WorldWideScience

Sample records for concordance problem quantitative

  1. Concorde

    CERN Multimedia

    Bernard

    1971-01-01

    Concorde -volera, volera pas et comment volera-t-il? Film: les Concordes de vol Le Commandant Bernard présente le Concorde, "né" en 1962, et commente l'appareil qui est d'actualité- commentaires techniques à l'aide d'une maquette et présentation des dias

  2. Quantitative Reasoning in Problem Solving

    Science.gov (United States)

    Ramful, Ajay; Ho, Siew Yin

    2015-01-01

    In this article, Ajay Ramful and Siew Yin Ho explain the meaning of quantitative reasoning, describing how it is used in the to solve mathematical problems. They also describe a diagrammatic approach to represent relationships among quantities and provide examples of problems and their solutions.

  3. Attention problems and Attention-Deficit/Hyperactivity Disorder in discordant and concordant monozygotic twins: Evidence of environmental mediators.

    NARCIS (Netherlands)

    Lehn, H.; Derks, E.M.; Hudziak, J.; Heutink, P.; van Beijsterveldt, C.E.M.; Boomsma, D.I.

    2007-01-01

    OBJECTIVE: To study familial and nonfamilial environmental influences on attention problems and attention-deficit/hyperactivity disorder (ADHD) in monozygotic twins discordant and concordant-high and low for these traits. METHOD: Ninety-five twin pairs from The Netherlands Twin Register were

  4. Assessment of precision and concordance of quantitative mitochondrial DNA assays: a collaborative international quality assurance study

    NARCIS (Netherlands)

    Hammond, Emma L.; Sayer, David; Nolan, David; Walker, Ulrich A.; Ronde, Anthony de; Montaner, Julio S. G.; Cote, Helene C. F.; Gahan, Michelle E.; Cherry, Catherine L.; Wesselingh, Steven L.; Reiss, Peter; Mallal, Simon

    2003-01-01

    Background: A number of international research groups have developed DNA quantitation assays in order to investigate the role of mitochondrial DNA depletion in anti-retroviral therapy-induced toxicities. Objectives: A collaborative study was undertaken to evaluate intra-assay precision and between

  5. Contouring Variability of the Penile Bulb on CT Images: Quantitative Assessment Using a Generalized Concordance Index

    Energy Technology Data Exchange (ETDEWEB)

    Carillo, Viviana [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Cozzarini, Cesare [Department of Radiotherapy, San Raffaele Scientific Institute, Milano (Italy); Perna, Lucia; Calandra, Mauro [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Gianolini, Stefano [Medical Software Solutions GmbH, Hagendorn (Switzerland); Rancati, Tiziana [Prostate Cancer Program, IRCCS National Institute of Cancer, Milano (Italy); Spinelli, Antonello Enrico [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Vavassori, Vittorio [Department of Radiotherapy, Cliniche Gavazzeni Humanitas, Bergamo (Italy); Villa, Sergio [Department of Radiotherapy 1, IRCCS National Institute of Cancer, Milano (Italy); Valdagni, Riccardo [Prostate Cancer Program, IRCCS National Institute of Cancer, Milano (Italy); Department of Radiotherapy 1, IRCCS National Institute of Cancer, Milano (Italy); Fiorino, Claudio, E-mail: fiorino.claudio@hsr.it [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy)

    2012-11-01

    Purpose: Within a multicenter study (DUE-01) focused on the search of predictors of erectile dysfunction and urinary toxicity after radiotherapy for prostate cancer, a dummy run exercise on penile bulb (PB) contouring on computed tomography (CT) images was carried out. The aim of this study was to quantitatively assess interobserver contouring variability by the application of the generalized DICE index. Methods and Materials: Fifteen physicians from different Institutes drew the PB on CT images of 10 patients. The spread of DICE values was used to objectively select those observers who significantly disagreed with the others. The analyses were performed with a dedicated module in the VODCA software package. Results: DICE values were found to significantly change among observers and patients. The mean DICE value was 0.67, ranging between 0.43 and 0.80. The statistics of DICE coefficients identified 4 of 15 observers who systematically showed a value below the average (p value range, 0.013 - 0.059): Mean DICE values were 0.62 for the 4 'bad' observers compared to 0.69 of the 11 'good' observers. For all bad observers, the main cause of the disagreement was identified. Average DICE values were significantly worse from the average in 2 of 10 patients (0.60 vs. 0.70, p < 0.05) because of the limited visibility of the PB. Excluding the bad observers and the 'bad' patients,' the mean DICE value increased from 0.67 to 0.70; interobserver variability, expressed in terms of standard deviation of DICE spread, was also reduced. Conclusions: The obtained values of DICE around 0.7 shows an acceptable agreement, considered the small dimension of the PB. Additional strategies to improve this agreement are under consideration and include an additional tutorial of the so-called bad observers with a recontouring procedure, or the recontouring by a single observer of the PB for all patients included in the DUE-01 study.

  6. Contouring Variability of the Penile Bulb on CT Images: Quantitative Assessment Using a Generalized Concordance Index

    International Nuclear Information System (INIS)

    Carillo, Viviana; Cozzarini, Cesare; Perna, Lucia; Calandra, Mauro; Gianolini, Stefano; Rancati, Tiziana; Spinelli, Antonello Enrico; Vavassori, Vittorio; Villa, Sergio; Valdagni, Riccardo; Fiorino, Claudio

    2012-01-01

    Purpose: Within a multicenter study (DUE-01) focused on the search of predictors of erectile dysfunction and urinary toxicity after radiotherapy for prostate cancer, a dummy run exercise on penile bulb (PB) contouring on computed tomography (CT) images was carried out. The aim of this study was to quantitatively assess interobserver contouring variability by the application of the generalized DICE index. Methods and Materials: Fifteen physicians from different Institutes drew the PB on CT images of 10 patients. The spread of DICE values was used to objectively select those observers who significantly disagreed with the others. The analyses were performed with a dedicated module in the VODCA software package. Results: DICE values were found to significantly change among observers and patients. The mean DICE value was 0.67, ranging between 0.43 and 0.80. The statistics of DICE coefficients identified 4 of 15 observers who systematically showed a value below the average (p value range, 0.013 — 0.059): Mean DICE values were 0.62 for the 4 “bad” observers compared to 0.69 of the 11 “good” observers. For all bad observers, the main cause of the disagreement was identified. Average DICE values were significantly worse from the average in 2 of 10 patients (0.60 vs. 0.70, p < 0.05) because of the limited visibility of the PB. Excluding the bad observers and the “bad” patients,” the mean DICE value increased from 0.67 to 0.70; interobserver variability, expressed in terms of standard deviation of DICE spread, was also reduced. Conclusions: The obtained values of DICE around 0.7 shows an acceptable agreement, considered the small dimension of the PB. Additional strategies to improve this agreement are under consideration and include an additional tutorial of the so-called bad observers with a recontouring procedure, or the recontouring by a single observer of the PB for all patients included in the DUE-01 study.

  7. Negative ... concord?

    NARCIS (Netherlands)

    Giannakidou, A

    The main claim of this paper is that a general theory of negative concord (NC) should allow for the possibility of NC involving scoping of a universal quantifier above negation. I propose that Greek NC instantiates this option. Greek n-words will be analyzed as polarity sensitive universal

  8. Concorde Re-visited

    Science.gov (United States)

    Horton, Peter; Moore, Peter

    This year marks the twentieth anniversary of the introduction of Concorde into commercial airline service. The first commercial flights were on 21 January 1976 - British Airways from Heathrow to Bahrain and Air France from Paris to Rio via Dakar. Later in that year commercial flights to Washington/Dulles began on 24 May. Services to New York were delayed until 22 November 1977. The first flight of Concorde was some seven years earlier. The prototype took off out of Toulouse on 2 March 1969 and this was followed by 002 from Filton to Fairford on 9 April. At the time it was anticipated that this was the beginning of an era when supersonic flight would be the normal way to travel long distances. Now, in 1996, Concorde is still the world's only supersonic commercial passenger airliner in airline service. This is an extraordinary achievement. The Boeing SST proved to be too ambitious and the programme was halted in 1971 after the United States Government withdrew support, while the Russian TU 144 was beset with problems. One TU 144 crashed at the Paris Air Show in 1973. The aircraft entered internal airline service in December 1975, flying supersonically between Moscow and Alma-Ata, capital of Kazakhstan, carrying mail and freight, but it did not have the range to operate viable intercontinental passenger serives. Certainly by 1985, if not many years before, the TU 144 was out of service.

  9. The Stable Concordance Genus

    OpenAIRE

    Kearney, M. Kate

    2013-01-01

    The concordance genus of a knot is the least genus of any knot in its concordance class. Although difficult to compute, it is a useful invariant that highlights the distinction between the three-genus and four-genus. In this paper we define and discuss the stable concordance genus of a knot, which describes the behavior of the concordance genus under connected sum.

  10. Problem-based learning on quantitative analytical chemistry course

    Science.gov (United States)

    Fitri, Noor

    2017-12-01

    This research applies problem-based learning method on chemical quantitative analytical chemistry, so called as "Analytical Chemistry II" course, especially related to essential oil analysis. The learning outcomes of this course include aspects of understanding of lectures, the skills of applying course materials, and the ability to identify, formulate and solve chemical analysis problems. The role of study groups is quite important in improving students' learning ability and in completing independent tasks and group tasks. Thus, students are not only aware of the basic concepts of Analytical Chemistry II, but also able to understand and apply analytical concepts that have been studied to solve given analytical chemistry problems, and have the attitude and ability to work together to solve the problems. Based on the learning outcome, it can be concluded that the problem-based learning method in Analytical Chemistry II course has been proven to improve students' knowledge, skill, ability and attitude. Students are not only skilled at solving problems in analytical chemistry especially in essential oil analysis in accordance with local genius of Chemistry Department, Universitas Islam Indonesia, but also have skilled work with computer program and able to understand material and problem in English.

  11. Quick answers to quantitative problems a pocket primer

    CERN Document Server

    Page, G William

    1991-01-01

    No matter the field, professionals need to respond quickly to quantitative problems as they arise and to develop a quick understanding of what the data mean. Whether you are an aide to a city council member trying to decipher the true meaning of a citizen opinion poll, a private consultant to the health department estimating the number of pregnant teenagers in a neighborhood, or the executive director of a small agency striving to present your budget facts precisely and clearly, the techniques presented here are helpful to you and your work.Key Features* Presents relatively simple techniques t

  12. From inverse problems in mathematical physiology to quantitative differential diagnoses.

    Directory of Open Access Journals (Sweden)

    Sven Zenker

    2007-11-01

    Full Text Available The improved capacity to acquire quantitative data in a clinical setting has generally failed to improve outcomes in acutely ill patients, suggesting a need for advances in computer-supported data interpretation and decision making. In particular, the application of mathematical models of experimentally elucidated physiological mechanisms could augment the interpretation of quantitative, patient-specific information and help to better target therapy. Yet, such models are typically complex and nonlinear, a reality that often precludes the identification of unique parameters and states of the model that best represent available data. Hypothesizing that this non-uniqueness can convey useful information, we implemented a simplified simulation of a common differential diagnostic process (hypotension in an acute care setting, using a combination of a mathematical model of the cardiovascular system, a stochastic measurement model, and Bayesian inference techniques to quantify parameter and state uncertainty. The output of this procedure is a probability density function on the space of model parameters and initial conditions for a particular patient, based on prior population information together with patient-specific clinical observations. We show that multimodal posterior probability density functions arise naturally, even when unimodal and uninformative priors are used. The peaks of these densities correspond to clinically relevant differential diagnoses and can, in the simplified simulation setting, be constrained to a single diagnosis by assimilating additional observations from dynamical interventions (e.g., fluid challenge. We conclude that the ill-posedness of the inverse problem in quantitative physiology is not merely a technical obstacle, but rather reflects clinical reality and, when addressed adequately in the solution process, provides a novel link between mathematically described physiological knowledge and the clinical concept of

  13. From Inverse Problems in Mathematical Physiology to Quantitative Differential Diagnoses

    Science.gov (United States)

    Zenker, Sven; Rubin, Jonathan; Clermont, Gilles

    2007-01-01

    The improved capacity to acquire quantitative data in a clinical setting has generally failed to improve outcomes in acutely ill patients, suggesting a need for advances in computer-supported data interpretation and decision making. In particular, the application of mathematical models of experimentally elucidated physiological mechanisms could augment the interpretation of quantitative, patient-specific information and help to better target therapy. Yet, such models are typically complex and nonlinear, a reality that often precludes the identification of unique parameters and states of the model that best represent available data. Hypothesizing that this non-uniqueness can convey useful information, we implemented a simplified simulation of a common differential diagnostic process (hypotension in an acute care setting), using a combination of a mathematical model of the cardiovascular system, a stochastic measurement model, and Bayesian inference techniques to quantify parameter and state uncertainty. The output of this procedure is a probability density function on the space of model parameters and initial conditions for a particular patient, based on prior population information together with patient-specific clinical observations. We show that multimodal posterior probability density functions arise naturally, even when unimodal and uninformative priors are used. The peaks of these densities correspond to clinically relevant differential diagnoses and can, in the simplified simulation setting, be constrained to a single diagnosis by assimilating additional observations from dynamical interventions (e.g., fluid challenge). We conclude that the ill-posedness of the inverse problem in quantitative physiology is not merely a technical obstacle, but rather reflects clinical reality and, when addressed adequately in the solution process, provides a novel link between mathematically described physiological knowledge and the clinical concept of differential diagnoses

  14. TERRAIN, Concord, Massachusetts

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Concord AOI consists of one area. Ground Control is collected throughout the AOI for use in the processing of LiDAR data to ensure data accurately represents the...

  15. Problems of standardized handling and quantitative evaluation of autoradiograms

    International Nuclear Information System (INIS)

    Treutler, H.C.; Freyer, K.

    1985-01-01

    In the last years autoradiography has gained increasing importance as a quantitative method of measuring radioactivity or element concentration. Mostly relative measurements are carried out. The optical density of the photographic emulsion produced by a calibrated radiation source is compared with that produced by a sample. The influences of different parameters, such as beta particle energy, backscattering, fading of the latent image, developing conditions, matrix effects and others on the results are described and the errors of the quantitative evaluation of autoradiograms are assessed. The performance of the method is demonstrated taking the quantitative determination of gold in silicon as an example

  16. Fast quantitative MRI as a nonlinear tomography problem

    NARCIS (Netherlands)

    Sbrizzi, Alessandro; Heide, Oscar van der; Cloos, Martijn; van der Toorn, A; Hoogduin, Hans; Luijten, Peter R; van den Berg, Cornelis A T

    2018-01-01

    Quantitative Magnetic Resonance Imaging (MRI) is based on a two-steps approach: estimation of the magnetic moments distribution inside the body, followed by a voxel-by-voxel quantification of the human tissue properties. This splitting simplifies the computations but poses several constraints on the

  17. Dissociative conceptual and quantitative problem solving outcomes across interactive engagement and traditional format introductory physics

    Directory of Open Access Journals (Sweden)

    Mark A. McDaniel

    2016-11-01

    Full Text Available The existing literature indicates that interactive-engagement (IE based general physics classes improve conceptual learning relative to more traditional lecture-oriented classrooms. Very little research, however, has examined quantitative problem-solving outcomes from IE based relative to traditional lecture-based physics classes. The present study included both pre- and post-course conceptual-learning assessments and a new quantitative physics problem-solving assessment that included three representative conservation of energy problems from a first-semester calculus-based college physics course. Scores for problem translation, plan coherence, solution execution, and evaluation of solution plausibility were extracted for each problem. Over 450 students in three IE-based sections and two traditional lecture sections taught at the same university during the same semester participated. As expected, the IE-based course produced more robust gains on a Force Concept Inventory than did the lecture course. By contrast, when the full sample was considered, gains in quantitative problem solving were significantly greater for lecture than IE-based physics; when students were matched on pre-test scores, there was still no advantage for IE-based physics on gains in quantitative problem solving. Further, the association between performance on the concept inventory and quantitative problem solving was minimal. These results highlight that improved conceptual understanding does not necessarily support improved quantitative physics problem solving, and that the instructional method appears to have less bearing on gains in quantitative problem solving than does the kinds of problems emphasized in the courses and homework and the overlap of these problems to those on the assessment.

  18. Effect of scaffolding on helping introductory physics students solve quantitative problems involving strong alternative conceptions

    Science.gov (United States)

    Lin, Shih-Yin; Singh, Chandralekha

    2015-12-01

    It is well known that introductory physics students often have alternative conceptions that are inconsistent with established physical principles and concepts. Invoking alternative conceptions in the quantitative problem-solving process can derail the entire process. In order to help students solve quantitative problems involving strong alternative conceptions correctly, appropriate scaffolding support can be helpful. The goal of this study is to examine how different scaffolding supports involving analogical problem-solving influence introductory physics students' performance on a target quantitative problem in a situation where many students' solution process is derailed due to alternative conceptions. Three different scaffolding supports were designed and implemented in calculus-based and algebra-based introductory physics courses involving 410 students to evaluate the level of scaffolding needed to help students learn from an analogical problem that is similar in the underlying principles involved but for which the problem-solving process is not derailed by alternative conceptions. We found that for the quantitative problem involving strong alternative conceptions, simply guiding students to work through the solution of the analogical problem first was not enough to help most students discern the similarity between the two problems. However, if additional scaffolding supports that directly helped students examine and repair their knowledge elements involving alternative conceptions were provided, e.g., by guiding students to contemplate related issues and asking them to solve the targeted problem on their own first before learning from the analogical problem provided, students were more likely to discern the underlying similarities between the problems and avoid getting derailed by alternative conceptions when solving the targeted problem. We also found that some scaffolding supports were more effective in the calculus-based course than in the algebra

  19. Research on a Unique Instructional Framework for Elevating Students’ Quantitative Problem Solving Abilities

    Science.gov (United States)

    Prather, Edward E.; Wallace, Colin Scott

    2018-06-01

    We present an instructional framework that allowed a first time physics instructor to improve students quantitative problem solving abilities by more than a letter grade over what was achieved by students in an experienced instructor’s course. This instructional framework uses a Think-Pair-Share approach to foster collaborative quantitative problem solving during the lecture portion of a large enrollment introductory calculus-based mechanics course. Through the development of carefully crafted and sequenced TPS questions, we engage students in rich discussions on key problem solving issues that we typically only hear about when a student comes for help during office hours. Current work in the sophomore E&M course illustrates that this framework is generalizable to classes beyond the introductory level and for topics beyond mechanics.

  20. A Quantitative Method for Localizing User Interface Problems: The D-TEO Method

    Directory of Open Access Journals (Sweden)

    Juha Lamminen

    2009-01-01

    Full Text Available A large array of evaluation methods have been proposed to identify Website usability problems. In log-based evaluation, information about the performance of users is collected and stored into log files, and used to find problems and deficiencies in Web page designs. Most methods require the programming and modeling of large task models, which are cumbersome processes for evaluators. Also, because much statistical data is collected onto log files, recognizing which Web pages require deeper usability analysis is difficult. This paper suggests a novel quantitative method, called the D-TEO, for locating problematic Web pages. This semiautomated method explores the decomposition of interaction tasks of directed information search into elementary operations, deploying two quantitative usability criteria, search success and search time, to reveal how a user navigates within a web of hypertext.

  1. Quantitative Trait Loci Mapping Problem: An Extinction-Based Multi-Objective Evolutionary Algorithm Approach

    Directory of Open Access Journals (Sweden)

    Nicholas S. Flann

    2013-09-01

    Full Text Available The Quantitative Trait Loci (QTL mapping problem aims to identify regions in the genome that are linked to phenotypic features of the developed organism that vary in degree. It is a principle step in determining targets for further genetic analysis and is key in decoding the role of specific genes that control quantitative traits within species. Applications include identifying genetic causes of disease, optimization of cross-breeding for desired traits and understanding trait diversity in populations. In this paper a new multi-objective evolutionary algorithm (MOEA method is introduced and is shown to increase the accuracy of QTL mapping identification for both independent and epistatic loci interactions. The MOEA method optimizes over the space of possible partial least squares (PLS regression QTL models and considers the conflicting objectives of model simplicity versus model accuracy. By optimizing for minimal model complexity, MOEA has the advantage of solving the over-fitting problem of conventional PLS models. The effectiveness of the method is confirmed by comparing the new method with Bayesian Interval Mapping approaches over a series of test cases where the optimal solutions are known. This approach can be applied to many problems that arise in analysis of genomic data sets where the number of features far exceeds the number of observations and where features can be highly correlated.

  2. Concordance des classifications et étude quantitative du recoupement des collections : les bibliothèques de la Faculté des Sciences de l’Université de Genève

    OpenAIRE

    Souiller-Dufaux, Cynthia; Maurer, Aline; Krause, Jan Brice

    2008-01-01

    Cette étude évalue la collection de monographies de la Faculté des Sciences de l'Université de Genève. Sur cette base, une étude plus approfondie peut être menée dans le but de mettre en place une politique d'acquisition et une gestion des collections communes des sept bibliothèques de la faculté. Un tableau de concordance entre les sept classifications a été établi afin d'obtenir un référentiel commun et d'étudier les sujets couverts par plusieurs bibliothèques. Des scripts Python ont été dé...

  3. Comparison between Roche and Xpert in HIV-1 RNA quantitation: A high concordance between the two techniques except for a CRF02_AG subtype variant with high viral load titters detected by Roche but undetected by Xpert.

    Science.gov (United States)

    Avidor, Boaz; Matus, Natalia; Girshengorn, Shirley; Achsanov, Svetlana; Gielman, Simona; Zeldis, Irene; Schweitzer, Inbal; Adler, Amos; Turner, Dan

    2017-08-01

    HIV-1 viral load (VL) testing is important to predict viral progression and to monitor the response to antiretroviral therapy. New HIV-1 VL tests are continuously introduced to the market. Their performance is usually compared to Abbott and/or Roche HIV-1 VL assays, as reference. The Xpert HIV-1 VL test was recently introduced, but its performance compared to Roche has not been sufficiently studied. To compare the Xpert assay with Roche and to assess its use in the HIV clinical laboratory. A total of 383 plasma samples of HIV-1 infected patients previously tested by Roche, were retrospectively tested by Xpert to determine concordance between the two assays. Samples included a diversity of HIV-1 subtypes and a wide range of VLs. There was a high concordance between the two assays, except for a CRF02_AG subtype variant with high VL titters, that was detected by Roche but undetected by Xpert. The 5' long terminal repeat gene region of this virus, targeted by the Xpert assay, was amplified and sequenced. A 25 nucleotide insert was identified, but was unmatched to any known sequences of HIV-1. This particular insert, however could not explain the false-negativity by the Xpert assay. This study underlines the challenge to routine VL testing due to the high genetic diversity of HIV-1. Clinicians should, therefore be advised that a negative VL in cases where the clinical picture does not match the laboratory report, might in fact be, a false-negative result of the VL assay. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Problems with the quantitative spectroscopic analysis of oxygen rich Czech coals

    Energy Technology Data Exchange (ETDEWEB)

    Pavlikova, H.; Machovic, V.; Cerny, J. [Inst. of Chemical Technology, Prague (Czechoslovakia); Sebestova, E. [Inst. of Rock Structure and Mechanics, Prague (Czechoslovakia)

    1995-12-01

    Solid state NMR and FTIR spectroscopies are two main methods used for the structural analysis of coals and their various products. Obtaining quantitative parameters from coals, such as arornaticity (f{sub a}) by the above mentioned methods can be a rather difficult task. Coal samples of various rank were chosen for the quantitative NMR, FTIR and EPR analyses. The aromaticity was obtained by the FTIR, {sup 13}C CP/MAS and SP/MAS NMR experiments. The content of radicals and saturation characteristics of coals were measured by EPR spectroscopy. The following problems have been discussed: 1. The relationship between the amount of free radicals (N{sub g}) and f{sub a} by NMR. 2. The f{sub a} obtained by solid state NMR and FTIR spectroscopies. 3. The differences between the f{sub a} measured by CP and SP/NMR experiments. 4. The relationship between the content of oxygen groups and the saturation responses of coals. The reliability of our results was checked by measuring the structural parameters of Argonne premium coals.

  5. Lack of quantitative training among early-career ecologists: a survey of the problem and potential solutions

    Directory of Open Access Journals (Sweden)

    Frédéric Barraquand

    2014-03-01

    Full Text Available Proficiency in mathematics and statistics is essential to modern ecological science, yet few studies have assessed the level of quantitative training received by ecologists. To do so, we conducted an online survey. The 937 respondents were mostly early-career scientists who studied biology as undergraduates. We found a clear self-perceived lack of quantitative training: 75% were not satisfied with their understanding of mathematical models; 75% felt that the level of mathematics was “too low” in their ecology classes; 90% wanted more mathematics classes for ecologists; and 95% more statistics classes. Respondents thought that 30% of classes in ecology-related degrees should be focused on quantitative disciplines, which is likely higher than for most existing programs. The main suggestion to improve quantitative training was to relate theoretical and statistical modeling to applied ecological problems. Improving quantitative training will require dedicated, quantitative classes for ecology-related degrees that contain good mathematical and statistical practice.

  6. An adaptation of the Interpersonal Problem Areas Rating Scale: pilot and interrater agreement study Adaptação da Escala de Áreas Problema da Psicoterapia Interpessoal: estudo piloto e avaliação de concordância

    Directory of Open Access Journals (Sweden)

    Ana Claudia Fontes de Andrade

    2008-12-01

    Full Text Available OBJECTIVE: This article describes the adaptation of a rating scale of interpersonal psychotherapy problem areas to include a fifth problem area appropriate to bipolar disorder and an interrater agreement study in identifying interpersonal problem areas and selecting a primary treatment focus if patients were to engage in treatment. METHOD: Five research interpersonal psychotherapists assessed nine audiotapes of a single interview with five bipolar and four unipolar patients in which the interpersonal inventory and identification of problem areas were undertaken. RESULTS: Raters agreed on presence and absence of problem areas in seven tapes. Kappas for identification of problem areas were 1.00 (grief, 0.77 (role dispute, 0.61 (role transition, 0.57 (interpersonal deficits and 1.00 (loss of healthy self. Kappa for agreement on a primary clinical focus if patients were to engage in interpersonal psychotherapy treatment was 0.64. CONCLUSIONS: The adaptation of the original scale to include an area pertinent to bipolar disorder proved to be applicable and relevant for use with this population. The results show substantial interrater agreement in identifying problem areas and potential treatment focus.OBJETIVO: Este artigo descreve a adaptação de uma escala de avaliação de áreas problema da psicoterapia interpessoal que inclui uma área própria ao transtorno bipolar e um estudo de concordância em identificar áreas problema e selecionar um foco primário de tratamento caso os pacientes fossem participar de tratamento. MÉTODO: Cinco terapeutas interpessoais avaliaram nove audiotapes de uma única entrevista com cinco pacientes bipolares e quatro pacientes unipolares em que o inventário interpessoal e identificação de áreas problema foram empreendidos. RESULTADOS: Os avaliadores concordaram na presença e ausência de áreas problema em sete fitas. Kappas para identificação de áreas problema foram 1,00 (luto, 0,77 (disputa de papel, 0

  7. Concordance for prognostic models with competing risks

    DEFF Research Database (Denmark)

    Wolbers, Marcel; Blanche, Paul; Koller, Michael T

    2014-01-01

    The concordance probability is a widely used measure to assess discrimination of prognostic models with binary and survival endpoints. We formally define the concordance probability for a prognostic model of the absolute risk of an event of interest in the presence of competing risks and relate i...

  8. Design and Evaluation of Digital Learning Material to Support Acquisition of Quantitative Problem-Solving Skills Within Food Chemistry

    NARCIS (Netherlands)

    Diederen, J.; Gruppen, H.; Hartog, R.; Voragen, A.G.J.

    2005-01-01

    One of the modules in the course Food Chemistry at Wageningen University (Wageningen, The Netherlands) focuses on quantitative problem-solving skills related to chemical reactions. The intended learning outcomes of this module are firstly, to be able to translate practical food chemistry related

  9. Visualization of Problem Solving Related to the Quantitative Composition of Solutions in the Dynamic "GeoGebra" Environment

    Science.gov (United States)

    Kostic, V. Dj.; Jovanovic, V. P. Stankov; Sekulic, T. M.; Takaci, Dj. B.

    2016-01-01

    Problem solving in the field of quantitative composition of solutions (QCS), expressed as mass share and molar concentration, is essential for chemistry students. Since successful chemistry education is based on different mathematical contents, it is important to be proficient in both mathematical and chemistry concepts as well as interconnections…

  10. Qualitative Research? Quantitative Research? What's the Problem? Resolving the Dilemma via a Postconstructivist Approach.

    Science.gov (United States)

    Shank, Gary

    It is argued that the debate between qualitative and quantitative research for educational researchers is actually an argument between constructivism and positivism. Positivism has been the basis for most quantitative research in education. Two different things are actually meant when constructivism is discussed (constructivism and…

  11. Integrated cosmological probes: concordance quantified

    Energy Technology Data Exchange (ETDEWEB)

    Nicola, Andrina; Amara, Adam; Refregier, Alexandre, E-mail: andrina.nicola@phys.ethz.ch, E-mail: adam.amara@phys.ethz.ch, E-mail: alexandre.refregier@phys.ethz.ch [Department of Physics, ETH Zürich, Wolfgang-Pauli-Strasse 27, CH-8093 Zürich (Switzerland)

    2017-10-01

    Assessing the consistency of parameter constraints derived from different cosmological probes is an important way to test the validity of the underlying cosmological model. In an earlier work [1], we computed constraints on cosmological parameters for ΛCDM from an integrated analysis of CMB temperature anisotropies and CMB lensing from Planck, galaxy clustering and weak lensing from SDSS, weak lensing from DES SV as well as Type Ia supernovae and Hubble parameter measurements. In this work, we extend this analysis and quantify the concordance between the derived constraints and those derived by the Planck Collaboration as well as WMAP9, SPT and ACT. As a measure for consistency, we use the Surprise statistic [2], which is based on the relative entropy. In the framework of a flat ΛCDM cosmological model, we find all data sets to be consistent with one another at a level of less than 1σ. We highlight that the relative entropy is sensitive to inconsistencies in the models that are used in different parts of the analysis. In particular, inconsistent assumptions for the neutrino mass break its invariance on the parameter choice. When consistent model assumptions are used, the data sets considered in this work all agree with each other and ΛCDM, without evidence for tensions.

  12. Quantitative and qualitative approaches in educational research — problems and examples of controlled understanding through interpretive methods

    Science.gov (United States)

    Neumann, Karl

    1987-06-01

    In the methodological discussion of recent years it has become apparent that many research problems, including problems relating to the theory of educational science, cannot be solved by using quantitative methods. The multifaceted aspects of human behaviour and all its environment-bound subtle nuances, especially the process of education or the development of identity, cannot fully be taken into account within a rigid neopositivist approach. In employing the paradigm of symbolic interactionism as a suitable model for the analysis of processes of education and formation, the research has generally to start out from complex reciprocal social interactions instead of unambigious connections of causes. In analysing several particular methodological problems, the article demonstrates some weaknesses of quantitative approaches and then shows the advantages in and the necessity for using qualitative research tools.

  13. Quantitative analysis by microchip capillary electrophoresis – current limitations and problem-solving strategies

    NARCIS (Netherlands)

    Revermann, T.; Götz, S.; Künnemeyer, Jens; Karst, U.

    2008-01-01

    Obstacles and possible solutions for the application of microchip capillary electrophoresis in quantitative analysis are described and critically discussed. Differences between the phenomena occurring during conventional capillary electrophoresis and microchip-based capillary electrophoresis are

  14. Genotype-Specific Concordance of Chlamydia trachomatis Genital Infection Within Heterosexual Partnerships.

    Science.gov (United States)

    Schillinger, Julia A; Katz, Barry P; Markowitz, Lauri E; Braslins, Phillip G; Shrier, Lydia A; Madico, Guillermo; Van Der Pol, Barbara; Orr, Donald P; Rice, Peter A; Batteiger, Byron E

    2016-12-01

    Sexual transmission rates of Chlamydia trachomatis (Ct) cannot be measured directly; however, the study of concordance of Ct infection in sexual partnerships (dyads) can help to illuminate factors influencing Ct transmission. Heterosexual men and women with Ct infection and their sex partners were enrolled and partner-specific coital and behavioral data collected for the prior 30 days. Microbiological data included Ct culture, and nucleic acid amplification testing (NAAT), quantitative Ct polymerase chain reaction, and ompA genotyping. We measured Ct concordance in dyads and factors (correlates) associated with concordance. One hundred twenty-one women and 125 men formed 128 dyads. Overall, 72.9% of male partners of NAAT-positive women and 68.6% of female partners of NAAT-positive men were Ct-infected. Concordance was more common in dyads with culture-positive members (78.6% of male partners, 77% of female partners). Partners of women and men who were NAAT-positive only had lower concordance (33.3%, 46.4%, respectively). Women in concordant dyads had significantly higher median endocervical quantitative Ct polymerase chain reaction values (3,032) compared with CT-infected women in discordant dyads (1013 inclusion forming units DNA equivalents per mL; P model coitus-specific transmission probabilities.

  15. Civic Friendship in Aristotle: Concord and Fraternity

    Directory of Open Access Journals (Sweden)

    Oriol Farrés Juste

    2015-05-01

    Full Text Available the article shows the importance of friendship in the context of Aristotelian political philosophy. this importance is verified in its specific weight compared with justice. As it is known, Aristotle argues that the pursuit of friendship outranks the pursuit of justice in the polis. Particularly, the article focuses on the role of concord, as a special type of civic friendship, in terms of preserving the unity and stability of the polis. to grasp its significance, we have to consider the role of concord as a supplement of the political condition of the human being. Concord is necessary in the light of the trend to the struggle between the parts of the city, between the demos and the oligarchs. Since this fight endangers the continuity of the polis, concord among citizens becomes a privileged background of early republican fraternity, which has not enjoyed sufficient attention in the field of history of political philosophy.

  16. Sociodemographic Correlates of HIV Discordant and Concordant ...

    African Journals Online (AJOL)

    AIDS is significant. An understanding of the characteristics of HIV- affected couples will help modify preventive strategies. The aim of this study was to compare the HIV discordant and concordant partnerships for sociodemographic ...

  17. Continuous Measurements and Quantitative Constraints: Challenge Problems for Discrete Modeling Techniques

    Science.gov (United States)

    Goodrich, Charles H.; Kurien, James; Clancy, Daniel (Technical Monitor)

    2001-01-01

    We present some diagnosis and control problems that are difficult to solve with discrete or purely qualitative techniques. We analyze the nature of the problems, classify them and explain why they are frequently encountered in systems with closed loop control. This paper illustrates the problem with several examples drawn from industrial and aerospace applications and presents detailed information on one important application: In-Situ Resource Utilization (ISRU) on Mars. The model for an ISRU plant is analyzed showing where qualitative techniques are inadequate to identify certain failure modes and to maintain control of the system in degraded environments. We show why the solution to the problem will result in significantly more robust and reliable control systems. Finally, we illustrate requirements for a solution to the problem by means of examples.

  18. The link between resource problems and interorganisational relationships : A quantitative study of Western European sport clubs

    NARCIS (Netherlands)

    Pamela Wicker; Jeroen Scheerder; Steven Vos; Christoph Breuer

    2013-01-01

    According to the resource dependence theory, organisations draw upon interorganisational relationships to address the need for additional resources. The purpose of this study was to analyse whether sport clubs with serious resource problems regarding members, human resources (volunteers and

  19. Problem of the Classification of Quantitative Noun in the German Language

    Directory of Open Access Journals (Sweden)

    Elvira L. Shubina

    2015-01-01

    Full Text Available This work is dedicated to the semantic classification of quantitative noun on the basis of a structural study (Nquant + (Adj +N (ein Glas frisches Wasser, since this model reveals the greatest variety of grammatical formulation. These word combinations can form by the genitive government eine Tasse starken Kaffees by the grammatical agreement ein Eimer kaltes Wasser, or by the adjunction mit einem Korb reife Apfel. The suggested classification of the noun performing the function of the first components is based on the form of the noun acting as the first component. Types of the first components fall into three groups: 1. The nouns, which specify quantitative characteristics of objects and substances. Two subgroups are also distingshed: word combinations with a noun in a singular form Nquant1a as the second component and word combinations with a noun in a plural form as the second component Nquant1b; 2. The nouns defining a group of living beings and objects Nquant2; 3. The nouns which formation is grounded on quantitative nouns Nquant3. Normative recommendations on the choice of subordinate connection type should be connected at least at the present stage of existence of German literary language, exactly with the semantics of the nouns which are the first components in these word combinations. The article illustrates that all types of constructions (organizes whether on the basis of government, agreement and or adjunction are connected with the completely specific semantic characteristics of the name, i.e., these nouns belong to one of three groups of noun - first components.

  20. Consanguinity and spousal concordance in Kuwait.

    Science.gov (United States)

    al-Kandari, Y; Crews, D E; Poirier, F E

    2002-12-01

    Consanguineous marriage is favored in Kuwait. This research focuses on the relationship of physical and cultural traits to marriage types in Kuwait and examines concordance as a function of consanguinity and marriage duration. In a nonrandom opportunistic sample of 242 couples anthropometric and blood pressure data have been collected as well as data on acculturation, religiosity, Farsi proficiency, level of education, occupation, and attitudes regarding fertility. Significant concordances occur in cultural characteristics among couples in all three types of marriages with respect to the degree of religiosity, acculturation, language similarity, education, and occupation. Non-consanguineous spouses have the highest concordance in educational level, occupation, and degree of acculturation, but the lowest for religiosity and Farsi proficiency. Nonkin marriages seem to be based on personal preferences. In the wider potential nonkin marriage pool spouses show more concordance in stature and education indicating the positive assortative mating for those traits. Non-consanguineous spouses show a significant association for triceps and subscapular skinfold thicknesses hip and waist circumferences, and body fat distribution. Unrelated spouses exhibit more concordance for physical traits than do related spouses. There is a significant correlation between spouses in first and double cousin marriages as well as in spouses in second and less than second cousin unions for systolic and diastolic blood pressure, while non-consanguineous spouses show a significant association in diastolic blood pressure only.

  1. Agency Problems and Airport Security: Quantitative and Qualitative Evidence on the Impact of Security Training.

    Science.gov (United States)

    de Gramatica, Martina; Massacci, Fabio; Shim, Woohyun; Turhan, Uğur; Williams, Julian

    2017-02-01

    We analyze the issue of agency costs in aviation security by combining results from a quantitative economic model with a qualitative study based on semi-structured interviews. Our model extends previous principal-agent models by combining the traditional fixed and varying monetary responses to physical and cognitive effort with nonmonetary welfare and potentially transferable value of employees' own human capital. To provide empirical evidence for the tradeoffs identified in the quantitative model, we have undertaken an extensive interview process with regulators, airport managers, security personnel, and those tasked with training security personnel from an airport operating in a relatively high-risk state, Turkey. Our results indicate that the effectiveness of additional training depends on the mix of "transferable skills" and "emotional" buy-in of the security agents. Principals need to identify on which side of a critical tipping point their agents are to ensure that additional training, with attached expectations of the burden of work, aligns the incentives of employees with the principals' own objectives. © 2016 Society for Risk Analysis.

  2. Guideline concordance of treatment for depressive disorders in Canada.

    Science.gov (United States)

    Duhoux, Arnaud; Fournier, Louise; Nguyen, Cat Tuong; Roberge, Pasquale; Beveridge, Rachelle

    2009-05-01

    Depression is one of the most prevalent mental health problems worldwide with considerable social and economic burdens. While practice guidelines exist, their adherence is inconsistent in clinical practice. To provide up-to-date national estimates of the adequacy of treatment received by Canadians having suffered a major depressive disorder (MDD) and examine factors associated with this adequacy. To evaluate the impact of different definitions of guideline-concordant treatment on the results. Data were drawn from the Canadian Community Health Survey, cycle 1.2: Mental Health and Well-Being (CCHS 1.2), a nationally representative survey conducted in 2002 and targetting persons aged 15 years or older living in private dwellings. In order to calculate the prevalence of treatment adequacy, we used a sample of 1,563 individuals meeting the criteria for MDD in the 12 months preceding the survey. A subset of 831 subjects who reported having used health services for mental health purposes at least once during that time served to identify the factors associated with treatment adequacy. Four definitions of minimally adequate treatment were considered and covariates were selected according to a well-known behavioral model. The analyses consisted of prevalence estimates and logistic regression models. Among selected subjects, 55% received guideline-concordant treatment according to the Canadian guidelines. Inadequacy was more prevalent in rural settings, for less complex cases, and in the general medical sector. Depending on the definition, prevalence of guideline-concordant treatment ranged between 48 and 71%, and factors associated with guideline-concordant treatment were mainly need factors and sector of care. A large proportion of people with a depressive disorder do not receive minimally adequate treatment. Improved access to and quality of treatment is required, especially in primary care settings.

  3. Are qualitative and quantitative sleep problems associated with delinquency when controlling for psychopathic features and parental supervision?

    Science.gov (United States)

    Backman, Heidi; Laajasalo, Taina; Saukkonen, Suvi; Salmi, Venla; Kivivuori, Janne; Aronen, Eeva T

    2015-10-01

    The aim of this study was to explore the relationship between sleep, including both qualitative and quantitative aspects, and delinquent behaviour while controlling for psychopathic features of adolescents and parental supervision at bedtime. We analysed data from a nationally representative sample of 4855 Finnish adolescents (mean age 15.3 years, 51% females). Sleep problems, hours of sleep and delinquency were evaluated via self-report. Psychopathic features were measured with the Antisocial Process Screening Device - Self-Report. In negative binomial regressions, gender and sleep-related variables acted as predictors for both property and violent crime after controlling for psychopathic features and parental supervision at bedtime. The results suggest that both sleep problems (at least three times per week, at least for a year) and an insufficient amount of sleep (less than 7 h) are associated with property crime and violent behaviour, and the relationship is not explained by gender, degree of parental supervision at bedtime or co-occurring psychopathic features. These results suggest that sleep difficulties and insufficient amount of sleep are associated with delinquent behaviour in adolescents. The significance of addressing sleep-related problems, both qualitative and quantitative, among adolescents is thus highlighted. Implications for a prevention technique of delinquent behaviour are discussed. © 2015 European Sleep Research Society.

  4. Is problem-based learning associated with students’ motivation? A quantitative and qualitative study

    NARCIS (Netherlands)

    M. Wijnen (Marit); S.M.M. Loyens (Sofie); L. Wijnia (Lisette); G. Smeets (Guus); M.J. Kroeze (Maarten); H.T. van der Molen (Henk)

    2017-01-01

    textabstractIn this study, a mixed-method design was employed to investigate the association between a student-centred, problem-based learning (PBL) method and law students’ motivation. Self-determination theory (SDT) states that autonomous motivation, which is associated with higher academic

  5. Models and methods of emotional concordance.

    Science.gov (United States)

    Hollenstein, Tom; Lanteigne, Dianna

    2014-04-01

    Theories of emotion generally posit the synchronized, coordinated, and/or emergent combination of psychophysiological, cognitive, and behavioral components of the emotion system--emotional concordance--as a functional definition of emotion. However, the empirical support for this claim has been weak or inconsistent. As an introduction to this special issue on emotional concordance, we consider three domains of explanations as to why this theory-data gap might exist. First, theory may need to be revised to more accurately reflect past research. Second, there may be moderating factors such as emotion regulation, context, or individual differences that have obscured concordance. Finally, the methods typically used to test theory may be inadequate. In particular, we review a variety of potential issues: intensity of emotions elicited in the laboratory, nonlinearity, between- versus within-subject associations, the relative timing of components, bivariate versus multivariate approaches, and diversity of physiological processes. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. On the concordance genus of topologically slice knots

    OpenAIRE

    Hom, Jennifer

    2012-01-01

    The concordance genus of a knot K is the minimum Seifert genus of all knots smoothly concordant to K. Concordance genus is bounded below by the 4-ball genus and above by the Seifert genus. We give a lower bound for the concordance genus of K coming from the knot Floer complex of K. As an application, we prove that there are topologically slice knots with 4-ball genus equal to one and arbitrarily large concordance genus.

  7. Problems involved in quantitative gamma camera scintigraphy. C. Sensitivity and homogeneity

    International Nuclear Information System (INIS)

    Erbsmann, F.; Paternot, J.; Piepsz, A.; Dobbeleire, A.; Froideville, J.L.

    1976-01-01

    A constant sensitivity of the scintillation camera is an important feature of quantitative digital scintigraphy and must be controlled as much as other factors. The phantom distribution is an excellent test of the camera adjusment but according to present knowledge cannot be used to make corrections of any kind. The best way to reduce the effect of spatial sensitivity variations is to use the same part of the detector constantly to measure the standard as well as the two successive kidneys. Users who wish to measure the uptake of both kidneys simultaneously are advised to measure the standard in the approximate position of the two kidneys and to check that the count rate difference is not more than 5% for example, a higher value requiring a camera adjustment [fr

  8. Quantitative and Qualitative Analysis of Reported Dreams and the Problem of Double Hermeneutics in Clinical Research

    Directory of Open Access Journals (Sweden)

    Siamak Movahedi

    2012-12-01

    Full Text Available The aim of this article is to show that statistical analysis and hermeneutics are not mutually exclusive. Although statistical analysis may capture some patterns and regularities, statistical methods may themselves generate different types of interpretation and, in turn, give rise to even more interpretations. The discussion is lodged within the context of a quantitative analysis of dream content. I attempted to examine the dialogical texts of reported dreams monologically, but soon found myself returning to dialogic contexts to make sense of statistical patterns. One could cogently argue that the reported statistical relationships in this study, rather than pointing to any interaction among the “signifieds,” speak only to the relationships among the “signifiers” that were being played out through various actors on the analytic or scientific stage, since all of the constructs used in theorizing about, interpreting, and telling dreams come from the same discursive system.

  9. Quantitative and qualitative problems of short film production in cinema education in Turkey

    Directory of Open Access Journals (Sweden)

    Erkanı Mehmet Emrah

    2016-01-01

    Full Text Available Although Turkish cinema has completed its 100 years, short film could not find the place it deserves in the institutions and in the sector. There are problems in terms of the narrative and technical characteristics of short films beside presentation, marketing and international festival attendance issues. Low budgets, course schedules and structures of the cinema departments and short films and the sector’s ignorance of the importance of short film are the obstacles to the development of short films in Turkey. Increasing the government support, strengthening the cooperation between the sector and the university, improving the festivals’ screening conditions, reforming the arrangements to increase the sponsorship incentives, solving the equipment problems of the institutions will positively affect the productivity of Turkish cinema.

  10. Concordance analysis for QTL detection in dairy cattle: a case study of leg morphology

    DEFF Research Database (Denmark)

    van den Berg, Irene; Rodrigue; Fritz, Sebastien

    2014-01-01

    The present availability of sequence data gives new opportunities to narrow down from QTL (quantitative trait locus) regions to causative mutations. Our objective was to decrease the number of candidate causative mutations in a QTL region. For this, a concordance analysis was applied for a leg co...

  11. How students process equations in solving quantitative synthesis problems? Role of mathematical complexity in students’ mathematical performance

    Directory of Open Access Journals (Sweden)

    Bashirah Ibrahim

    2017-10-01

    Full Text Available We examine students’ mathematical performance on quantitative “synthesis problems” with varying mathematical complexity. Synthesis problems are tasks comprising multiple concepts typically taught in different chapters. Mathematical performance refers to the formulation, combination, and simplification of equations. Generally speaking, formulation and combination of equations require conceptual reasoning; simplification of equations requires manipulation of equations as computational tools. Mathematical complexity is operationally defined by the number and the type of equations to be manipulated concurrently due to the number of unknowns in each equation. We use two types of synthesis problems, namely, sequential and simultaneous tasks. Sequential synthesis tasks require a chronological application of pertinent concepts, and simultaneous synthesis tasks require a concurrent application of the pertinent concepts. A total of 179 physics major students from a second year mechanics course participated in the study. Data were collected from written tasks and individual interviews. Results show that mathematical complexity negatively influences the students’ mathematical performance on both types of synthesis problems. However, for the sequential synthesis tasks, it interferes only with the students’ simplification of equations. For the simultaneous synthesis tasks, mathematical complexity additionally impedes the students’ formulation and combination of equations. Several reasons may explain this difference, including the students’ different approaches to the two types of synthesis problems, cognitive load, and the variation of mathematical complexity within each synthesis type.

  12. Negative concord and the scope of universals

    NARCIS (Netherlands)

    Giannakidou, A

    2000-01-01

    In this paper, I propose an analysis of Greek negative concord (NC) in terms of quantifier scope. It is shown that there is no evidence that Greek NC n-words are indefinites or negative quantifiers, NC n-words are analysed as universal quantifiers, which are sensitive to negative polarity, and which

  13. Concord, Convergence and Accommodation in Bilingual Children

    Science.gov (United States)

    Radford, Andrew; Kupisch, Tanja; Koppe, Regina; Azzaro, Gabriele

    2007-01-01

    This paper examines the syntax of "GENDER CONCORD" in mixed utterances where bilingual children switch between a modifier in one language and a noun in another. Particular attention is paid to how children deal with potential gender mismatches between modifier and noun, i.e., if one of the languages has grammatical gender but the other does not,…

  14. Problems in implementation of the spatial plan of the Republic of Srpska until 2015: Quantitative analysis

    Directory of Open Access Journals (Sweden)

    Bijelić Branislav

    2017-01-01

    Full Text Available The implementation of spatial plans in the Republic of Srpska is certainly the weakest phase of the process of spatial planning in this entity. It is particularly evident in the case of the Spatial Plan of the Republic of Srpska until 2015 which is the highest strategic spatial planning document in the Republic of Srpska. More precisely, the implementation of spatial plans has been defined as the carrying out of spatial planning documents, i.e. planning propositions as defined in the spatial plans. For the purpose of this paper, a quantitative analysis of the implementation of the planning propositions envisioned by this document has been carried out. The difference between what was planned and what was implemented at the end of the planning period (ex-post evaluation of planning decisions is presented in this paper. The weighting factor is defined for each thematic field and planning proposition, where the main criterion for determining the weighting factor is the share of the planning proposition and thematic field in the estimated total costs of the plan (financial criterion. The paper has also tackled the issue of the implementation of the Spatial Plan of Bosnia and Herzegovina for the period 1981 - 2000, as well as of the Spatial Plan of the Republic of Srpska 1996 - 2001 - Phased Plan for the period 1996 - 2001, as the previous strategic spatial planning documents of the highest rank covering the area of the Republic of Srpska. The research results have proven primary hypothesis of the paper that the level of the implementation of Spatial Plan of the Republic of Srpska until 2015 is less than 10%.

  15. Faculty Grading of Quantitative Problems: A Mismatch between Values and Practice

    Science.gov (United States)

    Petcovic, Heather L.; Fynewever, Herb; Henderson, Charles; Mutambuki, Jacinta M.; Barney, Jeffrey A.

    2013-04-01

    Grading practices can send a powerful message to students about course expectations. A study by Henderson et al. (American Journal of Physics 72:164-169, 2004) in physics education has identified a misalignment between what college instructors say they value and their actual scoring of quantitative student solutions. This work identified three values that guide grading decisions: (1) a desire to see students' reasoning, (2) a readiness to deduct points from solutions with obvious errors and a reluctance to deduct points from solutions that might be correct, and (3) a tendency to assume correct reasoning when solutions are ambiguous. These authors propose that when values are in conflict, the conflict is resolved by placing the burden of proof on either the instructor or the student. Here, we extend the results of the physics study to earth science ( n = 7) and chemistry ( n = 10) instructors in a think-aloud interview study. Our results suggest that both the previously identified three values and the misalignment between values and grading practices exist among science faculty more generally. Furthermore, we identified a fourth value not previously recognized. Although all of the faculty across both studies stated that they valued seeing student reasoning, the combined effect suggests that only 49% of faculty across the three disciplines graded work in such a way that would actually encourage students to show their reasoning, and 34% of instructors could be viewed as penalizing students for showing their work. This research may contribute toward a better alignment between values and practice in faculty development.

  16. Consumer perspectives of medication-related problems following discharge from hospital in Australia: a quantitative study.

    Science.gov (United States)

    Eassey, Daniela; Smith, Lorraine; Krass, Ines; McLAchlan, Andrew; Brien, Jo-Anne

    2016-06-01

    The aim of this study was to investigate the consumer's perspectives and experiences regarding medication related problems (MRPs) following discharge from hospital. A cross-sectional study was conducted using an online 80-question survey. Survey participants were recruited through an online market research company. Five hundred and six participants completed the survey. Participants were included if they were aged 50 years or older, taking 5 or more prescription medicines, had been admitted to hospital with a minimum stay of 24 h, admitted to hospital within the last 4 months and discharged from hospital within the last 1 month. The survey comprised questions measuring: health literacy, health status, medication safety (measured by reported MRPs), missed dose(s), role of health professionals, health services and cost, and socio-demographic status. Descriptive and univariate statistics and logistic regression analysis was performed to examine the predictors of experiencing MRPs. Four main risk factors of MRPs emerged as significant: health literacy (P < 0.05), health status (P < 0.05), consumer engagement (P < 0.05) and cost of medicines (P = 0.001). Participants reporting a lack of perceived control over their medicines (OR 6.3; 95% CI: 3.4-11.8) or those who played less of a role in follow-up discussions with their healthcare professionals (OR 7.6; 95% CI: 1.3-45.7) were more likely to experience a self-reported MRP. This study provides insight into consumers' experiences and perceptions of self-reported MRPs following hospital discharge. Results highlight novel findings demonstrating the importance of consumer engagement in developing processes to ensure medication safety on patient discharge. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  17. Optimisation of information influences on problems of consequences of Chernobyl accident and quantitative criteria for estimation of information actions

    International Nuclear Information System (INIS)

    Sobaleu, A.

    2004-01-01

    Consequences of Chernobyl NPP accident still very important for Belarus. About 2 million Byelorussians live in the districts polluted by Chernobyl radionuclides. Modern approaches to the decision of after Chernobyl problems in Belarus assume more active use of information and educational actions to grow up a new radiological culture. It will allow to reduce internal doze of radiation without spending a lot of money and other resources. Experience of information work with the population affected by Chernobyl since 1986 till 2004 has shown, that information and educational influences not always reach the final aim - application of received knowledge on radiating safety in practice and changing the style of life. If we take into account limited funds and facilities, we should optimize information work. The optimization can be achieved on the basis of quantitative estimations of information actions effectiveness. It is possible to use two parameters for this quantitative estimations: 1) increase in knowledge of the population and experts on the radiating safety, calculated by new method based on applied theory of the information (Mathematical Theory of Communication) by Claude E. Shannon and 2) reduction of internal doze of radiation, calculated on the basis of measurements on human irradiation counter (HIC) before and after an information or educational influence. (author)

  18. Cluster infall in the concordance LCDM model

    OpenAIRE

    Pivato, Maximiliano C.; Padilla, Nelson D.; Lambas, Diego G.

    2005-01-01

    We perform statistical analyses of the infall of dark-matter onto clusters in numerical simulations within the concordance LCDM model. By studying the infall profile around clusters of different mass, we find a linear relation between the maximum infall velocity and mass which reach 900km/s for the most massive groups. The maximum infall velocity and the group mass follow a suitable power law fit of the form, V_{inf}^{max} = (M/m_0)^{gamma}. By comparing the measured infall velocity to the li...

  19. Cross-method validation as a solution to the problem of excessive simplification of measurement in quantitative IR research

    DEFF Research Database (Denmark)

    Beach, Derek

    2007-01-01

    The purpose of this article is to make IR scholars more aware of the costs of choosing quantitative methods. The article first shows that quantification can have analytical ‘costs’ when the measures created are too simple to capture the essence of the systematized concept that was supposed...... detail based upon a review of the democratic peace literature. I then offer two positive suggestions for a way forward. First, I argue that quantitative scholars should spend more time validating their measures, and in particular should engage in multi-method partnerships with qualitative scholars...... that have a deep understanding of particular cases in order to exploit the comparative advantages of qualitative methodology, using the more accurate qualitative measures to validate their own quantitative measures. Secondly, quantitative scholars should lower their level of ambition given the often poor...

  20. Assessing clinical reasoning in optometry using the script concordance test.

    Science.gov (United States)

    Faucher, Caroline; Dufour-Guindon, Marie-Pier; Lapointe, Gabrielle; Gagnon, Robert; Charlin, Bernard

    2016-05-01

    Clinical reasoning is central to any health profession but its development among learners is difficult to assess. Over the last few decades, the script concordance test (SCT) has been developed to solve this dilemma and has been used in many health professions; however, no study has been published on the use of the script concordance test in optometry. The purpose of this study was to develop and validate a script concordance test for the field of optometry. A 101-question script concordance test (27 short clinical scenarios) was developed and administered online to a convenience sample of 23 second-year and 19 fourth-year students of optometry. It was also administered to a reference panel of 12 experienced optometrists to develop the scoring key. An item-total correlation was calculated for each question. Cronbach's alpha coefficient was used to evaluate the script concordance test reliability and a t-test compared the two groups. A final 77-question script concordance test was created by eliminating questions with low item-total correlation. Cronbach's alpha for this optimised 77-question script concordance test was 0.80. A group comparison revealed that the second-year students' scores (n = 23; mean score = 66.4 ± 7.87 per cent) were statistically lower (t = -4.141; p Optometry © 2016 Optometry Australia.

  1. The Effects of Representation Format in Problem Representation on Qualitative Understanding and Quantitative Proficiency in a Learning Game Context

    Science.gov (United States)

    Lee, Sungwoong

    2016-01-01

    Reports and surveys by the U.S. government and international organizations have repeatedly acknowledged the achievement problem in math in K-12 regardless of various efforts (e.g., by the U.S. Department of Education) to diminish it. To address the problem in math achievement in K-12, teachers, scholars, and the U.S. government have developed…

  2. The Concordance of Parent and Child Immunization.

    Science.gov (United States)

    Robison, Steve G; Osborn, Andrew W

    2017-05-01

    A substantial body of work has related survey-based parental vaccine hesitancy to noncompliant childhood immunization. However little attention has been paid to the connection between parents' own immunization behavior and the immunizations their children receive. Using the Oregon ALERT Immunization Information System, we identified adult caregiver-child pairs for children between 9 months and 17 years of age. The likelihood of adult-child concordance of influenza immunization per influenza season from 2010-2011 through 2014-2015 was assessed. The utility of adult immunization as a predictor was also assessed for other, noninfluenza recommended immunizations for children and adolescents. A total of 450 687 matched adult caregiver-child pairs were included in the study. The children of immunizing adults were 2.77 times more likely to also be immunized for seasonal influenza across all seasons (95% confidence interval, 2.74-2.79), with similar results applying within each season. Adult immunization status was also significantly associated with the likelihood of children and adolescents getting other noninfluenza immunizations, such as the human papillomavirus vaccine (HPV). When adults improved their own behavior from nonimmunizing to immunizing across influenza seasons, their children if not immunized in the previous season were 5.44 times (95% confidence interval, 5.35-5.53) more likely to become immunized for influenza. Children's likelihood of following immunization recommendations is associated with the immunization behavior of their parents. Encouraging parental immunization is a potential tool for increasing children's immunization rates. Copyright © 2017 by the American Academy of Pediatrics.

  3. Estimating Twin Pair Concordance for Age of Onset

    DEFF Research Database (Denmark)

    Scheike, Thomas H; Hjelmborg, Jacob B; Holst, Klaus K

    2015-01-01

    that they will develop the disease. The aim of this contribution is to show that the standard casewise concordance and standard prevalence estimators do not work in general for age-of-onset data. We show how one can in fact do something easy and simple even with censored data. The key is to take age into account when......Twin and family data provide a key source for evaluating inheritance of specific diseases. A standard analysis of such data typically involves the computation of prevalences and different concordance measures such as the casewise concordance, that is the probability that one twin has the disease...

  4. Disease-Concordant Twins Empower Genetic Association Studies

    DEFF Research Database (Denmark)

    Tan, Qihua; Li, Weilong; Vandin, Fabio

    2017-01-01

    and ordinary healthy samples as controls. We examined the power gain of the twin-based design for various scenarios (i.e., cases from monozygotic and dizygotic twin pairs concordant for a disease) and compared the power with the ordinary case-control design with cases collected from the unrelated patient...... concordant for a disease, should confer increased power in genetic association analysis because of their genetic relatedness. We conducted a computer simulation study to explore the power advantage of the disease-concordant twin design, which uses singletons from disease-concordant twin pairs as cases...... population. Simulation was done by assigning various allele frequencies and allelic relative risks for different mode of genetic inheritance. In general, for achieving a power estimate of 80%, the sample sizes needed for dizygotic and monozygotic twin cases were one half and one fourth of the sample size...

  5. Moderators of Implicit-Explicit Exercise Cognition Concordance.

    Science.gov (United States)

    Berry, Tanya R; Rodgers, Wendy M; Markland, David; Hall, Craig R

    2016-12-01

    Investigating implicit-explicit concordance can aid in understanding underlying mechanisms and possible intervention effects. This research examined the concordance between implicit associations of exercise with health or appearance and related explicit motives. Variables considered as possible moderators were behavioral regulations, explicit attitudes, and social desirability. Participants (N = 454) completed measures of implicit associations of exercise with health and appearance and questionnaire measures of health and appearance motives, attitudes, social desirability, and behavioral regulations. Attitudes significantly moderated the relationship between implicit associations of exercise with health and health motives. Identified regulations significantly moderated implicit-explicit concordance with respect to associations with appearance. These results suggest that implicit and explicit exercise-related cognitions are not necessarily independent and their relationship to each other may be moderated by attitudes or some forms of behavioral regulation. Future research that takes a dual-processing approach to exercise behavior should consider potential theoretical moderators of concordance.

  6. Patient-provider language concordance and colorectal cancer screening.

    Science.gov (United States)

    Linsky, Amy; McIntosh, Nathalie; Cabral, Howard; Kazis, Lewis E

    2011-02-01

    Patient-provider language barriers may play a role in health-care disparities, including obtaining colorectal cancer (CRC) screening. Professional interpreters and language-concordant providers may mitigate these disparities. DESIGN, SUBJECTS, AND MAIN MEASURES: We performed a retrospective cohort study of individuals age 50 years and older who were categorized as English-Concordant (spoke English at home, n = 21,594); Other Language-Concordant (did not speak English at home but someone at their provider's office spoke their language, n = 1,463); or Other Language-Discordant (did not speak English at home and no one at their provider's spoke their language, n = 240). Multivariate logistic regression assessed the association of language concordance with colorectal cancer screening. Compared to English speakers, non-English speakers had lower use of colorectal cancer screening (30.7% vs 50.8%; OR, 0.63; 95% CI, 0.51-0.76). Compared to the English-Concordant group, the Language-Discordant group had similar screening (adjusted OR, 0.84; 95% CI, 0.58-1.21), while the Language-Concordant group had lower screening (adjusted OR, 0.57; 95% CI, 0.46-0.71). Rates of CRC screening are lower in individuals who do not speak English at home compared to those who do. However, the Language-Discordant cohort had similar rates to those with English concordance, while the Language-Concordant cohort had lower rates of CRC screening. This may be due to unmeasured differences among the cohorts in patient, provider, and health care system characteristics. These results suggest that providers should especially promote the importance of CRC screening to non-English speaking patients, but that language barriers do not fully account for CRC screening rate disparities in these populations.

  7. Are physicians and patients in agreement? Exploring dyadic concordance.

    Science.gov (United States)

    Coran, Justin J; Koropeckyj-Cox, Tanya; Arnold, Christa L

    2013-10-01

    Dyadic concordance in physician-patient interactions can be defined as the extent of agreement between physicians and patients in their perceptions of the clinical encounter. The current research specifically examined two types of concordance: informational concordance-the extent of agreement in physician and patient responses regarding patient information (education, self-rated health, pain); and interactional concordance-the extent of physician-patient agreement regarding the patient's level of confidence and trust in the physician and the perceived quality of explanations concerning diagnosis and treatment. Using a convenience sample of physicians and patients (N = 50 dyads), a paired survey method was tested, which measured and compared physician and patient reports to identify informational and interactional concordances. Factors potentially related to dyadic concordance were also measured, including demographic characteristics (patient race, gender, age, and education) and clinical factors (whether this was a first visit and physician specialty in family medicine or oncology). The paired survey showed informational discordances, as physicians tended to underestimate patients' pain and overestimate patient education. Interactional discordances included overestimating patients' understanding of diagnosis and treatment explanations and patients' level of confidence and trust. Discordances were linked to patient dissatisfaction with physician listening, having unanswered questions, and feeling the physician had not spent enough time. The paired survey method effectively identified physician-patient discordances that may interfere with effective medical practice; this method may be used in various settings to identify potential areas of improvement in health communication and education.

  8. Caregiver-Teacher Concordance of Challenging Behaviors in Children with Autism Spectrum Disorder Served in Community Mental Health Settings

    Science.gov (United States)

    Stadnick, Nicole; Chlebowski, Colby; Brookman-Frazee, Lauren

    2017-01-01

    Children with autism spectrum disorder (ASD) exhibit high rates of challenging behaviors that impair functioning and represent the primary presenting problem in mental health (MH) services. Obtaining symptom reports from multiple informants is critical for treatment planning. This study evaluated caregiver-teacher concordance of ratings of the…

  9. The Usefulness of Qualitative and Quantitative Approaches and Methods in Researching Problem-Solving Ability in Science Education Curriculum

    Science.gov (United States)

    Eyisi, Daniel

    2016-01-01

    Research in science education is to discover the truth which involves the combination of reasoning and experiences. In order to find out appropriate teaching methods that are necessary for teaching science students problem-solving skills, different research approaches are used by educational researchers based on the data collection and analysis…

  10. Estimating twin concordance for bivariate competing risks twin data

    DEFF Research Database (Denmark)

    Scheike, Thomas; Holst, Klaus K.; Hjelmborg, Jacob B.

    2014-01-01

    For twin time-to-event data, we consider different concordance probabilities, such as the casewise concordance that are routinely computed as a measure of the lifetime dependence/correlation for specific diseases. The concordance probability here is the probability that both twins have experience...... events with the competing risk death. We thus aim to quantify the degree of dependence through the casewise concordance function and show a significant genetic component...... the event of interest. Under the assumption that both twins are censored at the same time, we show how to estimate this probability in the presence of right censoring, and as a consequence, we can then estimate the casewise twin concordance. In addition, we can model the magnitude of within pair dependence...... over time, and covariates may be further influential on the marginal risk and dependence structure. We establish the estimators large sample properties and suggest various tests, for example, for inferring familial influence. The method is demonstrated and motivated by specific twin data on cancer...

  11. Concordance between clinical and histopathologic diagnoses of oral mucosal lesions.

    Science.gov (United States)

    Patel, Kush J; De Silva, Harsha L; Tong, Darryl C; Love, Robert M

    2011-01-01

    To study the epidemiology of oral soft tissue lesions in New Zealand from 2002 to 2006 and to determine the concordance between the clinical diagnosis and the definitive histopathologic diagnosis achieved by general dental practitioners and by specialists. The details from biopsy referrals and the corresponding histopathologic reports of oral soft tissue lesions were recorded into a statistical software package, and the concordance between the clinical diagnosis and histopathologic diagnosis was determined for all the lesions. Most biopsies were benign lesions, and both clinician groups achieved a high diagnostic concordance for these lesions. However, when considering all lesion types, the overall concordance for both groups was a moderate 50.6%, with little difference between specialists and general dental practitioners, although specialists were more accurate in diagnosing a malignant or premalignant lesion. The clinical and histopathologic concordance achieved by oral health practitioners in New Zealand appears to be moderate. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Modified task-based learning program promotes problem-solving capacity among Chinese medical postgraduates: a mixed quantitative survey.

    Science.gov (United States)

    Tian, Yanping; Li, Chengren; Wang, Jiali; Cai, Qiyan; Wang, Hanzhi; Chen, Xingshu; Liu, Yunlai; Mei, Feng; Xiao, Lan; Jian, Rui; Li, Hongli

    2017-09-07

    Despite great advances, China's postgraduate education faces many problems, for example traditional lecture-based learning (LBL) method provides fewer oppotunities to apply knowledge in a working situation. Task-based learning (TBL) is an efficient strategy for increasing the connections among skills, knowledge and competences. This study aimed to evaluate the effect of a modified TBL model on problem-solving abilities among postgraduate medical students in China. We allocated 228 first-year postgraduate students at Third Military Medical University into two groups: the TBL group and LBL group. The TBL group was taught using a TBL program for immunohistochemistry. The curriculum consisted of five phases: task design, self-learning, experimental operations, discussion and summary. The LBL group was taught using traditional LBL. After the course, learning performance was assessed using theoretical and practical tests. The students' preferences and satisfaction of TBL and LBL were also evaluated using questionnaires. There were notable differences in the mean score rates in the practical test (P 80) in the TBL group was higher than that in the LBL group. We observed no substantial differences in the theoretical test between the two groups (P > 0.05). The questionnaire results indicated that the TBL students were satisfied with teaching content, teaching methods and experiment content. The TBL program was also beneficial for the postgraduates in completing their research projects. Furthermore, the TBL students reported positive effects in terms of innovative thinking, collaboration, and communication. TBL is a powerful educational strategy for postgraduate education in China. Our modified TBL imparted basic knowledge to the students and also engaged them more effectively in applying knowledge to solve real-world issues. In conclusion, our TBL established a good foundation for the students' future in both medical research and clinical work.

  13. Inhomogeneity and the foundations of concordance cosmology

    International Nuclear Information System (INIS)

    Clarkson, Chris; Maartens, Roy

    2010-01-01

    The apparent accelerating expansion of the universe is forcing us to examine the foundational aspects of the standard model of cosmology-in particular, the fact that dark energy is a direct consequence of the homogeneity assumption. We discuss the foundations of the assumption of spatial homogeneity, in the case when the Copernican principle is adopted. We present results that show how (almost) homogeneity follows from (almost) isotropy of various observables. The analysis requires fully nonlinear field equations-i.e. it is not possible to use second- or higher-order perturbation theory, since one cannot assume a homogeneous and isotropic background. Then we consider what happens if the Copernican principle is abandoned in our Hubble volume. The simplest models are inhomogeneous but spherically symmetric universes which do not require dark energy to fit the distance modulus. Key problems in these models are to compute the CMB anisotropies and the features of large-scale structure. We review how to construct perturbation theory on a non-homogeneous cosmological background, and discuss the complexities that arise in using this to determine the growth of large-scale structure.

  14. Concordance between Stages of Behavior Change Questionnaire and IPAQ

    Directory of Open Access Journals (Sweden)

    Priscila Missaki Nakamura

    2013-12-01

    Full Text Available A low rate of physical activity (PA participation is observed worldwide. The identification of feasible and reliable instruments able to accurately measuring PA and help in the development of interventions to promote PA are necessary. This study aimed to analyze the concordance between the Stages of Behavior Change Questionnaire (SBCQ and the International Physical Activity Questionnaire (IPAQ long-version in assessing adult leisure-time physical activity (LTPA. A total of 1.588 adults completed the IPAQ to assess LTPA and the participants who performed more than 10 min/week were classified in active individuals. Using the SBCQ, active individuals were those classified in the action or maintenance stage and inactive individuals were those classified in the precontemplation, contemplation or preparation stage. The concordance between SBCQ and IPAQ was found to be 0.80. Separated by gender, it was observed a concordance between the two instruments of 0.82 for women, and 0.77 for men. Regarding age group, it was found to be 0.81 for young and middle-aged adults, and 0.77 for older people. The SBCQ presented a very good concordance with IPAQ to assess LTPA.

  15. Common Ground? The Concordance of Sarcopenia and Frailty Definitions

    NARCIS (Netherlands)

    Reijnierse, Esmee M.; Trappenburg, Marijke C.; Blauw, Gerard Jan; Verlaan, Sjors; de van der Schueren, Marian A.E.; Meskers, Carel G.M.; Maier, Andrea B.

