary endpoint was change from baseline body weight at 12 weeks. Within group paired t-tests were used to examine changes from baseline in a completers population. Differences between gender and age subgroups were examined using bivariate t-tests and mixed model regression analyses. For the primary endpoint at 12 weeks, body weight among completers (n = 185) was reduced by a mean of 10.9 ± 5.6 kg (-10.1%, p meal plan was well tolerated, and program adherence was >85%. The 4 & 2 & 1 Plan used at Medifast Weight Control Centers was effective for weight loss, preservation of lean mass and improvement in cardiometabolic risk factors. The plan was generally well tolerated in a broad population of overweight and obese adults. #NCT02150837.

  19. High Rates of Diabetes Mellitus, Pre-diabetes and Obesity Among Somali Immigrants and Refugees in Minnesota: A Retrospective Chart Review.

    Science.gov (United States)

    Njeru, Jane W; Tan, Eugene M; St Sauver, Jennifer; Jacobson, Debra J; Agunwamba, Amenah A; Wilson, Patrick M; Rutten, Lila J; Damodaran, Swathi; Wieland, Mark L

    2016-12-01

    We examined the prevalence of cardiovascular risk factors among Somali refugees at a midwestern hospital in the U.S. This was a retrospective cohort study of 1007 adult Somali patients and an age and frequency-matched cohort of non-Somali patients actively empanelled to a large, academic primary care practice network in the Midwest United States between January 1, 2011 and December 31, 2012. Cardiovascular risk factors were obtained by chart review and compared between the two cohorts using a Chi squared test. Median age was 35 years (Q1, Q3; 27, 50). The prevalence of diabetes was significantly higher among Somali versus non-Somali patients (12.1 vs 5.3 %; p = 0.0001), as was prediabetes (21.3 vs 17.2 %; p obesity (34.6 vs 32.1 %; p = 0.047). After adjusting for age, sex, body mass index, education and employment, among the Somali patients, the odds ratio (95 % confidence interval) for diabetes was 2.78 (1.76-4.40) and 1.57 (1.16-2.13) for pre-diabetes. There was a significantly higher prevalence of diabetes, pre-diabetes and obesity among Somali patients compared with non-Somali patients. Further research into the specific causes of these disparities and development of targeted effective and sustainable interventions to address them is needed.

  20. Two Bilateral Zygomatic Implants Placed and Immediately Loaded: A Retrospective Chart Review with Up-to-54-Month Follow-up.

    Science.gov (United States)

    Neugarten, Jay; Tuminelli, Frank J; Walter, Leora

    To report on the outcome of placement of two bilateral zygomatic implants with an immediately loaded prosthesis. A retrospective chart review was conducted of all patients treated with zygomatic implants between August 1, 2011 and June 6, 2016. All patients had at least two zygomatic implants placed bilaterally and immediately loaded with a provisional prosthesis the same day of implant placement. The implants were Nobel Biocare TiUnite or machined surface with lengths of 30 to 52.5 mm. All patients were treated by a team consisting of one surgeon, a restorative dentist or prosthodontist, an anesthesiologist, and a laboratory technician. Implant success was defined as successful integration of the implant; prosthetic success was defined as retention of the prosthesis under normal function. One hundred five zygomatic implants were placed and immediately loaded in 28 patients over a period of 1 to 60 months. Ages ranged from 46 to 81 years, with 26 female and 2 male patients. All the implants were placed by one surgeon. The immediate load on the day of implant placement was completed by either one of 2 prosthodontists or 11 restorative dentists. Implant success was 96% (101/105). All four failed implants were in one patient and were TiUnite surface coated. This study demonstrated that two zygomatic implants bilaterally placed and immediately loaded with a full-arch splinted prosthesis will provide a predictable outcome.

  1. Newly diagnosed exudative age-related macular degeneration treated with pegaptanib sodium monotherapy in US community-based practices: medical chart review study

    Directory of Open Access Journals (Sweden)

    Xu Xiao

    2010-02-01

    Full Text Available Abstract Background Studies have shown that early detection and treatment of neovascular age-related macular degeneration (NV-AMD can delay vision loss and blindness. The objective of this study was to evaluate the efficacy/safety of intravitreal pegaptanib sodium monotherapy in treatment-naïve subjects with newly diagnosed NV-AMD and to gain insight into characteristics of lesions treated in community-based practices. Methods From seven private US practices, charts were retrospectively reviewed on 73 subjects with previously untreated subfoveal choroidal NV-AMD treated with their first dose of pegaptanib monotherapy on/after 4/1/2005 through 6/5/2006, receiving ≥4 treatments at 6-week intervals over 21 weeks. Primary endpoint: mean visual acuity (VA change from baseline to month 6. Results 75% of lesions were occult, and 82% were subfoveal. From baseline to month 6, mean VA change was -0.68 lines; 58% and 16% gained ≥0 and ≥3 lines of VA, and 70% were responders ( Conclusion Pegaptanib is effective in real-world patients with treatment-naïve NV-AMD in uncontrolled community-based retina practices.

  2. Mazindol in narcolepsy and idiopathic and symptomatic hypersomnia refractory to stimulants: a long-term chart review.

    Science.gov (United States)

    Nittur, Nandini; Konofal, Eric; Dauvilliers, Yves; Franco, Patricia; Leu-Semenescu, Smaranda; Cock, Valérie Cochen De; Inocente, Clara O; Bayard, Sophie; Scholtz, Sabine; Lecendreux, Michel; Arnulf, Isabelle

    2013-01-01

    Mazindol is a tricyclic, anorectic, non-amphetamine stimulant used in narcolepsy and obesity since 1970. This study aimed to evaluate the long-term benefit/risk ratio in drug-resistant hypersomniacs and cataplexy sufferers. By retrospective analysis of the patients' files in the hospitals of Paris-Salpêtrière (n=91), Montpellier (n=40) and Lyon (n=8), the benefit (Epworth Sleepiness Score (ESS), cataplexy frequency, authorization renewal) and tolerance (side-effects, vital signs, electrocardiogram and cardiac echography) of mazindol were assessed. The 139 patients (45% men) aged 36±15years (range: 9-74) suffered narcolepsy (n=94, 66% with cataplexy), idiopathic (n=37) and symptomatic hypersomnia (n=8) refractory to modafinil, methylphenidate and sodium oxybate. Under mazindol (3.4±1.3mg/day, 1-6mg) for an average of 30months, the ESS decreased from 17.7±3.5 to 12.8±5.1, with an average fall of -4.6±4.7 (pMazindol has a long-term, favorable benefit/risk ratio in 60% of drug-resistant hypersomniacs, including a clear benefit on cataplexy. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Unmet needs in the treatment of idiopathic pulmonary fibrosis-insights from patient chart review in five European countries.

    Science.gov (United States)

    Maher, Toby M; Molina-Molina, Maria; Russell, Anne-Marie; Bonella, Francesco; Jouneau, Stéphane; Ripamonti, Elena; Axmann, Judit; Vancheri, Carlo

    2017-09-15

    Two antifibrotic drugs, pirfenidone and nintedanib, are approved by the European Medicines Agency and the US Food and Drug Administration for the treatment of idiopathic pulmonary fibrosis (IPF). In this analysis, treatment patterns of European patients with IPF were investigated to understand antifibrotic prescribing and identify unmet needs in IPF treatment practice. Between February and March 2016, respiratory physicians from France, Germany, Italy, Spain, and the UK participated in an online questionnaire designed to collect information on IPF treatment patterns in patients under their care. Patients were categorized as treated (received approved antifibrotics) or untreated (did not receive approved antifibrotics, but may have received other unapproved therapies). Classification of IPF diagnosis (confirmed/suspected) and severity ('mild'/'moderate'/'severe') for each patient was based on the individual physician's report. Patients' perspectives were not recorded in this study. In total, 290 physicians responded to the questionnaire. Overall, 54% of patients with IPF did not receive treatment with an approved antifibrotic. More patients had a confirmed IPF diagnosis in the treated (84%) versus the untreated (51%) population. Of patients with a confirmed diagnosis, 40% did not receive treatment. The treated population was younger than the untreated population (67 vs 70 years, respectively; p ≤ 0.01), with more frequent multidisciplinary team evaluation (83% vs 57%, respectively; p ≤ 0.01). A higher proportion of untreated patients had forced vital capacity > 80% at diagnosis versus treated patients. Of patients with 'mild' IPF, 71% did not receive an approved antifibrotic versus 41% and 60% of patients with 'moderate' and 'severe' IPF, respectively. Despite the availability of antifibrotic therapies, many European patients with confirmed IPF do not receive approved antifibrotic treatment. Importantly, there appears to be a reluctance to treat

  4. Epidemiology, microbiology, and treatment patterns of pediatric patients hospitalized with pneumonia at two hospitals in China: a patient chart review study.

    Science.gov (United States)

    Wen, Zehuai; Wei, Jia; Xue, Huiling; Chen, Yunqin; Melnick, David; Gonzalez, Jesus; Hackett, Judith; Li, Xiaoyan; Cao, Zhaolong

    2018-01-01

    The etiology, epidemiology, treatment patterns, and clinical outcomes of neonatal and pediatric pneumonia patients in China are not well reported. This retrospective chart review study aimed to describe such information among neonatal (0 to 27 days) and pediatric (28 days to <18 years) pneumonia patients in two regions of China. Electronic medical records of pneumonia hospitalizations (aged <18 years) admitted between 2008 and 2013 from four hospitals under Guangdong Provincial Hospital of Chinese Medicine (Southern China) and between 2010 and 2014 at Peking University People's Hospital (Beijing, Northern China) were reviewed. The average age of neonatal hospitalizations in Beijing (n=92) was 3.5 days. The mean length of hospital stay was 11.2 days, and no deaths occurred. Staphylococcus epidermidis was the most common bacteria found in Beijing patients, whereas Mycoplasma pneumoniae was the most common bacteria found in Guangdong patients. The average age of pediatric hospitalizations was 3.3 (±3.1) and 6.5 (±5.6) years in Guangdong (n=3,046) and Beijing (n=222), respectively. The mean length of hospital stay was 17.4 and 5.8 days, and overall mortality rates were 0.2% and 0.5%. The findings revealed a low level of bacterial isolation and hence microbiological diagnoses. There was a low level of in-hospital mortality due to pneumonia, and the majority of hospitalizations were discharged from hospital, suggesting that current practice was generally effective. Neonatal hospitalizations were greater than pediatric hospitalizations in Beijing along with disparity in bacterial profile when compared with Guangdong, intending a need to improve neonatal pneumonia prophylaxis and selection of appropriate treatment.

  5. In vitro fertilisation with recombinant follicle stimulating hormone requires less IU usage compared with highly purified human menopausal gonadotrophin: results from a European retrospective observational chart review

    Directory of Open Access Journals (Sweden)

    Blackmore Stuart

    2010-11-01

    Full Text Available Abstract Background Previous studies have reported conflicting results for the comparative doses of recombinant follicle stimulating hormone (rFSH and highly purified human menopausal gonadotrophin (hMG-HP required per cycle of in vitro fertilisation (IVF; the aim of this study was to determine the average total usage of rFSH versus hMG-HP in a 'real-world' setting using routine clinical practice. Methods This retrospective chart review of databases from four European countries investigated gonadotrophin usage, oocyte and embryo yield, and pregnancy outcomes in IVF cycles (± intra-cytoplasmic sperm injection using rFSH or hMG-HP alone. Included patients met the National Institute for Health and Clinical Excellence (NICE guideline criteria for IVF and received either rFSH or hMG-HP. Statistical tests were conducted at 5% significance using Chi-square or t-tests. Results Of 30,630 IVF cycles included in this review, 74% used rFSH and 26% used hMG-HP. A significantly lower drug usage per cycle for rFSH than hMG-HP (2072.53 +/- 76.73 IU vs. 2540.14 +/- 883.08 IU, 22.6% higher for hMG-HP; p Conclusions Based on these results, IVF treatment cycles with rFSH yield statistically more oocytes (and more mature oocytes, using significantly less IU per cycle, versus hMG-HP. The incidence of all OHSS and hospitalisations due to OHSS was significantly higher in the rFSH cycles compared to the hMG-HP cycles. However, the absolute incidence of hospitalisations due to OHSS was similar to that reported previously. These results suggest that the perceived required dosage with rFSH is currently over-estimated, and the higher unit cost of rFSH may be offset by a lower required dosage compared with hMG-HP.

  6. Digital Mapping, Charting, and Geodesy Analysis Program (DMAP) Technical Review of Proposed Ice Objects for AML

    National Research Council Canada - National Science Library

    Mesick, Hillary

    2001-01-01

    .... It is noted that MFF and HRE (or ESB) both contain Sea Ice-Ice Area and Land Ice-Ice Area. Separate consideration will be given to removing all ice from MFF to ensure that there is no duplication of data...

  7. Head and Shoulders: Testing the Profitability of this Chart Pattern of Technical Analysis in the Brazilian Stock Market

    Directory of Open Access Journals (Sweden)

    Pedro Gabriel Boainain

    2009-06-01

    Full Text Available Starting from an adapted version of Osler and Chang (1995 methodology, this article empirically evaluates the profitability of investment strategies based on identification of the Head and Shoulders chart pattern in the Brazilian stock market. For that purpose, several investment strategies conditioned by the identification of the Head and Shoulders pattern (in its basic and inverted forms by a computer algorithm in daily price series of 30 stocks from January 1994 to January 2009 were defined. Confidence intervals consistent with the null hypothesis that no strategies with positive returns can be based only on historical data were constructed using the Bootstrap sample inference technique in order to test the predictive power of each strategy. More specifically, the mean returns obtained by each strategy when applied to the stock's price series were compared to those obtained by the same strategies when applied to 1.000 artificial price series -- for each stock -- generated in a parametric manner, by an E-GARCH, and in a nonparametric one. Overall, our results show that it is possible to create strategies conditioned by the occurrence of Head and Shoulders, with positive returns, which indicates that these patterns can capture from stock historical prices some signals about their future price trend that makes possible to create profitable strategies. Nevertheless, the same conclusions are not valid for the pattern in its inverted form and when the effects of taxes and transaction costs are considered, depending on their magnitude, neither in its basic form.

  8. Treatment patterns and outcomes for patients with locally advanced basal cell carcinoma before availability of Hedgehog pathway inhibitors: a retrospective chart review.

    Science.gov (United States)

    Lear, John T; Basset-Seguin, Nicole; Kaatz, Martin; Jouary, Thomas; Mortier, Laurent; Fabrizio, Tommaso; Herd, Robert; Leverkus, Martin; Revil, Cedric; Page, Damian R; Grob, Jean-Jacques

    2017-08-01

    Understanding the molecular basis of basal cell carcinoma (BCC) has led to development of Hedgehog pathway inhibitors (HPIs) for patients with advanced forms of BCC (aBCC). A practical definition of aBCC as a distinct disease entity is unavailable, and epidemiological information is limited. To conduct the RONNIE study to describe characteristics, treatment patterns, and outcomes of patients with aBCC during the period preceding HPI introduction, as well as results from patients with locally advanced BCC (laBCC). A retrospective chart review was conducted using data from adult patients with a new diagnosis of laBCC between 1 st January 2005 and 31 st December 2010. The study period was 1 st January 2005 to 31 st December 2011 to allow for inclusion of at least 12 months of follow-up information for all patients. Treatment data were available for 106/117 patients. Radiation and excisional surgery were the most common first-line treatment options (43.4% and 23.5% of patients, respectively). Patients typically received multiple subsequent treatments; no apparent trend or pattern was observed. Complete visual response, partial visual response, and stable disease were obtained in 51.9%, 25.9%, and 11.1% of patients, respectively, after first-line surgery, and in 53.7%, 22.0%, and 9.8%, respectively, after first-line radiation. Median progression-free survival after first-line treatment was 32.1 months. Median overall survival was 78.8 months. These data represent a baseline for laBCC before HPIs became part of the treatment algorithm. The observed heterogeneity of treatment patterns highlights the lack of an established standard treatment for laBCC before HPIs were available.

  9. International Retrospective Chart Review of Treatment Patterns in Severe Familial Mediterranean Fever, Tumor Necrosis Factor Receptor-Associated Periodic Syndrome, and Mevalonate Kinase Deficiency/Hyperimmunoglobulinemia D Syndrome.

    Science.gov (United States)

    Ozen, Seza; Kuemmerle-Deschner, Jasmin B; Cimaz, Rolando; Livneh, Avi; Quartier, Pierre; Kone-Paut, Isabelle; Zeft, Andrew; Spalding, Steve; Gul, Ahmet; Hentgen, Veronique; Savic, Sinisa; Foeldvari, Ivan; Frenkel, Joost; Cantarini, Luca; Patel, Dony; Weiss, Jeffrey; Marinsek, Nina; Degun, Ravi; Lomax, Kathleen G; Lachmann, Helen J

    2017-04-01

    Periodic fever syndrome (PFS) conditions are characterized by recurrent attacks of fever and localized inflammation. This study examined the diagnostic pathway and treatments at tertiary centers for familial Mediterranean fever (FMF), tumor necrosis factor receptor-associated periodic syndrome (TRAPS), and mevalonate kinase deficiency (MKD)/hyperimmunoglobulinemia D syndrome (HIDS). PFS specialists at medical centers in the US, the European Union, and the eastern Mediterranean participated in a retrospective chart review, providing de-identified data in an electronic case report form. Patients were treated between 2008 and 2012, with at least 1 year of followup; all had clinical and/or genetically proven disease and were on/eligible for biologic treatment. A total of 134 patients were analyzed: FMF (n = 49), TRAPS (n = 47), and MKD/HIDS (n = 38). Fever was commonly reported as severe across all indications. Other frequently reported severe symptoms were serositis for FMF patients and elevated acute-phase reactants and gastrointestinal upset for TRAPS and MKD/HIDS. A long delay from disease onset to diagnosis was seen within TRAPS and MKD/HIDS (5.8 and 7.1 years, respectively) compared to a 1.8-year delay in FMF patients. An equal proportion of TRAPS patients first received anti-interleukin-1 (anti-IL-1) and anti-tumor necrosis factor (anti-TNF) biologic agents, whereas IL-1 blockade was the main choice for FMF patients resistant to colchicine and MKD/HIDS patients. For TRAPS patients, treatment with anakinra versus anti-TNF treatments as first biologic agent resulted in significantly higher clinical and biochemical responses (P = 0.03 and P patterns and diagnostic delays highlight the need for greater awareness and improved diagnostics for PFS. This real-world treatment assessment supports the need for further refinement of treatment practices. © 2016, American College of Rheumatology.

  10. Pressure injury progression and factors associated with different end-points in a home palliative care setting: a retrospective chart review study.

    Science.gov (United States)

    Artico, Marco; D'Angelo, Daniela; Piredda, Michela; Petitti, Tommasangelo; Lamarca, Luciano; de Marinis, Maria Grazia; Dante, Angelo; Lusignani, Maura; Matarese, Maria

    2018-03-13

    Patients with advanced illnesses show the highest prevalence for pressure ulcers. In the palliative care setting the ultimate goal is injury healing, but equally important is wound maintenance, wound palliation (wound-related pain and symptom management), and primary and secondary wound prevention. To describe the course of healing for pressure ulcers in a home palliative care setting according to different end-points, and to explore patient and caregiver characteristics and specific care activities associated with their achievement. Four-year retrospective chart review of 669 patients cared for in a home palliative care service, of those 124 (18.5%) patients had at least one pressure ulcer with a survival rate ≤6 months. The proportion of healed pressure ulcers was 24.4%. Of the injuries not healed, 34.0% were in a maintenance phase, while 63.6% were in a process of deterioration. Body Mass Index (p=0.0014), artificial nutrition (p=0.002), and age <70 years (p=0.022) emerged as predictive factors of pressure ulcer complete healing. Artificial nutrition, age, male caregiver (p=0.034) and spouse (p=0.036) were factors significantly associated with a more rapid pressure ulcer healing. Continuous deep sedation was a predictive factor for pressure ulcer deterioration and significantly associated with a more rapid worsening. Pressure ulcer healing is a realistic aim in home palliative care, particularly for injuries not exceeding Stage II occurring at least two weeks before death. When assessing pressure ulcers, our results highlight the need to also pay attention to artificial nutrition, continuous deep sedation, and the caregiver's role and gender. Copyright © 2018. Published by Elsevier Inc.

  11. Nuclear industry chart

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    As part of a survey on Switzerland a pull-out organisation chart is presented of the nuclear industry showing Swiss government bodies and industrial concerns. Their interests, connections with each other and their associations with international and other national organizations and firms are indicated. (U.K.)

  12. Synthetic growth reference charts

    NARCIS (Netherlands)

    Hermanussen, Michael; Stec, Karol; Aßmann, Christian; Meigen, Christof; Van Buuren, Stef

    2016-01-01

    Objectives: To reanalyze the between-population variance in height, weight, and body mass index (BMI), and to provide a globally applicable technique for generating synthetic growth reference charts. Methods: Using a baseline set of 196 female and 197 male growth studies published since 1831, common

  13. INIS: Terminology charts

    International Nuclear Information System (INIS)

    1970-08-01

    This document is one in a series of publications known as the INIS Reference Series. It is to be used in conjunction with the INIS indexing manual and the INIS thesaurus for the preparation of input to the INIS database. The thesaurus and terminology charts in their first edition (Rev.0) were produced as the result of an agreement between the International Atomic Energy Agency (IAEA) and the European Atomic Energy Community (Euratom). Except for minor changes the terminology and the interrelationships between terms are those of the December 1969 edition of the Euratom Thesaurus. The purpose of the terminology harts is to display the descriptors of the thesaurus in the context of their hierarchical and other semantic relationships. Hierarchically related terms are grouped in clusters, each representing one of the principal concepts of a subject field. The descriptors are grouped around or under the broadest term of the clusters which is printed in upper case. The hierarchical relationships within the clusters are shown by the arrangement of the terms in smaller boxes within the larger boxes circumscribing the clusters. The clusters are connected by lines of various thickness, representing the other (mostly non-hierarchical) relationships. These connections are the equivalent to 'see also' and 'related term' cross-references. The thickness of the lines represents the strength of the semantic relations, or, in the practice of a retrieval system the probability that one term replacing a connected term in a query, will still yield pertinent references. The figures accompanying the descriptors represent their frequency of assignment to the first 987,000 documents stored in the Euratom system (May 1970). They are presented in order to show the relative importance of the descriptors within the subject field. The asterisks (*) accompanying descriptors in the charts refer to descriptors, for which a scope note can be found in the INIS: Thesaurus at the time the charts went

  14. Epidemiology, microbiology, and treatment patterns of pediatric patients hospitalized with pneumonia at two hospitals in China: a patient chart review study

    Directory of Open Access Journals (Sweden)

    Wen Z

    2018-03-01

    Full Text Available Zehuai Wen,1 Jia Wei,2 Huiling Xue,2 Yunqin Chen,2 David Melnick,3 Jesus Gonzalez,4 Judith Hackett,5 Xiaoyan Li,1 Zhaolong Cao6 1Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 2AstraZeneca R&D Information China, Shanghai, China; 3Anti-Infectives Actavis, Inc. Harborside Financial Center, Jersey City, NJ, USA; 4AstraZeneca, Manchester, UK; 5AstraZeneca, Gaithersburg, MD, USA; 6Peking University People’s Hospital, Beijing, China Background: The etiology, epidemiology, treatment patterns, and clinical outcomes of neonatal and pediatric pneumonia patients in China are not well reported. This retrospective chart review study aimed to describe such information among neonatal (0 to 27 days and pediatric (28 days to <18 years pneumonia patients in two regions of China. Methods: Electronic medical records of pneumonia hospitalizations (aged <18 years admitted between 2008 and 2013 from four hospitals under Guangdong Provincial Hospital of Chinese Medicine (Southern China and between 2010 and 2014 at Peking University People’s Hospital (Beijing, Northern China were reviewed. Results: The average age of neonatal hospitalizations in Beijing (n=92 was 3.5 days. The mean length of hospital stay was 11.2 days, and no deaths occurred. Staphylococcus epidermidis was the most common bacteria found in Beijing patients, whereas Mycoplasma pneumoniae was the most common bacteria found in Guangdong patients. The average age of pediatric hospitalizations was 3.3 (±3.1 and 6.5 (±5.6 years in Guangdong (n=3,046 and Beijing (n=222, respectively. The mean length of hospital stay was 17.4 and 5.8 days, and overall mortality rates were 0.2% and 0.5%. Conclusion: The findings revealed a low level of bacterial isolation and hence microbiological diagnoses. There was a low level of in-hospital mortality due to pneumonia, and the majority of hospitalizations were discharged from hospital, suggesting

  15. The use of the prospective NIMH Life Chart Method as a bipolar mood assessment method in research : A systematic review of different methods, outcome measures and interpretations

    NARCIS (Netherlands)

    Koenders, M. A.; Nolen, W. A.; Giltay, E. J.; Hoencamp, E.; Spijker, A. T.

    2015-01-01

    Background: The severity of bipolar disorder can be assessed using the daily prospective National Institute of Mental Health's Life Chart Method (LCM-p). Also for scientific research the LCM-p, has been used frequently. However, processing and analyzing the LCM-p for research purposes, are

  16. Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey.

    Science.gov (United States)

    Sadosky, Alesia; Schaefer, Caroline; Mann, Rachael; Bergstrom, Felicia; Baik, Rebecca; Parsons, Bruce; Nalamachu, Srinivas; Nieshoff, Edward; Stacey, Brett R; Anschel, Alan; Tuchman, Michael

    2013-01-01

    The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN) seeking treatment in the US. This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use. The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%), depressive symptoms (41.1%), and anxiety (35.7%). The mean pain severity score was 5.2 (0-10 scale), and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0-10 scale) overall, with 2.0 among mild, 5.1 among moderate, and 7.0 among severe. The mean Medical Outcomes Study sleep problems index score was 48.5 (0-100 scale). The mean health state utility score was 0.61. Among subjects employed for pay, mean overall work impairment was 43.6%. Across all subjects, mean overall activity impairment was 52.3%. In total, 81.3% were prescribed at least one medication for their pDPN; 50.9% reported taking at least one nonprescription medication. Adjusted mean annualized total direct and indirect costs per subject were $4841 and $9730, respectively. Outcomes related to pain interference with function, sleep, health status, activity impairment, prescription medication use, and direct and indirect

  17. A comparison of intimate partner violence and associated physical injuries between cohabitating and married women: a 5-year medical chart review

    Directory of Open Access Journals (Sweden)

    Janet Yuen-Ha Wong

    2016-11-01

    Full Text Available Abstract Background Cohabitation, referring to a co-residential romantic relationship between two intimate partners without a marriage license, has become widely accepted in contemporary societies. It has been found that cohabitating women have a higher risk of experiencing intimate partner violence (IPV than married women. However, as yet, no studies have investigated the level and pattern of IPV-associated physical injuries and its mental health impact on cohabitating women. Therefore, we aim to compare IPV-associated physical injuries between cohabitating and married women by conducting a review of 5-year medical records from the emergency departments of two major public hospitals in Hong Kong. Methods This is a retrospective cohort study. Using two computerized systems, we identified the medical charts of 1011 women who had experienced IPV and presented at emergency departments between 2010 and 2014, of which, 132 were cohabitating and 833 were married. Results Cohabitating women were significantly younger (p-value < .0001 and had obtained a higher educational level (p-value = .008 than married women. After adjusting for those two variables, the logistic regression models showed that cohabitating women were approximately 2.1 times more likely than married women to present with head, neck, or facial injuries (OR = 2.1, 95% CI = 1.30–3.40, p = .002, and the risk of having multiple injuries in different locations (head, neck, face, torso, limbs was almost twice that for cohabitating women compared with married women (OR = 1.82, 95% CI = 1.25–2.65, p = .001. Furthermore, cohabitating women were almost two times as likely as married women to experience more than one method of physical violence (OR = 1.72, 95% CI = 1.18–2.51, p = .005. There were no significant differences regarding mental health, police reporting, and discharge plans. Conclusions Owing to recent social changes to the family

  18. Weighing Rain Gauge Recording Charts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Weighing rain gauge charts record the amount of precipitation that falls at a given location. The vast majority of the Weighing Rain Gauge Recording Charts...

  19. NOAA Raster Navigational Charts (RNC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA, National Ocean Service, Office of Coast Survey, Marine Chart Division is responsible to build and maintain a suite of more than 1000 nautical charts that are...

  20. A process variability control chart

    NARCIS (Netherlands)

    Riaz, M.; Does, R.J.M.M.

    2009-01-01

    In this study a Shewhart type control chart namely the Vt chart, is proposed for improvedmonitoring of the process variability of a quality characteristic of interest Y . The proposed control chart is based on the ratio type estimator of the variance using a single auxiliary variable X. It is

  1. ICAO Aeronautical chart production: aerodrome obstruction charts from small–format aerial digital imagery

    Directory of Open Access Journals (Sweden)

    Jorge Padro Molina

    2012-11-01

    Full Text Available Aeronautical charts and aerodrome obstruction charts, provide information about obstacles around the airport, so pilots and air traffic controllers can comply with the procedures and limitations of its utilization. Safety in aviation demands updated and precise aeronautical charts production, adopting the standards of the International Civil Aviation Organization (ICAO. In this paper the methodology employed to generate obstruction charts for five airports in Mexico, using aerial digital imagery obtained with small–format cameras, is described. Through two aerial surveys on each airport, from 10 000 and 5 000 feet above ground level, two orthomosaics were generated covering the airport influence area, the runway, and the obstacle limitation surfaces: approach/Take–off climb, transitional, inner horizontal, and conical. Using stereopair photointerpretation most of the obstacles were identified, and by means of the orthomosaics; aerodrome charts, and aerodrome obstruction charts types A, B and C, were generated. Using satellite geodetic receivers, 18 points were surveyed on each runway in order to obtain its dimensions, and to establish ground control points for mosaics generation. Throughout detailed field work, height and location of the obstacles were verified, and finally, after several reviewing processes by aeronautical authorities, generation of ICAO charts was concluded when all airport maps were integrated in a Geographical Information System.

  2. National operative case log growth charts in otolaryngology-head and neck surgery training.

    Science.gov (United States)

    Jabbour, Noel; Tsue, Terance

    2015-01-01

    To report national standard case log growth curves for operative procedures in otolaryngology and to describe a method by which program directors can chart surgical case numbers over resident training to longitudinally assess sufficiency of cases and parity between residents. Data visualization and analysis. American Council for Graduate Medical Education (ACGME) national case log data for otolaryngology residency. National data set; no individual subjects. National statistical case log reports for otolaryngology were obtained from the ACGME for each postgraduate year (PGY) level in 2009, 2010, and 2011. Estimated means and standard deviations were calculated. The mean and increments of standard deviation were graphed against time to create case log growth charts, similar to pediatric growth charts. Case log growth charts were made for each ACGME Otolaryngology Residency Review Committee key indicator procedure. Progress of an individual resident or of a cohort of residents may be graphed against this growth chart background over their training time. National operative case log growth charts allow residents and program directors to graphically assess progress in obtaining a sufficient variety and number of operative procedures over time throughout training. This can provide early identification when residents begin to fall below the growth curve during training. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  3. Frequency and Type of Prosthetic Complications Associated with Interim, Immediately Loaded Full-Arch Prostheses: A 2-Year Retrospective Chart Review.

    Science.gov (United States)

    Drago, Carl

    2016-08-01

    The purpose of this report was to retrospectively evaluate implant and immediate full-arch prosthesis survival rates over a 24-month period; patients were consecutively treated with immediate occlusal loading. Dental arch, gender, and implant orientation (vertical vs. tilted) were also noted. All Brånemark System implants (Nobel Active) and interim, all-acrylic resin prostheses placed in patients following an All-on-Four™ protocol, in a single private practice were assessed by retrospective patient chart review. The amount of space provided surgically for implant restorative components and prostheses was determined from measurements of the vertical heights of the interim prostheses in the right/left anterior and posterior segments. These measurements were made in the laboratory. Interim prosthetic repairs (type, frequency, length of time from insertion) were analyzed by type, arch, gender, and implant orientation. Implant survival and insertion torque values were also measured. Inclusion criteria consisted of all Brånemark System implants placed with the All-on-Four protocol from September 1, 2011, until August 31, 2013. Specific dietary instructions were given for the first 7 days immediately postoperatively and for the weeks prior to insertion of the definitive prostheses. One hundred twenty-nine patients, comprising 191 arches (766 implants) from September 1, 2011, until August 31, 2013, were included in the study. One patient experienced implant failure yielding an overall implant survival rate (SR) of 99.5% (762 of 766). Four hundred twenty-six of 430 maxillary implants and 336 of 336 mandibular implants survived for SRs of 99.1% and 100%, respectively. Regarding implant orientation, 415 of 417 tilted implants (SR 99.5%) and 343 of 345 (CSR 95.6%) vertical implants were noted to be clinically stable. Interim, all-acrylic resin prostheses were in place for a mean of 199.2 days; mandibular prostheses were in place for an average of 195.4 days; maxillary

  4. Burden of illness associated with painful diabetic peripheral neuropathy among adults seeking treatment in the US: results from a retrospective chart review and cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Sadosky A

    2013-02-01

    Full Text Available Alesia Sadosky,1 Caroline Schaefer,2 Rachael Mann,3 Felicia Bergstrom,2 Rebecca Baik,2 Bruce Parsons,1 Srinivas Nalamachu,4 Edward Nieshoff,5 Brett R Stacey,6 Alan Anschel,7 Michael Tuchman81Pfizer Inc, New York, NY, 2Covance Market Access Services Inc, Gaithersburg, MD, 3Covance Market Access Services Inc, San Diego, CA, 4International Clinical Research Institute, Overland Park, KS, 5Rehabilitation Institute of Michigan/Wayne State University, Detroit, MI, 6Oregon Health and Science University, Portland, OR, 7Rehabilitation Institute of Chicago, Chicago, IL, 8Palm Beach Neurological Center, Palm Beach Gardens, FL, USABackground: The purpose of this study was to characterize the burden of illness among adult subjects with painful diabetic peripheral neuropathy (pDPN seeking treatment in the US.Methods: This observational study recruited 112 subjects with pDPN during routine visits from general practitioner and specialist sites. Subjects completed a one-time questionnaire, which included demographics, symptom duration, health care resource use, out-of-pocket costs, employment status, and validated measures that assessed pain, functioning, sleep, anxiety and depression, health status, and productivity. Investigators completed a case report form based on a 6-month retrospective chart review to capture clinical information, pDPN-related treatments, and other pDPN-related health care resource use over the past 6 months. Annualized costs were extrapolated based on reported 6-month health care resource use.Results: The mean age of the subjects was 61.1 years, 52.7% were female, and 17.9% were in paid employment. The most common comorbid conditions were sleep disturbance/insomnia (43.8%, depressive symptoms (41.1%, and anxiety (35.7%. The mean pain severity score was 5.2 (0–10 scale, and 79.5% reported moderate or severe pain. The mean pain interference with function score was 5.0 (0–10 scale overall, with 2.0 among mild, 5.1 among moderate, and 7

  5. Concise nuclear isobar charts

    Energy Technology Data Exchange (ETDEWEB)

    Bucka, H.

    1986-01-01

    In the Concise Nuclear Isobar Charts, data on binding energies of protons and neutrons in the ground state and excitation energies for low-lying nuclear energy levels are displayed, both of which are of great interest for transition processes as well as for questions of nuclear structure. Also, quantum numbers for angular momentum and parity are shown for these energy levels. For the stable nuclei, data for the relative abundances, and for unstable nucleon configurations, the transition probabilities are included in the data displayed. Due to the representation chosen for the atomic nuclei, in many cases a very clear first survey of systematic properties of nuclear energy states as well as spontaneous decay processes is achieved.

  6. EXIT Chart Aided Design of Periodically Punctured Turbo Codes

    OpenAIRE

    Babich, F.; Crismani, A.; Maunder, R. G.

    2010-01-01

    EXtrinsic Information Transfer (EXIT) charts have proved to be an effective tool for studying the convergence behaviour of iterative decoders. However, classical EXIT chart analysis fails to assess the performance of turbo codes in which the systematic bits are punctured periodically. In this letter, a novel 3-Dimensional (3D) EXIT chart technique is proposed for accurately modeling the convergence behaviour of turbo codes that are punctured following a periodic pattern. Finally, the novel 3D...

  7. WWW chart of the nuclides

    International Nuclear Information System (INIS)

    Huang Xiaolong; Zhou Chunmei; Zhuang Youxiang; Zhao Zhixiang; Golashvili, T.V.; Chechev, V.P.

    2000-01-01

    WWW chart of the nuclides was established on the basis of the latest evaluations of nuclear structure and decay data. By viewing WWW chart of the nuclides, one can retrieve the fundamental data of nuclide such as atomic mass, abundance, spin and parity; the decay mode, branching ratio, half-life and Q-value of radioactive nuclide, energy and intensity of strong γ-ray, etc. The URL (Uniform Resource Locator) of WWW chart of the nuclides is: http://myhome.py.gd.cn/chart/index,asp

  8. 2009 Analysis Platform Review Report

    Energy Technology Data Exchange (ETDEWEB)

    Ferrell, John [Office of Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States

    2009-12-01

    This document summarizes the recommendations and evaluations provided by an independent external panel of experts at the U.S. Department of Energy Biomass Program’s Analysis platform review meeting, held on February 18, 2009, at the Marriott Residence Inn, National Harbor, Maryland.

  9. Analogue photonic link design charts for microwave engineering applications

    Directory of Open Access Journals (Sweden)

    Vincent J. Urick

    2015-02-01

    Full Text Available A set of unique design charts for intensity-modulation direct-detection microwave photonics links is presented. The charts facilitate link design and analysis, clearly demonstrating performance trade-offs in terms of standard microwave performance metrics.

  10. Use of basal insulin and the associated clinical outcomes among elderly nursing home residents with type 2 diabetes mellitus: a retrospective chart review study.

    Science.gov (United States)

    Davis, Keith L; Wei, Wenhui; Meyers, Juliana L; Kilpatrick, Brett S; Pandya, Naushira

    2014-01-01

    The management of type 2 diabetes mellitus in long-term care (LTC) settings can be complex as a result of age-related complications. Despite guideline recommendations, sliding scale insulin remains commonplace in the LTC setting and data on basal insulin use are lacking. This retrospective study used medical chart data and the Minimum Data Set from elderly LTC facility patients who received basal insulin (insulin glargine, insulin detemir, or neutral protamine Hagedorn insulin) for the treatment of diabetes, to investigate the practice patterns and associated clinical outcomes. A total of 2,096 elderly, insulin-treated patients in LTC were identified, with 59.5% of them (N=1,247) receiving basal insulin. Of these, more than 50% of patients received sliding scale insulin in co-administration with basal insulin. Despite its ease of use, insulin pen use was very low, at 14.6%. Significant differences were observed between the basal insulin groups for glycated hemoglobin level and dosing frequency. Hypoglycemia was uncommon -17.2% of patients experienced at least one event, and there was no significant difference in the prevalence of hypoglycemia between the groups. These data suggest the underutilization of basal insulin in the LTC setting and worryingly high combinational use with sliding scale insulin. Differences in glycated hemoglobin and dosing frequencies between types of basal insulin warrant further comparative effectiveness studies.

  11. Charting the nuclear future

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Agitation in the area of the Australian present research reactor, near Sydney is aimed against reactors, old and new. The Australian Government is trying to take the heat out of the debate by establishing a Research Reactor Review. The term of reference require the review to say if a new reactor is needed and if so where. The issues is become adversial with the local Sutherland shire council opposing the new reactor. The executive director of ANSTO explains the reasons and the advantages of replacing the Hifar reactor, which is 34 years old. The new reactor design, a swimming pool type, would permit grater productivity and even higher level of safety

  12. Computational analysis of nanofluids: A review

    Science.gov (United States)

    Qureshi, M. Zubair Akbar; Ashraf, Muhammad

    2018-02-01

    Nanofluids and heat transfer enhancement in real systems continue to be a widely research area of nanotechnology. An effort has been made to give a comprehensive review on time-wise development from different aspects of the nanofluids. The exceptional structures of nanofluids, for example, dispersion of nanoparticles volume fraction, thermophoresis phenomenon, Brownian motion, improvement in thermal conductivity, and especially heat transfer enhancement, etc., have been addressed in a mathematical perspective. The influence of important parameters like particle's (loading, material, size and shape-factor), base fluids type, temperature, additives, clustering and p H value has been considered. In addition, the summary-chart is presented for a better understanding of the mathematical structure of the Newtonian as well as non-Newtonian nanofluids. Some important results have been discussed for future work. This review article will be helpful for scientists and researchers.