    2016-01-01

    Objectives: This study aimed to explore the concordance between definitions of sarcopenia and frailty in a clinically relevant population of geriatric outpatients. Design: Data were retrieved from a cross-sectional study. Setting: The study was performed in a geriatric outpatient clinic of a

  16. The Concordance of Multilingual Legal Texts at the WTO

    Science.gov (United States)

    Condon, Bradly J.

    2012-01-01

    Multilingualism is a sensitive and complex subject in a global organisation such as the World Trade Organization (WTO). In the WTO legal texts, there is a need for full concordance, not simply translation. This article begins with an overview of the issues raised by multilingual processes at the WTO in the negotiation, drafting, translation,…

  17. Modeling Concordance Correlation Coefficient for Longitudinal Study Data

    Science.gov (United States)

    Ma, Yan; Tang, Wan; Yu, Qin; Tu, X. M.

    2010-01-01

    Measures of agreement are used in a wide range of behavioral, biomedical, psychosocial, and health-care related research to assess reliability of diagnostic test, psychometric properties of instrument, fidelity of psychosocial intervention, and accuracy of proxy outcome. The concordance correlation coefficient (CCC) is a popular measure of…

  18. Concordance between brain 18F-FDG PET and cerebrospinal fluid biomarkers in diagnosing Alzheimer's disease.

    Science.gov (United States)

    Rubí, S; Noguera, A; Tarongí, S; Oporto, M; García, A; Vico, H; Espino, A; Picado, M J; Mas, A; Peña, C; Amer, G

    Cortical posterior hypometabolism on PET imaging with 18 F-FDG (FDG-PET), and altered levels of Aß 1-42 peptide, total Tau (tTau) and phosphorylated Tau (pTau) proteins in cerebrospinal fluid (CSF) are established diagnostic biomarkers in Alzheimer's disease (AD). An evaluation has been made of the concordance and relationship between the results of FDG-PET and CSF biomarkers in symptomatic patients with suspected AD. A retrospective review was carried out on 120 patients with cognitive impairment referred to our Cognitive Neurology Unit, and who were evaluated by brain FDG-PET and a lumbar puncture for CSF biomarkers. In order to calculate their Kappa coefficient of concordance, the result of the FDG-PET and the set of the three CSF biomarkers in each patient was classified as normal, inconclusive, or AD-compatible. The relationship between the results of both methods was further assessed using logistic regression analysis, including the Aß 1-42 , tTau and pTau levels as quantitative predictors, and the FDG-PET result as the dependent variable. The weighted Kappa coefficient between FDG-PET and CSF biomarkers was 0.46 (95% CI: 0.35-0.57). Logistic regression analysis showed that the Aß 1-42 and tTau values together were capable of discriminating an FDG-PET result metabolically suggestive of AD from one non-suggestive of AD, with a 91% sensitivity and 93% specificity at the cut-off line Aß 1-42 =44+1.3×tTau. The level of concordance between FDG-PET and CSF biomarkers was moderate, indicating their complementary value in diagnosing AD. The Aß 1-42 and tTau levels in CSF help to predict the patient FDG-PET cortical metabolic status. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  19. Concord Grape Juice Supplementation Improves Memory Function In Older Adults with Mild Cognitive Impairment

    Science.gov (United States)

    Concord grape juice contains flavonoid polyphenol compounds, which have antioxidant and anti-inflammatory properties and influence neuronal signaling. Concord grape juice supplementation has been shown to reduce inflammation, blood pressure, and vascular pathology in individuals with cardiovascular...

  20. Price squeezes in electric power: The new Battle of Concord

    International Nuclear Information System (INIS)

    Kwoka, J.E. Jr.

    1992-01-01

    The US Court of Appeals opinion in Town of Concord v. Boston Edison offers a vigorous statement of the position that in a regulated market, what may appear to be a price squeeze almost certainly cannot harm the competitive process and therefore should not be held to violate the antitrust laws. While not disputing the possibility of self-serving claims of price squeezes, this article shows that truly anticompetitive price squeezes may indeed occur in the electric power industry and cannot be so readily dismissed. This analysis begins with a brief factual and economic background on price squeezes, then addresses arguments made in Concord and elsewhere seeking to disprove their possibility, and demonstrate that sound economics and good policy require a more balanced approach

  1. Does patient-provider gender concordance affect mental health care received by primary care patients with major depression?

    Science.gov (United States)

    Chan, Kitty S; Bird, Chloe E; Weiss, Robert; Duan, Naihua; Meredith, Lisa S; Sherbourne, Cathy D

    2006-01-01

    We sought to determine whether patient-provider gender concordance influences the detection and care of depression and comorbid anxiety and substance use in patients with major depression Cross-sectional analyses of baseline patient survey data linked with provider data were performed. Data based on routine primary care visits in clinics from a variety of health systems serving diverse patient populations across the United States. Participants all had major depression. Depression care was examined in the Quality Improvement for Depression (QID) Collaboration sample (n patients = 1,428, n providers = 389). In a subanalysis of data solely from 714 patients and 157 providers from Partners-In-Care, one of the projects participating in QID, we also examined detection of anxiety disorder and alcohol or drug problems. Rates of detection and care of mental health problems in primary care were low even among patients with major depression. Except for anxiety counseling in female patients, patient-provider gender concordance did not improve care as hypothesized. However, female providers were more likely to counsel on anxiety and less likely to counsel on alcohol or drug use than male providers. Female patients were less likely to be counseled on alcohol or drug use compared with male patients. Detection and care of mental health and substance use problems for patients with major depression is not influenced by patient-provider gender concordance. However, depressed female patients may have greater unmet needs for alcohol and drug use counseling than their male counterparts.

  2. 76 FR 59167 - Siemens Medical Solutions USA, Inc., Oncology Care Systems Division, Concord, CA; Siemens Medical...

    Science.gov (United States)

    2011-09-23

    ... Medical Solutions USA, Inc., Oncology Care Systems Division, Concord, CA; Siemens Medical Solutions USA... Solutions USA, Inc. (Siemens), Oncology Care Systems Division, Concord, California (subject firm). The...., Oncology Care Systems Division, Concord, California (TA-W-73,158) and Siemens Medical Solutions USA, Inc...

  3. Mapcurves: a quantitative method for comparing categorical maps.

    Science.gov (United States)

    William W. Hargrove; M. Hoffman Forrest; Paul F. Hessburg

    2006-01-01

    We present Mapcurves, a quantitative goodness-of-fit (GOF) method that unambiguously shows the degree of spatial concordance between two or more categorical maps. Mapcurves graphically and quantitatively evaluate the degree of fit among any number of maps and quantify a GOF for each polygon, as well as the entire map. The Mapcurve method indicates a perfect fit even if...

  4. Concordance-based Kendall's Correlation for Computationally-Light vs. Computationally-Heavy Centrality Metrics: Lower Bound for Correlation

    Directory of Open Access Journals (Sweden)

    Natarajan Meghanathan

    2017-01-01

    Full Text Available We identify three different levels of correlation (pair-wise relative ordering, network-wide ranking and linear regression that could be assessed between a computationally-light centrality metric and a computationally-heavy centrality metric for real-world networks. The Kendall's concordance-based correlation measure could be used to quantitatively assess how well we could consider the relative ordering of two vertices vi and vj with respect to a computationally-light centrality metric as the relative ordering of the same two vertices with respect to a computationally-heavy centrality metric. We hypothesize that the pair-wise relative ordering (concordance-based assessment of the correlation between centrality metrics is the most strictest of all the three levels of correlation and claim that the Kendall's concordance-based correlation coefficient will be lower than the correlation coefficient observed with the more relaxed levels of correlation measures (linear regression-based Pearson's product-moment correlation coefficient and the network wide ranking-based Spearman's correlation coefficient. We validate our hypothesis by evaluating the three correlation coefficients between two sets of centrality metrics: the computationally-light degree and local clustering coefficient complement-based degree centrality metrics and the computationally-heavy eigenvector centrality, betweenness centrality and closeness centrality metrics for a diverse collection of 50 real-world networks.

  5. Systems-based biological concordance and predictive reproducibility of gene set discovery methods in cardiovascular disease.

    Science.gov (United States)

    Azuaje, Francisco; Zheng, Huiru; Camargo, Anyela; Wang, Haiying

    2011-08-01

    The discovery of novel disease biomarkers is a crucial challenge for translational bioinformatics. Demonstration of both their classification power and reproducibility across independent datasets are essential requirements to assess their potential clinical relevance. Small datasets and multiplicity of putative biomarker sets may explain lack of predictive reproducibility. Studies based on pathway-driven discovery approaches have suggested that, despite such discrepancies, the resulting putative biomarkers tend to be implicated in common biological processes. Investigations of this problem have been mainly focused on datasets derived from cancer research. We investigated the predictive and functional concordance of five methods for discovering putative biomarkers in four independently-generated datasets from the cardiovascular disease domain. A diversity of biosignatures was identified by the different methods. However, we found strong biological process concordance between them, especially in the case of methods based on gene set analysis. With a few exceptions, we observed lack of classification reproducibility using independent datasets. Partial overlaps between our putative sets of biomarkers and the primary studies exist. Despite the observed limitations, pathway-driven or gene set analysis can predict potentially novel biomarkers and can jointly point to biomedically-relevant underlying molecular mechanisms. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Hair analysis and its concordance with self-report for drug users presenting in emergency department.

    Science.gov (United States)

    Sharma, Gaurav; Oden, Neal; VanVeldhuisen, Paul C; Bogenschutz, Michael P

    2016-10-01

    Secondary analysis using data from the National Drug Abuse Treatment Clinical Trials Network randomized trial (NCT # 01207791), in which 1285 adult ED patients endorsing moderate to severe problems related to drug use were recruited from 6 US academic hospitals. To investigate the utility of hair analysis in drug use disorder trials with infrequent visits, and its concordance with Timeline Follow Back (TLFB). This study compared the self-reported drug use on the TLFB instrument with the biological measure of drug use from hair analysis for four major drug classes (Cannabis, Cocaine, Prescribed Opioids and Street Opioids). Both hair analysis and TLFB were conducted at 3, 6 and 12 month follow-up visit and each covered a 90-day recall period prior to the visit. The concordance between the hair sample results and the TLFB was high for cannabis and street opioids, but was low to moderate for cocaine and prescribed opioids. Under-reporting of drug use given the positive hair sample was always significantly lower for the drug the study participant noted as their primary drug of choice compared with other drugs the participant reported taking, irrespective of whether the drug of choice was cannabis, cocaine, street opioids and prescribed opioids. Over-reporting of drug use given the negative hair sample was always significantly higher for the drug of choice, except for cocaine. This study extends the literature on hair analysis supporting its use as a secondary outcome measure in clinical trials. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Concordance: Design Ideal for Facilitating Situated Negotiations in Out-of-clinic Healthcare

    DEFF Research Database (Denmark)

    Bagalkot, Naveen L.; Gronvall, Erik; Sokoler, Tomas

    2014-01-01

    Healthcare HCI research has explored various designs that encourage people to follow prescribed treatments, mostly adopting compliance and adherence as design ideals. However, within the medical sciences the notion of concordance also exists. Concordance promotes negotiation between the patient...... and healthcare professional for forging a therapeutic alliance. However, the HCI community has still not adopted concordance as a design ideal. This paper revisits four old design-cases to explore the role of concordance in out-of-clinic healthcare. We argue that concordance, as a design ideal, can guide new...... designs that promote a more active patient-role both at the clinic and beyond....

  8. A short note on jackknifing the concordance correlation coefficient.

    Science.gov (United States)

    Feng, Dai; Baumgartner, Richard; Svetnik, Vladimir

    2014-02-10

    Lin's concordance correlation coefficient (CCC) is a very popular scaled index of agreement used in applied statistics. To obtain a confidence interval (CI) for the estimate of CCC, jackknifing was proposed and shown to perform well in simulation as well as in applications. However, a theoretical proof of the validity of the jackknife CI for the CCC has not been presented yet. In this note, we establish a sufficient condition for using the jackknife method to construct the CI for the CCC. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Ancient-modern concordance in Ayurvedic plants: some examples.

    Science.gov (United States)

    Dev, S

    1999-10-01

    Ayurveda is the ancient (before 2500 b.c.) Indian system of health care and longevity. It involves a holistic view of man, his health, and illness. Ayurvedic treatment of a disease consists of salubrious use of drugs, diets, and certain practices. Medicinal preparations are invariably complex mixtures, based mostly on plant products. Around 1,250 plants are currently used in various Ayurvedic preparations. Many Indian medicinal plants have come under scientific scrutiny since the middle of the nineteenth century, although in a sporadic fashion. The first significant contribution from Ayurvedic materia medica came with the isolation of the hypertensive alkaloid from the sarpagandha plant (Rouwolfia serpentina), valued in Ayurveda for the treatment of hypertension, insomnia, and insanity. This was the first important ancient-modern concordance in Ayurvedic plants. With the gradual coming of age of chemistry and biology, disciplines central to the study of biologic activities of natural products, many Ayurvedic plants have been reinvestigated. Our work on Commiphora wightti gum-resin, valued in Ayurveda for correcting lipid disorders, has been described in some detail; based on these investigations, a modern antihyperlipoproteinemic drug is on the market in India and some other countries. There has also been concordance for a few other Ayurvedic crude drugs such as Asparagus racemosus, Cedrus deodara, and Psoralea corylifolia.

  10. Concordance of vitamin D peripheral levels in infertile couples' partners.

    Science.gov (United States)

    Paffoni, Alessio; Ferrari, Stefania; Mangiarini, Alice; Noli, Stefania; Bulfoni, Alessandro; Vigano, Paola; Parazzini, Fabio; Somigliana, Edgardo

    2017-08-01

    A large number of evidence supports the role of vitamin D insufficiency in both women and men infertility. However, no studies have evaluated the rate of concordance of vitamin D status between the partners. This finding might open new scenarios in the interpretation of the available data linking vitamin D insufficiency and infertility. In the present cross-sectional study, 103 consecutive infertile couples were recruited between April and May 2014. Both partners concomitantly provided a serum sample for the assessment of 25-hydroxy-vitamin D [25-(OH)-D]. Vitamin D insufficiency was defined as serum 25-(OH)-D D insufficient, corresponding to a rate of 73%. Overall, concordance was observed in 73 couples (71%), thus higher than the expected 61% (0.732 + 0.272) based on chance (p = 0.007). The Pearson coefficient of correlation R2 between the partners of the couples was 0.52 (p D insufficiency according to the causes of infertility. Serum 25-(OH)-D correlates within the partners of infertile couples. Further evidence is warranted to determine the clinical relevance and possible clinical applications of this finding.

  11. Justify Your Answer: The Role of Written Think Aloud in Script Concordance Testing.

    Science.gov (United States)

    Power, Alyssa; Lemay, Jean-Francois; Cooke, Suzette

    2017-01-01

    Construct: Clinical reasoning assessment is a growing area of interest in the medical education literature. Script concordance testing (SCT) evaluates clinical reasoning in conditions of uncertainty and has emerged as an innovative tool in the domain of clinical reasoning assessment. SCT quantifies the degree of concordance between a learner and an experienced clinician and attempts to capture the breadth of responses of expert clinicians, acknowledging the significant yet acceptable variation in practice under situations of uncertainty. SCT has been shown to be a valid and reliable clinical reasoning assessment tool. However, as SCT provides only quantitative information, it may not provide a complete assessment of clinical reasoning. Think aloud (TA) is a qualitative research tool used in clinical reasoning assessment in which learners verbalize their thought process around an assigned task. This study explores the use of TA, in the form of written reflection, in SCT to assess resident clinical reasoning, hypothesizing that the information obtained from the written TA would enrich the quantitative data obtained through SCT. Ninety-one pediatric postgraduate trainees and 21 pediatricians from 4 Canadian training centers completed an online test consisting of 24 SCT cases immediately followed by retrospective written TA. Six of 24 cases were selected to gather TA data. These cases were chosen to allow all phases of clinical decision making (diagnosis, investigation, and treatment) to be represented in the TA data. Inductive thematic analysis was employed when systematically reviewing TA responses. Three main benefits of adding written TA to SCT were identified: (a) uncovering instances of incorrect clinical reasoning despite a correct SCT response, (b) revealing sound clinical reasoning in the context of a suboptimal SCT response, and (c) detecting question misinterpretation. Written TA can optimize SCT by demonstrating when correct examinee responses are based on

  12. Estimating the concordance probability in a survival analysis with a discrete number of risk groups.

    Science.gov (United States)

    Heller, Glenn; Mo, Qianxing

    2016-04-01

    A clinical risk classification system is an important component of a treatment decision algorithm. A measure used to assess the strength of a risk classification system is discrimination, and when the outcome is survival time, the most commonly applied global measure of discrimination is the concordance probability. The concordance probability represents the pairwise probability of lower patient risk given longer survival time. The c-index and the concordance probability estimate have been used to estimate the concordance probability when patient-specific risk scores are continuous. In the current paper, the concordance probability estimate and an inverse probability censoring weighted c-index are modified to account for discrete risk scores. Simulations are generated to assess the finite sample properties of the concordance probability estimate and the weighted c-index. An application of these measures of discriminatory power to a metastatic prostate cancer risk classification system is examined.

  13. Numerical modelling of the Concorde wake during ZEBRE

    Energy Technology Data Exchange (ETDEWEB)

    Gierens, K. [Deutsche Forschungsanstalt fuer Luft- und Raumfahrt e.V. (DLR), Oberpfaffenhofen (Germany). Inst. fuer Physik der Atmosphaere

    1997-12-31

    Numerical simulations of the Concorde contrail during the ZEBRE experiment have been performed. The main goal of the simulations is to reproduce the fast vanishing of the contrail which disappeared 20-30 s after exhaust. It is difficult to evaporate ice crystals during the jet and vortex phase of the aircraft wake, when the exhaust products are trapped in the vortex cores. The trapping also excludes spatial dispersion of the ice crystals as an explanation of the short contrail lifetime. The disappearance of the contrail within 20-30 s requires that a substantial part of the exhaust gases escapes from the region that is later on trapped in the vortex cores. (author) 10 refs.

  14. Numerical modelling of the Concorde wake during ZEBRE

    Energy Technology Data Exchange (ETDEWEB)

    Gierens, K [Deutsche Forschungsanstalt fuer Luft- und Raumfahrt e.V. (DLR), Oberpfaffenhofen (Germany). Inst. fuer Physik der Atmosphaere

    1998-12-31

    Numerical simulations of the Concorde contrail during the ZEBRE experiment have been performed. The main goal of the simulations is to reproduce the fast vanishing of the contrail which disappeared 20-30 s after exhaust. It is difficult to evaporate ice crystals during the jet and vortex phase of the aircraft wake, when the exhaust products are trapped in the vortex cores. The trapping also excludes spatial dispersion of the ice crystals as an explanation of the short contrail lifetime. The disappearance of the contrail within 20-30 s requires that a substantial part of the exhaust gases escapes from the region that is later on trapped in the vortex cores. (author) 10 refs.

  15. Clinical, mammographic, and pathologic concordance in breast cancer

    International Nuclear Information System (INIS)

    Rodriguez Cascaret, Argenis; Martin Rodriguez, Andres; Hernandez Castellanos, Kirenia

    2011-01-01

    An observational descriptive and cross-sectional study was carried out in 100 patients with breast cancer, who attended the Breast Care Department at 'Conrado Benitez' Teaching Oncology Hospital in Santiago de Cuba from August 2009 to July 2010, to characterize them according to imaging, pathological, clinical, and general variables. Percentage as summary measure to statically validate the results and Kappa index to determine diagnostic concordance were used. Women between 40-49 years with history of fibrocystic breast disease and palpable lesions, as well as lump in the right breast, upper outer quadrant and periphery of the breast, tumor greater than one centimeter in diameter and infiltrating ductal carcinoma in the stages III-b and IV prevailed in the case material.(author)

  16. A robust bayesian estimate of the concordance correlation coefficient.

    Science.gov (United States)

    Feng, Dai; Baumgartner, Richard; Svetnik, Vladimir

    2015-01-01

    A need for assessment of agreement arises in many situations including statistical biomarker qualification or assay or method validation. Concordance correlation coefficient (CCC) is one of the most popular scaled indices reported in evaluation of agreement. Robust methods for CCC estimation currently present an important statistical challenge. Here, we propose a novel Bayesian method of robust estimation of CCC based on multivariate Student's t-distribution and compare it with its alternatives. Furthermore, we extend the method to practically relevant settings, enabling incorporation of confounding covariates and replications. The superiority of the new approach is demonstrated using simulation as well as real datasets from biomarker application in electroencephalography (EEG). This biomarker is relevant in neuroscience for development of treatments for insomnia.

  17. Molecular Concordance Between Primary Breast Cancer and Matched Metastases

    DEFF Research Database (Denmark)

    Krøigård, Anne Bruun; Larsen, Martin Jakob; Thomassen, Mads

    2016-01-01

    Clinical management of breast cancer is increasingly personalized and based on molecular profiling. Often, primary tumors are used as proxies for systemic disease at the time of recurrence. However, recent studies have revealed substantial discordances between primary tumors and metastases, both....... The purpose of this review is to illuminate the extent of cancer genome evolution through disease progression and the degree of molecular concordance between primary breast cancers and matched metastases. We present an overview of the most prominent studies investigating the expression of endocrine receptors......, transcriptomics, and genome aberrations in primary tumors and metastases. In conclusion, biopsy of metastatic lesions at recurrence of breast cancer is encouraged to provide optimal treatment of the disease. Furthermore, molecular profiling of metastatic tissue provides invaluable mechanistic insight...

  18. Towards a Re-Conceptualization of Teachers' Self-Efficacy Beliefs: Tackling Enduring Problems with the Quantitative Research and Moving On

    Science.gov (United States)

    Wyatt, Mark

    2014-01-01

    Various commentators have argued for years that the study of teachers' self-efficacy (TSE) beliefs, largely dominated by quantitative research methodologies, has been confused. Contentious issues include the very conceptualization of these beliefs, how they are defined and accessed through research and how the research is used. One of the…

  19. Prediction future asset price which is non-concordant with the historical distribution

    Science.gov (United States)

    Seong, Ng Yew; Hin, Pooi Ah

    2015-12-01

    This paper attempts to predict the major characteristics of the future asset price which is non-concordant with the distribution estimated from the price today and the prices on a large number of previous days. The three major characteristics of the i-th non-concordant asset price are the length of the interval between the occurrence time of the previous non-concordant asset price and that of the present non-concordant asset price, the indicator which denotes that the non-concordant price is extremely small or large by its values -1 and 1 respectively, and the degree of non-concordance given by the negative logarithm of the probability of the left tail or right tail of which one of the end points is given by the observed future price. The vector of three major characteristics of the next non-concordant price is modelled to be dependent on the vectors corresponding to the present and l - 1 previous non-concordant prices via a 3-dimensional conditional distribution which is derived from a 3(l + 1)-dimensional power-normal mixture distribution. The marginal distribution for each of the three major characteristics can then be derived from the conditional distribution. The mean of the j-th marginal distribution is an estimate of the value of the j-th characteristics of the next non-concordant price. Meanwhile, the 100(α/2) % and 100(1 - α/2) % points of the j-th marginal distribution can be used to form a prediction interval for the j-th characteristic of the next non-concordant price. The performance measures of the above estimates and prediction intervals indicate that the fitted conditional distribution is satisfactory. Thus the incorporation of the distribution of the characteristics of the next non-concordant price in the model for asset price has a good potential of yielding a more realistic model.

  20. Concordance between local, institutional, and central pathology review in glioblastoma: implications for research and practice: a pilot study.

    Science.gov (United States)

    Gupta, Tejpal; Nair, Vimoj; Epari, Sridhar; Pietsch, Torsten; Jalali, Rakesh

    2012-01-01

    There is significant inter-observer variation amongst the neuro-pathologists in the typing, subtyping, and grading of glial neoplasms for diagnosis. Centralized pathology review has been proposed to minimize this inter-observer variation and is now almost mandatory for accrual into multicentric trials. We sought to assess the concordance between neuro-pathologists on histopathological diagnosis of glioblastoma. Comparison of local, institutional, and central neuro-oncopathology reporting in a cohort of 34 patients with newly diagnosed supratentorial glioblastoma accrued consecutively at a tertiary-care institution on a prospective trial testing the addition of a new agent to standard chemo-radiation regimen. Concordance was sub-optimal between local histological diagnosis and central review, fair between local diagnosis and institutional review, and good between institutional and central review, with respect to histological typing/subtyping. Twelve (39%) of 31 patients with local histological diagnosis had identical tumor type, subtype and grade on central review. Overall agreement was modestly better (52%) between local diagnosis and institutional review. In contrast, 28 (83%) of 34 patients had completely concordant histopathologic diagnosis between institutional and central review. The inter-observer reliability test showed poor agreement between local and central review (kappa statistic=0.12, 95% confidence interval (CI): -0.03-0.32, P=0.043), but moderate agreement between institutional and central review (kappa statistic=0.51, 95%CI: 0.17-0.84, P=0.00003). Agreement between local diagnosis and institutional review was fair. There exists significant inter-observer variation regarding histopathological diagnosis of glioblastoma with significant implications for clinical research and practice. There is a need for more objective, quantitative, robust, and reproducible criteria for better subtyping for accurate diagnosis.

  1. Giant-cell arteritis. Concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement

    International Nuclear Information System (INIS)

    Boysson, Hubert de; Dumont, Anael; Boutemy, Jonathan; Maigne, Gwenola; Martin Silva, Nicolas; Sultan, Audrey; Bienvenu, Boris; Aouba, Achille; Liozon, Eric; Ly, Kim Heang; Lambert, Marc; Aide, Nicolas; Manrique, Alain

    2017-01-01

    The purpose of our study was to assess the concordance of aortic CT angiography (CTA) and FDG-PET/CT in the detection of large-vessel involvement at diagnosis in patients with giant-cell arteritis (GCA). We created a multicenter cohort of patients with GCA diagnosed between 2010 and 2015, and who underwent both FDG-PET/CT and aortic CTA before or in the first ten days following treatment introduction. Eight vascular segments were studied on each procedure. We calculated concordance between both imaging techniques in a per-patient and a per-segment analysis, using Cohen's kappa concordance index. We included 28 patients (21/7 women/men, median age 67 [56-82]). Nineteen patients had large-vessel involvement on PET/CT and 18 of these patients also presented positive findings on CTA. In a per-segment analysis, a median of 5 [1-7] and 3 [1-6] vascular territories were involved on positive PET/CT and CTA, respectively (p = 0.03). In qualitative analysis, i.e., positivity of the procedure suggesting a large-vessel involvement, the concordance rate between both procedures was 0.85 [0.64-1]. In quantitative analysis, i.e., per-segment analysis in both procedures, the global concordance rate was 0.64 [0.54-0.75]. Using FDG-PET/CT as a reference, CTA showed excellent sensitivity (95%) and specificity (100%) in a per-patient analysis. In a per-segment analysis, sensitivity and specificity were 61% and 97.9%, respectively. CTA and FDG-PET/CT were both able to detect large-vessel involvement in GCA with comparable results in a per-patient analysis. However, PET/CT showed higher performance in a per-segment analysis, especially in the detection of inflammation of the aorta's branches. (orig.)

  2. Giant-cell arteritis. Concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement

    Energy Technology Data Exchange (ETDEWEB)

    Boysson, Hubert de; Dumont, Anael; Boutemy, Jonathan; Maigne, Gwenola; Martin Silva, Nicolas; Sultan, Audrey; Bienvenu, Boris; Aouba, Achille [Caen University Hospital, Department of Internal Medicine, Caen (France); Liozon, Eric; Ly, Kim Heang [Limoges University Hospital, Department of Internal Medicine, Limoges (France); Lambert, Marc [Lille University Hospital, Department of Internal Medicine, Lille (France); Aide, Nicolas [Caen University Hospital, Department of Nuclear Medicine, Caen (France); INSERM U1086 ' ' ANTICIPE' ' , Francois Baclesse Cancer Centre, Caen (France); Manrique, Alain [Caen University Hospital, Department of Nuclear Medicine, Caen (France); Normandy University, Caen (France)

    2017-12-15

    The purpose of our study was to assess the concordance of aortic CT angiography (CTA) and FDG-PET/CT in the detection of large-vessel involvement at diagnosis in patients with giant-cell arteritis (GCA). We created a multicenter cohort of patients with GCA diagnosed between 2010 and 2015, and who underwent both FDG-PET/CT and aortic CTA before or in the first ten days following treatment introduction. Eight vascular segments were studied on each procedure. We calculated concordance between both imaging techniques in a per-patient and a per-segment analysis, using Cohen's kappa concordance index. We included 28 patients (21/7 women/men, median age 67 [56-82]). Nineteen patients had large-vessel involvement on PET/CT and 18 of these patients also presented positive findings on CTA. In a per-segment analysis, a median of 5 [1-7] and 3 [1-6] vascular territories were involved on positive PET/CT and CTA, respectively (p = 0.03). In qualitative analysis, i.e., positivity of the procedure suggesting a large-vessel involvement, the concordance rate between both procedures was 0.85 [0.64-1]. In quantitative analysis, i.e., per-segment analysis in both procedures, the global concordance rate was 0.64 [0.54-0.75]. Using FDG-PET/CT as a reference, CTA showed excellent sensitivity (95%) and specificity (100%) in a per-patient analysis. In a per-segment analysis, sensitivity and specificity were 61% and 97.9%, respectively. CTA and FDG-PET/CT were both able to detect large-vessel involvement in GCA with comparable results in a per-patient analysis. However, PET/CT showed higher performance in a per-segment analysis, especially in the detection of inflammation of the aorta's branches. (orig.)

  3. A Place Called Home: Educational Reform in a Concord, Massachusetts School, 1897-1914

    Science.gov (United States)

    Morice, Linda C.

    2012-01-01

    This paper examines the role of place in the reform efforts of two teachers who established Miss White's Home School in Concord, Massachusetts (USA). Flora and Mary White rebelled against the prevailing industrial model of instruction in tax-supported schools where they taught. As a solution, they moved to Concord--a nonconformist town with a…

  4. Concordance Between Clinical Practice and Published Evidence: Findings From Virginia Commonwealth University School of Dentistry.

    Science.gov (United States)

    Chiang, Harmeet K; Best, Al M; Sarrett, David C

    2017-09-01

    To evaluate the concordance between clinical practice and published evidence by dental faculty and graduating students of the Virginia Commonwealth University School of Dentistry. A questionnaire previously developed by the National Dental Practice-Based Research Network with 12 clinical scenarios was administered to VCU faculty and graduating students. Responses were scored as either consistent or inconsistent with published evidence and then analyzed for differences between dental faculty, graduating students, and the national results. There were 43 dental faculty members with at least half-time student contact who responded to the survey. Faculty concordance ranged from 33% to 100%, and general practice faculty had the highest concordance (82%). Eighty-five of the graduating class of 98 responded to the survey, and student concordance ranged from 18% to 92% and averaged 67%. General practice faculty had higher concordance with published evidence than recently graduated dental students. Graduating students and dental faculty demonstrated higher concordance with evidence-based practice than practitioners in the National Dental Practice-Based Research Network. General practice dental faculty demonstrated adequate concordance, but students demonstrated only a medium-level concordance. Practitioners involved in teaching dental students are better able to keep up with evolving evidence and are better able to demonstrate evidence-based practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Is There Concordance in Attitudes and Beliefs between Parents and Scientists about Autism Spectrum Disorder?

    Science.gov (United States)

    Fischbach, Ruth L.; Harris, Mark J.; Ballan, Michelle S.; Fischbach, Gerald D.; Link, Bruce G.

    2016-01-01

    There is no reported investigation comparing concordance in attitudes and beliefs about autism spectrum disorder between parents of children with autism spectrum disorder and scientists who research autism spectrum disorder. To investigate the level of concordance between these groups on causes of autism, priorities of research, perceived stigma,…

  6. Phenotypic concordance in familial inflammatory bowel disease (IBD). Results of a nationwide IBD Spanish database.

    Science.gov (United States)

    Cabré, Eduard; Mañosa, Míriam; García-Sánchez, Valle; Gutiérrez, Ana; Ricart, Elena; Esteve, Maria; Guardiola, Jordi; Aguas, Mariam; Merino, Olga; Ponferrada, Angel; Gisbert, Javier P; Garcia-Planella, Esther; Ceña, Gloria; Cabriada, José L; Montoro, Miguel; Domènech, Eugeni

    2014-07-01

    Disease outcome has been found to be poorer in familial inflammatory bowel disease (IBD) than in sporadic forms, but assessment of phenotypic concordance in familial IBD provided controversial results. We assessed the concordance for disease type and phenotypic features in IBD families. Patients with familial IBD were identified from the IBD Spanish database ENEIDA. Families in whom at least two members were in the database were selected for concordance analysis (κ index). Concordance for type of IBD [Crohn's disease (CD) vs. ulcerative colitis (UC)], as well as for disease extent, localization and behaviour, perianal disease, extraintestinal manifestations, and indicators of severe disease (i.e., need for immunosuppressors, biological agents, and surgery) for those pairs concordant for IBD type, were analyzed. 798 out of 11,905 IBD patients (7%) in ENEIDA had familial history of IBD. Complete data of 107 families (231 patients and 144 consanguineous pairs) were available for concordance analyses. The youngest members of the pairs were diagnosed with IBD at a significantly younger age (p<0.001) than the oldest ones. Seventy-six percent of pairs matched up for the IBD type (κ=0.58; 95%CI: 0.42-0.73, moderate concordance). There was no relevant concordance for any of the phenotypic items assessed in both diseases. Familial IBD is associated with diagnostic anticipation in younger individuals. Familial history does not allow predicting any phenotypic feature other than IBD type. Copyright © 2013 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  7. Genetic analysis of rare disorders: Bayesian estimation of twin concordance rates

    NARCIS (Netherlands)

    van den Berg, Stéphanie Martine; Hjelmborg, J.

    2012-01-01

    Twin concordance rates provide insight into the possibility of a genetic background for a disease. These concordance rates are usually estimated within a frequentistic framework. Here we take a Bayesian approach. For rare diseases, estimation methods based on asymptotic theory cannot be applied due

  8. 78 FR 5717 - Safety Zone; Military Ocean Terminal Concord Safety Zone, Suisun Bay, Military Ocean Terminal...

    Science.gov (United States)

    2013-01-28

    ...-AA00 Safety Zone; Military Ocean Terminal Concord Safety Zone, Suisun Bay, Military Ocean Terminal... Guard is establishing a safety zone in the navigable waters of Suisun Bay near Military Ocean Terminal Concord, CA in support of military onload and offload operations. This safety zone is established to...

  9. Concordance of Beta-papillomavirus across anogenital and oral anatomic sites of men: The HIM Study.

    Science.gov (United States)

    Nunes, Emily M; López, Rossana V M; Sudenga, Staci L; Gheit, Tarik; Tommasino, Massimo; Baggio, Maria L; Ferreira, Silvaneide; Galan, Lenice; Silva, Roberto C; Lazcano-Ponce, Eduardo; Giuliano, Anna R; Villa, Luisa L; Sichero, Laura

    2017-10-01

    We evaluated the concordance between β-HPVs detected in external genital skin, anal canal, and oral cavity specimens collected simultaneously from 717 men that were participating in the multinational HIM Study. Viral genotyping was performed using the Luminex technology. Species- and type-specific concordance was measured using kappa statistics for agreement. Overall, concordance of β-HPVs across sites was low and mainly observed among paired genital/anal canal samples. When grouped by species, solely β-4 HPVs showed moderate concordance in genital/anal pairs (κ = 0.457), which could be attributed to the substantial concordance of HPV-92 in men from Brazil and Mexico (κ > 0.610). β-HPV type concordance was higher in Mexico, where HPV-19 was consistently concordant in all anatomic site combinations. Our analysis indicates that type-specific concordance across sites is limited to few viral types; however, these infections seem to occur more often than would be expected by chance, suggesting that although rare, there is agreement among sites. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. The script concordance test as a tool to evaluate clinical reasoning in neonatology.

    Science.gov (United States)

    Ben Hamida, Emira; Ayadi, Imen; Marrakchi, Zahra; Quinton, André

    2017-05-01

    Script concordance test aims to evaluate knowledge organization, which represents an essential component of the clinical competence. To build a script concordance test and demonstrate its relevance in the evaluation of Neonatology skills. A script concordance test including 20 vignettes and 20 items, was provided to 52 fourth year medical students and 11 family medicine interns. Script concordance test scores obtained by experts were higher then those obtained by students and family medicine interns. The scores (out of 100) were 82.52 ± 7.35 CI95% [77.26-87.78] for the experts, 58.52 ± 9.72 CI95% [55.82-61.23] for the students, and 63.17±11.36 IC95%  [55.53-70.81] (p<0.0001) for the interns. Our data suggest that script concordance tests could be used to assess the acquisition of clinical reasoning among fourth year medical students in neonatolgy.

  11. Racing the Moon’s shadow with Concorde 001

    CERN Document Server

    Léna, Pierre

    2015-01-01

    This is the unique story of  observing a total solar exlipse for no less than 74 consecutive minutes. On the summer morning of June 30, 1973, the Sun rises on the Canary Islands. But it is strangely indented by the Moon. The eclipse of the century has just begun. From the west, the lunar shadow rushes to the African coast at a velocity of over 2000 kilometers per hour. Astronomers on the ground will enjoy seven short minutes of total eclipse to study the solar corona - too short for Pierre Lena and seven scientists who board the Concorde 001 prototype, an extraordinary plane to become the first commercial supersonic aircraft. With André Turcat as chief pilot and a crew of five, at 17000 m altitude, the aircraft remains in the lunar shadow for 74 minutes, a record time of scientific observations not yet beaten and allowing for exceptional measurements. Science, technology, aviation and history combine in the story of a unique human adventure aboard a legendary aircraft, illustrated with a rich and original ...

  12. Concordance analysis of methylation biomarkers detection in self-collected and physician-collected samples in cervical neoplasm

    International Nuclear Information System (INIS)

    Chang, Cheng-Chang; Huang, Rui-Lan; Liao, Yu-Ping; Su, Po-Hsuan; Hsu, Yaw-Wen; Wang, Hui-Chen; Tien, Chau-Yang; Yu, Mu-Hsien; Lin, Ya-Wen; Lai, Hung-Cheng

    2015-01-01

    Non-attendance at gynecological clinics is a major limitation of cervical cancer screening and self-collection of samples may improve this situation. Although HPV testing of self-collected vaginal samples is acceptable, the specificity is inadequate. The current focus is increasing self-collection of vaginal samples to minimize clinic visits. In this study, we analyzed the concordance and clinical performance of DNA methylation biomarker (PAX1, SOX1, and ZNF582) detection in self-collected vaginal samples and physician-collected cervical samples for the identification of cervical neoplasm. We enrolled 136 cases with paired methylation data identified from abnormal Pap smears (n = 126) and normal controls (n = 10) regardless of HPV status at gynecological clinics. The study group comprised 37 cervical intraepithelial neoplasm I (CIN1), 23 cervical intraepithelial neoplasm II (CIN2), 16 cervical intraepithelial neoplasm III (CIN3), 30 carcinoma in situ (CIS), 13 squamous cell carcinomas (SCCs) and seven adenocarcinomas (ACs)/adenosquamous carcinomas (ASCs). PAX1, SOX1 and ZNF582 methylation in study samples was assessed by real-time quantitative methylation-specific polymerase chain reaction analysis. We generated methylation index cutoff values for the detection of CIN3+ in physician-collected cervical samples for analysis of the self-collected group. Concordance between the physician-collected and self-collected groups was evaluated by Cohen’s Kappa. Sensitivity, specificity and area under curve (AUC) were calculated for detection of CIN3+ lesions. Finally, we produced an optimal cutoff value with the best sensitivity from the self-collected groups. We generated a methylation index cutoff value from physician-collected samples for detection of CIN3+. There were no significant differences in sensitivity, specificity of PAX1, SOX1 and ZNF582 between the self-collected and physician-collected groups. The methylation status of all three genes in the normal control

  13. Qualitative and quantitative analysis of the students’ perceptions to the use of 3D electronic models in problem-based learning

    Directory of Open Access Journals (Sweden)

    Hai Ming Wong

    2017-06-01

    Full Text Available Faculty of Dentistry of the University of Hong Kong has introduced innovative blended problem-based learning (PBL with the aid of 3D electronic models (e-models to Bachelor of Dental Surgery (BDS curriculum. Statistical results of pre- and post-semester questionnaire surveys illustrated compatibility of e-models in PBL settings. The students’ importance ratings of two objectives “Complete assigned tasks on time” and “Active listener”, and twenty-two facilitator evaluation items including critical thinking and group problem-solving skills had increased significantly. The students’ PBL preparation behavior, attentions to problem understanding, problem analysis, and learning resource quality were also found to be related to online support of e-models and its software. Qualitative analysis of open-ended questions with visual text analytic software “Leximancer” improved validity of statistical results. Using e-model functions in treatment planning, problem analysis and giving instructions provided a method of informative communication. Therefore, it is critical for the faculty to continuously provide facilitator training and quality online e-model resources to the students.

  14. Problem Solving in the Natural Sciences and Early Adolescent Girls' Gender Roles and Self-Esteem a Qualitative and Quantitative Analysis from AN Ecological Perspective

    Science.gov (United States)

    Slavkin, Michael

    What impact do gender roles and self-esteem have on early adolescent girls' abilities to solve problems when participating in natural science-related activities? Bronfenbrenner's human ecology model and Barker's behavior setting theory were used to assess how environmental contexts relate to problem solving in scientific contexts. These models also provided improved methodology and increased understanding of these constructs when compared with prior research. Early adolescent girls gender roles and self-esteem were found to relate to differences in problem solving in science-related groups. Specifically, early adolescent girls' gender roles were associated with levels of verbal expression, expression of positive affect, dominance, and supportive behavior during science experiments. Also, levels of early adolescent girls self-esteem were related to verbal expression and dominance in peer groups. Girls with high self-esteem also were more verbally expressive and had higher levels of dominance during science experiments. The dominant model of a masculine-typed and feminine-typed dichotomy of problem solving based on previous literature was not effective in Identifying differences within girls' problem solving. Such differences in the results of these studies may be the result of this study's use of observational measures and analysis of the behavior settings in which group members participated. Group behavior and problem-solving approaches of early adolescent girls seemed most likely to be defined by environmental contexts, not governed solely by the personalities of participants. A discussion for the examination of environmental factors when assessing early adolescent girls' gender roles and self-esteem follows this discussion.

  15. Geohydrology and limnology of Walden Pond, Concord, Massachusetts

    Science.gov (United States)

    Colman, John A.; Friesz, Paul J.

    2001-01-01

    The trophic ecology and ground-water contributing area of Walden Pond, in Concord and Lincoln, Mass., were investigated by the U.S. Geological Survey in cooperation with the Massachusetts Department of Environmental Management from April 1997 to July 2000. Bathymetric investigation indicated that Walden Pond (24.88 hectares), a glacial kettle-hole lake with no surface inlet or outlet, has three deep areas. The maximum depth (30.5 meters) essentially was unchanged from measurements made by Henry David Thoreau in 1846. The groundwater contributing area (621,000 square meters) to Walden Pond was determined from water-table contours in areas of stratified glacial deposits and from land-surface contours in areas of bedrock highs. Walden Pond is a flow-through lake: Walden Pond gains water from the aquifer along its eastern perimeter and loses water to the aquifer along its western perimeter. Walden Pond contributing area also includes Goose Pond and its contributing area. A water budget calculated for Walden Pond, expressed as depth of water over the lake surface, indicated that 45 percent of the inflow to the lake was from precipitation (1.215 meters per year) and 55 percent from ground water (1.47 meters per year). The groundwater inflow estimate was based on the average of two different approaches including an isotope mass-balance approach. Evaporation accounted for 26 percent of the outflow from the lake (0.71 meters per year) whereas lake-water seepage to the groundwater system contributed 74 percent of the outflow (1.97 meters per year). The water-residence time of Walden Pond is approximately 5 years. Potential point sources of nutrients to ground water, the Concord municipal landfill and a trailer park, were determined to be outside the Walden Pond groundwater contributing area. A third source, the septic leach field for the Walden Pond State Reservation facilities, was within the groundwater contributing area. Nutrient budgets for the lake indicated that

  16. Behavioral and neural concordance in parent-child dyadic sleep patterns.

    Science.gov (United States)

    Lee, Tae-Ho; Miernicki, Michelle E; Telzer, Eva H

    2017-08-01

    Sleep habits developed in adolescence shape long-term trajectories of psychological, educational, and physiological well-being. Adolescents' sleep behaviors are shaped by their parents' sleep at both the behavioral and biological levels. In the current study, we sought to examine how neural concordance in resting-state functional connectivity between parent-child dyads is associated with dyadic concordance in sleep duration and adolescents' sleep quality. To this end, we scanned both parents and their child (N=28 parent-child dyads; parent M age =42.8years; adolescent M age =14.9years; 14.3% father; 46.4% female adolescent) as they each underwent a resting-state scan. Using daily diaries, we also assessed dyadic concordance in sleep duration across two weeks. Our results show that greater daily concordance in sleep behavior is associated with greater neural concordance in default-mode network connectivity between parents and children. Moreover, greater neural and behavioral concordances in sleep is associated with more optimal sleep quality in adolescents. The current findings expand our understanding of dyadic concordance by providing a neurobiological mechanism by which parents and children share daily sleep behaviors. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Work happiness among teachers: a day reconstruction study on the role of self-concordance.

    Science.gov (United States)

    Tadić, Maja; Bakker, Arnold B; Oerlemans, Wido G M

    2013-12-01

    Self-concordant work motivation arises from one's authentic choices, personal values, and interests. In the present study, we investigated whether self-concordant motivation may fluctuate from one work-related task to the next. On the basis of self-determination theory, we hypothesized that momentary self-concordance buffers the negative impact of momentary work demands on momentary happiness. We developed a modified version of the day reconstruction method to investigate self-concordance, work demands, and happiness during specific work-related tasks on a within-person and within-day level. In total, 132 teachers completed a daily diary on three consecutive work days as well as a background questionnaire. The daily diary resulted in 792 reported work activities and activity-related work demands, self-concordance, and happiness scores. Multilevel analysis showed that-for most work activities-state self-concordant motivation buffered the negative association of work demands with happiness. These findings add to the literature on motivation and well-being by showing that the levels of self-concordance and happiness experienced by employees vary significantly on a within-day level and show a predictable pattern. We discuss theoretical and practical implications of the findings to increase employees' well-being. © 2013.

  18. Evolutions in clinical reasoning assessment: The Evolving Script Concordance Test.

    Science.gov (United States)

    Cooke, Suzette; Lemay, Jean-François; Beran, Tanya

    2017-08-01

    Script concordance testing (SCT) is a method of assessment of clinical reasoning. We developed a new type of SCT case design, the evolving SCT (E-SCT), whereby the patient's clinical story is "evolving" and with thoughtful integration of new information at each stage, decisions related to clinical decision-making become increasingly clear. We aimed to: (1) determine whether an E-SCT could differentiate clinical reasoning ability among junior residents (JR), senior residents (SR), and pediatricians, (2) evaluate the reliability of an E-SCT, and (3) obtain qualitative feedback from participants to help inform the potential acceptability of the E-SCT. A 12-case E-SCT, embedded within a 24-case pediatric SCT (PaedSCT), was administered to 91 pediatric residents (JR: n = 50; SR: n = 41). A total of 21 pediatricians served on the panel of experts (POE). A one-way analysis of variance (ANOVA) was conducted across the levels of experience. Participants' feedback on the E-SCT was obtained with a post-test survey and analyzed using two methods: percentage preference and thematic analysis. Statistical differences existed across levels of training: F = 19.31 (df = 2); p decision-making process. The E-SCT demonstrated very good reliability and was effective in distinguishing clinical reasoning ability across three levels of experience. Participants found the E-SCT engaging and representative of real-life clinical reasoning and decision-making processes. We suggest that further refinement and utilization of the evolving style case will enhance SCT as a robust, engaging, and relevant method for the assessment of clinical reasoning.

  19. Guideline concordance of new statin prescriptions: who got a statin?

    Science.gov (United States)

    Cascino, Thomas; Vali, Marzieh; Redberg, Rita; Bravata, Dawn M; Boscardin, John; Eilkhani, Elnaz; Keyhani, Salomeh

    2017-09-01

    Statins are recommended to reduce serum cholesterol in patients at risk for atherosclerotic cardiovascular disease. Despite the prevalence of statin use, little is known about the indications for new prescriptions. We assessed the concordance of new statin prescriptions in the Veterans Health Administration (VHA) compared with the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, or ATP III) guidelines (the guidelines in force in 2012) and the American College of Cardiology (ACC)-American Heart Association (AHA) 2013 guidelines. Cross-sectional study. We identified every patient who received a new prescription (no statin use in the prior year) in the VHA in 2012. Patients were excluded if they had incomplete data, triglycerides greater than 400 mg/dL, or fewer than 2 primary care visits to ensure adequate baseline data to calculate Framingham and ACC-AHA 2013 risk scores. We identified 250,243 new statin prescriptions in 2012 in the VHA, with 121,081 meeting inclusion criteria. Among new prescriptions, 68% were prescribed for primary prevention and 32% were prescribed for secondary prevention. Among patients receiving new statins for primary prevention, 48% did not have an indication supported by the ATP III guideline and 20% did not have an indication supported by the ACC/AHA guideline. Overall, approximately 19% of patients may have received a statin for an indication not supported by either guideline. Veterans are commonly prescribed statins for indications not supported by professional society guidelines. The finding of common use of statins outside established guidelines represents an opportunity to improve the quality and value of the healthcare delivery.

  20. Quantitative Analysis of the Principal-Agent Problem in Commercial Buildings in the U.S.: Focus on Central Space Heating and Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Blum, Helcio; Sathaye, Jayant

    2010-05-14

    We investigate the existence of the principal-agent (PA) problem in non-government, non-mall commercial buildings in the U.S. in 2003. The analysis concentrates on space heating and cooling energy consumed by centrally installed equipment in order to verify whether a market failure caused by the PA problem might have prevented the installation of energy-efficient devices in non-owner-occupied buildings (efficiency problem) and/or the efficient operation of space-conditioning equipment in these buildings (usage problem). Commercial Buildings Energy Consumption Survey (CBECS) 2003 data for single-owner, single-tenant and multi-tenant occupied buildings were used for conducting this evaluation. These are the building subsets with the appropriate conditions for assessing both the efficiency and the usage problems. Together, these three building types represent 51.9percent of the total floor space of all buildings with space heating and 59.4percent of the total end-use energy consumption of such buildings; similarly, for space cooling, they represent 52.7percent of floor space and 51.6percent of energy consumption. Our statistical analysis shows that there is a usage PA problem. In space heating it applies only to buildings with a small floor area (<_50,000 sq. ft.). We estimate that in 2003 it accounts for additional site energy consumption of 12.3 (+ 10.5 ) TBtu (primary energy consumption of 14.6 [+- 12.4] TBtu), corresponding to 24.0percent (+- 20.5percent) of space heating and 10.2percent (+- 8.7percent) of total site energy consumed in those buildings. In space cooling, however, the analysis shows that the PA market failure affects the complete set of studied buildings. We estimate that it accounts for a higher site energy consumption of 8.3 (+-4.0) TBtu (primary energy consumption of 25.5 [+- 12.2]TBtu), which corresponds to 26.5percent (+- 12.7percent) of space cooling and 2.7percent (+- 1.3percent) of total site energy consumed in those buildings.

  1. Concordance of attachment representations in preschool siblings assessed by the attachment story completion task

    OpenAIRE

    Werner, Helene; Zahn, Salome; Titze, Karl; Walitza, Susanne; Zulauf Logoz, Marina

    2015-01-01

    Several studies have indicated only a modest concordance of attachment security in siblings in infancy. Until now, very little was known about the concordance of siblings’ attachment security beyond infancy, as assessed by the attachment story completion task. This cross-sectional study aims to examine the concordance of attachment representations of 38 first-born (4–7 years) and 38 second-born (3–5 years) siblings living in middle-class two-parent families. Personality factors and the level ...

  2. Assessment of clinical reasoning: A Script Concordance test designed for pre-clinical medical students.

    Science.gov (United States)

    Humbert, Aloysius J; Johnson, Mary T; Miech, Edward; Friedberg, Fred; Grackin, Janice A; Seidman, Peggy A

    2011-01-01

    The Script Concordance test (SCT) measures clinical reasoning in the context of uncertainty by comparing the responses of examinees and expert clinicians. It uses the level of agreement with a panel of experts to assign credit for the examinee's answers. This study describes the development and validation of a SCT for pre-clinical medical students. Faculty from two US medical schools developed SCT items in the domains of anatomy, biochemistry, physiology, and histology. Scoring procedures utilized data from a panel of 30 expert physicians. Validation focused on internal reliability and the ability of the SCT to distinguish between different cohorts. The SCT was administered to an aggregate of 411 second-year and 70 fourth-year students from both schools. Internal consistency for the 75 test items was satisfactory (Cronbach's alpha = 0.73). The SCT successfully differentiated second- from fourth-year students and both student groups from the expert panel in a one-way analysis of variance (F(2,508) = 120.4; p students from the two schools were not significantly different (p = 0.20). This SCT successfully differentiated pre-clinical medical students from fourth-year medical students and both cohorts of medical students from expert clinicians across different institutions and geographic areas. The SCT shows promise as an easy-to-administer measure of "problem-solving" performance in competency evaluation even in the beginning years of medical education.

  3. Physical activity and concordance between objective and perceived walkability.

    Science.gov (United States)

    Arvidsson, Daniel; Kawakami, Naomi; Ohlsson, Henrik; Sundquist, Kristina

    2012-02-01

    The study's purpose was to investigate concordance between objective and perceived neighborhood walkability, their associations with self-reported walking and objective physical activity, and sociodemographic characteristics of individuals in neighborhoods with objectively assessed high walkability who misperceive it as low. In 1925 individuals age 20-66 yr of both high and low neighborhood walkability recruited from administrative areas in the city of Stockholm, Sweden, objective neighborhood walkability was assessed within a 1000-m radius of each individual's residential address using geographic information systems. Perceived walkability was based on the Neighborhood Environment Walkability Scale. Walking was assessed using the International Physical Activity Questionnaire, and total physical activity and moderate-to-vigorous physical activity (MVPA) were assessed by an accelerometer (ActiGraph). Sociodemographic characteristics were self-reported. Objective and perceived neighborhood walkability agreed in 67.0% of the individuals, with κ = 0.34 (95% confidence interval (CI) = 0.30-0.38). One-third of the individuals in neighborhoods with objectively assessed high walkability misperceived it as low. This nonconcordance was more common among older and married/cohabiting individuals. After adjustment for sociodemographic characteristics, high objective neighborhood walkability was associated with 35.0 (95% CI = 14.6-64.6) and 10.5 (95% CI = -5.2 to 28.5) more minutes per week of walking for transportation and leisure, respectively, and 2.8 (95% CI = 0.9-5.0) more minutes per day of MVPA. High perceived neighborhood walkability was associated with 41.5 (95% CI = 15.8-62.9) and 21.8 (95% CI = 2.8-40.0) more minutes per week of walking for transportation and leisure, respectively, and 1.7 (95% CI = -0.3 to 3.7) more minutes per day of MVPA. Objective and perceived neighborhood walkability both contribute to the amount of walking and objective physical activity. Both

  4. 2010 Federal Emergency Management Agency (FEMA) Topographic Lidar: Concord River Watershed, Massachusetts

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Concord AOI consists of one area. Ground Control is collected throughout the AOI for use in the processing of LiDAR data to ensure data accurately represents the...

  5. What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies.

    Science.gov (United States)

    Reardon, Tessa; Harvey, Kate; Baranowska, Magdalena; O'Brien, Doireann; Smith, Lydia; Creswell, Cathy

    2017-06-01

    A minority of children and adolescents with mental health problems access treatment. The reasons for poor rates of treatment access are not well understood. As parents are a key gatekeeper to treatment access, it is important to establish parents' views of barriers/facilitators to accessing treatment. The aims of this study are to synthesise findings from qualitative and quantitative studies that report parents' perceptions of barriers/facilitators to accessing treatment for mental health problems in children/adolescents. A systematic review and narrative synthesis were conducted. Forty-four studies were included in the review and were assessed in detail. Parental perceived barriers/facilitators relating to (1) systemic/structural issues; (2) views and attitudes towards services and treatment; (3) knowledge and understanding of mental health problems and the help-seeking process; and (4) family circumstances were identified. Findings highlight avenues for improving access to child mental health services, including increased provision that is free to service users and flexible to their needs, with opportunities to develop trusting, supportive relationships with professionals. Furthermore, interventions are required to improve parents' identification of mental health problems, reduce stigma for parents, and increase awareness of how to access services.

  6. Concordance measures and second order stochastic dominance-portfolio efficiency analysis

    Czech Academy of Sciences Publication Activity Database

    Kopa, Miloš; Tichý, T.

    2012-01-01

    Roč. 15, č. 4 (2012), s. 110-120 ISSN 1212-3609 R&D Projects: GA ČR(CZ) GBP402/12/G097 Institutional support: RVO:67985556 Keywords : dependency * concordance * portfolio selection * second order stochastic dominance Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.633, year: 2012 http://library.utia.cas.cz/separaty/2013/E/kopa-concordance measures and second order stochastic dominance- portfolio efficiency analysis.pdf

  7. Investigating spousal concordance of diabetes through statistical analysis and data mining.

    Directory of Open Access Journals (Sweden)

    Jong-Yi Wang

    Full Text Available Spousal clustering of diabetes merits attention. Whether old-age vulnerability or a shared family environment determines the concordance of diabetes is also uncertain. This study investigated the spousal concordance of diabetes and compared the risk of diabetes concordance between couples and noncouples by using nationally representative data.A total of 22,572 individuals identified from the 2002-2013 National Health Insurance Research Database of Taiwan constituted 5,643 couples and 5,643 noncouples through 1:1 dual propensity score matching (PSM. Factors associated with concordance in both spouses with diabetes were analyzed at the individual level. The risk of diabetes concordance between couples and noncouples was compared at the couple level. Logistic regression was the main statistical method. Statistical data were analyzed using SAS 9.4. C&RT and Apriori of data mining conducted in IBM SPSS Modeler 13 served as a supplement to statistics.High odds of the spousal concordance of diabetes were associated with old age, middle levels of urbanization, and high comorbidities (all P < 0.05. The dual PSM analysis revealed that the risk of diabetes concordance was significantly higher in couples (5.19% than in noncouples (0.09%; OR = 61.743, P < 0.0001.A high concordance rate of diabetes in couples may indicate the influences of assortative mating and shared environment. Diabetes in a spouse implicates its risk in the partner. Family-based diabetes care that emphasizes the screening of couples at risk of diabetes by using the identified risk factors is suggested in prospective clinical practice interventions.

  8. Decision-Making in Pediatric Transport Team Dispatch Using Script Concordance Testing.

    Science.gov (United States)

    Rajapreyar, Prakadeshwari; Marcdante, Karen; Zhang, Liyun; Simpson, Pippa; Meyer, Michael T

    2017-11-01

    Our objective was to compare decision-making in dispatching pediatric transport teams by Medical Directors of pediatric transport teams (serving as experts) to that of Pediatric Intensivists and Critical Care fellows who often serve as Medical Control physicians. Understanding decision-making around team composition and dispatch could impact clinical management, cost effectiveness, and educational needs. Survey was developed using Script Concordance Testing guidelines. The survey contained 15 transport case vignettes covering 20 scenarios (45 questions). Eleven scenarios assessed impact of intrinsic patient factors (e.g., procedural needs), whereas nine assessed extrinsic factors (e.g., weather). Pediatric Critical Care programs accredited by the Accreditation Council for Graduate Medical Education (the United States). Pediatric Intensivists and senior Critical Care fellows at Pediatric Critical Care programs were the target population with Transport Medical Directors serving as the expert panel. None. Survey results were scored per Script Concordance Testing guidelines. Concordance within groups was assessed using simple percentage agreement. There was little concordance in decision-making by Transport Medical Directors (median Script Concordance Testing percentage score [interquartile range] of 33.9 [30.4-37.3]). In addition, there was no statistically significant difference between the median Script Concordance Testing scores among the senior fellows and Pediatric Intensivists (31.1 [29.6-33.2] vs 29.7 [28.3-32.3], respectively; p = 0.12). Transport Medical Directors were more concordant on reasoning involving intrinsic patient factors rather than extrinsic factors (10/21 vs 4/24). Our study demonstrates pediatric transport team dispatch decision-making discordance by pediatric critical care physicians of varying levels of expertise and experience. Script Concordance Testing at a local level may better elucidate standards in medical decision-making within

  9. The concordance of directly and indirectly measured built environment attributes and physical activity adoption

    Directory of Open Access Journals (Sweden)

    O'Connor Daniel P

    2011-07-01

    Full Text Available Background Physical activity (PA adoption is essential for obesity prevention and control, yet ethnic minority women report lower levels of PA and are at higher risk for obesity and its comorbidities compared to Caucasians. Epidemiological studies and ecologic models of health behavior suggest that built environmental factors are associated with health behaviors like PA, but few studies have examined the association between built environment attribute concordance and PA, and no known studies have examined attribute concordance and PA adoption. Purpose The purpose of this study was to associate the degree of concordance between directly and indirectly measured built environment attributes with changes in PA over time among African American and Hispanic Latina women participating in a PA intervention. Method Women (N = 410 completed measures of PA at Time 1 (T1 and Time 2 (T2; environmental data collected at T1 were used to compute concordance between directly and indirectly measured built environment attributes. The association between changes in PA and the degree of concordance between each directly and indirectly measured environmental attribute was assessed using repeated measures analyses. Results There were no significant associations between built environment attribute concordance values and change in self-reported or objectively measured PA. Self-reported PA significantly increased over time (F(1,184 = 7.82, p = .006, but this increase did not vary by ethnicity or any built environment attribute concordance variable. Conclusions Built environment attribute concordance may not be associated with PA changes over time among minority women. In an effort to promote PA, investigators should clarify specific built environment attributes that are important for PA adoption and whether accurate perceptions of these attributes are necessary, particularly among the vulnerable population of minority women.

  10. Corpus-aided language pedagogy : the use of concordance lines in vocabulary instruction

    OpenAIRE

    Kazaz, İlknur

    2015-01-01

    Ankara : The Program of Teaching English as a Foreign Language Bilkent University, 2015. Thesis (Master's) -- Bilkent University, 2015. Includes bibliographical references leaves 83-91. This study investigated the effectiveness of the use of a concordance software and concordance lines as a pedagogical tool to learn the target vocabulary of a text book. The purpose of the study was to compare the effects of corpus-aided vocabulary instruction with traditional vocabulary teac...

  11. Adherence to Cardiovascular Disease Medications: Does Patient-Provider Race/Ethnicity and Language Concordance Matter?

    OpenAIRE

    Traylor, Ana H.; Schmittdiel, Julie A.; Uratsu, Connie S.; Mangione, Carol M.; Subramanian, Usha

    2010-01-01

    BACKGROUND: Patient-physician race/ethnicity and language concordance may improve medication adherence and reduce disparities in cardiovascular disease (CVD) by fostering trust and improved patient-physician communication. OBJECTIVE: To examine the association of patient race/ethnicity and language and patient-physician race/ethnicity and language concordance on medication adherence rates for a large cohort of diabetes patients in an integrated delivery system. DESIGN: We studied 131,277 adul...

  12. Quantitative Analysis of Motor Status in Parkinson’s Disease Using Wearable Devices: From Methodological Considerations to Problems in Clinical Applications

    Directory of Open Access Journals (Sweden)

    Masahiko Suzuki

    2017-01-01

    Full Text Available Long-term and objective monitoring is necessary for full assessment of the condition of patients with Parkinson’s disease (PD. Recent advances in biotechnology have seen the development of various types of wearable (body-worn sensor systems. By using accelerometers and gyroscopes, these devices can quantify motor abnormalities, including decreased activity and gait disturbances, as well as nonmotor signs, such as sleep disturbances and autonomic dysfunctions in PD. This review discusses methodological problems inherent in wearable devices. Until now, analysis of the mean values of motion-induced signals on a particular day has been widely applied in the clinical management of PD patients. On the other hand, the reliability of these devices to detect various events, such as freezing of gait and dyskinesia, has been less than satisfactory. Quantification of disease-specific changes rather than nonspecific changes is necessary.

  13. A concordance-based study to assess doctors’ and nurses’ mental models in Internal Medicine

    Science.gov (United States)

    Chan, K. C. Gary; Muller-Juge, Virginie; Cullati, Stéphane; Hudelson, Patricia; Maître, Fabienne; Vu, Nu V.; Savoldelli, Georges L.; Nendaz, Mathieu R.

    2017-01-01

    Interprofessional collaboration between doctors and nurses is based on team mental models, in particular for each professional’s roles. Our objective was to identify factors influencing concordance on the expectations of doctors’ and nurses’ roles and responsibilities in an Internal Medicine ward. Using a dataset of 196 doctor-nurse pairs (14x14 = 196), we analyzed choices and prioritized management actions of 14 doctors and 14 nurses in six clinical nurse role scenarios, and in five doctor role scenarios (6 options per scenario). In logistic regression models with a non-nested correlation structure, we evaluated concordance among doctors and nurses, and adjusted for potential confounders (including prior experience in Internal Medicine, acuteness of case and gender). Concordance was associated with number of female professionals (adjusted OR 1.32, 95% CI 1.02 to 1.73), for acute situations (adjusted OR 2.02, 95% CI 1.13 to 3.62), and in doctor role scenarios (adjusted OR 2.19, 95% CI 1.32 to 3.65). Prior experience and country of training were not significant predictors of concordance. In conclusion, our concordance-based approach helped us identify areas of lower concordance in expected doctor-nurse roles and responsibilities, particularly in non-acute situations, which can be targeted by future interprofessional, educational interventions. PMID:28792524

  14. Transitions from hospital to community care: the role of patient-provider language concordance.

    Science.gov (United States)

    Rayan, Nosaiba; Admi, Hanna; Shadmi, Efrat

    2014-01-01

    Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients' discharge from hospital to community care, specifically examining the relationship between patient-provider language concordance and the quality of transitional care. This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0-100 scale)) and on the primary-care post-discharge visit. Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient-provider language concordance was present in 49% of minority patients' discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients.

  15. Receipt of Guideline-Concordant Treatment in Elderly Prostate Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Ronald C., E-mail: Ronald_chen@med.unc.edu [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Carpenter, William R. [Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Hendrix, Laura H. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Bainbridge, John [Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Wang, Andrew Z. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Nielsen, Matthew E. [Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); and others

    2014-02-01

    Purpose: To examine the proportion of elderly prostate cancer patients receiving guideline-concordant treatment, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: A total of 29,001 men diagnosed in 2004-2007 with localized prostate cancer, aged 66 to 79 years, were included. We characterized the proportion of men who received treatment concordant with the National Comprehensive Cancer Network guidelines, stratified by risk group and age. Logistic regression was used to examine covariates associated with receipt of guideline-concordant management. Results: Guideline concordance was 79%-89% for patients with low- or intermediate-risk disease. Among high-risk patients, 66.6% of those aged 66-69 years received guideline-concordant management, compared with 51.9% of those aged 75-79 years. Discordance was mainly due to conservative management—no treatment or hormone therapy alone. Among the subgroup of patients aged ≤76 years with no measured comorbidity, findings were similar. On multivariable analysis, older age (75-79 vs 66-69 years, odds ratio 0.51, 95% confidence interval 0.50-0.57) was associated with a lower likelihood of guideline concordance for high-risk prostate cancer, but comorbidity was not. Conclusions: There is undertreatment of elderly but healthy patients with high-risk prostate cancer, the most aggressive form of this disease.

  16. A concordance-based study to assess doctors' and nurses' mental models in Internal Medicine.

    Directory of Open Access Journals (Sweden)

    Katherine S Blondon

    Full Text Available Interprofessional collaboration between doctors and nurses is based on team mental models, in particular for each professional's roles. Our objective was to identify factors influencing concordance on the expectations of doctors' and nurses' roles and responsibilities in an Internal Medicine ward. Using a dataset of 196 doctor-nurse pairs (14x14 = 196, we analyzed choices and prioritized management actions of 14 doctors and 14 nurses in six clinical nurse role scenarios, and in five doctor role scenarios (6 options per scenario. In logistic regression models with a non-nested correlation structure, we evaluated concordance among doctors and nurses, and adjusted for potential confounders (including prior experience in Internal Medicine, acuteness of case and gender. Concordance was associated with number of female professionals (adjusted OR 1.32, 95% CI 1.02 to 1.73, for acute situations (adjusted OR 2.02, 95% CI 1.13 to 3.62, and in doctor role scenarios (adjusted OR 2.19, 95% CI 1.32 to 3.65. Prior experience and country of training were not significant predictors of concordance. In conclusion, our concordance-based approach helped us identify areas of lower concordance in expected doctor-nurse roles and responsibilities, particularly in non-acute situations, which can be targeted by future interprofessional, educational interventions.

  17. A valoração de traços de concordância dentro do DP Concord features valuing within DP

    Directory of Open Access Journals (Sweden)

    Telma M.V. Magalhães

    2004-06-01

    Full Text Available Este trabalho argumenta em favor da valoração dos traços de concordância dentro do DP em termos da operação Agree (Chomsky, 1999 sem a necessidade de estipular nenhum outro mecanismo para tanto. Mostro que Agree dá conta da valoração de traços tanto no nível da sentença quanto no nível do DP, contra a sugestão de Chomsky (1999 de que concordância no DP envolveria algum outro mecanismo de checagem.This paper argues in favor of a concord features valuing within the DP in terms of the Agree operation (Chomsky, 1999, with no recourse to any other mechanism. I show that Agree accounts for feature valuing both in the sentence level as well as in the DP, contrary to Chomsky's (1999 suggestion that concord in DP should involve some other checking mechanism.

  18. Insomnia From Drug Treatments: Evidence From Meta-analyses of Randomized Trials and Concordance With Prescribing Information.

    Science.gov (United States)

    Doufas, Anthony G; Panagiotou, Orestis A; Panousis, Periklis; Wong, Shane Shucheng; Ioannidis, John P A

    2017-01-01

    To determine whether drugs used to treat diverse conditions cause insomnia symptoms and whether their prescription information is concordant with this evidence. We conducted a survey of meta-analyses (Cochrane Database of Systematic Reviews) and comparisons with package inserts compiled in the Physicians' Desk Reference (PDR). We identified randomized controlled trials (RCTs) in which any drug had been evaluated vs placebo and sleep had been assessed. We collectively referred to insomnia-related outcomes as sleep disturbance. We also searched the PDR to identify any insomnia symptoms listed for drugs with RCT evidence available. Seventy-four Cochrane systematic reviews corresponding to 274 RCTs assessed 88 drugs in 27 different conditions, providing evidence on 109 drug-condition pairs. Of these 88 drugs, 5 decreased sleep problems and 19 increased sleep problems; 64 drugs had no nominally statistically significant effect on sleep. Acetylcholinesterase inhibitors, dopamine agonists, and selective serotonin reuptake inhibitors were the drug classes most importantly associated with sleep disturbance. Of 35 drugs that included disturbed sleep as an adverse effect in the PDR, only 14 had RCT evidence supporting such effect, and 2 had evidence of increasing and decreasing sleep problems in RCTs, although this was not shown in the PDR. We identified weak concordance between the PDR and RCTs (weighted κ=0.31; P<.001). The RCTs offer substantial evidence about the common effects of drugs on the risk of sleep disturbance; currently, prescription information only partially agrees with the available randomized evidence. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  19. Evaluation of mammographic density patterns: reproducibility and concordance among scales

    Directory of Open Access Journals (Sweden)

    Garrido-Estepa Macarena

    2010-09-01

    Full Text Available Abstract Background Increased mammographic breast density is a moderate risk factor for breast cancer. Different scales have been proposed for classifying mammographic density. This study sought to assess intra-rater agreement for the most widely used scales (Wolfe, Tabár, BI-RADS and Boyd and compare them in terms of classifying mammograms as high- or low-density. Methods The study covered 3572 mammograms drawn from women included in the DDM-Spain study, carried-out in seven Spanish Autonomous Regions. Each mammogram was read by an expert radiologist and classified using the Wolfe, Tabár, BI-RADS and Boyd scales. In addition, 375 mammograms randomly selected were read a second time to estimate intra-rater agreement for each scale using the kappa statistic. Owing to the ordinal nature of the scales, weighted kappa was computed. The entire set of mammograms (3572 was used to calculate agreement among the different scales in classifying high/low-density patterns, with the kappa statistic being computed on a pair-wise basis. High density was defined as follows: percentage of dense tissue greater than 50% for the Boyd, "heterogeneously dense and extremely dense" categories for the BI-RADS, categories P2 and DY for the Wolfe, and categories IV and V for the Tabár scales. Results There was good agreement between the first and second reading, with weighted kappa values of 0.84 for Wolfe, 0.71 for Tabár, 0.90 for BI-RADS, and 0.92 for Boyd scale. Furthermore, there was substantial agreement among the different scales in classifying high- versus low-density patterns. Agreement was almost perfect between the quantitative scales, Boyd and BI-RADS, and good for those based on the observed pattern, i.e., Tabár and Wolfe (kappa 0.81. Agreement was lower when comparing a pattern-based (Wolfe or Tabár versus a quantitative-based (BI-RADS or Boyd scale. Moreover, the Wolfe and Tabár scales classified more mammograms in the high-risk group, 46.61 and 37

  20. Accuracy and interobserver concordance of echocardiographic assessment of right ventricular size and systolic function: a quality control exercise.