  13. Inland Electronic Navigational Charts (IENC)

    Data.gov (United States)

    Army Corps of Engineers, Department of the Army, Department of Defense — These Inland Electronic Navigational Charts (IENCs) were developed from available data used in maintenance of Navigation channels. Users of these IENCs should be...

  14. Safe Minimum Internal Temperature Chart

    Science.gov (United States)

    ... JSR 286) Actions ${title} Loading... Safe Minimum Internal Temperature Chart Safe steps in food handling, cooking, and ... from other foods. Cook —Cook to the right temperature. Chill —Refrigerate food promptly. Cook all food to ...

  15. NOAA Electronic Navigational Charts (ENC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Office of Coast Survey (OCS) has been involved in the development of a NOAA Electronic Navigational Chart (NOAA ENC) suite to support the marine transportation...

  16. Use of basal insulin and the associated clinical outcomes among elderly nursing home residents with type 2 diabetes mellitus: a retrospective chart review study

    Directory of Open Access Journals (Sweden)

    Davis KL

    2014-10-01

    Full Text Available Keith L Davis,1 Wenhui Wei,2 Juliana L Meyers,1 Brett S Kilpatrick,3 Naushira Pandya4 1RTI Health Solutions, Research Triangle Park, NC, USA; 2Sanofi US, Inc, Bridgewater, NJ, USA; 3AnalytiCare, LLC, Glenview, IL, USA; 4Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA Background: The management of type 2 diabetes mellitus in long-term care (LTC settings can be complex as a result of age-related complications. Despite guideline recommendations, sliding scale insulin remains commonplace in the LTC setting and data on basal insulin use are lacking.Methods: This retrospective study used medical chart data and the Minimum Data Set from elderly LTC facility patients who received basal insulin (insulin glargine, insulin detemir, or neutral protamine Hagedorn insulin for the treatment of diabetes, to investigate the practice patterns and associated clinical outcomes.Results: A total of 2,096 elderly, insulin-treated patients in LTC were identified, with 59.5% of them (N=1,247 receiving basal insulin. Of these, more than 50% of patients received sliding scale insulin in co-administration with basal insulin. Despite its ease of use, insulin pen use was very low, at 14.6%. Significant differences were observed between the basal insulin groups for glycated hemoglobin level and dosing frequency. Hypoglycemia was uncommon -17.2% of patients experienced at least one event, and there was no significant difference in the prevalence of hypoglycemia between the groups.Conclusion: These data suggest the underutilization of basal insulin in the LTC setting and worryingly high combinational use with sliding scale insulin. Differences in glycated hemoglobin and dosing frequencies between types of basal insulin warrant further comparative effectiveness studies. Keywords: long-term care, nursing homes, type 2 diabetes mellitus, insulin detemir, insulin glargine, NPH insulin

  17. A video strip chart program

    International Nuclear Information System (INIS)

    Jones, N.L.

    1994-01-01

    A strip chart recorder has been utilized for trend analysis of the Oak Ridge National Laboratory EN tandem since 1987. At the EN, the author could not afford the nice eight channel thermal pen recorder that was used at the 25 URC. He had to suffice with two channel fiber tip or capillary pen type recorders retrieved from salvage and maintained with parts from other salvaged recorders. After cycling through several machines that eventually became completely unserviceable, a search for a new thermal recorder was begun. As much as he hates to write computer code, he decided to try his hand at getting an old data acquisition unit, that had been retrieved several years ago from salvage, to meet his needs. A BASIC language compiler was used because time was not available to learn a more advanced language. While attempting to increase acquisition and scroll speed on the 6 MHz 80286 that the code was first developed on, it became apparent that scrolling only the first small portion of the screen at high speed and then averaging that region and histogramming the average provided both the speed necessary for capturing fairly short duration events, and a trend record without use of back scrolling and disk storage routines. This turned out to be quite sufficient

  18. Patterns of hydroxyurea use and clinical outcomes among patients with polycythemia vera in real-world clinical practice: a chart review.

    Science.gov (United States)

    Parasuraman, Shreekant; DiBonaventura, Marco; Reith, Kelly; Naim, Ahmad; Concialdi, Kristen; Sarlis, Nicholas J

    2015-01-01

    Hydroxyurea (HU) is among the most commonly used cytoreductive treatments for polycythemia vera (PV), but previous research and clinical experience suggest that not all patients respond optimally, consistently, or durably to HU treatment. This study investigated patterns of HU use and impact on disease control among patients with PV in real-world clinical practice in the United States. Oncologists and hematologists recruited between April and July 2014 reported data from patient charts. Treatment history and disease symptom comparisons between HU subgroups were performed using Chi square tests or one-way analyses of variance for categorical and continuous variables. Other analyses were performed using descriptive statistics. Overall, 329 physicians participated and provided data on 1309 patients with PV (62.3 % male; mean age = 62.5 years, mean time since diagnosis = 5.2 years). In the 229 (17.5 %) patients who had stopped HU, the most common reasons for HU discontinuation-as assessed by the treating clinician-were inadequate response (29.3 %), intolerance (27.5 %), and disease progression (12.7 %). Among patients currently on HU, a significant proportion had elevated blood cell counts: 34.4 % had hematocrit values ≥45 %, 59.4 % had platelet levels >400 × 10(9)/L, and 58.2 % had WBC counts > 10 × 10(9)/L. Two-thirds (66.3 %) of patients had ≥1 elevated count, 40.3 % had ≥2 elevated counts, and 19.8 % had all 3 counts elevated. The most common PV-related signs and symptoms among all patients were fatigue and splenomegaly. Although many patients with PV benefit from HU therapy, some continue to have suboptimal control of their disease, as evidenced by persistence of abnormally elevated blood cell counts and the continued experience of disease-related manifestations (signs and symptoms). These data further denote a significant medical need for some patients with PV currently or previously treated with HU.

  19. Real-world treatment patterns of gout patients treated with colchicine or other common treatments for gout in acute care settings: a retrospective chart review study.

    Science.gov (United States)

    Shiozawa, Aki; Cloutier, Martin; Heroux, Julie; Guerin, Annie; Wu, Eric Q; Jackson, Robert

    2015-08-01

    To describe real-world treatment patterns of patients receiving colchicine or other treatments during a gout-related emergency room or acute care facility (ER/ACF) visit. An online physician-administered questionnaire was used to collect chart data on 500 patients with a gout-related ER/ACF visit after 16 October 2009; 250 patients receiving colchicine (Colchicine Cohort) and 250 receiving NSAIDs, systemic corticosteroids, narcotics, allopurinol, febuxostat, pegloticase, probenecid, or sulfinpyrazone (Other Cohort). Patient characteristics and treatment received/prescribed during the ER/ACF visit (Period 1 [P1]), at discharge (P2), and at the first follow-up visit (P3) are reported. A total of 45 rheumatologists and 63 primary care physicians participated in the study. Patient mean age was 51 years and 74.8% were male. The most common treatments in the Other Cohort were NSAIDs (59.6%), systemic corticosteroids (45.2%), and narcotics (33.6%). The 500 patients contributed 307 distinct treatment patterns from P1 to P3. Of the 20.6% patients not prescribed a treatment in P2, 60.2% were restarted on a treatment in P3. Of the 78.6% treated patients in P2, 27.0% had a treatment adjustment (dose increase, treatment add-on, or initiation of a different gout-related treatment - not with a urate lowering therapy only) in P3; for 72.6% of these patients, physicians justified the treatment adjustment by inadequacy of the treatment for maintenance therapy, insufficient dosage, or inadequate response. In the Colchicine Cohort, 60.8% of patients were prescribed colchicine consistently from P1 to P3, while 26.8% and 17.7% of patients in the Other Cohort were prescribed consistently NSAIDs and systemic corticosteroids from P1 to P3, respectively. Specific nature of the acute gout-related symptoms or potential attack/flare during the ER/ACF visit was not recorded. Real-world clinical practice reveals a substantial number of distinct treatment patterns and frequent treatment

  20. Complex Control Chart Interpretation

    Directory of Open Access Journals (Sweden)

    Darja Noskievičová

    2013-05-01

    Electric rules several different sets have been created (Nelson rules, Boeing AQS rules, Trietsch rules. This paper deals with the comparison analysis of these sets of rules, their basic statistical properties and the mistakes accompanying their application using SW support. At the end of this paper some recommendations for the correct application of the runs tests are formulated.

  1. Supernova Search Charts and Handbook, Pack/set ICL

    Science.gov (United States)

    Thompson, Gregg D.; Bryan, James T., Jr.

    This unique atlas contains 248 charts of more than 300 of the brightest galaxies, each specially prepared to facilitate the discovery of supernovae. The comparison of these charts with the field seen in a telescope enables any extragalactic supernova to be spotted immediately. The charts include 345 galaxies printed on translucent paper for use on a light-box, each one carrying an explanation of the constellation in which the galaxy lies, special characteristics of the galaxy, observing instructions, expected maximum brightness for the supernovae in each galaxy, and the reference for the sequence. A handbook accompanies the charts advising on their use, on how to make and record supernova discoveries, and reviewing the present understanding of supernovae. Published for an international market, these charts carry real potential for numerous discoveries of supernovae. The Supernovea Search Charts are a must for both serious observers and the growing number of deep sky enthusiasts around the world. '...these charts and the handbook will eventually increase the detection rate of supernovae.' New Scientist'...a much needed addition to the library of the active observer who wishes to hunt for these most important objects.' Observatory'...a mine of useful information and contains many hints on observing supernovae, as well as appendices on current supernova research.' Contemporary Physics'..they are a valuable asset to the field of supernovae searching' Journal of the British Astronomical Association

  2. Curvas de crescimento pôndero-estatural em crianças com síndrome de Down: uma revisão sistemática Growth charts in children with Down syndrome: a systematic review

    Directory of Open Access Journals (Sweden)

    Nathalie Jeanne M. Bravo-Valenzuela

    2011-06-01

    Full Text Available OBJETIVO: Revisar, de forma sistemática, as curvas de crescimento de crianças e adolescentes com síndrome de Down de diferentes países publicadas entre 1978 e 2008. FONTES DOS DADOS: Revisão sistemática baseada em dados eletrônicos (Medline, Lilacs e algumas referências de artigos citados, sendo selecionados títulos científicos publicados no intervalo de 30 anos. Analisadas as principais características dessas curvas de crescimento nos diferentes países. Excluídos estudos exclusivos de perímetro cefálico e os que não incluíam a construção de curvas de peso e/ ou estatura na síndrome de Down. As variáveis de peso e estatura/comprimento foram expressas em kg, centímetros e/ou escores Z. SÍNTESE DOS DADOS: Baixo peso e comprimento ao nascimento, baixa estatura final, prevalência de sobrepeso/ obesidade e reduzida velocidade de crescimento são caracte-rísticas importantes do crescimento na síndrome de Down. Cardiopatias congênitas e outras comorbidades podem ocorrer na síndrome, contribuindo para comprometer mais o crescimento deficiente. Nos estudos revisados, a média de estatura final variou entre 141,9 e 155cm para o gênero feminino e entre 150 e 165cm para o masculino (desvio padrão: -2,0 a -4,0. CONCLUSÕES: Reduzida velocidade de crescimento esta-tural, baixa estatura final e crescimento puberal total mais curto e precoce foram observados. Após o final da infância, ocorreu prevalência de sobrepeso/obesidade. É importante o uso de curvas específicas para a síndrome de Down para o reconhecimento precoce e adequado de doenças adicionais e/ou de sobrepeso/obesidade incipiente.OBJECTIVE: To systematic review studies of growth charts in children and teenagers with Down syndrome from differ-ent countries published between 1978 and 2008. DATA SOURCES: Electronic databases (Medline, Lilacs and references of the selected citations of papers published be-tween 1972-2008. The growth charts of Down syndrome in

  3. Long-term major clinical outcomes in patients with long chain fatty acid oxidation disorders before and after transition to triheptanoin treatment--A retrospective chart review.

    Science.gov (United States)

    Vockley, Jerry; Marsden, Deborah; McCracken, Elizabeth; DeWard, Stephanie; Barone, Amanda; Hsu, Kristen; Kakkis, Emil

    2015-01-01

    Long chain fatty acid oxidation disorders (LC-FAODs) are caused by defects in the metabolic pathway that converts stored long-chain fatty acids into energy, leading to a deficiency in mitochondrial energy production during times of physiologic stress and fasting. Severe and potentially life threatening clinical manifestations include rhabdomyolysis, hypoglycemia, hypotonia/weakness, cardiomyopathy and sudden death. We present the largest cohort of patients to date treated with triheptanoin, a specialized medium odd chain (C7) triglyceride, as a novel energy source for the treatment of LC-FAOD. This was a retrospective, comprehensive medical record review study of data from 20 of a total 24 patients with LC-FAOD who were treated for up to 12.5 years with triheptanoin, as part of a compassionate use protocol. Clinical outcomes including hospitalization event rates, number of hospitalization days/year, and abnormal laboratory values were determined for the total period of the study before and after triheptanoin treatment, as well as for specified periods before and after initiation of triheptanoin treatment. Other events of interest were documented including rhabdomyolysis, hypoglycemia, and cardiomyopathy. LC-FAOD in these 20 subjects was associated with 320 hospitalizations from birth to the end date of study. The mean hospitalization days/year decreased significantly by 67% during the period after triheptanoin initiation (n=15; 5.76 vs 17.55 vs; P=0.0242) and a trend toward a 35% lower hospitalization event rate was observed in the period after triheptanoin initiation compared with the before-treatment period (n=16 subjects >6 months of age; 1.26 vs 1.94; P=0.1126). The hypoglycemia event rate per year in 9 subjects with hypoglycemia problems declined significantly by 96% (0.04 vs 0.92; P=0.0091) and related hospitalization days/year were also significantly reduced (n=9; 0.18 vs 8.42; P=0.0257). The rhabdomyolysis hospital event rate in 11 affected subjects was

  4. Flowcharting with D-charts

    Science.gov (United States)

    Meyer, D.

    1985-01-01

    A D-Chart is a style of flowchart using control symbols highly appropriate to modern structured programming languages. The intent of a D-Chart is to provide a clear and concise one-for-one mapping of control symbols to high-level language constructs for purposes of design and documentation. The notation lends itself to both high-level and code-level algorithmic description. The various issues that may arise when representing, in D-Chart style, algorithms expressed in the more popular high-level languages are addressed. In particular, the peculiarities of mapping control constructs for Ada, PASCAL, FORTRAN 77, C, PL/I, Jovial J73, HAL/S, and Algol are discussed.

  5. Global Horizons (Briefing Charts)

    Science.gov (United States)

    2013-08-01

    Computing ‐ Location Independence ‐ Security ‐ Resiliency ‐ Efficient Algorithms ‐ Efficient HPC Advanced Nuclear • 70% Efficient • Quantum  dots...L)  Neuroscience  based brain  computer interfaces (L/F) Foundation s of Trust  Measurement, Vulnerability  Model/Analysis, & Verification  (L...Real‐Time Cyber Reverse  Engineering  (L/F)  Software Anti‐Tamper (L)  Secure Virtualization (F)  Information Integrity V&V  Quantum  Communication (L

  6. CHARTE D'AUDIT INTERNE

    International Development Research Centre (IDRC) Digital Library (Canada)

    sblanchard

    30 mars 2015 ... CHARTE D'AUDIT INTERNE. Mars 2015. 2. Assurances et conseils afin de soutenir le développement par l'innovation. La présente charte établit l'objet, le caractère indépendant et la portée de la fonction d'audit interne au CRDI de même que les pouvoirs et les responsabilités qui y sont associés et les.

  7. Angiogenesis inhibitor therapies for metastatic renal cell carcinoma: effectiveness, safety and treatment patterns in clinical practice-based on medical chart review.

    Science.gov (United States)

    Choueiri, Toni K; Duh, Mei Sheng; Clement, Jessica; Brick, Ashley J; Rogers, Miranda J; Kwabi, Christabel; Shah, Karishma; Percy, Andrew G; Antràs, Lucia; Jayawant, Sujata S; Chen, Kristina; Wang, Si-Tien; Luka, Andi; Neary, Maureen P; McDermott, David; Oh, William K

    2010-05-01

    To assess the effectiveness, safety, and treatment patterns of anti-angiogenic agents in metastatic renal cell carcinoma (mRCC) in tertiary clinical practice settings. We retrospectively reviewed the medical records in two tertiary oncology centres in the USA for all patients treated while off clinical trials from April 2003 to June 2008 who met the entry criteria and received one or more prescriptions for sunitinib or sorafenib, or one or more intravenous administrations of bevacizumab (off-label) as first-line anti-angiogenic treatment. The objective response rate (ORR) reviewed by independent physicians, adverse events (AEs), and treatment modifications were assessed. Among 144 patients receiving sunitinib (57), sorafenib (62) and bevacizumab (25), the median treatment duration was 10.5, 8.1 and 7.9 months, and the ORR was 37%, 9% and 13%, respectively. The ORR was lower for patients with metastases to bone, brain, lungs or lymph nodes. Common AEs (all grades) for sunitinib were fatigue (53%), diarrhoea (37%); for sorafenib, diarrhoea (50%), fatigue (40%); for bevacizumab, fatigue (40%), nausea (24%). In all, 34 (60%), 51 (82%) and 20 (80%) patients receiving sunitinib, sorafenib and bevacizumab, respectively, discontinued treatment; 10 (18%), 11 (18%) and four (16%) discontinued due to AEs; 21%, 40% and 12% had a dose interruption, and 30%, 35% and 0% had a dose reduction. Currently available anti-angiogenic agents had considerable effectiveness in clinical practice. However, the response rates appeared to be low in certain subgroups, but sample sizes were small. Patients had significant rates of AEs, many of which led to treatment modifications. The findings from this retrospective study suggest that there is a need for better-tolerated therapies for mRCC.

  8. Marketing medicines: charting the rise of modern therapeutics through a systematic review of adverts in UK medical journals (1950-1980).

    Science.gov (United States)

    Green, A Richard; Haddad, Peter M; Aronson, Jeffrey K

    2018-02-14

    To examine how pharmaceutical products that were first marketed between 1950 and 1980 were promoted to physicians through advertisements and briefly review advertising regulations and accuracy of the advertisements in the light of modern knowledge. We systematically reviewed advertisements promoting drugs for specific therapeutic areas, namely central nervous system disorders (anxiety and sleep disorders, depression, psychoses, and Parkinson's disease), respiratory disorders, cardiovascular disorders, and gastrointestinal disorders. We examined about 800 issues of the British Medical Journal (1950-1980) and about 150 issues of World Medicine (1965-1984). Advertising material was minimally regulated until the mid-1970s. Many drugs were marketed with little preclinical or clinical knowledge and some with the expectation that prescribers would obtain further data. The peak of advertising occurred in parallel with the surge in the release of novel drugs during the 1960s, but declined markedly after the mid-1970s. Advertisements generally contained little useful prescribing information. The period we investigated saw the release of many novel pharmaceuticals in the therapeutic areas we examined, and many (or their class successors) still play important therapeutic roles, including benzodiazepines, tricyclic antidepressants, phenothiazines, levodopa, selective and non-selective β-adrenoceptor antagonists, thiazide diuretics, β-adrenoceptor agonists, and histamine H 2 receptor antagonists. Advertising pharmaceuticals in the BMJ and World Medicine in 1950-1980 was poorly regulated and often lacked rigour. However, advertisements were gradually modified in the light of increasing clinical pharmacological knowledge, and they reflect an exciting period for the introduction of many drugs that continue to be of benefit today. © 2018 The British Pharmacological Society.

  9. Treatment approach, delivery, and follow-up evaluation for cardiac rhythm disease management patients receiving radiation therapy: retrospective physician surveys including chart reviews at numerous centers.

    Science.gov (United States)

    Gossman, Michael S; Wilkinson, Jeffrey D; Mallick, Avishek

    2014-01-01

    In a 2-part study, we first examined the results of 71 surveyed physicians who provided responses on how they address the management of patients who maintained either a pacemaker or a defibrillator during radiation treatment. Second, a case review study is presented involving 112 medical records reviewed at 18 institutions to determine whether there was a change in the radiation prescription for the treatment of the target cancer, the method of radiation delivery, or the method of radiation image acquisition. Statistics are provided to illustrate the level of administrative policy; the level of communication between radiation oncologists and heart specialists; American Joint Committee on Cancer (AJCC) staging and classification; National Comprehensive Cancer Network (NCCN) guidelines; tumor site; patient׳s sex; patient׳s age; device type; manufacturer; live monitoring; and the reported decisions for planning, delivery, and imaging. This survey revealed that 37% of patient treatments were considered for some sort of change in this regard, whereas 59% of patients were treated without regard to these alternatives when available. Only 3% of all patients were identified with an observable change in the functionality of the device or patient status in comparison with 96% of patients with normal behavior and operating devices. Documented changes in the patient׳s medical record included 1 device exhibiting failure at 0.3-Gy dose, 1 device exhibiting increased sensor rate during dose delivery, 1 patient having an irregular heartbeat leading to device reprogramming, and 1 patient complained of twinging in the chest wall that resulted in a respiratory arrest. Although policies and procedures should directly involve the qualified medical physicist for technical supervision, their sufficient involvement was typically not requested by most respondents. No treatment options were denied to any patient based on AJCC staging, classification, or NCCN practice standards. Copyright

  10. Treatment approach, delivery, and follow-up evaluation for cardiac rhythm disease management patients receiving radiation therapy: Retrospective physician surveys including chart reviews at numerous centers

    Energy Technology Data Exchange (ETDEWEB)

    Gossman, Michael S., E-mail: MGossman@TSRCC.com [Regulation Directive Medical Physics, Russell, KY (United States); Wilkinson, Jeffrey D. [Medtronic, Inc., Mounds View, MN (United States); Mallick, Avishek [Department of Mathematics, Marshall University, Huntington, WV (United States)

    2014-01-01

    In a 2-part study, we first examined the results of 71 surveyed physicians who provided responses on how they address the management of patients who maintained either a pacemaker or a defibrillator during radiation treatment. Second, a case review study is presented involving 112 medical records reviewed at 18 institutions to determine whether there was a change in the radiation prescription for the treatment of the target cancer, the method of radiation delivery, or the method of radiation image acquisition. Statistics are provided to illustrate the level of administrative policy; the level of communication between radiation oncologists and heart specialists; American Joint Committee on Cancer (AJCC) staging and classification; National Comprehensive Cancer Network (NCCN) guidelines; tumor site; patient's sex; patient's age; device type; manufacturer; live monitoring; and the reported decisions for planning, delivery, and imaging. This survey revealed that 37% of patient treatments were considered for some sort of change in this regard, whereas 59% of patients were treated without regard to these alternatives when available. Only 3% of all patients were identified with an observable change in the functionality of the device or patient status in comparison with 96% of patients with normal behavior and operating devices. Documented changes in the patient's medical record included 1 device exhibiting failure at 0.3-Gy dose, 1 device exhibiting increased sensor rate during dose delivery, 1 patient having an irregular heartbeat leading to device reprogramming, and 1 patient complained of twinging in the chest wall that resulted in a respiratory arrest. Although policies and procedures should directly involve the qualified medical physicist for technical supervision, their sufficient involvement was typically not requested by most respondents. No treatment options were denied to any patient based on AJCC staging, classification, or NCCN practice standards.

  11. Digital Mapping, Charting, and Geodesy Analysis Program Technical Review of Urban Vector Smart Map (UV Map) Prototype 1

    Science.gov (United States)

    1994-03-11

    Attributes, Radio Frequency, Electro-Optical Reflectivity HYDROGRAPHY Waterfall , Sounding, Piling, Rock, Left Bank Delineation, Right Bank Wreck...RESOLUTION (meters) (meters) (range, mode) (range, mode) HYDROGRAPHY River, Stream, Waterfall , Lake/ Abs Hz: 0.5 - 15 Hz: I - 125 Pond, Spring/Water Hole...Shoreline, Sounding, Open Water, Abs Vert: 0.05 - 125 Breakwater, Jetty, Seawall , Piling, Mode: 1 Rock, Wreck, Underwater Cable, Rel Vert: 0.05 - 125 Shipping

  12. A customised portable LogMAR chart with adjustable chart illumination for use as a mass screening device in the rural population

    Directory of Open Access Journals (Sweden)

    Gouthaman M

    2005-01-01

    Full Text Available Aim: To develop a customised, portable, cost-effective (logarithmic minimal angle resolution LogMAR chart with adjustable illumination for use as a mass vision-screening device in the rural population. Materials and Methods : Visual acuity of 100 individuals was evaluated with a customised chart and compared with the standard Early Treatment Diabetic Retinopathy Study (ETDRS chart and Snellen′s Chart. Bland and Altman analytical techniques were used for analysis. Results: Test-retest variability of the customised chart was just a one-line difference (95% CI for agreement, and so were the results with the standard ETDRS charts; a variability of 3-line was noted with Snellen′s chart. Two-line differences were observed when comparison was made with Standard ETDRS chart and 2 to 3-line differences with Snellen′s chart. Conclusion: The customised portable LogMAR chart with adjustable illumination shows less test-retest variability and better agreement with standard ETDRS chart; therefore, it can be used as a mass vision-screening device in rural settings.

  13. Charting the Giants

    Science.gov (United States)

    2004-06-01

    zero expansion asymptotically after an infinite time and has a flat geometry). All three observational tests by means of supernovae (green), the cosmic microwave background (blue) and galaxy clusters converge at a Universe around Ωm ~ 0.3 and ΩΛ ~ 0.7. The dark red region for the galaxy cluster determination corresponds to 95% certainty (2-sigma statistical deviation) when assuming good knowledge of all other cosmological parameters, and the light red region assumes a minimum knowledge. For the supernovae and WMAP results, the inner and outer regions corespond to 68% (1-sigma) and 95% certainty, respectively. References: Schuecker et al. 2003, A&A, 398, 867 (REFLEX); Tonry et al. 2003, ApJ, 594, 1 (supernovae); Riess et al. 2004, ApJ, 607, 665 (supernovae) Galaxy clusters are far from being evenly distributed in the Universe. Instead, they tend to conglomerate into even larger structures, "super-clusters". Thus, from stars which gather in galaxies, galaxies which congregate in clusters and clusters tying together in super-clusters, the Universe shows structuring on all scales, from the smallest to the largest ones. This is a relict of the very early (formation) epoch of the Universe, the so-called "inflationary" period. At that time, only a minuscule fraction of one second after the Big Bang, the tiny density fluctuations were amplified and over the eons, they gave birth to the much larger structures. Because of the link between the first fluctuations and the giant structures now observed, the unique REFLEX catalogue - the largest of its kind - allows astronomers to put considerable constraints on the content of the Universe, and in particular on the amount of dark matter that is believed to pervade it. Rather interestingly, these constraints are totally independent from all other methods so far used to assert the existence of dark matter, such as the study of very distant supernovae (see e.g. ESO PR 21/98) or the analysis of the Cosmic Microwave background (e

  14. Patient characteristics and treatment patterns in chronic myeloid leukemia: evidence from a multi-country retrospective medical record chart review study.

    Science.gov (United States)

    Mitra, Debanjali; Trask, Peter C; Iyer, Shrividya; Candrilli, Sean D; Kaye, James A

    2012-03-01

    We conducted a retrospective medical record review of 1,063 patients to examine patient characteristics and treatment patterns among adults with Philadelphia chromosome and/or BCR-ABL-positive chronic-phase chronic myeloid leukemia in the USA, UK, Germany, and Japan. Patients who were included received first-line treatment with imatinib between 1 January 2005 and 31 December 2009 and were not enrolled in a randomized clinical trial between first-line treatment initiation and end of recorded follow-up. The average age was 55 years; 60% were male. On average, patients were initiated on imatinib 2.7 months post-diagnosis and received therapy for 22 months [19 months (USA) to 25 months (Japan)], at a median dose of 400 mg/day. Thirteen percent [8% (Japan) to 16% (UK)] had dose escalation to a median 800 mg/day. Twenty-nine percent discontinued imatinib, primarily due to resistance or disease progression. Among 148 patients receiving second-line dasatinib and 113 receiving nilotinib, a greater proportion in the USA and Germany received nilotinib (54% in each country), while fewer patients in Japan and the UK received nilotinib (47 and 17%, respectively). On average, patients had second-line therapy initiated 25 months post-diagnosis and received treatment for 11 months (dasatinib) or 8 months (nilotinib). Patients initiating dasatinib had more advanced disease than those initiating nilotinib.

  15. Effectiveness of physical therapists serving as primary care musculoskeletal providers as compared to family practice providers in a deployed combat location: a retrospective medical chart review.

    Science.gov (United States)

    McGill, Troy

    2013-10-01

    A medical records review to compare efficiency and effectiveness of a physical therapist (PT) functioning as a musculoskeletal primary care provider (PCP) compared to family practice (FP) physicians functioning as musculoskeletal PCP. (1) Use of medication/imaging studies will be significantly less with a PT as PCP compared to FP as PCP. (2) Return-to-duty (RTD) rate will show significant increases when patients with musculoskeletal conditions are seen by PT as compared to FP. One PT practicing in a deployed combat location collected data on patients that presented directly to the PT clinic or FP clinic for care of musculoskeletal complaints. Treatment patterns of two Air Force physicians were accessed regarding patients with musculoskeletal conditions. Fifty-four patients were randomly selected for the PT group and 95 patients for FP group. AHLTA was searched for cases reported from June 2009 to January 2010. Data regarding age, gender, medication, imaging use, and return to duty (RTD) rate were collected. Of the study population, 126 (84%) were males, 23 (16%) were females (age range: 19-54, mean 29). RTD rate was 50% greater for PT. Rate of medication and imaging use for PT was 24% and 11%, whereas FP was 90% and 82%, respectively (p < 0.01). Using PT as the musculoskeletal PCP was shown to be an effective and efficient practice model to assess and treat patients with musculoskeletal complaints. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  16. The use of quality control performance charts to analyze cesarean delivery rates nationally.

    LENUS (Irish Health Repository)

    Turner, Michael J

    2012-02-01

    OBJECTIVE: To examine the use of quality control performance charts to analyze cesarean rates nationally. METHODS: Information on cesarean rates was obtained for all 19 Irish maternity hospitals receiving state funding in 2009. All women who underwent cesarean delivery of a live or stillborn infant weighing 500 g or more between January 1 and December 31 were included. Deliveries were classified as elective or emergency. Individual hospitals were not identified in the analysis. RESULTS: The mean rates per hospital of elective and emergency cesarean were 12.9+\\/-2.6% (n=9337) and 13.8+\\/-3.0% (n=9989), respectively-giving an overall mean rate of 26.7+\\/-4.2% (n=19326) per hospital. Cesarean rates were normally distributed. Using a quality control performance chart with a cutoff 2 standard deviations from the mean, 1 hospital was above the normal range for both total and elective cesareans, indicating that its pre-labor obstetric practices warrant clinical review. Another hospital had a mean emergency cesarean rate above the normal range, indicating that its labor ward practices warrant review. CONCLUSION: Quality control performance charts can be used to analyze cesarean rates nationally and, thus, to identify hospitals at which obstetric practices should be reviewed.

  17. A retrospective chart review of drug treatment patterns and clinical outcomes among patients with metastatic or recurrent soft tissue sarcoma refractory to one or more prior chemotherapy treatments.

    Science.gov (United States)

    Wagner, Michael J; Amodu, Leo Ismaila; Duh, Mei Sheng; Korves, Caroline; Solleza, Franco; Manson, Stephanie C; Diaz, José; Neary, Maureen P; Demetri, George D

    2015-03-25

    Limited clinical data on real-world practice patterns are available for patients with metastatic/relapsed soft tissue sarcomas (STS). The primary objective of this study was to evaluate treatment patterns in patients with metastatic/relapsed STS following failure of prior chemotherapy by examining data collected from 2000 to 2011 from a major tertiary academic cancer center in the United States. Medical records, including community-based referral records, from a tertiary cancer center for adult patients with metastatic/relapsed STS with confirmed disease progression who commenced second-line treatment between January 1, 2000 and February 4, 2011, and with at least 3 months of follow-up data following second-line treatment initiation, were retrospectively reviewed. Overall survival, time to progression, and clinician-reported tumor response were collected. A total of 99 patients (leiomyosarcoma, n = 48; synovial cell sarcoma, n = 7; liposarcoma, n = 5; or other histological subtypes, n = 39) received an average of four lines of treatment (maximum of 10). No consistent or dominant regimens were used in each treatment line beyond the second line. Median second-line treatment duration was 4.1 months (95% confidence interval, 3.0-5.0). Overall, 72 of 99 patients (73%) discontinued second-line treatment due to progressive disease. Median progression-free survival from initiation of second-line treatment varied across regimens from 2.0 to 6.6 months (overall median, 5.4 months). Wide variations in treatment were evident, with no single standard of care for patients with metastatic/relapsed STS. Most patients discontinued second-line treatment due to progressive disease, often receiving additional systemic therapy with other drugs. These data suggest a high unmet need for more efficacious treatment options and improved data collection to guide practice among patients with relapsed/refractory STS.

  18. Risk factors and co-morbidities associated with changes in renal function among antiretroviral treatment-naïve adults in South Africa: A chart review.

    Science.gov (United States)

    Assaram, Shirelle; Mashamba-Thompson, Tivani P; Magula, Nombulelo P

    2018-01-01

    Our systematic scoping review has demonstrated a research gap in antiretroviral treatment (ART) nephrotoxicity as well as in the long-term outcomes of renal function for patients on ART in South Africa. Bearing in mind the high prevalence of human immunodeficiency virus (HIV) in South Africa, this is of great concern. To determine the risk factors and co-morbidities associated with changes in renal function in HIV-infected adults in South Africa. We conducted a retrospective study of 350 ART-naïve adult patients attending the King Edward VIII HIV clinic, Durban, South Africa. Data were collected at baseline (pre-ART) and at six, 12, 18 and 24 months on ART. Renal function was assessed in the 24-month period using the Modification of Diet in Renal Disease equation and was categorised into normal renal function (estimated glomerular filtration rate [eGFR] ≥ 60), moderate renal impairment (eGFR 30-59), severe renal impairment (eGFR 15-29) and kidney failure (eGFR 0.05. The vast majority of patients were initiated on tenofovir disoproxil fumarate (TDF) (90.6%), in combination with lamivudine (3TC) (100%) and either efavirenz (EFV) (56.6%) or nevirapine (NVP) (43.4%). This study reports a low prevalence of baseline renal impairment in HIV-infected ART-naïve outpatients. An improvement in renal function after the commencement of ART has been demonstrated in this population. However, the long-term outcomes of patients with HIV-related renal disease are not known.

  19. Real-world dosing and drug costs with everolimus or axitinib as second targeted therapies for advanced renal cell carcinoma: a retrospective chart review in the US.

    Science.gov (United States)

    Pal, Sumanta K; Jonasch, Eric; Signorovitch, James E; Reichmann, William M; Li, Nanxin; Liu, Zhimei; Perez, Jose Ricardo; Vogelzang, Nicholas J

    2016-01-01

    To describe dosing patterns and to compare the drug costs per month spent in progression-free survival (PFS) among patients with advanced renal cell carcinoma (aRCC) treated with everolimus or axitinib following a first tyrosine kinase inhibitor (TKI). A medical record retrospective review was conducted among medical oncologists and hematologists/oncologists in the US. Patient eligibility criteria included: (1) age ≥18 years; (2) discontinuation of first TKI (sunitinib, sorafenib, or pazopanib) for medical reasons; (3) initiation of axitinib or everolimus as a second targeted therapy during February 2012-January 2013. Real-world dosing patterns were summarized. Dose-specific drug costs (as of October 2014) were based on wholesale acquisition costs from RED BOOK Online. PFS was compared between everolimus and axitinib using a multivariable Cox proportion hazards model. Everolimus and axitinib drug costs per month of PFS were compared using multivariable gamma regression models. A total of 325 patients received everolimus and 127 patients received axitinib as second targeted therapy. Higher proportions of patients treated with axitinib vs everolimus started on a higher than label-recommended starting dose (14% vs 2%) or experienced dose escalation (11% vs 1%) on second targeted therapy. The PFS did not differ significantly between patients receiving everolimus or axitinib (adjusted hazard ratio (HR) = 1.16; 95% confidence interval [CI] = 0.73-1.82). After baseline characteristics adjustment, axitinib was associated with 17% ($1830) higher drug costs per month of PFS compared to everolimus ($12,467 vs $10,637; p < 0.001). Retrospective observational study design and only drug acquisition costs considered in drug costs estimates. Patients with aRCC receiving axitinib as second targeted therapy were more likely to initiate at a higher than label-recommended dose and were more likely to dose escalate than patients receiving everolimus. With similar observed

  20. Treatment patterns and duration in post-menopausal women with HR+/HER2- metastatic breast cancer in the US: a retrospective chart review in community oncology practices (2004-2010).

    Science.gov (United States)

    Macalalad, Alexander R; Hao, Yanni; Lin, Peggy L; Signorovitch, James E; Wu, Eric Q; Ohashi, Erika; Zhou, Zhou; Kelley, Caroline

    2015-02-01

    Clinical guidelines prefer endocrine therapy (ET) as initial treatment for post-menopausal women with hormone receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2-) metastatic breast cancer (mBC). Chemotherapy (CT) should be reserved for patients who develop symptomatic visceral disease or have no clinical benefit after three sequential ET regimens. It is unclear if real-world clinical practice reflects these guidelines. To describe treatment patterns and treatment durations by lines of therapy for ET and CT among post-menopausal HR+/HER2- mBC patients. Charts were reviewed from a network of community-based oncology practices of eligible patients who had progressed after initiating adjuvant or first-line treatment for mBC between 1 January 2004 and 30 September 2010. Extracted chart data included demographics, treatment histories, and outcomes. Treatment duration was estimated using Kaplan-Meier estimators. A total of 144 patients were studied. Patients received a median of two lines of ET, and <10% had three or more lines of ET before receiving CT. From first line to second line, the median treatment duration was 11.6 to 4.9 months for ET overall; 13.8 to 10.5 months for anastrozole; 18.6 to 7.0 months for letrozole; and 5.1 to 2.9 months for fulvestrant. For CT, the median duration was 5.1 months in the first line and 3.7 months and below in subsequent lines. During the study period (1 January 2004 - 30 September 2012), most patients received <3 lines of ET before receiving CT. The drop in median duration of ET from first to second line suggests that single agent ETs might not be as effective beyond the first line. A key limitation of this study was the small sample size. In addition, more research is needed to further investigate the short treatment duration of fulvestrant across early lines of therapy (which could indicate lack of efficacy).

  1. Angiogenesis inhibitor therapies for advanced renal cell carcinoma: toxicity and treatment patterns in clinical practice from a global medical chart review.

    Science.gov (United States)

    Oh, William K; McDermott, David; Porta, Camillo; Levy, Antonin; Elaidi, Reza; Scotte, Florian; Hawkins, Robert; Castellano, Daniel; Bellmunt, Joaquim; Rha, Sun Young; Sun, Jong-Mu; Nathan, Paul; Feinberg, Bruce A; Scott, Jeffrey; McDermott, Ray; Ahn, Jin-Hee; Wagstaff, John; Chang, Yen-Hwa; Ou, Yen-Chuan; Donnellan, Paul; Huang, Chao-Yuan; McCaffrey, John; Chiang, Po-Hui; Chuang, Cheng-Keng; Korves, Caroline; Neary, Maureen P; Diaz, Jose R; Mehmud, Faisal; Duh, Mei Sheng

    2014-01-01

    The aim of this study was to assess the treatment patterns and safety of sunitinib, sorafenib and bevacizumab in real-world clinical settings in US, Europe and Asia. Medical records were abstracted at 18 community oncology clinics in the US and at 21 tertiary oncology centers in US, Europe and Asia for 883 patients ≥ 18 years who had histologically/cytologically confirmed diagnosis of advanced RCC and received sunitinib (n=631), sorafenib (n=207) or bevacizumab (n=45) as first-line treatment. No prior treatment was permitted. Data were collected on all adverse events (AEs) and treatment modifications, including discontinuation, interruption and dose reduction. Treatment duration was estimated using Kaplan-Meier analysis. Demographics were similar across treatment groups and regions. Median treatment duration ranged from 6.1 to 10.7 months, 5.1 to 8.5 months and 7.5 to 9.8 months for sunitinib, sorafenib and bevacizumab patients, respectively. Grade 3/4 AEs were experienced by 26.0, 28.0 and 15.6% of sunitinib, sorafenib and bevacizumab patients, respectively. Treatment discontinuations occurred in 62.4 (Asia) to 63.1% (US) sunitinib, 68.8 (Asia) to 90.0% (Europe) sorafenib, and 66.7 (Asia) to 81.8% (US) bevacizumab patients. Globally, treatment modifications due to AEs occurred in 55.1, 54.2 and 50.0% sunitinib, sorafenib and bevacizumab patients, respectively. This study in a large, global cohort of advanced RCC patients found that angiogenesis inhibitors are associated with high rates of AEs and treatment modifications. Findings suggest an unmet need for more tolerable agents for RCC treatment.