    Science.gov (United States)

    Ling, Lee Fong; Obuchowski, Nancy A; Rodriguez, Leonardo; Popovic, Zoran; Kwon, Deborah; Marwick, Thomas H

    2012-07-01

    Accurate assessment of right ventricular (RV) size (RVS) and RV systolic function (RVSF) is vital in the management of various conditions, but their assessment is challenging using echocardiography. The aim of this study was to determine the accuracy and interobserver concordance of qualitative and quantitative RV echocardiography. Fifteen readers evaluated RV function in 12 patients (360 readings) who underwent echocardiography and cardiac magnetic resonance for RV assessment. Readers qualitatively estimated RVS and RVSF as normal, mild, moderate, or severe and then reassessed quantitatively by adding RV dimensions, fractional area change, S', tricuspid annular plane systolic excursion, and RV index of myocardial performance. Cardiac magnetic resonance was used as the reference standard for grading RVS and RVSF. Quantitative measurements increased accuracy and interreader agreement compared to qualitative assessment alone, especially in normal categories. Readers' accuracy for diagnosing normal and severe RVS increased from 38% to 78% (P = .001) and from 70% to 97% (P = .018), and readers' accuracy for diagnosing normal and mild RVSF increased from 52% to 84% (P value of 0.40 to 0.77 (fair to good agreement) for RVS and from 0.43 to 0.66 (moderate to good agreement) for RVSF. Visual estimation of RVS and RVSF is inaccurate and has wide interobserver variability. Quantitation improves accuracy and reliability, especially in distinction of normal and abnormal. The reliability of mild and moderate grades remains inadequate, and further guidance is needed for the classification of abnormal categories. Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

  1. Divisional role of quantitative HER2 testing in breast cancer.

    Science.gov (United States)

    Yamamoto-Ibusuki, Mutsuko; Yamamoto, Yutaka; Fu, Peifen; Yamamoto, Satoko; Fujiwara, Saori; Honda, Yumi; Iyama, Ken-ichi; Iwase, Hirotaka

    2015-03-01

    Human epidermal growth factor receptor 2 (HER2) is amplified in human breast cancers in which therapy targeted to HER2 significantly improves patient outcome. We re-visited the use of real-time quantitative polymerase chain reaction (qPCR)-based assays using formalin-fixed paraffin-embedded (FFPE) tissues as alternative methods and investigated their particular clinical relevance. DNA and RNA were isolated from FFPE specimens and HER2 status was assessed by qPCR in 249 consecutive patients with primary breast cancer. Concordance with results forg immunohistochemistry (IHC) and in situ hybridization (ISH), clinical characteristics and survival was assessed. HER2 gene copy number had a stronger correlation with clinicopathological characteristics and excellent concordance with IHC/ISH results (Sensitivity: 96.7 %; concordance: 99.2 %). HER2 gene expression showed inadequate sensitivity, rendering it unsuitable to determine HER2 status (Sensitivity: 46.7 %; concordance: 92.1 %), but lower HER2 gene expression, leading to the classification of many cases as "false negative", contributed to a prediction of better prognosis within the HER2-amplified subpopulation. Quantitative HER2 assessments are suggested to have evolved their accuracy in this decade, which can be a potential alternative for HER2 diagnosis in line with the in situ method, while HER2 gene expression levels could provide additional information regarding prognosis or therapeutic strategy within a HER2-amplified subpopulation.

  2. Attention-Deficit/Hyperactivity Disorder (ADHD) in Adulthood: Concordance and Differences between Self- and Informant Perspectives on Symptoms and Functional Impairment.

    Science.gov (United States)

    Mörstedt, Beatrice; Corbisiero, Salvatore; Bitto, Hannes; Stieglitz, Rolf-Dieter

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a severe mental illness, associated with major impairment and a high comorbidity rate. Particularly undiagnosed ADHD in adulthood has serious consequences. Thus, a valid diagnosis is important. In adulthood, the diagnostic process for ADHD is complicated: symptoms may overlap with comorbid disorders, and the onset and progression of the disorder must be reconstructed retrospectively. Guidelines for the diagnostic process recommend the inclusion of additional informant ratings. Research into the relation between self- and informant ratings shows extremely heterogeneous results. The levels of agreement range from low to high. The focus of this study is the concordance and differences between self- and informant ratings on ADHD symptoms and impairments. In this regard, two possible influencing factors (gender and relationship type) are also examined. 114 people participated in this study, 77 with an ADHD diagnosis and 37 without a diagnosis. For all participants, either parents or partners also rated ADHD symptoms and impairments. Small to moderate concordance was found between self- and informant ratings, with females being slightly more concordant than males, particularly for ratings of problems with self-concept. Examination of the consistency within a particular perspective showed that people with ADHD seemed to be unaware of the causal relation between ADHD symptoms and their impairments. A close investigation found almost no influence of gender and relationship type on differences within perspectives. Based on these results, the implications for the diagnostic process are that additional informant information is clearly necessary and helpful.

  3. Attention-Deficit/Hyperactivity Disorder (ADHD in Adulthood: Concordance and Differences between Self- and Informant Perspectives on Symptoms and Functional Impairment.

    Directory of Open Access Journals (Sweden)

    Beatrice Mörstedt

    Full Text Available Attention-deficit/hyperactivity disorder (ADHD is a severe mental illness, associated with major impairment and a high comorbidity rate. Particularly undiagnosed ADHD in adulthood has serious consequences. Thus, a valid diagnosis is important. In adulthood, the diagnostic process for ADHD is complicated: symptoms may overlap with comorbid disorders, and the onset and progression of the disorder must be reconstructed retrospectively. Guidelines for the diagnostic process recommend the inclusion of additional informant ratings. Research into the relation between self- and informant ratings shows extremely heterogeneous results. The levels of agreement range from low to high. The focus of this study is the concordance and differences between self- and informant ratings on ADHD symptoms and impairments. In this regard, two possible influencing factors (gender and relationship type are also examined. 114 people participated in this study, 77 with an ADHD diagnosis and 37 without a diagnosis. For all participants, either parents or partners also rated ADHD symptoms and impairments. Small to moderate concordance was found between self- and informant ratings, with females being slightly more concordant than males, particularly for ratings of problems with self-concept. Examination of the consistency within a particular perspective showed that people with ADHD seemed to be unaware of the causal relation between ADHD symptoms and their impairments. A close investigation found almost no influence of gender and relationship type on differences within perspectives. Based on these results, the implications for the diagnostic process are that additional informant information is clearly necessary and helpful.

  4. Correlates of and couples' concordance in reports of recent sexual behavior and contraceptive use.

    Science.gov (United States)

    Koffi, Alain K; Adjiwanou, Visseho D; Becker, Stan; Olaolorun, Funmilola; Tsui, Amy O

    2012-03-01

    This study uses couple-level data to measure couples' concordance of self-reported time since last coitus and of condom and other contraceptive use at last sexual intercourse among monogamous couples in Liberia (N = 1,673), Madagascar (N = 4,138), and Namibia (N = 588). The study also examines the characteristics associated with sexual behavior and contraceptive use occurring in the 28 days prior to the interviews among couples whose reports are concordant. Overall, our study finds less than 75 percent concordance in reporting of time since last coitus. Use of condoms and other contraceptives yielded fair (0.27) to substantial (0.67) agreement on the kappa index. Factors predicting a shorter time since last coitus among concordant couples in at least two of the countries included wealth, spousal age difference, education, and both partners wanting another child. The discordant reports of recent sexual behavior and contraceptive use suggest that caution should be exercised when inferring couples' behavior from the report of one spouse, that concordant reports should be examined when possible, that methodological changes to improve the validity of spousal reports should be pursued, and that family planning and HIV-prevention programs should target those groups found to be using condoms and other contraceptives less frequently, particularly poorer couples.

  5. Concorde noise-induced building vibrations: International Airport Dulles. [studies by Langley Research Center

    Science.gov (United States)

    Mayes, W. H.; Scholl, H. F.; Stephens, D. G.; Holliday, B. G.; Deloach, R.; Finley, T. D.; Holmes, H. K.; Lewis, R. B.; Lynch, J. W.

    1977-01-01

    A series of studies were conducted to assess the noise-induced building vibrations associated with Concorde operations. The vibration levels of windows, walls, and floors were measured along with the associated noise levels of Concorde, subsonic aircraft and some nonaircraft events. Test sites included Sully Plantation which is adjacent to Dulles International Airport and three residential homes located in Montgomery County, Maryland. The measured vibration response levels due to Concorde operations were found to be: (1) higher than the levels due to other aircraft, (2) less than the levels due to certain household events which involve direct impulsive loading such as door and window closing, (3) less than criteria levels for building damage, and (4) comparable to levels which are perceptible to people.

  6. Concordance of autoimmune disease in a nationwide Danish systemic lupus erythematosus twin cohort

    DEFF Research Database (Denmark)

    Ulff-Møller, Constance Jensina; Svendsen, Anders Jørgen; Viemose, Louise Nørgaard

    2018-01-01

    OBJECTIVE: To determine the concordance of systemic lupus erythematosus (SLE) and co-aggregating autoimmune diseases among Danish twins. METHODS: SLE-affected twins were ascertained by record linkage between the National Patient Register (NPR) and the Danish Twin Registry (DTR). Registered SLE....... Another four co-twins had other autoimmune disease, corresponding to a probandwise concordance of any autoimmune disease of 50.0% in MZ (95% CI: 21.5-78.5) and 23.1% in DZ twins (95% CI: 8.18-50.3). CONCLUSION: Population-based Danish data suggest that SLE twin concordance is lower than previously...... reported, but still point to the importance of both genetic and environmental factors, and indicate a substantial co-aggregation of other autoimmune diseases in SLE twins....

  7. Concordance between preoperative and postoperative assessments of primary caries lesion depth: results from the Dental PBRN

    DEFF Research Database (Denmark)

    Nascimento, Marcelle M; Bader, James D; Qvist, Vibeke

    2010-01-01

    depths were recorded as being in the outer half (E1) or inner half (E2) of enamel, or in the outer third (D1), middle third (D2) or inner third (D3) of dentin. Most restorations were placed to treat lesions that were preoperatively assessed as extending to the D1 (53%) and D2 (25%) depths....... Of the restored caries lesions, 10% were preoperatively assessed as being limited to E2 depth and 3% to E1 depth. The majority of the restored enamel lesions were located on occlusal surfaces. Preoperative estimates of caries lesion depth were more concordant with postoperative depths when the lesion...... was at an advanced stage: 88% concordance at the D3 depth, compared to 54% concordance at the E1 depth. DPBRN dentists can discriminate caries lesions at different depths, but the accuracy of their depth assessments was higher for dentin than for enamel lesions. In general, DPBRN dentists were more likely...

  8. Quantitative analysis of receptor imaging

    International Nuclear Information System (INIS)

    Fu Zhanli; Wang Rongfu

    2004-01-01

    Model-based methods for quantitative analysis of receptor imaging, including kinetic, graphical and equilibrium methods, are introduced in detail. Some technical problem facing quantitative analysis of receptor imaging, such as the correction for in vivo metabolism of the tracer and the radioactivity contribution from blood volume within ROI, and the estimation of the nondisplaceable ligand concentration, is also reviewed briefly

  9. Quantitative research.

    Science.gov (United States)

    Watson, Roger

    2015-04-01

    This article describes the basic tenets of quantitative research. The concepts of dependent and independent variables are addressed and the concept of measurement and its associated issues, such as error, reliability and validity, are explored. Experiments and surveys – the principal research designs in quantitative research – are described and key features explained. The importance of the double-blind randomised controlled trial is emphasised, alongside the importance of longitudinal surveys, as opposed to cross-sectional surveys. Essential features of data storage are covered, with an emphasis on safe, anonymous storage. Finally, the article explores the analysis of quantitative data, considering what may be analysed and the main uses of statistics in analysis.

  10. [Methods of quantitative proteomics].

    Science.gov (United States)

    Kopylov, A T; Zgoda, V G

    2007-01-01

    In modern science proteomic analysis is inseparable from other fields of systemic biology. Possessing huge resources quantitative proteomics operates colossal information on molecular mechanisms of life. Advances in proteomics help researchers to solve complex problems of cell signaling, posttranslational modification, structure and functional homology of proteins, molecular diagnostics etc. More than 40 various methods have been developed in proteomics for quantitative analysis of proteins. Although each method is unique and has certain advantages and disadvantages all these use various isotope labels (tags). In this review we will consider the most popular and effective methods employing both chemical modifications of proteins and also metabolic and enzymatic methods of isotope labeling.

  11. Quantitative habitability.

    Science.gov (United States)

    Shock, Everett L; Holland, Melanie E

    2007-12-01

    A framework is proposed for a quantitative approach to studying habitability. Considerations of environmental supply and organismal demand of energy lead to the conclusions that power units are most appropriate and that the units for habitability become watts per organism. Extreme and plush environments are revealed to be on a habitability continuum, and extreme environments can be quantified as those where power supply only barely exceeds demand. Strategies for laboratory and field experiments are outlined that would quantify power supplies, power demands, and habitability. An example involving a comparison of various metabolisms pursued by halophiles is shown to be well on the way to a quantitative habitability analysis.

  12. Evaluating imaging-pathology concordance and discordance after ultrasound-guided breast biopsy

    Science.gov (United States)

    2018-01-01

    Ultrasound (US)-guided breast biopsy has become the main method for diagnosing breast pathology, and it has a high diagnostic accuracy, approaching that of open surgical biopsy. However, methods for confirming adequate lesion retrieval after US-guided biopsy are relatively limited and false-negative results are unavoidable. Determining imaging-pathology concordance after US-guided biopsy is essential for validating the biopsy result and providing appropriate management. In this review article, we briefly present the results of US-guided breast biopsy; describe general aspects to consider when establishing imaging-pathology concordance; and review the various categories of imaging-pathology correlations and corresponding management strategies. PMID:29169231

  13. Concordance between European and US case definitions of healthcare-associated infections

    Science.gov (United States)

    2012-01-01

    Background Surveillance of healthcare-associated infections (HAI) is a valuable measure to decrease infection rates. Across Europe, inter-country comparisons of HAI rates seem limited because some countries use US definitions from the US Centers for Disease Control and Prevention (CDC/NHSN) while other countries use European definitions from the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE) project. In this study, we analyzed the concordance between US and European definitions of HAI. Methods An international working group of experts from seven European countries was set up to identify differences between US and European definitions and then conduct surveillance using both sets of definitions during a three-month period (March 1st -May 31st, 2010). Concordance between case definitions was estimated with Cohen’s kappa statistic (κ). Results Differences in HAI definitions were found for bloodstream infection (BSI), pneumonia (PN), urinary tract infection (UTI) and the two key terms “intensive care unit (ICU)-acquired infection” and “mechanical ventilation”. Concordance was analyzed for these definitions and key terms with the exception of UTI. Surveillance was performed in 47 ICUs and 6,506 patients were assessed. One hundred and eighty PN and 123 BSI cases were identified. When all PN cases were considered, concordance for PN was κ = 0.99 [CI 95%: 0.98-1.00]. When PN cases were divided into subgroups, concordance was κ = 0.90 (CI 95%: 0.86-0.94) for clinically defined PN and κ = 0.72 (CI 95%: 0.63-0.82) for microbiologically defined PN. Concordance for BSI was κ = 0.73 [CI 95%: 0.66-0.80]. However, BSI cases secondary to another infection site (42% of all BSI cases) are excluded when using US definitions and concordance for BSI was κ = 1.00 when only primary BSI cases, i.e. Europe-defined BSI with ”catheter” or “unknown” origin and US-defined laboratory-confirmed BSI (LCBI), were

  14. Concordance between European and US case definitions of healthcare-associated infections

    Directory of Open Access Journals (Sweden)

    Hansen Sonja

    2012-08-01

    Full Text Available Abstract Background Surveillance of healthcare-associated infections (HAI is a valuable measure to decrease infection rates. Across Europe, inter-country comparisons of HAI rates seem limited because some countries use US definitions from the US Centers for Disease Control and Prevention (CDC/NHSN while other countries use European definitions from the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE project. In this study, we analyzed the concordance between US and European definitions of HAI. Methods An international working group of experts from seven European countries was set up to identify differences between US and European definitions and then conduct surveillance using both sets of definitions during a three-month period (March 1st -May 31st, 2010. Concordance between case definitions was estimated with Cohen’s kappa statistic (κ. Results Differences in HAI definitions were found for bloodstream infection (BSI, pneumonia (PN, urinary tract infection (UTI and the two key terms “intensive care unit (ICU-acquired infection” and “mechanical ventilation”. Concordance was analyzed for these definitions and key terms with the exception of UTI. Surveillance was performed in 47 ICUs and 6,506 patients were assessed. One hundred and eighty PN and 123 BSI cases were identified. When all PN cases were considered, concordance for PN was κ = 0.99 [CI 95%: 0.98-1.00]. When PN cases were divided into subgroups, concordance was κ = 0.90 (CI 95%: 0.86-0.94 for clinically defined PN and κ = 0.72 (CI 95%: 0.63-0.82 for microbiologically defined PN. Concordance for BSI was κ = 0.73 [CI 95%: 0.66-0.80]. However, BSI cases secondary to another infection site (42% of all BSI cases are excluded when using US definitions and concordance for BSI was κ = 1.00 when only primary BSI cases, i.e. Europe-defined BSI with ”catheter” or “unknown” origin and US-defined laboratory-confirmed BSI

  15. IFOP's survey for the Concorde foundation. Business leaders worry about the energy policy

    International Nuclear Information System (INIS)

    2012-03-01

    In partnership with the French public opinion institute (IFOP), the Concorde foundation has conducted a survey among 600 business leaders. Electricity appears as a fundamental element for companies and industry competitiveness and for French people's buying power. In the coming years, France must hedge against an excessive rise in the electricity price. Therefore, the next energy mix choice will be essential as a too costly kWh would greatly reduce our chances to revitalise our economy. As a conclusion, the Concorde foundation stresses on the importance of not losing one of our few competitive advantages

  16. Evolution of the cosmological horizons in a concordance universe

    Energy Technology Data Exchange (ETDEWEB)

    Margalef-Bentabol, Berta; Cepa, Jordi [Departamento de Astrofísica, Universidad de la Laguna, E-38205 La Laguna, Tenerife (Spain); Margalef-Bentabol, Juan, E-mail: bmb@cca.iac.es, E-mail: juanmargalef@estumail.ucm.es, E-mail: jcn@iac.es [Facultad de Ciencias Matemáticas, Universidad Complutense de Madrid, Madrid (Spain)

    2012-12-01

    The particle and event horizons are widely known and studied concepts, but the study of their properties, in particular their evolution, have only been done so far considering a single state equation in a decelerating universe. This paper is the first of two where we study this problem from a general point of view. Specifically, this paper is devoted to the study of the evolution of these cosmological horizons in an accelerated universe with two state equations, cosmological constant and dust. We have obtained simple expressions in terms of their respective recession velocities that generalize the previous results for one state equation only. With the equations of state considered, it is proved that both velocities remain always positive.

  17. [Concordances between autism spectrum disorders and attention deficit hyperactivity disorder].

    Science.gov (United States)

    Mulas, F; Roca, P

    2018-03-01

    The current literature acknowledges an overlap of genetic, clinical and neuropsychological aspects between autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), suggesting that there may be a common pattern that covers features ranging from the common genetic and structural aetiology to shared patterns of symptoms. To review the current advances in these common aspects. Several studies have pointed out preschool attentional difficulties as the basis of both disorders. From the genetic perspective, it is estimated that 50-72% of the genetic factors overlap between the two disorders. They also share a decrease in the volume of the corpus callosum and left frontal grey matter, as well as functional alterations such as dorsolateral prefrontal, striato-thalamic and superior parietal hypoactivation. Results are also found regarding executive functioning, with differential profiles for the two conditions, and also concerning the relationship between the repetitive and impulsive behaviours in the early stages of ASD and ensuing problems of hyperactivity. This new conception of the ASD-ADHD continuum, with a common neurodevelopmental basis and associated clinical features, could be of great use in clinical practice. It is suggested that this association should be taken into account when it comes to deciding on the treatment.

  18. Concordance in diagnostic testing for respiratory pathogens of bighorn sheep

    Science.gov (United States)

    Walsh, Daniel P.; Cassirer, E. Frances; Bonds, Michael D.; Brown, Daniel R.; Edwards, William H.; Weiser, Glen C.; Drew, Mark L.; Briggs, Robert E.; Fox, Karen A.; Miller, Michael W.; Shanthalingam, Sudarvili; Srikumaran, Subramaniam; Besser, Thomas E.

    2016-01-01

    Reliable diagnostic tests are essential for disease investigation and management. This is particularly true for diseases of free-ranging wildlife where sampling is logistically difficult precluding retesting. Clinical assays for wildlife diseases frequently vary among laboratories because of lack of appropriate standardized commercial kits. Results of diagnostic testing may also be called into question when investigators report different etiologies for disease outbreaks, despite similar clinical and pathologic findings. To evaluate reliability of diagnostic testing for respiratory pathogens of bighorn sheep (Ovis canadensis), we conducted a series of ring tests across 6 laboratories routinely involved in detection of Mycoplasma ovipneumoniae, Pasteurellaceae, lktA (the Pasteurellaceae gene encoding leukotoxin), and 3 reference laboratories. Consistency of results for replicate samples within laboratories was high (median agreement = 1.0). Agreement between laboratories was high for polymerase chain reaction (PCR) detection of M. ovipneumoniae and culture isolation of Mannheimia spp. and Bibersteinia trehalosi(median agreement = 0.89–0.95, Kappa = 0.65–0.74), and lower for PCR detection of Mannheimiaspp. lktA (median agreement = 0.58, Kappa = 0.12). Most errors on defined status samples were false negatives, suggesting test sensitivity was a greater problem than specificity. However, tests for M. haemolytica and lktA yielded some false positive results. Despite differences in testing protocols, median agreement among laboratories and correct classification of controls for most agents was ≥0.80, meeting or exceeding the standard required by federal proficiency testing programs. This information is valuable for interpreting test results, laboratory quality assessments, and advancing diagnosis of respiratory disease in wild sheep. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  19. English Collocation Learning through Corpus Data: On-Line Concordance and Statistical Information

    Science.gov (United States)

    Ohtake, Hiroshi; Fujita, Nobuyuki; Kawamoto, Takeshi; Morren, Brian; Ugawa, Yoshihiro; Kaneko, Shuji

    2012-01-01

    We developed an English Collocations On Demand system offering on-line corpus and concordance information to help Japanese researchers acquire a better command of English collocation patterns. The Life Science Dictionary Corpus consists of approximately 90,000,000 words collected from life science related research papers published in academic…

  20. Latitudinal variation of European freshwater diversity is not concordant across habitat types

    DEFF Research Database (Denmark)

    Hof, Christian; Brändle, Martin; Brandl, Roland

    of species richness with latitude, but a peak in central Europe. The regions differ in size, but the peak was not due to an area effect. However, the relationship between species richness and latitude was not concordant across the three basic habitat types: Species living in groundwater and running water...... biogeographic regions corroborates this line of arguments....

  1. Young Learners and Lexical Awareness: Children's Engagement with Wordlists and Concordances

    Science.gov (United States)

    MacGregor, Alex

    2014-01-01

    Sinclair (1991) found that lexical analysis can be overcomplicated, yet Johns (1994) called for investigation into whether corpus analysis can motivate beginners and near-beginners. The findings of this research suggest that young EFL learners can enjoy using corpus analysis tools (wordlists and concordances) to identify, classify, and generalize…

  2. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.F.; Smolders, M.; Laurant, M.G.H.; Meer, K. de; Spreeuwenberg, P.; Marwijk, H.W.J. van; Penninx, B.W.J.H.; Bensing, J.M.

    2010-01-01

    OBJECTIVE: To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. DESIGN: Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). PARTICIPANTS: Seven hundred and

  3. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.; Smolders, M.; Laurant, M.G.H.; van der Meer, K; Spreeuwenberg, P.; van Marwijk, H.W.J.; Penninx, B.W.J.H.; Bensing, J.M.

    2010-01-01

    Objective: To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Design: Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Participants: Seven hundred and

  4. Patient Factors Associated with Guideline-concordant Treatment of Anxiety and Depression in Primary Care

    NARCIS (Netherlands)

    Prins, Marijn A.; Verhaak, Peter F. M.; Smolders, Mirrian; Laurant, Miranda G. H.; van der Meer, Klaas; Spreeuwenberg, Peter; van Marwijk, Harm W. J.; Penninx, Brenda W. J. H.; Bensing, Jozien M.

    To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current

  5. A Descriptive Enquiry into Subject-Verb Concord in English Existential Constructions

    Science.gov (United States)

    Tsuchida, Takehiro

    2011-01-01

    Subject-verb concord in English existential constructions is often viewed as problematic from both prescriptive and descriptive approaches to grammar and causes considerable confusion among teachers and learners of English as a second language (ESL). This paper aims to disentangle debates over the curious usage of the "there" + plural noun phrase…

  6. Parent/Child Concordance about Bullying Involvement and Family Characteristics Related to Bullying and Peer Victimization

    Science.gov (United States)

    Holt, Melissa K.; Kaufman Kantor, Glenda; Finkelhor, David

    2009-01-01

    This study examined parent perspectives on bullying, parent/child concordance about bullying involvement, and family characteristics associated with bullying perpetration and peer victimization. Participants were 205 fifth-grade students and their parents. Students attended an urban, ethnically diverse school district in the Northeast. Youth…

  7. Brief Report: On the Concordance Percentages for Autistic Spectrum Disorder of Twins

    Science.gov (United States)

    Bohm, Henry V.; Stewart, Melbourne G.

    2009-01-01

    In the development of genetic theories of Autistic Spectrum Disorder (ASD) various characteristics of monozygotic (MZ) and dizygotic (DZ) twins are often considered. This paper sets forth a possible refinement in the interpretation of the MZ twin concordance percentages for ASD underlying such genetic theories, and, drawing the consequences from…

  8. Concordance between prenatal ultrasound and autopsy findings in a tertiary center.

    Science.gov (United States)

    Rodriguez, M Angeles; Prats, Pilar; Rodríguez, Ignacio; Cusí, Victoria; Comas, Carmina

    2014-08-01

    The aim of this study was to evaluate the ultrasound (US)/autopsy concordance in elective termination of pregnancies (TOP) due to fetal causes. We performed a retrospective evaluation of elective TOP from 2004 to 2012. Inclusion criteria were gestational age at termination autopsy data. Based on the US-autopsy concordance, cases were divided into four groups: Group 1: agreement; Group 2: autopsy confirmed all US findings but provided additional information; Group 3: autopsy didn't confirm all US findings; Group 4: disagreement. One hundred and fifty-one patients fulfilled the inclusion criteria during the study period. Central nervous system malformations (91.5%), cardiovascular anomalies (90.2%) and renal system malformations (91.3%) were confirmed by autopsy. We found less concordance in the abdominal and musculoskeletal anomalies (61.5% and 66.7%, respectively). There were 130 (86%) fetuses in group 1, 7 in group 2 (4.6%), 3 in group 3 (1.9%) and 11 in group 4 (7.2%). In 5.29% of cases, the autopsy added relevant information to the diagnosis and counselling. Diagnosis concordance between US and necropsy is achieved in almost 90% of cases. An autopsy may help to adjust the diagnosis and help in counselling the parents for a future pregnancy. © 2014 John Wiley & Sons, Ltd.

  9. Can Confirmation Measures Reflect Statistically Sound Dependencies in Data? The Concordance-based Assessment

    Directory of Open Access Journals (Sweden)

    Susmaga Robert

    2018-03-01

    Full Text Available The paper considers particular interestingness measures, called confirmation measures (also known as Bayesian confirmation measures, used for the evaluation of “if evidence, then hypothesis” rules. The agreement of such measures with a statistically sound (significant dependency between the evidence and the hypothesis in data is thoroughly investigated. The popular confirmation measures were not defined to possess such form of agreement. However, in error-prone environments, potential lack of agreement may lead to undesired effects, e.g. when a measure indicates either strong confirmation or strong disconfirmation, while in fact there is only weak dependency between the evidence and the hypothesis. In order to detect and prevent such situations, the paper employs a coefficient allowing to assess the level of dependency between the evidence and the hypothesis in data, and introduces a method of quantifying the level of agreement (referred to as a concordance between this coefficient and the measure being analysed. The concordance is characterized and visualised using specialized histograms, scatter-plots, etc. Moreover, risk-related interpretations of the concordance are introduced. Using a set of 12 confirmation measures, the paper presents experiments designed to establish the actual concordance as well as other useful characteristics of the measures.

  10. Concordance Between Administrator and Clinician Ratings of Organizational Culture and Climate.

    Science.gov (United States)

    Beidas, Rinad S; Williams, Nathaniel J; Green, Philip D; Aarons, Gregory A; Becker-Haimes, Emily M; Evans, Arthur C; Rubin, Ronnie; Adams, Danielle R; Marcus, Steven C

    2018-01-01

    Organizational culture and climate are important determinants of behavioral health service delivery for youth. The Organizational Social Context measure is a well validated assessment of organizational culture and climate that has been developed and extensively used in public sector behavioral health service settings. The degree of concordance between administrators and clinicians in their reports of organizational culture and climate may have implications for research design, inferences, and organizational intervention. However, the extent to which administrators' and clinicians' reports demonstrate concordance is just beginning to garner attention in public behavioral health settings in the United States. We investigated the concordance between 73 administrators (i.e., supervisors, clinical directors, and executive directors) and 247 clinicians in 28 child-serving programs in a public behavioral health system. Findings suggest that administrators, compared to clinicians, reported more positive cultures and climates. Organizational size moderated this relationship such that administrators in small programs (climate in contrast to administrators in large programs (≥466 youth clients served annually) who reported more positive cultures and climates than clinicians. We propose a research agenda that examines the effect of concordance between administrators and clinicians on organizational outcomes in public behavioral health service settings.

  11. Study of concord in the examination scripts of students of Ghana ...

    African Journals Online (AJOL)

    This paper investigates grammatical concord in undergraduate students' examination scripts in Ghana Technology University College (GTUC), a private university college in Ghana. Purposeful and critical discourse analytical methods are employed to analyse thirty (30) Communication Skills scripts of level 200 students of ...

  12. [Inter-rater concordance of the "Nursing Activities Score" in intensive care].

    Science.gov (United States)

    Valls-Matarín, Josefa; Salamero-Amorós, Maria; Roldán-Gil, Carmen; Quintana-Riera, Salvador

    2015-01-01

    To evaluate inter-rater concordance in the valuation of the "Nursing Activities Score". Cross-sectional descriptive study conducted from December 2012 until June 2013 in a general intensive care unit with twelve beds. Three evaluator nurses, simultaneously and independently, through the patient daily charts, scored the nursing workload using Nursing Activities Score scale in all patients admitted over 18 years old. Three hundreds and thirty-nine records were collected. The intra-class correlation coefficient (ICC) between evaluators was 0.92 (0.89-0.94). A perfect concordance was obtained in 39.1% of the items, with 52.2% having a high, and 8.7% having lower concordance, corresponding to two of the items with multiple scoring options. Significant differences between two of the evaluators (P=.049) were found. Although the inter-rater concordance was high, more accurate records are needed to reduce the variability of the items with multiple options and to allow more accuracy in the interpretation and measurement of the data regarding nursing workload. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  13. Concordant testing results between various Human Papillomavirus assays in primary cervical cancer screening

    DEFF Research Database (Denmark)

    de Thurah, Lena; Bonde, Jesper; Hoa Lam, Janni Uyen

    2018-01-01

    OBJECTIVES: Human Papillomavirus (HPV) assays are increasingly used for primary cervical screening and HPV vaccination effect monitoring. We undertook a systematic literature review to determine the concordance in positive test results (i.e., detection of HPV infections) between Hybrid Capture 2 ...

  14. Concordance of mother-daughter diurnal cortisol production: Understanding the intergenerational transmission of risk for depression.

    Science.gov (United States)

    LeMoult, Joelle; Chen, Michael C; Foland-Ross, Lara C; Burley, Hannah W; Gotlib, Ian H

    2015-05-01

    A growing body of research is demonstrating concordance between mother and child diurnal cortisol production. In the context of maternal history of depression, intergenerational concordance of cortisol production could contribute to hypercortisolemia in children of depressed mothers, which has been shown to increase risk for MDD. The current study is the first to examine concordance in diurnal cortisol production between mothers with a history of depression and their never-depressed, but high-risk, children. We collected salivary cortisol across 2 days from mothers with (remitted; RMD) and without (CTL) a history of recurrent episodes of depression and their never-depressed daughters. As expected, RMD mothers and their daughters both exhibited higher cortisol production than did their CTL counterparts. Moreover, both across and within groups, mothers' and daughters' cortisol production were directly coupled. These findings suggest that there is an intergenerational concordance in cortisol dysregulation that may contribute to hypercortisolemia in girls at familial risk for depression. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Concordance between maternal recall of birth complications and data from obstetrical records.

    Science.gov (United States)

    Keenan, Kate; Hipwell, Alison; McAloon, Rose; Hoffmann, Amy; Mohanty, Arpita; Magee, Kelsey

    2017-02-01

    Prenatal complications are associated with poor outcomes in the offspring. Access to medical records is limited in the United States and investigators often rely on maternal report of prenatal complications. We tested concordance between maternal recall and birth records in a community-based sample of mothers participating in a longitudinal study in order to determine the accuracy of maternal recall of perinatal complications. Participants were 151 biological mothers, who were interviewed about gestational age at birth, birthweight, and the most commonly occurring birth complications: nuchal cord and meconium aspiration when the female child was on average 6years old, and for whom birth records were obtained. Concordance between reports was assessed using one-way random intra-class coefficients for continuous measures and kappa coefficients for dichotomous outcomes. Associations between maternal demographic and psychological factors and discrepancies also were tested. Concordance was excellent for continuously measured birthweight (ICC=0.85, pbirth record and absence according to maternal recall. Receipt of public assistance was associated with a decrease in discrepancy in report of nuchal cord. Concordance between maternal retrospective report and medical birth records varies across different types of perinatal events. There was little evidence that demographic or psychological factors increased the risk of discrepancies. Maternal recall based on continuous measures of perinatal factors may yield more valid data than dichotomous outcomes. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  16. Parent and Teacher Concordance of Child Outcomes for Youth with Autism Spectrum Disorder

    Science.gov (United States)

    Dickson, Kelsey S.; Suhrheinrich, Jessica; Rieth, Sarah R.; Stahmer, Aubyn C.

    2018-01-01

    Cross-informant ratings of are considered gold standard for child behavioral assessment. To date, little work has examined informant ratings of adaptive functioning for youth with autism spectrum disorder (ASD). In a large, diverse sample of youth with ASD, this study evaluated parent-teacher concordance of ratings of adaptive functioning and…

  17. Concordance of Interests in Dynamic Models of Social Partnership in the System of Continuing Professional Education

    Science.gov (United States)

    Tarasenko, Larissa V.; Ougolnitsky, Guennady A.; Usov, Anatoly B.; Vaskov, Maksim A.; Kirik, Vladimir A.; Astoyanz, Margarita S.; Angel, Olga Y.

    2016-01-01

    A dynamic game theoretic model of concordance of interests in the process of social partnership in the system of continuing professional education is proposed. Non-cooperative, cooperative, and hierarchical setups are examined. Analytical solution for a linear state version of the model is provided. Nash equilibrium algorithms (for non-cooperative…

  18. Quantitative Finance

    Science.gov (United States)

    James, Jessica

    2017-01-01

    Quantitative finance is a field that has risen to prominence over the last few decades. It encompasses the complex models and calculations that value financial contracts, particularly those which reference events in the future, and apply probabilities to these events. While adding greatly to the flexibility of the market available to corporations and investors, it has also been blamed for worsening the impact of financial crises. But what exactly does quantitative finance encompass, and where did these ideas and models originate? We show that the mathematics behind finance and behind games of chance have tracked each other closely over the centuries and that many well-known physicists and mathematicians have contributed to the field.

  19. Patient factors associated with guideline-concordant treatment of anxiety and depression in primary care.

    Science.gov (United States)

    Prins, Marijn A; Verhaak, Peter F M; Smolders, Mirrian; Laurant, Miranda G H; van der Meer, Klaas; Spreeuwenberg, Peter; van Marwijk, Harm W J; Penninx, Brenda W J H; Bensing, Jozien M

    2010-07-01

    To identify associations of patient characteristics (predisposing, enabling and need factors) with guideline-concordant care for anxiety and depression in primary care. Analysis of data from the Netherlands Study of Depression and Anxiety (NESDA). Seven hundred and twenty-one patients with a current anxiety or depressive disorder, recruited from 67 general practitioners (GPs), were included. Diagnoses according to the Diagnostic and Statistic Manual of Mental Disorders, fourth edition (DSM-IV) were made using a structured and widely validated assessment. Socio-demographic and enabling characteristics, severity of symptoms, disability, (under treatment for) chronic somatic conditions, perceived need for care, beliefs and evaluations of care were measured by questionnaires. Actual care data were derived from electronic medical records. Criteria for guideline-concordant care were based on general practice guidelines, issued by the Dutch College of General Practitioners. Two hundred and eighty-one (39%) patients received guideline-concordant care. High education level, accessibility of care, comorbidity of anxiety and depression, and severity and disability scores were positively associated with receiving guideline-concordant care in univariate analyses. In multivariate multi-level logistic regression models, significant associations with the clinical need factors disappeared. Positive evaluations of accessibility of care increased the chance (OR = 1.31; 95%-CI = 1.05-1.65; p = 0.02) of receiving guideline-concordant care, as well as perceiving any need for medication (OR = 2.99; 95%-CI = 1.84-4.85; p depression than clinical need factors. Initiatives to improve GPs' communication skills around mental health issues, and to improve recognition of people suffering from anxiety disorders, could increase the number of patients receiving treatment for depression and anxiety in primary care.

  20. Spousal Concordance of Diabetes Mellitus among Women in Ajman, United Arab Emirates.

    Science.gov (United States)

    Al-Sharbatti, Shatha S; Abed, Yasmeen I; Al-Heety, Lujain M; Basha, Shaikh A

    2016-05-01

    Spousal concordance is defined as similar behaviours and associated health statuses between spouses. This study aimed to identify the concordance of diabetes mellitus (DM) and related variables among genetically unrelated couples in Ajman, United Arab Emirates (UAE). This cross-sectional study included 270 married women attending either the Mushairef Health Center or the Gulf Medical College Hospital in Ajman between May and November 2012. A validated questionnaire was designed to determine sociodemographic characteristics and a history or family history of DM, hypertension, coronary artery disease or dyslipidaemia among the women and their husbands. The weight, height, body mass index, waist circumference, fasting blood sugar and glycated haemoglobin (HbA1c) levels of all women were measured. Of the women, 39.3% of those with diabetic husbands and 39.9% of those with non-diabetic husbands were diabetic themselves (P >0.050). The prevalence of DM spousal concordance was 17.8%. A history of hypertension, coronary artery disease and dyslipidaemia was significantly more frequent among women whose husbands had a history of the same conditions (P = 0.001, 0.040 and 0.002, respectively). Spousal concordance of abnormal glycaemia among non-diabetic women with diabetic husbands was significant (P = 0.001). Having a diabetic husband (P = 0.006) and being obese (P = 0.009) were the only significant predictors of hyperglycaemia among non-diabetic women after controlling for confounding factors. There was significant concordance of abnormal glycaemia among non-diabetic women with diabetic husbands. The spouses of diabetic patients may therefore be a target population for regular hyperglycaemia and DM screening.

  1. Concordance of sleep and pain outcomes of diverse interventions: an umbrella review.

    Directory of Open Access Journals (Sweden)

    Anthony G Doufas

    Full Text Available BACKGROUND/OBJECTIVE: Pain influences sleep and vice versa. We performed an umbrella review of meta-analyses on treatments for diverse conditions in order to examine whether diverse medical treatments for different conditions have similar or divergent effects on pain and sleep. METHODS: We searched published systematic reviews with meta-analyses in the Cochrane Database of Systematic Reviews until October 20, 2011. We identified randomized trials (or meta-analyses thereof, when >1 trial was available where both pain and sleep outcomes were examined. Pain outcomes were categorized as headache, musculoskeletal, abdominal, pelvic, generic or other pain. Sleep outcomes included insomnia, sleep disruption, and sleep disturbance. We estimated odds ratios for all outcomes and evaluated the concordance in the direction of effects between sleep and various types of pain and the correlation of treatment effects between sleep and pain outcomes. RESULTS: 151 comparisons with 385 different trials met our eligibility criteria. 96 comparisons had concordant direction of effects between each pain outcome and sleep, while in 55 the effect estimates were in opposite directions (P<0.0001. In the 20 comparisons with largest amount of evidence, the experimental drug always had worse sleep outcomes and tended to have worse pain outcomes in 17/20 cases. For headache and musculoskeletal pain, 69 comparisons showed concordant direction of effects with sleep outcomes and 36 showed discordant direction (P<0.0001. For the other 4 pain types there were overall 27 vs. 19 pairs with concordant vs. discordant direction of effects (P = 0.095. There was a weak correlation of the treatment effect sizes for sleep vs. headache/musculoskeletal pain (r = 0.17, P = 0.092. CONCLUSIONS: Medical interventions tend to have effects in the same direction for pain and sleep outcomes, but exceptions occur. Concordance is primarily seen for sleep and headache or musculoskeletal

  2. The concordance between self-reported medication use and pharmacy records in pregnant women.

    Science.gov (United States)

    Cheung, K; El Marroun, H; Elfrink, M E; Jaddoe, V W V; Visser, L E; Stricker, B H Ch

    2017-09-01

    Several studies have been conducted to assess determinants affecting the performance or accuracy of self-reports. These studies are often not focused on pregnant women, or medical records were used as a data source where it is unclear if medications have been dispensed. Therefore, our objective was to evaluate the concordance between self-reported medication data and pharmacy records among pregnant women and its determinants. We conducted a population-based cohort study within the Generation R study, in 2637 pregnant women. The concordance between self-reported medication data and pharmacy records was calculated for different therapeutic classes using Yule's Y. We evaluated a number of variables as determinant of discordance between both sources through univariate and multivariate logistic regression analysis. The concordance between self-reports and pharmacy records was moderate to good for medications used for chronic conditions, such as selective serotonin reuptake inhibitors or anti-asthmatic medications (0.88 and 0.68, respectively). Medications that are used occasionally, such as antibiotics, had a lower concordance (0.51). Women with a Turkish or other non-Western background were more likely to demonstrate discordance between pharmacy records and self-reported data compared with women with a Dutch background (Turkish: odds ratio, 1.63; 95% confidence interval, 1.16-2.29; other non-Western: odds ratio, 1.33; 95% confidence interval, 1.03-1.71). Further research is needed to assess how the cultural or ethnic differences may affect the concordance or discordance between both medication sources. The results of this study showed that the use of multiple sources is needed to have a good estimation of the medication use during pregnancy. Copyright © 2017 John Wiley & Sons, Ltd.

  3. A quality control study on cytotechnologist-cytopathologist concordance and its relationship to the number of dots on the slide.

    Science.gov (United States)

    Bongiovanni, Massimo; De Saussure, Barbara; Kumar, Neeta; Pache, Jean-Claude; Cibas, Edmund S

    2009-01-01

    To study cytotechnologist (CT)-cytopathologist (CP) concordance for evaluating individual CTs' performance and for quality assurance and educational feedback. The interpretations of individual CTs were compared with the final interpretations (according to the 2001 Bethesda System) of the CP. Concordance percentages and kappa values were calculated for each CT and correlated with the numbers of dots on each slide, years of experience and percentage of work hours devoted to cytology. A total of 10,453 Pap tests were screened by 9 CTs during one year, out of which 993 (9.5%) were referred to one CP for a final interpretation. Mean concordance between the aggregate CT interpretations and those of the CP was 65.5%. Five CTs had good concordance, 3 had moderately good concordance, and one had surprisingly poor concordance that contrasted with good subjective impressions. No correlation was found between concordance and the average number of dots per slide, screening experience in cervicovaginal cytology or percentage of work hours devoted to cytology. Monitoring CT-CP concordance rates can unveil performance issues not detected by subjective impressions. An excessive number of dots per slide may not reflect poor diagnostic precision so much as a lack of confidence in interpretation.

  4. Intimate Partner Aggression Reporting Concordance and Correlates of Agreement among Men with Alcohol Use Disorders and Their Female Partners

    Science.gov (United States)

    Panuzio, Jillian; O'Farrell, Timothy J.; Marshall, Amy D.; Murphy, Christopher M.; Murphy, Marie; Taft, Casey T.

    2006-01-01

    This study examined relationship aggression reporting concordance among 303 men with alcohol use disorders and their female partners enrolled in couples-based alcohol abuse treatment. Agreement for physical and psychological aggression was generally consistent with, or higher than, concordance rates reported among other populations. Men's…

  5. New tendencies in isotopic analysis of pesticide residues from wines by mass spectrometry in concordance with the European standards

    International Nuclear Information System (INIS)

    Costinel, Diana; Lazar, Roxana Elena; Vremera, Raluca; Irimescu, Rodica; Saros-Rogobete, Gili

    2006-01-01

    Multi-isotope analysis, the determination of isotope ratios by mass spectrometry or magnetic resonance spectroscopy, becomes increasingly used in the food industry and by national food control laboratories as a method of authenticating both raw materials and finished products. These highly sophisticated techniques are capable of determining the botanical and geographical origin of a wide variety of foodstuffs, thus providing a means of detecting product adulteration and controlling mislabelling practices which are virtually impossible to circumvent. The European Union has officially adopted the used of isotope analysis as a means of controlling sugar addition in wines. Its successful implementation in the wine-producing Member States has considerably reduced the financial losses which the Community had incurred due to over - capitalisation. Coupling mass spectrometer with gas chromatograph is used for quantitative and qualitative analysis of traces of pesticides from food. The presence of pesticides in foods is harmful for the nervous system, the cardiovascular apparatus and decreases the immunity of human body. In addition, ensuring the foods quality and safety is a requirement, which must be fulfilled for the integration in EU. The subject of this paper is the presentation of the tests results of the isotopic analysis for pesticide residues in wines, in concordance with European Standard. (authors)

  6. Quantitative real-time RT-PCR and chromogenic in situ hybridization

    DEFF Research Database (Denmark)

    Rosa, Fabíola E; Silveira, Sara M; Silveira, Cássia G T

    2009-01-01

    . METHODS: To elucidate the molecular profile of HER-2 status, mRNA and protein expression in 75 invasive breast carcinomas were analyzed by real time quantitative RT-PCR (qRT-PCR) and IHC, respectively. Amplifications were evaluated in 43 of these cases by CISH and in 11 by FISH. RESULTS: The concordance...

  7. The ocean circulation inverse problem

    National Research Council Canada - National Science Library

    Wunsch, C

    1996-01-01

    .... This book addresses the problem of inferring the state of the ocean circulation, understanding it dynamically, and even forecasting it through a quantitative combination of theory and observation...

  8. An Integrated Architecture for Engineering Problem Solving

    National Research Council Canada - National Science Library

    Pisan, Yusuf

    1998-01-01

    .... This thesis describes the Integrated Problem Solving Architecture (IPSA) that combines qualitative, quantitative and diagrammatic reasoning skills to produce annotated solutions to engineering problems...

  9. Quantitative radiography

    International Nuclear Information System (INIS)

    Brase, J.M.; Martz, H.E.; Waltjen, K.E.; Hurd, R.L.; Wieting, M.G.

    1986-01-01

    Radiographic techniques have been used in nondestructive evaluation primarily to develop qualitative information (i.e., defect detection). This project applies and extends the techniques developed in medical x-ray imaging, particularly computed tomography (CT), to develop quantitative information (both spatial dimensions and material quantities) on the three-dimensional (3D) structure of solids. Accomplishments in FY 86 include (1) improvements in experimental equipment - an improved microfocus system that will give 20-μm resolution and has potential for increased imaging speed, and (2) development of a simple new technique for displaying 3D images so as to clearly show the structure of the object. Image reconstruction and data analysis for a series of synchrotron CT experiments conducted by LLNL's Chemistry Department has begun

  10. Quantitative lymphography

    International Nuclear Information System (INIS)

    Mostbeck, A.; Lofferer, O.; Kahn, P.; Partsch, H.; Koehn, H.; Bialonczyk, Ch.; Koenig, B.

    1984-01-01

    Labelled colloids and macromolecules are removed lymphatically. The uptake of tracer in the regional lymphnodes is a parameter of lymphatic flow. Due to great variations in patient shape - obesity, cachexia - and accompanying variations in counting efficiencies quantitative measurements with reasonable accuracy have not been reported to date. A new approach to regional absorption correction is based on the combination of transmission and emission scans for each patient. The transmission scan is used for calculation of an absorption correction matrix. Accurate superposition of the correction matrix and the emission scan is achieved by computing the centers of gravity of point sources and - in the case of aligning opposite views - by cross correlation of binary images. In phantom studies the recovery was high (98.3%) and the coefficient of variation of repeated measurement below 1%. In patient studies a standardized stress is a prerequisite for reliable and comparable results. Discrimination between normals (14.3 +- 4.2D%) and patients with lymphedema (2.05 +- 2.5D%) was highly significant using praefascial lymphography and sc injection. Clearence curve analysis of the activities at the injection site, however, gave no reliable data for this purpose. In normals, the uptake in lymphnodes after im injection is by one order of magnitude lower then the uptake after sc injection. The discrimination between normals and patients with postthromboic syndrome was significant. Lymphography after ic injection was in the normal range in 2/3 of the patients with lymphedema and is therefore of no diagnostic value. The difference in uptake after ic and sc injection demonstrated for the first time by our quantitative method provides new insights into the pathophysiology of lymphedema and needs further investigation. (Author)

  11. Validation of a semi-quantitative food frequency questionnaire to assess food groups and nutrient intake.

    Science.gov (United States)

    Macedo-Ojeda, Gabriela; Vizmanos-Lamotte, Barbara; Márquez-Sandoval, Yolanda Fabiola; Rodríguez-Rocha, Norma Patricia; López-Uriarte, Patricia Josefina; Fernández-Ballart, Joan D

    2013-11-01

    Semi-quantitative Food Frequency Questionnaires (FFQs) analyze average food and nutrient intake over extended periods to associate habitual dietary intake with health problems and chronic diseases. A tool of this nature applicable to both women and men is not presently available in Mexico. To validate a FFQ for adult men and women. The study was conducted on 97 participants, 61% were women. Two FFQs were administered (with a one-year interval) to measure reproducibility. To assess validity, the second FFQ was compared against dietary record (DR) covering nine days. Statistical analyses included Pearson correlations and Intraclass Correlation Coefficients (ICC). The de-attenuation of the ICC resulting from intraindividual variability was controlled. The validity analysis was complemented by comparing the classification ability of FFQ to that of DR through concordance between intake categories and Bland-Altman plots. Reproducibility: ICC values for food groups ranged 0.42-0.87; the range for energy and nutrients was between 0.34 and 0.82. ICC values for food groups ranged 0.35-0.84; the range for energy and nutrients was between 0.36 and 0.77. Most subjects (56.7-76.3%) classified in the same or adjacent quintile for energy and nutrients using both methods. Extreme misclassification was <6.3% for all items. Bland-Altman plots reveal high concordance between FFQ and DR. FFQ produced sufficient levels of reproducibility and validity to determine average daily intake over one year. These results will enable the analysis of possible associations with chronic diseases and dietary diagnoses in adult populations of men and women. Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  12. Learning-by-Concordance (LbC): introducing undergraduate students to the complexity and uncertainty of clinical practice.

    Science.gov (United States)

    Fernandez, Nicolas; Foucault, Amélie; Dubé, Serge; Robert, Diane; Lafond, Chantal; Vincent, Anne-Marie; Kassis, Jeannine; Kazitani, Driss; Charlin, Bernard

    2016-10-01

    A current challenge in medical education is the steep exposure to the complexity and uncertainty of clinical practice in early clerkship. The gap between pre-clinical courses and the reality of clinical decision-making can be overwhelming for undergraduate students. The Learning-by-Concordance (LbC) approach aims to bridge this gap by embedding complexity and uncertainty by relying on real-life situations and exposure to expert reasoning processes to support learning. LbC provides three forms of support: 1) expert responses that students compare with their own, 2) expert explanations and 3) recognized scholars' key-messages. Three different LbC inspired learning tools were used by 900 undergraduate medical students in three courses: Concordance-of-Reasoning in a 1 st -year hematology course; Concordance-of-Perception in a 2nd-year pulmonary physio-pathology course, and; Concordance-of-Professional-Judgment with 3rd-year clerkship students. Thematic analysis was conducted on freely volunteered qualitative comments provided by 404 students. Absence of a right answer was challenging for 1 st year concordance-of-reasoning group; the 2 nd year visual concordance group found radiology images initially difficult and unnerving and the 3 rd year concordance-of-judgment group recognized the importance of divergent expert opinion. Expert panel answers and explanations constitute an example of "cognitive apprenticeship" that could contribute to the development of appropriate professional reasoning processes.

  13. Which factors influence MRI-pathology concordance of tumour size measurements in breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Rominger, M.; Frauenfelder, T. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Berg, D. [Urbankrankenhaus Berlin, Anesthesiology, Berlin (Germany); Ramaswamy, A. [University Hospital Marburg, Pathology, Marburg (Germany); Timmesfeld, N. [Philipps University Marburg, Institute for Medical Biometry and Epidemiology, Marburg (Germany)

    2016-05-15

    To assess MRI-pathology concordance and factors influencing tumour size measurement in breast cancer. MRI tumour size (greatest diameter in anatomical planes (MRI-In-Plane) and greatest diameter along main tumour axis (MRI-MPR)) of 115 consecutive breast lesions (59 invasive lobular carcinoma, 46 invasive ductal carcinoma, and 10 ductal carcinoma in situ) was retrospectively compared to size measured at histopathology (pT size (Path-TNM) and greatest tumour diameter as relevant for excision (Path-Diameter; reference standard)). Histopathological tumour types, preoperative palpability, surgical management, additional high-risk lesions, and BI-RADS lesion type (mass versus non-mass enhancements) were assessed as possible influencing factors. Systematic errors were most pronounced between MRI-MPR and Path-TNM (7.1 mm, limits of agreement (LoA) [-21.7; 35.9]), and were lowest between MRI-In-Plane and Path-Diameter (0.2 mm, LoA [-19.7; 20.1]). Concordance rate of MRI-In-Plane with Path-Diameter was 86 % (97/113), overestimation 9 % (10/113) and underestimation 5 % (6/113); BI-RADS mass lesions were overestimated in 7 % (6/81) versus 41 % (13/32) for non-mass enhancements. On multivariate analysis only BI-RADS lesion type significantly influenced MRI-pathology concordance (p < 0.001). 2/59 (3 %) ILC did not enhance. Concordance rate varies according to the execution of MRI and histopathological measurements. Beyond this only non-mass enhancement significantly predicted discordance. (orig.)

  14. Prescribing and using self-injectable antiretrovirals: How concordant are physician and patient perspectives?

    OpenAIRE

    Cohen Calvin; Fisher Martin; Youle Michael; Kulasegaram Ranjababu; Fumaz Carmina R; Clotet Bonaventura; Katlama Christine; Kovacs Colin; Horne Robert; Slim Jihad; Shalit Peter; Cooper Vanessa; Tsoukas Christos

    2009-01-01

    Abstract Background The selection of agents for any treatment regimen is in part influenced by physician and patient attitudes. This study investigated attitudinal motivators and barriers to the use of self-injectable antiretroviral agents among physicians and patients and measured the degree of concordance between physician and patient perspectives. Methods Attitudes toward prescribing and usage of self-injectable antiretroviral therapy (SIAT) were assessed by structured interview in 2 cohor...

  15. Gender Differences in Depressive Symptoms Among HIV-Positive Concordant and Discordant Heterosexual Couples in China

    OpenAIRE

    Li, Li; Liang, Li-Jung; Lin, Chunqing; Ji, Guoping; Xiao, Yongkang

    2016-01-01

    HIV seropositive individuals and their heterosexual partners/spouses, either seropositive or seronegative, are facing several mental health challenges. The objective of this study was to examine gender differences in depressive symptoms among HIV-positive concordant and HIV-discordant couples. We identified heterosexual couples from participants of a randomized controlled trial conducted in Anhui province, China. A total of 265 couples, comprising 129 HIV+ male/HIV− female couples, 98 HIV− ma...

  16. Can magnetic resonance imaging accurately predict concordant pain provocation during provocative disc injection?

    International Nuclear Information System (INIS)

    Kang, Chang Ho; Kim, Yun Hwan; Kim, Jung Hyuk; Chung, Kyoo Byung; Sung, Deuk Jae; Lee, Sang-Heon; Derby, Richard

    2009-01-01

    To correlate magnetic resonance (MR) image findings with pain response by provocation discography in patients with discogenic low back pain, with an emphasis on the combination analysis of a high intensity zone (HIZ) and disc contour abnormalities. Sixty-two patients (aged 17-68 years) with axial low back pain that was likely to be disc related underwent lumbar discography (178 discs tested). The MR images were evaluated for disc degeneration, disc contour abnormalities, HIZ, and endplate abnormalities. Based on the combination of an HIZ and disc contour abnormalities, four classes were determined: (1) normal or bulging disc without HIZ; (2) normal or bulging disc with HIZ; (3) disc protrusion without HIZ; (4) disc protrusion with HIZ. These MR image findings and a new combined MR classification were analyzed in the base of concordant pain determined by discography. Disc protrusion with HIZ [sensitivity 45.5%; specificity 97.8%; positive predictive value (PPV), 87.0%] correlated significantly with concordant pain provocation (P < 0.01). A normal or bulging disc with HIZ was not associated with reproduction of pain. Disc degeneration (sensitivity 95.4%; specificity 38.8%; PPV 33.9%), disc protrusion (sensitivity 68.2%; specificity 80.6%; PPV 53.6%), and HIZ (sensitivity 56.8%; specificity 83.6%; PPV 53.2%) were not helpful in the identification of a disc with concordant pain. The proposed MR classification is useful to predict a disc with concordant pain. Disc protrusion with HIZ on MR imaging predicted positive discography in patients with discogenic low back pain. (orig.)

  17. Transjugular Intrahepatic Portosystemic Shunt Dysfunction: Concordance of Clinical Findings, Doppler Ultrasound Examination, and Shunt Venography.

    Science.gov (United States)

    Owen, Joshua M; Gaba, Ron Charles

    2016-01-01

    The objective of this study was to evaluate the concordance between clinical symptoms, Doppler ultrasound (US), and shunt venography for the detection of stent-graft transjugular intrahepatic portosystemic shunt (TIPS) dysfunction. Forty-one patients (M:F 30:11, median age 55 years) who underwent contemporaneous clinical exam, Doppler US, and TIPS venography between 2003 and 2014 were retrospectively studied. Clinical symptoms (recurrent ascites or variceal bleeding) were dichotomously classified as present/absent, and US and TIPS venograms were categorized in a binary fashion as normal/abnormal. US abnormalities included high/low (>190 or 50 cm/s), absent flow, and return of antegrade intra-hepatic portal flow. Venographic abnormalities included shunt stenosis/occlusion and/or pressure gradient elevation. Clinical and imaging concordance rates were calculated. Fifty-two corresponding US examinations and venograms were assessed. The median time between studies was 3 days. Forty of 52 (77%) patients were symptomatic, 33/52 (64%) US examinations were abnormal, and 20/52 (38%) TIPS venograms were abnormal. Concordance between clinical symptoms and TIPS venography was 48% (25/52), while the agreement between US and shunt venography was 65% (34/52). Clinical symptoms and the US concurred in 60% (31/52) of the patients. The sensitivity of clinical symptoms and US for the detection of venographically abnormal shunts was 80% (16/20) and 85% (17/20), respectively. Both clinical symptoms and the US had low specificity (25%, 8/32 and 50%, 16/32) for venographically abnormal shunts. Clinical findings and the US had low concordance rates with TIPS venography, with acceptable sensitivity but poor specificity. These findings suggest the need for improved noninvasive imaging methods for stent-graft TIPS surveillance.

  18. Correction of technical bias in clinical microarray data improves concordance with known biological information

    DEFF Research Database (Denmark)

    Eklund, Aron Charles; Szallasi, Zoltan Imre

    2008-01-01

    The performance of gene expression microarrays has been well characterized using controlled reference samples, but the performance on clinical samples remains less clear. We identified sources of technical bias affecting many genes in concert, thus causing spurious correlations in clinical data...... sets and false associations between genes and clinical variables. We developed a method to correct for technical bias in clinical microarray data, which increased concordance with known biological relationships in multiple data sets....

  19. Particulate Matter Resuspension in Mississippi Bight Evaluated with CONCORDE's Synthesis Model

    Science.gov (United States)

    O'Brien, S. J.; Quas, L. M.; Miles, T. N.; Pan, C.; Cambazoglu, M. K.; Soto Ramos, I. M.; Greer, A. T.; Church, I.; Wiggert, J. D.

    2017-12-01

    The CONsortium for oil spill exposure pathways in COastal River-Dominated Ecosystems (CONCORDE) was established to investigate the complex fine-scale biological, chemical and physical interactions in a marine system controlled by pulsed-river plume dynamics. During CONCORDE's spring 2016 field campaign, the In Situ Ichthyoplankton Imaging System (ISIIS) on the R/V Point Sur and the Scanfish on the R/V Pelican comprehensively characterized the physical and biological structure in the region. Increased suspended particulate matter was observed by the ISIIS, with concentrations at depth sufficient to completely occlude the in situ images of planktonic organisms. Data was also collected on the continental shelf during the spring cruise by the RU31 glider in the proximity of the Mississippi River Delta, east of the ISIIS / Scanfish transects. Backscatter and salinity observed by the Scanfish and glider showed elevated suspended particulate matter and increased salinity, suggesting a linkage to shoreward advection from the continental shelf of oceanic waters that are sufficiently energetic to drive sediment resuspension. As part of the CONCORDE research effort, a four-dimensional biogeochemical/lower trophic level synthesis model for Mississippi Sound and Bight has been developed, based on the Coupled Ocean-Atmosphere-Wave-Sediment Transport (COAWST) Modeling System. This study utilizes CONCORDE's synthesis model to investigate the physical forcing mechanisms affecting the increased suspended particulate matter concentration observed in the Mississippi Bight during spring 2016, and advection pathways between estuarine and shelf waters in the northern Gulf of Mexico. The results show that episodic, advection-driven resuspension is a critical aspect controlling suspended sediment distributions in Mississippi Bight, which has implications for observed spatio-temporal patterns of planktonic species.

  20. Transjugular Intrahepatic Portosystemic Shunt Dysfunction: Concordance of Clinical Findings, Doppler Ultrasound Examination, and Shunt Venography

    Directory of Open Access Journals (Sweden)

    Joshua M Owen

    2016-01-01

    Full Text Available Objectives: The objective of this study was to evaluate the concordance between clinical symptoms, Doppler ultrasound (US, and shunt venography for the detection of stent-graft transjugular intrahepatic portosystemic shunt (TIPS dysfunction. Materials and Methods: Forty-one patients (M:F 30:11, median age 55 years who underwent contemporaneous clinical exam, Doppler US, and TIPS venography between 2003 and 2014 were retrospectively studied. Clinical symptoms (recurrent ascites or variceal bleeding were dichotomously classified as present/absent, and US and TIPS venograms were categorized in a binary fashion as normal/abnormal. US abnormalities included high/low (>190 or 50 cm/s, absent flow, and return of antegrade intra-hepatic portal flow. Venographic abnormalities included shunt stenosis/occlusion and/or pressure gradient elevation. Clinical and imaging concordance rates were calculated. Results: Fifty-two corresponding US examinations and venograms were assessed. The median time between studies was 3 days. Forty of 52 (77% patients were symptomatic, 33/52 (64% US examinations were abnormal, and 20/52 (38% TIPS venograms were abnormal. Concordance between clinical symptoms and TIPS venography was 48% (25/52, while the agreement between US and shunt venography was 65% (34/52. Clinical symptoms and the US concurred in 60% (31/52 of the patients. The sensitivity of clinical symptoms and US for the detection of venographically abnormal shunts was 80% (16/20 and 85% (17/20, respectively. Both clinical symptoms and the US had low specificity (25%, 8/32 and 50%, 16/32 for venographically abnormal shunts. Conclusion: Clinical findings and the US had low concordance rates with TIPS venography, with acceptable sensitivity but poor specificity. These findings suggest the need for improved noninvasive imaging methods for stent-graft TIPS surveillance.

  1. Age of Onset in Concordant Twins and Other Relative Pairs With Multiple Sclerosis

    OpenAIRE

    Sadovnick, A. Dessa; Yee, Irene M.; Guimond, Colleen; Reis, Jacques; Dyment, David A.; Ebers, George C.

    2009-01-01

    The ages of onset in multiple sclerosis cases span more than 7 decades. Data are presented for affected relative pairs from a Canadian population base of 30,000 multiple sclerosis index cases (1993?2008). The effects of genetic sharing, parent of origin, intergenerational versus collinear differences, and gender on the ages of onset were evaluated in the following concordant pairs: monozygotic twins (n?=?29), dizygotic twins (n?=?10), siblings (n?=?614), first cousins (n?=?405), half siblings...

  2. Grading of Cerebral Glioma with Multiparametric MR Imaging and {sup 18}F-FDG-PET: Concordance and Accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jeong Hee; Kim, Ji-hoon; Sohn, Chul-Ho; Choi, Seung Hong; Yun, Tae Jin; Song, Yong Sub [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Kang, Won Jun [Seoul National University Hospital, Department of Nuclear Medicine, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Eun, Yong [Seoul National University, College of Medicine, Seoul (Korea, Republic of); Chang, Kee-Hyun [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Soonchunhyang University Bucheon Hospital, Department of Radiology, Bucheon (Korea, Republic of)

    2014-02-15

    To retrospectively evaluate concordance rates and predictive values in concordant cases among multiparametric MR techniques and FDG-PET to grade cerebral gliomas. Multiparametric MR imaging and FDG-PET were performed in 60 consecutive patients with cerebral gliomas (12 low-grade and 48 high-grade gliomas). As the dichotomic variables, conventional MRI, minimum apparent diffusion coefficient in diffusion-weighted imaging, maximum relative cerebral blood volume ratio in perfusion-weighted imaging, choline/creatine ratio and (lipid and lactate)/creatine ratio in MR spectroscopy, and maximum standardised uptake value ratio in FDG-PET in low- and high-grade gliomas were compared. Their concordance rates and positive/negative predictive values (PPV/NPV) in concordant cases were obtained for the various combinations of multiparametric MR techniques and FDG-PET. There were significant differences between low- and high-grade gliomas in all techniques. Combinations of two, three, four, and five out of the five techniques showed concordance rates of 77.0 ± 4.8 %, 65.5 ± 4.0 %, 58.3 ± 2.6 % and 53.3 %, PPV in high-grade concordant cases of 97.3 ± 1.7 %, 99.1 ± 1.4 %, 100.0 ± 0 % and 100.0 % and NPV in low-grade concordant cases of 70.2 ± 7.5 %, 78.0 ± 6.0 %, 80.3 ± 3.4 % and 80.0 %, respectively. Multiparametric MR techniques and FDG-PET have a concordant tendency in a two-tiered classification for the grading of cerebral glioma. If at least two examinations concordantly indicated high-grade gliomas, the PPV was about 95 %. (orig.)

  3. Concordance Between FISH Analysis of Her-2/Neu Gene in Breast Duct Carcinoma and Corresponding Axillary Nodal Metastases: Egyptian National Cancer Institute Experience.

    Science.gov (United States)

    Badawy, Omnia M; Hassan, Hannan; ELBakey, Heba A; Mosaad, Maha

    2018-05-10

    Breast cancer is a major health problem in Egypt. Her-2/Neu gene is routinely assessed for all breast cancer patients primarily by immunohistochemistry. At National Cancer Institute (NCI), Cairo University, Flourescence In Situ hybridization (FISH) analysis of Her-2/Neu gene is carried out for Her-2/Neu score 2 and for some cases of score 3 (particularly those assessed outside NCI). The test is performed essentially on the primary tumor. However, some situations require testing on corresponding lymph node metastases. There is a debate about the concordance between Her-2/Neu status in the primary tumor and synchronous lymph node metastases in various studies. The aim of this study was to test for the concordance between Her-2/Neu status in the primary breast tumor and corresponding axillary nodal metastases. This is a retrospective study in which FISH analysis of Her-2/Neu was carried out simultaneously on archived material of 50 cases previously diagnosed as invasive duct carcinoma and the corresponding nodal metastases from the Pathology Department, NCI. There was complete concordance between Her-2 status in the primary tumor and the corresponding axillary lymph node metastatic deposits in which Her-2 was amplified in 44% of the studied cohort of Egyptian patients. Her-2/Neu gene assessed by FISH analysis on synchronous lymph node metastases is strongly correlated with the primary tumor. Hence, it is justified to carry out the Her-2/Neu test on synchronous lymph nodes to decide on whether to carry out anti-Her-2/Neu target therapy. Further studies on other metastatic sites is recommended.

  4. Agreement between data obtained from repeated interviews with a six-years interval Concordância entre dados obtidos em entrevistas repetidas com seis anos de intervalo

    Directory of Open Access Journals (Sweden)

    Carolina Castro Martins

    2008-04-01

    Full Text Available The objective of the study was to compare information collected through face-to-face interviews at first time and six years later in a city of Southeastern Brazil. In 1998, 32 mothers (N=32 of children aged 20 to 30 months answered a face-to-face interview with structured questions regarding their children's brushing habits. Six years later this same interview was repeated with the same mothers. Both interviews were compared for overall agreement, kappa and weighted kappa. Overall agreement between both interviews varied from 41 to 96%. Kappa values ranged from 0.00 to 0.65 (very bad to good without any significant differences. The results showed lack of agreement when the same interview is conducted six years later, showing that the recall bias can be a methodological problem of interviews.O objetivo do estudo foi comparar a informação coletada em entrevista pessoal num primeiro momento e seis anos depois, em Minas Gerais. Em 1998, 32 mães (N=32 de crianças com idade entre 20 a 30 meses responderam à entrevista pessoal com questões estruturadas sobre os hábitos de escovação das crianças, sendo repetida seis anos depois. As duas entrevistas foram comparadas em concordância geral e em coeficientes kappa e kappa ponderado. A concordância geral entre as entrevistas variou de 41% a 96%. Os valores de kappa variaram de 0,00 a 0,65 (muito ruim a bom, sem diferença significativa. Os resultados mostraram que houve ausência de concordância quando a mesma entrevista foi conduzida seis anos depois, mostrando que o viés de memória pode ser um problema metodológico das entrevistas.

  5. Scalable whole-exome sequencing of cell-free DNA reveals high concordance with metastatic tumors.

    Science.gov (United States)

    Adalsteinsson, Viktor A; Ha, Gavin; Freeman, Samuel S; Choudhury, Atish D; Stover, Daniel G; Parsons, Heather A; Gydush, Gregory; Reed, Sarah C; Rotem, Denisse; Rhoades, Justin; Loginov, Denis; Livitz, Dimitri; Rosebrock, Daniel; Leshchiner, Ignaty; Kim, Jaegil; Stewart, Chip; Rosenberg, Mara; Francis, Joshua M; Zhang, Cheng-Zhong; Cohen, Ofir; Oh, Coyin; Ding, Huiming; Polak, Paz; Lloyd, Max; Mahmud, Sairah; Helvie, Karla; Merrill, Margaret S; Santiago, Rebecca A; O'Connor, Edward P; Jeong, Seong H; Leeson, Rachel; Barry, Rachel M; Kramkowski, Joseph F; Zhang, Zhenwei; Polacek, Laura; Lohr, Jens G; Schleicher, Molly; Lipscomb, Emily; Saltzman, Andrea; Oliver, Nelly M; Marini, Lori; Waks, Adrienne G; Harshman, Lauren C; Tolaney, Sara M; Van Allen, Eliezer M; Winer, Eric P; Lin, Nancy U; Nakabayashi, Mari; Taplin, Mary-Ellen; Johannessen, Cory M; Garraway, Levi A; Golub, Todd R; Boehm, Jesse S; Wagle, Nikhil; Getz, Gad; Love, J Christopher; Meyerson, Matthew

    2017-11-06

    Whole-exome sequencing of cell-free DNA (cfDNA) could enable comprehensive profiling of tumors from blood but the genome-wide concordance between cfDNA and tumor biopsies is uncertain. Here we report ichorCNA, software that quantifies tumor content in cfDNA from 0.1× coverage whole-genome sequencing data without prior knowledge of tumor mutations. We apply ichorCNA to 1439 blood samples from 520 patients with metastatic prostate or breast cancers. In the earliest tested sample for each patient, 34% of patients have ≥10% tumor-derived cfDNA, sufficient for standard coverage whole-exome sequencing. Using whole-exome sequencing, we validate the concordance of clonal somatic mutations (88%), copy number alterations (80%), mutational signatures, and neoantigens between cfDNA and matched tumor biopsies from 41 patients with ≥10% cfDNA tumor content. In summary, we provide methods to identify patients eligible for comprehensive cfDNA profiling, revealing its applicability to many patients, and demonstrate high concordance of cfDNA and metastatic tumor whole-exome sequencing.

  6. Concordance of Motion Sensor and Clinician-Rated Fall Risk Scores in Older Adults.

    Science.gov (United States)

    Elledge, Julie

    2017-12-01

    As the older adult population in the United States continues to grow, developing reliable, valid, and practical methods for identifying fall risk is a high priority. Falls are prevalent in older adults and contribute significantly to morbidity and mortality rates and rising health costs. Identifying at-risk older adults and intervening in a timely manner can reduce falls. Conventional fall risk assessment tools require a health professional trained in the use of each tool for administration and interpretation. Motion sensor technology, which uses three-dimensional cameras to measure patient movements, is promising for assessing older adults' fall risk because it could eliminate or reduce the need for provider oversight. The purpose of this study was to assess the concordance of fall risk scores as measured by a motion sensor device, the OmniVR Virtual Rehabilitation System, with clinician-rated fall risk scores in older adult outpatients undergoing physical rehabilitation. Three standardized fall risk assessments were administered by the OmniVR and by a clinician. Validity of the OmniVR was assessed by measuring the concordance between the two assessment methods. Stability of the OmniVR fall risk ratings was assessed by measuring test-retest reliability. The OmniVR scores showed high concordance with the clinician-rated scores and high stability over time, demonstrating comparability with provider measurements.

  7. Gender Differences in Depressive Symptoms Among HIV-Positive Concordant and Discordant Heterosexual Couples in China.

    Science.gov (United States)

    Li, Li; Liang, Li-Jung; Lin, Chunqing; Ji, Guoping; Xiao, Yongkang

    2017-03-01

    HIV seropositive individuals and their heterosexual partners/spouses, either seropositive or seronegative, are facing several mental health challenges. The objective of this study was to examine gender differences in depressive symptoms among HIV-positive concordant and HIV-discordant couples. We identified heterosexual couples from participants of a randomized controlled trial conducted in Anhui province, China. A total of 265 couples, comprising 129 HIV+ male/HIV- female couples, 98 HIV- male/HIV+ female couples, and 38 HIV-positive concordant couples, were included in the analyses. We collected data using the computer-assisted personal interview method. We used a linear mixed-effects regression model to assess whether gender differences in depressive symptoms varied across couple types. HIV-positive women reported a significantly higher level of depressive symptoms than their partners/spouses. HIV-positive women with HIV-positive partners had higher depressive symptoms than those with HIV-negative partners, whereas HIV-positive men reported similar levels of depressive symptoms regardless of their partners' serostatus. Among the concordant couples, those with the highest annual family income showed the greatest gender differences in depressive symptoms. We suggest that family interventions should be gender- and couple-type specific and that mental health counseling is warranted not only for HIV-positive women but also for HIV-negative women in an HIV-affected relationship.

  8. Patient-provider concordance with behavioral change goals drives measures of motivational interviewing consistency.

    Science.gov (United States)

    Laws, Michael Barton; Rose, Gary S; Beach, Mary Catherine; Lee, Yoojin; Rogers, William S; Velasco, Alyssa Bianca; Wilson, Ira B

    2015-06-01

    Motivational Interviewing (MI) consistent talk by a counselor is thought to produce "change talk" in clients. However, it is possible that client resistance to behavior change can produce MI inconsistent counselor behavior. We applied a coding scheme which identifies all of the behavioral counseling about a given issue during a visit ("episodes"), assesses patient concordance with the behavioral goal, and labels providers' counseling style as facilitative or directive, to a corpus of routine outpatient visits by people with HIV. Using a different data set of comparable encounters, we applied the concepts of episode and concordance, and coded using the Motivational Interviewing Treatment Integrity system. Patient concordance/discordance was not observed to change during any episode. Provider directiveness was strongly associated with patient discordance in the first study, and MI inconsistency was strongly associated with discordance in the second. Observations that MI-consistent behavior by medical providers is associated with patient change talk or outcomes should be evaluated cautiously, as patient resistance may provoke MI-inconsistency. Counseling episodes in routine medical visits are typically too brief for client talk to evolve toward change. Providers with limited training may have particular difficulty maintaining MI consistency with resistant clients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Embodied simulation as part of affective evaluation processes: task dependence of valence concordant EMG activity.

    Science.gov (United States)

    Weinreich, André; Funcke, Jakob Maria

    2014-01-01

    Drawing on recent findings, this study examines whether valence concordant electromyography (EMG) responses can be explained as an unconditional effect of mere stimulus processing or as somatosensory simulation driven by task-dependent processing strategies. While facial EMG over the Corrugator supercilii and the Zygomaticus major was measured, each participant performed two tasks with pictures of album covers. One task was an affective evaluation task and the other was to attribute the album covers to one of five decades. The Embodied Emotion Account predicts that valence concordant EMG is more likely to occur if the task necessitates a somatosensory simulation of the evaluative meaning of stimuli. Results support this prediction with regard to Corrugator supercilii in that valence concordant EMG activity was only present in the affective evaluation task but not in the non-evaluative task. Results for the Zygomaticus major were ambiguous. Our findings are in line with the view that EMG activity is an embodied part of the evaluation process and not a mere physical outcome.

  10. Concordance between macrophytes and macroinvertebrates in a Mediterranean river of central Apennine region.

    Science.gov (United States)

    Traversetti, Lorenzo; Scalici, Massimiliano; Ginepri, Valeria; Manfrin, Alessandro; Ceschin, Simona

    2014-05-01

    The main aim of this study was to improve the knowledge about the concordance among macrophytes and macroinvertebrates to provide complementary information and facilitate the procedures for quality assessment of river ecosystems. Macrophytes and macroinvertebrates were collected in 11 sampling sites along a central Apennine calcareous river in October 2008 and June 2009. The concordance between the two biomonitoring groups was tested according to several environmental parameters. The comparison of data matrix similarities by Mantel test showed differences in the assemblage of macrophytes and macroinvertebrates along the river since correlation values were 0.04, p > 0.05 in October 2008 and 0.39, p > 0.05 in June 2009. The study revealed lack of concordance between the two groups, emphasizing that the information provided by macrophytes and macroinvertebrates does not overlap in terms of response to environmental parameters. Indeed, the two different biological groups resulted useful descriptors of different parameters. Together, they could represent a complementary tool to reflect the river environmental quality.

  11. Super Memory Bros.: going from mirror patterns to concordant patterns via similarity enhancements.

    Science.gov (United States)

    Ozubko, Jason D; Joordens, Steve

    2008-12-01

    When memory is contrasted for stimuli belonging to distinct stimulus classes, one of two patterns is observed: a mirror pattern, in which one stimulus gives rise to higher hits but lower false alarms (e.g., the frequency-based mirror effect) or a concordant pattern, in which one stimulus class gives rise both to higher hits and to higher false alarms (e.g., the pseudoword effect). On the basis of the dual-process account proposed by Joordens and Hockley (2000), we predict that mirror patterns occur when one stimulus class is more familiar and less distinctive than another, whereas concordant patterns occur when one stimulus class is more familiar than another. We tested these assumptions within a video game paradigm using novel stimuli that allow manipulations in terms of distinctiveness and familiarity (via similarity). When more distinctive, less familiar items are contrasted with less distinctive, more familiar items, a mirror pattern is observed. Systematically enhancing the familiarity of stimuli transforms the mirror pattern to a concordant pattern as predicted. Although our stimuli differ considerably from those used in examinations of the frequency-based mirror effect and the pseudoword effect, the implications of our findings with respect to those phenomena are also discussed.

  12. Familial concordance for age at natural menopause: results from the Breakthrough Generations Study.

    Science.gov (United States)

    Morris, Danielle H; Jones, Michael E; Schoemaker, Minouk J; Ashworth, Alan; Swerdlow, Anthony J

    2011-09-01

    Existing estimates of the heritability of menopause age have a wide range. Furthermore, few studies have analyzed to what extent familial similarities might reflect shared environment, rather than shared genes. We therefore analyzed familial concordance for age at natural menopause and the effects of shared genetic and environmental factors on this concordance. Participants were 2,060 individuals comprising first-degree relatives, aged 31 to 90 years, and participating in the UK Breakthrough Generations Study. Menopause data were collected using a self-administered questionnaire and analyzed using logistic regression and variance-components models. Women were at an increased risk of early menopause (≤45 y) if their mother (odds ratio, 6.2; P menopause. Likewise, women had an increased risk of late menopause (≥54 y) if their relative had had a late menopause (mother: odds ratio, 6.1; P menopause age attributed to environmental factors shared by sisters. We confirm that early menopause aggregates within families and show, for the first time, that there is also strong familial concordance for late menopause. Both genes and shared environment were the source of variation in menopause age. Past heritability estimates have not accounted for shared environment, and thus, the effect of genetic variants on menopause age may previously have been overestimated.

  13. Concordance of sexual dysfunction and dissatisfaction by self-report and those by partner's perception in young adult couples.

    Science.gov (United States)

    Gungor, S; Keskin, U; Gülsün, M; Erdem, M; Ceyhan, S T; Ergün, A

    2015-07-01

    We evaluated concordance levels of young adult spouses (N=107 couples, total N=214) with regards to sexual satisfaction by using Golombock-Rust Inventory of Sexual Satisfaction (GRISS). Each spouse of the couples filled out both female and male forms of the GRISS. Self- and spouse-reported scores were analyzed in terms of inter-rater correlation and agreement. The prevalence of overall sexual dissatisfaction was 10.3% and 26.2% in wives and husbands, respectively. The correlation coefficient (r) between the self-reported overall sexual satisfaction scores and those assessed by the spouses was 0.25 (P=0.014) and 0.04 (P=0.680) for wives and husbands, respectively. The sensitivity for perception of partner's sexual problems ranged 11% to 47%, and the specificity was around 64% to 100%, except for vaginismus, which had a sensitivity of 83% and a specificity of 25%. The prevalance-adjusted and bias-adjusted kappa (PABAK) value for overall sexual dissatisfaction reported by themselves and that assessed by their spouses was 0.68 and 0.16 for the wives and husbands, respectively. For specific female sexual problems, the PABAK value was the highest in female dissatisfaction (0.81) followed by anorgasmia (0.78), female avoidance (0.44), vaginismus (0.44), infrequency (0.33), non-communication (0.14) and female nonsensuality (0.14). For specific male sexual problems, the PABAK value was the highest in male nonsensuality (1.00), followed by male dissatisfaction (0.78), infrequency (0.46), non-communication (0.42), male avoidance (0.36), impotence (0.27) and premature ejaculation (-0.04). Our findings suggested that in this clinical sample the partner's perception of sexual dysfunction and dissatisfaction did not correlate well with the subject's self-reported sexual problems, and generally male sexual problems were less correctly perceived by the partners than were female sexual problems. This result may provide helpful information for clinicians who take care of patients

  14. Setting health research priorities using the CHNRI method: VI. Quantitative properties of human collective opinion.

    Science.gov (United States)

    Yoshida, Sachiyo; Rudan, Igor; Cousens, Simon

    2016-06-01

    Crowdsourcing has become an increasingly important tool to address many problems - from government elections in democracies, stock market prices, to modern online tools such as TripAdvisor or Internet Movie Database (IMDB). The CHNRI method (the acronym for the Child Health and Nutrition Research Initiative) for setting health research priorities has crowdsourcing as the major component, which it uses to generate, assess and prioritize between many competing health research ideas. We conducted a series of analyses using data from a group of 91 scorers to explore the quantitative properties of their collective opinion. We were interested in the stability of their collective opinion as the sample size increases from 15 to 90. From a pool of 91 scorers who took part in a previous CHNRI exercise, we used sampling with replacement to generate multiple random samples of different size. First, for each sample generated, we identified the top 20 ranked research ideas, among 205 that were proposed and scored, and calculated the concordance with the ranking generated by the 91 original scorers. Second, we used rank correlation coefficients to compare the ranks assigned to all 205 proposed research ideas when samples of different size are used. We also analysed the original pool of 91 scorers to to look for evidence of scoring variations based on scorers' characteristics. The sample sizes investigated ranged from 15 to 90. The concordance for the top 20 scored research ideas increased with sample sizes up to about 55 experts. At this point, the median level of concordance stabilized at 15/20 top ranked questions (75%), with the interquartile range also generally stable (14-16). There was little further increase in overlap when the sample size increased from 55 to 90. When analysing the ranking of all 205 ideas, the rank correlation coefficient increased as the sample size increased, with a median correlation of 0.95 reached at the sample size of 45 experts (median of the rank

  15. Quantitative Thermochronology

    Science.gov (United States)

    Braun, Jean; van der Beek, Peter; Batt, Geoffrey

    2006-05-01

    Thermochronology, the study of the thermal history of rocks, enables us to quantify the nature and timing of tectonic processes. Quantitative Thermochronology is a robust review of isotopic ages, and presents a range of numerical modeling techniques to allow the physical implications of isotopic age data to be explored. The authors provide analytical, semi-analytical, and numerical solutions to the heat transfer equation in a range of tectonic settings and under varying boundary conditions. They then illustrate their modeling approach built around a large number of case studies. The benefits of different thermochronological techniques are also described. Computer programs on an accompanying website at www.cambridge.org/9780521830577 are introduced through the text and provide a means of solving the heat transport equation in the deforming Earth to predict the ages of rocks and compare them directly to geological and geochronological data. Several short tutorials, with hints and solutions, are also included. Numerous case studies help geologists to interpret age data and relate it to Earth processes Essential background material to aid understanding and using thermochronological data Provides a thorough treatise on numerical modeling of heat transport in the Earth's crust Supported by a website hosting relevant computer programs and colour slides of figures from the book for use in teaching

  16. Correlates of non-concordance between perceived and objective measures of walkability.

    Science.gov (United States)

    Gebel, Klaus; Bauman, Adrian; Owen, Neville

    2009-04-01

    Objective and self-reported physical environmental attributes have been related to physical activity. We examined the characteristics of adults who are resident in objectively identified high walkable neighborhoods but whose perceptions of neighborhood attributes are not concordant with objective attributes relating to high walkability. Neighborhood built-environment attributes relating to walkability (dwelling density, intersection density, land use mix, and net retail area) were determined objectively, using Geographic Information System databases; data on corresponding perceptions of local environment attributes (from the Neighborhood Environment Walkability Scale) were derived from a self-completion survey of a socially diverse sample of 2,650 adults aged 19 to 65. Objective and perceived walkability attributes were categorized using median splits, and correlates of non-concordance were determined using multiple logistic regression models. There was a fair overall agreement between objectively determined walkability and perceived walkability (Kappa = 0.35, 95% CI = 0.31-0.39). Among those resident in objectively assessed high walkable areas (n = 1,063), 32.1% perceived them to be low walkable; conversely, 32.7% (n = 1,021) resident in objectively determined low walkability areas perceived them to be high. For residents of objectively determined high walkable areas, the characteristics that differentiated those with perceptions of low walkability (non-concordant perceptions) from those with concordant perceptions of high walkability were: not being university-educated (OR = 1.47, 95% CI = 1.06-2.04); having lower household incomes (OR = 1.54, 95% CI = 1.09-2.17); being overweight (OR = 1.46, 95% CI = 1.03-2.07); and walking fewer days per week for transport (OR = 1.75, 95% CI = 1.11-2.70). Higher walking times and more positive cognitive variables were noted among participants who lived in a neighborhood with low walkability that was perceived as high compared

  17. Sources of variation influencing concordance between functional MRI and direct cortical stimulation in brain tumor surgery

    Directory of Open Access Journals (Sweden)

    Melanie A Morrison

    2016-10-01

    Full Text Available Object: Preoperative functional magnetic resonance imaging (fMRI remains a promising method to aid in the surgical management of patients diagnosed with brain tumors. For patients that are candidates for awake craniotomies, surgical decisions can potentially be improved by fMRI but this depends on the level of concordance between preoperative brain maps and the maps provided by the gold standard intraoperative method, direct cortical stimulation (DCS. There have been numerous studies of the concordance between fMRI and DCS using sensitivity and specificity measures, however the results are variable across studies and the key factors influencing variability are not well understood. Thus, the present work addresses the influence of technical factors on fMRI and DCS concordance. Methods: Motor and language mapping data were collected for a group of glioma patients (n = 14 who underwent both preoperative fMRI and intraoperative DCS in an awake craniotomy procedure for tumor removal. Normative fMRI data were also acquired in a healthy control group (n = 12. The fMRI and DCS mapping data were co-registered; true positive (TP, true negative (TN, false positive (FP and false negative (FN occurrences were tabulated over the exposed brain surface. Sensitivity and specificity were measured for the total group, and the motor and language sub-groups. The influence of grid placement, fMRI statistical thresholding, and task standardization were assessed. Correlations between proportions of agreement and error were carefully scrutinized to evaluate concordance more in-depth. Results: Concordance was significantly better for motor versus language mapping. There was an inverse relationship between TP and TN with increasing statistical threshold, and FP dominated the total error. Sensitivity and specificity were reduced when tasks were not standardized across fMRI and DCS. Conclusions: Although the agreement between fMRI and DCS is good, variability is introduced

  18. The quantitative Morse theorem

    OpenAIRE

    Loi, Ta Le; Phien, Phan

    2013-01-01

    In this paper, we give a proof of the quantitative Morse theorem stated by {Y. Yomdin} in \\cite{Y1}. The proof is based on the quantitative Sard theorem, the quantitative inverse function theorem and the quantitative Morse lemma.

  19. Perceptions around concordance – focus groups and semi‐structured interviews conducted with consumers, pharmacists and general practitioners

    OpenAIRE

    Bajramovic, Jasmina; Emmerton, Lynne; Tett, Susan E.

    2004-01-01

    Background  Achieving concordance by identifying beliefs about illness, treatment and medicine‐taking should impact positively on behaviour and consumer satisfaction with respect to treatment, and health outcomes may be improved.

  20. Fine Needle Aspiration Using Improved Agar Microbiopsy is Highly Concordant With Renal Mass Final Diagnosis and Subclassification

    NARCIS (Netherlands)

    Schieven, Louise W.; Smedts, Frank; Hopman, Anton H.; van der Wijk, Jan; Nijman, Rien J.; de Jong, Igle J.

    2009-01-01

    Purpose: Computerized tomography and ultrasound are usually sufficient for preoperative evaluation of renal masses greater than 5 cm. For renal masses less than 5 cm additional histological evaluation could improve diagnosis and treatment decisions. We investigated the concordance between an

  1. Concordance between myocardial perfusion scan assessed by SPECT and fractional flow reserve findings for detection of significant ischemia

    Directory of Open Access Journals (Sweden)

    Morteza Safi

    2016-09-01

    Conclusion: FFR and MPI with SPECT techniques showed significant concordance for detection of myocardial ischemia, regardless of the type of diseased coronary arteries. In this context, SPECT has high sensitivity and NPV for detection of ischemia compared with FFR.

  2. Impact of Patient-Provider Race, Ethnicity, and Gender Concordance on Cancer Screening: Findings from Medical Expenditure Panel Survey.

    Science.gov (United States)

    Malhotra, Jyoti; Rotter, David; Tsui, Jennifer; Llanos, Adana A M; Balasubramanian, Bijal A; Demissie, Kitaw

    2017-12-01

    Background: Racial and ethnic minorities experience lower rates of cancer screening compared with non-Hispanic whites (NHWs). Previous studies evaluating the role of patient-provider race, ethnicity, or gender concordance in cancer screening have been inconclusive. Methods: In a cross-sectional analysis using the Medical Expenditure Panel Survey (MEPS), data from 2003 to 2010 were assessed for associations between patient-provider race, ethnicity, and/or gender concordance and, screening (American Cancer Society guidelines) for breast, cervical, and colorectal cancer. Multivariable logistic analyses were conducted to examine associations of interest. Results: Of the 32,041 patient-provider pairs in our analysis, more than 60% of the patients were NHW, 15% were non-Hispanic black (NHB), and 15% were Hispanic. Overall, patients adherent to cancer screening were more likely to be non-Hispanic, better educated, married, wealthier, and privately insured. Patient-provider gender discordance was associated with lower rates of breast [OR, 0.83; 95% confidence interval (CI), 0.76-0.90], cervical (OR, 0.83; 95% CI, 0.76-0.91), and colorectal cancer (OR, 0.84; 95% CI, 0.79-0.90) screening in all patients. This association was also significant after adjusting for racial and/or ethnic concordance. Conversely, among NHWs and NHBs, patient-provider racial and/or ethnic concordance was not associated with screening. Among Hispanics, patient-provider ethnic discordant pairs had higher breast (58% vs. 52%) and colorectal cancer (45% vs. 39%) screening rates compared with concordant pairs. Conclusions: Patient-provider gender concordance positively affected cancer screening. Patient-provider ethnic concordance was inversely associated with receipt of cancer screening among Hispanics. This counter-intuitive finding requires further study. Impact: Our findings highlight the importance of gender concordance in improving cancer screening rates. Cancer Epidemiol Biomarkers Prev; 26

  3. Estimating HPV DNA Deposition Between Sexual Partners Using HPV Concordance, Y Chromosome DNA Detection, and Self-reported Sexual Behaviors.

    Science.gov (United States)

    Malagón, Talía; Burchell, Ann N; El-Zein, Mariam; Guénoun, Julie; Tellier, Pierre-Paul; Coutlée, François; Franco, Eduardo L

    2017-12-05

    Detection of human papillomavirus (HPV) DNA in genital samples may not always represent true infections but may be depositions from infected sexual partners. We examined whether sexual risk factors and a biomarker (Y chromosome DNA) were associated with genital HPV partner concordance and estimated the fraction of HPV detections potentially attributable to partner deposition. The HITCH study enrolled young women attending a university or college in Montréal, Canada, and their male partners, from 2005 to 2010. We tested baseline genital samples for Y chromosome DNA and HPV DNA using polymerase chain reaction. Type-specific HPV concordance was 42.4% in partnerships where at least one partner was HPV DNA positive. Y chromosome DNA predicted type-specific HPV concordance in univariate analyses, but in multivariable models the independent predictors of concordance were days since last vaginal sex (26.5% higher concordance 0-1 vs 8-14 days after last vaginal sex) and condom use (22.6% higher concordance in never vs always users). We estimated that 14.1% (95% confidence interval [CI], 6.3-21.9%) of HPV DNA detections in genital samples were attributable to vaginal sex in the past week. A substantial proportion of HPV DNA detections may be depositions due to recent unprotected vaginal sex. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  4. Quantitative performance monitoring

    International Nuclear Information System (INIS)

    Heller, A.S.

    1987-01-01

    In the recently published update of NUREG/CR 3883, it was shown that Japanese plants of size and design similar to those in the US have significantly fewer trips in a given year of operation. One way to reduce such imbalance is the efficient use of available plant data. Since plant data are recorded and monitored continuously for management feedback and timely resolution of problems, this data should be actively used to increase the efficiency of operations and, ultimately, for a reduction of plant trips in power plants. A great deal of information is lost, however, if the analytical tools available for the data evaluation are misapplied or not adopted at all. This paper deals with a program developed to use quantitative techniques to monitor personnel performance in an operating power plant. Visual comparisons of ongoing performance with predetermined quantitative performance goals are made. A continuous feedback is provided to management for early detection of adverse trends and timely resolution of problems. Ultimately, costs are reduced through effective resource management and timely decision making

  5. Quantitative ion implantation

    International Nuclear Information System (INIS)

    Gries, W.H.

    1976-06-01

    This is a report of the study of the implantation of heavy ions at medium keV-energies into electrically conducting mono-elemental solids, at ion doses too small to cause significant loss of the implanted ions by resputtering. The study has been undertaken to investigate the possibility of accurate portioning of matter in submicrogram quantities, with some specific applications in mind. The problem is extensively investigated both on a theoretical level and in practice. A mathematical model is developed for calculating the loss of implanted ions by resputtering as a function of the implanted ion dose and the sputtering yield. Numerical data are produced therefrom which permit a good order-of-magnitude estimate of the loss for any ion/solid combination in which the ions are heavier than the solid atoms, and for any ion energy from 10 to 300 keV. The implanted ion dose is measured by integration of the ion beam current, and equipment and techniques are described which make possible the accurate integration of an ion current in an electromagnetic isotope separator. The methods are applied to two sample cases, one being a stable isotope, the other a radioisotope. In both cases independent methods are used to show that the implantation is indeed quantitative, as predicted. At the same time the sample cases are used to demonstrate two possible applications for quantitative ion implantation, viz. firstly for the manufacture of calibration standards for instrumental micromethods of elemental trace analysis in metals, and secondly for the determination of the half-lives of long-lived radioisotopes by a specific activity method. It is concluded that the present study has advanced quantitative ion implantation to the state where it can be successfully applied to the solution of problems in other fields

  6. Dry Eye Disease: Concordance Between the Diagnostic Tests in African Eyes.

    Science.gov (United States)

    Onwubiko, Stella N; Eze, Boniface I; Udeh, Nnenma N; Onwasigwe, Ernest N; Umeh, Rich E

    2016-11-01

    To assess the concordance between the diagnostic tests for dry eye disease (DED) in a Nigerian hospital population. The study was a hospital-based cross-sectional survey of adults (≥18 years) presenting at the eye clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu; September-December, 2011. Participants' socio-demographic data were collected. Each subject was assessed for DED using the "Ocular Surface Disease Index" (OSDI) questionnaire, tear-film breakup time (TBUT), and Schirmer test. The intertest concordance was assessed using kappa statistic, correlation, and regression coefficients. The participants (n=402; men: 193) were aged 50.1±19.1 standard deviation years (range: 18-94 years). Dry eye disease was diagnosed in 203 by TBUT, 170 by Schirmer test, and 295 by OSDI; the concordance between the tests were OSDI versus TBUT (Kappa, κ=-0.194); OSDI versus Schirmer (κ=-0.276); and TBUT versus Schirmer (κ=0.082). Ocular Surface Disease Index was inversely correlated with Schirmer test (Spearman ρ=-0.231, P<0.001) and TBUT (ρ=-0.237, P<0.001). In the linear regression model, OSDI was poorly predicted by TBUT (β=-0.09; 95% confidence interval (CI): -0.26 to -0.03, P=0.14) and Schirmer test (β=-0.35, 95% CI: -0.53 to -0.18, P=0.18). At UNTH, there is poor agreement, and almost equal correlation, between the subjective and objective tests for DED. Therefore, the selection of diagnostic test for DED should be informed by cost-effectiveness and diagnostic resource availability, not diagnostic efficiency or utility.

  7. [Concordance in the registry of dementia among the main sources of clinical information].

    Science.gov (United States)

    Marta-Moreno, Javier; Obón-Azuara, Blanca; Gimeno-Felíu, Luis; Achkar-Tuglaman, Nesib Nicolás; Poblador-Plou, Beatriz; Calderón-Larrañaga, Amaia; Prados-Torres, Alexandra

    2016-01-01

    The objective of this work was to analyse the concordance in the registry of dementia among the main sources of clinical information, with the aim of determining their usefulness for epidemiological and clinical research. Descriptive study of patients assigned to the Aragon Health Service in 2010 (n=1,344,891). (i)the pharmacy billing database (n=9,392); (ii)Primary Care electronic health records (EHR) (n=9,471), and (iii)the hospital minimum basic data set (n=3,289). When studying the concordance of the databases, the group of patients with a specific treatment for dementia (i.e., acetylcholinesterase inhibitors and/or memantine) was taken as the reference. The diagnosis in Primary Care was missing for 47.3% of patients taking anti-dementia drugs. The same occurred with 38.3% of dementia patients admitted to hospital during the study year. Among patients with a diagnosis of dementia in the EHR, only half (52.3%) was under treatment for this condition. This percentage decreased to 34.4% in patients with the diagnosis registered in the hospital database. The weak concordance in the registry of the dementia diagnosis between the main health information systems makes their use and analysis more complex, and supports the need to include all available health data sources in order to gain a global picture of the epidemiological and clinical reality of this health condition. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Concordance of In-Home "Smart" Scale Measurement with Body Weight Measured In-Person.

    Science.gov (United States)

    Ross, Kathryn M; Wing, Rena R

    2016-06-01

    Newer "smart" scales that transmit participants' body weights directly to data collection centers offer the opportunity to simplify weight assessment in weight management research; however, little data exist on the concordance of these data compared to weights measured at in-person assessments. We compared the weights of 58 participants (mean±SD BMI = 31.6±4.8, age = 52.1±9.7 years, 86.2% White, 65.5% Female) measured by study staff at an in-person assessment visit to weights measured on the same day at home using BodyTrace "smart" scales. These measures occurred after 3 months of an internet-based weight management intervention. Weight (mean±SD) measured at the 3-month in-person assessment visit was 81.5±14.7kg compared to 80.4±14.5kg measured on the same day using in-home body weight scales; mean bias =1.1±0.8kg, 95% limits of agreement = -0.5 to 2.6. Two outliers in the data suggest that there may be greater variability between measurements for participants weighing above 110 kg. Results suggest good concordance between the measurements and support the use of the BodyTrace smart scale in weight management research. Future trials using BodyTrace scales for outcome assessment should clearly define protocols for measurement and associated instructions to participants (e.g., instruct individuals to weigh at the same time of day, similarly clothed). Finally, measure concordance should be investigated in a group of individuals weighing more than 110kg.

  9. Assessing Concordance of Drug-Induced Transcriptional Response in Rodent Liver and Cultured Hepatocytes.

    Directory of Open Access Journals (Sweden)

    Jeffrey J Sutherland

    2016-03-01

    Full Text Available The effect of drugs, disease and other perturbations on mRNA levels are studied using gene expression microarrays or RNA-seq, with the goal of understanding molecular effects arising from the perturbation. Previous comparisons of reproducibility across laboratories have been limited in scale and focused on a single model. The use of model systems, such as cultured primary cells or cancer cell lines, assumes that mechanistic insights derived from the models would have been observed via in vivo studies. We examined the concordance of compound-induced transcriptional changes using data from several sources: rat liver and rat primary hepatocytes (RPH from Drug Matrix (DM and open TG-GATEs (TG, human primary hepatocytes (HPH from TG, and mouse liver/HepG2 results from the Gene Expression Omnibus (GEO repository. Gene expression changes for treatments were normalized to controls and analyzed with three methods: 1 gene level for 9071 high expression genes in rat liver, 2 gene set analysis (GSA using canonical pathways and gene ontology sets, 3 weighted gene co-expression network analysis (WGCNA. Co-expression networks performed better than genes or GSA when comparing treatment effects within rat liver and rat vs. mouse liver. Genes and modules performed similarly at Connectivity Map-style analyses, where success at identifying similar treatments among a collection of reference profiles is the goal. Comparisons between rat liver and RPH, and those between RPH, HPH and HepG2 cells reveal lower concordance for all methods. We observe that the baseline state of untreated cultured cells relative to untreated rat liver shows striking similarity with toxicant-exposed cells in vivo, indicating that gross systems level perturbation in the underlying networks in culture may contribute to the low concordance.

  10. Prostate cancer: concordance between "1"8F-choline PET and CT in biochemical relapse

    International Nuclear Information System (INIS)

    Herández Pinzón, J.; Ferrarotti, C.; Ferrari, L.; Larrañaga, N.; Gallo, J.C.; Mena, D.; Bastianello, M.

    2016-01-01

    Objective: To establish the concordance between 18-fluor choline positron emission tomography (PET) and computed tomography (CT) for re-staging patients with biochemical relapse of prostate cancer according to the TNM system. Materials and methods: The medical records of the Molecular Imaging Section were retrospectively reviewed. The TNM classification was established by us for each method, and the Kappa concordance statistic was used to classify the results according to the Landis and Koch proposal. Results: The PET-choline reported 19 (59.4%) patients N0 and 13 (40.6%) N1, while CT reported 28 (87.5%) N0 and 4 (12.5%) N1. In metastasis classification PET-choline established M0 in 17 (53.1%) patients, M1a in 1 (3.1%), M1b in 5 (15.6%), M1c in 1 (3.1%), M1a + M1b in 7 (21.9%), and M1b + M1c in 1 (3.1%). On the other hand, CT was M0 in 23 (71.9%) patients, M1a in 2 (6.25%), M1a + M1b in 2 (6.25%), and M1b + M1c in 5 (15.6%). The correlation between PET-choline and CT in the TNM lymph node and metastasis classifications was 71.88%, with a Kappa of 0.3455 (standard error 0.1336; P=.0049) and 62.5% with Kappa 0.3725 (standard error 0.0847; P=.0001), respectively. Discussion: Several studies have shown a high diagnostic accuracy of PET-choline detecting the spread of the disease compared to conventional methods. Conclusion: There is poor concordance for metastatic and lymph node classifications according to the TNM system between choline-PET and CT. (authors) [es

  11. Sexual violence and associated factors among women in HIV discordant and concordant relationships in Uganda.

    Science.gov (United States)

    Shuaib, Faisal M B; Ehiri, John E; Jolly, Pauline; Zhang, Qionghui; Emusu, Donath; Ngu, Julius; Foushee, Herman; Katongole, Drake; Kirby, Russell; Wabwire-Mangen, Fred

    2012-01-01

    HIV serodiscordance is a sexual partnership in which one partner is infected with HIV while the other is not. Managing emotional and sexual intimacy in HIV serodiscordant unions can be difficult due to concerns about HIV transmission and the challenge of initiating and maintaining safe sex. In situations where couples are jointly aware of their HIV status, women in serodiscordant unions may face increased risk of partner violence. We conducted an investigation to assess risk factors for HIV serodiscordance and determine if HIV serodiscordance is associated with incident sexual violence among a cohort of women attending HIV post-test club services at three AIDS Information Centers (AICs) in Uganda. Using a prospective study of 250 women, we elicited information about sexual violence using structured face-to-face interviews. Sexual violence and risk factors were assessed and compared among HIV positive women in HIV discordant unions, HIV negative women in discordant unions, and HIV negative women in negative concordant unions. Multivariable logistic regression was used to assess the association between participants' serostatus and sexual violence. HIV negative women in serodiscordant relationships (36.1±11.1 years, range: 19-65 years) were significantly older than either HIV positive women in serodiscordant relationships (32.2±9.0 years, range: 18-56 years), or HIV negative women in concordant relationships (32.3±11.0 years, range: 18-62), (p=0.033). Early age at sexual debut was associated with a 2.4-fold increased risk of experiencing sexual violence (OR 2.4, 95% CI 1.27-4.65). Based on unadjusted analysis, HIV positive women in discordant relationship were at highest risk for sexual violence compared to HIV negative women in discordant unions, and HIV negative women in negative concordant unions. HIV negative women in discordant relationships and those in concordant negative relationships showed no increased risk for sexual violence. However, couples' HIV

  12. Exploring the Circulation Dynamics of Mississippi Sound and Bight Using the CONCORDE Synthesis Model

    Science.gov (United States)

    Pan, C.; Dinniman, M. S.; Fitzpatrick, P. J.; Lau, Y.; Cambazoglu, M. K.; Parra, S. M.; Hofmann, E. E.; Dzwonkowski, B.; Warner, S. J.; O'Brien, S. J.; Dykstra, S. L.; Wiggert, J. D.

    2017-12-01

    As part of the modeling effort of the GOMRI (Gulf of Mexico Research Initiative)-funded CONCORDE consortium, a high resolution ( 400 m) regional ocean model is implemented for the Mississippi (MS) Sound and Bight. The model is based on the Coupled Ocean Atmosphere Wave Sediment Transport Modeling System (COAWST), with initial and lateral boundary conditions drawn from data assimilative 3-day forecasts of the 1km-resolution Gulf of Mexico Navy Coastal Ocean Model (GOM-NCOM). The model initiates on 01/01/2014 and runs for 3 years. The model results are validated with available remote sensing data and with CONCORDE's moored and ship-based in-situ observations. Results from a three-year simulation (2014-2016) show that ocean circulation and water properties of the MS Sound and Bight are sensitive to meteorological forcing. A low resolution surface forcing, drawn from the North America Regional Reanalysis (NARR), and a high resolution forcing, called CONCORDE Meteorological Analysis (CMA) ) that resolves the diurnal sea breeze, are used to drive the model to examine the sensitivity of the circulation to surface forcing. The model responses to the low resolution NARR forcing and to the high resolution CMA are compared in detail for the CONCORDE Fall and Spring field campaigns when contemporaneous in situ data are available, with a focus on how simulated exchanges between MS Sound and MS Bight are impacted. In most cases, the model shows higher simulation skill when it is driven by CMA. Freshwater plumes of the MS River, MS Sound and Mobile Bay influence the shelf waters of the MS Bight in terms of material budget and dynamics. Drifters and dye experiments near Mobile Bay demonstrate that material exchanges between Mobile Bay and the Sound, and between the Sound and Bight, are sensitive to the wind strength and direction. A model - data comparison targeting the Mobile Bay plume suggests that under both northerly and southerly wind conditions the model is capable of

  13. Beyond concordance cosmology with magnification of gravitational-wave standard sirens.

    Science.gov (United States)

    Camera, Stefano; Nishizawa, Atsushi

    2013-04-12

    We show how future gravitational-wave detectors would be able to discriminate between the concordance Λ cold dark matter cosmological model and up-to-date competing alternatives, e.g., dynamical dark energy (DE) models or modified gravity (MG) theories. Our method consists of using the weak-lensing magnification effect that affects a standard-siren signal because of its traveling through the Universe's large scale structure. As a demonstration, we present constraints on DE and MG from proposed gravitational-wave detectors, namely Einstein Telescope and DECI-Hertz Interferometer Gravitational-Wave Observatory and Big-Bang Observer.

  14. Increased concordance of severe respiratory syncytial virus infection in identical twins

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; Stensballe, Lone Graff; Skytthe, Axel

    2008-01-01

    (concordance rate: 0.66 vs 0.53), which suggests genetic influences on disease severity. Genetic factors accounted for 16%, family environment for 73%, and nonshared environment for 11% of the individual susceptibility to develop severe respiratory syncytial virus infection. CONCLUSIONS: The severity...... of respiratory syncytial virus infection is determined partly by genetic factors. This result should stimulate the search for genetic markers of disease severity.......OBJECTIVE: We estimated differences in the severity of respiratory syncytial virus infection attributable to genetic and environmental factors. METHODS: Record linkage data on hospitalizations attributable to respiratory syncytial virus infection were gathered on all twins (12,346 pairs) born...

  15. Inflation with primordial broken power law spectrum as an alternative to the concordance cosmological model

    International Nuclear Information System (INIS)

    Pandolfi, Stefania; Giusarma, Elena; Lattanzi, Massimiliano; Melchiorri, Alessandro

    2010-01-01

    We consider cosmological models with a non-scale-invariant spectrum of primordial perturbations and assess whether they represent a viable alternative to the concordance ΛCDM model. We find that in the framework of a model selection analysis, the WMAP and 2dF data do not provide any conclusive evidence in favor of one or the other kind of model. However, when a marginalization over the entire space of nuisance parameters is performed, models with a modified primordial spectrum and Ω Λ =0 are strongly disfavored.

  16. A Bayesian Framework for Estimating the Concordance Correlation Coefficient Using Skew-elliptical Distributions.

    Science.gov (United States)

    Feng, Dai; Baumgartner, Richard; Svetnik, Vladimir

    2018-04-05

    The concordance correlation coefficient (CCC) is a widely used scaled index in the study of agreement. In this article, we propose estimating the CCC by a unified Bayesian framework that can (1) accommodate symmetric or asymmetric and light- or heavy-tailed data; (2) select model from several candidates; and (3) address other issues frequently encountered in practice such as confounding covariates and missing data. The performance of the proposal was studied and demonstrated using simulated as well as real-life biomarker data from a clinical study of an insomnia drug. The implementation of the proposal is accessible through a package in the Comprehensive R Archive Network.

  17. Achieving Goal-Concordant Care: A Conceptual Model and Approach to Measuring Serious Illness Communication and Its Impact

    Science.gov (United States)

    Curtis, J. Randall; Tulsky, James A.

    2018-01-01

    Abstract Background: High-quality care for seriously ill patients aligns treatment with their goals and values. Failure to achieve “goal-concordant” care is a medical error that can harm patients and families. Because communication between clinicians and patients enables goal concordance and also affects the illness experience in its own right, healthcare systems should endeavor to measure communication and its outcomes as a quality assessment. Yet, little consensus exists on what should be measured and by which methods. Objectives: To propose measurement priorities for serious illness communication and its anticipated outcomes, including goal-concordant care. Methods: We completed a narrative review of the literature to identify links between serious illness communication, goal-concordant care, and other outcomes. We used this review to identify gaps and opportunities for quality measurement in serious illness communication. Results: Our conceptual model describes the relationship between communication, goal-concordant care, and other relevant outcomes. Implementation-ready measures to assess the quality of serious illness communication and care include (1) the timing and setting of serious illness communication, (2) patient experience of communication and care, and (3) caregiver bereavement surveys that include assessment of perceived goal concordance of care. Future measurement priorities include direct assessment of communication quality, prospective patient or family assessment of care concordance with goals, and assessment of the bereaved caregiver experience. Conclusion: Improving serious illness care necessitates ensuring that high-quality communication has occurred and measuring its impact. Measuring patient experience and receipt of goal-concordant care should be our highest priority. We have the tools to measure both. PMID:29091522

  18. Attitudes toward concordance and self-efficacy in decision making: a cross-sectional study on pharmacist-patient consultations.

    Science.gov (United States)

    Ng, Yew Keong; Shah, Noraida Mohamed; Loong, Ly Sia; Pee, Lay Ting; Hidzir, Sarina Anim M; Chong, Wei Wen

    2018-01-01

    This study investigated patients' and pharmacists' attitudes toward concordance in a pharmacist-patient consultation and how patients' attitudes toward concordance relate to their involvement and self-efficacy in decision making associated with medication use. A cross-sectional study was conducted among patients with chronic diseases and pharmacists from three public hospitals in Malaysia. The Revised United States Leeds Attitudes toward Concordance (RUS-LATCon) was used to measure attitudes toward concordance in both patients and pharmacists. Patients also rated their perceived level of involvement in decision making and completed the Decision Self-Efficacy scale. One-way analysis of variance (ANOVA) and independent t -test were used to determine significant differences between different subgroups on attitudes toward concordance, and multiple linear regression was performed to find the predictors of patients' self-efficacy in decision making. A total of 389 patients and 93 pharmacists participated in the study. Pharmacists and patients scored M=3.92 (SD=0.37) and M=3.84 (SD=0.46) on the RUS-LATCon scale, respectively. Seven items were found to be significantly different between pharmacists and patients on the subscale level. Patients who felt fully involved in decision making (M=3.94, SD=0.462) scored significantly higher on attitudes toward concordance than those who felt partially involved (M=3.82, SD=0.478) and not involved at all (M=3.68, SD=0.471; p Decision Self-Efficacy scale. In multiple linear regression analysis, ethnicity, number of medications taken by patients, patients' perceived level of involvement, and attitudes toward concordance are significant predictors of patients' self-efficacy in decision making ( p making an informed decision. Further study is recommended on interventions involving pharmacists in supporting patients' involvement in medication-related decision making.

  19. Personal, family and social functioning among older couples concordant and discordant for high-risk alcohol consumption.

    Science.gov (United States)

    Moos, Rudolf H; Schutte, Kathleen K; Brennan, Penny L; Moos, Bernice S

    2011-02-01

    This study compares the personal, family and social functioning of older husbands and wives concordant or discordant for high-risk alcohol consumption and identifies predictors of changes in concordance and high-risk consumption. Three groups of couples were identified at baseline and followed 10 years later: (i) concordant couples in which husbands and wives engaged in low-risk alcohol consumption (n = 54); (ii) concordant couples in which husbands and wives engaged in high-risk alcohol consumption (n = 38); and (iii) discordant couples in which one partner engaged in high-risk alcohol consumption and the other partner did not (n = 75). At each follow-up, husbands and wives completed an inventory that assessed their personal, family and social functioning. Compared to the low-risk concordant group, husbands and wives in the high-risk concordant group were more likely to rely on tension-reduction coping, reported more friend approval of drinking, and were less involved in religious activities; however, they did not differ in the quality of the spousal relationship. The frequency of alcohol consumption declined among husbands in discordant couples, but not among husbands in concordant couples. Predictors of high-risk drinking included tension-reduction coping, friend approval of drinking and, for husbands, their wives' level of drinking. High-risk and discordant alcohol consumption do not seem to be linked to decrements in family functioning among older couples in long-term stable marriages. The predictors of heavy alcohol consumption among older husbands and wives identify points of intervention that may help to reduce their high-risk drinking. © 2010 Society for the Study of Addiction. No claim to US government works.

  20. Analysis of reliability of professor recommendation letters based on concordance with self-introduction letter.

    Science.gov (United States)

    Kim, Sang Hyun

    2013-12-01

    The purpose of this study was to examine the concordance between a checklist's categories of professor recommendation letters and characteristics of the self-introduction letter. Checklists of professor recommendation letters were analyzed and classified into cognitive, social, and affective domains. Simple correlation was performed to determine whether the characteristics of the checklists were concordant with those of the self-introduction letter. The difference in ratings of the checklists by pass or fail grades was analyzed by independent sample t-test. Logistic regression analysis was performed to determine whether a pass or fail grade was influenced by ratings on the checklists. The Cronbach alpha value of the checklists was 0.854. Initiative, as an affective domain, in the professor's recommendation letter was highly ranked among the six checklist categories. Self-directed learning in the self-introduction letter was influenced by a pass or fail grade by logistic regression analysis (pprofessor recommendation letters and the sum of all characteristics in the self-introduction letter.

  1. Coming close to the ideal alternative: The concordant-ranks strategy

    Directory of Open Access Journals (Sweden)

    Neda Kerimi

    2011-04-01

    Full Text Available We present the Concordant-Ranks (CR strategy that decision makers use to quickly find an alternative that is proximate to an ideal alternative in a multi-attribute decision space. CR implies that decision makers prefer alternatives that exhibit concordant ranks between attribute values and attribute weights. We show that, in situations where the alternatives are equal in multi-attribute utility (MAU, minimization of the weighted Euclidean distance (WED to an ideal alternative implies the choice of a CR alternative. In two experiments, participants chose among, as well as evaluated, alternatives that were constructed to be equal in MAU. In Experiment 1, four alternatives were designed in such a way that the choice of each alternative would be consistent with one particular choice strategy, one of which was the CR strategy. In Experiment 2, participants were presented with a CR alternative and a number of arbitrary alternatives. In both experiments, participants tended to choose the CR alternative. The CR alternative was on average evaluated as more attractive than other alternatives. In addition, measures of WED, between given alternatives and the ideal alternative, by and large agreed with the preference order for choices and attractiveness evaluations of the different types of alternatives. These findings indicate that both choices and attractiveness evaluations are guided by proximity of alternatives to an ideal alternative.

  2. Family history assessment of personality disorders: I. Concordance with direct interview and between pairs of informants.

    Science.gov (United States)

    Ferro, T; Klein, D N

    1997-01-01

    The present study examined the concordance of the Family History Interview for Personality Disorders (FHIPD) with diagnoses based on direct interviews and between pairs of informants. Subjects were 224 probands participating in a series of studies of the familial transmission of mood and personality disorders and their first-degree relatives. Proband informants and relatives provided information about themselves on the Structured Clinical Interview for DSM-III-R (SCID), Personality Disorder Examination (PDE), and Eysenck Personality Questionnaire (EPQ). Information from informants about relatives was collected with the FHIPD. All assessments were made blindly and independently. Using Kappa, concordance between proband informants' family histories and relative direct reports on specific personality disorders was low, ranging from -.01 to .28, with a median of .10. Kappa for a diagnosis of any personality disorder was .16. When two independent informant reports were compared, Kappas for specific Axis II disorders ranged from .10 to .72, with a median of .28. Kappa for a diagnosis of any personality disorder was .36. These data suggest that subjects and informants provide different perspectives on Axis II psychopathology, and support the use of both sources of information whenever possible.

  3. The concordance of ultrasound technique versus X-ray to confirm endotracheal tube position in neonates.

    Science.gov (United States)

    Chowdhry, R; Dangman, B; Pinheiro, J M B

    2015-07-01

    Given the distressingly high incidence of ETT malposition in the neonatal population, patients are exposed to ionizing radiation to confirm endotracheal tube (ETT) position. Our objective is to determine if ultrasound technique is concordant with X-ray in determining whether an ETT is deeply positioned or not. Prospective observational clinical trial. After obtaining informed consent, patients with an ETT who required X-ray for clinical reasons underwent sonographic evaluation of the ETT by an ultrasound technologist or pediatric radiologist, usually within the hour. A total of 56 image pairs were obtained from 29 patients. Ninety-eight percent of the ultrasound/X-ray image pairs were suitable for analysis. The concordance of ultrasound with X-ray to identify deeply and not deeply positioned ETTs was 95% (53/56). The sensitivity of ultrasound to detect deeply positioned ETTs on X-ray was 86% (6/7). The specificity of ultrasound to detect ETTs that were not deeply positioned on X-ray was 96% (47/49). As the largest clinical trial of its kind to date, with the greatest number of ultrasound operators, we have further established US as a feasible imaging modality to determine whether an ETT is deeply positioned or not.

  4. Inter and intra-observer concordance for the diagnosis of portal hypertension gastropathy.

    Science.gov (United States)

    Casas, Meritxell; Vergara, Mercedes; Brullet, Enric; Junquera, Félix; Martínez-Bauer, Eva; Miquel, Mireia; Sánchez-Delgado, Jordi; Dalmau, Blai; Campo, Rafael; Calvet, Xavier

    2018-03-01

    At present there is no fully accepted endoscopic classification for the assessment of the severity of portal hypertensive gastropathy (PHG). Few studies have evaluated inter and intra-observer concordance or the degree of concordance between different endoscopic classifications. To evaluate inter and intra-observer agreement for the presence of portal hypertensive gastropathy and enteropathy using different endoscopic classifications. Patients with liver cirrhosis were included into the study. Enteroscopy was performed under sedation. The location of lesions and their severity was recorded. Images were videotaped and subsequently evaluated independently by three different endoscopists, one of whom was the initial endoscopist. The agreement between observations was assessed using the kappa index. Seventy-four patients (mean age 63.2 years, 53 males and 21 females) were included. The agreement between the three endoscopists regarding the presence or absence of PHG using the Tanoue and McCormack classifications was very low (kappa scores = 0.16 and 0.27, respectively). The current classifications of portal hypertensive gastropathy have a very low degree of intra and inter-observer agreement for the diagnosis and assessment of gastropathy severity.

  5. [Concordance between the zinc sulphate flotation and centrifugal sedimentation methods for the diagnosis of intestinal parasites].

    Science.gov (United States)

    Inês, Elizabete De Jesus; Pacheco, Flavia Thamiris Figueiredo; Pinto, Milena Carneiro; Mendes, Patrícia Silva de Almeida; Da Costa-Ribeiro, Hugo; Soares, Neci Matos; Teixeira, Márcia Cristina Aquino

    2016-12-01

    The diagnosis of intestinal parasitic infections depends on the parasite load, the specific gravity density of the parasite eggs, oocysts or cysts, and the density and viscosity of flotation or sedimentation medium where faeces are processed. To evaluate the concordance between zinc sulphate flotation and centrifugal sedimentation in the recovery of parasites in faecal samples of children. Faecal samples of 330 children from day care centers were evaluated by zinc sulphate flotation and centrifugal sedimentation techniques. The frequencies of detection of parasites by each method were determined and the agreement between the diagnostic techniques was evaluated using the kappa index, with 95% confidence intervals. The faecal flotation in zinc sulphate diagnosed significantly more cases of Trichuris trichiura infection when compared to centrifugal sedimentation (39/330; 11.8% vs. 13/330; 3.9%, p<0.001), with low diagnostic concordance between methods (kappa=0.264; 95% CI: 0.102-0.427). Moreover, all positive samples for Enterobius vermicularis eggs (n=5) and Strongyloides stercoralis larvae (n=3) were diagnosed only by zinc sulphate. No statistical differences were observed between methods for protozoa identification. The results showed that centrifugal flotation in zinc sulphate solution was significantly more likely to detect light helminths eggs such as those of T. trichiura and E. vermicularis in faeces than the centrifugal sedimentation process.

  6. Aligning conservation goals: are patterns of species richness and endemism concordant at regional scales?

    Directory of Open Access Journals (Sweden)

    Ricketts, T. H.

    2001-01-01

    Full Text Available Biodiversity conservation strategies commonly target areas of high species richness and/or high endemism. However, the correlation between richness and endemism at scales relevant to conservation is unclear; these two common goals of conservation plans may therefore be in conflict. Here the spatial concordance between richness and endemism is tested using five taxa in North America: butterflies, birds, mammals, amphibians, and reptiles. This concordance is also tested using overall indices of richness and endemism (incorporating all five taxa. For all taxa except birds, richness and endemism were significantly correlated, with amphibians, reptiles, and the overall indices showing the highest correlations (rs = 0.527-0.676. However, 'priority sets' of ecoregions (i.e., the top 10% of ecoregions based on richness generally overlapped poorly with those based on endemism (< 50% overlap for all but reptiles. These results offer only limited support for the idea that richness and endemism are correlated at broad scales and indicate that land managers will need to balance these dual, and often conflicting, goals of biodiversity conservation.

  7. Concordance between otic cytology and culture in diagnosis of external otitis canine by Malassezia spp

    Directory of Open Access Journals (Sweden)

    Adriana Pulido-Villamarín

    2015-09-01

    Full Text Available Objective. To determine the correlation between microbiological culture and otic cytology for diagnoses of external otitis by Malassezia in dogs. Materials and methods. 158 ear swabs of dogs with clinical diagnosis of external otitis were analyzed by cytology, mycological culture and metabolic tests. Results. Were obtained a positive results by cytology of 62% and 75.3% by culture. The 31.1% of isolates were identified as M. pachydermatis, 12.6% as M. furfur and 56.3% were classified as Malassezia spp., because was not possible to define the species. We found a positive concordance between cytology and culture for Malassezia spp., of 0.76 with a kappa index of 0.448 (95% CI 0.30 to 0.60 which represents a moderate strength of concordance between the two techniques, without regard the identified species. Conclusions. The use of a diagnostic test is not enough to establish the participation of Malassezia spp., as a causal disease agent.

  8. Concordant Patterns of Brain Structure in Mothers with Recurrent Depression and Their Never-Depressed Daughters.

    Science.gov (United States)

    Foland-Ross, Lara C; Behzadian, Negin; LeMoult, Joelle; Gotlib, Ian H

    2016-01-01

    A growing body of research has demonstrated that having a mother with a history of major depressive disorder (MDD) is one of the strongest predictors of depression in adolescent offspring. Few studies, however, have assessed neural markers of this increased risk for depression, or examined whether risk-related anomalies in adolescents at maternal risk for depression are related to neural abnormalities in their depressed mothers. We addressed these questions by examining concordance in brain structure in two groups of participants: mothers with a history of depression and their never-depressed daughters, and never-depressed mothers and their never-depressed daughters. We scanned mothers with (remitted; RMD) and without (control; CTL) a history of recurrent episodes of depression and their never-depressed daughters, computed cortical gray matter thickness, and tested whether mothers' thickness predicted daughters' thickness. Both RMD mothers and their high-risk daughters exhibited focal areas of thinner cortical gray matter compared with their CTL/low-risk counterparts. Importantly, the extent of thickness anomalies in RMD mothers predicted analogous abnormalities in their daughters; this pattern was not present in CTL/low-risk dyads. We identified neuroanatomical risk factors that may underlie the intergenerational transmission of risk for MDD. Our findings suggest that there is concordance in brain structure in dyads that is affected by maternal depression, and that the location, direction, and extent of neural anomalies in high-risk offspring mirror those of their recurrent depressed mothers. © 2016 S. Karger AG, Basel.

  9. Concordance and interchangeability of biometric measurements of ocular axial length in patients awaiting cataract surgery.

    Science.gov (United States)

    Martín-Serrano, María José; Roman-Ortiz, Carmen; Villa-Sáez, M Luz; Labrador-Castellanos, M Purificación; Blanco-Carrasco, Rosario; Lozano-Ballesteros, Felicidad; Pedraza-Martín, Carmen; José-Herrero, M Teresa San; López-Ropero, Ana M; Tenías Burillo, José María

    2014-01-01

    To estimate in patients awaiting cataract surgery the concordance and interchangeability of axial eye length measurements performed with the aid of various biometric methods (optical or ultrasonic) by different operators (nurses) at different times during the period prior to surgery. We selected 182 consecutive eyes from 91 patients.Ocular axial length was measured with the aid of 2 methods (IOLMaster® and Ocuscan®) by 9 randomly allocated technicians at 2 different times during the waiting period. The concordance between measurements was evaluated by means of the intraclass correlation coefficient (ICC); the interchangeability of the results was assessed with Bland Altman plots and Passing and Bablok regression. The measurements were consistent between biometric methods (ICC 0.975, 95% confidence interval [CI] 0.968 to 0.980) and measurement dates (ICC 0.996, 95% CI 0.995 to 0.997). Interobserver agreement was more heterogeneous (ICC range 0.844 to 0.998). No systematic errors were observed among the various biometric methods and measurement dates. Because measurement of axial length in phakic patients may be technician-dependent, the technician's experience should be noted in the protocols of ophthalmology services.

  10. Whipple Resection: Concordance Between Frozen Section And Permanent Section Diagnosis Of Surgical Margins.

    Science.gov (United States)

    Bilal, Muhammad; Tariq, Hina; Mamoon, Nadira

    2018-01-01

    Margin assessment is done in Whipple procedures which are usually performed to resect tumours of head of pancreas and ampullary/periampullary region. Aims and objective of the study are to determine the concordance between frozen sections (FS) and permanent sections (PS) of surgical margins in Whipple resections. It is a retrospective study, from January 2008 to January 2015 (07 years). It includes the specimen with malignancy in final report and for which FS of pancreatic and/or CBD margin(s) were requested. Data was retrieved from Laboratory information system (LIS) database. Of the 41 bile duct margins in cases of ampullary tumours, 03 were positive on FS as well as PS, 35 were negative on FS as well as on PS. Results showed 100% sensitivity, 92.1% specificity, 50% PPV and 100% NPV. Results of 36 pancreatic margins in cases of ampullary showed 100% sensitivity, 97.1% specificity, 50% PPV and 100% NPV. In pancreatic carcinoma cases, none of CBD margins were reported as positive on FS, 02 margins reported as negative were found positive on PS, while 17 were negative on FS as well as PS. Results showed 100% specificity and 89.5% NPV. Of the 27 pancreatic margins tested in pancreatic tumours 100% sensitivity, 94.1% specificity, 88.9% PPV and 100% NPV was found. Factors such as absent prior tissue diagnosis and/or inflammatory processes make margin diagnosis difficult. However, a high concordance was observed between our FS and PS diagnosis.

  11. Concord Grape Juice Polyphenols and Cardiovascular Risk Factors: Dose-Response Relationships

    Science.gov (United States)

    Blumberg, Jeffrey B.; Vita, Joseph A.; Chen, C. -Y. Oliver

    2015-01-01

    Pure fruit juices provide nutritional value with evidence suggesting some of their benefits on biomarkers of cardiovascular disease risk may be derived from their constituent polyphenols, particularly flavonoids. However, few data from clinical trials are available on the dose-response relationship of fruit juice flavonoids to these outcomes. Utilizing the results of clinical trials testing single doses, we have analyzed data from studies of 100% Concord grape juice by placing its flavonoid content in the context of results from randomized clinical trials of other polyphenol-rich foods and beverages describing the same outcomes but covering a broader range of intake. We selected established biomarkers determined by similar methods for measuring flow-mediated vasodilation (FMD), blood pressure, platelet aggregation, and the resistance of low density lipoprotein cholesterol (LDL) to oxidation. Despite differences among the clinical trials in the treatment, subjects, and duration, correlations were observed between the dose and FMD. Inverse dose-response relationships, albeit with lower correlation coefficients, were also noted for the other outcomes. These results suggest a clear relationship between consumption of even modest serving sizes of Concord grape juice, flavonoid intake, and effects on risk factors for cardiovascular disease. This approach to dose-response relationships may prove useful for testing other individual foods and beverages. PMID:26633488

  12. Equivalent dose measurements on board an Armenian Airline flight and Concord (9-17 km)

    International Nuclear Information System (INIS)

    Akopova, A.B.; Melkonyan, A.A.; Tatikyan, S.Sh.; Capdevielle, J-N.

    2002-01-01

    The results of investigations of the neutron component (E=1-10 MeV) of cosmic radiation on board the 'Armenian Airlines' aircrafts using nuclear photoemulsion are presented. The emulsions were exposed on the flights from Yerevan to Moscow, St.-Petersburg, Beirut, Athens, Frankfurt, Amsterdam, Paris and Sofia, and on Concord supersonic flights from Paris to New York. The dependence of the neutron fluxes, and on absorbed and equivalent doses on the flight parameters were investigated. On the flights of the supersonic Concord, with an altitude of 17 km, the neutron fluxes were essentially higher in comparison to those measured on Armenian airliners. It is interesting to note, that the neutron flux and equivalent dose rate decrease with altitude up to 470 km in space, for example, on board the STS-57. The shape of the differential energy spectrum for fast neutrons is the same on all Armenian airlines flights, but significantly different at 17 km altitude, where the flux in the energy region above 3 MeV is increasing

  13. Equivalent dose measurements on board an Armenian Airline flight and Concord (9-17 km)

    Energy Technology Data Exchange (ETDEWEB)

    Akopova, A.B. E-mail: akopova@lx2.yerphi.am; Melkonyan, A.A.; Tatikyan, S.Sh.; Capdevielle, J-N

    2002-12-01

    The results of investigations of the neutron component (E=1-10 MeV) of cosmic radiation on board the 'Armenian Airlines' aircrafts using nuclear photoemulsion are presented. The emulsions were exposed on the flights from Yerevan to Moscow, St.-Petersburg, Beirut, Athens, Frankfurt, Amsterdam, Paris and Sofia, and on Concord supersonic flights from Paris to New York. The dependence of the neutron fluxes, and on absorbed and equivalent doses on the flight parameters were investigated. On the flights of the supersonic Concord, with an altitude of 17 km, the neutron fluxes were essentially higher in comparison to those measured on Armenian airliners. It is interesting to note, that the neutron flux and equivalent dose rate decrease with altitude up to 470 km in space, for example, on board the STS-57. The shape of the differential energy spectrum for fast neutrons is the same on all Armenian airlines flights, but significantly different at 17 km altitude, where the flux in the energy region above 3 MeV is increasing.

  14. The diagnostic concordance of endoanal ultrasonography and endoanal MRI in cases of anorectal fistula

    International Nuclear Information System (INIS)

    Kim, Wan Tae; Yoo, Weon Young; Moon, Hee Jung; Shin, Hyun Ja; Joo, Jae Sik

    2000-01-01

    To evaluate the preoperative diagnostic concordance of morphologic classification of anorectal fistula by endoanal ultrasonography (EUSG) and endoanal magnetic resonance imaging (EMRI). Between January 1998 and March 1999, 17 patients with anorectal fistula underwent endoanal ultrasonography and magnetic resonance imaging for preoperative assessment. The types of fistula and abscess formation were evaluated, and the findings compared with those obtained during surgery. The overall accordance of anorectal fistula was 76% (13 of 17 cases) on ultrasonography and 94% (16 of 17 cases) on magnetic resonance imaging. According to the findings of EUSG, the accordance of each type of anorectal fistula was as follows: transphineteric, 92% (11 of 12 cases); suprasphinteric, 33% (1 of 3); and extrasphincteric, 50% (1 of 2), while for EMRI, the respective figures were 100% (12 of 12 cases), 67% (2 of 3), and 100% (2 of 2). An analysis of reproducibility using kappa value showed that overall concordance between endoanal ultrasonography and surgery (κ=0.820) as well as between endoanal MRI and surgery (κ=0.866), was very close. For the evaluation of anorectal fistula, preoperative endoanal magnetic resonance imaging was more accurate and informative than endoanal ultrasonography

  15. Concordance between Self and Standardized Patient Ratings of Medical Students' Communication Skills.

    Science.gov (United States)

    Je, Min Ji; Lee, Su Hyun; Lee, Chang Hyung; Kim, Sung Soo

    2013-03-01

    The purpose of this study was to examine the concordance between self and standardized patient (SP) ratings of medical students' communication skills. Forty-three students interviewed SPs. The students were asked to complete a communication skills questionnaire that comprised 2 measures (empathy and interpersonal communication) before the interview. After each student's interview with the SP, the latter completed the same questionnaire as the students. Based on Lin's concordance coefficient, there was strong disconcordance between students' self-ratings and the SPs' ratings. With regard to empathic communication, more than 50% of students who considered themselves higher than middle level were regarded by SP as low level. On interpersonal communication, 39% of students who assessed themselves as higher than middle level were scored low level by SPs. There was strong disconcordance between students' self-ratings and the SPs' ratings-students tended to overevaluate themselves regarding their communication skills. These differences might result in patient dissatisfaction and noncompliance. Further, it could become a serious hindrance to the development of a good doctor-patient relationship. Medical educators should make sincere efforts to reduce this gap by teaching medical students the importance of the patients' perception of his doctors' communication skills.

  16. Quantitative Decision Support Requires Quantitative User Guidance

    Science.gov (United States)

    Smith, L. A.

    2009-12-01

    for a given problem is presented. Based on climate science, meteorology, and the details of the question in hand, this approach identifies necessary (never sufficient) conditions required for the rational use of climate model output in quantitative decision support tools. Inasmuch as climate forecasting is a problem of extrapolation, there will always be harsh limits on our ability to establish where a model is fit for purpose, this does not, however, limit us from identifying model noise as such, and thereby avoiding some cases of the misapplication and over interpretation of model output. It is suggested that failure to clearly communicate the limits of today’s climate model in providing quantitative decision relevant climate information to today’s users of climate information, would risk the credibility of tomorrow’s climate science and science based policy more generally.

  17. A Comparison of Total Antioxidant Capacities of Concord, Purple, Red, and Green Grapes Using the CUPRAC Assay

    Directory of Open Access Journals (Sweden)

    Connor M. Callaghan

    2013-10-01

    Full Text Available Considering how popular grapes are in terms of their antioxidant benefits, we compared concord, purple, red, and green grapes for total antioxidant capacity (TAC and carbohydrate concentration. All grapes were acquired from commercial sources and samples of each were separated into skinned and not skinned groups. Each whole grape and the skins were individually homogenized and then separated into pulp and supernatant fractions. Each fraction was analyzed for total TAC and carbohydrates. The concord grapes and purple grapes had significantly higher TAC in the homogenates than did the red or green grapes. The concord grapes and green grapes had significantly higher TAC in the pulp than in the cytosol whereas the red and purple grapes had approximately the same amount. The majority of the TAC of the purple and red grapes was in the skin whereas the concord and green grapes had approximately the same TAC in the skin and pulp. The concord and purple grapes had the highest TAC when compared to the red and green grapes, whereas the red and green grapes had approximately the same total TAC.

  18. Influence knowledge and behavior of TB medical personnels’ concordance principle based communications skill at primary healthcare, Medan, Indonesia

    Science.gov (United States)

    Wahyuni, A. S.; Soeroso, N. N.; Alona, I.; Yunanda, Y.; Siregar, I.

    2018-03-01

    Concordance behavior of TB management is a form of collaboration among doctors, personnel, and patients in treating TB. Approvalamong them could be achieved if credibility and policy occur. This study is aimed to analyze the influence of TB medical personnel’s concordance behaviour principle to patient obedience at primary health care in Medan.The design of this study was quasi experimental, focusing on interventional primary health care, which is those who applied concordance behaviour principle to non-interventionalprimary health care. The population is TB patients, starting from 18 years old, TB category I with positive Acid Fast Bacilli Smear Test (AFBST), and taking TB regimens at Medan. Seventy- four patients were selected to be samples. They had undergone interview based on validated concordance principle, knowledge, behavior, and treatment. Data were analyzed using chi- square. The percentage of knowledge, behavior of TB patient to the treatment is higher on interventional primary health care than noninterventional ones. Treatment awareness based on concordance principle is expected to planish DOTS-based TB programs.

  19. Where Do Self-Concordant Goals Come From? The Role of Domain-Specific Psychological Need Satisfaction.

    Science.gov (United States)

    Milyavskaya, Marina; Nadolny, Daniel; Koestner, Richard

    2014-06-01

    Previous research has shown that self-concordant goals are more likely to be attained. But what leads someone to adopt a self-concordant goal in the first place? The present research addresses this question by looking at the domains in which goals are set, focusing on the amount of psychological need satisfaction experienced in these domains. Across three experimental studies, we demonstrate that domain-related need satisfaction predicts the extent to which people adopt self-concordant goals in a given domain, laying the foundation for successful goal pursuit. In addition, we show that need satisfaction influences goal self-concordance because in need-satisfying domains people are both more likely to choose the most self-concordant goal (among a set of comparable choices), and are more likely to internalize the possible goals. The implications of this research for goal setting and pursuit as well as for the importance of examining goals within their broader motivational framework are discussed. © 2014 by the Society for Personality and Social Psychology, Inc.

  20. Core self-evaluations and job and life satisfaction: the role of self-concordance and goal attainment.

    Science.gov (United States)

    Judge, Timothy A; Bono, Joyce E; Erez, Amir; Locke, Edwin A

    2005-03-01

    The present study tested a model explaining how the core self-evaluations (i.e., positive self-regard) concept is linked to job and life satisfaction. The self-concordance model, which focuses on motives underlying goal pursuit, was used as an explanatory framework. Data were collected from 2 samples: (a) 183 university students (longitudinal measures of goal attainment and life satisfaction were used) and (b) 251 employees (longitudinal measures of goal attainment and job satisfaction were utilized). In both studies, the core self-evaluations concept was positively related to goal self-concordance, meaning that individuals with positive self-regard were more likely to pursue goals for intrinsic and identified (value-congruent) reasons. Furthermore, in both studies, goal self-concordance was related to satisfaction (job satisfaction in Study 1 and life satisfaction in Study 2).