  2. Treatment charts in radiation therapy

    International Nuclear Information System (INIS)

    Macia, M.; De Blas, R.; Monfa, C.; Bonet, A.; Rubio, A.M.

    1993-01-01

    The radiotherapy treatment chart (dose prescription, set-up parameters, dose computation and daily dose recording form) represents an important working tool in radiotherapy, not only as a compilation of data, but also as a method of communication among physicians, physicists and technicians. In addition to administrative and medical data, physical and simulation data that are indispensable for the daily accurate reproduction of the therapy procedures should be recorded, as well as accurate daily entries of the fractional and cumulative absorbed doses. Moreover, any radiation therapy quality assurance programme must rely on the accessibility of the radiation treatment history and a correct record of the therapy protocol in order to be verifiable. We have analysed the treatment charts of 92 European Departments of Radiation Oncology, with the aim of identifying their salient characteristics and data recorded. The study shows strong differences among the charts analysed, not only in the amount of information recorded, but also in the kind of data and concepts used. (author) 6 refs., 1 fig

  3. Development of disease-specific growth charts in Turner syndrome and Noonan syndrome

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Isojima

    2017-12-01

    Full Text Available Many congenital diseases are associated with growth failure, and patients with these diseases have specific growth patterns. As the growth patterns of affected individuals differ from those of normal populations, it is challenging to detect additional conditions that can influence growth using standard growth charts. Disease-specific growth charts are thus very useful tools and can be helpful for understanding the growth pattern and pathogenesis of congenital diseases. In addition, disease-specific growth charts allow doctors to detect deviations from the usual growth patterns for early diagnosis of an additional condition and can be used to evaluate the effects of growth-promoting treatment for patients. When developing these charts, factors that can affect the reliability of the charts should be considered. These factors include the definition of the disease with growth failure, selection bias in the measurements used to develop the charts, secular trends of the subjects, the numbers of subjects of varying ages and ethnicities, and the statistical method used to develop the charts. In this review, we summarize the development of disease-specific growth charts for Japanese individuals with Turner syndrome and Noonan syndrome and evaluate the efforts to collect unbiased measurements of subjects with these diseases. These charts were the only available disease-specific growth charts of Turner syndrome and Noonan syndrome for Asian populations and were developed using a Japanese population. Therefore, when these charts are adopted for Asian populations other than Japanese, different growth patterns should be considered.

  4. Development of disease-specific growth charts in Turner syndrome and Noonan syndrome.

    Science.gov (United States)

    Isojima, Tsuyoshi; Yokoya, Susumu

    2017-12-01

    Many congenital diseases are associated with growth failure, and patients with these diseases have specific growth patterns. As the growth patterns of affected individuals differ from those of normal populations, it is challenging to detect additional conditions that can influence growth using standard growth charts. Disease-specific growth charts are thus very useful tools and can be helpful for understanding the growth pattern and pathogenesis of congenital diseases. In addition, disease-specific growth charts allow doctors to detect deviations from the usual growth patterns for early diagnosis of an additional condition and can be used to evaluate the effects of growth-promoting treatment for patients. When developing these charts, factors that can affect the reliability of the charts should be considered. These factors include the definition of the disease with growth failure, selection bias in the measurements used to develop the charts, secular trends of the subjects, the numbers of subjects of varying ages and ethnicities, and the statistical method used to develop the charts. In this review, we summarize the development of disease-specific growth charts for Japanese individuals with Turner syndrome and Noonan syndrome and evaluate the efforts to collect unbiased measurements of subjects with these diseases. These charts were the only available disease-specific growth charts of Turner syndrome and Noonan syndrome for Asian populations and were developed using a Japanese population. Therefore, when these charts are adopted for Asian populations other than Japanese, different growth patterns should be considered.

  5. Progress in the technology of nautical charting

    Digital Repository Service at National Institute of Oceanography (India)

    Joseph, A.

    surveying; chart projection schemes; the role of radio and satellite-based position-fixing systems; the technology of the modern electronic nautical charts; and applications of computers in modern navigation. The article also peeps into possible future...

  6. NOAA Seamless Raster Navigational Charts (RNC)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Seamless Raster Chart Server provides a seamless collarless mosaic of the NOAA Raster Navigational Charts (RNC). The RNC are a collection of approximately...

  7. Air Emissions Sources, Charts and Maps

    Data.gov (United States)

    U.S. Environmental Protection Agency — Air Emissions provides (1) interactive charts supporting national, state, or county charts, (2) county maps of criteria air pollutant emissions for a state, and (3)...

  8. Nursing diagnosis taxonomy across the Atlantic Ocean: congruence between nurses' charting and the NANDA taxonomy.

    Science.gov (United States)

    Thoroddsen, Asta; Thorsteinsson, Hrund Sch

    2002-02-01

    The purpose of this study was to analyse expressions or terms used by nurses in Iceland to describe patient problems. The classification of NANDA was used as reference. The research questions were: (a) Does NANDA terminology represent patient problems documented by Icelandic nurses? (b) If so, what kind of nursing diagnoses does it represent? (c) What kind of patient problems are not represented by NANDA terminology? (d) What are the most frequent nursing diagnoses used? A retrospective chart review was conducted in a 400 bed acute care hospital in Iceland. The sample was defined as nursing diagnosis statements in charts of patients hospitalized in two 6-month periods in two separate years. The data were analysed according to a predefined grading system based on the PES format or Problem -- (A)aetiology -- Signs and symptoms. A total of 1217 charts were used for the study, which yielded 2171 nursing diagnoses statements for analysis. Charts with at least one nursing diagnosis documented were 60.1% and the number of diagnoses per patient ranged from 0 to 10, with 65% of charts with three diagnoses or less. The number of diagnoses correlated with patients' length of stay, but not with increased age of the patients. The average number of statements per patient was 3.28. Almost 60% of the diagnoses were according to NANDA terminology, another 20% were stated as procedures, medical diagnoses or risks for complications. The 20 most frequently used nursing diagnoses accounted for 80% of all diagnoses documented. Discrepancy between nurses' documentation on emotional problems and availability of diagnosis in the NANDA taxonomy was evident. It can be concluded that the NANDA taxonomy seems to be culturally relevant for nurses in different cultures.

  9. Growth charts from controversy to consensus

    Directory of Open Access Journals (Sweden)

    Vaman Khadilkar

    2012-01-01

    Full Text Available Growth follows a specific set of patterns inspite of variability in children. This led to the development of growth charts . As growth provides an interplay of many factors, growth chart helps monitor growth and diagnose disease. They are also used for epidemiological purpose. There are many growth charts available. Training of health care workers to use and interpret growth chart in the children is needed for national health.

  10. Shewhart control charts in new perspective

    NARCIS (Netherlands)

    Albers, Willem/Wim; Kallenberg, W.C.M.

    2007-01-01

    The effects of estimating parameters and the violation of the assumption of normality when dealing with control charts are discussed. Corrections for estimating errors and extensions of the normal control chart to parametric and nonparametric charts are investigated. The underlying theory is

  11. Vogtle Electric Generating Plant ETE Analysis Review

    Energy Technology Data Exchange (ETDEWEB)

    Diediker, Nona H.; Jones, Joe A.

    2006-12-09

    Under contract with the Nuclear Regulatory Commission (NRC), staff from Pacific Northwest National Laboratory (PNNL) and Sandia National Laboratory (SNL)-Albuquerque reviewed the evacuation time estimate (ETE) analysis dated April 2006 prepared by IEM for the Vogtle Electric Generating Plant (VEGP). The ETE analysis was reviewed for consistency with federal regulations using the NRC guidelines in Review Standard (RS)-002, Supplement 2 and Appendix 4 to NUREG-0654, and NUREG/CR-4831. Additional sources of information referenced in the analysis and used in the review included NUREG/CR-6863 and NUREG/CR-6864. The PNNL report includes general comments, data needs or clarifications, and requests for additional information (RAI) resulting from review of the ETE analysis.

  12. CHART in lung cancer: Economic evaluation and incentives for implementation

    International Nuclear Information System (INIS)

    Lievens, Yolande; Kesteloot, Katrien; Bogaert, Walter van den

    2005-01-01

    Background and purpose: To investigate the financial consequences and the impact on daily implementation of CHART in lung cancer. Patients and methods: A cost-effectiveness and cost-utility analysis were performed using Markov models, comparing the early and delayed costs and effects of CHART for NSCLC over a 4-year time span from a societal viewpoint. The outcome estimates were based on the CHART literature, the cost estimates on the standard practice of the Leuven University Hospitals, the radiotherapy costs being derived from an activity-based costing (ABC) programme developed in the department. Results: The additional societal cost per life-year gained was EURO 9164, the incremental cost per quality-adjusted life-year EURO 11,576. Sensitivity analyses confirmed the robustness of these results, the incremental cost-utility ratio remaining well under 20,000 EURO /QALY in all tested circumstances. The threshold analyses found the results of the study to be sensitive to the cost of CHART and to the quality of life after treatment. More specifically, standard treatment would become the optimal treatment if CHART would have a higher cost or would result in more long-term side effects. Conclusion: CHART should not be denied to patients with NSCLC on the basis of clinical or economic arguments. Other factors such as socio-economical, institutional, practical departmental and physician-bound barriers most probably explain the lack of implementation into daily practice

  13. Accuracy of nurse documentation of delirium symptoms in medical charts.

    Science.gov (United States)

    Voyer, Philippe; Cole, Martin G; McCusker, Jane; St-Jacques, Sylvie; Laplante, Johanne

    2008-04-01

    The purpose of this study undertaken in an acute care hospital was to evaluate sensitivity and specificity of the documentation of nurse-reported delirium symptoms in medical charts. This is a descriptive study based on the clinical assessments of a study nurse and nursing notes in the medical charts of 226 delirious older patients newly admitted to an acute care hospital. The results of this prospective validation study indicated that documentation of delirium symptoms is poor. Disorientation, agitation and altered level of consciousness were the three symptoms yielding a higher level of sensitivity, but even so said symptoms were reported in less than a third of the medical charts. Univariate analysis suggested that higher comorbidity level, more severe symptoms of delirium and the use of physical restraints were associated with more valid documentation of delirium symptoms in medical charts. Lastly, this study corroborates results of previous studies, indicating that documentation of delirium symptoms in medical charts can be improved. Future study should target improving nurse documentation of delirium symptoms in medical charts.

  14. The Sputum Colour Chart as a predictor of lung inflammation, proteolysis and damage in non-cystic fibrosis bronchiectasis: a case-control analysis.

    Science.gov (United States)

    Goeminne, Pieter C; Vandooren, Jennifer; Moelants, Eva A; Decraene, Ann; Rabaey, Evelyn; Pauwels, Ans; Seys, Sven; Opdenakker, Ghislain; Proost, Paul; Dupont, Lieven J

    2014-02-01

    Non-cystic fibrosis bronchiectasis (NCFB) is characterized by a vicious cycle of airway infection, inflammation and structural damage with inappropriate mucus clearance. Our aim was to relate the value of proteolytic enzymes, proteolytic enzyme activity and inflammatory markers to disease severity and symptoms in patients with NCFB. Sputum induction in NCFB patients and healthy controls was performed. Sputum was analysed for total and differential cell count, markers of inflammation (CXCL8 (also known as interleukin-8) and tumour necrosis factor-α (TNF-α)) and proteolytic enzymes (neutrophil elastase (NE), gelatin zymography and total gelatinolytic activity (TGA)). Each patient was evaluated by spirometry, Leicester Cough Questionnaire (LCQ) and Sputum Colour Chart (SCC). Patient files were analysed to determine Pseudomonas aeruginosa colonization status. The computed tomography (CT) closest to the date sputum induction was scored by a radiologist. NCFB patients showed significantly higher neutrophils, CXCL8, TNF-α, NE and TGA than healthy controls. TGA subanalysis showed that the majority of the activity was NE (82 ± 6.4%). Residual activity was mainly zinc ion-dependent matrix metalloproteinase (MMP) activity (18 ± 6.4%). Subanalysis showed that patients with chronic Pseudomonas aeruginosa colonization had more activated MMP-9. Correlations were seen between proteolytic enzymes and inflammation and disease severity (spirometry and CT score), but not with the LCQ. SCC was associated with increased markers of inflammation, proteolytic enzymes and worse CT score. We show that sputum purulence assessment in daily clinical practice using the SCC is a quick and easy tool that reflects severity of inflammation, destruction and proteolytic enzymatic activity/presence. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  15. Crystalline silicotitanate gate review analysis

    International Nuclear Information System (INIS)

    Schlahta, S.N.; Carreon, R.; Gentilucci, J.A.

    1997-11-01

    Crystalline silicotitanate (CST) is an ion-exchange method for removing radioactive cesium from tank waste to allow the separation of the waste into high- and low-level fractions. The CST, originally developed Sandia National Laboratories personnel in association with Union Oil Products Corporation, has both a high affinity and selectivity for sorbing cesium-137 from highly alkaline or acidic solutions. For several years now, the U.S. Department of Energy has funded work to investigate applying CST to large-scale removal of cesium-137 from radioactive tank wastes. In January 1997, an expert panel sponsored by the Tanks Focus Area met to review the current state of the technology and to determine whether it was ready for routine use. The review also sought to identify any technical issues that must be resolved or additional CST development that must occur before full implementation by end-users. The CST Gate Review Group concluded that sufficient work has been done to close developmental work on CST and turn the remaining site-specific tasks over to the users. This report documents the review group''s findings, issues, concerns, and recommendations as well as responses from the Tanks Focus Area expert staff to specific pretreatment and immobilization issues

  16. A retrospective chart review of the clinical and psychosocial profile of psychotic adolescents with co-morbid substance use disorders presenting to acute adolescent psychiatric services at Tygerberg Hospital

    Directory of Open Access Journals (Sweden)

    Anusha Lachman

    2012-05-01

    Full Text Available Background. A large number of adolescents meet criteria for ‘dual diagnosis’ (a psychiatric disorder plus co-morbid substance use disorder (SUD, which prolongs treatment response and complicates intervention strategies. The current service model in Cape Town divides the care of such patients into psychiatric treatment and a separate substance use intervention. Child and adolescent mental health services face the challenge of high rates of readmission of adolescents into psychiatric facilities before utilisation of community-based substance abuse services. Objective. There is a scarcity of available treatment guidelines for dual-diagnosis adolescents, and a lack of systematically documented epidemiological and clinical data in South African adolescent populations. Method. A retrospective chart review of adolescent psychiatric admissions to the Tygerberg Adolescent Psychiatric Unit during 2010 was conducted. Relevant epidemiological, clinical and demographic data for those presenting with a dual diagnosis (specifically psychotic disorders and SUD was recorded. Results. Results suggest a high prevalence of SUD among adolescents presenting with a first-episode psychosis. Statistically significant correlations with lower levels of education were found in those with ongoing substance abuse (specifically cannabis and methamphetamine, and a significant relationship between choice of debut drug and ongoing drug use was also demonstrated. Risk factors for SUD (psychosocial adversities, childhood trauma, family and community exposure to substances, early debut drug ages, risky sexual behaviours, and clinical psychiatric profiles of adolescents with dual diagnosis are described. Conclusions. This cohort had an enhanced risk as a result of genetic vulnerability and environmental availability of substances, and the findings emphasise the differences in presentation, choice of drugs of abuse and psychosocial difficulties of adolescents with a dual

  17. 2011 Biomass Program Platform Peer Review: Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Haq, Zia [Office of Energy Efficiency and Renewable Energy (EERE), Washington, DC (United States)

    2012-02-01

    This document summarizes the recommendations and evaluations provided by an independent external panel of experts at the 2011 U.S. Department of Energy Biomass Program’s Analysis Platform Review meeting.

  18. Match Analysis in Volleyball: a systematic review

    Directory of Open Access Journals (Sweden)

    Miguel Silva

    2016-03-01

    Full Text Available The present article aims to review the available literature on match analysis in adult male Volleyball. Specific key words "performance analysis", "match analysis", "game analysis", "notational analysis", "tactical analysis", "technical analysis", "outcome" and "skills" were used to search relevant databases (PubMed, Web of Science, SportDiscus, Academic Search Complete and the International Journal of Performance Analysis in Sport. The research was conducted according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta analyses guidelines. Of 3407 studies initially identified, only 34 were fully reviewed, and their outcome measures extracted and analyzed. Studies that fit all inclusion criteria were organized into two levels of analysis, according to their research design (comparative or predictive and depending on the type of variables analyzed (skills and their relationship with success, play position and match phase. Results show that from a methodological point of view, comparative studies where currently complemented with some predictive studies. This predictive approach emerged with the aim to identify the relationship between variables, considering their possible interactions and consequently its effect on team performance, contributing to a better understanding of Volleyball game performance through match analysis. Taking into account the limitations of the reviewed studies, future research should provide comprehensive operational definitions for the studied variables, using more recent samples, and consider integrating the player positions and match phase contexts into the analysis of Volleyball.

  19. Growth charts for children with Ellis–van Creveld syndrome

    Science.gov (United States)

    Eilers, Paul H. C.; Lawrence, Kate; Hennekam, Raoul C. M.; Versteegh, Florens G. A.

    2010-01-01

    Ellis–van Creveld (EvC) syndrome is a congenital malformation syndrome with marked growth retardation. In this study, specific growth charts for EvC patients were derived to allow better follow-up of growth and earlier detection of growth patterns unusual for EvC. With the use of 235 observations of 101 EvC patients (49 males, 52 females), growth charts for males and females from 0 to 20 years of age were derived. Longitudinal and cross-sectional data were collected from an earlier review of growth data in EvC, a database of EvC patients, and from recent literature. To model the growth charts, the GAMLSS package for the R statistical program was used. Height of EvC patients was compared to healthy children using Dutch growth charts. Data are presented both on a scale for age and on a scale for the square root of age. Compared to healthy Dutch children, mean height standard deviation score values for male and female EvC patients were −3.1 and −3.0, respectively. The present growth charts should be useful in the follow-up of EvC patients. Most importantly, early detection of growth hormone deficiency, known to occur in EvC, will be facilitated. PMID:20830486

  20. Growth charts for children with Ellis-van Creveld syndrome.

    Science.gov (United States)

    Verbeek, Sabine; Eilers, Paul H C; Lawrence, Kate; Hennekam, Raoul C M; Versteegh, Florens G A

    2011-02-01

    Ellis-van Creveld (EvC) syndrome is a congenital malformation syndrome with marked growth retardation. In this study, specific growth charts for EvC patients were derived to allow better follow-up of growth and earlier detection of growth patterns unusual for EvC. With the use of 235 observations of 101 EvC patients (49 males, 52 females), growth charts for males and females from 0 to 20 years of age were derived. Longitudinal and cross-sectional data were collected from an earlier review of growth data in EvC, a database of EvC patients, and from recent literature. To model the growth charts, the GAMLSS package for the R statistical program was used. Height of EvC patients was compared to healthy children using Dutch growth charts. Data are presented both on a scale for age and on a scale for the square root of age. Compared to healthy Dutch children, mean height standard deviation score values for male and female EvC patients were -3.1 and -3.0, respectively. The present growth charts should be useful in the follow-up of EvC patients. Most importantly, early detection of growth hormone deficiency, known to occur in EvC, will be facilitated.

  1. Packaging Review Guide for Reviewing Safety Analysis Reports for Packagings

    Energy Technology Data Exchange (ETDEWEB)

    DiSabatino, A; Biswas, D; DeMicco, M; Fisher, L E; Hafner, R; Haslam, J; Mok, G; Patel, C; Russell, E

    2007-04-12

    This Packaging Review Guide (PRG) provides guidance for Department of Energy (DOE) review and approval of packagings to transport fissile and Type B quantities of radioactive material. It fulfills, in part, the requirements of DOE Order 460.1B for the Headquarters Certifying Official to establish standards and to provide guidance for the preparation of Safety Analysis Reports for Packagings (SARPs). This PRG is intended for use by the Headquarters Certifying Official and his or her review staff, DOE Secretarial offices, operations/field offices, and applicants for DOE packaging approval. This PRG is generally organized at the section level in a format similar to that recommended in Regulatory Guide 7.9 (RG 7.9). One notable exception is the addition of Section 9 (Quality Assurance), which is not included as a separate chapter in RG 7.9. Within each section, this PRG addresses the technical and regulatory bases for the review, the manner in which the review is accomplished, and findings that are generally applicable for a package that meets the approval standards. This Packaging Review Guide (PRG) provides guidance for DOE review and approval of packagings to transport fissile and Type B quantities of radioactive material. It fulfills, in part, the requirements of DOE O 460.1B for the Headquarters Certifying Official to establish standards and to provide guidance for the preparation of Safety Analysis Reports for Packagings (SARPs). This PRG is intended for use by the Headquarters Certifying Official and his review staff, DOE Secretarial offices, operations/field offices, and applicants for DOE packaging approval. The primary objectives of this PRG are to: (1) Summarize the regulatory requirements for package approval; (2) Describe the technical review procedures by which DOE determines that these requirements have been satisfied; (3) Establish and maintain the quality and uniformity of reviews; (4) Define the base from which to evaluate proposed changes in scope

  2. Adherence to the Australian National Inpatient Medication Chart: the efficacy of a uniform national drug chart on improving prescription error.

    Science.gov (United States)

    Atik, Alp

    2013-10-01

    In 2006, the National Inpatient Medication Chart (NIMC) was introduced as a uniform medication chart in Australian public hospitals with the aim of reducing prescription error. The rate of regular medication prescription error in the NIMC was assessed. Data was collected using the NIMC Audit Tool and analyzed with respect to causes of error per medication prescription and per medication chart. The following prescription requirements were assessed: date, generic drug name, route of administration, dose, frequency, administration time, indication, signature, name and contact details. A total of 1877 medication prescriptions were reviewed. 1653 prescriptions (88.07%) had no contact number, 1630 (86.84%) did not have an indication, 1230 and 675 (35.96%) used a drug's trade name. Within 261 medication charts, all had at least one entry, which did not include an indication, 258 (98.85%) had at least one entry, which did not have a contact number and 200 (76.63%) had at least one entry, which used a trade name. The introduction of a uniform national medication chart is a positive step, but more needs to be done to address the root causes of prescription error. © 2012 John Wiley & Sons Ltd.

  3. Table tennis match analysis: a review.

    Science.gov (United States)

    Fuchs, Michael; Liu, Ruizhi; Malagoli Lanzoni, Ivan; Munivrana, Goran; Straub, Gunter; Tamaki, Sho; Yoshida, Kazuto; Zhang, Hui; Lames, Martin

    2018-03-15

    In table tennis, many different approaches to scientific founded match analysis have been developed since the first ones in the 1960s. The aim of this paper is to give a review on some of the most acknowledged methods of match analysis in table tennis. The first chapter presents a historical overview of match analysis from all over the world. The second part reviews different approaches to match analysis in more detail, using the performance analysis classification of theoretical and practical performance analysis. The review includes the most actual theoretical performance analysis techniques in table tennis: performance indices, simulative approaches, momentum analysis, footwork analysis, and finally an approach which uses top expert knowledge for a comprehensive technical-tactical analysis. In the section of practical performance analysis, the paper presents two "best practice" examples describing performance analysis procedures of the two most successful countries of the last Olympics: China and Japan. The paper ends with a summary on the impact of the different approaches and gives an outlook on promising new developments.

  4. Neurofibromatosis type 1 growth charts.

    Science.gov (United States)

    Clementi, M; Milani, S; Mammi, I; Boni, S; Monciotti, C; Tenconi, R

    1999-12-03

    Growth abnormalities such as macrocephaly and short stature have been described and are considered a consistent finding in neurofibromatosis type 1 (NF1), one of the most common autosomal dominant disorders in man. We present here a clinical study on the growth profile of a sample of NF1 patients collected through a population-based registry that covers three contiguous regions of North-East Italy (NEI-NF Registry). Auxometric traits of 528 NF1 patients have been measured with the aim of drawing growth charts for height, weight, and head circumference (OFC). Height velocity charts were based on a subset of 143 children who underwent multiple measurements. No differences in height were apparent between NF1 and normal subjects up to age 7 (girls) and 12 (boys) years; subsequently, the 50th centile of NF1 subjects tends to overlap with the 25th centile of normal subjects, and the 3rd centile is much lower in NF1 subjects than in normal subjects, mainly during adolescence. The negatively skewed distribution of height seems to indicate that height growth impairment affects only a proportion of NF1 subjects; height growth impairment does not seem related to disease severity. As for weight, our data suggest that slight overweight is a characteristic of adult NF1 subjects (mainly among males), independent of disease severity. Height growth velocity is normal during childhood for both sexes, whereas the pubertal spurt is slightly anticipated and reduced in NF1 boys but not in girls. Our data confirm previous observations that macrocrania affects most NF1 subjects; the shape of the head growth curve is similar in NF1 and normal girls, whereas NF1 boys present an OFC pubertal growth spurt much more pronounced and delayed than normal boys. The disproportion between OFC and height seems to be related to disease severity in boys but not in girls. Growth charts presented here can be useful in neurofibromatosis clinics for the identification of the effects of secondary growth

  5. Review Essay: Does Qualitative Network Analysis Exist?

    Directory of Open Access Journals (Sweden)

    Rainer Diaz-Bone

    2007-01-01

    Full Text Available Social network analysis was formed and established in the 1970s as a way of analyzing systems of social relations. In this review the theoretical-methodological standpoint of social network analysis ("structural analysis" is introduced and the different forms of social network analysis are presented. Structural analysis argues that social actors and social relations are embedded in social networks, meaning that action and perception of actors as well as the performance of social relations are influenced by the network structure. Since the 1990s structural analysis has integrated concepts such as agency, discourse and symbolic orientation and in this way structural analysis has opened itself. Since then there has been increasing use of qualitative methods in network analysis. They are used to include the perspective of the analyzed actors, to explore networks, and to understand network dynamics. In the reviewed book, edited by Betina HOLLSTEIN and Florian STRAUS, the twenty predominantly empirically orientated contributions demonstrate the possibilities of combining quantitative and qualitative methods in network analyses in different research fields. In this review we examine how the contributions succeed in applying and developing the structural analysis perspective, and the self-positioning of "qualitative network analysis" is evaluated. URN: urn:nbn:de:0114-fqs0701287

  6. Uranium enrichment management review: summary of analysis

    International Nuclear Information System (INIS)

    1981-01-01

    In May 1980, the Assistant Secretary for Resource Applications within the Department of Energy requested that a group of experienced business executives be assembled to review the operation, financing, and management of the uranium enrichment enterprise as a basis for advising the Secretary of Energy. After extensive investigation, analysis, and discussion, the review group presented its findings and recommendations in a report on December 2, 1980. The following pages contain background material on which that final report was based. This report is arranged in chapters that parallel those of the uranium enrichment management review final report - chapters that contain summaries of the review group's discussion and analyses in six areas: management of operations and construction; long-range planning; marketing of enrichment services; financial management; research and development; and general management. Further information, in-depth analysis, and discussion of suggested alternative management practices are provided in five appendices

  7. Impact of Scribes on Physician Satisfaction, Patient Satisfaction, and Charting Efficiency: A Randomized Controlled Trial.

    Science.gov (United States)

    Gidwani, Risha; Nguyen, Cathina; Kofoed, Alexis; Carragee, Catherine; Rydel, Tracy; Nelligan, Ian; Sattler, Amelia; Mahoney, Megan; Lin, Steven

    2017-09-01

    Scribes are increasingly being used in clinical practice despite a lack of high-quality evidence regarding their effects. Our objective was to evaluate the effect of medical scribes on physician satisfaction, patient satisfaction, and charting efficiency. We conducted a randomized controlled trial in which physicians in an academic family medicine clinic were randomized to 1 week with a scribe then 1 week without a scribe for the course of 1 year. Scribes drafted all relevant documentation, which was reviewed by the physician before attestation and signing. In encounters without a scribe, the physician performed all charting duties. Our outcomes were physician satisfaction, measured by a 5-item instrument that included physicians' perceptions of chart quality and chart accuracy; patient satisfaction, measured by a 6-item instrument; and charting efficiency, measured by time to chart close. Scribes improved all aspects of physician satisfaction, including overall satisfaction with clinic (OR = 10.75), having enough face time with patients (OR = 3.71), time spent charting (OR = 86.09), chart quality (OR = 7.25), and chart accuracy (OR = 4.61) (all P values patient satisfaction. Scribes increased the proportion of charts that were closed within 48 hours (OR =1.18, P =.028). To our knowledge, we have conducted the first randomized controlled trial of scribes. We found that scribes produced significant improvements in overall physician satisfaction, satisfaction with chart quality and accuracy, and charting efficiency without detracting from patient satisfaction. Scribes appear to be a promising strategy to improve health care efficiency and reduce physician burnout. © 2017 Annals of Family Medicine, Inc.

  8. GL chart of accounts maintenance for HANDI 2000 business management system

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, D.

    1998-08-24

    The chart of accounts is reviewed and compared to DOE annually. The Accounting Group identifies and processes necessary changes at this time. Sub-accounts are added on a monthly basis to track new funding sources.

  9. A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format.

    Science.gov (United States)

    Fenton, Tanis R

    2003-12-16

    The Babson and Benda 1976 "fetal-infant growth graph" for preterm infants is commonly used in neonatal intensive care. Its limits include the small sample size which provides low confidence in the extremes of the data, the 26 weeks start and the 500 gram graph increments. The purpose of this study was to develop an updated growth chart beginning at 22 weeks based on a meta-analysis of published reference studies. The literature was searched from 1980 to 2002 for more recent data to complete the pre and post term sections of the chart. Data were selected from population studies with large sample sizes. Comparisons were made between the new chart and the Babson and Benda graph. To validate the growth chart the growth results from the National Institute of Child Health and Human Development Neonatal Research Network (NICHD) were superimposed on the new chart. The new data produced curves that generally followed patterns similar to the old growth graph. Mean differences between the curves of the two charts reached statistical significance after term. Babson's 10th percentiles fell between the new data percentiles: the 5th to 17th for weight, the 5th and 15th for head circumference, and the 6th and 16th for length. The growth patterns of the NICHD infants deviated away from the curves of the chart in the first weeks after birth. When the infants reached an average weight of 2 kilograms, those with a birthweight in the range of 700 to 1000 grams had achieved greater than the 10th percentile on average for head growth, but remained below the 3rd percentile for weight and length. The updated growth chart allows a comparison of an infant's growth first with the fetus as early as 22 weeks and then with the term infant to 10 weeks. Comparison of the size of the NICHD infants at a weight of 2 kilograms provides evidence that on average preterm infants are growth retarded with respect to weight and length while their head size has caught up to birth percentiles. As with all

  10. A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format

    Directory of Open Access Journals (Sweden)

    Fenton Tanis R

    2003-12-01

    Full Text Available Abstract Background The Babson and Benda 1976 "fetal-infant growth graph" for preterm infants is commonly used in neonatal intensive care. Its limits include the small sample size which provides low confidence in the extremes of the data, the 26 weeks start and the 500 gram graph increments. The purpose of this study was to develop an updated growth chart beginning at 22 weeks based on a meta-analysis of published reference studies. Methods The literature was searched from 1980 to 2002 for more recent data to complete the pre and post term sections of the chart. Data were selected from population studies with large sample sizes. Comparisons were made between the new chart and the Babson and Benda graph. To validate the growth chart the growth results from the National Institute of Child Health and Human Development Neonatal Research Network (NICHD were superimposed on the new chart. Results The new data produced curves that generally followed patterns similar to the old growth graph. Mean differences between the curves of the two charts reached statistical significance after term. Babson's 10th percentiles fell between the new data percentiles: the 5th to 17th for weight, the 5th and 15th for head circumference, and the 6th and 16th for length. The growth patterns of the NICHD infants deviated away from the curves of the chart in the first weeks after birth. When the infants reached an average weight of 2 kilograms, those with a birthweight in the range of 700 to 1000 grams had achieved greater than the 10th percentile on average for head growth, but remained below the 3rd percentile for weight and length. Conclusion The updated growth chart allows a comparison of an infant's growth first with the fetus as early as 22 weeks and then with the term infant to 10 weeks. Comparison of the size of the NICHD infants at a weight of 2 kilograms provides evidence that on average preterm infants are growth retarded with respect to weight and length while

  11. Isomers chart; Table des isomeres

    Energy Technology Data Exchange (ETDEWEB)

    Dupont-Gautier, P.; Chantelot, S.; Moisson, N. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1967-07-01

    The nuclear isomers are nuclides offering the same mass number and the same atomic number, but different energy levels. In the following chart the zero energy ground states are omitted and the metastable isomers, i.e. of non-zero energy, known and of measurable lifetime, are listed. The lower limit of this lifetime was set here to 0.1 x 10{sup -6} s. The various isomers were classified in increasing lifetimes. (authors) [French] Les isomeres nucleaires sont des nucleides presentant le meme nombre de masse et le meme numero atomique, mais des niveaux energetiques differents. Dans la table suivante, on a neglige les etats fondamentaux d'energie nulle et on a recense les isomeres metastables, c'est-a-dire d'energie non nulle, connus et de periode mesurable. La limite inferieure de cette periode a ete fixee ici a 0,1 x 10{sup -6} s. Les differents isomeres ont ete classes par periodes croissantes. (auteurs)

  12. A review of sensitivity analysis techniques

    Energy Technology Data Exchange (ETDEWEB)

    Hamby, D.M.

    1993-12-31

    Mathematical models are utilized to approximate various highly complex engineering, physical, environmental, social, and economic phenomena. Model parameters exerting the most influence on model results are identified through a {open_quotes}sensitivity analysis.{close_quotes} A comprehensive review is presented of more than a dozen sensitivity analysis methods. The most fundamental of sensitivity techniques utilizes partial differentiation whereas the simplest approach requires varying parameter values one-at-a-time. Correlation analysis is used to determine relationships between independent and dependent variables. Regression analysis provides the most comprehensive sensitivity measure and is commonly utilized to build response surfaces that approximate complex models.

  13. 49 CFR 236.718 - Chart, dog.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog. A...

  14. Robust control charts in statistical process control

    NARCIS (Netherlands)

    Nazir, H.Z.

    2014-01-01

    The presence of outliers and contaminations in the output of the process highly affects the performance of the design structures of commonly used control charts and hence makes them of less practical use. One of the solutions to deal with this problem is to use control charts which are robust

  15. Chart of the nuclides - Strasbourg 1990

    International Nuclear Information System (INIS)

    Antony, M.S.

    1991-01-01

    Data were compiled for a nuclide chart over the last two years. The compilation is complete to the end of September 1990. The chart includes about 30000 data. Decay modes are represented by colours. Announcement capabilities and prices are given. (G.P.) 3 refs

  16. Obtaining the Andersen's chart, triangulation algorithm

    DEFF Research Database (Denmark)

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation or stabilizing soil response. The process of obtaining the original chart has...

  17. 47 CFR 73.333 - Engineering charts.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Engineering charts. 73.333 Section 73.333 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES FM Broadcast Stations § 73.333 Engineering charts. This section consists of the following Figures 1, 1a, 2, and...

  18. Smart Aeronautical Chart Management System Design

    Science.gov (United States)

    Pakdil, M. E.; Celik, R. N.; Kaya, Ö.; Konak, Y. C.; Guney, C.

    2015-10-01

    Civil aviation is developing rapidly, and the number of domestic and international operations is increasing exponentially every year than the previous one. Airline companies with increased air traffic and the number of passengers increase the demand of new aircrafts. An aircraft needs not only fuel but also pilot and aeronautical information (charts, digital navigation information, flight plan, and etc.) to perform flight operation. One of the most important components in aeronautical information is the terminal chart. Authorized institution in every state is responsible to publish their terminal charts for certain periods. Although these charts are produced in accordance with ICAO's Annex 4 and Annex 15, cartographic representation and page layout differs in each state's publication. This situation makes difficult to read them by pilots. In this paper, standard instrument departure (SID) charts are analysed to produce by use of cutting-edge and competitive technologies instead of classical computer-aided drawing and vector based graphic applications that are currently used by main chart producers. The goal is to design efficient and commercial chart management system that is able to produce aeronautical charts with same cartographic representation for all states.

  19. The Conjugate Acid-Base Chart.

    Science.gov (United States)

    Treptow, Richard S.

    1986-01-01

    Discusses the difficulties that beginning chemistry students have in understanding acid-base chemistry. Describes the use of conjugate acid-base charts in helping students visualize the conjugate relationship. Addresses chart construction, metal ions, buffers and pH titrations, and the organic functional groups and nonaqueous solvents. (TW)

  20. SMART AERONAUTICAL CHART MANAGEMENT SYSTEM DESIGN

    Directory of Open Access Journals (Sweden)

    M. E. Pakdil

    2015-10-01

    Full Text Available Civil aviation is developing rapidly, and the number of domestic and international operations is increasing exponentially every year than the previous one. Airline companies with increased air traffic and the number of passengers increase the demand of new aircrafts. An aircraft needs not only fuel but also pilot and aeronautical information (charts, digital navigation information, flight plan, and etc. to perform flight operation. One of the most important components in aeronautical information is the terminal chart. Authorized institution in every state is responsible to publish their terminal charts for certain periods. Although these charts are produced in accordance with ICAO’s Annex 4 and Annex 15, cartographic representation and page layout differs in each state’s publication. This situation makes difficult to read them by pilots. In this paper, standard instrument departure (SID charts are analysed to produce by use of cutting-edge and competitive technologies instead of classical computer-aided drawing and vector based graphic applications that are currently used by main chart producers. The goal is to design efficient and commercial chart management system that is able to produce aeronautical charts with same cartographic representation for all states.

  1. Toward developing a standardized Arabic continuous text reading chart.

    Science.gov (United States)

    Alabdulkader, Balsam; Leat, Susan Jennifer

    Near visual acuity is an essential measurement during an oculo-visual assessment. Short duration continuous text reading charts measure reading acuity and other aspects of reading performance. There is no standardized version of such chart in Arabic. The aim of this study is to create sentences of equal readability to use in the development of a standardized Arabic continuous text reading chart. Initially, 109 Arabic pairs of sentences were created for use in constructing a chart with similar layout to the Colenbrander chart. They were created to have the same grade level of difficulty and physical length. Fifty-three adults and sixteen children were recruited to validate the sentences. Reading speed in correct words per minute (CWPM) and standard length words per minute (SLWPM) was measured and errors were counted. Criteria based on reading speed and errors made in each sentence pair were used to exclude sentence pairs with more outlying characteristics, and to select the final group of sentence pairs. Forty-five sentence pairs were selected according to the elimination criteria. For adults, the average reading speed for the final sentences was 166 CWPM and 187 SLWPM and the average number of errors per sentence pair was 0.21. Childrens' average reading speed for the final group of sentences was 61 CWPM and 72 SLWPM. Their average error rate was 1.71. The reliability analysis showed that the final 45 sentence pairs are highly comparable. They will be used in constructing an Arabic short duration continuous text reading chart. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  2. Systematic review with meta-analysis

    DEFF Research Database (Denmark)

    Kimer, N; Krag, A; Møller, Søren

    2014-01-01

    BACKGROUND: Rifaximin is recommended for prevention of hepatic encephalopathy (HE). The effects of rifaximin on overt and minimal HE are debated. AIM: To perform a systematic review and meta-analysis of randomised controlled trials (RCTs) on rifaximin for HE. METHODS: We performed electronic...

  3. Retro-review of flow injection analysis

    DEFF Research Database (Denmark)

    Ruzicka, Jaromir; Hansen, Elo Harald

    2008-01-01

    It is indeed unusual for authors to review their own monograph – J. Ruzicka, E.H. Hansen, Flow Injection Analysis, 2nd Edition, Wiley, Chichester, West Sussex, UK, 1988. – and even more so if the book was published 20 years ago. Yet such an exercise might yield a perspective on the progress of an...

  4. FusionCharts Beginner's Guide The Official Guide for FusionCharts Suite

    CERN Document Server

    Nadhani, Sanket; Bhattacharya, Shamasis

    2012-01-01

    The book is written as a practical, step-by-step guide to using FusionCharts Suite. The book not only teaches you the fundamentals and implementation of FusionCharts Suite, but also makes you the data visualization guru among your friends and colleagues by teaching how to select the right chart type and usability tips. Filled with examples, code samples and practical tips in a no-nonsense way, the book is a breeze to read.This book is both for beginners and advanced web developers who need to create interactive charts for their web applications. No previous knowledge of FusionCharts Suite is a

  5. Development and validation of a new Chinese reading chart for children.

    Science.gov (United States)

    Cheung, Josephine P Y; Liu, Dilys S K; Lam, Catherine C C; Cheong, Allen M Y

    2015-09-01

    This study aimed to develop and validate a new Chinese reading chart for children. The characteristics of reading profiles among Hong Kong children were also investigated. A new reading chart was developed using the design principles of the MNREAD chart. Children (N = 169) aged seven to 11 years with normal vision and no developmental or reading difficulties were recruited from four local Hong Kong primary schools located in four different districts. Reading performance was measured using three versions of the new Chinese reading chart for children as well as six short passages. Repeated reading measures were conducted for 79 participants 4-8 weeks later. A linear mixed-model analysis was performed for the reading measures to identify the contribution of each source of variation (individual participant, among-charts within-session and between-sessions, and error) to the total variance. Three reading parameters were derived from the Chinese reading chart for children - maximum reading speed (MRS), critical print size (CPS) and reading acuity (RA). Results from the linear mixed-model and Bland and Altman analyses revealed that all three versions of the chart were reproducible, with little variability among-charts and between-sessions (p reading speed measured by the chart and ordinary children's reading passages confirmed the usefulness of the chart for assessing children's reading performance (Rc = 0.67, 95% CI of 0.60-0.73). We developed and validated a new Chinese reading chart for children for quantifying reading performance in Chinese children with normal reading ability. This standardised clinical test can be reliably used to measure the MRS, CPS and RA in Chinese-speaking children. Further research is needed to evaluate the validity of this chart for assessing reading performance in Chinese children with reading difficulties, dyslexia or low vision. © 2015 The Authors Ophthalmic & Physiological Optics © 2015 The College of Optometrists.

  6. Effect of age and anticonvulsants on seizure threshold during bilateral electroconvulsive therapy with brief-pulse stimulus: A chart-based analysis

    Science.gov (United States)

    Nitturkar, Abhishek R.; Sinha, Preeti; Bagewadi, Virupakshappa I.; Thirthalli, Jagadisha

    2016-01-01

    Background: Efficacy and adverse effects of electroconvulsive therapy (ECT) depend on the extent to which the electrical stimulus exceeds patients' seizure thresholds (STs). Titration method of estimating ST is recommended. Age and co-prescribed anticonvulsants (ACs) are known to affect ST. Literature on ST in bilateral ECT (BLECT) is sparse. Objective: To explore the clinical and demographic determinants of ST in a clinically representative sample of patients prescribed with BLECT. Materials and Methods: ECT records of 640 patients who received BLECT in 2011 in an academic psychiatric setting were studied. Demographic, clinical, pharmacological, and ECT details were analyzed. As per the standard practice, during the 1st ECT session, ST was determined by titration method, starting with 30 milli-Coulombs (mC) and increasing by 30 mC and thence in steps of 60 mC. Increase in ST over up to 6th session of ECT was noted. Receiver operating characteristic curve was used to find age cut-off with high specificity for ST ≥120 mC. The associations of ST and increase in ST with the age cut-off and other clinical factors were assessed using Chi-square test and logistic regression analysis. Results: The mean age was 30.98 years (+11.23 years) and mean ST at 1st ECT session was 130.36 mC (+51.96 mC). There was significantly high positive correlation (r = 0.37, P < 0.001) between age and ST. Cut-off age of 45 years had high specificity: Only 4.6% of those older than 45 years had ST <120 mC. Higher proportion of patients on AC had ST ≥120 mC. These associations were seen even after controlling for potential confounds of each other using logistic regression analysis. The results were similar for increase in ST over the course of ECT. Sex, diagnosis, use of antipsychotics, antidepressants, lithium, and benzodiazepines (BZPs) had no effect on ST or its increase. Conclusions: For BLECT using brief-pulse stimulus, ST depends on age and use of AC. For patients above the age of 45

  7. A human factors approach to observation chart design can trump health professionals' prior chart experience.

    Science.gov (United States)

    Christofidis, Melany J; Hill, Andrew; Horswill, Mark S; Watson, Marcus O

    2013-05-01

    To determine whether experienced health professionals recognise patient deterioration more accurately and efficiently using (a) novel observation charts, designed from a human factors perspective, or (b) chart designs with which they have long-term experience. Participants were 101 health professionals experienced in using either a multiple parameter track-and-trigger chart or a graphical chart with no track-and-trigger system. Participants were presented with realistic abnormal and normal patient observations recorded on six hospital observation charts of varying design quality, including the chart that participants were familiar with (or a very similar design). Across 48 trials, the participant was asked to specify if any of the vital sign observations were abnormal, or if all of the observations were normal. Participants' overall error rates (i.e., proportion of incorrect responses) and response times, the main outcome measures, were calculated for each observation chart. Participants made significantly fewer errors and responded significantly faster when using a novel user-friendly chart compared with all the other designs, including the charts that they were experienced with in a clinical setting. The findings suggest that, at least in the contexts examined, superior observation chart design appears to trump familiarity. Hence, hospitals motivated to improve the detection of patient deterioration should implement charts designed from a human factors perspective, rather than simply maintaining the status quo of reliance on clinical experience. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Watershed-based Morphometric Analysis: A Review

    Science.gov (United States)

    Sukristiyanti, S.; Maria, R.; Lestiana, H.

    2018-02-01

    Drainage basin/watershed analysis based on morphometric parameters is very important for watershed planning. Morphometric analysis of watershed is the best method to identify the relationship of various aspects in the area. Despite many technical papers were dealt with in this area of study, there is no particular standard classification and implication of each parameter. It is very confusing to evaluate a value of every morphometric parameter. This paper deals with the meaning of values of the various morphometric parameters, with adequate contextual information. A critical review is presented on each classification, the range of values, and their implications. Besides classification and its impact, the authors also concern about the quality of input data, either in data preparation or scale/the detail level of mapping. This review paper hopefully can give a comprehensive explanation to assist the upcoming research dealing with morphometric analysis.

  9. Semiotic evaluation of Lithuania military air navigation charts

    Science.gov (United States)

    Ovodas, Donatas; Česnulevičius, Algimantas

    2014-06-01

    Research of semiotic aspects Lithuanian military air navigation charts was based on the semantic, graphic and information load analysis. The aim of semantic analysis was to determine how the conventional cartographical symbols, used in air navigation charts, correspond with carto-linguistic and carto-semiotic requirements. The analysis of all the markings was performed complex and collected by questionnaire were interviewed various respondents: pilots, cartographers and other chart users. The researches seek two aims: evaluate information and graphical load of military air navigation charts. Information load evaluated to calculate all objects and phenomenon, which was in 25 cm² of map. Charts analysis showed that in low flight charts (LFC) average information load are 4 - 5 times richer than in the operational maps. Map signs optimization on LFC has to be managed very carefully, choosing signs that can reduce the load of information and helps for the information transfer process. Graphical load of maps evaluated of aeronautical maps is not great (5 - 12%) and does not require reduction the information load and generalization of charts. Air navigation charts analysis pointed that not all air navigation sings correspond carto-semiotic requirements and must be improved. The authors suggested some new sings for military air navigation chart, which are simpler, equivalent to human psychophysical perception criteria, creates faster communication and less load on the chart. Badania semiotycznych aspektów litewskich wojskowych map żeglugi powietrznej bazowały na semantycznej, graficznej i informacyjnej analizie treści tych map. Celem analizy semantycznej było określenie na ile tradycyjne symbole kartograficzne stosowane na mapach nawigacji lotniczej są zgodne z wymogami języka kartograficznego oraz zasadami stosowania znaków kartograficznych. Powyższe analizy przeprowadzono w sposób kompleksowy, informacje zebrano za pomocą ankiet, przeprowadzając wywiady w r

  10. Google Charts Testing | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Google Charts Testing. The following item is a demo of Google GeoChart. Please note that geo chart can only recognize country name or city name rather than location or address (that is google my map's expertise). Additionally, Geo chart does support title and legend. To render geo chart properly, please get a ...

  11. [Calculating the mean visual acuity and the change in visual acuity with a decimal acuity chart].

    Science.gov (United States)

    Touzeau, O

    2003-06-01

    The decimal visual acuity chart is not easy to use for statistical analysis and requires a transformation into LogMAR units (decimal logarithm of the Minimum Angle Resolution). In contrast to the decimal chart, the logarithmic chart has an arithmetic progression and a constant interval between lines. The LogMAR chart makes statistical analysis of visual acuity easy. Change in visual acuity is calculated directly by subtracting LogMAR data, while the average visual acuity is obtained with the arithmetic mean value of the LogMAR data. The mean acuity expressed in LogMAR units can be transformed into a decimal chart for a more comprehensive result. To calculate the average visual acuity directly from the decimal data, the geometric mean value must be used instead of the arithmetic mean value.

  12. Critical incidents related to opioid infusions in children: a five-year review and analysis.

    Science.gov (United States)

    West, Nicholas; Nilforushan, Vahid; Stinson, Jonathan; Ansermino, J Mark; Lauder, Gillian

    2014-04-01

    Opioids have a narrow therapeutic index and have the potential to cause significant harm. Developmental and pharmacogenetic factors put children, and especially infants, at increased risk of complications. We performed a retrospective root cause analysis to identify the factors associated with critical incidents in children receiving opioid infusions in a tertiary care children's hospital. Following institutional ethical approval, we identified potential critical incidents during 2004 to 2009 from patient safety and pharmacy data. Patients' medical charts were reviewed and a timeline of events that occurred before, during, and following each incident was generated. A safety assessment code score was assigned to each incident according to its severity and probability of recurrence, and incidents with a score ≥ 8 were selected for root cause analysis. Root causes were identified and classified, formal causal statements were written, and action plans were recommended. One hundred and sixty-six medical charts were reviewed, and 58 of these included one (45/58) or more (13/58) relevant critical incidents. The resulting harms were of minor to moderate severity. Fourteen incidents were submitted for detailed analysis, from which 31 root causes were identified. The most frequent and significant root causes involved defects in pre-printed order sheets, lack of a nursing guidelines for infusions (rate, adjustment, weaning), and inadequate guidelines for monitoring and recording pain, vital signs, and arousal scores. The root causes of a range of critical incidents have been identified, and these have been used to generate recommendations for improving both patient safety and quality of analgesia for children receiving opioid infusions for acute pain management.

  13. Systematising "System": One Reviewer's Analysis of the Review Process

    Science.gov (United States)

    Coniam, David

    2011-01-01

    This paper describes one reviewer's experience of reviewing for the journal "System" over an eight-year period, 2003-2011. The paper reports on the reviews produced by the single reviewer, which have been compiled into a specific purpose--an "occluded"--corpus (Swales, 1996) of 122 reviews, comprising 93,000 words. The paper first describes the…

  14. Application of Special Cause Control Charts to Green Sand Process

    Directory of Open Access Journals (Sweden)

    Perzyk M.

    2015-12-01

    Full Text Available Statistical Process Control (SPC based on the well known Shewhart control charts, is widely used in contemporary manufacturing industry, including many foundries. However, the classic SPC methods require that the measured quantities, e.g. process or product parameters, are not auto-correlated, i.e. their current values do not depend on the preceding ones. For the processes which do not obey this assumption the Special Cause Control (SCC charts were proposed, utilizing the residual data obtained from the time-series analysis. In the present paper the results of application of SCC charts to a green sand processing system are presented. The tests, made on real industrial data collected in a big iron foundry, were aimed at the comparison of occurrences of out-of-control signals detected in the original data with those appeared in the residual data. It was found that application of the SCC charts reduces numbers of the signals in almost all cases It is concluded that it can be helpful in avoiding false signals, i.e. resulting from predictable factors.

  15. Growth charts for Australian children with achondroplasia.

    Science.gov (United States)

    Tofts, Louise; Das, Sandeep; Collins, Felicity; Burton, Karen L O

    2017-08-01

    Achondroplasia is an autosomal dominant disorder, the most common genetic cause of short stature in humans. Reference curves for head circumference, weight, height, and BMI are needed in clinical practice but none exist for the Australian population. This study aimed to produce head circumference, height, weight, and BMI reference percentile curves for Australian children and adolescents with achondroplasia. Measurements of head circumference, height and weight taken at clinical visits were retrospectively extracted from the electronic medical record. Age was corrected for prematurity. Patients were excluded from head circumference analysis if they had significant neurosurgical complications and from the weight and BMI analysis when they had a clinical diagnosis of overweight. Measurements were available on 138 individuals (69 males and 69 females) taken between 1970 and 2015, with over 50% collected since 2005. A total of 3,352 data points were available. The LMS method was used to produce growth charts with estimated centiles (10, 25, 50, 75, and 90th) separately for males and females. For females birth weight was 3 kg (2.5-3.5 kg), birth length 48 cm (44-50 cm) and head circumference 37.5 cm (36-39 cm), adult height was 125 cm (116-132 cm), weight 42 kg (34-54 kg), and head circumference 58 cm (55.5-60.5 cm) all 50th centile (10-90th). For males birth weight was 3.5 kg (3-4 kg), length 49 cm (46-52 cm) and head circumference 38.5 cm (36-41 cm), adult height was 134 cm (125-141 cm), weight 41 kg (24.5-57 kg) and head circumference 61 cm (58-64 cm). The curves are similar to previously published reference data from the USA and have expected population wide variation from curves from an Argentinian population. Despite limitations of our curves for adolescents (12 years and older) due to data paucity, these Australian growth charts for children and adolescents with achondroplasia will be a useful reference in clinical

  16. Performance Analysis of Surfing: A Review.

    Science.gov (United States)

    Farley, Oliver R L; Abbiss, Chris R; Sheppard, Jeremy M

    2017-01-01

    Farley, ORL, Abbiss, CR, and Sheppard, JM. Performance Analysis of Surfing: A Review. J Strength Cond Res 31(1): 260-271, 2017-Despite the increased professionalism and substantial growth of surfing worldwide, there is limited information available to practitioners and coaches in terms of key performance analytics that are common in other field-based sports. Indeed, research analyzing surfing performance is limited to a few studies examining male surfers' heart rates, surfing activities through time-motion analysis (TMA) using video recordings and Global Positioning Satellite (GPS) data during competition and recreational surfing. These studies have indicated that specific activities undertaken during surfing are unique with a variety of activities (i.e., paddling, resting, wave riding, breath holding, and recovery of surfboard in the surf). Furthermore, environmental and wave conditions also seem to influence the physical demands of competition surfing. It is due to these demands that surfers are required to have a high cardiorespiratory fitness, high muscular endurance, and considerable strength and anaerobic power, particular within the upper torso. By exploring various methods of performance analysis used within other sports, it is possible to improve our understanding of surfing demands. In so doing this will assist in the development of protocols and strategies to assess physiological characteristics of surfers, monitor athlete performance, improve training prescription, and identify talent. Therefore, this review explores the current literature to provide insights into methodological protocols, delimitations of research into athlete analysis and an overview of surfing dynamics. Specifically, this review will describe and review the use of TMA, GPS, and other technologies (i.e., HR) that are used in external and internal load monitoring as they pertain to surfing.

  17. Canalplasty: the technique and the analysis of its results

    NARCIS (Netherlands)

    van Spronsen, Erik; Ebbens, Fenna A.; Mirck, Peter G. B.; van Wettum, Cathelijne H. M.; van der Baan, Sieberen

    2013-01-01

    To describe the technique for canalplasty as performed in the Academic Medical Center, Amsterdam, the Netherlands and to present the results of this technique. Retrospective chart analysis. Charts of patients who underwent a canalplasty prodedure between 2001 and 2010 were reviewed for indication

  18. Interactive Financial Charts- Agency Financial Reports

    Data.gov (United States)

    General Services Administration — For a visual depiction of GSA's Balance Sheet and Statement of Net Cost, please use the interactive charts to view the financial results for fiscal years 2007-2013.

  19. Chart Supplements - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — The Chart Supplements are searchable by individual airport in PDF format. They contain data on public and joint use airports, seaplane bases, heliports, VFR airport...

  20. Flood tracking chart, Amite River Basin, Louisiana

    Science.gov (United States)

    Callender, Lawrence E.; McCallum, Brian E.; Brazelton, Sebastian R.; Anderson, Mary L.; Ensminger, Paul A.

    1998-01-01

    The Amite River Basin flood tracking chart is designed to assist emergency response officials and the local public in making informed decisions about the safety of life and property during floods along the Amite and Comite Rivers and Bayou Manchac in southeastern Louisiana. This chart is similar in concept to the charts used to track hurricanes; the user can record the latest river stage information at selected gaging stations and the latest flood crest predictions. The latest stage data can be compared to historical flood peaks as well as to the slab or pier elevation of a threatened property. The chart also discusses how to acquire the latest river stage data from the Internet and a recorded voice message.

  1. Great Lakes Ice Charts, Version 1

    Data.gov (United States)

    National Aeronautics and Space Administration — These charts show ice extent and concentration three times weekly during the ice season, for all lakes except Ontario, from the 1973/74 ice season through the...

  2. 77 FR 13683 - Government/Industry Aeronautical Charting Forum Meeting

    Science.gov (United States)

    2012-03-07

    ... Federal Aviation Administration Government/Industry Aeronautical Charting Forum Meeting AGENCY: Federal...-annual meeting of the Federal Aviation Administration (FAA) Aeronautical Charting Forum (ACF) to discuss... Charting Forum. BILLING CODE M ...

  3. New chart to evaluate weight faltering

    OpenAIRE

    Wright, C.; Avery, A.; Epstein, M.; Birks, E.; Croft, D.

    1998-01-01

    A new chart was designed to aid accurate identification of weight faltering and failure to thrive. It provides guidance on the lower limits of expected weight gain for children, whatever their initial centile position. The chart's theoretical basis, the process of its construction, and its evaluation are described in this paper.
 Evaluation was by a self completion questionnaire, where respondents answered questions about a range of standardised growth patterns, plotted on old...

  4. The European chart of territorial planning

    International Nuclear Information System (INIS)

    1998-01-01

    In this chapter the European chart of territorial planning is included. This European chart contains next chapters: Introduction; The mission of the territorial planning; The basic aims; Realization of aims of the territorial planning; The confirmation of the European co-operation. In the Appendix the Specific aims: (1) The village territory; (2) The urban territory; (3) The boundary territory; (4) The mountain territory; (5) The structurally weak territory; (6) The decaying territory; (7) The coastal territories and islands

  5. The World Health Organization Fetal Growth Charts

    DEFF Research Database (Denmark)

    Kiserud, Torvid; Piaggio, Gilda; Carroli, Guillermo

    2017-01-01

    BACKGROUND: Perinatal mortality and morbidity continue to be major global health challenges strongly associated with prematurity and reduced fetal growth, an issue of further interest given the mounting evidence that fetal growth in general is linked to degrees of risk of common noncommunicable...... nature of the study, sample size is a limiting factor for generalization of the charts. CONCLUSIONS: This study provides WHO fetal growth charts for EFW and common ultrasound biometric measurements, and shows variation between different parts of the world....

  6. Contamination of medical charts: an important source of potential infection in hospitals.

    Directory of Open Access Journals (Sweden)

    Kuo-Hu Chen

    Full Text Available OBJECTIVE: This prospective study aims to identify and compare the incidence of bacterial contamination of hospital charts and the distribution of species responsible for chart contamination in different units of a tertiary hospital. METHODS: All beds in medical, surgical, pediatric, and obstetric-gynecologic general wards (556 and those in corresponding special units (125 including medical, surgical, pediatric intensive care units (ICUs, the obstetric tocolytic unit and delivery room were surveyed for possible chart contamination. The outer surfaces of included charts were sampled by one experienced investigator with sterile cotton swabs rinsed with normal saline. RESULTS: For general wards and special units, the overall sampling rates were 81.8% (455/556 and 85.6% (107/125 (p = 0.316; the incidence of chart contamination was 63.5% and 83.2%, respectively (p0.05. Special units had a significantly higher incidence of bacterial contamination due to Staphylococcus aureus (17.8%, Methicillin-resistant Staphylococcus aureus (9.3%, Streptococcus viridans (9.4%, Escherichia coli (11.2%, Klebsiella pneumoniae (7.5%, and Acinetobacter baumannii (7.5%. Logistic regression analysis revealed the incidence of chart contamination was 2- to 4-fold higher in special units than in general wards [odds ratios: 1.97-4.00]. CONCLUSIONS: Noting that most hospital charts are contaminated, our study confirms that a hospital chart is not only a medical record but also an important source of potential infection. The plastic cover of the medical chart can harbor potential pathogens, thus acting as a vector of bacteria. Additionally, chart contamination is more common in ICUs. These findings highlight the importance of effective hand-washing before and after handling medical charts. However, managers and clinical staff should pay more attention to the issue and may consider some interventions.

  7. Development of Markup Language for Medical Record Charting: A Charting Language.

    Science.gov (United States)

    Jung, Won-Mo; Chae, Younbyoung; Jang, Bo-Hyoung

    2015-01-01

    Nowadays a lot of trials for collecting electronic medical records (EMRs) exist. However, structuring data format for EMR is an especially labour-intensive task for practitioners. Here we propose a new mark-up language for medical record charting (called Charting Language), which borrows useful properties from programming languages. Thus, with Charting Language, the text data described in dynamic situation can be easily used to extract information.

  8. Application of a binomial cusum control chart to monitor one drinking water indicator

    Directory of Open Access Journals (Sweden)

    Elisa Henning

    2014-02-01

    Full Text Available The aim of this study is to analyze the use of a binomial cumulative sum chart (CUSUM to monitor the presence of total coliforms, biological indicators of quality of water supplies in water treatment processes. The sample series were monthly taken from a water treatment plant and were analyzed from 2007 to 2009. The statistical treatment of the data was performed using GNU R, and routines were created for the approximation of the upper limit of the binomial CUSUM chart. Furthermore, a comparative study was conducted to investigate whether there is a significant difference in sensitivity between the use of CUSUM and the traditional Shewhart chart, the most commonly used chart in process monitoring. The results obtained demonstrate that this study was essential for making the right choice in selecting a chart for the statistical analysis of this process.

  9. On multivariate control charts Sobre gráficos de controle multivariados

    OpenAIRE

    Marianne Frisén

    2011-01-01

    Industrial production requires multivariate control charts to enable monitoring of several components. Recently there has been an increased interest also in other areas such as detection of bioterrorism, spatial surveillance and transaction strategies in finance. In the literature, several types of multivariate counterparts to the univariate Shewhart, EWMA and CUSUM methods have been proposed. We review general approaches to multivariate control chart. Suggestions are made on the special chal...

  10. Trial Sequential Analysis in systematic reviews with meta-analysis

    DEFF Research Database (Denmark)

    Wetterslev, Jørn; Jakobsen, Janus Christian; Gluud, Christian

    2017-01-01

    . The results of the meta-analyses should relate the total number of randomised participants to the estimated required meta-analytic information size accounting for statistical diversity. When the number of participants and the corresponding number of trials in a meta-analysis are insufficient, the use......BACKGROUND: Most meta-analyses in systematic reviews, including Cochrane ones, do not have sufficient statistical power to detect or refute even large intervention effects. This is why a meta-analysis ought to be regarded as an interim analysis on its way towards a required information size...... for statistical significance when the diversity-adjusted required information size and the corresponding number of required trials for the meta-analysis have not been reached. Trial Sequential Analysis provides a frequentistic approach to control both type I and type II errors. We define the required information...

  11. On the constrained economic design of control charts: a literature review Sobre planejamento de gráficos de controle com restrição: uma revisão da literatura

    Directory of Open Access Journals (Sweden)

    Giovanni Celano

    2011-06-01

    Full Text Available The economic design is an appealing approach to settle the design parameters of a control chart. Unfortunately, the economic models to design control charts have been scarcely implemented by quality practitioners due to the simplifying assumptions when representing the multifaceted complexity and constraints present within manufacturing and transactional environments. Although there has been an increasing scepticism about the economic models usefulness in practice, some recent studies proposed in literature face the problem of the control charts economic design from a new point of view: the objective is to achieve a well balanced trade-off between the operational and the statistical aspects. Under this perspective, the economic design problem can be intended in a broader sense as the constrained design of a SPC inspection procedure. This paper presents a discussion of some recent trends in the economic design stream of research and outlines the importance of considering the constraints related to SPC resources availability and modelling the occurrence of random shifts.O planejamento econômico é uma abordagem interessante para estabelecer os parâmetros de um gráfico de controle. Infelizmente, os modelos econômicos para planejar gráficos de controle têm sido pouco aplicados por profissionais de qualidade, devido às suposições simplificadoras utilizadas para representar complexos e multifacetados (com restrições presentes processos de produção e ambientes transacionais. Embora tenha havido um crescente ceticismo sobre a utilidade de modelos econômicos, na prática, alguns estudos recentes na literatura tratam o problema de planejameto econômico dos gráficos de controle sob um novo ponto de vista: o objetivo é conseguir um bom trade-off e ligação entre aspectos operacionais e estatísticos. Sob essa perspectiva, o problema de planejamento econômico pode ser visto, em um sentido mais amplo, como um planejamento com restrição em

  12. Trial Sequential Analysis in systematic reviews with meta-analysis

    Directory of Open Access Journals (Sweden)

    Jørn Wetterslev

    2017-03-01

    Full Text Available Abstract Background Most meta-analyses in systematic reviews, including Cochrane ones, do not have sufficient statistical power to detect or refute even large intervention effects. This is why a meta-analysis ought to be regarded as an interim analysis on its way towards a required information size. The results of the meta-analyses should relate the total number of randomised participants to the estimated required meta-analytic information size accounting for statistical diversity. When the number of participants and the corresponding number of trials in a meta-analysis are insufficient, the use of the traditional 95% confidence interval or the 5% statistical significance threshold will lead to too many false positive conclusions (type I errors and too many false negative conclusions (type II errors. Methods We developed a methodology for interpreting meta-analysis results, using generally accepted, valid evidence on how to adjust thresholds for significance in randomised clinical trials when the required sample size has not been reached. Results The Lan-DeMets trial sequential monitoring boundaries in Trial Sequential Analysis offer adjusted confidence intervals and restricted thresholds for statistical significance when the diversity-adjusted required information size and the corresponding number of required trials for the meta-analysis have not been reached. Trial Sequential Analysis provides a frequentistic approach to control both type I and type II errors. We define the required information size and the corresponding number of required trials in a meta-analysis and the diversity (D2 measure of heterogeneity. We explain the reasons for using Trial Sequential Analysis of meta-analysis when the actual information size fails to reach the required information size. We present examples drawn from traditional meta-analyses using unadjusted naïve 95% confidence intervals and 5% thresholds for statistical significance. Spurious conclusions in

  13. Big Data and Dementia: Charting the Route Ahead for Research, Ethics, and Policy

    Directory of Open Access Journals (Sweden)

    Marcello Ienca

    2018-02-01

    Full Text Available Emerging trends in pervasive computing and medical informatics are creating the possibility for large-scale collection, sharing, aggregation and analysis of unprecedented volumes of data, a phenomenon commonly known as big data. In this contribution, we review the existing scientific literature on big data approaches to dementia, as well as commercially available mobile-based applications in this domain. Our analysis suggests that big data approaches to dementia research and care hold promise for improving current preventive and predictive models, casting light on the etiology of the disease, enabling earlier diagnosis, optimizing resource allocation, and delivering more tailored treatments to patients with specific disease trajectories. Such promissory outlook, however, has not materialized yet, and raises a number of technical, scientific, ethical, and regulatory challenges. This paper provides an assessment of these challenges and charts the route ahead for research, ethics, and policy.

  14. Big Data and Dementia: Charting the Route Ahead for Research, Ethics, and Policy.

    Science.gov (United States)

    Ienca, Marcello; Vayena, Effy; Blasimme, Alessandro

    2018-01-01

    Emerging trends in pervasive computing and medical informatics are creating the possibility for large-scale collection, sharing, aggregation and analysis of unprecedented volumes of data, a phenomenon commonly known as big data. In this contribution, we review the existing scientific literature on big data approaches to dementia, as well as commercially available mobile-based applications in this domain. Our analysis suggests that big data approaches to dementia research and care hold promise for improving current preventive and predictive models, casting light on the etiology of the disease, enabling earlier diagnosis, optimizing resource allocation, and delivering more tailored treatments to patients with specific disease trajectories. Such promissory outlook, however, has not materialized yet, and raises a number of technical, scientific, ethical, and regulatory challenges. This paper provides an assessment of these challenges and charts the route ahead for research, ethics, and policy.

  15. A multicenter, retrospective chart review study comparing index therapy change rates in open-angle glaucoma or ocular hypertension patients newly treated with latanoprost or travoprost-Z monotherapy.

    Science.gov (United States)

    Fain, Joel M; Kotak, Sameer; Mardekian, Jack; Bacharach, Jason; Edward, Deepak P; Rauchman, Steven; Brevetti, Teresa; Fox, Janet L; Lovelace, Cherie

    2011-06-13

    Because latanoprost and the original formulation of travoprost that included benzalkonium chloride (BAK) have been shown to be similar with regard to tolerability, we compared initial topical intraocular pressure (IOP)-lowering medication change rates in patients newly treated with latanoprost or travoprost-Z monotherapy. At 14 clinical practice sites, medical records were abstracted for patients with a diagnosis of open-angle glaucoma or ocular hypertension and who were ≥40 years of age, had a baseline and at least one follow-up visit, and had no prior history of ocular prostaglandin use. Data regarding demographics, ocular/systemic medical histories, clinical variables, therapy initiations and reasons for changes, adverse events, and resource utilization were recorded from randomly chosen eligible charts. Primary outcomes were rates of and reasons for changing from the initial therapy within six months and across the full study period (1000 days). Data from 900 medical charts (latanoprost, 632; travoprost-Z, 268) were included. For both cohorts, average follow-up was >1 year. Cohorts were similar with regard to age (median ~67 years), gender distribution (>50% female), and diagnosis (~80% with open-angle glaucoma). Within six months, rates of index therapy change for latanoprost versus travoprost-Z were 21.2% (134/632) and 28.7% (77/268), respectively (p = 0.0148); across the full study period, rates were 34.5% (218/632) and 45.2% (121/268), respectively (p = 0.0026). Among those who changed their index therapy, insufficient IOP control was the most commonly reported reason followed by adverse events; hyperemia was the most commonly reported adverse event at index therapy change. In this "real world" study of changes in therapy in patients prescribed initial monotherapy with latanoprost with BAK or travoprost-Z with SofZia, medication changes were common in both treatment groups but statistically significantly more frequent with travoprost-Z.

  16. A multicenter, retrospective chart review study comparing index therapy change rates in open-angle glaucoma or ocular hypertension patients newly treated with latanoprost or travoprost-Z monotherapy

    Directory of Open Access Journals (Sweden)

    Edward Deepak P

    2011-06-01

    Full Text Available Abstract Background Because latanoprost and the original formulation of travoprost that included benzalkonium chloride (BAK have been shown to be similar with regard to tolerability, we compared initial topical intraocular pressure (IOP-lowering medication change rates in patients newly treated with latanoprost or travoprost-Z monotherapy. Methods At 14 clinical practice sites, medical records were abstracted for patients with a diagnosis of open-angle glaucoma or ocular hypertension and who were ≥40 years of age, had a baseline and at least one follow-up visit, and had no prior history of ocular prostaglandin use. Data regarding demographics, ocular/systemic medical histories, clinical variables, therapy initiations and reasons for changes, adverse events, and resource utilization were recorded from randomly chosen eligible charts. Primary outcomes were rates of and reasons for changing from the initial therapy within six months and across the full study period (1000 days. Results Data from 900 medical charts (latanoprost, 632; travoprost-Z, 268 were included. For both cohorts, average follow-up was >1 year. Cohorts were similar with regard to age (median ~67 years, gender distribution (>50% female, and diagnosis (~80% with open-angle glaucoma. Within six months, rates of index therapy change for latanoprost versus travoprost-Z were 21.2% (134/632 and 28.7% (77/268, respectively (p = 0.0148; across the full study period, rates were 34.5% (218/632 and 45.2% (121/268, respectively (p = 0.0026. Among those who changed their index therapy, insufficient IOP control was the most commonly reported reason followed by adverse events; hyperemia was the most commonly reported adverse event at index therapy change. Conclusions In this "real world" study of changes in therapy in patients prescribed initial monotherapy with latanoprost with BAK or travoprost-Z with SofZia, medication changes were common in both treatment groups but statistically

  17. Feedback from Users of Electronic Chart Technology

    Science.gov (United States)

    Edmonds, David

    This paper was presented at the Third Electronic Chart Technology Conference, SASMEX International, Brighton, 22-23 April 1998.Electronic Chart Systems have been used by mariners across the entire user spectrum without official standards or specifications for 10 years. In the last three years, the debate has centred on chart data and the merits of differing cartographic technologies. There is little new that can be said for or against raster or vector technologies except what actual users might say to support the requirements of their day-to-day operations. Today, we approach a new stage as ENCs start to become available but only for limited areas. This in turn means that ENCs are capable of supporting the only approved electronic chart system, ECDIS, in a limited way. There is an urgent need for alternatives to ECDIS to cover those areas where ENCs will continue to be unavailable for the foreseeable future. This paper therefore summarizes a feedback from users of RCDS and ECDIS-type systems to demonstrate the benefits which can be secured from official recognition of RCDS systems as the legal equivalent of paper chart navigation.

  18. Transmission Line Adapted Analytical Power Charts Solution

    Science.gov (United States)

    Sakala, Japhet D.; Daka, James S. J.; Setlhaolo, Ditiro; Malichi, Alec Pulu

    2017-08-01

    The performance of a transmission line has been assessed over the years using power charts. These are graphical representations, drawn to scale, of the equations that describe the performance of transmission lines. Various quantities that describe the performance, such as sending end voltage, sending end power and compensation to give zero voltage regulation, may be deduced from the power charts. Usually required values are read off and then converted using the appropriate scales and known relationships. In this paper, the authors revisit this area of circle diagrams for transmission line performance. The work presented here formulates the mathematical model that analyses the transmission line performance from the power charts relationships and then uses them to calculate the transmission line performance. In this proposed approach, it is not necessary to draw the power charts for the solution. However the power charts may be drawn for the visual presentation. The method is based on applying derived equations and is simple to use since it does not require rigorous derivations.

  19. A PIP chart for nuclear plant safety

    International Nuclear Information System (INIS)

    Suzuki, Tatsujiro; Yamaoka, Taiji

    1992-01-01

    While it is known that social and political aspects of nuclear safety issues are important, little study has been done on identifying the breadth of stakeholders whose policies have important influences over nuclear plant safety in a comprehensive way. The objectives of this study are to develop a chart that visually identifies important stakeholders and their policies and illustrates these influences in a hierarchical representation so that the relationship between stakeholders and nuclear safety will be better understood. This study is based on a series of extensive interviews with major stakeholders, such as nuclear plant managers, corporate planning vice presidents, state regulators, news media, and public interest groups, and focuses on one US nuclear power plant. Based on the interview results, the authors developed a conceptual policy influence paths (PIP) chart. The PIP chart illustrates the hierarchy of influence among stakeholders. The PIP chart is also useful in identifying possible stakeholders who can be easily overlooked without the PIP chart. In addition, it shows that influence flow is circular rather than linear in one direction

  20. Comparing distance visual acuity measurement with a novel eye chart and the Landolt C chart in a population of children aged 6-18 years.

    Science.gov (United States)

    Gorham, John P; Bruce, Beau B; Hutchinson, Amy K

    2017-12-01

    The Handy Eye Chart™ is designed to assist in evaluating the visual acuity of patients with non-standard communication styles. The Handy Eye Chart™ has been previously validated against the early treatment diabetic retinopathy study (ETDRS) chart. The aim of this research is to compare visual acuity outcomes with The Handy Eye Chart™ against the international gold standard, the Landolt C chart, in a population of children. Sixty participants between the ages of 6 and 18 were recruited at the Pediatric Section of the Department of Ophthalmology at the Emory Eye Center. Visual acuity was evaluated using The Handy Eye Chart™ and the Landolt C Chart, altering the order of administration between charts. The visual acuity data were compared using t test, linear regression, and Bland-Altman analysis. The mean difference in visual acuity was 0.02 logMAR (CI 0.009-0.04, p = 0.002). The correlation coefficient was 0.98. The Bland-Altman analysis shows the 95% limits of agreement between the charts to be -0.14 to 0.09 logMAR. The Handy Eye Chart™ is a valid measure of visual acuity when compared with the international gold standard, the Landolt C Chart.

  1. Italian cardiovascular mortality charts of the CUORE project: are they comparable with the SCORE charts?

    LENUS (Irish Health Repository)

    Donfrancesco, Chiara

    2010-08-01

    The aim of this study was to build risk charts for the assessment of cardiovascular mortality of the CUORE project, an Italian longitudinal study, and to compare them with the systematic coronary risk evaluation (SCORE) project charts for low risk European countries.

  2. APPLICATION OF U-CHART AND C-CHART IN TECHNOLOGICAL PROCESS OF PRIMARY WOOD PROCESSING

    Directory of Open Access Journals (Sweden)

    Damjan Stanojević

    2014-01-01

    Full Text Available Control charts are statistical methods of quality control. Basically it is a graph where the abscissa represents the order of control, and the ordinate is marked with parameter values, which are controled by samples over a certain size. Using charts determine varying quality and also related the stability and capacity of the production process in relation to the established control limits. Dr. Schuchardt, which can be regarded as the creator of control charts, says that their mission: to maintain the production process in a state of control, to lead the production process into a state of control, to show that the state of control has been achieved. According to Dr. Schuchardt „for a phenomenon is said to be controlled if based on current data we can predict, at least within certain limits, how the phenomenon will change in the future. Here, under certain prediction within limits means that we can determine, at least approximately, the probability that the phenomenon is found within the given limits“. Control charts for attribute quality characteristics are: p- control chart, m- control chart, u- control chart, c- control chart.

  3. Token reinforcement: a review and analysis.

    Science.gov (United States)

    Hackenberg, Timothy D

    2009-03-01

    Token reinforcement procedures and concepts are reviewed and discussed in relation to general principles of behavior. The paper is divided into four main parts. Part I reviews and discusses previous research on token systems in relation to common behavioral functions--reinforcement, temporal organization, antecedent stimulus functions, and aversive control--emphasizing both the continuities with other contingencies and the distinctive features of token systems. Part II describes the role of token procedures in the symmetrical law of effect, the view that reinforcers (gains) and punishers (losses) can be measured in conceptually analogous terms. Part III considers the utility of token reinforcement procedures in cross-species analysis of behavior more generally, showing how token procedures can be used to bridge the methodological gulf separating research with humans from that with other animals. Part IV discusses the relevance of token systems to the field of behavioral economics. Token systems have the potential to significantly advance research and theory in behavioral economics, permitting both a more refined analysis of the costs and benefits underlying standard economic models, and a common currency more akin to human monetary systems. Some implications for applied research and for broader theoretical integration across disciplines will also be considered.

  4. Individuals charts and additional tests for changes in spread

    NARCIS (Netherlands)

    Trip, A.; Wieringa, J.E.

    A number of authors have indicated that it is not a good idea to use the moving range chart (MR-chart) with all individuals chart to detect shifts in the spread. However, the combination of these charts is still used in practice and even presented as 'best practice' in some cases. In addition, some

  5. Time contour expression of limited range phenomena on stack chart; Jugo chart jo deno kyokuchi gensho jikan contour

    Energy Technology Data Exchange (ETDEWEB)

    Kametani, T.

    1997-05-27

    Time contour expression of limited range phenomena on stack chart is examined for further improvement on the result of the ultimate interpretation in the seismic reflection survey. The policy is made clear from the beginning that local phenomena are to be discussed, and data prior CMP stacking is interpreted in detail. For this purpose, it is effective to make use of the time contour expression in the midpoint-offset plane simultaneously with the CMP and COP panels. For the review of data prior to CMP stacking, it is convenient to use the CMP (CDP) stacking chart in which the data is arranged methodically. In this chart, all the channels which are crude data prior to stacking are plotted on midpoint-offset coordinates, which plane is called the MOD (Midpoint Offset Domain) panel. Various panels can be chosen unrestrictedly, and their mutual relations can be easily grasped. When data points are given a time axis, they can be expressed in a time contour. Studies are conducted about the underground structure, multiple reflection paths divided by it, and characteristics of detour reflection attributable to faults. 4 refs., 9 figs.