  1. Lesion concordance, image quality and artefacts in PET/CT. Results of a multicenter study

    International Nuclear Information System (INIS)

    Stergar, H.; Bockisch, A.; Krause, B.J.; Eschmann, S.M.; Juergens, K.U.; Kuehl, H.; Pfannenberg, A.C.; Stollfuss, J.; Weckesser, M.

    2010-01-01

    This study had three major objectives: (1.) to record the number of concordant (both in PET and CT) pathological lesions in different body regions/organs, (2.) to evaluate the image quality and (3.) to determine both, the quantity and the quality of artefacts in whole body FDG PET/CT scans. Routine whole body scans of 353 patients referred to FDG-PET/CT exams at 4 university hospitals were employed. All potentially malignant lesions in 13 different body regions/organs were classified as either concordant or suspicious in FDG-PET or CT only. In the latter case the diagnostic relevance of this disparity was judged. The image quality in PET and CT was rated as a whole and separately in 5 different body regions. Furthermore we investigated the frequency and site of artefacts caused by metal implants and oral or intravenous contrast media as well as the subjective co-registration quality (in 4 body regions) and the diagnostic impact of such artefacts or misalignment. In addition, the readers rated the diagnostic gain of adding the information from the other tomographic method. In total 1941 lesions (5.5 per patient) were identified, 1094 (56%) out of which were concordant. 602 (71%) out of the 847 remaining lesions were detected only with CT, 245 (29%) were only PET-positive. As expected, CT particularly depicted the majority of lesions in the lungs and abdominal organs. However, the diagnostic relevance was greater with PET-only positive lesions. Most of the PET/CT scans were performed with full diagnostic CT including administration of oral and intravenous contast media (> 80%). The image quality in PET and CT was rated excellent. Artefacts occurred in more than 60% of the scans and were mainly due to (dental) metal implants and contrast agent. Nevertheless there was almost no impact on diagnostic confidence if reading of the non attenuation corrected PET was included. The co-registration quality in general was also rated as excellent. Misalignment mostly occurred due

  2. An astronomical age for the Bishop Tuff and concordance with radioisotopic dates

    DEFF Research Database (Denmark)

    Rivera, Tiffany; Zeeden, Christian; Storey, Michael

    2014-01-01

    The Bishop Tuff forms a key stratigraphic horizon for synchronization of Quaternary sedimentary records in North America. The unit stratigraphically overlies the Matuyama-Brunhes geomagnetic polarity reversal by several thousand years; high-precision dating of this tuff may be valuable for regional...... and global correlation of records. The Quaternary time scale is anchored by 40Ar/39Ar ages on lava flows and ash layers where available, with stage boundaries and geomagnetic reversals including astronomically tuned records. However, astronomical dating has not yet validated the high-precision 238U/206Pb...... ages, including new single crystal 40Ar/39Ar sanidine fusion analyses presented here, which demonstrates that concordance through multiple dating techniques is achievable within the Quaternary...

  3. Power Estimation for Gene-Longevity Association Analysis Using Concordant Twins

    DEFF Research Database (Denmark)

    Tan, Qihua; Zhao, Jing Hua; Kruse, Torben A

    2014-01-01

    Statistical power is one of the major concerns in genetic association studies. Related individuals such as twins are valuable samples for genetic studies because of their genetic relatedness. Phenotype similarity in twin pairs provides evidence of genetic control over the phenotype variation...... in a population. The genetic association study on human longevity, a complex trait that is under control of both genetic and environmental factors, has been confronted by the small sample sizes of longevity subjects which limit statistical power. Twin pairs concordant for longevity have increased probability...... an approximate of 2- to 3-fold increase in sample sizes needed for longevity cutoff at age 90 as compared with that at age 95. Overall, our results showed high value of twins in genetic association studies on human longevity....

  4. Concordance of self-report and measured height and weight of college students.

    Science.gov (United States)

    Quick, Virginia; Byrd-Bredbenner, Carol; Shoff, Suzanne; White, Adrienne A; Lohse, Barbara; Horacek, Tanya; Kattelmann, Kendra; Phillips, Beatrice; Hoerr, Sharon L; Greene, Geoffrey

    2015-01-01

    This study examined associations between college students' self-report and measured height and weight. Participants (N = 1,686) were 77% white, 62% female, aged 18-24 years (mean ± SD, 19.1 ± 1.1 years), and enrolled at 8 US universities. Body mass index (BMI) was calculated for self-report (via online survey); trained researchers measured height and weight and categorized them as normal (18.5 to obese (30 to obese (≥ 35). Concordance of self-report vs objectively measured BMI groups using chi-square revealed that 93% were accurate, 4% were underestimated, and 2.7% were overestimated. Pearson correlations and adjusted linear regression revealed significant associations between self-report and measured BMI (r = .97; P students. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  5. On the heritability of psoriatic arthritis. Disease concordance among monozygotic and dizygotic twins

    DEFF Research Database (Denmark)

    Pedersen, Ole Birger; Svendsen, Anders Jørgen; Ejstrup, Leif

    2008-01-01

    OBJECTIVE: In a nationwide unselected twin population to estimate the relative importance of genetic and environmental effectors in the etiopathogenesis of psoriatic arthritis (PsA). METHODS: The study comprised three Danish nationwide twin cohorts. In 1994 and 2002 a total of 37,388 and 46......,418 Danish twin individuals respectively were asked by questionnaire if they had PsA. Twins reporting PsA were invited to participate in a clinical examination. Patients were classified according to the Moll and Wright (M&W) and the CASPAR criteria. Heritability was estimated by probandwise concordance rates...... and variance component analysis. RESULTS: 228 twin individuals reported PsA. Following diagnostic validation in 184 (81%), 50 probands were diagnosed with PsA according to the M&W criteria. Five of their co-twins were either dead, had emigrated, or did not participate in the twin study and nine did not respond...

  6. Cosmic microwave background and supernova constraints on quintessence: Concordance regions and target models

    International Nuclear Information System (INIS)

    Caldwell, Robert R.; Doran, Michael

    2004-01-01

    We perform a detailed comparison of the Wilkinson Microwave Anisotropy Probe measurements of the cosmic microwave background (CMB) temperature and polarization anisotropy with the predictions of quintessence cosmological models of dark energy. We consider a wide range of quintessence models, including a constant equation of state, a simply parametrized, time-evolving equation of state, a class of models of early quintessence, and scalar fields with an inverse-power law potential. We also provide a joint fit to the Cosmic Background Imager (CBI) and Arcminute Cosmology Bolometer Array Receiver (ACBAR) CMB data, and the type 1a supernovae. Using these select constraints we identify viable, target models which should prove useful for numerical studies of large scale structure formation, and to rapidly estimate the impact to the concordance region when new or improved observations become available

  7. Concordance Rates of Adolescent Idiopathic Scoliosis in a Danish Twin Population

    DEFF Research Database (Denmark)

    Simony, Ane; Carreon, Leah Y; Højmark, Karen

    2016-01-01

    STUDY DESIGN: Clinical, radiological and genetic determination of zygosity of twin pairs from the Danish Twin Registry who self-reported having Adolescent Idiopathic Scoliosis (AIS). OBJECTIVE: To establish concordance rates of AIS. SUMMARY OF BACKGROUND DATA: The aetiology of and the true mode...... reported. METHODS: All 46,418 twins registered in the Danish Twin Registry born from 1931 to 1982 were sent a survey, which included questions about scoliosis. The survey was returned by 34,944 individuals (75.3%) representing 23,204 pairs. From this study, 548 individuals representing 274 complete twin...... pairs where at least one twin self-reported having scoliosis were invited to a clinical and radiological examination. Zygosity was established by genetic testing. RESULTS: 182 individuals (33.2%) of the original cohort agreed to participate, 128 of whom had scoliosis by self-report. There were 91 twin...

  8. Filtration of the classical knot concordance group and Casson-Gordon invariants

    Science.gov (United States)

    Kim, Taehee

    2004-09-01

    It is known that if every prime power branched cyclic cover of a knot in S(3) is a homology sphere, then the knot has vanishing Casson-Gordon invariants. We construct infinitely many examples of (topologically) non-slice knots in S(3) whose prime power branched cyclic covers are homology spheres. We show that these knots generate an infinite rank subgroup of scrf_{(1.0)}/scrf_{(1.5)} for which Casson-Gordon invariants vanish in Cochran-Orr-Teichner's filtration of the classical knot concordance group. As a corollary, it follows that Casson-Gordon invariants are not a complete set of obstructions to a second layer of Whitney disks.

  9. The validity and reliability of script concordance test in otolaryngology residency training.

    Science.gov (United States)

    Iravani, Kamyar; Amini, Mitra; Doostkam, Aida; Dehbozorgian, Mahnaz

    2016-04-01

    The script concordance test (SCT) is one the best tools used to evaluate clinical reasoning in ill-defined clinical situations. The aim of this study was to demonstrate SCT application in otolaryngology residency training. A 20 item otolaryngology SCT containing 60 questions was administered to 26 otolaryngology residents. The test was prepared by two otolaryngologists familiar to medical education. These questions have been validated by otolaryngology experts. The panel consisted of 9 academic staff in the field of otolaryngology. Pearson correlation test was used to assess the reliability of the test. The obtained mean scores were 68.4±5.8 (out of 100) for residents and 78.2±6.4(out of 100) for experts. There was a significant difference between the two scores (preliable tool to evaluate clinical reasoning in otolaryngology residents. It should be included in otolaryngology residency training.

  10. Balance Problems

    Science.gov (United States)

    ... often, it could be a sign of a balance problem. Balance problems can make you feel unsteady. You may ... related injuries, such as a hip fracture. Some balance problems are due to problems in the inner ...

  11. Genetic determinants of LDL, lipoprotein(a), triglyceride-rich lipoproteins and HDL: concordance and discordance with cardiovascular disease risk

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Tybjærg-Hansen, Anne

    2011-01-01

    To evaluate whether new and known genetic determinants of plasma levels of LDL cholesterol, lipoprotein(a), triglyceride-rich lipoproteins, and HDL cholesterol associate with the risk of cardiovascular disease expected from the effect on lipoprotein levels. Concordance or discordance of such gene......To evaluate whether new and known genetic determinants of plasma levels of LDL cholesterol, lipoprotein(a), triglyceride-rich lipoproteins, and HDL cholesterol associate with the risk of cardiovascular disease expected from the effect on lipoprotein levels. Concordance or discordance...

  12. Maternal mood and concordant maternal and infant salivary cortisol during heel lance while in kangaroo care.

    Science.gov (United States)

    Castral, T C; Warnock, F; Dos Santos, C B; Daré, M F; Moreira, A C; Antonini, S R R; Scochi, C G S

    2015-03-01

    Maternal kangaroo care (MKC) is a naturalistic intervention that alleviates neonatal pain, and mothers are assumed to play a stress regulatory role in MKC. Yet, no MKC infant pain study has examined relationship between maternal and infant stress reactivity concurrently, or whether post-partum depression and/or anxiety (PPDA) alters maternal and neonatal stress response and the regulatory effects of MKC. To examine the concordance of salivary cortisol reactivity between 42 mothers and their stable preterm infants during routine infant heel lance (HL) while in MKC and to compare salivary cortisol between groups of mothers with and without PPDA and their infants. Maternal and infant salivary cortisol samples were collected pre-HL and 20 min post-HL with two additional maternal samples at night and in the morning. Mothers and infants were allocated to with PPDA versus without PPDA study groups on the basis of maternal post-natal mental health assessment scores. Higher mothers' cortisol pre-HL was weakly associated with higher infants' salivary cortisol in response to the HL procedure. Maternal depression and/or anxiety were not associated with infants' cortisol. During HL, both groups of mothers and infants showed no change in salivary cortisol. Concordance between mother and infant salivary cortisol supports the maternal stress regulatory role in MKC. MKC may have stress regulatory benefits for mothers and their preterm infants during HL independent of PPDA. Future MKC studies that target mothers with altered mood will help to build on these findings. © 2014 European Pain Federation - EFIC®

  13. Improvisation versus guideline concordance in surgical antibiotic prophylaxis: a qualitative study.

    Science.gov (United States)

    Broom, Jennifer; Broom, Alex; Kirby, Emma; Post, Jeffrey J

    2018-05-28

    Surgical antibiotic prophylaxis (SAP) is a common area of antimicrobial misuse. The aim of this study was to explore the social dynamics that influence the use of SAP. 20 surgeons and anaesthetists from a tertiary referral hospital in Australia participated in semi-structured interviews focusing on experiences and perspectives on SAP prescribing. Interview data were analysed using the framework approach. Systematic analysis of the participants' account of the social factors influencing SAP revealed four themes. First, antibiotic prophylaxis is treated as a low priority with the competing demands of the operating theatre environment. Second, whilst guidelines have increased in prominence in recent years, there exists a lack of confidence in their ability to protect the surgeon from responsibility for infectious complications (thus driving SAP over-prescribing). Third, non-concordance prolonged duration of SAP is perceived to be driven by benevolence for the individual patient. Finally, improvisation with novel SAP strategies is reported as ubiquitous, and acknowledged to confer a sense of reassurance to the surgeon despite potential non-concordance with guidelines or clinical efficacy. Surgical-specific concerns have thus far not been meaningfully integrated into antimicrobial stewardship (AMS) programmes, including important dynamics of confidence, trust and mitigating fear of adverse infective events. Surgeons require specific forms of AMS support to enact optimisation, including support for strong collaborative ownership of the surgical risk of infection, and intra-specialty (within surgical specialties) and inter-specialty (between surgery, anaesthetics and infectious diseases) intervention strategies to establish endorsement of and address barriers to guideline implementation.

  14. A community study of language concordance in Russian patients with diabetes.

    Science.gov (United States)

    Mehler, Philip S; Lundgren, Rita A; Pines, Irina; Doll, Katherine

    2004-01-01

    Unique challenges exist in the provision of culturally and linguistically appropriate health care to ethnically diverse populations. The purpose of this study was to improve the metabolic control of Russian patients with diabetes through increased attention to language and cultural concordance between the provider and patient. This is a retrospective cohort study of 55 Russian immigrant type 2 patients with diabetes to assess levels of glycemic, lipid, and blood pressure control before and after the arrival of a bilingual Russian internist trained in both the United States and Russia. Paired t test was used to compare these parameters before and after the bilingual Russian provider joined our practice. Overall, the mean low density lipoprotein (LDL) level decreased by 20% from 126 mg/dL to 102 mg/dL (P=.0002) respectively before and after the Russian provider began treating these patients. Mean hemoglobin A1c decreased from 8.4% to 8.0% (P=.007), and diastolic blood pressure was reduced from 82.7 mm Hg to 76.3 mm Hg (P=.0002). Systolic blood pressure also improved from 143.2 mm Hg to 140.6 mm Hg (P=.3). At the end of the study period more than 90% of the patients with diabetes were appropriately taking lipid-lowering medications and an angiotensin converting enzyme (ACE) inhibitor. Our findings suggest that it is important to facilitate the health care of ethnically diverse minority populations in a manner that attempts to maximize language and cultural concordance. These potential benefits will assume an even greater importance with the expansive growth of ethnic minorities in the United States and their unique healthcare needs.

  15. Spousal concordance and reliability of the 'Prudence Score' as a summary of diet and lifestyle.

    Science.gov (United States)

    Parekh, Sanjoti; King, David; Owen, Neville; Jamrozik, Konrad

    2009-08-01

    This paper describes a composite 'Prudence Score' summarising self-reported behavioural risk factors for non-communicable diseases. If proved robust, the 'Prudence score' might be used widely to encourage large numbers of individuals to adopt and maintain simple, healthy changes in their lifestyle. We calculated the 'Prudence Score' based on responses collected in late 2006 to a postal questionnaire sent to 225 adult patients aged 25 to 75 years identified from the records of two general medical practices in Brisbane, Australia. Participants completed the behavioural, dietary and lifestyle items in relation to their spouse as well as themselves. The spouse or partner of each addressee completed their own copy of the study questionnaire. Kappa scores for spousal concordance with probands' reports (n = 45 pairs) on diet-related items varied between 0.35 (for vegetable intake) to 0.77 (for usual type of milk consumed). Spousal concordance values for other behaviours were 0.67 (physical activity), 0.82 (alcohol intake) and 1.0 (smoking habits). Kappa scores for test-retest reliability (n = 53) varied between 0.47 (vegetable intake) and 0.98 (smoking habits). The veracity of self-reported data is a challenge for studies of behavioural change. Our results indicate moderate to substantial agreement from life partners regarding individuals' self-reports for most of the behavioural risk items included in the 'Prudence Score'. This increases confidence that key aspects of diet and lifestyle can be assessed by self-report. The 'Prudence Score' potentially has wide application as a simple and robust tool for health promotion programs.

  16. Concordance of self-reported and medical chart information on cancer diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Shu Xiao Ou

    2011-05-01

    Full Text Available Abstract Background Self-reported information is an important tool for collecting clinical information for epidemiologic studies and in clinical settings where electronic medical records are not employed and shared. Methods Using data collected from the Shanghai Breast Cancer Survival Study (SBCSS, a population-based, prospective cohort study of 5,042 women diagnosed with breast cancer in Shanghai, China, we compared the concordance of patient questionnaire responses to a survey administered approximately 6 months after cancer diagnosis with medical chart information obtained from the diagnostic hospitals for several disease and treatment-related variables. Results Of 5,042 SBCSS participants, medical chart information was available for 4,948 women (98.1%. Concordance between patient self-reported and medical chart information was high for the majority of disease-related variables, including: diagnosing hospital (agreement: 98.7%, kappa: 0.99, type of surgery conducted (94.0%, 0.53, ER/PR status (94.5%, 0.91, and tumor position (98.2%, 0.97, as well as for important calendar dates, such as date of diagnosis, surgery, and first chemotherapy treatment. The 10 most commonly used chemotherapeutic drugs were all reported with agreement rates of at least 82%, with associated kappa values that ranged from 0.41 for calcium folinate to 0.76 for vinorelbine. Conclusions Our study found high validity for patient self-reported information for a variety of disease and treatment-related variables, suggesting the utility of self-reports as an important source of clinical information for both epidemiological research and patient care.

  17. Merger of Multiple Accreting Black Holes Concordant with Gravitational-wave Events

    Science.gov (United States)

    Tagawa, Hiromichi; Umemura, Masayuki

    2018-03-01

    Recently, the advanced Laser Interferometer Gravitational-Wave Observatory (aLIGO) has detected black hole (BH) merger events, most of which are sourced by BHs more massive than 30 M ⊙. Especially, the observation of GW170104 suggests dynamically assembled binaries favoring a distribution of misaligned spins. It has been argued that mergers of unassociated BHs can be engendered through a chance meeting in a multiple BH system under gas-rich environments. In this paper, we consider the merger of unassociated BHs, concordant with the massive BH merger events. To that end, we simulate a multiple BH system with a post-Newtonian N-body code incorporating gas accretion and general relativistic effects. As a result, we find that gas dynamical friction effectively promotes a three-body interaction of BHs in dense gas of n gas ≳ 106 cm‑3, so that BH mergers can take place within 30 Myr. This scenario predicts an isotropic distribution of spin tilts. In the concordant models with GW150914, the masses of seed BHs are required to be ≳25 M ⊙. The potential sites of such chance meeting BH mergers are active galactic nucleus (AGN) disks and dense interstellar clouds. Assuming the LIGO O1, we roughly estimate the event rates for PopI BHs and PopIII BHs in AGN disks to be ≃1–2 yr‑1 and ≃1 yr‑1, respectively. Multiple episodes of AGNs may enhance the rates by roughly an order of magnitude. For massive PopI BHs in dense interstellar clouds the rate is ≃0.02 yr‑1. Hence, high-density AGN disks are a more plausible site for mergers of chance meeting BHs.

  18. Concordance in the Health Behaviors of Couples by Age: A Cross-sectional Study

    Directory of Open Access Journals (Sweden)

    Seungmin Jeong

    2018-01-01

    Full Text Available Objectives To investigate concordance in the health behaviors of women and their partners according to age and to investigate whether there was a stronger correlation between the health behaviors of housewives and those of their partners than between the health behaviors of non-housewives and those of their partners. Methods We used data obtained from women participants in the 2015 Korea Community Health Survey who were living with their partners. The outcome variables were 4 health behaviors: smoking, drinking, eating salty food, and physical activity. The main independent variables were the partners’ corresponding health behaviors. We categorized age into 4 groups (19-29, 30-49, 50-64, and ≥ 65 years and utilized multivariate logistic regression analysis, stratifying by age group. Another logistic regression analysis was stratified by whether the participant identified as a housewife. Results Data from 64 971 women older than 18 years of age were analyzed. Of the 4 health behaviors, the risk of smoking (adjusted odds ratio [aOR], 4.65; 95% confidence interval [CI], 3.93 to 5.49 was highest when the participant’s partner was also a smoker. Similar results were found for an inactive lifestyle (aOR, 2.56; 95% CI, 2.45 to 2.66, eating salty food (aOR, 2.48; 95% CI, 2.36 to 2.62; and excessive drinking (aOR, 1.89; 95% CI, 1.80 to 1.98. In comparison to non-housewives, housewives had higher odds of eating salty food. Conclusions The health behaviors of women were positively correlated with those of their partners. The magnitude of the concordance differed by age group.

  19. A SNP panel and online tool for checking genotype concordance through comparing QR codes.

    Directory of Open Access Journals (Sweden)

    Yonghong Du

    Full Text Available In the current precision medicine era, more and more samples get genotyped and sequenced. Both researchers and commercial companies expend significant time and resources to reduce the error rate. However, it has been reported that there is a sample mix-up rate of between 0.1% and 1%, not to mention the possibly higher mix-up rate during the down-stream genetic reporting processes. Even on the low end of this estimate, this translates to a significant number of mislabeled samples, especially over the projected one billion people that will be sequenced within the next decade. Here, we first describe a method to identify a small set of Single nucleotide polymorphisms (SNPs that can uniquely identify a personal genome, which utilizes allele frequencies of five major continental populations reported in the 1000 genomes project and the ExAC Consortium. To make this panel more informative, we added four SNPs that are commonly used to predict ABO blood type, and another two SNPs that are capable of predicting sex. We then implement a web interface (http://qrcme.tech, nicknamed QRC (for QR code based Concordance check, which is capable of extracting the relevant ID SNPs from a raw genetic data, coding its genotype as a quick response (QR code, and comparing QR codes to report the concordance of underlying genetic datasets. The resulting 80 fingerprinting SNPs represent a significant decrease in complexity and the number of markers used for genetic data labelling and tracking. Our method and web tool is easily accessible to both researchers and the general public who consider the accuracy of complex genetic data as a prerequisite towards precision medicine.

  20. A SNP panel and online tool for checking genotype concordance through comparing QR codes.

    Science.gov (United States)

    Du, Yonghong; Martin, Joshua S; McGee, John; Yang, Yuchen; Liu, Eric Yi; Sun, Yingrui; Geihs, Matthias; Kong, Xuejun; Zhou, Eric Lingfeng; Li, Yun; Huang, Jie

    2017-01-01

    In the current precision medicine era, more and more samples get genotyped and sequenced. Both researchers and commercial companies expend significant time and resources to reduce the error rate. However, it has been reported that there is a sample mix-up rate of between 0.1% and 1%, not to mention the possibly higher mix-up rate during the down-stream genetic reporting processes. Even on the low end of this estimate, this translates to a significant number of mislabeled samples, especially over the projected one billion people that will be sequenced within the next decade. Here, we first describe a method to identify a small set of Single nucleotide polymorphisms (SNPs) that can uniquely identify a personal genome, which utilizes allele frequencies of five major continental populations reported in the 1000 genomes project and the ExAC Consortium. To make this panel more informative, we added four SNPs that are commonly used to predict ABO blood type, and another two SNPs that are capable of predicting sex. We then implement a web interface (http://qrcme.tech), nicknamed QRC (for QR code based Concordance check), which is capable of extracting the relevant ID SNPs from a raw genetic data, coding its genotype as a quick response (QR) code, and comparing QR codes to report the concordance of underlying genetic datasets. The resulting 80 fingerprinting SNPs represent a significant decrease in complexity and the number of markers used for genetic data labelling and tracking. Our method and web tool is easily accessible to both researchers and the general public who consider the accuracy of complex genetic data as a prerequisite towards precision medicine.

  1. The Relationship Between Ants and Lycaeides melissa samuelis (Lepidoptera: Lycaenidae) at Concord Pine Barrens, NH, USA.

    Science.gov (United States)

    Pascale, Elizabeth G; Thiet, Rachel K

    2016-04-22

    The Karner blue butterfly (Lycaeides melissa samuelis Nabokov) (Lepidoptera: Lycaenidae) is a federally listed, endangered species that has experienced dramatic decline over its historic range. In surviving populations, Karner blue butterflies have a facultative mutualism with ants that could be critically important to their survival where their populations are threatened by habitat loss or disturbance. In this study, we investigated the effects of ants, wild blue lupine population status (native or restored), and fire on adult Karner blue butterfly abundance at the Concord Pine Barrens, NH, USA. Ant frequency (the number of times we collected each ant species in our pitfall traps) was higher in restored than native lupine treatments regardless of burn status during both Karner blue butterfly broods, and the trend was statistically significant during the second brood. We observed a positive relationship between adult Karner blue butterfly abundance and ant frequency during the first brood, particularly on native lupine, regardless of burn treatment. During the second brood, adult Karner blue butterfly abundance and ant frequency were not significantly correlated in any treatments or their combinations. Our findings suggest that a combination of native and restored lupine is important for supporting both Karner blue butterflies and ants at the Concord Pine Barrens, and that burning does not affect the mutualism. Thus, scientists and managers at the site may wish to target their habitat management activities to best support both Karner blue butterflies and the particular ant species that provide the greatest benefit to their survival. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. [Population problem, comprehension problem].

    Science.gov (United States)

    Tallon, F

    1993-08-01

    Overpopulation of developing countries in general, and Rwanda in particular, is not just their problem but a problem for developed countries as well. Rapid population growth is a key factor in the increase of poverty in sub-Saharan Africa. Population growth outstrips food production. Africa receives more and more foreign food, economic, and family planning aid each year. The Government of Rwanda encourages reduced population growth. Some people criticize it, but this criticism results in mortality and suffering. One must combat this ignorance, but attitudes change slowly. Some of these same people find the government's acceptance of family planning an invasion of their privacy. Others complain that rich countries do not have campaigns to reduce births, so why should Rwanda do so? The rate of schooling does not increase in Africa, even though the number of children in school increases, because of rapid population growth. Education is key to improvements in Africa's socioeconomic growth. Thus, Africa, is underpopulated in terms of potentiality but overpopulated in terms of reality, current conditions, and possibilities of overexploitation. Africa needs to invest in human resources. Families need to save, and to so, they must refrain from having many children. Africa should resist the temptation to waste, as rich countries do, and denounce it. Africa needs to become more independent of these countries, but structural adjustment plans, growing debt, and rapid population growth limit national independence. Food aid is a means for developed countries to dominate developing countries. Modernization through foreign aid has had some positive effects on developing countries (e.g., improved hygiene, mortality reduction), but these also sparked rapid population growth. Rwandan society is no longer traditional, but it is also not yet modern. A change in mentality to fewer births, better quality of life for living infants, better education, and less burden for women must occur

  3. Consumers' experiences and values in conventional and alternative medicine paradigms: a problem detection study (PDS

    Directory of Open Access Journals (Sweden)

    Emmerton Lynne

    2012-04-01

    Full Text Available Abstract Background This study explored consumer perceptions of complementary and alternative medicine (CAM and relationships with CAM and conventional medicine practitioners. A problem detection study (PDS was used. The qualitative component to develop the questionnaire used a CAM consumer focus group to explore conventional and CAM paradigms in healthcare. 32 key issues, seven main themes, informed the questionnaire (the quantitative PDS component - 36 statements explored using five-point Likert scales. Results Of 300 questionnaires distributed (Brisbane, Australia, 83 consumers responded. Results indicated that consumers felt empowered by using CAM and they reported positive relationships with CAM practitioners. The perception was that CAM were used most effectively as long-term therapy (63% agreement, but that conventional medicines would be the best choice for emergency treatment (81% agreement. A majority (65% reported that doctors appeared uncomfortable about consumers' visits to CAM practitioners. Most consumers (72% believed that relationships with and between health practitioners could be enhanced by improved communication. It was agreed that information sharing between consumers and healthcare practitioners is important, and reported that "enough" information is shared between CAM practitioners and consumers. Consumers felt comfortable discussing their medicines with pharmacists, general practitioners and CAM practitioners, but felt most comfortable with their CAM practitioners. Conclusions This PDS has emphasized the perceived importance of open communication between consumers, CAM and conventional providers, and has exposed areas where CAM consumers perceive that issues exist across the CAM and conventional medicine paradigms. There is a lot of information which is perceived as not being shared at present and there are issues of discomfort and distrust which require resolution to develop concordant relationships in healthcare

  4. Concordance between a simpler definition of major depressive disorder and Diagnostic and statistical manual of mental disorders, fourth edition: an independent replication in an outpatient sample.

    Science.gov (United States)

    Zimmerman, Mark; Emmert-Aronson, Benjamin O; Brown, Timothy A

    2011-01-01

    The diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) symptom criteria for major depressive disorder (MDD) are somewhat lengthy with several studies showing that clinicians have difficulty recalling all 9 symptoms. Moreover, the criteria include somatic symptoms that are difficult to apply in patients with medical illnesses. To address these problems, a simpler definition of MDD was developed that did not include the somatic symptoms. Previous reports found high levels of agreement between the simplified and full DSM-IV definition of MDD. However, the same research group has conducted all previous studies of psychiatric patients. The goal of the present study was to determine if a high level of concordance between the 2 definitions would be replicated in an independent setting. We interviewed 2907 psychiatric outpatients presenting for treatment at the Boston University Center for Anxiety and Related Disorders. A trained diagnostic rater administered a semistructured interview and inquired about all symptoms of depression for all patients. A high level of agreement was found between the DSM-IV and the simpler definition of MDD. The absolute level of agreement between the 2 definitions was 95.5% and the κ coefficient was 0.88. Thus, consistent with previous studies, a high level of concordance was found between a simpler definition of MDD and the DSM-IV definition. This new definition offers 2 advantages over the current DSM-IV definition-it is briefer, and it is easier to apply with medically ill patients because it is free of somatic symptoms. Implications of these findings for DSM-5 are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Avaliação da concordância da sialometria e cintilografia de glândulas salivares em pacientes com boca seca Evaluation of the concordance of sialometry and salivary glands scintigraphy in dry mouth patients

    Directory of Open Access Journals (Sweden)

    Bianca Maria Liquidato

    2006-02-01

    Full Text Available INTRODUÇÃO: São utilizados vários exames para avaliar os pacientes com queixa de boca seca e, especialmente, os pacientes com Síndrome de Sjögren, em que estes exames fazem parte de critérios de classificação para estudos científicos. OBJETIVO: Desta maneira, procurou-se avaliar se haveria concordância entre os resultados da sialometria e da cintilografia de glândulas salivares para, se esta concordância estiver presente, optar por apenas um dos dois exames. CASUÍSTICA E MÉTODO: Foram avaliados 72 pacientes com boca seca, divididos em grupos não-Síndrome de Sjögren, com Síndrome de Sjögren primária e com Síndrome de Sjögren secundária. Os resultados de sialometria e cintilografia de glândulas salivares foram estudados, procurando-se dimensionar a concordância existente entre eles, através do teste de Kappa. RESULTADOS: Observou-se concordância igual ou próxima de zero entre os dois testes. CONCLUSÃO: Pelos resultados observados, não é possível fazer a opção por um ou outro exame, devendo ambos serem realizados.INTRODUCTION: Many diagnostic tests are used to evaluate dry mouth patients, especially the ones with Sjögren’s Syndrome, to whom these tests are part of classification criteria for scientific studies. AIM: Thus, the concordance between results of sialometry and salivary glands scintigraphy was evaluated; if positive, it would enable the choice of one or the other for diagnosis. PATIENTS AND METHOD: Seventy-two dry mouth patients were divided into non-Sjögren’s Syndrome group, primary Sjögren’s Syndrome group and secondary Sjögren’s Syndrome group. The concordance among sialometry and scintigraphy results was evaluated by Kappa test. RESULTS: It was observed that their concordance was equal or near to zero. CONCLUSION: It is not possible to make a choice between these tests and both should be performed.

  6. Computational complexity a quantitative perspective

    CERN Document Server

    Zimand, Marius

    2004-01-01

    There has been a common perception that computational complexity is a theory of "bad news" because its most typical results assert that various real-world and innocent-looking tasks are infeasible. In fact, "bad news" is a relative term, and, indeed, in some situations (e.g., in cryptography), we want an adversary to not be able to perform a certain task. However, a "bad news" result does not automatically become useful in such a scenario. For this to happen, its hardness features have to be quantitatively evaluated and shown to manifest extensively. The book undertakes a quantitative analysis of some of the major results in complexity that regard either classes of problems or individual concrete problems. The size of some important classes are studied using resource-bounded topological and measure-theoretical tools. In the case of individual problems, the book studies relevant quantitative attributes such as approximation properties or the number of hard inputs at each length. One chapter is dedicated to abs...

  7. Concordance with the New American Plate guidelines of the American Institute for Cancer Research in Guatemalan children

    NARCIS (Netherlands)

    Solomons, N.W.; Montenegro-Bethancourt, G.; Vasquez, C.; Vossenaar, M.; Doak, C.M.

    2009-01-01

    Objective: To determine concordance with the New American Plate guideline that no more than one-third of one's plate be covered with foods of animal origin in Guatemalan schoolchildren. Methods: Dietary intake data collected with a 24-h pictorial diary in a convenience sample of 449 third- and

  8. Availability of Care Concordant With Patient-centered Medical Home Principles Among Those With Chronic Conditions: Measuring Care Outcomes.

    Science.gov (United States)

    Pourat, Nadereh; Charles, Shana A; Snyder, Sophie

    2016-03-01

    Care delivery redesign in the form of patient-centered medical home (PCMH) is considered as a potential solution to improve patient outcomes and reduce costs, particularly for patients with chronic conditions. But studies of prevalence or impact at the population level are rare. We aimed to assess whether desired outcomes indicating better care delivery and patient-centeredness were associated with receipt of care according to 3 important PCMH principles. We analyzed data from a representative population survey in California in 2009, focusing on a population with chronic condition who had a usual source of care. We used bivariate, logistic, and negative-binomial regressions. The indicators of PCMH concordant care included continuity of care (personal doctor), care coordination, and care management (individual treatment plan). Outcomes included flu shots, count of outpatient visits, any emergency department visit, timely provider communication, and confidence in self-care. We found that patients whose care was concordant with all 3 PCMH principles were more likely to receive flu shots, more outpatient care, and timely response from providers. Concordance with 2 principles led to some desired outcomes. Concordance with only 1 principle was not associated with desired outcomes. Patients who received care that met 3 key aspects of PCMH: coordination, continuity, and management, had better quality of care and more efficient use of the health care system.

  9. Concordance between VDU-users' ratings of comfort and perceived exertion with experts' observations of workplace layout and working postures.

    Science.gov (United States)

    Lindegård, A; Karlberg, C; Wigaeus Tornqvist, E; Toomingas, A; Hagberg, M

    2005-05-01

    The aim of the present study was to evaluate the concordance (agreement) between VDU-users' ratings of comfort and ergonomists' observations of workplace layout, and the concordance between VDU-users' ratings of perceived exertion and ergonomists' observations of working postures during VDU-work. The study population consisted of 853 symptom free subjects. Data on perceived comfort in different dimensions and data regarding perceived exertion in different body locations were collected by means of a questionnaire. Data concerning workplace layout and working postures were collected with an observation protocol, by an ergonomist. Concordance between ratings of comfort and observations of workplace layout was reasonably good for the chair and the keyboard (0.60, 0.58) and good regarding the screen and the input device (0.72, 0.61). Concordance between ratings of perceived exertion and observations of working postures indicated good agreement (0.63-0.77) for all measured body locations (neck, shoulder, wrist and trunk). In conclusion ratings of comfort and perceived exertion could be used as cost-efficient and user-friendly methods for practitioners to identify high exposure to poor workplace layout and poor working postures.

  10. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients : A cohort study

    NARCIS (Netherlands)

    Romaguera, Dora; Ward, Heather; Wark, Petra A.; Vergnaud, Anne Claire; Peeters, Petra H.; van Gils, Carla H.; Ferrari, Pietro; Fedirko, Veronika; Jenab, Mazda; Boutron-Ruault, Marie Christine; Dossus, Laure; Dartois, Laureen; Hansen, Camilla Plambeck; Dahm, Christina Catherine; Buckland, Genevieve; Sánchez, María José; Dorronsoro, Miren; Navarro, Carmen; Barricarte, Aurelio; Key, Timothy J.; Trichopoulou, Antonia; Tsironis, Christos; Lagiou, Pagona; Masala, Giovanna; Pala, Valeria; Tumino, Rosario; Vineis, Paolo; Panico, Salvatore; Bueno-de-Mesquita, H. Bas; Siersema, PD; Ohlsson, Bodil; Jirström, Karin; Wennberg, Maria; Nilsson, Lena M.; Weiderpass, Elisabete; Kühn, Tilman; Katzke, Verena; Khaw, Kay Tee; Wareham, Nick J.; Tjønneland, Anne; Boeing, Heiner; Quirós, José R.; Gunter, Marc J.; Riboli, Elio; Norat, Teresa

    2015-01-01

    Background: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance

  11. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study

    NARCIS (Netherlands)

    Romaguera, D.; Ward, H.; Wark, P.A.; Vergnaud, A.C.; Peeters, P.H.M.; Gils, C.H. van; Ferrari, P.; Fedirko, V.; Jenab, M.; Boutron-Ruault, M.C.; Dossus, L.; Dartois, L.; Hansen, C.P.; Dahm, C.C.; Buckland, G.; Sanchez, M.J.; Dorronsoro, M.; Navarro, C; Barricarte, A.; Key, T.J.; Trichopoulou, A.; Tsironis, C.; Lagiou, P.; Masala, G.; Pala, V.; Tumino, R.; Vineis, P.; Panico, S.; Bueno-de-Mesquita, H.B.; Siersema, P.D.; Ohlsson, B.; Jirstrom, K.; Wennberg, M.; Nilsson, L.M.; Weiderpass, E.; Kuhn, T.; Katzke, V.; Khaw, K.T.; Wareham, N.J.; Tjonneland, A.; Boeing, H.; Quiros, J.R.; Gunter, M.J.; Riboli, E.; Norat, T.

    2015-01-01

    BACKGROUND: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance

  12. Public health surveillance of cancer survival in the United States and worldwide: The contribution of the CONCORD programme.

    Science.gov (United States)

    Allemani, Claudia; Coleman, Michel P

    2017-12-15

    CONCORD is a programme for the global surveillance of cancer survival. In 2015, the second cycle of the program (CONCORD-2) established long-term surveillance of cancer survival worldwide, for the first time, in the largest cancer survival study published to date. CONCORD-2 provided cancer survival trends for 25,676,887 patients diagnosed during the 15-year period between 1995 and 2009 with 1 of 10 common cancers that collectively represented 63% of the global cancer burden in 2009. Herein, the authors summarize the past, describe the present, and outline the future of the CONCORD programme. They discuss the difference between population-based studies and clinical trials, and review the importance of international comparisons of population-based cancer survival. This study will focus on the United States. The authors explain why population-based survival estimates are crucial for driving effective cancer control strategies to reduce the wide and persistent disparities in cancer survival between white and black patients, which are likely to be attributable to differences in access to early diagnosis and optimal treatment. Cancer 2017;123:4977-81. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  13. Emotion dysregulation and dyadic conflict in depressed and typical adolescents: Evaluating concordance across psychophysiological and observational measures

    Science.gov (United States)

    Crowell, Sheila E.; Baucom, Brian R.; Yaptangco, Mona; Bride, Daniel; Hsiao, Ray; McCauley, Elizabeth; Beauchaine, Theodore P.

    2014-01-01

    Many depressed adolescents experience difficulty regulating their emotions. These emotion regulation difficulties appear to emerge in part from socialization processes within families and then generalize to other contexts. However, emotion dysregulation is typically assessed within the individual, rather than in the social relationships that shape and maintain dysregulation. In this study, we evaluated concordance of physiological and observational measures of emotion dysregulation during interpersonal conflict, using a multilevel actor-partner interdependence model (APIM). Participants were 75 mother-daughter dyads, including 50 depressed adolescents with or without a history of self-injury, and 25 typically developing controls. Behavior dysregulation was operationalized as observed aversiveness during a conflict discussion, and physiological dysregulation was indexed by respiratory sinus arrhythmia (RSA). Results revealed different patterns of concordance for control versus depressed participants. Controls evidenced a concordant partner (between-person) effect, and showed increased physiological regulation during minutes when their partner was more aversive. In contrast, clinical dyad members displayed a concordant actor (within-person) effect, becoming simultaneously physiologically and behaviorally dysregulated. Results inform current understanding of emotion dysregulation across multiple levels of analysis. PMID:24607894

  14. Effects of concord grape juice on appetite, diet, body weight, lipid profile, and antioxidant status of adults

    Science.gov (United States)

    Concord grape juice (CGJ) is a rich source of phenolic antioxidants with a range of putative health benefits. However, high beverage energy and fructose intake may lead to weight gain and insulin resistance, respectively. This study assessed the effects of CGJ consumption for 12-wk on appetite, di...

  15. Emotion dysregulation and dyadic conflict in depressed and typical adolescents: evaluating concordance across psychophysiological and observational measures.

    Science.gov (United States)

    Crowell, Sheila E; Baucom, Brian R; Yaptangco, Mona; Bride, Daniel; Hsiao, Ray; McCauley, Elizabeth; Beauchaine, Theodore P

    2014-04-01

    Many depressed adolescents experience difficulty in regulating their emotions. These emotion regulation difficulties appear to emerge in part from socialization processes within families and then generalize to other contexts. However, emotion dysregulation is typically assessed within the individual, rather than in the social relationships that shape and maintain dysregulation. In this study, we evaluated concordance of physiological and observational measures of emotion dysregulation during interpersonal conflict, using a multilevel actor-partner interdependence model (APIM). Participants were 75 mother-daughter dyads, including 50 depressed adolescents with or without a history of self-injury, and 25 typically developing controls. Behavior dysregulation was operationalized as observed aversiveness during a conflict discussion, and physiological dysregulation was indexed by respiratory sinus arrhythmia (RSA). Results revealed different patterns of concordance for control versus depressed participants. Controls evidenced a concordant partner (between-person) effect, and showed increased physiological regulation during minutes when their partner was more aversive. In contrast, clinical dyad members displayed a concordant actor (within-person) effect, becoming simultaneously physiologically and behaviorally dysregulated. Results inform current understanding of emotion dysregulation across multiple levels of analysis. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Concordance between nurse-reported quality of care and quality of care as publicly reported by nurse-sensitive indicators

    NARCIS (Netherlands)

    D. Stalpers (Dewi); R.A.M.M. Kieft (Renate A. M. M.); D. van der Linden (Dimitri); M.J. Kaljouw (Marian J.); M.J. Schuurmans (Marieke )

    2016-01-01

    textabstractBackground: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between

  17. Concordance between nurse-reported quality of care and quality of care as publicly reported by nurse-sensitive indicators

    NARCIS (Netherlands)

    Stalpers, Dewi; Kieft, Renate A M M; Van Der Linden, Dimitri; Kaljouw, Marian J.; Schuurmans, Marieke J.

    2016-01-01

    Background: Nurse-sensitive indicators and nurses' satisfaction with the quality of care are two commonly used ways to measure quality of nursing care. However, little is known about the relationship between these kinds of measures. This study aimed to examine concordance between nurse-sensitive

  18. National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses with Clinical Reassessments

    Science.gov (United States)

    Kessler, Ronald C.; Avenevoli, Shelli; Green, Jennifer; Gruber, Michael J.; Guyer, Margaret; He, Yulei; Jin, Robert; Kaufman, Joan; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen R.

    2009-01-01

    The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnoses that was based on the World Health Organization's Composite International Diagnostic Interview (CIDI) and implemented in the National comorbidity survey replication adolescent supplement is found to have good individual-level concordance with diagnosis based on blinded…

  19. An Explication of Concordance between Man's Mental Structure and the Narrative Structure in the Light of Vygotsky's SCT

    Science.gov (United States)

    Azabdaftari, Behrooz

    2013-01-01

    This paper seeks to throw light on the concordance between man's mental structure and the structure of narrative with regard to Vygotsky's sociocultural theory. In so doing, the author first provides the backdrop of the literature on the topic by first explaining Vygotsky's approach to the genesis of mind, and then gives a synoptic account of the…

  20. A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder

    Science.gov (United States)

    Mazurek, Micah O.; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M.; Hundley, Rachel J.; Poulsen, Marie; Kanne, Stephen M.; Macklin, Eric A.; Handen, Benjamin L.

    2017-01-01

    The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children…

  1. The CpG island methylator phenotype is concordant between primary colorectal carcinoma and matched distant metastases.

    Science.gov (United States)

    Cohen, Stacey A; Yu, Ming; Baker, Kelsey; Redman, Mary; Wu, Chen; Heinzerling, Tai J; Wirtz, Ralph M; Charalambous, Elpida; Pentheroudakis, George; Kotoula, Vassiliki; Kalogeras, Konstantine T; Fountzilas, George; Grady, William M

    2017-01-01

    The CpG island methylator phenotype (CIMP) in stage III colon cancer (CRC) has been associated with improved survival after treatment with adjuvant irinotecan-based chemotherapy. In this analysis, we determine whether CIMP status in the primary CRC is concordant with the CIMP status of matched metastases in order to determine if assessment of CIMP status in the primary tumor can be used to predict CIMP status of metastatic disease, which is relevant for patient management as well as for understanding the biology of CIMP CRCs. We assessed the CIMP status of 70 pairs of primary CRC and matched metastases using a CRC-specific panel of five markers ( CACNA1G , IGF2 , NEUROG1 , RUNX3 , and SOCS1 ) where CIMP positive was defined as 3/5 positive markers at a percent methylated reference threshold of ≥10%. Concordance was compared using the Fisher's exact test and P  CIMP status in the primary tumor and matched metastasis; five (7.0%) of the pairs were concordantly CIMP positive. Only one pair (1.4%) had divergent CIMP status, demonstrating CIMP positivity (4/5 markers positive) in the primary tumor, while the matched metastasis was CIMP negative (0 markers positive). CIMP status is generally concordant between primary CRCs and matched metastases. Thus, CIMP status in the primary tumor is maintained in matched metastases and can be used to inform CIMP-based therapy options for the metastases.

  2. Genetic determinants of LDL, lipoprotein(a), triglyceride-rich lipoproteins and HDL: concordance and discordance with cardiovascular disease risk

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Tybjærg-Hansen, Anne

    2011-01-01

    To evaluate whether new and known genetic determinants of plasma levels of LDL cholesterol, lipoprotein(a), triglyceride-rich lipoproteins, and HDL cholesterol associate with the risk of cardiovascular disease expected from the effect on lipoprotein levels. Concordance or discordance...... of such genetic determinants with cardiovascular disease risk will either favor or disfavor that these lipoproteins are causally related to cardiovascular disease....

  3. Concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation.

    Science.gov (United States)

    Li, John; Weissberg, Zoe; Bevilacqua, Thomas A; Yu, Gordon; Weber, Kristy; Sebro, Ronnie

    2018-04-01

    To compare the concordance between fine-needle aspiration and core biopsies for osseous lesions by lesion imaging appearance and CT attenuation. Retrospective review of 215 FNAs of osseous lesions performed in conjunction with core biopsy at our institution over a 6-year period (2011-2016). FNAs were interpreted independently of core biopsies. We assessed if FNA in conjunction with core biopsy increased diagnostic accuracy compared to core biopsy alone. We also calculated the concordance between FNA and core biopsy by lesion appearance, lesion CT attenuation, lesion histology, lesion location and FNA needle gauge size. Core biopsy alone provided the diagnosis in 207/215 cases (96.3%), however, the FNA provided the diagnosis in the remaining 8/215 cases (3.7%) where the core biopsy was non-diagnostic. There were 154 (71.6%) lytic lesions, 21 (9.8%) blastic lesions, 25 (11.6%) mixed lytic and blastic lesions and 15 (7.0%) lesions that were neither lytic nor blastic. The concordance between FNA and core biopsy for lytic osseous lesions (136/154 cases, 88.3%) was statistically significantly higher than that for blastic osseous lesions (13/21 cases, 61.9%) [P = 4.2 × 10 -3 ; 95% CI (0.02, 0.50)]. The concordance between FNA and core biopsy was higher for low-attenuation- (110/126) than high-attenuation (58/77) lesions (P = 0.028). The concordance between FNA and core biopsy was also higher for metastases (102/119 cases, 85.7%) than non-metastases (78/96, 81.3%) [P = 0.487; 95% CI (- 0.15, 0.065)]. There was no difference in the rate of concordance between FNA and core biopsy by lesion location or FNA needle gauge size (P > 0.05). FNA with core biopsy increases diagnostic rate compared to core biopsy alone or FNA alone. The concordance between FNA and core biopsy is higher for lytic lesions than for blastic lesions; and higher for low-attenuation lesions than for high-attenuation lesions.

  4. Concordance Between Different Amyloid Immunoassays and Visual Amyloid Positron Emission Tomographic Assessment.

    Science.gov (United States)

    Janelidze, Shorena; Pannee, Josef; Mikulskis, Alvydas; Chiao, Ping; Zetterberg, Henrik; Blennow, Kaj; Hansson, Oskar

    2017-12-01

    Visual assessment of amyloid positron emission tomographic (PET) images has been approved by regulatory authorities for clinical use. Several immunoassays have been developed to measure β-amyloid (Aβ) 42 in cerebrospinal fluid (CSF). The agreement between CSF Aβ42 measures from different immunoassays and visual PET readings may influence the use of CSF biomarkers and/or amyloid PET assessment in clinical practice and trials. To determine the concordance between CSF Aβ42 levels measured using 5 different immunoassays and visual amyloid PET analysis. The study included 262 patients with mild cognitive impairment or subjective cognitive decline from the Swedish BioFINDER (Biomarkers for Identifying Neurodegenerative Disorders Early and Reliably) cohort (recruited from September 1, 2010, through December 31, 2014) who had undergone flutemetamol F 18 ([18F]flutemetamol)-labeled PET. Levels of CSF Aβ42 were analyzed using the classic INNOTEST and the newer modified INNOTEST, fully automated Lumipulse (FL), EUROIMMUN (EI), and Meso Scale Discovery (MSD) assays. Concentrations of CSF Aβ were assessed using an antibody-independent mass spectrometry-based reference measurement procedure. The concordance of CSF Aβ42 levels and Aβ42:Aβ40 and Aβ42:tau ratios with visual [18F]flutemetamol PET status. Of 262 participants (mean [SD] age, 70.9 [5.5] years), 108 were women (41.2%) and 154 were men (58.8%). The mass spectrometry-derived Aβ42 values showed higher correlations with the modified Aβ42-INNOTEST (r = 0.97), Aβ42-FL (r = 0.93), Aβ42-EI (r = 0.93), and Aβ42-MSD (r = 0.95) assays compared with the classic Aβ42-INNOTEST assay (r = 0.88; P ≤ .01). The signal in the classic Aβ42-INNOTEST assay was partly quenched by recombinant Aβ1-40 peptide. However, the classic Aβ42-INNOTEST assay showed better concordance with visual [18F]flutemetamol PET status (area under the receiver operating characteristic curve [AUC], 0.92) compared with the

  5. Evaluation of concordance among three cardiac output measurement techniques in adult patients during cardiovascular surgery postoperative care.

    Science.gov (United States)

    Muñoz, L; Velandia, A; Reyes, L E; Arevalo-Rodríguez, I; Mejía, C; Asprilla, D; Uribe, D V; Arevalo, J J

    2017-12-01

    The standard method for cardiac output measuring is thermodilution although it is an invasive technique. Transesophageal Echocardiography (TEE) offers a dynamic and functional alternative to thermodilution. Analyze concordance between two TEE methods and thermodilution for cardiac output assessment. Observational concordance study in cardiovascular surgery patients that required pulmonary artery catheter. TEE cardiac output measurement at both mitral annulus (MA) and left ventricle outflow tract (LVOT) were performed. Results were compared with thermodilution. Correlation was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. Statistical analysis was undertaken in STATA 13.0. Twenty-five patients were enrolled. Fifty two percent of patients were male, median age and ejection fraction was 63 years and 35% respectively. Median thermodilution, LVOT and MA -measured cardiac output was 3.25 L/min, 3.46 L/min and 8.4 L/min respectively. Different values between thermodilution and MA measurements were found (Lin concordance=0.071; Confidence Interval 95%=-0.009 to 0.151; Spearman's correlation=0.22) as values between thermodilution and LVOT (Lin concordance=0.232; Confidence Interval 95%=-0.12 a 0.537; Spearman's correlation 0.28). Bland-Altman analysis showed greater difference between MA measurements and thermodilution (DM=-0.408; Bland-Altman Limits=-0.809 to -0.007), than the other echocardiographic findings (DM=0.007; Bland-Altman Limits=-0.441 to 0.428). Results from cardiac output measurement by doppler and 2D-TEE on both MA and LVOT do not correlate with those obtained by thermodilution. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  6. The three-body problem

    CERN Document Server

    Marchal, Christian

    1990-01-01

    Recent research on the theory of perturbations, the analytical approach and the quantitative analysis of the three-body problem have reached a high degree of perfection. The use of electronics has aided developments in quantitative analysis and has helped to disclose the extreme complexity of the set of solutions. This accelerated progress has given new orientation and impetus to the qualitative analysis that is so complementary to the quantitative analysis. The book begins with the various formulations of the three-body problem, the main classical results and the important questions and conje

  7. Speech Problems

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Speech Problems KidsHealth / For Teens / Speech Problems What's in ... a person's ability to speak clearly. Some Common Speech and Language Disorders Stuttering is a problem that ...

  8. The evaluation of an intervention based on the application of patient self-completion concordance forms in Dutch community pharmacies and the effect on adherence to chronic medication

    NARCIS (Netherlands)

    Geurts, Marlies M. E.; Pot, Johan L. W.; Schepers, Emiel H.; Tromp, Chris; Colijn, Corine G.; Dijkstra, Arie; de Gier, Johan J.

    Objective: To evaluate the use of patient self-completion concordance forms and to determine the effect of patient counselling by using concordance forms on adherence to chronic medication. Methods: Patients with a prescription for new chronic treatment were randomised in an intervention or control

  9. Concordance among remission and admission diagnoses at intensive care unit, Hospital Universitario San José, Popayán, 2011

    Directory of Open Access Journals (Sweden)

    Victor Daniel Montenegro

    2012-03-01

    Full Text Available There are few published studies about diagnostic concordance in hospital services. The objective of this study was to calculate the concordance among remission and admission diagnoses from Hospital Universitario San José adult intensive care unit (I.C.U. of Popayán, 2011. Methods: Descriptive and retrospective study about concordance between the main remission and admission diagnoses from patients admitted in the Hospital adult intensive care unit; 914 patients were studied from the intensive care unit database, months January to December 2011. Statistical analysis about sociodemographic variables was performed, and Kappa index according to Landis and Koch scale among remission and admission diagnoses defined as priority was calculated. Results: It was found al almost perfect level of concordance in the diagnoses pancreatitis and intoxication, a substantial level of concordance in the diagnoses acute coronary syndrome, convulsive status, gastric cancer and eclampsia, a moderate level of concordance in the diagnoses stroke, head trauma, politraumatism and cardiac failure, and a fair level of concordance in the diagnoses sepsis, pneumonia, chronic obstructive pulmonary disease (COPD, gastrointestinal bleeding, acute respiratory infection and acute respiratory distress syndrome. Conclusion: Six of the seventeen studied diagnoses presented an outstanding concordance level; this can be related to factors such as: physicians’, diagnostic ability, provenance of the patients remitted to the I.C.U. and diagnostic coding made by health staff.

  10. Adrenal vein sampling in primary aldosteronism: concordance of simultaneous vs sequential sampling.

    Science.gov (United States)

    Almarzooqi, Mohamed-Karji; Chagnon, Miguel; Soulez, Gilles; Giroux, Marie-France; Gilbert, Patrick; Oliva, Vincent L; Perreault, Pierre; Bouchard, Louis; Bourdeau, Isabelle; Lacroix, André; Therasse, Eric

    2017-02-01

    Many investigators believe that basal adrenal venous sampling (AVS) should be done simultaneously, whereas others opt for sequential AVS for simplicity and reduced cost. This study aimed to evaluate the concordance of sequential and simultaneous AVS methods. Between 1989 and 2015, bilateral simultaneous sets of basal AVS were obtained twice within 5 min, in 188 consecutive patients (59 women and 129 men; mean age: 53.4 years). Selectivity was defined by adrenal-to-peripheral cortisol ratio ≥2, and lateralization was defined as an adrenal aldosterone-to-cortisol ratio ≥2, the contralateral side. Sequential AVS was simulated using right sampling at -5 min (t = -5) and left sampling at 0 min (t = 0). There was no significant difference in mean selectivity ratio (P = 0.12 and P = 0.42 for the right and left sides respectively) and in mean lateralization ratio (P = 0.93) between t = -5 and t = 0. Kappa for selectivity between 2 simultaneous AVS was 0.71 (95% CI: 0.60-0.82), whereas it was 0.84 (95% CI: 0.76-0.92) and 0.85 (95% CI: 0.77-0.93) between sequential and simultaneous AVS at respectively -5 min and at 0 min. Kappa for lateralization between 2 simultaneous AVS was 0.84 (95% CI: 0.75-0.93), whereas it was 0.86 (95% CI: 0.78-0.94) and 0.80 (95% CI: 0.71-0.90) between sequential AVS and simultaneous AVS at respectively -5 min at 0 min. Concordance between simultaneous and sequential AVS was not different than that between 2 repeated simultaneous AVS in the same patient. Therefore, a better diagnostic performance is not a good argument to select the AVS method. © 2017 European Society of Endocrinology.

  11. Concordance and predictive value of two adverse drug event data sets.

    Science.gov (United States)

    Cami, Aurel; Reis, Ben Y

    2014-08-22

    Accurate prediction of adverse drug events (ADEs) is an important means of controlling and reducing drug-related morbidity and mortality. Since no single "gold standard" ADE data set exists, a range of different drug safety data sets are currently used for developing ADE prediction models. There is a critical need to assess the degree of concordance between these various ADE data sets and to validate ADE prediction models against multiple reference standards. We systematically evaluated the concordance of two widely used ADE data sets - Lexi-comp from 2010 and SIDER from 2012. The strength of the association between ADE (drug) counts in Lexi-comp and SIDER was assessed using Spearman rank correlation, while the differences between the two data sets were characterized in terms of drug categories, ADE categories and ADE frequencies. We also performed a comparative validation of the Predictive Pharmacosafety Networks (PPN) model using both ADE data sets. The predictive power of PPN using each of the two validation sets was assessed using the area under Receiver Operating Characteristic curve (AUROC). The correlations between the counts of ADEs and drugs in the two data sets were 0.84 (95% CI: 0.82-0.86) and 0.92 (95% CI: 0.91-0.93), respectively. Relative to an earlier snapshot of Lexi-comp from 2005, Lexi-comp 2010 and SIDER 2012 introduced a mean of 1,973 and 4,810 new drug-ADE associations per year, respectively. The difference between these two data sets was most pronounced for Nervous System and Anti-infective drugs, Gastrointestinal and Nervous System ADEs, and postmarketing ADEs. A minor difference of 1.1% was found in the AUROC of PPN when SIDER 2012 was used for validation instead of Lexi-comp 2010. In conclusion, the ADE and drug counts in Lexi-comp and SIDER data sets were highly correlated and the choice of validation set did not greatly affect the overall prediction performance of PPN. Our results also suggest that it is important to be aware of the

  12. Guideline-Concordant Cancer Care and Survival Among American Indian/Alaskan Native Patients

    Science.gov (United States)

    Javid, Sara H.; Varghese, Thomas K.; Morris, Arden M.; Porter, Michael P.; He, Hao; Buchwald, Dedra; Flum, David R.

    2014-01-01

    BACKGROUND American Indians/Alaskan Natives (AI/ANs) have the worst 5-year cancer survival of all racial/ethnic groups in the United States. Causes for this disparity are unknown. The authors of this report examined the receipt of cancer treatment among AI/AN patients compared with white patients. METHODS This was a retrospective cohort study of 338,204 patients who were diagnosed at age ≥65 years with breast, colon, lung, or prostate cancer between 1996 and 2005 in the Surveillance, Epidemiology, and End Results-Medicare database. Nationally accepted guidelines for surgical and adjuvant therapy and surveillance were selected as metrics of optimal, guideline-concordant care. Treatment analyses compared AI/ANs with matched whites. RESULTS Across cancer types, AI/ANs were less likely to receive optimal cancer treatment and were less likely to undergo surgery (P ≤ .025 for all cancers). Adjuvant therapy rates were significantly lower for AI/AN patients with breast cancer (P <.001) and colon cancer (P = .001). Rates of post-treatment surveillance also were lower among AI/ANs and were statistically significantly lower for AI/AN patients with breast cancer (P = .002) and prostate cancer (P <.001). Nonreceipt of optimal cancer treatment was associated with significantly worse survival across cancer types. Disease-specific survival for those who did not undergo surgery was significantly lower for patients with breast cancer (hazard ratio [HR], 0.62), colon cancer (HR, 0.74), prostate cancer (HR, 0.52), and lung cancer (HR, 0.36). Survival rates also were significantly lower for those patients who did not receive adjuvant therapy for breast cancer (HR, 0.56), colon cancer (HR, 0.59), or prostate cancer (HR, 0.81; all 95% confidence intervals were <1.0). CONCLUSIONS Fewer AI/AN patients than white patients received guideline-concordant cancer treatment across the 4 most common cancers. Efforts to explain these differences are critical to improving cancer care and

  13. Analysis of Canis mitochondrial DNA demonstrates high concordance between the control region and ATPase genes

    Directory of Open Access Journals (Sweden)

    White Bradley N

    2010-07-01

    Full Text Available Abstract Background Phylogenetic studies of wild Canis species have relied heavily on the mitochondrial DNA control region (mtDNA CR to infer species relationships and evolutionary lineages. Previous analyses of the CR provided evidence for a North American evolved eastern wolf (C. lycaon, that is more closely related to red wolves (C. rufus and coyotes (C. latrans than grey wolves (C. lupus. Eastern wolf origins, however, continue to be questioned. Therefore, we analyzed mtDNA from 89 wolves and coyotes across North America and Eurasia at 347 base pairs (bp of the CR and 1067 bp that included the ATPase6 and ATPase8 genes. Phylogenies and divergence estimates were used to clarify the evolutionary history of eastern wolves, and regional comparisons of nonsynonomous to synonomous substitutions (dN/dS at the ATPase6 and ATPase8 genes were used to elucidate the potential role of selection in shaping mtDNA geographic distribution. Results We found high concordance across analyses between the mtDNA regions studied. Both had a high percentage of variable sites (CR = 14.6%; ATP = 9.7% and both phylogenies clustered eastern wolf haplotypes monophyletically within a North American evolved lineage apart from coyotes. Divergence estimates suggest the putative red wolf sequence is more closely related to coyotes (DxyCR = 0.01982 ± 0.00494 SD; DxyATP = 0.00332 ± 0.00097 SD than the eastern wolf sequences (DxyCR = 0.03047 ± 0.00664 SD; DxyATP = 0.00931 ± 0.00205 SD. Neutrality tests on both genes were indicative of the population expansion of coyotes across eastern North America, and dN/dS ratios suggest a possible role for purifying selection in the evolution of North American lineages. dN/dS ratios were higher in European evolved lineages from northern climates compared to North American evolved lineages from temperate regions, but these differences were not statistically significant. Conclusions These results demonstrate high concordance between coding

  14. Hemiequilibrium problems

    Directory of Open Access Journals (Sweden)

    Muhammad Aslam Noor

    2004-01-01

    Full Text Available We consider a new class of equilibrium problems, known as hemiequilibrium problems. Using the auxiliary principle technique, we suggest and analyze a class of iterative algorithms for solving hemiequilibrium problems, the convergence of which requires either pseudomonotonicity or partially relaxed strong monotonicity. As a special case, we obtain a new method for hemivariational inequalities. Since hemiequilibrium problems include hemivariational inequalities and equilibrium problems as special cases, the results proved in this paper still hold for these problems.

  15. Quantitative investment analysis

    CERN Document Server

    DeFusco, Richard

    2007-01-01

    In the "Second Edition" of "Quantitative Investment Analysis," financial experts Richard DeFusco, Dennis McLeavey, Jerald Pinto, and David Runkle outline the tools and techniques needed to understand and apply quantitative methods to today's investment process.

  16. Rigour in quantitative research.

    Science.gov (United States)

    Claydon, Leica Sarah

    2015-07-22

    This article which forms part of the research series addresses scientific rigour in quantitative research. It explores the basis and use of quantitative research and the nature of scientific rigour. It examines how the reader may determine whether quantitative research results are accurate, the questions that should be asked to determine accuracy and the checklists that may be used in this process. Quantitative research has advantages in nursing, since it can provide numerical data to help answer questions encountered in everyday practice.

  17. The Guderley problem revisited

    International Nuclear Information System (INIS)

    Ramsey, Scott D.; Kamm, James R.; Bolstad, John H.

    2009-01-01

    The self-similar converging-diverging shock wave problem introduced by Guderley in 1942 has been the source of numerous investigations since its publication. In this paper, we review the simplifications and group invariance properties that lead to a self-similar formulation of this problem from the compressible flow equations for a polytropic gas. The complete solution to the self-similar problem reduces to two coupled nonlinear eigenvalue problems: the eigenvalue of the first is the so-called similarity exponent for the converging flow, and that of the second is a trajectory multiplier for the diverging regime. We provide a clear exposition concerning the reflected shock configuration. Additionally, we introduce a new approximation for the similarity exponent, which we compare with other estimates and numerically computed values. Lastly, we use the Guderley problem as the basis of a quantitative verification analysis of a cell-centered, finite volume, Eulerian compressible flow algorithm.

  18. Reproducibility of radionuclide gastroesophageal reflux studies using quantitative parameters and potential role of quantitative assessment in follow-up

    International Nuclear Information System (INIS)

    Fatima, S.; Khursheed, K.; Nasir, W.; Saeed, M.A.; Fatmi, S.; Jafri, S.; Asghar, S.

    2004-01-01

    Radionuclide gastroesophageal reflux studies have been widely used in the assessment of gastroesophageal reflux disease (GERD) in infants and children. Various qualitative and quantitative parameters have been used for the interpretation of reflux studies but there is little consensus on the use of these parameters in routine gastroesophageal reflux scintigraphic studies. Aim of this study was to evaluate the methodological issues underlying the qualitative and quantitative assessment of gastroesophageal reflux and to determine the potential power of the reflux index calculation in follow-up assessment of the reflux positive patients. Methods: Total 147 patients suffering from recurrent lower respiratory tract infection, asthma and having strong clinical suspicion of GER were recruited in the study. Dynamic scintigraphic study was acquired for 30 minutes after oral administration of 99mTc phytate. Each study was analyzed three times by two nuclear medicine physicians. Clinical symptoms were graded according to predefined criteria and there correlation with severity reflux was done. Time activity curves were generated by drawing ROIs from esophagus. Reflux index was calculated by the standard formula and cut off value of 4% was used for RI calculation. Reflux indices were used for follow-up assessments in reflux positive patients. Kappa statistics and chi square test were used to evaluate the agreement and concordance between qualitative and quantitative parameters. Results: Tlae over all incidence of reflux in total study population was 63.94 %( 94 patients). The kappa value for both qualitative and quantitative parameters showed good agreement for intra and inter-observer reproducibility (kappa value > 0.75). Concordance between visual analysis and time activity curves was not observed. Reflux index and visuat interpretation shows concordance in the interpretation. The severity of clinical symptoms was directly related to the severity of the reflux observed in the

  19. Quantitation: clinical applications

    International Nuclear Information System (INIS)

    Britton, K.E.

    1982-01-01

    Single photon emission tomography may be used quantitatively if its limitations are recognized and quantitation is made in relation to some reference area on the image. Relative quantitation is discussed in outline in relation to the liver, brain and pituitary, thyroid, adrenals, and heart. (U.K.)

  20. Environmental assessment proposed license renewal of Nuclear Metals, Inc. Concord, Massachusetts

    Energy Technology Data Exchange (ETDEWEB)

    Miller, R.L.; Easterly, C.E.; Lombardi, C.E.; Treitler, I.E.; Winbow, R.T.; Zimmerman, G.P. [Oak Ridge National Lab., TN (United States)

    1997-02-01

    The US Nuclear Regulatory Commission (NRC) has prepared this Environmental Assessment (EA) to evaluate environmental issues associated with the renewal of licenses issued by NRC for facilities operated by Nuclear Metals, Inc. (NMI) in Concord, Massachusetts. By renewing the licenses, NRC proposes to allow the continuation of ongoing operations involving radioactive materials at NMI`s facilities. This EA focuses on the potential impacts related to air emissions at NMI during normal (incident-free) operations and accidental releases. Findings indicate that there are only two areas of potential concern. First, modeling results for sulfur dioxide (SO{sub 2}) emissions from the boilers during normal operations indicate that the potential exists for exceeding the short-term National Ambient Air Quality Standards (NAAQS). NMI is prepared to undertake mitigative action to prevent potential exceedances of the short-term SO{sub 2} NAAQS, and the Massachusetts Department of Environmental Protection is prepared to resolve the issue via a permit/approval change or through a Consent Order. Second, in the unlikely event of a severe fire, predicted sulfuric acid (H{sub 2}SO{sub 4}) concentrations based on conservative (upper bound) modeling exceed the Emergency Response Planning Guideline (ERPG) levels. NMI has committed to NRC to give a briefing for local emergency response officials regarding the potential for an accidental H{sub 2}SO{sub 4} release.

  1. Average and dispersion of the luminosity-redshift relation in the concordance model

    Energy Technology Data Exchange (ETDEWEB)

    Ben-Dayan, I. [DESY Hamburg (Germany). Theory Group; Gasperini, M. [Bari Univ. (Italy). Dipt. di Fisica; Istituto Nazionale di Fisica Nucleare, Bari (Italy); Marozzi, G. [College de France, 75 - Paris (France); Geneve Univ. (Switzerland). Dept. de Physique Theorique and CAP; Nugier, F. [Ecole Normale Superieure CNRS, Paris (France). Laboratoire de Physique Theorique; Veneziano, G. [College de France, 75 - Paris (France); CERN, Geneva (Switzerland). Physics Dept.; New York Univ., NY (United States). Dept. of Physics

    2013-03-15

    Starting from the luminosity-redshift relation recently given up to second order in the Poisson gauge, we calculate the effects of the realistic stochastic background of perturbations of the so-called concordance model on the combined light-cone and ensemble average of various functions of the luminosity distance, and on their variance, as functions of redshift. We apply a gauge-invariant light-cone averaging prescription which is free from infrared and ultraviolet divergences, making our results robust with respect to changes of the corresponding cutoffs. Our main conclusions, in part already anticipated in a recent letter for the case of a perturbation spectrum computed in the linear regime, are that such inhomogeneities not only cannot avoid the need for dark energy, but also cannot prevent, in principle, the determination of its parameters down to an accuracy of order 10{sup -3} - 10{sup -5}, depending on the averaged observable and on the regime considered for the power spectrum. However, taking into account the appropriate corrections arising in the non-linear regime, we predict an irreducible scatter of the data approaching the 10% level which, for limited statistics, will necessarily limit the attainable precision. The predicted dispersion appears to be in good agreement with current observational estimates of the distance-modulus variance due to Doppler and lensing effects (at low and high redshifts, respectively), and represents a challenge for future precision measurements.