  6. Developing a Logarithmic Chinese Reading Acuity Chart.

    Science.gov (United States)

    Han, Qi-Ming; Cong, Lin-Juan; Yu, Cong; Liu, Lei

    2017-06-01

    An individual's reading ability cannot be reliably predicted from his/her letter acuity, contrast sensitivity, and visual field extent. We developed a set of Chinese reading acuity charts (C-READ) to assess the reading ability of Chinese readers, based on the collective wisdom of previously published reading acuity charts, especially the MNRead and the Radner Reading Charts. The C-READ consists of three charts. Each consists sixteen 12-character simplified Chinese sentences crafted from first- to third-grade textbooks. One hundred eighteen native Chinese-speaking college students (aged 22.1 ± 2.1 years) with normal or corrected to normal near vision (-0.26 ± 0.05 logMAR) were included in the study to develop the C-READ charts, to test the homogeneity of the three charts, and to validate the C-READ against the text paragraphs from the International Reading Speed Texts (IReST) with corrected and uncorrected near vision. The reading acuity, critical print size, and maximum reading speed for young normal native Chinese-speaking readers were 0.16 ± 0.05 logMAR, 0.24 ± 0.06 logMAR, and 273.44 ± 34.37 characters per minute (mean ± SD), respectively. The reliability test revealed no significant differences among the three C-READ charts and no significant test order effect in the three reading parameters. Regression analyses showed that the IReST reading speed could be reliably predicted by the C-READ maximum reading speed under the corrected near-vision condition (adjusted R = 0.72) and by C-READ maximum reading speed and critical print size under the uncorrected near-vision condition (adjusted R = 0.69). The three C-READ charts are very comparable to each other, and there is no significant order effect. Reading test results can accurately predict continuous text reading performance quantified by the IReST reading speed over a wide range of refractive errors. The C-READ is a reliable and valid clinical instrument for quantifying reading performance in simplified

  7. Geo structural chart of Uruguay. Scale 1/2.000.000

    International Nuclear Information System (INIS)

    Preciozzi, F.; Spoturno, F.; Heinzen, W.

    1979-01-01

    This work is about the Geo-Structural Chart of Uruguay , Esca le 1 / 2,000,000. The geological information synthesis in the country, obtained from: published geological work or whose information is registered by laboratory work and geophysical surveys. This Chart will allow an overview of the degree of geological knowledge of Uruguay, restricted to the limits imposed by the scale of this work. The realization of this Chart included a thorough and careful compilation, critical analysis, standardization and interpretation of all geological and geophysical maps available in the country

  8. Systematic reviews with meta-analysis: Why, when, and how?

    NARCIS (Netherlands)

    Crocetti, E.

    2016-01-01

    Systematic reviews with meta-analysis represent the gold standard for conducting reliable and transparent reviews of the literature. The purpose of this article is threefold: (a) to address why and when it is worthwhile to conduct a systematic review with meta-analysis, covering advantages of this

  9. Measuring e-Commerce service quality from online customer review using sentiment analysis

    Science.gov (United States)

    Kencana Sari, Puspita; Alamsyah, Andry; Wibowo, Sulistyo

    2018-03-01

    The biggest e-Commerce challenge to understand their market is to chart their level of service quality according to customer perception. The opportunities to collect user perception through online user review is considered faster methodology than conducting direct sampling methodology. To understand the service quality level, sentiment analysis methodology is used to classify the reviews into positive and negative sentiment for five dimensions of electronic service quality (e-Servqual). As case study in this research, we use Tokopedia, one of the biggest e-Commerce service in Indonesia. We obtain the online review comments about Tokopedia service quality during several month observations. The Naïve Bayes classification methodology is applied for the reason of its high-level accuracy and support large data processing. The result revealed that personalization and reliability dimension required more attention because have high negative sentiment. Meanwhile, trust and web design dimension have high positive sentiments that means it has very good services. The responsiveness dimension have balance sentiment positive and negative.

  10. Navigating features: a topologically informed chart of electromyographic features space.

    Science.gov (United States)

    Phinyomark, Angkoon; Khushaba, Rami N; Ibáñez-Marcelo, Esther; Patania, Alice; Scheme, Erik; Petri, Giovanni

    2017-12-01

    The success of biological signal pattern recognition depends crucially on the selection of relevant features. Across signal and imaging modalities, a large number of features have been proposed, leading to feature redundancy and the need for optimal feature set identification. A further complication is that, due to the inherent biological variability, even the same classification problem on different datasets can display variations in the respective optimal sets, casting doubts on the generalizability of relevant features. Here, we approach this problem by leveraging topological tools to create charts of features spaces. These charts highlight feature sub-groups that encode similar information (and their respective similarities) allowing for a principled and interpretable choice of features for classification and analysis. Using multiple electromyographic (EMG) datasets as a case study, we use this feature chart to identify functional groups among 58 state-of-the-art EMG features, and to show that they generalize across three different forearm EMG datasets obtained from able-bodied subjects during hand and finger contractions. We find that these groups describe meaningful non-redundant information, succinctly recapitulating information about different regions of feature space. We then recommend representative features from each group based on maximum class separability, robustness and minimum complexity. © 2017 The Authors.

  11. Charts for interpreting wildland fire behavior characteristics

    Science.gov (United States)

    Patricia L. Andrews; Richard C. Rothermel

    1982-01-01

    The fire characteristics chart is proposed as a graphical method ofpresenting two primary characteristics of fire behavior – spread rate and intensity. Its primary use is communicating and interpreting either site-specific predictions of fire behavior or National Fire-Danger Rating System (NFDRS) indexes and components. Rate of spread, heat per unit area, flame length...

  12. Progress in the technology of nautical charting

    Digital Repository Service at National Institute of Oceanography (India)

    Joseph, A.

    ". The article skims through the various aspects of safety of navigation such as nautical charts created by the Arabs in the medieval days of stellar navigation in the Indian Ocean; the contributions by the Chinese, the British, and the Portuguese; hydrographic...

  13. Charting environmental pollution. [by noise measurements

    Science.gov (United States)

    Halpert, E.; Bizo, F.; Karacsonyi, Z.

    1974-01-01

    It is found that areas affected by different noxious agents are within the limits traced for high noise level areas; consequently, it is suggested that high noise pressure levels should be used as the primary indication of environmental pollution. A complex methodology is reported for charting environmental pollution due to physical, chemical and biological noxious agents on the scale of an industrial district.

  14. NEW APPROACH FOR MEASUREMENT OF THE EFFICIENCY OF Cpm AND Cpmk CONTROL CHARTS

    Directory of Open Access Journals (Sweden)

    María Teresa Carot

    2013-12-01

    Full Text Available Process capability analysis is a very effective way for improving process quality by relating process variation to customer requirements. It compares the output of a process to the specification limits by using process capability indices (PCIs. PCIs provide numerical measures on whether aprocess conforms to the defined manufacturing capability prerequisite. In this paper, a new approach based on non-central Chi-Square, ω and φ distributions is presented to design the capability control charts. The main purpose of this work is to investigate the efficiency of the proposed control charts comparing with the traditional control charts. The advantage of using the proposed capability control charts is that, the practitioner can monitor the process mean and the process variability by looking at one chart. Moreover the proposed capability control charts are easily appended to X-R control chart and provide judgments considering the ability of a process to meet requirements. To demonstrate the applicability of the proposed approach an illustrative example is conducted.

  15. Technical-and-economic analysis and optimization of the full flow charts of processing of radioactive wastes on a polyfunctional plant of pyrochemical processing of the spent nuclear fuel of fast reactors

    Science.gov (United States)

    Gupalo, V. S.; Chistyakov, V. N.; Kormilitsyn, M. V.; Kormilitsyna, L. A.; Osipenko, A. G.

    2015-12-01

    When considering the full flow charts of processing of radioactive wastes (RAW) on a polyfunctional plant of pyrochemical processing of the spent nuclear fuel of NIIAR fast reactors, we corroborate optimum technical solutions for the preparation of RAW for burial from a standpoint of heat release, dose formation, and technological storage time with allowance for technical-and-economic and ecological indices during the implementation of the analyzed technologies and equipment for processing of all RAW fluxes.

  16. Charts of episodes and chronometric duration have implications for provinces such as the Kaapvaal

    Directory of Open Access Journals (Sweden)

    H. de la R. Winter

    1997-07-01

    Full Text Available An accurate basin analysis and knowledge of its evolutionary development being a prerequisite framework for metallogenic model­ling, a procedure was developed for the Kaapvaal Province to maximise quantitative observational data and constrain assumptions and interpretations. Employing an episodes chart to display various events interactively and its conversion to a geochronometric chart as the geological model, the method was applied to existing stratigraphic studies.

  17. Earthquake Hazard Analysis Methods: A Review

    Science.gov (United States)

    Sari, A. M.; Fakhrurrozi, A.

    2018-02-01

    One of natural disasters that have significantly impacted on risks and damage is an earthquake. World countries such as China, Japan, and Indonesia are countries located on the active movement of continental plates with more frequent earthquake occurrence compared to other countries. Several methods of earthquake hazard analysis have been done, for example by analyzing seismic zone and earthquake hazard micro-zonation, by using Neo-Deterministic Seismic Hazard Analysis (N-DSHA) method, and by using Remote Sensing. In its application, it is necessary to review the effectiveness of each technique in advance. Considering the efficiency of time and the accuracy of data, remote sensing is used as a reference to the assess earthquake hazard accurately and quickly as it only takes a limited time required in the right decision-making shortly after the disaster. Exposed areas and possibly vulnerable areas due to earthquake hazards can be easily analyzed using remote sensing. Technological developments in remote sensing such as GeoEye-1 provide added value and excellence in the use of remote sensing as one of the methods in the assessment of earthquake risk and damage. Furthermore, the use of this technique is expected to be considered in designing policies for disaster management in particular and can reduce the risk of natural disasters such as earthquakes in Indonesia.

  18. MO-A-BRB-00: Electronic Charting in EBRT and Brachytherapy

    International Nuclear Information System (INIS)

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  19. MO-A-BRB-03: Integration Issues in Electronic Charting for External Beam Therapy

    International Nuclear Information System (INIS)

    Sutlief, S.

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  20. MO-A-BRB-02: Considerations and Issues in Electronic Charting for Brachytherapy

    International Nuclear Information System (INIS)

    Richardson, S.

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  1. [Ophthalmologic reading charts : Part 2: Current logarithmically scaled reading charts].

    Science.gov (United States)

    Radner, W

    2016-12-01

    To analyze currently available reading charts regarding print size, logarithmic print size progression, and the background of test-item standardization. For the present study, the following logarithmically scaled reading charts were investigated using a measuring microscope (iNexis VMA 2520; Nikon, Tokyo): Eschenbach, Zeiss, OCULUS, MNREAD (Minnesota Near Reading Test), Colenbrander, and RADNER. Calculations were made according to EN-ISO 8596 and the International Research Council recommendations. Modern reading charts and cards exhibit a logarithmic progression of print sizes. The RADNER reading charts comprise four different cards with standardized test items (sentence optotypes), a well-defined stop criterion, accurate letter sizes, and a high print quality. Numbers and Landolt rings are also given in the booklet. The OCULUS cards have currently been reissued according to recent standards and also exhibit a high print quality. In addition to letters, numbers, Landolt rings, and examples taken from a timetable and the telephone book, sheet music is also offered. The Colenbrander cards use short sentences of 44 characters, including spaces, and exhibit inaccuracy at smaller letter sizes, as do the MNREAD cards. The MNREAD cards use sentences of 60 characters, including spaces, and have a high print quality. Modern reading charts show that international standards can be achieved with test items similar to optotypes, by using recent technology and developing new concepts of test-item standardization. Accurate print sizes, high print quality, and a logarithmic progression should become the minimum requirements for reading charts and reading cards in ophthalmology.

  2. IAEA Review for Gap Analysis of Safety Analysis Capability

    International Nuclear Information System (INIS)

    Basic, Ivica; Kim, Manwoong; Huges, Peter; Lim, B-K; D'Auria, Francesco; Louis, Vidard Michael

    2014-01-01

    improvement of nuclear safety in the participating host organization and host member countries. To achieve this goal, the EM is to establish a process of discussion and comparison of gap findings, which will lead to sharing of information, experience, strengths and weaknesses among the participants, and foster regional cooperation to improve the weaknesses and improve safety generally. The pilot mission was conducted from 28 October to 1 November for one week at the National Nuclear Agency (BATAN) in Indonesia by the mission team formulated with 6 international experts who have considerable knowledge and experience in the field of safety analysis such as the deterministic safety analysis (DSA) and probabilistic safety analysis (PSA). Some comments and recommendations were given to BATAN management to support the establishment and maintenance of safety analysis capability and human resource, organizational and training aspects. Those aspects are important as a measure of the progress being made and an indicator of areas in SATG within the framework of the Extra-budgetary Programme on the Safety of Nuclear Installations in Southeast Asia, the Pacific, and Far East Countries (the EBP-Asia) or other cooperation programme, such as the IAEA Technical Cooperation programme. Provided in 2013 the Review of Gap Analysis for BATAN (Indonesian Nuclear Safety Regulatory Body) could be good reference for all other newcomer countries which started or plans nuclear power plant installation. (authors)

  3. GENERALISATION OF SUBMARINE FEATURES ON NAUTICAL CHARTS

    Directory of Open Access Journals (Sweden)

    E. Guilbert

    2012-07-01

    Full Text Available On most large scale and middle scale maps, relief is represented by contours and spot heights. In order to adapt the representation to the scale, the terrain is generalised either by smoothing or filtering the terrain model or by simplifying the contours. However this approach is not applicable to nautical chart construction where terrain features are selected according to their importance for navigation. This paper presents an approach for the consideration of feature attributes in the generalisation of a set of contours with respect to nautical chart constraints. Features are defined by sets of contours and a set of generalisation operators applied to features is presented. The definitions are introduced in a multi-agent system in order to perform automatic generalisation of a contour set. Results are discussed on a case study and directions for future work are presented.

  4. JDATAVIEWER – JAVA-Based Charting Library

    CERN Document Server

    Kruk, G

    2009-01-01

    The JDataViewer is a Java-based charting library developed at CERN, with powerful, extensible and easy to use function editing capabilities. Function edition is heavily used in Control System applications, but poorly supported in products available on the market. The JDataViewer enables adding, removing and modifying function points graphically (using a mouse) or by editing a table of values. Custom edition strategies are supported: developer can specify an algorithm that reacts to the modification of a given point in the function by automatically adapting all other points. The library provides all typical 2D plotting types (scatter, polyline, area, bar, HiLo, contour), as well as data point annotations and data indicators. It also supports common interactors to zoom and move the visible view, or to select and highlight function segments. A clear API is provided to configure and customize all chart elements (colors, fonts, data ranges ...) programmatically, and to integrate non-standard rendering types, inter...

  5. APLIKASI GANTT CHART PADA ALGORITMA PENJADUALAN PROSES

    Directory of Open Access Journals (Sweden)

    Sri Handayani

    2014-01-01

    Full Text Available Operating system is a compulsory subject taken in the Information Technology Student FTIK - USM . In the discussion of the material management process of the operating systems course , there are some scheduling algorithm which processes need to be understood and any existing process scheduling algorithm presented in the form of Grantt Charts . Because of the difficulties experienced by students in understanding the process of scheduling algorithms by an Operating System become researchers inspiration to conduct this study to make an application Grantt Chart.. This study uses a waterfall system development , where the flow will follow the research the phase in waterfall . This application will be built using Visual Basic 6 .  The purpose of this research is to produce an application of learning are presented in graphical form to facilitate students in understanding the material scheduling process performed by an operating system so that students can also understand how a computer can do multiple processes simultaneously.

  6. Influence of real-world characteristics on outcomes for patients with methicillin-resistant Staphylococcal skin and soft tissue infections: a multi-country medical chart review in Europe.

    Science.gov (United States)

    Nathwani, Dilip; Eckmann, Christian; Lawson, Wendy; Solem, Caitlyn T; Corman, Shelby; Stephens, Jennifer M; Macahilig, Cynthia; Simoneau, Damien; Chambers, Richard; Li, Jim Z; Haider, Seema

    2014-09-02

    Patient-related (demographic/disease) and treatment-related (drug/clinician/hospital) characteristics were evaluated as potential predictors of healthcare resource use and opportunities for early switch (ES) from intravenous (IV)-to-oral methicillin-resistant Staphylococcus aureus (MRSA)-active antibiotic therapy and early hospital discharge (ED). This retrospective observational medical chart study analyzed patients (across 12 European countries) with microbiologically confirmed MRSA complicated skin and soft tissue infections (cSSTI), ≥3 days of IV anti-MRSA antibiotics during hospitalization (July 1, 2010-June 30, 2011), and discharged alive by July 31, 2011. Logistic/linear regression models evaluated characteristics potentially associated with actual resource use (length of IV therapy, length of hospital stay [LOS], IV-to-oral antibiotic switch), and ES and ED (using literature-based and expert-verified criteria) outcomes. 1542 patients (mean ± SD age 60.8 ± 16.5 years; 61.5% males) were assessed with 81.0% hospitalized for MRSA cSSTI as the primary reason. Several patient demographic, infection, complication, treatment, and hospital characteristics were predictive of length of IV therapy, LOS, IV-to-oral antibiotic switch, or ES and ED opportunities. Outcomes and ES and ED opportunities varied across countries. Length of IV therapy and LOS (r = 0.66, p  0.05). Certain patient and treatment characteristics were associated with increased odds of ES (healthcare-associated/ hospital-acquired infection) and ED (patient living arrangements, healthcare-associated/ hospital-acquired infection, initiating MRSA-active treatment 1-2 days post cSSTI index date, existing ED protocol), while other factors decreased the odds of ES (no documented MRSA culture, ≥4 days from admission to cSSTI index date, IV-to-oral switch, IV line infection) and ED (dementia, no documented MRSA culture, initiating MRSA-active treatment ≥3 days post cSSTI index date

  7. Intelligent Bar Chart Plagiarism Detection in Documents

    Science.gov (United States)

    Al-Dabbagh, Mohammed Mumtaz; Salim, Naomie; Alkawaz, Mohammed Hazim; Saba, Tanzila; Al-Rodhaan, Mznah; Al-Dhelaan, Abdullah

    2014-01-01

    This paper presents a novel features mining approach from documents that could not be mined via optical character recognition (OCR). By identifying the intimate relationship between the text and graphical components, the proposed technique pulls out the Start, End, and Exact values for each bar. Furthermore, the word 2-gram and Euclidean distance methods are used to accurately detect and determine plagiarism in bar charts. PMID:25309952

  8. Intelligent bar chart plagiarism detection in documents.

    Science.gov (United States)

    Al-Dabbagh, Mohammed Mumtaz; Salim, Naomie; Rehman, Amjad; Alkawaz, Mohammed Hazim; Saba, Tanzila; Al-Rodhaan, Mznah; Al-Dhelaan, Abdullah

    2014-01-01

    This paper presents a novel features mining approach from documents that could not be mined via optical character recognition (OCR). By identifying the intimate relationship between the text and graphical components, the proposed technique pulls out the Start, End, and Exact values for each bar. Furthermore, the word 2-gram and Euclidean distance methods are used to accurately detect and determine plagiarism in bar charts.

  9. Paperless chart recording helps cut costs

    International Nuclear Information System (INIS)

    Collier, K.; Sullivan, M.E.

    1997-01-01

    Turbine generator data acquisition systems using personal computers have been installed at the Limerick BWR power plant to replace paper-based chart recorders. This plant is already one of the lowest cost nuclear power plants in the US and this innovation will boost operating efficiency still further. The Limerick control room now has wall-mounted touch screen video displays which provide operators with real-time, electronically achieved information and improving information flow, with a consolidated, consistent user interface. (UK)

  10. Solid Rocket Testing at AFRL (Briefing Charts)

    Science.gov (United States)

    2016-10-21

    19b. TELEPHONE NUMBER (Include area code) 10/21/2016 Briefing Charts 01 October 2016 - 31 October 2016 Solid Rocket Testing at AFRL Robert Antypas Air...Unclassified SAR 18 R. Antypas N/A Solid Rocket Testing at AFRL 21 Oct 2016 Robert Antypas AFRL/RQRO -Distribution A: Approved for Public Release...Distribution Unlimited. PA#16492 2 Agenda • Solid Rocket Motors • History of Sea Level Testing • Small Component Testing • Full-scale Testing • Altitude

  11. Change Point Detection with Robust Control Chart

    Directory of Open Access Journals (Sweden)

    Ng Kooi Huat

    2011-01-01

    Full Text Available Monitoring a process over time using a control chart allows quick detection of unusual states. In phase I, some historical process data, assumed to come from an in-control process, are used to construct the control limits. In Phase II, the process is monitored for an ongoing basis using control limits from Phase I. In Phase II, observations falling outside the control limits or unusual patterns of observations signal that the process has shifted from in-control process settings. Such signals trigger a search for assignable cause and, if the cause is found, corrective action will be implemented to prevent its recurrence. The purpose of this paper is to introduce a new methodology appropriate for constructing a robust control chart when a nonnormal or a contaminated data that may arise in phase I state. Through extensive Monte Carlo simulations, we examine the behaviors and performances of the proposed MM robust control chart when there is a process shift in mean.

  12. Chesapeake Highway Advisories Routing Traffic, Chart, Business Plan

    Science.gov (United States)

    1996-10-01

    THE BUSINESS PLAN IS ORGANIZED INTO FOUR MAJOR SECTIONS. THE FIRST SECTION IS INTRODUCTORY IN NATURE AND PROVIDES BACKGROUND INFORMATION ON ITS AND THE CHART PROGRAM IN MARYLAND. IT INCLUDES THE CHART MISSION, GOALS AND OBJECTIVES, AS WELL AS OVERVIE...

  13. Arctic Sea Ice Charts from Danish Meteorological Institute, 1893 - 1956

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — From 1893 to 1956, the Danish Meteorological Institute (DMI) created charts of observed and inferred sea ice extent for each summer month. These charts are based on...

  14. A new Snellen's visual acuity chart with 'Indian' numerals.

    OpenAIRE

    Al-Salem, M

    1987-01-01

    'Indian' numerals, which are popular among the Arab population, were used to devise a new Snellen's visual acuity chart. The new chart has the advantages of a reading chart. It keeps the patient's interest, does not miss alexic patients, and is quicker to perform. It is also devoid of the many disadvantages of a kinetic response chart (the capital E letter or Landolt's broken rings), especially that of the limited option of test objects.

  15. A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format

    OpenAIRE

    Fenton Tanis R

    2003-01-01

    Abstract Background The Babson and Benda 1976 "fetal-infant growth graph" for preterm infants is commonly used in neonatal intensive care. Its limits include the small sample size which provides low confidence in the extremes of the data, the 26 weeks start and the 500 gram graph increments. The purpose of this study was to develop an updated growth chart beginning at 22 weeks based on a meta-analysis of published reference studies. Methods The literature was searched from 1980 to 2002 for mo...

  16. School size effects: review and conceptual analysis

    NARCIS (Netherlands)

    Scheerens, Jaap; Hendriks, Maria A.; Luyten, Johannes W.; Luyten, Hans; Hendriks, Maria; Scheerens, Jaap

    2014-01-01

    In this chapter, a review of international review studies on school size effects is presented. Next, ingredients of a more contextualized and tentative causal mediation model of school size effects are discussed. The chapter is completed by a short overview of school size effects as found in

  17. 78 FR 52230 - Government/Industry Aeronautical Charting Forum Meeting

    Science.gov (United States)

    2013-08-22

    ... Federal Aviation Administration Government/Industry Aeronautical Charting Forum Meeting AGENCY: Federal...-annual meeting of the Federal Aviation Administration (FAA) Aeronautical Charting Forum (ACF) to discuss...), notice is hereby given of a meeting of the FAA Aeronautical Charting Forum to be held from October 29...

  18. 75 FR 11225 - Government/Industry Aeronautical Charting Forum Meeting

    Science.gov (United States)

    2010-03-10

    ... Federal Aviation Administration Government/Industry Aeronautical Charting Forum Meeting AGENCY: Federal... Forum (ACF 10-01) to discuss informational content and design of aeronautical charts and related.... App. II), notice is hereby given of a meeting of the FAA Aeronautical Charting Forum to be held from...

  19. 77 FR 50759 - Government/Industry Aeronautical Charting Forum Meeting

    Science.gov (United States)

    2012-08-22

    ... TRANSPORTATION Federal Aviation Administration Government/Industry Aeronautical Charting Forum Meeting AGENCY... announces the bi-annual meeting of the Federal Aviation Administration (FAA) Aeronautical Charting Forum... hereby given of a meeting of the FAA Aeronautical Charting Forum to be held from October 23 through...

  20. 78 FR 12415 - Government/Industry Aeronautical Charting Forum Meeting

    Science.gov (United States)

    2013-02-22

    ... Federal Aviation Administration Government/Industry Aeronautical Charting Forum Meeting AGENCY: Federal...-annual meeting of the Federal Aviation Administration (FAA) Aeronautical Charting Forum (ACF) to discuss...), notice is hereby given of a meeting of the FAA Aeronautical Charting Forum to be held from April 23...

  1. 76 FR 12211 - Government/Industry Aeronautical Charting Forum Meeting

    Science.gov (United States)

    2011-03-04

    ... Federal Aviation Administration Government/Industry Aeronautical Charting Forum Meeting AGENCY: Federal...-annual meeting of the Federal Aviation Administration (FAA) Aeronautical Charting Forum (ACF) to discuss... of a meeting of the FAA Aeronautical ] Charting Forum to be held from April 26 through April 28, 2011...

  2. 75 FR 54221 - Government/Industry Aeronautical Charting Forum Meeting

    Science.gov (United States)

    2010-09-03

    ... Aeronautical Charting Forum Meeting AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of... Administration (FAA) Aeronautical Charting Forum (ACF) to discuss informational content and design of... the FAA Aeronautical Charting Forum to be held from October 26 through October 28, 2010, from 8:30 a.m...

  3. Individual Charts and Additional Tests for Changes in Spread

    NARCIS (Netherlands)

    Trip, A.; Wieringa, J.E.

    2006-01-01

    Abstract A number of authors have indicated that it is not a good idea to use the MR-chart with an individuals chart to detect shifts in the spread. However, the combination of these charts is still used in practice and even presented as `best practice' in some cases. In addition, some more recent

  4. Enhanced Cumulative Sum Charts for Monitoring Process Dispersion

    Science.gov (United States)

    Abujiya, Mu’azu Ramat; Riaz, Muhammad; Lee, Muhammad Hisyam

    2015-01-01

    The cumulative sum (CUSUM) control chart is widely used in industry for the detection of small and moderate shifts in process location and dispersion. For efficient monitoring of process variability, we present several CUSUM control charts for monitoring changes in standard deviation of a normal process. The newly developed control charts based on well-structured sampling techniques - extreme ranked set sampling, extreme double ranked set sampling and double extreme ranked set sampling, have significantly enhanced CUSUM chart ability to detect a wide range of shifts in process variability. The relative performances of the proposed CUSUM scale charts are evaluated in terms of the average run length (ARL) and standard deviation of run length, for point shift in variability. Moreover, for overall performance, we implore the use of the average ratio ARL and average extra quadratic loss. A comparison of the proposed CUSUM control charts with the classical CUSUM R chart, the classical CUSUM S chart, the fast initial response (FIR) CUSUM R chart, the FIR CUSUM S chart, the ranked set sampling (RSS) based CUSUM R chart and the RSS based CUSUM S chart, among others, are presented. An illustrative example using real dataset is given to demonstrate the practicability of the application of the proposed schemes. PMID:25901356

  5. Comparison of documentation of patient reported adverse drug reactions on both paper-based medication charts and electronic medication charts at a New Zealand hospital.

    Science.gov (United States)

    Shen, Wilson; Wong, Bernice; Chin, Jessica Yi Ping; Lee, Michael; Coulter, Carolyn; Braund, Rhiannon

    2016-10-28

    Known adverse drug reactions (ADRs) can have profound effects on disease states, as well as prescribing practice. Therefore, the correct and complete documentation of each individual patient's ADR history, upon hospital admission, is important in optimising that individual patient's pharmacotherapy. This study investigated the documentation of ADRs at a tertiary New Zealand hospital, on both paper-based medication charts and electronic medication charts to quantify both the number of ADRs patients self-report, as well as the differences between recording of that information in electronic and paper-based charting systems. Following ethical approval, inpatient medication charts on the general medical ward (electronic prescribing), or the general surgical ward (paper-based medication charts) were viewed for documented ADRs-as reported by each patient on admission. Consecutive patient charts (and electronic clinical management system) were viewed until 50 patients from each ward, each with at least one documented ADR, (in any of the information sources) were obtained. Patient demographic information, ADR history and discrepancies between information sources were determined. In both wards 114 patients were reviewed in order to find 50 patients with documented ADRs. In the medical ward (electronic) 44 (90%) patients had discrepancies in ADR information between different information sources and in the surgical ward (paper) this occurred in 49 (98%) patients. A large number of patients self-report ADRs. Full documentation of patient reported ADRs is required to adequately inform future prescribing decisions. Discrepancies between ADR information recorded in different information systems exist, but information sharing between electronic and non-electronic sources could be prioritised in order to allow full and complete information to be collected, stored and utilised; and reduce the current inadequacies.

  6. Bicycle injury documentation before and after charting intervention.

    Science.gov (United States)

    Monroe, Kathy; Nichols, Michele; Bates, Robin; Meredith, Mark; Hunter, John; King, William D

    2008-07-01

    Previous studies have shown that routinely completed free-text emergency department medical records contain limited information necessary for injury surveillance. We instituted an injury documentation sheet into our emergency department records to evaluate the impact on completeness of bicycle injury documentation rates. The pretest/posttest study design used E-codes to identify bicycle-related injuries. A standardized data collection tool was utilized to review these charts. Time periods before (January 1 to December 31, 2004) and after (January 1 to June 30, 2005) institution of a standardized documentation sheet were reviewed. Data were entered into the computer program, Epistat, and scores were used for comparison. Initial review (n = 667) revealed mean age of patients 8.6 years, with 46% African American and 67% male. Helmet usage was documented in 49% of the charts (81 were wearing helmets; 245 were not wearing helmets). Mechanism of injury was documented as bicycle alone in 587, bicycle versus car in 13, and bicycle versus stationary object in 64. After implementation of an injury data sheet (n = 205), it was found that the mean age was 9.24 years, with 51% African American and 43% male. Helmet use was documented in 77% of cases (26 wearing helmets; 132 not wearing). Mechanism was documented as bicycle alone in 125, bicycle versus car in 66, and bicycle versus stationary object in 14. Helmet use was much more frequently documented after the initiation of an injury documentation reminder sheet (z = 6.97; P < 0.001; 95% confidence interval, 20.2-35.8). The use of standard injury documentation prompts increased completeness of documentation. With improved documentation, more accurate injury surveillance can be performed.

  7. A retrospective chart study: The pathway to a diagnosis for adults referred for ASD assessment

    NARCIS (Netherlands)

    Geurts, H.M.; Jansen, M.D.

    2012-01-01

    Charts of 125 adults (18 to 82 years), referred to an autism expert team for Autism Spectrum Disorder (ASD) assessment, were reviewed to explore the pathway to an adulthood ASD diagnosis. The participants first contacted the mental health care clinic at a median age of 19 years (range 2 to 78

  8. On the Mathematics behind the CUSUM Control Charts

    DEFF Research Database (Denmark)

    Madsen, Henrik

    1998-01-01

    This paper describes the mathematics behind CUSUM control charts. An introduction to CUSUM charts is found in (Madsen 1998).CUSUM charts are well suited for checking a measuring system in operation for any departure from some target or specified values. In general they can be used for:- detecting...... from CEN-TC 69. However the presentation in ISO/CD 7871 concentrates on the level, whereas CUSUM charts for detecting changes in the precision are not discussed.This document outlines the theory of CUSUM control charts, and both CUSUM procedures for detecting a drift as well as CUSUM procedures...

  9. Using Statistical Process Control to Drive Improvement in Neonatal Care: A Practical Introduction to Control Charts.

    Science.gov (United States)

    Gupta, Munish; Kaplan, Heather C

    2017-09-01

    Quality improvement (QI) is based on measuring performance over time, and variation in data measured over time must be understood to guide change and make optimal improvements. Common cause variation is natural variation owing to factors inherent to any process; special cause variation is unnatural variation owing to external factors. Statistical process control methods, and particularly control charts, are robust tools for understanding data over time and identifying common and special cause variation. This review provides a practical introduction to the use of control charts in health care QI, with a focus on neonatology. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. LOFT blowdown loop piping thermal analysis Class I review

    International Nuclear Information System (INIS)

    Kinnaman, T.L.

    1978-01-01

    In accordance with ASME Code, Section III requirements, all analyses of Class I components must be independently reviewed. Since the LOFT blowdown loop piping up through the blowdown valve is a Class I piping system, the thermal analyses are reviewed. The Thermal Analysis Branch comments to this review are also included. It is the opinion of the Thermal Analysis Branch that these comments satisfy all of the reviewers questions and that the analyses should stand as is, without additional considerations in meeting the ASME Code requirements and ANC Specification 60139

  11. Association between Iron Deficiency Anemia and Febrile Seizure: a Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Nasehi

    2013-04-01

    Full Text Available Febrile seizure is the most common convulsive disorder in children and different studies reported controversial results about the association between this disorder and iron deficiency. In some studies, iron level in children with febrile seizure is higher than control and in some reports it is less than the control group. So, we systematically reviewed all the studies in this field and analyzed their findings using meta-analysis methods. This review and meta-analysis was conducted by iron and fever keywords on articles published in the databases PubMed, Google Scholar and Federated search of medical digital library that includes a variety of international databases. All articles dated at the end of March 2012 were studied. Case-control studies were selected and quality assessment of studies were surveyed by STROB criteria and information requirements, including the status of iron deficiency anemia, iron levels and ferritin level of eligible studies were extracted and analyzed by Comprehensive Meta-Analysis Version 2.0 software and the Forest and Funnel chart was drawn. Finally 11 studies included 1357 children with febrile seizure and 1347 children in the control group were evaluated. The odds ratio of iron deficiency anemia in children with febrile seizure in comparison to the control group was 1.27 (OR = 1.27, CI95%: 1.03 -1.56. Ferritin level was not significant between the two groups (p=0.08, but the iron level in the two groups was significant (p=0.000. Iron deficiency is considered as a risk factor in the incidence of febrile seizure and interventional studies can be helpful to confirm this hypothesis.

  12. Adaptation of Know, Want to Know, and Learned Chart for Problem-Based Learning.

    Science.gov (United States)

    Bailey, Lori A

    2017-08-01

    The KWL (Know, Want to know, Learned) chart was introduced to facilitate student critical thinking in a large, multisite, medical-surgical nursing course that uses problem-based learning. Before class, students complete KWL charts in conjunction with concept videos to document prior learning. Then, they form groups to work on case studies during class. Faculty review the KWL charts for evidence of problem-solving growth. If evidence exists that students struggle with a concept, those results are used to remediate the content. Students and faculty indicated that the KWL provided students with needed structure for addressing the ambiguities built into case studies. Students suggested minor revisions to the tool. Use of the KWL has the potential to improve performance and critical thought in problem-based learning classrooms. Use of the KWL as a means of structuring student critical thinking and decision making should be explored further. [J Nurs Educ. 2017;56(8):506-508.]. Copyright 2017, SLACK Incorporated.

  13. Systematic review with meta-analysis

    DEFF Research Database (Denmark)

    Roda, G; Narula, N; Pinotti, R

    2017-01-01

    BACKGROUND: Disease extent in ulcerative colitis is one of the major factors determining prognosis over the long-term. Disease extent is dynamic and a proportion of patients presenting with limited disease progress to more extensive forms of disease over time. AIM: To perform a systematic review ...

  14. Systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Lo, B; Prosberg, M V; Gluud, L L

    2018-01-01

    BACKGROUND: The Inflammatory Bowel Disease Disability Index (IBD-DI) has recently been developed for patients with Crohn's disease (CD) and ulcerative colitis (UC). AIM: To assess the severity of disability and associated factors using the IBD-DI, and review the validity of the IBD-DI as a tool. ...

  15. Systematic review and a meta-analysis

    African Journals Online (AJOL)

    We systematically reviewed the available literature and meta-analyzed the data which was specialized in Down syndrome (DS) diagnosis with proteomic techniques. Pubmed, EBSCOhost and ScienceDirect searches for relevant articles published from inception until July 2010 were obtained and ten articles were selected.

  16. An unsupervised aspect detection model for sentiment analysis of reviews

    NARCIS (Netherlands)

    Bagheri, Ayoub; Saraee, M.; de Jong, Franciska M.G.

    With the rapid growth of user-generated content on the internet, sentiment analysis of online reviews has become a hot research topic recently, but due to variety and wide range of products and services, the supervised and domain-specific models are often not practical. As the number of reviews

  17. Mission Task Analysis for the NATO Defence Requirements Review

    National Research Council Canada - National Science Library

    Armstrong, Stuart

    2005-01-01

    This paper gives a general outline of the NATO Defense Requirements Review (DRR) and how mission analysis has been used to provide a consistent and detailed approach to the decomposition of complex military missions...

  18. Genome cartography: charting the apicomplexan genome.

    Science.gov (United States)

    Kissinger, Jessica C; DeBarry, Jeremy

    2011-08-01

    Genes reside in particular genomic contexts that can be mapped at many levels. Historically, 'genetic maps' were used primarily to locate genes. Recent technological advances in the determination of genome sequences have made the analysis and comparison of whole genomes possible and increasingly tractable. What do we see if we shift our focus from gene content (the 'inventory' of genes contained within a genome) to the composition and organization of a genome? This review examines what has been learned about the evolution of the apicomplexan genome as well as the significance and impact of genomic location on our understanding of the eukaryotic genome and parasite biology. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. THE CHART ROMANIA-NATO-UE

    Directory of Open Access Journals (Sweden)

    Duduială Popescu Lorena

    2009-05-01

    Full Text Available viewed in the context of geopolitical and geostrategic current and through the elements of distinction in terms of identity and cultural institutions, chart Romania - NATO / Israel - EU stands under the sign of the common interest channel, firstly, on common values and hence the collective interests of the partners involved in the two organizational structures. Noteworthy in this context is the extent of bilateral involvement of Romania in the bodies and the politico-military, represented by NATO (the North Atlantic Treaty Organization, which is primarily military values and the construction superstate permanent expansion and development - European Union , both generating as much for our country as obligations of a politico-military security, and economic, social, institutional, cultural.

  20. Standard Review Plan for the review of safety analysis reports for nuclear power plants: LWR edition

    International Nuclear Information System (INIS)

    1987-06-01

    The Standard Review Plan (SRP) is prepared for the guidance of staff reviewers in the Office of Nuclear Reactor Regulation in performing safety reviews of applications to construct or operate nuclear power plants. The principal purpose of the SRP is to assure the quality and uniformity of staff reviews and to present a well-defined base from which to evaluate proposed changes in the scope and requirements of reviews. It is also a purpose of the SRP to make information about regulatory matters widely available and to improve communication and understanding of the staff review process by interested members of the public and the nuclear power industry. The safety review is primarily based on the information provided by an applicant in a Safety Analysis Report (SAR). The SAR must be sufficiently detailed to permit the staff to determine whether the plant can be built and operated without undue risk to the health and safety of the public. The SAR is the principal document in which the applicant provides the information needed to understand the basis upon which this conclusion has been reached. The individual SRP sections address, in detail, who performs the review, the matters that are reviewed, the basis for review, how the review is accomplished, and the conclusions that are sought. The safety review is performed by 25 primary branches. One of the objectives of the SRP is to assign the review responsibilities to the various branches and to define the sometimes complex interfaces between them. Each SRP section identifies the branch that has the primary review responsibility for that section. In some review areas the primary branch may require support, and the branches that are assigned these secondary review responsibilities are also identified for each SRP section

  1. Facial Image Analysis in Anthropology: A Review

    Czech Academy of Sciences Publication Activity Database

    Kalina, Jan

    2011-01-01

    Roč. 49, č. 2 (2011), s. 141-153 ISSN 0323-1119 Institutional support: RVO:67985807 Keywords : face * computer-assisted methods * template matching * geometric morphopetrics * robust image analysis Subject RIV: IN - Informatics, Computer Science

  2. Functional analysis of verbal behavior: a brief review.

    Science.gov (United States)

    Plavnick, Joshua B; Normand, Matthew P

    2013-01-01

    A variation of the preintervention functional analysis of problem behavior has recently been extended to identify the function of verbal behavior emitted by children with autism. Recent research suggests that a functional analysis of verbal behavior might be beneficial in evaluating previous instruction and guiding the selection of future educational targets and instructional procedures. The present paper reviews previous literature on the functional analysis of verbal behavior and identifies avenues for future research. © Society for the Experimental Analysis of Behavior.

  3. Blinded with Science or Informed by Charts? A Replication Study

    OpenAIRE

    Dragicevic , Pierre; Jansen , Yvonne

    2018-01-01

    International audience; We provide a reappraisal of Tal and Wansink's study "Blinded with Science" , where seemingly trivial charts were shown to increase belief in drug efficacy, presumably because charts are associated with science. Through a series of four replications conducted on two crowdsourcing platforms, we investigate an alternative explanation, namely, that the charts allowed participants to better assess the drug's efficacy. Considered together, our experiments suggest that the ch...

  4. The making of Andersen’s liquefaction chart

    DEFF Research Database (Denmark)

    Sabaliauskas, Tomas; Ibsen, Lars Bo

    Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation stabilizing soil response.The process of obtaining the original chart has bee...... improved. Algorithm based approximation is introduced. Pore pressure dependent ultimate bearing capacity normalization factor is introduced to normalize the chart....

  5. Control of psychomotor agitation and aggressive behavior in patients with autistic disorder: a retrospective chart review Controle da agitação psicomotora e agressividade em pacientes com autismo: estudo retrospectivo de revisão de prontuário

    Directory of Open Access Journals (Sweden)

    Camila Marinho Novaes

    2008-01-01

    Full Text Available OBJECTIVE: To evaluate the efficacy of pharmacotherapy on the symptoms of psychomotor agitation and aggressive behavior in a sample of patients with autistic spectrum disorder. METHOD: The charts of all patients with a diagnosis of autistic spectrum disorder, receiving care for psychomotor agitation and/or aggressive behavior in two psychiatric outpatient departments between 2001 and 2006, were reviewed. The Clinical Global Impression-Severity and -Improvement scales (CGI-S and CGI-I were applied to the data retrieved from the charts. RESULTS: The majority of the 26 patients included were treated with second-generation antipsychotics. A positive, statistically significant correlation was found between the implementation of pharmacotherapy and a reduction in CGI-S scores (pOBJETIVO: Avaliar a eficácia do tratamento farmacológico dos sintomas de agitação psicomotora e agressividade em amostra de pacientes com transtorno do espectro autista. MÉTODO: Foram revisados os prontuários de pacientes com diagnóstico de transtorno do espectro autista que procuraram atendimento por apresentarem agitação psicomotora e/ou heteroagressividade, atendidos entre 2001 e 2006, em dois ambulatórios de psiquiatria. Para avaliação da evolução dos pacientes aplicou-se às informações do prontuário a escala de Impressão Clínica Global Sintomas (ICG-S e a Impressão Clínica Global Melhora (ICG-M. RESULTADOS: A maioria dos 26 pacientes estava em tratamento com antipsicóticos de segunda geração. Houve correlação positiva e estatisticamente significativa entre a introdução do tratamento farmacológico e a redução nos escores da ICG-S (p<0,05. A evolução do tratamento farmacológico foi melhor para os pacientes sem retardo mental do que para aqueles com retardo mental (p<0,05. A maioria dos pacientes que obteve melhora clínica com o tratamento participava de ao menos uma intervenção auxiliar ao tratamento principal (p<0,05. CONCLUSÃO: Os

  6. Age-related iso-MAC charts for isoflurane, sevoflurane and desflurane in man.

    Science.gov (United States)

    Nickalls, R W D; Mapleson, W W

    2003-08-01

    The motivation for this study was the current difficulty in estimating the total age-related MAC for a patient in a clinical setting. Age-related iso-MAC charts for isoflurane, sevoflurane and desflurane were developed for the clinically useful MAC range (0.6-1.6), age range 5-95 yr, and put in a convenient form for use by practising anaesthetists. The charts are based on Mapleson's meta-analysis (1996) of the available MAC data and can be used to allow for the contribution of nitrous oxide to the total MAC. The charts indicate the influence of age on anaesthetic requirements, showing, for example, that a total MAC of 1.2 using isoflurane and nitrous oxide 67% in oxygen requires an end-expired isoflurane concentration of only 0.25% in a patient of 95 yr vs 1% in a 5-yr-old patient. Colleagues found the charts to be helpful and simple to use clinically. The iso-MAC charts show clearly how patient age can be used to guide the choice of end-expired agent concentration. They also allow a consistent total MAC to be maintained when changing the inspired nitrous oxide concentration, thereby reducing the chance of inadvertent awareness, particularly at the extremes of age.

  7. EPA Enforcement and Compliance History Online: Water Effluent Charts Details

    Data.gov (United States)

    U.S. Environmental Protection Agency — Detailed Discharge Monitoring Report (DMR) data supporting effluent charts for one Clean Water Act discharge permit. Includes effluent parameters, amounts discharged...

  8. New standardized visual acuity charts in hindi and gujarati

    Directory of Open Access Journals (Sweden)

    Khamar Bakulesh

    1996-01-01

    Full Text Available Conventional Snellen visual acuity chart has unequal difficulty score and irregular progression in letter size causing jumping effect at different visual acuity levels. There is also increase in number of letters from above downwards. Consequently one or two mistakes per line has different meaning of visual acuity at different levels. We designed a new visual acuity chart of fourteen lines in Hindi and Gujarati to facilitate standardization in visual acuity measurement. These charts are designed for use at six meter distance, and the illumination is provided from front. These charts provide a standardized way of measuring visual acuity using local languages.

  9. EPA Enforcement and Compliance History Online: Water Effluent Charts Downloads

    Data.gov (United States)

    U.S. Environmental Protection Agency — Detailed Discharge Monitoring Report (DMR) data supporting effluent charts for one Clean Water Act discharge permit. Includes effluent parameters, amounts discharged...

  10. Review of compartmental analysis in ecosystem science

    International Nuclear Information System (INIS)

    O'Neill, R.V.

    1978-01-01

    The compartment model has a large number of applications in ecosystem science. An attempt is made to outline the problem areas and objectives for which this type of model has particular advantages. The areas identified are an adequate model of tracer movement through an undisturbed but non-equilibrium ecosystem; an adequate model of the movement of material in greater than tracer quantity through an ecosystem near steady state; a minimal model based on limited data; a tool for extrapolating past trends; a framework for the summarization of large data sets; and a theoretical tool for exploring and comparing limited aspects of ecosystem dynamics. The review is set in an historical perspective which helps explain why these models were adopted in ecology. References are also provided to literature which documents available mathematical techniques in an ecological context

  11. Systems Analysis and Education Research Literature Review.

    Science.gov (United States)

    Geisinger, Robert W.

    Systems approaches, developed in World War II for military and business operations, have been applied increasingly to educational affairs. Educational systems analysis has received widespread usage in finance and accounting, and has also been successfully applied to information systems, instructional systems development, school design and…

  12. Sequence analysis by iterated maps, a review.

    Science.gov (United States)

    Almeida, Jonas S

    2014-05-01

    Among alignment-free methods, Iterated Maps (IMs) are on a particular extreme: they are also scale free (order free). The use of IMs for sequence analysis is also distinct from other alignment-free methodologies in being rooted in statistical mechanics instead of computational linguistics. Both of these roots go back over two decades to the use of fractal geometry in the characterization of phase-space representations. The time series analysis origin of the field is betrayed by the title of the manuscript that started this alignment-free subdomain in 1990, 'Chaos Game Representation'. The clash between the analysis of sequences as continuous series and the better established use of Markovian approaches to discrete series was almost immediate, with a defining critique published in same journal 2 years later. The rest of that decade would go by before the scale-free nature of the IM space was uncovered. The ensuing decade saw this scalability generalized for non-genomic alphabets as well as an interest in its use for graphic representation of biological sequences. Finally, in the past couple of years, in step with the emergence of BigData and MapReduce as a new computational paradigm, there is a surprising third act in the IM story. Multiple reports have described gains in computational efficiency of multiple orders of magnitude over more conventional sequence analysis methodologies. The stage appears to be now set for a recasting of IMs with a central role in processing nextgen sequencing results.

  13. Triclosan: A review on systematic risk assessment and control from the perspective of substance flow analysis.

    Science.gov (United States)

    Huang, Chu-Long; Abass, Olusegun K; Yu, Chang-Ping

    2016-10-01

    Triclosan (TCS) is a broad spectrum antibacterial agent mainly used in Pharmaceutical and Personal Care Products. Its increasing use over recent decades have raised its concentration in the environment, with commonly detectable levels found along the food web-from aquatic organisms to humans in the ecosystem. To date, there is shortage of information on how to investigate TCS's systematic risk on exposed organisms including humans, due to the paucity of systematic information on TCS flows in the anthroposphere. Therefore, a more holistic approach to mass flow balancing is required, such that the systematic risk of TCS in all environmental matrices are evaluated. From the perspective of Substance Flow Analysis (SFA), this review critically summarizes the current state of knowledge on TCS production, consumption, discharge, occurrence in built and natural environments, its exposure and metabolism in humans, and also the negative effects of TCS on biota and humans. Recent risk concerns have mainly focused on TCS removal efficiencies and metabolism, but less attention is given to the effect of mass flows from source to fate during risk exposure. However, available data for TCS SFA is limited but SFA can derive logical systematic information from limited data currently available for systematic risk assessment and reduction, based on mass flow analysis. In other words, SFA tool can be used to develop a comprehensive flow chart and indicator system for the risk assessment and reduction of TCS flows in the anthroposphere, thereby bridging knowledge gaps to streamline uncertainties related to policy-making on exposure pathways within TCS flow-lines. In the final analysis, specifics on systematic TCS risk assessment via SFA, and areas of improvement on human adaptation to risks posed by emerging contaminants are identified and directions for future research are suggested. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Dental x-ray validation study: comparison of information from patient interviews and dental charts

    International Nuclear Information System (INIS)

    Preston-Martin, S.; Bernstein, L.; Maldonado, A.A.; Henderson, B.E.; White, S.C.

    1985-01-01

    Information was collected from dentists of a subset of participants in a case-control interview study conducted in Los Angeles County, California, in August 1980-August 1981 to evaluate the relationship of dental x-rays to tumors of the parotid gland. Complete dental charts were available from 142 dentists of 84 cases and from 130 dentists of 79 control. Analysis of data from these interview chart comparisons indicates that recall appears to be unbiased since the measures of agreement between interview and dental chart data are similar for cases and controls. The authors further conclude that interview data alone may be used for case-control comparisons of dental x-ray exposure and would, because of unbiased misclassification, tend to underestimate the relative risks. 12 references, 3 tables

  15. Use of risk-adjusted CUSUM charts to monitor 30-day mortality in Danish hospitals

    Directory of Open Access Journals (Sweden)

    Rasmussen TB

    2018-04-01

    Full Text Available Thomas Bøjer Rasmussen, Sinna Pilgaard Ulrichsen, Mette Nørgaard Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark Background: Monitoring hospital outcomes and clinical processes as a measure of clinical performance is an integral part of modern health care. The risk-adjusted cumulative sum (CUSUM chart is a frequently used sequential analysis technique that can be implemented to monitor a wide range of different types of outcomes.Objective: The aim of this study was to describe how risk-adjusted CUSUM charts based on population-based nationwide medical registers were used to monitor 30-day mortality in Danish hospitals and to give an example on how alarms of increased hospital mortality from the charts can guide further in-depth analyses.Materials and methods: We used routinely collected administrative data from the Danish National Patient Registry and the Danish Civil Registration System to create risk-adjusted CUSUM charts. We monitored 30-day mortality after hospital admission with one of 77 selected diagnoses in 24 hospital units in Denmark in 2015. The charts were set to detect a 50% increase in 30-day mortality, and control limits were determined by simulations.Results: Among 1,085,576 hospital admissions, 441,352 admissions had one of the 77 selected diagnoses as their primary diagnosis and were included in the risk-adjusted CUSUM charts. The charts yielded a total of eight alarms of increased mortality. The median of the hospitals’ estimated average time to detect a 50% increase in 30-day mortality was 50 days (interquartile interval, 43;54. In the selected example of an alarm, descriptive analyses indicated performance problems with 30-day mortality following hip fracture surgery and diagnosis of chronic obstructive pulmonary disease.Conclusion: The presented implementation of risk-adjusted CUSUM charts can detect significant increases in 30-day mortality within 2 months, on average, in most

  16. Concordance of chart and billing data with direct observation in dental practice.

    Science.gov (United States)

    Demko, Catherine A; Victoroff, Kristin Zakariasen; Wotman, Stephen

    2008-10-01

    The commonly used methods of chart review, billing data summaries and practitioner self-reporting have not been examined for their ability to validly and reliably represent time use and service delivery in routine dental practice. A more thorough investigation of these data sources would provide insight into the appropriateness of each approach for measuring various clinical behaviors. The aim of this study was to assess the validity of commonly used methods such as dental chart review, billing data, or practitioner self-report compared with a 'gold standard' of information derived from direct observation of routine dental visits. A team of trained dental hygienists directly observed 3751 patient visits in 120 dental practices and recorded the behaviors and procedures performed by dentists and hygienists during patient contact time. Following each visit, charts and billing records were reviewed for the performed and billed procedures. Dental providers characterized their frequency of preventive service delivery through self-administered surveys. We standardized the observation and abstraction methods to obtain optimal measures from each of the multiple data sources. Multi-rater kappa coefficients were computed to monitor standardization, while sensitivity, specificity, and kappa coefficients were calculated to compare the various data sources with direct observation. Chart audits were more sensitive than billing data for all observed procedures and demonstrated higher agreement with directly observed data. Chart and billing records were not sensitive for several prevention-related tasks (oral cancer screening and oral hygiene instruction). Provider self-reports of preventive behaviors were always over-estimated compared with direct observation. Inter-method reliability kappa coefficients for 13 procedures ranged from 0.197 to 0.952. These concordance findings suggest that strengths and weaknesses of data collection sources should be considered when investigating

  17. A review of intelligent systems for heart sound signal analysis.

    Science.gov (United States)

    Nabih-Ali, Mohammed; El-Dahshan, El-Sayed A; Yahia, Ashraf S

    2017-10-01

    Intelligent computer-aided diagnosis (CAD) systems can enhance the diagnostic capabilities of physicians and reduce the time required for accurate diagnosis. CAD systems could provide physicians with a suggestion about the diagnostic of heart diseases. The objective of this paper is to review the recent published preprocessing, feature extraction and classification techniques and their state of the art of phonocardiogram (PCG) signal analysis. Published literature reviewed in this paper shows the potential of machine learning techniques as a design tool in PCG CAD systems and reveals that the CAD systems for PCG signal analysis are still an open problem. Related studies are compared to their datasets, feature extraction techniques and the classifiers they used. Current achievements and limitations in developing CAD systems for PCG signal analysis using machine learning techniques are presented and discussed. In the light of this review, a number of future research directions for PCG signal analysis are provided.

  18. Medication Adherence Apps: Review and Content Analysis.

    Science.gov (United States)

    Ahmed, Imran; Ahmad, Niall Safir; Ali, Shahnaz; Ali, Shair; George, Anju; Saleem Danish, Hiba; Uppal, Encarl; Soo, James; Mobasheri, Mohammad H; King, Dominic; Cox, Benita; Darzi, Ara

    2018-03-16

    Medication adherence is an expensive and damaging problem for patients and health care providers. Patients adhere to only 50% of drugs prescribed for chronic diseases in developed nations. Digital health has paved the way for innovative smartphone solutions to tackle this challenge. However, despite numerous apps available claiming to improve adherence, a thorough review of adherence apps has not been carried out to date. The aims of this study were to (1) review medication adherence apps available in app repositories in terms of their evidence base, medical professional involvement in development, and strategies used to facilitate behavior change and improve adherence and (2) provide a system of classification for these apps. In April 2015, relevant medication adherence apps were identified by searching the Apple App Store and the Google Play Store using a combination of relevant search terms. Data extracted included app store source, app price, documentation of health care professional (HCP) involvement during app development, and evidence base for each respective app. Free apps were downloaded to explore the strategies used to promote medication adherence. Testing involved a standardized medication regimen of three reminders over a 4-hour period. Nonadherence features designed to enhance user experience were also documented. The app repository search identified a total of 5881 apps. Of these, 805 fulfilled the inclusion criteria initially and were tested. Furthermore, 681 apps were further analyzed for data extraction. Of these, 420 apps were free for testing, 58 were inaccessible and 203 required payment. Of the 420 free apps, 57 apps were developed with HCP involvement and an evidence base was identified in only 4 apps. Of the paid apps, 9 apps had HCP involvement, 1 app had a documented evidence base, and 1 app had both. In addition, 18 inaccessible apps were produced with HCP involvement, whereas 2 apps had a documented evidence base. The 420 free apps were

  19. Information Landscaping: Information Mapping, Charting, Querying and Reporting Techniques for Total Quality Knowledge Management.

    Science.gov (United States)

    Tsai, Bor-sheng

    2003-01-01

    Total quality management and knowledge management are merged and used as a conceptual model to direct and develop information landscaping techniques through the coordination of information mapping, charting, querying, and reporting. Goals included: merge citation analysis and data mining, and apply data visualization and information architecture…

  20. Evaluation of Dermatology Practice Online Reviews: Lessons From Qualitative Analysis.

    Science.gov (United States)

    Smith, Robert J; Lipoff, Jules B

    2016-02-01

    Patient satisfaction is an increasingly important component of health care quality measures. Online reviews of physicians represent a promising platform for capturing patient perspectives of care. To identify qualitative themes associated with patient reviews of dermatologic care on consumer reporting websites. A qualitative analysis was conducted of patient-generated reviews of dermatology practices on 2 consumer review platforms. Yelp is an online consumer portal for users to review their experience with local businesses; ZocDoc is an online patient-scheduling portal that provides opportunity for patients to write reviews of physician practices. A total of 518 reviews from 45 dermatology practices on Yelp and 4921 reviews from 45 dermatology providers on ZocDoc were collected from 3 geographically diverse cities: Philadelphia, Pennsylvania; Houston, Texas; and Seattle, Washington. The study was conducted from January 15 to July 15, 2015. Reviews were separated into high-scoring and low-scoring groups. An inductive qualitative method was used to code and identify key themes associated with positive and negative patient experiences. Analysis was completed upon reaching thematic saturation. Reported as mean (95% CI), the overall Yelp score for the 45 selected practices was 3.46 of 5 stars (3.17-3.75) and overall ZocDoc score for the 45 selected practices was 4.72 of 5 stars (4.47-4.80). The proportion of individual reviews giving a score of 5.0 was significantly higher on ZocDoc (3986 [81.0%]) than on Yelp (229 [44.2%]) (P dermatology providers. Online consumer review websites are designed to facilitate instantaneous and public communication among patients. These platforms provide elaborate and timely data for dermatologists to garner insight into their patients' experiences. The themes identified in this study are consistent with past satisfaction studies and may aid dermatologists in optimizing the patient care experience.

  1. Range charts and no-space graphs

    Science.gov (United States)

    Edwards, L.E.

    1978-01-01

    No-space graphs present one solution to the familiar problem: given data on the occurrence of fossil taxa in separate, well-sampled sections, determine a range chart; that is, a reasonable working hypothesis of the total range in the area in question of each taxon studied. The solution presented here treats only the relative sequence of biostratigraphic events (first and last occurrences of taxa) and does not attempt to determine an amount of spacing between events. Relative to a hypothesized sequence, observed events in any section may be in-place or out-of-place. Out-of-place events may indicate (1) the event in question reflects a taxon that did not fill its entire range (unfilled-range event), or (2) the event in question indicates a need for the revision of the hypothesized sequence. A graph of relative position only (no-space graph) can be used to facilitate the recognition of in-place and out-of-place events by presenting a visual comparison of the observations from each section with the hypothesized sequence. The geometry of the graph as constructed here is such that in-place events will lie along a line series and out-of-place events will lie above or below it. First-occurrence events below the line series and last-occurrence events above the line series indicate unfilled ranges. First-occurrence events above the line series and last-occurrence events below the line series indicate a need for the revision of the hypothesis. Knowing this, the stratigrapher considers alternative positionings of the line series as alternative range hypotheses and seeks the line series that best fits his geologic and paleontologic judgment. No-space graphs are used to revise an initial hypothesis until a final hypothesis is reached. In this final hypothesis every event is found in-place in at least one section, and all events in all sections may be interpreted to represent in-place events or unfilled-range events. No event may indicate a need for further range revision. The

  2. VARIATION OF CHART DATUM TOWARDS MARITIME DELIMITATION DUE TO RISING SEA LEVEL

    Directory of Open Access Journals (Sweden)

    A. R. M. Faizuddin

    2017-10-01

    Full Text Available The importance of Chart Datum in hydrographic surveying is inarguable because its determination is part of the process to obtain the actual depth of bathymetry. The Chart Datum has a relationship with the determination of base points because any uncertainty of the base points would definitely cause uncertainty to the determination of the maritime baseline. If there is any doubt on the baselines, it will then cause doubt on the maritime zones as well which includes the equidistant line that forms the border between the two countries. However, due to the ongoing rising sea level, there has been some variations of the Chart Datum in some areas in Malaysia. This research discusses about the variation of Mean Sea Level and Chart Datum for the tide gauge stations at Geting, Cendering, Sedili and Tioman at East Coast and Kukup, Langkawi, Lumut and Penang at the West Coast of Peninsular Malaysia. The tidal analysis was carried out by using the 23 years of data beginning at 1993 to 2015. The observed tidal data for 23 years were processed and analysed by using GeoTide software. In this research, the Harmonic Analysis technique was used in order to calculate the values of Mean Sea Level and the Chart Datum while the slope of the shoreline is modelled by using Global Mapper. The linear trend of the Mean Sea Level and the Chart Datum was analysed to determine the increase of the annual sea level in millimetres accuracy and also to determine the variation of the Chart Datum for each tidal station and its impact towards maritime baseline. The result has shown that the linear trend of sea level rise varies from 24 millimetres per year up to 168 millimetres per year at the East Coast and 24 millimetres per year up to 96 millimetres per year at the West Coast of Peninsular Malaysia. As for the maritime baseline, results has indicated that there exist shifting in the horizontal which are varies from 1.564 metres per year to 3.299 metres per year at the East Coast

  3. Variation of Chart Datum Towards Maritime Delimitation due to Rising Sea Level

    Science.gov (United States)

    Faizuddin, A. R. M.; Razali, M. M.

    2017-10-01

    The importance of Chart Datum in hydrographic surveying is inarguable because its determination is part of the process to obtain the actual depth of bathymetry. The Chart Datum has a relationship with the determination of base points because any uncertainty of the base points would definitely cause uncertainty to the determination of the maritime baseline. If there is any doubt on the baselines, it will then cause doubt on the maritime zones as well which includes the equidistant line that forms the border between the two countries. However, due to the ongoing rising sea level, there has been some variations of the Chart Datum in some areas in Malaysia. This research discusses about the variation of Mean Sea Level and Chart Datum for the tide gauge stations at Geting, Cendering, Sedili and Tioman at East Coast and Kukup, Langkawi, Lumut and Penang at the West Coast of Peninsular Malaysia. The tidal analysis was carried out by using the 23 years of data beginning at 1993 to 2015. The observed tidal data for 23 years were processed and analysed by using GeoTide software. In this research, the Harmonic Analysis technique was used in order to calculate the values of Mean Sea Level and the Chart Datum while the slope of the shoreline is modelled by using Global Mapper. The linear trend of the Mean Sea Level and the Chart Datum was analysed to determine the increase of the annual sea level in millimetres accuracy and also to determine the variation of the Chart Datum for each tidal station and its impact towards maritime baseline. The result has shown that the linear trend of sea level rise varies from 24 millimetres per year up to 168 millimetres per year at the East Coast and 24 millimetres per year up to 96 millimetres per year at the West Coast of Peninsular Malaysia. As for the maritime baseline, results has indicated that there exist shifting in the horizontal which are varies from 1.564 metres per year to 3.299 metres per year at the East Coast and from 1

  4. Review and analysis of biomass gasification models

    DEFF Research Database (Denmark)

    Puig Arnavat, Maria; Bruno, Joan Carles; Coronas, Alberto

    2010-01-01

    The use of biomass as a source of energy has been further enhanced in recent years and special attention has been paid to biomass gasification. Due to the increasing interest in biomass gasification, several models have been proposed in order to explain and understand this complex process......, and the design, simulation, optimisation and process analysis of gasifiers have been carried out. This paper presents and analyses several gasification models based on thermodynamic equilibrium, kinetics and artificial neural networks. The thermodynamic models are found to be a useful tool for preliminary...

  5. A retrospective chart review of the clinical and psychosocial profile ...

    African Journals Online (AJOL)

    use was also demonstrated. Risk factors for SUD (psychosocial adversities, childhood trauma, family and community exposure to substances, early debut drug ages), risky sexual behaviours, and clinical psychiatric profiles of adolescents with dual diagnosis are described. Conclusions. This cohort had an enhanced risk as ...

  6. A Review of Shock Mitigation Techniques (Briefing Charts)

    Science.gov (United States)

    2015-04-01

    material, determine layer size which filters mechanical waves in a desired frequency range [7] N.A. Winfree et al, 2010, “Mechanical filter for...simulation with optimization algorithms to obtain the optimum design parameters. • Shock Filter Design: fitness function involves a weighted penalty for a... passband in a specified frequency range. • Design parameters: layer thickness, number of layers, density, elastic modulus. [10] Hussein, M.I

  7. Control of wastewater using multivariate control chart

    Science.gov (United States)

    Nugraha, Jaka; Fatimah, Is; Prabowo, Rino Galang

    2017-03-01

    Wastewater treatment is a crucial process in industry cause untreated or improper treatment of wastewater may leads some problems affecting to the other parts of environmental aspects. For many kinds of wastewater treatments, the parameters of Biological Oxygen Demand (BOD), Chemical Oxygen Demand (COD), and the Total Suspend Solid (TSS) are usual parameters to be controlled as a standard. In this paper, the application of multivariate Hotteling T2 Individual was reported to control wastewater treatment. By using wastewater treatment data from PT. ICBP, east Java branch, while the fulfillment of quality standards are based on East Java Governor Regulation No. 72 Year 2013 on Standards of Quality of Waste Water Industry and / or Other Business Activities. The obtained results are COD and TSS has a correlation with BOD values with the correlation coefficient higher than 50%, and it is is also found that influence of the COD and TSS to BOD values are 82% and 1.9% respectively. Based on Multivariate control chart Individual T2 Hotteling, it is found that BOD-COD and BOD-TSS are each one subgroup that are outside the control limits. Thus, it can be said there is a process that is not multivariate controlled, but univariately the variables of BOD, COD and TSS are within specification (standard quality) that has been determined.

  8. Charting the history of agricultural experiments.

    Science.gov (United States)

    Parolini, Giuditta

    2015-09-01

    Agricultural experimentation is a world in constant evolution, spanning multiple scientific domains and affecting society at large. Even though the questions underpinning agricultural experiments remain largely the same, the instruments and practices for answering them have changed constantly during the twentieth century with the advent of new disciplines like molecular biology, genomics, statistics, and computing. Charting this evolving reality requires a mapping of the affinities and antinomies at work within the realm of agricultural research, and a consideration of the practices, tools and social and political structures in which agricultural experiments are grounded. Three main questions will be addressed to provide an overview of the complex world of agricultural research investigated by the special issue: What is an agricultural experiment? Who is an experimenter in agriculture? Where do agricultural experiments take place? It will become apparent that agricultural experiments have a wide relevance for human development as they touch upon concerns related to human health and nutrition, contribute to policy discussions, and can affect the social and political structures in which farming is embedded.

  9. Do RuralMothers Comprehend the Growth Chart | Ibekwe | Nigerian ...

    African Journals Online (AJOL)

    Background: Growth chart is an educational tool to motivate mothers to take appropriate action to maintain and or improve their child's nutrition. Its ability to performthis function depends on maternal comprehension. Objective: To determinematernal comprehension of the growth chart, and also identify factors that influence it.

  10. 47 CFR 73.699 - TV engineering charts.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false TV engineering charts. 73.699 Section 73.699 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES Television Broadcast Stations § 73.699 TV engineering charts. This section consists of the following Figures...

  11. Negative Binomial charts for monitoring high-quality processes

    NARCIS (Netherlands)

    Albers, Willem/Wim

    Good control charts for high quality processes are often based on the number of successes between failures. Geometric charts are simplest in this respect, but slow in recognizing moderately increased failure rates p. Improvement can be achieved by waiting until r > 1 failures have occurred, i.e. by

  12. US Nuclear Regulatory Commission organization charts and functional statements

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    This document is the US NRC organizational structure and chart as of July 1, 1996. It contains the org charts for the Commission, ACRS, ASLAB, Commission staff offices, Executive Director for Operations, Office of the Inspector General, Program offices, and regional offices.

  13. Quality Control Charts in Large-Scale Assessment Programs

    Science.gov (United States)

    Schafer, William D.; Coverdale, Bradley J.; Luxenberg, Harlan; Jin, Ying

    2011-01-01

    There are relatively few examples of quantitative approaches to quality control in educational assessment and accountability contexts. Among the several techniques that are used in other fields, Shewart charts have been found in a few instances to be applicable in educational settings. This paper describes Shewart charts and gives examples of how…

  14. 46 CFR 232.3 - Chart of accounts.

    Science.gov (United States)

    2010-10-01

    ... stated in any revision to generally accepted accounting principles, the meaning of the latter shall... UNIFORM FINANCIAL REPORTING REQUIREMENTS § 232.3 Chart of accounts. (a) Purpose of accounts. A contractor shall use this chart of accounts as a guide for preparing the financial statements and for other...

  15. Reliability of FAMACHA© chart for the evaluation of anaemia in ...

    African Journals Online (AJOL)

    The reliability of FAMACHA© chart for identifying anaemic goats was compared with Packed Cell Volume (PCV). The colour of the lower eyelids was graded with FAMACHA© chart based on FAMACHA© scores (FS) of 1-5. The animals were scored from severely anaemic (white or FS 5) through moderately anaemic (pink or ...

  16. US Nuclear Regulatory Commission organization charts and functional statements

    International Nuclear Information System (INIS)

    1996-01-01

    This document is the US NRC organizational structure and chart as of July 1, 1996. It contains the org charts for the Commission, ACRS, ASLAB, Commission staff offices, Executive Director for Operations, Office of the Inspector General, Program offices, and regional offices

  17. Early concepts and charts of ocean circulation

    Science.gov (United States)

    Peterson, R. G.; Stramma, L.; Kortum, G.

    Charts of ocean currents from the late nineteenth century show that already by then the patterns of surface circulation in regions away from polar latitudes were well understood. This fundamental knowledge accumulated gradually through centuries of sea travel and had reached a state of near correctness by the time dedicated research cruises, full-depth measurements and the practical application of the dynamical method were being instituted. Perhaps because of the foregoing, many of the pioneering works, critical to establishing what the upper-level circulation is like, the majority of the charts accompanying them, and several of the groundbreaking theoretical treatments on the physics of currents, are only poorly known to present-day oceanographers. In this paper we trace Western developments in knowledge and understanding of ocean circulation from the earliest times to the late-1800s transition into the modern era. We also discuss certain peripheral advances that proved critical to the subject. The earliest known ideas, dating from the Bronze Age and described by Homer, necessarily reflect severe limitations to geographical knowledge, as well as basic human predilections toward conjecture and exaggeration in the face of inadequate information. People considered the earth to be flat and circular, with the ocean flowing like a river around it. They also believed in horrific whirlpools, a concept that persisted into the Renaissance and which would later provide subject material for modern literature. From the Greek Classical Age, we find hydrologic theories of Earth's interior being laced with subterranean channels (Socrates) and all motion deriving from a divine force forever propelling the heavens toward the west, the primum mobile (Aristotle). These ideas, particularly the latter, dominated opinions about ocean circulation into the late Renaissance. By late Antiquity mariners had very likely acquired intimate knowledge of coastal currents in the Mediterranean, but

  18. Designing new UK-WHO growth charts: implications for health staff use and understanding of charts and growth monitoring.

    Science.gov (United States)

    Wright, Charlotte M; Sachs, Magda; Short, John; Sharp, Laura; Cameron, Kirsty; Moy, Robert J

    2012-07-01

    New pre-school UK charts have been produced incorporating the new World Health Organization growth standards based on healthy breastfed infants. This paper describes the process by which the charts and evidence-based instructions were designed and evaluated, and what it revealed about professional understanding of charts and growth monitoring. A multidisciplinary expert group drew on existing literature, new data analyses and parent focus groups as well as two series of chart-plotting workshops for health staff. The first series explored possible design features and general chart understanding. The second evaluated an advanced prototype with instructions, using plotting and interpretation of three separate scenarios on the old charts, compared with the new charts. The first plotting workshops (46 participants) allowed decisions to be made about the exact chart format, but it also revealed widespread confusion about use of adjustment for gestation and the plotting of birthweight. In the second series (78 participants), high levels of plotting inaccuracy were identified on both chart formats, with 64% of respondents making at least one major mistake. Significant neonatal weight loss was poorly recognized. While most participants recognized abnormal and normal growth patterns, 13-20% did not. Many respondents had never received any formal training in chart use. Growth charts are complex clinical tools that are, at present, poorly understood and inconsistently used. The importance of clear guidelines and formal training has now been recognized and translated into supporting educational materials (free to download at http://www.growthcharts.rcpch.ac.uk). © 2011 Blackwell Publishing Ltd.

  19. New body composition reference charts for preterm infants.

    Science.gov (United States)

    Demerath, Ellen W; Johnson, William; Davern, Bridget A; Anderson, Christina G; Shenberger, Jeffrey S; Misra, Sonya; Ramel, Sara E

    2017-01-01

    The American Academy of Pediatrics (AAP) has recommended that nutritional management of the preterm infant should aim to achieve body composition that replicates the in utero fetus, but intrauterine body composition reference charts for preterm infants are lacking. Our objective was to create body composition reference curves for preterm infants that approximate the body composition of the in utero fetus from 30 to 36 wk of gestation. A total of 223 ethnically diverse infants born at 30 + 0 to 36 + 6 wk of gestation were enrolled. Inclusion and exclusion criteria were specified so that the sample would represent healthy appropriately growing fetuses (e.g., singleton, birth weight appropriate for their gestational age, and medically stable). Cross-sectional reference values were generated for fat mass (FM), fat-free mass (FFM), and percentage body fat (PBF) by gestational age (GA), with the use of air-displacement plethysmography (ADP) and the lambda-mu-sigma method for percentile estimation. GA-specific percentile values and a percentile and z score calculator for FFM, FM, and PBF are presented. These values aligned closely with ADP centile values published for term infants from 36 to 38 wk of gestation. The medians were also similar to the mean values for the reference fetus derived from chemical analysis previously. To our knowledge, these are the first body composition reference charts for total FM and FFM at birth in preterm infants to assist in following AAP guidelines. Future work will test the clinical utility of body composition monitoring for improving nutritional management in this population. This trial was registered at clinicaltrials.gov as NCT02855814. © 2017 American Society for Nutrition.

  20. The effectiveness of robust RMCD control chart as outliers’ detector

    Science.gov (United States)

    Darmanto; Astutik, Suci

    2017-12-01

    A well-known control chart to monitor a multivariate process is Hotelling’s T 2 which its parameters are estimated classically, very sensitive and also marred by masking and swamping of outliers data effect. To overcome these situation, robust estimators are strongly recommended. One of robust estimators is re-weighted minimum covariance determinant (RMCD) which has robust characteristics as same as MCD. In this paper, the effectiveness term is accuracy of the RMCD control chart in detecting outliers as real outliers. In other word, how effectively this control chart can identify and remove masking and swamping effects of outliers. We assessed the effectiveness the robust control chart based on simulation by considering different scenarios: n sample sizes, proportion of outliers, number of p quality characteristics. We found that in some scenarios, this RMCD robust control chart works effectively.

  1. Comparing Resident Self-Report to Chart Audits for Quality Improvement Projects: Accurate Reflection or Cherry-Picking?

    Science.gov (United States)

    Kuperman, Ethan F; Tobin, Kristen; Kraschnewski, Jennifer L

    2014-12-01

    Resident engagement in quality improvement is a requirement for graduate medical education, but the optimal means of instruction and evaluation of resident progress remain unknown. To determine the accuracy of self-reported chart audits in measuring resident adherence to primary care clinical practice guidelines. During the 2010-2011 academic year, second- and third-year internal medicine residents at a single, university hospital-based program performed chart audits on 10 patients from their primary care clinic to determine adherence to 16 US Preventive Services Task Force primary care guidelines. We compared residents' responses to independent audits of randomly selected patient charts by a single external reviewer. Self-reported data were collected by 18 second-year and 15 third-year residents for 330 patients. Independently, 70 patient charts were randomly selected for review by an external auditor. Overall guideline compliance was significantly higher on self-reported audits compared to external audits (82% versus 68%, P self-reported data. Although third-year residents self-reported higher guideline adherence than second-year residents (86% versus 78%, P self-reported chart audits may significantly overestimate guideline adherence. Increased supervision and independent review appear necessary to accurately evaluate resident performance.

  2. Pathway-based analysis tools for complex diseases: a review.

    Science.gov (United States)

    Jin, Lv; Zuo, Xiao-Yu; Su, Wei-Yang; Zhao, Xiao-Lei; Yuan, Man-Qiong; Han, Li-Zhen; Zhao, Xiang; Chen, Ye-Da; Rao, Shao-Qi

    2014-10-01

    Genetic studies are traditionally based on single-gene analysis. The use of these analyses can pose tremendous challenges for elucidating complicated genetic interplays involved in complex human diseases. Modern pathway-based analysis provides a technique, which allows a comprehensive understanding of the molecular mechanisms underlying complex diseases. Extensive studies utilizing the methods and applications for pathway-based analysis have significantly advanced our capacity to explore large-scale omics data, which has rapidly accumulated in biomedical fields. This article is a comprehensive review of the pathway-based analysis methods-the powerful methods with the potential to uncover the biological depths of the complex diseases. The general concepts and procedures for the pathway-based analysis methods are introduced and then, a comprehensive review of the major approaches for this analysis is presented. In addition, a list of available pathway-based analysis software and databases is provided. Finally, future directions and challenges for the methodological development and applications of pathway-based analysis techniques are discussed. This review will provide a useful guide to dissect complex diseases. Copyright © 2014 The Authors. Production and hosting by Elsevier Ltd.. All rights reserved.

  3. Book Review Geostatistical Analysis of Compositional Data

    Energy Technology Data Exchange (ETDEWEB)

    Carle, S F

    2007-03-26

    Compositional data are represented as vector variables with individual vector components ranging between zero and a positive maximum value representing a constant sum constraint, usually unity (or 100 percent). The earth sciences are flooded with spatial distributions of compositional data, such as concentrations of major ion constituents in natural waters (e.g. mole, mass, or volume fractions), mineral percentages, ore grades, or proportions of mutually exclusive categories (e.g. a water-oil-rock system). While geostatistical techniques have become popular in earth science applications since the 1970s, very little attention has been paid to the unique mathematical properties of geostatistical formulations involving compositional variables. The book 'Geostatistical Analysis of Compositional Data' by Vera Pawlowsky-Glahn and Ricardo Olea (Oxford University Press, 2004), unlike any previous book on geostatistics, directly confronts the mathematical difficulties inherent to applying geostatistics to compositional variables. The book righteously justifies itself with prodigious referencing to previous work addressing nonsensical ranges of estimated values and error, spurious correlation, and singular cross-covariance matrices.

  4. 78 FR 4477 - Review of Safety Analysis Reports for Nuclear Power Plants, Introduction

    Science.gov (United States)

    2013-01-22

    ... COMMISSION Review of Safety Analysis Reports for Nuclear Power Plants, Introduction AGENCY: Nuclear... subsection to NUREG-0800, ``Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power..., Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power Plants: Integral...