  2. Concordance of outcomes of pairs of kidneys transplanted into different recipients.

    LENUS (Irish Health Repository)

    Traynor, Carol

    2012-09-01

    Kidney transplant outcomes are influenced by donor characteristics, including age and gender. Additional donor factors, both genetic and environmental, also influence graft outcome. We aim to assess the strength of donor factors in determining kidney transplant outcomes by comparing paired kidneys from a single donor transplanted into different recipients. We conducted a retrospective cohort study of outcomes of pairs of deceased donor kidneys transplanted in our centre between 1992 and 2008. We examined the relationship within pairs for eGFR at 1 year and at 5 years post-transplant using Spearman\\'s Correlation and the concordance of pairs of transplant kidneys with respect to the occurrence of acute rejection and delayed graft function (DGF). A total of 652 recipient pairs were analysed. Spearman\\'s correlation for eGFR was 0.36 at 1 year and 0.36 at 5 years post-transplant. The incidence of DGF was 11%. The odds ratio of DGF occurring if the contralateral kidney had DGF was 5.99 (95% CI, 3.19-11.25). There is a significant degree of relationship within pairs of kidneys transplanted from the same donor for serum creatinine at 1 year and 5 years post-transplant and also for the occurrence of delayed graft function.

  3. Concordant posterior urethral valves in male monochorionic twins with secondary prune belly syndrome.

    Science.gov (United States)

    Nouaili, Emira Ben Hamida; Chaouachi, Sihem; Nouira, Faouzi; Benmassoud, Ines; Laabidi, Kamel; Chaouachi, Beji; Marrakchi, Zahra

    2008-12-01

    Posterior urethral valves (PUVs), the most common congenital cause of lower urinary tract obstruction, have been described to occur in identical and nonidentical twins. Until now, reports have been published on 15 cases of PUVs. We report a new case of concordant PUVs in one set of male monochorionic twins with secondary Prune Belly Syndrome. The twins were born by elective cesarean section at 38 weeks of gestation to a 36-year-old mother, gravida 6, para 6. On ultrasound perfomed at 18 weeks's gestation, both fetuses showed signs of PUVs. At birth, physical examination of both revealed a secondary Prune Belly Syndrome (PBS). Postnatal renal ultrasound confirmed the diagnosis of PUV. The two infants underwent transurethral resection of the valves after a cystoscopic evaluation of the urethra. Since this procedure, their voiding has been unremarkable with stable renal function and sterile urine until their discharge. We have documented a rare association between VUP and PBS in two monochiorionic twins. More studies are needed to throw light on the significance of the present associated anomalies.

  4. Measuring Treatment Outcomes in Comorbid Insomnia and Fibromyalgia: Concordance of Subjective and Objective Assessments.

    Science.gov (United States)

    Mundt, Jennifer M; Crew, Earl C; Krietsch, Kendra; Roth, Alicia J; Vatthauer, Karlyn; Robinson, Michael E; Staud, Roland; Berry, Richard B; McCrae, Christina S

    2016-02-01

    In insomnia, actigraphy tends to underestimate wake time compared to diaries and PSG. When chronic pain co-occurs with insomnia, sleep may be more fragmented, including more movement and arousals. However, individuals may not be consciously aware of these arousals. We examined the baseline concordance of diaries, actigraphy, and PSG as well as the ability of each assessment method to detect changes in sleep following cognitive behavioral therapy for insomnia (CBT-I). Adults with insomnia and fibromyalgia (n = 113) were randomized to CBT-I, CBT for pain, or waitlist control. At baseline and posttreatment, participants completed one night of PSG and two weeks of diaries/actigraphy. At baseline, objective measures estimated lower SOL, higher TST, and higher SE than diaries (ps treatment-related changes. PSG values did not change significantly for any sleep parameters. However, diaries showed improvements in SOL, WASO, and SE, and actigraphy also detected the WASO and SE improvements (ps treatment-related changes than PSG; PSG failed to detect any improvements, but actigraphy demonstrated changes in WASO and SE, which were also found with diaries. In comorbid insomnia/fibromyalgia, actigraphy may therefore have utility in measuring treatment outcomes. © 2015 American Academy of Sleep Medicine.

  5. The association of soda sales tax and school nutrition laws: a concordance of policies.

    Science.gov (United States)

    Greathouse, K Leigh; Chriqui, Jamie; Moser, Richard P; Agurs-Collins, Tanya; Perna, Frank M

    2014-10-01

    The current research examined the association between state disfavoured tax on soda (i.e. the difference between soda sales tax and the tax on food products generally) and a summary score representing the strength of state laws governing competitive beverages (beverages that compete with the beverages in the federally funded school lunch programme) in US schools. The Classification of Laws Associated with School Students (CLASS) summary score reflected the strength of a state's laws restricting competitive beverages sold in school stores, vending machines, school fundraisers and à la carte cafeteria items. Bridging the Gap (BTG) is a nationally recognized research initiative that provided state-level soda tax data. The main study outcome was the states' competitive beverage summary scores for elementary, middle and high school grade levels, as predicted by the states' disfavoured soda tax. Univariate and multivariate analyses were conducted, adjusting for year and state. Data from BTG and CLASS were used. BTG and CLASS data from all fifty states and the District of Columbia from 2003 to 2010 were used. A higher disfavoured soda sales tax was generally associated with an increased likelihood of having strong school beverage laws across grade levels, and especially when disfavoured soda sales tax was >5 %. These data suggest a concordance between states' soda taxes and laws governing beverages sold in schools. States with high disfavoured sales tax on soda had stronger competitive beverage laws, indicating that the state sales tax environment may be associated with laws governing beverage policy in schools.

  6. San Francisco folio, California, Tamalpais, San Francisco, Concord, San Mateo, and Haywards quadrangles

    Science.gov (United States)

    Lawson, Andrew Cowper

    1914-01-01

    The five sheets of the San Francisco folio the Tamalpais, Ban Francisco, Concord, Ban Mateo, and Haywards sheets map a territory lying between latitude 37° 30' and 38° and longitude 122° and 122° 45'. Large parts of four of these sheets cover the waters of the Bay of San Francisco or of the adjacent Pacific Ocean. (See fig. 1.) Within the area mapped are the cities of San Francisco, Oakland, Berkeley, Alameda, Ban Rafael, and San Mateo, and many smaller towns and villages. These cities, which have a population aggregating about 750,000, together form the largest and most important center of commercial and industrial activity on the west coast of the United States. The natural advantages afforded by a great harbor, where the railways from the east meet the ships from all ports of the world, have determined the site of a flourishing cosmopolitan, commercial city on the shores of San Francisco Bay. The bay is encircled by hilly and mountainous country diversified by fertile valley lands and divides the territory mapped into two rather contrasted parts, the western part being again divided by the Golden Gate. It will therefore be convenient to sketch the geographic features under four headings (1) the area east of San Francisco Bay; (2) the San Francisco Peninsula; (3) the Marin Peninsula; (4) San Francisco Bay. (See fig. 2.)

  7. Concordance of programmatic and laboratory-based multidrug-resistant tuberculosis treatment outcomes in Peru.

    Science.gov (United States)

    Alexy, E R; Podewils, L J; Mitnick, C D; Becerra, M C; Laserson, K F; Bonilla, C

    2012-01-01

    Confirmation of cure for multidrug-resistant tuberculosis (MDR-TB) patients requires laboratory tests for Mycobacterium tuberculosis growth on culture media. Outcome decisions dictate patient management, and inaccuracies place patients at an increased risk of morbidity and mortality, and may contribute to continued transmission of MDR-TB. To examine concordance between programmatic and laboratory-based MDR-TB treatment outcomes. The study population included 1658 MDR-TB patients in Peru treated between 1996 and 2002 with both program and laboratory-based outcomes. Laboratory-based outcomes were assigned according to international standards requiring at least five consecutive negative cultures in the last 12 months of treatment to confirm cure. Compared to the global culture-defined standard classification, only 1.1% of treatment successes, but 54.3% of failures, were misclassified programmatically. Overall, 10.4% of patients identified by a clinician as having a successful treatment outcome still had cultures positive for MDR-TB. Most patients with successful treatment outcomes by strict culture definitions were also classified by clinicians as having successful outcomes. However, many culture-confirmed failures were missed. In light of delays and incomplete access to culture in MDR-TB programs, efforts should be made to improve the accuracy of programmatically determined treatment outcomes.

  8. Testing concordance of instrumental variable effects in generalized linear models with application to Mendelian randomization

    Science.gov (United States)

    Dai, James Y.; Chan, Kwun Chuen Gary; Hsu, Li

    2014-01-01

    Instrumental variable regression is one way to overcome unmeasured confounding and estimate causal effect in observational studies. Built on structural mean models, there has been considerale work recently developed for consistent estimation of causal relative risk and causal odds ratio. Such models can sometimes suffer from identification issues for weak instruments. This hampered the applicability of Mendelian randomization analysis in genetic epidemiology. When there are multiple genetic variants available as instrumental variables, and causal effect is defined in a generalized linear model in the presence of unmeasured confounders, we propose to test concordance between instrumental variable effects on the intermediate exposure and instrumental variable effects on the disease outcome, as a means to test the causal effect. We show that a class of generalized least squares estimators provide valid and consistent tests of causality. For causal effect of a continuous exposure on a dichotomous outcome in logistic models, the proposed estimators are shown to be asymptotically conservative. When the disease outcome is rare, such estimators are consistent due to the log-linear approximation of the logistic function. Optimality of such estimators relative to the well-known two-stage least squares estimator and the double-logistic structural mean model is further discussed. PMID:24863158

  9. Exclusive double outlet right ventricle with atrioventricular concordance and pulmonary stenosis. Results of reconstructive surgery.

    Science.gov (United States)

    Busquet, J; Fontan, F; Choussat, A; Caianiello, G; Fernandez, G

    1988-01-01

    Double outlet right ventricle associated with atrioventricular concordance, pulmonary stenosis and situs solitus of the atria is a subset of double outlet right ventricle related through the surgical treatment. From 1974 to 1985, 14 patients, 5 males, 9 females (mean age 8.9 years, range 13 months-22 years) were operated upon. All patients had infundibular stenosis and normal or large pulmonary arteries. The apex of the heart was to the right in 2 patients, the right and left ventricles were superior and inferior in 2 patients and 1 patient had both anomalies. The ventricular septal defect was subaortic in 11 patients (aorto-mitral discontinuity in 5) and non-committed in 3 patients. Three patients had 2 ventricular septal defects. The aorta was anterior in 3 patients and to the right of the pulmonary artery in 11 patients. All patients, through a transventricular and transatrial approach, had a reconstructive surgery. In 3 patients, an aortic homograft valved conduit was used. One patient had the ventricular septal defect enlarged. There was one early death (7.1%) from high residual right ventricle pressure and no late death. One patient had a transient atrioventricular block. One patient was reoperated upon for a residual ventricular septal defect. All survivors had a good clinical result. Re-evaluation in 8 patients confirmed excellent haemodynamics: the right ventricle to pulmonary artery pressure gradient decreased from 80 mm Hg (range 60-95) preoperatively to 24 mm Hg (range 3-32) postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Does mindfulness prepare adolescents for value-behavior concordance? Examining the role of value content.

    Science.gov (United States)

    Warren, Michael T; Wray-Lake, Laura

    2017-07-01

    Great thinkers throughout history advocated living one's values, yet little research has examined factors that contribute to adolescents' value-behavior concordance (VBC). Mindfulness may foster VBC via heightened awareness of values, but VBC for intrinsic values may be more adaptive than VBC for extrinsic values. To situate mindfulness in developmental context, we examined age and attachment security as predictors of mindfulness. We collected self- and parent-report data from 299 families (M age-adolescents  = 14.45, SD = 1.68; 51% female) from 42 US states to test these ideas. Results indicated that mindfulness was positively associated with intrinsic VBC but was negatively linked with extrinsic VBC, and both kinds of VBC partially mediated the link from mindfulness to meaning (but not life satisfaction). Attachment security was associated with higher mindfulness. Overall, mindfulness may deliver its benefits by helping young people avoid behaviors that align with extrinsic values. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  11. Effects of Concord grape juice on cognitive and motor deficits in aging.

    Science.gov (United States)

    Shukitt-Hale, Barbara; Carey, Amanda; Simon, Laura; Mark, David A; Joseph, James A

    2006-03-01

    Animals and humans show increased motor and cognitive declines with aging that are thought to be due to increased susceptibility to the long-term effects of oxidative stress and inflammation. Previous findings have suggested that reversals in these age-related declines might be accomplished by increasing the dietary intake of polyphenolics found in fruits and vegetables, especially those identified as being high in antioxidant and anti-inflammatory activities. We investigated the beneficial effects of two concentrations of Concord grape juice (10% and 50%) compared with a calorically matched placebo for their effectiveness in reversing age-related deficits in behavioral and neuronal functions in aged Fischer 344 rats. Rats that drank the 10% grape juice from age 19 to 21 mo had improvements in oxotremorine enhancement of K+-evoked release of dopamine from striatal slices and in cognitive performance on the Morris water maze, and the 50% grape juice produced improvements in motor function. These findings suggest that, in addition to their known beneficial effects on cancer and heart disease, polyphenolics in foods may be beneficial in reversing the course of neuronal and behavioral aging, possibly through a multiplicity of direct and indirect effects that can affect a variety of neuronal parameters.

  12. Concordance between monetary and sexual delay discounting in men who have sex with men.

    Science.gov (United States)

    Jones, Jeb; Guest, Jodie L; Sullivan, Patrick S; Kramer, Michael R; Jenness, Samuel M; Sales, Jessica M

    2017-12-07

    Background: Delay discounting has been found to be associated with numerous health-related outcomes, including risky sexual behaviour. To date, it is unclear whether delay discounting measured in different domains is associated within individuals. The goal of this study was to assess the concordance of monetary and sexual delay discounting in men who have sex with men. Methods: Participants completed an online survey, including the Monetary Choice Questionnaire and the Sexual Discounting Task. Linear regression models were used to assess the association between monetary and sexual discount rates. Results: Sexual discount rates did not predict monetary discount rates. There was a substantial amount of clustering of sexual discount rates, requiring sexual discounting data to be categorised. Conclusions: Monetary and sexual delay discounting are distinct processes that are not necessarily associated within individuals, and monetary delay discounting is not an appropriate proxy measure for sexual impulsivity. Data from the Sexual Discounting Task are typically rank-transformed for analysis. These data suggest that this might be an invalid method of analysis. Future studies should investigate the distribution of their data to determine if it is appropriate to analyse sexual discounting data as a continuous measure.

  13. Environmental assessment proposed license renewal of Nuclear Metals, Inc. Concord, Massachusetts

    International Nuclear Information System (INIS)

    Miller, R.L.; Easterly, C.E.; Lombardi, C.E.; Treitler, I.E.; Winbow, R.T.; Zimmerman, G.P.

    1997-02-01

    The US Nuclear Regulatory Commission (NRC) has prepared this Environmental Assessment (EA) to evaluate environmental issues associated with the renewal of licenses issued by NRC for facilities operated by Nuclear Metals, Inc. (NMI) in Concord, Massachusetts. By renewing the licenses, NRC proposes to allow the continuation of ongoing operations involving radioactive materials at NMI's facilities. This EA focuses on the potential impacts related to air emissions at NMI during normal (incident-free) operations and accidental releases. Findings indicate that there are only two areas of potential concern. First, modeling results for sulfur dioxide (SO 2 ) emissions from the boilers during normal operations indicate that the potential exists for exceeding the short-term National Ambient Air Quality Standards (NAAQS). NMI is prepared to undertake mitigative action to prevent potential exceedances of the short-term SO 2 NAAQS, and the Massachusetts Department of Environmental Protection is prepared to resolve the issue via a permit/approval change or through a Consent Order. Second, in the unlikely event of a severe fire, predicted sulfuric acid (H 2 SO 4 ) concentrations based on conservative (upper bound) modeling exceed the Emergency Response Planning Guideline (ERPG) levels. NMI has committed to NRC to give a briefing for local emergency response officials regarding the potential for an accidental H 2 SO 4 release

  14. [Concordance between hospital prescriptions and recommendations in the treatment of mania].

    Science.gov (United States)

    Laforgue, Edouard-Jules; Bulteau, Samuel; Cholet, Jennyfer; Victorri-Vigneau, Caroline; Guitteny, Marie; Mauduit, Nicolas; Vanelle, Jean-Marie; Sauvaget, Anne

    2017-06-01

    There are differences between recommendations and practice in the pharmacological treatment of acute mania. The objective was to assess conformity of the anti-manic prescription between national recommendations (Haute Autorité de santé [French health authority, HAS] and "résumé des caractéristiques du produit" [product characteristics, RCP]) and clinical practice. We observed the drug prescriptions of in-patients for a manic episode. The main outcome measure was the concordance rate with the recommendations of the drugs prescriptions at the 48th hour. The secondary outcome repeated the same process with the hospital discharge statement of switches, associations, the presence of symptomatic and antidepressant treatments. Sixty-six episodes were included, 40 patients (60%) had a prescription complies with RCP recommendations H48 and 46 patients (70%) to HAS. These rates fall at hospital discharge. Off-label prescriptions, drug combinations and choices of not listed molecules are the most common reasons for non-conformity. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  15. Spousal concordance in the use of alternative tobacco products: A multi-country investigation.

    Science.gov (United States)

    Roberts, Megan E; Banse, Rainer; Ebbeler, Christine; Ferketich, Amy K

    2017-02-01

    Married couples often share similar health-related characteristics and behaviors, including cigarette smoking status. Despite their rising popularity in the U.S., little research has examined the patterns of spousal concordance (SC) for alternative tobacco products (ATPs), such as e-cigarettes, cigars, and hookah. The purpose of this project was to examine the roles of age, gender, and culture in the strength of SC for these ATPs. Analyses focused on a diverse community sample of married individuals in Ohio, U.S. (N=278), but also examined patterns in Austria, Greece, Israel, the Netherlands, and Slovakia. All participants completed a survey in which they indicated both their own, and their spouse's ever-use of various tobacco products. For the U.S. sample, SC was highest for e-cigarettes, flavored e-cigarettes, flavored cigarettes, and hookah (ϕs=0.48- 0.61); SC appeared to be stronger among younger couples, and when there was only a small female vs. male differences in use. Similar patterns were found in the other countries, with a few key exceptions. In particular, there was low SC for e-cigarettes and flavored e-cigarettes in the other countries, where e-cigarettes had been federally regulated by the time of data collection. Overall, these findings have implications for the continued spreading popularity of these tobacco use behaviors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. A big data approach to the concordance of the toxicity of pharmaceuticals in animals and humans.

    Science.gov (United States)

    Clark, Matthew; Steger-Hartmann, Thomas

    2018-07-01

    Although lack of efficacy is an important cause of late stage attrition in drug development the shortcomings in the translation of toxicities observed during the preclinical development to observations in clinical trials or post-approval is an ongoing topic of research. The concordance between preclinical and clinical safety observations has been analyzed only on relatively small data sets, mostly over short time periods of drug approvals. We therefore explored the feasibility of a big-data analysis on a set of 3,290 approved drugs and formulations for which 1,637,449 adverse events were reported for both humans animal species in regulatory submissions over a period of more than 70 years. The events reported in five species - rat, dog, mouse, rabbit, and cynomolgus monkey - were treated as diagnostic tests for human events and the diagnostic power was computed for each event/species pair using likelihood ratios. The animal-human translation of many key observations is confirmed as being predictive, such as QT prolongation and arrhythmias in dog. Our study confirmed the general predictivity of animal safety observations for humans, but also identified issues of such automated analyses which are on the one hand related to data curation and controlled vocabularies, on the other hand to methodological changes over the course of time. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

  17. Concordance Between Veterans' Self-Report and Documentation of Surrogate Decision Makers: Implications for Quality Measurement.

    Science.gov (United States)

    Garner, Kimberly K; Dubbert, Patricia; Lensing, Shelly; Sullivan, Dennis H

    2017-01-01

    The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. To better understand the potential implementation of this Measuring What Matters quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker. Examination of patient responses to self-assessment questions from advance health care planning educational groups conducted in one medical center primary care clinic and seven community-based outpatient primary care clinics. We assessed the concordance between patient reports of identifying and naming a surrogate decision maker and having completed an advance directive (AD) with presence of an AD in the electronic medical record. Of veterans without a documented AD on file, more than half (66%) reported that they had talked with someone they trusted and nearly half (52%) reported that they had named someone to communicate their preferences. Our clinical project data suggest that many more veterans may have initiated communications with surrogate decision makers than is evident in the electronic medical record. System changes are needed to close the gap between veterans' plans for a surrogate decision maker and the documentation available to acute care health care providers. Published by Elsevier Inc.

  18. Contextual Influences on Concordance between Maternal Report and Laboratory Observation of Toddler Fear

    Science.gov (United States)

    Kiel, Elizabeth J.; Hummel, Alexandra C.

    2016-01-01

    Emotion and temperament researchers have faced an enduring issue of how to best measure children’s tendencies to express specific emotions. Inconsistencies between laboratory observation and parental report have made it challenging for researchers to determine the utility of these different forms of measurement. The current study examined the effect of laboratory episode characteristics (i.e., threat-level of the episode, maternal involvement) on concordance between maternal report and laboratory observation of toddler fear. The sample included 111 mother-toddler dyads who participated in a laboratory assessment when toddlers were approximately 24-months-old. Toddler fear was assessed both via maternal report and observation from a number of laboratory episodes that varied in their level of threat and whether mothers were free or constrained in their involvement in the task. Results indicated that maternal report related to the observed fear composites for low-threat, but not high-threat episodes. On the other hand, maternal involvement in the laboratory episodes did not moderate the relation between maternal report and laboratory observation of fear. These results suggest that the threat-level of laboratory episodes designed to elicit fear, but not maternal involvement in these episodes, may be important to take into consideration when assessing their relation to maternal report of fear and fearful temperament. PMID:27606826

  19. Interindividual concordance of methylation profiles in human genes for tumor necrosis factors α and β

    International Nuclear Information System (INIS)

    Kochanek, S.; Toth, M.; Dehmel, A.; Renz, D.; Doerfler, W.

    1990-01-01

    The DNA in mammalian genomes is characterized by complex patterns of DNA methylation that reflect the states of all genetic activities of that genome. The modified nucleotide 5-methyldeoxycytidine ( 5 mdC) can affect the interactions of specific proteins with DNA sequence motifs. The most extensively studied effect of sequence-specific methylations is that of the long-term silencing of eukaryotic (mammalian) promoters. The authors have initiated studies on the methylation status of parts of the human genome to view patterns of DNA methylation as indicators for genetic activities. In this report, analyses using both restriction enzyme-Southern blotting and the very precise genomic sequencing technique have been done. The results are characterized by a remarkable interindividual concordance of DNA methylation in specific human cell types. The patterns are identical in the DNA from one cell type for different individuals even of different genetic origins but different in the DNA from different cell types. The TNF-β promoter is methylated in granulocytes from 9 different individuals, and TNF-β is not expressed. In human lymphocytes, the main source of TNF-β, the TNF-β promoter is free of 5 mdC residues

  20. Addressing issues associated with evaluating prediction models for survival endpoints based on the concordance statistic.

    Science.gov (United States)

    Wang, Ming; Long, Qi

    2016-09-01

    Prediction models for disease risk and prognosis play an important role in biomedical research, and evaluating their predictive accuracy in the presence of censored data is of substantial interest. The standard concordance (c) statistic has been extended to provide a summary measure of predictive accuracy for survival models. Motivated by a prostate cancer study, we address several issues associated with evaluating survival prediction models based on c-statistic with a focus on estimators using the technique of inverse probability of censoring weighting (IPCW). Compared to the existing work, we provide complete results on the asymptotic properties of the IPCW estimators under the assumption of coarsening at random (CAR), and propose a sensitivity analysis under the mechanism of noncoarsening at random (NCAR). In addition, we extend the IPCW approach as well as the sensitivity analysis to high-dimensional settings. The predictive accuracy of prediction models for cancer recurrence after prostatectomy is assessed by applying the proposed approaches. We find that the estimated predictive accuracy for the models in consideration is sensitive to NCAR assumption, and thus identify the best predictive model. Finally, we further evaluate the performance of the proposed methods in both settings of low-dimensional and high-dimensional data under CAR and NCAR through simulations. © 2016, The International Biometric Society.

  1. The proposed 'concordance-statistic for benefit' provided a useful metric when modeling heterogeneous treatment effects.

    Science.gov (United States)

    van Klaveren, David; Steyerberg, Ewout W; Serruys, Patrick W; Kent, David M

    2018-02-01

    Clinical prediction models that support treatment decisions are usually evaluated for their ability to predict the risk of an outcome rather than treatment benefit-the difference between outcome risk with vs. without therapy. We aimed to define performance metrics for a model's ability to predict treatment benefit. We analyzed data of the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) trial and of three recombinant tissue plasminogen activator trials. We assessed alternative prediction models with a conventional risk concordance-statistic (c-statistic) and a novel c-statistic for benefit. We defined observed treatment benefit by the outcomes in pairs of patients matched on predicted benefit but discordant for treatment assignment. The 'c-for-benefit' represents the probability that from two randomly chosen matched patient pairs with unequal observed benefit, the pair with greater observed benefit also has a higher predicted benefit. Compared to a model without treatment interactions, the SYNTAX score II had improved ability to discriminate treatment benefit (c-for-benefit 0.590 vs. 0.552), despite having similar risk discrimination (c-statistic 0.725 vs. 0.719). However, for the simplified stroke-thrombolytic predictive instrument (TPI) vs. the original stroke-TPI, the c-for-benefit (0.584 vs. 0.578) was similar. The proposed methodology has the potential to measure a model's ability to predict treatment benefit not captured with conventional performance metrics. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. A Bayesian estimate of the concordance correlation coefficient with skewed data.

    Science.gov (United States)

    Feng, Dai; Baumgartner, Richard; Svetnik, Vladimir

    2015-01-01

    Concordance correlation coefficient (CCC) is one of the most popular scaled indices used to evaluate agreement. Most commonly, it is used under the assumption that data is normally distributed. This assumption, however, does not apply to skewed data sets. While methods for the estimation of the CCC of skewed data sets have been introduced and studied, the Bayesian approach and its comparison with the previous methods has been lacking. In this study, we propose a Bayesian method for the estimation of the CCC of skewed data sets and compare it with the best method previously investigated. The proposed method has certain advantages. It tends to outperform the best method studied before when the variation of the data is mainly from the random subject effect instead of error. Furthermore, it allows for greater flexibility in application by enabling incorporation of missing data, confounding covariates, and replications, which was not considered previously. The superiority of this new approach is demonstrated using simulation as well as real-life biomarker data sets used in an electroencephalography clinical study. The implementation of the Bayesian method is accessible through the Comprehensive R Archive Network. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Neuropsychological Profiles of Written Expression Learning Disabilities Determined by Concordance-Discordance Model Criteria.

    Science.gov (United States)

    Fenwick, Melanie E; Kubas, Hanna A; Witzke, Justin W; Fitzer, Kim R; Miller, Daniel C; Maricle, Denise E; Harrison, Gina L; Macoun, Sarah J; Hale, James B

    2016-01-01

    Children with specific learning disabilities (SLD) have disparate neuropsychological processing deficits that interfere with academic achievement in spelling, writing fluency, and/or written expression (WE). Although there are multiple potential causes of WE SLD, there is a paucity of research exploring this critical academic skill from a neuropsychological perspective. This study examined the neuropsychological profiles of WE SLD subtypes defined using the concordance-discordance model (C-DM) of SLD identification. Participants were drawn from a sample of 283 children (194 boys, 89 girls) aged 6 years to 16 years old (M(age) = 9.58 years, SD = 2.29 years) referred for comprehensive neuropsychological evaluations in school settings and subsequently selected based on C-DM determined spelling, writing fluency, and WE SLD. WE SLD subtypes differed on several psychomotor, memory, and executive function measures (F range = 2.48-5.07, p range = .049 to <.001), suggesting that these children exhibit distinct patterns of neuropsychological processing strengths and weaknesses. Findings have relevance for differential diagnosis of WE subtypes, discriminating WE SLD subtypes from low WE achievement, and developing differentiated evidence-based instruction and intervention for children with WE SLD. Limitations and future research will be addressed.

  4. Advanced Imaging and Receipt of Guideline Concordant Care in Women with Early Stage Breast Cancer

    Directory of Open Access Journals (Sweden)

    Elizabeth Trice Loggers

    2016-01-01

    Full Text Available Objective. It is unknown whether advanced imaging (AI is associated with higher quality breast cancer (BC care. Materials and Methods. Claims and Surveillance Epidemiology and End Results data were linked for women diagnosed with incident stage I-III BC between 2002 and 2008 in western Washington State. We examined receipt of preoperative breast magnetic resonance imaging (MRI or AI (defined as computed tomography [CT]/positron emission tomography [PET]/PET/CT versus mammogram and/or ultrasound (M-US alone and receipt of guideline concordant care (GCC using multivariable logistic regression. Results. Of 5247 women, 67% received M-US, 23% MRI, 8% CT, and 3% PET/PET-CT. In 2002, 5% received MRI and 5% AI compared to 45% and 12%, respectively, in 2008. 79% received GCC, but GCC declined over time and was associated with younger age, urban residence, less comorbidity, shorter time from diagnosis to surgery, and earlier year of diagnosis. Breast MRI was associated with GCC for lumpectomy plus radiation therapy (RT (OR 1.55, 95% CI 1.08–2.26, and p=0.02 and AI was associated with GCC for adjuvant chemotherapy for estrogen-receptor positive (ER+ BC (OR 1.74, 95% CI 1.17–2.59, and p=0.01. Conclusion. GCC was associated with prior receipt of breast MRI and AI for lumpectomy plus RT and adjuvant chemotherapy for ER+ BC, respectively.

  5. Integrated genomics and proteomics of the Torpedo californica electric organ: concordance with the mammalian neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Mate Suzanne E

    2011-05-01

    Full Text Available Abstract Background During development, the branchial mesoderm of Torpedo californica transdifferentiates into an electric organ capable of generating high voltage discharges to stun fish. The organ contains a high density of cholinergic synapses and has served as a biochemical model for the membrane specialization of myofibers, the neuromuscular junction (NMJ. We studied the genome and proteome of the electric organ to gain insight into its composition, to determine if there is concordance with skeletal muscle and the NMJ, and to identify novel synaptic proteins. Results Of 435 proteins identified, 300 mapped to Torpedo cDNA sequences with ≥2 peptides. We identified 14 uncharacterized proteins in the electric organ that are known to play a role in acetylcholine receptor clustering or signal transduction. In addition, two human open reading frames, C1orf123 and C6orf130, showed high sequence similarity to electric organ proteins. Our profile lists several proteins that are highly expressed in skeletal muscle or are muscle specific. Synaptic proteins such as acetylcholinesterase, acetylcholine receptor subunits, and rapsyn were present in the electric organ proteome but absent in the skeletal muscle proteome. Conclusions Our integrated genomic and proteomic analysis supports research describing a muscle-like profile of the organ. We show that it is a repository of NMJ proteins but we present limitations on its use as a comprehensive model of the NMJ. Finally, we identified several proteins that may become candidates for signaling proteins not previously characterized as components of the NMJ.

  6. Detection of expression quantitative trait Loci in complex mouse crosses: impact and alleviation of data quality and complex population substructure.

    Science.gov (United States)

    Iancu, Ovidiu D; Darakjian, Priscila; Kawane, Sunita; Bottomly, Daniel; Hitzemann, Robert; McWeeney, Shannon

    2012-01-01

    Complex Mus musculus crosses, e.g., heterogeneous stock (HS), provide increased resolution for quantitative trait loci detection. However, increased genetic complexity challenges detection methods, with discordant results due to low data quality or complex genetic architecture. We quantified the impact of theses factors across three mouse crosses and two different detection methods, identifying procedures that greatly improve detection quality. Importantly, HS populations have complex genetic architectures not fully captured by the whole genome kinship matrix, calling for incorporating chromosome specific relatedness information. We analyze three increasingly complex crosses, using gene expression levels as quantitative traits. The three crosses were an F(2) intercross, a HS formed by crossing four inbred strains (HS4), and a HS (HS-CC) derived from the eight lines found in the collaborative cross. Brain (striatum) gene expression and genotype data were obtained using the Illumina platform. We found large disparities between methods, with concordance varying as genetic complexity increased; this problem was more acute for probes with distant regulatory elements (trans). A suite of data filtering steps resulted in substantial increases in reproducibility. Genetic relatedness between samples generated overabundance of detected eQTLs; an adjustment procedure that includes the kinship matrix attenuates this problem. However, we find that relatedness between individuals is not evenly distributed across the genome; information from distinct chromosomes results in relatedness structure different from the whole genome kinship matrix. Shared polymorphisms from distinct chromosomes collectively affect expression levels, confounding eQTL detection. We suggest that considering chromosome specific relatedness can result in improved eQTL detection.

  7. Explaining the Mind: Problems, Problems

    OpenAIRE

    Harnad, Stevan

    2001-01-01

    The mind/body problem is the feeling/function problem: How and why do feeling systems feel? The problem is not just "hard" but insoluble (unless one is ready to resort to telekinetic dualism). Fortunately, the "easy" problems of cognitive science (such as the how and why of categorization and language) are not insoluble. Five books (by Damasio, Edelman/Tononi...

  8. Fault Severity Evaluation and Improvement Design for Mechanical Systems Using the Fault Injection Technique and Gini Concordance Measure

    Directory of Open Access Journals (Sweden)

    Jianing Wu

    2014-01-01

    Full Text Available A new fault injection and Gini concordance based method has been developed for fault severity analysis for multibody mechanical systems concerning their dynamic properties. The fault tree analysis (FTA is employed to roughly identify the faults needed to be considered. According to constitution of the mechanical system, the dynamic properties can be achieved by solving the equations that include many types of faults which are injected by using the fault injection technique. Then, the Gini concordance is used to measure the correspondence between the performance with faults and under normal operation thereby providing useful hints of severity ranking in subsystems for reliability design. One numerical example and a series of experiments are provided to illustrate the application of the new method. The results indicate that the proposed method can accurately model the faults and receive the correct information of fault severity. Some strategies are also proposed for reliability improvement of the spacecraft solar array.

  9. Goal striving, goal attainment, and well-being: adapting and testing the self-concordance model in sport.

    Science.gov (United States)

    Smith, Alison; Ntoumanis, Nikos; Duda, Joan

    2007-12-01

    Grounded in self-determination theory (Deci & Ryan, 1985) and the self-concordance model (Sheldon & Elliot, 1999), this study examined the motivational processes underlying goal striving in sport as well as the role of perceived coach autonomy support in the goal process. Structural equation modeling with a sample of 210 British athletes showed that autonomous goal motives positively predicted effort, which, in turn, predicted goal attainment. Goal attainment was positively linked to need satisfaction, which, in turn, predicted psychological well-being. Effort and need satisfaction were found to mediate the associations between autonomous motives and goal attainment and between attainment and well-being, respectively. Controlled motives negatively predicted well-being, and coach autonomy support positively predicted both autonomous motives and need satisfaction. Associations of autonomous motives with effort were not reducible to goal difficulty, goal specificity, or goal efficacy. These findings support the self-concordance model as a framework for further research on goal setting in sport.

  10. Concordance of mutation detection in circulating tumor DNA in early clinical trials using different blood collection protocols

    DEFF Research Database (Denmark)

    Ahlborn, Lise B.; Madsen, Mette; Jonson, Lars

    2017-01-01

    in a clinical setting. Here we investigate the concordance between standard blood collection for molecular analysis using immediate separation of plasma, compared to the use of collection tubes allowing for delayed processing. Methods: In this study, we measured the fractional abundance of tumor specific...... patients with advanced solid cancers enrolled in early clinical trials. Results: Concordance in the fractional abundance of mutations in ctDNA isolated from blood collected in either K3EDTA or BCT tubes from patients with different solid cancers was observed. Conclusions: This study indicates that BCT...... mutations (BRAF p.V600E and PIK3CA p.H1047R) in ctDNA isolated from blood samples collected in either cell-stabilizing Cell-Free DNA BCT tubes (delayed processing within 72 hours) or standard K3EDTA tubes (immediate processing within 15 minutes). Twenty-five blood sample pairs (EDTA/BCT) were collected from...

  11. Intergeracionalidade de estilos educativos parentais : continuidade ou mudança? : concordância ou discordância?

    OpenAIRE

    Marques, Joana Isabel Correia

    2012-01-01

    Tese de mestrado, Psicologia (Secção de Psicologia Clínica e da Saúde - Núcleo de Psicologia Clínica Sistémica), Universidade de Lisboa, Faculdade de Psicologia, 2012 O presente estudo exploratório, baseado numa abordagem qualitativa, tem como objectivo estudar a continuidade e concordância entre os Estilos Educativos Parentais dos Avós (Geração 1 – G1) e dos Pais (Geração 2 - G2), e a concordância e discordância na percepção dos Estilos Educativos Parentais (EEP) entre os Pais (G2) e Filh...

  12. A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder.

    Science.gov (United States)

    Mazurek, Micah O; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M; Hundley, Rachel J; Poulsen, Marie; Kanne, Stephen M; Macklin, Eric A; Handen, Benjamin L

    2017-09-01

    The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

  13. Effects of Concord grape juice on ambulatory blood pressure in prehypertension and stage 1 hypertension.

    Science.gov (United States)

    Dohadwala, Mustali M; Hamburg, Naomi M; Holbrook, Monika; Kim, Brian H; Duess, Mai-Ann; Levit, Aaron; Titas, Megan; Chung, William B; Vincent, Felix B; Caiano, Tara L; Frame, Alissa A; Keaney, John F; Vita, Joseph A

    2010-11-01

    Consumption of flavonoid-containing foods may be useful for the management of hypertension. We investigated whether 100% Concord grape juice lowers blood pressure in patients with prehypertension and stage 1 hypertension. We conducted a double-blind crossover study to compare the effects of grape juice (7 mL · kg⁻¹ · d⁻¹) and matched placebo beverage on 24-h ambulatory blood pressure, stress-induced changes in blood pressure, and biochemical profile. Participants consumed each beverage for 8 wk with a 4-wk rest period between beverages. They ceased consumption of grapes and other flavonoid-containing beverages throughout the study. We enrolled 64 otherwise healthy patients taking no antihypertensive medications (31% women, 42% black, age 43 ± 12 y). Baseline mean (± SD) cuff blood pressure was 138 ± 7 (systolic)/82 ± 7 (diastolic) mm Hg. No effects on the primary endpoint of 24-h mean systolic blood pressure, diastolic blood pressure, or stress-induced changes in blood pressure were observed. A secondary endpoint was nocturnal dip in systolic pressure. At baseline, nocturnal pressure was 8.3 ± 7.1% lower at night than during daytime. The mean nocturnal dip increased 1.4 percentage points after grape juice and decreased 2.3 percentage points after placebo (P = 0.005). Fasting blood glucose was 91 ± 10 mg/dL at baseline for the entire cohort. Glucose decreased 2 mg/dL after consumption of grape juice and increased 1 mg/dL after consuming the placebo (P = 0.03). We observed no effect of grape juice on ambulatory blood pressure in this cohort of relatively healthy individuals with modestly elevated blood pressure. Secondary analyses suggested favorable effects on nocturnal dip and glucose homeostasis that may merit further investigation. This trial was registered at clinicaltrials.gov as NCT00302809.

  14. Effects of Concord grape juice on ambulatory blood pressure in prehypertension and stage 1 hypertension123

    Science.gov (United States)

    Dohadwala, Mustali M; Hamburg, Naomi M; Holbrook, Monika; Kim, Brian H; Duess, Mai-Ann; Levit, Aaron; Titas, Megan; Chung, William B; Vincent, Felix B; Caiano, Tara L; Frame, Alissa A; Keaney, John F

    2010-01-01

    Background: Consumption of flavonoid-containing foods may be useful for the management of hypertension. Objective: We investigated whether 100% Concord grape juice lowers blood pressure in patients with prehypertension and stage 1 hypertension. Design: We conducted a double-blind crossover study to compare the effects of grape juice (7 mL · kg−1 · d−1) and matched placebo beverage on 24-h ambulatory blood pressure, stress-induced changes in blood pressure, and biochemical profile. Participants consumed each beverage for 8 wk with a 4-wk rest period between beverages. They ceased consumption of grapes and other flavonoid-containing beverages throughout the study. Results: We enrolled 64 otherwise healthy patients taking no antihypertensive medications (31% women, 42% black, age 43 ± 12 y). Baseline mean (±SD) cuff blood pressure was 138 ± 7 (systolic)/82 ± 7 (diastolic) mm Hg. No effects on the primary endpoint of 24-h mean systolic blood pressure, diastolic blood pressure, or stress-induced changes in blood pressure were observed. A secondary endpoint was nocturnal dip in systolic pressure. At baseline, nocturnal pressure was 8.3 ± 7.1% lower at night than during daytime. The mean nocturnal dip increased 1.4 percentage points after grape juice and decreased 2.3 percentage points after placebo (P = 0.005). Fasting blood glucose was 91 ± 10 mg/dL at baseline for the entire cohort. Glucose decreased 2 mg/dL after consumption of grape juice and increased 1 mg/dL after consuming the placebo (P = 0.03). Conclusions: We observed no effect of grape juice on ambulatory blood pressure in this cohort of relatively healthy individuals with modestly elevated blood pressure. Secondary analyses suggested favorable effects on nocturnal dip and glucose homeostasis that may merit further investigation. This trial was registered at clinicaltrials.gov as NCT00302809. PMID:20844075

  15. Concordance between patient and clinician assessment of dry eye severity and treatment response in Taiwan.

    Science.gov (United States)

    Yeh, Po-Ting; Chien, Hsu-Chih; Ng, Kwong; Tseng, Sung-Huei; Chen, Wei-Li; Hou, Yu-Chih; Wang, I-Jong; Chu, Hsiao-Sung; Kao Yang, Yea-Huei; Hu, Fung-Rong

    2015-05-01

    Accurate diagnosis and early recognition of dry eye symptoms are important in the management of dry eye disease (DED). This study aimed to evaluate concordance between patient and clinician assessment of DED severity and treatment response. This cross-sectional study was conducted in 2 ophthalmology clinics in Taiwan. Clinicians assessed severity based on the Dry Eye Workshop severity grading (levels 1-4; where 4 = most severe), whereas patients completed the Ocular Surface Disease Index questionnaire. To evaluate the treatment response, patients completed the Subject Global Assessment scale, and clinicians independently assessed patients using the Clinical Global Impression scale. A total of 466 patients were included. Clinicians graded 88.3% of patients as level 1/2, 9.0% as level 3, and 2.7% as level 4 Dry Eye Workshop severity, whereas 44.9% of patients reported normal/mild symptoms, 17.1% with moderate severity, and 38.0% with severe DED. Patients were primarily treated with artificial tears. The clinician assessed 10.3% of patients as unchanged on disease severity after treatment and 88.0% as improved, whereas 49.2% of patients reported dry eye symptoms being almost the same after treatment and 34.6% reported improved symptoms. There was low agreement between clinician and patient assessments in terms of disease severity (rho = 0.17, P treatment response (rho = 0.22, P treatment response between patient and clinician assessment. Clinicians may underestimate DED severity and persistence of dry eye symptoms after treatment with artificial tears.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01942226.

  16. Concordance of DSM-5 and DSM-IV-TR classifications for autism spectrum disorder.

    Science.gov (United States)

    Ohashi, Kei; Mizuno, Yoshifumi; Miyachi, Taishi; Asai, Tomoko; Imaeda, Masayuki; Saitoh, Shinji

    2015-12-01

    The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013. Autism spectrum disorder (ASD) has been structured for the three subtypes of pervasive developmental disorder (PDD), but the number of impairment in social and communication dimension is not stated. The subjects were 68 children who visited the Department of Psychology and Development at Nagoya City University Hospital for the first time between the ages of 6 and 15 years old. We retrospectively re-examined the subjects using DSM-IV-TR criteria and DSM-5 criteria with two rules (two of three and one of three on the social and communication dimension) and examined the concordance rate. Forty subjects were diagnosed with PDD, and 28 were not. The mean PDD subject age was 9.4 years, and mean IQ was 84.0 on the Wechsler Intelligence Scale for Children III or 62.7 on the Tanaka-Binet test. Twenty-seven (68%) of the PDD subjects were classified with ASD using DSM-5 criteria when the two of three rule was applied, while 32 (80%) were classified with ASD when the one of three rule was applied. All subjects without PDD were not diagnosed with ASD on DSM-5 criteria. DSM-5 criteria may exclude high functioning and older subjects from ASD because they tend to be atypical. The diagnostic procedure for DSM-5 criteria is ambiguous, especially in high functioning subjects and those diagnosed at an older age. © 2015 Japan Pediatric Society.

  17. Postmortem CT compared to autopsy in children; concordance in a forensic setting.

    Science.gov (United States)

    Sieswerda-Hoogendoorn, Tessa; Soerdjbalie-Maikoe, Vidija; de Bakker, Henri; van Rijn, Rick R

    2014-11-01

    The aim of this study is to assess the accuracy of postmortem CT (PMCT) in determining the cause of death in children who underwent a forensic autopsy because of a suspected nonnatural death. We selected forensic pediatric autopsies at the Netherlands Forensic Institute, whereby the subject underwent PMCT between 1-1-2008 and 31-12-2012. Cause of death was independently scored by a radiologist and a pathologist. Cause of death was classified (1) in categories being natural, unnatural, and unknown; (2) according to the ICD-10; and (3) according to institutional classification. In the study period, 189 pediatric forensic autopsies were performed. Fifteen were excluded because of putrefaction. Of the remaining 174 autopsies, 98 (56%) underwent PMCT. PMCT and autopsy identified the same category in 69/98 cases (70%, kappa 0.49). They identified the same cause of death in 66/98 cases (67%, kappa 0.5) using ICD-10; in 71/98 (72%, kappa 0.62) using a forensic classification. PMCT performed better in unnatural deaths (59-67 % agreement) than in natural deaths (0 % agreement). If no cause of death was detected with autopsy, PMCT failed to identify a cause of death in 98% (39/40). Pediatric PMCT does identify the majority of unnatural causes of death, but does not identify new diagnoses (true positives) if no cause of death is found during autopsy. Diagnostic accuracy in natural deaths is low. • The case mix is an important predictor for the concordance between PMCT and autopsy. • In case of an unnatural death, 72--81% of PMCT results matches autopsy results. • In case of a natural death, 0% of PMCT results matches autopsy results. • If no cause of death is identified with autopsy, 98% of PMCT results concurs.

  18. Know your tools - concordance of different methods for measuring brain volume change after ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew [The University of Melbourne, Departments of Medicine and Neurology, Melbourne Brain Centre rate at The Royal Melbourne Hospital, Parkville, Victoria (Australia); Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M. [The University of Melbourne, Department of Radiology, The Royal Melbourne Hospital, Parkville (Australia); Churilov, Leonid [The University of Melbourne, The Florey Institute of Neurosciences and Mental Health, Parkville (Australia); Parsons, Mark W. [University of Newcastle and Hunter Medical Research Institute, Priority Research Centre for Translational Neuroscience and Mental Health, Newcastle (Australia)

    2015-07-15

    Longitudinal brain volume changes have been investigated in a number of cerebral disorders as a surrogate marker of clinical outcome. In stroke, unique methodological challenges are posed by dynamic structural changes occurring after onset, particularly those relating to the infarct lesion. We aimed to evaluate agreement between different analysis methods for the measurement of post-stroke brain volume change, and to explore technical challenges inherent to these methods. Fifteen patients with anterior circulation stroke underwent magnetic resonance imaging within 1 week of onset and at 1 and 3 months. Whole-brain as well as grey- and white-matter volume were estimated separately using both an intensity-based and a surface watershed-based algorithm. In the case of the intensity-based algorithm, the analysis was also performed with and without exclusion of the infarct lesion. Due to the effects of peri-infarct edema at the baseline scan, longitudinal volume change was measured as percentage change between the 1 and 3-month scans. Intra-class and concordance correlation coefficients were used to assess agreement between the different analysis methods. Reduced major axis regression was used to inspect the nature of bias between measurements. Overall agreement between methods was modest with strong disagreement between some techniques. Measurements were variably impacted by procedures performed to account for infarct lesions. Improvements in volumetric methods and consensus between methodologies employed in different studies are necessary in order to increase the validity of conclusions derived from post-stroke cerebral volumetric studies. Readers should be aware of the potential impact of different methods on study conclusions. (orig.)

  19. MVisAGe Identifies Concordant and Discordant Genomic Alterations of Driver Genes in Squamous Tumors.

    Science.gov (United States)

    Walter, Vonn; Du, Ying; Danilova, Ludmila; Hayward, Michele C; Hayes, D Neil

    2018-06-15

    Integrated analyses of multiple genomic datatypes are now common in cancer profiling studies. Such data present opportunities for numerous computational experiments, yet analytic pipelines are limited. Tools such as the cBioPortal and Regulome Explorer, although useful, are not easy to access programmatically or to implement locally. Here, we introduce the MVisAGe R package, which allows users to quantify gene-level associations between two genomic datatypes to investigate the effect of genomic alterations (e.g., DNA copy number changes on gene expression). Visualizing Pearson/Spearman correlation coefficients according to the genomic positions of the underlying genes provides a powerful yet novel tool for conducting exploratory analyses. We demonstrate its utility by analyzing three publicly available cancer datasets. Our approach highlights canonical oncogenes in chr11q13 that displayed the strongest associations between expression and copy number, including CCND1 and CTTN , genes not identified by copy number analysis in the primary reports. We demonstrate highly concordant usage of shared oncogenes on chr3q, yet strikingly diverse oncogene usage on chr11q as a function of HPV infection status. Regions of chr19 that display remarkable associations between methylation and gene expression were identified, as were previously unreported miRNA-gene expression associations that may contribute to the epithelial-to-mesenchymal transition. Significance: This study presents an important bioinformatics tool that will enable integrated analyses of multiple genomic datatypes. Cancer Res; 78(12); 3375-85. ©2018 AACR . ©2018 American Association for Cancer Research.

  20. Adrenal incidentalomas showing unilateral concordant visualization by adrenocortical scintigraphy. Comparison with adenomas in Cushing's syndrome

    International Nuclear Information System (INIS)

    Tani, Atsushi; Nakajo, Masayuki; Tsuchimochi, Shinsaku; Nakabeppu, Yoshiaki; Umanodan, Tomokazu

    2000-01-01

    An adrenocortical adenoma causing Cushing's syndrome (Cushing's adenoma) produces a unilateral concordant visualization (UCV) imaging pattern in which the adenoma is only visualized on radioiodocholesterol adrenocortical scintigraphy. But because this imaging pattern is also noted in some patients with adrenal incidentalomas, we examined whether the UCV-incidentaloma was essentially identical with Cushing's adenoma and would develop Cushing's syndrome. The subjects were 9 patients with UCV-incidentalomas (mean size, 30 mm; range, 20-45 mm) and 6 patients with Cushing's adenomas (mean size, 28 mm; range, 25-35 mm). Endocrinological evaluations showed several abnormalities including blunted diurnal rhythm of plasma cortisol within the normal range, low plasma ACTH and/or high 24-hr urinary 17-OHCS levels in 8 of 9 patients with UCV-incidentalomas, but these abnormalities did not meet the diagnostic criteria of Cushing's syndrome. Adrenal uptake of the tracer in the patients with UCV-incidentalomas was not statistically different from that in the patients with Cushing's adenomas and had no relationship with hormonal values in either patient group. Tumor size on CT correlated with the levels of 24-hr urinary 17-OHCS (r=0.75, p=0.02) and plasma cortisol at 7:00 (r=0.82, p=0.007) in the patients with UCV-incidentalomas, but not in the patients with Cushing's adenomas. Although 3 UCV-incidentalomas increased slightly in size, none of 9 patients with UCV-incidentalomas has developed Cushing's syndrome for 4 to 52 months. These results suggest that the UCV-incidentaloma may be essentially different from the Cushing's adenoma and unlikely to develop Cushing's syndrome. (author)

  1. Dynamics of bounded confidence opinion in heterogeneous social networks: Concord against partial antagonism

    Science.gov (United States)

    Kurmyshev, Evguenii; Juárez, Héctor A.; González-Silva, Ricardo A.

    2011-08-01

    Bounded confidence models of opinion dynamics in social networks have been actively studied in recent years, in particular, opinion formation and extremism propagation along with other aspects of social dynamics. In this work, after an analysis of limitations of the Deffuant-Weisbuch (DW) bounded confidence, relative agreement model, we propose the mixed model that takes into account two psychological types of individuals. Concord agents (C-agents) are friendly people; they interact in a way that their opinions always get closer. Agents of the other psychological type show partial antagonism in their interaction (PA-agents). Opinion dynamics in heterogeneous social groups, consisting of agents of the two types, was studied on different social networks: Erdös-Rényi random graphs, small-world networks and complete graphs. Limit cases of the mixed model, pure C- and PA-societies, were also studied. We found that group opinion formation is, qualitatively, almost independent of the topology of networks used in this work. Opinion fragmentation, polarization and consensus are observed in the mixed model at different proportions of PA- and C-agents, depending on the value of initial opinion tolerance of agents. As for the opinion formation and arising of “dissidents”, the opinion dynamics of the C-agents society was found to be similar to that of the DW model, except for the rate of opinion convergence. Nevertheless, mixed societies showed dynamics and bifurcation patterns notably different to those of the DW model. The influence of biased initial conditions over opinion formation in heterogeneous social groups was also studied versus the initial value of opinion uncertainty, varying the proportion of the PA- to C-agents. Bifurcation diagrams showed an impressive evolution of collective opinion, in particular, radical changes of left to right consensus or vice versa at an opinion uncertainty value equal to 0.7 in the model with the PA/C mixture of population near 50/50.

  2. Retinopathy diabetic screening by non-mydriatic retinography: concordance between primary care physicians, nurses and ophthalmologists.

    Science.gov (United States)

    Rodríguez Villa, Susana; Suárez Muñiz, María Teresa; De Dios Del Valle, Ricardo; Alonso Álvarez, Crisanto

    To compare the evaluation of retinographies by a teleophthalmology nurse and primary care physicians (PCP) with an ophthalmologist referral hospital (gold standard). Cross-sectional study on a random sample of 337 patients on the teleophthalmology programme from January 2010 to January 2015. We analyzed the diagnostic evaluation (whether or not it presented findings of RD) and the therapeutic assessment (whether or not referral to the opthalmology department was needed) which were conducted independently on the sample retinographies by the PCP, a nurse and an ophthalmologist (gold standard). Reliability and concordance between the gold standard and the PCP and the nurse were checked and the statistical analyses were supported using SPSSv.23.00 software and diagnostic test reliability calculators (EPIDAT 4.1). In the diagnosis of RD, the nurse presented: sensitivity (S): 0.96; specificity (Sp): 0.89; PPV: 0.58; NPV: 0.99; Kappa index: 0.67 and PCP: S: 0.98; Sp: 0.99; PPV: 0.96; NPV: 0.99; Kappa index: 0.96. In the referral to ophthalmology assessed by the nurse: S: 0.83; Sp: 0.83; PPV: 0.51; NPV: 0.96; Kappa Index: 0.53 and PCP: S: 0.62; Sp: 0.76; PPV: 0.36; NPV: 0.90; Kappa index: 0.29. A nursing teleophthalmology programme could perform population screening for RD with the same quality as PCP. This would increase coverage, in addition to providing better use of resources by avoiding intermediate patient appointments through PCP and increased health savings. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  3. Prevalence and concordance of smoking among mothers and fathers within the Pacific Islands Families Study.

    Science.gov (United States)

    Tautolo, El-Shadan; Schluter, Philip J; Taylor, Steve

    2011-09-01

    Cigarette smoking continues to contribute to the adverse mortality and morbidity rates for Pacific people in New Zealand. Using a large cohort study of Pacific families, this paper investigates the prevalence of smoking amongst Pacific mothers and fathers over three time-points, up to six years after the arrival of their child, to determine the concordance of both partners' reports of that smoking. Moreover, the patterns of smoking between partners were investigated over the three major Pacific ethnicities that reside in New Zealand (Samoan, Tongan and Cook Island Māori). Maternal self-report prevalence of smoking estimates ranged from 29.8% (1-year) to 33.6% (6-years). Paternal self-reported prevalence of smoking estimates were higher, and ranged from 37.9% (2-years) to 45.2% (6-years). The prevalence estimates for smoking in both mothers and fathers over all three measurement waves were higher than the 26.9% reported for Pacific people in the 2006/07 New Zealand Health Survey. No significant change in fathers' smoking prevalence over time was observed (p = 0.37); however a significant increase in mothers' smoking prevalence over time was noted (p = 0.002). Significantly, for about 25% of Pacific children both their parents were current smokers. Reducing infant exposure to tobacco smoke, by encouraging parents to quit smoking or banning smoking in the home and local environment (such as vehicles), is likely to bring about improved health outcomes for many Pacific children. Findings suggest that the interaction between parents should be considered rather than focusing on mothers' or fathers' smoking behaviour in isolation.

  4. Know your tools - concordance of different methods for measuring brain volume change after ischemic stroke

    International Nuclear Information System (INIS)

    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew; Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M.; Churilov, Leonid; Parsons, Mark W.

    2015-01-01

    Longitudinal brain volume changes have been investigated in a number of cerebral disorders as a surrogate marker of clinical outcome. In stroke, unique methodological challenges are posed by dynamic structural changes occurring after onset, particularly those relating to the infarct lesion. We aimed to evaluate agreement between different analysis methods for the measurement of post-stroke brain volume change, and to explore technical challenges inherent to these methods. Fifteen patients with anterior circulation stroke underwent magnetic resonance imaging within 1 week of onset and at 1 and 3 months. Whole-brain as well as grey- and white-matter volume were estimated separately using both an intensity-based and a surface watershed-based algorithm. In the case of the intensity-based algorithm, the analysis was also performed with and without exclusion of the infarct lesion. Due to the effects of peri-infarct edema at the baseline scan, longitudinal volume change was measured as percentage change between the 1 and 3-month scans. Intra-class and concordance correlation coefficients were used to assess agreement between the different analysis methods. Reduced major axis regression was used to inspect the nature of bias between measurements. Overall agreement between methods was modest with strong disagreement between some techniques. Measurements were variably impacted by procedures performed to account for infarct lesions. Improvements in volumetric methods and consensus between methodologies employed in different studies are necessary in order to increase the validity of conclusions derived from post-stroke cerebral volumetric studies. Readers should be aware of the potential impact of different methods on study conclusions. (orig.)

  5. Favorable effects of concord grape juice on endothelial function and arterial stiffness in healthy smokers.

    Science.gov (United States)

    Siasos, Gerasimos; Tousoulis, Dimitris; Kokkou, Eleni; Oikonomou, Evangelos; Kollia, Maria-Eleni; Verveniotis, Aleksis; Gouliopoulos, Nikolaos; Zisimos, Konstantinos; Plastiras, Aris; Maniatis, Konstantinos; Stefanadis, Christodoulos

    2014-01-01

    Smoking is associated with impaired vascular function. Concord grape juice (CGJ), a rich source of flavonoids, can modify cardiovascular risk factors. Endothelial function and arterial stiffness are surrogate markers of arterial health. We examined the impact of CGJ on arterial wall properties in healthy smokers. We studied the effect of a 2-week oral treatment with CGJ in 26 healthy smokers on 3 occasions (day 0 (baseline), day 7, and day 14) in a randomized, placebo-controlled, double-blind, crossover study. Measurements were taken before (pSm), immediately after (Sm0), and 20 minutes after (Sm20) cigarette smoking. Endothelial function was evaluated by flow-mediated dilation (FMD) of the brachial artery. Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness. Compared with placebo, treatment with CGJ resulted in a significant improvement in pSm values of FMD (P = 0.02) and PWV (P = 0.04). At baseline, smoking decreased FMD in both the CGJ group (P FMD on day 7 (P = 0.02) and day 14 (P < 0.001). Moreover, at baseline, smoking induced a significant elevation in PWV in both the CGJ group (P = 0.02) and the placebo group (P = 0.04). Treatment with CGJ prevented the smoking-induced elevation in PWV on day 7 (P = 0.003) and day 14 (P < 0.001). CGJ consumption improved endothelial function and vascular elastic properties of the arterial tree in healthy smokers and attenuated acute smoking-induced impairment of arterial wall properties.

  6. Diurnal rhythm and concordance between objective and subjective hot flashes: the Hilo Women's Health Study.

    Science.gov (United States)

    Sievert, Lynnette L; Reza, Angela; Mills, Phoebe; Morrison, Lynn; Rahberg, Nichole; Goodloe, Amber; Sutherland, Michael; Brown, Daniel E

    2010-01-01

    The aims of this study were to test for a diurnal pattern in hot flashes in a multiethnic population living in a hot, humid environment and to examine the rates of concordance between objective and subjective measures of hot flashes using ambulatory and laboratory measures. Study participants aged 45 to 55 years were recruited from the general population of Hilo, HI. Women wore a Biolog hot flash monitor (UFI, Morro Bay, CA), kept a diary for 24 hours, and also participated in 3-hour laboratory measures (n = 199). Diurnal patterns were assessed using polynomial regression. For each woman, objectively recorded hot flashes that matched subjective experience were treated as true-positive readings. Subjective hot flashes were considered the standard for computing false-positive and false-negative readings. True-positive, false-positive, and false-negative readings were compared across ethnic groups by chi analyses. Frequencies of sternal, nuchal, and subjective hot flashes peaked at 1500 +/- 1 hours with no difference by ethnicity. Laboratory results supported the pattern seen in ambulatory monitoring. Sternal and nuchal monitoring showed the same frequency of true-positive measures, but nonsternal electrodes picked up more false-positive readings. Laboratory monitoring showed very low frequencies of false negatives. There were no ethnic differences in the frequency of true-positive or false-positive measures. Women of European descent were more likely to report hot flashes that were not objectively demonstrated (false-negative measures). The diurnal pattern and peak in hot flash occurrence in the hot humid environment of Hilo were similar to results from more temperate environments. Lack of variation in sternal versus nonsternal measures and in true-positive measures across ethnicities suggests no appreciable effect of population variation in sweating patterns.

  7. Concordance between phylogeographical and biogeographical patterns in the Brazilian Cerrado: diversification of the endemic tree Dalbergia miscolobium (Fabaceae).

    Science.gov (United States)

    Novaes, Renan Milagres Lage; Ribeiro, Renata Acácio; Lemos-Filho, José Pires; Lovato, Maria Bernadete

    2013-01-01

    Few studies have addressed the phylogeography of species of the Cerrado, the largest savanna biome of South America. Here we aimed to investigate the phylogeographical structure of Dalbergia miscolobium, a widespread tree from the Cerrado, and to verify its concordance with plant phylogeographical and biogeographical patterns so far described. A total of 287 individuals from 32 populations were analyzed by sequencing the trnL intron of the chloroplast DNA and the internal transcribed spacer of the nuclear ribosomal DNA. Analysis of population structure and tests of population expansion were performed and the time of divergence of haplotypes was estimated. Twelve and 27 haplotypes were identified in the cpDNA and nrDNA data, respectively. The star-like network configuration and the mismatch distributions indicated a recent spatial and demographic expansion of the species. Consistent with previous tree phylogeographical studies of Cerrado trees, the cpDNA also suggested a recent expansion towards the southern Cerrado. The diversity of D. miscolobium was widespread but high levels of genetic diversity were found in the Central Eastern and in the southern portion of Central Western Cerrado. The combined analysis of cpDNA and nrDNA supported a phylogeographic structure into seven groups. The phylogeographical pattern showed many concordances with biogeographical and phylogeographical studies in the Cerrado, mainly with the Cerrado phytogeographic provinces superimposed to our sampling area. The data reinforced the uniqueness of Northeastern and Southeastern Cerrados and the differentiation between Eastern and Western Central Cerrados. The recent diversification of the species (estimated between the Pliocene and the Pleistocene) and the 'genealogical concordances' suggest that a shared and persistent pattern of species diversification might have been present in the Cerrado over time. This is the first time that an extensive 'genealogical concordance' between

  8. Concordance of Time-of-Flight MRA and Digital Subtraction Angiography in Adult Primary Central Nervous System Vasculitis.

    Science.gov (United States)

    de Boysson, H; Boulouis, G; Parienti, J-J; Touzé, E; Zuber, M; Arquizan, C; Dequatre, N; Detante, O; Bienvenu, B; Aouba, A; Guillevin, L; Pagnoux, C; Naggara, O

    2017-10-01

    3D-TOF-MRA and DSA are 2 available tools to demonstrate neurovascular involvement in primary central nervous system vasculitis. We aimed to compare the diagnostic concordance of vessel imaging using 3D-TOF-MRA and DSA in patients with primary central nervous system vasculitis. We retrospectively identified all patients included in the French primary central nervous system vasculitis cohort of 85 patients who underwent, at baseline, both intracranial 3D-TOF-MRA and DSA in an interval of no more than 2 weeks and before treatment initiation. Two neuroradiologists independently reviewed all 3D-TOF-MRA and DSA imaging. Brain vasculature was divided into 25 arterial segments. Concordance between 3D-TOF-MRA and DSA for the identification of arterial stenosis was assessed by the Cohen κ Index. Thirty-one patients met the inclusion criteria, including 20 imaged with a 1.5T MR unit and 11 with a 3T MR unit. Among the 25 patients (81%) with abnormal DSA findings, 24 demonstrated abnormal 3D-TOF-MRA findings, whereas all 6 remaining patients with normal DSA findings had normal 3D-TOF-MRA findings. In the per-segment analysis, concordance between 1.5T 3D-TOF-MRA and DSA was 0.82 (95% CI, 0.75-0.93), and between 3T 3D-TOF-MRA and DSA, it was 0.87 (95% CI, 0.78-0.91). 3D-TOF-MRA shows a high concordance with DSA in diagnostic performance when analyzing brain vasculature in patients with primary central nervous system vasculitis. In patients with negative 3T 3D-TOF-MRA findings, the added diagnostic value of DSA is limited. © 2017 by American Journal of Neuroradiology.

  9. [Concordance of glomerular filtration rate with creatinine clearance in 24-hour urine and Schwartz and Schwartz updated].

    Science.gov (United States)

    Salazar-Gutiérrez, María Luisa; Ochoa-Ponce, Cristina; Lona-Reyes, Juan Carlos; Gutiérrez-Íñiguez, Sara Ivonne

    Reference methods for the quantification of the glomerular filtration rate (GFR) are difficult to use in clinical practice; formulas for evaluating GFR based on serum creatinine (SCr) and/or creatinine clearance are used. The aim of this study was to quantify the correlation and concordance of GFR with creatinine clearance in 24-hour urine (GFR24) and Schwartz and Schwartz updated formulas. Cross-sectional study involving healthy pediatric patients and with chronic kidney disease (CKD) from 5 to 16.9 years. Linear correlation between GFR 24 and two formulas was evaluated with the Pearson correlation coefficient (r) and intraclass correlation coefficient (ICC). We studied 134 patients, of which 59.7% were male. Mean age was 10.8 years. The average GFR24 was 140.34ml/min/1.73m 2 ; 34.3% (n=46) had GFR <90ml/min/1.73m 2 . Moderate linear correlation between GFR24 and Schwartz (r= 0.63) and Schwartz updated (r= 0.65) formulas was observed. There was good concordance between the GFR24 and Schwartz (ICC= 0.77) and updated Schwartz (ICC= 0.77) formulas. Schwartz classical formula in patients with GFR24 ≥ 90ml/min/1.73m 2 estimated higher values, while Schwartz updated underestimated values. There is moderate correlation and good concordance between the GFR24 and Schwartz and Schwartz updated formulas. The concordance was better in patients with obesity and lower in women, patients with hyperfiltration and normal weight. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  10. Concordance of the late night salivary cortisol in patients with Cushing's syndrome and elevated urine-free cortisol.

    Science.gov (United States)

    Doi, Suhail A R; Clark, Justin; Russell, Anthony W

    2013-04-01

    The concordance of the late night salivary cortisol (LNSC) results with the 24-h urine-free cortisol (UFC) results in the biochemical screening for Cushing's syndrome is unknown. We investigated this in a population of Cushing's syndrome subjects. We used meta-analytic methods to pool proportions of LNSC-positive subjects from diagnostic evaluations of Cushing's syndrome subjects where both tests were performed and the UFC was elevated (any level). Cushing's syndrome was confirmed in all subjects by two out of three conventional tests. LNSC was collected between 22:00 to 24:00 h and measured around the same time period as the UFC. Minimum cutoffs of ≥4 and ≥10 nmol/L were used to determine concordance with the UFC and studies were limited to those that used radioimmunoassays or electrochemiluminiscence immunoassays for LNSC. The concordance of LNSC ≥4 nmol/L was 97 % (95 % CI 95-99 %) and studies were homogeneous. With LNSC ≥10 nmol/L, there was heterogeneity and two groups were discernible with a pooled concordance of 69 % (95 % CI 60-77 %) and 95 % (95 % CI 92-97 %). Within these sub-groups, studies were homogeneous and there was no difference between them in collection methods, assays used, geographic location, year of publication, or the quality of the underlying studies. The LNSC at a very specific cutoff detects at best 95 % of cases and at worst 69 % of cases of Cushing's syndrome that are UFC positive. The two tests become equivalent at the more sensitive cutoff (>4 nmol/L). We conclude that, given its many benefits and the currently documented equivalence to the UFC, the LNSC should replace the conventional 24-h UFC as the frontline test when screening for Cushing's syndrome.

  11. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    Science.gov (United States)

    2012-01-01

    Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9) than with the adult section (F4) of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population) is not identical with the population examined using the ICD (clinical population). PMID:23267678

  12. Psychiatric patients' preferences and experiences in clinical decision-making: examining concordance and correlates of patients' preferences.

    Science.gov (United States)

    De las Cuevas, Carlos; Peñate, Wenceslao; de Rivera, Luis

    2014-08-01

    To assess the concordance between patients' preferred role in clinical decision-making and the role they usually experience in their psychiatric consultations and to analyze the influence of socio-demographic, clinical and personality characteristics on patients' preferences. 677 consecutive psychiatric outpatients were invited to participate in a cross-sectional survey and 507 accepted. Patients completed Control Preference Scale twice consecutively before consultation, one for their preferences of participation and another for the style they usually experienced until then, and locus of control and self-efficacy scales. Sixty-three percent of psychiatric outpatients preferred a collaborative role in decision-making, 35% preferred a passive role and only a 2% an active one. A low concordance for preferred and experienced participation in medical decision-making was registered, with more than a half of patients wanting a more active role than they actually had. Age and doctors' health locus of control orientation were found to be the best correlates for participation preferences, while age and gender were for experienced. Psychiatric diagnoses registered significant differences in patients' preferences of participation but no concerning experiences. The limited concordance between preferred and experienced roles in psychiatric patients is indicative that clinicians need to raise their sensitivity regarding patient's participation. The assessment of patient's attribution style should be useful for psychiatrist to set objectives and priority in the communication with their patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. A Comparison of Self-reported Medication Adherence to Concordance Between Part D Claims and Medication Possession.

    Science.gov (United States)

    Savitz, Samuel T; Stearns, Sally C; Zhou, Lei; Thudium, Emily; Alburikan, Khalid A; Tran, Richard; Rodgers, Jo E

    2017-05-01

    Medicare Part D claims indicate medication purchased, but people who are not fully adherent may extend prescription use beyond the interval prescribed. This study assessed concordance between Part D claims and medication possession at a study visit in relation to self-reported medication adherence. We matched Part D claims for 6 common medications to medications brought to a study visit in 2011-2013 for the Atherosclerosis Risk in Communities study. The combined data consisted of 3027 medication events (claims, medications possessed, or both) for 2099 Atherosclerosis Risk in Communities study participants. Multinomial logistic regression estimated the association of concordance (visit only, Part D only, or both) with self-reported medication adherence while controlling for sociodemographic characteristics, veteran status, and availability under Generic Drug Discount Programs. Relative to participants with high adherence, medication events for participants with low adherence were approximately 25 percentage points less likely to match and more likely to be visit only (PDiscount Programs were 3 percentage points more likely to be visit only. Part D claims were substantially less likely to be concordant with medications possessed at study visit for participants with low self-reported adherence. This result supports the construction of adherence proxies such as proportion days covered using Part D claims.