  5. Analytical and Numerical Design Analysis of Concentric Tube Heat Exchangers – A Review

    Science.gov (United States)

    Silaipillayarputhur, Karthik; Mughanam, Tawfiq Al; Mojil, Abdulaziz Al; Dhmoush, Mohammed Al

    2017-12-01

    This paper considers an analytical and a numerical approach in the design of a concentric tube heat exchanger. Sensible heat transfer is considered in the analysis and the heat exchanger is developed for actual operating conditions in a chemical plant. The heat exchanger is a concentric tube heat exchanger where hot oil exchanges heat with hot water. Hot oil is in the inner pipe and the heating medium, hot water, is in the outer pipe (annular side) of the heat exchanger. An analytical model employing effectiveness-number of transfer units (ε-NTU) approach and log mean temperature difference (LMTD) approach were employed in the design of the concentric tube heat exchanger. In the design process, performance charts were developed for concentric tube heat exchanger. Performance charts describe the performance of the heat exchanger in terms of crucial dimensionless parameters. Performance charts help to select the right number of transfer units (NTU) for the given heat exchanger. Both parallel and counter flow configurations were considered for the design analysis. Likewise, a numerical model was also considered in the design of the heat exchanger. The results from the analysis are presented and compared. From the results it can be seen that both numerical and analytical approaches produce the exact same results. The designer certainly has the flexibility to choose an appropriate design methodology based on the available inputs and requirements.

  6. Ethical and legal questions as regards filling out dental clinical charts

    Directory of Open Access Journals (Sweden)

    Mauro Henrique Nogueira Guimarãe de Abreu

    Full Text Available Objective: Evaluate imperfections in filling out dental clinical history charts of patients attended at the “Universidade Estadual de Montes Claros – Unimontes”, in 2005, from the ethical and legal aspects. Method: Descriptive statistical analysis, Pearson’s correlation, Chi-Square test (p<0.05 with Bonferroni correction in a contingency table (p<0.003 tests were performed, and Anova – Tukey (p<0.05 were calculate using SPSS software. This study was conducted using 881 clinical history charts of 19 subjects. Results: The highest percentage of charts concerned Stomatology (12% and 8 th period of the course (25%. The majority (63.3% of chartshad fields left blank and in 68% the handwriting was illegible. Unjustifiable erasures were found in 74.7% of charts. The majority of charts (98% were filled out in ink. The treatment plan was signed by course tutor in 83% of the cases. The term of consent was signed in the 94.9 % of the charts. As regards mistakes, 5.1% of documents had one error; 42% two errors; 23.5% three or more errors (average 1.89(± 0.9; percentile 25%=1; 50%=2 and 75%=2. The difference in the proportion of errors as regards filling out all fields differed statistically among the periods (p<0.05. Conclusion: It was concluded that an alarming number of documents were filled out incorrectly. The worst filling out performance was shown in the 5th, 6th and 7th periods (p<0.05.

  7. Advances in growth chart design and use: the UK experience.

    Science.gov (United States)

    Wright, Charlotte M; Williams, Anthony F; Cole, Tim J

    2013-01-01

    As part of the process of adopting the WHO standard in the United Kingdom, the Royal College of Paediatrics and Child Health (RCPCH) was commissioned by the UK Department of Health to design new UK-WHO growth charts. The working group for this project combined expertise ranging from statistics and graphic design to qualitative research, as well as paediatrics, nursing and dietetics. New charts for children under 4 years were published in 2009 and are now widely used in the UK and beyond (www.growthcharts.rcpch.ac.uk). This paper will describe what we have learned in general about the process of designing charts and how these principles were applied to the design of a novel chart designed specifically for sick and premature infants. A successful design first requires clarity about the exact purpose of the chart and who will use it. The layout of the chart can then be varied in many ways to fit that use and ensure users are not misled. Users need consistent and well-evidenced rules for chart use. Drafting the instructions serves as a powerful test of the validity and clarity of the design. However, charts need also to be formally evaluated, as expert views will not reflect those of the average user. The Neonatal and Infant Close Monitoring (NICM) chart included various novel design features, including date boxes for gestational age adjustment and low SD lines to help assess very small infants. It was evaluated at three stages using plotting exercises and each phase led to substantial design changes. Growth charts are conceptually very complex, with the capacity to mislead as well as inform and should always be formally evaluated before implementation. Copyright © 2013 S. Karger AG, Basel.

  8. Management implementation plan for a safety analysis and review system

    International Nuclear Information System (INIS)

    Hulburt, D.A.; Berkey, B.D.

    1981-04-01

    The US Department of Energy has issued an Order, DOE 5481.1, which establishes uniform requirements for the preparation and review of Safety Analysis for DOE Operations. The Management Implementation Plan specified herein establishes the administrative procedures and technical requirements for implementing DOE 5481.1 to Operations under the cognizance of the Pittsburgh Energy Technology Center. This Implementation Plan is applicable to all present and future Operations under the cognizance of PETC. The Plan identifies those Operations for which DOE 5481.1 is applicable and those Operations for which no further analysis is required because the initial determination and review has concluded that DOE 5481.1 does not apply

  9. Structural Reliability Analysis of Wind Turbines: A Review

    Directory of Open Access Journals (Sweden)

    Zhiyu Jiang

    2017-12-01

    Full Text Available The paper presents a detailed review of the state-of-the-art research activities on structural reliability analysis of wind turbines between the 1990s and 2017. We describe the reliability methods including the first- and second-order reliability methods and the simulation reliability methods and show the procedure for and application areas of structural reliability analysis of wind turbines. Further, we critically review the various structural reliability studies on rotor blades, bottom-fixed support structures, floating systems and mechanical and electrical components. Finally, future applications of structural reliability methods to wind turbine designs are discussed.

  10. Moral Matters: De-Romanticising Worker Agency and Charting Future Directions for Labour Geography

    OpenAIRE

    Hastings, T.

    2016-01-01

    The rise of labour geography over the last 20 years has ensured that labour politics, worker rights and employment-related struggles have remained strong themes in economic geography. This article provides an updated review of labour geography's development, charting its expansion from an early focus on organised spatial ‘resistance’ at a range of scales, to a more varied project incorporating a wider range of analytical and empirical inquiries. Despite this progression the paper suggests tha...

  11. Automated metabolic gas analysis systems: a review.

    Science.gov (United States)

    Macfarlane, D J

    2001-01-01

    The use of automated metabolic gas analysis systems or metabolic measurement carts (MMC) in exercise studies is common throughout the industrialised world. They have become essential tools for diagnosing many hospital patients, especially those with cardiorespiratory disease. Moreover, the measurement of maximal oxygen uptake (VO2max) is routine for many athletes in fitness laboratories and has become a defacto standard in spite of its limitations. The development of metabolic carts has also facilitated the noninvasive determination of the lactate threshold and cardiac output, respiratory gas exchange kinetics, as well as studies of outdoor activities via small portable systems that often use telemetry. Although the fundamental principles behind the measurement of oxygen uptake (VO2) and carbon dioxide production (VCO2) have not changed, the techniques used have, and indeed, some have almost turned through a full circle. Early scientists often employed a manual Douglas bag method together with separate chemical analyses, but the need for faster and more efficient techniques fuelled the development of semi- and full-automated systems by private and commercial institutions. Yet, recently some scientists are returning back to the traditional Douglas bag or Tissot-spirometer methods, or are using less complex automated systems to not only save capital costs, but also to have greater control over the measurement process. Over the last 40 years, a considerable number of automated systems have been developed, with over a dozen commercial manufacturers producing in excess of 20 different automated systems. The validity and reliability of all these different systems is not well known, with relatively few independent studies having been published in this area. For comparative studies to be possible and to facilitate greater consistency of measurements in test-retest or longitudinal studies of individuals, further knowledge about the performance characteristics of these

  12. Charting the development of cognitive mapping.

    Science.gov (United States)

    Nazareth, Alina; Weisberg, Steven M; Margulis, Katherine; Newcombe, Nora S

    2018-06-01

    Developmental research beginning in the 1970s has suggested that children's ability to form cognitive maps reaches adult levels during early adolescence. However, this research has used a variety of testing procedures, often in real-world environments, which have been difficult to share widely across labs and to use to probe components of mapping, individual differences in success, and possible mechanisms of development and reasons for individual variation. In this study, we charted the development of cognitive mapping using a virtual navigation paradigm, Silcton, that allows for testing samples of substantial size in a uniform way and in which adults show marked individual differences in the formation of accurate route representations and/or in route integration. The current study tested children aged between 8 and 16 years. In terms of components of normative development, children's performance reached adult levels of proficiency at around age 12, but route representation progressed significantly more quickly than route integration. In terms of individual differences, by age 12 children could be grouped into the same three categories evident in adults: imprecise navigators (who form only imprecise ideas of routes), non-integrators (who represent routes more accurately but are imprecise in relating two routes), and integrators (who relate the two routes and, thus, form cognitive maps). Thus, individual differences likely originate during childhood. In terms of correlates, perspective-taking skills predicted navigation performance better than mental rotation skills, in accord with the view that perspective taking operates on extrinsic spatial representations, whereas mental rotation taps intrinsic spatial representations. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Reference chart of inspiratory muscle strength: a new tool to monitor the effect of pre-operative training.

    Science.gov (United States)

    van Buuren, S; Hulzebos, E H J; Valkenet, K; Lindeman, E; van Meeteren, N L U

    2014-06-01

    To develop a reference chart to monitor inspiratory muscle strength during pre-operative inspiratory muscle training for patients at high risk of developing postoperative pulmonary complications awaiting coronary artery bypass graft (CABG) surgery. Secondary data analysis using patients from the intervention arm of a randomised clinical trial. University medical centre. Patients at high risk of developing postoperative pulmonary complications awaiting CABG surgery. Patients performed inspiratory muscle training seven times per week for at least 2 weeks before surgery. Maximal inspiratory muscle strength. A new reference chart was produced using a non-linear time trend model with a normal error structure. The chart is a novel tool for monitoring the progress of inspiratory muscle training for physiotherapy practice. Wider use of this chart is recommended. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  14. Synthetic-type control charts for time-between-events monitoring.

    Science.gov (United States)

    Yen, Fang Yen; Chong, Khoo Michael Boon; Ha, Lee Ming

    2013-01-01

    This paper proposes three synthetic-type control charts to monitor the mean time-between-events of a homogenous Poisson process. The first proposed chart combines an Erlang (cumulative time between events, Tr ) chart and a conforming run length (CRL) chart, denoted as Synth-Tr chart. The second proposed chart combines an exponential (or T) chart and a group conforming run length (GCRL) chart, denoted as GR-T chart. The third proposed chart combines an Erlang chart and a GCRL chart, denoted as GR-Tr chart. By using a Markov chain approach, the zero- and steady-state average number of observations to signal (ANOS) of the proposed charts are obtained, in order to evaluate the performance of the three charts. The optimal design of the proposed charts is shown in this paper. The proposed charts are superior to the existing T chart, Tr chart, and Synth-T chart. As compared to the EWMA-T chart, the GR-T chart performs better in detecting large shifts, in terms of the zero- and steady-state performances. The zero-state Synth-T4 and GR-Tr (r = 3 or 4) charts outperform the EWMA-T chart for all shifts, whereas the Synth-Tr (r = 2 or 3) and GR-T 2 charts perform better for moderate to large shifts. For the steady-state process, the Synth-Tr and GR-Tr charts are more efficient than the EWMA-T chart in detecting small to moderate shifts.

  15. Synthetic-type control charts for time-between-events monitoring.

    Directory of Open Access Journals (Sweden)

    Fang Yen Yen

    Full Text Available This paper proposes three synthetic-type control charts to monitor the mean time-between-events of a homogenous Poisson process. The first proposed chart combines an Erlang (cumulative time between events, Tr chart and a conforming run length (CRL chart, denoted as Synth-Tr chart. The second proposed chart combines an exponential (or T chart and a group conforming run length (GCRL chart, denoted as GR-T chart. The third proposed chart combines an Erlang chart and a GCRL chart, denoted as GR-Tr chart. By using a Markov chain approach, the zero- and steady-state average number of observations to signal (ANOS of the proposed charts are obtained, in order to evaluate the performance of the three charts. The optimal design of the proposed charts is shown in this paper. The proposed charts are superior to the existing T chart, Tr chart, and Synth-T chart. As compared to the EWMA-T chart, the GR-T chart performs better in detecting large shifts, in terms of the zero- and steady-state performances. The zero-state Synth-T4 and GR-Tr (r = 3 or 4 charts outperform the EWMA-T chart for all shifts, whereas the Synth-Tr (r = 2 or 3 and GR-T 2 charts perform better for moderate to large shifts. For the steady-state process, the Synth-Tr and GR-Tr charts are more efficient than the EWMA-T chart in detecting small to moderate shifts.

  16. A randomised multicentre trial of CHART versus conventional radiotherapy in head and neck cancer

    International Nuclear Information System (INIS)

    Dische, Stanley; Saunders, Michele; Barrett, Ann; Harvey, Angela; Gibson, Della; Parmar, Mahesh

    1997-01-01

    Background and purpose: Continuous, hyperfractionated, accelerated radiotherapy (CHART) has shown promise of improved tumour control and reduced late morbidity in pilot studies and has now been tested in a multicentre randomised controlled clinical trial. Material and methods: Patients with squamous cell cancer in the main sites within the head and neck region with the general exception of early T1 N0 tumours were entered into the study by 11 centres. There was a 3:2 randomisation to either CHART, where a dose of 54 Gy was given in 36 fractions over 12 days, or to conventional therapy where 66 Gy was given in 33 fractions over 6.5 weeks. A total of 918 patients were included over a 5 year period from March 1990. Results: Acute Morbidity: Acute radiation mucositis was more severe with CHART, occurred earlier but settled sooner and was in nearly all cases healed by 8 weeks in both arms. Skin reactions were less severe and settled more quickly in the CHART treated patients. Tumour control and survival: Life table analyses of loco-regional control, primary tumour control, nodal control, disease-free interval, freedom from metastasis and survival showed no evidence of differences between the two arms. In exploratory subgroup analyses there was evidence of a greater response to CHART in younger patients (P = 0.041) and poorly differentiated tumours appeared to fare better with conventional radiotherapy (P = 0.030). In the larynx there was evidence of a trend towards increasing benefit with more advanced T stage (P = 0.002). Late treatment related morbidity: Osteoradionecrosis occurred in 0.4% of patients after CHART and 1.4% of patients after conventional radiotherapy. The incidence of chondritis or cartilage necrosis was similar in both arms. Life table analysis showed evidence of reduced severity in a number of late morbidities in favour of CHART. These were most striking for skin telangiectasia, superficial and deep ulceration of the mucosa and laryngeal oedema

  17. Peer review of strategic analysis of material accounting

    International Nuclear Information System (INIS)

    Opelka, J.H.; Bennett, C.A.; Goldman, A.J.; Higinbotham, W.A.; Jaech, J.L.; Lucas, W.F.; Lumb, R.F.

    1979-01-01

    A Peer Review Group knowledgeable about game theory and safeguards was organized to assess the utility of strategic analysis for analyzing inventory differences in particular and safeguards events in general. The group concluded that game theory may provide a useful basis for arriving at safeguards decisions, and could be a complementary--not alternative--tool to statistical analysis. The group recommended further development of game theory in areas of potential application

  18. Atomic spectrometry update : a review of advances in environmental analysis

    OpenAIRE

    Butler, Owen T.; Cairns, Warren R. L.; Cook, Jennifer M.; Davidson, Christine M.

    2016-01-01

    This is the 31st annual review of the application of atomic spectrometry to the chemical analysis of environmental samples. This update refers to papers published approximately between August 2014 and July 2015 and continues the series of Atomic Spectrometry Updates (ASUs) in Environmental Analysis that should be read in conjunction with other related ASUs in the series, namely: clinical and biological materials, foods and beverages; advances in atomic spectrometry and related techniques; ele...

  19. Review of applications of Bayesian meta-analysis in systematic reviews

    Directory of Open Access Journals (Sweden)

    Melissa Glenda Lewis

    2015-01-01

    Full Text Available Background: Systematic reviews are important sources of evidence in health care research. These reviews may or may not include meta-analysis as a statistical assimilation of the results of several studies in order to acquire a pooled estimate. Systematic review with meta-analysis is considered as a robust method of evidence synthesis. The methodology concerned with traditional meta-analysis does not incorporate external prior information. Hence, Bayesian methods are essential due to the natural process of incorporating the past information and updating the belief. Bayesian methods to meta-analysis have been developed with a motivation from the limitations of traditional meta-analysis such as dealing with missing data, problem with limited number of studies and problem with sparse event data in both the groups. The present article aims to unearth as to what extent Bayesian methods have been used in systematic reviews, evolution and its applications. This article also highlights the existing challenges and opportunities. Methods: The literature search was performed in databases such as Cochrane, PubMed, ProQuest and Scopus using the keywords “Bayesian Meta-analysis” and “Bayesian Meta-analyses”. All the methodology and application oriented papers specific to Bayesian meta-analysis were considered relevant for this review. Conclusion: Bayesian meta-analysis has gained popularity in the field of evidence synthesis of clinical trials. However, it did not pick up momentum in summarizing public health interventions, owing to the fact that public health interventions are targeted to highly heterogeneous population, multi-component interventions, and multiple outcomes and influenced by the context

  20. Periodic safety review of the HTR-10 safety analysis

    International Nuclear Information System (INIS)

    Chen Fubing; Zheng Yanhua; Shi Lei; Li Fu

    2015-01-01

    Designed by the Institute of Nuclear and New Energy Technology (INET) of Tsinghua University, the 10 MW High Temperature Gas-cooled Reactor-Test Module (HTR-10) is the first modular High Temperature Gas-cooled Reactor (HTGR) in China. According to the nuclear safety regulations of China, the periodic safety review (PSR) of the HTR-10 was initiated by INET after approved by the National Nuclear Safety Administration (NNSA) of China. Safety analysis of the HTR-10 is one of the key safety factors of the PSR. In this paper, the main contents in the review of safety analysis are summarized; meanwhile, the internal evaluation on the review results is presented by INET. (authors)

  1. Cancer Nursing Education: Literature Review and Documentary Analysis.

    Science.gov (United States)

    Langton, Helen; Blunden, Gillian; Hek, Gill

    The knowledge and skills needed by cancer nurses and the content and strategies of England's existing cancer nursing education programs were examined. The study included a comprehensive literature review and an analysis of course documents from selected English National Board-approved post-qualifying cancer nursing and palliative care courses…

  2. Quantitative Analysis of Complex Tropical Forest Stands: A Review ...

    African Journals Online (AJOL)

    FIRST LADY

    Disciplinary Journal, Ethiopia. Vol. 4 (3a) July, 2010. ISSN 1994-9057 (Print). ISSN 2070-0083 (Online). Quantitative Analysis of Complex Tropical Forest. Stands: A Review (Pp. 367-377). Oyebade, B. A. - Forest Biometrics & Measurement Unit, ...

  3. Acoustic Analysis of Voice in Singers: A Systematic Review

    Science.gov (United States)

    Gunjawate, Dhanshree R.; Ravi, Rohit; Bellur, Rajashekhar

    2018-01-01

    Purpose: Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers. Method: A…

  4. A Review of Citation Analysis Methodologies for Collection Management

    Science.gov (United States)

    Hoffmann, Kristin; Doucette, Lise

    2012-01-01

    While there is a considerable body of literature that presents the results of citation analysis studies, most researchers do not provide enough detail in their methodology to reproduce the study, nor do they provide rationale for methodological decisions. In this paper, we review the methodologies used in 34 recent articles that present a…

  5. Astronomical Books and Charts in the Book of Bibliographie Coreenne

    Directory of Open Access Journals (Sweden)

    Ki-Won Lee

    2008-06-01

    Full Text Available We investigate astronomical materials listed in the book of Bibliographie Coreenne written by Maurice Courant. He classified ancient Korean books into nine Divisions (部 and thirty six Classes (類, and published them as three volumes (ranging from 1894 to 1896 and one supplement (in 1901. In total, 3,821 books including astronomical ones are listed together with information on physical size, possessional place, bibliographical note, and so forth. Although this book is an essential one in the field of Korea bibliography and contains many astronomical materials such as Cheon-Mun-Ryu-Cho 天文類抄, Si-Heon-Seo 時憲書, and Cheon-Sang-Yeol-Cha-Bun-Ya-Ji-Do 天象列次分野之圖, it has not been well known to the public nor to astronomical society. Of 3,821 catalogues, we found that about 50 Items (種 are related to astronomy or astrology, and verified that most of them are located in the Kyujanggak Royal Library 奎章閣. We also found an unknown astronomical chart, Hon-Cheon-Chong-Seong-Yeol-Cha-Bun-Ya-Ji-Do 渾天總星列次分野之圖. Because those astronomical materials are not well known to international astronomical community and there have been few studies on the materials in Korea, we here introduce and review them, particularly with the astronomical viewpoint.

  6. Astronomical Books and Charts in the Book of Bibliographie Coreenne

    Science.gov (United States)

    Lee, Ki-Won; Yang, Hong-Jin; Park, Myeong-Gu

    2008-06-01

    We investigate astronomical materials listed in the book of Bibliographie Coréenne written by Maurice Courant. He classified ancient Korean books into nine Divisions (?) and thirty six Classes (?), and published them as three volumes (ranging from 1894 to 1896) and one supplement (in 1901). In total, 3,821 books including astronomical ones are listed together with information on physical size, possessional place, bibliographical note, and so forth. Although this book is an essential one in the field of Korea bibliography and contains many astronomical materials such as Cheon-Mun-Ryu-Cho ????, Si-Heon-Seo ??????, and Cheon-Sang-Yeol-Cha-Bun-Ya-Ji-Do ????????, it has not been well known to the public nor to astronomical society. Of 3,821 catalogues, we found that about 50 Items (?) are related to astronomy or astrology, and verified that most ! of them are located in the Kyujanggak Royal Library ???. We also found an unknown astronomical chart, Hon-Cheon-Chong-Seong-Yeol-Cha-Bun-Ya-Ji-Do ??????????. Because those astronomical materials are not well known to international astronomical community and there have been few studies on the materials in Korea, we here introduce and review them, particularly with the astronomical viewpoint.

  7. Tactile Acuity Charts: A Reliable Measure of Spatial Acuity

    Science.gov (United States)

    Bruns, Patrick; Camargo, Carlos J.; Campanella, Humberto; Esteve, Jaume; Dinse, Hubert R.; Röder, Brigitte

    2014-01-01

    For assessing tactile spatial resolution it has recently been recommended to use tactile acuity charts which follow the design principles of the Snellen letter charts for visual acuity and involve active touch. However, it is currently unknown whether acuity thresholds obtained with this newly developed psychophysical procedure are in accordance with established measures of tactile acuity that involve passive contact with fixed duration and control of contact force. Here we directly compared tactile acuity thresholds obtained with the acuity charts to traditional two-point and grating orientation thresholds in a group of young healthy adults. For this purpose, two types of charts, using either Braille-like dot patterns or embossed Landolt rings with different orientations, were adapted from previous studies. Measurements with the two types of charts were equivalent, but generally more reliable with the dot pattern chart. A comparison with the two-point and grating orientation task data showed that the test-retest reliability of the acuity chart measurements after one week was superior to that of the passive methods. Individual thresholds obtained with the acuity charts agreed reasonably with the grating orientation threshold, but less so with the two-point threshold that yielded relatively distinct acuity estimates compared to the other methods. This potentially considerable amount of mismatch between different measures of tactile acuity suggests that tactile spatial resolution is a complex entity that should ideally be measured with different methods in parallel. The simple test procedure and high reliability of the acuity charts makes them a promising complement and alternative to the traditional two-point and grating orientation thresholds. PMID:24504346

  8. [Growth charts: Impact on the prevalence of nutritional disorders].

    Science.gov (United States)

    Polo Martín, P; Abellan, J J; Nájar Godoy, M I; Álvarez de Laviada Mulero, T

    2015-05-01

    The references used to assess child growth in Spain are the graphs of the Orbegozo Foundation and the charts of the World Health Organization (WHO). The objective of this study is to analyze the differences between the two charts for weight, height and body mass index, and assess their relevance to identify growth or nutritional problems. The values of the extreme percentiles of height, weight and body mass index for each sex from 0 to 10 years in both charts are compared. For each value Absolute differences and Z scores are calculated for each value. To evaluate the impact on the prevalence of the various nutritional or growth disorders the location of the value of the respective percentiles of in each of the charts were assessed. Significant differences were observed between the 3th percentile of height and weight, 97th of weight, and 85th and 97th of body mass index. Marked differences were observed for the extreme values of body mass index. During the first years, the Orbegozo charts overestimate the prevalence of malnutrition (between 2% and 19% depending on age and sex) compared to the WHO charts. In subsequent ages Orbegozo underestimates WHO between 0.7% and 2.89%. Orbegozo underestimates the prevalence of overweight (between 2.5% and 14.8%) compared to the WHO charts. The 97th percentile of Body mass index in the Orbegozo charts corresponds in most cases with WHO percentiles above 99.99%. The two charts analyzed have significant differences from a clinical and the public health point of view, in the estimation of overweight/obesity and malnutrition. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  9. Tactile acuity charts: a reliable measure of spatial acuity.

    Directory of Open Access Journals (Sweden)

    Patrick Bruns

    Full Text Available For assessing tactile spatial resolution it has recently been recommended to use tactile acuity charts which follow the design principles of the Snellen letter charts for visual acuity and involve active touch. However, it is currently unknown whether acuity thresholds obtained with this newly developed psychophysical procedure are in accordance with established measures of tactile acuity that involve passive contact with fixed duration and control of contact force. Here we directly compared tactile acuity thresholds obtained with the acuity charts to traditional two-point and grating orientation thresholds in a group of young healthy adults. For this purpose, two types of charts, using either Braille-like dot patterns or embossed Landolt rings with different orientations, were adapted from previous studies. Measurements with the two types of charts were equivalent, but generally more reliable with the dot pattern chart. A comparison with the two-point and grating orientation task data showed that the test-retest reliability of the acuity chart measurements after one week was superior to that of the passive methods. Individual thresholds obtained with the acuity charts agreed reasonably with the grating orientation threshold, but less so with the two-point threshold that yielded relatively distinct acuity estimates compared to the other methods. This potentially considerable amount of mismatch between different measures of tactile acuity suggests that tactile spatial resolution is a complex entity that should ideally be measured with different methods in parallel. The simple test procedure and high reliability of the acuity charts makes them a promising complement and alternative to the traditional two-point and grating orientation thresholds.

  10. Tactile acuity charts: a reliable measure of spatial acuity.

    Science.gov (United States)

    Bruns, Patrick; Camargo, Carlos J; Campanella, Humberto; Esteve, Jaume; Dinse, Hubert R; Röder, Brigitte

    2014-01-01

    For assessing tactile spatial resolution it has recently been recommended to use tactile acuity charts which follow the design principles of the Snellen letter charts for visual acuity and involve active touch. However, it is currently unknown whether acuity thresholds obtained with this newly developed psychophysical procedure are in accordance with established measures of tactile acuity that involve passive contact with fixed duration and control of contact force. Here we directly compared tactile acuity thresholds obtained with the acuity charts to traditional two-point and grating orientation thresholds in a group of young healthy adults. For this purpose, two types of charts, using either Braille-like dot patterns or embossed Landolt rings with different orientations, were adapted from previous studies. Measurements with the two types of charts were equivalent, but generally more reliable with the dot pattern chart. A comparison with the two-point and grating orientation task data showed that the test-retest reliability of the acuity chart measurements after one week was superior to that of the passive methods. Individual thresholds obtained with the acuity charts agreed reasonably with the grating orientation threshold, but less so with the two-point threshold that yielded relatively distinct acuity estimates compared to the other methods. This potentially considerable amount of mismatch between different measures of tactile acuity suggests that tactile spatial resolution is a complex entity that should ideally be measured with different methods in parallel. The simple test procedure and high reliability of the acuity charts makes them a promising complement and alternative to the traditional two-point and grating orientation thresholds.

  11. Create dynamic charts in Microsoft Office Excel 2007 and beyond

    CERN Document Server

    Scheck, Reinhold

    2009-01-01

    Extend your Excel 2007 skills-and create more-powerful and compelling charts in less time. Guided by an Excel expert, you'll learn how to turn flat, static charts into dynamic solutions-where you can visualize and manipulate data countless ways with a simple mouse click. Get the hands-on practice and examples you need to produce your own, professional-quality results. No programming required! Maximize the impact of your ideas and data! Learn how your design decisions affect perception and comprehensionMatch the right chart type to your communication objectiveVisualize-then build-your solut

  12. Standard review plan for reviewing safety analysis reports for dry metallic spent fuel storage casks

    International Nuclear Information System (INIS)

    1988-01-01

    The Cask Standard Review Plan (CSRP) has been prepared as guidance to be used in the review of Cask Safety Analysis Reports (CSARs) for storage packages. The principal purpose of the CSRP is to assure the quality and uniformity of storage cask reviews and to present a well-defined base from which to evaluate proposed changes in the scope and requirements of reviews. The CSRP also sets forth solutions and approaches determined to be acceptable in the past by the NRC staff in dealing with a specific safety issue or safety-related design area. These solutions and approaches are presented in this form so that reviewers can take consistent and well-understood positions as the same safety issues arise in future cases. An applicant submitting a CSAR does not have to follow the solutions or approaches presented in the CSRP. However, applicants should recognize that the NRC staff has spent substantial time and effort in reviewing and developing their positions for the issues. A corresponding amount of time and effort will probably be required to review and accept new or different solutions and approaches

  13. Topic Modeling in Sentiment Analysis: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Toqir Ahmad Rana

    2016-06-01

    Full Text Available With the expansion and acceptance of Word Wide Web, sentiment analysis has become progressively popular research area in information retrieval and web data analysis. Due to the huge amount of user-generated contents over blogs, forums, social media, etc., sentiment analysis has attracted researchers both in academia and industry, since it deals with the extraction of opinions and sentiments. In this paper, we have presented a review of topic modeling, especially LDA-based techniques, in sentiment analysis. We have presented a detailed analysis of diverse approaches and techniques, and compared the accuracy of different systems among them. The results of different approaches have been summarized, analyzed and presented in a sophisticated fashion. This is the really effort to explore different topic modeling techniques in the capacity of sentiment analysis and imparting a comprehensive comparison among them.

  14. Nursing diagnoses: factors affecting their use in charting standardized care plans.

    Science.gov (United States)

    Lee, Ting-Ting

    2005-05-01

    The purpose of this study was to explore factors that may affect nurses' use of nursing diagnoses in charting standardized nursing care plans in their daily practice. Care plans have been viewed as providing a structured approach to the assessment, planning and delivery of patient care. Nonetheless, the challenge for many institutions is to help professional nursing staff refine their understanding of nursing diagnoses and charting skills, to identify patient problems and propose appropriate care plans. Twelve clinical nurses working at a medical center in Taiwan underwent one-on-one in-depth interviews from May to July 2000. Data analysis was based on Miles and Huberman's data reduction, data display, and a conclusion verification process to investigate the charting process. Nurses tended to match patient conditions to the designated nursing diagnoses, be unfamiliar with statements of related factors, use objective data to describe patient conditions, ignore descriptions of nursing goals, dutifully check interventions without always executing them, and choose the same evaluation to meet hospital requirements. These findings suggest that using educational programmes for enhancing nurses' ability to use nursing diagnoses and exploring the process of diagnostic reasoning would improve the quality of patient documentation. The trend in health care is to focus on chart audit to reveal indicators of quality of care. Therefore, the experience of nurses in this study could be applied to in-service training programmes by institutions that are replacing traditional, manually written care plans with a standardized care planning system, thus helping other nurses through this transition process.

  15. Seasonal ARMA-based SPC charts for anomaly detection: Application to emergency department systems

    KAUST Repository

    Kadri, Farid

    2015-10-22

    Monitoring complex production systems is primordial to ensure management, reliability and safety as well as maintaining the desired product quality. Early detection of emergent abnormal behaviour in monitored systems allows pre-emptive action to prevent more serious consequences, to improve system operations and to reduce manufacturing and/or service costs. This study reports the design of a new methodology for the detection of abnormal situations based on the integration of time-series analysis models and statistical process control (SPC) tools for the joint development of a monitoring system to help supervising of the behaviour of emergency department services (EDs). The monitoring system developed is able to provide early alerts in the event of abnormal situations. The seasonal autoregressive moving average (SARMA)-based exponentially weighted moving average (EWMA) anomaly detection scheme proposed was successfully applied to the practical data collected from the database of the paediatric emergency department (PED) at Lille regional hospital centre, France. The method developed utilizes SARMA as a modelling framework and EWMA for anomaly detection. The EWMA control chart is applied to the uncorrelated residuals obtained from the SARMA model. The detection results of the EWMA chart are compared with two other commonly applied residual-based tests: a Shewhart individuals chart and a Cumulative Sum (CUSUM) control chart.

  16. Paediatric Northern Score centile charts for the chest radiograph in cystic fibrosis

    International Nuclear Information System (INIS)

    McCormick, J.; Conway, S.P.; Mehta, A.

    2007-01-01

    Aim: To create the first national centile charts for the chest radiograph Northern Score using the UK Cystic Fibrosis (CF) Database (UKCFD). Materials and methods: All active patients for 2002 from the UKCFD were analysed in 1-year cohorts from 0 to 18 years. Northern Score results from the annual review forms were used to construct centile lines for the 5th, 25th, 50th, 75th, 95th centiles. Results: There were 1806 patients with recorded Northern Score data for 2002 (927 male patients, male:female ratio 1.05). The centile chart demonstrates a quasi-linear rise throughout childhood. A Northern Score in excess of age in years equates to >95th centile in school-aged CF patients. Conclusion: This centile chart provides a disease-specific reference range for monitoring individual patients or for evaluating therapeutic change using the dominant chest radiograph scoring system in the UK. Patients, parents and clinicians may find these useful during the annual review process

  17. Activities. Patterns in the Hundred Chart--Part 1.

    Science.gov (United States)

    Ajose, Sunday

    1991-01-01

    An activity for grades 6-10 designed to allow students to explore a hundred chart to discover patterns is presented. Discussed are materials, objectives, and procedures. Three worksheets with answers are provided, and an extension activity is suggested. (CW)

  18. Grand Canyon VFR Chart - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — The Federal Aviation Administration (FAA) digital-Visual Chart series is designed to meet the needs of users who require georeferenced raster images of a FAA Visual...

  19. 76 FR 53530 - Government/Industry Aeronautical Charting Forum Meeting

    Science.gov (United States)

    2011-08-26

    ... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Government/Industry Aeronautical Charting Forum Meeting AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of public meeting. SUMMARY: This notice announces the bi-annual meeting of the Federal Aviation Administration (FAA...

  20. The new numbers contrast sensitivity chart for contrast sensitivity measurement

    Directory of Open Access Journals (Sweden)

    Bharkbhum Khambhiphant

    2011-10-01

    Conclusions: These charts show reasonable agreement and can be used interchangeably with the MARS. It is helpful for Thai people who can only read numbers in doing the test. We can use them in routinely contrast sensitivity measurement.

  1. System Behaviour Charts Inform an Understanding of Biodiversity Recovery

    Directory of Open Access Journals (Sweden)

    Simon A. Black

    2015-01-01

    Full Text Available Practitioners working with species and ecosystem recovery typically deal with the complexity of, on one hand, lack of data or data uncertainties and, on the other hand, demand for critical decision-making and intervention. The control chart methods of commercial and industrial and environmental monitoring can complement an ecological understanding of wildlife systems including those situations which incorporate human activities and land use. Systems Behaviour Charts are based upon well-established control chart methods to provide conservation managers with an approach to using existing data and enable insight to aid timely planning of conservation interventions and also complement and stimulate research into wider scientific and ecological questions. When the approach is applied to existing data sets in well-known wildlife conservation cases, the subsequent Systems Behaviour Charts and associated analytical criteria demonstrate insights which would be helpful in averting problems associated with each case example.

  2. Screening efficacy of a simplified logMAR chart

    Directory of Open Access Journals (Sweden)

    Naganathan Muthuramalingam

    2016-04-01

    Aim: This study evaluates the efficacy of a simplified logMAR chart, designed for VA testing over the conventional Snellen chart, in a school-based vision-screening programme. Methods: We designed a simplified logMAR chart by employing the principles of the Early Treatment Diabetic Retinopathy Study (ETDRS chart in terms of logarithmic letter size progression, inter-letter spacing, and inter-line spacing. Once the simplified logMAR chart was validated by students in the Elite school vision-screening programme, we set out to test the chart in 88 primary and middle schools in the Tiruporur block of Kancheepuram district in Tamil Nadu. One school teacher in each school was trained to screen a cross-sectional population of 10 354 primary and secondary school children (girls: 5488; boys: 4866 for VA deficits using a new, simplified logMAR algorithm. An experienced paediatric optometrist was recruited to validate the screening methods and technique used by the teachers to collect the data. Results: The optometrist screened a subset of 1300 school children from the total sample. The optometrist provided the professional insights needed to validate the clinical efficacy of the simplified logMAR algorithm and verified the reliability of the data collected by the teachers. The mean age of children sampled for validation was 8.6 years (range: 9–14 years. The sensitivity and the specificity of the simplified logMAR chart when compared to the standard logMAR chart were found to be 95% and 98%, respectively. Kappa value was 0.97. Sensitivity of the teachers’ screening was 66.63% (95% confidence interval [CI]: 52.73–77.02 and the specificity was 98.33% (95% CI: 97.49–98.95. Testing of VA was done under substandard illumination levels in 87% of the population. A total of 10 354 children were screened, 425 of whom were found to have some form of visual and/or ocular defect that was identified by the teacher or optometrist. Conclusion: The simplified logMAR testing algorithm

  3. 49 CFR 236.338 - Mechanical locking required in accordance with locking sheet and dog chart.

    Science.gov (United States)

    2010-10-01

    ... locking sheet and dog chart. 236.338 Section 236.338 Transportation Other Regulations Relating to... in accordance with locking sheet and dog chart. Mechanical locking shall be in accordance with locking sheet and dog chart currently in effect. ...

  4. Gulf of Mexico IFR Aeronautical Chart Index - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — The IFR Enroute Aeronautical Chart series is designed to meet the needs of users who require a digital version chart. This is the visual index to the charts for the...

  5. Shape Memory Alloy Isolation Valves: Public Quad Chart

    Science.gov (United States)

    2017-05-12

    NUMBER (Include area code) 12 May 2017 Briefing Charts 12 April 2017 - 12 May 2017 Shape Memory Alloy Isolation Valves: Public Quad Chart William...spacecraft (15+ yrs) • Shaped memory alloy isolation valves provide an intrinsically safe isolation system that increases lifetime >5x over SOTA and...Shape Memory Alloy Isolation Valves POC: W. Hargus, Ph.D., AFRL/RQRC B-52 Teardrop Antenna Depolymerization WC-130J Leading Edge Erosion Distribution

  6. Bivariate copulas on the exponentially weighted moving average control chart

    Directory of Open Access Journals (Sweden)

    Sasigarn Kuvattana

    2016-10-01

    Full Text Available This paper proposes four types of copulas on the Exponentially Weighted Moving Average (EWMA control chart when observations are from an exponential distribution using a Monte Carlo simulation approach. The performance of the control chart is based on the Average Run Length (ARL which is compared for each copula. Copula functions for specifying dependence between random variables are used and measured by Kendall’s tau. The results show that the Normal copula can be used for almost all shifts.

  7. Selected charts: National Waste Terminal Storage Program

    International Nuclear Information System (INIS)

    1977-01-01

    Staff members of the Office of Waste Isolation on October 21, 1977 reviewed the status of the OWI Waste Management Program for Commissioner E.E. Varanini III, State of California Energy Resources Conservation and Development Commission, and members of his staff. Copies of the viewgraphs and 35-mm slides shown at the briefing are compiled

  8. Hybrid soft computing systems for electromyographic signals analysis: a review

    Science.gov (United States)

    2014-01-01

    Electromyographic (EMG) is a bio-signal collected on human skeletal muscle. Analysis of EMG signals has been widely used to detect human movement intent, control various human-machine interfaces, diagnose neuromuscular diseases, and model neuromusculoskeletal system. With the advances of artificial intelligence and soft computing, many sophisticated techniques have been proposed for such purpose. Hybrid soft computing system (HSCS), the integration of these different techniques, aims to further improve the effectiveness, efficiency, and accuracy of EMG analysis. This paper reviews and compares key combinations of neural network, support vector machine, fuzzy logic, evolutionary computing, and swarm intelligence for EMG analysis. Our suggestions on the possible future development of HSCS in EMG analysis are also given in terms of basic soft computing techniques, further combination of these techniques, and their other applications in EMG analysis. PMID:24490979

  9. Transgender Phonosurgery: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Song, Tara Elena; Jiang, Nancy

    2017-05-01

    Objectives Different surgical techniques have been described in the literature to increase vocal pitch. The purpose of this study is to systematically review these surgeries and perform a meta-analysis to determine which technique increases pitch the most. Data Sources CINAHL, Cochrane, Embase, Medline, PubMed, and Science Direct. Review Methods A systematic review and meta-analysis of the literature was performed using the CINAHL, Cochrane, Embase, Medline, PubMed, and Science Direct databases. Studies were eligible for inclusion if they evaluated pitch-elevating phonosurgical techniques in live humans and performed pre- and postoperative acoustic analysis. Data were gathered regarding surgical technique, pre- and postoperative fundamental frequencies, perioperative care measures, and complications. Results Twenty-nine studies were identified. After applying inclusion and exclusion criteria, a total of 13 studies were included in the meta-analysis. Mechanisms of pitch elevation included increasing vocal cord tension (cricothyroid approximation), shortening the vocal cord length (cold knife glottoplasty, laser-shortening glottoplasty), and decreasing mass (laser reduction glottoplasty). The most common interventions were shortening techniques and cricothyroid approximation (6 studies each). The largest increase in fundamental frequency was seen with techniques that shortened the vocal cords. Preoperative speech therapy, postoperative voice rest, and reporting of patient satisfaction were inconsistent. Many of the studies were limited by low power and short length of follow-up. Conclusions Multiple techniques for elevation of vocal pitch exist, but vocal cord shortening procedures appear to result in the largest increase in fundamental frequency.