  14. Is There a Concordance Between the Gleason Scores of Needle Biopsy and Radical Prostatectomy Specimens in Prostatic Carsinoma?

    Directory of Open Access Journals (Sweden)

    Faruk Özgör

    2016-03-01

    Full Text Available Aim: To evaluate the concordance between the Gleason Scores (GS of prostate biopsy and radical prostatectomy specimens. Methods: Prostate biopsy was performed in 1135 patients with the suspicion of prostate cancer in our clinic between 2008 and 2012. A total of 366 patients were diagnosed with prostate cancer. Radical prostatectomy was performed in 73 of these patients and GS of pathology specimens were included in this study for comparison. The patients were divided into three groups (low intermediate- and high-risk patients according to the D’amico risk classification for prostate cancer. Results: The median age of the patients was 64.2±6.1 years (54- 73. The mean prostate specific antigen level was 20.34 ng/mL and the mean biopsy core number was 12±0.58. A statistically significant concordance was detected between the GS of biopsy specimens and radical prostatectomy materials in 65.7% of patients (p<0.01. There were 40 patients in the low-risk group, however, 8 (20% of them were identified to be intermediate-risk patients and one (2.5% was found to be a high-risk patient after radical prostatectomy. Conclusion: Concordance between the GS of prostate biopsy and radical prostatectomy materials are important for selection of the appropriate treatment

  15. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

    Directory of Open Access Journals (Sweden)

    Adornetto Carmen

    2012-12-01

    Full Text Available Abstract Background Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD, specific phobia, social phobia, and generalized anxiety disorder (GAD. Methods A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule’s Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified. Results DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9 than with the adult section (F4 of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. Conclusions The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population is not identical with the population examined using the ICD (clinical population.

  16. Breast Intraductal Papillomas without Atypia in Radiologic-Pathologic Concordant Core Needle Biopsies: Predictors of Upgrade to Carcinoma at Excision

    Science.gov (United States)

    Pareja, Fresia; Corben, Adriana; Brennan, Sandra; Murray, Melissa P.; Bowser, Zenica; Jakate, Kiran; Sebastiano, Christopher; Morrow, Monica; Morris, Elizabeth; Brogi, Edi

    2016-01-01

    Background The surgical management of breast intraductal papilloma without atypia (IDP) identified at core needle biopsy (CNB) is controversial. We assessed the rate of upgrade to carcinoma at surgical excision, and identified parameters predictive of upgrade. Methods We identified women with CNB diagnosis of intraductal papilloma without atypia or carcinoma at our center between 2003 and 2013. Radiologic-pathologic concordance was assessed for all cases, and discordant cases were excluded. We correlated the radiologic and clinicopathologic features of patients with CNB diagnosis of IDP with upgrade to carcinoma at surgical excision. Results Our study population consists of 189 women with 196 IDPs; 166 women (171 IDPs) underwent excision. The upgrade rate was 2.3% (4/171). The upgrade lesions were 2 invasive lobular carcinomas and 2 cases of ductal carcinoma in situ (DCIS). One case of DCIS involved the residual IDP, whereas the other 3 carcinomas were ≥8 mm away. Twenty-four women (25 IDPs) did not undergo excision, and had stable imaging at follow-up (median of 23.5 months). Conclusions The upgrade rate at excision of IDP diagnosed at CNB with radiologic-pathologic concordance is 2.3%. Our findings suggest that observation is appropriate for patients with radiologic-pathologic concordant CNB yielding IDP, regardless of its size. PMID:27315013

  17. Prostate Problems

    Science.gov (United States)

    ... know the exact cause of your prostate problem. Prostatitis The cause of prostatitis depends on whether you ... prostate problem in men older than age 50. Prostatitis If you have a UTI, you may be ...

  18. General problems

    International Nuclear Information System (INIS)

    2005-01-01

    This article presents the general problems as natural disasters, consequences of global climate change, public health, the danger of criminal actions, the availability to information about problems of environment

  19. Learning Problems

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Learning Problems KidsHealth / For Kids / Learning Problems What's in ... for how to make it better. What Are Learning Disabilities? Learning disabilities aren't contagious, but they ...

  20. Ankle Problems

    Science.gov (United States)

    ... Read MoreDepression in Children and TeensRead MoreBMI Calculator Ankle ProblemsFollow this chart for more information about problems that can cause ankle pain. Our trusted Symptom Checker is written and ...

  1. Quantitative analysis chemistry

    International Nuclear Information System (INIS)

    Ko, Wansuk; Lee, Choongyoung; Jun, Kwangsik; Hwang, Taeksung

    1995-02-01

    This book is about quantitative analysis chemistry. It is divided into ten chapters, which deal with the basic conception of material with the meaning of analysis chemistry and SI units, chemical equilibrium, basic preparation for quantitative analysis, introduction of volumetric analysis, acid-base titration of outline and experiment examples, chelate titration, oxidation-reduction titration with introduction, titration curve, and diazotization titration, precipitation titration, electrometric titration and quantitative analysis.

  2. Quantitative Algebraic Reasoning

    DEFF Research Database (Denmark)

    Mardare, Radu Iulian; Panangaden, Prakash; Plotkin, Gordon

    2016-01-01

    We develop a quantitative analogue of equational reasoning which we call quantitative algebra. We define an equality relation indexed by rationals: a =ε b which we think of as saying that “a is approximately equal to b up to an error of ε”. We have 4 interesting examples where we have a quantitative...... equational theory whose free algebras correspond to well known structures. In each case we have finitary and continuous versions. The four cases are: Hausdorff metrics from quantitive semilattices; pWasserstein metrics (hence also the Kantorovich metric) from barycentric algebras and also from pointed...

  3. Quantitative autoradiography of neurochemicals

    International Nuclear Information System (INIS)

    Rainbow, T.C.; Biegon, A.; Bleisch, W.V.

    1982-01-01

    Several new methods have been developed that apply quantitative autoradiography to neurochemistry. These methods are derived from the 2-deoxyglucose (2DG) technique of Sokoloff (1), which uses quantitative autoradiography to measure the rate of glucose utilization in brain structures. The new methods allow the measurement of the rate of cerbral protein synthesis and the levels of particular neurotransmitter receptors by quantitative autoradiography. As with the 2DG method, the new techniques can measure molecular levels in micron-sized brain structures; and can be used in conjunction with computerized systems of image processing. It is possible that many neurochemical measurements could be made by computerized analysis of quantitative autoradiograms

  4. Concordance of gene expression in human protein complexes reveals tissue specificity and pathology

    DEFF Research Database (Denmark)

    Börnigen, Daniela; Pers, Tune Hannes; Thorrez, Lieven

    2013-01-01

    Disease-causing variants in human genes usually lead to phenotypes specific to only a few tissues. Here, we present a method for predicting tissue specificity based on quantitative deregulation of protein complexes. The underlying assumption is that the degree of coordinated expression among prot...

  5. Molecular classification of endometrial carcinoma on diagnostic specimens is highly concordant with final hysterectomy: Earlier prognostic information to guide treatment.

    Science.gov (United States)

    Talhouk, Aline; Hoang, Lien N; McConechy, Melissa K; Nakonechny, Quentin; Leo, Joyce; Cheng, Angela; Leung, Samuel; Yang, Winnie; Lum, Amy; Köbel, Martin; Lee, Cheng-Han; Soslow, Robert A; Huntsman, David G; Gilks, C Blake; McAlpine, Jessica N

    2016-10-01

    Categorization and risk stratification of endometrial carcinomas is inadequate; histomorphologic assessment shows considerable interobserver variability, and risk of metastases and recurrence can only be derived after surgical staging. We have developed a Proactive Molecular Risk classification tool for Endometrial cancers (ProMisE) that identifies four distinct prognostic subgroups. Our objective was to assess whether molecular classification could be performed on diagnostic endometrial specimens obtained prior to surgical staging and its concordance with molecular classification performed on the subsequent hysterectomy specimen. Sequencing of tumors for exonuclease domain mutations (EDMs) in POLE and immunohistochemistry for mismatch repair (MMR) proteins and p53 were applied to both pre- and post-staging archival specimens from 60 individuals to identify four molecular subgroups: MMR-D, POLE EDM, p53 wild type, p53 abn (abnormal). Three gynecologic subspecialty pathologists assigned histotype and grade to a subset of samples. Concordance of molecular and clinicopathologic subgroup assignments were determined, comparing biopsy/curetting to hysterectomy specimens. Complete molecular and pathologic categorization was achieved in 57 cases. Concordance metrics for pre- vs. post-staging endometrial samples categorized by ProMisE were highly favorable; average per ProMisE class sensitivity(0.9), specificity(0.96), PPV(0.9), NPV(0.96) and kappa statistic 0.86(95%CI, 0.72-0.93), indicating excellent agreement. We observed the highest level of concordance for 'p53 abn' tumors, the group associated with the worst prognosis. In contrast, grade and histotype assignment from original pathology reports pre- vs. post-staging showed only moderate levels of agreement (kappa=0.55 and 0.44 respectively); even with subspecialty pathology review only moderate levels of agreement were observed. Molecular classification can be achieved on diagnostic endometrial samples and accurately

  6. Three-dimensional ultrasound in the diagnosis of Müllerian duct anomalies and concordance with magnetic resonance imaging.

    Science.gov (United States)

    Bermejo, C; Martínez Ten, P; Cantarero, R; Diaz, D; Pérez Pedregosa, J; Barrón, E; Labrador, E; Ruiz López, L

    2010-05-01

    To demonstrate the value of three-dimensional (3D) ultrasound in the diagnosis of uterine malformations and its concordance with magnetic resonance imaging (MRI). This study included 286 women diagnosed with uterine malformation by 3D ultrasound, having been referred to our clinics on suspicion of uterine malformation following clinical and/or conventional two-dimensional ultrasound examination. With the exception of three with intact hymen, patients underwent both bimanual examination and speculoscopy before and/or after sonography. MRI was performed in 65 cases. We analyzed the diagnostic concordance between the techniques in the study of uterine malformations. Using 3D ultrasound we diagnosed: one case with uterine agenesis; 10 with unicornuate uterus, four of which also underwent MRI; six with didelphic uterus, one of which had MRI; 45 with bicornuate uterus, 12 of which had MRI; 125 with septate uterus (18 with two cervices), 42 of which had MRI (six with two cervices); 96 with arcuate uterus, three of which had MRI; and three with diethylstilbestrol (DES) iatrogenic uterine malformations, all of which had MRI. Among the 65 which underwent MRI, the diagnosis was: four cases with unicornuate uterus, 10 with bicornuate uterus (two with two cervices), 45 with septate uterus (five with two cervices), three with arcuate uterus and three with DES-related uterine malformations. The concordance between 3D ultrasound and MRI was very good (kappa index, 0.880 (95% CI, 0.769-0.993)). Discrepancies in diagnosis between the two techniques occurred in four cases. There was very good concordance in the diagnosis of associated findings (kappa index, 0.878 (95% CI, 0.775-0.980)), this analysis identifying differences in two cases. There is a high degree of concordance between 3D ultrasound and MRI in the diagnosis of uterine malformations, the relationship between cavity and fundus being visualized equally well with both techniques. 3D ultrasound should be complemented by

  7. Qualitative and quantitative descriptions of glenohumeral motion.

    Science.gov (United States)

    Hill, A M; Bull, A M J; Wallace, A L; Johnson, G R

    2008-02-01

    Joint modelling plays an important role in qualitative and quantitative descriptions of both normal and abnormal joints, as well as predicting outcomes of alterations to joints in orthopaedic practice and research. Contemporary efforts in modelling have focussed upon the major articulations of the lower limb. Well-constrained arthrokinematics can form the basis of manageable kinetic and dynamic mathematical predictions. In order to contain computation of shoulder complex modelling, glenohumeral joint representations in both limited and complete shoulder girdle models have undergone a generic simplification. As such, glenohumeral joint models are often based upon kinematic descriptions of inadequate degrees of freedom (DOF) for clinical purposes and applications. Qualitative descriptions of glenohumeral motion range from the parody of a hinge joint to the complex realism of a spatial joint. In developing a model, a clear idea of intention is required in order to achieve a required application. Clinical applicability of a model requires both descriptive and predictive output potentials, and as such, a high level of validation is required. Without sufficient appreciation of the clinical intention of the arthrokinematic foundation to a model, error is all too easily introduced. Mathematical description of joint motion serves to quantify all relevant clinical parameters. Commonly, both the Euler angle and helical (screw) axis methods have been applied to the glenohumeral joint, although concordance between these methods and classical anatomical appreciation of joint motion is limited, resulting in miscommunication between clinician and engineer. Compounding these inconsistencies in motion quantification is gimbal lock and sequence dependency.

  8. Task activation and functional connectivity show concordant memory laterality in temporal lobe epilepsy.

    Science.gov (United States)

    Sideman, Noah; Chaitanya, Ganne; He, Xiaosong; Doucet, Gaelle; Kim, Na Young; Sperling, Michael R; Sharan, Ashwini D; Tracy, Joseph I

    2018-04-01

    In epilepsy, asymmetries in the organization of mesial temporal lobe (MTL) functions help determine the cognitive risk associated with procedures such as anterior temporal lobectomy. Past studies have investigated the change/shift in a visual episodic memory laterality index (LI) in mesial temporal lobe structures through functional magnetic resonance imaging (fMRI) task activations. Here, we examine whether underlying task-related functional connectivity (FC) is concordant with such standard fMRI laterality measures. A total of 56 patients with temporal lobe epilepsy (TLE) (Left TLE [LTLE]: 31; Right TLE [RTLE]: 25) and 34 matched healthy controls (HC) underwent fMRI scanning during performance of a scene encoding task (SET). We assessed an activation-based LI of the hippocampal gyrus (HG) and parahippocampal gyrus (PHG) during the SET and its correspondence with task-related FC measures. Analyses involving the HG and PHG showed that the patients with LTLE had a consistently higher LI (right-lateralized) than that of the HC and group with RTLE, indicating functional reorganization. The patients with RTLE did not display a reliable contralateral shift away from the pathology, with the mesial structures showing quite distinct laterality patterns (HG, no laterality bias; PHG, no evidence of LI shift). The FC data for the group with LTLE provided confirmation of reorganization effects, revealing that a rightward task LI may be based on underlying connections between several left-sided regions (middle/superior occipital and left medial frontal gyri) and the right PHG. The FCs between the right HG and left anterior cingulate/medial frontal gyri were also observed in LTLE. Importantly, the data demonstrate that the areas involved in the LTLE task activation shift to the right hemisphere showed a corresponding increase in task-related FCs between the hemispheres. Altered laterality patterns based on mesial temporal lobe epilepsy (MTLE) pathology manifest as several

  9. 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

  10. The Concordance between Patients' Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?

    Science.gov (United States)

    Prieto-Velasco, Mario; Quiros, Pedro; Remon, Cesar

    2015-01-01

    It is desirable for patients to play active roles in the choice of renal replacement therapy (RRT). Patient decision aid tools (PDAs) have been developed to allow the patients to choose the option best suited to their individual needs. An observational, prospective registry was conducted in 26 Spanish hospitals between September 2010 and May 2012. The results of the patients' choice and the definitive RRT modality were registered through the progressive implementation of an Education Process (EP) with PDAs designed to help Chronic Kidney Disease (CKD) patients choose RRT. Patients included in this study: 1044. Of these, 569 patients used PDAs and had made a definitive choice by the end of registration. A total of 88.4% of patients chose dialysis [43% hemodialysis (HD) and 45% peritoneal dialysis (PD)] 3.2% preemptive living-donor transplant (TX), and 8.4% conservative treatment (CT). A total of 399 patients began RRT during this period. The distribution was 93.4% dialysis (53.6% HD; 40% PD), 1.3% preemptive TX and 5.3% CT. The patients who followed the EP changed their mind significantly less often [kappa value of 0.91 (95% CI, 0.86-0.95)] than those who did not follow it, despite starting unplanned treatment [kappa value of 0.85 (95% CI, 0.75-0.95]. A higher agreement between the final choice and a definitive treatment was achieved by the EP and planned patients [kappa value of 0.93 (95% CI, 0.89-0.98)]. Those who did not go through the EP had a much lower index of choosing PD and changed their decision more frequently when starting definitive treatment [kappa value of 0.73 (95% CI, 0.55-0.91)]. Free choice, assisted by PDAs, leads to a 50/50 distribution of PD and HD choice and an increase in TX choice. The use of PDAs, even with an unplanned start, achieved a high level of concordance between the chosen and definitive modality.

  11. Familial concordance of phenotype and microbial variation among siblings with CF.

    Science.gov (United States)

    Picard, Elie; Aviram, Micha; Yahav, Yaakov; Rivlin, Joseph; Blau, Hanna; Bentur, Lea; Avital, Avraham; Villa, Yael; Schwartz, Shepard; Kerem, Batsheva; Kerem, Eitan

    2004-10-01

    The clinical spectrum of cystic fibrosis (CF) is influenced by the cystic fibrosis transmembrane conductance regulator (CFTR) genotype. However, variable courses of the disease were demonstrated among patients with identical genotypes. Since siblings share identical CFTR mutations and environmental factors, they can serve as a model to assess the effect of modifier genes on disease expression, and also to evaluate cross-infection. The aim of this study was to compare disease expression among siblings with CF. All sibling pairs treated at 7 CF centers in Israel were included in the study. Data were collected from patients' medical charts. Fifty families with at least 2 siblings were identified. As expected, the second-born sibling was diagnosed at an earlier age compared to the first-born. The mode of CF presentation at diagnosis showed significant familial concordance. In the families where the first sibling presented with gastrointestinal manifestations, 79% of the second siblings also presented with gastrointestinal manifestations. When gastrointestinal manifestations were absent in the first sibling, only 12% of the second siblings presented with gastrointestinal manifestations (P sibling presented with respiratory symptoms, 60% of the second siblings presented with the similar symptoms. However, when the first sibling presented without respiratory symptoms, only 12% of the second siblings presented with respiratory symptoms (P sibling had MI, 8 (80%) of the subsequent siblings had MI. On the other hand, in the 39 families where the first-born sibling did not have MI, only 2 (5%) subsequent siblings had MI (P siblings. P. aeruginosa grew from sputum in 89% of our study patients. When P. aeruginosa was isolated from the first-born patient, 91% of the second siblings were also positive for P. aeruginosa, whereas when the initial sibling was not a carrier of P. aeruginosa, only 50% of subsequent siblings were positive (P sibling than in the first for the two

  12. Morbidities, concordance, and predictors of preterm premature rupture of membranes among pregnant women at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria.

    Science.gov (United States)

    Okeke, T C; Enwereji, J O; Adiri, C O; Onwuka, C I; Iferikigwe, E S

    2016-01-01

    Preterm premature rupture of membranes (PPROM) is a challenging complication of pregnancies and an important cause of perinatal morbidity and mortality. Management of morbidities associated with PPROM is fraught with controversy. However, women should be informed of these complications. This article aimed to review the morbidities, concordance, and predictors of PPROM over a 10-year period. This was a retrospective review of morbidities, concordance, and predictors of PPROM among pregnant women at the University of Nigeria Teaching Hospital, Enugu, Nigeria between January 1, 1999, and December 31, 2008. The morbidities, concordance, and predictors of PPROM were expressed by regression analysis output for PPROM. Primigravidae had the highest occurrence of PPROM. Increasing parity does not significantly influence the incidence of PPROM. The concordance and predictors of PPROM are maternal age (P women should be informed of these complications.

  13. Qualitative and Quantitative Hippocampal MRI Assessments in Intractable Epilepsy

    Directory of Open Access Journals (Sweden)

    Paramdeep Singh

    2013-01-01

    Full Text Available Aims. To acquire normative data of hippocampal volumes and T2 relaxation times, to evaluate and compare qualitative and quantitative assessments in evaluating hippocampi in patients with different durations of intractable epilepsy, and to propose an imaging protocol based on performance of these techniques. Methods. MRI analysis was done in 50 nonepileptic controls and 30 patients with intractable epilepsy on 1.5T scanner. Visual assessment and hippocampal volumetry were done on oblique coronal IR/T2W and T1W MP-RAGE images, respectively. T2 relaxation times were measured using 16-echo Carr-Purcell-Meiboom-Gill sequence. Volumetric data was normalized for variation in head size between individuals. Patients were divided into temporal ( and extratemporal ( groups based on clinical and EEG localization. Results. In controls, right hippocampal volume was slightly more than the left with no effect of age or gender. In TLE patients, hippocampal volumetry provided maximum concordance with EEG. Visual assessment of unilateral pathology concurred well with measured quantitative values but poorly in cases with bilateral pathologies. There were no significant differences of mean values between extratemporal group and controls group. Quantitative techniques detected mild abnormalities, undetected on visual assessment. Conclusions. Quantitative techniques are more sensitive to diagnose bilateral and mild unilateral hippocampal abnormalities.

  14. Sociale problemer

    DEFF Research Database (Denmark)

    Christensen, Anders Bøggild; Rasmussen, Tove; Bundesen, Peter Verner

    Sociale problemer kan betragtes som selve udgangspunktet for socialt arbejde, hvor ambitionen er at råde bod på problemerne og sikre, at udsatte borgere får en bedre tilværelse. Det betyder også, at diskussionen af sociale problemer er afgørende for den sociale grundfaglighed. I denne bog sætter en...... række fagfolk på tværs af det danske socialfaglige felt fokus på sociale problemer. Det diskuteres, hvad vi overhovedet forstår ved sociale problemer, hvordan de opstår, hvilke konsekvenser de har, og ikke mindst hvordan man som fagprofessionel håndterer sociale problemer i det daglige arbejde. Bogen er...... skrevet som lærebog til professionsuddannelser, hvor sociale problemer udgør en dimension, bl.a. socialrådgiver-, pædagog- og sygeplejerskeuddannelserne....

  15. Concordance with prescribing information dosage recommendations for dipeptidyl-peptidase-4 inhibitors among type 2 diabetes mellitus patients with moderate to severe chronic kidney disease.

    Science.gov (United States)

    Huang, Huan; Shetty, Sharash; Bauer, Elise; Lang, Kathleen

    2018-06-01

    To estimate the proportion of patients with moderate to severe chronic kidney disease (CKD) whose initial dipeptidyl-peptidase-4 inhibitor (DPP4-i) dosage was concordant with prescribing information (label) recommendations in the United States. Adult patients with type 2 diabetes mellitus (T2DM) who initiated a DPP4-i (linagliptin, sitagliptin, saxagliptin) between 1 January 2011 and 30 June 2014 were identified using electronic medical records and administrative claims, with index date being the date of first observed DPP4-i treatment. Patients were required to have chronic kidney disease (CKD) stage 3b, 4 or 5 (estimated Glomerular Filtration Rate [eGFR] value <45 ml/min/1.73 m 2 ) during the 12 month pre-index period. Patients were classified as concordant or not concordant based on whether the first prescribed dose was consistent with label recommendations. Demographics, clinical characteristics, resource use and costs during pre-index were evaluated by DPP4-i concordance status. Of the 492 patients (323 sitagliptin, 57 saxagliptin, 112 linagliptin), 36.2% were prescribed doses that were not concordant with label recommendations (44.9% for sitagliptin, 57.9% for saxagliptin and 0% for linagliptin [which does not require dosage adjustment]). Concordant patients were slightly older (mean age 71 years vs. 68, p = .01) but had similar gender distribution (55% vs. 60% female, p = .31) compared to those who were not concordant. They had lower general health status (Charlson Comorbidity Score 2.6 vs. 2.2, p = .03), and had similar pre-index all-cause total costs ($25,245 vs. $21,972, p = .68) and lower pre-index T2DM-related costs ($1618 vs. $1922, p = .05). More than a third of DPP4-i patients with CKD stage 3b or higher were prescribed doses not concordant with DPP4-i label dosage recommendations.

  16. Bedrock geologic map of the Miles Pond and Concord quadrangles, Essex and Caledonia Counties, Vermont, and Grafton County, New Hampshire

    Science.gov (United States)

    Rankin, Douglas W.

    2018-04-20

    The bedrock geologic map of the Miles Pond and Concord quadrangles covers an area of approximately 107 square miles (276 square kilometers) in east-central Vermont and adjacent New Hampshire, north of and along the Connecticut River. This map was created as part of a larger effort to produce a new bedrock geologic map of Vermont through the collection of field data at a scale of 1:24,000. The majority of the map area consists of the Bronson Hill anticlinorium, a post-Early Devonian structure that is cored by metamorphosed Cambrian to Silurian sedimentary, volcanic, and plutonic rocks. A major feature on the map is the Monroe fault, interpreted to be a west-directed, steeply dipping Late Devonian (Acadian) thrust fault. To the west of the Monroe fault, rocks of the Connecticut Valley-Gaspé trough dominate and consist primarily of metamorphosed Silurian and Devonian sedimentary rocks. To the north, the Victory pluton intrudes the Bronson Hill anticlinorium. The Bronson Hill anticlinorium consists of the metamorphosed Albee Formation, the Ammonoosuc Volcanics, the Comerford Intrusive Complex, the Highlandcroft Granodiorite, and the Joselin Turn tonalite. The Albee Formation is an interlayered, feldspathic metasandstone and pelite that is locally sulfidic. Much of the deformed metasandstone is tectonically pinstriped. In places, one can see compositional layering that was transposed by a steeply southeast-dipping foliation. The Ammonoosuc Volcanics are lithologically complex and predominantly include interlayered and interfingered rhyolitic to basaltic volcanic and volcaniclastic rocks, as well as lesser amounts of siltstone, phyllite, graywacke, and grit. The Comerford Intrusive Complex crops out east of the Monroe fault and consists of metamorphosed gabbro, diorite, tonalite, aplitic tonalite, and crosscutting diabase dikes. Abundant mafic dikes from the Comerford Intrusive Complex intruded the Albee Formation and Ammonoosuc Volcanics east of the Monroe fault. The

  17. Quantitative Analysis of Thallium-201 Myocardial Tomograms

    International Nuclear Information System (INIS)

    Kim, Sang Eun; Nam, Gi Byung; Choi, Chang Woon

    1991-01-01

    The purpose of this study was to assess the ability of quantitative Tl-201 tomography to identify and localize coronary artery disease (CAD). The study population consisted of 41 patients (31 males, 10 females; mean age 55 ± 7 yr) including 14 with prior myocardial infarction who underwent both exercise Tl-201 myocardium SPECT and coronary angiography for the evaluation of chest pain. From the short axis and vertical long axis tomograms, stress extent polar maps were generated by Cedars-Sinai Medical Center program, and the 9 stress defect extent (SDE) was quantified for each coronary artery territory. For the purpose of this study, the coronary circulation was divided into 6 arterial segments, and the myocardial ischemic score (MIS) was calculated from the coronary angiogram. Sensitivity for the detection of CAD (>50% coronary stenosis by angiography) by stress extent polar map was 95% in single vessel disease, and 100% in double and triple vessel diseases. Overall sensitivity was 97%<. Sensitivity and specificity for the detection of individual diseased vessels were, respectively, 87% and 90% for the left anterior descending artery (LAD), 36% and 93% for the left circumflex artery (LCX), and 71% and 70%, for the right coronary artery (RCA). Concordance for the detection of individual diseased vessels between the coronary angiography and stress polar map was fair for the LAD (kappa=0.70), and RCA (kappa=0.41) lesions, whereas it was poor for the LCK lesions (kappa =0.32) There were significant correlations between the MIS and SDE in LAD (rs=0. 56, p=0.0027), and RCA territory (rs=0.60, p=0.0094). No significant correlation was found in LCX territory. When total vascular territories were combined, there was a significant correlation between the MIS and SDE (rs=0.42, p=0,0116). In conclusion, the quantitative analysis of Tl-201 tomograms appears to be accurate for determining the presence and location of CAD.

  18. Quantitative Reasoning Learning Progressions for Environmental Science: Developing a Framework

    Directory of Open Access Journals (Sweden)

    Robert L. Mayes

    2013-01-01

    Full Text Available Quantitative reasoning is a complex concept with many definitions and a diverse account in the literature. The purpose of this article is to establish a working definition of quantitative reasoning within the context of science, construct a quantitative reasoning framework, and summarize research on key components in that framework. Context underlies all quantitative reasoning; for this review, environmental science serves as the context.In the framework, we identify four components of quantitative reasoning: the quantification act, quantitative literacy, quantitative interpretation of a model, and quantitative modeling. Within each of these components, the framework provides elements that comprise the four components. The quantification act includes the elements of variable identification, communication, context, and variation. Quantitative literacy includes the elements of numeracy, measurement, proportional reasoning, and basic probability/statistics. Quantitative interpretation includes the elements of representations, science diagrams, statistics and probability, and logarithmic scales. Quantitative modeling includes the elements of logic, problem solving, modeling, and inference. A brief comparison of the quantitative reasoning framework with the AAC&U Quantitative Literacy VALUE rubric is presented, demonstrating a mapping of the components and illustrating differences in structure. The framework serves as a precursor for a quantitative reasoning learning progression which is currently under development.

  19. Automated approach to quantitative error analysis

    International Nuclear Information System (INIS)

    Bareiss, E.H.

    1977-04-01

    A method is described how a quantitative measure for the robustness of a given neutron transport theory code for coarse network calculations can be obtained. A code that performs this task automatically and at only nominal cost is described. This code also generates user-oriented benchmark problems which exhibit the analytic behavior at interfaces. 5 figures, 1 table

  20. Engaging Business Students in Quantitative Skills Development

    Science.gov (United States)

    Cronin, Anthony; Carroll, Paula

    2015-01-01

    In this paper the complex problems of developing quantitative and analytical skills in undergraduate first year, first semester business students are addressed. An action research project, detailing how first year business students perceive the relevance of data analysis and inferential statistics in light of the economic downturn and the…

  1. Instrumentation and quantitative methods of evaluation

    International Nuclear Information System (INIS)

    Beck, R.N.; Cooper, M.D.

    1991-01-01

    This report summarizes goals and accomplishments of the research program entitled Instrumentation and Quantitative Methods of Evaluation, during the period January 15, 1989 through July 15, 1991. This program is very closely integrated with the radiopharmaceutical program entitled Quantitative Studies in Radiopharmaceutical Science. Together, they constitute the PROGRAM OF NUCLEAR MEDICINE AND QUANTITATIVE IMAGING RESEARCH within The Franklin McLean Memorial Research Institute (FMI). The program addresses problems involving the basic science and technology that underlie the physical and conceptual tools of radiotracer methodology as they relate to the measurement of structural and functional parameters of physiologic importance in health and disease. The principal tool is quantitative radionuclide imaging. The objective of this program is to further the development and transfer of radiotracer methodology from basic theory to routine clinical practice. The focus of the research is on the development of new instruments and radiopharmaceuticals, and the evaluation of these through the phase of clinical feasibility. 234 refs., 11 figs., 2 tabs

  2. Hearing Problems

    Science.gov (United States)

    ... Read MoreDepression in Children and TeensRead MoreBMI Calculator Hearing ProblemsLoss in the ability to hear or discriminate ... This flow chart will help direct you if hearing loss is a problem for you or a ...

  3. Estrogen and progesterone receptor testing in breast carcinoma: concordance of results between local and reference laboratories in Brazil

    Directory of Open Access Journals (Sweden)

    Sheila Cristina Lordelo Wludarski

    Full Text Available CONTEXT AND OBJECTIVE: Breast cancer accounts for approximately one quarter of all cancers in females. Estrogen and progesterone receptor testing has become an essential part of the clinical evaluation of breast carcinoma patients, and accurate results are critical in identifying patients who may benefit from hormone therapy. The present study had the aim of investigating the concordance of the results from hormone receptor tests between a reference laboratory and local (or community laboratories in Brazil. DESIGN AND SETTING: Retrospective study at a reference pathology laboratory. METHODS: The concordance in the results from hormone receptor tests between a reference laboratory and 146 local laboratories in Brazil was compared in relation to 500 invasive breast carcinoma cases, using immunohistochemistry. RESULTS: There was concordance in 89.4% (447/500 cases and 85.0% (425/500 cases of the results from estrogen (κ = 0.744, P < 0.001 and progesterone (κ = 0.688, P < 0.001 receptor tests, respectively, between local and reference laboratories. This was similar to findings in other countries. The false negative rates from estrogen and progesterone receptor tests in local laboratories were 8.7% and 14.4%, respectively. The false positive rates from estrogen and progesterone receptor tests in local laboratories were 15.5% and 16.0%, respectively. CONCLUSION: Technical and result interpretation issues may explain most of the discordances in hormone receptor testing in local laboratories. Validation of estrogen and progesterone receptor tests at local laboratories, with rigorous quality control measures, is strongly recommended in order to avoid erroneous treatment of breast cancer patients.

  4. Concordance négative optionnelle : contrastes forts et faibles entre picard et québécois

    Directory of Open Access Journals (Sweden)

    Dagnac Anne

    2016-01-01

    Full Text Available Cet article, basédeux études decorpus,comparele phénomène de la concordance négative(CNenpicard et enfrançais montréalais. Après avoir défini les phénomènes étudiés, il présenterapidement lefonctionnement de la négation et de la concordance négative en picard, et leurressemblances avec le système montréalais.La concordance entre marqueur négatifet mot-N y est à la fois possible et optionnelle: j’n’in sais (mie rien ‘je n’en sais rien’ (picard, j’ai (pasrien contre la loi cent un ‘je n’ai rien contre la loi cent un’ (québécois. Les contrastes en termes de contextes syntaxiques permettant ou non la CNoptionnelle, conduisent à poser ces deux dialectes commetypologiquement distinctssur des points considérés comme théoriquement cruciaux, comme la possibilité de la CNentre un marqueur denégation et un mot-N préverbalou dans des énoncés fragmentaires. Néanmoins, onmontre qu’une prise en compte plus fine des propriétéslexicalesdes items en jeuet de leurs fréquences d’emploi relativesmodifiece schéma typologique:elle montred’étonnantes convergences entre les deux systèmes, qui invitent à repenser la manière d’aborder la microvariation syntaxique. L’article défend enfin l’hypothèse que les différences entre les deux dialectes reposent sur l’existence d’un marqueur secondaire en picard, occupant une position syntaxique distinctedu marqueur pas ou point.

  5. Quantitative film radiography

    International Nuclear Information System (INIS)

    Devine, G.; Dobie, D.; Fugina, J.; Hernandez, J.; Logan, C.; Mohr, P.; Moss, R.; Schumacher, B.; Updike, E.; Weirup, D.

    1991-01-01

    We have developed a system of quantitative radiography in order to produce quantitative images displaying homogeneity of parts. The materials that we characterize are synthetic composites and may contain important subtle density variations not discernible by examining a raw film x-radiograph. In order to quantitatively interpret film radiographs, it is necessary to digitize, interpret, and display the images. Our integrated system of quantitative radiography displays accurate, high-resolution pseudo-color images in units of density. We characterize approximately 10,000 parts per year in hundreds of different configurations and compositions with this system. This report discusses: the method; film processor monitoring and control; verifying film and processor performance; and correction of scatter effects

  6. Problem Posing

    OpenAIRE

    Šilhavá, Marie

    2009-01-01

    This diploma thesis concentrates on problem posing from the students' point of view. Problem posing can be either seen as a teaching method which can be used in the class, or it can be used as a tool for researchers or teachers to assess the level of students' understanding of the topic. In my research, I compare three classes, one mathematics specialist class and two generalist classes, in their ability of problem posing. As an assessment tool it seemed that mathemathics specialists were abl...

  7. Back of the Envelope Reasoning for Robust Quantitative Problem Solving

    Science.gov (United States)

    2007-12-31

    limited numeric vocabulary, for example, the Pirahã tribe in Amazonia [Gordon, 2004] and Munduruku [Pica et al., 2004], an Amazonian language... investigation of category structure: 1. Level of categorization: Rosch [1978] identifies three levels of categorization: subordinate, basic-level...Using Common Sense Knowledge to Overcome Brittleness and Knowledge Acquisition Bottlenecks. AI Magazine . Lenhart K. Schubert and Matthew Tong

  8. Popular Problems

    DEFF Research Database (Denmark)

    Skovhus, Randi Boelskifte; Thomsen, Rie

    2017-01-01

    This article introduces a method to critical reviews and explores the ways in which problems have been formulated in knowledge production on career guidance in Denmark over a 10-year period from 2004 to 2014. The method draws upon the work of Bacchi focussing on the ‘What's the problem represented...... to be’ (WPR) approach. Forty-nine empirical studies on Danish youth career guidance were included in the study. An analysis of the issues in focus resulted in nine problem categories. One of these, ‘targeting’, is analysed using the WPR approach. Finally, the article concludes that the WPR approach...... provides a constructive basis for a critical analysis and discussion of the collective empirical knowledge production on career guidance, stimulating awareness of problems and potential solutions among the career guidance community....

  9. Sleep Problems

    Science.gov (United States)

    ... For Consumers Consumer Information by Audience For Women Sleep Problems Share Tweet Linkedin Pin it More sharing ... 101 KB) En Español Medicines to Help You Sleep Tips for Better Sleep Basic Facts about Sleep ...

  10. Mouth Problems

    Science.gov (United States)

    ... such as sores, are very common. Follow this chart for more information about mouth problems in adults. ... cancers. See your dentist if sharp or rough teeth or dental work are causing irritation. Start OverDiagnosisThis ...

  11. Kidney Problems

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Kidney Problems Basic Facts & Information The kidneys are two ... kidney (renal) diseases are called nephrologists . What are Kidney Diseases? For about one-third of older people, ...

  12. Knapsack problems

    CERN Document Server

    Kellerer, Hans; Pisinger, David

    2004-01-01

    Thirteen years have passed since the seminal book on knapsack problems by Martello and Toth appeared. On this occasion a former colleague exclaimed back in 1990: "How can you write 250 pages on the knapsack problem?" Indeed, the definition of the knapsack problem is easily understood even by a non-expert who will not suspect the presence of challenging research topics in this area at the first glance. However, in the last decade a large number of research publications contributed new results for the knapsack problem in all areas of interest such as exact algorithms, heuristics and approximation schemes. Moreover, the extension of the knapsack problem to higher dimensions both in the number of constraints and in the num­ ber of knapsacks, as well as the modification of the problem structure concerning the available item set and the objective function, leads to a number of interesting variations of practical relevance which were the subject of intensive research during the last few years. Hence, two years ago ...

  13. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France); University Bordeaux Segalen, Bordeaux Cedex (France); Bullier, Eric; Riviere, Annalisa [Hopital Haut-Leveque, CHU Bordeaux, Department of Nuclear Medicine, Pessac (France); Dromer, Claire [Hopital Haut-Leveque, CHU Bordeaux, Department of Respiratory Diseases, Pessac (France); Picard, Francois [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiology, Pessac (France); Billes, Marc-Alain [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiac Surgery, Pessac (France); Corneloup, Olivier [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France)

    2014-01-15

    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  14. Familial concordance of metabolic syndrome in Korean population--Korean National Health and Nutrition Examination Survey 2005.

    Science.gov (United States)

    Lee, Myung Ha; Kim, Hyeon Chang; Thomas, G Neil; Ahn, Song Vogue; Hur, Nam Wook; Choi, Dong Phil; Suh, Il

    2011-09-01

    To investigate the familial concordance of metabolic syndrome and its components in a nationally representative survey in Korean. We used data from the Korean National Health and Nutrition Examination Survey (KNHANES), a nationwide survey examining the general health and nutritional status of the Korean people. We enrolled 1641 married couples and 1527 parents-1342 offspring. Prevalence of the metabolic syndrome was 17.1% for husbands, 11.7% for wives, 14.3% for parents, and 7.2% for offspring. After adjustment for age, there were strong positive correlations between family members for the metabolic variables. Compared with husbands whose wives did not have metabolic syndrome, adjusted odds ratio in husbands whose wives had metabolic syndrome was 1.43 (95% CI: 1.10-1.87) for the risk of having metabolic syndrome. Similarly, wives whose husbands had metabolic syndrome had 1.41 (95% CI: 1.08-1.84) times higher risk of having metabolic syndrome. Compared with children whose parents did not have metabolic syndrome, adjusted odds ratio in children with at least one parent with the metabolic syndrome was 2.56 (95% CI: 1.09-5.98) for the metabolic syndrome. Our study revealed that there is significant familial concordance for metabolic syndrome and its components in Korean families. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. The script concordance test in radiation oncology: validation study of a new tool to assess clinical reasoning

    International Nuclear Information System (INIS)

    Lambert, Carole; Gagnon, Robert; Nguyen, David; Charlin, Bernard

    2009-01-01

    The Script Concordance test (SCT) is a reliable and valid tool to evaluate clinical reasoning in complex situations where experts' opinions may be divided. Scores reflect the degree of concordance between the performance of examinees and that of a reference panel of experienced physicians. The purpose of this study is to demonstrate SCT's usefulness in radiation oncology. A 90 items radiation oncology SCT was administered to 155 participants. Three levels of experience were tested: medical students (n = 70), radiation oncology residents (n = 38) and radiation oncologists (n = 47). Statistical tests were performed to assess reliability and to document validity. After item optimization, the test comprised 30 cases and 70 questions. Cronbach alpha was 0.90. Mean scores were 51.62 (± 8.19) for students, 71.20 (± 9.45) for residents and 76.67 (± 6.14) for radiation oncologists. The difference between the three groups was statistically significant when compared by the Kruskall-Wallis test (p < 0.001). The SCT is reliable and useful to discriminate among participants according to their level of experience in radiation oncology. It appears as a useful tool to document the progression of reasoning during residency training

  16. [Concordance among analysts from Latin-American laboratories for rice grain appearance determination using a gallery of digital images].

    Science.gov (United States)

    Avila, Manuel; Graterol, Eduardo; Alezones, Jesús; Criollo, Beisy; Castillo, Dámaso; Kuri, Victoria; Oviedo, Norman; Moquete, Cesar; Romero, Marbella; Hanley, Zaida; Taylor, Margie

    2012-06-01

    The appearance of rice grain is a key aspect in quality determination. Mainly, this analysis is performed by expert analysts through visual observation; however, due to the subjective nature of the analysis, the results may vary among analysts. In order to evaluate the concordance between analysts from Latin-American rice quality laboratories for rice grain appearance through digital images, an inter-laboratory test was performed with ten analysts and images of 90 grains captured with a high resolution scanner. Rice grains were classified in four categories including translucent, chalky, white belly, and damaged grain. Data was categorized using statistic parameters like mode and its frequency, the relative concordance, and the reproducibility parameter kappa. Additionally, a referential image gallery of typical grain for each category was constructed based on mode frequency. Results showed a Kappa value of 0.49, corresponding to a moderate reproducibility, attributable to subjectivity in the visual analysis of grain images. These results reveal the need for standardize the evaluation criteria among analysts to improve the confidence of the determination of rice grain appearance.

  17. [Clinical usefulness of IDEA and CARS: concordance with DSM-IV-TR in children and adolescents with suspicion of PDD].

    Science.gov (United States)

    García-López, C; Narbona, J

    2014-02-01

    Observational scales are useful to estimate the severity of symptoms in PDD as well as to monitor their evolution. a) To analyze the concordance between diagnoses based on the Autism Spectrum Inventory (Inventario del Espectro Autista, IDEA)) and the Childhood Autism Rating Scale (CARS), compared to DSM-IV-TR criteria, in subjects with a suspicion of pervasive developmental disorders (PDD), and b) to study the discrimination power of both scales to differentiate between a clinical diagnosis situated in the autism spectrum. Fifty-six children and adolescents, between 2 and 20 years-old, who attended our Neuropediatric Unit due to suspicion of PDD. Independently, two clinicians evaluated the presence of PDD symptoms; one of them according to DSM-IV-TR criteria and the other one based on the application of IDEA and CARS. The concordance of IDEA and CARS when compared to DSM-IV-TR classification was 73 and 82%, respectively, with a sensitivity of 1 and 0,83 and a specificity of 0,61 and 0,82, respectively. Both scales correctly discriminated between autistic disorder and other clinical diagnoses. Both IDEA and CARS are useful instruments to detect and monitor autism symptoms in the context of routine clinical practice. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  18. Short interval follow-up after a benign concordant MR-guided vacuum assisted breast biopsy - is it worthwhile?

    Energy Technology Data Exchange (ETDEWEB)

    Shaylor, Sara D.; Melsaether, Amy N.; Gupta, Avani; Babb, James; Moy, Linda [NYU School of Medicine, Department of Radiology, New York, NY (United States); Heller, Samantha L. [St. George' s Healthcare Trust, Department of Radiology, London (United Kingdom); Gupta, Dipti [Northwestern Memorial Hospital, Breast and Women' s Imaging Center, Chicago, IL (United States)

    2014-06-15

    To determine the utility of short-interval follow-up after benign concordant MRI-guided breast biopsy. Institutional review board approved, retrospective review of consecutive biopsies performed over 3 years (2007-10) yielded 170 women with 188 lesions that were considered benign concordant. Indication for original study, biopsy results, follow-up recommendations, compliance and outcomes of subsequent MRI and mammography examinations were reviewed. The most common indication for breast MRI was high-risk screening 119/170 (70 %). Overall, 59 % of lesions (113/188) had follow-up MRI. Of those lesions (n = 113), 43 % (49/113) presented within 7 months, 26 % (29/113) presented within 8-13 months, 11.5 % (13/113) presented within 14-22 months, and 19 % (22/113) presented after 23 months. At initial follow-up, 37 % of lesions were stable and 61 % were decreased in size. Three lesions were recommended for excision based on follow-up imaging with one malignancy diagnosed 2 years following biopsy. One additional patient had MRI-detected bilateral cancers remote from the biopsy site 3 years after biopsy. Overall cancer yield of lesions with follow-up MRI was 0.9 % (1/113); no cancers were detected at 6 months. Our data suggests that 6-month follow-up may not be required and that annual screening MRI would be acceptable to maintain a reasonable cancer detection rate. (orig.)

  19. Molecular cloning and biochemical characterization of the UDP-glucose: flavonoid 3-O-glucosyltransferase from Concord grape (Vitis labrusca).

    Science.gov (United States)

    Hall, Dawn; Yuan, Xiao Xin; Murata, Jun; De Luca, Vincenzo

    2012-02-01

    Glucosylation of anthocyanidin substrates at the 3-O-position is crucial for the red pigmentation of grape berries and wine. The gene that encodes the enzyme involved in this reaction has been cloned from Vitis labrusca cv. Concord, heterologously expressed, and the recombinant enzyme (rVL3GT) was characterized. VL3GT has 96% amino acid sequence identity with Vitis vinifera VV3GT and groups phylogenetically with several other flavonoid 3-O-glycosyltransferases. In vitro substrate specificity studies and kinetic analyses of rVL3GT indicate that this enzyme preferentially glucosylates cyanidin as compared with quercetin. Crude protein extracts from several Concord grape tissues were assayed for glucosyltransferase activity with cyanidin and quercetin as acceptor substrates. A comparison of the VL3GT activities toward with these substrates showed that the 3GT enzyme activity is consistent with the expression of VL3GT in these tissues and is coincident with the biosynthesis of anthocyanins in both location and developmental stages. Enzyme activities in grape mesocarp, pre-veraison exocarp, leaf, flower bud, and flower tissues glucosylated quercetin but not cyanidin at high rates, suggesting the presence of additional enzymes which are able to glucosylate the 3-O-position of flavonols with higher specificity than anthocyanidins. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. [Concordance between a head circumference growth function and intellectual disability in relation with the cause of microcephaly].

    Science.gov (United States)

    Coronado, R; Macaya Ruíz, A; Giraldo Arjonilla, J; Roig-Quilis, M

    2015-08-01

    Our aim was to investigate the correlations between patterns of head growth and intellectual disability among distinct aetiological presentations of microcephaly. 3,269 head circumference (HC) charts of patients from a tertiary neuropediatric unit were reviewed and 136 microcephalic participants selected. Using the Z-scores of registered HC measurements we defined the variables: HC Minimum, HC Drop and HC Catch-up. We classified patients according to the presence or absence of intellectual disability (IQ below 71) and according to the cause of microcephaly (idiopathic, familial, syndromic, symptomatic and mixed). Using Discriminant Analysis a C-function was defined as C=HC Minimum + HC Drop with a cut-off level of C=-4.32 Z-score. In our sample 95% of patients scoring below this level, severe microcephaly, were classified in the disabled group while the overall concordance was 66%. In the symptomatic-mixed group the concordance between HC function and outcome reached 82% in contrast to only 54% in the idiopathic-syndromic group (P-value=0.0002). We defined a HC growth function which discriminates intellectual disability of microcephalic patients better than isolated HC measurements, especially for those with secondary and mixed aetiologies. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  1. Short interval follow-up after a benign concordant MR-guided vacuum assisted breast biopsy - is it worthwhile?

    International Nuclear Information System (INIS)

    Shaylor, Sara D.; Melsaether, Amy N.; Gupta, Avani; Babb, James; Moy, Linda; Heller, Samantha L.; Gupta, Dipti

    2014-01-01

    To determine the utility of short-interval follow-up after benign concordant MRI-guided breast biopsy. Institutional review board approved, retrospective review of consecutive biopsies performed over 3 years (2007-10) yielded 170 women with 188 lesions that were considered benign concordant. Indication for original study, biopsy results, follow-up recommendations, compliance and outcomes of subsequent MRI and mammography examinations were reviewed. The most common indication for breast MRI was high-risk screening 119/170 (70 %). Overall, 59 % of lesions (113/188) had follow-up MRI. Of those lesions (n = 113), 43 % (49/113) presented within 7 months, 26 % (29/113) presented within 8-13 months, 11.5 % (13/113) presented within 14-22 months, and 19 % (22/113) presented after 23 months. At initial follow-up, 37 % of lesions were stable and 61 % were decreased in size. Three lesions were recommended for excision based on follow-up imaging with one malignancy diagnosed 2 years following biopsy. One additional patient had MRI-detected bilateral cancers remote from the biopsy site 3 years after biopsy. Overall cancer yield of lesions with follow-up MRI was 0.9 % (1/113); no cancers were detected at 6 months. Our data suggests that 6-month follow-up may not be required and that annual screening MRI would be acceptable to maintain a reasonable cancer detection rate. (orig.)

  2. Concordant association validates MGMT methylation and protein expression as favorable prognostic factors in glioma patients on alkylating chemotherapy (Temozolomide).

    Science.gov (United States)

    Pandith, Arshad A; Qasim, Iqbal; Zahoor, Wani; Shah, Parveen; Bhat, Abdul R; Sanadhya, Dheera; Shah, Zafar A; Naikoo, Niyaz A

    2018-04-30

    O 6 -methylguanine-DNA methyltransferase (MGMT) promoter methylation and its subsequent loss of protein expression has been identified to have a variable impact on clinical outcome of glioma patients indicated for chemotherapy with alkylating agents (Temozolomide). This study investigated methylation status of MGMT gene along with in situ protein expression in malignant glioma patients of different histological types to evaluate the associated clinical outcome vis-a-vis use of alkylating drugs and radiotherapy. Sixty three cases of glioma were evaluated for MGMT promoter methylation by methylation-specific PCR (MS-PCR) and protein expression by immunostaining (IHC). Methylation status of MGMT and loss of protein expression showed a very high concordant association with better survival and progression free survival (PFS) (p < 0.0001). Multivariate Cox regression analysis showed both MGMT methylation and loss of protein as significant independent prognostic factors in glioma patients with respect to lower Hazard Ratio (HR) for better OS and PFS) [p < 0.05]. Interestingly concordant MGMT methylation and lack of protein showed better response in TMZ therapy treated patient subgroups with HR of 2.02 and 0.76 (p < 0.05). We found the merits of prognostication of MGMT parameters, methylation as well as loss of its protein as predictive factors for favorable outcome in terms of better survival for TMZ therapy.

  3. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    International Nuclear Information System (INIS)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu; Bullier, Eric; Riviere, Annalisa; Dromer, Claire; Picard, Francois; Billes, Marc-Alain; Corneloup, Olivier

    2014-01-01

    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  4. Concordância entre citologia, colposcopia e histopatologia cervical Agreement between cytology, colposcopy and cervical histopathology

    Directory of Open Access Journals (Sweden)

    Letícia Maria Correia Katz

    2010-08-01

    Full Text Available OBJETIVO: avaliar a concordância da citologia convencional por Papanicolaou repetida no momento da colposcopia com os achados colposcópicos e a histopatologia. MÉTODOS: o estudo foi realizado no Laboratório Central de Saúde Pública do Estado de Pernambuco (LACEN, de janeiro a julho de 2008, em 397 mulheres com exame citopatológico alterado encaminhadas para avaliação colposcópica. No momento da colposcopia, repetiu-se a citologia em meio convencional, pesquisando-se os achados colposcópicos anormais. A nomenclatura citológica utilizada foi a de Bethesda e a histopatológica, da Organização Mundial de Saúde. A citologia no momento da colposcopia e a colposcopia foram comparadas entre si e com o resultado do histopatológico obtido por biópsia dirigida. A concordância entre os métodos foi avaliada pelo coeficiente Kappa (K, além do teste χ2 a um nível de significância de 5%. RESULTADOS: foi encontrada uma concordância fraca entre a citologia realizada no momento da colposcopia e a colposcopia, K=0,33 (IC95%=0,21-0,45 e entre a colposcopia e a histopatologia, K=0,35 (IC95%=0,39-0,51. Para a concordância entre citologia no momento da colposcopia e histopatologia, o Kappa foi de 0,41 (IC95%=0,29-0,530, considerado moderado. CONCLUSÕES: houve melhor concordância entre citologia e histopatologia do que entre colposcopia e citologia ou colposcopia e histopatologia.PURPOSE: to evaluate the agreement between conventional cytology using the Papanicolaou test, repeated at the time of colposcopy, with colposcopic and histopathological findings. METHODS: the study was carried out at the central public health laboratory of the state of Pernambuco between January and July, 2008, involving 397 women referred for colposcopic evaluation following an abnormal cervical smear test. Cytology was repeated at the time of colposcopy using conventional method, with particular attention being paid to the presence of abnormal colposcopic findings

  5. Computer-assisted sequential quantitative analysis of gallium scans in pulmonary sarcoidosis

    International Nuclear Information System (INIS)

    Rohatgi, P.K.; Bates, H.R.; Noss, R.W.

    1985-01-01

    Fifty-one sequential gallium citrate scans were performed in 22 patients with biopsy-proven sarcoidosis. A computer-assisted quantitative analysis of these scans was performed to obtain a gallium score. The changes in gallium score were correlated with changes in serum angiotensin converting enzyme (SACE) activity and objective changes in clinical status. There was a good concordance between changes in gallium score, SACE activity and clinical assessment in patients with sarcoidosis, and changes in gallium index were slightly superior to SACE index in assessing activity of sarcoidosis. (author)

  6. Avaliação da concordância na aplicação da Escala de Braden interobservadores Evaluación de la concordancia en la aplicación de la Escala de Braden interobservadores Measuring interrater reliability in application of the Braden Scale

    Directory of Open Access Journals (Sweden)

    Noemi Marisa Brunet Rogenski

    2012-01-01

    ó prevalencia del 19,5% en el hospital y el 63,6% en la Unidad de Cuidados Intensivos, el 15,6% en la Clínica Quirúrgica, el 13,9% en la Clínica Médica y el 0% en la Semi-Intensiva. Respecto a la concordancia entre los observadores en la evaluación clínica de los pacientes, la percepción sensorial, actividad, movilidad y fricción/corte presentaron fortísima concordancia. Humedad y nutrición, baja concordancia, sugiriendo que esos sub escores deben ser discutidos para verificar las causas de la controversia. CONCLUSIÓN: Los estudios de prevalencia de úlcera por presión posibilitan verificar la extensión del problema y ofrecen subsidios para la construcción de estrategias y programas de prevención.OBJECTIVES: To verify pressure ulcer prevalence in hospital units of adult patients in the University Hospital of the University of São Paulo (HU-USP, and to verify interrater reliability in risk assessment, using the Braden Scale. METHODS: A quantitative, exploratory study. Data were collected by six trained collaborators who conducted physical exams and risk assessment in 87 patients, an evaluation that is considered the "gold standard". Data from the assessments performed by the nurses, of those same patients, were collected from the patient records. RESULTS: We verified the pressure ulcer prevalence within the hospital was 19.5%, with 63.6% prevalence in the intensive care unit, 15.6% in the surgical clinic, 13.9% in the medical clinic, and 0% in the semi-intensive [step-down] unit. Regarding interrater reliability in the clinical evaluation of the patients, there was strong agreement in the subscores of: sensory perception, activity, mobility, friction/shear. Moisture and nutrition showed lower agreement, suggesting that these subscores require discussion to verify the causes of the discrepancies. CONCLUSION: Pressure ulcer prevalence studies provide the possibility to verify the extent of the problem and provide input for the construction of strategies and

  7. Quantitative gated SPECT- a comparative study of two algorithms for parameters of perfusion and LV function

    International Nuclear Information System (INIS)

    Ali, A.Z.

    2007-01-01

    Full text: Aim: To compare the perfusion and LV function parameters as quantified by 4D-MSPECT and ECT in the same patient group and a qualitative comparison of the reconstructed slices by two different experts. Materials and methods: Thirty-one consecutive patients underwent gated myocardial perfusion SPECT using a two-day protocol. The gated and ungated data were reconstructed by back projection method. Quantitative analysis was performed on the same set of reconstructed slices by 4D-MSPECT and Emory Cardiac Tool Box. The reconstructed slices were read qualitatively by two different experts on their respective systems. Polar map and functional analysis was performed in both softwares and the results were compared. Results: The concordance between the two experts qualitatively was seen in 78/93(84%) coronary territories. The polar map defects were comparable in LAD (r-value of 0.87) and LCX (r-value of 0.76) territories whereas RCA defects (r-value of 0.04) were not at all correlating. The defect severity showed concordance in 68/93 (73%) coronary territories. There was concordance between 4DMSPECT and the qualitative interpretation in 84/93 (90%) coronary territories whereas ECT showed concordance in only 70/93(75%) coronary territories. The overall sensitivity is marginally higher for ECT (100% vs. 96%) but the overall specificity is much higher with 4 DMSPECT (88% vs. 65%). ESV showed good correlation(r=0.94) of the two softwares with no significant difference in means. EDV and LVEF although had good correlation(r = 0.96 and 0.89) showed high difference in means (p<0.01). Conclusion: Between 4D-MSPECT and ECT, 4D-MSPECT is marginally superior to ECT with reference to qualitative interpretation in view of better specificity. The LVEF values between the two softwares should also not be used interchangeably. (author)

  8. Concordance of U.S. Army Psychology Conference Proceedings from 1958 through 1988

    Science.gov (United States)

    1990-06-01

    DENTISTRY 76 020 PARTICIPANT/PROBLEM ORIENTED CASE CONFERENCE:AN ALTERNATIVE 76 035 REGIONAL PSYCH CONSLTNT PRGRM OF CONUS ARMY HEALTH SERVICES 76 039...APPLICATION OF GROUP DYNAMICS TO PREVENTIVE DENTISTRY 82 297 FOOD AND CHEMICAL SENSITIVITY IN EMOTIONAL DISTURBANCES 82 305 ARMY CLINICAL PSYCHOLOGIST...BIOPSYCHOSOCIAL 872 183 BIOSTATISTICS 85F 163 BOREDOM 85 175 BRAIN DAMAGE 600 BRAIN DAMAGE 85 215 BRAIN DAMAGE 85 221 BRAIN DAMAGE 85F 196 BRAIN

  9. Quantitative secondary electron detection

    Science.gov (United States)

    Agrawal, Jyoti; Joy, David C.; Nayak, Subuhadarshi

    2018-05-08

    Quantitative Secondary Electron Detection (QSED) using the array of solid state devices (SSD) based electron-counters enable critical dimension metrology measurements in materials such as semiconductors, nanomaterials, and biological samples (FIG. 3). Methods and devices effect a quantitative detection of secondary electrons with the array of solid state detectors comprising a number of solid state detectors. An array senses the number of secondary electrons with a plurality of solid state detectors, counting the number of secondary electrons with a time to digital converter circuit in counter mode.

  10. Quantitative Activities for Introductory Astronomy

    Science.gov (United States)

    Keohane, Jonathan W.; Bartlett, J. L.; Foy, J. P.

    2010-01-01

    We present a collection of short lecture-tutorial (or homework) activities, designed to be both quantitative and accessible to the introductory astronomy student. Each of these involves interpreting some real data, solving a problem using ratios and proportionalities, and making a conclusion based on the calculation. Selected titles include: "The Mass of Neptune” "The Temperature on Titan” "Rocks in the Early Solar System” "Comets Hitting Planets” "Ages of Meteorites” "How Flat are Saturn's Rings?” "Tides of the Sun and Moon on the Earth” "The Gliese 581 Solar System"; "Buckets in the Rain” "How Hot, Bright and Big is Betelgeuse?” "Bombs and the Sun” "What Forms Stars?” "Lifetimes of Cars and Stars” "The Mass of the Milky” "How Old is the Universe?” "Is The Universe Speeding up or Slowing Down?"

  11. Quantitative pulsed eddy current analysis

    International Nuclear Information System (INIS)

    Morris, R.A.

    1975-01-01

    The potential of pulsed eddy current testing for furnishing more information than conventional single-frequency eddy current methods has been known for some time. However, a fundamental problem has been analyzing the pulse shape with sufficient precision to produce accurate quantitative results. Accordingly, the primary goal of this investigation was to: demonstrate ways of digitizing the short pulses encountered in PEC testing, and to develop empirical analysis techniques that would predict some of the parameters (e.g., depth) of simple types of defect. This report describes a digitizing technique using a computer and either a conventional nuclear ADC or a fast transient analyzer; the computer software used to collect and analyze pulses; and some of the results obtained. (U.S.)

  12. Innovations in Quantitative Risk Management

    CERN Document Server

    Scherer, Matthias; Zagst, Rudi

    2015-01-01

    Quantitative models are omnipresent –but often controversially discussed– in todays risk management practice. New regulations, innovative financial products, and advances in valuation techniques provide a continuous flow of challenging problems for financial engineers and risk managers alike. Designing a sound stochastic model requires finding a careful balance between parsimonious model assumptions, mathematical viability, and interpretability of the output. Moreover, data requirements and the end-user training are to be considered as well. The KPMG Center of Excellence in Risk Management conference Risk Management Reloaded and this proceedings volume contribute to bridging the gap between academia –providing methodological advances– and practice –having a firm understanding of the economic conditions in which a given model is used. Discussed fields of application range from asset management, credit risk, and energy to risk management issues in insurance. Methodologically, dependence modeling...

  13. Calculus problems

    CERN Document Server

    Baronti, Marco; van der Putten, Robertus; Venturi, Irene

    2016-01-01

    This book, intended as a practical working guide for students in Engineering, Mathematics, Physics, or any other field where rigorous calculus is needed, includes 450 exercises. Each chapter starts with a summary of the main definitions and results, which is followed by a selection of solved exercises accompanied by brief, illustrative comments. A selection of problems with indicated solutions rounds out each chapter. A final chapter explores problems that are not designed with a single issue in mind but instead call for the combination of a variety of techniques, rounding out the book’s coverage. Though the book’s primary focus is on functions of one real variable, basic ordinary differential equations (separation of variables, linear first order and constant coefficients ODEs) are also discussed. The material is taken from actual written tests that have been delivered at the Engineering School of the University of Genoa. Literally thousands of students have worked on these problems, ensuring their real-...

  14. Quantitative Characterization of Nanostructured Materials

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Frank (Bud) Bridges, University of California-Santa Cruz

    2010-08-05

    The two-and-a-half day symposium on the "Quantitative Characterization of Nanostructured Materials" will be the first comprehensive meeting on this topic held under the auspices of a major U.S. professional society. Spring MRS Meetings provide a natural venue for this symposium as they attract a broad audience of researchers that represents a cross-section of the state-of-the-art regarding synthesis, structure-property relations, and applications of nanostructured materials. Close interactions among the experts in local structure measurements and materials researchers will help both to identify measurement needs pertinent to real-world materials problems and to familiarize the materials research community with the state-of-the-art local structure measurement techniques. We have chosen invited speakers that reflect the multidisciplinary and international nature of this topic and the need to continually nurture productive interfaces among university, government and industrial laboratories. The intent of the symposium is to provide an interdisciplinary forum for discussion and exchange of ideas on the recent progress in quantitative characterization of structural order in nanomaterials using different experimental techniques and theory. The symposium is expected to facilitate discussions on optimal approaches for determining atomic structure at the nanoscale using combined inputs from multiple measurement techniques.

  15. Infrared thermography quantitative image processing

    Science.gov (United States)

    Skouroliakou, A.; Kalatzis, I.; Kalyvas, N.; Grivas, TB

    2017-11-01

    Infrared thermography is an imaging technique that has the ability to provide a map of temperature distribution of an object’s surface. It is considered for a wide range of applications in medicine as well as in non-destructive testing procedures. One of its promising medical applications is in orthopaedics and diseases of the musculoskeletal system where temperature distribution of the body’s surface can contribute to the diagnosis and follow up of certain disorders. Although the thermographic image can give a fairly good visual estimation of distribution homogeneity and temperature pattern differences between two symmetric body parts, it is important to extract a quantitative measurement characterising temperature. Certain approaches use temperature of enantiomorphic anatomical points, or parameters extracted from a Region of Interest (ROI). A number of indices have been developed by researchers to that end. In this study a quantitative approach in thermographic image processing is attempted based on extracting different indices for symmetric ROIs on thermograms of the lower back area of scoliotic patients. The indices are based on first order statistical parameters describing temperature distribution. Analysis and comparison of these indices result in evaluating the temperature distribution pattern of the back trunk expected in healthy, regarding spinal problems, subjects.

  16. CDX2 expression is concordant between primary colorectal cancer lesions and corresponding liver metastases independent of chemotherapy: a single-center retrospective study in Japan.

    Science.gov (United States)

    Shigematsu, Yasuyuki; Inamura, Kentaro; Mise, Yoshihiro; Saiura, Akio; Rehnberg, Emil; Yamamoto, Noriko; Ishikawa, Yuichi; Takahashi, Shunji; Kanda, Hiroaki

    2018-03-30

    Loss of caudal-type homeobox transcription factor 2 (CDX2) expression in colorectal cancers (CRCs) has recently been proposed as a promising predictive biomarker for not only prognosis but also response to chemotherapy. However, the relationship between alterations in CDX2 expression during cancer progression and response to chemotherapy remains unclear. We herein aimed to determine the concordance of CDX2 expression between primary CRCs and corresponding liver metastases, in association with chemotherapy. Primary CRCs exhibited heterogeneous CDX2 expression. Seven of the 144 CRCs in the cohort (4.9%, 95% confidential interval, 2.0%-9.8%) were CDX2-negative. The concordance rate of the CDX2 expression status in patients who did not receive chemotherapy was 100% ( P = 0.041), whereas the concordance rate among patients who received chemotherapy only after primary resection was 96.3% ( P = 0.005). Moreover, the concordance rate in patients who received chemotherapy before both primary resection and liver metastasectomy was 100% ( P < 0.001). CDX2 expression status was highly concordant between primary CRCs and corresponding liver metastases, independent of chemotherapy, suggesting that the CDX2 expression status in CRCs was not affected by metastasis or chemotherapy. A total of 144 consecutive patients with CRC who were treated at a single center in Japan between 2006 and 2014 were included. Formalin-fixed paraffin-embedded whole sections of surgically resected primary CRCs and corresponding liver metastases were assessed for CDX2 expression by immunohistochemistry.

  17. Smoking During Adolescence as a Risk Factor for Attention Problems.

    Science.gov (United States)

    Treur, Jorien L; Willemsen, Gonneke; Bartels, Meike; Geels, Lot M; van Beek, Jenny H D A; Huppertz, Charlotte; van Beijsterveldt, Catharina E M; Boomsma, Dorret I; Vink, Jacqueline M

    2015-11-01

    Cigarette smoking and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid. One explanation is that individuals with ADHD use cigarettes as "self-medication" to alleviate their attention problems. However, animal studies reported that exposure to nicotine during adolescence influences the developing brain and negatively affects attention. This is the first human study exploring the effects of smoking during adolescence on attention problems. Longitudinal data on smoking and attention problems were available for 1987 adult and 648 adolescent monozygotic twin pairs from the Netherlands Twin Register. Twin pairs were classified as concordant/discordant for smoking and compared on attention problems. Within adult discordant pairs, the difference in attention problems between the smoking and never-smoking twins was first assessed cross-sectionally. In longitudinal analyses, the increase in attention problems from adolescence, when neither twin smoked, to adulthood was compared within discordant pairs. In subgroups with longitudinal data from childhood and adolescence, changes in smoking concordance and subsequent changes in attention problems were explored. Adult twins who ever smoked reported significantly more attention problems than their never-smoking co-twin. Longitudinal analyses showed a larger increase in attention problems from adolescence to adulthood in smoking twins than their never-smoking co-twin (p adolescence, smoking twins had more attention problems than their never-smoking co-twin, whereas scores were similar before smoking was initiated or after both twins started smoking (not significant in all groups). Results from this genetically informative study suggest smoking during adolescence leads to higher attention problem scores, lasting into adulthood. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. [Evaluation of the nutritional status of children under 5 years of age: concordance between anthropometric indices in the indigenous population of Chiapas (Mexico)].

    Science.gov (United States)

    Ochoa-Díaz López, Héctor; García-Parra, Esmeralda; Flores-Guillén, Elena; García-Miranda, Rosario; Solís-Hernández, Roberto

    2017-07-28

    Nutritional status is determined through various methods, including anthropometry. In children under 5 years of age indeces as weight/age (w/a), height/age (h/a), weight/height (w/h) and body mass index (BMI) are used. The purpose of this article is to analyze and compare the ability of different anthropometric indeces to identify children from marginalized communities in Chiapas (Mexico) with nutritional problems. To analyze the correlation among the different anthropometric indeces to determine the nutritional status of children under 5 years of age in poor rural areas with a background of short stature. Cross-sectional study in 1,160 children under 5 years of age in 13 high poverty communities in three regions of Chiapas. The variables studied were age, sex, weight and height. Nutritional status was determined through the indeces w/a, h/a, w/h and BMI. Field staff in charge of taking measurements of weight and height were trained and standardized. Kappa coefficients for agreement between the indeces were calculated. No correlation between BMI and w/a and h/a was found. The prevalence of malnutrition according to h/a was 64.8%. Only high concordance (0.726) between BMI and w/h was found. BMI showed a low prevalence of malnutrition and a higher prevalence of overweight and obesity rates. For a reliable and accurate diagnosis in individuals with a background of chronic malnutrition, it is recommended to use the four indeces together. Doing so it will reduce the risk of underestimating or overestimating nutritional status and will focus actions toward addressing and improving the health and nutrition of children living under extreme poverty conditions.

  19. Comparison of Parent's and Teachers' Perceptions of Children's Behavior: A Study of Attentional Problems in a Natural Setting

    Science.gov (United States)

    Rappaport, Lisa N.

    2006-01-01

    The purpose of this study was to investigate concordance of reports of hyperactive and distractible behavior from three different sources: parents, teachers, and the child, using two different instruments, the ADHD Rating Scale and the Gordon Diagnostic System (GDS). The incidence rate of attentional problems that any of the sources reported in…

  20. Problems and solutions in quantum physics

    CERN Document Server

    Ficek, Zbigniew

    2016-01-01

    This book contains tutorial problems with solutions for the textbook Quantum Physics for Beginners. The reader studying the abstract field of quantum physics needs to solve plenty of practical, especially quantitative, problems. This book places emphasis on basic problems of quantum physics together with some instructive, simulating, and useful applications. A considerable range of complexity is presented by these problems, and not too many of them can be solved using formulas alone.