  10. A computer-controlled conformal radiotherapy system. IV: Electronic chart

    International Nuclear Information System (INIS)

    Fraass, Benedick A.; McShan, Daniel L.; Matrone, Gwynne M.; Weaver, Tamar A.; Lewis, James D.; Kessler, Marc L.

    1995-01-01

    Purpose: The design and implementation of a system for electronically tracking relevant plan, prescription, and treatment data for computer-controlled conformal radiation therapy is described. Methods and Materials: The electronic charting system is implemented on a computer cluster coupled by high-speed networks to computer-controlled therapy machines. A methodical approach to the specification and design of an integrated solution has been used in developing the system. The electronic chart system is designed to allow identification and access of patient-specific data including treatment-planning data, treatment prescription information, and charting of doses. An in-house developed database system is used to provide an integrated approach to the database requirements of the design. A hierarchy of databases is used for both centralization and distribution of the treatment data for specific treatment machines. Results: The basic electronic database system has been implemented and has been in use since July 1993. The system has been used to download and manage treatment data on all patients treated on our first fully computer-controlled treatment machine. To date, electronic dose charting functions have not been fully implemented clinically, requiring the continued use of paper charting for dose tracking. Conclusions: The routine clinical application of complex computer-controlled conformal treatment procedures requires the management of large quantities of information for describing and tracking treatments. An integrated and comprehensive approach to this problem has led to a full electronic chart for conformal radiation therapy treatments

  11. An Exponentially Weighted Moving Average Control Chart for Bernoulli Data

    DEFF Research Database (Denmark)

    Spliid, Henrik

    2010-01-01

    We consider a production process in which units are produced in a sequential manner. The units can, for example, be manufactured items or services, provided to clients. Each unit produced can be a failure with probability p or a success (non-failure) with probability (1-p). A novel exponentially ...... weighted moving average (EWMA) control chart intended for surveillance of the probability of failure, p, is described. The chart is based on counting the number of non-failures produced between failures in combination with a variance-stabilizing transformation. The distribution function...... of the transformation is given and its limit for small values of p is derived. Control of high yield processes is discussed and the chart is shown to perform very well in comparison with both the most common alternative EWMA chart and the CUSUM chart. The construction and the use of the proposed EWMA chart...... are described and a practical example is given. It is demonstrated how the method communicates the current failure probability in a direct and interpretable way, which makes it well suited for surveillance of a great variety of activities in industry or in the service sector such as in hospitals, for example...

  12. Improvement of WWW chart of the nuclides interface

    International Nuclear Information System (INIS)

    Okamoto, Tsutomu; Minato, Futoshi; Iwamoto, Osamu; Koura, Hiroyuki

    2016-03-01

    The booklet 'chart of the nuclides' is issued every 4 years since 1976 from Nuclear Data Center, Japan Atomic Energy Agency. The chart of the nuclides for WWW (World Wide Web) was developed in 1999 in order to be available from the Internet browser. The Internet connection speeds, browser functions and JavaScript libraries has, however, progressed at present compared with the Internet technology in those days. In connection with the release of the 2014 edition of the chart of the nuclides, the interface of the WWW chart of the nuclides has been improved by introducing new Internet technologies aiming at enhancing convenience on accessibilities via browsers. We introduced a scrolling screen that would make capabilities of easy screen movement on a map with the addition of the drag scrolling function. Considering smart phone access, the light-weight edition which introduced automatic switch was prepared. The new system results in reduction in access time and usefulness in mobile environment. The method of making figures of the chart was reconsidered due to addition of new decay schemes to the 2014 edition. SVG (Scalable Vector Graphics) was adopted so as to make figures easily. It is concluded that the accessibilities of WWW chart of the nuclides are substantially improved from the previous version by introducing the new technologies. (author)

  13. Analytical techniques for wine analysis: An African perspective; a review

    International Nuclear Information System (INIS)

    Villiers, André de; Alberts, Phillipus; Tredoux, Andreas G.J.; Nieuwoudt, Hélène H.

    2012-01-01

    Highlights: ► Analytical techniques developed for grape and wine analysis in Africa are reviewed. ► The utility of infrared spectroscopic methods is demonstrated. ► An overview of separation of wine constituents by GC, HPLC, CE is presented. ► Novel LC and GC sample preparation methods for LC and GC are presented. ► Emerging methods for grape and wine analysis in Africa are discussed. - Abstract: Analytical chemistry is playing an ever-increasingly important role in the global wine industry. Chemical analysis of wine is essential in ensuring product safety and conformity to regulatory laws governing the international market, as well as understanding the fundamental aspects of grape and wine production to improve manufacturing processes. Within this field, advanced instrumental analysis methods have been exploited more extensively in recent years. Important advances in instrumental analytical techniques have also found application in the wine industry. This review aims to highlight the most important developments in the field of instrumental wine and grape analysis in the African context. The focus of this overview is specifically on the application of advanced instrumental techniques, including spectroscopic and chromatographic methods. Recent developments in wine and grape analysis and their application in the African context are highlighted, and future trends are discussed in terms of their potential contribution to the industry.

  14. Analytical techniques for wine analysis: An African perspective; a review

    Energy Technology Data Exchange (ETDEWEB)

    Villiers, Andre de, E-mail: ajdevill@sun.ac.za [Department of Chemistry and Polymer Science, Stellenbosch University, Private Bag X1, Matieland 7602, Stellenbosch (South Africa); Alberts, Phillipus [Department of Chemistry and Polymer Science, Stellenbosch University, Private Bag X1, Matieland 7602, Stellenbosch (South Africa); Tredoux, Andreas G.J.; Nieuwoudt, Helene H. [Institute for Wine Biotechnology, Department of Viticulture and Oenology, Stellenbosch University, Private Bag X1, Matieland 7602, Stellenbosch (South Africa)

    2012-06-12

    Highlights: Black-Right-Pointing-Pointer Analytical techniques developed for grape and wine analysis in Africa are reviewed. Black-Right-Pointing-Pointer The utility of infrared spectroscopic methods is demonstrated. Black-Right-Pointing-Pointer An overview of separation of wine constituents by GC, HPLC, CE is presented. Black-Right-Pointing-Pointer Novel LC and GC sample preparation methods for LC and GC are presented. Black-Right-Pointing-Pointer Emerging methods for grape and wine analysis in Africa are discussed. - Abstract: Analytical chemistry is playing an ever-increasingly important role in the global wine industry. Chemical analysis of wine is essential in ensuring product safety and conformity to regulatory laws governing the international market, as well as understanding the fundamental aspects of grape and wine production to improve manufacturing processes. Within this field, advanced instrumental analysis methods have been exploited more extensively in recent years. Important advances in instrumental analytical techniques have also found application in the wine industry. This review aims to highlight the most important developments in the field of instrumental wine and grape analysis in the African context. The focus of this overview is specifically on the application of advanced instrumental techniques, including spectroscopic and chromatographic methods. Recent developments in wine and grape analysis and their application in the African context are highlighted, and future trends are discussed in terms of their potential contribution to the industry.

  15. A systematic review protocol: social network analysis of tobacco use.

    Science.gov (United States)

    Maddox, Raglan; Davey, Rachel; Lovett, Ray; van der Sterren, Anke; Corbett, Joan; Cochrane, Tom

    2014-08-08

    Tobacco use is the single most preventable cause of death in the world. Evidence indicates that behaviours such as tobacco use can influence social networks, and that social network structures can influence behaviours. Social network analysis provides a set of analytic tools to undertake methodical analysis of social networks. We will undertake a systematic review to provide a comprehensive synthesis of the literature regarding social network analysis and tobacco use. The review will answer the following research questions: among participants who use tobacco, does social network structure/position influence tobacco use? Does tobacco use influence peer selection? Does peer selection influence tobacco use? We will follow the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines and search the following databases for relevant articles: CINAHL (Cumulative Index to Nursing and Allied Health Literature); Informit Health Collection; PsycINFO; PubMed/MEDLINE; Scopus/Embase; Web of Science; and the Wiley Online Library. Keywords include tobacco; smoking; smokeless; cigarettes; cigar and 'social network' and reference lists of included articles will be hand searched. Studies will be included that provide descriptions of social network analysis of tobacco use.Qualitative, quantitative and mixed method data that meets the inclusion criteria for the review, including methodological rigour, credibility and quality standards, will be synthesized using narrative synthesis. Results will be presented using outcome statistics that address each of the research questions. This systematic review will provide a timely evidence base on the role of social network analysis of tobacco use, forming a basis for future research, policy and practice in this area. This systematic review will synthesise the evidence, supporting the hypothesis that social network structures can influence tobacco use. This will also include exploring the relationship between social

  16. Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

    Directory of Open Access Journals (Sweden)

    Rebecca Levy

    2010-01-01

    Full Text Available Background: Electronic medical records (EMRs provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution′s initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting strategy within the EMR. Methods: A focus group of our hospital′s transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater real-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encountered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also

  17. Development and validation of the Greek version of the MNREAD acuity chart.

    Science.gov (United States)

    Mataftsi, Asimina; Bourtoulamaiou, Areti; Haidich, Anna-Bettina; Antoniadis, Antonis; Kilintzis, Vassilis; Tsinopoulos, Ioannis T; Dimitrakos, Stavros

    2013-01-01

    The aim of this study was to develop MNREAD acuity charts in the Greek language (MNREAD-GR) and establish their repeatability in a normal-sighted population. One hundred and eighty Greek sentences were constructed based on the design principles of the Minnesota Low Vision Reading Test. The software used to validate them for width was adjusted to the parameters of the non-Latin characters used in the Greek language (MNTest-GR) and width-validated sentences were then checked for literacy by two language teachers. Pilot testing followed in 20 adults and two groups of 20 children. Subsequently, three versions of the MNREAD-GR chart were printed and validated for repeatability: 20 adults read MNREAD-GR charts 1, 2 and 3 in random order over two sessions. A linear mixed-model analysis was performed for near visual acuity (VA), maximum reading speed and critical print size to identify the contribution of each source (individual subject, session, chart and residual error) to the total variance. Subject variance determined the intraclass correlation coefficient. One hundred of the initial 180 sentences were validated with MNTest-GR and approved for literacy correctness. Of those, 57 sentences were selected after pilot testing, and used in the final printed chart in random distribution among three versions. The intraclass correlation coefficients were 0.72 for VA, 0.87 for maximum reading speed and 0.46 for critical print size. The between-charts within-session within-subject component accounted for a maximum five per cent of the variance. The between-sessions within-subject component had a maximum of one per cent. The coefficient of repeatability was 0.08 logMAR for VA, 46.96 words per minute for maximum reading speed and 0.10 logMAR for critical print size. The created MNREAD-GR acuity chart is a standardised clinical test that can be used reliably to measure near acuity, reading speed and critical print size in Greek-speaking literate patients of all ages. © 2012 The

  18. Treatment of MRSA pneumonia: Clinical and economic comparison of linezolid vs. vancomycin – a retrospective analysis of medical charts and re-imbursement data of real-life patient populations

    Directory of Open Access Journals (Sweden)

    Wilke, Michael H.

    2017-01-01

    Full Text Available Objectives: To supplement the data collected in randomized clinical trials, the present study in patients with methicillin resistant (MRSA pneumonia was conducted to explore the clinical effectiveness of linezolid and vancomycin in a routine clinical setting. Further, the overall costs of the patients' stay in the intensive care unit (ICU were compared.Methods: This was a retrospective analysis of medical and reimbursement data of adult patients who were treated for MRSA pneumonia with linezolid or vancomycin. Since the subjects were not randomly assigned to treatments, propensity score adjustment was applied to reduce a potential selection bias.Results: In total, 226 patients were included; 95 received linezolid and 131 received vancomycin as initial therapy for MRSA pneumonia. Switches to another antibiotic were observed in 4 patients (4.2% receiving linezolid and in 23 patients (17.6% receiving vancomycin (logistic regression analysis; odds ratio linezolid/vancomycin: 0.183; 95% confidence interval [CI]: 0.052–0.647; p<0.01. All-cause in-hospital mortality was also lower in patients receiving linezolid (22 patients [23.2%] vs. 54 patients [41.2%] (logistic regression analysis; odds ratio linezolid/vancomycin: 0.351; 95% CI: 0.184–0.671; p<0.01. The analysis of the total costs of stay in ICU did not reveal any major differences between the two treatment groups (cost ratio linezolid/vancomycin: 1.29; 95% CI: 0.84–1.98; p=0.24.Conclusions: These findings confirm in a routine clinical setting that linezolid is a valuable therapeutic alternative to vancomycin for the treatment of MRSA pneumonia. However, prospective studies in real-life patient populations are warranted.

  19. Treatment of MRSA pneumonia: Clinical and economic comparison of linezolid vs. vancomycin - a retrospective analysis of medical charts and re-imbursement data of real-life patient populations

    OpenAIRE

    Wilke, MH; Becker, K; Kloss, S; Heimann, SM; Goldmann, A; Weber, B; Pletz, MW; Simon, P; Petrik, C

    2017-01-01

    Objectives: To supplement the data collected in randomized clinical trials, the present study in patients with methicillin resistant Staphylococcus aureus (MRSA) pneumonia was conducted to explore the clinical effectiveness of linezolid and vancomycin in a routine clinical setting. Further, the overall costs of the patients' stay in the intensive care unit (ICU) were compared.Methods: This was a retrospective analysis of medical and reimbursement data of adult patients who were treated for...

  20. Combining color chart, colorimetric measurement and chemical compounds for postharvest quality of white wine grapes.

    Science.gov (United States)

    Sollazzo, Marco; Baccelloni, Simone; D'Onofrio, Claudio; Bellincontro, Andrea

    2018-01-03

    This paper provides data for the potential use of a color chart to establish the best quality of white wine grapes destined for postharvest processing. Grechetto, Vermentino and Muscat of Alexandria white wine grape varieties were tested by sampling berries at different dates during their quality attribute evolution. A color chart and reflectance spectrocolorimeter were used in combination with analyses of total carotenoids and chlorophylls in all three varieties and of volatile organic compounds (VOCs) in Grechetto alone. Total carotenoids decreased from 0.85 to 0.76 µg g -1 in Grechetto berries and from 0.70 to 0.46 µg g -1 in Vermentino berries while increased from 0.70 to 0.80 µg g -1 in Muscat berries during ripening. Total chlorophylls decreased in all varieties, and a strict correlation was found between hue angle (measured by color chart or spectrocolorimeter) and chlorophyll disappearance, with R 2 ranging from 0.81 to 0.95 depending on the variety. VOCs were only measured in Grechetto grapes, and a significant increase in glycosylation was found with ripening. The concentration of different classes of VOCs exhibited a clear decrease during ripening, except for terpenoids and esters which showed a peak at the beginning. The benzenoid class reached the highest concentration, which was almost 50% of the total. Cluster analysis using Ward's method enabled the best grape quality to be identified. This experimental work highlights that a color chart is cheap and easy to use to define the right quality stage for white wine grapes. The color chart enabled the enochemical features to be matched with the VOC results for the aromatic maturity of Grechetto. © 2018 Society of Chemical Industry. © 2018 Society of Chemical Industry.

  1. North Atlantic IFR Route Planning Chart GEO-TIFF - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — North Atlantic Route Chart is designed for FAA Controllers to monitor transatlantic flights, this 5-color chart shows oceanic control areas, coastal navigation aids,...

  2. North Atlantic IFR Route Planning Chart PDF File - Aeronautical Information Services Digital Products

    Data.gov (United States)

    Department of Transportation — North Atlantic Route Chart is designed for FAA Controllers to monitor transatlantic flights, this 5-color chart shows oceanic control areas, coastal navigation aids,...

  3. Proposal of computation chart for general use for diffusion prediction of discharged warm water

    International Nuclear Information System (INIS)

    Wada, Akira; Kadoyu, Masatake

    1976-01-01

    The authors have developed the unique simulation analysis method using the numerical models for the prediction of discharged warm water diffusion. At the present stage, the method is adopted for the precise analysis computation in order to make the prediction of the diffusion of discharged warm water at each survey point, but instead of this method, it is strongly requested that some simple and easy prediction methods should be established. For the purpose of meeting this demand, in this report, the computation chart for general use is given to predict simply the diffusion range of discharged warm water, after classifying the semi-infinite sea region into several flow patterns according to the sea conditions and conducting the systematic simulation analysis with the numerical model of each pattern, respectively. (1) Establishment of the computation conditions: The special sea region was picked up as the area to be investigated, which is semi-infinite facing the outer sea and along the rectilineal coast line from many sea regions surrounding Japan, and from the viewpoint of the flow and the diffusion characteristics, the sea region was classified into three patterns. 51 cases in total various parameters were obtained, and finally the simulation analysis was performed. (2) Drawing up the general use chart: 28 sheets of the computation chart for general use were drawn, which are available for computing the approximate temperature rise caused by the discharged warm water diffusion. The example of Anegasaki Thermal Power Station is given. (Kako, I.)

  4. Kornati Islands on Old Geographic Maps and Charts

    Directory of Open Access Journals (Sweden)

    Josip Faričić

    2005-09-01

    Full Text Available Based on the analysis of cartographic sources, the paper analyses the historical and geographical development of the Kornati islands, the largest group of Croatian islands. The old maps were used first of all as the means of geographic research that, being necessarily correlated to the simultaneous historical written sources and modern topographic and maritime maps, make the basis for creating a research platform for relevant scientific results to be achieved. On the basis of the old maps it is possible, among other things to anticipate that the Kornati islands used to have great geotraffic significance on the eastern Adriatic sailing route. According to the development of geographic concepts and cartographic methods, the geographic vision of the Kornati islands has been gradually clarified ever since the 16th century. The chart from the Carta di cabotaggio del Mare Adriatico edition published by the Military and Geographic Institute from Milan (1822-1824 presents the turning point with the first complete and mostly precise presentation of the Kornati islands group on the basis of hydrographic and topographic field measurements.

  5. Off the Chart: The Crimean War in British Public Consciousness

    Directory of Open Access Journals (Sweden)

    A. L. Berridge

    2015-05-01

    Full Text Available The Crimean War revealed in this issue of '19' is of such rich and varied historical interest as to make a mystery of its relative obscurity with the general public in the UK. My own article adopts a novelist’s perspective to chart some aspects of this popular decline, exploring the treatment of the Siege of Sebastopol through the media of painting, literature, and cinema, and considering whether those aspects of the war that have made the greatest impression on the public mind are also those that make it least commercially attractive. It also examines the more official legacy, from the treatment of war dead to the changing face of sculpted memorials, and by comparing British commemoration with that of Russians in Crimea, discusses the possible role played in national memory by both shame and pride. In a final brief analysis of the 1968 film 'The Charge of the Light Brigade', I consider the extent to which modern rejection of Victorian values has created historical distortion, and whether a more truthful presentation might better serve the cause of preserving an important war in the British public consciousness.

  6. Discriminant analysis for repeated measures data: a review

    Directory of Open Access Journals (Sweden)

    Lisa Lix

    2010-09-01

    Full Text Available Discriminant analysis (DA encompasses procedures for classifying observations into groups (i.e., predictive discriminative analysis and describing the relative importance of variables for distinguishing amongst groups (i.e., descriptive discriminative analysis. In recent years, a number of developments have occurred in DA procedures for the analysis of data from repeated measures designs. Specifically, DA procedures have been developed for repeated measures data characterized by missing observations and/or unbalanced measurement occasions, as well as high-dimensional data in which measurements are collected repeatedly on two or more variables. This paper reviews the literature on DA procedures for univariate and multivariate repeated measures data, focusing on covariance pattern and linear mixed-effects models. A numeric example illustrates their implementation using SAS software.

  7. CrossFit Overview: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Claudino, João Gustavo; Gabbett, Tim J; Bourgeois, Frank; Souza, Helton de Sá; Miranda, Rafael Chagas; Mezêncio, Bruno; Soncin, Rafael; Cardoso Filho, Carlos Alberto; Bottaro, Martim; Hernandez, Arnaldo Jose; Amadio, Alberto Carlos; Serrão, Julio Cerca

    2018-02-26

    CrossFit is recognized as one of the fastest growing high-intensity functional training modes in the world. However, scientific data regarding the practice of CrossFit is sparse. Therefore, the objective of this study is to analyze the findings of scientific literature related to CrossFit via systematic review and meta-analysis. Systematic searches of the PubMed, Web of Science, Scopus, Bireme/MedLine, and SciELO online databases were conducted for articles reporting the effects of CrossFit training. The systematic review followed the PRISMA guidelines. The Oxford Levels of Evidence was used for all included articles, and only studies that investigated the effects of CrossFit as a training program were included in the meta-analysis. For the meta-analysis, effect sizes (ESs) with 95% confidence interval (CI) were calculated and heterogeneity was assessed using a random-effects model. Thirty-one articles were included in the systematic review and four were included in the meta-analysis. However, only two studies had a high level of evidence at low risk of bias. Scientific literature related to CrossFit has reported on body composition, psycho-physiological parameters, musculoskeletal injury risk, life and health aspects, and psycho-social behavior. In the meta-analysis, significant results were not found for any variables. The current scientific literature related to CrossFit has few studies with high level of evidence at low risk of bias. However, preliminary data has suggested that CrossFit practice is associated with higher levels of sense of community, satisfaction, and motivation.

  8. Statistical process control charts for monitoring military injuries.

    Science.gov (United States)

    Schuh, Anna; Canham-Chervak, Michelle; Jones, Bruce H

    2017-12-01

    An essential aspect of an injury prevention process is surveillance, which quantifies and documents injury rates in populations of interest and enables monitoring of injury frequencies, rates and trends. To drive progress towards injury reduction goals, additional tools are needed. Statistical process control charts, a methodology that has not been previously applied to Army injury monitoring, capitalise on existing medical surveillance data to provide information to leadership about injury trends necessary for prevention planning and evaluation. Statistical process control Shewhart u-charts were created for 49 US Army installations using quarterly injury medical encounter rates, 2007-2015, for active duty soldiers obtained from the Defense Medical Surveillance System. Injuries were defined according to established military injury surveillance recommendations. Charts display control limits three standard deviations (SDs) above and below an installation-specific historical average rate determined using 28 data points, 2007-2013. Charts are available in Army strategic management dashboards. From 2007 to 2015, Army injury rates ranged from 1254 to 1494 unique injuries per 1000 person-years. Installation injury rates ranged from 610 to 2312 injuries per 1000 person-years. Control charts identified four installations with injury rates exceeding the upper control limits at least once during 2014-2015, rates at three installations exceeded the lower control limit at least once and 42 installations had rates that fluctuated around the historical mean. Control charts can be used to drive progress towards injury reduction goals by indicating statistically significant increases and decreases in injury rates. Future applications to military subpopulations, other health outcome metrics and chart enhancements are suggested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Should the WHO Growth Charts Be Used in France?

    Science.gov (United States)

    Scherdel, Pauline; Botton, Jérémie; Rolland-Cachera, Marie-Françoise; Léger, Juliane; Pelé, Fabienne; Ancel, Pierre Yves; Simon, Chantal; Castetbon, Katia; Salanave, Benoit; Thibault, Hélène; Lioret, Sandrine; Péneau, Sandrine; Gusto, Gaelle; Charles, Marie-Aline; Heude, Barbara

    2015-01-01

    Background Growth charts are an essential clinical tool for evaluating a child's health and development. The current French reference curves, published in 1979, have recently been challenged by the 2006 World Health Organization (WHO) growth charts. Objective To evaluate and compare the growth of French children who were born between 1981 and 2007, with the WHO growth charts and the French reference curves currently used. Design Anthropometric measurements from French children, who participated in 12 studies, were analyzed: 82,151 measurements were available for 27,257 children in different age groups, from birth to 18 years. We calculated and graphically compared mean z-scores based on the WHO and French curves, for height, weight and Body Mass Index (BMI) according to age and sex. The prevalence of overweight using the WHO, the French and International Obesity Task Force definitions were compared. Results Our population of children was on average 0.5 standard deviations taller than the French reference population, from the first month of life until puberty age. Mean z-scores for height, weight and BMI were closer to zero based on the WHO growth charts than on the French references from infancy until late adolescence, except during the first six months. These differences not related to breastfeeding rates. As expected, the prevalence of overweight depended on the reference used, and differences varied according to age. Conclusion The WHO growth charts may be appropriate for monitoring growth of French children, as the growth patterns in our large population of French children were closer to the WHO growth charts than to the French reference curves, from 6 months onwards. However, there were some limitations in the use of these WHO growth charts, and further investigation is needed. PMID:25761138

  10. Charted Choices 2013-2017. An analysis of ten election programmes. Effects on the economy and the environment; Keuzes in Kaart 2013-2017. Een analyse van tien verkiezingsprogramma's. Effecten op economie en milieu

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-05-15

    At the request of ten political parties, the Netherlands Bureau for Economic Policy Analysis (CPB) and PBL Netherlands Environmental Assessment Agency have mapped out the effects of the respective election platforms on the economy and the environment. The analysis shows that each of the proposed policy measures included in the platforms has both advantages and disadvantages. The platforms thus reflect the diverse choices that have been made by the parties. The publication presents the impact of party programs on public finances, purchasing power and employment. Also included in the publication are analyses in the field of mobility, energy and climate, nature, education, housing and healthcare [Dutch] De verkiezingsprogramma's 2012 laten zien welke keuzes politieke partijen maken voor de jaren 2013-2017. De programma's tonen aan dat er echt iets te kiezen valt voor de komende kabinetsperiode. Hoe gaan we na de economische crisis de overheidsfinancien weer op orde brengen en hoe snel? Verhogen we de AOW-leeftijd en beperken we de aftrek van de hypotheekrente, of juist niet? Hoe verminderen we de filedruk? Willen we klimaatverandering aanpakken en zo ja, hoe dan? Is het de moeite waarde om meer geld uit te geven aan onderwijs of innovatie? Hoeveel trekken we uit voor natuur? Hoe kunnen we de woningmarkt beter laten functioneren? Hoe gaan we om met de stijging van de kosten van de zorg? In de aanloop naar de verkiezingen van 12 september 2012 hebben tien politieke partijen - VVD, PvdA, PVV, CDA, SP, D66, GroenLinks, ChristenUnie, SGP, DPK - gevraagd om een analyse van hun verkiezingsprogramma's. Het CPB heeft de economische effecten geanalyseerd, het PBL de effecten op milieu.

  11. New aids for the non-invasive prenatal diagnosis of achondroplasia: dysmorphic features, charts of fetal size and molecular confirmation using cell-free fetal DNA in maternal plasma.

    Science.gov (United States)

    Chitty, L S; Griffin, D R; Meaney, C; Barrett, A; Khalil, A; Pajkrt, E; Cole, T J

    2011-03-01

    To improve the prenatal diagnosis of achondroplasia by constructing charts of fetal size, defining frequency of sonographic features and exploring the role of non-invasive molecular diagnosis based on cell-free fetal deoxyribonucleic acid (DNA) in maternal plasma. Data on fetuses with a confirmed diagnosis of achondroplasia were obtained from our databases, records reviewed, sonographic features and measurements determined and charts of fetal size constructed using the LMS (lambda-mu-sigma) method and compared with charts used in normal pregnancies. Cases referred to our regional genetics laboratory for molecular diagnosis using cell-free fetal DNA were identified and results reviewed. Twenty-six cases were scanned in our unit. Fetal size charts showed that femur length was usually on or below the 3(rd) centile by 25 weeks' gestation, and always below the 3(rd) by 30 weeks. Head circumference was above the 50(th) centile, increasing to above the 95(th) when compared with normal for the majority of fetuses. The abdominal circumference was also increased but to a lesser extent. Commonly reported sonographic features were bowing of the femora, frontal bossing, short fingers, a small chest and polyhydramnios. Analysis of cell-free fetal DNA in six pregnancies confirmed the presence of the c.1138G > A mutation in the FGRF3 gene in four cases with achondroplasia, but not the two subsequently found to be growth restricted. These data should improve the accuracy of diagnosis of achondroplasia based on sonographic findings, and have implications for targeted molecular confirmation that can reliably and safely be carried out using cell-free fetal DNA. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.

  12. A Combined Control Chart for Identifying Out–Of–Control Points in Multivariate Processes

    Directory of Open Access Journals (Sweden)

    Marroquín–Prado E.

    2010-10-01

    Full Text Available The Hotelling's T2 control chart is widely used to identify out–of–control signals in multivariate processes. However, this chart is not sensitive to small shifts in the process mean vec tor. In this work we propose a control chart to identify out–of–control signals. The proposed chart is a combination of Hotelling's T2 chart, M chart proposed by Hayter et al. (1994 and a new chart based on Principal Components. The combination of these charts identifies any type and size of change in the process mean vector. Us ing simulation and the Average Run Length (ARL, the performance of the proposed control chart is evaluated. The ARL means the average points within control before an out–of–control point is detected, The results of the simulation show that the proposed chart is more sensitive that each one of the three charts individually

  13. Comparison of reading speed with 3 different log-scaled reading charts.

    Science.gov (United States)

    Buari, Noor Halilah; Chen, Ai-Hong; Musa, Nuraini

    2014-01-01

    A reading chart that resembles real reading conditions is important to evaluate the quality of life in terms of reading performance. The purpose of this study was to compare the reading speed of UiTM Malay related words (UiTM-Mrw) reading chart with MNread Acuity Chart and Colenbrander Reading Chart. Fifty subjects with normal sight were randomly recruited through randomized sampling in this study (mean age=22.98±1.65 years). Subjects were asked to read three different near charts aloud and as quickly as possible at random sequence. The charts were the UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart, respectively. The time taken to read each chart was recorded and any errors while reading were noted. Reading performance was quantified in terms of reading speed as words per minute (wpm). The mean reading speed for UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart was 200±30wpm, 196±28wpm and 194±31wpm, respectively. Comparison of reading speed between UiTM-Mrw Reading Chart and MNread Acuity Chart showed no significant difference (t=-0.73, p=0.72). The same happened with the reading speed between UiTM-Mrw Reading Chart and Colenbrander Reading Chart (t=-0.97, p=0.55). Bland and Altman plot showed good agreement between reading speed of UiTM-Mrw Reading Chart with MNread Acuity Chart with the Colenbrander Reading Chart. UiTM-Mrw Reading Chart in Malay language is highly comparable with standardized charts and can be used for evaluating reading speed. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  14. Three-dimensional cephalometric analysis in orthodontics: a systematic review.

    Science.gov (United States)

    Pittayapat, P; Limchaichana-Bolstad, N; Willems, G; Jacobs, R

    2014-05-01

    The scientific evidence of 3D cephalometry in orthodontics has not been well established. The aim of this systematic review was to evaluate the evidence for the diagnostic efficacy of 3D cephalometry in orthdontics, focusing on measurement accuracy and reproducibility of landmark identification. PubMed, EMBASE and the Cochrane library (from beginning to March 13, 2012) were searched. Search terms included: cone-beam computed tomography; tomography, spiral computed; imaging, three-dimensional; orthodontics. Two reviewers read the retrieved articles and selected relevant publications based on pre-established inclusion criteria. The selected publications had to elucidate the hierarchical model of the efficacy of diagnostic imaging systems by Fryback and Thornbury. The data was then extracted according to two protocols, which were based on the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Next, levels of evidence were categorized into 3 groups: low, moderate and high evidence. 571 publications were found by database search strategies and 50 additional studies by hand search. A total of 35 publications were included in this review. Limited evidence for the diagnostic efficacy of 3D cephalometry was found. Only 6 studies met the criteria for a moderate level of evidence. Accordingly, this systematic review reveals that there is still need for methodologically standardized studies on 3D cephalometric analysis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Mathematical models of ABE fermentation: review and analysis.

    Science.gov (United States)

    Mayank, Rahul; Ranjan, Amrita; Moholkar, Vijayanand S

    2013-12-01

    Among different liquid biofuels that have emerged in the recent past, biobutanol produced via fermentation processes is of special interest due to very similar properties to that of gasoline. For an effective design, scale-up, and optimization of the acetone-butanol-ethanol (ABE) fermentation process, it is necessary to have insight into the micro- and macro-mechanisms of the process. The mathematical models for ABE fermentation are efficient tools for this purpose, which have evolved from simple stoichiometric fermentation equations in the 1980s to the recent sophisticated and elaborate kinetic models based on metabolic pathways. In this article, we have reviewed the literature published in the area of mathematical modeling of the ABE fermentation. We have tried to present an analysis of these models in terms of their potency in describing the overall physiology of the process, design features, mode of operation along with comparison and validation with experimental results. In addition, we have also highlighted important facets of these models such as metabolic pathways, basic kinetics of different metabolites, biomass growth, inhibition modeling and other additional features such as cell retention and immobilized cultures. Our review also covers the mathematical modeling of the downstream processing of ABE fermentation, i.e. recovery and purification of solvents through flash distillation, liquid-liquid extraction, and pervaporation. We believe that this review will be a useful source of information and analysis on mathematical models for ABE fermentation for both the appropriate scientific and engineering communities.

  16. Understanding medical symptoms: a conceptual review and analysis.

    Science.gov (United States)

    Malterud, Kirsti; Guassora, Ann Dorrit; Graungaard, Anette Hauskov; Reventlow, Susanne

    2015-12-01

    The aim of this article is to present a conceptual review and analysis of symptom understanding. Subjective bodily sensations occur abundantly in the normal population and dialogues about symptoms take place in a broad range of contexts, not only in the doctor's office. Our review of symptom understanding proceeds from an initial subliminal awareness by way of attribution of meaning and subsequent management, with and without professional involvement. We introduce theoretical perspectives from phenomenology, semiotics, social interactionism, and discourse analysis. Drew Leder's phenomenological perspectives deal with how symptom perception occurs when any kind of altered balance brings forward a bodily attention. Corporeality is brought to explicit awareness and perceived as sensations. Jesper Hoffmeyer's biosemiotic perspectives provide access to how signs are interpreted to attribute meaning to the bodily messages. Symptom management is then determined by the meaning of a symptom. Dorte E. Gannik's concept "situational disease" explains how situations can be reviewed not just in terms of their potential to produce signs or symptoms, but also in terms of their capacity to contain symptoms. Disease is a social and relational phenomenon of containment, and regulating the situation where the symptoms originate implies adjusting containment. Discourse analysis, as presented by Jonathan Potter and Margaret Wetherell, provides a tool to notice the subtle ways in which language orders perceptions and how language constructs social interaction. Symptoms are situated in culture and context, and trends in modern everyday life modify symptom understanding continuously. Our analysis suggests that a symptom can only be understood by attention to the social context in which the symptom emerges and the dialogue through which it is negotiated.

  17. [Review and analysis of the review results of Taiwan nurses association nursing projects (2011~2013)].

    Science.gov (United States)

    Chang, Li-Yin; Chen, Yu-Chih; Huang, Kuang-Chi; Huang, Jui-Lan; Lee, Tso-Ying

    2015-04-01

    Nursing projects are a key part of N4 professional competency training for nursing personnel. Low passage rates for these projects have been shown to negatively affect the intent of nursing personnel to advance further in the nursing ladder system. This study analyzes the scores for nursing projects between 2011 and 2013, the passage rate for these projects, and the differences in passage rates between different types of projects. This retrospective and descriptive study collected data on nursing projects conducted under the auspices of the Taiwan Nurses Association between 2011 and 2013. Furthermore, the comments of reviewers on 100 nursing projects were randomly selected and subjected to content analysis. A total of 3,359 nursing projects were examined. Eliminating unqualified nursing projects left a total of 3,246 projects for the dataset. A total of 1,099 projects were scored with passing grades, giving a passing rate of 33.9%. The authors of these passing projects worked primarily in northern Taiwan, worked in medical centers, and worked in intensive care departments. The projects submitted by authors in central Taiwan had the highest average score and passing rate, while those living in offshore islands had the lowest average score and passing rate. Most of the project topics belonged to the category: "improvement of nursing service skills or quality" (77.3%). Items with the lowest scores were: validation of questions, analysis of the current situation, and evaluation of results. The topics of nursing projects did not relate significantly to passing rate. However, years of experience, geographic location of hospital, level of institution, and department each had a statistically significant impact on the passage rate. A content analysis of reviewer comments was used to extract common problems. Most of the positive comments were related to the category of "literature review and reference", while most of the negative comments were related to the categories of

  18. [Model-based biofuels system analysis: a review].

    Science.gov (United States)

    Chang, Shiyan; Zhang, Xiliang; Zhao, Lili; Ou, Xunmin

    2011-03-01

    Model-based system analysis is an important tool for evaluating the potential and impacts of biofuels, and for drafting biofuels technology roadmaps and targets. The broad reach of the biofuels supply chain requires that biofuels system analyses span a range of disciplines, including agriculture/forestry, energy, economics, and the environment. Here we reviewed various models developed for or applied to modeling biofuels, and presented a critical analysis of Agriculture/Forestry System Models, Energy System Models, Integrated Assessment Models, Micro-level Cost, Energy and Emission Calculation Models, and Specific Macro-level Biofuel Models. We focused on the models' strengths, weaknesses, and applicability, facilitating the selection of a suitable type of model for specific issues. Such an analysis was a prerequisite for future biofuels system modeling, and represented a valuable resource for researchers and policy makers.

  19. Breath analysis using external cavity diode lasers: a review

    Science.gov (United States)

    Bayrakli, Ismail

    2017-04-01

    Most techniques that are used for diagnosis and therapy of diseases are invasive. Reliable noninvasive methods are always needed for the comfort of patients. Owing to its noninvasiveness, ease of use, and easy repeatability, exhaled breath analysis is a very good candidate for this purpose. Breath analysis can be performed using different techniques, such as gas chromatography mass spectrometry (MS), proton transfer reaction-MS, and selected ion flow tube-MS. However, these devices are bulky and require complicated procedures for sample collection and preconcentration. Therefore, these are not practical for routine applications in hospitals. Laser-based techniques with small size, robustness, low cost, low response time, accuracy, precision, high sensitivity, selectivity, low detection limit, real-time, and point-of-care detection have a great potential for routine use in hospitals. In this review paper, the recent advances in the fields of external cavity lasers and breath analysis for detection of diseases are presented.

  20. Regional differences in treatment rates for patients with chronic hepatitis C infection: Systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Philip Vutien

    Full Text Available Treatment rates with interferon-based therapies for chronic hepatitis C have been low. Our aim was to perform a systematic review of available data to estimate the rates and barriers for antiviral therapy for chronic hepatitis C.We conducted a systematic review and meta-analysis searching MEDLINE, SCOPUS through March 2016 and abstracts from recent major liver meetings for primary literature with available hepatitis C treatment rates. Random-effects models were used to estimate effect sizes and meta-regression to test for potential sources of heterogeneity.We included 39 studies with 476,443 chronic hepatitis C patients. The overall treatment rate was 25.5% (CI: 21.1-30.5% and by region 34% for Europe, 28.3% for Asia/Pacific, and 18.7% for North America (p = 0.008. On multivariable meta-regression, practice setting (tertiary vs. population-based, p = 0.04, region (Europe vs. North America p = 0.004, and data source (clinical chart review vs. administrative database, p = 0.025 remained significant predictors of heterogeneity. The overall treatment eligibility rate was 52.5%, and 60% of these received therapy. Of the patients who refused treatment, 16.2% cited side effects, 13.8% cited cost as reasons for treatment refusal, and 30% lacked access to specialist care.Only one-quarter of chronic hepatitis C patients received antiviral therapy in the pre-direct acting antiviral era. Treatment rates should improve in the new interferon-free era but, cost, co-morbidities, and lack of specialist care will likely remain and need to be addressed. Linkage to care should even be of higher priority now that well-tolerated cure is available.