  1. Thyroid Problems

    Science.gov (United States)

    ... Home › Aging & Health A to Z › Thyroid Problems Font size A A A Print Share Glossary Basic ... enough thyroid hormone, usually of the thyroxine (T4) type of hormone. Your T4 levels can drop temporarily ...

  2. Balance Problems

    Science.gov (United States)

    ... fully trust your sense of balance. Loss of balance also raises the risk of falls. This is a serious and even life-threatening ... 65. Balance disorders are serious because of the risk of falls. But occasionally balance problems may warn of another health condition, such ...

  3. Extending Quantitative Easing

    DEFF Research Database (Denmark)

    Hallett, Andrew Hughes; Fiedler, Salomon; Kooths, Stefan

    The notes in this compilation address the pros and cons associated with the extension of ECB quantitative easing programme of asset purchases. The notes have been requested by the Committee on Economic and Monetary Affairs as an input for the February 2017 session of the Monetary Dialogue....

  4. Quantitative Moessbauer analysis

    International Nuclear Information System (INIS)

    Collins, R.L.

    1978-01-01

    The quantitative analysis of Moessbauer data, as in the measurement of Fe 3+ /Fe 2+ concentration, has not been possible because of the different mean square velocities (x 2 ) of Moessbauer nuclei at chemically different sites. A method is now described which, based on Moessbauer data at several temperatures, permits the comparison of absorption areas at (x 2 )=0. (Auth.)

  5. Lung cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study.

    Science.gov (United States)

    Richards, Thomas B; Henley, S Jane; Puckett, Mary C; Weir, Hannah K; Huang, Bin; Tucker, Thomas C; Allemani, Claudia

    2017-12-15

    Results from the second CONCORD study (CONCORD-2) indicated that 5-year net survival for lung cancer was low (range, 10%-20%) between 1995 and 2009 in most countries, including the United States, which was at the higher end of this range. Data from CONCORD-2 were used to analyze net survival among patients with lung cancer (aged 15-99 years) who were diagnosed in 37 states covering 80% of the US population. Survival was corrected for background mortality using state-specific and race-specific life tables and age-standardized using International Cancer Survival Standard weights. Net survival was estimated for patients diagnosed between 2001 and 2003 and between 2004 and 2009 at 1, 3, and 5 years after diagnosis by race (all races, black, and white); Surveillance, Epidemiology, and End Results Summary Stage 2000; and US state. Five-year net survival increased from 16.4% (95% confidence interval, 16.3%-16.5%) for patients diagnosed 2001-2003 to 19.0% (18.8%-19.1%) for those diagnosed 2004-2009, with increases in most states and among both blacks and whites. Between 2004 and 2009, 5-year survival was lower among blacks (14.9%) than among whites (19.4%) and ranged by state from 14.5% to 25.2%. Lung cancer survival improved slightly between the periods 2001-2003 and 2004-2009 but was still low, with variation between states, and persistently lower survival among blacks than whites. Efforts to control well established risk factors would be expected to have the greatest impact on reducing the burden of lung cancer, and efforts to ensure that all patients receive timely and appropriate treatment should reduce the differences in survival by race and state. Cancer 2017;123:5079-99. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  6. A critical evaluation of the Beckman Coulter Access hsTnI: Analytical performance, reference interval and concordance.

    Science.gov (United States)

    Pretorius, Carel J; Tate, Jillian R; Wilgen, Urs; Cullen, Louise; Ungerer, Jacobus P J

    2018-05-01

    We investigated the analytical performance, outlier rate, carryover and reference interval of the Beckman Coulter Access hsTnI in detail and compared it with historical and other commercial assays. We compared the imprecision, detection capability, analytical sensitivity, outlier rate and carryover against two previous Access AccuTnI assay versions. We established the reference interval with stored samples from a previous study and compared the concordances and variances with the Access AccuTnI+3 as well as with two commercial assays. The Access hsTnI had excellent analytical sensitivity with the calibration slope 5.6 times steeper than the Access AccuTnI+3. The detection capability was markedly improved with the SD of the blank 0.18-0.20 ng/L, LoB 0.29-0.33 ng/L and LoD 0.58-0.69 ng/L. All the reference interval samples had a result above the LoB value. At a mean concentration of 2.83 ng/L the SD was 0.28 ng/L (CV 9.8%). Carryover (0.005%) and outlier (0.046%) rates were similar to the Access AccuTnI+3. The combined male and female 99th percentile reference interval was 18.2 ng/L (90% CI 13.2-21.1 ng/L). Concordance amongst the assays was poor with only 16.7%, 19.6% and 15.2% of samples identified by all 4 assays as above the 99th, 97.5th and 95th percentiles. Analytical imprecision was a minor contributor to the observed variances between assays. The Beckman Coulter Access hsTnI assay has excellent analytical sensitivity and precision characteristics close to zero. This allows cTnI measurement in all healthy individuals and the capability to identify numerically small differences between serial samples as statistically significant. Concordance in healthy individuals remains poor amongst assays. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  7. Oral human papillomavirus (HPV) infection in men who have sex with men: prevalence and lack of anogenital concordance

    Science.gov (United States)

    King, Eleanor M; Gilson, Richard; Beddows, Simon; Soldan, Kate; Panwar, Kavita; Young, Carmel; Jit, Mark; Edmunds, W John; Sonnenberg, Pam

    2015-01-01

    Objectives To estimate the prevalence of oral detectable human papillomavirus (HPV) DNA in HIV-negative men who have sex with men (MSM) attending a sexual health clinic in London and concordance with anogenital HPV infection. Such data are important to improve our understanding of the epidemiology of oral HPV and the potential use of vaccines to prevent oropharyngeal cancers. Methods Paired oral rinse samples and anogenital samples were available from 151 HIV-negative MSM within a larger cross-sectional survey. All samples were tested in parallel for 21 types of HPV DNA using an in-house assay. Results The median age of participants was 30 (IQR 25–35). The prevalence of any oral HPV and of high-risk HPV (HR-HPV) was 13.7% (n=21; 95% CI 8.7 to 20.2) and 5.9% (n=9; 95% CI 2.7 to 10.9) compared with 64.9% (n=98; 95% CI 56.7 to 72.5) and 34.4% (n=52; 95% CI 26.9 to 42.6) in any anogenital sample, respectively. The prevalence of types prevented by the bivalent (HPV16/18), quadrivalent (HPV6/11/16/18) and nonavalent (HPV6/11/16/18/31/33/45/52/58) vaccines was 1.3% (95% CI 0.2 to 4.7), 2.6% (95% CI 0.7 to 6.6) and 4.6% (95% CI 1.9 to 9.3), respectively. There was no concordance between HPV genotypes detected in oral and anogenital sites. Conclusions HR-HPV DNA, including HPV 16/18, was detected in oral specimens from HIV-negative MSM attending sexual health clinics, suggesting a potential role for vaccination, but is far less common than anogenital infection. How this relates to the risk and natural history of HPV-related head and neck cancers warrants further study. Lack of concordance with anogenital infection also suggests that oral HPV infection should be considered separately when estimating potential vaccine impact. PMID:25887283

  8. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    International Nuclear Information System (INIS)

    Yoon, Seok Nam

    2012-01-01

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from

  9. Record completeness and data concordance in an anesthesia information management system using context-sensitive mandatory data-entry fields.

    Science.gov (United States)

    Avidan, Alexander; Weissman, Charles

    2012-03-01

    Use of an anesthesia information management system (AIMS) does not insure record completeness and data accuracy. Mandatory data-entry fields can be used to assure data completeness. However, they are not suited for data that is mandatory depending on the clinical situation (context sensitive). For example, information on equal breath sounds should be mandatory with tracheal intubation, but not with mask ventilation. It was hypothesized that employing context-sensitive mandatory data-entry fields can insure high data-completeness and accuracy while maintaining usability. A commercial off-the-shelf AIMS was enhanced using its built-in VBScript programming tool to build event-driven forms with context-sensitive mandatory data-entry fields. One year after introduction of the system, all anesthesia records were reviewed for data completeness. Data concordance, used as a proxy for accuracy, was evaluated using verifiable age-related data. Additionally, an anonymous satisfaction survey on general acceptance and usability of the AIMS was performed. During the initial 12 months of AIMS use, 12,241 (99.6%) of 12,290 anesthesia records had complete data. Concordances of entered data (weight, size of tracheal tubes, laryngoscopy blades and intravenous catheters) with patients' ages were 98.7-99.9%. The AIMS implementation was deemed successful by 98% of the anesthesiologists. Users rated the AIMS usability in general as very good and the data-entry forms in particular as comfortable. Due to the complexity and the high costs of implementation of an anesthesia information management system it was not possible to compare various system designs (for example with or without context-sensitive mandatory data entry-fields). Therefore, it is possible that a different or simpler design would have yielded the same or even better results. This refers also to the evaluation of usability, since users did not have the opportunity to work with different design approaches or even different

  10. HER2 testing on core needle biopsy specimens from primary breast cancers: interobserver reproducibility and concordance with surgically resected specimens

    Directory of Open Access Journals (Sweden)

    Yamamoto Sohei

    2010-10-01

    Full Text Available Abstract Background Accurate evaluation of human epidermal growth factor receptor type-2 (HER2 status based on core needle biopsy (CNB specimens is mandatory for identification of patients with primary breast cancer who will benefit from primary systemic therapy with trastuzumab. The aim of the present study was to validate the application of HER2 testing with CNB specimens from primary breast cancers in terms of interobserver reproducibility and comparison with surgically resected specimens. Methods A total of 100 pairs of archival formalin-fixed paraffin-embedded CNB and surgically resected specimens of invasive breast carcinomas were cut into sections. All 100 paired sections were subjected to HER2 testing by immunohistochemistry (IHC and 27 paired sections were subjected to that by fluorescence in situ hybridization (FISH, the results being evaluated by three and two observers, respectively. Interobserver agreement levels in terms of judgment and the concordance of consensus scores between CNB samples and the corresponding surgically resected specimens were estimated as the percentage agreement and κ statistic. Results In CNB specimens, the percentage interobserver agreement of HER2 scoring by IHC was 76% (κ = 0.71 for 3 × 3 categories (0-1+ versus 2+ versus 3+ and 90% (κ = 0.80 for 2 × 2 categories (0-2+ versus 3+. These levels were close to the corresponding ones for the surgically resected specimens: 80% (κ = 0.77 for 3 × 3 categories and 92% (κ = 0.88 for 2 × 2 categories. Concordance of consensus for HER2 scores determined by IHC between CNB and the corresponding surgical specimens was 87% (κ = 0.77 for 3 × 3 categories, and 94% (κ = 0.83 for 2 × 2 categories. Among the 13 tumors showing discordance in the mean IHC scores between the CNB and surgical specimens, the results of consensus for FISH results were concordant in 11. The rate of successful FISH analysis and the FISH positivity rate in cases with a HER2 IHC score of

  11. HER2 testing on core needle biopsy specimens from primary breast cancers: interobserver reproducibility and concordance with surgically resected specimens

    International Nuclear Information System (INIS)

    Tsuda, Hitoshi; Kurosumi, Masafumi; Umemura, Shinobu; Yamamoto, Sohei; Kobayashi, Takayuki; Osamura, Robert Yoshiyuki

    2010-01-01

    Accurate evaluation of human epidermal growth factor receptor type-2 (HER2) status based on core needle biopsy (CNB) specimens is mandatory for identification of patients with primary breast cancer who will benefit from primary systemic therapy with trastuzumab. The aim of the present study was to validate the application of HER2 testing with CNB specimens from primary breast cancers in terms of interobserver reproducibility and comparison with surgically resected specimens. A total of 100 pairs of archival formalin-fixed paraffin-embedded CNB and surgically resected specimens of invasive breast carcinomas were cut into sections. All 100 paired sections were subjected to HER2 testing by immunohistochemistry (IHC) and 27 paired sections were subjected to that by fluorescence in situ hybridization (FISH), the results being evaluated by three and two observers, respectively. Interobserver agreement levels in terms of judgment and the concordance of consensus scores between CNB samples and the corresponding surgically resected specimens were estimated as the percentage agreement and κ statistic. In CNB specimens, the percentage interobserver agreement of HER2 scoring by IHC was 76% (κ = 0.71) for 3 × 3 categories (0-1+ versus 2+ versus 3+) and 90% (κ = 0.80) for 2 × 2 categories (0-2+ versus 3+). These levels were close to the corresponding ones for the surgically resected specimens: 80% (κ = 0.77) for 3 × 3 categories and 92% (κ = 0.88) for 2 × 2 categories. Concordance of consensus for HER2 scores determined by IHC between CNB and the corresponding surgical specimens was 87% (κ = 0.77) for 3 × 3 categories, and 94% (κ = 0.83) for 2 × 2 categories. Among the 13 tumors showing discordance in the mean IHC scores between the CNB and surgical specimens, the results of consensus for FISH results were concordant in 11. The rate of successful FISH analysis and the FISH positivity rate in cases with a HER2 IHC score of 2+ differed among specimens processed at

  12. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass

  13. Concordance of X-ray cluster data with big bang nucleosynthesis in mixed dark matter models

    International Nuclear Information System (INIS)

    Strickland, R.W.; Schramm, D.N.

    1997-01-01

    If the hot, X-ray-emitting gas in rich clusters forms a fair sample of the universe as in cold dark matter (CDM) models and the universe is at the critical density Ω T =1, then the data appear to imply a baryon fraction Ω b,X (Ω b,X ≡Ω b derived from X-ray cluster data), larger than that predicted by big bang nucleosynthesis (BBN). While other systematic effects such as clumping can lower Ω b,X , in this paper we use an elementary analysis to show that a simple admixture of hot dark matter (HDM; low-mass neutrinos) with CDM to yield mixed dark matter shifts Ω b,X down so that significant overlap with Ω b from BBN can occur for H 0 approx-lt 73kms -1 Mpc -1 , even without invoking the possible aforementioned effects. The overlap interval is slightly larger for lower mass neutrinos since fewer of them cluster on the scale of the hot X-ray gas. We illustrate this result quantitatively in terms of a simple isothermal model. More realistic velocity dispersion profiles, with less centrally peaked density profiles, imply that fewer neutrinos are trapped and thus further increase the interval of overlap. copyright 1997 The American Astronomical Society

  14. Critical Quantitative Inquiry in Context

    Science.gov (United States)

    Stage, Frances K.; Wells, Ryan S.

    2014-01-01

    This chapter briefly traces the development of the concept of critical quantitative inquiry, provides an expanded conceptualization of the tasks of critical quantitative research, offers theoretical explanation and justification for critical research using quantitative methods, and previews the work of quantitative criticalists presented in this…

  15. Quantitative Modeling of Earth Surface Processes

    Science.gov (United States)

    Pelletier, Jon D.

    This textbook describes some of the most effective and straightforward quantitative techniques for modeling Earth surface processes. By emphasizing a core set of equations and solution techniques, the book presents state-of-the-art models currently employed in Earth surface process research, as well as a set of simple but practical research tools. Detailed case studies demonstrate application of the methods to a wide variety of processes including hillslope, fluvial, aeolian, glacial, tectonic, and climatic systems. Exercises at the end of each chapter begin with simple calculations and then progress to more sophisticated problems that require computer programming. All the necessary computer codes are available online at www.cambridge.org/9780521855976. Assuming some knowledge of calculus and basic programming experience, this quantitative textbook is designed for advanced geomorphology courses and as a reference book for professional researchers in Earth and planetary science looking for a quantitative approach to Earth surface processes. More details...

  16. Bridging the Gap: Racial concordance as a strategy to increase African American participation in breast cancer research.

    Science.gov (United States)

    Frierson, Georita M; Pinto, Bernardine M; Denman, Deanna C; Leon, Pierre A; Jaffe, Alex D

    2017-11-01

    Lack of African American females in breast cancer research has been receiving substantial attention. This study seeks to identify research perceptions and motivating factors needed to increase racial/ethnic minority participation in breast cancer research. A total of 57 African American women (Σ = 47.8 years), from Rhode Island and Texas, completed a questionnaire and focus group. While many participants were not breast cancer survivors, they reported knowledge of their racial group's risk for breast cancer. One major finding that could be seen as both a facilitator and barrier is racial concordance between participant and researcher. Cultural sensitivity and trust building is recommended to increase minority participation.

  17. Assessment of intercentre reproducibility and epidemiological concordance of Legionella pneumophila serogroup 1 genotyping by amplified fragment length polymorphism analysis

    DEFF Research Database (Denmark)

    Fry, N K; Bangsborg, Jette Marie; Bernander, S

    2000-01-01

    The aims of this work were to assess (i) the intercentre reproducibility and epidemiological concordance of amplified fragment length polymorphism analysis for epidemiological typing of Legionella pneumophila serogroup 1, and (ii) the suitability of the method for standardisation and implementation...... by members of the European Working Group on Legionella Infections. Fifty coded isolates comprising two panels of well-characterised strains, a "reproducibility" panel (n=20) and an "epidemiologically related" panel (n=30), were sent to 13 centres in 12 European countries. Analysis was undertaken in each...... using gel analysis software yielded R=1.00 and E=1.00, with 12, 13 or 14 types. This method can be used as a simple, rapid screening tool for epidemiological typing of isolates of Legionella pneumophila serogroup 1. Results demonstrate that the method can be highly reproducible (R=1...

  18. Twin studies of schizophrenia: from bow-and-arrow concordances to star wars Mx and functional genomics.

    Science.gov (United States)

    Cardno, A G; Gottesman, I I

    2000-01-01

    Twin studies have been vital for establishing an important genetic contribution to the etiology of schizophrenia. The five newest studies since 1995 from Europe and Japan have confirmed earlier findings. They yielded probandwise concordance rates of 41-65% in monozygotic (MZ) pairs and 0-28% in dizygotic (DZ) pairs, and heritability estimates of approximately 80-85%. Twin studies are also valuable for investigating the etiological relationships between schizophrenia and other disorders, and the genetic basis of clinical heterogeneity within schizophrenia. Studies of discordant MZ pairs provide further insights into non-inherited factors that contribute to the multifactorial etiology of this disorder. More recently, twin studies have begun to be used to directly investigate molecular genetic and epigenetic processes underlying schizophrenia. Copyright 2000 Wiley-Liss, Inc.

  19. Effects of Concept Mapping and Problem Solving Instructional ...

    African Journals Online (AJOL)

    Administrator

    (iii). lack of organizational skill in solving quantitative problems. (Onwu, 1982, Onwu ... improved in terms of conceptual thinking, intuitive knowledge and insightful ... Problem Solving: This is a cognitive learning strategy which has to do with ...

  20. Complementarity problems

    CERN Document Server

    Isac, George

    1992-01-01

    The study of complementarity problems is now an interesting mathematical subject with many applications in optimization, game theory, stochastic optimal control, engineering, economics etc. This subject has deep relations with important domains of fundamental mathematics such as fixed point theory, ordered spaces, nonlinear analysis, topological degree, the study of variational inequalities and also with mathematical modeling and numerical analysis. Researchers and graduate students interested in mathematical modeling or nonlinear analysis will find here interesting and fascinating results.

  1. Agricultural problems

    International Nuclear Information System (INIS)

    Bickerton, George E.

    1997-01-01

    Although there were not reasons to deplore against major activity release from any of the 110 industrial reactors authorized to operate in US, the nuclear incident that occurred at the Three Mile Island Plant in 1979 urged the public conscience toward the necessity of readiness to cope with events of this type. The personnel of the Emergency Planning Office functioning in the frame of US Department of Agriculture has already participated in around 600 intervention drillings on a federal, local or state scale to plan, test or asses radiological emergency plans or to intervene locally. These exercises allowed acquiring a significant experience in elaborating emergency plans, planning the drillings, working out scenarios and evaluation of the potential impact of accidents from the agricultural point of view. We have also taken part in different international drillings among which the most recent are INEX 1 and RADEX 94. We have found on these occasions that the agricultural problems are essential preoccupations in most of the cases no matter if the context is international, national, local or of state level. The paper poses problems specifically related to milk, fruits and vegetables, soils, meat and meat products. Finally the paper discusses issues like drilling planning, alarm and notification, sampling strategy, access authorizations for farmers, removing of contamination wastes. A number of social, political and economical relating problems are also mentioned

  2. Just say "I don't": lack of concordance between teen report and biological measures of drug use.

    Science.gov (United States)

    Delaney-Black, Virginia; Chiodo, Lisa M; Hannigan, John H; Greenwald, Mark K; Janisse, James; Patterson, Grace; Huestis, Marilyn A; Ager, Joel; Sokol, Robert J

    2010-11-01

    Prevalence estimates of illicit drug use by teens are typically generated from confidential or anonymous self-report. While data comparing teen self-report with biological measures are limited, adult studies identify varying degrees of under-reporting. Hair analyses for cocaine, opiates and marijuana were compared to confidential teen self- and parent-reported teen drug use in a longitudinal cohort of >400 high-risk urban teens and parents. Both teens and parents substantially underreported recent teen cocaine and opiate use. However, compared with parents, teens were more likely to deny biomarker-verified cocaine use. Teen specimens (hair) were 52 times more likely to identify cocaine use compared with self-report. Parent hair analyses for cocaine and opiate use were 6.5 times and 5.5 times, respectively, more likely to indicate drug use than were parental self-report. The lack of concordance between self-report and bioassay occurred despite participant's knowledge that a "certificate of confidentiality" protected both teen and adult participants, and that the biological specimens would be tested for drugs. These findings confirm prior reports of adult under-reporting of their own drug use while extending our understanding of teen's self-admitted drug use. The lack of concordance between teen self- or parent-reported teen drug use and biomarkers confirm our concerns that both teen- and parent-reported teen drug use is limited, at least for youth in high-risk urban settings. Methods of ascertainment other than self- or parent-report must be considered when health care providers, researchers and public health agencies attempt to estimate teen drug-use prevalence.

  3. MRI follow-up after concordant, histologically benign diagnosis of breast lesions sampled by MRI-guided biopsy.

    Science.gov (United States)

    Li, Jie; Dershaw, D David; Lee, Carol H; Kaplan, Jennifer; Morris, Elizabeth A

    2009-09-01

    Follow-up MRI can be useful to confirm a benign diagnosis after MRI-guided breast biopsy. This retrospective study was undertaken to evaluate appropriate timing and imaging interpretation for the initial follow-up MRI when a benign, concordant histology is obtained using MRI-guided breast biopsy. Retrospective review was performed of 177 lesions visualized only by MRI in 172 women who underwent 9-gauge, vacuum-assisted core biopsy and marker placement with imaging-concordant benign histology. All underwent follow-up MRI within 12 months. Timing of the follow-up study, change in size, results of second biopsy if performed, and distance of localizing marker to the lesion on the follow-up study were recorded. At initial follow-up, 155 lesions were decreased or gone, 14 lesions were stable, and eight were enlarged. Seventeen (9.6%, 17/177) lesions underwent a second biopsy, including six enlarging, 10 stable, and one decreasing. Of these, four were malignant. Enlargement was seen in two carcinomas at 6 and 12 months. Two carcinomas, one stable at 2 months and another stable at 3 and 11 months, were rebiopsied because of suspicion of a missed lesion in the former and worrisome mammographic and sonographic changes in the latter. The distance of the marker from the lesion on follow-up did not correlate with biopsy accuracy. Follow-up MRI did not detect missed cancers because of lesion enlargement before 6 months after biopsy; two of four missed cancers were stable. The localizing marker can deploy away from the target despite successful sampling.

  4. Major depressive episodes are associated with poor concordance with therapy in rheumatoid arthritis patients: the impact on disease outcomes.

    Science.gov (United States)

    Cabrera-Marroquín, Ricardo; Contreras-Yáñez, Irazú; Alcocer-Castillejos, Natasha; Pascual-Ramos, Virginia

    2014-01-01

    Our objective was to investigate associations between major depressive episodes (MDE), concordance with therapy (CwT) and disease outcomes in rheumatoid arthritis patients. Seventy-eight outpatients receiving ≥1 disease modifying anti-rheumatic drug and without significant comorbidity had concomitant rheumatic and psychiatric evaluations. CwT was defined according to a questionnaire. MDE was defined using the Mini International Neuropsychiatric Interview and the severity of depressive symptoms was assessed with the Beck Depression Inventory (BDI-II). Appropriated statistic was used. IRB approval was obtained. Patients included (73 ♀) had (mean±SD) age of 44±10 years and (median, range) disease duration of 10 years (5.2-15.8). Current MDE were diagnosed in 24 patients (30.8%); 60 patients (76.9%) were CwT. Patient-non-CwT were more frequently diagnosed with MDE and tend to have higher BDI scores. They had significantly more disease activity according to patient-pain VAS and swollen joint counts. Both groups were similar regarding demographic variables, treatment and comorbid conditions. Forty-one patients (53%) had clinically important depressive symptoms (BDI≥10), among them 20 had mild depression, 14 moderate and 7 severe depression. Patient-non-CwT had more frequently moderate depression (according to BDI score) than their counterparts and similar tendency was found regarding severe depression. Patient-CwT who additionally had lower BDI scores had better disease outcomes than concordant patients with higher BDI scores. Similar results were found in non-CwT patients but statistical significance was limited to disease activity. Prevalence of current MDE in RA patients was of 31%; those patients had poorer CwT and worse outcomes than mentally healthy patients.

  5. HER-2, ER, PR status concordance in primary breast cancer and corresponding metastatic lesion in lymph node in Chinese women.

    Science.gov (United States)

    Li, Min Hua; Hou, Chuan Ling; Wang, Cheng; Sun, Ai Jing

    2016-04-01

    To compare the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in the primary site and the metastatic lesion of lymph nodes in invasive breast cancer for investigating whether the expression of these biomarkers in the primary site could act as a surrogate to the lymphatic metastatic lesion in the same patient. In lymphatic metastatic lesion and corresponding primary lesion of 107 cases of invasive breast cancer, ER and PR statuses were assessed by immunohistochemistry (IHC). HER-2 expression level was evaluated by IHC and/or fluorescence in situ hybridization (FISH). In the primary lesions, 43.9% were ER positive; 46.7% were PR positive; 34.6% were HER-2 positive. In corresponding lymphatic metastatic lesions, the HER-2 status was concordant in 90 patients; 9 patients were diagnosed positive in metastatic lesion while negative in primary lesion; 8 patients were negative in metastatic lesion while positive in primary site (agreement, 84.1%; κ=0.647). A change in ER status was observed in 24 cases: 17 cases positive in metastatic site while negative in primary site; 7 cases negative in metastatic site while positive in primary site (agreement, 77.6%; κ=0.534). PR status discordance between the primary lesion and the metastatic regional lymph nodes was reported in 19 cases (agreement, 82.2%; κ=0.640). This study revealed that there was only a moderate concordance of ER, PR and HER-2 status between primary tumors and metastatic lymph nodes. These results indicate that it was inappropriate to predict the status of ER, PR and HER-2 in metastatic lymph nodes based on the results of evaluation of that in primary lesions. Copyright © 2015 Elsevier GmbH. All rights reserved.

  6. Detection of Parathyroid Autofluorescence Using Near-Infrared Imaging: A Multicenter Analysis of Concordance Between Different Surgeons.

    Science.gov (United States)

    Kahramangil, Bora; Dip, Fernando; Benmiloud, Fares; Falco, Jorge; de La Fuente, Martin; Verna, Silvina; Rosenthal, Raul; Berber, Eren

    2018-04-01

    Parathyroid glands (PGs) exhibit autofluorescence (AF) when excited by near-infrared laser. This multicenter study aims to analyze how this imaging could facilitate the detection of PGs during thyroidectomy and parathyroidectomy procedures. This was a retrospective Institutional Review Board-approved analysis of prospectively collected data at three centers. Near-infrared fluorescence imaging (NIFI) was used to detect AF from PGs during thyroidectomy and parathyroidectomy procedures. Logistic regression analysis was performed to assess the utility of NIFI to identify PGs and concordance at these centers. Overall, 210 patients underwent total thyroidectomy (n = 95), thyroid lobectomy (n = 41), and parathyroidectomy (n = 74) (n = 70 per center). Using NIFI, AF was detected from 98% of visually identified PGs. Upon initial exploration, 46% of PGs were not visible to the naked eye due to coverage by soft tissue, but AF from these glands could be detected by NIFI without any further dissection. Overall, a median of one PG per patient was detected by NIFI in this fashion before being identified visually (p = nonsignificant between centers). On logistic regression, smaller PGs were more likely to be missed visually, but localized by AF on NIFI (odds ratio with increasing size, 0.91; p = 0.02). In our experience, NIFI facilitated PG identification by detecting their AF, before conventional recognition by the surgeon, in 37-67% of the time. Despite the variability in this rate across centers, there was a concordance in detecting AF from 97 to 99% of the PGs using NIFI. We suggest the incorporation of AF on NIFI alongside conventional visual cues to aid identification of PGs during neck operations.

  7. Concordance of the Resting State Networks in Typically Developing, 6-to 7-Year-Old Children and Healthy Adults

    Directory of Open Access Journals (Sweden)

    Shalini Narayana

    2017-04-01

    Full Text Available Though fairly well-studied in adults, less is known about the manifestation of resting state networks (RSN in children. We examined the validity of RSN derived in an ethnically diverse group of typically developing 6- to 7-year-old children. We hypothesized that the RSNs in young children would be robust and would reliably show significant concordance with previously published RSN in adults. Additionally, we hypothesized that a smaller sample size using this robust technique would be comparable in quality to pediatric RSNs found in a larger cohort study. Furthermore, we posited that compared to the adult RSNs, the primary sensorimotor and the default mode networks (DMNs in this pediatric group would demonstrate the greatest correspondence, while the executive function networks would exhibit a lesser degree of spatial overlap. Resting state functional magnetic resonance images (rs-fMRI were acquired in 18 children between 6 and 7 years recruited from an ethnically diverse population in the Mid-South region of the United States. Twenty RSNs were derived using group independent component analysis and their spatial correspondence with previously published adult RSNs was examined. We demonstrate that the rs-fMRI in this group can be deconstructed into the fundamental RSN as all the major RSNs previously described in adults and in a large sample that included older children can be observed in our sample of young children. Further, the primary visual, auditory, and somatosensory networks, as well as the default mode, and frontoparietal networks derived in this group exhibited a greater spatial concordance with those seen in adults. The motor, temporoparietal, executive control, dorsal attention, and cerebellar networks in children had less spatial overlap with the corresponding RSNs in adults. Our findings suggest that several salient RSNs can be mapped reliably in small and diverse pediatric cohort within a narrow age range and the evolution of these

  8. [Standardization of the Test Your Memory and evaluation of their concordance with the outcome of the psychometric examination].

    Science.gov (United States)

    Ferrero-Arias, J; Turrión-Rojo, M A

    2016-05-01

    To explore the relationship between scores on the Test Your Memory (TYM) battery and findings from a more exhaustive neurocognitive assessment. The TYM and fourteen psychometric tests were administered to 84 subjects aged 50 or older who attended an outpatient neurology clinic due to cognitive symptoms. Each patient's cognitive state was determined independently from his/her score on the TYM (CDR 0, n=25; CDR 0.5, n=45; CDR 1, n=14). We analysed concurrent validity of TYM scores and results from the psychometric tests, as well as the degree of concordance between the two types of measurement, by contrasting normalised data from each instrument. Although the intraclass correlation coefficient was 0.67 (confidence interval 95%, 0.53-0.77), analysis of the Bland-Altman plot and the curve on the survival-agreement plot (Luiz et al. method) demonstrates that the individual distances between the two methods exhibit excessive dispersion from a clinical viewpoint. TYM-based predictions of the mean z-score on psychometric tests differed substantially from real results in 30% of the subjects. Concordance of 95% can only be achieved by accepting absolute inter-instrument differences of up to 0.87 as identical values. Furthermore, the TYM underestimates cognitive performance for low values and overestimates it for high values. The TYM is a cognitive screening test which should not be used to predict results on psychometric tests or to detect cognitive changes in clinical trials. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  9. Method for appraising model validity of randomised controlled trials of homeopathic treatment: multi-rater concordance study

    Science.gov (United States)

    2012-01-01

    Background A method for assessing the model validity of randomised controlled trials of homeopathy is needed. To date, only conventional standards for assessing intrinsic bias (internal validity) of trials have been invoked, with little recognition of the special characteristics of homeopathy. We aimed to identify relevant judgmental domains to use in assessing the model validity of homeopathic treatment (MVHT). We define MVHT as the extent to which a homeopathic intervention and the main measure of its outcome, as implemented in a randomised controlled trial (RCT), reflect 'state-of-the-art' homeopathic practice. Methods Using an iterative process, an international group of experts developed a set of six judgmental domains, with associated descriptive criteria. The domains address: (I) the rationale for the choice of the particular homeopathic intervention; (II) the homeopathic principles reflected in the intervention; (III) the extent of homeopathic practitioner input; (IV) the nature of the main outcome measure; (V) the capability of the main outcome measure to detect change; (VI) the length of follow-up to the endpoint of the study. Six papers reporting RCTs of homeopathy of varying design were randomly selected from the literature. A standard form was used to record each assessor's independent response per domain, using the optional verdicts 'Yes', 'Unclear', 'No'. Concordance among the eight verdicts per domain, across all six papers, was evaluated using the kappa (κ) statistic. Results The six judgmental domains enabled MVHT to be assessed with 'fair' to 'almost perfect' concordance in each case. For the six RCTs examined, the method allowed MVHT to be classified overall as 'acceptable' in three, 'unclear' in two, and 'inadequate' in one. Conclusion Future systematic reviews of RCTs in homeopathy should adopt the MVHT method as part of a complete appraisal of trial validity. PMID:22510227

  10. Just Say “I Don’t”: Lack of Concordance Between Teen Report and Biological Measures of Drug Use

    Science.gov (United States)

    Delaney-Black, Virginia; Chiodo, Lisa M.; Hannigan, John H.; Greenwald, Mark K.; Janisse, James; Patterson, Grace; Huestis, Marilyn A.; Ager, Joel; Sokol, Robert J.

    2012-01-01

    BACKGROUND Prevalence estimates of illicit drug use by teens are typically generated from confidential or anonymous self-report. While data comparing teen self-report with biological measures are limited, adult studies identify varying degrees of under-reporting. METHODS Hair analyses for cocaine, opiates and marijuana were compared to confidential teen self- and parent-reported teen drug use in a longitudinal cohort of >400 high-risk urban teens and parents. RESULTS Both teens and parents substantially underreported recent teen cocaine and opiate use. However, compared with parents, teens were more likely to deny biomarker-verified cocaine use. Teen specimens (hair) were 52 times more likely to identify cocaine use compared with self-report. Parent hair analyses for cocaine and opiate use were 6.5 times and 5.5 times, respectively, more likely to indicate drug use than were parental self-report. The lack of concordance between self-report and bioassay occurred despite participant’s knowledge that a “certificate of confidentiality” protected both teen and adult participants, and that the biological specimens would be tested for drugs. CONCLUSIONS These findings confirm prior reports of adult under-reporting of their own drug use while extending our understanding of teen’s self-admitted drug use. The lack of concordance between teen self- or parent-reported teen drug use and biomarkers confirm our concerns that both teen- and parent-reported teen drug use is limited, at least for youth in high-risk urban settings. Methods of ascertainment other than self- or parent-report must be considered when health care providers, researchers and public health agencies attempt to estimate teen drug-use prevalence. PMID:20974792

  11. Analysis of the concordance rates between core needle biopsy and surgical excision in patients with breast cancer Análise das taxas de concordância entre a biópsia com agulha grossa e a excisão cirúrgica em pacientes com câncer de mama

    Directory of Open Access Journals (Sweden)

    Marcos Desidério Ricci

    2012-10-01

    Full Text Available OBJECTIVE: To evaluate whether immunohistochemical marker studies performed on core needle biopsy (CNB specimens accurately reflect the marker status of the tumor obtained from final surgical specimen. METHODS: This was a retrospective study that used the database of the Division of Mastology of the Hospital das Clínicas, São Paulo, Brazil. Sixty-nine patients submitted to ultrasound-guided CNB diagnosed with breast cancer were retrospectively analyzed. Immunohistochemistry (IHC on core biopsy specimens was compared to that of excisional biopsy regarding estrogen receptor (ER, progesterone receptor (PR, human epidermal gowth factor receptor 2 gene (HER2, p53, and Ki67. The analysis of the concordance between CNB and surgical biopsy was performed using the kappa (k coefficient (95% CI. RESULTS: A perfect concordance between the labeling in the surgical specimens and the preoperative biopsies in p53 (k = 1.0; 95% CI: 0.76-1.0 was identified. There was an almost perfect concordance for ER (k = 0.89; 95% CI: 0.65-1.0 and a substantial concordance for PR (k = 0.70; 95% CI: 0.46-0.93. HER2 (k = 0.61; 95% CI: 0.38-0.84 and Ki-67 (k = 0.74; 95% CI: 0.58-0.98 obtained a substantial concordance this analysis. CONCLUSION: The results of this study indicate that the immunohistochemical analysis of ER, PR, Ki-67, and p53 from core biopsy specimens provided results that accurately reflect the marker status of the tumor. The concordance rate of HER2 was less consistent; although it produced substantial concordance, values were very close to moderate concordance.OBJETIVO: Avaliar se a análise dos marcadores imunoistoquímicos obtidos por meio de espécimes de core biopsy (CB refletem com precisão o perfil dos marcadores tumorais obtidos por biópsia cirúrgica excisional (BCE. MÉTODOS: Estudo retrospectivo usando dados da Divisão de Mastologia do Hospital das Clínicas de São Paulo. Sessenta e nove pacientes submetidas à CB guiada por ultrassom com

  12. Ground based measurements of particulate emissions from supersonic transports. Concorde olympus engine

    Energy Technology Data Exchange (ETDEWEB)

    Whitefield, Ph D; Hagen, D E [Missouri Univ., Rolla, MO (United States). Cloud and Aerosol Sciences Lab.; Lilenfeld, H V [McDonnell Douglas Corp., St. Louis, MO (United States)

    1998-12-31

    The application of a mobile aerosol monitoring facility, the Mobile Aerosol Sampling System (MASS) is described to characterize engine aerosol emissions from the Rolls Royce Olympus Engine. The multi-configurational MASS has been employed in both ground and airborne field operations. It has been successfully flown on research aircrafts. In ground tests the MASS has participated in numerous jet engine related ground tests, and has been deployed to resolve aerosol generation problems in a high power chemical laser system. In all cases the measurements were made on samples taken from a harsh physical and chemical environment, with both high and low temperature and pressure, and in the presence of highly reactive gases. (R.P.) 9 refs.

  13. Ground based measurements of particulate emissions from supersonic transports. Concorde olympus engine

    Energy Technology Data Exchange (ETDEWEB)

    Whitefield, Ph.D.; Hagen, D.E. [Missouri Univ., Rolla, MO (United States). Cloud and Aerosol Sciences Lab.; Lilenfeld, H.V. [McDonnell Douglas Corp., St. Louis, MO (United States)

    1997-12-31

    The application of a mobile aerosol monitoring facility, the Mobile Aerosol Sampling System (MASS) is described to characterize engine aerosol emissions from the Rolls Royce Olympus Engine. The multi-configurational MASS has been employed in both ground and airborne field operations. It has been successfully flown on research aircrafts. In ground tests the MASS has participated in numerous jet engine related ground tests, and has been deployed to resolve aerosol generation problems in a high power chemical laser system. In all cases the measurements were made on samples taken from a harsh physical and chemical environment, with both high and low temperature and pressure, and in the presence of highly reactive gases. (R.P.) 9 refs.

  14. Applied quantitative finance

    CERN Document Server

    Chen, Cathy; Overbeck, Ludger

    2017-01-01

    This volume provides practical solutions and introduces recent theoretical developments in risk management, pricing of credit derivatives, quantification of volatility and copula modeling. This third edition is devoted to modern risk analysis based on quantitative methods and textual analytics to meet the current challenges in banking and finance. It includes 14 new contributions and presents a comprehensive, state-of-the-art treatment of cutting-edge methods and topics, such as collateralized debt obligations, the high-frequency analysis of market liquidity, and realized volatility. The book is divided into three parts: Part 1 revisits important market risk issues, while Part 2 introduces novel concepts in credit risk and its management along with updated quantitative methods. The third part discusses the dynamics of risk management and includes risk analysis of energy markets and for cryptocurrencies. Digital assets, such as blockchain-based currencies, have become popular b ut are theoretically challenging...

  15. Quantitative skeletal scintiscanning

    International Nuclear Information System (INIS)

    Haushofer, R.

    1982-01-01

    330 patients were examined by skeletal scintiscanning with sup(99m)Tc pyrophosphate and sup(99m)methylene diphosphonate in the years between 1977 and 1979. Course control examinations were carried out in 12 patients. The collective of patients presented with primary skeletal tumours, metastases, inflammatory and degenerative skeletal diseases. Bone scintiscanning combined with the ''region of interest'' technique was found to be an objective and reproducible technique for quantitative measurement of skeletal radioactivity concentrations. The validity of nuclear skeletal examinations can thus be enhanced as far as diagnosis, course control, and differential diagnosis are concerned. Quantitative skeletal scintiscanning by means of the ''region of interest'' technique has opened up a new era in skeletal diagnosis by nuclear methods. (orig./MG) [de

  16. Quantitative FDG in depression

    Energy Technology Data Exchange (ETDEWEB)

    Chua, P.; O`Keefe, G.J.; Egan, G.F.; Berlangieri, S.U.; Tochon-Danguy, H.J.; Mckay, W.J.; Morris, P.L.P.; Burrows, G.D. [Austin Hospital, Melbourne, VIC (Australia). Dept of Psychiatry and Centre for PET

    1998-03-01

    Full text: Studies of regional cerebral glucose metabolism (rCMRGlu) using positron emission tomography (PET) in patients with affective disorders have consistently demonstrated reduced metabolism in the frontal regions. Different quantitative and semi-quantitative rCMRGlu regions of interest (ROI) comparisons, e.g. absolute metabolic rates, ratios of dorsolateral prefrontal cortex (DLPFC) to ipsilateral hemisphere cortex, have been reported. These studies suffered from the use of a standard brain atlas to define ROls, whereas in this case study, the individual``s magnetic resonance imaging (MRI) scan was registered with the PET scan to enable accurate neuroanatomical ROI definition for the subject. The patient is a 36-year-old female with a six-week history of major depression (HAM-D = 34, MMSE = 28). A quantitative FDG PET study and an MRI scan were performed. Six MRI-guided ROls (DLPFC, PFC, whole hemisphere) were defined. The average rCMRGlu in the DLPFC (left = 28.8 + 5.8 mol/100g/min; right = 25.6 7.0 mol/100g/min) were slightly reduced compared to the ipsilateral hemispherical rate (left = 30.4 6.8 mol/100g/min; right = 29.5 7.2 mol/100g/min). The ratios of DLPFC to ipsilateral hemispheric rate were close to unity (left = 0.95 0.29; right 0.87 0.32). The right to left DLPFC ratio did not show any significant asymmetry (0.91 0.30). These results do not correlate with earlier published results reporting decreased left DLPFC rates compared to right DLPFC, although our results will need to be replicated with a group of depressed patients. Registration of PET and MRI studies is necessary in ROI-based quantitative FDG PET studies to allow for the normal anatomical variation among individuals, and thus is essential for accurate comparison of rCMRGlu between individuals.

  17. Quantitative FDG in depression

    International Nuclear Information System (INIS)

    Chua, P.; O'Keefe, G.J.; Egan, G.F.; Berlangieri, S.U.; Tochon-Danguy, H.J.; Mckay, W.J.; Morris, P.L.P.; Burrows, G.D.

    1998-01-01

    Full text: Studies of regional cerebral glucose metabolism (rCMRGlu) using positron emission tomography (PET) in patients with affective disorders have consistently demonstrated reduced metabolism in the frontal regions. Different quantitative and semi-quantitative rCMRGlu regions of interest (ROI) comparisons, e.g. absolute metabolic rates, ratios of dorsolateral prefrontal cortex (DLPFC) to ipsilateral hemisphere cortex, have been reported. These studies suffered from the use of a standard brain atlas to define ROls, whereas in this case study, the individual''s magnetic resonance imaging (MRI) scan was registered with the PET scan to enable accurate neuroanatomical ROI definition for the subject. The patient is a 36-year-old female with a six-week history of major depression (HAM-D = 34, MMSE = 28). A quantitative FDG PET study and an MRI scan were performed. Six MRI-guided ROls (DLPFC, PFC, whole hemisphere) were defined. The average rCMRGlu in the DLPFC (left = 28.8 + 5.8 mol/100g/min; right = 25.6 7.0 mol/100g/min) were slightly reduced compared to the ipsilateral hemispherical rate (left = 30.4 6.8 mol/100g/min; right = 29.5 7.2 mol/100g/min). The ratios of DLPFC to ipsilateral hemispheric rate were close to unity (left = 0.95 0.29; right 0.87 0.32). The right to left DLPFC ratio did not show any significant asymmetry (0.91 0.30). These results do not correlate with earlier published results reporting decreased left DLPFC rates compared to right DLPFC, although our results will need to be replicated with a group of depressed patients. Registration of PET and MRI studies is necessary in ROI-based quantitative FDG PET studies to allow for the normal anatomical variation among individuals, and thus is essential for accurate comparison of rCMRGlu between individuals

  18. Quantitative methods for management and economics

    CERN Document Server

    Chakravarty, Pulak

    2009-01-01

    ""Quantitative Methods for Management and Economics"" is specially prepared for the MBA students in India and all over the world. It starts from the basics, such that even a beginner with out much mathematical sophistication can grasp the ideas and then comes forward to more complex and professional problems. Thus, both the ordinary students as well as ""above average: i.e., ""bright and sincere"" students would be benefited equally through this book.Since, most of the problems are solved or hints are given, students can do well within the short duration of the semesters of their busy course.

  19. Quantitative traits and diversification.

    Science.gov (United States)

    FitzJohn, Richard G

    2010-12-01

    Quantitative traits have long been hypothesized to affect speciation and extinction rates. For example, smaller body size or increased specialization may be associated with increased rates of diversification. Here, I present a phylogenetic likelihood-based method (quantitative state speciation and extinction [QuaSSE]) that can be used to test such hypotheses using extant character distributions. This approach assumes that diversification follows a birth-death process where speciation and extinction rates may vary with one or more traits that evolve under a diffusion model. Speciation and extinction rates may be arbitrary functions of the character state, allowing much flexibility in testing models of trait-dependent diversification. I test the approach using simulated phylogenies and show that a known relationship between speciation and a quantitative character could be recovered in up to 80% of the cases on large trees (500 species). Consistent with other approaches, detecting shifts in diversification due to differences in extinction rates was harder than when due to differences in speciation rates. Finally, I demonstrate the application of QuaSSE to investigate the correlation between body size and diversification in primates, concluding that clade-specific differences in diversification may be more important than size-dependent diversification in shaping the patterns of diversity within this group.

  20. Conceptual Problem Solving in High School Physics

    Science.gov (United States)

    Docktor, Jennifer L.; Strand, Natalie E.; Mestre, José P.; Ross, Brian H.

    2015-01-01

    Problem solving is a critical element of learning physics. However, traditional instruction often emphasizes the quantitative aspects of problem solving such as equations and mathematical procedures rather than qualitative analysis for selecting appropriate concepts and principles. This study describes the development and evaluation of an…

  1. Avaliação da concordância interobservadores na análise da polipose nasossinusal por meio da tomografia computadorizada Evaluation of the concordance between observers in sinunasal polyposis through computed tomographic analysis

    Directory of Open Access Journals (Sweden)

    Elaine A. Mendes

    2004-08-01

    Full Text Available Polipose nasossinusal (PNS é uma entidade de etiologia controversa, caracterizada por uma condição inflamatória da superfície mucosa das fossas nasais e seios paranasais, bilateralmente. A queixa principal do paciente consiste na obstrução nasal e, ao exame físico, observam-se freqüentemente massas polipóides ocupando as cavidades nasais em extensões variáveis. Além da rinoscopia anterior e da endoscopia nasal, o uso da tomografia computadorizada (TC torna-se necessário para avaliação das fossas nasais e da presença ou não do acometimento dos seios paranasais por essas massas, bem como a sua extensão. Este trabalho tem como objetivo avaliar a concordância interobservadores, por meio da análise da tomografia computadorizada, de 32 casos de PNS. FORMA DE ESTUDO: Clínico prospectivo. CASUÍSTICA E MÉTODOS: Foram avaliadas 32 TC de pacientes portadores PNS por dois observadores experientes, separadamente, em relação à presença ou não de 3 sinais tomográficos sugestivos dessa doença: (1 alargamento infundibular do complexo ostiomeatal, (2 abaulamento lateral da lâmina papirácea e (3 apagamento do trabeculado ósseo etmoidal. RESULTADOS: Observou-se Qui-quadrado não significante para o primeiro e segundo sinais (p=0,7055 e p=0,2057 e significante para o terceiro (p=0,0040. Contudo, o coeficiente de correlação de Kendall entre os dois observadores foi significante para os três sinais tomográficos acima citados (pSinonasal polyposis (SNP is a condition with a controversial aethiology, known by bilaterally inflammatory mucous membranes of nasal and paranasal sinuses. The major patient's complaint is nasal obstruction, and polypoid masses in different sizes can be found during nasal cavity examination. Beyond anterior rhinoscophy and nasal endoscopy, screening sinus computed tomography (SSCT is necessary to measure the size and the extent of the polyps into nasal cavities and paranasal sinuses. The purpose of this

  2. Quantitative assessment of valvular regurgitation using radionuclide ventriculography

    International Nuclear Information System (INIS)

    Shi Rongfang

    1992-01-01

    Radionuclide ventriculography has been used to assess quantitatively the extent of mitral and aortic regurgitation in 70 patients and compared to echocardiography and the finding of surgery. Two radionuclide parameters were measured: regurgitant index (RI) = left ventricular stroke counts/right ventricular stroke counts; and regurgitant fraction (RF) = left ventricular stroke counts-right ventricular stroke counts/left ventricular stroke counts. In 28 patients without valvular heart disease, the RI was 1.10 ± 0.15 and Rf was 10.3 ± 15.0%, respectively. However, in patients with valvular regurgitation, the RI and RF were 3.41 ± 1.73 and 61.1 ± 21.2%, respectively. A good correlation was found between the results obtained by radionuclide techniques and the findings of surgery and doppler studies. The level of concordance between RI and surgical findings was 91.7%. Follow up studies in 10 patients after valvular replacement surgery showed the RI and RF return to normal. These data suggested that radionuclide ventriculography is very useful for quantitative assessment of valvular regurgitation

  3. Clinical application of quantitative 99Tcm-pertechnetate thyroid imaging

    International Nuclear Information System (INIS)

    Gao Yongju; Xie Jian; Yan Xinhui; Wand Jiebin; Zhu Xuanmin; Liu Lin; Sun Haizhou

    2002-01-01

    Objective: To investigate the clinical value of quantitative 99 Tc m -pertechnetate thyroid imaging for the diagnosis and therapeutic evaluation in patients with thyroid disease. Methods: With the Siemens Orbit SPECT, 99 Tc m sodium pertechnetate thyroid imaging was performed on a control group and 108 patients with Graves' disease, 58 patients with Hashimoto's disease, 41 patients with subacute thyroiditis. Three functional parameters were calculated as follows: AR=5 min thyroid count/1 min thyroid count; UI=20 min thyroid count/thigh count; T d =imaging interval between carotid and thyroid. Results: 1) Three functional parameters were basically concordant with serological parameters in patients with Graves' disease. While uptake was high in patients who had contracted Graves' disease for ≤0.5 year, for those whose disease relapsed within 2 years the 99 Tc m thyroid uptake increased when the antithyroid medication was stopped. 2) Thyroid images of hyperthyroid patients with Hashimoto's disease showed increased perfusion and 99 Tc m uptake, a pattern similar to that found in Graves' disease. Differences in T d , AR , UI were not significant among euthyroid, subclinical hypothyroid patients with Hashimoto's disease, so uptake ratios could indicate the thyroid activity. 3) Delayed thyroid image and diffuse uptake decrease were found in hyperthyroid patients with SAT, however, focal damages were observed in euthyroid patients. Conclusion: Quantitative 99 Tc m -pertechnetate thyroid imaging is a significantly helpful technique in the diagnosis and treatment for common thyroid disorders

  4. Vaginal and anal human papillomavirus infection and seropositivity among female sex workers in amsterdam, the Netherlands: prevalence, concordance and risk factors

    NARCIS (Netherlands)

    Marra, E.; Kroone, N.; Freriks, E.; van Dam, C. L.; Alberts, C. J.; Hogewoning, A. A.; Bruisten, S.; van Dijk, A.; Kroone, M. M.; Waterboer, T.; Schim van der Loeff, M. F.

    2017-01-01

    We studied prevalence, risk factors and concordance of vaginal and anal HPV infection and L1 seropositivity among female sex workers (FSW) in Amsterdam. In 2016, FSW aged ≥18 years having a sexually transmitted infections (STI) consultation were invited to participate. Participation entailed taking

  5. Concordant bone marrow involvement of diffuse large B-cell lymphoma represents a distinct clinical and biological entity in the era of immunotherapy

    DEFF Research Database (Denmark)

    Yao, Zhilei; Deng, Lijuan; Xu-Monette, Z Y

    2018-01-01

    In diffuse large B-cell lymphoma (DLBCL), the clinical and biological significance of concordant and discordant bone marrow (BM) involvement have not been well investigated. We evaluated 712 de novo DLBCL patients with front-line rituximab-containing treatment, including 263 patients with positiv...

  6. Quantitative cardiac computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, M.; Dueber, C.; Wolff, P.; Erbel, R.; Hoffmann, T.

    1985-06-01

    The scope and limitations of quantitative cardiac CT have been evaluated in a series of experimental and clinical studies. The left ventricular muscle mass was estimated by computed tomography in 19 dogs (using volumetric methods, measurements in two axes and planes and reference volume). There was good correlation with anatomical findings. The enddiastolic volume of the left ventricle was estimated in 22 patients with cardiomyopathies; using angiography as a reference, CT led to systematic under-estimation. It is also shown that ECG-triggered magnetic resonance tomography results in improved visualisation and may be expected to improve measurements of cardiac morphology.

  7. F# for quantitative finance

    CERN Document Server

    Astborg, Johan

    2013-01-01

    To develop your confidence in F#, this tutorial will first introduce you to simpler tasks such as curve fitting. You will then advance to more complex tasks such as implementing algorithms for trading semi-automation in a practical scenario-based format.If you are a data analyst or a practitioner in quantitative finance, economics, or mathematics and wish to learn how to use F# as a functional programming language, this book is for you. You should have a basic conceptual understanding of financial concepts and models. Elementary knowledge of the .NET framework would also be helpful.

  8. Concordant pressure paresthesia during interlaminar lumbar epidural steroid injections correlates with pain relief in patients with unilateral radicular pain.

    Science.gov (United States)

    Candido, Kenneth D; Rana, Maunak V; Sauer, Ruben; Chupatanakul, Lalida; Tharian, Antony; Vasic, Vladimir; Knezevic, Nebojsa Nick

    2013-01-01

    Transforaminal and interlaminar epidural steroid injections are commonly used interventional pain management procedures in the treatment of radicular low back pain. Even though several studies have shown that transforaminal injections provide enhanced short-term outcomes in patients with radicular and low back pain, they have also been associated with a higher incidence of unintentional intravascular injection and often dire consequences than have interlaminar injections. We compared 2 different approaches, midline and lateral parasagittal, of lumbar interlaminar epidural steroid injection (LESI) in patients with unilateral lumbosacral radiculopathic pain. We also tested the role of concordant pressure paresthesia occurring during LESI as a prognostic factor in determining the efficacy of LESI. Prospective, randomized, blinded study. Pain management center, part of a teaching-community hospital in a major metropolitan US city. After Institutional Review Board approval, 106 patients undergoing LESI for radicular low back pain were randomly assigned to one of 2 groups (53 patients each) based on approach: midline interlaminar (MIL) and lateral parasagittal interlaminar (PIL). Patients were asked to grade any pressure paresthesia as occurring ipsilaterally or contralaterally to their "usual and customary pain," or in a distribution atypical of their daily pain. Other variables such as: the Oswestry Disability Index questionnaire, pain scores at rest and during movement, use of pain medications, etc. were recorded 20 minutes before the procedure, and on days 1, 7, 14, 21, 28, 60, 120, 180 and 365 after the injection. Results of this study showed statistically and clinically significant pain relief in patients undergoing LESI by both the MIL and PIL approaches. Patients receiving LESI using the lateral parasagittal approach had statistically and clinically longer pain relief then patients receiving LESI via a midline approach. They also had slightly better quality of

  9. The Quantitative Preparation of Future Geoscience Graduate Students

    Science.gov (United States)

    Manduca, C. A.; Hancock, G. S.

    2006-12-01

    Modern geoscience is a highly quantitative science. In February, a small group of faculty and graduate students from across the country met to discuss the quantitative preparation of geoscience majors for graduate school. The group included ten faculty supervising graduate students in quantitative areas spanning the earth, atmosphere, and ocean sciences; five current graduate students in these areas; and five faculty teaching undergraduate students in the spectrum of institutions preparing students for graduate work. Discussion focused in four key ares: Are incoming graduate students adequately prepared for the quantitative aspects of graduate geoscience programs? What are the essential quantitative skills are that are required for success in graduate school? What are perceived as the important courses to prepare students for the quantitative aspects of graduate school? What programs/resources would be valuable in helping faculty/departments improve the quantitative preparation of students? The participants concluded that strengthening the quantitative preparation of undergraduate geoscience majors would increase their opportunities in graduate school. While specifics differed amongst disciplines, a special importance was placed on developing the ability to use quantitative skills to solve geoscience problems. This requires the ability to pose problems so they can be addressed quantitatively, understand the relationship between quantitative concepts and physical representations, visualize mathematics, test the reasonableness of quantitative results, creatively move forward from existing models/techniques/approaches, and move between quantitative and verbal descriptions. A list of important quantitative competencies desirable in incoming graduate students includes mechanical skills in basic mathematics, functions, multi-variate analysis, statistics and calculus, as well as skills in logical analysis and the ability to learn independently in quantitative ways

  10. Modelação computacional de padrões variáveis de concordância em português

    Directory of Open Access Journals (Sweden)

    Leonel Figueiredo de Alencar

    2014-03-01

    Full Text Available Este trabalho descreve a implementação de um parser para um fragmento do português no XLE, sistema que constitui o estado da arte para o desenvolvimento de gramáticas computacionais baseadas no modelo gerativo da LFG. O fragmento abrange os seguintes aspectos da concordância verbal,sujeitos à variação dialetal: (i concordância sintática do chamado pronome a gente, com formas verbais de terceira pessoa do singular e semântica coma primeira e terceira do plural; (ii concordância do pronome tu, com a segunda e a terceira do singular e do pronome vocês, com a segunda e terceira do plural; (iii concordância semântica de um DP definido no plural, com a primeira pessoa do plural. Para derivar os diferentes padrões de concordância nesse domínio, constatados no português padrão e em alguns dialetos não padrão tanto do português do Brasil quanto do português europeu, são propostas estruturas de traços para os DPs e flexões verbais em que se distingue entre traços sintático-formais e traços semântico-discursivos. Mostra-se que as diferenças entre os dialetos investigados em relação a (i – (iiipodem ser derivadas por meio da ativação ou desativação desses traços.

  11. Surgical site infections among high-risk patients in clean-contaminated head and neck reconstructive surgery: concordance with preoperative oral flora.

    Science.gov (United States)

    Yang, Ching-Hsiang; Chew, Khong-Yik; Solomkin, Joseph S; Lin, Pao-Yuan; Chiang, Yuan-Cheng; Kuo, Yur-Ren

    2013-12-01

    Salivary contamination of surgical wounds in clean-contaminated head and neck surgery with free flap reconstruction remains a major cause of infection and leads to significant morbidity. This study investigates the correlation between intraoral flora and surgical site infections (SSIs) among high-risk head and neck cancer patients undergoing resection and free flap reconstruction. One hundred twenty-nine patients were identified as being at high risk for infective complications based on cancer stage, tumor size, comorbid factors, and extent of reconstruction. All patients had intraoral swab cultures before surgery. Patients with culture-confirmed SSI after surgery were chosen for analysis, using the κ index and its 95% confidence interval for concordance analysis. All patients received clindamycin and gentamicin for antibiotic prophylaxis for 5 days. Antibiotic susceptibility testing of all isolates was obtained and analyzed. Thirty-seven patients experienced SSI, or an infection rate of 28.3%, occurring at a mean of 9.3 postoperative days. The overall concordance between oral flora and SSI was fair to moderate (κ index of 0.25), but detailed analysis shows a higher concordance for known and opportunistic pathogens, such as Pseudomonas aeruginosa and Enterococcus faecalis, compared to typical oral commensals. Antibiotic susceptibility tests show rapid and significant increases in resistance to clindamycin, indicating a need for a more effective alternative. Predicting pathogens in SSI using preoperative oral swabs did not demonstrate a good concordance in general for patients undergoing clean-contaminated head and neck surgery, although concordance for certain pathogenic species seem to be higher than for typical intraoral commensals. The rapid development of resistance to clindamycin precludes its use as a prophylactic agent.

  12. Quantitative clinical radiobiology

    International Nuclear Information System (INIS)

    Bentzen, S.M.

    1993-01-01

    Based on a series of recent papers, a status is given of our current ability to quantify the radiobiology of human tumors and normal tissues. Progress has been made in the methods of analysis. This includes the introduction of 'direct' (maximum likelihood) analysis, incorporation of latent-time in the analyses, and statistical approaches to allow for the many factors of importance in predicting tumor-control probability of normal-tissue complications. Quantitative clinical radiobiology of normal tissues is reviewed with emphasis on fractionation sensitivity, repair kinetics, regeneration, latency, and the steepness of dose-response curves. In addition, combined modality treatment, functional endpoints, and the search for a correlation between the occurrence of different endpoints in the same individual are discussed. For tumors, quantitative analyses of fractionation sensitivity, repair kinetics, reoxygenation, and regeneration are reviewed. Other factors influencing local control are: Tumor volume, histopathologic differentiation and hemoglobin concentration. Also, the steepness of the dose-response curve for tumors is discussed. Radiobiological strategies for improving radiotherapy are discussed with emphasis on non-standard fractionation and individualization of treatment schedules. (orig.)

  13. Evaluation of Concordance between Hip and Spine T Scores in the Diagnosis of Osteoporosis in Men Over Age of Fifty

    Directory of Open Access Journals (Sweden)

    Oya Özdemir

    2015-12-01

    Full Text Available Objective: The aim of this study was to evaluate the concordance in diagnosis of osteoporosis based on the World Health Organization (WHO classification of bone mineral density (BMD measurements of hip and spine in men aged ≥50 years. Materials and Methods: The BMD measurements, which were measured via dual x-ray energy absorptiometry (DXA, of 10.049 patients admitted to our hospital between January 1, 2012 and August 1, 2013 were retrospectively reviewed and 649 men aged ≥50 years were included in the study. It was defined as minor discordance when the difference between two sites was no more than one WHO diagnostic class. Major discordance was present when one site is osteoporotic and the other is normal. Results: The mean age of the participants was 68.7±9.1 (50-93 years. The mean values of lumbar spine and total hip BMD values were 1.1681±0.231 (0.629-2.267 g/cm2 and 0.933±0.152 (0.414-1.444 g/cm2, respectively. According to L1-L4 vertebra T score, 54.4% of the individuals were classified as normal, 33% were osteopenic, and 12.6% were osteoporotic. Whereas, according to total femur T score 41.7% of participants were normal, 47.5% had osteopenia, and 10.8% had osteoporosis. Concordance of T scores, minor discordance, and major discordance were seen in 59.6%, 37.6%, and 2.8% of the patients, respectively. Conclusion: In this study, it was shown that in 4 of every 10 male patients aged ≥50 years tested by DXA, T score discordance between spine and total hip measurement sites is present. This ratio is similar to the results of previous studies investigating the prevalence of this phenomenon in larger samples including both postmenopausal women and men. Clinicians should keep in their mind that T score discordance is a prevalent finding and can be related to various physiological and pathological patient factors as well as the performance or analysis of DXA itself.

  14. Concordance of self-reported hormonal contraceptive use and presence of exogenous hormones in serum among African women.

    Science.gov (United States)

    Pyra, Maria; Lingappa, Jairam R; Heffron, Renee; Erikson, David W; Blue, Steven W; Patel, Rena C; Nanda, Kavita; Rees, Helen; Mugo, Nelly R; Davis, Nicole L; Kourtis, Athena P; Baeten, Jared M

    2018-04-01

    Studies that rely on self-report to investigate the relationship between hormonal contraceptive use and HIV acquisition and transmission, as well as other health outcomes, could have compromised results due to misreporting. We determined the frequency of misreported hormonal contraceptive use among African women with and at risk for HIV. We tested 1102 archived serum samples from 664 African women who had participated in prospective HIV prevention studies. Using a novel high-performance liquid chromatography-mass spectrometry assay, we quantified exogenous hormones for injectables (medroxyprogesterone acetate or norethisterone), oral contraceptives (OC) (levonorgestrel or ethinyl estradiol) and implants (levonorgestrel or etonogestrel) and compared them to self-reported use. Among women reporting hormonal contraceptive use, 258/358 (72%) of samples were fully concordant with self-report, as were 642/744 (86%) of samples from women reporting no hormonal contraceptive use. However, 42/253 (17%) of samples from women reporting injectable use, 41/66 (62%) of samples from self-reported OC users and 3/39 (8%) of samples from self-reported implant users had no quantifiable hormones. Among self-reported nonusers, 102/744 (14%) had ≥1 hormone present. Concordance between self-reported method and exogenous hormones did not differ by HIV status. Among African women with and at risk for HIV, testing of exogenous hormones revealed agreement with self-reported contraceptive use for most women. However, unexpected exogenous hormones were identified among self-reported hormonal contraceptive users and nonusers, and an important fraction of women reporting hormonal contraceptive use had no hormones detected; absence of oral contraceptive hormones could be due, at least in part, to samples taken during the hormone-free interval. Misreporting of hormonal contraceptive use could lead to biased results in observational studies of the relationship between contraceptive use and health

  15. Hand trauma: A prospective observational study reporting diagnostic concordance in emergency hand trauma which supports centralised service improvements.

    Science.gov (United States)

    Miranda, B H; Spilsbury, Z P; Rosala-Hallas, A; Cerovac, S

    2016-10-01

    Hand injuries are common, contributing up to 30% of accident and emergency (A&E) attendances. The aim of this study was to prospectively analyse the pathological demographics of hand injuries in a level 1 trauma centre with a Hand Trauma Unit and direct A&E links, and compare clinical and intra-operative findings. The null hypothesis was that there would be no differences between clinical and intra-operative findings (100% diagnostic concordance). Data were prospectively collected for referrals during 2012. Referral diagnosis, additional pathologies found on clinical assessment and intra-operative findings were documented on a live database accessible from both the Hand Unit and associated operating theatres. Odds ratios were calculated using SAS. Injuries (1526) were identified in 1308 patients included in the study. Diagnostic concordance between Hand Unit clinical examination and intra-operative findings was 92.5% ± 2.85% (mean ± SEM); this was lower for flexor tendon injuries (56.3%) because a greater number of additional pathologies were found intra-operatively (2.25 ± 0.10). This 'trend' was noted across multiple referral pathologies including phalangeal fractures (1.28 ± 0.02; 82.9%), lacerations (1.33 ± 0.04; 79.1%), extensor tendon injuries (1.30 ± 0.05; 87.8%) and dislocations (1.18 ± 0.05; 87.8%). Odds ratio analysis indicated a relationship between primary referral diagnoses that were more or less likely to be associated with additional injuries (p management of hand trauma. Our findings, coupled with the presented relevant literature reports, lead us to advocate that A&E departments should move towards a system wherein links to specialist hand trauma services are in place; we hereby present useful data for hospitals implementing such services. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  16. Conceptual problem solving in high school physics

    OpenAIRE

    Jennifer L. Docktor; Natalie E. Strand; José P. Mestre; Brian H. Ross

    2015-01-01

    Problem solving is a critical element of learning physics. However, traditional instruction often emphasizes the quantitative aspects of problem solving such as equations and mathematical procedures rather than qualitative analysis for selecting appropriate concepts and principles. This study describes the development and evaluation of an instructional approach called Conceptual Problem Solving (CPS) which guides students to identify principles, justify their use, and plan their solution in w...

  17. A study of behaviour problems and psychiatric disorders among people with intellectual disability

    OpenAIRE

    Myrbakk, Even

    2008-01-01

    The present thesis investigates behaviour problems and their relationship to psychiatric disorders in people with intellectual disability living in the northern part of Norway, as well as the concordances between four of the most commonly used assessment instruments for psychiatric disorders in people with intellectual disability. A total of one hundred and eighty-one individuals with intellectual disability living in the counties of Nordland, Troms and Finnmark participated in the studies. ...

  18. Cosmology problems

    International Nuclear Information System (INIS)

    Lukash, V.N.

    1983-01-01

    Information discussed at the 18th General Assembly of the International Astronomical Union and Symposium on ''Early Universe Evolution and Its Modern Structure'' on the problems of relic radiation, Hubble expansion, spatial structure and physics of the early Universe is presented. The spectrum of relic radioemission differs but slightly from the equilibrium one in the maximum range. In G. Smith (USA) opinion such difference may be caused by any radiosources radiating in the same wave range. The absence of unanimous opinion of astronomers on Hubble constant value is pointed out. G.Tam-man (Switzerland) estimates the Hubble constant 50+-7 km/s. J. Voculer (USA) gives a twice greater value. Such divergence is ca sed by various methods of determining distances up to remote galaxies and galaxy clusters. Many reports deal with large-scale Universe structure. For the first time considered are the processes which occurred in the epoch at times about 10 -35 c from the beginning of the Universe expansion. Such possibility is presented by the theory of ''great unification'' which permits to explain some fundamental properties of the Universe: spatial uniformity of isotropic expansion, existence of small primary density perturbations

  19. Automatic quantitative metallography

    International Nuclear Information System (INIS)

    Barcelos, E.J.B.V.; Ambrozio Filho, F.; Cunha, R.C.

    1976-01-01

    The quantitative determination of metallographic parameters is analysed through the description of Micro-Videomat automatic image analysis system and volumetric percentage of perlite in nodular cast irons, porosity and average grain size in high-density sintered pellets of UO 2 , and grain size of ferritic steel. Techniques adopted are described and results obtained are compared with the corresponding ones by the direct counting process: counting of systematic points (grid) to measure volume and intersections method, by utilizing a circunference of known radius for the average grain size. The adopted technique for nodular cast iron resulted from the small difference of optical reflectivity of graphite and perlite. Porosity evaluation of sintered UO 2 pellets is also analyzed [pt

  20. Concordance of DNA methylation profiles between breast core biopsy and surgical excision specimens containing ductal carcinoma in situ (DCIS).

    Science.gov (United States)

    Chen, Youdinghuan; Marotti, Jonathan D; Jenson, Erik G; Onega, Tracy L; Johnson, Kevin C; Christensen, Brock C

    2017-08-01

    The utility and reliability of assessing molecular biomarkers for translational applications on pre-operative core biopsy specimens assume consistency of molecular profiles with larger surgical specimens. Whether DNA methylation in ductal carcinoma in situ (DCIS), measured in core biopsy and surgical specimens are similar, remains unclear. Here, we compared genome-scale DNA methylation measured in matched core biopsy and surgical specimens from DCIS, including specific DNA methylation biomarkers of subsequent invasive cancer. DNA was extracted from guided 2mm cores of formalin fixed paraffin embedded (FFPE) specimens, bisulfite-modified, and measured on the Illumina HumanMethylation450 BeadChip. DNA methylation profiles of core biopsies exhibited high concordance with matched surgical specimens. Within-subject variability in DNA methylation was significantly lower than between-subject variability (all Pcore biopsy and surgical specimens, 15%, and a pathway analysis of these CpGs indicated enrichment for genes related with wound healing. Our results indicate that DNA methylation measured in core biopsies are representative of the matched surgical specimens and suggest that DCIS biomarkers measured in core biopsies can inform clinical decision-making. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.